Consumer Health Digest #10-17

Your Weekly Update of News and Reviews
April 29, 2010

Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.

Another "biomedical treatment" provider facing disciplinary action. The Texas Medical Board has charged Jesus Caquias, M.D. with providing substandard care that involved negligence, inadequate recordkeeping, poor medical judgment, poor decision-making, failure to use proper diligence, and/or non-therapeutic prescribing and/or treatment. Caquias operates a medical office in Brownsville, Texas and worked part-time for CARE Clinics, an Austin-based facility that offered dubious and expensive services for children with autistic spectrum disorders. The charges involved dealings with four patients. Two patients diagnosed with autism and another one with headaches were given IV vitamin infusions and other inappropriate treatments at his office. The fourth patient was a child whose mother brought him to a CARE satellite clinic in Florida whose staff Caquias had trained. The complaint states that staff members, who were not licensed to practice medicine, used his signature stamp to order an "extremely large battery of diagnostic tests and several prescriptions." The board charged that his failure to prevent his stamp from being misused "demonstrated a lack of proper diligence in his professional practice." Caquias has been disciplined twice by the Texas Board. In 2006, it concluded that he had failed to maintain adequate medical records and ordered him to (a) resign from his role as a gatekeeper in the county indigent program, (b) undergo remedial training in recordkeeping, and (c) have his practice monitored for two years. In 2007, he signed an agreed order under which he was fined $5,000 and agreed to stop (a) advertising in a manner that would cause confusion to the public, (b) using overly broad claims that would "tend to mislead the public as to cures for diseases" and (c) advertising with references to organizations not recognized by the American Board of Medical Specialties. The misconduct described in the pending charges looks far more serious.

Lyme guidelines revalidated. The Infectious Diseases Society of America, which agreed to review its 2006 guidelines for diagnosing and treating Lyme Disease, has concluded that they were "based on the highest-quality medical/scientific evidence available at the time and are supported by evidence that has been published in more recent years." [Special review panel unanimously upholds Lyme disease treatment guidelines: Short-term antibiotics proven to be best treatment for patients. IDSA news release, April 22, 2010] Although there is a clear scientific consensus that it is pointless to administer antibiotics for many months after the causative organism is eradicated, advocates of longterm use persuaded Connecticut Attorney General Richard Blumenthal to investigate whether IDSA had violated state antitrust law by excluding opposing viewpoints and permitting members with financial ties to marketers of Lyme-related products to serve on its guideline committee. After its legal costs passed $250,000, the IDSA agreed to have a new panel review its guidelines even though they were based on sound science and panelists had no conflicts of interest. Outside observers have commented that "the daunting potential for litigation by those unhappy with the outcomes of treatment guidelines may well chill the willingness of medical associations to make appropriate scientific evaluations of controversial topics—a development that would significantly threaten patient care and increase medical costs." [Kraemer JD, Gostin LO. Science, politics, and values: The politicization of professional practice guidelines. JAMA 301:665-667, 2009]

In June 2009, Connecticut enacted a law to protect doctors within the state who prescribe or administer more than four weeks of antibiotic treatment to Lyme patients. Public Act No. 09-128 prohibits the Connecticut Department of Health from disciplining doctors solely for doing this, provided that they make an appropriate diagnosis and keep appropriate records. They can still be disciplined, however, for inappropriate diagnosis and failing to meet other standards of care.

Gary Null says he was poisoned by his own product. Gary Null is suing the manufacturer of Gary Null's Ultimate Power Meal. The complaint alleges:

Within the past two days, Null's Web sites have posted at least three reactions to publicity about the suit. One said that he was "completely and totally healthy and everything is fine." Another said that "none of the retail product reached the market" and he had "returned to complete health." But after a Los Angeles Times blog noted that these statements contradicted what the lawsuit said, he replaced them with one that said he was "feeling substantially better."

Null is one of the nation's leading promoters of dubious treatment for serious disease. He has refused to answer several questions about his credentials. It may be interesting to see what the legal proceedings uncover.

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This page was posted on April 30, 2010.