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Study: Lawsuits increase for laser procedures by nonphysicians

Friday October 18, 2013
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Lawsuits related to laser procedures conducted by nonphysicians are increasing, particularly outside traditional medical settings, according to a study.

Nonphysicians performing skin laser surgery in the study, published Oct. 16 on the website of JAMA Dermatology, included nurse practitioners, RNs, medical assistants, electrologists and aestheticians, among others.

Skin-related laser procedures such as hair removal remain one of the most popular elective types of laser surgery performed in the U.S., according to background information in the study. To meet demand, more nonphysicians are performing these procedures.

“Procedures performed by untrained individuals, particularly in nonmedical settings, are more likely to result in litigation,” lead author H. Ray Jalian, MD, clinical instructor of medicine in the division of dermatology at UCLA’s David Geffen School of Medicine, said in a news release. “Consumers should be aware that laser treatments are medical procedures and should verify the training, certification and experience of the person performing the procedure."

Researchers identified the frequency of medical professional liability claims stemming from skin laser surgery performed by nonphysicians by using an online national database of public legal documents.

In 175 cases related to injury from skin laser surgery from 1999 to 2012, researchers found 75 (42.9%) cases involving a nonphysician. The percentage of cases involving nonphysicians increased from 36.3% in 2008 to 77.8% in 2011.

Laser hair removal was the most commonly performed procedure. While a third of laser hair removal procedures were performed by nonphysicians, 75.5% of hair removal lawsuits from 2004 to 2012 involved nonphysicians. The rate increased to 85.7% between 2008 and 2012.

To meet the demand for these procedures, physician delegation of laser surgery has grown significantly in the past decade. Nonsupervised laser surgery is performed legally in many states at nonmedical facilities such as medical spas that offer aesthetic and cosmetic procedures. Physicians and other laser operators should be aware of their state laws, especially in regard to physician supervision of nonphysician operators, the authors said.

Jalian noted that in the correct setting with close on-site supervision and appropriate training, the use of nonphysician operators can prove to be a productive and safe environment for patients.

Study abstract: http://archderm.jamanetwork.com/article.aspx?articleid=1754984

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