Snowman123

Some changes happening. Firstly the background : I'm not sure how other countries around the globe are responding to cleaning up the industry, or if hair transplant clinics etc are caught up in this ( plasticsurgery.org.au has a section on their site, so i assume it may well be ), but generally I'd say it would be a good thing to have some professional accreditations that better serve to set standards that give confidence and reliability. What's happening in your country to improve professional standards?

At this stage I don't want to comment any more on the legal and chargeback process, since I'm disclosing too much, including the strategy. I'll let the Bank and WhichLegal run the line of advice and actions, as well as the referrer respond to the "notice of intention". That said, being a supplier of services ties them into the rules of the credit card company. That's separate from the legal process and any associated processes of withholding funds, in lieu of that, which in a commercial setting is quite usual, until things are settled between parties or adjudicated. In this context, it's irrelevant whether part of the package was fulfilled or not, and because they are in breach of contract, it doesn't apply now with regards to the deposit. If members have a contractual grievance in the UK, they now know who to go to, which is the purpose of the OP. If it involves a credit card they have the following recourse: - Bank / chargeback scheme - Financial Ombudsman - Small claims Court - Leveraging potential outcomes to use as pressure to settle Again, I've commented too much .... I'm not a lawyer, the Bank or an investigating authority (Trading Standards) and will leave that to their guidance and actions.

Yes it was done This is the context regarding the offset: I hope that clarifies things.

I'm not sure how the chargeback will work in lieu of consequential losses permitted with offsets under the credit card scheme for consumer protection. I'll wait for the response from the hair transplant referrer and also the Bank, then get advice from the solicitors as to how the claim is structured and funds are best secured and recovered. Usually in disputes monies are withheld where possible, pending settlement or legal outcome determinations. That's what the referrer tried to do on their side with the cash they held and I will do, if advised. It was done as part of the overall package.

I noticed ( if it's genuine - and i believe it is ) that this guy is Diabetes 1 (not 2 as per me). According to the Diabetes UK.org thread i opened, he can quite possibly have an HbA1c below 6.0.

Well that's their fixed policy view in their guidelines. Maybe there are other factors. Maybe their medical indemnity insurance doesn't permit any discretion for risk over a low hba1c, regardless of their professional opinion - who knows. Zero doctors consulted and no scalp examinations. Just photos and medical history. But that's how it's done for the majority of candidates going to Turkey - Y/N? It's always better in hindsight, I guess and at the end of the day folks are travelling to Turkey in large numbers. I doubt if they would be as wised up as those on these forums, plus it's an unregulated industry ( isn't that a concern for many having cosmetic surgery). My research comprised of a) 4 successful hair transplants ( friends sons in their late 20's, early 30's ) through this specific referral company, that i saw and heard from first hand - they were satisfied b) NHS guidance per https://www.nhs.uk/conditions/cosmetic-procedures/hair-transplant/ - no mention of diabetes being high risk c) (i) Australian government medical authorities https://www.healthdirect.gov.au/hair-transplant ( Where I reside 50% of the time over the year and i consider reliable ) - no mention of diabetes being high risk (ii) https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hair-transplant-surgery No mention of diabetes d) US .gov medical sites covering risk including https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719980/ d) friends also going for HT, using this referral company, who we compared notes between us with e) numerous independent videos demonstrating the before and after process, such as Swedish hair transplant journey f) professional inputs from the UK referral company consulting with the clinic, approving my visit on known medical history (albeit if the hba1c guidelines were made known to me I would not have gone + this could have been done in the UK** ) - trusted these guys and have several friends still going with them ** I was also short on time as I had to return overseas within a 4 week window At the end of the day one has to put themselves at the mercy of professional inputs, none that cite controlled diabetes as a risk. What could go wrong in a controlled environment with anti biotics and a stable medical history? Clearly, all cosmetic procedures have an aesthetic and medical risk. They confirmed on consultation at the clinic that the donor area could support 3,000 grafts. Only the risk of infection was communicated. I guess this is subjective. To me it's not, I'd like my money back and be compensated according to the law. I'm not comfortable with the error by the referral company and them being rewarded with my money, and folks in the same position as me researching a recourse, or planning, can have better knowledge. Who knows, the referral company may lift their game and provide a better benchmark for service in the future. Which Legal Service is in the thick of consumer matters, generally at the lower level of $$ complaints and in the position to refer the complaint to media and consumer affairs for deeper investigation. If people just roll over and give up where would we be ? I don't therefore don't think it's futile for myself or others. It's time consuming, I agree. The more it goes on, the more motivated I am to see it sorted. Not really. That's not the point of the legal advice if you take a closer look. Medical culpability on a general scale is complex these days, which is why professional indemnity is so expensive and disputes take a long time. Luckily, I'm not talking about culpability as a result of the surgical and aesthetic view. One risk I do see is the inability to ensure medical cover for negligence in a Turkish hospital. Are there insurances that can cover this - I didn't see any, and I'm doubtful they would pay up easily anyway. Private health funds maybe ? 1 don't know. I'm not so sure. In law you have to strengthen your case and sometimes through the investigation process more facts and avenues come to light. At the end of the day it's a commercial decision and nothing in law is certain, so it comes down to the value of what you're doing v's doing nothing. From a strategic point of view, the UK referrer has to weigh up the balance to. All they have to do is consider the argument and commercial risks against themselves and fight or settle. But the more they fight, the higher the risks are for them in terms of costs to reputation. The $$'s are minimal for them, looking at their company balance sheet. Getting the emotion out of it, is important to keep a clear focus IMO. It's OT, but Is there a checklist of things to be aware of that members can rely on when selecting a clinic service ?

Certainly, I accepted that and told the surgeon who refused me that I respected their view, even though I am still questioning it. There just seems to be no standardised approach and there seems to be a lot of discretion surrounding medical objectivity v subjectivity. That said, this clinic had a policy, as i stated of not performing over a very low hba1c result of 6.0 I guess I'm coming to the conclusion that the "loss of opportunity" is based on the probable fact that if I had known their threshold of refusal, I could have gone elsewhere to plenty of other clinics. I've opened a thread on https://forum.diabetes.org.uk/boards/threads/hair-transplant-safety-with-diabetes-hba1c-test.103707/ at Diabetes.org.uk to see if it can provide any further perspective

Gold. Does it look like a genuine review to you?

So there is no universally accepted standard for procedure or qualification? That's a worry. Not really : We'll see what their response is - they have 14 days to reply to the formal notice sent from the legal team.

My argument is that they had a policy and they refused to communicate it. Which Legal say that's culpable and exposed to a breach of the cited Act's referenced above. I did and they have an article that publishes their guidelines of 6.0 - only saw it later when i had reason to investigate it. If I'd known, I would never have travelled. I don't want to name the UK referrer at this stage, but will do if/when the solicitor approves it as it will have an impact on the referrers reputation - my hope is that they will see sense and settle. Yes I agree to a point, but according to the legal advice I'm receiving "repeat performance" is a remedy. So if they don't want to do it, they may have to pay another to do it. That's written into the law - so it can be forced on them as a breach of a Court determination is a criminal offence - so I'm told.

How do they determine the acceptable levels. I get what you are saying, in general terms, but is there a clinical basis. I'm lost, but have come across this article

1. Yes 2. Yes, but they refused to answer asking me to have the test in the Istanbul hospital clinic. They had a policy and did not communicate it. The UK referral company has the policy published on their website, but didn't cite it in communication with me. I do have it in writing on WhatsApp and screenshots of the web article on the policy ( seen later by me ), just in case the information goes missing. 3. Per 2, I had no reason to believe without the information that i would be refused the procedure. There would have been no point to travel, and be encouraged to travel if they had alerted me to their policy. There were no adverse findings from the test. My diabetes is under control with tablets I'm trying to get clinical inputs on the acceptable HbA1c levels. Diabetes UK have said 6.5 is by the definition of Diabetes 2, and that surgical guidance permits sub 8.0 as acceptable. I've started a thread on Diabetes UK to see if i can get any inputs of a clinical nature, since the clinic and UK referrer have shut down answering my questions on this. I sense that their policy is without scientific medical basis - but i could be wrong - can anyone help?

Yes, they did. No, all direct communication was via the UK agent. However, I did communicate indirectly and asked them for the range of HbA1c acceptability. At that point I hadn’t read their policy of 6.0 until the dispute started and I investigated further. Section 49 of the Consumer Rights Act 2015 requires the contracted party’s service to be carried out with reasonable skill and care. This holds any work done to the standard of a competent professional. Which Legal advise that the problems described show that they have failed in their legal obligations and therefore a claim against breach of contract is valid. What I now want to focus on is the clinical basis for refusing the procedure, since this is the basis for ramping up the separate claim for the loss of opportunity. The UK company say that the surgical guidance and thresholds of HbA1c of diabetes at 6.5 cited by Diabetes UK, do not apply since the threshold in Turkey is different. Well they market on a UK domain/website to a UK audience and contract in the UK. Diabetes UK have asked me to establish the clinical basis as they say the actions of the UK company are prejudicial to those diagnosed with Diabetes. Does anyone know the clinical basis for handling persons with controlled diabetes 2?

Yes, I did, but it was too late as I was in the hospital then. I sense that the refusal to proceed ( and the policy of needing to be below an HbA1c of 6.0 is ) is not medically sound anyway. I’d like to be able to find that thought professionally verified to see if one of the remedies proposed by Which Legal is to have the procedure subject to a “ repeat performance “. Does anyone know about this?

PS: 1 important tip Which UK gave me. For added protection use credit cards versus debit cards as the credit card schemes offer chargeback protection on consequential losses, making thing a lot easier, rather than splitting a transaction chargeback and processing a small claims court approach.

Thought I'd update the thread with progress. I've had excellent guidance from Which Legal, having been briefed, to write formally to the UK referral company, notifying them that they are in breach of contract under the Consumer Rights Act 2015 for not exercising "reasonable care" during the onboarding process and that I reserve the right, without notice, to report them to Trading Standards under a criminal code within the Consumer Protection Act 2006 for misleading omissions. They say that I can claim consequential losses, such as flights, disruptions and seek repeat performance. I'm not sure if i can get them to pay for going to another HT specialist though, as they won't be able to do it under their policy anyway ( and why would i want to ). They are providing templates for me to send to them. I won't mention their name yet, so members can only guess, but if negotiations or possible mediation fails ( an option is to use a small claims court mediation service ), I'm sufficiently cranky and motivated to spread the word and use some PR friends to make sure it sticks. Any thoughts out there that you feel I should be looking for in addition to this?

Thanks for your opinion here which increases my clarity and confidence in my approach. I did some research to see what free options are available, before I get into the legal side of things here at https://www.moneysavingexpert.com/reclaim/visa-mastercard-chargeback/ . The process is outlined and there appears to be backup through a) a chargeback appeal process or, b) the Financial Ombudsman if the appeal process is not used. The amount I can claim is fairly small, as it only relates to payments made directly to the HT referral service ( at some point I'll name the UK based firm, if they don't make an effort to recognise my complaint). They have partially refunded to me £1260 approx. Outstanding is my deposit £250 and an add on to the package costing £400 (teeth whitening). I would not have proceeded with the teeth whitening in Turkey if i had not been going, as it was not a lot cheaper than i could get with my local dentist. Then there's the hotels and transfers, which i paid as part of the package which is around £400. I think that I will also chargeback my hospital costs in Istanbul which were for my hb1ac blood test £60 and my cardio test £120 approx, which were unnecessary since they were going to refuse me based on their internal guidance anyway. So I'll organise a chargeback and they can argue between themselves about the dud referral from the HT specialists, requiring me to have these tests. What I cannot claim in a chargeback are my airfare and travelling expenses which is around £300 which were paid separately outside of my dealings with the HT referral company. Failing, that there is the small claims court - which i think would be a pain and expensive to both claim and defend. The costs will certainly be higher than the claim. But I'll likely do it as my hope is they will recognise it's commercially stupid to hold out processing a defence, and they run a big risk of losing and with all the PR / goodwill losses that will go with the process - ( I have a business that uses PR online successfully which i can target ). If the Financial Ombudsman fails, can you then go down to the small claims court? I also found that Which UK offer a legal advice service on chargebacks which may be useful for only £9/pm //legalservice.which.co.uk/consumer/goods/section-75-chargeback/ plus a small joining fee. I've gotta say that the people I'm dealing with are not addressing my questions which kinda makes negotiation a pain. They are simply saying that i made a decision to go and signed off on it. They omit that they should have refused my acceptance based on the medical knowledge that they knew about me and had published ( which i had not seen or had communicated to me ). Really, the way these folks are defending themselves says a lot about the quality of their referral and complaints process. I will out them if they don't shape up soon and defend any fallout if they try to stop reputation damage. But i guess members can already guess who they are. Update: I have proceeded separately with the chargeback process for the medical tests which were paid directly ( and were unnecessary) with the Istanbul Hospital that carried them out on the instruction of the HT unit.

That would be great / thanks. My feeling is that a letter that I draft and a lawyer modifies and frames better might make them take things more seriously, hopefully without going to the small claims Court etc.

I wonder what any of the HT businesses or middlemen use to have disputes resolved. The small claims court looks like a pain to process through. Better an ombudsman service. but I couldn’t find one. The middleman has refunded approx 50% of funds I paid. It’s just the half I want for wasted airfares, transfers, hotels, hospital tests which were unnecessary, and they’re being difficult / un professional Being unregulated makes it somewhat more complicated.

What would these be?

Well they've done this: Is there an independent Ombudsman in the UK or body to deal with this, though? I just cannot find anything on how to deal with this without going legal. In my case, if it has to go to Court, I will, but I'd like to avoid going legal for such a small recovery amount.

Are there any UK ombudsman services or other avenues to help resolve or adjudicate a dispute with a HT referral service to Turkish HT specialists. The UK service provider referred me to the HT team in Turkey when they should have known i would not be suitable with their providers by not meeting the required HbA1c threshold. They had full knowledge of my diabetes 2 (which is controlled and low level ), because I told them at the outset with medical forms and WhatsApp communication. Diabetes 2, by definition is measured at 6.5 ( according to Diabetes UK .org ). I subsequently located an article on their website which stated that they do not do procedure above 6.0, so you can't be diabetic and be below 6.0. Diabetes UK .org state in their surgical guidance that it is safe under 8.0. When I asked the UK service provider before committing they said that I would have to fly to Turkey to find out from tests. At this point i had not seen the article on their website, reviewed and authorised by a Dr ) and in any event they should have known that this was unnecessary as I would be refused due to the material i had provided. I have initiated a charge back ( Visa card ) on direct expenses made to the service provider, which may get knocked back in favour of external dispute resolution. The service provider has already provided a partial refund for GBP 1260. They are not co operating on the exchange of facts, being evasive and not answering questions to assist resolution. I want a full refund for the outstanding deposit ( GBP 250 ), associated expenses ( hotels, transfers, airfares to Turkey ) totalling overall a further GBP 1000.00 approximately. I'm not sure if i can claim for wasted time. How do you process a claim through an independent Ombudsman or similar in the UK? Does anyone have a contact?

Any suggestions of HT service provider that i can get a quote from to compare with, that would provide services for a diabetic 2 person with an HbA1c of 7.3 and on the day reading of around 5.5-6.0. No underlying conditions and tablet controlled.

I’ve just contacted Diabetes UK for guidance. So put my notes here should any further inputs be available. By definition they say pre Diabetes 2 starts at an HbA1c of 6.5%. A rate of 7.3% ( in my case ) falls well below the surgical procedure guidelines of 8.5%. My diabetes is controlled by tablets. Diabetes UK has suggested I ask what is the clinical basis for refusing treatment under 6.0.

Well, as you say, this range is pre diabetic, so why has Longevita included it in their cited article. Do some clinics require pre procedure clearance from specialists before proceeding? Why not an endocrinologist report ? My feeling is that the article is a mistake and the threshold is way too low provided the patient is otherwise healthy and it’s under control. In the absence of specific medical guidelines relating to the a1c that can be cited to counteract concerns I think diabetics would not have confidence that clinics are communicating well to them. One of the US .gov medical studies I cited above said that clear transparent communication was an imperative in the patient / clinic relationship. very unsettling IMO