Washington Court Upholds $13M Malpractice Verdict Against Cosmetic Surgeon
October 1, 2025 7 minutes read
By Damian D. Capozzola, Esq., and Jamie Terrence, RN
News
A Washington appeals court has upheld a $13 million jury verdict against a plastic surgeon accused of botched cosmetic procedures and deceptive business practices, marking one of the state’s more notable malpractice rulings in recent years. The panel rejected the defense’s claims that improper evidence tainted the trial, instead finding that the outcome was supported by substantial evidence and that no reversible error occurred.
The dispute arose after the plaintiff underwent multiple elective surgeries, including a tummy tuck, arm lift, breast lift, and liposuction, that left her with disfigurement, persistent infections, and emotional and physical trauma. The defendant, a licensed physician and owner of a medical spa, denied wrongdoing and challenged numerous evidentiary rulings, including the admission of prior disciplinary actions and testimony from other patients.
Jurors awarded $11 million to the plaintiff and $2 million to her husband for loss of consortium, with additional Consumer Protection Act (CPA) damages bringing the total to more than $13 million. On appeal, the defense contended that the court improperly allowed prejudicial material. But the appellate panel affirmed the previous decision, holding that any alleged missteps were harmless in light of the overall strength of the plaintiff’s case. The decision offers key legal lessons for healthcare providers navigating malpractice exposure.
Background
In 2020, the plaintiff consulted a Washington-based cosmetic clinic for a series of elective procedures. Over the span of one week, she underwent two rounds of outpatient surgery: the first involved a tummy tuck and liposuction, and the second included an arm lift, breast lift, and additional liposuction. The procedures were performed using local anesthesia and oral sedatives — no intravenous access was obtained. Postoperative complications arose quickly. The plaintiff’s wounds failed to heal properly, and some reopened multiple times. One arm incision became infected, but no diagnostic testing was done for nearly two weeks. Eventually, the plaintiff sought treatment elsewhere, reporting scarring, disfigurement, and emotional distress.
She and her husband filed suit, alleging medical negligence, lack of informed consent, breach of promise, and violations of Washington’s CPA. Her husband also asserted a claim for loss of consortium.
At trial, multiple expert witnesses criticized the defendant’s treatment decisions. They testified that the plaintiff’s risk factors, including diabetes and smoking, should have prompted further preoperative screening. Experts also flagged excessive surgical tension, improper wound management, and inadequate disclosure of risks as deviations from the standard of care. The plaintiff testified she was medicated before signing consent forms, and a clinic staff member acknowledged signing as a witness without observing her signature.
Jurors also heard that the plaintiff discovered the clinic online, where promotional materials emphasized minimal scarring and quick recovery. She claimed this advertising misrepresented the risks. The court admitted limited evidence of prior disciplinary actions, along with testimony from another former patient who described a similarly rushed consent process and lack of discussion of surgical risks. In August 2023, a jury awarded $11 million in damages to the plaintiff, $2 million to her husband, and $34,186 in CPA damages. A supplemental judgment added $79,000 in legal fees and $25,000 in treble damages, bringing the total to more than $13 million.
On appeal, the defense challenged the trial court’s evidentiary rulings, especially the admission of the prior disciplinary order and related testimony from a regulatory official. The provider argued this evidence constituted improper character evidence under Evidence Rule 404(b) and unfairly prejudiced the jury. The defense also objected to the testimony of the second patient, who described her own experience undergoing surgery at the clinic.
Separately, the defense contended that the plaintiff’s CPA claim was duplicative of her malpractice claim and should have been dismissed under Washington law. They argued that the plaintiff had failed to show any injury to business or property separate from the alleged medical negligence.
In July 2025, the Washington Court of Appeals rejected all arguments and affirmed the verdict. The court ruled that, even if some challenged evidence was admitted in error, it was harmless given the overwhelming support in the record. The court also upheld the CPA claim, concluding that the plaintiff presented sufficient evidence that misleading advertising played a material role in her decision to proceed with surgery.
What This Means for You
One of the key arguments on appeal in this case was centered on prejudice, specifically, the defense’s claim that the jury was improperly swayed by prior disciplinary findings and testimony unrelated to the plaintiff’s treatment. Nearly all evidence admitted at trial is, by design, prejudicial to one side. The question is whether it is unfairly prejudicial.
In Washington (and in most states), trial courts must weigh whether evidence, while technically relevant, might unfairly influence the jury by stirring emotions, appealing to bias, or causing the jury to decide based on character rather than conduct. This balancing test is governed by the rules of evidence, which are designed to prevent juries from deciding cases based on who they think the defendant “is” rather than what they actually did.
In this case, the defendant argued that the jury should never have seen a redacted disciplinary order involving nine other patients or heard testimony from a state medical commission representative and another former patient. The defense claimed this amounted to improper “prior bad acts” evidence, which is prejudicial information used to imply the defendant had a history of doing bad things, and, therefore, likely did something wrong in the current case as well.
The trial court disagreed and allowed the evidence. It reasoned that this evidence was not being used to show character or propensity but instead to help illustrate the provider’s routine preparation practices and standard operating procedures. The appellate court affirmed, emphasizing that, even if the evidence was admitted in error, it was not unfairly prejudicial in context. The court noted that there was substantial, independent evidence of negligence, including expert testimony about inadequate screening, poor surgical judgment, and substandard follow-up care, that supported the verdict on its own.
More generally, note that most healthcare facilities, including independent surgical centers, use credentialing procedures and mentoring to assure the competency of their medical and surgical staffs. Part of that process includes the review of public records concerning physician litigation as well as state medical board records. Additionally, physicians usually are required to provide self-disclosure of litigated cases they have been involved in.
Unfortunately, informed consent generally often occurs immediately before the procedure, when the patient is being prepped in an outpatient setting. A nurse or other non-independent or even licensed healthcare provider asks the patient to sign a form that says that the physician has gone over the risks and benefits of the procedure. Very few patients in that high-stress situation refuse to sign if they have not had that conversation because that would result in the cancellation of the surgery. In these cases, the medical record will show documentation of consent despite the patient’s claims to the contrary.
For providers and litigators, the takeaway is that, when challenging the admission of damaging evidence, it is not enough to argue that it hurt their case. They must show that it created a serious risk of the jury making its decision based on emotion or assumption, rather than the facts and law. If the rest of the record supports the outcome, appellate courts will almost always defer to the trial judge’s discretion.
One notable strategic aspect of the plaintiff’s case was the decision to bring a claim not just for medical negligence, but also under Washington’s CPA. While the bulk of the $13 million damages award came from traditional tort claims, the CPA claim added a meaningful advantage.
The CPA claim was based on allegations that the defendant’s advertising was deceptive. The plaintiff testified she discovered the provider through online videos and a promotional website showing minimal scarring and touting the safety of multiple procedures performed under local anesthesia. The jury ultimately agreed that this marketing was misleading and materially influenced her decision to proceed with surgery.
While the jury only awarded $34,186 in damages under the CPA, the real significance came when the trial court awarded the plaintiff $79,000 in attorney’s fees and $25,000 in treble damages. That is because Washington’s CPA, like many consumer protection laws in other states, allows for fee-shifting and potential statutory enhancements that traditional negligence claims do not.
Under the American Rule, parties typically bear their own legal costs unless a contract or statute provides otherwise. Most personal injury and malpractice suits do not allow for recovery of attorneys’ fees. But consumer protection statutes are an exception. By adding a CPA count based on misleading business practices, the plaintiff opened a door to recovering her legal expenses.
The defense tried to shut that door on appeal, arguing that the CPA claim was duplicative of the negligence theory and impermissibly sought recovery for personal injury, which is generally not compensable under the statute. They cited prior Washington cases in which CPA claims were dismissed because they were functionally medical malpractice claims in disguise.
But the Court of Appeals found this case distinguishable. The court emphasized that the plaintiff was not just suing for botched surgery, but that she was also challenging the way the defendant marketed her services to the public. The court found that the plaintiff had offered sufficient evidence of public-facing conduct that induced her to purchase services she otherwise would not have bought.
These sorts of nuanced issues can vary greatly by state and should be discussed with knowledgeable local counsel. For plaintiffs’ lawyers, in appropriate cases, consumer protection claims can be powerful complements to traditional tort theories. Even if the statutory damages are modest, fee-shifting provisions and treble damages can significantly improve the overall recovery. For defense counsel, this means being ready to distinguish between true marketing misconduct and claims that simply repackage alleged malpractice.
Damian D. Capozzola, Esq., The Law Offices of Damian D. Capozzola, Los Angeles
Jamie Terrence, RN, President and Founder, Healthcare Risk Services, Former Director of Risk Management Services (2004-2013), California Hospital Medical Center, Los Angeles
Reference
- Decided on July 21, 2025, in the Court of Appeals of the State of Washington, Case No. 85851-3-I.
A Washington appeals court has upheld a $13 million jury verdict against a plastic surgeon accused of botched cosmetic procedures and deceptive business practices, marking one of the state’s more notable malpractice rulings in recent years. The panel rejected the defense’s claims that improper evidence tainted the trial, instead finding that the outcome was supported by substantial evidence and that no reversible error occurred.
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