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Frequently asked questions
- What has caused this issue?
- How was this identified?
- What did the investigation show?
- What infection control problems were identified?
- What procedures are classified as "at risk"?
- Are there and physical symptoms if people have been infected?
- Can you describe the testing process?
- When will results be available?
- Where will testing take place?
- Do patients have to pay to see their doctor and have their blood test done?
- What do patients do if they have a positive test result?
- What does it mean if I have a positive test result?
- How many patients are at risk?
- Are there services like this being provided by other people?
- How can I protect myself?
- How can I make a complaint about a practitioner?
- Where can I get further information?
What has caused this issue?
Following a recent complaint to the Health Care Complaints Commission (HCCC), NSW Health has become aware that Ms Pu Liu, also known as Mabel Liu, has been performing cosmetic procedures from premises situated at 14/239 Great North Road, Five Dock. Ms Liu is not a medical practitioner registered in Australia.
Inspection of the residential unit in Five Dock found evidence of poor infection control.
There is a risk that clients who have had cosmetic procedures performed at this address may have been exposed to blood-borne viruses such as hepatitis B, hepatitis C and HIV. There is also a risk of skin and soft tissue infections and poor cosmetic results.
Injectable drugs not approved for use in Australia were also found on the premises, raising concerns about the safety and effectiveness of these medicines.
The HCCC has issued an order prohibiting Ms Mabel Liu from:
- Providing any cosmetic surgical and medical procedures, including any cosmetic surgery that involves cutting beneath the skin and any cosmetic medical procedure that involves piercing the skin
- Possessing any Schedule 4 drugs for cosmetic use including botulinum toxin (Botox) and hyaluronic acid injection preparations (dermal fillers).
NSW Health recommends that clients who have had procedures performed by Ms Liu at this address should seek the advice of a GP and be tested for blood-borne viruses (hepatitis, B, hepatitis C and HIV.)
How was this identified?
A client who had a poor outcome from a cosmetic surgical procedure performed by Ms Liu at the Five Dock premises made a formal complaint to the Health Care Complaints Commission.
What did the investigations show?
The inspection of the premises in Five Dock found evidence that surgical and other procedures were being performed at the premises; drugs for injection that are not registered for use in Australia; and a general environment not suitably fitted out for the performance of surgical procedures.
What infection control problems were identified?
There was evidence of a lack of hygiene, possible re-use of medications and equipment between patients, and a lack of effective cleaning and sterilisation. Sharing items that should be sterile between patients can allow infection to spread from one person to another.
What procedures are classified as “at risk”?
Based on the very poor level of infection control measures found at the premises, there is a concern that any procedure in which the skin was cut or penetrated such as surgery, stitching or injection undertaken at the Five Dock unit could pose a risk of infection. This could be an acute skin or soft tissue bacterial infection, or a blood-borne virus.
Are there any physical symptoms if people have been infected?
There are two main risks of infection: an acute skin or soft tissue bacterial infection caused by unclean hands and instruments (non-sterile technique), and; infection caused by blood-borne viruses.
People experiencing acute skin or soft tissue bacterial infections might experience:
- increased pain at the site of the procedure
- the site may be red, hot, swollen and painful
- there may be pus or the wound may smell; stitches may come apart
- tiredness, sickness or a fever (temperature above 37.5°C)
- becoming very unwell (“septic”) and needing antibiotics urgently.
People will experience these symptoms in the first few days after a procedure. If you feel unwell or experience any of the above after having a cosmetic procedure done, you should seek health advice from your GP.
People exposed to a blood-borne virus might experience:
- no symptoms for months or years afterwards
- a mild illness when first infected
- uncommonly, people present with acute hepatitis when first infected with hepatitis B or hepatitis C, which causes liver problems and may lead to hospitalisation.
Infections with these viruses can be detected by a blood test.
Can you describe the testing process?
Testing for blood borne viruses is straightforward – all that is required is for you to attend your GP and ask to be tested. Your GP can order a blood test to check if you have hepatitis B, hepatitis C or HIV. We suggest you take this fact sheet with you when you visit your GP.
When will results be available?
Results for hepatitis B, hepatitis C and HIV testing are usually available within a few days of testing.
Where will testing take place?
Blood tests can be arranged by your GP, and can usually be collected at local pathology collection centres.
Do patients have to pay to see their doctor and have their blood test done?
Patients should follow their usual practice when visiting their doctor and get the blood tests through the usual Medicare processes.
What do patients do if they have a positive test result?
You should talk to your doctor about your results.
What does it mean if I have a positive test result?
A positive result means that you have been infected with a blood borne virus sometime in the past. For hepatitis B and C, you may have cleared the virus by yourself, or you may have a long-term (chronic) infection. Your doctor will tell you whether or not your infection is active now. HIV infection is a lifelong infection. There are effective treatments for these infections, so it is important to know whether you are infected or not, so that you can be assessed and receive treatment if needed.
There are many ways in which people can get infected with HIV and hepatitis B and C viruses. If you have been recently infected with one of these viruses, your doctor should notify the local Public Health Unit and work with the local Public Health Unit to investigate possible sources of your infection.
For more information on infection with blood borne viruses please refer to the Hepatitis B, Hepatitis C or HIV fact sheets.
How many patients are at risk?
Due to the poor record keeping practices at the Five Dock premises, it is not clear how many clients may be at risk.
Are there services like this being provided by other people?
There may be other unregistered practitioners operating in NSW who perform cosmetic procedures and/or surgeries in unregulated, unlicensed premises including homes and hotels. These may also pose a health risk.
How can I protect myself?
If you are considering cosmetic surgical and medical procedures you should undertake careful research and make sure the person doing the procedure is qualified to do so. Members of the public can search the Australian Health Practitioner Regulation Agency (AHPRA) register to check that a health practitioner is registered.
How can I make a complaint about a practitioner?
If you have had a procedure with a poor outcome or have concerns about a practitioner or location you can inform the HCCC on 1800 043 159. This phone line operates from 9am to 5pm on weekdays and can provide advice on how to make a complaint. Information about how to make a complaint can also be accessed from the HCCC’s website.
Further information on how to protect yourself and how to make a complaint is available in a public warning made by the HCCC on 30 June 2016.
Where can I get further information?
Contact your local Public Health Unit on 1300 066 055.