Texas Med Spa Charges: Understanding Precedent for Criminal Law in Medicine

In 2023, a Texas med spa became the center of national attention after a patient died following an IV therapy treatment. The person administering the infusion had no medical training, there was no good faith exam, and no medical personnel were present to handle emergencies. The medical director, an anesthesiologist, was not on site and had limited involvement with the spa.

Recently, local news reported criminal murder and manslaughter charges against the owner and the medical director. ByrdAdatto partners Brad Adatto, JD, Jeff Segal, MD, JD, and Alex Thiersch, JD, spoke about the charges in an episode of AmSpa’s Medical Spa Insider podcast.

The Initial Response: Why This Case Is Different

“This has been a very big deal in Texas,” said Thiersch. “The legislature was involved. There was a lot of media attention. There seemed to be a push, a very public push to have something done.”

In 2025, the Texas governor signed “Jenifer’s Law,” named after the patient, requiring elective IV therapy to be administered by trained, supervised providers with a registered nursing license or higher, acting under proper delegation. The medical board disciplined the physician medical director with a limited suspension, preventing supervision or delegation to other medical providers.

Why Criminal Charges Are Unexpected

While criminal charges in this case are not surprising given the public outcry, the murder charge caught these attorneys’ attention. “Murder to me, you know, it seems like you have to have some sort of intent,” said Thiersch.

Jeff Segal referenced the “Dr. Death” case in Dallas, where criminal charges were used in a novel way to prosecute medical errors. “Criminalization of medical care is unusual. It’s high profile. It’s newsworthy because it is rare. And a lot of it depends upon intent,” Segal explained.

Segal broke down the levels of intent:

• Intent to kill (murder): Deliberate actions meant to cause death.
• Willful blindness: Conscious disregard for substantial risk.
• Negligent homicide (manslaughter): Actions that should have foreseen danger, even if not intentional.

The state must prove these charges beyond a reasonable doubt. “All it takes is a juror to say, ‘you know what, I have doubt.’ And then that’s the end of that case,” Segal explained.

Intent, Negligence and Board Actions

“For most of us who practice medicine, if there’s a problem, it’s usually due to an inadvertent unintentional mistake,” Segal said. “And the civil system generally disposes of that properly. If the practitioner is a danger to the public, the board may get involved and it may be anything from any type of disciplinary action from a reprimand to suspension to promotion to revocation, all the above.”

Thiersch and Adatto discuss the disconnect between the medical board’s limited suspension of the physician’s license and the DA’s decision to pursue criminal charges. Adatto notes, “The medical board is going to look at this individual as to what did they normally do? What kind of complaints if any have ever been?” In this instance, the medical board’s decision was along the lines of “‘You can continue as the anesthesiologist, but you clearly don’t have a good take on being able to delegate to others.’”

How Jenifer’s Law Changes IV Delegation in Texas

Adatto pointed out that a physician delegating to unlicensed individuals was legal at the time. “IV therapy. If it is done, there’s a whole bunch of rules, but one of which is only RNs or highers can deliver IV now in Texas. So that was a change in the law. So at the time when he was delegating to this individual, the physician, it was not against the law. The question is whether or not it was a good sound medical decision-making and in this case now criminal.”

Medical Aesthetics is the Practice of Medicine

Adatto warned, “There are certain things that you need to remember that this is the practice of medicine. And because of that, you need to fall back on that and not fall into the retail side of it.”

Segal added, “There’s a temptation to believe this is retail, but you know, even gyms, the gym that I go to has a defibrillator sitting on the wall… These are medical procedures. They’re called medical spas for a reason. They’re medical procedures. And it’s easy to get lulled into complacency believing that it’s not any different than getting your hair cut.”

Adatto also highlighted the importance of protocols and compliance: “Do you have the right protocols? Do you have the right people? Are you clearing the patients properly? Like stop and hit the pause button because if an event like that happens at your med spa… there’s a reputational factor that comes with that.”

Protecting Your Practice

Staying compliant and informed is more important than ever. AmSpa membership offers resources, legal updates, and guidance to help owners navigate complex regulations.

“This is a golden opportunity for everyone out there to really rethink what are they doing, how are they doing it, and where do they need to tighten their practice,” said Adatto.

Big events like this are a moment for every medical spa owner to pause and reassess their protocols. Embrace compliance, protect your reputation, and join AmSpa to stay ahead of regulatory changes.