Jurors hear claim cosmetic surgeon used cheaper drug - News

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Nov. 06, 2008
Copyright © Las Vegas Review-Journal

Jurors hear claim cosmetic surgeon used cheaper drug

Knockoff version costs half price of Botox

By ADRIENNE PACKER
REVIEW-JOURNAL

Why would a successful cosmetic surgeon throw away his career to save a few thousand dollars a year by buying a knockoff version of Botox for wrinkle reduction, procedures that amount to less than 5 percent of his sales?

That's the question defense attorney Ronald Richards posed to a jury Wednesday in his opening statement in the trial of Las Vegas cosmetic surgeon Stephen Seldon and his wife, Deborah, an office manager.

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Richards disputed the government's contention that, despite a signed agreement with patients confirming the clinic would use Botox, Seldon injected them with a cheaper, non-government approved product called TRItox.

"You are not going to hear of any evidence that Dr. Seldon's patients had any problems," Richards told the jury seated Wednesday. "That's because Dr. Seldon only used Botox."

Richard said not one patient will testify that they came into the Seldons' A New You clinic expecting to be injected with Botox only to be treated with TRItox.

The couple is charged with mail fraud and misbranding a drug held for sale. The government claims that the Seldons purchased the drug TRItox, which has never been tested by the Food and Drug Administration, from a Tucson, Ariz.-based company called Toxin Research International Inc.

During a one-year period ending in October 2004, the couple purchased 19,000 units of TRItox for $36,925, half the cost of Botox, Assistant U.S. Attorney Crane Pomerantz told jurors.

"The defendants were interested in padding their bank accounts and, in doing so, used their patients as guinea pigs," Pomerantz said, referring to the use of TRItox. "They used it and used it and used it and they lied and they lied and they lied."

The vials of TRItox were marked with labels that read, "For research purposes only, not for human use," Pomerantz said.

The owner of Toxin Research International Inc., Chad Livdahl, pleaded guilty in 2005 to conspiring to commit fraud in connection with distributing TRItox as a substitute for Botox. His guilty plea came after four patients at a Florida clinic became ill after being injected with the drug.

Livdahl, who is serving a nine-year sentence, is expected to testify during the trial that the Seldons regularly purchased the product from him. Richards pointed out that Livdahl also was indicted on charges of perjuring himself on the witness stand and said he cannot be trusted.

"The very core of their case is who their witness is," said Richards, who called Livdahl a "fantastic con man" who convinced more than 200 doctors nationwide to test the product because an FDA approval supposedly was imminent.

Richards pointed out that it is not illegal for physicians to test new products on themselves. He said the Seldons never used it on their patients.

But Pomerantz suggested that the Seldons' records related to Botox and TRItox purchases are fishy.

In October 2003, Allergan Inc., the only company licensed to manufacture Botox, stopped supplying Seldon's clinic with the product when he fell behind on bills, Pomerantz said.

Having marketed their Botox procedures in local magazines but no longer with a source for Botox, the Seldons began purchasing TRItox from Livdahl's company that same month, Pomerantz said.

An Allergan representative noticed the advertisements and confronted the Seldons.

"They were rude, abrupt and dismissive," Pomerantz said. "They were comfortable with what they were using."

Richards said the Seldons needed some Botox at their practice for the small number of procedures they did. He said Allergan is not the only source for the product and that many physicians and distributors are interested in getting rid of surplus drugs.

The trial is scheduled to continue this morning before U.S. District Judge Kent Dawson.

Contact reporter Adrienne Packer at apacker@reviewjournal.com or 702-384-8710.

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Please enter your name Name: Please enter your email Email: Please enter a comment COMMENTS : (word count limit is 300) You have reached the maximum number of words allowed Current Word Count: Note: Comments made by reporters and editors of the Las Vegas Review-Journal are presented with a yellow background. lisa wrote on December 04, 2008 09:36 PM: Anyone that knows debbie knows that she did not administer drug the dr did. he and only him should be punished. she has 3 children and a father that has had a quad by-pass and none of them will make it without her. how many more victims need to punished in this case??? how can she be punished for purchasing the tritox that is not a crime. giving it to patients without their knowledge is the crime. i could go and purchase tritox will i get arrested??? She is not the one that took the oath, she is not the doctor, so why is she getting tried and convicted. this must be another way for the government to punish women and gain more money by convicting 1 doctor and his wife. what did she really do????? to buy the product is not the crime only the administering the drug to patients that is the real crime Darlien Breeze wrote on November 18, 2008 03:33 PM: What was the outcome of the trial? Or is it still in progress? Confused. wrote on November 16, 2008 01:11 PM: Why is Livdahl in prison when he "according to the court records" identified the product as "For Research Purposes Only - Not for Human Use". Is he at fault for these doctors taking it upon themselves to "inject" their patients? Why wouldn't it be the other way around with the doctors being incarcerated?? Livdahl "labeled" the product correctly, the doctors chose to use it on humans!! I don't get it!! Barbara wrote on November 15, 2008 04:33 AM: Whether Dr. Seldon and his wife used the knock-off Botox or not isn't really the question. The matter is that it was purchased for the purpose of using it when they knew it was not FDA approved. It is akin to pre-meditated murder even if the intended victim never actually gets killed. The intent is illegal. When is this trial over and does anyone know yet the outcome? Giving Facts.. wrote on November 14, 2008 03:30 PM: In Nov. 2004, four people were poisoned with botulism toxin type A commonly known as "Botox" when delivered in a 1 nonogram quantity. The vendor of "Botox" Alergan had it produced by a lab in Irvine, CA. Livdahl had his product conpounded by the same lab. The Dr. in FL "Bach McComb" purchased botulism toxim in concentrated form, from this lab, and didn't dilute it properly and poised himself and 3 others with this toxin. It was not Livdahl's Tritox. The gov't knowing this supplied false informtion to a grand jury in Ft. Lauderdale resulting in the indictment of Dr. Livdahl and his companies. Dec. 2004 the gov't issued a memo stating they made a "typographical error". The material that posioned the 4 people was not Tritox. The courts wouldn't correct this egregious error and contined prosecution. The gov't brought a 45 count indictment which forced Dr. Livdahl to plead out, because if he lost at trial he could spend 25 years in prison (for something he didn't do!!). Subsequently, over 200 Dr. were investigated. Virtually all plead out and paid huge settlements. The Seldon case is the same, the gov't only wants money, lots of it. They have collected over 2.5 million to date. This shouldn't have been a FDA case as this product isn't a drug nor a biologic...this is a natural occuring toxin. Alergan convinced the gov't to prosecute as it eliminated their competition. Tritox sold for 1/2 the cost of Botox for the same product. Alergon earned 987 million dollars on Botox last year alone. To date no complaints have been filed against the Tritox product. Jane wrote on November 07, 2008 02:40 PM: I've known the Seldon's for years and it's not about "greed"! They would have never knowingly risk a prospers business and their reputation they both work so very hard all of these years for this. Ronald Richards opening statement was right on, "Why would a successful cosmetic surgeon throw away his career to save a few thousand dollars a year." George wrote on November 06, 2008 01:24 PM: This comes as no surprise to anyone who has dealt with Debbie Seldon in the past. Mom always said cheaters never prosper. Talk. About. Karma. Bob wrote on November 06, 2008 05:51 AM: Why would the prominent doctor use an inferior drug to save a few thousand dollars a year? The same reason we have a crisis at the Endoscopy Center. GREED.