Colorado public health officials investigated a cluster of neurological symptoms in three women who received botulinum toxin injections at a medical spa. The symptoms, which began the same day as the injections, included numbness and tingling, muscle weakness, dysphonia, blurred vision, and neck stiffness. They resolved within a few days, but none of the women knew at the time that the product was not FDA approved.
The investigation began after the first patient reported symptoms to the Rocky Mountain Poison and Drug Safety in January 2026. Working with the CDC and FDA, the Colorado Department of Public Health and Environment inspected the spa, where they found both approved and unapproved products on site. They also identified unsafe practices, including use of a preservative-containing diluent, use of single-dose vials for multiple patients, inadequate temperature monitoring, and use of reconstituted product past its beyond-use date.
A survey of 52 patients treated at the spa in December 2025 and January 2026 found two additional symptomatic cases, bringing the total to three. All had received injections from the same lot of the unapproved product. The spa was told to stop using unapproved products, and a formal complaint was submitted against the provider's license. Officials said the symptoms could have resulted from unknown product concentration, contamination, or improper preparation, administration, or storage. Similar problems have been flagged before, including FDA warning letters to websites selling unapproved botulinum toxin and a 2024 CDC warning about counterfeit or mishandled products.