Accusation against Lois March, M.D.


Lois March, M.D., an ear, nose, and throat specialist who practices in Cotrell, Georgia, is facing charges that she improperly helped Dan Raber, an unlicensed person who treats patients for cancer. Press reports indicate that Raber is being investigated and might be charged for practicing medicine without a license. Meanwhile, Georgia’s Composite Board of Medical Examiners has accused March of providing pain management to several patients whom Raber treated with a bloodroot paste, including one man whose flesh was eaten so badly from his shoulder that the bone was exposed.


BEFORE THE OFFICE OF STATE ADMINISTRATIVE HEARINGS

STATE OF GEORGIA

IN THE MATTER OF

LOIS MARCH, M.D.,
LICENSE NO. 46310,

Respondent

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DOCKET NO. 20060014

FILED JULY 26, 2005

MATTERS ASSERTED
AND STATUTES AND RULES INVOLVED

Pursuant to O.C.G.A. 50-13-13, the Composite State Board of Medical Examiners ("the Board") hereby provides Respondent with the matters asserted and the statutes and rules involved for purposes of revoking the Respondent's license. The matters asserted below, if correct, constitute sufficient grounds for the revocation of Respondent's license to practice as a physician.

MATTERS ASSERTED

1.

Lois March ("Respondent") was issued license number 46310 to practice as a physician in the State of Georgia on September 3, 1998. She was so licensed at all times relevant herein.

2.

The "Respondent is a medical doctor whose specialty area of practice is ear, nose and throat medicine.

3.

In 2003-2005, the Respondent saw and treated several patients who sought treatment for cancer or suspected cancer from Dan Raber ("Raber"), a person not licensed to practice medicine.

4.

The patients were brought to the Respondent by Raber or referred to her by Raber.

5.

At all times, the Respondent knew or should have known that the patients were receiving treatment for cancer or suspected cancer from Raber, who was not licensed to practice medicine.

6 .

At all times, the Respondent knew or should have known that Raber was not licensed to practice medicine.

7.

At all times, the Respondent knew or should have known that Raber was treating the patients for cancer or suspected cancer even though he was not licensed to practice medicine

8.

At all times, the Respondent knew or should have known that the patients were being subjected to treatment of their cancer or suspected cancer by Raber with bloodroot or compounds containing bloodroot.

9.

At all times, the Respondent knew or should have known that treatment of cancer or suspected cancer with bloodroot or compounds containing bloodroot is not an acceptable medical treatment of cancer.

10.

At all times, the Respondent knew or should have known that Raber was selling bloodroot and/or compounds containing bloodroot to patients as a cure for cancer.

11.

At all times, the Respondent was knew or should have known that bloodroot and/or compounds containing bloodroot is a caustic, tissue destroying substance that eats away human skin and flesh. The Respondent observed the loss of skin and flesh in the patients that she treated.

12.

At all times, the Respondent knew or should have known that bloodroot, and/or compounds containing bloodroot, would inflict horrific loss of skin and flesh on the patients that Respondent saw and to whom the Respondent was providing pain medication so that they could continue to receive the bloodroot treatment.

13.

At all times, the Respondent knew or should have known that bloodroot and/or bloodroot compounds would inflict horrendous pain and suffering in the patients that Respondent saw and to whom the Respondent was providing pain medications so that they could continue to receive the bloodroot treatment.

14.

At all times, the Respondent knew or should have known that the patients required pain management treatment for their horrendous pain and suffering in order to endure the bloodroot treatment provided by Raber.

15.

At all times, the Respondent knew or should have known that Raber needed the Respondent to provide pain management treatment to the patients so that the patients could continue to receive the bloodroot treatment from Raber.

16.

At all times, the Respondent knew or should have known that her pain management treatment, including giving prescriptions for pain medications., narcotics and controlled substances of the patients, was given to facilitate the continued bloodroot treatment provided by Raber.

17.

At all times, the Respondent knew or should have known 'that her pain management treatment of the patients was given to facilitate the unlicensed practice of medicine by Raber.

18.

The Respondent did not report Raber's illegal, unlicensed practice of medicine to the Board or any local law enforcement agency. Instead, the Respondent aided and abetted Raber's illegal unlicensed practice of medicine.

19.

The Respondent knew or should have known that certain female patients sought treatment from Raber for breast cancer. The Respondent knew or should have known that Raber's unlicensed practice of medicine with bloodroot mutilated their breasts and caused excruciating pain.

20.

The Respondent knew or should have known that Raber's unlicensed practice of medicine with bloodroot mutilated the patients and caused excruciating pain.

21.

The Respondent knew or should have known that Raber performed surgery on the forehead of J.B., a patient with a reported history of basal cell carcinoma of the forehead, The Respondent knew or should have known that Raber cut the patient's forehead until he exposed the patient's skull. At the time of surgery, the Respondent was speaking to Raber by telephone as he was performing the surgery to the patient's forehead.

22.

The Respondent provided medications and therapeutic support for Raber's bloodroot treatment which treatment caused tissue destruction and pain. The pain management and therapeutic support provided by the Respondent enabled Raber to continue the use of the bloodroot treatment on the patients.

23.

The Respondent failed to properly diagnosis and treat the patients. The Respondent failed to properly maintain records on the patients.

24.

The Respondent assisted Raber in his unlicensed practice of medicine. The Respondent knew or should have known that the patients were given treatment by Raber for cancer or suspected cancer.

25.

The Respondent assisted Raber in his treatment of cancer or suspected cancer with bloodroot which is not a medically recognized form of treatment for cancer.

26.

The Respondent utilized Raber to supervise and manage the patients to whom Respondent had provided prescriptions for drugs and controlled substances.

27.

In 2001, the Respondent treated the minor patient, T.B., for allergies. The Respondent directed that the patient and her mother bring in substances from their home in vials. The Respondent's course of treatment for the allergies was to have the patient hold up one of the vials while the Respondent tapped on her back. The Respondent's course of treatment also was to have the patient rub her stomach in a circular motion with one hand and tap over her heart with the fingers of the other hand. The Respondent informed the patient and her mother that these acts would rid her body of allergies.

28.

S.K. was a patient of Respondent's in October 2003. Medical records show that S.K. went to the Respondent with a reported case of breast cancer for pain management after starting bloodroot treatment.

29.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient S.K., and concluded that the diagnosis, treatment, and recordkeeping of patient S.K. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The minimum standard of care of diagnosis for a patient who reported a history of breast cancer would require obtaining pathology or biopsy reports to confirm the history of breast cancer. The Respondent failed to obtain pathology or biopsy reports to confirm the reported history of breast cancer;

(b) The minimum standard of care for diagnosis and treatment of a patient with wound injury to her breast would include removal of dressings on the injury and to provide wound care. The Respondent failed to remove the dressings or to provide wound care;

(c) The minimum standard of care for diagnosis and treatment for a physician specializing in ear, nose, and throat medicine would require such physician not to provide medications for pain and withdrawal therapy. The Respondent provided medications for pain and for withdrawal therapy outside the scope of her ENT specialty;

(d) The minimum standard of care for treatment would require not prescribing such an amount of narcotics that the patient suffered from withdrawal and risked addiction. The Respondent prescribed such a large amount of narcotics that the patient suffered from withdrawal and risked addiction;

(e) The minimum standard of care for treatment would require that the Respondent not provide medical/therapeutic support for destructive therapy administered by a person not licensed to practice medicine nor to allow the patient to receive narcotic and pain management medications under the supervision of such an unlicensed person. The Respondent provided ongoing medical/therapeutic support for the destructive therapy administered by a person not licensed to practice medicine and allowed the patient to receive narcotic and pain management medications under the supervision of such unlicensed person.

30.

J.B. was a patient of Respondent in January 2004. Medical records show that J.B. went to Respondent for cellulitis and pain management with an undocumented history of cellcarcinoma of the forehead.

31.

A Board-appointed peer review evaluated Respondent's diagnosis, treatment, and recordkeeping of patient J.B., and concluded that the diagnosis, treatment, and recordkeeping of patient J.B. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) A minimum standard of care for diagnosis of a patient reporting a history of basal cell carcinoma would require obtaining pathology or biopsy reports to confirm the reported history. The Respondent failed to obtain pathology or biopsy reports to confirm the reported history of basal cell carcinoma;

(b) A minimum standard of care for diagnosis of a patient with cellulitis and an ongoing wound would require antibiotics possibly culture directed and wound care and dressings/debridement. The Respondent failed to require antibiotics possibly culture directed and failed to provide wound care and dressings/debridement.

(c) A minimum standard of care for treatment would require that no medical/therapeutic support be provided for tissue destructive therapy administered by a person not licensed to practice medicine. The Respondent provided medications and therapeutic support for the tissue destructive bloodroot therapy administered by an unlicensed person.

32.

J,H. was a patient of Respondent's in May and June 2002. Medical records show that J.H. went to Respondent for treatment with a reported history of metastatic breast cancer with dysphagia and aspiration,

33.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient J. H. and concluded that the diagnosis, treatment, and recordkeeping of patient J.H. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care of diagnosis of a patient with a reported history of neck mass, dysphagia, and TVC paralysis requires workup with biopsy, CT chest, and panendoscopy before an accurate diagnosis of metastatic breast cancer is made. The Respondent failed to obtain such a workup on the patient;

(b) The standard of care of treatment would not be to use prevacid to resolve dysphagia and aspiration, or to prescribe duragesic patches that could suppress respiration and cause worsening of aspiration. The Respondent, however, used prevacid and duragesic patch in the treatment of the patient;

(c) The standard of care of treatment would not be to provide pain management in support of tissue destructive therapy of unknown efficacy by a person not licensed to practice medicine. The Respondent, however, provided such treatment in support of tissue destructive therapy of unknown efficacy by a person not licensed to practice medicine;

(d) The standard of care for recordkeeping would require documentation of duragesic indications and response to treatment. The Respondent failed to document duragesic indications a~d response to treatment.

34.

M.B: was a patient of Respondent in December 2002. Medical records show that M.B. went to Respondent for pain management with an undocumented history of melanoma of the shoulder/back.

35.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient M.B., and concluded that the diagnosis, treatment, and recordkeeping of patient M.B. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for diagnosis and treatment of a patient with an undocumented melanoma of the shoulder/back, which is outside the scope of normal ENT practice, is not to provide pain management for painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine. The Respondent, however, as. a physician specializing in ENT practice, provided pain management to the patient with an undocumented melanoma of the shoulder/back for support of painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine.

36.

M.C. was a patient of Respondent in January and February 2003. Medical records show that M.C. went to Respondent for pain management of an undocumented metastatic breast cancer.

37.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient M.C., and concluded that the diagnosis, treatment, and recordkeeping of patient M.C. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care of diagnosis and treatment of a patient with an undocumented metastatic breast cancer, which is outside the scope of normal ENT practice, is not to provide pain management for painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine. The Respondent, however, as a physician specializing in ENT practice, provided pain management to the patient with an undocumented metastatic breast cancer for support of painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine;

(b) The standard of care of recordkeeping would require documentation of a prescription for hydrocodone/APAP 10325 #60, and supporting notes and diagnosis noted. The Respondent failed to document such a prescription and any supporting notes and diagnosis;

(c) The standard of care of treatment would require adequate discharge planning for the patient. The Respondent inadequately performed discharge planning for the patient via telephone and internet monitoring only.

38.

K.S. was a patient of Respondent in January 2003. Medical records show that K.S. went to Respondent with a history of medullary cancer of the thyroid for pain management.

39.

A Board-appointed a peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient K. S., and concluded that the diagnosis, treatment, and recordkeeping of patient K.S. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for diagnosis and treatment of a patient with an undocumented history of medullary cancer of thyroid is not to provide pain management for painful unproven bloodroot therapy, that causes tissue destruction, by a person not licensed to practice medicine. The Respondent provided pain management to the patient with a an undocumented history of medullary cancer of thyroid for support of painful .unproven bloodroot therapy that caused tissue destruction by a person not licensed to practice medicine;

(b) The standard of care for treatment of a patient with an undocumented history of medullary cancer of the thyroid would be to. obtain a biopsy to confirm such cancer; The Respondent failed to obtain a biopsy to confirm such cancer;

(c) The standard of care for treatment of a patient with an open neck wound the size that patient K.S. had would require biopsy specific inpatient treatment and reconstruction and not just narcotics and telephone support. The Respondent failed to treat the patient with biopsy, specific inpatient treatment, and reconstruction, but only provided narcotics and telephone support.

40.

C.S, was a patient of Respondent in February 2003. Medical records show that C.S. went to Respondent for pain management with an undocumented history of breast cancer.

41.

A Board-appointed peer reviewer evaluated the Respondent's diagnosis, treatment, and recordkeeping of patient CoSo and concluded that the diagnosis, treatment, and recordkeeping of patient C.S. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for the treatment of a patient with an undocumented history of breast cancer is not to provide pain management for painful unproven blood root therapy that causes tissue destruction by a person not licensed to practice medicine. The Respondent, however, provided pain management for painful unproven bloodroot therapy that causes tissue destruction administered by an unlicensed person;

(b) The standard of care for the treatment of pain management is not to rely on an unlicensed person to supervise and manage the pain that the physician is treating. The Respondent, however, relied on an unlicensed person to supervise and manage the patient's pain that the physician was treating.

42.

L.B. was a patient of Respondent in February 2003. Medical records show that LoB. went to Respondent for pain management with an undocumented history of breast cancer.

43.

A Board-appointed peer reviewer evaluated Respondents' diagnosis, treatment, and recordkeeping of patient L.B. and concluded that the diagnosis, treatment, and recordkeeping of patient L.B. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for diagnosis and treatment of a patient with an undocumented history of breast cancer, which is outside the scope of normal ENT practice, is not to provide pain management for painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine. The Respondent, however, as a physician specializing in ENT practice, provided pain management to the patient with an undocumented history of breast cancer for support of painful unproven bloodroot therapy by such an unlicensed person;

(b) The standard of care for diagnosis would require diagnosis and biopsy of supraclavicular suspicious nodes. The Respondent failed to diagnose and biopsy such supraclavicular suspicious nodes.

44.

G.C.B. was a patient of Respondent in March 20050 Medical records show that G.C.B. went to Respondent for a neck lesion.

45.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient G.C.B., and concluded that the diagnosis, treatment, and recordkeeping of patient G.C.B. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for recordkeeping of a patient with a neck lesion that is excised is to document follow-up for suture removal and contact to discuss pathology results. The Respondent failed to document follow-up for suture removal and contact to discuss pathology results.

46.

B.C. was a patient of Respondent in September and October 2003. Medical records show that B.C. went to Respondent for pain management with an undocumented breast cancer.

47.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient B.C., and concluded that the diagnosis, treatment, and recordkeeping of patient B.C. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for diagnosis and treatment of a patient with an undocumented history of breast cancer, which is outside the scope of normal ENT practice, is not to provide pain management for painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine. The Respondent, however, provided pain management to the patient with an undocumented history of breast cancer for support of painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice. medicine;

(b) The standard of care for diagnosis of a patient with a supraclavicular mass would be to biopsy for diagnostic purposes and obtain pretreatment laboratory results. The Respondent failed to biopsy for diagnostic purposes or obtain pretreatment laboratory results.

48.

M.A. was a patient of Respondent in December 2003. Medical records show that M.A. went to Respondent with an undocumented history of breast cancer for pain management and for a possible urinary tract infection.

49.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient M.A., and concluded that the diagnosis, treatment, and recordkeeping of patient M.A. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for diagnosis and treatment of' a patient with an undocumented history of breast cancer, which is outside the scope of normal ENT practice, is not to provide pain management for painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine. The Respondent, however, as a physician specializing in ENT practice, provided pain management to the patient with an undocumented history of breast cancer for support of painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine;

(b) The standard of care for treatment of pain management is not to prescribe excessive amounts of narcotics to patients. The Respondent, however, prescribed in excess of 200 pills of narcotics in a short period of ten days to facilitate the patient's painful treatment with bloodroot;

(c) The standard of care for diagnosis of a patient with a history of undocumented breast cancer would be to obtain a biopsy and pathology report to confirm the cancer. The Respondent failed to obtain a biopsy and pathology report to confirm the cancer;

(d) The standard of care for recordkeeping for a patient who undergoes urinanalysis would be to document contact with the patient after the results were obtained and to document the medications for treatment. The Respondent failed to document contact with the patient and the medications for treatment after the urinanalysis.

50.

B.G. was a patient of Respondent in April-July 2004 and January 2005. Medical records show that B.G. went to Respondent pain management with multiple basal cell cancers of the face, neck, and ears and actinic keratosis.

51.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient B.G., and concluded that the diagnosis, treatment, and recordkeeping of patient B.G. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for diagnosis and treatment of a patient is not to provide pain management for painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine. The Respondent, however, provided pain management to the patient for support of painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine.

(b) The standard of care for diagnosis would be to send in biopsy or margins on suspected basal cell cancers of the patient's face, neck and ears for pathology reports. The Respondent failed to send in biopsies or margins on such suspected basal cell cancers for pathology reports;

(c) The standard of care for recordkeeping would require documentation of pain medications, patient counseling, and patient consents. The Respondent's medical records on this patient are incomplete, handwritten, very difficult to read; do not document the dose, brand, and duration of pain medication; do not document patient counseling; and do not document patient consent to office procedures.

52.

R.L. was a patient of Respondent from September-November 2004. Medical records show that RoLo went to Respondent with multiple skin lesions for pain management.

53.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient R.L., and concluded that the diagnosis, treatment, and recordkeeping of patient R.L. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for diagnosis and treatment is not to provide pain management for painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine. The Respondent, however, provided pain management to the patient for support of painful unproven bloodroot therapy that causes tissue destruction by a person not licensed to practice medicine;

(b) The standard of care for diagnosis of a patient who presents with exposed bone and joint in his shoulder caused by bloodroot therapy would be to refer the patient to orthopedic treatment. The Respondent failed to refer the patient who had such exposed bone and joint to orthopedic treatment;

(c) The standard of care for recordkeeping of a patient from whom the physician removes areas of his torso would be to document patient consent, pathology reports, and details of the areas removed. The Respondent failed to document such patient consent, pathology reports, and details of the areas of the torso removed.

54.

N.R. was a patient of Respondent in October 2004. Medical records show that N.R. went to Respondent with a left axilla mass with a history of lymphoma.

55.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping of patient N.R., and concluded that the diagnosis, treatment, and recordkeeping of patient N.R. departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for recordkeeping for a patient who undergoes an office biopsy of a mass in the left axilla would be to document patient consent and to document the exact location of the biopsy site. The Respondent failed to document the patient's consent and to document the exact location of the biopsy site.

56.

D.R. was a patient of Respondent from in or about 2002 to in or about 20050 Medical records show D.R. went to Respondent for treatment of various complaints, including back lesions, hypogonadism with testosterone injections, CHF, pharyngitis, sinusitis, and hyperglycemia.

57.

A Board-appointed peer reviewer evaluated Respondent's diagnosis, treatment, and recordkeeping on patient D.R., and concluded that the diagnosis, treatment, and recordkeeping of patient D.R, departed from and failed to conform to the minimum standard of acceptable and prevailing practice in the following ways:

(a) The standard of care for recordkeeping would be to document the results of all tests performed and to document appropriate information on controlled substances that are prescribed. The Respondent failed to document the test results of a sleep study performed in July 2002 and failed to document appropriate information, including office notes, history, or diagnosis for prescriptions of a controlled substance, hydrocodon/apap 7.5 #750, that Respondent called in for the patient on or about August 26, 2002 and January 24, 2003.

This page was posted on August 27, 2005.

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