Lyme Handbook

It is time to update you once again on the status of the charges that I have been fighting before the Connecticut Medical Examining Board (CMEB). I cannot thank you enough for the many expressions of support and encouragement that you have been sending my way over the past several months. These have made a huge difference to me, enabling me to maintain my determination to prevail.

In this update, I will focus on the most recent developments in what has become a long series of charges and investigations by the CMEB and Connecticut Department of Health (CT DPH). For more detailed background information, I refer you to my letter dated Sept. 5, 2008, which is posted on the following Web site: http://www.lymesite.com.

Currently, there have been two separate and distinct cases against me. The original case is under appeal, and the second case pertains to a new set of charges regarding a different set of patients.

In addition to this, we have learned that the court-appointed monitor has brought a number of complaints about me to the CMEB, which appear to be based on his reliance on the Infectious Diseases Society of America (IDSA) guidelines as the alleged “gold standard” for the diagnosis and treatment of Lyme disease. These currently are under investigation, but at this point no formal charges have been filed in relation to them.

I was brought up on a series of charges pertaining to two children from one family in Nevada, whose parents were involved in a post-divorce decree custody dispute. The children involved in the case were doing quite well and there was no allegation of harm done to either of them as a result of their treatment.

In its decision of December, 2007, CMEB imposed a $10,000 fine, a reprimand and two years of monitored probation. Despite these disappointing recommendations, this case was not lost. My license to practice medicine was not suspended or limited.

However, the CMEB introduced a very restrictive four-part standard of care for Lyme disease at the very end of the proceedings. Left unopposed, this test would set a very dangerous precedent, and could be used against other doctors to shut down the treatment of chronic Lyme disease. It clearly had to be appealed.

Most of the charges that I was found “guilty” of were stayed, or suspended, pending the outcome of the appeal, including the four-part standard of care. The one exception was the monitoring requirement. I was required to find and pay for a board-certified pediatrician, licensed in the state of Connecticut, to conduct periodic chart reviews at my office for a period of two years.

A hearing was held in Superior Court to review the question of the panel member’s bias. The judge rejected our arguments. The case is now on appeal to the Connecticut Appellate Court; the brief in support of my position is due in April.

The Department of Public Health then filed another series of complaints against me. This set of charges differs from the first case in that it involves three separate families, with the respective cases conjoined into one proceeding. Although the exact facts differ, the cases are similar in that two of them involve non-custodial fathers filing complaints. In none of the cases were any of the children involved harmed; indeed, as with the first case, the children all are doing very well.

The CT DPH called on Dr. Lawrence Zemel and Dr. Peter Krause to provide expert testimony contesting my treatment.

Following lengthy hearings concluding last May, a three-member panel has issued its “proposed memorandum of decision” (MOD). This was be voted on by the CMEB on Feb. 16, following the presentation of oral arguments by both attorneys.

The third count involving one of the families was completely dismissed.

The testimony of Zemel was thrown out, with the panel characterizing him as clearly biased against physicians who treat chronic Lyme, and against many of the labs that they use.

The first count was upheld: this pertained to the charge that I had “improperly” ordered serology (diagnostic) testing prior to examining the patients. This seems strange, because, as far as we know, there were no patient complaints or patient harm. It is also difficult to comprehend why pre-examination testing should ever be the basis of disciplinary action against a physician.

The second count against me also was upheld. The issue here was the prescription of antibiotics to a patient whose symptoms were quite consistent with both Lyme and Babesiosis. I had obtained a comprehensive history from the referring practitioner who had contacted me about the case, and also from the patient’s mother. An ER had recorded an EM rash that went untreated My schedule was so heavily booked that I could not see the patient for a number of weeks. I was confident that the patient should be started on antibiotics immediately, and that the risk of not treating would be greater than the risk of treating. The patient did well.

In this case, the panel has denied that charges have been brought against me because I am a Lyme specialist. Instead, it has characterized its findings as generic and pertaining to medical practice as a whole. This is why we have not been able to utilize the recently passed physician protection bill in Connecticut.

Nevertheless, it is rather difficult to understand why such matters should have ever reached this level, or why their two expert witnesses were specialists in tick-borne diseases. There have been no patient complaints, other than disaffected fathers involved in contested custody or divorce proceedings, and no harm has come to any of the children, who in fact have done well.

Once again, the panel has not recommended that my medical license be revoked. They have, however, recommended the following sanctions: Another $10,000 fine and four years of supervised probation, with a monitor again hired at my own expense.

Why I continue to fight:

Some of you have expressed dismay that the Connecticut Department of Public Health has spent so much taxpayer money on these charges. You have been concerned that they will continue to bring charges against me until I am forced to close my office.

This process has been undeniably stressful. It has been painful to see so much time, energy and valuable resources being expended on my defense. I continue to believe, however, that it is critical for me to continue to fight these charges and to prevail.

“¢ We must stand up for what we believe and know to be right in the matter of diagnosis and treatment of tick-borne disease.

“¢ I am painfully concerned about the lack of effective care for children afflicted with tick borne disease. Because I decided to fight these charges when all of this began some six years ago, several thousand additional pediatric Lyme patients have received an appropriate diagnosis and treatment for their tick-borne disease.

“¢ A successful outcome for me will both hearten and protect other physicians who wish to diagnose and treat Lyme disease comprehensively, and will encourage other pediatricians in particular to train with me.

“¢ We must send a clear message to health departments across the country that we will not be bullied, or allow our right to medical treatment to be trampled.

Dr. Charles Ray Jones, M.D., is a pediatrician based in New Haven.