RICHMOND, Va. — Mandy Moore, Audrey Andrews, and Angela Oliver say they had faith and confidence in their former breast surgeon, Dr. Sasa Grae Espino — until the aftermath of their various operations.
"I put my trust in her, and I put my trust in that hospital," Moore said.
"I guess I trusted her," Andrews said.
"I trusted her. I trusted her," Oliver said.
According to lawsuits filed by the Virginia women, Espino performed an unnecessary preventative double mastectomy on Moore, a complex breast reconstruction on Andrews that a plastic surgeon later told her was "not consistent with the standard of care," and multiple breast reconstruction surgeries on Oliver, as well as an abdominal surgery, which allegedly left her with "severe and permanent injuries."
"The scars when I look in the mirror, I see Frankenstein," Oliver said.
Espino was credentialed by Chippenham Johnston-Willis Hospitals to perform breast reconstruction surgeries, according to a spokesperson for their owner HCA.
But the lawsuits claim the doctor performed procedures beyond the scope of her practice and training.
In addition to suing Espino, the women are suing the hospitals and HCA, alleging they negligently credentialed Espino.
So what is negligent credentialing?
"The trial court that's probably cited the most often talks about that a hospital failed to exercise reasonable care, to ensure the competence of its medical staff and to supervise the care provided in the hospital by those staff physicians," Rodney Adams, Professor of Health Law and Medical Ethics at VCU and the University of Richmond, said.
Adams, who previously defended hospitals and doctors as a trial lawyer, says that claim has been tough to prove in court.
"The Virginia Supreme Court has not decided that question," he said.
Espino's lawyers previously told CBS 6 that Espino's "specialized fellowship, education, training, and surgical experience qualifies her to perform breast reconstruction surgeries."
Espino is a board-certified general surgeon who completed a breast surgery fellowship at Northwestern in 2017.
In an HCA promotional video posted on Facebook in October 2021, Espino described her training.
"I also did implant reconstruction training at Northwestern, meaning I do my own implant reconstruction," Espino said in the video. "What that means for patients is they don't have to go to so many different surgeons."
CBS 6 investigative reporter Melissa Hipolit spoke with two breast surgeons who asked not to be identified and who also completed a breast surgery fellowship at Northwestern. Both said they spent one month rotating on plastics and that the rotation was meant to expose fellows to plastic surgery — not train them to perform reconstructive procedures.
HCA promotional material given to Espino's patients states she completed a Breast and Reconstructive Surgery fellowship at Northwestern. But Northwestern says they do not offer a combined breast and reconstructive surgery fellowship. Their program is simply a Breast Surgery fellowship.
Richmond-area board-certified plastic surgeons Dr. Lewis Ladocsi and Dr. Steven Montante, both of whom have performed the same procedures at issue in these lawsuits, say they do not understand how Espino received privileges at CJW to perform complex breast reconstruction.
"The process for granting privileges and allowing surgeons to take care of patients broke down," Ladocsi said.
"What was the motivation?" Montante asked. "What was going through the hospital administration's minds? What was it that allowed them to credential her in such a way?"
Adams, who is not involved in the cases, says in general a Medical Executive Committee of doctors at a hospital signs off on what procedures each physician can perform. While plastic surgeons may believe only plastic surgeons should perform breast reconstruction, Adams says it is not unheard of for a hospital to credential a general surgeon if the committee believes they have demonstrated competence.
"It may be the case volume, the case load, and the types of cases in that fellowship met the criteria of the Medical Executive Committee," Adams said.
Oliver says she hopes to learn more about how Espino got credentialed at CJW to perform the surgeries she did on her.
"They have an obligation to make sure they're putting the right people in the right positions to do these operations and surgeries and take care of people," Oliver said.
The hospital is requesting the negligent credentialing claim in Andrews' and Moore's lawsuits be dismissed and denies that Espino was not qualified to perform Andrews' surgery. Oliver's lawsuit has not yet been served, so the hospital has not yet responded to it.
A spokesperson for HCA previously told CBS 6 that Espino's request for privileges was carefully reviewed by the Credentials and Medical Executive Committees.
Espino has denied the allegations in Andrews' and Moore's lawsuits and has not filed a response to Oliver's complaint.
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