Mum who went to Turkey for 'barbaric' Brazilian bum lift died following 'woeful' post-op care

A mother-of-three who travelled to Turkey for a Brazilian bum lift died of an embolism following 'woeful to completely non-existent' post-operative care, a coroner has concluded.

Demi Leigh-Regan Agoglia, 26, from Little Hulton, Salford, died of 'misadventure', 'contributed to by neglect', assistant coroner professor John Pollard said. He vowed to write to the health secretary 'to stop this frankly barbaric medical practice being conducted to such low standards'.

Ms Agoglia travelled to Turkey to have 'BBL' surgery on January 4 and underwent her surgery the following day. The operation took place without 'proper informed consent' and following 'peremptory' pre-op procedures, said Prof Pollard, who slammed the Turkish authorities who 'refused to co-operate with the coronial process'.

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"I do find the post-operative care varied from woeful to completely non-existent," said Prof Pollard, who added that by the time she was taken to hospital following her collapse, Ms Agoglia was already in 'an irrecoverable state'.

The inquest in Bolton heard Ms Agoglia was described as healthy, but had been diagnosed with ADHD and bipolar disorder. Her mother, Christine Tydd, said the day before her daughter was due to fly to Turkey, she told her she didn't need to go because 'she was a good looking girl'.

Ms Tydd told the inquest: "She said she wanted to go. She was conscious about the way she looked - there was no changing her mind." Ms Agogliai and her then partner, Bradley Jones, flew to Turkey on January 1 this year and were due to return on January 8, the day she died.

Ms Tydd, said she received a text message from Mr Bradley saying 'she's gone'. She said she and other family members were speaking to Ms Agoglia over FaceTime in Turkey and the day before she died, she was 'laughing and joking'.

Ms Tydd added: "She said that apart from the bruise on her stomach, she had got the bum she always wanted. She said she had a bit of discomfort, but that was it. She said she was fine and just wanted to come home."

Mr Jones, in evidence, said Ms Agoglia found 'Comfort Zone Surgery' advertised in Turkey on either Facebook or Instagram and had 'decided to book herself in'. Saying Ms Agoglia didn't need the procedure, he said: "I did not want her to go, I did not want to go with her."

He told the court she had wanted the surgery 'for some time' and said he asked her not to have it done, but added that she had seen 'some celebrity advertising the surgery'. Ms Agoglia, however, booked the surgery three months in advance, the inquest heard.

Mr Jones told how they travelled to Turkey and were put up in a 'residential villa' by Comfort Zone together with others having surgery. They were taken by taxi to Avrasya Hospital, near Istanbul, the following day. Bloods were taken from Demi, he said, and she was put in a gown.

She was then taken for surgery, returning to a room they were given four-and-a-half hours later. "She was shaking and very, very cold," said Mr Jones. "It was scary watching her."

The inquest heard 'staff' at the hospital put a heater on the floor with tubes running under her bedsheets to warm her. They stayed overnight and were taken back to the villa the next day in the same taxi.

Staff, Mr Jones said, came to the villa to check whether Ms Agoglia could stand up and empty her drains, but he said they had to stay in Turkey for five days under the deal.

Ms Agoglia, the inquest heard, complained of a tight chest on the fourth day after the surgery, but Mr Jones said they were only given a WhatsApp number to communicate with the hospital. The inquest heard that 'bizarrely', she was fed cucumber by staff at one stage.

He said eventually, Ms Agoglia couldn't breathe properly and collapsed onto the floor of their room in the villa after trying to stand. Mr Jones said her face went white and her eyes were rolling, adding he thought she was having a fit. The inquest heard a 'staff' member arrived after Mr Jones and others tried desperately to get help.

Ms Agoglia was then put back into the same taxi and taken back to the hospital, being given CPR during the journey. The inquest heard she was taken away at the hospital and Mr Jones was put into a separate room.

He said he was told she was in intensive care, but a surgeon and a doctor later told him 'they had done everything they could but Ms Agoglia had passed away'. The inquest heard Mr Jones was then taken to a consulate, where it was stated nurses involved weren't qualified. He said paperwork was missing and the hospital had signed a 'fit to fly' document.

"I felt the aftercare was terrible," Mr Jones told the inquest. "There were not many checks done. The fit to fly letter was done straight away."

Dr Omar Tillo, a consultant plastic surgeon giving evidence as an expert witness, said the procedure involves the transfer of fat tissue to the hips and buttocks to give a fuller figure, but said there were strict rules, policies and procedures in the UK.

He agreed with coroner John Pollard that Ms Agoglia's surgery and whole experience was 'lacking in care and due consideration'.

Dr Tillo hit out at a lack of pre and post-operative care, questioned a consent form that was signed and criticised a lack of documentary records. Notes supplied by the hospital were dated incorrectly and Dr Tillo said there was no evidence 'informed consent' was given. "Maybe she did not even know what she was signing," he added.

"The care in the villa seems to have been sub-standard. There were people with no proper qualifications making decisions. It is a catalogue of things that you expect to be done."

Dr Tillo, who questioned whether the case amounted to 'manslaughter', also slammed a 'gravely sub-standard response' when Ms Agoglia collapsed.

The inquest, however, heard Bolton Coroners' Court tried repeatedly to get statements from the hospital, from medical authorities in Turkey and from the surgeon who performed the procedure, but coroner's officer Hannah Hargreaves said: "We had no response at all to any email."

A cause of death after a post-mortem examination was given as unascertained, but the inquest heard the 'most likely' cause was a microscopic fat embolism, where fat tissue leaks into blood vessels.

Coroner Mr Pollard said Ms Agoglia's care was 'grossly lacking' and criticised 'scant information'. He said he would be writing a 'letter of concern' to Health Secretary Wes Streeting MP, saying his research revealed cases like Demi's were happening on a 'regular basis'. But, he added, the government has no jurisdiction over hospitals abroad.

The inquest heard more than a million 'medical tourists' visit Turkey each year. Speaking outside court, Ms Agoglia's sister Chloe said: "The one thing I would say is for people not to get this surgery."

Prof Pollard said it was 'indicative of the poor level of care' that she was transported in a taxi rather than an ambulance, describing how Dr Tillo had 'spelt out all the failures and failings he was able to assess from the evidence and the sparse documentation available to him'.

The doctor had found there was no record of any ITU admission or of any tests and scans carried out, all of which was essential, the court was told.

Prof Pollard noted the main medical cause of death was 'microscopic fat embolism' and returned a 'misadventure' conclusion, going on to say it was contributed to by neglect.

He added: "I do feel something further needs to be done to stop this frankly barbaric medical practice being conducted to such low standards that would certainly not be tolerated in the UK."