Bed Bugs, Piercings and Pedophiles

Dr. Javad Sajan  00:00

Ever wondered what motivates people to get plastic surgery? Did they regret it? What can we learn from the stories of plastic surgery patients? I'm Dr. Javad Sajan. And this is the plastic surgeon podcast. Welcome to our minisode called clinic talk. In the clinic talk episodes, Sabrina Sargent and I discuss unique and memorable events that happen at our plastic surgery practice. Sabrina, how's it going?

Sabrina Sajan  00:42

It's going great. 

Dr. Javad Sajan  00:44

So, at our practice, we have so many special events that happen, right? 

Sabrina Sajan  00:50

Definitely. 

Dr. Javad Sajan  00:51

And we can't talk about patient names are any unique identifying stuff, but we have some really really, really unique store. Right, definitely when these stories are not just with patients, but also with the staff that we have the privilege of working with. Today we're going to talk about three memorable events, if you will. So the first one has to do with bedbugs, right, Sabrina? This is something that's really unbelievable. So Sabrina and I come every morning to the to clinic and the practice together and we go home together and it's really amazing. I feel really blessed. So, we came on the surgery day to our surgery center. And I go in, and as I'm going into the practice, I'm in the elevator, my phones blowing up all these texts and calls and they can't pick it up. It's in the elevator and our anesthesia provider. Patrick is blowing up my phone. And I'm trying to come I'm trying to come pick up the I'm trying to pick up the phone in the elevator. It's just ringing like crazy and I'm losing him in and out. So I get walk in the door and Patrick runs to me Right, Sabrina. Yeah. And he's like Javad! Javad! Javan! I'm like, Patrick, what's going on buddy? Patrick. It's an amazing anesthesia provider, but sometimes you can get a little worked up, right. And what did he tell me? Yeah, Sabrina.

Sabrina Sajan  02:14

He's like, we have a situation Javad!

Dr. Javad Sajan  02:18

So I'm like, okay, Patrick, let's go my office. So we go and we sit down and he's like, the patient has died bags. I'm like, Patrick, bro. What do you mean? He's like there's sores and ulcers everywhere. There's bedbugs. We can't do the surgery. I'm like, Patrick, how do you know there's bedbugs? He's like I saw sores. And then I asked him, so did you ask the patient and he's like, yeah, yeah. They said they may have had bedbugs.

Sabrina Sajan  02:47

And then and then Angela wachsen. Angela is one of our nurses here. And Angela runs to the office. And she says, Well, first they didn't tell us they were had bad bugs. They said I haven't itching problem.

Dr. Javad Sajan  03:01

Yeah. The Angela told us, there's ice crap. The patient said they scratched themselves, right? Yes.

Sabrina Sajan  03:05

There was a matching problem.

Dr. Javad Sajan  03:07

Yes. And then what and what did Angela say after that?

Sabrina Sajan  03:10

Angela said, Are you sure you have a scratch and problem? They said, Yeah, yeah, this is normal. This happens all the time.

Dr. Javad Sajan  03:15

So I go in, and then I'm sorry. I have conflicting reports. I hear there's a scratching problem. I hear there's bedbugs. Everyone is freaked out right because not everyone knows bedbugs are not something you can easily get rid of if you have them. So I go in there to talk to the patient. And the patient has these little sores all over their legs and abdomen and in the area. I'm going to do the surgery I'm not going to tell you guys which area and so I asked them what's going on. In first the patient tells me while doc you know i i like to pick up myself and you know, some people are pickers they pick up themselves. I'm like, Okay, well, that's cool. I'm like, how do you pick on the backside or your ankle? And they're like, well You know, I was at my friend's house and they had some bed bugs but I don't have any bedbugs. I had my house inspected by my doctor. So they sit down. Now I didn't sit down. I was worried about bedbugs. So I stand in the corner of the room and I basically asked the patient down. So you're telling me that the physician or doctor or provider, you have went to your house to inspect the bugs? And they're like, No, no, no, no, they looked at me. I don't have any bedbugs. But my friend might have had bedbugs. But I don't have any bedbugs. I've been totally checked, right, Serena?

Sabrina Sajan  04:32

Yeah. They denied everything. Basically.

Dr. Javad Sajan  04:34

Yes. They totally denied everything. So then I said, you know, we can't do the surgery at all right? Mm hmm. So I said we're not doing the surgery. I'm sorry. I need a certainty that you don't have bedbugs. And for many reasons, right, Sabrina? Definitely. Yeah. What are what are what are some of those reasons why we need to know.

Sabrina Sajan  04:56

Well, we need to know because it's, you know, they're open wounds and because we're doing surgical procedure, we have to make sure that there's no open wounds or any infections going on before we start the surgery.

Dr. Javad Sajan  05:06

Exactly. And the other problem with that is if this patient really has bedbugs, and we have them in our facility, that's like a huge risk, right? 

Sabrina Sajan  05:14

Definitely.

Dr. Javad Sajan  05:14

So we canceled the surgery. So I told the patient, Look, I'm sorry, we can't do the surgery. We got to cancel it. And then the patient. Our coordinator will be here to reschedule you and tell you what we need because we'll need a doctor's clearance. We'll need to make sure there's no bugs running around, right. And so I leave and before the coordinator comes back, the patient opens the door slams a shot and runs out of the office. Yeah, it was unbelievable. So then we're trying to get ahold of the patient. No one's responding, right? Yes. And we're like, Wow, this is so weird. And then we, we don't hear anything for a day or two. And then we get all these review notifications, right? Yes. So the patient wrote This long, long review of not pertinent to the bedbugs being super negative, that we cancel the surgery. Yes. So obviously we know we called the patient we finally got ahold of them. And we told them, you know, this isn't fair. You're leaving us a review for canceling surgery because of bedbugs. And it was just a lot of back and forth. And we were happy to give the patient a refund all the time. And we offer that to them, right? Yes,

Sabrina Sajan  06:32

definitely.

Dr. Javad Sajan  06:33

So after going back and forth, so many times where they were not doing, the patient demanded surgery. And I remember the patient whole side and I even ended up talking to them, and they said, Do my surgery, I don't want to refund and if we don't do my surgery, I'm gonna write more reviews. Yeah. And you know what I told them? Go ahead. No, because I can't jeopardize one, the safety of the practice the safety of the patients. And now I have this combative suit. But I don't know I don't want to deal with, right? So we ended up not doing the surgery, the patient left these ridiculously fake reviews. And eventually, Some time passed and reached out back to us. And they said, Okay, I'll take my money and remove the fake reviews, because the reviews had nothing to do 00 or why we cancel the surgery. So basically, we gave them a refund, and then everybody walked away and it was over. Yes, right. But this is like a bigger issue that we have in our clinic.

Sabrina Sajan  07:29

Oh, and then after that, when the patient Yes. When the patient runs out of the office, Patrick and Angela run and put on hazmat suits. 

Dr. Javad Sajan  07:38

Oh my God, this was something right. So basically, the patient got us a letter that he had bedbugs, but we didn't know we didn't trust them. So at the same time when when they left, right, we didn't know. So we had to shut that room down. They were the patient only sat in one chair in the exam room. And when Patrick and Angela put on this, like my delegates was radiation people right Right and they, they went to Home Depot and we bought all that stuff. What was it?

Sabrina Sajan  08:03

Yes, we bought a steamer then we bought a humidifier. Then we shampoo the entire carpet in that room and all the furniture and it was a whole day worth of cleaning.

Dr. Javad Sajan  08:15

Exactly. And we couldn't use the room. We have to we've we followed all the protocols for potential bedbug decontamination it was this whole ordeal. Yes, it was something else.

Sabrina Sajan  08:26

So the entire surgery time was used to clean the room.

Dr. Javad Sajan  08:29

Exactly, exactly. They you know, the the real question is asked if we know something we deal with all the time, is when people intimidate us, or threaten to leave fake reviews unless we meant to their will. Mm hmm. And do you think that's been happening a little bit more as we're getting more known? 

Sabrina Sajan  08:47

Yes and it's a little sad because a lot of patients will start demanding things over the phone like you must do my surgery or you must give me this price. I will not pay any more than this and so forth. But You know, we try our best to do whatever we can for the patient to make it work for them, such as this bed bug patient, when they call it after a couple days, they were cursing over the phone, they were that upset that we weren't doing their procedure. 

Dr. Javad Sajan  09:15

So you do with the patients more than I do as far as when, you know, when they have certain issues, or someone's not happy with either a med spa or cream or anything like that. So how do you handle the patients that sometimes are saying give me this, I'm going to give you a bad review. What do you mean, how do you manage those?

Sabrina Sajan  09:34

Well, we first you know, the main important part is to listen to these patients and you know, we give them a call, we hear you we hear them out and that's that's the most important thing. I think that's what a lot of patients are really looking for, is to see if someone's gonna reach out. But we always, always, always reach out to every patient. We always make sure everyone has a great experience at our practice. So we you know, call them we hear them out. We want to understand what they're looking For them, we give them an understanding of where we're coming from and why a price is the way it is or why we can't proceed with surgery. And many times, you know, most patients are able to understand where we're coming from, but they are those few outliers that don't understand that and end up, you know, leaving negative or fake reviews. 

Dr. Javad Sajan  10:21

And it's so wild because usually when someone leaves a bad review, it is not just they're not upset about that service. It's usually something else. And they're using that as a way of getting out their anger or whatever they're feeling. Don't you think? So?

Sabrina Sajan  10:36

Yes.

Dr. Javad Sajan  10:38

That was a wild episode. I'm really happy with stood our ground. You know, there was a lot more interesting stuff that happened with that case, right? We can talk about all of that. But let's talk about our next one. Yes. What's the next one?

Sabrina Sajan  10:51

So the next one is, I guess an ex employee. You can say one day employee.

Dr. Javad Sajan  10:57

Oh, this was a wild episode. So Part of our practice that's been the hardest to recruit for and maintain is the inch is the role of insurance coordinator, right? Yes, this was absolutely wild. So we hired a person we can't say their name obviously.

Sabrina Sajan  11:16

Well, first they came in for the interview. Okay. super sweet. We interviewed them they were really really nice. Super experienced had about 30 years of insurance experience on knew all the words and knew exactly how to answer the questions. And as part of our interview process, for every position that we have here, we set up a job shadow day. So we did the interview. Amazing. We set up a job shadow for this individual. They came in for the shadow.

Dr. Javad Sajan  11:47

I remember that this person brought cookies. Yes. And I didn't use these words, but this person has so much experience people were people were like, oh, wow, these are like my grandma's cookies and this person reminds them Remind some of the other staff about their great grandma and the patient like that. Right? She liked being called that. 

Sabrina Sajan  12:06

Yes. Yeah. 

Dr. Javad Sajan  12:07

She was called the patient grandma cuz she liked that. I'm sorry, though. The staff member. Yes.

Sabrina Sajan  12:14

The staff member Yes, she gave, I guess the grandma five, two people and she was really sweet and really very caring. And, you know, she after her shadow was completed, she hugged all the employees that she shadowed with she, you know, talked about how she can't wait to join our practice and super, super sweet. Everyone loved her and after usually when our shadow is done, we get feedback from everyone and everyone had only positive things to say right?

Dr. Javad Sajan  12:43

I remember that. And she had a cool story because she was a farmer. And then she had some issue with on the farm she was living because her boyfriend kicked her out of the farm because he had somebody new. So then she was like that was a little red flag. That whole story That she was with her boyfriend on his farm. And he was like, You can't be on my farm because I have this other girl on my farm. Tonight, you got to find your own place. And there was all this little drama thing going on. Right? And that's why she was trying to work now.

Sabrina Sajan  13:11

Yes. And another funny part of our interview I still remember till today is we always ask people, like, you know, what your What are you looking for? What are you looking to make, um, you know, you'd like to give a good, get a good understanding of you want to make sure that they're able to live on their own. And what we offer them is, you know, good enough for them to be happy. And I remember she said, I want $7 an hour.

Dr. Javad Sajan  13:34

That's what she said. That was while literally, she literally

Sabrina Sajan  13:37

said $7 an hour. And I said to her, that that's not even the minimum wage. And she's like, Yeah, I know that. She said, I just want $7 an hour because this is my passion. I love to do insurance work. I love to do the billing side of things. And that's enough for me to just, you know, be happy and be on my own.

Dr. Javad Sajan  13:56

And when now we ended up making her an offer, and we couldn't Or $7. So we paid her a reasonable we offered her right. Yes, a reasonable wage for that job. And she ended up taking it.

Sabrina Sajan  14:08

Yes. And then during her, you know, we always ask a few preliminary questions during their interview. And they also have a little form that they have to fill out where, you know, asked like, you know, their past criminal history, so if they had felonies, I'd asked if they've never arrested and things like that. And you know, everything was clear, everything looked good. She except on

Dr. Javad Sajan  14:27

what you saw reported and how you would ask her in the interview, I asked everyone if you've ever been arrested or convicted of a crime, I remember she said no,

Sabrina Sajan  14:33

correct. And all for him. She said, No, and everything looked great. We're like, Oh, this is gonna be an amazing hire. She's amazing. She has a lot of experience. The team was excited to have her and then her first day. I still remember her background check was taking forever to come back. Do you remember that

Dr. Javad Sajan  14:51

Oh, usually comes back within a day. And we don't get people access to any patient data until their background check comes so when she was in the He started in the office.

Sabrina Sajan  15:00

We We also, we pushed a start date out as well because her background check wasn't coming back she had she had like, loads of addresses on her background and check information. So her background check wasn't coming back. So we pushed your start date out to make sure we would get it in time.

Dr. Javad Sajan  15:16

Yeah. And then we stopped her in the office because she said she wanted to work if you just had her do paperwork. She didn't see any patient information, right. She was just like, doing some admin stuff.

Sabrina Sajan  15:25

Yes, it was. It was the her first day and I still remember. I get a call. I was we were at the Seattle office. And I get a call from the Lynwood office because this individual start at the Lynwood office. And the call comes and she was like the they were like, Oh, this individual started their job today. It was like probably the first our second hour of their position. And they're like, their background check came back. And I'm like, and what? And you remember they said,

Dr. Javad Sajan  15:57

they said she's a pedophile?

Sabrina Sajan  15:58

Yes. And I was like, What do you mean? And they were like, she is a pedophile. And I was like, explained to me what is the background check, say? And they said that she's a sex offender.

Dr. Javad Sajan  16:09

That was crazy. I almost fell over when you told me that

Sabrina Sajan  16:12

I was shocked out of my mind that this individual decided not to disclose information and didn't think that we would find out.

Dr. Javad Sajan  16:23

I know and I was really happy that we know we always take precautions and she never had access to any patient data. Because we know we take care of children correct? Yeah, we are. We have pictures of children's I've done surgeries on who are under 18 are obvious, obviously their children. And I was like, Oh my goodness. So

Sabrina Sajan  16:41

then I told them my total Linwood office I take her into a room. I sure there's two people in the room and then they they called me and put me on speaker and then

Dr. Javad Sajan  16:49

you know, they call the lawyer. Yes. And that our law or medical law firm, yeah, so on one line, we call the medical law firm on the other line, this individual with two other of our seniors leads were in a room. Um, and the medical law firm said that unfortunately, we're unable to continue our employment with our office, and we call the lawyer just to make sure we can legitimately fire her and not have an issue because there's all these laws that you got to work around when you have employees, right. And we always want to follow the law. And the lawyers were like, totally fine, you know, get rid of her ASAP,

Sabrina Sajan  17:24

correct is that you have to escort her right now. Um, and just to get you no idea what this individual was thinking, we asked her, we said, you know, what, what's the story behind this? Can you tell us a little bit? And she says, oh, many many years ago, my partner was

Dr. Javad Sajan  17:47

hidden naked pictures of Yes. So he learners or something?

Sabrina Sajan  17:51

Yes. So she said that he was caught. Big do too. child pornography. Yeah. And she says she had nothing do with it. And her partner had everything to do with it. And then I said, well, then why is it on your record? And she told us that? Well, when it all went down, and you know, we were kind of, they kind of found out that it was us, the police or the FBI, whoever the people are that come and get you. They basically told her that if she was to tell the police or the officials against that guy that she was worth, they would let her go, and they would put the entire jail time on him and she ended up doing that, which is why I think her partner got all the jail time and she was let go of it. But they said that she would still be registered as a sex offender. She had

Dr. Javad Sajan  18:41

probation or something. Right? That was unbelievable. How do you come to a medical practice? lie about your background? fill out a background check my on that and then expect to get away with it. Yeah, that's really sad. It was so sad. You know, it makes you really realize that sometimes I hate to say this, the people that you least expect to be people you can trust are the ones that sometimes are the ones you trust, you end up trusting the least because of their

Sabrina Sajan  19:12

actions. Mm hmm. You know, you I would have never imagined never in a million years that she would have been a sex offender.

Dr. Javad Sajan  19:20

Oh, that was so crazy. You know, I'm just happy. I didn't have any of grandma's cookies. While she like she tried to hug me, or one of our staff was pregnant at the time. Yeah. And she was like, Oh, I saw her looking at my baby.

Sabrina Sajan  19:41

She was like, I'm not walking her out. I need to shut up. And two of our staff leads had to escort her out of the building. Oh my god, you only lasted two hours, two hours.

Dr. Javad Sajan  19:52

You know, I have a record for last. Oh god. I'm gonna talk about that one today. So what's our what's our next one? Our last one.

Sabrina Sajan  20:02

Our last one for today is going to be piercing. Oh my goodness, guys.

Dr. Javad Sajan  20:08

This is a public service announcement. Okay. So before we do surgery, all of our patients meet with our nurse three weeks before and they go through the checklist right, Sabrina? Yes. So what is the checklist say about piercings,

Sabrina Sajan  20:23

remove all piercings before your surgery date.

Dr. Javad Sajan  20:27

And then the signer form about that too, right?

Sabrina Sajan  20:29

Yes, they sign a consent that says I have removed all of my piercings before my surgery.

Dr. Javad Sajan  20:35

So we go to do surgery on this patient. They have a lot of piercings, they talents have taken everything out. Now we're not when people have a lot of piercings for like extra causes. We're like, Are you sure? Everything is out? We are three people ask them the anesthesia provider, the nurse and I do and we are verified.

Sabrina Sajan  20:51

And can you tell everyone a little bit about why it's important to remove the piercings?

Dr. Javad Sajan  20:55

Oh, yeah, absolutely. So when we do surgery, we use electric cars. endosurgery electrocautery also known as what I call the fire stick, okay, stick Yeah, I see is a smoke stick. It's a looks like a pen that you hold in your hand, it's hooked up to a wire to a base machine. And that emits heat in the form of electricity and you use it to stop blood vessels and to cut tissue. So it's a really critical tool in surgery. Now, when you use that device, you have to have the patient grounded, we put a pad on their thigh, and that absorbs any of the current, right, because the current goes through the body. So if you have metal anywhere in your body, or piercings that are metal, they will attract electricity from the pen, and the patient will get a permanent burn and that tissue will melt. There's been there have been cases where people have lost their ears. There had parts of their genitals deformed because they had genital piercings nipples, too. So we are super careful because the last thing we want from our elective surgery someone having a wild complication, those burns are not repairable. Once tissue is dead, it's died and he gets replaced with really thick scar tissue and it's disfiguring. horrendous. So we have this patient with a lot of piercings pretty normal in Seattle, everybody has piercings. So we they take all their piercings off, they go to the or so in the war, the patient is put to sleep like normal. And then when when they're put to sleep, we have to put in a catheter for doing a long surgery or certain surgeries. So the urine can drain during the surgery in the catheter. So the nurse goes in to put the catheter and she stops and I'm in the room, you know, getting ready for the surgery going through the list with the with the other nurse and she's like, Doctor, I can't put the catheter. I'm like, What do you mean you can't put the catheter she's like, I can't put the catheter and we're like what's going on? And she said the nurse too. This, there are piercings in the area of the vagina. I saw the patient didn't tell us and they left piercings in their vagina. They had three piercings. And now we're in this conundrum or situation right. So what do we do with this piercings? We don't have consent to take them off? Do I Do we just leave them and do the surgery? And what do we do? So we had our anesthesia provider, Patrick, who was really familiar with piercings because he's seen so many of them. And they all wear glass or plastic. Okay, so there were three piercings, safety glasses, glass or plastic. We still don't want them in the area. Just because it could cause pressure or other issues. So he looked at them they were in a safe area, and we decided not to remove them because we didn't want to damage their tissue. None of us are experts in vaginal piercings. So we left the piercings there. There was no metal on them. Thank God, I would have had to cancel the surgery. Wow. And then we did the surgery and things went great. There was no damage. But that could have been a near cancel. And we would have tremendous cost to everybody and risk had we not even looked in mintaro.

Sabrina Sajan  24:11

Yep. Because the patient was already asleep so you could didn't get the consent.

Dr. Javad Sajan  24:14

Yeah, that was that was, that was something else. piercings are dangerous guys. No one wants you to remove them without a reason. The reason we remove them is purely for the safety of our patients. Yep. Sabrina, you help so many patients through the process of surgery. We can say without hesitation, thank God, you know, you've never had anything done. Right? People ask that all the time.

Sabrina Sajan  24:35

Yes, I'm got anything. I'm just gonna put

Dr. Javad Sajan  24:37

it out there. Okay, stop asking. So in helping all these patients through their journeys, if you had to tell people one thing that would help them prepare for surgery or for their consultation, what would that be?

Sabrina Sajan  24:51

Um, I think the most important thing I see throughout our practice and an advice I would give to new patients that are coming for their console. Is to definitely do your homework and research so that you're able to ask the right questions at your consultation. I cannot tell you how many times we have patients come in for their consultation, they haven't done their homework, they're not prepared to ask the right questions with the doctor. And many times they will leave after the consultation and give us a call within the next day or week or, you know, month and ask more questions. And that's perfectly fine. Everyone's you know, everyone can ask as many questions as possible, but it's really important that when they're coming in for their consultation, they have the right questions that they can ask directly to the doctor. Because a lot of times if there's a patient that does give us a call back and has follow up questions, what we do is we set up another consultation appointment or we set up a phone call and a lot of times a doctor schedule is really busy, and they want their questions answered really quickly and that might take a week, two weeks might take a month. To get them on the schedule. So it's really important that when they do come in for their consultation, just ask the right questions. Do your homework, take your time. So that way you're prepared for a consultation.

Dr. Javad Sajan  26:12

That's great advice. One of the things I really believe in is you have to be comfortable, confident, and certain about your procedure and your doctor and the only way you can do that is by doing what you just said. Sabrina, thank you so much for joining us. You all can find Sabrina on Instagram at Sabrina Sajan.

Sabrina Sajan  26:33

No, it's Missus Sajan. 

Dr. Javad Sajan  26:34

Oh, yes, yes at Missus Sajan. Thanks for listening to the plastic surgeon podcast and tune in next week where I have an amazing patient who is a physician. She's going to talk about botched surgery that she had that I repaired. It's going to be a phenomenal story. catch us on all social media at real doctor Seattle. And you can watch me on snapchat at real doctor Seattle. Watch my surgeries live. Bam, What.