Disciplinary Action against
James J. Mahoney, D.O.
Stephen Barrett, M.D.
In 2007, the Texas Medical Board charged James J. Mahoney, D.O. with improperly managing the care of a 61-year-old woman. The Board's complaint, shown below, states that he did not evaluate her properly, did not keep adequate records, administered EDTA chelation therapy and several other treatments that had no therapeutic value, and failed to refer the patient elsewhere when her symptoms worsened. In 2008, the case was settled with a mediated agreed order requiring Mahoney to attend a remedial course in medical record-keeping and then have his charts monitored for a six-month period. Mahoney, who refers to himself as "America's Natural Health Coach," operates the Center for Hope and Healing in Southlake, Texas, where he offers many types of questionable treatments.
HEARING CONDUCTED BY THE
TEXAS STATE OFFICE OF ADMINISTRATIVE HEARINGS
SOAH DOCKET NO. ____________________
TEXAS MEDICAL LICENSE NO. H-0591
IN THE MATTER OF THE
JAMES JOSEPH MAHONEY. D.O.
TEXAS MEDICAL BOARD
TO THE HONORABLE TEXAS MEDICAL BOARD AND THE HONORABLE ADMINISTRATIVE LAW JUDGE TO BE ASSIGNED:
COMES NOW, the Staff of the Texas Medical Board (the "Board"), and files this Complaint against James Joseph Mahoney. D.O., ("Respondent"), based on Respondent's alleged violations of the Medical Practice Act (“the Act"), Title 3, Subtitle B. Texas Occupations Code, and would show the following:
The filing of this Complaint and the relief requested are necessary to protect the health and public interest of the citizens of the State of Texas. as provided in Section 151.003 of the Act.
II. LEGAL AUTHORITY AND JURISDICTION
Respondent is a Texas physician and holds Texas Medical License No. H-0591, issued by the Board on December 3, 1986, which was in full force and effect at nil times material and relevant to this Complaint. All jurisdictional requirements hove been satisfied. The Respondent received notice of the Informal Settlement Conference (ISC), and appeared at the ISC. All procedural rules were complied with, including but not limited to. Board Rules 182 and 187. as applicable.
III. PROCEDURAL BACKGROUND
1. The Board received information that Respondent may have violated the Act and, based on that information, conducted an investigation. The investigation compiled evidence that supports allegations of a violation.
2. Respondent was invited to attend an Informal Show Compliance Proceeding and Settlement Conference ("ISC"), held un March 30, 2007, which was conducted in accordance with §2001.054(c), TEX. GOV’T CODE and §164.004 of the Act. The Board representatives. including at least one physician ("Panel"). reviewed and considered evidence from the investigation, as well as an)' information presented by Respondent. The Panel determined that Respondent hud not shown compliance with all requirements of the Act.
3. In an attempt to resolve this matter informally, the Panel offered Respondent a proposed Agreed Order, setting forth certain terms and conditions. Respondent failed and/or refused to agree to the proposed settlement offer and no agreement to settle this matter has been reached by the parties.
IV. FACTUAL ALLEGATIONS
Board Staff has received information and on that information believes that Respondent has violated the Act. Based on such information and belief, Board Staff alleges:
1. Respondent treated L.H. for a variety of health-related matters with complementary and alternative therapies from December 3, 2002, to February of 2006.
2. L.H., a 61 year-old female patient, presented to Respondent on December 3, 2002, desiring an evaluation regarding a diagnosis of multiple sclerosis (MS) and Lyme Disease, and complaining of limited energy and mobility. L.H.'s referring physician had prescribed several medications: Amoxicillin. Zithromax, Neurontin, Nystatin, Diflucan, Macrodantin, Premarin, Provera, Thyroid, and vitamins.
3. Respondent noted on December 3, 2002, that L.H.’s labs "show severe immunological deficiency and multiple viral infections in addition to Lyme disease antigens.” Respondent recorded that L.H.’s current diagnoses included: uncontrolled chronic pain syndrome, acute somatic dysfunction of cervical, thoracic, lumbar, sacral and lower extremity regions; mixed chronic infections including EBV, CM, Lyme disease: hypothyroidism by history; progressive neurological degenerative disease; MS by history; bilateral lower extremity neuropathy; metabolic derangement: and mild depression.
4. Respondent's treatment included magnesium. fish oil. digestive enzymes. probiotics and methylacobolamine. L.H. was treated with intravenous (IV) Glutathione 2 gm for "neurologic support.” Respondent's prescribing of the Glutathione is non-therapeutic.
5. On March 4, 2003, Respondent documented that L.H. "has discontinued all of her antibiotic therapies." Respondent's exam shows musculoskeletal changes, continued lower extremity edema. and resolution of abnormal neurologic exam relative to previous exams. Respondent again treated L.H. with an IV of Glutathione. Respondent failed to document a full workup of neurologic degeneration" and a compelling indication to treat with Glutathione.
6. L.H. returned on January 13, 2004, and complaining of ubdominu1 bloating, significant pain in feet. fatigue and dizziness. L.H. is treated with N Glutathione, Methylcobalamine, 1M dexamethasone and Depomedrol "for acute flare." Respondent also treated L.H. with "IV fluids and a nutrient and fatigue protocol," which includes an IV of Edate Calcium Disodium (EDTA) for pain reduction. The use of Glutathione' for neurological benefit and EDTA for "nutrition protocol" is non-therapeutic.
7. On May 24, 2004, Respondent notes that L.H. has "improving lower extremity swelling and pain on her current nutritional regimen. Stool analysis reveals poor immune function with many pathogens." Respondent's treatment included nutritional support protocol, increased "probiotics," and to start Uva Ursi and Caprylic Acid 500 mg 3x/day for I month. It is not within the standard of cure to treat the patient with Uva Ursi and Caprylic Acid for the treatment of gastrointestinal disorders. Respondent did not document Esophogoduodenoscopy (EGD) or a Colonoscopy to rule out pathology, and there was no documentation of an evaluation by Gastroenterology.
8. On March 15, 2005, L.H. visited Respondent for increased shortness of breath and describes possible paroxysmal nocturnal dyspnea. Respondent regularly prescribes Cortef 10 mg from March of 2005 through February of 2006, with indication only noted as "fatigue.” It is not within the standard of care to use Cortef for "fatigue," In addition, Respondent failed to monitor the patient's bone density and ophthalmologic concerns when using the Cortef.
9. Respondent failed to meet the standard of care in that he failed to keep accurate and complete medical records as to documentation and communications with the patient's concurrent healthcare providers informing them of his treatment plans for L.H.; engaging in nontherapeutic prescribing; failed to rule out a cardiac/vascular etiology of lower extremity edema; failed to properly examine and work up the patient's abdominal pain used EDT A in a nontherapeutic manner; and failed to appropriately work up or refer the patient when she developed worsening neurological symptoms.
V. APPLICABLE STATUTES, RULES, AND AGENCY POLICY
Respondent's conduct, us described above, constitutes grounds for the Board to revoke or suspend Respondent's Texas medical license or to impose any other authorized means of discipline upon the Respondent. The following statutes. rules, and agency policy are applicable to this matter:
A. Procedures for the Conduct of this Hearing:
1. Section 164.007(a) of the Act requires that the Board adopt procedures governing formal disposition of a contested case before the State Office of Administrative Hearings.
2. 22 TEX. ADMIN. CODE, Chapter 187 sets forth the procedures adopted by the Board under the requirement of Section 164.007(a} of the Act.
3. TEX. ADMIN. CODE §ISS.3(c} provides that the procedural rules of the state agency on behalf of which the hearing is conducted govern procedural matters that relate to the hearing as required by law, to wit: Section 164.007(a) of the Act, as cited above.
4. TEX. ADMIN. CODE, CHAPTER 155 sets forth the rules of procedure adopted by SOAH for contested case proceedings.
B. Violations Warranting Disciplinary Action:
1. Section 164.051(a)(6) of the Act authorizes the Board to take disciplinary action against Respondent based on Respondent's failure to practice medicine in an acceptable professional manner consistent with public health and welfare. Board Rule § 190.8(1)(A), (B), and (C) defines the failure to practice in an acceptable professional manner consistent with public health and welfare within the meaning of the Act includes, but is not limited to, failure to treat a patient according to the generally accepted standard of cure; negligence in performing medical services; and failure to use proper diligence in one's professional practice.
2. Section 164.051(a)(5) of the Act authorizes the Board to take disciplinary action against Respondent based upon Respondent's unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injure the public.
3 Sections 164.052(a)(5) and 164.053(a)(5) of the Act authorizes the Board to take disciplinary action against Respondent based on Respondent prescribing or administering a drug or treatment that is nontherapeutic in nature: or nontherapeutic in the manner the drug or treatment is administered or prescribed.
C. Sanctions that May Be Imposed:
1. Section 164.001 of the Act authorizes the Board to impose a range of disciplinary actions against a person for violation of the Act or a Board rule. Such sanctions include: revocation, suspension, probation, public reprimand. limitation or restriction on practice, counseling or treatment, required educational or counseling programs, monitored practice, public service, and an administrative penalty.
2. Chapter 165, Subchapter A of the Act sets forth statutory requirements for the amount and basis of an administrative penalty.
3. 22 TEX. ADMIN. CODE Chapter 187.39 authorizes the Board to assess, in addition to any penalty imposed, costs of the investigation and administrative hearing in the case of 8 default judgment or upon adjudication that Respondent is in violation of the Act after a trial on the merits.
4. 22 TEX. ADMIN. CODE Chapter 190 provides disciplinary guidelines intended to provide guidance and a framework of analysis for administrative law judges in the making of recommendations in contested licensure and disciplinary matters and to provide guidance as to the types of conduct that constitute violations of the Act or board rules.
5. 22 TEX. ADMIN. CODE Chapter 190.15 provides the authority for this Board to consider aggravating factors in this case.
VI. NOTICE TO RESPONDENT
IF YOU DO NOT FILE A WRITTEN ANSWER TO THIS NOTICE WITH THE STATE OFFICE OF ADMINISTRATIVE HEARINGS WITHIN 20 DAYS OF THE DATE NOTICE OF SERVICE WAS MAILED, A DEFAULT JUDGMENT MAY BE ENTERED AGAINST YOU, WHICH MAY INCLUDE THE DENIAL OF LICENSURE OR ANY OR ALL OF THE REQUESTED SANCTIONS INCLUDING THE REVOCATION OF YOUR LICENSE. IF YOU FILE A WRITTEN ANSWER, BUT THEN FAIL TO ATTEND THE HEARING. A DEFAULT JUDGMENT MAY BE ENTERED AGAINST YOU, WHICH MAY INCLUDE THE DENIAL OF UCENSURE OR ANY OR ALL OF TUE REQUESTED SANCTIONS INCLUDING THE REVOCATION OF YOUR LICENSE. A COPY OF ANY RESPONSE YOU FILE WITH THE STATE OFFICE OF ADMINISTRATIVE HEARINGS SHALL ALSO BE PROVIDED TO THE BEARINGS COORDINATOR OF THE TEXAS STATE BOARD OF MEDICAL EXAMINERS.
\PURSUANT TO 22 TEX. ADMIN. CODE § 187.27(a)(2), A WRITTEN ANSWER SHALL SPECIFICALLY ADMIT OR DENY EACH FACTUAL ALLEGATION MADE AGAINST THE RESPONDENT.
WHEREFORF., PREMISES CONSIDERED, Board Staff requests that an administrative law judge employed by the State Office of Administrative Hearings conduct a contested case hearing on the merits of the Complaint, in accordance with Section 164.007(a) of the Act. Upon final hearing, Board Staff requests that the Honorable Administrative Law Judge issue 8 Proposal for Decision ("PFD") that reflects Respondent's violation of the Act as set forth in this Complaint. Following issuance of the PFD, Board Staff requests that the Board. pursuant to § 164.001 and § 165.003 of the Act and Board Rules 187.30. 187.39. 190.8, 190.14, 190.15 and 190.16, enter an Order imposing any and all sanctions or disciplinary measures necessary to protect health and public welfare, including the imposition on Respondent of SO/AH hearing costs and an administrative penalty.
TEXAS MEDICAL BOARD By:
Mark Martyn, Staff Attorney
Texas State Bar No. 24029708
Files with the Texas Medical Board on August 24, 2007
Donald W. Patrick, M.D., J.D.
Texas Medical Board
This page was posted on August 24, 2008.