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    How well do you know the law?

    Dermatologist and lawyer Mathew M. Avram, M.D., J.D., explains what cosmetic physicians need to know about the law and how to decrease lawsuit risks.


    Indicators of Lawsuit Risk

    Physicians who take the steps needed to avoid adverse side effects will decrease potential liability, according to Dr. Avram.

    One of the best ways to avoid bad outcomes and potential lawsuits from laser procedures, for example, is to perform the procedures correctly, by watching for endpoints, according to Dr. Avram.

    “In other words, when you do certain treatments, there are endpoints that are associated with safe treatment, and there are endpoints that are associated with unsafe treatment,” he says.

    When treating vascular lesions with vascular lasers, including pulsed dye lasers, the treatment endpoints should be vessel clearance and transient purpura (including purpura that lasts for several days). But if there’s whitening or graying while using a vascular laser to treat broken blood vessels or rosacea, that’s an indication that the treatment is too strong, Dr. Avram says.

    During laser hair removal, appropriate endpoints include perifollicular erythema and edema.

    “If you see tissue contraction or changes in the epidermis, that’s an indication that the treatment is not being performed in a safe manner,” he says. “Finally, for tattoos or pigmented lesions, you’d want to see whitening of the epidermis, which is a safe and effective endpoint. Splatter or removal of the entire epidermis with the treatment would be considered an unsafe clinical endpoint.”

    The duration of the adverse side effects is also an important indicator of lawsuit risk.

    “If something is temporary, there doesn’t tend to be legal consequences; rather, it just goes away with time and hand holding. But as the complication becomes more long-lasting or permanent, the odds that some liability will be attached to it will be greater, because there will be more harm suffered by the patient,” Dr. Avram says.

    Lisette Hilton
    Lisette Hilton, president of Words Come Alive, has written about health care, the science and business of medicine, fitness and wellness ...


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