By Robert J. Fisher, JD, ByrdAdatto

At the end of 2018, much was written about the Texas Botox arrests that resulted in four different medical spa providers being led away in handcuffs or turning themselves into police. These arrests sent shockwaves through the medical spa community, as it marked an aggressive change in enforcement.

However, as of now, three of the four people arrested are no longer being criminally pursued by the state. Michelle Bogle, the LVN injector, and Paula Springer-Bryant, MD, the medical director supervising Savvy Chic MedSpa, were both "no billed" in March 2019. A "no bill" means that the grand jury did not find sufficient grounds to indict the accused. Additionally, Ricky Delatorre-Aguirre, a medical assistant performing injections for RD Aesthetica MedSpa without any proper physician oversight, had his case dismissed July 2019. The Houston district attorney indicated on the dismissal motion that while there was probable cause, the case could not be proven beyond a reasonable doubt at that time. Melissa Diaz Galvan, a medical assistant who was charged with the unlicensed practice of medicine and is being accused of writing prescriptions to patients on a prescription pad belonging to a physician, was the final person indicted. Her case is still ongoing with the next scheduled court date in February.

Perhaps the dismissals and no-bills described above were due to the extremely technical and nuanced nature of the laws that were being violated, which resulted in the district attorney's office not being able to clearly translate to the grand jury the violations that occurred. On the other side of the coin, the case against Galvan appears to be more straightforward, as the district attorney can show the exact prescription page(s) she was signing on a physician's pad.

Regardless, we would caution medical spa operators against letting their guard down and thinking that this is a sign of decreased criminal enforcement. Those who can remember the opening voiceover in the TV show Law & Order know that the justice system is made up of the police who investigate the crime and attorneys who prosecute the offenders. While these specific circumstances resulted in dismissals, it does not mean that the police will stop arresting medical spa personnel. It is critical to maintain compliance to prevent arrest in the first place. Even with a dismissal, the image of being led away in handcuffs from your facility is one that is best avoided. We will continue to monitor and provide updates on the enforcement actions being taken by the Houston police and other law enforcement units across the country.

As a final word of caution, the Texas Botox arrests made headlines because of the criminal allegations. Each of these providers and medical spas likely will have to continue to defend their licenses and ability to practice before the medical board. Although they may not face jail time, their livelihoods may hang in the balance.

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Robert J. Fisher's passion for health care traces back to his high school days of shadowing doctors. His passion evolved in college to study as a pre-med major. The last major evolution of Robert's interest in health care was the transition to an interest in health care law. With this education, a business attorney for a father, and a renowned orthopedic surgeon for a father-in-law, Robert has the pedigree for success as a business and health care attorney at ByrdAdatto.