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John Oliver on the unregulated business of med spas: ‘People are going to get hurt'
John Oliver on the unregulated business of med spas: ‘People are going to get hurt'

The Guardian

time23 minutes ago

  • Health
  • The Guardian

John Oliver on the unregulated business of med spas: ‘People are going to get hurt'

John Oliver looked into the booming industry of med spas in the US on the latest Last Week Tonight. 'You're probably at least familiar with them,' he explained of the facilities, either because you've seen one pop up in your neighborhood, or you've been pushed by one of thousands of influencer videos about them.' 'Med spa' is a catch-all term for a facility that provides aesthetic procedures, both medical (lasers, Botox and IV drips) and non-medical (facials). In the age of Instagram, it's a lucrative business, with an estimated 10,000 or more med spas nationwide, generating $17bn annually. But 'while many med spas are safe and staffed by actual professionals', said Oliver, 'the rapid rise of med spas has also been accompanied a rapid rise' in stories of malpractice or procedures gone awry. That's because 'this whole industry can fall into a regulatory gray area,' as many of their procedures fall between esthetic services and traditional medical practice. 'Other services definitely fall under the practice of medicine, but no one – from practitioners, to customers, to law enforcement – acts like it,' said Oliver. There are currently no federal standards for med spas, and no legal definition for what one even is. 'And that has left the market wide open for bad actors,' Oliver explained, calling med spas the 'wild west' of medicine. 'If an industry can grow this fast and be run this loosely, people are going to get hurt,' he added. Oliver dissected the 'perfect storm' of factors for this wild west, starting with many med spas' franchising model, with all-cash businesses that can be opened anywhere. 'It's not exactly reassuring to hear a medical facility being pitched the same way you'd pitch a Subway sandwich shop,' he joked. 'I know both technically involve getting suspicious-looking goo inside you, but through vastly different delivery systems.' The regulatory frameworks also vary wildly by state. In New Jersey, only a doctor can perform laser hair removal, while anyone can in New York. In Texas, anyone can get certified to become an injector, and practice anywhere in the state. The laws are so behind the reality of med spas in Oklahoma that the state advises nurses to use their own professional judgment to determine what procedures they can provide based on the relevant laws. 'Which feels like they're one step away from just telling nurses to ask a Magic 8 Ball, 'am I allowed to give this woman chin filler?'' Oliver quipped. 'What this means is from the services they sell to the people they employ to the stuff they inject into you, med spas can be far less vigorously vetted than you may assume,' he noted. Some med spa procedures, such as facials, have scientific backing, while others – such as 'ionic foot detox bath' or 'ultraviolet blood irradiation' – do not. Some med spas also provide procedures like 'sculptsure' via devices that are FDA 'cleared'. As Oliver already covered in an episode on medical devices, FDA cleared 'doesn't really mean shit'. FDA approval means the device is both safe and backed by 'valid scientific evidence', while cleared simply means that it can be legally marketed. 'Which is barely one step above an FDA stamp declaring 'this exists!'' Oliver joked. 'Ideally, you'd have a doctor talk you through the risks and benefits of any sort of procedure on offer,' he continued, 'but that's not possible at many med spas.' While they are required to be supervised by a medical professional with 'full practice authority', that supervision can be done remotely, sometimes from professionals located hours away. Most of the staff in med spas are nurse practitioners, physician assistants and registered nurses. 'Nothing against people who hold those jobs – they can be extremely skilled,' Oliver noted. 'But their training on the procedures done in med spas can be thin at best,' as there are very few dermatology programs for non-doctors. Oliver cited one service that claimed to allow someone to inject Botox after just a day of training, 'which really does not feel like enough training to shoot a paralyzing neurotoxin into someone's face'. Especially one that could have deadly side-effects, as was the case with one central Texas woman who had a seizure after being injected with Botox by someone with non-medical certification; the med spa's protocol for emergencies was to call their supervising physician, a pediatrician located a three-hour drive away. 'A lot of the protections you associate with medical offices just don't apply to med spas,' Oliver summarized. 'Oversight can be incredibly lax,' as most states don't even require that med spas register their existence. In sum, Oliver said, med spas can cut corners both on their staffing and the contents of their injectables, and the market is rife with counterfeits. He referenced the story of one influencer who went to a med spa for B12 shots, got upsold 'fat dissolving' injectables, and ended up in the hospital for four months with a necrotizing, antibiotic-resistant skin infection. Her lawsuit against the practitioner, who injected her with a substance bought off Alibaba, hit a dead end, as he was unlicensed and had no malpractice insurance nor assets. 'The lack of accountability is honestly not that surprising,' said Oliver. 'If you're injured at an unlicensed med spa, there's often little to no recourse unless law enforcement takes an interest in your case.' And while it's easy to judge those that seek out the procedures, Oliver noted that 'it's both reasonable to want these services and to expect the people providing them to be licensed and adequately supervised. But far too often, they just aren't.' What can be done? 'Bare minimum, state laws and regulation should be clearly written, well publicized and enforced,' Oliver said. But 'laws can only do so much when they're ignored, and when demand is this high, and there is such a clear profit motive, there is always going to be the possibility that sketchy providers will break the rules.' He encouraged people to look up the names and credentials of any provider, get a full consultation and see the vials of any injectables before receiving them. 'And if they respond by acting defensively or won't show them to you, get the fuck out of there,' he concluded, because 'in too many places, it is far too easy to set up something that has all the appearances of medicine, but none of the protections.'

Twins' Doctor Must Face Player Malpractice Claim Due To Florida Workers' Comp Exception
Twins' Doctor Must Face Player Malpractice Claim Due To Florida Workers' Comp Exception

Forbes

time30-05-2025

  • Health
  • Forbes

Twins' Doctor Must Face Player Malpractice Claim Due To Florida Workers' Comp Exception

Photo byRyan Costello was a promising young baseball player. After being drafted in the 31st round of the 2017 Major League Baseball (MLB) Draft by the Seattle Mariners, and later traded to the Minnesota Twins, he worked his way through the clubs' A and AA affiliates. Sadly, his career was cut short when he was found dead in his hotel room in November 2019 while in New Zealand preparing to participate in the Australian Baseball League. In an ongoing lawsuit in Florida state court, Costello's family alleges that malpractice by Dr. David Olson, a Twins' team doctor, led to Costello's death. The lawsuit has pushed forward on some close legal calls. A Missed Diagnosis According to their December 2021 complaint, Costello's parents allege that as part of a 2019 spring training physical, an electrocardiogram (EKG) revealed that Costello had cardiac abnormalities. Further, Costello's parents claim that Costello should have undergone more testing before being allowed to participate in any strenuous activities. Nevertheless, Dr. Olson allegedly marked Costello's health report as 'Normal' with 'No Further Action Necessary,' clearing Costello to return to spring training. Costello's parents claim that the abnormalities were later determined to be Wolff-Parkinson-White syndrome, 'a cardiac condition that is treatable but that can make vigorous physical activity dangerous and potentially fatal.' Indeed, Costello's death was apparently caused by a cardiac arrythmia, a condition connected with Wolff-Parkinson-White syndrome. Evading Arbitration Dr. Olson first moved to compel the action to arbitration according to the arbitration provision in the Major League Agreement (MLA), also known as the Major League Constitution. The MLA was incorporated by reference into Costello's minor league player contract. Before going further, it is important to understand the context of this arbitration provision. MLB players have long been unionized and, as a result, negotiate collective bargaining agreements governing the terms and conditions of their employment, including relevant arbitration clauses. Minor league players did not unionize until 2022 and did not have a collective bargaining agreement until 2023. Consequently, prior to that point, minor league players were subject to the terms unilaterally imposed by MLB, its major league clubs, and their minor league affiliates. Some of those terms, like the arbitration provision, are included in the MLA, which is simply an agreement among the 30 MLB clubs. The arbitration provision at issue stated as follows: 'All disputes and controversies related in any way to professional baseball between Clubs or between a Club(s) and any Major League Baseball entity(ies) (including in each case, without limitation, their owners, officers, directors, employees and players), other than those whose resolution is expressly provided for by another means in this Constitution, the Major League Rules, the Basic Agreement with the Major League Baseball Players Association, or the collective bargaining agreement with any representative of the Major League umpires, shall be submitted to the Commissioner, as arbitrator, who, after hearing, shall have the sole and exclusive right to decide such disputes and controversies and whose decision shall be final and unappealable.' Major League Constitution, Art. VI, Sec. 1. Consequently, as eventually explained by the District Court of Appeal of Florida, 'the arbitration provision applies to disputes that are related in any way to professional baseball and that are between either: (1) two or more Clubs; or (2) one or more Club(s) and one or more Major League Baseball entity(ies).' Importantly, the court reiterated that '[b] The trial court granted Dr. Olson's motion to compel, relying on Wolf v. Rawlings Sporting Goods, a 2010 case in which the Southern District of New York, applying the same arbitration provision, also granted a motion to compel arbitration. In Wolf, a former minor leaguer sued MLB, Minor League Baseball and a variety of other parties after his skull was fractured by a pitch that he said was the result of a defective helmet. In a December 8, 2023 decision, the District Court of Appeal of Florida, Sixth District, disagreed and reversed. In its reading, the present action 'is a dispute between a player of a Club and an employee of the same Club.' It is an 'intra-Club dispute' and such disputes are not within the scope of the arbitration provision. The court also differentiated Wolf, asserting that the claims there 'plainly fell within the scope of the arbitration provision.' Evading Workers' Compensation Law Following the case's remand back to the trial court, Dr. Olson argued that the Costellos' claims were barred by workers' compensation laws, which generally provide the exclusive avenue for resolving disputes over workplace injuries, including deaths. Workers' compensation laws also generally bar lawsuits against coworkers. Instead, the injured worker is intended to be fully compensated by the workers' compensation insurance system. As an initial matter, Dr. Olson's argument hinged on a surprising fact – that he was a co-employee of Costello. While athletic trainers are typically employees of professional sports clubs, doctors are usually independent contractors. Indeed, in several cases brought by players, athletic trainers have successfully asserted the workers' compensation defense while doctors have not (see chapters 2 and 3 of this report for discussion of such litigation). In a March 11, 2025 decision, the court denied Dr. Olson's motion for summary judgment based on the workers' compensation defense. The result turned on the application of Florida rather than Minnesota law. The court determined that Florida law – where Dr. Olson examined Costello – should apply. Florida's workers' compensation law, however, does not cover professional athletes. In other words, because professional athletes cannot be compensated by the workers' compensation system, they (or, in this case, their estate representatives) are not barred from bringing claims against their employers or co-employees arising out of workplace injuries. Dr. Olson has appealed the court's decision, which has resulted in a stay of the proceedings until an appellate decision is rendered. If the appeal is unsuccessful, expect Dr. Olson and his insurer to seek a settlement rather than face the exorbitant amounts often awarded to professional athletes by juries in medical malpractice cases.

Diego Maradona's homicide trial is declared invalid by court
Diego Maradona's homicide trial is declared invalid by court

CNN

time29-05-2025

  • General
  • CNN

Diego Maradona's homicide trial is declared invalid by court

The homicide trial of Diego Maradona's medical team for alleged malpractice was declared invalid by an Argentine court on Thursday. The decision comes after one of the three judges overseeing the case was removed due to a possible lack of impartiality and for allegedly authorizing the filming of a documentary during court hearings. The trial, which started on March 11, must now start from scratch. This is a developing story and will be updated.

Diego Maradona's homicide trial is declared invalid by court
Diego Maradona's homicide trial is declared invalid by court

CNN

time29-05-2025

  • General
  • CNN

Diego Maradona's homicide trial is declared invalid by court

The homicide trial of Diego Maradona's medical team for alleged malpractice was declared invalid by an Argentine court on Thursday. The decision comes after one of the three judges overseeing the case was removed due to a possible lack of impartiality and for allegedly authorizing the filming of a documentary during court hearings. The trial, which started on March 11, must now start from scratch. This is a developing story and will be updated.

Diego Maradona's homicide trial is declared invalid by court
Diego Maradona's homicide trial is declared invalid by court

CNN

time29-05-2025

  • General
  • CNN

Diego Maradona's homicide trial is declared invalid by court

The homicide trial of Diego Maradona's medical team for alleged malpractice was declared invalid by an Argentine court on Thursday. The decision comes after one of the three judges overseeing the case was removed due to a possible lack of impartiality and for allegedly authorizing the filming of a documentary during court hearings. The trial, which started on March 11, must now start from scratch. This is a developing story and will be updated.

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