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The Maine Board of Licensure in Medicine on Tuesday held its third hearing on the suspension of Dr. Meryl Nass related to her treatment recommendations for patients with COVID-19.
As it did on day two of the hearings, held on Oct. 27, 2022, the board focused on Nass’ alleged “sloppy” record-keeping for three patients she treated and on her prescribing of ivermectin and hydroxychloroquine for those patients.
The board suspended Nass, a member of the Children’s Health Defense scientific advisory board, on Jan. 12, 2022, without a hearing.
The board initially accused Nass of “unprofessional” and “disruptive” behavior, spreading “misinformation” and prescribing hydroxychloroquine and a “deworming medication” (ivermectin) to patients.
However, the board withdrew the accusations of “misinformation” on Sept. 26, 2022, just prior to her first hearing date, Oct. 11, 2022.
The board’s case now rests on Nass’ alleged non-adherence to the medical “standard of care” as it pertained to ivermectin and hydroxychloroquine for treating COVID-19 and on the alleged “record-keeping” issues.
Two witnesses hired by the board — Dr. Thomas Courtney of the Maine Medical Center and Dr. Jeremy Samuel Faust, an emergency physician at Brigham and Women’s Hospital in Massachusetts and instructor at Harvard Medical School — testified during Tuesday’s proceedings, and Nass’ attorney, Gene Libby, cross-examined Courtney.
Cross-examination pokes holes in ‘expert witness’ testimony
Throughout his testimony, Courtney repeated his assertion that Nass did not follow an adequate standard of care in prescribing ivermectin and hydroxychloroquine to three patients, alleged improprieties in her communication and remote (telemedicine) consultations with the patients, and claimed Nass’ record-keeping was lacking.
But Courtney was obliged to walk back significant portions of his earlier testimony under his cross-examination by Libby.
For instance, Courtney claimed Nass did not adhere to an appropriate standard of care because she failed to advise two of her patients who didn’t recover as expected to seek care at an emergency room.
But under cross-examination, he acknowledged Nass had, in fact, advised the patients to go to the ER.
Courtney also criticized Nass for not prescribing monoclonal antibodies to her patients, one of whom was pregnant.
However, when cross-examined, Courtney admitted that, unlike hydroxychloroquine, monoclonal antibodies were not recommended for pregnant women and most monoclonal antibodies available at the time Nass was advising her patients were known to be ineffective against the Omicron variant of COVID-19, the dominant strain of the virus at that time.
Libby pointed out that the pregnant patient fully recovered eight days after the onset of her illness and had a normal birth, during which she was administered hydroxychloroquine and monoclonal antibodies.
Because evidence shows monoclonal antibodies are ineffective for pregnant women, the patient’s full recovery was credited to hydroxychloroquine.
Courtney also criticized Nass for making decisions about a patient’s care, including which medications to prescribe, on the basis of incomplete medical records.
He later walked back those claims after Libby demonstrated that Nass had received extensive documentation about the condition of one of the patients from his spouse, who provided Nass with vital signs, including the patient’s blood oxygen level.
Libby noted the three patients had specifically requested not to be treated with remdesivir, had asked to be prescribed ivermectin and hydroxychloroquine — and were fully within their rights as patients to request such treatment. Courtney was obliged to concur.
Libby also pointed out that off-label prescriptions of medications such as ivermectin and hydroxychloroquine, even for uses other than their primary purpose, are well within the generally accepted standard of care for physicians, and that federal agencies such as the U.S. Food and Drug Administration (FDA) and the National Institutes of Health do not issue binding requirements in this regard.
Courtney confirmed these statements.
In another characteristic exchange, Courtney, who had previously been critical of alleged gaps in Nass’s record keeping, was forced to concede that he did not “personally have a strong opinion on it.”
Referring to Courtney’s testimony, Nass wrote on her blog that despite his “opining that I lacked the fitness to practice medicine, he was unable to identify a single thing I had done wrong in my records.”
“I sent 2 patients to the ER when they did not recover as expected, although one of the board’s initial charges against me was that I failed to do so,” Nass wrote.
She likened the board’s accusations against her to “simply throwing lots of spaghetti on the wall to try and overwhelm me with charges so I would wilt and surrender my license.”
Referring to the medical claims Courtney made, Nass wrote:
“Courtney did not know the difference between an EUA [Emergency Use Authorization] product and a licensed drug. He incorrectly repeated a false claim made only once by FDA that the EUA for HCQ [hydroxychloroquine] was withdrawn because you would need to administer a toxic dose to get benefit. He had clearly failed to give that assertion any thought. Nor had he evaluated the U.S. government literature showing it to be false.
“He thought I should have treated 2 outpatients with monoclonal antibodies, but eventually agreed that cases in December 2021 were a mix of Omicron and Delta when the patients were ill, that none of their variants had been sequenced so we did not know which variant they had, and the monoclonals would not have worked against Omicron variants, which were likely to have been present then.”
“Doctor Courtney doesn’t read journal articles,” Nass wrote. “He sticks by the recommendations of government agencies and his specialty organization, the Infectious Diseases Society of America (IDSA).”
Nass noted that the IDSA was sued by the State of Connecticut “for denying the existence of chronic Lyme disease.”
In the brief time that was available for Faust to begin his testimony, he focused on attacking the credibility of Dr. Harvey Risch, an epidemiologist at the Yale University School of Public Health, for a journal article he wrote finding that treatments such as hydroxychloroquine were effective against COVID-19.
Nass had relied in part on Risch’s findings in dispensing hydroxychloroquine to her patients. During his testimony, Faust claimed, “There’s no disagreement here among the most prestigious experts in this area” with regard to the purported lack of effectiveness of hydroxychloroquine in treating COVID-19 patients.
Nass wrote:
“Faust was the Board’s epidemiology expert. He got some of the epidemiology right and he got a lot wrong. His arrogance when he was not sure of the answer was off-putting. He insulted Yale epidemiology professor Harvey Risch. He insulted my ability to read a journal article and he had a novel theory that this was sufficient disqualification to justify revoking my license.
“No one mentioned that Dr. Courtney could not cite journal articles used for forming his opinions on COVID treatment, having solely relied on pronouncements from government agencies.
“Should his license be revoked for that? Of course not.”
Nass also pointed out that Faust is a proponent of pregnant women receiving multiple mRNA injections. For instance, he was the lead author of “Pregnancy should be a condition eligible for additional doses of COVID-19 messenger RNA vaccines,” published in November 2022 in the American Journal of Obstetrics and Gynecology MFM.
Nass also wrote that Faust “publicly melted down when the mask mandate on planes was lifted,” accusing the Centers for Disease Control and Prevention of “killing babies.”
Next hearing set for March 2
The Maine board has scheduled two more hearings, the next one for March 2.
However, according to Nass, “The questioning of Dr. Faust is likely to take half a day more. Then I have 8 witnesses to go, including 3 patients who are at issue.”
About 140,000 people tuned in to Tuesday’s live broadcast of the proceedings, according to Nass.
Children’s Health Defense is providing support for Nass’ legal team.
Watch Tuesday’s hearing here:
