A doctor and three registered nurses will be arraigned Monday in Fresno County Superior Court on felony charges of unlawful practice of medicine involving Botox injections and laser hair removal at the Mystique Medical Spa in northeast Fresno.
Dr. Mark Lawrence Nazarian, 57, and nurses Elsa Flores Ortiz, 41, Crystal Ines Bartolome, 33, and and Jaclynne Theresa Burris, 56, posted bail after a criminal complaint was filed in July.
Ortiz and Bartolome are charged with four counts of unauthorized practice of medicine; Burris faces three charges of unauthorized practice of medicine; and Nazarian is charged with aiding and abetting the unlicensed practice of medicine.
An attorney for Nazarian, however, said Thursday that the doctor and the three nurses are innocent.
Fresno defense lawyer Mark Coleman said Nazarian always is present at the clinic when the nurses give Botox injections or do laser hair removal treatment under his guidance. He also said the nurses have completed extensive training in the cosmetic procedures.
Fresno attorneys Christopher Caine, who represents Burris, and W. Scott Quinlan, who represents Bartolome, also deny any kind of wrongdoing by the defendants. Coleman and Quinlan said it is their hope to resolve the case without criminal charges.
Ortiz’s attorney, Mark Moktarian of Los Angeles, could not be reached to comment.
The arrests stem from a 2014 investigation by the California Department of Consumer Affairs in which undercover investigators went into Mystique Medical Spa, posing as customers.
People use Botox injections to improve facial wrinkles, prevent chronic migraine headaches and treat muscle stiffness and spasms. It must be prescribed by a doctor. Mystique spa’s website only shows Nazarian still working there with different nurses.
The arrests stem from a 2014 investigation by the California Department of Consumer Affairs in which undercover investigators, posing as customers, went into the spa at 7161 N. Howard Ave., near Fresno and Herndon avenues. The investigators later obtained warrants to get medical records. In addition they talked to clients of the four defendants.
According to an affidavit by senior investigator Michael Poore, the state agency received an anonymous tip that nurses at Mystique Medical Spa were administering Botox without proper oversight.
The affidavit says Burris, Ortiz and Bartolome “practiced medicine without a license by providing services that were beyond the scope of their license, and without first ensuring that the patients had received a good faith medical examination by a medical doctor, physician’s assistant or nurse practitioner.”
Nazarian, as the medical director of Mystique Medical Spa, “had a duty to supervise the RNs. He failed to ensure that the patients who had received injections of Botox and other prescription medications as well as laser hair removal treatments had received a good faith medical examination prior to these services being provided by RNs.”
Poore, one of the investigators who went undercover, said in his affidavit that he spoke with Burris about Botox injections.
“I asked if I had to go see a doctor or anything,” Poore says in his affidavit.
“No,” Burris stated, according to the document.
Poore also wrote that Burris told him that Botox injections were done on a walk-in basis and “that I would be ‘in and out.’ ”
The affidavit says a nurse told an undercover investigator that she “performed injections on a daily basis and is trained to do them.”
The affidavit says Ortiz told an undercover investigator that she “performed injections on a daily basis and is trained to do them.”
A customer who received laser hair removal treatments told investigators that she was pleased with the service and said Bartolome did the treatment. The customer said Ortiz gave her Botox injections, the affidavit says.
Another customer told the investigators that he paid $500 for laser hair-removal treatment and received nine of them over a year. He also said he was satisfied with the service, saying he experienced no side effects or problems.
The customer told investigators that he did not see Nazarian before the treatments. When he finally saw the doctor, he said Nazarian’s consultation was “quick and lame.”
The customer “noted that Dr. Nazarian asked him a few health questions and did not perform any physical examination,” the affidavit states.