title: Increased risk of litigation associated with laser surgery by nonphysician operators.
abstract: OBJECTIVE
  Controversy exists regarding the role of nonphysicians performing laser surgery and the increased risk of injury associated with this practice.
  
  
  OBJECTIVE
  To identify the incidence of medical professional liability claims stemming from cutaneous laser surgery performed by nonphysician operators (NPOs).
  
  
  METHODS
  Search of an online national database of public legal documents involving laser surgery by NPOs.
  
  
  METHODS
  Laser surgery by nonphysicians.
  
  
  METHODS
  Frequency and nature of cases, including year of litigation, certification of provider and operator, type of procedure performed, clinical setting of injury, and cause of legal action.
  
  
  RESULTS
  From January 1999, to December 2012, we identified 175 cases related to injury secondary to cutaneous laser surgery. Of these, 75 (42.9%) were cases involving an NPO. From 2008 to 2011, the percentage of cases with NPOs increased from 36.3% to 77.8%. Laser hair removal was the most commonly performed procedure. Despite the fact that approximately only one-third of laser hair removal procedures are performed by NPOs, 75.5% of hair removal lawsuits from 2004 to 2012 were performed by NPOs. From 2008 to 2012, this number increased to 85.7%. Most cases (64.0%) by NPOs were performed outside of a traditional medical setting.
  
  
  CONCLUSIONS
  Claims related to cutaneous laser surgery by NPOs, particularly outside of a traditional medical setting, are increasing. Physicians and other laser operators should be aware of their state laws, especially in regard to physician supervision of NPOs.
authors.affiliation: Division of Dermatology, University of California, Los Angeles2Wellman Center for Photomedicine, Massachusetts General Hospital, Boston.
authors.forename: H Ray
authors.initials: HR
authors.lastname: Jalian
authors.affiliation: Paul Hastings, LLC, New York, New York.
authors.forename: Chris A
authors.initials: CA
authors.lastname: Jalian
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Boston4Department of Dermatology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Mathew M
authors.initials: MM
authors.lastname: Avram
mesh_terms: D000488:Allied Health Personnel / Q000331:legislation & jurisprudence*; D001505:Beauty Culture / Q000331:legislation & jurisprudence*; D016208:Databases, Factual; D006204:Hair Removal / Q000009:adverse effects*; D006801:Humans; D062325:Intense Pulsed Light Therapy / Q000009:adverse effects; D053685:Laser Therapy / Q000009:adverse effects*; D016365:Liability, Legal; D010819:Physician's Role; D010820:Physicians / Q000331:legislation & jurisprudence*; D012060:Rejuvenation; D014481:United States