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[LU213]

Anyone can have complaints and deaths in a very long career.  The surgery didn't originate in America and no one should presume Americans are the best at it or have the most experience.  I don't know much about Dr. Paley. I have no doubt he is excellent. I didn't consider doctors that required 3 month stays without exception but below are items that show no one has a perfect record. 

State Complaint against Paley
https://www.sun-sentinel.com/local/palm-beach/fl-doctor-dror-paley-20160318-story.html

State finds Paley supervised surgery but didn't perform it so it is dismissed against him and launched against dr he supervised.
https://www.sun-sentinel.com/health/fl-doctor-paley-wrong-limb-complaint-dismissed-20170227-story.html

Malpractice Suit against Paley
https://center.mdmalpracticeattorney.com/files/2013/12/SOC2010-398R.pdf

Recent infringement lawsuit against Paley
https://www.globenewswire.com/en/news-release/2020/10/06/2104528/0/en/IMED-Surgical-Files-Federal-Lawsuit-Against-Orthex-Dror-Paley-OrthoPediatrics-and-Squadron-Capital.html

Reviews in America of Dr. Paley

https://www.ratemds.com/doctor-ratings/30268/Dr-Dror-Paley-West+Palm+Beach-FL.html/

[Masteryourlife]

Answering it he previous messages ,as I said...This doctor is not one to be considered as well with others. Period.

About the last Message ,Paley has a fraudulent story also at Sinai for some devices and that is why I would not go with him (also his age and so on) .
I am in Europe and it says the other links you shared can't be seen in my country so if you can summarize what they talk about would help me , so that I can at least answear properly

[Masteryourlife]

I think it isn't wise to conclude the patien already had a rare underlying condition after s*** happened. A good surgeron with a good protocol should had performed comprehensive pre op tests so that the patient wouldn't qualify for the surgery.

THANK YOU !
Can we keep this thread alive forever ?
People need to know about those things/surgeons.

[Arcon]

I think it isn't wise to conclude the patien already had a rare underlying condition after s*** happened. A good surgeron with a good protocol should had performed comprehensive pre op tests so that the patient wouldn't qualify for the surgery.

He didn't have an underlying condition, he started an extreme diet and fasting method in the last days without notifying his doctor.

[thankscience]

He didn't have an underlying condition, he started an extreme diet and fasting method in the last days without notifying his doctor.

Do you know what diet it was by any chance?

[Arcon]

Do you know what diet it was by any chance?

Some kind of long fasting diet, I don't know more.

[Arcon]

Anyone can have complaints and deaths in a very long career.  The surgery didn't originate in America and no one should presume Americans are the best at it or have the most experience.  I don't know much about Dr. Paley. I have no doubt he is excellent. I didn't consider doctors that required 3 month stays without exception but below are items that show no one has a perfect record. 

State Complaint against Paley
https://www.sun-sentinel.com/local/palm-beach/fl-doctor-dror-paley-20160318-story.html

State finds Paley supervised surgery but didn't perform it so it is dismissed against him and launched against dr he supervised.
https://www.sun-sentinel.com/health/fl-doctor-paley-wrong-limb-complaint-dismissed-20170227-story.html

Malpractice Suit against Paley
https://center.mdmalpracticeattorney.com/files/2013/12/SOC2010-398R.pdf

Recent infringement lawsuit against Paley
https://www.globenewswire.com/en/news-release/2020/10/06/2104528/0/en/IMED-Surgical-Files-Federal-Lawsuit-Against-Orthex-Dror-Paley-OrthoPediatrics-and-Squadron-Capital.html

Reviews in America of Dr. Paley

https://www.ratemds.com/doctor-ratings/30268/Dr-Dror-Paley-West+Palm+Beach-FL.html/

Thank you @LU213.  Those reviews are quite concerning as they question his professional integrity. I am starting to believe that if it wasn't for the increased sensitivity that most CLL patients have about keeping their privacy, there would have been more complaints or lawsuits against Paley and CLL. He is not trustowrthy imo.

[Humanoid]

Some kind of long fasting diet, I don't know more.

The patient died. So we cannot crosscheck whether he trully did long fasting diet or not. Also we cannot conclude that fasting leads to embolism or not. I want to believe, but...

[V21]

Based on another post it seems the patient already had a rare underlying condition. I think there was already high risk, irrespective of the doctor.

That's not true, he did not have rare underlying conditions.

[indication]

I think it isn't wise to conclude the patien already had a rare underlying condition after s*** happened. A good surgeron with a good protocol should had performed comprehensive pre op tests so that the patient wouldn't qualify for the surgery.

+100

Unless the tests are super expensive and the condition is incredibly rare.

[indication]

It's a good thing to hear that the doctor is not changing his blood thinner protocol. That proves that there was some rare situation at play here. It would be easy for the doctor to just prescribe blood thinners at this point to all patients like Paley does. But if he is not changing it then it must mean he has really thought this through and decided.

[overandover]

It's a good thing to hear that the doctor is not changing his blood thinner protocol. That proves that there was some rare situation at play here. It would be easy for the doctor to just prescribe blood thinners at this point to all patients like Paley does. But if he is not changing it then it must mean he has really thought this through and decided.

Doctor changing his protocol means admission for doing something wrong he is just trying to cover his back legally. If he had a medical condition why doc didn't test for it.

[thankscience]

As someone else mentioned, there would be little need to change his protocol or do more pre-op tests if the condition is incredibly rare (if indeed true).

[V21]

I was very friendly with the guy. He did not have any rare conditions. From a legal point of view, Dr changing protocol would mean admission that something could have been done to prevent the issue from happening, so no way they change protocol. I find amusing how people quickly try to rationalize what happened trying to find a "rare condition" on this guy, in order to think this tragedy could not happen to themselves. Guess what? This patient had no conditions, had done his research for years (he was a member in the forum), was disciplined and smart and worked hard. So yeah, this could have happened to any of us. There can be a discussion regarding the need of Xarelto, the fact that he did fasting for years (but everyone here knew about that, it was no secret), the incredibly bad luck he had... but it's just dumb to say he had rare conditions when he had none.

[Masteryourlife]

I was very friendly with the guy. He did not have any rare conditions. From a legal point of view, Dr changing protocol would mean admission that something could have been done to prevent the issue from happening, so no way they change protocol. I find amusing how people quickly try to rationalize what happened trying to find a "rare condition" on this guy, in order to think this tragedy could not happen to themselves. Guess what? This patient had no conditions, had done his research for years (he was a member in the forum), was disciplined and smart and worked hard. So yeah, this could have happened to any of us. There can be a discussion regarding the need of Xarelto, the fact that he did fasting for years (but everyone here knew about that, it was no secret), the incredibly bad luck he had... but it's just dumb to say he had rare conditions when he had none.

Then why in the world you don't spam this story ?
Xeralto and diet are not "details" in this process .
Same thing hapoened to Guichet about blood thinners with the indian guy and a huge story was built on (thankfully).
The guy was a normal guy as any other.
The fact we have to learn to look at xrays,to remind doctors ITB realease ,blood thinners and so in ,its really sad.
IT SHOULD NOT BE OUR DUTY to check those things after the insane amount payed .
Therefore several weeks after the procedure , i don t see how this could be patient fault only.
If he had a condition , doctor fault !
If he didn't take xeralto ,chances are doctor didn't prescribe them longer since he was a member of the forum and knew how important it is!
If he dieted or fasted...I find it hard to believe that some deficit in vitamins and nutrients are what causes this ; it can lead to delayed consolidation or things like that but death ? Wow...
Idk , I am not a former patient neither I am a doctor but stay away from those "cheap" alternatives doctors operating in those weird countries. Period !
Can't stress enough with this !
This guy dreamed LIKE ALL OF US!
Please stay safe and stick to the bests in 1 st world country .

[Arcon]

If he dieted or fasted...I find it hard to believe that some deficit in vitamins and nutrients are what causes this ; it can lead to delayed consolidation or things like that but death ? Wow...
Idk , I am not a former patient neither I am a doctor but stay away from those "cheap" alternatives doctors operating in those weird countries. Period !
Can't stress enough with this !
This guy dreamed LIKE ALL OF US!
Please stay safe and stick to the bests in 1 st world country .

Oh, you must be one of those "God bless America" kind of guys!
Well, if you wanna talk about risks and regulation take a look at how great the All-American Stryde was; it gloriously failed and withdrawn within less than two years (!!) from its  introduction; Let me remind you that it was European and UK doctors and the UK Authorities who first red flagged the problems of Stryde, when the US doctors and FDA were just doing“ business as usual”. Or, see all these public litigations and reviews against Paley that @LU213 shared earlier; he would probably have lost his licence for at least a couple of years if he was in the UK or most countries in the EU.

Better stop this “1st world country” moto of yours because ,imo, there are good and bad professionals and adequate public regulation on both sides of the pond.

Finally, if you take the time to google “fasting and thrombosis risk” you will find many studies about blood clots, strokes, fasting etc. (This by the way could serve as a useful piece of advice to our Muslim bros here doing LL during the Ramadan period).

[Masteryourlife]

Oh, you must be one of those "God bless America" kind of guys!
Well, if you wanna talk about risks and regulation take a look at how great the All-American Stryde was; it gloriously failed and withdrawn within less than two years (!!) from its  introduction; Let me remind you that it was European and UK doctors and the UK Authorities who first red flagged the problems of Stryde, when the US doctors and FDA were just doing“ business as usual”. Or, see all these public litigations and reviews against Paley that @LU213 shared earlier; he would probably have lost his licence for at least a couple of years if he was in the UK or most countries in the EU.

Better stop this “1st world country” moto of yours because ,imo, there are good and bad professionals and adequate public regulation on both sides of the pond.

Finally, if you take the time to google “fasting and thrombosis risk” you will find many studies about blood clots, strokes, fasting etc. (This by the way could serve as a useful piece of advice to our Muslim bros here doing LL during the Ramadan period).

You clearly didn't read carefully my previous posts .
I am not an "God bless America" person because I am not even from Us/neither I live there/ plan to do the surgery there .
Europe has regulations but do not have experienced doctors (at least that do CLL) , like other places ,like US.
On top of that the medical system is public therefore its safer for emergencies but good luck for things like CLL .
ON TOP OF THAT , I always said that if I have to go trought this I will pick dr.Lee also because he pointed out the s**** about Stryde early on when he had his first cases and he didn't operate with the nail as soon as that came out .
So I am not about America ; Paley also said that for him stryde would be still out and he would have let ppl decide if to go with it or not "with a disclaimer".
as I also said , I can't see the posts about Paley because that website is not available in my country so I don't know what is in there but hands down he is the most experienced surgeon so instead of thinking that he fails so others are allowed to fail too ,think that his volumes is insanely higher then "new" cll doctors popping out so complications when you do thousands of LLS can arise unfortunately.
ALSO if that happens with Paley or other "1st world surgeons" ,can you imagine what happens in other places ?

I don't know where are you from but I already put it out there that I perfectly know how things runs in country like Turkey,Greece and u name it !

So what I am saying is not " you are 100% safe in us" but that you are way more unsafe somewhere else and that the 10 k or 20 k less ,does not worth the % of risk increased when you decide to go in bad hospitals with barely unknown doctors .
That was my point !
You can agree or not agree but mine it's just logic, I have no interest in putting down a more affordable surgeon because it would benefit me as well , but stop trying to convince yourself (talking in general) that a cheap version can equal the skills/care/knowledge of an expensive version .
Costa are dictated by doctors name and experience but also from the anesthesia machine they us , the anesthesiologist hired , the pt hired ,the nurses hired and so on .
With such a delicate procedure I can't see how someone can go in bad hospitals with unknown doctors in poor countries like Greece where money is everything.
My point of view tho , maybe I am wrong idk but that's what I think .

[Humanoid]

Finally, if you take the time to google “fasting and thrombosis risk” you will find many studies about blood clots, strokes, fasting etc. (This by the way could serve as a useful piece of advice to our Muslim bros here doing LL during the Ramadan period).

Ramadhan 2021 wasn’t in October/November, the day tragedy happened, it was in April/May

[Arcon]

Ramadhan 2021 wasn’t in October/November, the day tragedy happened, it was in April/May

My comment about Ramadan was a more general note about long fasting... I didn't mean that the patient in Greece was fasting because of Ramadan.

[c]

谁有证据证明这件事情呢，我只看到了讨论，到没有新闻或者官方声明，虽然通过讨论感觉是真的。

[LLSouthAmerica]

I find it tiring how a lot of people here try to justify all bad outcomes with "rare conditions" or "bad doctors"... this is a high-risk surgery, even when doing everything correctly there is a TRUE chance you may die. You have to make peace with it...

[LU213]

I want to just confirm for the record that our friend  was not Muslim. I do agree that Arcon's comment was just a general warning statement to people who fast for religious reasons and did not imply our deceased friend was Muslim.   Our friend had pain in his right leg that he found strange and he often voiced concerns about it. These concerns were trivialized by the medical personnel other than the doctor (we were never present when he was with the dr).  I don't know if that had anything to do with it or not but their response bothered my parent who would talk to me about how she didn't like how they made light of his weird pain.  He then got a compression sleeve for his right thigh because no one did anything.

Dr. Giotikas told me the patient had rare background factors. I gather from his email that he was talking about the fasting being an unusual/little known risk in thrombosis.  He did not say that our fellow LL patient had rare underlying medical conditions. It is possible that someone misinterpreted that statement by mistake.   

I find it hard to believe that the patient did not inform the doctor of his dietary activities prior to surgery.  Dr Giotikas sent out two emails to the existing patients regarding the tragedy.  Like the rest of us, our fellow LL patient was not taking Xarelto.

Because of what happened to the guy whose sister wrote the story, I was keenly aware of symptoms of DVT and PE (although sometimes there are no symptoms). It was why I would not go alone. I think even though doctors make us sign waivers that we are aware of the risks, since it is a risk, doctors should explain to us the signs and what to do if it happens.  Certainly we should ask prior to the surgery but many are like me,  young and inexperienced.  We think that asking a question is a betrayal of our trust in the doctor but it is NOT. 

If the internet is correct, I searched and most people who get PE do not die and even most people that get the dangerous FE survive.  We have one guy in this forum that got a FE during surgery with Paley that survived.  So it is best to get help at the first minor sign even if it seems  trivial.   Many people die of FE getting the BBL which has been called the riskiest cosmetic procedure. The risk that was just a theory has just become very real.

[Masteryourlife]

I want to just confirm for the record that our friend  was not Muslim. I do agree that Arcon's comment was just a general warning statement to people who fast for religious reasons and did not imply our deceased friend was Muslim.   Our friend had pain in his right leg that he found strange and he often voiced concerns about it. These concerns were trivialized by the medical personnel other than the doctor (we were never present when he was with the dr).  I don't know if that had anything to do with it or not but their response bothered my parent who would talk to me about how she didn't like how they made light of his weird pain.  He then got a compression sleeve for his right thigh because no one did anything.

Dr. Giotikas told me the patient had rare background factors. I gather from his email that he was talking about the fasting being an unusual/little known risk in thrombosis.  He did not say that our fellow LL patient had rare underlying medical conditions. It is possible that someone misinterpreted that statement by mistake.   

I find it hard to believe that the patient did not inform the doctor of his dietary activities prior to surgery.  Dr Giotikas sent out two emails to the existing patients regarding the tragedy.  Like the rest of us, our fellow LL patient was not taking Xarelto.

Because of what happened to the guy whose sister wrote the story, I was keenly aware of symptoms of DVT and PE (although sometimes there are no symptoms). It was why I would not go alone. I think even though doctors make us sign waivers that we are aware of the risks, since it is a risk, doctors should explain to us the signs and what to do if it happens.  Certainly we should ask prior to the surgery but many are like me,  young and inexperienced.  We think that asking a question is a betrayal of our trust in the doctor but it is NOT. 

If the internet is correct, I searched and most people who get PE do not die and even most people that get the dangerous FE survive.  We have one guy in this forum that got a FE during surgery with Paley that survived.  So it is best to get help at the first minor sign even if it seems  trivial.   Many people die of FE getting the BBL which has been called the riskiest cosmetic procedure. The risk that was just a theory has just become very real.

And now I would like to know how for someone this is not ,even partially, the surgeons fault ?
Knowing risks is a thing , but they guy in this message explained perfectly what more or less the situation looked like and as he said A) I doubt he didn't inform he was fasting and B) this surgeon popped out just couple years ago and he already had this outcome .
Can someone stop defending surgeons no matter what just because it is a f*****g high risk surgery ?
It is high risk for many factors but it is not high risk for death to the point were couple deaths here and there are ok and need to be accepted .
Wtf is wrong with some of you ?
This surgery takes with it OTHER risks like lose of ROM , athletic ability and so on that makes it risky .
But fractures of any type and LL of any type are performed every year for non cosmetic porpuses and I don't see bodies laying on the streets dead by fractures and LLD as we should given that a small amount of CLL had some bad outcomes , a Big amount of other patients should have bigger numbers right ?!
Like what?
Those risks are involved in any orthopedic surgery but giving xeralto is not a rocket science .
This guy just said that they didn't prescribe it to anyone !!!!!!!!!!!!
Anyone can do what they want , idc , but er are all here to achieve our dreams and I would like to cheer with each other one day and maybe meet one of you guys , not to f******* end up reading this things !
He didn't die for something the surgeon could not do ,at least from the report of the guy who IS THERE !
someone please correct me if I am wrong because I really don't get how some ppl think here .

[V21]

I haven't yet commented in this matter because, even though I feel very strongly about the situation, I'd rather not present my opinions as fact in a case as serious as this. I do see some misconceptions and outright excuses in this thread, so I can provide these facts:


We all are prescribed Xarelto, but only for around 3 weeks, whereas other doctors like Betz or Paley give you Xarelto during all lenghtening. Giotikas reasoning is that Xarelto can cause serious side effects, and that the chance of clots after 3 weeks is extremely low with full weightbearing. I cannot give an informed opinion on this matter, as my field of expertise is Law, and not Medicine. I do think that, even if the chances are extremely low, I'd rather risk side effects (like liver issues) rather than embolism, and it seems that other doctors think the same. Again, I'm no expert on this matter, and this may have just been a freak accident.


The patient was disciplined, cautious and smart. He did previous research, in fact I met him initially trought this forum. The issue was not at all due to lack of mobilization, as he walked more than any of us. The week he had the embolism he was even walking home from PT, instead of taking taxi.

He had a fasting diet for years, that's true. However, it's a lie that he kept that secret: he was talking about it very often and EVERYONE knew about that. In fact, I personally heard him recommend that diet to one of the PT people. The Dr says he did not allow him to fast, but the patient personally told me that he asked him and was allowed as long as he took enough calories per day. I can't say the Dr is lying, as I never heard the real conversation and I only have the word of the guy, but 100% everyone knew about his fasting diet.

He had extremely bad luck due to the fact that the week before the incident he got the flu. A theory can be that he had COVID (fever, cough, muscle pain),  cause it can cause clots , but he said he did a rapid test and came back negative. The thing is that, due to just having flu, when he started having embolism symptons (cough, chest pain) it seems that he just thought it was flu symptons again. In fact, I have an audio of him 1 hour before the incident, and he told me that he still had some symptons, but he was feeling "back to normal".

He did have thigh pain for weeks prior to the incident, but I don't think it was related, as he was told it was an issue with his IT bands

[chicitita]

This is heartbreaking. How long after his surgery did this happen?

This makes me so afraid.

[thankscience]

Thanks for all the information for those who actually knew him. It sounds like it's just really bad luck.

Correct me if I'm wrong, but doesn't Assayag also only prescribe Xarelto for the first few weeks?

[LU213]

Morningstar had the flu too.  He at first thought it was COVID.  I wonder where they caught the flu?  The head nurse wasn't vaccinated. She said she didn't trust the vaccine.

[thankscience]

I'm surprised it's not a requirement to be vaccinated there. Was the patient also vaccinated?

[Arcon]

I think all previous comments sound reasonable, I agree with @V21's post about not presenting opinions as facts because it only adds to the confusion. Imo, the best thing for those who are seriously considering Giotikas is to ask him directly about incidents, protocols, risks etc. For those who have met Giotikas it is common place that he is honest and knowledgeable and very open(not to say blatant!) with risks, problems, difficulties etc, so  I would anticipate to receive some clear answers that make sense.

[V21]

I'm surprised it's not a requirement to be vaccinated there. Was the patient also vaccinated?

The pacient was not vaccinated, that's why I thought COVID could be a reason, cause it can cause blood clots (happened to my father, mildly). However, both him and Morning Star tested negative, so it seems it was just flu probably.

[V21]

Another relevant fact: it happened 6-7 weeks after surgery. I think that's the craziest thing here, as far as I know the chances of embolism so long after surgery should be extremely low (with a full weight bearing nail).