Kristine Brecht: $13 Million Verdict, License Suspension, and Bankruptcy

Kristine Brecht is a Washington state physician, board certified in family medicine, whose Burien cosmetic surgery clinic produced a $13 million jury verdict for medical negligence, a five-year suspension of her medical license, and an appellate ruling in July 2025 affirming the judgment against her. At least one patient was left permanently disfigured, and a separate 2019 incident involving a patient’s death figured in the state’s regulatory case against her.¹²

A Family Medicine Doctor Marketing Cosmetic Surgery

Brecht graduated from Saba University School of Medicine in 1999 and completed a family medicine residency at UMass Chan Medical School in 2005.³ She was not board certified in any surgical specialty. She nevertheless opened Aesthetic Rejuvenation Spa in Burien, south of Seattle in King County, where she was the sole owner and operator and performed tummy tucks, arm lifts, breast lifts, and liposuction.⁴

Rather than using general anesthesia or intravenous sedation, Brecht developed and trademarked a protocol she called “Cinderella anesthesia,” which relied on oral oxycodone and lorazepam.⁵ The jury that later heard the Elmi case also found she had used misleading advertising on YouTube and the spa’s website, presenting herself as an expert with “the best technology” to attract patients. Brecht testified she was the sole decision-maker for the spa’s marketing.¹

The Nasra Elmi Surgeries

In September 2020, Brecht performed two rounds of cosmetic surgery on Nasra Elmi in the space of a week. On September 1 she performed an abdominoplasty and liposuction, and on September 8 she performed an arm lift, breast lift, and additional liposuction. Both procedures used local anesthesia combined with oral sedation. Brecht did not establish intravenous access for either surgery.¹

Elmi had diabetes. Expert witnesses testified that Brecht never documented or tested her A1C, a basic measure of blood sugar control, and that clearing a diabetic patient for elective surgery without that information fell below the standard of care. Experts also described post-operative failures: tape that stripped Elmi’s skin, no scar-reduction medication, and a ten-day delay in testing for infection after Brecht noticed a foul odor from the arm incision. Vital signs were checked every 15 minutes rather than the recommended three-to-five-minute intervals, and Elmi was discharged 30 minutes after surgery.⁵

Elmi’s incisions failed to heal. The arm incision, running from armpit to elbow, opened in several places. She developed infections, necrotizing tissue on her stomach and arms, and extensive permanent scarring. She testified she can no longer wear short-sleeved clothing and continues to seek treatment.¹

Consent was a separate problem. Elmi testified that before each procedure she was given a mixture of Ambien, oxycodone, Phenergan, and lorazepam, and then asked to sign documents while medicated. A medical assistant acknowledged signing the forms as a witness without actually watching Elmi sign. Experts described the forms themselves as blurry and hard to read, lacking Brecht’s signature, and silent on risks specific to a patient with diabetes and a smoking history. Elmi testified that Brecht told her she was a “perfect candidate,” called herself “the best,” and said the tummy tuck scar would be unnoticeable.¹

The $13 Million Verdict and Appeal

Elmi and her husband, Robert Blanton, sued Brecht and Aesthetic Rejuvenation Spa. On August 4, 2023, a King County jury found for the plaintiffs on every claim: medical negligence, lack of informed consent, breach of promise, and violation of Washington’s Consumer Protection Act. The plaintiffs were represented by Ruby K. Aliment and Vanessa J. Firnhaber Oslund of Bergman Oslund Udo Little.⁶

The damages:

$11,000,000 to Nasra Elmi for past and future damages
$2,000,000 to Robert Blanton for loss of consortium
$34,186 in financial loss under the Consumer Protection Act
$79,000 in attorney fees and $25,000 in treble damages, awarded in a supplemental judgment on September 25, 2023

The total judgment was $13,138,186.⁴

Brecht appealed, arguing that the trial court improperly admitted evidence of her prior disciplinary orders and a former patient’s testimony about her own experience with the clinic, and that she should have been granted a mistrial. On July 21, 2025, Division One of the Washington Court of Appeals affirmed the judgment in a unanimous, unpublished opinion, holding that any evidentiary errors were harmless given the weight of the evidence and that the challenged evidence was of “minor significance considering the evidence as a whole.”¹⁷ Brecht petitioned the Washington Supreme Court for review; the respondents’ answer was filed on October 24, 2025, and no ruling on the petition has been reported.⁸⁶

License Suspension and Regulatory History

The Elmi verdict was not Brecht’s first run-in with Washington regulators. On October 22, 2021, she entered a stipulated order with the Washington Department of Health admitting that between October 2019 and January 2020 she had performed cosmetic surgical procedures and operated an ambulatory surgical facility without a license. The order restricted her from performing procedures requiring sedation and from operating an ambulatory surgical facility.¹

On August 4, 2021, she entered an agreed order with the Washington Medical Commission acknowledging unprofessional conduct in the treatment of nine patients. The order permanently prohibited her from performing procedures requiring sedation without an anesthesiologist or nurse anesthetist present, permanently banned her from supervising physician assistants, and indefinitely restricted her prescribing of Schedule II–IV controlled substances. The commission cited inadequate anesthesia practice, inappropriate opioid and benzodiazepine prescribing, lack of staff supervision, inadequate post-operative care, and poor recordkeeping.⁹

Among the events behind the commission’s action was a 2019 patient death. According to the commission’s findings, Brecht performed an abdominoplasty and liposuction on a patient in her mid-50s who was a poor candidate for oral sedation, and allegedly failed to perform an adequate physical examination or obtain a sufficient medical history. Three days after surgery the patient returned with difficulty breathing; Brecht allegedly failed to provide supplemental oxygen or call an ambulance, and the patient died two days later.¹⁰

In September 2022 the commission issued a new suspension order and statement of charges, alleging Brecht had violated the 2021 restrictions by continuing to perform procedures requiring sedation. After a two-day hearing in March 2023, the commission found she had failed to comply, and on July 18, 2023, imposed a five-year suspension of her medical license. To regain her license, Brecht would need to complete a multidisciplinary forensic assessment of her fitness to practice and finish a pre-approved mini-residency or re-entry-to-practice program.²

Insurance Fight and Bankruptcy

Whether Elmi and Blanton will actually collect the $13 million remains unsettled. In February 2024, The Medical Protective Company, Brecht’s malpractice insurer, filed a declaratory judgment action in the U.S. District Court for the Western District of Washington seeking a ruling on its coverage obligations. The case, The Medical Protective Company v. Nasra Elmi, Robert Blanton, Aesthetic Rejuvenation Spa, PLLC, and Kristine Brecht, M.D. (No. 2:24-cv-00212-RAJ), is before Judge Richard A. Jones.¹¹

Brecht also filed for bankruptcy. In September 2024 the U.S. Bankruptcy Court for the Western District of Washington lifted the automatic stay to allow the coverage dispute to proceed.¹² The insurer filed a motion for summary judgment, and the district court issued an amended order on that motion on June 5, 2026. The coverage dispute has not been finalized in the available record, and what the plaintiffs ultimately recover will depend on how it ends and what assets remain in the bankruptcy proceeding.¹¹

1
Washington State Courts. Elmi v. Aesthetic Rejuvenation Spa, No. 85851-3-I
2
Washington Medical Commission. WMC Suspends King County MD Kristine Brecht
3
U.S. News & World Report. Dr. Kristine S. Brecht
4
Oslund Legal. Court of Appeals Affirms Jury’s $13 Million Verdict in Medical Negligence Case
5
Newsweek. Plastic Surgery Infection, Necrotizing Wounds, Lawsuit
6
Washington State Courts. Respondents’ Answer to Petition for Review, No. 104620-1
7
Law360. Wash. Plastic Surgeon Can’t Get $13M Jury Verdict Overturned
8
Washington State Courts. Petition for Review, No. 104620-1
9
GovDelivery – Washington Medical Commission. Agreed Order, Dr. Kristine S. Brecht
10
Fox 13 Seattle. King County Physician’s License Suspended Following Allegations From WA Medical Commission
11
Leagle. Medical Protective Co. v. Elmi, No. 2:24-cv-00212-RAJ
12
Justia. Order Granting Motion to File Second Amended Complaint, No. 2:24-cv-00212-RAJ