It is not unusual for fellows to give injections of this nature, Ms. Silverman, the hospital spokeswoman, said. ''Plastic surgery fellows are completely trained surgeons who have independent operating privileges,'' she said. The state report said that the surgeon did not sufficiently question Ms. Goldsmith about her medical history, which it considered ''significant.'' Ms. Goldsmith, 54, the author of ''The First Wives Club'' and other novels, entered Manhattan Eye, Ear and Throat on Jan. 7 for a chin tuck. Her surgeon was Dr. Norman Pastorek, whose practice has focused on plastic surgery for the last 25 years, although he is certified by the American Board of Otolaryngology, the speciality of ear, nose and throat doctors.
