State investigating claims local plastic surgeon failed to treat infections, complications

Dr. Thomas Jeneby says complications usually patient's fault

SAN ANTONIO – He's a well-known local plastic surgeon who has gained national attention for sharing live videos of his surgeries on social media.

Some of Dr. Thomas Jeneby's former patients claim he failed to properly care for them after their breast augmentation surgeries which left their bodies infected and deformed.

The Defenders began looking into the women's allegations earlier this year when one of those former patients published a blog about her negative experience with Dr. Jeneby.

Starr Marks said she saw a commercial Jeneby bought that aired during the Super Bowl promoting his "mommy makeovers."

She said she was compelled to share her story publicly and since then she's learned she's not alone.

In early March the Defenders brought Marks and more than a dozen other former patients together to discuss their experiences. Some of the women agreed to share their identities while others wanted to remain anonymous because they were embarrassed or were in the process of taking legal action against Jeneby.

When the group was asked how many of them ended up with infections after having surgery done with Jeneby every one of them raised their hands.

"My original surgery was in July and then in November I had them re-implanted. Because I had the infection they had to take them out." said Alison Ellington.

The women all said Jeneby made them feel as if they were the only patient to have complications.

"He told me this has never happened to anyone before," one woman said.

"He told me that too," said another woman.

Marks said she was surprised by the response to her blog. While she never named Jeneby in her story she said several women began contacting her asking if he was her surgeon and then shared similar experiences.

"When I was getting the responses and the messages, I cried," Marks said. "I just cried because I was like, 'Oh my gosh. I'm not alone.' So many women have reached out since. Women that are traumatized, that are deformed. They're just so appreciative that they're not alone."

According to medical records reviewed by the Defenders Jeneby performed a breast augmentation on Marks in April 2016. Just 10 days later one of her breasts was leaking fluid. Marks said she contacted Jeneby's office and was told not to worry.

"It was probably about a week after I just started having uncomfortableness, pain, chest tightness, and I would call and they were like, 'No, all of that's normal. Don't worry about it,'" Marks said.

As days passed Marks said she became more ill and her incisions began to open and fluid continued to flow from her breast.

"I just felt a gush of fluid from underneath my sports bra and when I looked there was just this awful discolored ugly fluid that had come out," Marks said. "He re-stitched the hole that was leaking the fluid. He told me I was doing too much."

A month post-surgery and after several visits to Jeneby, Marks said she learned her breast was infected with MRSA, or methicillin-resistant Staphylococcus aureus, and E. coli bacteria.

Marks said being diagnosed with the infection helped her realize what was happening with her body.

"Oh my God! This pain that I've been having -- I associated everything with the infection, because I'm thinking, 'It's invading my chest cavity, my muscles,'" Marks said. "People get septic and they die from MRSA. It should never be taken lightly."

Jeneby removed the implants and Marks sought treatment from other doctors, eventually getting 20 sessions in a hyperbaric chamber to heal her breasts. She said she has since had another doctor repair the damage.

"But I'm left with scars, scars that are an everyday reminder of what I endured, the pain that I went through," Marks said. "It was just a very traumatic experience because, just, 'How did I get here?' is what I kept saying. 'How did I get here? How did this happen?'"

During the group meeting, some of the former patients shared similar stories of their infections and complications.

"I had blistering and pus coming out and it was just angry-looking," one woman said. "He told me less than 3 percent get infection."

Everyone in the group said they thought they were the only patients who experienced problems until they read Marks' blog.

"He makes you feel like it's your fault, you did something or it's all in your head. I was in so much pain and he just made it seem like I had a low pain tolerance," said former patient Crystal Shotwell. "When I read her blog it was just like my story, just condensed and smaller because mine was like a 3-month-long ordeal. I was so mad and at the same time I felt so bad. Deep down I really wanted to be the only one that experienced that. I didn't want anyone else to go through what I had gone through. It was awful and to know that everyone else has gone through that, and there's probably more, there's probably so many more."

The women said Jeneby made them feel as if they were to blame for the infections and complications but they believe he's responsible. Some of the women claim he performed exams on them when they were infected and he failed to wear gloves.

"He lifts your boob up. It's leaking. He goes, 'Oh it's leaking really bad. I'm going to suture it. I'll be right back.' He walks out and you're thinking he's going to come with gloves. No, he just sutures you up," one woman said.

Marks said she'd like to see Jeneby put out of business.

"I think that he really needs to look at his practices and if he chooses to stay in practice that he kind of needs to go to a standstill and figure out, 'What are we doing wrong?" Marks said.

All of the women the Defenders interviewed said they had breast augmentations done by Jeneby within the past two to three years and they all had infections that required multiple surgeries and even required some of them to have their implants removed.

At least three of the women have filed complaints with the Texas Medical Board and have received letters informing them that an investigation is being conducted into Jeneby's postoperative care.

Dr. Jeneby said he's looking forward to hearing the board's findings.

"I welcome it because they will see that the paperwork is in line, the procedure was done well and that the postoperative care was acceptable," Jeneby said.

Jeneby is a board-certified plastic surgeon with good reviews and he claims to have a 90 percent patient satisfaction rate. He has practiced plastic surgery in San Antonio for the past 15 years.

Aside from a minor violation from the Texas Medical Board in 2009 for using advertising that was "false, misleading or deceptive," Jeneby has a clean record.

Privacy laws prevent him from talking about patients so Jeneby could not specifically address the concerns raised by the women the Defenders talked to.

He said complications do happen but they are often the patient's fault for not following his orders.

"If a doctor tells you they haven't had complications they haven't operated enough," Jeneby said. "There is no plastic surgeon in this city that I know that hasn't had some, no way. These patients circulate around all of us. There isn't one doctor that I haven't seen his complications and there isn't one doctor that probably hasn't seen mine."

Jeneby said he was not surprised that some of his former patients were complaining about ending up with infections after he operated on them but said it takes a toll on him when things go wrong.

"I'm deeply distressed and I'm in pain about it. I hate that anybody has a complication. We want to make sure that all of our patients have a great result. We just can't control for everything and its maddening," Jeneby said. "I would love to make it a zero complication year. I would love to have all complications gone, and we're getting close, but we cannot make it zero. It is impossible to make it zero and until we all come to terms with that, before you do any surgery you have to read the instructions, the preoperative, the consents, and the postoperative."

Jeneby said over the years he's performed roughly 4,800 surgeries and about 3 percent of his patients will develop some complications.

"So you can expect somewhere in the range of for every 1,000 surgeries I've done, you can expect about 30 to 45, maybe 3 to 4 percent," Jeneby said. "Some minor ones can be cataloged as unhappiness with something and then major ones obviously would be hospitalizations, which I have very few. At 4,800, even if I were to get, let's say I get 5 percent, that would be 270 (complications). That's a lot but that's what you get when you operate."

Some of Jeneby's former patients said their breasts were infected with MRSA, E. coli or Pseudomonas bacteria which Jeneby said could come from anywhere.

"Not to say they couldn't have gotten something here, I'm not saying that, but to have different types of bacteria, that are ubiquitous, all over, is very hard to say that this is the place that did it, or that's the place," Jeneby said. "If you have one bacteria, one source, the same one each time, you could make an argument experimentally that this is the place it came from. 'I'm getting the same thing.' But if you have different things, it's very hard to say that that's the place."

Jeneby gave the Defenders a tour of his offices including the operating room which he moved to after performing surgeries in local hospitals for eight years. He said since moving to the surgery center his complication rate has dropped.

"In this place we don't have different types of surgery. We have clean procedures, all plastic," Jeneby said. "So that's why I created it and if you look at the studies overall, the place where you'll have the least amount of complicating plastic surgery is outpatient, office based surgery centers because they have the least exposure to different types of patients."

Jeneby's operating room and offices are inspected and certified by the Joint Commission, which also certifies hospitals, nursing homes and other medical centers. The agency renewed his certification last year and it is good for three years.

"We had no spectacular faults. They find some things, like there's some dust on something, or they'll say the employment records have something, but we don't have anything that shows problems with our aseptic techniques," Jeneby said. "They come every three years but they can pop in any time and they've popped in a couple times and what they do is they literally run their finger down objects. They go and they look at about 20 different logs that you have including autoclave logs which (show how often we) sterilize equipment. They look at your cleanliness logs, when you terminally cleaned each room, what cleanliness products you're using. It's hard for us but you can be rest assured that we only picked the highest level of accreditation for this type of office-based surgery."

Jeneby said he informs all of his patients of potential risks complications and requires them to sign several documents acknowledging the risks.

"And we send them home with paperwork probably this thick, almost an inch thick, and do you know how many people read them? Less than 10 percent," Jeneby said.

 He said most patients who have problems usually overwork themselves too quickly after surgery and infections are likely caused by improper wound care.

"I hear them later, after I replace the implant, they're like, 'Dr. J, I really didn't listen to you the first time. I just didn't want to tell you,' and I hear that 50 percent of the time because the second time around, they're more careful," Jeneby said. "They start to listen. They take care of their environment. They call their parents in to watch children. They don't deal with their animals, their work. They take a little bit more time off of work. Remember, surgery is surgery. It's not sexy like you see on TV. You have to heal."

When answering to allegations he didn't wear gloves while examining some of the patients who had infections, Jeneby said he didn't recall doing that.

"It could be but I don't do it often and if I did I definitely didn't touch the incision. I probably got close to them but I always put on gloves when I'm touching the actual incision," Jeneby said.

While Jeneby said he has lost some patients because of Starr Marks blog he's not worried it will ruin his business and he's looking forward to the Texas Medical Board clearing him of any wrongdoing.

"I think the state board will come up with good resolutions to this. I hope that nothing comes of it but I think we have a good board and they're very fair," Jeneby said. "It's the first time I've had more than a couple (complaints) in one sitting but again I think that the board will do a good job and realize that I'm an open book. They can read everything that they need to read and if they have any questions I'm around.  We had some patients who decided to go somewhere else and that's fine."

Jeneby said the Texas Medical Board has informed him that two of five current complaints against him have already been dismissed. He said investigators determined "he performed within the standard of care."

Jeneby is also still facing a malpractice lawsuit filed in February. It's not the first time he has been sued by patients. He successfully had three other suits against him dismissed in 2009, 2010 and 2014 and he said he expects the latest suit to also be dismissed.

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