A woman facing extradition to the US over the death of a patient who had silicone injections could have "suicidal intentions", a court heard.
Kelly Mayhew, 34, died in 2015 after having cosmetic surgery injections in her buttocks at a house in Queens, New York.
Westminster Magistrates' Court is hearing the extradition case against Donna Francis, 37, of Loughton, Essex.
A psychiatrist has told the court Ms Francis has depression.
The court heard she could face charges of criminally negligent homicide and unauthorised practise of a profession.
Prosecutor Caroline Brown said: "It is alleged that Ms Francis was involved in the injection of cosmetic liquid silicone through the tissue of Ms Mayhew's buttocks.
"That silicone being in the wrong form caused systemic emboli which led to the death of Ms Mayhew."
The court heard Ms Francis was present as medical staff battled to save Ms Mayhew's life, but she moved to the UK the next day. She was arrested in the UK in May 2017.
Forensic psychiatrist Andrew Forrester told magistrates Ms Mayhew was suffering from a non-psychotic moderate-to-severe depressive episode and he was concerned her mental state could worsen.
Mr Forrester said: "The fact of an order of extradition and the removal of her from her daughter would be significant factors likely to cause a deterioration in her condition and could provoke suicidal intentions."
He also expressed concerns about conditions in US jails and sought assurances that Ms Francis would have access to psychiatric treatment.
The case is due to resume on Tuesday.