Physician Not Liable for Negligent Treatment Provided by Physician’s Assistant

A physician who did not see or treat a patient was not held liable for the patient’s severe reaction to cosmetic facial injections used off-label by a physician’s assistant, according to an opinion from a Washington appeals court that affirms the trial court opinion. The patient sought elective cosmetic injections to help her look “more rested” and a receptionist scheduled an appointment for injections with Botox and Restylane. On the day of her appointment, the patient was informed that she would be treated by a physician’s assistant, although she signed patient identification forms that identified the defendant as her physician. The physician’s assistant injected Botox into the patient’s lower forehead and Restylane into the area around her mouth. He injected the remaining Restylane into the patient’s lower forehead, although the product had not been approved for this use by the U.S. Food and Drug Administration, and he did not obtain informed consent for this treatment. The patient had redness and tingling in her forehead by the time she arrived home and received follow-up treatment by the physician’s assistant for these symptoms and an infection that appeared, but the treatment was unsuccessful. It was too late to treat the resulting deep scars by the time the complication was diagnosed by another provider as necrosis.