William Rea, M.D. Facing Charges
by the Texas Medical Board

Stephen Barrett, M.D.


In 2007, as noted below, the Texas Medical Board charged William J. Rea, M.D. with (a) using pseudoscientific test methods, (b) failing to make accurate diagnoses, (c) providing "nonsensical" treatments, (d) failing to properly inform patients that his approach is unproven, (e) practicing in areas for which he has not been trained, and (f) representing himself certified by a board that is not recognized by the American Board of Medical Specialties.

In 2010, the board approved a mediated agreed order under which Rea must revise the form he uses to obtain consent to treat patients with injections of environmental substances. The order was based upon Rea's failure to obtain informed consent from five patients diagnosed with chemical sensitivity and/or environmental sensitivity. During the investigation, Rea testified that a "car exhaust" solution he used for injections was so dilute that only an "electromagnetic imprint" of the original active substances remained. The revised consent form must state that (a) his injections contain only the “electromagnetic imprint” of the agents in question, (b) the therapy is not FDA-approved, and (c) the therapeutic value of the therapy is disputed. In addition, he must not start using any formulations that contain any amounts of substances classified as hazardous or carcinogenic by the Environmental Protection Agency or any other federal or statesregulatory agency. The charges not related to informed consent were dropped as part of the settlement. Rea is also licensed in Ohio. After learning about the Texas case, the Ohio Board of Medicine ruled that even though Rea was not practicing in Ohio, it would hold him to the same restrictions. Rea appealed this decision, but in 2013, the Franklin County (Ohio) Court of Common Pleas upheld the Ohio Board's ruling.

Rea, who operates the Environmental Health Center in Dallas, Texas, is best known for his promotion of the concept of multiple chemical sensitivity (MCS), a diagnosis not recognized as valid by the scientific community. Quackwatch has a detailed discussion of "MCS."


HEARING CONDUCTED BY THE
TEXAS STATE OFFICE OF ADMINISTRATIVE HEARINGS
SOAH DOCKET NO. ____________________
TEXAS MEDICAL LICENSE NO. D-2294

IN THE MATTER OF THE

COMPLAINT AGAINST

William James Rea, M.D.

BEFORE THE

TEXAS MEDICAL BOARD

COMPLAINT

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 William James Rea, M.D., (“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:

I. INTRODUCTION

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. D-2294, issued by the Board on June 22, 1965, which was in full force and effect at all times material and relevant to this Complaint. All jurisdictional requirements have been satisfied.

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 support allegations of a violation.

2. Respondent was invited to attend an Informal Show Compliance Proceeding and Settlement Conference (“ISC”), held on March 9, 2007, which was conducted in accordance with §2001.054(c), Tex. Gov’t Code and §164.004 of the Act. The Board representatives, including one physician and one public member (“Panel”), reviewed and considered evidence from the investigation, as well as any information presented by Respondent. The Panel determined that Respondent had not shown compliance with all requirements of the Act. The Panel recommended that a formal complaint be filed at the State Office of Administrative Hearings.

IV. FACTUAL ALLEGATIONS

Board Staff has received information and based on that information believes that Respondent has violated the Act. Based on such information and belief, Board Staff alleges:

A. VIOLATIONS OF THE STANDARD OF CARE. With regard to each of the patients mentioned below, Respondent has committed common and consistent actions that violate the Act and Board Rules. This pattern of substandard medical practice makes Respondent’s conduct even more egregious than if it had occurred in a single case. Respondent has violated the standard of care for each of these patients as follows:

  1. Respondent’s testing methods are below the standard of care.

    a) The tests do not even qualify as experimental, and are more properly described as pseudoscience. There are no reputable studies from peer review journals that confirm their use in clinical practice. For example:

    1. Checking for genetic single nucleotide polymorphism (SNPs) that is “abnormal” has no clinical relevance.
    2. Single photon emission tomography (SPECT) scanning is used without validation to establish a diagnosis of “neurocognitive” disorders.
    3. There is no scientific basis for using skin testing to establish a diagnosis of an allergy to neurotransmitters or lake algae. In fact, there is no such disorder.
    4. Some of these tests such as pupillography have no basis in the scientific literature at all.
    5. There is no scientific basis for other routine evaluations done by Respondent such as hair mineral analysis, venous blood gas analysis, pupillography, and thermography.

    b) Respondent’s skin testing procedures are sloppy, inconclusive, and not consistent with any practice standards.

    c) Respondent’s unscientific tests mislead patients into believing they have either an autoimmune or immunologic basis for their complaints, when, in fact, they do not.

  2. Respondent fails to properly interpret tests.

    a) A simple test for delayed hypersensitivity (cell mediated immunity) is a test for anergy or lack of anergy.

    1. In one patient discussed below (E.F.), Respondent remarked that the test was “abnormal” and suggestive of significant immune system dysfunction. In fact, the test showed that there was a significant response to several antigens, which is a normal response.

    2. Yet for another patient (E.L.), the cell mediated immune response test was negative (no response). No response is a significant finding suggestive of anergy. For this patient, no further work-up was done to evaluate or confirm a significant finding suggestive of T-cell mediated immune defect. No attempt was made to refer the patient to a board-certified immunologist to evaluate a complex defect such as this in a person who has had multiple pneumonias-based history.

    b) Respondent demonstrates a substandard knowledge of basic immunology. Important issues in the understanding of basic immunology are obviously lacking from Respondent’s interpretation of tests and diagnostic studies.

    c) Respondent repeatedly fails to appropriately apply the results of his testing. The diagnoses given do not follow from the testing results. Since many of the tests performed have no clinical utility or application, they may yield objective results, such as with pupillography, but the fact that they are objective does not mean they have any clinical significance.

    d) The SPECT scan reports all read word-for-word the same for all patients. These reports are highly subjective and have no accepted pathologic correlation.

  3. Respondent’s diagnoses are not supported by accurate interpretation of valid tests. a) Respondent gives the patients diagnoses of deficiencies in immune function when the tests themselves show this is not the case. b) Respondent gives diagnoses that are nonexistent in the medical literature. Respondent seemed to have coined some syndrome called “vasculitis-radix paradox.” There is no scientific basis for such a syndrome. It is well below the standard of care to use these pseudoscientific methods to diagnose illnesses.

  4. Respondent’s treatments are inappropriate, not based on any evidence, not based on any physiologic correlate, and are nonsensical.

    a) The “heat depuration therapy” is simply a sauna, which has no known medical therapeutic indication for the diseases Respondent purports to treat.

    b) Respondent’s treatments are potentially harmful. Injections of neurotransmitters, mycotoxins, jet fuel, natural gas, and other chemicals can be a dangerous practice.

  5. The patient consents do not inform the patient regarding the unproven nature of the therapies and testing recommended. These tests are unnecessary and not likely to lead to clinical diagnoses that are helpful or consistent with the clinical findings.

  6. Respondent’s training and certification do not qualify him to perform his clinical practice. Respondent is not board certified as an allergist and not trained as an allergist. His initial training in the 1970s was in the field of thoracic surgery. He claims to have board certification in the field of environmental medicine, which is not recognized by the American Board of Internal Medicine.

  7. Respondent’s violations involve more than one patient and cause an increased potential for harm to the public. Respondent’s treatments that he provided to these five patients are intentional, premeditated, knowing, or grossly negligent acts that constitute a violation of the Act.

Respondent’s violations of the Medical Practice Act discussed above are demonstrated in his care and treatment of the following patients:

  1. PATIENT A.R.:

    a) Respondent first saw A.R. on September 16, 2002. A.R. complained of headaches, sinusitis, chronic fatigue, joint pains and muscle pains. A.R. attributed her problems to paint fume exposure 13 years before.

    b) Respondent noted that A.R. had “dysfunctional neurocognitive symptoms.” Her medical history showed that she previously had a thyroidectomy and problems with multiple sensitivities involving thyroid medications. Respondent also noted that A.R. was sensitive to a variety of other materials such as newspapers, car exhaust, perfumes, carpets and various other common household products and allergens.

    c) Based on his examination of A.R., Respondent concluded she had a “positive Romberg test.” He recorded that she showed “erythematous” and “swollen turbinates” on nasal examination.

    d) Respondent evaluated A.R. with numerous tests. These included SPECT brain scan, hair mineral analysis, blood mineral analysis, cell mediated immunity evaluation, urine trichothecene levels, stool cultures, skin testing, venous blood gas analysis, pupillography, thermography and amino acid profiles. He also ordered serum analyses for aromatic and chlorinated hydrocarbons as well as pesticides and polychlorinated biphenyl.

    e) Based on these tests, Respondent diagnosed A.R. with a toxic encephalopathy, toxic effects of petrochemicals and solvents, toxic effects of pesticides, toxic effects of heavy metals, toxic effects of molds and mycotoxins, immune deregulation, hypothyroid, malabsorption, amino acid deficiencies, multiple vitamin deficiencies, allergic rhinitis, food sensitivity, mold sensitivity, pollen sensitivity, chemical sensitivity, chronic fatigue, fibromyalgia, and autonomic nervous system dysfunction.

    f) Respondent treated A.R. with environmental controls, expensive antigen injections, heat depuration therapy, intravenous therapies, and 18-day oxygen treatments were prescribed.

    g) No medical research or practice provides any basis for these kinds of therapies.

    h) As more fully discussed in subsection A, above, Respondent’s testing methods and treatment were below the standard of care and non-therapeutic.

  2. PATIENT E.F.:

a) Respondent first saw E.F. on March 26, 2003. E.F. complained of dizziness, nausea, headache, palpitations, labored breathing and restless legs. Prior medical records showed that E.F. had been diagnosed with an autoimmune disease 13 years earlier. E.F. said she suffered problems with bladder pain and migraines. She also reported mold in her home, which was blown from a neighbor’s house that was being remedied.

b) Based on the physical exam of E.F., Respondent noted that she had a “positive Romberg test” and swollen nasal mucosa. Petechiae were also noted on the abdomen, and her hands were “cold.”

c) Respondent performed a variety of tests on E.F. There was skin tested for numerous allergens. Urine trichothecene level was measured twice. Pupillography, thermography, and various assays for heavy metals in her red blood cells were performed. E.F. also had single-nucleotide polymorphism (SNP) measured for the cytochrome P-450 system. Measuring single nucleotide polymorphism in clinical practice is not relevant to this patient.

d) Respondent noted in the medical records that E.F. had “abnormalities” of the red-blood-cell heavy metal levels. Specifically, Respondent documented that there were “slightly elevated” levels of cadmium, lead, and mercury. There were two separate tests on different dates and all results were below the reference range provided by the laboratory. Respondent documented that E.F. had “abnormal or elevated“ CD4 count, but did not note the CD4 count. Respondent noted an abnormal cell mediated immunity (CMI) test, strongly suggesting “immune system dysfunction,” but the CMI test was within levels seen in patients with a normal immune system.

e) Respondent treated E.F. with antigen injections, saunas, IV therapy and environmental controls.

f) No medical research or practice provides any basis for these kinds of therapies.

g) As more fully discussed in subsection A, above, Respondent’s testing methods and treatment were below the standard of care and non-therapeutic.

  1. PATIENT R.B.:

a) Respondent first saw R.B. on September 2, 2003. She complained of edema (swelling), stiff arms, constant urination, and a rash.

b) Respondent performed a variety of tests and concluded that R.B. had a “positive Romberg test” and “pedal edema.” Respondent noted that hair analyses, performed on four separate occasions, showed various “abnormalities.” Respondent tested R.B.’s urine for toxic metals on two occasions. A SPECT brain scan, Respondent noted, revealed salt and pepper “abnormalities.” Pupillography, thermography and unfounded skin testing were done.  The thermography was interpreted by Respondent to indicate that the patient had “paradoxic-vasculitis.”

c) Respondent ‘s treatment of R.B. included a variety of treatments. These included environmental controls and heat depuration. He also ordered antigen injections and intravenous therapies, which included a large variety of neurotransmitters, histamine, serotonin, acetylcholine, dopamine, methacholine, norepinephrine, and epinephrine.

d) No medical research or practice provides any basis for these kinds of therapies.

e) As more fully discussed below, Respondent’s testing methods and treatment were below the standard of care.

f) As more fully discussed in subsection A, above, Respondent’s testing methods and treatment were below the standard of care and non-therapeutic.

  1. PATIENT J.S.:

a) Respondent first saw J.S. on May 11, 2004, when she complained of chemical sensitivity and she stated she had problems with electromagnetic field sensitivity. She said she had lethargy, joint pain, and “brain fog,” which began after exposure to fallout from the World Trade Center on September 11, 2001.

b) Respondent noted in the medical records that J.S. had a “positive Romberg test.” swollen nasal passages, cyanosis of both the hands and the feet, and some petechiae and telangiectasis.

c) Respondent conducted a variety of tests on J.S, including pupillography, hair mineral analysis, SPECT brain scan, thermography, skin testing, and a many other lab studies, primarily at the Respondent’s office in Dallas, Texas.

d) J.S. was treated with various therapies. Respondent recommended she avoid exposure to putative offending agents (environmental controls), He also gave her antigen injections, including histamine, serotonin, acetylcholine, various foods, salt and even aflatoxin. In addition, Respondent gave her heat depuration (purification) therapy, which essentially is sauna treatment.

e) No medical research or practice provides any basis for these kinds of therapies.

f) As more fully discussed in subsection A, above, Respondent’s testing methods and treatment were below the standard of care and non-therapeutic.

  1. PATIENT E.L.:

a) Respondent first saw E.L. on November 22, 2004. E.L. complained of knee pain, right hand numbness, chronic fatigue, insomnia, and severe allergic state. E.L.’s medical history showed that he had pneumonia on four occasions, Epstein-Barr infection, E. coli urinary tract infections twice, and helicobacter pylori infection. After examination, Respondent noted that E.L. had swollen nasal mucosa and turbinates.

b) Respondent ordered a variety of tests for E.L. Among other tests, Respondent performed an amino acid profile, urine testing, skin testing, T and B lymphocyte count, hair mineral analysis, blood mineral analysis, and venous blood gas analysis.

c) The T and B lymphocyte counts were documented to be “abnormal;” however, the levels were actually within normal limits. The skin tests were “abnormal,” but Respondent failed to follow up on them. The blood mineral analysis was documented as “abnormal,” but the levels were found within the reference range for the laboratory.

d) E.L. had skin testing done for sensitivity to acetylcholine, dopamine, methacholine, norepinephrine, epinephrine, jet fuel, natural gas, titanium, lake algae and fusaric acid.

e) E.L. was treated with environmental controls, antigen injections, heat purification, intravenous therapy, and an 18-day oxygen therapy.

f) No medical research or practice provides any basis for these kinds of therapies.

g) As more fully discussed in subsection A, above, Respondent’s testing methods and treatment were below the standard of care and non-therapeutic.

C. THE STANDARD OF CARE FOR A REASONABLE AND PRUDENT PHYSICIAN:

  1. Experimental medical procedures. The standard of care for using experimental medical procedures must meet three requirements:

    a) they must be based on scientific background;

    b) the patient must sign an informed consent to experimental treatment and therapy, and clearly understand that the therapies are experimental;

    c) the experimental treatment and/or diagnostics must be done in the context of a clearly delineated and Institutional Review Board (IRB) approved experimental protocol.

  2. Medical Evaluation and Therapy. The standard of care for medical evaluation and therapy includes, but is not limited to:

    a) evaluation and therapy must be evidence-based;

    b) evaluation and therapy must be generally accepted as the standard of care by experts in the field and/or the community of physicians practicing in the field;

    c) the validity and/or efficacy of new evaluation and therapeutic regimens must be established through community consensus and/or evidence-based methods. For example, to treat appendicitis with surgery is not only appropriate but the clear standard of care because it is a well-established and efficacious treatment. To treat appendicitis with a non-operative approach would be below the standard of care;

    d) doing no harm is necessary, but not sufficient, to meet the standard of care. For example, there are several situations in which the standard of care may be breached: if a serious mistake is made, but no harm is done, that is still considered a breach of the standard of care; if a placebo is used to treat a patient who has not consented to an experimental protocol, it may not harm the patient, but it is still a breach of the standard of medical care; or if a medically inapplicable or nonsensical test is used to establish a diagnosis, then even if it does not hurt the patient, it is still a breach of the standard of care; or if a medically nonsensical, non-established or non-existent diagnosis is given to a patient, then even if it does not hurt the patient it is still a breach of the standard of care.

  3. Allergy Testing and Treatment. The standard of care with regard to allergy testing and treatment includes, but is not limited to:

    a) testing must be done in a standardized, generally accepted manner;

    b) reporting and interpretation of results must be done in a standardized, generally accepted manner;

    c) evaluation and therapy must be evidence-based;

    d) evaluation and therapy must be generally accepted as the standard of care by experts in the field and/or the community of physicians practicing in the field;

    e) the validity and/or efficacy of new evaluation and therapeutic regimens must be established through community consensus and/or evidence-based methods. For example, to treat appendicitis with surgery is not only appropriate but the clear standard of care because it is a well-established and efficacious treatment. To treat appendicitis with a non-operative approach would be below the standard of care;

    f) doing no harm is necessary, but not sufficient, to meet the standard of care. For example, there are several situations in which the standard of care may be breached: if a serious mistake is made, but no harm is done, that is still considered a breach of the standard of care; if a placebo is used to treat a patient who has not consented to an experimental protocol, it may not harm the patient, but it is still a breach of the standard of medical care; or if a medically inapplicable or nonsensical test is used to establish a diagnosis, then even if it does not hurt the patient, it is still a breach of the standard of care; or if a medically nonsensical, non-established or non-existent diagnosis is given to a patient, then even if it does not hurt the patient it is still a breach of the standard of care.

V. APPLICABLE STATUTES, RULES, AND AGENCY POLICY

Respondent's conduct, as 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:

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. 1 Tex. Admin. Code §155.3(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. 1 Tex. Admin. Code, Chapter 155 sets forth the rules of procedure adopted by SOAH for contested case proceedings.

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(A), (B), (D), and (I) define failure to practice medicine in an acceptable professional manner as, but not limited to: failure to treat a patient according to the generally accepted standard of care; negligence in performing medical services; failure to safeguard against potential complications; failure to obtain informed consent from the patient or other person authorized by law to consent to treatment on the patient’s behalf before performing tests, treatments or procedures.

  2. Section 164.052(a)(5) and 164.053 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. Board Rule §190.8(2)(J) defines unprofessional or dishonorable conduct as, but not limited to, providing medically unnecessary services to a patient.

  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.

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 a 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 LICENSURE OR ANY OR ALL OF THE 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 HEARINGS COORDINATOR OF THE TEXAS STATE BOARD OF MEDICAL EXAMINERS.

PURSUANT TO TEX. ADMIN. CODE 187.27(a)(2), A WRITTEN ANSWER SHALL SPECIFICALLY ADMIT OR DENY EACH FACTUAL ALLEGATION MADE AGAINST THE RESPONDENT.

WHEREFORE, 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 a 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 SOAH hearing costs and an administrative penalty.

Respectfully submitted,

TEXAS MEDICAL BOARD

By:
Mark Martyn, Staff Attorney
Texas State Bar No. 24029708
Telephone: (512) 305-7088
FAX # (512) 305-7007
333 Guadalupe, Tower 3, Suite 610
Austin, Texas 78701

Filed with the Texas Medical Board on August 24, 2007.

____________________________________
Donald W. Patrick, M.D., J.D.
Executive Director
Texas Medical Board

This page was revised on July 10, 2013.

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