Laser Surgery

Over the past 20 years, laser surgery procedures such as laser hair removal, skin rejuvenation, and treatment of leg veins, have been on the rise.  However, lawsuits relating to injury from these types of procedures have also increased, and a new study found that physicians have been held liable even if they were not personally operating the device, according to Med Page Today.  As there are no federal requirements as to who can use lasers for cutaneous purposes, the risk of injury or malpractice is high, and patients should proceed cautiously if they consider a dermatologic laser procedure.

Dr. H. Ray Jalian from the Department of Dermatology at Harvard Medical School, along with colleagues from other medical establishments, searched the Westlaw Next database for evidence of litigation involving cutaneous injury after laser surgery.  They found 174 cases that were reported sometime in the past 25 years and met their criteria for the retrospective study.

Results, which were published in the February JAMA Dermatology, revealed that although physicians actually performed the procedure in only 100 of the cases, the physicians were listed as the defendants in 146 of the cases.  Plastic surgeons were most commonly involved, representing 26 percent of cases, and dermatologists were second, representing 21 percent of cases.  The study authors noted that a “significant number of physicians are offering or supervising laser skin treatments outside the scope of their specialty.”  Many cases also cited nonphysicians such as nurses and aestheticians as the laser operators.

Researchers found that the number of cases gradually increased over time and peaked in 2010.  Hair removal was the most common procedure leading to injury and legal action and accounted for 36 percent of the cases.  Skin rejuvenation, along with treatment of vascular lesions and leg veins, were also frequently cited in the study.  Common injuries that result include burns, scars, and changes in pigments, which many plaintiffs explained caused emotional distress and lower quality of life.

An Illinois woman named Rheutalia Thomas recently filed a lawsuit claiming the “careless use of a laser” by an employee at Dermatique Laser and Skin in 2011 that left her burned, disfigured and scarred.  Although she reached a confidential settlement in a 2008 case with Dermatique over injuries sustained during a hair removal session, Thomas filed the second lawsuit due to the high costs of her medical treatments.  The lawsuit lists 19 ways in which Dermatique and its employee were careless and negligent, including failure to train and supervise the employee in how to perform laser hair removal or how to use related equipment.

Since there are no federal requirements on cutaneous laser use, regulations are left to the states, leaving uncertainty about what type of training or supervision is needed.  Dr. Bruce Brod, clinical associate professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, notes how this study is a cautionary tale showing that there is a substantial level of risk when using the laser:  “It validates our suspicions that lawsuits seem to occur with greater frequency when laser procedures are not a core part of the training for that specialty or when it is delegated to nonphysicians.”

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