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Death after surgery draws concern

Cosmetic procedure before 40th birthday

By Ben Wolford
Globe Correspondent / August 12, 2011

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FRAMINGHAM - Adriana Paula Da Silva Toledo was on the brink of 40.

Friends and family said the single mother of three probably had the milestone birthday in mind when she went for cosmetic surgery on Saturday.

“She wanted to be beautiful,’’ her father, Aparecido Alfredo Da Silva, said yesterday after her funeral.

Da Silva Toledo died Sunday, one day after a breast augmentation procedure at a Framingham medical spa on a busy commercial strip. Woozy on the afternoon after the operation, she fell in her parents’ bathroom and hit her head. The Framingham Fire Department ferried her to MetroWest Medical Center, a fire official said, and she died there a few hours later, three days shy of her 40th birthday.

Da Silva Toledo’s family has retained a lawyer while awaiting autopsy results. Her death recalls lingering concerns over how the state monitors increasingly popular beauty clinics.

Since moving to the United States nine years ago, Da Silva Toledo, a native of Sao Paulo, Brazil, had been raising three daughters - ages 3, 12, and 21 - on this city’s south side as a housekeeper, her family said.

Few people knew she was planning to have the breast augmentation, said her sister-in-law, Fernanda Mendez. She said Da Silva Toledo’s eldest daughter drove her to Destination Beauty MedSpa on Saturday, where she underwent a 90-minute operation.

The doctor who runs the medical spa, Dr. Sanjeev Sharma, is “very popular in the Brazilian community,’’ Mendez said.

A spokeswoman for Sharma said she could not comment on Da Silva Toledo’s operation or confirm she was a patient because of medical privacy laws. But the spa representative released a statement yesterday.

“Dr. Sharma was extremely saddened to learn of the death of Adriana Silva,’’ according to a statement from Nancy J. Sterling, a crisis communications specialist for ML Strategies.

“His thoughts and prayers are with the Silva family during this difficult time,’’ she said. “Dr. Sharma, a board certified physician, has been practicing medicine without incident for 16 years.’’

The spa’s website advertises saline breast augmentations for $3,500 and silicone for $4,500. Patients will feel tired the first day, the website cautions, urging them to stay home.

After her breast procedure, Da Silva Toledo returned home and slept, her sister-in-law said.

The next morning, her oldest daughter came over to make her breakfast. Da Silva Toledo was still groggy.

Around 2:30 p.m., she went to the bathroom and fell. Paramedics responded to the address and found a woman lying in a shower stall with a weak pulse and labored breathing, a Framingham Fire Department official said. At the hospital, doctors told her family she had hours to live.

“We told her parents that it might be the last opportunity to see her alive,’’ Mendez said.

Da Silva Toledo died before midnight Sunday.

“We don’t know yet’’ whether the operation had anything to do with her death, said Da Silva Toledo’s brother, Fabiano Da Silva.

Neither the Middlesex district attorney’s office nor the Framingham Police Department had information about the incident, and the Board of Registration in Medicine, which licenses Massachusetts physicians, would not confirm or deny whether it was investigating.

Sharma has not been disciplined by the Board of Registration in Medicine within the past 10 years, its records show. He also has a full license to practice medicine, which would allow him to perform operations, said Russell Aims, a board spokesman. But Sharma has not reported a certified specialty in plastic surgery, which Aims said is “an important question for all patients to ask.’’

The state Department of Public Health has oversight of clinics, but the law exempts practices from licensing by the health agency if they are owned and operated by the physician. State records show Sharma manages Destination Beauty LLC.

A 24-year-old Brazilian emigre who lived in Framingham died in 2006 after undergoing illegal liposuction in the basement of a condominium.

That same year, state lawmakers formed a task force to examine whether medical spas should face tighter regulation.

State Senator Richard T. Moore of Uxbridge is sponsoring legislation that would restrict employees at medical spas to perform procedures only within their expertise.

“Given the concerns that were raised by this most recent event and the ones that we have had in recent years . . . this we hope would give the public a level of confidence,’’ Moore said.

Ben Wolford can be reached at bwolford@globe.com.