Guest Column: To Botox or not, that is the question; or, is there such a thing as friends in Hollywood?

If you live in this town, and by that I mean “this” town, you would have been visiting another planet to have not known about the terrible squabble between Irena Medavoy, the wife of celebrity studio executive-producer Mike Medavoy, and celebrity dermatologist Dr. Arnold Klein, who is being represented by celebrity lawyer Howard Weitzman of Delorean and O.J. fame. Hollywood’s finest has lined up on both sides of the aisle, as if waiting for the “envelope, please.” Adding to this mix, and perhaps at center stage, is Botox’s manufacturer, Allergan Inc., which is being sued along with Klein. Finally, at stake is the survival of Hollywood friendships, and voila, we have the best reality show since the original survivor.

This case seems to have polarized the Hollywood community into two factions-those who love Botox and Dr. Arnold Klein, its most notable advocate (as a disclaimer, my wife loves Klein, as she has been a patient of his for decades, since the early days of the miracle drug Retin-A, though she has never had Botox injections), and those who identify with Irena Medavoy, who has purportedly suffered from serious, debilitating side effects from Klein’s Botox injections. Of course, it doesn’t hurt Medavoy’s case that husband Mike is a powerful Hollywood mogul. And as such, that is why Hollywood’s finest finds itself straddling a delicate divide.

Here’s what seems to be at the bottom of this case. Botox injections are used to combat wrinkles. But there’s a catch. It may not be for everyone. Botox is basically a refined toxin that temporarily paralyzes facial muscles so that the lines and wrinkles disappear.

Medavoy, a long-time patient of Klein, had been receiving Botox injections purportedly for the last year- and a-half and was due for her quarterly injection of Botox for cosmetic purposes. This being part of a regularly scheduled “maintenance program.” Up to that point, Medavoy apparently suffered no ill side effects and was quoted as saying: “I don’t know anybody who wasn’t using it … every single friend. Absolutely. We all have the same forehead … No expression kind of thing.” But Medavoy also suffered from migraine headaches. While not specifically approved by the FDA for treatment of migraines, there has been empirical evidence that it can mitigate them. And it is not against medical ethics to try off-label uses yet to be approved by the FDA. Klein, on the leading edge of dermatological applications for cosmetic purposes, injected botox into Medavoy’s temples in an effort to alleviate her migraines.

Medavoy alleges that eight days later she had a “headache like I had never experienced in my life … it was like being tortured every day.” Her friend Vanna White testified that Medavoy had to cancel trips to Europe and Hawaii and cancel her famed annual Golden Globes party. She was unable to attend the Oscars in 2002 and has claimed that she was bed-ridden for months because of the unbearable migraine pain.

The Medavoys claim that Klein failed to disclose his allegedly lucrative relationship with Allergan as its most important paid consultant, thus concealing an inherent conflict of interest. Further, they claim that Klein administered too strong a dose of Botox in the temples and that Klein’s records were altered by his nurse to reflect a lower dosage (0.15 cc) than that actually given (1.5 cc). Klein’s nurse testified she had a “habit” of putting the decimal point in the wrong place … “if there were issues about something that was done, I wanted it to be as clear as possible.” Lastly, the Medavoys claim that there was no informed consent because Klein’s written form failed to advise of the risks of severe migraines even from small dosages of Botox.

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Weitzman will surely argue that Irena Medavoy was a sophisticated user of medical services for a number of pre-existing conditions, including migraine headaches and cosmetic enhancements, and that she was specifically knowledgeable about the risks of Botox; that Klein, being a fastidious doctor, would have orally explained the procedures and the attendant risks of these new treatments. Weitzman will emphasize that Medavoy was in fact being treated by a neurologist for her pre-existing migraines and that her condition was not exacerbated by the injections. There will be a battle of experts that may either assist or confuse the jury.

This case may be entertaining for us court watchers, but the consequences of an adverse verdict for the principal players are potentially devastating. The question of whether to “Botox” will be left up to a jury of lay people who can hardly identify with Botox parties and the jet-setting Medavoys who occupy a reported 14,000-square foot mansion and all that that lifestyle conveys, or with the highly regarded Klein, the dermatologist to the stars whom Liz Taylor adores and described as “… the definitive description of a perfectionist.”

Finally, if this isn’t enough, Allergen may have the most to lose, as it closes in on a billion dollar-a-year market while the safety of its product is being challenged. While we don’t yet know the jury’s verdict, we do know that in Hollywood, the alignment of friendships is always a slippery slope.

13StarsManager
13StarsManagerhttps://malibutimes.com
The Malibu Times is the first newspaper in Malibu, serving the community since 1946.

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