Thursday, May 23, 2013

Mark Geier: Not a Leg to Stand On

Poor, poor Mark Geier. For those who don't know, Dr. Mark Geier is half of the father-son team that developed the "Lupron Protocol" for treating autism. Put simply, Geier and his son came up with the scientifically unsupported idea that testosterone and mercury bind together in humans, allegedly causing autism. His treatment for this involves dosing children with leuprolide, followed by chelation. Leuprolide (also known by the brand name Lupron) is legitimately used for treatment of precocious puberty and as part of IVF treatment. It is also used off-label to chemically castrate sex offenders.

Dr. Geier, through his Institute of Chronic Illness and Genetic Centers of America, misdiagnosed autistic children with precocious puberty so he could claim that he was using Lupron on label, rather than for an unapproved, experimental indication (i.e., autism). This also allowed him to bill insurance companies for the lupron. His actions got him into hot water with various state medical boards, starting with his medical license in Maryland being suspended on April 27, 2011. Since then, one by one, 11 of his 12 medical licenses were suspended, an application for a thirteenth license in Ohio was denied, and some of those suspensions became complete revocations. The last actions I wrote about were the revocation of his license in Missouri and suspension of his Illinois license. At the time, the only state left in which Dr. Geier could practice was Hawaii.

As of April 11, 2013, that is no longer the case.

Although his license listing on the Hawaii state Professional and Vocational Licensing search has yet to be updated as of this writing, searching the state's RICO Complaint History database reveals that the board revoked his license last month. The case number is MED 2011-79-L (if the link to the PDF doesn't work, go to the OAH Decisions web site, click on OAH Final Orders and search for "Geier"). According to the Final Order, a petition for disciplinary action against Dr. Geier was filed on July 17, 2012, Geier was notified on November 19, and a hearing was held on February 5 of this year. Dr. Geier failed to appear for the hearing and did not file for exceptions or extensions to delay the hearing.

The key findings of fact mentioned by the board are Geier's suspension in Maryland, which he did not report, and his suspension in Indiana, which he also failed to report to the Hawaii board. They quote finding number 7 from the Indiana ruling:
7. The Maryland Order states that 'the public health, safety or welfare imperatively requires emergency action in this case' due to the Maryland Board's Investigative Findings, which concluded that Respondent:

a. misdiagnosed autistic children with precocious puberty and other genetic abnormalities and treated them with potent hormonal therapy ('Lupron therapy') and chelation therapy, both of which had a substantial risk of adverse side effects, thus exposing children to needless risk of harm;

b. failed to conduct adequate physical examinations of patients in several instances before starting Lupron therapy;

c. failed to obtain adequate informed consent from the parents of autistic children he treated;
d. endangered autistic children by administering a treatment protocol that has a substantial risk of harm and is neither consistent with evidence-based medicine nor generally accepted in the relevant scientific community;
e. misrepresented his credentials by declaring himself to be a board-certified epidemiologist and geneticist, which he was not; and,
f. maintained an Institutional Review Board which does not meet Federal regulations.
Based on these facts, the Regulated Industries Complaints Office charged Mark Geier with "violating HRS §§ 453-8(a)(7), 453-8(a)(8), 453-8(a)(l 1) and 453-8(a)(14) and 436B-19(17). These sections state that a license may be revoked, limited, suspended or denied for:
(7) Professional misconduct, hazardous negligence causing bodily injury to another, or manifest incapacity in the practice of medicine, osteopathy or surgery;

(8) Incompetence or multiple instances of negligence, including but not limited to the consistent use of medical service, which is inappropriate or unnecessary;

(11) Revocation, suspension, or other disciplinary action by another state or federal agency of a license, certificate, or medical privilege for reasons as provided in this section;
(14) Failure to report to the board, in writing, any disciplinary decision issued against the licensee or the applicant in another jurisdiction within thirty days after the disciplinary decision is issued[.]
and that grounds for revocation may be based on:
(17) Violating this chapter, the applicable licensing laws, or any rule or order of the licensing authority.
And with that, Mark Geier's last leg was swept from under him. Yet he and his son are still speaking at the AutismOne conference in Chicago this Saturday at 1:45pm, still promoting their Lupron Protocol for autism. Their slide deck is conveniently freely available. At a quick look, it looks like they plan to Gish Gallop all over their audience and distract them with sciencey babble and out-of-context quotes. I haven't taken a deep look yet into the studies they cite, but I did notice that their graph showing mercury excretion and glutathione excretion is lifted from a study on metal toxicity (Reproductive and developmental toxicity of metals, by Clarkson et al., 1985). Here's their slide:


Bearing in mind that the Geiers' business model and presence at AutismOne depend on blaming vaccines, the only source of any form of mercury from vaccines is the preservative thimerosal. Now, thimerosal has not been used in pediatric vaccines since 2001, with the exception of some multi-dose vials of flu vaccines. It should also be noted that thimerosal contains a specific form of mercury: ethylmercury. So, what type of mercury is being described in that table? Methylmercury, a far more toxic substance that is metabolized very differently than ethylmercury and which persists in the body for much longer. From the original 1985 study, here's the text accompanying the figure, emphasis added:
Figure 11. Ontogenic changes in the biliary secretion of methylmercury and reduced glutathione in developing rats. An intravenous injection of mercury (1 mg/kg) as methylmercury chloride (CH3HgCI) labeled with the 203Hg isotope was given to 14-day-old, 21-day-old, and 28-day-old rats, and bile was collected every hour for 4 h. The group size was between 8 and 12 animals. The secretion rates were those measured 3 h after the mercury administration. For further details, see the report of Ballatori & Clarkson (2).
So this table does not represent anything remotely connected to vaccines, thimerosal or autism, let alone effects in humans. Just one example of the intellectual sleight of hand to be expected from Dr. Geier and his son during their presentation. Perhaps other bloggers will go into the rest of the studies cited in the presentation.

On a related note, I thought I'd check up on what I wrote about one of Mark Geier's colleagues, Dr. John Ling Young. In February of this year, Dr. Young's license to practice medicine in Maryland was suspended due to his prescribing Lupron in violation of a number of state medical regulations. As with Dr. Geier, Dr. Young had licenses in a number of other states. Since I was looking into license statuses, I figured I'd see if there had been any developments in those states:
  • California - Suspended as of March 25, 2013. A Petition to Revoke was filed May 20, 2013.
  • Distric of Columbia - Expired.
  • Florida - Currently active through January 31, 2015. He has not reported any disciplinary actions.
  • Illinois - License expires July 31, 2014, but is listed as "Inactive". Has not reported any disciplinary actions.
  • Indiana - Currently active through October 31, 2013. He has not reported any disciplinary actions.
  • Kentucky - Expired February 28, 2013.
  • Maryland - Suspended as of February 13, 2013. Affirmed March 28, 2013. 
  • Missouri - Currently active through January 31, 2014. Notes that disciplinary action has been taken in another state.
  • Pennsylvania - Inactive. Expired December 31, 2012. No disciplinary actions are noted.
  • Texas - Had a license that Expired August 31, 2011 and was cancelled due to nonpayment September 6, 2012. 
  • Virginia - Unable to find any license for Dr. Young.
  • Washington - Suspended as of April 9, 2013. Dr. Young, after being investigated by the board, had entered into an agreement that he would not see or treat any patients, that he would not renew his license and that he would pay a $5,000 penalty. That was six days before Maryland suspended his license. The Maryland suspension was provided to the Washington board and, pending further disciplinary actions, his license was suspended on April 9.
Overall, not a great deal has changed with John Young, with a couple notable exceptions. California and Washington both suspended his licenses in their respective states. He has four licenses that are expired, but still has three active licenses, out of twelve.

It seems like every time I look, the Geier edifice crumbles just a little more. Mark Geier and his son David continue to chalk up disgrace after disgrace, and they bring down those who throw their lot in with them. Mark Geier no longer has a leg to stand on. How long before he moves shop to someplace like Tijuana?
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5 comments:

  1. Todd, thanks for all your work. It's disgraceful that the Geiers are still being applauded by credulous parents at AutismOne.

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  2. Indeed. And, as evidenced by Dr. Young's case, they have no problem using other physicians to continue to treat patients indirectly by just getting others to sign off on the appropriate forms, sometimes without even seeing the patient!

    ReplyDelete
  3. Thanks for following this and keeping the light shining on this misconduct.

    There is so much misconduct in the faux-autism-treatment world. Sadly, it has to rise to this level and be made public before any action is taken. And this took years.

    By the way, I would also add emphasis to the dose in that study--1mg/kg.

    Hey, he's just talking to a bunch of parents who really want to help their disabled kids. Why should he give them the truth?

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  4. This is excellent news. Thanks so much for keeping the spotlight trained on the Geiers. I agree; it's just incredible to me that AutismOne continues to feature them year after year. I can't help but wonder if any of the other conference presenters have ever expressed any reservations to the Arrangas about their continued promotion of their work.

    One thing I'm still curious about: After I learned that the Geiers had moved to Florida, I Googled their address and discovered that in October 2011, David A.
    Geier filed an LLC annual report with the Florida Department of Corporations identifying himself as a Managing Member of "DAP Pharmaceuticals". Yellowpages.com has them listed as a mail order pharmacy. I'm guessing that the company dispenses the drugs prescribed by the Geiers' accomplices in order to avoid third-party scrutiny of their prescribing practices, but have no way of confirming that.

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  5. While we are on the subject of the Autism One conference, is there any word on how that is going? I see pictures on AOA, but no video yet. I would have loved to know whether Jake Crosby tried to crash the AOA talks or how Kerri "Bleach Enema" Rivera's presentation transpired. I wanted to cover it for my own Facebook blog, but alas, no webcasting.

    ReplyDelete

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