A Tucson doctor has surrendered his medical license over issues with prescribing and his supervision of liposuction procedures.
Laurance Silverman signed documents to voluntarily give up his license Nov. 10, following a medical board investigation that began in 2015, board documents show.
The investigation was triggered by Silverman’s disclosure on his medical license renewal in 2015 that in May 2014 he had surrendered his U.S. Drug Enforcement Agency (DEA) certificate to prescribe controlled substances.
Silverman had surrendered his DEA certificate for providing controlled substance prescriptions to patients without performing an exam, Arizona Medical Board records say.
The investigation also found that Silverman admitted to allowing a nonmedically licensed individual to perform tumescent liposuction procedures on patients at the “med spa” where Silverman was medical director.
An agreement with the medical board that is part of the surrender says Silverman’s conduct, uncovered in the investigation, constitutes unprofessional conduct.
The Arizona Medical Board can accept the surrender of the license of a physician under investigation if the licensee is either unable to safely engage in the practice of medicine or has committed an act of unprofessional conduct, board officials say.
Silverman had been licensed to practice medicine in Arizona since 1992 and the state medical board lists his areas of interest as physical medicine and rehabilitation.
The Arizona Medical Board documents do not provide a timeline for the unprofessional conduct, do not name the med spa, and the complete investigative file on the case is not public record.
Reached by telephone, Silverman said he feels he was a victim of circumstance as the unprofessional conduct was related to a time when he was supervising a medical assistant named Gustavo Nuñez.
Nuñez, who is in his 50s, is in jail and awaiting trial on charges that he performed liposuction procedures without a medical license. He was arrested in 2013 after a DEA investigation into his clinic, called NuTec, in an industrial warehouse at 1656 N. 15th Ave.
Silverman had previously been Nuñez’s medical director when they worked together at LaserOne, a salon day spa in Tucson. Silverman worked there for four years and left in 2012, he told the Star. While working there he had assumed Nuñez was qualified to perform the procedures he was doing, he said — although LaserOne’s co-owner says Silverman would have had to vet Nuñez’s background before agreeing to hire him.
In a court filing that’s part of the state’s criminal case against Nuñez, prosecutors say that Silverman and Nuñez performed about 12 liposuctions together at LaserOne.
Silverman told the Star he will testify for the state against Nuñez in the criminal case.
“According to my contract, everyone who worked there under me was supposed to be licensed and qualified to do procedures,” Silverman said. “I am upset with LaserOne.” He declined to answer any follow-up questions.
Callie Cox, co-owner of LaserOne, said she has no knowledge of the medical board investigation. Silverman was the medical director when Nuñez was hired, so he would have had to both approve his hiring and know his background, she said.
She said that Nuñez’s arrest was related to events that occurred after he left the day spa.
“I would not even have brought Gustavo on board if Dr. Silverman did not approve of him,” Cox said. “Everything we did when Dr. Silverman was here was on the table as far as I know. There was no funny business here.”
Nuñez left LaserOne at the end of 2012 to focus on providing services at his own clinic, the court filings say. In a 2014 interview with the DEA, Silverman said that when he left he did independent examinations for insurance companies.
Silverman had an issue with Arizona Medical Board once before for a problem while he was supervising Nuñez.
In 2011, the board reprimanded Silverman after a patient, a 55-year-old women, complained that the lip injections she received in 2010 caused severe swelling and necrosis. The board documents don’t specify where Silverman was working at the time, only that he was supervising Nuñez.
Nuñez performed the lip augmentation with a dermal filler, the board’s investigation found. The woman said she called Silverman after business hours because of the swelling but was unable to reach anyone, the records say.
An outside medical consultant hired by the board found that Nuñez had no record of being certified as a medical assistant, though he did meet the minimum standards for acting as a medical assistant under Arizona law.
However, the outside medical consultant found that in plastic surgery and dermatology it is not accepted practice to allow even certified medical assistants to perform sensitive cosmetic filler injections.
That’s because their training for injections does not include those for cosmetic purposes, and weekend courses and company-sponsored training do not qualify as recognized formal training or certification, the consultant said.
The board in 2011 also found that Silverman violated the standard of care by failing to have after-hours phone support available to patients. The standard of care is to provide such support in the event of complications after cosmetic procedures.
He also violated the standard of care because the patient did not sign a “consent for treatment” form, the board found. Without that form, the board said there’s no assurance that the patient was aware of the risks involved with the procedure.