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Report: #1401866

Complaint Review: American Medical Experts - Washington Dist of Columbia

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  • Reported By: L.G. — Stateline Nevada USA
  • American Medical Experts 25448 Fritz Court Washington, Dist of Columbia USA

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In April 2015 I experienced facial damage caused by laser treatment and sought recourse to correct the damage. A “medical expert” (“Eric”) from American Medical Experts (AME) confirmed in writing (October 2015) that facial “damage is real,” causing “pronounced change” with wrinkling, jowl formation, and volume loss in cheeks.  Eric was a practicing dermatologist of 4 ½ years who had published one review on laser tattoo removal in his undisclosed organization’s journal.  I paid almost $1200 to receive an emailed copy of his report.  I was informed that if I wanted an “official” copy of the report with his full name on it plus a copy of his CV, I would need to pay another $1200.

Although I had sought treatment for one acne spot (as indicated in the doctor’s medical note), I was lasered excessively in areas of no concern with the laser even burning the inside of my lower right lip.  When the unsupervised technician did not laser the targeted area, I asked afterwards if she could try a second time to laser the spot, yet she missed again.  Consequently, a bruise developed to the side of the acne spot, and the fact that the acne spot didn’t show any change in the photos is further indication that she missed it completely.  Technician wrote in her notes that she lasered my vermillion border, not an area for which I had sought treatment, nor did I have issues with my lips at that time.  The result was change in lip shape, symmetry, sensation, thinning, and swelling.  Tech did not note that she lasered anywhere else on my face, yet the bruising/scarring/widespread harm prove that she did.

Significantly, Eric, the medical expert, ignored key issues.  He did not include comments about my lip change in his three-paragraph medical-expert report despite my repeated requests of him before and after he completed his opinion report to address my concerns.  Nor did he address the technician’s reported lasering intensity level that supposedly was triple the manufacturer’s recommended intensity level according to the number she wrote in her case notes.  I believe the intensity level was even higher than what she reported in the patient note because when I returned to the office seeking help for the horrific facial results, the second unsupervised tech lasered my cheek to “demo” the harmlessness of lasering, commenting that her laser intensity level was much lower than what the first technician had used.  Both technicians’ notes that I subsequently--and not without difficulty--obtained from the office state that the second technician actually used the next higher intensity level number up from what the first technician used for her intensity level.  So what exactly is the truth?  Is either tech providing it?

Eric, moreover, showed partiality.  Despite my questioning in December 2015 his report (that extended into 2017 following my initial 2015 submission of photographs and record of treatment history), Eric declared in January 2016 that he accepted the doctor/technicians’ documentation as the “official record” of truth.  He implied then, in 2016, that I was the one who had been lacking proof, that there was “lack of photography” in 26 photos that I had sent him with an “absence of objective positioning angles and mouth movements” (??).  I don’t know why he explained in a 2016 email that he had been unable to enhance the photos. He had not mentioned these issues to me in 2015 before he had made his decision.  Significantly, in 2015, he had already determined from my photographs that damage had in fact been done to my face at the dermatology office where I had sought treatment. 

He said scarring done to my face from lasering would be a worthy consequence for pursuing a legal case.  Yes, I do have both red and white scarring changes in the pigmentation following the lasering, but the point is that after the lasering, my dermatologist had to subsequently refer me to a cosmetic surgeon for a facelift.  This is an unbelievable consequence.  Is pronounced change in facial structure that includes accelerated aging therefore not worthy of--not good cause for--pursuing a legal case?  Yet Eric recommends taking legal action for unwanted pigment discoloration following improper treatment.  This reasoning makes no sense whatsoever.

Furthermore, Eric’s report was partially wrong, incomplete, unprofessional, and poorly worded to the point of it not being comprehensible. For example, he incorrectly wrote that I submitted one laser article (from JAMA about the troubling “trend” in laser safety) when I actually had included other materials (including information from the American Academy of Dermatology) that discuss the dangers and harms of lasering, especially when performed by incompetent people.

Another error was Eric’s statement that I reported changes to my face on April 9 to the dermatology office.  Not true, and the second tech’s note shows that I first returned to the office on April 3rd (after the April 1st laser) to show them the terrible laser consequences.  My photographed facial changes are obvious between April 2 and April 8.  The office doctor, relying only on memory of one short meeting with me, chose to report that he did not believe there was any notable change to my face.  Eric did not state his opinion on what the dated photos from this six-day period revealed to him as a medical expert.

Eric also underreported the number of times my face was lasered.  Even if he maintains his reliance only on the technicians’ notes and ignores my recorded treatment history, he will find his number to be in error (and that’s not counting the one laser hit I went back for to try to have the spot targeted directly.)  The first tech also did not make a note of the second laser attempt of the acne spot that I asked her to try redoing, the one acne spot I had sought help for.  She still missed the spot the second time.  Eric did not report this unrecorded incident or address it with regard to my photographs. (Incidentally, the office breached their contract by not photographing me before and after lasering as promised.  The office had also not fully informed me in the patient consent form of all the lasering risks, nor had the tech provided me with proper goggles.)

Other errors, oversights, and oversimplifications in Eric’s report exist.  For example, he wrote that I had a history of eczema despite there being no longstanding diagnosis.  He also did not quite accurately describe the doctor’s treatment counseling of meEric’s overall language, however, is of much greater concern. His first paragraph he titles “Facts.”  As mentioned, he gleaned his “facts” from the doctor/technicians’ notes without including my “facts,” my proof. His incomprehensible/unfinished key statements within his one-paragraph “Discussion” section are other significant oversights.  Nevertheless, Eric and company refused to amend the report unless I agreed to pay a re-evaluation and revision fee at $600/hr.

Eric’s report revealed the reality that doctors do not want to report bad results from lasering.  Although Eric suggested that my dermatologist report my treatment results in the literature, that is precisely the problem: What doctor wants to reveal error and malpractice?  Many patients are pleading online with the dermatology field and those with influence to hear their grievances, and I provided such patient stories for Eric’s review.

The dermatology office refused to disclose their malpractice policy information to me or my lawyer when I sought to file a case against them, nor would the Nevada Medical Board help me obtain the doctor’s malpractice insurance policy number and information.  Consumers have a right to know complaints brought against a doctor, yet the Board discloses no such background information on the doctors.   Both organizations obstructed me, and Nevada law only allows one year for a patient to file a malpractice case.  The State of Nevada Medical Board of Examiners held my material on this case for ten months.  They also did not respond to any of my questions about breaches in the Nevada Statutes & Regulations with regard to this “medical assistant,” which is the title/term that both the NV Statutes and dermatology office use in their written information for the public.

Even though Eric confirmed that facial damage had occurred, he stated after I questioned his report that I would need more proof that the laser was administered improperly in the wrong places by the tech.  The tech’s note that she lasered the “vermillion border” is indeed indicative of improper lasering.  I did not request lasering for my lips.  I also did not request lasering for “dilated capillaries” or for treatment of many scars, as Eric suggested.  After lasering, the lower lip area visibly swelled while the upper lip shrank and jowls formed as a result (showing obvious texture change on that overlasered area to the side of the mouth that I would be happy to point out), yet Eric stated in 2016, “There was no treatment in the affected areas.”  Did Eric therefore change his mind in 2016 and disclaim the negative lasering consequences of 2015 that have lasted and that he originally attested to?  Can he truly believe I was not lasered in these areas?  Was he confusing me with another patient?

The dermatology office wrote me that the tech was a “Board Certified Aesthetician” practicing “medical aesthetics,” but Eric wrote that the tech was a “questionably licensed aesthetician.”  This tech has no Board certification in Nevada and, as far as I know, was not currently board certified anywhere else at the time of lasering.  (The dermatology office would not give me the name of the other so-called tech who lasered me, which prevented me again from ascertaining certification.)  Furthermore, in Nevada, aestheticians by law are not allowed to laser.  I have a statement from the Minnesota Board of Cosmetology, which is the state where the first tech previously worked, that warns of the “medical aesthetician” title as a very misleading title to the consumer. 

In the end, Eric chose not to determine the exact cause of my confirmed facial damage from lasering in spite of all the evidence I provided.  It is essential that in the future more will be revealed about the cover-ups and protections that can occur for doctors, laser operators, and office staff who negligently and/or intentionally commit harm upon unsuspecting consumers.  Will the field commit to rethinking its ethics and stopping fraudulent damage?  It’s time!

*************************

The Washington, DC, Better Business Bureau (BBB) allows a consumer only half an hour to respond online to the AME business’s response to my complaint and provides no warning to the consumer beforehand of this time limit. Below is a revised version of the response I sent to the BBB, a second letter of mine which BBB neither publicly posted nor acknowledged (in the “negative review” category).  BBB also subsequently removed most of the public content of another consumer’s “negative review” of the AME business yet still publicly posted AME’s response to that consumer.  BBB stated “complaint details [were] unavailable” with that consumer’s complaint as well as with mine. I would be curious to know how BBB justifies its A+ business rating for the AME business.

In my response to AME’s letter to BBB about my complaint, Mr. Eric Jacobs’s claim that American Medical Experts (AME) did its “job 100%” is far from the truth.

1)     I did not call Eric Jacobs the “medical expert” in my case in spite of what Mr. Jacobs claims. Who was doing what at the AME business, however, was not clear.  Ronny Hamad, the person who responded to me in September 2015 about AME services, was a company director who guided me with the contract details and submission process of my case.

2)    This past spring (May 27, 2017), I resumed contact again with Mr. Hamad regarding my old concerns and requests from 2015 and 2016 following my questioning of the medical expert’s report. I asked that my comments be forwarded to the medical expert and asked that Mr. Hamad let me know one way or another if he would forward my points to him, especially as it’s feedback that may help with future customers. By June 6, 2017, I inquired again, not having received any response. Mr. Hamad wrote me that Eric is out of the office.  It was not until June 20, 2017 (twenty-four days later), that Mr. Hamad emailed me that “Eric is still out of the office.”  I assumed Eric was the first name of the medical expert since Mr. Hamad had not informed me that he would not be notifying the medical expert about my questions.  It wasn’t until nearly a month later as mentioned, that Mr. Hamad emailed me that he’ll answer my inquiry for Eric because he “know[s] what Eric is going to say”--that there would be a cost for looking into the report matter that I’m raising once again.  Mr. Hammad is referring to Mr. Eric Jacobs.  Mr. Eric Jacobs, in fact, was also called an AME company “Director.” If Mr. Hamad (one director) knew how Eric (another director) was going to respond to my 2017 inquiry, then why did Mr. Hamad not inform me earlier? 

3)    I provided the doctor and technician names and their business address to AME in all the materials I sent them (except for one tech’s name that the dermatology office would not disclose to me).  Over two weeks later, Mr. Hamad emailed me that the medical expert still needed to know the address of the dermatology office and the names of the people involved in the case.  Had the medical expert read any of my documents?

4)    Mr. Jacobs stated I paid only ‘step one’ of AME’s payment process.  I did not default on any payment. I paid AME’s up-front fee of $1,200 to receive a professional report.  The report, an emailed draft, was an insubstantial, poorly written three-paragraph assessment of my case.  The “second step” Mr. Jacobs referred to was an additional $1,200 charge to obtain merely the medical expert’s actual name, signature, and CV.  

5)    Why would a company not provide a customer with the credentials and license information of its experts?  I chose not to pursue AME’s highly questionable “second step” payment process.

6)    When I began the process of getting an expert witness, I inquired about the steps I needed to take with AME.  I did not receive a “disclaimer” that AME sent to BBB stating that potential customers must agree to.  The emails from Mr. Hamad did not include information about an official agreement I would have had to make with the company beforehand.

7)    The company did not inform me that they would withhold the medical expert’s name on their emailed report but stated the report would be “unsigned.”  I was told after I got the report that I must pay the company an additional fee ($1,200) for the same report with the medical expert’s name and signature on it.

8)    Following my complaint, AME emailed BBB the medical expert’s CV that had nine question marks in the medical expert’s education/awards section.  Does that indicate that the AME cannot verify their medical expert’s credentials?

9)    Mr. Jacobs stated that I believed in a “guarantee [that] an expert will support the merit on any case.”  He stated that would be unethical for AME and “for a client like Ms. Goldsmith [to] ‘require’ such opinion is not honest.”  I made no such request.  A patient undeniably expects a medical expert to do a thorough and impartial assessment of her case, but obviously there are no guarantees of medical experts’ favorable opinions.  I do believe AME needs to address their medical experts’ decisions to dismiss key evidence.  How is that justified?  I had high expectations of AME and was disappointed when the medical expert did not address key factors in my case.  Mr. Jacobs’s statement that I’m not being honest is ridiculous.

10) I paid AME $1200 for a professional report and received from them a report that lacked in-depth attention to my concerns. AME did not explain the “additional work” they claimed to have done for me.  The expert had not adequately addressed my concerns and questions, and I followed up in 2015, 2016, and 2017 with the same issues.

11) AME did not address the points in my first letter to the BBB.  As a consumer, I repeatedly asked and paid for the medical expert to comment on the lip change caused by excessive lasering of that unrequested, sensitive area. An expert would have known this area should not have been lasered and that subsequent lip change did result. The medical expert avoided the question during and after his writing the report despite my repeated requests that he comment on this problem.

The medical expert stated that scarring from lasering is worth pursuing legally but that wrinkling and facial structural change from excessive lasering done in unneeded facial areas is not worth pursuing legally. That makes no sense to me.

12) Why should I pay extra for a medical expert to explain his report’s crucial but incomprehensible wording?  Or why should I pay for a medical expert to use the office notes at the exclusion of my own records and documentation?  I was the only provider of physical evidence in the form of dated photographs. The dermatological office had contracted to take photographs but had failed to do so before, during, or after treatment. 

The medical expert even reported wrongful “facts” that he took directly from the dermatology office notes while also wrongly interpreting some of those office notes in his report.  It also would have been helpful and less biased if the medical expert had used more professional language, such as “doctor/patient claims.”

13) As for the medical expert fixing what he calls “typos” in his report—which prevent full comprehension of the sentences in his “Discussions and Conclusion” paragraph—he totally misses the mark on one account.  In his original report, he stated that “perioral[around the mouth] wrinkling…is certainly far more pronounced in the later, post-treatment photos.”  In his subsequent letter to the BBB, after revising the next two sentences of his original medical expert report, he wrote, “Forehead wrinkling appears to be more pronounced” but as he writes in both documents, “The most pronounced change is seen in the lower face.”  He therefore confirmed laser damage to the lower face.  But forehead wrinkling?  I was not lasered there.  The tech lasered once to the side of my left brow for some reason, which did create a bruise and some wrinkling there, so I’m curious to know from what photos the expert determined a noticeable forehead change.  If he further supports my case by stating there’s more forehead wrinkling, then I am grateful.

14) The medical expert contradicted himself.  He noted laser damage to my forehead, as mentioned above, which is another example of harm done by lasering in the wrong area. His report was completed in 2015, but he wrote in 2016 that I had originally needed more documented proof of “treatments administered in the wrong spot.”  No treatment was needed on the forehead; therefore, according to the medical expert’s reasoning, lasering did happen in the wrong place and that lasering did cause damage as a result of technician error.

15) I sought help for one acne spot, which the doctor attested to in the case note; however, the medical expert didn’t address the laser’s “high setting” described in the tech’s note, nor did the medical expert mention the excessive amount of lasering—the claimed number of laser hits—to the face as another probable cause for facial damage.

16) If the medical expert were to treat a concerned patient such as myself, he would logically explain the usual preparation and procedure to the patient. Neither he nor the technician discussed treatment standards for my one-spot problem.

17) This was not a competent or licensed tech although the office falsely claimed she was a “board certified aesthetician.”  Even if she had been board certified in Nevada, which she was not, the Nevada State Board of Cosmetology law states that aestheticians are not permitted to laser.

18) I recommend the article “Elephant in the room of dermatology,” by Dr. Brett Coldiron, past president of the American Academy of Dermatology.  He warned about how the so-called wrong people can be performing dermatological services (at supposedly physician rates). Dr. Coldiron predicted future dire outcomes for such practices.  He seemingly resigned from his post at AAD for his strong ethical beliefs that unfortunately didn’t get the needed backing in the resistant dermatological field.

19) Eric Jacobs of AME stated to BBB that “merit” is lacking in my malpractice case. Yet, in contradiction, Mr. Jacobs sent me an email in 2015 in which the medical expert stated that my facial “damage is real” from the lasering that was performed.  Has AME changed its position?

20) I am not surprised that AME continues to ignore my concerns.  The relevant topics should have been covered in the medical expert’s report in more detail and my, the patient’s, written observations should have been given serious consideration and acknowledgement. 

21) Numerous patient grievances are on the web, some of which I sent to the medical expert including other articles about the very troubling practice of cover-ups by dermatologists and those whom they’ve hired to do their work for them.  The medical expert neither noted nor responded to this data and in fact claimed that I sent him only one article from JAMA (Journal of the American Medical Association).  Was he simply careless or did he perhaps choose not to note the data reported in journals, newsletters, and other health sources that I provided about the risks of lasering, especially when the laser machine and its instrument are operated by people who can lack training, education, supervision, and good intentions.

22) Like Dr. Coldiron, I also hope that dermatologists will honor their commitment to fully and ethically uphold patient care.  As I said, it’s time for change—accountability, monitoring, honest reporting, more medical research, and repair of “medical” damage.

23) Final note: If BBB’s purpose is to protect the consumer and to uphold high standards in business practices, the consumer needs more than thirty minutes to present the facts of flawed business practices.

This report was posted on Ripoff Report on 09/23/2017 12:19 AM and is a permanent record located here: https://www.ripoffreport.com/reports/american-medical-experts/washington-dist-of-columbia-20105/american-medical-experts-ame-did-not-provide-ethical-or-adequate-service-washington-dis-1401866. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content

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REBUTTALS & REPLIES:
4Author
0Consumer
1Employee/Owner

#5 Author of original report

Dr. Aton Mordechai Holzer of American Medical Experts (AME)

AUTHOR: LG - (United States)

POSTED: Friday, April 12, 2019

Please see my review of DR. ATON MORDECHAI HOLZER’s brief, unprofessional report and response to me via the American Medical Experts (AME) business complaint on this website.  Dr. Holzer not only failed to address the lip issue I had repeatedly requested of him to comment on for my $1200 service fee to AME, but he/AME eventually emailed me an unsigned commentary that was labeled report “draft.”

Due to lingering facial changes, the crookedness in my lip alignment worsened.  There was no acne on my lips (or inside the lower lip on the right where Samantha Reith lasered one time and caused long-lasting sore); however, Samantha Reith from the office of Advanced Dermatology and Cosmetic Surgery (also known as Advance Cosmetic Surgery & Dermatology// Tahoe Cosmetic Surgery & Dermatology// Advanced Dermatology) handwrote that she lasered my “vermillion [lip] border” “38” times at admittedly “higher settings” (not mentioning any other facial parts that she lasered).  Notably, the office falsely claimed in writing that Samantha Reith was a Nevada Board Certified Aesthetician specializing in medical aesthetics.

Samantha Reith also did not note in her record that I waited for her after the appointment to tell her that she hadn’t hit the acne spot that I was seeking some kind of dermatological treatment for.  She missed it the second time also as the bruising mark showed. It is reasonable to assume her actions were either unbelievably careless or blatantly intentional.  The Minnesota Board of Cosmetologist Examiners (a state where Samantha Reith once worked) warns that

"the term ‘medical estheticians’ may be misleading, inaccurate, and deceptive to the public and those receiving services.  Specifically, consumers may be misled to believe that a ‘medical esthetician’ has some type of advance medical training that has been licensed, registered, or sanctioned by the state of Minnesota or that the licensee has been authorized by the state to perform some type of medical service.  Due to the potential for the public confusion and concern for public safety, the Board would like to caution all licensees to monitor their advertising to ensure that they are fully and accurately disclosing their license status with the Board.  Estheticians using misleading or inaccurate terms in an advertising may be subject to discipline under section 155A.33."

According to Hennepin County, MN public records, in the spring of 2009 Samantha Reith was ordered by the owner of Renew Your Skin to stay away from this business where she wanted to work or she “would be removed by the police.” On June 3, 2009, Samantha Reith, plaintiff, failed to appear for her Minnesota court hearing and was not awarded monetary damages in her civil case. 

The other tech (the Stateline, Nevada, dermatology office would not provide her name) lasered three times on my cheek, totaling at least 42 hits to my small face, stated that Samantha’s settings were actually much higher than hers.  This contradicts what Samantha Reith handwrote on the final paperwork—that she (Samantha) used a lower laser setting than the second tech.  Although I requested to see my records, the office would not let me see my actual file.  They gave me a “copy” of it many days later after they had said on different occasions that it would be ready and available for me after my repeated requests.

Although Samantha Reith did not record in the patient note all her lasering areas to my face, my photos show bruising in questionable places that she didn’t report, and the swelling remains centered just below my bottom lip. Other consequences include changes in color, texture, volume, lip sensation, and shrinkage. Dr. Holzer did actually attest in his “medical expert” report that facial damage was done to me; however, he did not explain what a proper lasering procedure might be in such a case, an omission in his report that is suspect.

Attached below are some articles and postings with cautionary information for consumers on laser damage that I had highlighted and sent to Dr. Holzer when I sought his medical review of my case.  He did not refer to them but did acknowledge and wrongly record that I sent him only one article.  The other articles that were included are referenced below.  He failed to comment on the scores of numerous online complaints from people like me who also were dismissed in comparable cases.  Although many patients have been voicing complaints online on many websites for some time—even with some doctors concurring—dermatologists, as a whole, continue to claim there is nothing in the literature reporting negative results from lasers.  They wrongly continue to ignore patients who’ve been physically and psychologically damaged. 

***

In 2015 I provided the following articles for Dr. Mordechai Holzer when I submitted my case for review.  He did not respond:

“Increased Risk of Litigation Associated with Laser Surgery by Nonphysician Operators” in JAMA Dermatology journal 2014

http://www.aad.org/dw/monthly/2014/september/safety-first#allpages and article in Dermatology World Journal (September 9, 2014) with the statement by Dr. Dover,“Where we see a problem is lack of oversight, education, knowledge, and judgment.  If one of these is missing, there’s a potential problem.  If all four of those are missing, you’re really asking for trouble.”

“Dermatologists continue to press for medspa regulation to protect patient” article (9/14) by Ruth Carol (in Safety First)

“Laser surgery lawsuits against doctors on the rise” 2013 article by Genevra Pittman (in Health News)

“Lawsuits Involving Laser Treatments by Non-Docs on the Rise” (2013 HealthDay News article)

http://www.aad.org/media-resources/stats-and-facts/cosmetic-treatments/cosmetic-surgery warning by the American Academy of Dermatology

“Cosmetic care via laser can be risky” from The Republic 10/2014

***

Below are the sample reports from doctors and patients that I sent to Dr. Mordechai Holzer in 2015 as part of my case.  He neither addressed nor acknowledged any of them:

various websites/ research/ reports of laser harm/damage:

 

http://iplandlasersupport.blogspot.com/

http://iplandlasersupport.blogspot.com/2009/02/fat-lossatrophy-from-cosmetic-devices.html

http://iplandlaserdamagesupport.prophpbb.com/topic773.html

https://www.osha.gov/SLTC/laserhazards/index.html

https://www.youtube.com/watch?v=-_VQNm_3NHo

http://www.rosaceagroup.org/The_Rosacea_Forum/showthread.php?18795-Anybody-have-fat-loss-from-V-Beam

http://www.rosaceagroup.org/The_Rosacea_Forum/showthread.php?18795-Anybody-have-fat-loss-from-V-Beam

http://thescienceofacne.com/pdl/

http://www.realself.com/question/damage-VBeam …(talks about facial depressions?)

http://iplandlasersupport.blogspot.com/2009/02/fat-lossatrophy-from-cosmetic-devices.html

http://www.noviskin.co.za/treatments/vein-therapy/vein-therapy-leg/vein-therapy-leg-VBeam

http://www.realself.com/question/v-beam-facial-fat-loss

http://iplandlaserdamagesupport.prophpbb.com/topic3395.html

http://messageboards.makemeheal.com/non-surgical-cosmetic/ipl-and-fat-loss-poll-questions-t68784.html

http://www.skinacea.com/facials/lasers/side-effects.html#.VSl-e2aPU7A

http://iplandlaserdamagesupport.prophpbb.com/topic1131.html

http://www.rosaceagroup.org/The_Rosacea_Forum/showthread.php?19677-V-beam-The-quot-what-have-I-done-now-quot-feeling/page3

http://messageboards.makemeheal.com/non-surgical-cosmetic/warning-for-beam-laser-proceed-with-caution-t51232.html

http://www.rosaceagroup.org/The_Rosacea_Forum/showthread.php?18795-Anybody-have-fat-loss-from-V-Beam

http://iplandlaserdamagesupport.prophpbb.com/viewforum.php

http://www.electrooptics.com/features/f ... ture_id=52

http://www.medscape.com/viewarticle/554344

http://www.scripps.edu/researchservices ... nual07.php

Re: VBeam causing nerve damage

http://iplandlaserdamagesupport.prophpbb.com/topic773.html?sid=2e2c8774f67972312d40ede106e25459#p4267

http://iplandlaserdamagesupport.prophpbb.com/topic3872.html

IPL/Laser Operators discussing problems w/ IPL tx

 

Example quotes taken from online sources above:

Posted by redbysciton » Mon Apr 28, 2014 9:45 am

These posts in a users forum reveal treatment problems:

"Hi all,
Has anyone had any experiences with the Nd Yag 1064 in treating telangiectasias or spider veins? I have recently added that on my Joule platform. Quite disappointing really! It made a dent on my model's nose though not much changed for the telangiectasia."
12.5 | Registered Commenterchinh le
- See more at: http://medicalspamd.com/cosmetic-ipl-la ... a03AM.dpuf

I Wonder how the poor model feels about the dent in her nose.

Here is a provider wondering why he is seeing worsening telagectasia in Is after treatment w/IPL (Sciton BBL):

"Dear Dr. Chavelas,
Did you ever had in the beginnings worsening of cuperosis after treating with BBL only?
I just saw another client of mine today with more cuperosis than first time she came to me 1 month ago.
She was treated with 560 nm small addapter 22-24 j 10 ms 20c
Can you explain why some of the Is have this reaction?
I don't understand it.
I'll try treating them with Nd:yag as you said, but i'm trying to explain this phenomena and i can't.
Thank you for your time.
03.19 | Steve

Steve
No actually i have not seen any worsening of cuperosis after treating with only the BBL. But i have seen Is that they have not a very good result after just one BBL treatment and i had to combine with the Nd YAG as i told you before. Maybe your I was in this category and the worsening was a physical process of an unsuccessful treatment. Another exlpanation is that maybe there was a small burning after the session that could deteriorate your I.Which Fitz type had been your I ?
03.20 | charry

Thank you dr. Chavelas ,
skintype 3 was the I. I'll add the Nd:Yag. We have the Reveal from Canfield and we can monitor every little change, and i saw it was worse.
And it was not just one I, several, especially those with little vessels, difuse redness is working very nice.
Do you think that undertreating can cause worsening? With 560nm 15j, 15 ms, 15c - double pass i don't see always closure of the vessels.
Do you always see the closure of the vessels when doing a BBL 560 ? Maybe i'm just affecting a little bit the vessel wall and not a fully closure, and because of that the vessel will be more dilatated after the treatment. This is the only explanation i have. Thank you again for sharing this information with me.

- See more at: http://medicalspamd.com/cosmetic-ipl-la ... a03AM.dpuf

redbysciton

 

Posts: 114

Joined: Fri Apr 04, 2014 7:14 am

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"Temperature can be considered as a carcinogenic factor"

Posted by cveroleyva » Sat Aug 06, 2011 9:07 pm

This study talks about increasing levels of heat to the skin.

http://www.icnirp.de/documents/infrared.pdf

cveroleyva

 

Posts: 450

Joined: Tue Mar 01, 2011 2:43 am

 

Posted by DCNGA » Wed Oct 20, 2010 1:24 pm

PLASTIC GOGGLES ARE NOT EYE PROTECTION, unless they are specialized light/ray filtering goggles made specifically for use with laser/light devices. You must have specialized eye protection, made for use with laser/light devices to filter out the scattered rays/beams. Even the device makers are clear about this that specialized eye protection is REQUIRED. Many docs do not go to the expense of purchasing the specialized goggles and only buy the types used at tanning salons. This is a very bad thing. If you find out that you were only given non-specialized eye protection, report them to your state medical board. Fill out a complaint with the FDA about what has happened as well. This helps everyone and protects you as well that you have reported the problem.

 

from J Clin Aesthet Dermatol. 2012 Jun; 5(6): 45–53: As our understanding of the biological efficacy of various wavelength distributions evolves, so to will the range of IPL technology, particularly with regard to different wavelength filters, pulse durations, pulse frequencies, and cooling modalities to protect from side effects. The end result will be a widening domain of IPL’s clinical applications and indications. It will be incumbent on clinicians who use these devices with regularity for such new and emerging indications to report their clinical experiences in order to sustain our continued understanding of the technology’s long-term safety and efficacy profile.

 

The light emitted from the IPL is composed of a spectrum of colours from different wavelengths, enabling selective photo-absorption (light absorption) to different targets. In other words, using the IPL is like using a group of lasers in a single treatment. The heat generated by the absorbed energy causes damage to the vessels or pigmented areas stimulating the body's own natural healing process.

 

 DO NOT GET AN IPL, FRAXEL, OR ANY SIMILAR PROCEDURE!!! It is not worth the risk!! I have been a member here for many years, but never wrote a review. However, this is so important, that it needs to be said. I thought I did my research and went to a highly regarded Medical Spa that was operated by a doctor for my IPL. That was two weeks ago. I am now suffering SEVERE damage and I am going to need plastic surgery to correct the problems. The settings per the technician were conservative because it was my first (and only) IPL. I have post IPL rosacea (which I never had before) and acne. My skin has a wrinkly, orange peel texture too. This is the worst part...I woke up yesterday with huge dents on my face which are going to require fat grafting. I also found out that more damage will probably surface and my face will more than likely loose all of the fat layer. I am horribly damaged!!! I am not the only one...there are many, many more. Sometimes the fat loss and damage doesn't appear until months after the IPL. I wish I would have known that there was even a chance that this kind of damage could occur. I knew about the possibility of redness, swelling, and bruising, but I did not know about the fat loss and other complications. Many doctors claim that IPL can not do this...IT CAN and IT HAS!!!! I am currently under the treatment of a very good dermatologist and we are hoping that this process can be stopped with oral steroids.

 

 I really wish I had done more extensive research before having this procedure. I later found medical texts online stating (and showing) that pinholes and "atrophic" scars can occur, usually from "insufficient cooling." Then I found a study where the authors tested a number of IPL machines, all unnnamed, and found variations as much as +/- 20% from the manufacturers' specs in EVERY PARAMETER measured - fluence, pulse rate, temperature, wavelength, etc. And this was after calibration. The machines may not have been the same one used on me, but this worries me. Then I read a paper finding an increase in lipid peroxidase levels (a marker for ageing/oxidative stress) in IPL treated skin 6x HIGHER than from UV light. Another paper suggested using topical antioxidants after tx to combat this. If I'd known that, I would've been been slathering antioxidants under the vaseline!

 
I feel the one tx gave me the equivalent of years' worth of bad rosacea flares. I have a close relative with severe rhinophyma, and I told the doc about my hx and this relative before tx. I am now researching aftercare and hoping my skin will eventually recover. Can I cover things up w/ mu? Mostly, but my routine is now more complicated and requires more effort and mu than before the tx. Where before I never needed moisturizer, now I must use Cerave CREAM AM & PM. Yet I still have oily skin and breakouts! Bottom line: use extreme caution if you have oily skin and an inflammatory type of rosacea that reacts badly to heat. Any of the following could have caused my outcome: operator error, machine error, or an unknown/ unpublicized contraindication to IPL, such as the specific type of rosacea I have. I also now know that there is a great deal of controversy among drs. over whether IPL helps or worsens melasma type pigmentation. I was not told this - brochures and info given state it is safe, "no downtime," gentler than laser, and effective for hyperpigmentation and rosacea redness. Be cautious w IPL!

 

Hi It sounds like your laser that had horrible results is what I have had, but called the v-beam laser. It is the worst laser I have ever used or experienced. I do not recommend it. I think because of all of the skin sensitizing ingreadients that you use to control your acne may have also not helped. I think if you are going to get any laser you need to stop your topical acne products for at least 7 days prior. I would like you to read the new book by Perricone, for acne. It helps mainly for typical acne, not hormonal acne on the chin. It also will help reduce your rosacea. What I learned from the book, (I don't use his products) is mainly that I was eating a lot of foods like corn, popcorn, sugars, dried fruits, fruit juice etc that were feeding my acne or inflamation. When I changed my diet, my rosacea went down A LOT. I think your face due to all that crap you have had to try as well as that bad laser experience you face is easily inflamed and topically sensitive. Also, most lasers are great, accept V-beam! Also whoever does the laser makes a difference too. Some people don't know the right settings to use.
from skinacea.com

 

i look older and different now with bad skin...just very aged. it is hard for me because i am 41 but looked very young for my age, without wrinkles and i had great skin. i was still getting carded every few months! darn. so, i went from looking 30 to 50. it is like a bad horror film.

 

i was only doing this for some slight hyperpigmentation and a few broken caps on my nose. it destroyed my face and i am completely devastated.
it is three months since my last treatment and every time i look in the mirror there are more scars and dents.

 
Now I have dents, scars and holes all across both cheeks and every day it gets worse. I have been scarred for life by IPL and my cheeks have been completely flattened.

  • March 26, 2015 I received IPL only 6 weeks ago and have aged incredibly. I have wrinkles around my lips, sagging skin and orange peel chin. I'm very sad to have lost my youth and very worried about how quickly my face will continue to age.

This is a double edged sword for those who've suffered fat loss or other damage from lasers and IPL devices. The pain of showing that proof is difficult, emotionally. Yet the proof IS the faces of those who've suffered damage from these devices. When confronted, most doctors will not recognize the damage or they will attribute the damage to something/anything other than the device. I'm sure many doctors fear the legal repercussions but most Is want validation that what they are seeing is real, most doctors fear being sued and won't acknowledge it. It's a hamster wheel for victims

 

People Wake Up!!! Do Not Do Fraxel or IPL!!
My damage was caused by IPL 6 months ago. Fraxel and IPL seem to be causing the same damage. (Thermage nightmare?) I have fat loss in my entire face, eyelids, cheeks, jaw line, along with scars, bumps in my skin, vision problems, pain in cheek, jaw and brestbone (my chest was done also), broken blood vessesl and more! There are suppose to be NO Burns, NO fat loss, NO permanent scaring, NO eye problems, No permanent redness, NO hypopigmentation,NO depression with IPL or Fraxel!! That is what the medical community around the states are telling their patients. Doctors are lying to you! Dermatologists are lying to you! Plastic Surgeons are lying to you. Nurses and Aestheticians are lying to you! Medical Boards are lying to you! Manufactures are lying to you! The FDA and the Government are lying to you! They are only interested in protecting this Billion Dollar industry, and do not care about the severe damage it has caused to 1000's of people. These procedures are the new "CASH COW" for the industry and the manufacturers and doctors will go to great lengths to keep this from the public.
The people that did these procedures will tell you, "these devices couldn't have done this damage, they don't go deep enough in to the skin---they don't cause fat loss, they don't get hot enough---oh the burn scars will go away in two years--you had eye protection on, you can't have eye problems-----and the biggest lie, it's natural aging causing your skin to sag and face to lose volume! These are the lies I am hearing in every damage case. NO ONE prematurely ages 10-20 years in the matter of 4 Months.
Question your doctors about that. Ask him how much extra revenue he is making a year by adding this device to his practice and then paying poorly trained nurses and estheticians to do the damage. And yes, for the Professional Doctors and Plastic Surgeons who have caused this damage, you are a disgrace, with criminal intentions, who took a vow "do no harm, patient safety first" but turned it into "admit no fault, offer no help, just collect the cash and run" I would never wish this on my own worst enemy, yet I can only hope that this would happen to doctors wives, daughters, sisters, or mothers, so then you would understand the torment and hell you have put us all in, a life of disfigurement, isolation, financial distress, and emotional and psychological torture. And offering no help to any of us! Are there any real doctors out there that actually care about people, if so, please stand up! We need you.
As for the doctors who respond on this site, you owe these members the truth. One doctor will comment this can happen and the next comments it cannot. You all know the truth, it's in your seminars, lectures you attend, on doctors discussion boards, and if you don't know the facts, either research it or don't comment. You are jeopardizing hundreds of members by telling them these devices are safe. Could it only be to try to harness more cosmetic business? Would you put your own loved ones in harms way if you weren't sure whether they would be damaged or not because you were not warned beforehand of possible permanent DNA damage to your skin? I bet not.
No, these results don't happen to everyone, but to more than enough and that number is growing, by 40 percent according the the AAD in 2009. There is tons of research out there proving these machines cause this. Even papers from the FDA discussing adverse events about botox and injectibles and how long should they allow this to continue especially since the damage is happening to healthy people! There are hundreds of victims on various sites telling their stories of burns, fat loss, vision problems, hypo scaring, etc. There are serious side effects happening, most irreversible, that doctors, esthetians and the manufacturers are NOT telling us about. TAKE PICTURES, THEY DO NOT LIE, KEEP TAKING PICTURES, THEY ARE VERY IMPORTANT PROOF! People need to start making noise to get attention drawn to this epidemic of damage. These devices are in every town now, and unless everyone that has been damages speaks up, hundreds of thousands of people will be victimized by this in the future. Please, lets help each other!

 

 

                         

 

 

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#4 Author of original report

name of AMA's hired dermatologist

AUTHOR: L. - (United States)

POSTED: Monday, October 22, 2018

name of the medical doctor assigned to this case, whose name he and American Medical Experts (AMA) refused to disclose, is Dr. Aton Mordechai Holzer

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#3 Author of original report

American Medical Experts (AME's) patient confidentiality breach

AUTHOR: L - (United States)

POSTED: Saturday, March 10, 2018

Note: American Medical Experts (AME) did not have patient consent here to reveal patient identity.   There are confidentiality laws and ethics that doctors--and the people who work with the doctors--are to uphold when publicly discussing patient records and correspondence. This website informs that postings cannot be altered or removed. Consumers beware. 

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#2 Author of original report

American Medical Experts ,AME, misleading again

AUTHOR: Lynne - (United States)

POSTED: Thursday, March 08, 2018

There is nothing new in this rebuttal.  It is actuallly misleading.  The letter is out of sequence, is not current, and does not provide new information as it appears to do.  AME posted this letter to the Better Business Bureau on August 29, 2017, following my original complaint.  My response to AME’s “facts” and claims (their August 29, 2017, rebuttal) was posted above on this website on September 23, 2017 (below the row of asterisks.) 

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#1 REBUTTAL Owner of company

Misinformation - facts are not correct

AUTHOR: ERIC - (United States)

POSTED: Thursday, March 08, 2018

To Whom it may concern, we are responding to Lynne Goldsmith.  We see there is some misinformation of who the expert witness is, I (Eric J*****) am not the expert, I am one of the directors of the company, please see the work product and all the email... correspondence.  I am not sure how she came up with that conclusion.  We did our job 100% and had a very well qualified Board Certified Dermatologist expert review *** **'s records and imaging back in 2015 (2 years ago) and prepare an expert witness report based on the materials and imaging provided.   We cannot guarantee an expert will support the merit on any case, that would be unethical and for a client like *** *** "require" such opinion is not honest.  We have a two step process to contain the clients cost as in the case with *** *.  She only paid "step one" of our two step process for the review and confidential work product report as detailed on our website and in the email sent to her when she first called back in 2015 that details our service and our two step process. 

Here is our disclaimer that is found on our website:  American Medical Experts, LLC helps patients and families who have been possible victims of Medical Malpractice and Personal Injury cases.  We also assist on any cases that require expert witnesses from independent medical examinations – IMEs, Life Care Plans, prison / jail cases, expert opinions in automobile accidents, workers’ compensation, federal claims, Vaccine, DUI cases and disability cases. DISCLAIMER: We can have our experts review your case to see if it has merit. We cannot guarantee a supportive opinion on your case since our medical expert witnesses provide honest, unbiased opinions on the merit, or lack of merit, of your case. We want to help you in your case as much as possible, but in some cases, the expert may be unable to see any instance(s) of malpractice or liability in the facts. American Medical Experts has no control over the opinions written by the expert witnesses and is therefore not responsible if you do not receive a supportive opinion. In addition, American Medical Experts has the right to decline your case for any reason. In addition, some experts require the plaintiff to have a retained attorney to move forward on the case after the signed report; American Medical Experts makes no guarantee of an expert’s participation. Once you have read the above disclaimer and agree to its stipulations, you can send us your case for review. Please follow the instructions aboutHow To Send Your Case to AME. NOTE: we do NOT accept payment in the form of personal checks or personal credit card transactions. You may pay by 1) cashier’s check, 2) money order, or 3) wire/funds transfer. Once your review is complete and if you have a supportive opinion by an expert, AME may be able help refer you to an attorney in your area since we have tens of thousands of attorneys in our database. Call our office (888-678-EXPERTS) for details. The expert's qualifications are found below: ***** (Independent Contractor); admitting privileges at **** Hospital **** July 2011-: ***, South Miami (***) **; admitting privileges at *** Hospital of Miami LICENSURE American Board of Dermatology: PASS; Board Certified as of examination date, July 29, 2010 ***** Step 3: *** Step 2: **** Step 1: * TRAINING 2010-2011: The ** Hospital, Houston, TX: Fellowship, ***/Procedural Dermatology, ****, MD 2006-2010: University of ***, Birmingham, AL: Residency in Dermatology (2+2 Clinical/Research Track) 2005-2006: ***** Medical Center, New York, NY: Internship in Internal Medicine EDUCATION/AWARDS August 2001-June 2005: ***** Medical College of ******* University, New York, NY MD with Honors in Research ? *** Memorial Prize, 2005 ? The “Good Physician” Award, 2005 ? *** Class of 2005 Student Council Award, 2002 ? Special recognition in Fundamentals of Genetic Medicine course for service to the class, 2001 August 2000-June 2001: *** University, Jerusalem, Israel Completed Winter Seminar in Medical Ethics at the *** Institute, ****** ***** Medical Center, Jerusalem June 1999-June 2000: *** Graduate School of **** University, New York, NY MA (Modern Jewish History) ? **** Graduate Fellowship Award August 1994-June 1999: ******* College of ******* University, New York, NY  BA, summa c*m laude (Biology) ? ****** Award for Outstanding Service to the Student Body ? **** Award for Excellence in Science and Judaic Studies ? **** Institute Scholar, Summer Undergraduate Research Program at ***** College of Medicine ? Dean’s List, all semesters RESEARCH EXPERIENCE July 2008-June 2010: University of *** at Birmingham, Department of Dermatology, Post-Doctoral Fellow. Sponsor: Dr. ****. Effects of cytokine knockouts and genetic mutations on the genesis of melanocytic nevi and melanoma in mice; immunization with mutant HRAS peptide for melanoma prevention; effect of toll-like receptor polymorphisms in human susceptibility to non-melanoma skin cancer. Summer 2002: ***** Medical College of ******* University, Department of Dermatology, Research Assistant. Sponsor: Dr. ****. Immunomodulatory effects of extracellular ATP on epidermal Langerhans cells. Summer 1998: **** College of Medicine, Department of Rheumatology, **** Institute Scholar. Sponsor: Dr. **. Mechanism by which ******* administration prevents onset of systemic lupus erythematosus in murine SLE models. Summer 1997: **** College of Medicine, Department of Neuroscience, Research Assistant. Sponsor: Dr. ***. Genetic regulation of myelination in Schwann cells. MEMBERSHIPS AND APPOINTMENTS AAD; ASDS; ACMS; Miami Dermatological Society; ******* College of **** Surgeons  The bulk of *** * complaint is about her underlying case in which the Board Certified Dermatologist determined she does not have merit based on the records reviewed.  Again, we cannot guarantee a supportive opinion and this first step in which she paid went toward the review of her records and the report she received.  Please see our work product report that outlines our two step process and what she "paid for" and what she received is correct.  We even went further to assist her and did "additional work" and did not charge her for more questions and answers (see the email chain and the expert's reply):

After the expert did his review and wrote his report (found in the attached work product report), ** had the following comments that we shared with the expert for his feedback at no additional cost: "Dear Doctor, I  hope you are well. I just got some feedback that on the *** case that I want to share with you to get your feedback and see what you can do to help. Here is what she said, "Hello.  I recently had a medical review sent to me from your company and would like to request that the reviewer amend incorrect or incomplete information in the report. The reviewer states that I was "first seen for treatment of acne scars and telangiectasias (dilated capillaries)."  No, I went for help with ONE SCAR ONLY, as Dr. *** noted on April 1, treatment "for spot," an office charge of $50. Reviewer also incorrectly writes that patient has "history of eczema."  Please observe that no "history" is noted by Dr. **, as this is a first diagnosis for patient with new medication prescribed. Reviewer also notes wrinkles around patient's mouth prior to treatment, yet please review the clear photo from just four months prior to the lasering on November 27 to see that there is only one short, faint mark above upper right lip.  The March 21st photo also shows only the one acne trouble "spot" between the nose and mouth that I, patient, had sought help with, which was the visible issue. The reviewer also does not mention in the "Facts" paragraph of report the one extra laser that I requested and received following my scheduled appointment with technician due to her actually missing the acne spot when lasering during the first meeting.  I explained my emailed photos for reviewer and showed how technician had missed the actual spot and lasered indirectly and at a different intensity around the area twice. 

This was "fact."  Photo 22 also showed blistering in the surrounding area where I didn't even have my problem scar, which demonstrates in my opinion technician incompetence along with the blistering effect that also appears on my lower lip that was previously pointed out to reviewer in photo 26, I believe. As for the technician increasing the lasering intensity to expedite treatment, as she writes about in her patient note--in which no second appointments were made as a result--the scar is still present, however; so the job which should have been simple and small wasn't even done properly the first or second time during the same day that patient waited around and met a second time (unscheduled) with the same technician. For the reviewer, too, to note that the Dr. ******* "did not appreciate a difference on exam and noted that this effect is not supported in the literature," I would like to know if the reviewer himself/herself noted the difference from the April 4 photo to the April 8 photo following the April 1 lasering.  The change in lip contour and the vertical lengthening of space between the nose and mouth appear glaringly different when I myself and others view them, these photos. 

The reviewer, incidentally never did comment about the change in lips' vertical widths and the horizontal lengths (along with thinner right upper lip) about which I requested an opinion from the reviewer. Yes, I would still like the reviewer to comment on the lips pre and post laser job. Reviewer also states "positioning" and "quality" of photographs sometimes make it hard to evaluate although reviewer does write that there are "pronounced" changes.  Several profile post-laser photos that I emailed of different facial positions were added to further show the protruding lower lip area change even though frontal photos also show this change, such as in photos April 2 and September 24.  Furthermore, as mentioned, the photos are clear enough for a viewer to determine that change has indeed taken place in a short amount of time; no professional photographer is needed to prove this.  Please review the pre-laser photos if necessary for comparison. Please also note that by written contract, as quoted, dermatology office was to have photographed my face before, during, and after lasering; yet they failed to take this promised action, which to me, contrary to what reviewer states, unequivocally shows a "breach in standard of care."

  Let me also add as another "breach in standard of care" that appropriate goggles, according to my consumer findings, were not used to cover my face when lasering.  As a result, more wrinkling occurred around my eyes in the socket area as seen from photos of November 27 and April 10, for example. The reviewer also writes some sentences that are not finished in the report, not complete or clear, which I would like for reviewer to revise.  They are: "Periorbital wrinkling appears constant between before Forehead wrinkling appears to be more pronounced" is one sentence.  Another sentence is "The most pronounced change is seen in the lower face, which is indeed w." If this aging or changing of the face is not in the "literature," as the reviewer and Dr. ******* states, does that make the problem for patients not exist or not be possible altogether?  So then how will these patient stories such as mine get in the literature if doctors and "aestheticians" keep dismissing these patients' reactions, and not record the medical findings in the "literature" and/or not try to help the problem by even simply acknowledging it?  What's it going to take for doctors to be honest and open about certain lasers and their potential complications?  It's a very unethical situation that deserves attention in the medical field, especially in light of how medical doctors' Hippocratic oath urges them to abide by the credo to "do no harm."

Let me ask this:  Can you and other dermatologists say with confidence that you are doing no harm by doing nothing about this problem and not taking a stand when people come forward to explain skin consequences from lasering?  My answer to that question would unquestionably be no.  Perhaps as more and more consumers come forward in the future about this kind of harm as they have already been doing online for some time, dermatologists and technicians might then have to closely face and address the possible harms of lasers one way or another.  That is my hope. Finally, let me ask this: If this were you or your child or your partner that you were evaluating in this dermatological case, would you give the same assessment as you gave me, and would you have this same technician work on your face?  Do you believe there is a difference in care between a medical doctor and a non-medical aesthetician?  In Nevada it appears that technicians don't have to be monitored or licensed, which is a very frightful and wrong thing to do for a consumer who puts his or trust in someone whom he/she believes has knowledge and ethics about what she's/he's doing, someone whose intentions are by all means good. In the end, I am very sorry that you could not have been able to take a stand on this matter in spite of agreeing that the lasering caused damage to my face, yes.  The damage was not just physical however, but was and is mental and emotional in its impact. At this point, the consequence of my office visit is something that I now have to deal with every day and will have to deal with for the rest of my life unless I elect to have other procedures done to my face that "professionals" now recommend that I do for the first time in my life following my laser mistreatment in April of 2015. These new recommended procedures are treatments that I never would have even given a thought to.  They are procedures that are non-viable options for me." 

The expert's response:  On 2016-01-11 13:05, the Expert wrote: "Thanks, Eric. Let me state from the outset that I saw my role here as to act in ****'s best interest by determining for her whether a lawsuit has a chance of success, or if it would likely ultimately be unsuccessful and constitute a waste of her time, emotion and resources. I would be doing her a disservice if I gave her the answer she wants to hear rather than my honest assessment of the chances of success.   It's been a while since I've seen this but if memory serves me, I did what I could to piece together the history as it appears in the medical documentation. Of course this may not match *** *****'s own recollections or the truth, but it stands as the official record in the absence of proof to the contrary. Without enhancement, the photos unfortunately don't show enough to prove that laser treatments were administered in the wrong spot. If establishing that would clinch the case, it would be worth more attention, but unfortunately this sequella is not tied to laser treatment in the literature and so there is nothing to establish that this breach in standard of care, if it occurred, was the cause of the damages. If there is scarring caused by laser in areas treated in error, then this is worth pursuing. Likewise for lack of photography or goggles -- the breaches there just don't connect with the harm. Eye injury would certainly qualify for the latter, but in its absence there isn't much we can do with the information.  

As far as the photos go, my goal was to assess what a jury would say when presented with the same photos -- and in my judgment there is some wrinkling in the earlier photos, and that the absence of objective positioning angles and mouth movements makes it difficult to assess wrinkling parameters with certainty. However, if her attorney feels that these are not insurmountable and a jury could be convinced otherwise, great; unfortunately, the crux -- that the damages can't be connected to the breaches -- still gets in the way of a successful claim.   I don't know how the errors crept into my report -- are they in the original I sent? I am usually very careful to review and I apologize if this occurred.   As far as her frustrations, I sympathize. I had never heard of this effect before this case. The way for this to gain traction is the publication of a case report, which her treating dermatologist would be best equipped to do. Mechanistically, it is difficult to explain this effect scientifically, as there was no treatment in the affected areas, but perhaps an academic researcher could propose a basis for this once a series of cases has appeared."   Regarding the typo, "Thank you. I apologize for the errors in the second to last paragraph -- here is what those sentences should have read:   "Forehead wrinkling appears to be more pronounced but the quality of pretreatment photos is insufficient to determine this with certainty. The most pronounced change is seen in the lower face, which is indeed more wrinkled in the later photographs."   Apologies, omitted the previous sentence:   "Periorbital wrinkling appears constant between before and after photographs. Forehead wrinkling appears to be more pronounced but the quality of pretreatment photos is insufficient to determine this with certainty. The most pronounced change is seen in the lower face, which is indeed more wrinkled in the later photographs."

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