Mon, Dec 06, 2004 - Page 16 News List

Is it Botox? Or is it bogus?

A case of botulism poisoning in the US has put a question mark over the efficacy of Botox treatments as a magic bullet for wrinkles



To millions of Americans, Botox is a magic bullet.

A few pinpricks and in a day the face is

returned to an approximation of its teenage

self, unlined and uninjured by the relentless insult of adult life.

But devotees of the youth potion were dismayed last week to learn that four people who went for wrinkle-smoothing treatments had been hospitalized for possible botulism poisoning.

There are many unanswered questions in the case. Investigators want to know whether a former osteopath in South Florida gave patients and himself injections of a bogus Botox, either homemade or illegally imported. (The former osteopath also fell ill.)

Botox, a toxin derivative that temporarily paralyzes tiny muscles that cause wrinkles, is manufactured by Allergan Inc, a California company. But doctors say there is a growing underground market for do-it-yourself and illegally imported or manufactured anti-aging compounds that are supposed to do what Botox does -- at a fraction of the cost -- but have not been approved for use in the US.

The Centers for Disease Control and Prevention, with the New Jersey and Florida health departments, are testing a Florida couple and the former doctor, along with an employee of the clinic, for botulism poisoning. Tim O'Connor, the spokesman for the Palm Beach County Health Department, said the Florida couple "exhibited all the signs of botulism" and had been treated with a botulism antidote.

Dr Leonard Hochstein, a plastic surgeon in Aventura, Florida, has administered Botox for five years and has not suspended its use because of the recent cases. He added, however, "I think there will be a reduction in interest in Botox, at least for a while. Anytime we have one of these nightmare knock-off do-it-yourself surgery scares, it affects all of us."

Allergan defended its popular product last week. A company spokeswoman, Stephanie Fagan, issued a statement saying that only two vials of Botox had been sold to the Advanced Integrated Medical Center in the last 12 months, enough for two to eight treatments. (A standard treatment in New York City would cost US$400 to US$1,000.) In an e-mail message, Fagan wrote that the company had investigated all the manufacturing and quality assurance processes and found no irregularities. No other doctors or patients have reported any other adverse events, she said.

The case came to the public's attention when Eric Kaplan, a South Florida chiropractor, and his wife, Bonnie, told doctors that they fell ill after they received shots they thought were Botox at the clinic in Oakland Park during Thanksgiving week. The Kaplans, who were admitted to Palm Beach Gardens Medical Center Nov. 26, were in serious but stable condition on Thursday.

Bach McComb, 47, the man they said injected them, was also hospitalized, along with his companion, Alma Hall. McComb, who has worked at the clinic, and Hall were admitted to the Bayonne Medical Center in Bayonne, New Jersey (McComb, who lives in Florida, had come to New Jersey to visit his mother.) Both spent at least part of last week on respirators. A man answering the phone at McComb's mother's house in Bayonne said she was too upset to speak. McComb was not available for comment.

O'Connor said Florida's health agency and the Centers for Disease Control were investigating what McComb might have injected the patients and himself with, whether Botox, a black-market or homemade formulation of botulinum, or something else.

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