Les Breitman Loses Medical License

Stephen Barrett, M.D.


In January 2012, the Medical Board of California charged Les Breitman, M.D. with gross and repeated negligence; inadequate recordkeeping; false advertising; "dishonesty or corruption"; and general unprofessional conduct. Breitman's operates the Alternative Cancer Treatment Center of Southern California in Oceanside, California. He has also done business at the same address under the names "Integrative Cancer and Medical Treatment Center" and "Institute for Anti-Aging Medicine." The facility's Web site states it "specializes in IPT Treatment for cancer and natural bio-identical hormone replacement and optimization for women and men." The complaint (shown below) alleges that Breitman negligently treated a woman with cancer and that his Web site "generally misrepresented the benefit of his treatment and the dangers of his treatment" and "contained material representations that were represented as fact even though they were not based on fact." In July 2012, the board concluded that the accusations were valid and revoked Breitman's license.

IPT (insulin-potentiated therapy) usually involves giving substandard doses of chemotherapy drugs after administering of insulin. Proponents claim that intravenous insulin increases the effect of medications so that lower doses can be used. They also suggest that the insulin somehow makes cells more permeable so that certain drugs enter more easily. However, there is no logical reason to believe this is true and no scientific evidence showing that IPT is safe or effective as a cancer treatment.

Juergan Winkler, M.D., another physician identified on the clinic Web site, has also been subjected to disciplinary action.


BEFORE THE
DIVISION OF MEDICAL QUALITY
MEDICAL BOARD OF CALIFORNIA
DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA


In the Matter of the Accusation Against:
LES BREITMAN, M.D.
2204 EI Camino Real, Suite 104 Oceanside, CA 92054

Physician's and Surgeon's Certificate
No. A 21592

Respondent.


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Case No.10-2008-189611

ACCUSATION

Filed January 7, 2011.

 

Complainant alleges:

PARTIES

1. Linda K. Whitney (hereinafter "Complainant") brings this Accusation solely in her official capacity as the Executive Director of the Medical Board of California, Department of Consumer Affairs.

2. On or about July 1, 1965, the Medical Board of California issued Physician's and Surgeon's Certificate No. A 21592 to LES BREITMAN, M.D. (hereinafter "Respondent"). The Physician's and Surgeon's Certificate was in full force and effect at all times relevant to the charges brought herein and will expire on February 29,2012, unless renewed.

JURISDICTION

3. This Accusation is brought before the Medical Board of California (Board), Department of Consumer Affairs, under the authority of the following laws. All section references are to the Business and Professions Code (Code) unless otherwise indicated.

4. Section 2227 of the Code provides that a licensee who is found guilty under the Medical Practice Act may have his or her license revoked, suspended for a period not to exceed one year, placed on probation and required to pay the costs of probation monitoring, be publicly reprimanded, or have such other action taken in relation to discipline as the Division deems proper.

5. Section 2234 of the Code states:

"The Division of Medical Quality1 shall take action against any licensee who is charged with unprofessional conduct. In addition to other provisions of this article, unprofessional conduct includes, but is not limited to, the following:

"(a) Violating or attempting to violate, directly or indirectly, assisting in or abetting the violation of, or conspiring to violate any provision of this chapter [Chapter 5, the Medical Practice Act].

"(b) Gross negligence.

"(c) Repeated negligent acts. To be repeated, there must be two or more negligent acts or omissions. An initial negligent act or omission followed by a separate and distinct departure from the applicable standard of care shall constitute repeated negligent acts.

"(1) An initial negligent diagnosis followed by an act or omission medically appropriate for that negligent diagnosis of the patient shall constitute a single negligent act.

"(2) When the standard of care requires a change in the diagnosis, act, or omission that constitutes the negligent act described in paragraph (1), including, but not limited to, a reevaluation of the diagnosis or a change in treatment, and the licensee's conduct departs from the applicable standard of care, each departure constitutes a separate and distinct breach of the standard of care.”

". . .

"(e) The commission of any act involving dishonesty or corruption which is substantially related to the qualifications, functions, or duties of a physician and surgeon."

1California Business and Professions Code section 2002, as amended and effective January 1, 2008, provides that, unless otherwise expressly provided, the term "board" as used in the State Medical Practice Act (Cal. Bus. & Prof. Code, §§2000, et. seq.) means the "Medical Board of California," and references to the "Division of Medical Quality" and "Division of Licensing" in the Act or any other provision of law shall be deemed to refer to the Board.

6. Section 2266 of the Code states: "The failure of a physician and surgeon to maintain adequate and accurate records relating to the provision of services to their patients constitutes unprofessional conduct."

7. Section 2271 of the Code states: "Any advertising in violation of Section 17500, relating to false or misleading advertising, constitutes unprofessional conduct."

8. Section 17500 of the Code states:

"It is unlawful for any person, firm, corporation or association, or any employee thereof with intent directly or indirectly to dispose of real or personal property or to perform services, professional or otherwise, or anything of any nature whatsoever or to induce the public to enter into any obligation relating thereto, to make or disseminate or cause to be made or disseminated before the public in this state, or to make or disseminate or cause to be made or disseminated from this state before the public in any state, in any newspaper or other publication, or any advertising device, or by public outcry or proclamation, or in any other manner or means whatever, including over the Internet, any statement, concerning that real or personal property or those services, professional or otherwise, or concerning any circumstance or matter of fact connected with the proposed performance or disposition thereof, which is untrue or misleading, and which is known, or which by the exercise of reasonable care should be known, to be untrue or misleading, or for any person, firm, or corporation to so make or disseminate or cause to be so made or disseminated any such statement as part of a plan or scheme with the intent not to sell that personal property or those services, professional or otherwise, so advertised at the price stated therein, or as so advertised. Any violation of the provisions of this section is a misdemeanor punishable by imprisonment in the county jail not exceeding six months, or by a fine not exceeding two thousand five hundred dollars ($2,500), or by both that imprisonment and fine."

9. Unprofessional conduct under California Business and Professions Code section 2234 is conduct which breaches the rules or ethical code of the medical profession, or conduct which is unbecoming to a member in good standing of the medical profession, and which demonstrates an unfitness to practice medicine.2

2Shea v. Board of Medical Examiners (1978) 81 Cal.App.3d 564,575. May 1, 2007.

FIRST CAUSE FOR DISCIPLINE

(Gross Negligence)

10. Respondent is subject to disciplinary action under sections 2227 and 2234, as defined in section 2234, subdivision (b), of the Code, in that he was grossly negligent in his care and treatment of patient K.F. The circumstances are set forth below:

11. At all times relevant herein, respondent specialized in providing Insulin Potentiation Therapy OPT), a form of low dose chemotherapy. On his website. respondent references a "Kinder & Gentler Chemotherapy" and describes IPT as follows:

"If there is a chemotherapy drug that works against a particular type of tumor, it is believed to work better with IPT. The insulin employed enables the physician to direct all the chemotherapeutic agents to the cancer cells only, bypassing the normal cells and thereby sparing the patient the throes of conventional chemotherapy. Therefore, only approximately 10% of the customary dosage of conventional chemotherapy arc required. And as a result of this low dosage, with far less toxicity, up to four different chemotherapeutic agents can be administered at each weekly treatment!"

12. On or about April 9, 2007, patient K.F., a 52 year-old female suffering from metastatic malignant melanoma, presented to respondent for low dose chemotherapy treatment. Respondent provided low dose chemotherapy to patient K.F. on or about April 19, 24 ,27 and

13. Prior to beginning chemotherapy, respondent reviewed laboratory testing provided to him by patient K.F. He did not obtain any other comprehensive laboratory testing during his treatment of K.F. While rendering chemotherapy to patient K.F., respondent performed glucose testing only twice per session. The first testing was done prior to the start or the session. The second and final test took place when respondent or his nurse believed the patient has reached the "therapeutic moment."

14. Prior to receiving chemotherapy from respondent on or about April 27 and May 1, 2007, patient K.F. complained to respondent about sores in her mouth and other ailments.

15. Patient K.F. was to return to respondent for further treatment on May 8, 2007, but did not because she was admitted to UCSD Thornton Hospital with a complaint of lever and a white blood cell count of 5003 with no neutrophils4 that was associated with malaise, headache, muscle pain, chills, and painful mucositis.5 During her hospitalization, she received Neupogen,6 "broad spectrum antibiotics and Dilaudid for pain. She also complained of lower extremity paresthesia.7 While hospitalized, patient K.F. requested her records from respondent; however, he claimed they were missing, failed to provide them and took no steps to reconstruct the missing records.

3The normal range for WBC count is 4,300 to 10,800 cells per cubic millimeter (Cl111l1)

4Neutrophils are the most common type of white blood cell, comprising about SO-70'Yc, or all white blood cells.

5Mucositis is the inflammation of the mucous membranes lining the digestive tract 11'0111 the mouth on down to the anus. Mucositis is a common side effect of chemotherapy.

6Neupogen is a drug given to patients who have neutropenia (low neutrophil count).

7Paresthesia is a sensation of numbness or tingling on the skin.

16. Respondent committed gross negligence in his care and treatment or patient K.F. which included, but was not limited to, the following.

(a) Respondent failed to order any follow up laboratory testing prior to the administration of additional chemotherapy on or about April 24, 27 and May 1, 2007;

 (b) Respondent failed to perform adequate glucose testing during the administration of chemotherapy on or about April] 9, 24, 27 and May 1, 2007;

(c) Respondent treated patient K.F. with chemotherapy on or about April 27 and May 1, 2007, even though she was suffering from mouth sores and other ailments; and

(d) Respondent intentionally mislead patient K.F. and prospective patients that he attracts to his practice via his website containing intentionally vague, misleading or side-effect minimizing information regarding IPT with respect to its use in cancer treatment.

SECOND CAUSE FOR DISCIPLINE

(Repeated Negligent Acts)

17. Respondent has further subjected his Physician's and Surgeon's Certificate No. A 21592 to disciplinary action under sections 2227 and 2234, as defined by section 2234, subdivision (c), of the Code, in that he committed repeated negligent acts in his care and treatment of patient K.F., as more particularly alleged hereinafter:

18. Paragraphs 10 through 16, above, are hereby incorporated by reference and realleged as if fully set forth herein.

19. Respondent committed repeated negligent acts, including but not limited, to the following;

(a) Respondent failed to reconstruct or attempt to reconstruct patient K.F.'s missing chart.

(b) Respondent failed to order any follow up laboratory testing prior to the administration of additional chemotherapy on or about April 24, 27 and May 1, 2007;
 
(c) Respondent failed to perform adequate glucose testing during the administration of chemotherapy on or about April 19, 24, 27 and May L 2007;

(d) Respondent treated patient K.F. with chemotherapy on or about April 27 and May 1, 2007, even though she was suffering from mouth sores and other ailments; and

(e) Respondent intentionally mislead patient K.F. and prospective patients that he attracts to his practice via his website containing intentionally vague, misleading or side-effect minimizing information regarding IPT with respect to its use in cancer treatment.

THIRD CAUSE FOR DISCIPLINE

(Failure to Maintain Adequate or Accurate Medical Records)

20. Respondent has further subjected his Physician's and Surgeon's Certificate No. A 21592 to disciplinary action under sections 2227 and 2234, as defined by section 2266, of' the Code, in that respondent failed to maintain adequate and accurate records in regards to his care and treatment of patient K.F., as more particularly alleged hereinafter.

21. Paragraphs 10 through 19, above, are hereby incorporated by reference and realleged as if fully set forth herein.

FOURTH CAUSE FOR DISCIPLINE

(False Advertising)

22. Respondent has further subjected his Physician's and Surgeon's Certificate No. A 21592 to disciplinary action under sections 2227 and 2234, as defined by section 2271, of the Code, in that he disseminated false and misleading representations through his website, in violation of section 17500 of the Code. The circumstances are set forth below:

23. Paragraphs 10 through 16, above, are hereby incorporated by reference as if fully set forth herein.

24. Respondent's website, at all times relevant herein, stated that, "Is IPT just as effective as the chemotherapy my oncologist would prescribe? It does appear that the percentages for remission and survival are at least as good as with conventional chemotherapy, and probably much better." In fact, this representation is untrue or misleading, lacks substantiation and is based solely on Respondent's personal experience rather than peer reviewed studies or other valid scientific analysis.

25. Respondent's website, at all times relevant herein, stated: "Arc there any side effects of IPT treatment? Almost none. There is certainly no hair loss, no going home to shiver in bed for a day or two, and no severe vomiting. There is occasional constipation, which is easily controlled by simple medications. Some nausea is occasionally encountered for a few hours after the first couple of treatments, but this is also easily managed." In fact, this representation is untrue or misleading, lacks substantiation and is inconsistent with Respondent's own observations including his observation of patients losing clumps of hair.

26. Respondent's website, at all time relevant herein, stated: "As compared to conventional chemotherapy, there are no severe and debilitating side effects. The patient can easily continue with normal daily activities, enjoying a high quality of life while avoiding severe vomiting, hair loss, or fevers." In fact, this representation is untrue or misleading, lacks substantiation and is inconsistent with Respondent's own observations including his observation of patients losing clumps of hair.

27. Respondent's website, at all times relevant herein, stated: "Arc there any dangers in 1PT treatment? Unlike with conventional chemotherapy, there have been no reported deaths as a result of IPT. In brief, there is no danger. The worst side effect encountered is easily managed constipation. Unlike conventional chemotherapy, anemia and decreased platelet counts are unusual and usually not so severe as to require transfusions." In fact, this representation is untrue or misleading, lacks substantiation, is purportedly based on Respondent's personal experience rather than peer reviewed studies or other valid scientific analysis, and is inconsistent with Respondent's own observations at his practice.

28. Respondent's website, at all times relevant herein, generally misrepresented the benefit of his treatment and the dangers of his treatment.

29. Respondent's website, at all times relevant herein, contained material representations that were represented as fact even though they were not based on fact.

FIFTH CAUSE FOR DISCIPLINE

(Dishonesty or Corruption)

30. Respondent is further subject to disciplinary action under sections 2227 and 2234, as defined in section 2234, subdivision (e), of the Code, in that he committed an act or acts of dishonesty or corruption in connection with his care and treatment of patient K.F. and other patients, as more particularly described hereinafter:

31. Paragraphs 22 through 29 above, which are hereby incorporated by reference as if fully set forth herein.

SIXTH CAUSE FOR DISCIPLINE

(General Unprofessional Conduct)

32. Respondent has further subjected his Physician's and Surgeon's Certificate No. A 21592 to disciplinary action under sections 2227 and 2234 of the Code in that he has engaged in conduct which breaches the rules or ethical code of the medical profession, or conduct which i: unbecoming to a member in good standing of the medical profession, and which demonstrates an unfitness to practice medicine, in his care and treatment of patient K.F. and other patients as mort particularly described hereinafter:

33. Paragraphs 22 through 29 above, which arc hereby incorporated by reference a: if fully set forth herein.

PRAYER

WHEREFORE, Complainant requests that a hearing be held on the matters herein alleged, and that following the hearing, the Medical Board of California issue a decision:

1. Revoking or suspending Physician's and Surgeon's Certificate No A 21592, heretofore issued to respondent LES BREITMAN, M.D.;

2. Revoking, suspending or denying approval of respondent LES BREITMAN, M.D.'s authority to supervise physician's assistants, pursuant to section 3527 of the Code;

3. Ordering respondent LES BREITMAN, M.D., if placed on probation, to pay the costs of probation monitoring; and

4. Taking such other and further action as necessary and proper.

DATED: January 7, 2011

_________________________
Linda K. Whitney
Executive Director
Medical Board of'. California
Department of Consumer Affairs
State of California
Complainant

EDMUND G. BROWN JR.
Attorney General of California
THOMAS S. LAZAR
Supervising Deputy Attorney General
DAVID CHAN
Deputy Attorney General State Bar No. 159343
110 West "A" Street, Suite 1100
San Diego, CA 92101
P.O. Box 85266
San Diego, CA 92186-5266
Telephone: (619) 645-2600
Facsimile: (619) 645-2061
E-mail: David.Chan@doj.ca.gov
Attorneys for Complainant

This page was revised on August 31, 2013.

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