Hunter Biden's business partners, assistants visited White House over 80 times when Biden was VP

 Four business partners, a vice president, and two assistants at Hunter Biden’s now-defunct firm visited the White House more than 80 times when his father was vice president in the Obama administration, Fox News Digital has found.

President Biden has repeatedly insisted he had no knowledge of Hunter's business dealings amid dual criminal and congressional investigations into the first son and his family. 

However, Joan Mayer, who says she was the vice president of Hunter’s now-defunct investment firm Rosemont Seneca Advisors from 2008 to 2017 on Linkedin, made at least 17 visits to the White House during that time, according to visitor logs reviewed by Fox News Digital.

In October 2009, Mayer attended a vice presidential briefing and met with then-Biden aide Danielle Borrin. Less than a month later, she met with then-Biden executive assistant Nancy Orloff in the West Wing. In July 2013, she met in the West Wing with Kellen Suber, another executive assistant to Vice President Biden at the time, according to the logs.

President Biden and his son Hunter Biden attend the annual Easter Egg Roll on the South Lawn of the White House on April 10, 2023. (Drew Angerer/Getty Images)

In December 2013 and 2014, Mayer attended holiday receptions at the vice president's White House residence at Number One Observatory Circle, according to visitor logs. In September 2015, she attended a Jewish community reception at the vice president’s residence. She also met with Kaitlyn Demers, who was serving as an associate counsel in Biden's office, in June 2016 at the Eisenhower Executive Office Building (EEOB), which houses the vice president’s ceremonial office.

Another former Hunter Biden assistant, Anne Marie Person, visited the Obama White House at least five times before she left the firm in 2014 to join then-Vice President Biden's staff, according to the visitor logs. One of those visits included an April 2014 meeting with Kathy Chung, the former Biden aide who currently serves as the Pentagon's deputy director of protocol, and was likely interview-related ahead of starting her job there.

Throughout much of her five-year tenure working for Biden during the Obama administration, Chung regularly communicated with Hunter, transmitting information about his father's schedule and passing messages directly from the then-vice president to Hunter and assistants in his office, Fox News Digital previously reported.

Hunter Biden during the annual Easter Egg Roll at the White House on April 10, 2023. (Andrew Caballero-Reynolds/AFP via Getty Images)

In May 2014, Person was hired as a staff assistant to the then-vice president. Her brother, Francis "Fran" Person, was a longtime Biden aide who left the White House just a few months after she joined Biden's office. 

FOX Business previously reported on Fran Person's ties to Hunter and how Rosemont Seneca Advisors had a financial stake in a company run by Fran and a Chinese executive with ties to officials at some of the highest levels of the Communist Party of China. Person previously claimed that "Hunter Biden, Rosemont Seneca Advisors or any affiliate or associate have never held any equity in any Harves affiliated company," despite multiple emails from Hunter and his business partner Eric Schwerin contradicting this claim. 

Fran Person, a former adviser to Vice President Joe Biden, unsuccessfully ran for Congress in South Carolina's 5th Congressional District in 2016. (Fran Person/YouTube screenshot)

Fran would go on to visit the White House at least seven times after he left his role there and later became a top executive at the Harves Group, a DC-based affiliate of China's Harves Century Group, a "top tier private chinese real estate development firm," according to a 2015 email from Fran to Hunter. Person previously told Fox News Digital the visits were "personal in nature" and that he was "visiting with old colleagues and friends" 

Both Person siblings kept in frequent contact with Hunter and Schwerin, then-president of Rosemont Seneca Advisors, during their Obama-Biden administration roles using their government emails, Fox News Digital previously reported. 

Person and Mayer did not respond to Fox News Digital inquiries on whether they discussed Rosemont Seneca business during their visits with White House officials.

Counselor to the President Steve Ricchetti gestures after playing a round of golf with President Biden at Wilmington Country Club in Wilmington, Delaware, on April 17, 2021. (Jim Watson/AFP via Getty Images)

Schwerin, who "managed almost every aspect" of the financial life of the Bidens, according to Hunter's ex-wife, was no stranger to the White House when Biden was vice president, visiting at least 27 times during the Obama administration. He met with Anne Marie Person at least three times between February and June 2016, a Fox News Digital review found. Steve Ricchetti, who currently serves as Biden's White House counselor, also met with Schwerin at least twice in 2016. The two visits occurred in room 272 on Feb. 29 and room 276 on Aug. 17 at the Old Executive Office Building (OEOB)

In addition to Person and Ricchetti, Schwerin made three other visits with staffers from Vice President Biden's office in 2016, including John McGrail, who was a counselor to Biden, on July 15 and Sept. 9 at the White House. He also met with Kaitlyn Demers, who was serving as an associate counsel in Biden's office in 2016, on June 28. She served as a special assistant to President Biden and chief of staff Ron Klain until last summer.

President Biden and first lady Jill Biden, joined by Hunter Biden, at an art show for their granddaughter Maisy Biden at the University of Pennsylvania in Philadelphia, on April 1, 2023. (Mandel Ngan/AFP via Getty Images)

President Biden and Hunter Biden  (Nicholas Kamm/AFP via Getty Images)

John Robinson "Rob" Walker, another one of Hunter Biden’s former business partners at Rosemont Seneca Partners, appeared on the White House visitor logs at least 16 times when Biden was vice president. Walker’s name resurfaced last month when House Oversight Committee Republicans said they obtained records showing members of the Biden family received more than $1 million in payments from accounts related to Walker and their Chinese business ventures in 2017.

Devon Archer, the co-founder of Rosemont Seneca Partners, visited then-Vice President Biden at least twice, in 2009 and 2014. The December 2009 visit was a holiday reception at Biden's residence and the April 2014 visit was with Biden in the West Wing. He also played golf with Biden and Hunter at least once during the Obama administration in August 2014 in the Hamptons, months after they joined the board of Burisma Holdings.

Hunter’s former personal assistant, Katie Dodge, visited the Obama White House at least nine times from December 2012 to July 2015.

Dodge met with Suber, Biden's then-executive assistant, in the Went Wing on January 15, 2013, and again three days later on Jan. 18. She attended an inaugural reception at the vice president's residence in January 2013, and two holiday receptions at his residence in December 2013 and 2014 – the same events attended by Mayer.

President Joe Biden and his son, Hunter Biden, step off Air Force One, Saturday, Feb. 4, 2023, at Hancock Field Air National Guard Base in Syracuse, N.Y.  (AP Photo/Patrick Semansky)

Another Hunter business associate, Arlene Busch, formerly a partner at Rosemont Seneca Partners, the parent company of Rosemont Seneca Advisors, visited the White House at least four times between 2009 and 2013. Two of those visits were to the vice president’s residence for holiday receptions, and one of those receptions was the same one attended by Mayer and Dodge on Dec. 15, 2013, according to the logs.

Now-defunct Rosemont Seneca Technology Partners (RSTP) co-founder and managing partner Neil Callahan and RSTP managing director John DeLoche also visited the White House in April 2014. The visits appeared to be for tours. The point person they met with for the tours, which were a week apart, was Suber.

The White House, Hunter's attorney, Dodge and Busch did not respond to Fox News Digital's requests for comment.

https://www.foxnews.com/politics/hunter-bidens-business-partners-assistants-visited-white-house-80-times-when-biden-vp

Early Adulthood Hypertension, Blood Pressure ChangeTied to Late-Life Neuroimaging Biomarkers

 Kristen M. George, PhD¹; Pauline Maillard, PhD²; Paola Gilsanz, ScD³; et al

Key Points

Question  Are hypertension and blood pressure change in early adulthood associated with late-life brain health, and is there variation by sex?

Findings  In this cohort study of 427 adults 50 years and older, hypertension and increasing blood pressure in early adulthood were associated with lower mean regional brain volumes and poorer white matter integrity in late life. These associations were stronger in men compared with women for some regions.

Meaning  These findings suggest that prevention and treatment of hypertension in early adulthood has important implications for late-life brain health and may be especially important for men.

Abstract

Importance  The association between hypertension developed before midlife and late-life brain health is understudied and, because of the cardioprotective benefits of estrogen before menopause, may differ by sex.

Objective  To assess the association of early adulthood hypertension and blood pressure (BP) change with late-life neuroimaging biomarkers and examine potential sex differences.

Design, Setting, and Participants  This cohort study used data from the Study of Healthy Aging in African Americans (STAR) and Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study, which were harmonized longitudinal cohorts of racially and ethnically diverse adults aged 50 years and older from the San Francisco Bay area and Sacramento Valley in California. The STAR was conducted from November 6, 2017, to November 5, 2021, and the KHANDLE study was conducted from April 27, 2017, to June 15, 2021. The current study included 427 participants from the KHANDLE and STAR studies who received health assessments between June 1, 1964, and March 31, 1985. Regional brain volumes and white matter (WM) integrity were measured via magnetic resonance imaging between June 1, 2017, and March 1, 2022.

Exposures  Hypertension status (normotension, transition to hypertension, and hypertension) and BP change (last measure minus first measure) were assessed at 2 multiphasic health checkups (MHCs; 1964-1985) in early adulthood (ages 30-40 years).

Main Outcomes and Measures  Regional brain volumes and WM integrity were measured using 3T magnetic resonance imaging and z standardized. General linear models adjusted for potential confounders (demographic characteristics and study [KHANDLE or STAR]) were used to assess the association of hypertension and BP change with neuroimaging biomarkers. Sex interactions were tested.

Results  Among 427 participants, median (SD) ages were 28.9 (7.3) years at the first MHC, 40.3 (9.4) years at the last MHC, and 74.8 (8.0) years at neuroimaging. A total of 263 participants (61.6%) were female and 231 (54.1%) were Black. Overall, 191 participants (44.7%) had normotension, 68 (15.9%) transitioned to hypertension, and 168 (39.3%) had hypertension. Compared with participants who had normotension, those who had hypertension and those who transitioned to hypertension had smaller cerebral volumes (hypertension: β = −0.26 [95% CI, −0.41 to −0.10]; transition to hypertension: β = −0.23 [95% CI, −0.44 to −0.23]), with similar differences in cerebral gray matter volume (hypertension: β = −0.32 [95% CI, −0.52 to −0.13]; transition to hypertension: β = −0.30 [95% CI, −0.56 to −0.05]), frontal cortex volume (hypertension: β = −0.43 [95% CI, −0.63 to −0.23]; transition to hypertension: β = −0.27 [95% CI, −0.53 to 0]), and parietal cortex volume (hypertension: β = −0.22 [95% CI, −0.42 to −0.02]; transition to hypertension: β = −0.29 [95% CI, −0.56 to −0.02]). Participants with hypertension also had smaller hippocampal volume (β = −0.22; 95% CI, −0.42 to −0.02), greater ventricular volumes (lateral ventricle: β = 0.44 [95% CI, 0.25-0.63]; third ventricle: β = 0.20 [95% CI, 0.01-0.39]), larger free water volume (β = 0.35; 95% CI, 0.18-0.52), and lower fractional anisotropy (β = −0.26; 95% CI, −0.45 to −0.08) than those who had normotension. Holding hypertension status constant, a 5-mm Hg increase in systolic BP was associated with smaller temporal cortex volume (β = −0.03; 95% CI, −0.06 to −0.01), while a 5-mm Hg increase in diastolic BP was associated with smaller parietal cortex volume (β = −0.06; 95% CI, −0.10 to −0.02). The negative association of hypertension and BP change with regional brain volumes appeared stronger in men than women for some regions.

Conclusions and Relevance  In this cohort study, early adulthood hypertension and BP change were associated with late-life volumetric and WM differences implicated in neurodegeneration and dementia. Sex differences were observed for some brain regions whereby hypertension and increasing BP appeared more detrimental for men. These findings suggest that prevention and treatment of hypertension in early adulthood is important for late-life brain health, particularly among men.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802984

Complex work with people improves episodic memory, promotes brain reserve, reduces dementia risk

 Max E. Coleman, Meghan E. H. Roessler, Siyun Peng, Adam R. Roth, Shannon L. Risacher, Andrew J. Saykin, Liana G. Apostolova, Brea L. Perry



https://doi.org/10.1002/alz.13035

Abstract

Individuals with more complex jobs experience better cognitive function in old age and a lower risk of dementia, yet complexity has multiple dimensions. Drawing on the Social Networks in Alzheimer Disease study, we examine the association between occupational complexity and cognition in a sample of older adults (N = 355). A standard deviation (SD) increase in complex work with people is associated with a 9% to 12% reduction in the probability of mild cognitive impairment or dementia, a 0.14–0.19 SD increase in episodic memory, and a 0.18–0.25 SD increase in brain reserve, defined as the gap (residual) between global cognitive function and magnetic resonance imaging (MRI) indicators of brain atrophy. In contrast, complexity with data or things is rarely associated with cognitive outcomes. We discuss the clinical and methodological implications of these findings, including the need to complement data-centered activities (e.g., Sudoku puzzles) with person-centered interventions that increase social complexity.

CONFLICTS OF INTEREST STATEMENT

Andrew J. Saykin: Avid Radiopharmaceuticals, a subsidiary of Eli Lilly, provided Saykin with the in-kind contribution of a PET-tracer precursor to Indiana University. Liana G. Apostolova: Received consulting fees from Biogen, NIH Biobank, Two Labs, Eli Lilly, IQVIA, GE Healthcare, Florida Department of Health, Eisai, Genentech, and Roche Diagnostics; holds stock or stock options in Cassava Neurosciences and Golden Seeds; and has received equipment from Avid Radiopharmaceuticals, Life Molecular Imaging, and Roche Diagnostics. All other authors have no conflict of interest to disclose. Author disclosures are available in the supporting information.

https://alz-journals.onlinelibrary.wiley.com/doi/abs/10.1002/alz.13035

Michigan Officials Monitoring Large Outbreak of Fungal Infections Tied to Paper Mill

 Public health officials are continuing to investigate and monitor a large outbreak of blastomycosis, a type of fungal infection that can become serious if not treated, tied to a paper mill in Michigan's Upper Peninsula.

As of last Friday, the local agency leading the investigation -- Public Health, Delta & Menominee Countiesopens in a new tab or window -- has reported that more than 90 peopleopens in a new tab or window have been potentially affected by the outbreak associated with the Billerud Paper Mill in Escanaba.

Specifically, there have been 19 confirmed cases, in addition to 74 probable cases in those with a positive antigen or antibody test, the agency said.

"Although the source of the infection has not been established, we continue to take this matter very seriously and are following recommendations from health and government officials and implementing numerous, proactive steps to protect the health and safety of our employees, contractors, and visitors," Brian Peterson, vice president of operations for the paper mill, said in a statement in the health department announcement.

Importantly, the infection does not spread person-to-person, or between animals and people, the agency noted.

Blastomycosis is caused by a fungus that lives in moist soil and decomposing matter like wood and leaves, according to the CDCopens in a new tab or window. The infection can occur after breathing in fungal spores. Symptoms include fever, cough, chest pain, difficulty breathing, night sweats, fatigue, weight loss, muscle aches, and joint pain. Though fatalities are rare, they can occur.

Public Health, Delta & Menominee Counties said that any individuals experiencing symptoms should contact their healthcare providers to discuss whether testing for blastomycosis is recommended.

The current outbreak appears to be the largest ever reported. Previously, a 2013 study published in Clinical Infectious Diseases,opens in a new tab or window which examined a community outbreak of blastomycosis in Wisconsin, concluded in part that the 55-person outbreak was "the largest ever reported." However, there have been other clusters of blastomycosis over the years, and exact case counts can prove elusive.

Cornelius Clancy, MD, director of the mycology research unit at the University of Pittsburgh School of Medicine, told MedPage Today that the current outbreak is indeed a large cluster and could potentially end up at the top of the list in terms of size.

Infections are "usually related or presumed to be related to some sort of common environmental source," Clancy said. Oftentimes, infections arise in areas of construction or other disruption to the environment where the fungus is embedded, with the fungus becoming aerosolized into spores that are inhaled.

A common scenario is that additional cases of blastomycosis are identified after an affected individual initially thought to have bacterial pneumonia does not get better with normal antibiotic treatment, Clancy explained. It can take "relatively severe cases to draw everyone's attention to the fact that cases are occurring."

"It can cause severe disease even in people who don't have known underlying medical conditions or immunosuppression," he added. "And in people who do have other medical conditions ... the risk of having a serious case is higher."

However, unlike COVID-19 or other viral infections, a person is not going to travel to another area and transmit blastomycosis to others, he noted. "You're going to have some sort of geographically condensed area where spores were dispersed," he said.

Clancy stressed that it is important for healthcare providers in endemic areas to be aware of infections and keep blastomycosis in mind should they have patients with an unexplained clinical syndrome. That awareness is essential to testing for, diagnosing, and treating blastomycosis with antifungal medications when needed, he added.

"We are seeing more and more of these fungal infections, in general," he said.

A spokesperson for Public Health, Delta & Menominee Counties declined MedPage Today's request for further comment on the matter, citing an ongoing investigation, but did note that an additional update is expected in the coming days.

https://www.medpagetoday.com/special-reports/features/103965

What Makes Brazilian Butt Lifts So Deadly?

 In surgical circles, the Brazilian butt lift (BBL) is known as the deadliest aesthetic procedure ever performed, and despite several calls to improve outcomes, recent data suggest mortality is only getting worse -- especially in South Florida.

Sunny, image-conscious Miami is home to a substantial proportion of the country's high-volume, low-cost clinics where U.S. patients flock for the procedure. Despite widely publicized deaths and changes in rules about performing the procedure in Florida, researchers say it's still causing harm.

"You have people from all over the United States coming to Florida, and they have these complications, and unfortunately, they either have to receive hospital care or they perish," Pat Pazmiño, MD, an assistant professor of plastic and reconstructive surgery at the University of Miami Miller School of Medicine, told MedPage Today. "And it's affecting the whole country."

Pazmiño and colleagues recently published an analysisopens in a new tab or window of the factors that make South Florida a particularly dangerous place for the BBL, which is also known as gluteal fat grafting. They analyzed 25 BBL deaths resulting from pulmonary fat embolism (PFE), where fat globules travel through the bloodstream and cut off circulation. Blocked pulmonary vessels can lead to respiratory failure and death.

They found most of the deaths occurred after plastic surgery associations and Florida regulators tried to make the procedure safer.

'The Most Dangerous Aesthetic Procedure Ever Performed'

The Brazilian butt lift became popular over the past 2 decades, with procedures surging more than 800% over the last decade alone, from 7,382

opens in a new tab or window in 2011 to 61,387opens in a new tab or window in 2021, according to data from the American Society for Aesthetic Plastic Surgery.

Whereas in the '90s, women prized big breasts and a thin silhouette, now wider hips and a fuller buttocks are the ideal, plastic surgeons told MedPage Today.

"Forty years ago, it may have been Kate Moss or Pamela Anderson," M. Mark Mofid, MD, associate clinical professor of plastic surgery at the University of California San Diego, told MedPage Today. "Now it's Jennifer Lopez and it's Kim Kardashian, and they look very different from the America that existed forty years ago."

During a BBL, a surgeon uses liposuction to remove fat from the abdomen, flanks, or back of an anesthetized patient. The surgeon then uses a syringe attached to a cannula to reinject or "graft" the reserved fat into the buttocks. The cannula is inserted repeatedly deep under the skin, fanning out from a few small incision points to distribute the fat across different areas.

It's known as a "blind" procedure, and surgeons can inadvertently injure the large vessels in the muscle or even inject fat directly into those vessels if the cannula goes too deep. The fat can travel via the bloodstream to the heart and lungs, and deaths from such a pulmonary fat embolism can occur within hours of the procedure, or even on the operating table.

Sometimes, this has happened when a patient was turned from a prone to a supine position on the operating table, putting pressure on the lower buttocks, according to Pazmiño's analysis.

It wasn't until recently that plastic surgeons realized some BBL procedures were going very wrong. Mofid started performing BBLs at a time when only two other surgeons in the country were doing them. But as their popularity grew, he became alarmed by reports of BBL-related deaths in journals and conferences.

Given those concerns, Mofid and a group of surgeons formed the Aesthetic Surgery Education and Research Foundation (ASERF). In 2017, they published one of the first studies

opens in a new tab or window quantifying BBL deaths.

"What we found was just absolutely jaw-dropping and shocking," Mofid said. "We had determined that this was likely one of the most dangerous operations in the world, and certainly the most dangerous aesthetic procedure ever performed."

Of 692 plastic surgeons surveyed, 3% said they had had at least one PFE death, and 7% reported at least one PFE from gluteal fat grafting. Mofid and colleagues estimated the mortality rate for BBLs to be between one in 2,351 to one in 6,241. By comparison, cosmetic breast surgery has an estimated mortality rateopens in a new tab or window of one in 72,000.

Arthur Perry, MD, a plastic surgeon at Lenox Hill Hospital in New York, said any death from an aesthetic procedure is alarming. "One death in a plastic surgeon's office and you pretty much want to retire from medicine," he said. "It's terrible."

"Remember, no one ever died of a skinny buttocks," Perry told MedPage Today.

"It's not like you're [in] pulmonary failure, heart failure, or something like that, and we need to operate because you're going to die," he said. "The risk-benefit ratio has to be better in cosmetic surgery."

While the surgical literature shows that the vast majority of deaths from BBLs occur when a patient suffers a PFE, these events are hard to quantify because of different reporting standards for various state medical examiners. BBL complications are even harder to track, because of limited follow-up by clinics that perform them and few state reporting requirements.

Deaths Worse After Warnings

As Mofid and colleagues published their paper in 2017, the Miami-Dade County Medical Examiner had determined that PFE was indeed the cause of death for five patients who had died in South Florida that year.

Pazmiño and ASERF assembled a task force. They had plastic surgeons perform BBLs as they usually would on cadavers with color-coded fat, and then dissected them.

Based on the results, the task force issued a warning in 2018

opens in a new tab or window that was widely distributed to members of plastic surgery societies. To avoid injuring blood vessels and risking PFEs, they warned, surgeons should only inject into the subcutaneous fat, and not inject at a downward angle. They should also use a stiff cannula instead of one that could bend and accidentally inject deeper.

A subsequent surveyopens in a new tab or window of plastic surgeons in 2019 revealed that the warning, and a wider public education campaign, had worked -- the BBL mortality rate appeared to have dropped to 1 in 14,952.

The Florida Board of Medicine also introduced a "subcutaneous-only injection" emergency ruleopens in a new tab or window in 2019, alerting every physician in the state not to inject into the deep gluteal muscle fascia. If they did, they could face disciplinaryopens in a new tab or window actionopens in a new tab or window.

"One would assume that because of all these advances, BBL-related deaths would have decreased since 2019," Pazmiño and co-authors wrote in their recent study. "Unfortunately, in South Florida, the opposite happened."

From 2019 to 2022, there have been 12 deaths due to PFE following BBL in South Florida, according to Pazmiño and colleagues. Eight of those deaths occurred in 2021 alone.

Importantly, of the 25 BBL-related PFE deaths in South Florida from 2010 to 2022, the vast majority (23) were performed at what Pazmiño's study calls "high-volume budget clinics."

Budget Clinic Cluster

Pazmiño and colleagues mapped out the 25 deaths, revealing clusters of clinics, with the greatest concentration along 8th Street near the neighborhoods of Westchester and West Gables.

"Low-budget, high-volume" clinics lean heavily on social media and advertise BBLs for as little as $2,900, according to the paper. From a quick Google search, it's easy to find oneopens in a new tab or window that offers a special payment plan of $27 per month for the procedure, and even partners withopens in a new tab or window a medical credit company to attract patients who might otherwise not be able to afford it.

Plastic surgeons MedPage Today spoke with and Board of Medicine records from a meetingopens in a new tab or window where three BBL surgeons with PFE deaths were disciplined revealed the dangerous practices fueling them. The clinics were hiring contract physicians who rotated in and out of various clinics, performing as many as eight to 10 BBLs a day, according to Pazmiño's paper.

Experienced surgeons say this is not possible to do safely. Both Pazmiño and Mofid said it takes them 2.5 hours to do one BBL, and they schedule at most three in a day. "After 10 years, that's how efficient I've become," Pazmiño said.

Mofid said that at a Miami clinic his colleague has since left, the colleague had confided that he'd been performing an average of 11 BBLs a day.

"The only way you can do that is just blatant disregard for a patient," Mofid said. "I don't know how you could do that."

One surgeon, John Sampson, MD, who was banned from performing BBLs by the medical board, told the board his patient death happened after his seventh surgery of the dayopens in a new tab or window -- at 8:31 p.m. Another surgeonopens in a new tab or window, Sergio Alvarez, MD, said he barely remembered the patient he'd killed, according to Pazmiño's paper.

"It doesn't take a mathematical genius to figure out that they're doing something very wrong," Mofid said.

A 2021 investigation by National Geographic

opens in a new tab or window found that surgeons at one clinic were running multiple BBLs at the same time, rotating between rooms.

"What's happening in these clinics is that the board-certified surgeon is not doing the whole procedure, so they're letting non-doctors do the liposuction in the background," Pazmiño said.

Mofid said that while he can't prove it, "that's the only way that you can do it -- is by having someone who's not a physician do the case."

What surprised Pazmiño was that 69% of the surgeons behind the 25 deaths were board certified by the American Board of Plastic Surgery. Even though patients have learned to search for practices with board-certified surgeons, he said, the credential is not enough.

"We want to emphasize that board certification alone has not protected these patients," Pazmiño said.

Pazmiño said it would seem ridiculous, "If I told you, 'oh my gosh, yesterday I did the most beautiful shaped-breast [implant] in the parking lot, can you believe I had a problem afterwards?' And then you will say 'well, my God, you did it in the parking lot' and I would say, 'But I'm board certified!'"

He said, "Board certified is not enough."

Can BBLs Be Safer?

Florida's medical board, alarmed by the continuing deaths, passed a second, temporary emergency ruleopens in a new tab or window in 2022. Surgeons would only be allowed to perform three BBLs per day and require ultrasound guidance to help limit their grafting placement to the subcutaneous space only.

The board recently proposed a more permanent ruleopens in a new tab or window that would limit surgeons to five BBLs a day.

Surgeons who want to keep patients safe -- and uphold the field's reputation -- say they're not sure what the solution is.

"They told us to inject only into the fat, and the deaths continue. They told us to use ultrasound, and the deaths continue," said Perry, who has reviewed autopsies related to BBL PFE deaths and does not perform the procedure.

He's opening up a new practice in Manhattan, and will not allow BBLs there. "I feel it's just a procedure that at this point in time is too dangerous to do."

Pazmiño, who teaches the procedure, insisted that keeping grafts within the subcutaneous fat is safe.

Initially, Mofid agreed, but he's not so sure anymore. Less than a month ago, a doctor who used to do autopsies in Los Angeles County reached out to Mofid about four or five BBL patients he'd learned of who had died with microscopic fat in the lungs after fat grafting, instead of the larger pieces of fat they'd come to associate with PFE after BBL.

"Now, after talking to [the colleague], it's hard for me to absolutely state with 100% confidence that this was a completely safe operation, if it's done correctly," Mofid said.

He thinks enacting a law that prohibits non-board-certified plastic surgeons from running medical group practices would go a long way in protecting patients.

"The likelihood that enacting that legislation would save lives is very high," he said. "And I think that there would probably be zero mortalities in the state of Florida."

Stricter control of the procedure and more rigorous studies are also needed, Perry said. "I'm not wild about someone telling me how to operate," he said. "But I understand. I mean, this is an epidemic. There are hundreds and hundreds of deaths."

"I think there's no question," he added, "that this procedure should not be done in the United States."

https://www.medpagetoday.com/special-reports/exclusives/103970

WW International: Goldman Sachs upgrades to buy from neutral

 

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AstraZeneca: Morgan Stanley moves from Equal-Weight to Overweight

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