Brazilian charged with manslaughter in illegal plastic surgery

FRAMINGHAM, Mass. --A Brazilian doctor and his wife were accused of manslaughter Friday for allegedly conducting illegal liposuction surgery on a massage table on a woman who died because of the procedure.

The charges were in addition to lesser counts previously filed against Luiz Carlos Ribeiro and his wife, Ana Maria Miranda Ribeiro, in the July 30 death of Fabiola DePaula. The Ribeiros pleaded not guilty on July 31 in Framingham District Court to unauthorized practice of medicine and drug charges.

The new charges were announced as the office of Middlesex District Attorney Martha Coakley disclosed autopsy findings indicating the 24-year-old Framingham woman died as a result of the surgery. DePaula, a native of Brazil, was pronounced dead shortly after being brought unconscious to a Framingham hospital, authorities said.

The autopsy listed the cause of death as "intraoperative complications," including pulmonary fat emboli -- fat clots in the lungs. Coakley said doctors told her the complication is a rare but known risk of liposuction.

Had the fat-removal procedure been done in a hospital, medical staff would have been better equipped to deal with it, she said.

Luiz Ribeiro allegedly performed liposuction on DePaula in the basement of a condominium in Framingham. Authorities said Ribeiro was not licensed to practice medicine in Massachusetts, but had a medical license in Brazil. Coakley said Ribeiro's specialty in Brazil was not plastic surgery, but didn't say what his specialty was.

Authorities believe Ana Maria Miranda Ribeiro assisted in the surgery and administered drugs used in the procedure, Coakley said.

The condominium's owner, Ana Celia Pena Sielemenn, 40, of Framingham, was charged with distributing illegal narcotics to people undergoing plastic surgery. She pleaded not guilty at her Aug. 1 arraignment and was ordered held on $25,000 bail.

Coakley said the investigation continued into whether additional charges would be filed against Sielemenn.

Authorities say DePaula underwent plastic surgery to her nose by Ribeiro earlier in the week before the liposuction. They believe she paid a total of $3,300 for the two procedures -- much less than what those surgeries typically cost.

Coakley said the Ribeiros attracted customers through word-of-mouth, by undercutting prices offered by licensed U.S. plastic surgeons and because they spoke Portuguese. Two other women have come forward saying also had surgery by Ribeiro, but Coakley said there were many more.

"He was well-known in the community," Coakley said.

She said the Ribeiros had apparently been traveling between Brazil and Massachusetts on a regular basis for two or three years. The defendants charged from $1,800 to $3,000 per procedure, Coakley has said.

At their arraignment on the initial charges, Luiz Ribeiro was ordered held on $250,000 cash bail while his wife's bail was set at $50,000. They also were ordered to surrender their passports. Both remain in custody and face arraignment on the new charges Aug. 25.

A phone message seeking comment from the Luiz Carlos Ribeiro's attorney, Jeanne Earley, was not immediately returned Friday.

Prosecutors said the couple, originally from Belo Horizonte, Brazil, had 30-day work visas for the sole purpose of performing plastic surgery in the basement of Sielemenn's condominium. Framingham, a town of about 67,000 about 20 miles west of Boston, is home to an estimated 14,000 Brazilian immigrants.

Coakley said she was worried that some in the community did not understand the risks involved with illegal surgeries. Authorities believe illegal surgeries are more widespread than they originally thought, she said.

"People think this is an extension of getting my nails done, getting my hair done," Coakley said. "We stress that there should be a lesson learned from the death of this young woman."