Florida Trend | Florida's Business Authority

Mishaps


Burned: Selen Adak says she suffered second- and third-degree burns on her leg during hair removal treatment at American Laser Centers in Boca Raton.

Walk into a local medical spa, and you may be swept away by the scent of aromatherapy and the promise of youthful rejuvenation. But medical experts warn that a spate of incidents around the country should alert consumers to the potential dangers they face when undergoing any cosmetic procedure.

Selen Adak, a 24-year-old Palm Beach County woman, suffered 300 second- and third-degree burns on her leg from a laser hair removal treatment performed by a technician at the American Laser Centers in Boca Raton, according to her attorney, David Zappitell. In a lawsuit, Adak says she was receiving the final treatment in a package of six laser hair treatments in October 2005 when she felt pain and alerted the technician working on her. When Adak got up from the treatment table, she says her leg was bright red and swollen and later developed a dark brown checkerboard pattern. Zappitell says the technician provided Adak with ice. The plastic surgeon affiliated with the center was not on-site at the time of the incident and later refused to examine her, he says. Today, Adak is too uncomfortable with her appearance because of the pigmentation damage to wear shorts or short skirts, Zappitell says.

Florida Trend found that nine doctors affiliated with medical spas around the state have settled more than $2.1 million in malpractice claims. In several cases, physicians were sued for burning patients with lasers.

The American Society for Dermatologic Surgery reports that its members have noted a 45% increase in the number of patients requesting treatment for complications such as burns, splotching and irreversible pigmentation and scars from laser hair removal, chemical peels, microdermabrasion and other cosmetic procedures performed by cosmetologists, aestheticians and others without adequate training or supervision.

Dr. Steven Rosenberg, a Palm Beach dermatologist and member of the Florida Society of Dermatology, blames such problems on loose regulation. "As it turns out, we're now finding there were big problems with the medical spas. They're not licensed under any category. There is no official department that regulates medical spas," says Rosenberg. "So much is going on without adequate supervision or real experience."

In 2003, a Department of Health inspection of a Pensacola medical spa called Body Indulgence revealed that an unsupervised medical assistant had been performing laser hair removal for more than a year, often with no supervision. It's illegal in Florida for anyone other than physicians, physician assistants, nurse practitioners or boardcertified electrologists to perform laser hair removal. As punishment for breaking the law, the spa's supervising doctor, Michael Rush, was fined $1,500 and made to complete 10 hours of community service.
Other than requiring a physician to be on staff at a medical spa, Florida has no guidelines specifically aimed at medical spas, and several medical spa owners interviewed by Florida Trend seemed unsure of exactly which procedures could be done by which employees and with what level of supervision. The businesses' operating rules are essentially determined by what sort of activities are being conducted at any specific site.


Due diligence: Dr. Steve Cimerberg, who owns Advanced Medical Spa in Plantation, says patients should not be shy about investigating doctors. With laser hair removal, he says, "There's no board certification for this type of training."

While cosmetologists, facial specialists or full specialists can perform microdermabrasions, for example, Botox injections are more highly regulated. Generally, the state conducts no inspections of medical spas unless a complaint is filed against the facility.

Dr. Steve Cimerberg, who transformed his medical practice into the Advanced Medical Spa in Plantation in 1999, says patients should not be shy about investigating doctors. That means asking about training, asking to see before and after pictures of people they've treated, asking who will perform the procedure and where the doctor will be in case of emergency. "Certainly, the number of places these services are offered has proliferated, and in order to get the best outcome, the consumer needs to make sure they go to the best practitioner of this kind of treatment," Cimerberg says.

Still, knowing whether physicians have mastered their craft is easier said than done. When it comes to laser hair removal, "there's no board certification for this type of training," Cimerberg admits. "This type of training is the type of training where a physician would seek out lecturebased and hands-on training and sometimes individual training in learning how to do the procedures."

? Safety Check
Consumers can pull physician license information online at http:// ww2.doh.state.fl.us/mqaservices/ to see if a physician has ever been disciplined by the state board of medicine. To see whether a physician has been sued for medical malpractice, check with the Florida Department of Financial Services at https://apps.fldfs.com/PLCR/Search/ MPLClaim.aspx.