Death at salon highlights need for tighter beauty services regulations

The death of a woman at a beauty clinic this year highlights the need for tighter industry regulations and better consumer awareness, writes Sasha Gonzales

PUBLISHED : Monday, 11 August, 2014, 9:39am
UPDATED : Monday, 11 August, 2014, 11:38am

In June, dance teacher Lee Ka-ying died while undergoing liposuction at a private clinic in Tsim Sha Tsui. The 32-year-old fell into a coma during the treatment and never woke up.

Lee, who had given birth to a baby daughter nine months earlier, weighed 113kg at the time of her death.

The clinic, which specialises in hair transplants, is currently under investigation by the Health Department and Hong Kong police.

However, Lee's case is not unique. In 2012, a 46-year-old woman died and three other women became seriously ill after receiving a beauty treatment involving blood transfusions at a salon in Causeway Bay; all four women had contracted a rare deadly superbug.

A report by the Hospital Authority said the woman died of septic shock, which is usually caused by a bacterial infection.

The beauty treatment supposed to improve her skin and immune system - typically used to treat cancer patients - led to her death. The three other women reportedly experienced fever, dizziness and diarrhoea.

While these two deaths are extreme cases, they don't come as a huge shock in an industry that has proved difficult to regulate.

In 2013, the Consumer Council received 1,081 complaints about beauty services carried out by the city's salons and treatment centres. Complaints were made about scarring, medical complications, severe skin reactions after treatments went wrong, and the lack of information about whether people performing the procedures were properly qualified to do so. Some consumers also said they were pressured by sales staff to sign up for costly treatments, despite knowing little about the safety or nature of the procedure.

Gilly Wong Fung-han, the council's chief executive, says it's hard to protect consumers from unscrupulous beauty therapists and unsafe practices.

"To protect consumers who are receiving cosmetic procedures, proper regulations should be in place, covering control over material and device safety, training and qualification for operation of the procedures, venue and facility requirements," she says. "Since this involves regulation over the cosmetic industry and medical practitioners, it's a challenging task for the government, but a necessary step to safeguard consumers."

Wong also wants better public education and greater awareness about the risks associated with various cosmetic procedures.

It is difficult to regulate the industry, according to a plastic surgeon from the Hong Kong Association of Cosmetic Surgery who does not wish to named.

"At the moment, the Medical Council has very strict guidelines on the code of conduct of doctors practising in Hong Kong," the surgeon says. "And yet there are almost no rules on beauty centres offering quasi-medical or medical treatments. Official guidelines on what is a medical procedure have only recently been put into place."

Other issues complicate the matter. Firstly, Hong Kong does not have a system of registration for clinics or facilities where cosmetic procedures are performed. Secondly, there is no legislation in place to say that only certain types of doctors are allowed to perform cosmetic surgery.

"In Hong Kong, any doctor with a basic medical degree can perform cosmetic procedures, in any clinic," the surgeon says.

In a bid to strengthen the regulation of private healthcare facilities, the government set up a working group to focus on the priority area of "defining high risk medical procedures/practices performed in ambulatory [movable] setting". Expert groups were also formed to cover procedures in five priority areas: "surgical", endoscopic", "dental", "chemotherapy, diagnostic/interventional radiology" and "haemodialysis, cardiac catheterisation, lithotripsy".

Under the proposals, a procedure defined as "high-risk" - if performed outside a hospital - will have to be performed in a regulated movable facility, which will be subject to a set of regulatory standards and measures.

Yet these regulations are not simple and include things such as governance, functional design, equipment maintenance, safety issues, infection control and sterile supplies, the surgeon says.

Only non-high-risk procedures can be performed in a doctor's clinic that has not attained regulated movable facility status. The risk of a procedure is said to be related to the nature of the procedure, the level of anaesthesia and the condition of the patient.

Yet whatever the guidelines and regulations, it is ultimately the responsibility of consumers to learn more about the procedures they are having done, including the safety of the materials, equipment and technology, and assess potential risks and complications. Consumers must ensure the person carrying out the procedure is qualified to do so.

The surgeon says: "When it comes to cosmetic surgical procedures, specialists in plastic surgery are the only recognised speciality - [people] who have undergone six years of training and assessment in this area.

"Many non-specialists show certificates of courses they have attended, to prove they have received the necessary training, but these courses are often only several days long."

The surgeon says it is vital to ask questions about a procedure; if you will be unconscious, sleeping or heavily sedated during the procedure, you must insist an anaesthetist is present.

"I would advise people to do research about the surgical procedure before the consultation. Ask questions. If the doctor sounds unsure or can't provide reassuring answers, look elsewhere."

The surgeon also warns people not to make impulsive purchases if they are in doubt. "If something goes wrong, and the doctor fails to make things right, you have the option of suing the doctor, or making a complaint to the Hong Kong Medical Council. But it can take years for the Medical Council to process your complaint due to the backlog of cases."