name of the medical doctor assigned to this case, whose name he and American Medical Experts (AME) refused to disclose, is Dr. Aton Mordechai Holzer
In April 2015 I experienced facial damage caused by laser treatment and sought recourse to correct the damage. A medical expert (Eric) from American Medical Experts (AME) confirmed in writing (October 2015) that facial damage is real, causing pronounced change with wrinkling, jowl formation, and volume loss in cheeks. Eric was a practicing dermatologist of 4 ½ years who had published one review on laser tattoo removal in his undisclosed organizations journal. I paid almost $1200 to receive an emailed copy of his report. I was informed that if I wanted an official copy of the report with his full name on it plus a copy of his CV, I would need to pay another $1200.
Although I had sought treatment for one acne spot (as indicated in the doctors medical note), I was lasered excessively in areas of no concern with the laser even burning the inside of my lower right lip. When the unsupervised technician did not laser the targeted area, I asked afterwards if she could try a second time to laser the spot, yet she missed again. Consequently, a bruise developed to the side of the acne spot, and the fact that the acne spot didnt show any change in the photos is further indication that she missed it completely. Technician wrote in her notes that she lasered my vermillion border, not an area for which I had sought treatment, nor did I have issues with my lips at that time. The result was change in lip shape, symmetry, sensation, thinning, and swelling. Tech did not note that she lasered anywhere else on my face, yet the bruising/scarring/widespread harm prove that she did.
Significantly, Eric, the medical expert, ignored key issues. He did not include comments about my lip change in his three-paragraph medical-expert report despite my repeated requests of him before and after he completed his opinion report to address my concerns. Nor did he address the technicians reported lasering intensity level that supposedly was triple the manufacturers recommended intensity level according to the number she wrote in her case notes. I believe the intensity level was even higher than what she reported in the patient note because when I returned to the office seeking help for the horrific facial results, the second unsupervised tech lasered my cheek to demo the harmlessness of lasering, commenting that her laser intensity level was much lower than what the first technician had used. Both technicians notes that I subsequently--and not without difficulty--obtained from the office state that the second technician actually used the next higher intensity level number up from what the first technician used for her intensity level. So what exactly is the truth? Is either tech providing it?
Eric, moreover, showed partiality. Despite my questioning in December 2015 his report (that extended into 2017 following my initial 2015 submission of photographs and record of treatment history), Eric declared in January 2016 that he accepted the doctor/technicians documentation as the official record of truth. He implied then, in 2016, that I was the one who had been lacking proof, that there was lack of photography in 26 photos that I had sent him with an absence of objective positioning angles and mouth movements (??). I dont know why he explained in a 2016 email that he had been unable to enhance the photos. He had not mentioned these issues to me in 2015 before he had made his decision. Significantly, in 2015, he had already determined from my photographs that damage had in fact been done to my face at the dermatology office where I had sought treatment.
He said scarring done to my face from lasering would be a worthy consequence for pursuing a legal case. Yes, I do have both red and white scarring changes in the pigmentation following the lasering, but the point is that after the lasering, my dermatologist had to subsequently refer me to a cosmetic surgeon for a facelift. This is an unbelievable consequence. Is pronounced change in facial structure that includes accelerated aging therefore not worthy of--not good cause for--pursuing a legal case? Yet Eric recommends taking legal action for unwanted pigment discoloration following improper treatment. This reasoning makes no sense whatsoever.
Furthermore, Erics report was partially wrong, incomplete, unprofessional, and poorly worded to the point of it not being comprehensible. For example, he incorrectly wrote that I submitted one laser article (from JAMA about the troubling trend in laser safety) when I actually had included other materials (including information from the American Academy of Dermatology) that discuss the dangers and harms of lasering, especially when performed by incompetent people.
Another error was Erics statement that I reported changes to my face on April 9 to the dermatology office. Not true, and the second techs note shows that I first returned to the office on April 3rd (after the April 1st laser) to show them the terrible laser consequences. My photographed facial changes are obvious between April 2 and April 8. The office doctor, relying only on memory of one short meeting with me, chose to report that he did not believe there was any notable change to my face. Eric did not state his opinion on what the dated photos from this six-day period revealed to him as a medical expert.
Eric also underreported the number of times my face was lasered. Even if he maintains his reliance only on the technicians notes and ignores my recorded treatment history, he will find his number to be in error (and thats not counting the one laser hit I went back for to try to have the spot targeted directly.) The first tech also did not make a note of the second laser attempt of the acne spot that I asked her to try redoing, the one acne spot I had sought help for. She still missed the spot the second time. Eric did not report this unrecorded incident or address it with regard to my photographs. (Incidentally, the office breached their contract by not photographing me before and after lasering as promised. The office had also not fully informed me in the patient consent form of all the lasering risks, nor had the tech provided me with proper goggles.)
Other errors, oversights, and oversimplifications in Erics report exist. For example, he wrote that I had a history of eczema despite there being no longstanding diagnosis. He also did not quite accurately describe the doctors treatment counseling of me. Erics overall language, however, is of much greater concern. His first paragraph he titles Facts. As mentioned, he gleaned his facts from the doctor/technicians notes without including my facts, my proof. His incomprehensible/unfinished key statements within his one-paragraph Discussion section are other significant oversights. Nevertheless, Eric and company refused to amend the report unless I agreed to pay a re-evaluation and revision fee at $600/hr.
Erics report revealed the reality that doctors do not want to report bad results from lasering. Although Eric suggested that my dermatologist report my treatment results in the literature, that is precisely the problem: What doctor wants to reveal error and malpractice? Many patients are pleading online with the dermatology field and those with influence to hear their grievances, and I provided such patient stories for Erics review.
The dermatology office refused to disclose their malpractice policy information to me or my lawyer when I sought to file a case against them, nor would the Nevada Medical Board help me obtain the doctors malpractice insurance policy number and information. Consumers have a right to know complaints brought against a doctor, yet the Board discloses no such background information on the doctors. Both organizations obstructed me, and Nevada law only allows one year for a patient to file a malpractice case. The State of Nevada Medical Board of Examiners held my material on this case for ten months. They also did not respond to any of my questions about breaches in the Nevada Statutes & Regulations with regard to this medical assistant, which is the title/term that both the NV Statutes and dermatology office use in their written information for the public.
Even though Eric confirmed that facial damage had occurred, he stated after I questioned his report that I would need more proof that the laser was administered improperly in the wrong places by the tech. The techs note that she lasered the vermillion border is indeed indicative of improper lasering. I did not request lasering for my lips. I also did not request lasering for dilated capillaries or for treatment of many scars, as Eric suggested. After lasering, the lower lip area visibly swelled while the upper lip shrank and jowls formed as a result (showing obvious texture change on that overlasered area to the side of the mouth that I would be happy to point out), yet Eric stated in 2016, There was no treatment in the affected areas. Did Eric therefore change his mind in 2016 and disclaim the negative lasering consequences of 2015 that have lasted and that he originally attested to? Can he truly believe I was not lasered in these areas? Was he confusing me with another patient?
The dermatology office wrote me that the tech was a Board Certified Aesthetician practicing medical aesthetics, but Eric wrote that the tech was a questionably licensed aesthetician. This tech has no Board certification in Nevada and, as far as I know, was not currently board certified anywhere else at the time of lasering. (The dermatology office would not give me the name of the other so-called tech who lasered me, which prevented me again from ascertaining certification.) Furthermore, in Nevada, aestheticians by law are not allowed to laser. I have a statement from the Minnesota Board of Cosmetology, which is the state where the first tech previously worked, that warns of the medical aesthetician title as a very misleading title to the consumer.
In the end, Eric chose not to determine the exact cause of my confirmed facial damage from lasering in spite of all the evidence I provided. It is essential that in the future more will be revealed about the cover-ups and protections that can occur for doctors, laser operators, and office staff who negligently and/or intentionally commit harm upon unsuspecting consumers. Will the field commit to rethinking its ethics and stopping fraudulent damage? Its time!
The Washington, DC, Better Business Bureau (BBB) allows a consumer only half an hour to respond online to the AME businesss response to my complaint and provides no warning to the consumer beforehand of this time limit. Below is a revised version of the response I sent to the BBB, a second letter of mine which BBB neither publicly posted nor acknowledged (in the negative review category). BBB also subsequently removed most of the public content of another consumers negative review of the AME business yet still publicly posted AMEs response to that consumer. BBB stated complaint details [were] unavailable with that consumers complaint as well as with mine. I would be curious to know how BBB justifies its A+ business rating for the AME business.
In my response to AMEs letter to BBB about my complaint, Mr. Eric Jacobss claim that American Medical Experts (AME) did its job 100% is far from the truth.
1) I did not call Eric Jacobs the medical expert in my case in spite of what Mr. Jacobs claims. Who was doing what at the AME business, however, was not clear. Ronny Hamad, the person who responded to me in September 2015 about AME services, was a company director who guided me with the contract details and submission process of my case.
2) This past spring (May 27, 2017), I resumed contact again with Mr. Hamad regarding my old concerns and requests from 2015 and 2016 following my questioning of the medical experts report. I asked that my comments be forwarded to the medical expert and asked that Mr. Hamad let me know one way or another if he would forward my points to him, especially as its feedback that may help with future customers. By June 6, 2017, I inquired again, not having received any response. Mr. Hamad wrote me that Eric is out of the office. It was not until June 20, 2017 (twenty-four days later), that Mr. Hamad emailed me that Eric is still out of the office. I assumed Eric was the first name of the medical expert since Mr. Hamad had not informed me that he would not be notifying the medical expert about my questions. It wasnt until nearly a month later as mentioned, that Mr. Hamad emailed me that hell answer my inquiry for Eric because he know[s] what Eric is going to say--that there would be a cost for looking into the report matter that Im raising once again. Mr. Hammad is referring to Mr. Eric Jacobs. Mr. Eric Jacobs, in fact, was also called an AME company Director. If Mr. Hamad (one director) knew how Eric (another director) was going to respond to my 2017 inquiry, then why did Mr. Hamad not inform me earlier?
3) I provided the doctor and technician names and their business address to AME in all the materials I sent them (except for one techs name that the dermatology office would not disclose to me). Over two weeks later, Mr. Hamad emailed me that the medical expert still needed to know the address of the dermatology office and the names of the people involved in the case. Had the medical expert read any of my documents?
4) Mr. Jacobs stated I paid only step one of AMEs payment process. I did not default on any payment. I paid AMEs up-front fee of $1,200 to receive a professional report. The report, an emailed draft, was an insubstantial, poorly written three-paragraph assessment of my case. The second step Mr. Jacobs referred to was an additional $1,200 charge to obtain merely the medical experts actual name, signature, and CV.
5) Why would a company not provide a customer with the credentials and license information of its experts? I chose not to pursue AMEs highly questionable second step payment process.
6) When I began the process of getting an expert witness, I inquired about the steps I needed to take with AME. I did not receive a disclaimer that AME sent to BBB stating that potential customers must agree to. The emails from Mr. Hamad did not include information about an official agreement I would have had to make with the company beforehand.
7) The company did not inform me that they would withhold the medical experts name on their emailed report but stated the report would be unsigned. I was told after I got the report that I must pay the company an additional fee ($1,200) for the same report with the medical experts name and signature on it.
8) Following my complaint, AME emailed BBB the medical experts CV that had nine question marks in the medical experts education/awards section. Does that indicate that the AME cannot verify their medical experts credentials?
9) Mr. Jacobs stated that I believed in a guarantee [that] an expert will support the merit on any case. He stated that would be unethical for AME and for a client like Ms. Goldsmith [to] require such opinion is not honest. I made no such request. A patient undeniably expects a medical expert to do a thorough and impartial assessment of her case, but obviously there are no guarantees of medical experts favorable opinions. I do believe AME needs to address their medical experts decisions to dismiss key evidence. How is that justified? I had high expectations of AME and was disappointed when the medical expert did not address key factors in my case. Mr. Jacobss statement that Im not being honest is ridiculous.
10) I paid AME $1200 for a professional report and received from them a report that lacked in-depth attention to my concerns. AME did not explain the additional work they claimed to have done for me. The expert had not adequately addressed my concerns and questions, and I followed up in 2015, 2016, and 2017 with the same issues.
11) AME did not address the points in my first letter to the BBB. As a consumer, I repeatedly asked and paid for the medical expert to comment on the lip change caused by excessive lasering of that unrequested, sensitive area. An expert would have known this area should not have been lasered and that subsequent lip change did result. The medical expert avoided the question during and after his writing the report despite my repeated requests that he comment on this problem.
The medical expert stated that scarring from lasering is worth pursuing legally but that wrinkling and facial structural change from excessive lasering done in unneeded facial areas is not worth pursuing legally. That makes no sense to me.
12) Why should I pay extra for a medical expert to explain his reports crucial but incomprehensible wording? Or why should I pay for a medical expert to use the office notes at the exclusion of my own records and documentation? I was the only provider of physical evidence in the form of dated photographs. The dermatological office had contracted to take photographs but had failed to do so before, during, or after treatment.
The medical expert even reported wrongful facts that he took directly from the dermatology office notes while also wrongly interpreting some of those office notes in his report. It also would have been helpful and less biased if the medical expert had used more professional language, such as doctor/patient claims.
13) As for the medical expert fixing what he calls typos in his report--which prevent full comprehension of the sentences in his Discussions and Conclusion paragraph--he totally misses the mark on one account. In his original report, he stated that perioral [around the mouth] wrinkling...is certainly far more pronounced in the later, post-treatment photos. In his subsequent letter to the BBB, after revising the next two sentences of his original medical expert report, he wrote, Forehead wrinkling appears to be more pronounced but as he writes in both documents, The most pronounced change is seen in the lower face. He therefore confirmed laser damage to the lower face. But forehead wrinkling? I was not lasered there. The tech lasered once to the side of my left brow for some reason, which did create a bruise and some wrinkling there, so Im curious to know from what photos the expert determined a noticeable forehead change. If he further supports my case by stating theres more forehead wrinkling, then I am grateful.
14) The medical expert contradicted himself. He noted laser damage to my forehead, as mentioned above, which is another example of harm done by lasering in the wrong area. His report was completed in 2015, but he wrote in 2016 that I had originally needed more documented proof of treatments administered in the wrong spot. No treatment was needed on the forehead; therefore, according to the medical experts reasoning, lasering did happen in the wrong place and that lasering did cause damage as a result of technician error.
15) I sought help for one acne spot, which the doctor attested to in the case note; however, the medical expert didnt address the lasers high setting described in the techs note, nor did the medical expert mention the excessive amount of lasering--the claimed number of laser hits--to the face as another probable cause for facial damage.
16) If the medical expert were to treat a concerned patient such as myself, he would logically explain the usual preparation and procedure to the patient. Neither he nor the technician discussed treatment standards for my one-spot problem.
17) This was not a competent or licensed tech although the office falsely claimed she was a board certified aesthetician. Even if she had been board certified in Nevada, which she was not, the Nevada State Board of Cosmetology law states that aestheticians are not permitted to laser.
18) I recommend the article Elephant in the room of dermatology, by Dr. Brett Coldiron, past president of the American Academy of Dermatology. He warned about how the so-called wrong people can be performing dermatological services (at supposedly physician rates). Dr. Coldiron predicted future dire outcomes for such practices. He seemingly resigned from his post at AAD for his strong ethical beliefs that unfortunately didnt get the needed backing in the resistant dermatological field.
19) Eric Jacobs of AME stated to BBB that merit is lacking in my malpractice case. Yet, in contradiction, Mr. Jacobs sent me an email in 2015 in which the medical expert stated that my facial damage is real from the lasering that was performed. Has AME changed its position?
20) I am not surprised that AME continues to ignore my concerns. The relevant topics should have been covered in the medical experts report in more detail and my, the patients, written observations should have been given serious consideration and acknowledgement.
21) Numerous patient grievances are on the web, some of which I sent to the medical expert including other articles about the very troubling practice of cover-ups by dermatologists and those whom theyve hired to do their work for them. The medical expert neither noted nor responded to this data and in fact claimed that I sent him only one article from JAMA (Journal of the American Medical Association). Was he simply careless or did he perhaps choose not to note the data reported in journals, newsletters, and other health sources that I provided about the risks of lasering, especially when the laser machine and its instrument are operated by people who can lack training, education, supervision, and good intentions.
22) Like Dr. Coldiron, I also hope that dermatologists will honor their commitment to fully and ethically uphold patient care. As I said, its time for change--accountability, monitoring, honest reporting, more medical research, and repair of medical damage.
23) Final note: If BBBs purpose is to protect the consumer and to uphold high standards in business practices, the consumer needs more than thirty minutes to present the facts of flawed business practices.
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