James Webber, M.D. Surrenders
California Medical License

Stephen Barrett, M.D.


In 2014, James Webber, M.D., who, for decades had used nonstandard methods to diagnose and treat supposed glandular disorders, surrendered his California medical license in the wake of charges that he had treated a patient negligently. The Accusation (show below) states that he treated a 47-year-old man with Armour Thyroid after improperly diagnosing him with low thyroid function. He was also accused of improperly diagnosing adrenal insufficiency and mycoplasma pneumonia and failing to properly treat the patient's high blood pressure.

In 1984, California's medical board concluded that Webber had improperly treated five patients, placed him on probation for ten years, and required that he undergo six months of retraining, pass a special examination, and take take 40 more hours per year of continuing education courses than needed for license renewal. The board's order stated: "While he exhibited extremely poor judgment in the case management of these patients, he is a good candidate for rehabilitation provided that he successfully completes the re-education and training set forth in the probationary order. Part of respondent's problems stem from his preoccupation with 'neuroregulator dysfunction' and his attempts to treat chemical imbalances rather than relying on more traditional medical methodology."

In 1995, Webber was disciplined for aiding and abetting an unlicensed provider named Colette Fields, who had operated the Laser Research Medical Clinic where she administered cold laser treatment for pain. In 1991, Fields pleaded "no contest" to the unlawful practice of law and was placed on summary probation for three years. The administrative law judge who evaluated the charges against Webber described Fields as a "con artist" and noted that, among other things, Webber had improperly signed documents that enabled Fields to get paid by insurance companies. The judge's report to the board concluded that Webber had shown "an extreme form of naiveté bordering on the stupid" but thought at that time he was helping patients. The medical board extended Webber's probation and extra educational requirement for five more years.


KAMALA D. HARRIS
Attorney General of California
THOMAS S. LAZAR
Supervising Deputy Attorney General
MARTIN W. HAGAN
Deputy Attorney General
State Bar No. 155553
110 West "A" Street, Suite 1100
San Diego, CA 92101
P.O. Box 85266
San Diego, CA 92186-5266
Telephone: (619) 645-2094
Facsimile: (619) 645-2061
Attorneys for Complainant

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


In the Matter of the Accusation Against:

JAMES WEBBER, M.D.
5059 Newport Avenue, Suite 201
San Diego, CA 92107

Physician's and Surgeon's Certificate
No. G29186

Respondent.


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Case No. 09-2012-224202

ACCUSATION

Complainant alleges:

PARTIES

1. Kimberly Kirchmeyer (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 April 22, 1975, the Medical Board of California issued Physician's and Surgeon's Certificate Number 029186 to James Webber, M.D. (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 July 31, 2015, 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 states 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 which may include a requirement that the licensee complete relevant educational courses, or have such other action taken in relation to discipline as the Board deems proper.

5. Section 2234 of the Code, states:

"The board 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.

"(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.

"(d) Incompetence.

". . .

"(f) Any action or conduct which would have warranted the denial of a certificate.

". . . ."

FIRST CAUSE FOR DISCIPLINE

(Gross Negligence)

6. Respondent has subjected his Physician's and Surgeon's Certificate Number 029186 to disciplinary action under sections 2227 and 2234, as defined by section 2234, subdivision (b), of the Code, in that he committed gross negligence in his care and treatment of patient DB, as more particularly alleged herein:

7. On or about May 29, 2008, patient DB, a forty-seven (47) year old male, saw Respondent for the first time. The patient's goal of treatment was to "Feel Better" and address issues concerning "joint pain" and "weight loss.'' Patient DB reported having "a six-year history of progressive decline in vigor" and rated his overall energy at 3 on a scale of 10. Patient DB indicated he had been doing "shift work for the last five years" and reported a weight gain of approximately 60 pounds over the last six years. On physical examination, patient DB's weight was 253 pounds, height 5 feet 10 % inches, regular pulse of 60, blood pressure of 210/110 sitting and 220/120 standing at the beginning his office visit and blood pressure of 170/120 sitting and 188/104 standing at the end of his office visit. Respondent's clinical assessment of pati~nt DB was hypothyroidism (insufficient production of thyroid hormone from the thyroid) with goiter (enlarged thyroid gland); mild hypoadrenia (adrenal gland insufficiency); adult human growth hormone deficiency syndrome; hypogonadism (diminished function of the testes resulting in low testosterone); hypertension (high blood pressure);1 carbohydrate dysmetabolism likely hyperleptinemia; and leptin resistance. Respondent's treatment plan included, among other things: (1) obtaining baseline lab studies for autoimmune status and rule out infection; (2) therapeutic trial of Armour Thyroid 30 mg tablets,2 three tablets to begin with, and then increase by 30 mg per week while monitoring basal temperature and pulse; (3) Adrenal Rebuilder tablets, two with each meal, Prednisolorre 5 mg q.a.m. (every morning); (4) Iodoral tablets 5-6 per day; (5) CoQ10 (Co-enzyme nutrient which is intended to increase energy) 120-150 mg daily; (6) DHEA 100 mg per cc with 5% Pentoxifylline 0.2 cc to be applied to genitals b.i.d. (twice a day); (7) topical Testosterone l00 mg per cc with Pentoxifylline 0.2 cc to be applied to genitals b.i.d. (twice a day); (8) Vitamin D3 5000 IU at bedtime; (9) melatonin 0.5 mg to 3 mg for shift work; and 10) hold HGH and hold Progesterone. At the office visit of May 29, 2008, laboratory tests were ordered and then reported on June 4, 2008. There were no laboratory tests ordered to confirm Respondent's clinical assessment of hypoadrenia. Moreover, the lab results did not support the clinical assessment of hypothyroidism.

1Untreated hypertension (high blood pressure) can lead to coronary artery disease, heart failure, heart attack, stroke, kidney damage, angina (chest pain related to heart disease), peripheral artery disease and other serious medical conditions.

2Armour Thyroid tablets are used as replacement or supplemental therapy in patients with hypothyroidism. The warning for Armour Thyroid tablet indicates that "[l]arger doses may produce serious or even life-threatening manifestations of toxicity" and that "[tjhe use of thyroid hormones in the therapy of obesity, alone or combined with other drugs, is unjustified and has been shown to be ineffective." Under a written "Action Plan for New Patients," Respondent instructed patient DB to "[s ]tart with 3 tablets [of Armour Thyroid 30 mg] and increase by 1 each week up to 8 tablets." The Armour Thyroid was ordered from Wellness Pharmacy.

8. On or about July 22, 2008, patient DB had another office visit with Respondent. At this visit, patient DB had a noticeable change in sweating but no significant change in heart rate and basal temperature. Patient DB's weight was 252 pounds, blood pressure was 138/98 while sitting and 122/104 while standing. Respondent's assessment at this time was central hypothyroidism, hypoadrenia, hypogonadism, hyperinsulinemia, mycoplasma pneumonia possible and likely torn right medial or posterior meniscus. Respondent's treatment plan for this visit included, among other things, reducing the previously prescribed Armour Thyroid to 30 mg b.i.d. (twice a day); and starting a Sustained Release T3 (SR-T3) protocol3 at 7.5 mcg twice a day. Patient DB was instructed to increase the SR-T3 by 7.5 mcg every week unless mitigated by rise in temperature or pulse rate. Patient DB was also prescribed Minocycline, an antiobiotic, to treat a mycroplasma infection and was instructed to continue the testosterone and DHEA to be applied to his genitals and to continue with various supplements and vitamins,

3Sustained Release T3 (SR-T3) is a compounded drug which is used as part of "thyroid hormone therapy" to address the insufficient production ofT3 (triiodothyronine), which is one of the hormones produced by the thyroid. The SR-T3 was ordered from Wellness Pharmacy.

9. On or about September 8, 2008, patient DB had a "phone consult'' with Respondent. Patient DB's weight was 236 pounds. Respondent's assessment was hypothyroidism with T3 resistance and likely T4/r-T3 predominance and goiter, hypoadrenia improved, hypogonadism improved and adult human growth deficiency syndrome. Respondent's treatment plan included, among other things, staying on the Armour Thyroid 30 mg, twice a day and "accelerate T3 protocol 7.5 per increase" with "[fjive new strengths added starting with 75 mcg twice a day." In regard to the SR-T3 dosage, patient DB was instructed in the "Action Plan" to"[c]ontinue to go up in strength in Sustained Release T3 . . . next four strengths . . .75 mcg, 82.5 mcg, 90 mcg. Increase every two weeks." (Ellipsis in original.) Patient DB was also to continue taking Hydrocortisone 20 mg one-half tab three times a day, Methylprednisolone 4 mg daily and the DHEA and testosterone creams that were to be applied to his genitals and continue with various supplements and vitamins. An orthopedic consultation was also recommended to evaluate likely torn meniscus.

10. On or about March 23, 2009, patient DB had an office visit with Respondent. At this time patient DB was taking, among other things, Armour Thyroid 30 mg twice a day and the SR-T3 at 255 mcg twice a day. He was using the Adrenal Rebuilders at approximately six per day in divided doses and Hydrocortisone 30 mg per day in divided doses. The patient had discontinued the Minocin for the mycoplasma pneumonia presumed infection. Patient DB's weight was 232 pounds, blood pressure was 170/100 sitting and 150/110 standing and there were cystic acne lesions noted on his back. Respondent's assessment was hypothyroidism central with moderate T3 resistance (improving), hypoadrenia (improved), hypogonadism (improved), mycoplasma pneumonia antibodies present (currently unaddressed), bilateral ankle pain (continuing) and cystic acne. Respondent's plan for further treatment was to continue with the Armour Thyroid 30 mg twice a day and the SR-T3 255 mcg twice a day, continue with the various vitamins and supplements, additional labs prior to next appointment4 and resume Minocycline I 00 mg on alternate days with interspersed probiotics.5

4The certified medical records from Respondent do not have any additional labs results being reported after those reported on June 4, 2008.

5In addition to the above, patient DB was instructed to increase Hydrocortisone 20 mg to ¼ to ½ tablet four to six times a day or stay at ½ three times a day; continue all his previously prescribed medications and supplements; and add Integra Lean (lrvingia Gabonesis) one twice daily for at least 10 weeks and also to take New Max GL (Glutathione capsule) one packet twice daily.

11. On or about September 24, 2009, patient DB had another office visit with Respondent. Patient DB presented with "a one-month history of cough following a Medrol Dosepak6 for presumed traumatic tendinitis" related to a left wrist fracture. Toe patient's cough was nonproductive, however, on two occasions he had coughed up very thick sputum. The patient was experiencing some shortness of breath at rest and dyspnea (shortness of breath) on exertion, his energy level was reported as "very low." At the time of this visit, patient DB was taking, among other things, Ann our Thyroid 30 mg twice a day with SR-T3 at 360 mcg twice a day. On physical examination, patient DB's weight was 214 pounds, pulse 80, blood pressure of 130/100 sitting and 138/100 standing and his thyroid was not enlarged. Respondent's assessment was hypothyroidism Type 2 with moderate T3 receptor resistance (improved), hypodrenia, hypogonadism, upper respiratory infection and possible pneumonia/bronchitis, diastolic hypertension, mycoplasma pneumonia (antibodies are positive); and low glomerular filtration rate. Respondent's plan for future treatment included, but was not limited to, continuing the SR-T3 at 360 mcg twice a day with the Armour Thyroid 30 mg twice a day, laboratory tests prior to the next visit scheduled for five and one-half months later and continuation of previously prescribed medications and supplements.

6Medrol is the brand name for methylprednisolone, a glucocorticoid. Glucocorticoids are adrenocorticoatal steroids which are readily absorbed into the gastrointestinal tract. Methylprednisolone is typically used as an anti-inflammatory. Other common uses included arthritis therapy and short-term treatment of bronchial inflammation or acute bronchitis due to various respiratory diseases.

12. On or about February 19, 2010, patient DB presented to the Emergency Room (ER) at the Veterans Administration (VA) Medical Center in Virginia with a history of cough and wheezing for four days along with shortness of breath. Patient DB reported an "irregular heartbeat" feeling for approximately one month with the shortness of breath worsening on exertion while shoveling snow which prompted the ER visit. Patient DB had been taking his SR-T3 at 345 rncg twice a day but had discontinued the medication approximately two days prior to the ER visit. Other medications included the Hydrocortisone, Minocycline, Adrenal Rebuilder and Probiotics. In the ER, patient DB was diagnosed with atrial fibrillation (rapid ventricular response) with his heart rate going as high as 220 beats per minute with a blood pressure reading of 216/151. Lab tests were ordered. The patient was administered a Diltiazem drip to address the atrial fibrillation and was then transferred to the Intensive Care Unit (ICU).

13. On or about February 22, 2010, an Endocrinology consult was obtained and patient DB was seen by Dr. JM. The medical record for this consultation noted, in pertinent part, that patient DB was a 49 year old white male "with rapid Afib who has been taking large dose T3" with concerns expressed over the amount of T3 being taken by the patient." The medical note further indicated "THERE IS NO EVIDENCE THAT THIS PATIENT WAS EVER HYPOTHYROID, HIS PRIOR PHYSICIAN WAS ACTING BEYOND ANY GUIDELINES . . ." As to any adrenal issue, Dr. JM noted, in pertinent part, "there is no evidence the patient ever had an adrenal issue."

14. On or about February 23, 2010, patient DB was seen again by Dr. JM. In the medical record for this visit, Dr. JM noted, in pertinent part, "Hyperthyroidism: There is no evidence the patient ever had underlying thyroid diseases, his hyperthyroidism was medication induced, and the patient should improve by stopping his meds." Dr. JM found "[t]here is no reason to delay discharge for an endocrine reason, patient can be DC'ed [discharged] once stable from a cardiac standpoint." Patient DB was discharged on February 23, 2010, with a discharge diagnosis of "Atrial fibrillation with RVR [rapid ventricular response] secondary to hyperthyroidism." As part of the discharge instructions, patient DB was advised not to take anymore T3 and/or endocrine supplements.

15. Respondent has committed gross negligence in the care and treatment of patient DB, which included, but was not limited to, the following:

(a) Respondent improperly diagnosed patient DB as suffering from a hypothyroid condition;

(b) Respondent improperly and excessively prescribed patient DB thyroid medications including, but not limited to, Sustained Release T3 (SR-T3) and Armour Thyroid, for weight loss and/or a misdiagnosed hypothyroid condition without adequate informed consent and then failed to properly monitor the continued use of the thyroid medications;

(c) Respondent improperly diagnosed patient DB as suffering from hypoadrenia and then improperly prescribed glucocorticoid medications including, but not limited to, Hydrocortisone and pregnenolone to treat the misdiagnosed hypoadrenia condition without adequate informed consent and then failed to properly monitor the continued use of the glucocorticoid medications;

(d) Respondent improperly diagnosed patient DB as suffering from an acute mycoplasma pneumonia infection and then improperly prescribed a minocycline antibiotic to treat the misdiagnosed acute mycoplasma pneumonia infection condition without adequate informed consent of taking antiobiotics on a long-term basis and then failed to properly monitor the continued use of the rninocycline antibiotic(s); and

(e) Respondent repeatedly failed to properly treat and/or manage patient DB's hypertension as evidenced through repeated systolic and/or diastolic blood pressure readings that were in the hypertensive range, and at times very elevated, and failed to provide adequate informed consent regarding the risks of hypertension including, but not limited to, the adverse effects on the cardiovascular system.

SECOND CAUSE FOR DISCIPLINE
(Repeated Negligent Acts)

16. Respondent has further subjected his Physician's and Surgeon's Certificate Number 029186 to disciplinary action under sections 2227 and 2234, as defined by section 2234, subdivision (c), of the Code, in that she committed repeated negligent acts in the care and treatment of patient DB, as more particularly alleged hereinafter:

(a) Paragraphs 6 through 15, above, are hereby incorporated by reference and realleged as if fully set forth herein;

(b) Respondent improperly diagnosed patient DB as suffering from a hypothyroid condition;

(c) Respondent improperly and excessively prescribed patient DB thyroid medications including, but not limited to, Sustained Release T3 (SR-T3) and Armour Thyroid, for weight loss and/or a misdiagnosed hypothyroid condition without adequate informed consent and then failed to properly monitor the continued use of the thyroid medications;

(d) Respondent improperly diagnosed patient DB as suffering from hypoadrenia and then improperly prescribed glucocorticoid medications including, but not limited to, Hydrocortisone and pregnenolone to treat the misdiagnosed hypoadrenia condition without adequate informed consent and then failed to properly monitor the continued use of the glucocorticoid medications;

(e) Respondent improperly diagnosed patient DB as suffering from an acute mycoplasma pneumonia infection and then improperly prescribed a minocycline antibiotic to treat the misdiagnosed acute mycoplasma pneumonia infection condition without adequate informed consent of taking antiobiotics on a long-term basis and then failed to properly monitor the continued use of the minocycline antibiotic(s);

(f) Respondent repeatedly failed to properly treat and/or manage patient DB's hypertension as evidenced through repeated systolic and/or diastolic blood pressure readings that were in the hypertensive range, and at times very elevated, and failed to provide adequate informed consent regarding the risks of hypertension including, but not limited to, the adverse effects on the cardiovascular system; and

(g) Respondent improperly diagnosed patient DB as suffering from hypogonadism and then improperly prescribed topical medications including, but not limited to, DHEA, Pentoxifylline and other topical medications, to be applied to his genitals lo treat the misdiagnosed hypogonadism without adequate informed consent of applying the topical medications to the genitals on a chronic basis and then failed to properly monitor the continued use of the topical medications.

DISCIPLINE CONSIDERATIONS

17. To determine the degree of discipline, if any, to be imposed on respondent, Complainant alleges that an Accusation was filed against Respondent on or about April 27, J 982, in a prior disciplinary action entitled In the Matter of the Accusation against: James Terry Webber, MD., Board of Medical Quality Assurance Case No. D-2890. The aforementioned Accusation alleged that Respondent engaged in unprofessional conduct when he issued improper prescriptions for excessive amounts of controlled substances and dangerous drugs to five patients during the 1978 to 1980 timeframe.8 On May 24, 1984, Respondent's medical license was revoked, the revocation was stayed, and Respondent was placed on probation for ten (10) years on various terms and conditions, including a prohibition against Respondent prescribing any schedule V controlled substances, no personal possession of any controlled substances except for those lawfully prescribed for a bona fide medical condition, maintaining proper records for all controlled substances prescribed during Respondent's probation, no prior treatment of any psychiatric conditions unless there is consultation and approval of the treatment plan by a Board approved consultant, submitting patient records to the Board upon request for periodic review, successful completion of an medical course related to "medical therapeutics in family practice," successful completion of "an intensive six-month clinical training program in medical therapeutics," successful completion of an oral examination following completion of the clinical training program; and the other standard terms and conditions of probation. That decision is now final and is incorporated by reference as if fully set forth herein.

8The Board found cause for discipline was established under section 2242, subdivision (a) [prescribing dangerous drugs without a proper prior examination and/or without medication indication] as to all five patients; and section 2234, subdivision (b) [repeated negligent acts] as to four of the five patients. The Board's decision noted, in pertinent part, that "Part of respondent's problems stem from his pre-occupation with 'neurological dysfunction' and his attempt to treat chemical imbalances rather than relying on more traditional medical methodology. He needs to pursue an educational and clinical program stressing case management with particular and physical and differential diagnosis."

18. To determine the degree of discipline, if any, to be imposed on respondent, Complainant alleges that an Accusation and Petition to Set Aside Stay Order and to Impose Revocation was filed against Respondent on or about September 25, 1992, in a prior disciplinary action entitled In the Matter of the Accusation against.' James T. Webber, MD., in Medical Board of California Case No. D-4697. The aforementioned Accusation and Petition to Set Aside Stay Order and to Impose Revocation generally alleged that Respondent engaged in unprofessional conduct under section 2234, subdivision (a), when he assisted in aiding and abetting a violation of the Medical Practice Act through his association with CF, an unlicensed health care provider, who operated the Laser Research Institute and the Laser Research Medical Clinic and provided cold laser treatment therapy. The Board found there was cause to discipline Respondent under section 2234, subdivision (a) [aiding and abetting a violation of the Medical Practice Act] and section 2261 [knowingly making or signing any documents related to the practice of medicine which contain false representations].9 On April 5, 1995, Respondent's medical license was revoked, the revocation was stayed, and Respondent was placed on probation for five (5) years on various terms and conditions, including a four month suspension of his medical license; successful completion of an education course; successful completion of an education course in Ethics; designation of a practice monitor; a continuation of many of the prior terms of probation from prior decision in Case No. D-2890; and the other standard terms and conditions of probation. That decision is now final and is incorporated by reference as if fully set forth herein.

9The Board's Decision stated, in pertinent part, that Respondent "never entertained the thought he was supporting an illegal enterprise" and "the weight of the evidence [did] not establish actual knowledge. However, respondent [could not] escape the imposition of discipline because he . . . had constructive notice (he should have known) of the facts showing a violation of the Medical Practice Act." The Decision also stated that Respondent "did a very foolish and naive thing" which allowed CF to "bill for services she was not entitled to; [h]e didn't supervise her in the application of laser therapy; [and] [h]is conduct allowed her to make treatment decisions she was not allowed to make."

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 Number G 29186, issued to Respondent James Webber, M.D.;

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

3. Ordering Respondent James Webber, M.D., to pay the Medical Board of California, if placed on probation, the costs of probation monitoring; and

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

DATED July 29, 2014

_____________________________
KIMBERLY KIRCHMEYER
Executive Director
Medical Board of California
Department of Consumer Affairs
State of California
Complainant

This page was posted on October 16 2016

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