A state appeals court has rejected a Manhattan physician’s defamation claim targeting former clients who went online to criticize the doctor and her medical spa, writing that while the clients’ online complaints “do mix fact and opinion” they “have a loose, figurative or hyperbolic tone” to them.

One defendant, Mimi Ishida, said in an online review she posted after visiting Dr. Roxana Kerns’ Manhattan-based medical spa, “In my honest opinion, [plaintiff] acts like a psychotic nutcase” and “I don’t think [plaintiff] even has her doctor’s license,” according to the opinion from the Appellate Division, First Department court tossing out Kerns’ defamation action.