Jonathan B. Murphy, M.D.,
Twice By Arizona Medical Board
Stephen Barrett, M.D.
Jonathan B. Murphy, M.D. has been reprimanded in 2014 and 2016 by the Arizona Medical Board. In the first case, as noted below, the board concluded that Murphy had treated a cancer patient inappropriately with insulin-potentiated chemotherapy and other nonstandard means and failed to used standard measures when the patient's condition worsened. In the 2016 case, the board ordered Murphy to serve six months on probation after concluding that he had written orders for a hospitalized cancer patient whom he had previous treated as an outpatient. The board's order stated that Murphy had (a) falsely represented himself as a member of the hospital staff, (b) accessed the patient's electronic record without authorization, (c) gave treatment orders that fell below the standard of care, and (d) "deviated from the standard of care by failing to have sufficient education, training and experience to hold himself out as a specialist in the field of oncology." Murphy was trained in internal medicine and pediatrics became =board certified in both about 20 years ago, but his certifications expired in 2004 and 2006. He now operates the AZ Good Health Center in Phoenix, Arizona, which describes him on its Web site as specializing in "integrative oncology."
BEFORE THE ARIZONA MEDICAL BOARD
|In the Matter of
JONATHAN B. MURPHY, M.D.Holder of License No. 44962
For the Practice of Allopathic Medicine
In the State of Arizona
FINDINGS OF FACT, CONCLUSIONS
The Arizona Medical Board ("Board") considered this matter at its public meeting on June 11, 2014. Jonathan B. Murphy, M.D. ("Respondent") appeared before the Board for a formal interview pursuant to the authority vested in the Board by A.RS. § 32-1451(H). After due consideration of the facts and law applicable to this matter, at its meeting on August 6, 2014, the Board voted to issue the following Findings of Fact, Conclusions of Law and Order.
FINDINGS OF FACT
1. The Board is the duly constituted authority for the regulation and control of the practice of allopathic medicine in the State of Arizona.
2. Respondent is the holder of license number 44962 for the practice of allopathic medicine in the State of Arizona.
3. The Board initiated case number MD-13-1050A after receiving a complaint regarding Respondent's care and treatment of a 62 year-old male patient ("GR"). The complaint alleged that Respondent provided GR with inappropriate oncology care and treatment and failed to explain the risks and benefits of non-evidence based chemotherapy.
4. In 2013, GR presented with dysphagia. He sought care through allopathic physicians and a gastroenterologist on an upper endoscopy documenting an obstructing lower esophageal lesion that on biopsy was adenocarcinoma. Imaging studies showed liver and lymph node metastases. It was recommended that GR see allopathic medical and radiation oncologists.
5. On April 10, 2013, GR was evaluated by Respondent at An Oasis of Healing. GR was treated with a combination of low dose chemotherapy potentiated with insulin, colonics, strict dietary changes, lymphatic massages, and various other pressure treatments. He also received a large number of supplements including infusions of several, ozone treatment of blood, as well as large doses of testosterone. This treatment was combined with the use of prescription palliative drugs including opiates, Zofran, lactulose, flagyl, scopolamine, and Procrit.
6. Because of chronic GI bleeding from the primary site, GR was regularly transfused. He then had a port-cath placed due to all of the IV therapies. Due to esophageal obstruction, GR finally had a feeding tube placed. GR was seen multiple times per week, and forty days into his treatment at An Oasis of Healing, GR had a number of lab studies drawn. There was no objective evidence of any response to therapy and on a follow up PET CT scan, there was marked disease progression. A physical exam was documented by Respondent only twice, once at the initial visit and again on June 26, 2013. GR died on July 14, 2013.
7. The Medical Consultant ("MC") found that Respondent deviated from the standard of care in his treatment of GR. Specifically, the MC stated that there was a delay in getting nutritional support via bypassing the esophageal obstruction, and that Respondent failed to deal with the obstruction either by endoscopic lumen enhancement endoscopically or by the use of radiotherapy or chemoradiotherapy.
8. The MC additionally found that Respondent failed to consider standard evidence based chemoradiotherapy or chemotherapy alone using doses found in clinical trials to be beneficial in all but the very earliest stages of esophageal cancer. The MC added that Respondent failed to have a multidisciplinary team of a medical oncologist, surgeon, radiotherapist, and gastroenterologist to care for GR using multidisciplinary expertise, and failed to recognize immediately that the anemia was related to blood loss from the esophageal primary and to consider palliative radiotherapy or multimodality therapy for the bleeding.
9. The MC commented that while transfusions are part of the therapy, Respondent did not recognize immediately why GR was becoming so anemic. The MC stated that the apparent excessive blood drawing may have contributed.
10. The standard of care for metastatic esophageal cancer requires a physician to consider systemic chemotherapy, radiotherapy to the primary site to control obstruction and bleeding, transfusion of RBCs as needed, palliative medications to control symptoms, feeding tube placement for nutrition, and hospice care.
11. Respondent deviated from the standard of care by failing to timely obtain nutritional support for GR, by failing to address the obstruction either by endoscopic lumen enhancement endoscopically or by the use of radiotherapy or chemoradiotherapy, by failing to consider standard evidence based chemoradiotherapy or chemotherapy alone, by failing to have a multidisciplinary team of medical specialists to care for GR, and by railing to recognize that the anemia was related to blood loss from the esophageal primary and failing to consider palliative radiotherapy or multimodality therapy for the bleeding.
12. Standard allopathic therapies have a proven potential to control bleeding, control esophageal obstruction, control symptoms and prolong survival.
CONCLUSIONS OF LAW
1. The Board possesses jurisdiction over the subject matter hereof and over Respondent.
2. The conduct and circumstances described above constitute unprofessional conduct pursuant to A.RS. § 32-1401 (27)(q) ("[a]ny conduct or practice that is or might be harmful or dangerous to the health of the patient or the public.;.
IT IS HEREBY ORDERED THAT Respondent is issued a Letter of Reprimand.
RIGHT TO PETITION FOR REHEARING OR REVIEW
Respondent is hereby notified that he has the right to petition for a rehearing or review. The petition for rehearing or review must be filed with the Board's Executive Director within thirty (30) days after service of this Order. A.RS.§ 41-1092.09(8). The petition for rehearing or review must set forth legally sufficient reasons for granting a rehearing or review. A.AC. R4-16-103. Service of this order is effective five (5) days after date of mailing. A.RS. § 41-1092.09(C). If a petition for rehearing or review is not filed, the Board's Order becomes effective thirty-five (35) days after it is mailed to Respondent.
Respondent is further notified that the filing of a motion for rehearing or review is required to preserve any rights of appeal to the Superior Court.
DATED AND EFFECTIVE this 8th day of October, 2014.
ARIZONA MEDICAL BOARD
C. Lloyd Vest, II
EXECUTED COPY of the foregoing mailed
This 8th day of August, 2014 to:
Jonathan B. Murphy, M.D.
Address of Record
ORIGINAL of the foregoing filed
this 8th day of August, 2014 with:
Arizona Medical Board
9545 E. Doubletree Ranch Road
Scottsdale, AZ 85258
Arizona Medical Board Staff
This page was posted on October 26, 2016.