Expertise · Peptides
BPC-157, TB-500, growth hormone secretagogues and compounded research peptides are covered here. The practice reviews the medical record and the standard of care. It provides expert opinions and testimony for counsel. Dr. Hannah-Shmouni has written the clinical reference texts on these agents.
Peptide cases sit in a place most experts cannot reach. These agents have no FDA approval, no labelled dosing and often no human trials. Yet they are prescribed, compounded and injected every day. A generalist expert may have no specific evidence to measure the care against. Counsel needs an opinion on what a reasonable physician could have known about BPC-157 or ipamorelin at the moment of prescribing. The question is whether moving past that evidence was defensible.
That is the literature I work in. I have published clinical reference texts on peptide therapeutics. I maintain an active precision-medicine practice where these requests arrive weekly. I review the primary evidence for each agent as it appears. My opinions rest on the state of knowledge at the time of care, not on hindsight.
Case Patterns
Compounds sold as "research chemicals" yet prescribed, injected in clinic or recommended by name — with no FDA approval, no established human dosing and an evidence base that is almost entirely preclinical. When a patient is harmed, the first question is what a prescriber could reasonably have believed about an agent that has never completed a human trial.
Ipamorelin, CJC-1295, sermorelin, tesamorelin and MK-677 prescribed for "optimization" without any workup of the growth hormone axis — no stimulation testing, no baseline IGF-1, no monitoring on therapy. The gap between what the marketing promised and what the chart documents is usually where these cases are decided.
503A and 503B compounding of peptides that have no approved reference product — questions of potency, sterility, endotoxin contamination and whether the pharmacy could lawfully compound the substance at all. Injection-site infections, systemic reactions and product mislabelling each leave a distinct trail in the record.
Peptides bought from gray-market vendors, resold or administered by med-spas, trainers and telehealth operations that never examined the patient. Tracing who supplied, who directed use and who owed a duty of care is often the threshold dispute — and the paperwork these operations keep, or fail to keep, is telling.
Patients told a peptide was "safe", "natural" or "FDA-approved" when it was none of those things. I compare what was represented against the published evidence at the time — a literature I know closely, having written the clinical reference texts on these agents.
What the Record Shows
Related expertise
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