Inside This Article:
- A woman reportedly suffered multiple infections after receiving injections of a filler at a medical spa in Philadelphia.
- More medical spas in the U.S. and Canada are offering increasingly complex procedures, potentially heightening the risk of a malpractice claim.
- When a medspa is sued, the facility’s Professional Liability Insurance can cover legal defense and indemnity payments.
- Spas must ensure that the appropriate medical personnel administer all procedures and that they be certified by the appropriate governing bodies.
- Robust risk mitigation is key as the medspa industry continues to grow.
A 35-year-old woman was left with an infection leading to hospitalization after receiving six injections of a dermal filler at a medical spa in Philadelphia late last year. According to the Philadelphia Inquirer, the woman began feeling sick just two days after paying $1,250 for a lower body contouring treatment. She was eventually diagnosed with an infection and hospitalized for four days after experiencing swelling, redness, pain and fever.
Months later, the woman has reportedly continued to battle infections and has alerted authorities that she believes the filler used in her procedure may have been counterfeit or contaminated. While the business has since shut down, an acute care physician who treated the woman told the newspaper that dermal filler complications are not uncommon and have even sent patients to the ICU.
“Unfortunately, I am not surprised by it,” said Timothy Barden, Senior Broker, Professional Liability, Burns & Wilcox, Houston, Texas. “We have seen an uptick over the last year or two in medspas and beauty spas expanding their service offerings. While the added services may yield additional streams of revenue, many times they do not have the controls and training in place to administer these types of procedures.”
We have seen an uptick over the last year or two in medspas and beauty spas expanding their service offerings. … Many times they do not have the controls and training in place to administer these types of procedures.
In this case, the treatment was performed by the spa’s owner, a licensed practical nurse who was reportedly not qualified to administer the procedure – commonly referred to as a “butt lift” – under Pennsylvania state law. This could mean that legal claims over the incident may not be covered by the facility’s Professional Liability Insurance, if they carried it, said Abby Lavertu, Senior Underwriter, Professional Liability, Burns & Wilcox, Vancouver, British Columbia.
“Usually that staff must be fully qualified to perform the services being offered,” Lavertu said. “They might not have had insurance at all, and if they did, it is likely the policy would not cover this loss. Having a lawsuit that hits six figures can be financially ruinous for owners.”
Risks grow as medspas take on more procedures
The medical aesthetics industry is growing by more than $1 billion per year and the number of new medspas opening annually shows no sign of receding, the American Med Spa Association noted in a 2024 industry update. The growth is driven in part by increased demand for noninvasive and minimally invasive aesthetic treatments such as Botox, according to a December report from Future Market Insights.
Meanwhile, many existing facilities have rapidly expanded their services, adding on weight loss treatments, laser procedures, platelet-rich plasma injections and more, Barden said. “Many of the services medspas are adding are considered higher-hazard,” he said, with insurance carriers seeing more claims related to these services. “They may also necessitate administration by a health care professional.”
In Canada, similar activity has been observed, Lavertu said. “We are seeing a trend toward medspas offering more invasive procedures,” she said. “There is a big focus on anti-aging treatments, and some of them can be pretty high-risk. With any treatment, we always want to make sure that staff are qualified and have the appropriate education in place, and that they are using equipment and products that are certified by Health Canada.”
Not all services will necessarily be covered by a medspa’s Professional Liability Insurance, however. “Some insurance policies exclude more invasive or experimental procedures, or they would require a bit more scrutiny or supervision,” Lavertu explained.
Lawsuit damages could reach millions
Malpractice claims against medspas can lead to significant losses. In 2023, a court awarded a $1.2 million judgment against a medical spa in Pennsylvania over botched chin injections that were given by a nurse who had a suspended license, according to Law.com. Early in 2024, a fitness influencer shared her story of getting vitamin injections at a medspa in Los Angeles and allegedly contracting a disease from the shots that left her in $2 million of medical debt, Moneywise reported last March.
Professional Liability Insurance is the primary policy that can respond to lawsuits related to medspa procedure complications, Barden said. “It can cover not only the cost of defense if the client were to bring a lawsuit against the medspa, but also indemnity — a payment to make the individual who has been wronged whole,” he said.
These policies are designed to include key coverages such as Errors & Omissions and Medical Malpractice, Lavertu said. “It is effectively providing financial protection for those offering medical services,” she said. “If you are sued, whether or not you are found to be negligent, this is the policy that could come into play to cover your legal defense.”
Professional Liability Insurance is often packaged with Commercial General Liability (CGL) Insurance, which can cover on-premises third-party bodily injury and property damage claims. Recommended liability limits are typically based on a medspa’s operations, number of procedures and annual revenue, Barden explained. “If it is a larger operation, we often recommend that they carry higher limits. Most of our carriers have the ability to offer up to $5 million on a primary basis, and we can go above that on Excess Liability Insurance,” he said.
Without insurance, many medspas “could lose their business” in the event of a lawsuit. “The damages sought in these types of lawsuits could be hundreds of thousands of dollars, if not millions of dollars,” said Barden.
The damages sought in these types of lawsuits could be hundreds of thousands of dollars, if not millions of dollars.
Mitigating risks in a ‘sensitive industry’
Given the rapid growth of the medspa industry, business owners should be in contact with their insurance carrier about any new service offerings. “If you are offering new services, it is important to do a review of your insurance program with your brokerage to make sure that your policy includes the scope of your new operations,” said Lavertu. “If the insurance company is not aware of the new services, it may not be covered.”
The use of dermal fillers for lower body augmentation, for example, is a procedure that is more commonly associated with a plastic surgery office than a medical spa, Barden said. “Larger, higher-level medspas that offer that sort of service can typically have physicians, nurse practitioners, CRNAs on staff,” he said. “When those controls are in place, we do have carriers that will write it.”
Despite the overall affordability of Professional Liability Insurance for medspas, many do not carry this coverage. “Many times, there is a lack of Professional Liability Insurance for medspas or they are underinsured on their limits,” he said. “Especially considering the risk transfer and the severity potential of a claim, it is pretty affordable for what you get.”
In addition to purchasing insurance, medspas can help mitigate their risks by staying up to date on product recalls, performing background checks on employees, utilizing releases of liability, and emphasizing informed consent for patients. “An owner is liable for what their employee does,” Lavertu said. “This is a sensitive industry. You are working closely with individuals’ bodies, and they can be very upset if an aesthetics procedure goes poorly.”
