Jarir Nakouzi, M.D. Placed on Probation (2011)

Stephen Barrett, M.D.


Jarir Nakouzi, M.D., who purported to treat cancer with homeopathic products, has signed a consent order under which he agreed to (a) pay $5,000, (b) stop using devices that measure skin resistance for diagnostic or treatment purposes, (c) stop making unsubstantiated claims that refrain from recommending, prescribing, or administering any alleged cancer treatment that lacks FDA approval or scientific support, and (d), serve probation for two years, during which at least 20 of his patient charts should be subject to random review by a supervisor acceptable to the Connecticut Department of Health. The agreement settled charges related to Nakouzi's treatment of a patient who had received standard treatment for breast cancer but was terminally ill. The complaint had charged that Nakouzi deviated from the standard of care by failing to get adequate informed consent, failing to maintain adequate documentation, and using a bioresonance device as a diagnostic technique. The situation was vividly described in a Newsweek article.


STATE OF CONNECTICUT
DEPARTMENT OF PUBLIC HEALTH
HEALTH CARE SYSTEMS BRANCH
CONNECTICUT MEDICAL EXAMINING BOARD

In re: Jarir Nakouzi, M.D.       Petition No. 2007-0424-001-060

CONSENT ORDER

WHEREAS, Jarir Nakouzi, M.D., of Bridgeport, Connecticut (hereinafter "respondent"), has been issued license number 212352 to practice as a physician and surgeon by the Department of Public Health (hereinafter "the Department") pursuant to Chapter 370 of the General Statutes of Connecticut, as amended; and,

WHEREAS, the Department alleges that:

1. Respondent provided care to patient M.N., who was suffering from advanced metastatic breast cancer, from on or about October 21, 2006 through on or about December 20, 2006 Respondent's care for M.N. failed to meet the standard of care, was inadequately documented, and was provided on the basis of inadequate informed consent.

2. The above described facts constitute grounds for disciplinary action pursuant to the General Statutes of Connecticut, §20-13c(4).

WHEREAS, respondent, in consideration of this Consent Order, has chosen not to contest the above allegations of wrongdoing but, while admitting no guilt or wrongdoing, agrees that for purposes of this or any future proceedings before the Connecticut Medical Examining Board (hereinafter "the Board"), this Consent Order shall have the same effect as if proven and ordered after a full hearing held pursuant to §§19a-10,19a-14 and 20-13c of the General Statutes of Connecticut.

NOW THEREFORE, pursuant to §§19a-14, 19a-17 and 20-13c of the General Statutes of Connecticut, respondent hereby stipulates and agrees to the following:

1. Respondent waives his right to a hearing on the merits of this matter.

2. Respondent shall pay a civil penalty of five thousand dollars ($5,000) by certified or cashier's check payable to "Treasurer, State of Connecticut." The check shall reference the Petition Number on the face of the check, and shall be payable at the time respondent submits the executed Consent Order to the Department.

3. Respondent's license shall be permanently restricted as follows:

a. Respondent may not use bioresonance, or other similar methods and devices that measure electrical activity at the skin, as a diagnostic or treatment modality;

b. Respondent.may not order, prescribe, dispense, recommend, or administer any remedy as a cure for cancer, or as an agent that prolongs the life expectancy of a patient with any cancer, unless said remedy is either (a) approved as such by the United States Food and Drug Administration or (b) its safety and effectiveness as such is established by published peer-reviewed studies of human clinical trials conducted under the supervision of a hospital or university independent review board, and then only for the conditions and doses studied.

4. Respondent's license shall be placed on probation for a period of two years under the following terms and conditions:

a. Respondent shall obtain at his own expense, the services of a physician who is board certified in internal medicine, pre-approved by the Department (hereinafter "supervisor"), to conduct a random review of twenty percent (20%) or twenty (20) of respondent's patient records, whichever is the larger number. In the event respondent has twenty (20) or fewer patients, the supervisor shall review all of respondent's patient records.

(1) Respondent shall provide a copy of this Consent Order to his practice supervisor. Respondent's supervisor shall furnish written confirmation to the Department of his or her engagement in that capacity and receipt of a copy of this Consent Order within fifteen (15) days of the effective date of this Consent Order.

(2) Respondent's supervisor shall conduct such review and meet with him not less than once every month for the first three months of his probationary period and quarterly for the remainder of the probationary period.

(3) The supervisor shall have the right to monitor respondent's practice by any other reasonable means which he or she deems appropriate. Respondent shall fully cooperate with the supervisor in providing such monitoring.

(4) Respondent shall be responsible for providing written supervisor reports directly to the Department monthly for the first three months of his probationary period and quarterly for the remainder of the probationary period. Such supervisor's reports shall include documentation of dates and duration of meetings with respondent, number and a general description of the patient records and patient medication orders and prescriptions reviewed, additional monitoring techniques utilized, and statement that respondent is practicing with reasonable skill and safety, and further that respondent's charts contain appropriate documentation of (a) pain assessment and management, (b) coordination with other providers, and (c) appropriate disclosure and discussion of the nature of treatment, its expected outcomes, and its risks and benefits.

5. All correspondence and reports are to be addressed to:

Bonnie Pinkerton, Nurse Consultant
Department of Public Health
410 Capitol Avenue, MS #12HSR
P.O. Box 340308
Hartford, CT 06134-0308

6. All reports required by the terms of this Consent Order shall be due according to a schedule to be established by the Department of Public Health.

7. Respondent shall comply with all state and federal statutes and regulations applicable to his licensure.

8. Respondent shall pay all costs necessary to comply with this Consent Order.

9. Any alleged violation of any provision of this Consent Order may result in the following procedures at the discretion of the Department:

a. The Department shall notify respondent in writing by first-class mail that the term(s) of this Consent Order have been violated, provided that no prior written consent for deviation from said term(s) has been granted.

b. Said notification shall include the acts or omission(s) which violate the term(s) of this Consent Order.

c. Respondent shall be allowed fifteen (15) days from the date of the mailing of notification required in paragraph 9.a. above to demonstrate to the satisfaction of the Department that he has complied with the terms of this Consent Order or, in the alternative, that he has cured the violation in question.

d. If respondent does not demonstrate compliance or cure the violation within the fifteen (15) days specified in the notification of violation to the satisfaction of the Department, he shall be entitled to a hearing before the Board which shall make a final determination of the disciplinary action to be taken.

e. Evidence presented to the Board by either the Department or respondent in any such hearing shall be limited to the alleged violation(s) of the term(s) of this Consent Order.

10. In the event respondent is not employed or self-employed as a physician and surgeon for periods of thirty (30) consecutive days or longer, respondent shall notify the Department in writing, Such periods of times shall not be counted in reducing the probationary period covered by this Consent Order and such terms shall be held in abeyance. During such time period, respondent shall not be responsible for complying with the terms of probation of this Consent Order. In the event respondent resumes practice as a physician and surgeon, respondent shall provide the Department with thirty (30) days prior written notice. Respondent shall not return to practice as a physician and surgeon without written pre­approval from the Department. Respondent agrees that the Department, in its complete discretion, may require additional documentation from respondent and/or require respondent to satisfy other conditions or terms as a condition precedent to respondent's return to practice. Respondent understands that any return to practice as a physician and surgeon without pre-approval from the Department shall constitute a violation of this Consent Order and may subject the respondent to further disciplinary action.

11. If, during the period of probation, respondent practices as a physician and surgeon outside Connecticut, he shall provide written notice to the Department concerning such employment. During such time period, respondent shall not be responsible for complying with the terms of probation of this Consent Order, and such time period shall not be counted in reducing the probationary period covered by this Consent Order. Respondent may comply with the terms of probation while practicing outside Connecticut if pre-approved by the Department. In the event respondent intends to return to practice as a physician and surgeon in Connecticut, respondent shall provide the Department with thirty (30) days prior written notice and agrees to comply with all terms and conditions contained in paragraph 4 above.

12. In the event respondent violates any term of this Consent Order, said violation may also constitute grounds for the Department to seek a summary suspension of his license before the Board.

13. Legal notice shall be sufficient if sent to respondent's last known address of record reported to the Practitioner Licensing and Investigations Section of the Healthcare Systems Branch of the Department.

14. This Consent Order is effective on the first day of the month immediately following the date this Consent Order is accepted and ordered by the Board.

15. Respondent understands that this Consent Order is a public document, and agrees that the Department's allegations as contained in this Consent Order shall be deemed true in any subsequent proceeding before the Medical Examining Board in which his compliance with this Consent Order or with §20-13c of the General Statutes of Connecticut, as amended, is at issue. Nothing in this paragraph shall operate as an admission of any fact or allegation in any action pending before the Connecticut Homeopathic Medical Examining Board. Further, respondent understands that any discipline imposed by this Consent Order shall be reported to the National Practitioner Data Bank and that all disciplinary actions will appear on his physician profile pursuant to Connecticut General Statutes 20-13j.

16. In the event respondent violates a term of this Consent Order, respondent agrees immediately to refrain from practicing as a physician and surgeon, upon request by the Department, with notice to the Board, for a period not to exceed 45 days. Respondent further agrees that failure to cooperate with the Department in its investigation during said 45 day period shall constitute grounds for the Department to seek a summary suspension of respondent's license. In any such summary action, respondent stipulates that failure to cooperate with the Department's investigation shall be considered by the Board and shall, as a matter of law, constitute a clear and immediate danger as required pursuant to Connecticut General Statutes, sections 4-182( c) and 19a-17( c). The Department and respondent understand that the Board has complete and final discretion as to whether a summary suspension is ordered.

17. Any extension of time or grace period for reporting granted by the Department shall not be a waiver or preclude .the Department from taking action at a later time. The Department shall not be required to grant future extensions of time or grace periods.

18. This Consent Order and terms set forth herein are not subject to reconsideration, collateral attack or judicial review under any form or in any forum. Respondent understands that this Consent Order shall not 'be subject to modification as a result of any claim that the terms contained herein may result in action by third parties, including, but not limited to, healthcare facilities and/or credentialing or licensure boards. Respondent assumes all responsibility for assessing such actions prior to the execution of this document. Further, this Order is not subject to appeal or review under the provisions of Chapters 54 or 368a of the General Statutes of Connecticut, provided that this stipulation shall not deprive respondent of any rights that he may have under the laws of the State of Connecticut or of the United States.

19. This Consent Order is a revocable offer of settlement which may be modified by mutual agreement or withdrawn by the Department at any time prior to its being executed by the last signatory.

20. Respondent permits a representative of the Legal Office of the Healthcare Systems Branch to present this Consent Order and the factual basis for this Consent Order to the Board. Respondent understands that the Board has complete and final discretion as to whether this executed Consent Order is approved or accepted.

21. Respondent has the right to consult with an attorney prior to signing this document.

22. The execution of this document has no bearing on any criminal liability without the written consent of the Director of the Medicaid Fraud Control Unit or the Bureau Chief of the Division of Criminal Justice's Statewide Prosecution Bureau. The purpose of this Consent Order is to resolve the pending administrative license disciplinary petition only, and is not intended to affect any civil or criminal liability or defense.

23. This Consent Order embodies the entire agreement of the parties with respect to this case.

All previous communications or agreements regarding the subject matter of this consent order, whether oral or written, between the parties are superseded unless expressly incorporated herein or made a part hereof.

I, Jarir Nakouzi, M.D., have read the above Consent Order, and I stipulate and agree to the terms as set forth therein. I further declare the execution of this Consent Order to be my free act and deed.

__________________________
Jarir Nakouzi, M.D. .

Subscribed and sworn to before me this 20th day of July 2011.

_________________________
Heidi M. Cilano
Commission of the Superior Court

The above Consent Order having been presented to the duly appointed agent of the Commissioner of the Department of Public Health on the 1st day of August 2011, it is hereby accepted.

_________________________
Jennifer Filippone, Section Chief
Practitioner Licensing and Investigations
Healthcare Systems Branch

The above Consent Order having been presented to the duly appointed agent of the Connecticut Medical Examining Board on the 20 day of September 2011, it is hereby ordered and accepted.

__________________________
Anne C. Doremus, Chair
Connecticut Medical Examining Board

This page was posted on October 1, 2011.

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