A mother-of-three who underwent “Brazilian butt lift” surgery in Turkey died just three days after the operation, following a catalog of poor care, an inquest has heard.
Demi Agoglia, 26, from Salford, Greater Manchesterdied in an Istanbul hospital on January 8.
She is said to have been ‘conscious about her appearance’ and insisted on undergoing the BBL procedure, which sees fat taken from elsewhere in the body and injected into the hips and buttocks.
On Wednesday, Bolton Coroner John Pollard ruled the medical cause of death was a microscopic fat embolism in which tissue leaks into the bloodstream.
He concluded that Ms. Agoglia died as a result of a fortuitous accident that contributed to neglect.
He said: “I find there was no appropriate informed consent in this matter, no appropriate pre-operative care and advice and no appropriate post-operative care.
“All of this meant that the overall care fell well below the standard expected of this type of treatment and the lack of care contributed significantly to Demi’s death.”
Pollard told Ms Agoglia’s family he would write to Health Secretary Wes Streeting, adding: “I feel something more needs to be done to stop this frankly barbaric medical practice being carried out at such low standards that it would certainly not be tolerated in the UK Kingdom. “
Bolton Coroner’s Court heard that Mrs Agoglia, of Little Hulton, had struggled with her mental health and was on medication for ADHD and bipolar disorder.
Her mother, Christine Tydd, told the hearing she told Ms Agoglia she was a “good girl” and did not need the operation, shortly before her daughter traveled to Turkey on January 4 with her partner, Bradley Jones.
He said: “She was conscious of her appearance. He didn’t change his mind.”
The local director Mr. Jones also said he did not want Ms Agoglia to have the surgery, but had booked the trip months in advance through a company called Comfort Zone Surgery after “she had seen some celebrity” advertising the procedure.
The couple stayed in a shared villa in Istanbul before being taken by taxi to the hospital.
After the operation, Ms Agoglia was “shaking” and looked “very, very cold”, Mr. Jones.
Comfort Zone staff were called to the villa after Ms Agoglia complained of chest tightness and they checked her blood pressure, but did not inspect the operation area or check her heart rate and pulse, the inquest heard.
Mrs Agoglia collapsed at the villa the following day and was taken back to Avrasya Hospital where she died.
The surgeon who performed the operation later told Jones that they had done all they could.
It later emerged that the Comfort Zone staff called to the villa were not registered nurses.
Giving expert evidence, Harley Street plastic surgeon Dr Omar Tillo noted the “completely bizarre” actions of Comfort Zone staff who tried to feed pieces of cucumber to Mrs Agoglia after she collapsed.
He said: “The lack of appropriate care and response, particularly the failure to deal with post-operative complications, is likely to have played a significant role in Demi’s tragic outcome.”
Dr Tillo said the BBL process takes place in the UK “within very strict rules to do it safely”.
Pathologist Dr Usha Chandran carried out a post-mortem examination on January 25 and ruled the cause of death “uncertain” because she found no evidence of a microscopic fat embolism.
But Mr. Pollard pointed out that decay can occur when there is such a delay between death and autopsy.
Dr. Tillo agreed with Mr. Pollard that it would seem “almost unbelievable” that the death of a young, healthy woman was not linked to the BBL surgery she underwent.
Dr Chandran told the hearing: “I’m really disturbed by Demi’s death and I feel that all these cosmetic procedures are being given a lot of attention by celebrities … and they are done in bad clinics.”
The inquest was told the coroner’s office had sent several emails to the Turkish hospital and the surgeons involved to get statements, but had received no response.
Mr. Pollard said: “Most investigations are sad in nature. This research is particularly important as it involved the death of a young woman with significant mental health problems who, despite being beautiful and her partner not believing she needed any improvement, insisted on having BBL surgery.
“I found he went to Turkey probably because the process was quicker and cheaper than the UK.
“We know little or nothing about the perioperative situation because the Turkish authorities have refused to cooperate with the coronavirus process.
“I find the post-op care to vary from dismal to completely non-existent.
“When she developed obvious symptoms of serious illness she was understandably not immediately recognized by her partner or untrained staff.
“By the time he got to the hospital it was frankly too late and he was in a critical condition.
“I think it was indicative of the poor level of care that at all times she was taken not by ambulance but by taxi, it was always the same taxi.
“I heard extremely helpful input from Dr. Tilos, who clearly explained all the failures and failures he could assess from the evidence and sparse documentation available to him.”
No record of intensive care admission or any tests and scans carried out had been produced, the inquest was told.
After the inquest, Mrs Agoglia’s sister Chloe, 23, said: “I just wouldn’t recommend anyone going to Turkey for possible surgery or researching more about it if they’re even thinking about it.
“She was so beautiful and just didn’t need any surgery. She only went for the sake of being so down on herself and not feeling good enough.
“Our Dem didn’t just leave her family behind, she left the most beautiful baby boys.
“Forever and always in our hearts Dem. We really gave it our all. Sleep well Dem.”
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