The American Med Spa Association (AmSpa) Releases Statement Regarding Texas Botox Arrest

Posted By American Med Spa Association, Thursday, November 15, 2018

Contact: Cathy Christensen (312) 981-0993 
CHICAGO, IL. (November 14, 2018) – In response to the recent arrest of Ms. Michelle Bogle, LVN, of Savvy Chic Medical Spa in Spring, Texas, outside of Houston, the American Med Spa Association (AmSpa) has released the following statement.
In regard to the arrest of Ms. Michelle Bogle, LVN, in Spring, Texas, outside of Houston, while the manner in which the arrest took place was surprising, the compliance and legal issues raised are ones that have been concerns to AmSpa for some time. Although all the facts are not known, news reports have alleged that Ms. Michele Bogle attempted to take several steps necessary to be compliant under Texas delegation and supervision regulations, most notably by engaging her medical director for a face-to-face consultation with the patient via FaceTime, which is permissible, provided all the necessary steps are taken under Texas telemedicine regulations. This initial consultation is always a necessary step prior to any cosmetic medical procedure taking place.
While bringing the physician in to the consult was an important step taken by Ms. Bogle, the allegations contained in the news reports state that the physician did not make a diagnosis or direct the treatment plan, instead leaving that critical step to Ms. Bogle. LVNs and RNs are not allowed, under Texas law, to make diagnoses or create treatment plans, and doing so can trigger an allegation of the unauthorized practice of medicine. Although it is important to reiterate that the facts have not been confirmed, it appears from news reports that because Ms. Bogle, and not the physician, made the diagnosis and created the treatment plan, this was the critical fact upon which the charges against Ms. Bogle were brought. Ms. Bogle has allegedly been charged with the unauthorized practice of medicine.
The implications of this story are far-reaching. This is the second instance of an LVN being charged with the unauthorized practice of medicine in recent months as a result of an undercover sting operation (the other occurred in California). AmSpa encourages all of its members—particularly those in Texas—to ensure that they strictly comply with every step of the Texas delegation and supervision rules governing cosmetic procedures, which can be found here. Following each step specifically is critical, and practitioners must take care to pay very close attention to the specifics of the rule and follow it exactly. As now has been seen, failure to do so may result in criminal prosecution, not to mention action by the medical and/or nursing boards.
There are a few statements in the news story that should be clarified, as AmSpa doesn’t believe they accurately reflect the law in the state of Texas. The story explicitly states that only NPs or PAs can inject Botox, and further states that RNs and LVNs are strictly prohibited from injecting even if proper supervision and delegation procedures are followed. This is not correct. There is no rule in Texas specifically prohibiting a physician from properly delegating injection procedures to an RN or LVN, provided all of the requirements of the delegation regulations are strictly followed.
For more information on Texas medical aesthetic legalities, as well as medical aesthetic legalities in all 50 states, log on to
About the American Med Spa Association (AmSpa)
The American Med Spa Association (AmSpa) provides business and legal resources to medical spas and aesthetic practices across the country. AmSpa’s events–including Medical Spa & Aesthetic Boot Camps and The Medical Spa Show–provide business and legal best-practices to anyone entering the medical spa space or looking to improve their existing practice. AmSpa members receive access to legal summaries of laws governing medical spas in their state, access to an exclusive, customized medical spa insurance package, and many other benefits. 312-981-0993,