Patchwork rules permit facilities to operate without a state license. Private accreditation agencies don't have to release records of complaints and offices that lose accreditation can quickly be certified by another agency.
Two years ago Marcia Garcia, a 39-year-old mother of five, came to a suburban office park in Anaheim Hills for outpatient plastic surgery. By day's end, she had bled to death from a puncture wound.
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