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3 Women Suffer Kidney Failure After Derriere Injections
Date:5/1/2008

The procedures were done at an unlicensed clinic in North Carolina, CDC says

THURSDAY, May 1 (HealthDay News) -- Three women who received derriere-enhancing injections at an unlicensed clinic in North Carolina developed kidney failure after the procedure.

Not only was the facility unlicensed, the person administering the shots was untrained and not medically supervised, and investigators later could not even determine what, exactly, was in the injections.

All three women subsequently recovered, yet their travails highlight the hazards of getting cosmetic or any other kind of procedure at unlicensed facilities with untrained personnel.

"It's always good to ask for the credentials of the person who is going to be providing a service," said Brant Goode, a U.S. Centers for Disease Control and Prevention career epidemiology field officer assigned to the North Carolina Division of Public Health in Raleigh.

"Being a savvy consumer of this kind of service takes some work, looking at labels, educating oneself about products. It's similar to anybody going for medical care, informing oneself, educating oneself about exactly what the procedure is, what the risks are, and the qualifications of the person providing the services," he said.

Goode is co-author of a report detailing the three cases that's published in the May 2 issue of the CDC's Morbidity and Mortality Weekly Report (MMWR).

Countless women are undergoing cosmetic surgery procedures, including getting silicone injected into their posteriors to improve their bottom line, or their lips or their breasts. But procedures and injections administered by unlicensed practitioners have resulted in complications and even, in some cases, death.

The Los Angeles Times recently likened Priscilla Presley's post-surgery facial profile to a Picasso painting. (The work was performed by an unlicensed surgeon, the newspaper reported). And the U.S. Food and Drug Administration on Thursday announced that certain flavors of the dietary supplements "Total Body Formula" and "Total Body Mega Formula" contained hazardous levels of chromium. Previously, Tropical Orange and Peach Nectar flavors of the products were shown to contain dangerous amounts of selenium. Almost 200 people have reported adverse reactions and the distributor has voluntarily recalled the products.

The MMWR reports on the three cases, all women who received injections on Dec. 8 and Dec. 22, 2007, at the same facility in North Carolina.

The first case involved a 42-year-old woman from the District of Columbia who, within 30 minutes of receiving the second injection (on Dec. 22), developed a headache, started vomiting, and reported that her urine resembled "purple blood." On Christmas Eve, she arrived at an emergency room in Maryland with acute kidney failure. She was hospitalized for 10 days but has since recovered.

Within one hour of receiving similar injections, a 26-year-old Illinois woman developed a headache, nausea, and had urine that she said was "burgundy" in color. On Dec. 23, she was found to be in acute kidney failure, underwent dialysis for five weeks but also recovered.

The third woman, 26 years old and from Maryland, developed pain in her abdomen as well as lightheadedness and nausea after being injected. She was hospitalized for two weeks and had to undergo dialysis, but she, too, recovered.

A North Carolina Division of Public Health investigation and inspection of the facility found multiple problems with infection-control procedures, among other issues.

The substance injected was purported to be silicone oil, but investigators were unable to confirm this. Since silicone oil has not previously been linked to kidney failure, it's likely another substance was present, the CDC report said.

There was no evidence that the facility's practitioner, trained as a radiology technician, had had training for cosmetic procedures or was medically supervised, although she claimed to be.

"The facility was a clinic that had a doctor's name associated with it, but that doctor had not recently been associated with that establishment," Goode said. "The practitioner was not licensed to conduct these procedures and did not have training or supervision to perform these procedures."

Early this year, the county health director issued an order prohibiting the facility from administering any injections. The practitioner has been arrested and charged with practicing medicine without a license, the CDC said.

All three women had heard of the facility directly or indirectly through Internet chat rooms.

"Information that comes to you by the Internet is not always gospel," said Dr. James Wells, a spokesman and past-president for the American Society of Plastic Surgeons. "This is a story we see all the time. A patient brings an article from the Internet thinking it must be true."

Wells said the only approved fillers for derriere augmentation are a patient's own fat cells, harvested and then re-injected, or hard silicone forms specifically devised for enhancement.

"There's a history of getting liquid injections done by hair dressers in local hotel rooms. Those are horror stories and this sounds like the same situation," Wells said. "This is not a minor, causal procedure. Start out by selecting a board-certified physician in a facility that is an operating room, not a strip mall. Make sure you're seen by the physician, not someone in an office whose training you have no understanding of."

More information

Visit the American Society of Plastic Surgeons for more on different types of cosmetic procedures.



SOURCES: Brant Goode, R.N., B.S.N., U.S. Centers for Disease Control and Prevention career epidemiology field officer, assigned to the North Carolina Division of Public Health, Raleigh; James Wells, M.D., past president and spokesman, American Society of Plastic Surgeons; May 2, 2008, Morbidity and Mortality Weekly Report; Los Angeles Times


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