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Official points to botox violations: Board director says medical assistants can’t administer drug

September 9, 2009 |

The anti-wrinkle drug botox has been illegally administered by medical assistants in the offices of plastic surgeons throughout the state, the executive director of the Nevada Board of Medical Examiners said Tuesday.

“I told physicians at our August retreat that our state pharmacy statutes do not allow medical assistants to give botox treatments,” Louis Ling said. “I think it was just ignorance of the statutes that allowed this to happen. The reason I knew it was because I used to be with the Pharmacy Board.”

Ling would not specifically name any doctors who might have had their medical assistants administer botox, but he said the practice is common throughout Nevada.

Larry Vinson, executive director of the Nevada Board of Pharmacy, which oversees licensing of pharmacies and investigates complaints, said medical assistants “are absolutely not allowed” to administer the drug.

Ling said he saw no reason to discipline doctors or medical assistants engaged in the practice.

“They didn’t know it was wrong,” said Ling, who added he is in the process of crafting further regulations to make it more clear to physicians who can administer the drug.

Illegal administration of drugs in Nevada is a felony.

Three plastic surgeons sought for comment on this story did not return calls.

Assemblywoman Sheila Leslie, D-Reno, a longtime critic of the medical board, was incredulous.

“How can this happen?” she asked. “Like I’ve said before, we’ve got to get rid of the medical board and start over.”

Botox carries such a serious risk of side effects, including swallowing and breathing problems, that earlier this year the Food and Drug Administration issued the order to place black box warnings on the injectable toxin, a warning usually reserved for drugs that have caused fatal heart attacks or strokes.

Derived from the paralytic agent botulinum toxin, botox in its natural form causes botulism, a potentially fatal paralyzing disease.

The FDA said such drugs must carry warning labels explaining that the material has the potential to spread from the injection site to distant parts of the body.

Ling said he believed there was little danger to the public from medical assistants administering the drug, though they were not trained in school to do so.

He said doctors screened the patients and trained medical assistants in what to do. He said the public should not confuse the practice in a doctor’s office to someone who gets the drug illegally and then administers it.

by Paul Harasim at or 702-387-2908.
September 9, 2009

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