Medical Board panel hears arguments in case over Dr. Leif Rogers and post‑operative pulmonary embolism

The Medical Board of California, Panel B, heard oral argument March 14, 2025, in the accusation against Dr. Leif Rogers, a plastic surgeon, arising from the postoperative death of a patient who suffered a pulmonary thromboembolism after elective cosmetic procedures. The panel took the matter under submission and will deliberate in closed session; no decision was announced at the hearing.

Deputy Attorney General Rebecca Smith argued that Rogers failed to obtain adequate preoperative clearance for the combined procedures, did not stage elective surgeries to limit anesthesia time, failed to consider or document prophylactic anticoagulation despite a DVT risk assessment in the chart, and did not document discussion of the device Renuvion’s non‑FDA‑approved status for the cosmetic use in question. Smith asked the panel to reject an ALJ’s proposed decision and impose more serious discipline.

Rogers’s counsel, Matthew Breuniger, urged the panel to give great weight to the administrative law judge’s factual findings and to reject the state’s request for increased discipline. Breuniger and defense experts argued that the patient had been cleared by her primary care physician for major surgery and that the combined procedures were within the range of accepted practice for accredited facilities. The defense also presented testimony from experts who said that consensus guidance at the time did not require routine anticoagulation unless a Caprini score of 8 or higher was reached.

Panel members questioned Rogers about his decision not to stage procedures and about documentation in the chart. Rogers said he had offered staged surgery but that the patient preferred a single operation; he said the primary care clearance described the patient as being in “excellent health,” and that he relied on that clearance when planning the combined procedures. Rogers acknowledged the death was devastating and told the panel he had changed practice processes since the event, including greater use of anticoagulation in some cases and additional documentation and safety checks.

The allegations include a claimed Caprini score of 4 on an internal prophylaxis worksheet placed in the chart; the worksheet’s printed recommendation at the time referenced anticoagulation for scores of 3–4 but the record shows no anticoagulant was ordered and no contemporaneous documentation of the clinical reason for withholding one. The state introduced expert testimony asserting that the patient’s age, obesity and the length and extent of surgery increased pulmonary embolism risk and that a surgeon should have considered anticoagulation. The defense introduced peer‑reviewed literature and testimony from experts who argued the standard of care did not mandate anticoagulation for every patient with these characteristics and that disclosure of a device’s FDA approval status is not universally required for informed consent.

After closing arguments the parties submitted the matter and the panel closed the record. The board will deliberate in closed session and issue a written decision later.