Cheap, counterfeit Botox administered by people who are not educated to perform facial injections and in locations without a doctor on call created a dangerous combination that placed more than a dozen women in the hospital.
In at least one case, a woman grew so ill that she required a ventilator to breathe.
Seventeen women in nine states reported symptoms ranging from blurred vision to difficulty swallowing and breathing after receiving what they thought were Botox injections to smooth small lines and wrinkles. Thirteen people were admitted to the hospital, with many requiring intensive care unit treatment.
The Centers for Disease Control and Prevention published an unsettling study on Thursday, detailing patients in New York City and Tennessee. A woman from Kentucky was admitted to a hospital in Tennessee. The women’s ages varied from 26 to 55.
About three days before their symptoms appeared, four women met at a relative’s home in Tennessee to have Botox injected into their faces, including the wrinkles between their brows. An investigation eventually revealed that the injectable substance was counterfeit and administered by someone who was not licensed.
“In some cases, providers were concerned about patients’ breathing to the point where they were admitting them to intensive care units to be able to monitor them more closely,” said Dr. Christine Thomas, medical director at the Tennessee Department of Health and primary author of the new report.
Thomas, an epidemic intelligence service officer at the CDC at the time of the investigation, described the situation as a “perfect storm.”
“We were seeing the injections happening in homes from people who weren’t licensed, and there was counterfeit product,” Mr. Thomas explained.
NBC News has uncovered one of the most disturbing cases of Botox-related injury fraud. A 49-year-old lady in Colorado received what she thought was Botox, but her vision quickly dimmed and her normally healthy body became extremely weak.
The woman was admitted to the hospital after struggling to swallow and breathe for nine days. Her condition deteriorated so severely that doctors had to intubate her and place her on a ventilator to help her breathe.
They had no notion what was wrong with her until a family member casually revealed that she had recently undergone Botox injections.
That certainly saved the woman’s life, according to Grace Nelson, a disease intervention supervisor at the Denver Department of Public Health and Environment who assisted in the inquiry.
“The patient was decompensating and in bad condition for us to do an interview,” Nelson told me. The information provided by a family member prompted Nelson’s team to intervene and assist in authorizing the administration of botulinum antitoxin to the woman to prevent further damage from the poison.
Nelson said the woman ended up in the hospital for more than two weeks and required more therapy.
Doctors authorized to administer Botox are concerned that more patients, such as the one in Colorado, will be hurt, especially as unregulated medical spas gain popularity.
“I’m extremely worried,” said Dr. Kate Dee, a physician and the founder of Glow Medispa in Seattle. “As more and more people order fake Botox off the internet, there could be anything in that vial.”
Fake Botox is not a new occurrence, according to George Karavetsos, a lawyer and former director of the FDA’s Office of Criminal Investigations.
“Counterfeit Botox has been in the U.S. supply chain for at least 20 years,” he claimed. “I have personally investigated and prosecuted cases of people who were either importing counterfeit Botox or formulating their version of counterfeit Botox here in the U.S. to sell to the domestic market, to med spas and other clinicians.”Efforts to address the influx of tainted Botox, including capturing those guilty in other countries, have mainly failed, according to Karavetsos.
“How can you stop it? It educates the consumer.”
Things to Keep in Mind Before Getting Botox
There are various methods for identifying potentially harmful situations.
Request a check on the vials. Thomas claimed her staff discovered misspellings on the bogus bottles. According to the FDA, the outside packaging of counterfeit Botox products:
- The active component is listed as “Botulinum Toxin Type A” instead of “OnabotulinumtoxinA.”
- This indicates 150-unit doses, which are not AbbVie units.
- Is published in a language other than English.
Botox should only be administered in a regulated medical setting and by a licensed professional.
“A cosmetology license is not a license to practice medicine,” Dee told me. And if the Botox is being administered at a salon, house, or hotel room, it’s “a giant red flag because those places don’t usually have a doctor anywhere near them.”
Thomas advised making sure providers are properly licensed ahead of time.
The Tennessee Department of Health, for example, provides a portal to search for licensed institutions, including medical spas, in the state.
Don’t be fooled by appearances, Karavetsos advised: “People go in and see a person in a white coat. They observe what appear to be experts administering Botox. “They are unwitting victims.”
Be careful of deals that seem too good to be true. One of the women treated in Tennessee “reported paying less for their injections than we know botulinum toxin costs,” Thomas explained.
NBC stated that the average price for Botox is around $15 per unit, therefore charging anything between $12 and $25 would be reasonable. This includes not just the vial but also consumables such as rubbing alcohol, gauze, refrigeration, and other overhead expenditures at medical facilities.
If someone charges significantly less — $6 to $9 per unit, for example — that’s a red flag.
“No one can do that long-term and stay in business,” Dee informed us. “It’s likely those people are doing this illegally.”