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Margaret L Larson ARNP PLLC

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Margaret L Larson ARNP PLLC Reviews (2)

Re: ID: [redacted]
11/10/16
To whom it may concern,
I have already responded to Ms. [redacted]’s complaint that once again Botox Cosmetic did not work for her. I addressed her concerns in that complaint. It is our policy to see patients 2 weeks after their treatment if they have any concerns. I do...

not know why she did not schedule that follow up. Before leaving the room with each and every Botox patient, including Ms. [redacted], I tell them if they have any concerns to see me at 2 weeks. I cannot address their concerns without this follow up. Also there is no record of her calling my office beyond the first call. I was unaware of her complaint until receiving the Groupon complaint.
At the time of treatment, Ms [redacted] presented with a considerable amount of wrinkles at rest on her face which were visible to the naked eye and in her REVEAL photograph. To address this I recommended chemical peels and tretinoin 0.05% to treat these wrinkles and documented in her chart. My staff and I told her that the Botox will soften their appearance but will not get rid of them. The Botox Consent form was signed by Ms. [redacted] describes how Botox works and clearly states Botox can soften the appearance of lines, it is not an exact science and there are no guarantee of results. She signed this consent and registration forms stating that she understands that there are no guarantees and all sales are final. In addition, she purchased the 40U Botox Groupon which clearly states it is for 2 areas or 2 treatments. She was told in consult that the 40Unit Groupon was for 2 areas only in order to have a good effect. She insisted on a treatment of 4 areas. My staff and I told her it is not enough to adequately treat her wrinkles around her eyes and she is likely to need more. So as to not make her angry, I agreed to treat the 4 areas as she requested. It was my understanding she understood it was inadequate to treat the crowsfeet and an introductory dose for the upper lip. The standard for wrinkles around the eyes is 24 units and she received 10units per her request.
Furthermore, I am extremely honest and diligent about providing the product people have purchased. I do not dilute my product and I follow the manufacturer’s recommendations for reconstituting the product. To state that I dilute my product is slanderous. Furthermore, there is no advantage for me to be dishonest.
Nevertheless upon receiving the Groupon posted complaint, I considered her previous experience with the product not working for her and suggested she may have developed an immunity (antibodies) to Botox Cosmetic. This Botox Cosmetic immunity is a phenomena I had not experienced in my practice prior to running this Botox Groupon Ad. Since running this Botox Groupon Ad I have seen a large number of new clients with a hand full who stated they had no response to a previous treatment, only Ms [redacted] and one other experienced this with a treatment from me. This other client has been good enough to follow up with me and she is going to try Xeomen, a different neurotoxin without the protein in Botox. As previously stated in my response to her original complaint and prior to my seeing her complaint, I attended the 2016 Botulinium Toxin Therapy Update for medical conditions. During discussion I asked the two physician speakers, who inject thousands of units a day for medical patients, if they knew of this immunity response and they both said yes. See my comment she cut/pasted into her complaint. The average injector is unaware of this phenomena so I am not surprised the people she asked had not heard of it. 
Today I called and reported Ms. [redacted]’s case of lack of response to Botox Cosmetic to Allergan, Inc. I asked if there is any evidence of this occurrence. Lori, Allergan’s clinical specialist, said “yes” and referenced the 2 Canthal Line Trials where 14 subjects (1.5%) experienced no response and had confirmed binding antibodies to the Botox Cosmetic. She said in summary there is no clear explanation. She did say that there is thought that medication and underlying disease may interfere with the response to Botox. She also said that high doses or frequent treatments can increase the risk of developing antibodies.
Despite the possibility that Ms. [redacted] has an immunity to Botox Cosmetic or not, she is not entitled to a refund. She has fully consented to treatment, received the product she purchased, acknowledged in writing her understanding of how Botox works and that there are no guarantees or refunds; and she chose not to follow up in a timely manner. Due to her attempt to slander my good name I am unwilling to provide her any further treatment, complimentary or at a charge, and I would not refer her to any of my colleagues.
Sincerely, Margaret L. Larson, ARNP

Complaint: [redacted]I am rejecting this response because: all stated is not true .  Doctor never atemt   to call me and I left several message on her phone number and talk with her staff .  Good doctor, as she presented her self she is,   aftera first information that patience is not happy will contact patient and personally talk with the patient. She never contact me but she respond to Groupon so she was aw are of my problem. I have Botox injection every 8 months with different doctor, his name can be provided if needed, and never experienced any problems .  so all statements provided by Dr L[redacted] is pure theory , practically she did not take any action to contact me and try to resolve the problem before, or after my elevation . Sincerely,[redacted]

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Address: 16233 Sylvester Rd SW Ste G30, Burien, Washington, United States, 98166-3045

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