The price of beauty.
- From: Sandy Cruden <sandycruden@xxxxxxxxx>
- Date: Mon, 29 Oct 2007 21:38:25 -0700
http://www.bangkokpost.com/News/30Oct2007_news28.php
THE PRICE OF BEAUTY
Regulating cosmetic procedures is not easy for officials
Story by PIYAPORN WONGRUANG
When she was approaching the age of 50, Raweewan Setarat dreamed of
looking young again.
So she went to a cosmetic clinic in suburban Bangkok, hoping the
doctors could fulfill her dream of looking younger. But instead of
becoming young and beautiful, Raweewan ended up going in and out the
clinic at least 20 times to fix bungled cosmetic treatment to her
face.
But her nightmare did not end there. Raweewan later engaged in a
series of controversies and legal battles, which badly affected her
daily life.
On Sept 13 she was waiting to receive some good news from the Food and
Drug Administration (FDA), where she had filed complaints against the
doctors who ran the clinic.
After investigating her complaint, the agency decided to file a
lawsuit against one of the doctors for using unregistered drugs and
producing drugs without permission. If found guilty, the doctor would
face a jail term for a maximum of three years and a fine of up to
3,000 baht for the first charge, and a five-year jail term plus a fine
of up to 10,000 baht for the second charge.
However, Raweewan never had the chance to hear the good news. She died
that day after being shot in front of her house in Bangkok's Bang Kapi
area.
"Raweewan had called me for help and we tried our best to help her. It
is very unfortunate that she died before learning of the outcome,"
said the FDA's secretary-general Siriwat Tiptaradol.
Raweewan is not the only person to have been involved in controversies
over cosmetic treatment, but her lengthy battle and her mysterious
death has left questions in many people's minds.
In recent years cosmetic treatments have gained popularity, partly
because people have become more concerned with their appearance.
Bangkok had about 400 registered cosmetic clinics last year, about
1/10th of the medical clinics in the city.
Cosmetic clinics perform medical services, so they are required to ask
permission from the Public Health Ministry's medical registration
division before opening, according to Tares Krassanairawiwong, a
director of the division.
Dr Tares said his staff inspect standards at the clinics, doctors and
equipment to consider whether the clinic should be allowed to do
business.
After clinics open for business, officials then check how they
operate. Sometimes they find that medical techniques other than those
declared to the division are being used.
This has partially led to controversies over treatment methods between
the clinic and customers, Dr Tares said.
In recent years the number of complaints of substandard cosmetic
treatment filed at the division has topped other complaints. Last year
the division received 430 complaints from cosmetic clinic customers.
"It's like driving a car. Some people might not stick to the rules and
the police cannot chase them for 24 hours. So the issue is also about
the responsibility clinic operators should have to their clients,"
said Dr Tares.
Although the division is responsible for registering cosmetic clinics,
each component of a clinic is supervised by different agencies.
For example, doctor's practices and the use of equipment is under the
supervision of the Medical Council of Thailand and the FDA,
respectively. The Office of the Consumer Protection Board, meanwhile,
oversees other matters that are beyond the two agencies' authority.
Dr Tares said although his division has full authority to withdraw a
clinic's licence or order a clinic to close if it fails to meet the
standards and regulations, the operator can re-apply for permission
and get a licence again under different names of the owners and
managers.
The clinic where Raweewan sought cosmetic treatment has reportedly re-
opened using new names after it was ordered to close.
Other shortcomings found in the process of tackling substandard
cosmetic clinics lie with the Medical Council.
Although the council can probe doctors for alleged violations of
medical ethics codes, the process is often lengthy as investigators
have to gather evidence before coming to any conclusions, according to
Pairoj Boonsirikamchai, the assistant to the secretary-general of the
council. "The council needs help from other agencies in investigating
a case, and this is why the probe takes time," Dr Pairoj said.
In Raweewan's case, she filed her complaint against the clinic's
doctor in 2004. The council has yet to reach any conclusions. It has
recently been confirmed that the substance injected into Raweewan's
face was hard to remove.
Dr Pairoj said the council would use this fact as grounds to consider
alleged wrongdoings by the doctor. However, no one has confirmed that
the substance is unsafe, and this requires further examination, he
added.
FDA secretary-general Siriwat conceded that in cosmetic treatment his
agency focuses mainly on the inspection of medical equipment and
substances deemed to pose high risks to clients. Those include lasers
and other popular substances, including silicone.
The substance that was injected into Raweewan's face was found to be
ground silicone. The FDA had not realised that such material was being
used until Raweewan filed her complaint.
According to Dr Siriwat, Raweewan's case has shed light on some
loopholes in drug regulations.
Under the regulations, doctors are allowed to produce drugs for
particular patients. If they want to produce drugs for mass use, they
have to ask permission from the agency, and register their drugs.
The doctor who provided treatment to Raweewan modified the silicone
and developed the new treatment. This is known as Biotechnique. The
doctor used the ground silicone on many clients without permission
from the agency.
Dr Siriwat said it is now clear that there are some loopholes in the
regulations governing the cosmetic business that may put customers at
risk.
"We have to accept that our regulations and rules have hardly caught
up with the changing trends of cosmetic treatment technology. We need
to overhaul our tools and integrate operations among relevant agencies
to better regulate the business," said Dr Siriwat.
The consumer protection office has banned the Biotechnique practice
until it is proved to be safe to customers. The agency also vowed to
pursue a civil lawsuit, demanding 12 million baht in compensation from
the clinic operator for causing damage to Raweewan.
The brave Raweewan is no longer here to hear all this. Sadly, her
children will have to fight these lengthy battles for their mother.
Council critical of clinic's homemade silicone
The lengthy dispute between Raweewan Setarat and a doctor at a
cosmetic clinic in Don Muang and her mysterious death has made the
"Biotechnique" process the talk-of-the town.
According to the Medical Council of Thailand, the Biotechnique process
has been modified from the medical technique widely used in the West
known as Bioplastic.
In some Western countries, doctors inject tiny silicone particles into
a particular part of the patient's body to form it into a desirable
shape. These particles can penetrate through tissues and stay between
cells.
The Thai doctor who has now been sued for causing damage to his client
had modified the technique and applied it at his clinic. Instead of
importing the silicone particles, the doctor produced them himself. He
ground up a medical silicone tube, which is normally used to drain
fluid from brains, and injected the tiny particles into his patient's
body.
The council has asked experts to look into the case and they came to
the conclusion that the particles, once injected into the body, were
hard to remove, making it difficult to correct if errors are made.
So this technique should not be used any more, the council was told.
However, more study is needed to prove if the technique is really
unsafe.
But to safeguard consumers, the Office of the Consumer Protection
Board has already banned the technique, citing a number of problems in
its use.
According to the controversial clinic's website, www.bioclinic.co.th,
the Biotechnique concept has been practised all over the world for
more than 30 years.
"In Thailand, we have developed a method of the micro-implant
injection technique that achieves much better results, creating a more
definite contour," the website claims.
"We can count on the Biotechnique to cause less injury to tissue and
shorten recovery time, especially in the case of surgical operations
that cause the large wounds," says information posted on the website.
******************************************
They do say that doctors bury their mistakes.
Sandy
Huay Khwaang
.
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