Malibu Murder Suspect In Fatal Butt Injection Trial Has Killed Before

LOS ANGELES, CA — Jury deliberations continued Wednesday in the murder trial of a Riverside County woman who allegedly injected silicone oil into a woman's buttocks just over a year after being found guilty of involuntary manslaughter involving another woman's death.

A prosecutor on Tuesday urged jurors to convict the woman, while a defense attorney countered that his client didn't do anything wrong involving the latest alleged victim.

The downtown Los Angeles jury was handed the case late Tuesday against Libby Adame, 55, who is charged with one count each of murder and practicing medicine without certification in connection with the March 24 death of 59-year-old 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 the Oct. 15, 2019, death of 26-year-old Karissa Rajpaul following buttocks injections administered at a Sherman Oaks home.

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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.

In her closing argument, Deputy District Attorney Lee Cernok told the panel that the judge in Adame's first trial had warned the defendant in April 2024 that she was "on notice of the dangers that could result" from her actions after 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.

"Did she know better?" the prosecutor asked jurors of Adame, saying the answer was "a resounding yes."

Santangelo died after being rushed from her home to a nearby hospital in Ventura County, with authorities subsequently determining that her cause of death was an embolism caused by a silicone injection, the prosecutor noted.

"There is no reasonable doubt in this case, ladies and gentlemen," the deputy district attorney said.

Defense attorney J. Michael Flanagan countered that "she did not do it," saying that there were "no injections this time by her."

He acknowledged that Adame had performed a "procedure" on Rajpaul in 2019 and that Rajpaul had died as a result of a silicone injection.

Adame's lawyer noted that his client was still on probation at the time of Santangelo's death and knew that she can't do "butt work" in California, but said the woman known as "the butt lady" or "La Tia" was working as a "consultant" on behalf of doctors who can legally perform buttocks injections in Tijuana, Mexico.

The defense attorney contended that his client wouldn't have had enough time to perform the procedure after arriving at the woman's house, and accused investigators of failing to adequately investigate after deciding that his client was the only suspect in the woman's death.

He said Adame saw that Santangelo already had bandages on her buttocks at the time of the consultation in the "beauty room" of the 59-year-old woman's home, arguing that someone else had performed the procedure earlier that resulted in the woman's death.

In her rebuttal argument, the prosecutor told jurors to hold Adame "responsible" and tell her that "she is not above the law."

Adame testified Monday in her own defense, denying that she was the one who gave Santangelo any injections the day she died.

"Do you know who did?" her attorney asked.

"No," the defendant responded.

Adame -- who told jurors that she had done thousands of the procedures -- said the puncture marks on Santangelo's buttocks were "too high" and that "it's not my work."

She said Santangelo kept clearing her throat from the time she arrived at the home and was "already breathing like she needed air." She said that the woman's husband told her to leave after he called 911.

"You just happened to arrive after she got the injections from someone else?" the prosecutor asked Adame during cross-examination.

"Yes," Adame responded.

The woman's husband, Frank Santangelo, testified that his wife of 24 years appeared to have been breathing normally before meeting with Adame and wanted a "butt enhancement" to correct lumps in her buttocks from hormone treatment but didn't want to increase the size of her buttocks.

He said his wife -- who had worked as an actress -- subsequently was "struggling to breathe," was squirming on the massage table and "had blood coming from each butt cheek."

The woman's husband testified that Adame told him, "This has never happened to a client of mine before."

He said Adame told him she might have something in her car that could help the woman and packed her bag, telling jurors that Adame never came back into the house again.

The woman's husband said he never saw his wife's phone again, but was eventually able to access her messages with Adame from her iCloud and alerted authorities after he recognized photos that his wife had taken of Adame's buttocks and tattoos in his presence that afternoon.

He said his wife was rushed to a hospital, where doctors told her that "she didn't make it."

Adame has remained behind bars since she was arrested May 12 by Los Angeles County Sheriff's Department personnel, jail records show.

By TERRI VERMEULEN KEITH
City News Service