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When three women developed kidney failure in December after receiving cosmetic injections at a Greensboro spa, several agencies joined the investigation and produced mounds of paperwork.

Sorting through it took months, but it led to 20 felony counts of prescription fraud filed this month against Lauretta Michelle Cheek , proprietor of Altmed of the Triad.

The drugs she is charged with obtaining were Novarel and Phentermine.

Novarel is used primarily to cause ovulation and treat infertility in women and to increase sperm count in men. Phentermine is used primarily as an appetite suppressant.

The arrest warrants did not indicate whether or how Cheek used the prescriptions she obtained.

Detective R.C. Cotten of the Guilford County Sheriff’s Office said the agencies involved included not only his department and the county Department of Public Health but also the N.C. Board of Pharmacy, the N.C. Department of Agriculture’s Food and Drug Protection Division, and the U.S. Centers for Disease Control and Prevention.

“When this all started coming about and the three patients contacted the board of health, it was a massive information-sharing onslaught by everybody,” Cotten said, “which is a good thing because everyone was then on board with what was going on.”

Cheek, 39 , of 5707 Landerwood Drive , initially was charged in March with a misdemeanor, practicing medicine without a license.

Neither Cheek nor her attorney returned phone messages left Wednesday.

The health department determined that the injections the women had received, for buttocks enhancement, were supposed to have been given by or under the supervision of a physician, but had not been.

The department could not determine what they had been injected with, and investigators still don’t know, Cotten said.

The women, who were from out of state, received two injections each, the first on Dec. 8 and the second Dec. 22. They all developed kidney failure soon after the second shot. The health department reported months ago that all three were recovering. No more recent information was available.

Cotten said the pharmacy board was notified in February by the Centers for Disease Control and Prevention that some Altmed patients had received prescriptions written in the name of a doctor at UNC-Chapel Hill. The board then assigned its investigator to the case.

The investigator obtained records from area pharmacies, then sent a 62-page report to Cotten in May. Board executive director Jay Campbell declined to comment Wednesday. The state Food and Drug Protection Division referred inquiries to the pharmacy board.

Cotten said reviewing the report took weeks, after which he obtained warrants for Cheek’s arrest on June 23.

Cotten called her attorney to arrange for her to be served with the warrants, which didn’t happen until Aug. 4.

“There was a bit of a delay on that scheduling, and finally it was, like, 'We have to get these done now,’” Cotten said.

Cheek is free on $1,500 bond, and her first court appearance is scheduled for Sept. 3.

Cotten said he does not expect to charge anyone besides Cheek in the case.

Contact Lex Alexander at 373-7088 or lex.alexander@news-record.com