Botox parties get nurse and doctor in license trouble

Botox injections led the nonsurgical category of cosmetic procedures in 2015.

Botox injections led the nonsurgical category of cosmetic procedures in 2015.

Botox injections led the nonsurgical category of cosmetic procedures in 2015.


A state board has accused registered nurse Rebekah Demoss of injecting Botox and other cosmetic drugs into patients at a Clovis day spa, at “Botox parties” at private homes, and even at her own home in Kingsburg, all without a doctor’s supervision.

Meanwhile, another state board is accusing Dr. Robert Adams Graham of aiding and abetting Demoss in her alleged unauthorized practice of medicine.

The accusations by the California Board of Registered Nursing and Medical Board of California do not contain any complaints from individual patients about the performance of the cosmetic treatments they received. And attorneys for Demoss and Graham contest the accusations.

The trouble for Demoss and Graham springs from two undercover sting operations in 2014 that were done by Department of Consumer Affairs. According to the nursing board, investigators first went undercover to a Botox and derma filler party at a Clovis home on Oct. 7, 2014, where Demoss allegedly was observed using syringes to inject drugs into the face of a person identified only as “S.G.”

On Nov. 3, 2014, a Consumer Affairs investigator conducted an undercover operation at a Clovis day spa. Demoss allegedly was seen using a syringe to inject a patient in her forehead, on her eyelids and in the corners of her mouth. The investigator said a doctor was not in the spa to examine the consumer.

That day and the next, Consumer Affairs investigators searched Demoss’ home and the office of ZLB Renovation and seized a number of items, including a blank prescription form belonging to a doctor identified as “Dr. G.” They also found syringes, vials and boxes of Botox, Juvéderm (a facial filler), Lidocaine (a local anesthetic), Radiesse (an injectable implant) and Lastisse (for longer eyelashes), and medical records of various patients.

In a telephone call Wednesday, Demoss said “seven people with the Department of Consumer Affairs came in with guns because I was making someone’s wrinkles go away. It was mind-boggling.”

Demoss said her cosmetic business, ZLB Renovation in Kingsburg, employed a medical director in 2014 at the time of the alleged incidents cited by the nursing board. The doctor was always reachable, she said. “I thought I was doing everything completely by the book.”

But since 2014, Demoss said, a doctor examines every patient.

Demoss said she has never had a complaint from a client, and her cosmetic business is a part-time endeavor. She is a nurse at Community Regional Medical Center in downtown Fresno, where she has worked for 21 years, she said. Demoss’s lawyer, Jeff Hammerschmidt of Fresno, said that “when patients were interviewed, they were very happy with the results. Ms. Demoss is considered to be at the top of her field and regularly has taught on her area of practice.”

The nursing board filed an accusation against Demoss on March 15 and cites seven causes for discipline, including the unauthorized practice of medicine, unlawfully furnishing or administering dangerous drugs and having a criminal conviction. She allegedly gave Botox and other cosmetic injections to hundreds of patients without a doctor’s supervision.

According to the nursing board, on Jan. 23 Demoss was convicted on her no-contest plea of dispensing or furnishing narcotics, a misdemeanor. She was sentenced to 180 days in the Fresno County Jail, with 176 days suspended, the board says. Hammerschmidt said Demoss did not serve four days in jail. “She was in custody for a short time – for a few hours and she bailed out.”

The Medical Board of California says Demoss employed Graham to be medical director of ZLB Renovation, and paid him $500 a month. The board said Graham did not examine patients and review patient medical records, and that he allowed Demoss to order medications using his name and medical license.

The medical board filed its accusation against Graham on Oct. 24.

Mark Coleman, a Fresno lawyer who represents Graham, reiterated that no patient had been harmed. He said Graham did review patient files, and Demoss has extensive training in cosmetic procedures.

“These types of cosmetic procedures are almost universally done by nurses with training and backgrounds similar to hers,” he said. The accusation against Graham is no more than a technical violation, he said.

“The medical board does everything it can to protect its turf,” Coleman said. “You go to a pharmacist, you get a flu shot, you get a shingles shot without any doctor being there.”

According to the medical board, registered nurses can perform cosmetic treatments, but a doctor must be immediately reachable to assist in care. And when prescription drugs or devices are used, a prior physical examination by a doctor is required.

In addition to aiding and abetting the unlicensed practice of medicine, the medical board says Graham committed gross negligence in allowing a registered nurse, whom he had agreed to supervise, to evaluate and treat patients with Botox and Juvéderm without a prior physical examination. The two drugs are used to remove wrinkles and smooth skin.

This story was originally published November 10, 2017 2:21 PM.

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