Pa. steps up surgical-licensing campaign The death of a young woman who underwent liposuction in May has officials notifying doctors of two-year-old changes.

After the death of an 18-year-old woman who underwent liposuction in a private medical office, Pennsylvania health officials have moved to enforce a two-year-old licensing regulation that has gone largely unnoticed by many doctors and even state regulators.

In November 1999, as the millions of procedures performed outside hospitals nationwide continued to grow, the Pennsylvania Department of Health updated its licensing regulations for "ambulatory surgical facilities." That meant that large surgical centers, as well as doctors' offices where surgery was done, had to meet strict criteria to help ensure patient safety.

But few doctors across the state have applied for that license - a lack of response that did not prompt a reaction from regulators at the Health Department. Its current effort to notify doctors about the regulations was not begun until Amy Fledderman of Newtown Square, Delaware County, died in May, two days after undergoing liposuction in the office of a King of Prussia plastic surgeon who did not have a license to operate the facility.

Pennsylvania Secretary of Health Robert S. Zimmerman Jr. said his department felt it was time to launch an all-out campaign to remind doctors that they need to adhere to the licensing regulations. He said the state had no way of knowing how many doctors perform surgery in their offices without the necessary license.

In addition to sending letters to the 75,000 doctors licensed to practice in the state, reminding them of these regulations, health officials will seek the cooperation of state medical licensing boards, medical societies, and other professional groups to bring attention to the rules, Zimmerman said.

He said that his department would work with doctors who want to be licensed, but that "if they can't get in compliance, they shouldn't be in the business."

Edward Dench Jr., vice president of the Pennsylvania Medical Society and an anesthesiologist from State College, said he believed many doctors are in the dark about the licensing regulations, even though his society posts information about the rules on its Web site.

The state, as required by law, published the 1999 regulations, which grew out of 1987 rules, in the Pennsylvania Bulletin. But, Dench said, "I don't think the state made a conscientious effort to let every doctor know."