Geier Suspension Upheld · 2012-04-18 15:45

Following a lengthy appeals process, on March 22, 2012, the Maryland Board of Physicians upheld the suspension of Dr. Mark Geier’s license to practice medicine. The decision follows that of the Maryland Office of Administrative Hearings, which ruled in September 2011 that the Board had “proved by a preponderance of the evidence that summary suspension of [Dr. Geier’s] license to practice medicine is imperatively required to protect the public health, safety or welfare”; and a Cease and Desist Order issued by the Board on January 25, 2012, and amended on February 22, following the discovery that Dr. Geier had continued to prescribe and authorize refills of medication after the suspension of his license.

From the Administrative Law Judge’s decision

Page 16: “[Dr. Geier’s] Evaluation of each of the Patients was deficient because it did not include either a complete physical examination of the Patient performed by [him] or a review by [him] of a recent complete physical examination record of the Patient provided to him by the Patients’ other medical providers.”

“None of the summaries of the information [Dr. Geier] received during his intake history from the Patients’ parents, or the summaries of the information [he] personally obtained from his examination of the Patients that are contained in the Records, or the prior medical records that may have been submitted to [him] and are contained in the Records, contain the results of a recent complete physical examination of the Patients, a complete medical history of the Patients with a review of all the relevant physical systems, an evaluation of the Patients’ heart or lungs, results of a recent physical examination of the Patients’ abdomens, or a Tanner Stage level of the Patients.

Page 18: “[Dr. Geier’s] evaluation of each of the Patients was deficient because it did not include a specific detailed identification of the presenting symptoms he was targeting for future treatment.”

Page 21: “[Dr. Geier’s] Evaluation of each of the Patients was deficient because he did not obtain sufficient information from the Patients to be able to accurately interpret the results of the lab tests he ordered for those Evaluations.”

Page 22: “[Dr. Geier’s] initial and continuing Evaluations of the Patients were deficient because his explanations and documentation of treatment plans were incomplete, because he failed to explain why medications were being added, modified, or deleted, and because he failed to include a rationale as to why specific therapies were chosen over others.”

Page 28: “[Dr. Geier] monitored the Patients’ response to his therapies only through the Parents’ brief, mostly vague reports and through the results of laboratory testing he could not accurately interpret. [His] monitoring plan for each Patient was inadequate to carefully monitor the Patient for response to treatment and to protect that Patient from adverse side effects. [His] monitoring plan was an insufficient platform upon which to make safe modifications of therapies.”

Page 32: “[Dr. Geier] prescribed chelation therapy for Patients […] without appropriate rest breaks to permit their bodies to recover from the stresses of chelation and thereby placed these Patients at risk of serious harm.”

Pages 38-39: “The missing components of [Dr. Geier’s] Evaluations and monitoring plans prevented [him] from being able to accurately assess whether Patients needed the therapies and treatment he prescribed for them, and from being able to accurately assess the risks and benefits to each Patient of each of those prescribed therapies and treatment. His monitoring plans for Patients lacked critically important information necessary to assess whether the Patients could be or were suffering adverse side effets from the treatments and therapies he prescribed. The missing components and deficiencies in [his] initial Evaluation and ongoing monitoring of Patients posed a risk of serious harm to each of these Patients. The missing components and deficiencies in [his] initial Evaluations and his inadequate monitoring of the Patients make it substantially likely that [his] evaluation and monitoring of other patients would be similarly defective and present a substantial likelihood of risk of serious harm to the health, safety, or welfare of the public.”

Pages 60-61: “The Records contain hundreds of pages of results from laboratory testing that the Patients endured on a monthly or more frequent basis. [Dr. Geier] testified in his sworn statement that he initiatied and modified the administration of Lupron and initiated and continued or discontinued chelation therapy based in large part upon the results of these tests. Yet, the Records contain no consistent documentation as to whether [he] reviewed those monthly lab test results or how his ongoing treatment reflected their results.”

Pages 62-63: “[I]nconsistencies between the [Dr. Geier’s] sworn statement and the Records he maintained of the Patients, the lack of information in the Records about treatment decisions and what led to those treatment decisions, the absence of evidence that [Dr. Geier] made decisions based on his own hands-on complete physical examination and/or receipt of complete medical histories, the lack of evidence that [Dr. Geier] was relying on fully-informed, objective reports of the Patients’ conditions, and the infrequency of in-person visits with many of the Patients are factors which establish that the Patients were at risk of serious harm: from a constricted information base, from a deficient basis for initiating treatment, and from a flawed system of monitoring adverse side effects and efficacy. I believe that these factual considerations imperatively require emergency action.

“I conclude that for all these reasons, the Patients’ health, safety or welfare was at risk of serious harm. Further, the existence of all these problems throughout all the Records raises a substantial likelihood that the risk of serious harm to the Patients was also posed to many other children with autism treated by [Dr. Geier]. I find that this meets the necessary standard for summary suspension of [Dr. Geier’s] license: allowing him to continue practicing medicine while formal charges are pending raises a substantial likelihood of risk of serious harm to the public health, safety or welfare.”

The Board agreed. From page 9 of its Final Decision and Order:

“For Dr. Geier to practice medicine at this time would constitute a danger to the patient community”

— a community consisting of children and young adults with autism at risk of maltreatment by profiteering ideologues and loving but misguided parents led to believe their scientifically unsupportable claims.

Both the Administrative Law Judge’s decision and the Board’s Final Decision and Order are contained in the document posted to the Board website.

Comments


  1. Thanks for staying on top of this story, Kathleen. Interesting to note, according to the Final Decision and Order, that Dr. Geier completed only 1 year of ob-gyn postgraduate clinical training at Johns Hopkins (1979), while his Wikipedia entry states that he was an assistant professor of ob-gyn at Hopkins from 1979 to 1982. Quite a disconnect of purported fact, and I suspect it’s just a symptom of wider dissembling by this very troubling man.

    bmartin    2012-04-19 10:49    #

  2. I do believe that it is possible to have a one year residency and then stay on as an assistant teaching professor for another 2 years as in Geier’s case. This is not a disconnect but what many young struggling students do if they have the offer to stay.

    — Amos Oliver Doyle    2012-05-04 16:55    #

  3. $10K fine.

    — _Arthur    2012-08-17 17:42    #

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