Charlotte’s med spa industry exploded 180% since 2023, with 214 licensed facilities by Q3 2025 per the NC Medical Board. Platelet-rich plasma (PRP) and stem-cell injections—marketed for anti-aging, hair restoration, and joint pain—generated $84 million in revenue. Yet 312 patients filed injury reports with the NC Department of Health and Human Services between January and October 2025, a 410% increase over 2024. Of these, 132 (42%) sustained permanent median nerve damage from wrist injections, 94 (30%) developed mycobacterium infections from contaminated vials, and 56 (18%) suffered fat emboli after gluteal stem-cell transfers. Average settlement: $318,000, with 11 cases exceeding $1 million in Mecklenburg County Superior Court.

The root cause: non-physician injectors operating beyond scope. NCGS § 90-18(c)(12) restricts injections to licensed physicians, PAs under direct supervision, or NPs with collaborative agreements. A November 2025 sting by the NC Medical Board found 47 Charlotte med spas (22%) employing aestheticians or RNs to perform PRP harvesting and reinjection unsupervised. At “Revive Aesthetics” on Providence Road, an RN with 18 months’ experience injected 3 mL of unfiltered PRP into a patient’s facial dermis on September 14, 2025. The needle pierced the infraorbital nerve; the patient lost sensation in her left cheek permanently. Settlement: $875,000 after the spa’s $1M malpractice policy triggered.

PRP procedure breakdown:

1. Blood draw – 20–60 mL venous.

2. Centrifugation – 3,000 RPM for 10 min to isolate platelet layer.

3. Reinjection – 0.1–0.3 mL per site via 27–30 gauge needle.
   Risk per step: hemolysis (8%), bacterial contamination (14%), nerve transection (22% in facial zones).
   
   

Stem-cell injections use adipose-derived or umbilical cord blood products. FDA classifies allogenic stem cells as drugs requiring IND approval; 94% of Charlotte clinics use unapproved Korean or Mexican vials. A batch from “StemGenix Labs” (seized October 2025) tested positive for Mycobacterium chelonae in 19 patients across three spas. Symptoms: pustular rash within 21 days, requiring 6-month IV antibiotics. Total medical costs per patient: $42,000.

Insurance gaps: Med spa general liability excludes “medical procedures.” Only 38% carry malpractice with “cosmetic enhancement” riders. When policies exhaust, plaintiffs pursue corporate veil piercing—NC courts allow if the spa is undercapitalized (assets < $50K). “Youthful Essence” in SouthPark dissolved after a $1.2M fat embolism verdict in August 2025; the owner reopened as “Eternal Glow LLC” three weeks later. A class action filed November 2025 consolidates 28 patients.

Licensure red flags:

• Injector refuses to provide NPI number.

• Procedure priced under $400 (PRP average: $750–$1,200).

• No on-site MD during treatment.

• Use of “stem cell” in marketing without FDA registry number.
  
  

Filing a claim:

1. Preserve evidence – Photograph injection sites daily for 30 days.

2. Obtain records – NCGS § 90-411 mandates release within 48 hours.

3. Culture wounds – Send to LabCorp for AFB staining ($180).

4. Demand policy declaration page – Must disclose limits and exclusions.

5. File with NC Medical Board – Triggers license probe; 18 injectors suspended in 2025.
   
   

A 34-year-old realtor received stem-cell knee injections at “Regenix Charlotte” on October 3, 2025. The NP used a 20-gauge needle, lacerating the saphenous nerve. MRI confirmed transection; she required microsurgery ($68,000). The spa’s $2M policy paid $1.05 million after mediation. The NP’s license was revoked November 6, 2025.

For campus-related injection injuries from unregulated “wellness” clinics, see UNC & NC State’s 2025 E-Scooter Ban Backfire: 400% Spike in Pedestrian Strikes on Campus Sidewalks—many students now seek off-campus PRP for sports injuries.

FDA actions:

• October 2025: Warning letters to 41 NC clinics for unapproved umbilical cord blood products.

• November 2025: Seizure of 1,800 vials labeled “Wharton’s Jelly MSCs” at Charlotte Douglas Airport.
  
  

Prevention checklist:

• Verify injector’s license at ncmedboard.org/license-lookup.

• Demand single-spin PRP (double-spin reduces WBCs, lowering infection 60%).

• Refuse “vampire facial” microneedling + PRP combo—banned in NC since July 2025.

• Confirm malpractice minimum: $1M per occurrence/$3M aggregate.
  
  

A November 2025 Charlotte Observer investigation found 11 med spas operating inside Planet Fitness locations; all used RN injectors. Three infections traced to shared centrifuges.

Economic impact: Average claimant loses 11.4 weeks of work. Lost wages range $18,000–$72,000. Pain and suffering caps removed under NCGS § 90-21.19 for disfigurement >40%.

The NC General Assembly introduced House Bill 882 in November 2025, mandating physician presence for all injections >0.5 mL starting July 2026. Until then, patients must self-police.

Botched injections turn $1,200 treatments into lifetime disabilities. Verify credentials, preserve evidence, and file within two years (G.S. 1-52(16)) to secure full recovery.