The N.C. Medical Board banned a Huntersville doctor from performing surgeries that require sedative anesthesia in his office after finding four patients received care "below standards of acceptable and prevailing medical" practice.
The board reprimanded Briggs Cook, who is listed as a doctor with PURE Facial Plastic Surgery and MedSpa. The board said Cook failed to perform adequate exams before operating on four patients and screen for risk factors.
In one instance, Cook performed a Quicklift (mid-face and neck lift) on the same day the patient was first seen, according to a consent order by the Medical Board. Cook did not take into account whether the patient had recently eaten or review past medical history, according to the order.
He also failed to provide proper anesthesia to a patient in 2015, when he gave the patient three dosages of 10 mg of diazepam, a sedative, for three procedures performed in the same day, according to the consent order. "This dosing is dangerous and potentially fatal," the order said.
That same patient saw Cook again in 2016 for a revision surgery of the Quicklift and Cook's operation notes document administering two ways of giving sedatives. "This inconsistent documentation of different medications administered by different routes (oral vs. intravenous) is clearly substandard," the order says.
That patient died following the revision surgery and Cook listed natural causes and cardiac arrest as the cause of death, according to the order.
There are many potential causes for the patient’s death, the order says, but "this cause could not have been ascertained by Dr. Cook as the operating surgeon. Dr. Cook should have requested an autopsy."
The Observer left a voicemail at Cook's office Monday afternoon and had not heard back by the time of publication.
The consent order said that in the cases of four patients, the N.C. Medical Board found "many concerns about Cook's preoperative assessments, histories and physicals, substandard documentation of surgical procedures, substandard documentation and administration of anesthesia ... and global concerns about the suitability of Dr. Cook's office as a setting for surgical procedures."
The board reprimanded Cook, which means he can still practice medicine. However, the board banned him from performing or supervising surgery that requires sedative anesthesia in an office.
"This specifically addresses the area of medicine where the licensee’s practice was found to be substandard," said Jean Fisher Brinkley, spokeswoman for the N.C. Medical Board. That attempts to ensure a similar situation will not occur in the future, she said.
On his website, Cook says he is certified by the American Board of Ophthalmology. Ophthalmologists can perform surgery on eyelids, eyeballs or tear ducts, said Kevin Smith, a doctor at Charlotte Plastic Surgery. “But facial surgery, like face lifts, is out of their area of core specialty.”
Cook’s case illustrates the need for North Carolina to pass a truth in advertising law, requiring doctors to be transparent about their expertise, said Smith, a board-certified plastic surgeon.
“Because North Carolina does not have truth-in-advertising, patients can be easily duped by false advertising,” Smith said. “Patients are in jeopardy because people can say they are something that they are not."
Patients should be diligent in seeking medical care, Smith said, by making sure their physicians are board certified in the areas they claim.
Patients should also make sure doctors are working in accredited facilities, he said.