Medical Spa Lawyer
Paddy Deighan, the Premier Medical Spa Lawyer

Jan
06

Platelet Rich Plasma (PRP) is utilzed in many aspects of aesthetic medicine. In my world of aesthetic medicine, the uses for PRP have continuously evolved. There will be additional uses in the future. However, I thought I would start the new year out with a review.

SKIN REJUVENATION: Probably the broadest application is skin rejuvenation. The reason is simple. This is the mpost requested aesthetic medical procedure. PRP injections have proven to be efficacious because they increase dermal collagen production levels. Consequently, skin appears more youthful and radiant.

Platelet Rich Plasma may also be utilized in conjunction with other modalities to increase the positve effects upon skin texture and tone. For example, topical application of PRP and/or microneedling together with injections of PRP may enhance the postive effects of PRP.

HAIR REJUVENATION: PRP has been successfully employed to treat androgenic alopecia (hair loss). Results have been very variable but it is undeniable that this modility holds a lot of potential as a frontline defense against hair loss and as a weapon to regrow lost hair.

PRP has been combines with transplantation surgery as well as utlized as a stand alone procedure. The results have been outstanding both in terms of hair density as well as number of follicular units (number of hairs) LOL.

ACNE SCARRING: PRP in conjunction with microneedling has also proven effective to approve the appearanace of scars. Best results may also require laser to dimish the discoloration but PRP and microneedling siugnificantly improve the appearanace of all scarring.

Paddy Deighan J.D. Ph.D

Jan
06

I am one of the people that finds it amazing that Influenza has seemingly disappeared during the pandemic.  I believe that many COVID cases are Influenza and that there are many false positives and misdiagnoses. Yes, COVID is a very serious health threat and proper care is necessary. However, we are being deceived in my opinion and the proof is in the CDC itself.

During last year’s flu season which began in October 2019, the Department of Health and Human Services reported up to 56 MILLION cases of influenza. 

Remember, this was the 2019 flu season… so before the Covid hysteria.

How many influenza cases do you think have been reported so far this flu season? 10 million? 1 million? 100,000? Guess!!!

According to the most recent CDC data, the total number of influenza cases reported in the Land of the Free this flu season through December 27, 2020 is a whopping 877.

That’s right,  fewer than 1,000 people in the US have had the flu during this flu season. 

Seriously? Are we honestly supposed to believe that our infallible public health officials have miraculously eradicated influenza?

Or is it possible that, maybe just maybe, influenza cases are being counted as COVID ?

We already know the Covid numbers have enjoyed quite a bit of fuzzy arithmetic. Covid reporting standards in many municipalities, states, and countries require that anyone who tests positive for COVID and passes away is automatically counted as a COVID-related death.

Motorcycle accidents, heart attacks, even cancer… they’re being counted as COVID deaths.

Just a few weeks ago there was a murder-suicide in Grand County, Colorado in which the police report listed cause of death as “blunt force injuries due to a gunshot wound”.

But Colorado public health officials listed both of the deceased as COVID deaths.

Even the CDC acknowledges that 94% of all reported COVID deaths were related to some other condition besides, or in addition to, COVID-1984. So only 6% of reported deaths were pure COVID.

The CDC also stated that, “on average, there were 2.6 additional conditions or causes” for every single COVID death reported in the Land of the Free, including (as we now know) murder, suicide, heart attack, and traffic accident.

It’s remarkable that, if someone tests positive for COVID and dies for any reason, the cause of death will often be reported as COVID.

Paddy Deighan J.D. Ph.D

Jan
01

In the country’s quest to save people from themselves, the Britain will ban “buy one get one free” offers, and other promotions, on unhealthy food items.

The rules which go into effect in April 2022 also forbid restaurants from giving free soda refills, and stop unhealthy items from being featured at the checkout.

The argument is that obesity related illness costs the socialized healthcare system of the UK 6 billion pounds per year. Who calculates this nonsense? Ya sure it isn’t 7 billion pounds?

Therefore the government has the right to dictate health standards to citizens and business alike.

Sounds a bit reminiscent of NYC Mayor Bloomberg’s soda ban a few years back. How’d that work out for saving health care dollars?

Sure curbing obesity is a noble objective but is this really going to work? If we want to really eat unhealthy food we are going to do it. Fact of the matter is that healhty food is waaay more expensive than unhealthy food. Lower the cost of health food!

The U.K. study determined that BOGO offers increased consumer purchases by 20% and this may be a good thing…but not if the consumer is buying unhealthy food in the eyes of the British government.

Thank God they lost the right to ram this down our unhealthy throats 244 years ago…but then again…we have our own insanity.

Paddy Deighan J.D. Ph.D

Dec
31

Love the emergency calls from clients during the holidays. We all receive them and it is seldom an emergency.  Certified mail from the IRS. Never a good thing. I maintain that nothing good comes certified mail LOL  Terry Bradshaw brings the check to you in a van – not certified mail!

So I advise the client that I just received the letter to and I will look into it. I received the letter too.

The IRS claims that the corporate client paid its taxes late. I do not file taxes, However,  by the acknowldgement on the notice, the taxes were filed timely and paid timely.  The Internal Revenue Service impounded a late fee of 84 cents . Yup, 84 cents. HOWEVER, the interest on the 84 cents is magically 92 cents after two months @ 6% statutory interest.

Internal Revenue Service

So the printing and mailing far exceeded the amount owed even if it was owed.  Not to mention that the amount is not owed.

As a final act of government efficicency, the notice was dated December 22, 2020 but the payment was due December 5, 2020.

Ya just can’t make this stuff up.

Paddy Deighan J.D. Ph.D

Dec
26

The United States Congress recently passed another ‘Covid relief’ bill. Technically it includes general spending provisions for Fiscal Year 2021 (to avert another government shut down).

However, the biggest chunk of the bill is COVID relief – which comprises nearly $1 trillion of the spending. The total bill is more than FIVE THOUSAND PAGES, and it embodies the old political phrase coined by Rahm Emanuel, “Never let a crisis go to waste.”

If the purpose of the bill really is to provide relief to Americans, then the bill should (in theory) be a few paragraphs at most.

But this bill is literally 5,593 pages… and contains some of the most absurd provisions imaginable.

For starters, Americans will receive $600 in ‘relief’.

So, we are not allowed to operate our business and earn a living for ourselves. In exchange, the government will will send us enough money to buy some new, warm,  clothes so you can stay warm while you stand in line at the free soup kitchen.

Page 1,461 of the bill, for example, authorizes nearly $135 million for BURMA (aka Myanmar) “to promote ethnic and religious tolerance…in Kachin, Karen, Rakhine, and Shan states”.

What bureaucrat could possibly come up with something so absurd? You get $600, but a bunch of corrupt generals in Burma get to rake in US taxpayer funds under the guise of ethnic and religious tolerance… but ONLY in FOUR out of Burma’s 14 states.

So tough luck if you’re a Burmese warlord living in the states of Bago or Yangon… because obviously it would be ridiculous to give those states any money.)

Another $45 million of taxpayer money (page 1,491) will be awarded to key government officials in Central America– places like El Salvador, Honduras, and Guatemala– in order to “combat corruption”. Now there is some money well spent.

You can’t make this stuff up– they are giving money to corrupt politicians to fund anti-corruption programs. It’s genius!

Another $10 million of taxpayer money (page 1,486) will be given to the government of Pakistan SPECIFICALLY for gender studies programs.

They’re giving piles of money to plenty of foreign countries, including Ukraine ($453 million), Sudan ($700 million), the Republic of Georgia ($132 million), Bangladesh ($198 million), Vietnam ($170 million), and several others.

Then there’s the small matter of $33 million for “democracy programs” in Venezuela. I’m sure Nicholas Maduro will use those funds well. Talk about throwing a shovel of dirt into the Grand Canyon!

Here’s a twist for ya – The real irony is that, while allocated $33 million for Venezuela on page 1498, page 1347 of the bill expressly prohibits any funding for Venezuela. Unbelievable.

Perhaps most noteworthy is that Members of Congress didn’t receive the final bill yesterday until roughly two hours before the scheduled vote.

So let’s put this into perspective. The all time World Speed Reading Competition champion is able to read an average of 4,200 words per minute with 67% comprehension.

So it would take her more than nine hours to read this bill in its entirety, and she’d still lose about a third of it.

There’s no way anyone in Congress was able to read this bill, or even thumb through enough of it to understand the big picture. And yet they still voted in favor of it, costing taxpayers another trillion dollars.

At least we are only a few days away from 2021!!!!

Paddy Deighan J.D. Ph.D

Dec
18

As a scientist with experience in the medical field, people have asked me to comment on the COVID 19 vaccines. I have read many medical studies so I can read lengthy studies VERY quickly because I know what is important and where to look.

Reading the Food and Drug Administration report on the Pfizer vaccine yielded some INTERESTING results.  

vaccines

The first notable event is that ZERO…yes ZERO of the study participants over the age of 75 (805 participants in this age group) contracted COVID.

A total of 20,000 subjects received the vaccine and an additional 20,000 participants received the placebo. 

Of the 20,000 that received the true vaccine ONLY 8 developed COVID (.04%). Yes several developed some transient complications. Astonishing.

Here’s where is gets interesting. Out of the 20,000 participants who received the placebo, ONLY 162 developed COVID symptoms. This is only 0.8% of the study participants that received the PLACEBO!!! 

I postulate that this is even more significant because they PROBABLY took more risks because they felt they were immunized (they did not know that thet received the placebo). 

Additionally, of these 162 that developed COVID symptoms, only THREE developed severe COVID symptoms.

What does this tell us??  

Paddy Deighan J.D. Ph.D

Mar
15

A bit off-topic but important nonetheless. Thousands of years ago, as far back as 3000 BC, the ancient Egyptians had developed a highly advanced system of writing using hieroglyphic symbols.

The used hieroglyphs for numbers as well.

A single line, for example, represented the number 1. Two strokes represented 2. Nine strokes for the number 9.

Since the Egyptians had not yet invented the “zero” in 3000 BC, representing the number 10 required a new symbol– a sort of upside down horseshoe.

So the number 99, for example, required eighteen different symbols: nine upside down horseshoes for the number 90, and another nine strokes for the number 9.

There was another symbol for 100, another for 1,000, and so forth.

The largest number in ancient Egypt was 1 million. As historian Will Durant wrote,

“The sign for 1,000,000 was a picture of a man striking his hands above his  head, as if to express amazement that such a number should exist.”

Today the national debt in the Land of the Free is just shy of $20 trillion.

It makes me wonder what symbol the ancient Egyptians would have used to represent such an absurd figure. Hope and change?

Even the concept of trillion is difficult for our minds to fully grasp as there is very little within our physical human experience which relates to it.

“Trillion” almost seems like a fantasy… a made-up number like “a bajillion” or “zillion”.

And yet, the debt is very real.

Of course, we’re told that the debt isn’t important.

Modern “experts” who win our society’s most esteemed prizes for intellectual achievement tells us that the debt doesn’t matter “because we owe it to ourselves.”

This is pitiful logic.

It’s true that “only” $6 trillion– 30% of US debt is owned by foreigners.

The rest is owned primarily by the Federal Reserve, Social Security trust funds, US banks, large US companies, and the federal government itself.

But I fail to see how this is relevant. A debt owed is a debt owed.

It’s not like the US government could simply default on the Federal Reserve in cavalier fashion; that would render the central bank completely insolvent and cause a major currency crisis.

Defaulting on the trillions of dollars owed to Social Security and other pension funds would effectively destroy the livelihoods of hundreds of millions of people.

Defaulting on the debt owed to banks in the United States would cause the biggest financial crisis in US history.

Defaulting on the $1+ trillion owed major US corporations would bankrupt a number of large businesses and cause a deep recession.

And defaulting on the Department of Defense would simply be idiotic; Congress would have to immediately bail out the military with emergency funds.

So it’s difficult to find any comfort in this “we owe it to ourselves” nonsense.

The truth is that the debt absolutely matters.

It’s not some casual rounding error; it’s a major issue that already sucks up hundreds of billions of dollars in tax revenue each year just to pay INTEREST.

And that’s at a time when the government’s average interest rate is just 2%… an all-time low.

But now interest rates are starting to rise from their historic lows.

The 30-year bond yield is proportionally 50% higher than its record low from just nine months ago.

It wasn’t even that long ago, just prior to the financial crisis in late 2007, that the government’s average interest rate was around 5%.

And even that number was considered incredibly low compared to previous decades.

Yet if the average interest rate returned to just 5% (which would still be FAR below the historic average), the government would spend more than $1 trillion each year just to pay INTEREST.

Naturally they’d have to borrow even MORE money, which would add even more to the debt and make their interest payments go up even more.

History is full of examples of debt bankrupting dominant superpowers, going all the way back even before the ancient Egyptians.

This time is not different.

Debt is a ticking time bomb. And in this case, given the widespread consequences across the world, the bomb is nuclear.

But it is incredibly foolish to ignore such a prodigious risk.

Imagine there’s literally a nuke sitting on your desk right now; you don’t know when it will go off… probably not for several years at least.

But would you honestly stick around to find out?

Sure, maybe by some miracle the situation will resolve itself. Maybe every foreign government wakes up tomorrow and simultaneously forgives US debt.

We can hope for the best.

But you won’t be worse off taking astute, conservative steps to distance yourself from such obvious risks… steps that make sense no matter what happens (or doesn’t happen) in the future.

Consider retirement, for example.

For many readers, you might still be decades away from retirement.

Given current data and trends, it’s entirely possible that the US government’s finances will have deteriorated into a default scenario by then.

Paddy Deighan

http://www.medicalandspaconsulting.com

Oct
02

Health Risks Associated with Tattoos

Tattoos are an art, a way of self-expression. But if you’re not careful, they may also cause a string of health risks. This is why health authorities warn against the safety of getting tattoos, especially when tattoo inks are not heavily regulated by the FDA. Here are some health risks associated with applying tattoos to one’s skin.

Lower_leg_Tattoo

  1. You may be allergic to ink or its materials.In May, NBC Newsreported that according to a new study conducted in New York City, 6 percent of respondents experienced skin problems more than four months after having tattoos applied to their bodies. Additionally, two-thirds of those who reported that they experienced rashes admitted to having allergies. Another study showed that red ink was linked to more rashes than other colors.
  1. You’re at risk for infections.The application of tattoos involves piercing the skin with a needle to inject colored ink below the skin’s surface, so you may be at risk for infections, especially if the parlor you’re getting a tattoo at is not clean. The FDA warns that dirty needles may pass infections such as hepatitis and HIV.

Dr. Marie Leger, a dermatologist at the New York University Langone Medical Center in New York City, also said that ink can also be contaminated by bacteria, which can pose a threat to your health. In 2012, an outbreak of skin infections spread in upstate New York, where a batch of grey ink which was contaminated with mycobacteria that caused Mycobacterium chelonae, was used. This type of bacteria is a relative of the mycobacteria that also causes tuberculosis and leprosy.

  1. You’re more prone to itching and redness from sun exposure.LiveSciencereports that according to a Danish study conducted in 2014, researchers found that 42 percent of tattooed sunbathers had adverse reactions, mostly due to sun exposure. Respondents reported swelling, itching and redness.

Additionally, when yellow ink is exposed to the sun for prolonged periods of time, the cadmium in the ink creates a reaction that can cause itching, redness and raised skin.

Not to mention that darker color tattoo ink will absorb more sun than natural skin tones and consequently, there is a greater risk of skin cancer.

  1. You may encounter difficulties getting MRI’s.The Huffington Postreports that those who sport tattoos may have problems getting magnetic resonance imaging exams, especially those with more black ink on their skin, because the ink contains iron oxide. In 2011, a case report showed that a professional football player’s black tattoo was “burned” while he was getting a MRI, and this resulted from electric currents forming in the iron in the tattoo ink.
  2. You may be at risk for nerve damage from carcinogenic nanoparticles found in ink. Health Impact Newsreports that according to a 2011 study published in The British Journal of Dermatology, nanoparticles can be found in tattoo inks, and black ink contains the smallest particles. The study also showed that some nanoparticles may be carcinogenic, or toxic enough to cause brain and nerve damage.

“Black tattoo inks are usually based on soot, are not regulated and may contain hazardous polycyclic aromatic hydrocarbons (PAHs). Part of PAHs possibly stay lifelong in skin, absorb UV radiation and generate singlet oxygen, which may affect skin integrity,” the study authors wrote. “Tattooing with black inks entails an injection of substantial amounts of phenol and PAHs into skin. Most of these PAHs are carcinogenic and may additionally generate deleterious singlet oxygen inside the dermis when skin is exposed to UVA (e.g. solar radiation).”

Paddy Deighan J.D. Ph.D

http://www.medicalandspaconsulting.com

Aug
26

I have written many articles on what services are medical and which ones are spa.  Despite what appears to be a clear line, there is a lot of questions concerning this distinction. I respond to many threads on LinkedIn as they relate to this topic and I am a bit surprised at the misinformation and lack of understanding that medical treatments may only be performed in a “medical” environment.

Accordingly, I can add some additional thought to further clarify the distinction between spa and medical treatments.  If a product or service is such that the implements or device used in the treatment requires  or is recommended for sterilization, then the service is almost always medical.

I recently read a review of a micro-needling device.  The device suggested that the components be sterilized in an autoclave after use. This all but assures that the treatment is medical. If there is any possibility of infection or transmission of pathogens, then a treatment will be considered medical. You may recall from prior articles that I have written, that there are two many issues in regard to whether a product, treatment, or service is medical : 1). is the treatment or product intended to diagnose or treat a medical condition and 2). is there a medical device being utilized in the delivery of the treatment.

Professionals constantly say to me that the manufacturer states that the service or device is not medical.  The New Jersey in me would respond that it is not their license on the line when they state that.  From a more practical view, you can review the FDA position on a device.  Ask the manufacturer if the device is a Class II or higher medical device.  The FDA indication will be visible on the device packaging or the device itself. If the device is Class II or higher, it does not matter what the manufacturer is telling you – the device IS by its FDA clearance, a medical device.

In one instance, an esthetician advised me that her state cosmetology board advised her that it is acceptable for her to perform micro needling.  My response was that she needs to ask the medical board (or nursing board) and the FDA.  She will receive different answers from those entities.

As I am known to say…”the answer you receive depends upon the question that you as and with whom you inquire”.

Paddy Deighan J.D. PhD

http://www.medicalandspaconsulting.com

Aug
19

The employee/Independent contractor scenario in spas and medical spas is very complex. The determination of whether a professional staff member is an employee or independent contractor is not easy to address. One thing that IS clear; the agreement that may be in effect is not the most significant issue. You can classify a professional staff member whatever you want to call them in an agreement, but this does not control the ultimate determination.

Irs

Many owners and professional staff want to be independent contractors but the reality is in many cases, the relationship is not sustainable. The Internal Revenue Service (IRS) has been looking at the spa industry more closely (possibly due in large part to tipping structures, but they are looking at the industry). The Service has been looking at many “tip” based businesses such as the taxi industry, restaurants and salons and spas.

The IRS has ruled sometimes that an independent contractor was really an employee because the business supplied TOWELS and LINEN! WOW!

A fundamental approach will be based on two key aspects of the relationship: 1. “control” over the professional staff members hours and days of service, and 2. requirement to utilize certain product lines or practice policies and protocols for certain procedures.

These are not easy issues to address because there are conflicting issues and goals. On one hand, the medical spa needs staff to be available during operational hours. It would be problematic to allow professional staff to decide the days and hours of service. However, providing schedule is a strong element of “control” over the staff member and this tends to be an employment situation.

The second issue is no less problematic.  A professional staff member may support a certain product line that is not offered by the facility. He or she may have a different protocol for a procedure.  The professional staff member may have his or her own protocols for a procedure – even something as seemingly straight forward as micro-dermasbrasion.  An ancillary concern is when there is a mixture of employees and contractors. The contractors may have more freedom to perform services and procedures and they deem appropriate and this can cause staff problems.

I address many such issues every day and please see my website Medicalandspaconsulting.com

Paddy Deighan J.D. Ph.D

http://www.medicalandspaconsulting.comMedical and Spa Consulting