Yesterday, an Ohio plastic surgeon, Katharine Grawe—who accumulated nearly 15 million likes by livestreaming operations on TikTok as “Doctor Roxy”—was permanently banned from practicing medicine and surgery in Ohio.

The decision came following a November 2022 suspension temporarily barring Grawe from seeing patients after the State Medical Board of Ohio reviewed “clear and convincing evidence” from multiple patients who were harmed during Grawe’s livestreamed surgeries. The board decided to suspend Grawe’s license, saying that her “continued practice presents a danger of immediate and serious harm to the public.”

The suspension notice details three anonymized patient complaints about “Doctor Roxy.” During one surgery that was livestreamed on TikTok, Grawe looked directly into the camera while inserting a thin tube called a cannula and performing liposuction on a patient.

“Despite liposuction being a blind surgery that requires awareness of the tip of the cannula to avoid injury, your attention to the camera meant at those moments you were not looking at the patient or palpating the location of the tip of the cannula,” the board wrote.

As a result of such negligence, that patient ended up needing a long hospital stay to deal with “free air in her abdomen,” a “perforated small bowel,” and a “necrotizing soft tissue infection,” the board wrote.

Another patient had to call 911 “due to cramping and severe abdominal pain” following a surgery involving a Brazilian butt lift, liposuction, and an umbilical hernia repair. That patient was rushed to the emergency room and had part of her small bowel removed after being diagnosed with a potentially fatal condition called rhabdomyolysis.

The third patient saw Grawe for a breast augmentation procedure involving silicone breast implants. In the days after that surgery, the patient felt nausea and noticed bleeding from the breast. The patient returned twice to Grawe’s office—Roxy Plastic Surgery—where Grawe delegated post-operation procedures to another surgeon and a nurse practitioner despite the patient’s “complex surgical history.” Ultimately, the patient had to go to the hospital to have the implants removed—which the board said that Grawe “erroneously” indicated to the hospital’s plastic surgeon had already happened.

“These outcomes were not normal complications like those that exist in the routine practice of medicine, but were rather caused by recklessness and disregard for the rules governing the practice of medicine in Ohio,” Jonathan B. Feibel, vice president of the medical board, said during the board’s hearing this week.

“Doctor Roxy” got two warnings

The board had warned Grawe twice before suspending her license of the potential ethical issues and their concerns about her departures from normal standards of care.

The first warning came in 2018 when the board told her that she needed “to maintain patient privacy when sharing photos or video via social media.” On TikTok, Grawe shared “pre-operative photos, pre-operative interviews with patients about their bodies, livestreams of their procedures, post-operative still images of patients taken in the operating room, and the cost of the procedure,” the board noted. Grawe also had a habit of responding “to viewers’ online questions” during livestreams “while the surgical procedure” remained “actively ongoing,” the board said.

Grawe responded to that warning by updating her patient consent form.

Her next warning came in September 2021, when the board “articulated multi-faceted issues” with Grawe’s “care of these patients, including concerns regarding the lack of informed consent, ethical concerns related to privacy and social media, and avoidable complications that required surgical revisions.”

At that point, the board recommended that Grawe “undertake remedial education courses related to complications of plastic surgery and professionalism/ethics.” Grawe complied by completing remedial education in “Ethical Social Media” and “Finesse in Mastopexy and Augmentation Mastopexy,” which only addressed patient complaints of surgeries to improve sagging of the breasts.

After that, she kept on posting videos to TikTok through October 2022, leading up to her suspension and yesterday’s decision to permanently revoke her medical license in Ohio. Feibel said during her hearing that Grawe had previously “dismissed complaints as coming from disgruntled former patients,” The Columbus Dispatch reported.

A spokesperson for the State Medical Board of Ohio, Jerica Stewart, told Ars that “a permanent revocation means Katharine Grawe will no longer be permitted to practice medicine and surgery in the State of Ohio.” Grawe was also fined “$4,500 based on her failure to meet standard of care,” Stewart said.

All actions taken are ultimately documented on the board’s website. Stewart said that once Grawe receives the final documents, the board’s order will also be available here.

Ars could not immediately reach Grawe or TikTok for comment. Grawe’s TikTok account remains active with more than 825,000 followers, but it is currently locked.

https://arstechnica.com/?p=1953654