By TERRI VERMEULEN KEITH
LOS ANGELES – A prosecutor told jurors Wednesday that a Riverside woman charged with murder for allegedly injecting silicone into a woman’s buttocks was convicted last year of involuntary manslaughter involving another woman’s death under similar circumstances, while a defense attorney countered that his client didn’t inject anything into the latest alleged victim.
Libby Adame, now 55, is charged with one count each of murder and practicing medicine without certification in connection with the March 24 death of Cindyana Santangelo of Malibu.
Adame and her daughter, Alicia Galaz, were convicted in March 2024 of involuntary manslaughter — but acquitted of the more serious charge of murder — stemming from Karissa Rajpaul’s Oct. 15, 2019, death.
Adame was also found guilty last year of three counts of practicing medicine without a certification, while her daughter was convicted of two counts of practicing medicine without a certification.
Adame was sentenced in April 2024 to four years and four months in state prison, while her daughter was sentenced to three years and eight months in state prison, with Los Angeles County Superior Court Judge George G. Lomeli subsequently agreeing with an argument by Galaz’s attorney that the two were entitled to additional credit for the time they underwent electronic monitoring while out of custody following their August 2021 arrests at the Riverside home they shared.
Adame has remained behind bars since she was arrested May 12 by Los Angeles County Sheriff’s Department personnel, jail records show.
In her opening statement, Deputy District Attorney Lee Cernok noted that the judge in Adame’s first case had told her that she was “on notice of the dangers that could result” from her actions following her conviction for involuntary manslaughter for Rajpaul’s death and that the judge had warned her that she could be charged with murder if it occurred again.
“That’s why we’re here,” the prosecutor told the downtown Los Angeles jury. “… This is not the first time.”
Cernok told jurors that the two women underwent the procedures because they wanted to “look and feel beautiful.”
The prosecutor said Adame packed up her belongings and left the home while Santangelo’s husband waited for paramedics to arrive. The woman was rushed to a hospital in Thousand Oaks, where she died within a few hours, Cernok said.
Defense attorney J. Michael Flanagan told the jury that his client “will be testifying in this case” and that she will testify that “she did not inject Cindyana Santangelo.”
He said his client was “acting as a consultant” and said the panel will see a chain of text messages between Adame and Santangelo in which he said “they never discussed a particular procedure.”
Flanagan noted that he had also represented Adame in the earlier case, telling jurors, “‘In that matter, she was charged with murder, just like she is here,” he said. The prosecutor — who also handled the prior case —quickly objected, with Superior Court Judge Sam Ohta sustaining the objection and both attorneys going across the courtroom to talk privately with the judge.
The prosecution’s first witness, Ventura County Assistant Chief Medical Examiner Dr. Othon Mena, testified that he noticed two skin breaks consistent with puncture sites on Santangelo’s left buttock and one puncture site on her right buttock and “noticed that a substance started coming out that shouldn’t be there” when he examined the woman during an autopsy.
He said the substance was subsequently tested and determined to be silicone, telling jurors that he believes Santangelo died as a result of a pulmonary embolism that was caused by silicone being injected into a muscle in the buttocks during a cosmetic procedure.
Mena said he classified the death as a homicide, telling jurors that it appeared to result from a medical procedure done by someone without a medical license.
Under cross-examination, he acknowledged that the woman had a number of physical conditions, including lung issues, and that she had surgery last December involving a breast implant that was leaking. He said he “did not see any leaking in the implants” at the time of the autopsy.
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