NC Medical Board Charges Against Dr. Rashid A. Buttar
Response to Charges - PDF - January 2010
Attorney Letter - PDF - March 26, 2009
Motion to Stay Proceedings and Response - PDF - March 25, 2009
Notice of Charges - PDF - March 10, 2009
Petition for Judicial Review - PDF - February 17, 2009
In the new notice of charges, the NCMB has dropped the clearly "false allegations" against Dr. Buttar, specifically of never having examined or visited or evaluated or seen the patients in question. These original charges, which have now been dropped, were noticeably and conspicuously inflammatory and a major alleged reason for prosecuting Dr. Buttar in the first place, based on the NCMB's premise of "patient safety”.
The first hearing and examination of the plain and simple evidence disproved their allegations, showing them to be blatantly unfounded and fabricated. The NCMB, in an obvious attempt to discredit Dr. Buttar, was in possession of and examining the medical charts in question for over 18 months before allegations were made and charges were filed and made public.
Now, after having the charts for over 3 years, they have finally dropped the only "real" evidence in this case. The same evidence that was planned to be used against Dr. Buttar (which in 18 months was never adequately reviewed), proved that Dr. Buttar was innocent of the false allegations made by the NCMB against him.
The mistrial due to ex parte is of further concern. The agenda of the NC Medical Board prosecutors, who were well aware of this departure from professional conduct yet waited to disclose it to the defense for a full 2 months after the facts were known to them, is suspicious.
Considering all this, as well as the previous 10 year history of the NCMB in persecuting Dr. Buttar based on NO complaints and NO cause, as well as Dr. Buttar's prominent role in helping pass legislation in 2003 to control the abusive power of the NCMB against doctors (Bill 886, Due Process for Physicians), the intention of the NCMB has become highly suspicious and overly concerning.
The NCMB has proceeded to prosecute this clearly non-existent case based upon 4 complaints by parties who all admitted to never having met Dr. Buttar previous to the first hearing. Furthermore, all these 4 parties have a clear financial motive. Since the filing of the original case, the NCMB has decided to drop 1 of the 4 complaints, after Dr. Buttar was awarded a financial judgment against the complainant.
In addition, all of the actual patients (not complainants) upon which this case is based are documented to have been appreciative and thankful of the treatment and care provided by Dr. Buttar, with objective evidence proving the efficacy of the treatment they received. Subjective improvements are also well documented, including that the patients outlived the prognoses given by their conventional oncologists.
Lastly, the mission and purpose of the NCMB is to ensure patient safety. The 3 remaining cases the NCMB tried were all concerning patients who were considered "terminal". There has clearly been NO patient harm, which was even admitted to by the ONLY ONE expert witness used by the NCMB. The "alleged" financial harm is even more ludicrous because now the NCMB is trying to dictate economic policy.
If Dr. Buttar's treatments were NOT effective, he would NOT be enjoying the privilege of taking care of people from 33 different countries. His practice would not be thriving and increasing in size were the allegations of the NCMB based on any fact. The lack of economic viability would have closed down Dr. Buttar's practice long ago if there were any truth to the false allegations made by the NCMB.
The blunt truth is that Dr. Buttar has exceeded the non-descript, vague, unclear and often contended upon definition of "standard of care". This has threatened the status quo, the "good old boy" network in the medical hierarchy in the great state of NC. This, along with the fact that Dr. Buttar teaches other doctors from around the world, that he protects patient and doctor rights by helping to change the law in NC, that he was President of the NC Integrative Medical Society for 6 years, and that he has been an outspoken critic against the NCMB’s abusive conduct towards good doctors and their attempts to restrict patient rights, has incited the medical hierarchy in the local region.
Under pretense of public safety, the medical hierarchy has released their GESTAPO agency, using the complaints of 4 non-patients all based on financial motive, to wage a war against Dr. Buttar who they clearly consider a threat and enemy of the NCMB and the NC Medical Society. The NCMB has used its power for a personal and professional agenda: to eliminate competition for the medical hierarchy.
This "competition" that the NCMB seeks to eliminate is more sought out by patients, provides better outcomes, has far lesser side effects and offers a better quality of life than what the traditional and obsolete medical hierarchy can provide. The evidence of this surrounds us every single day.
The NCMB gave a very clear message in response to the patients who testified to the success of their treatment under Dr. Buttar. These were patients whose conventional "standard of care" treatments had failed and who were sometimes labeled as "terminal”. This proves that the agenda of the NCMB was everything else BUT patient safety. If patient safety were the primary concern of the NCMB, they would be embracing Dr. Buttar and his colleagues, “begging" them to teach the rest of the medical providers in the great state of NC how to help more patients achieve a better outcome than they currently are receiving through the obsolete "standard of care".
BEFORE THE
NORTH CAROLINA MEDICAL BOARD
In re:
Rashid Ali Buttar, D.O.,
MOTION TO DECLARE A MISTRIAL
NOW COMES the Respondent, Rashid Ali Buttar, D.O., and moves Janelle A. Rliync,
M.D., President of the Board, for an Order declaring a mistrial of the proceedings before the Panel which heard cvidence in the above matter on April 23-24, 2008 and in support of their Motion shows to the Board as follows:
1. On Wednesday, April 23, Dr. Kirby, who is on staff with the Medical Board and
who participated in the investigation and preparation of Dr. Buttar's case, had an ex parle
comnlunication with 1-1. Arthur McCulloch, M.D. in the Board brake room during a recess in the formal proceedings. Dr. McCulloch is a member of the Panel assigned to hear evidence and to issue a recommended decision in this case.
2. Dr. Kirby gave Dr. McCulloch materials on Complimentary and Alternative
Medicine as follows:
1. Fundamentals of Complementary and Alternative Medicine by Marc S Micozzi.
2. Alternative Medicine: An Objective Assessment Edited by Phil B. Fontanarosa, MD.
3 The Duke Encyclopedia of New Medicine by the Center for Integrative Medicine at Duke University.
4. A wcbsite with the address: http://nccain.nili.~ov/clinictarila ls/alltrials.htin which lists "All NCCAM Clinical Trials" by either disease or treatment.
3. Counsel for Dr. Butiar is also informed and believe that Doctors Kirby and
McCulloch engaged in exparte discussions of the evidence in Dr. Buttar's case
4. It is evident that Dr. McCulloch reviewed the books and internet site over night
because on Thursday, April 24 he asked Dr. Wilson, an expert witness for Dr. Buttar, questions that related to some of these materials,
5. Marcus Jimison and Thomas Mansfield. Counsel for the Medical Board, became
aware of the exparte communication sometime on Thursday during the hearing. Counsel did not disclose this information to Dr. Buttar's attorneys so that it could be made a part of the record of the hearing. Mr. Jimison did cross-examine Dr. Buttar and refer to some of the same materials in his cross-examination.
6. Messrs. Jin~isona nd Mansfield first notified counsel for Dr. Buttar of the ex pane
communications between Dr. Kirby and Dr. McCulloch on May 19,2008, almost a month after the close of the hearing. In the intervening weeks, counsel for the Medical Board consulted with outside counsel and obtained an opinion that the exparie contact between Dr. Kirby and Dr. McCulloch was a violation of the Administrative Procedures Act. NCGS 150B-40 (d), which states:
(d) Unless required for disposition of an ex parte matter authorized by law, a
member of an agency assigned to make a decision or to make findings of fact and
conclusions of law in a contested case under this Article shall not communicate,
directly or indirectly, in connection with any issue of fact or question of law, with
any person or party or his representative, except on notice and opportunity for all
parties to participate. This prohibition begins at the time of the notice of hearing. An agency member may communicate with other members of the agency and may have the aid and advice of the agency staff other than the staff which has been or is engaged in investigating or prosecuting functions in connection with the case under consideration or a factually-related case. This section does not apply to an agency employee or party representative with professional training in accounting, actuarial science, economics or financial analysis insofar as the case involves financial practices or conditions.
7. The expane communications in violation of the above referenced statute were
prejudicial to Dr. Buttar because they deprived him of his right to confront and cross-examine
witnesses and evidence considered by the finder of facts in the hearing of the charges in this case
This error is in violation of the United States and North Carolina Constitutions, the law and
procedure mandated by our legislature, and the fundamental concepts of fairness rooted in our
judicial system.
8. Dr. Buttar reserves his right to file written exceptions to the Recommended Decision
of the Hearing Panel pursuant to NCGS 90-14.5, prior to a final decision by the Board in this matter.
WHEREFORE, the Respondent respectfully prays that Dr. Jenelle A. Rhyne as President of
the North Carolina Medical Board and presiding officer of the Hearing Panel grant this Motion for a Mistrial of the proceedings which took place before the Hearing Panel on April 23-24,2008 and Order that any retrial of these charges be before an administrative law judge pursuant to NCGS
150B-40 (e),
Respectfully submitted, this the 15 day of September, 2008.
H. Edward Knox
Lisa G. Godfrey
Attorneys for Respondent
FOR THE FIRM:
KIIOX, Brotherton, Knox & Godfrey
Post Office Box 30848
Charlotte, N.C. 28230-0848
Phone: (704) 372-1 360
Fax: (7041 372-7402 ~,
eknox@knoxlawcenter. corn
lgodfrey@knoxlawcenter.com
CERTIFICATE OF SERVICE
I, Lisa G. Godfiey, Attorney for Respondent, certify that I have this day served a copy of the
foregoing MOTION TO DECLARE A MISTRIAL on the following individual. a copy of same
via e-mail, addressed as follows:
VIA E-MAIL Marcus. Jimison@NCMEDBOARD.ORG
Mr Marcus B. Jimison
North Carolina Medical Board
Post Office Box 20007
Raleigh, NC 2761 9-0007
This the 15 day of September, 2008.
Lisa G. Godfrey
Attorney for Respondent
KNOX, BROTHERTON, KNOX & GODFREY
ATTORNEYS-AT-LAW
POST OFFICE BOX 30848
CHARLOTTE, NORTH CAROLINA 28230-0848
(704) 372-1360
FAX: (704) 372-7402
August 8, 2008
VIA E-MAIL Marcus.Jimison@NCMEDBOARD.ORG
& FIRST-CLASS MAIL
Mr. Marcus B. Jimison
North Carolina Medical Board
Post Office Box 20007
Raleigh, NC 27619-0007
Re: North Carolina Medical Board vs. Rashid Ali Buttar, D.O.
Dear Marcus:
We are in receipt of your letter of August 5, 2008. We do not recall your discussing a re-opening of the evidence before the panel of Drs. Rhyne, Walker and McCulloch. Given the nature of the ex parte communication between Drs. Kirby and McCulloch, we do not believe that this panel is qualified to decide the proper remedy for the errors that occurred during the hearing of May 23 and 24, 2008. If you have any case law or statutory authority to suggest otherwise, please provide it to us. It would not make sense to ask those who did not follow the rules to review their own conduct.
Rather, if we are unable to resolve this matter through a Consent Order, we would propose to present testimony to the full Board regarding the improprieties that took place. We plan to call the following witnesses:
(1) Dr. Kirby
(2) Dr. McCulloch
(3) Dr. Rhyne
(4) Dr. Walker
(5) Marcus Jimison
(6) Thomas Mansfield
We would propose to present this testimony when the full Board considers the recommen-dation of the panel. As of yet, we have not seen any proposed findings of fact or conclusions of law. Under N.C.G.S. § 90-14.5(c), we will be given an opportunity to file written exceptions to the recommended decision made before the hearing panel and to present oral arguments to the Board. As we told you on the telephone, both Eddie and I have substantial conflicts for the month of September. It was our understanding that you were going to determine whether a special meeting of the Board could be called sometime during the month of October. Before you set a date for that meeting, please contact our offices to determine our trial schedules. I am currently on the Lincoln County trial calendar for the week of October 27, 2008, but do not have any other trials during that month. Eddie has a Mecklenburg County trial beginning the week of October 6, 2008.
Because we anticipate calling you and Tom Mansfield as witnesses, we wanted to give you ample opportunity to obtain outside counsel in this matter. You had indicated in an earlier telephone conversation that you had already sought the advice of an outside attorney, so I assume you have somebody who is familiar with the facts and the law of the situation and can step in to assist you.
We look forward to hearing from you regarding a proposed consent resolution to this matter in the next few days.
Very truly yours,
/S/ Lisa Godfrey
H. Edward Knox
/S/ Lisa Godfrey
Lisa G. Godfrey
LGG/kgf
MEMORANDUM
TO: HEK
FROM: LGG
RE: BUTTAR v. MEDICAL BOARD
WHAT IS THE REMEDY FOR THE EX PARTE COMMUNICATIONS BETWEEN DR. KIRBY AND DR. McCULLOCH DURING THE HEARING BEFORE THE THREE MEMBER PANAL OF THE MEDICAL BOARD ON APRIL 23 AND 24, 2008?
Facts
On May 19, 2008 we received a call from Marcus Jimison and Thom Mansfield. At that time, they disclosed to us that on Wednesday, April 23, Dr. Kirby, who is on staff with the Medical Board and who participated in the investigation and preparation of Dr. Buttar’s case, had an ex parte communication with Dr. McCulloch in the Board brake room during a recess in the formal proceedings. Dr. Kirby gave Dr. McCulloch materials on Complimentary and Alternative Medicine. At this point we do not know the content of any discussions that took place, but the materials that Dr.Kirby provided to Dr. McCulloch were as follows:
1. Fundamentals of Complementary and Alternative Medicine by Marc S. Micozzi.
2. Alternative Medicine: An Objective Assessment Edited by Phil B. Fontanarosa, MD.
3. The Duke Encyclopedia of New Medicine by the Center for Integrative Medicine at Duke University.
4. A website with the address: http://nccam.nih.gov/clinicaltrials/alltrials.htm which lists “All NCCAM Clinical Trials” by either disease or treatment.
It is evident that Dr. McCulloch reviewed these materials over night because on Thursday, April 24 he asked Dr. Wilson, an expert witness for Dr. Buttar, questions that related to some of these materials.
Counsel for the Medical Board became aware of the ex parte communication sometime on Thursday during the hearing. Counsel did not disclose this information to Dr. Buttar’s attorneys or bring it to the attention of the President of the Medical Board who was the presiding officer at the hearing. Counsel for the Medical Board did cross-examine Dr. Buttar and refer to some of the same materials in his cross-examination.
When Marcus Jimison and Thom Mansfield disclosed this information to us on May 19, they said that the reason they had waited to tell us was that they had gotten an opinion of outside counsel on whether or not the communications between Dr. Kirby and Dr. McCulloch were prohibited by NCGS 150B-40 (d). This section states:
(d) Unless required for disposition of an ex parte matter authorized by law, a member of an agency assigned to make a decision or to make findings of fact and conclusions of law in a contested case under this Article shall not communicate, directly or indirectly, in connection with any issue of fact or question of law, with any person or party or his representative, except on notice and opportunity for all parties to participate. This prohibition begins at the time of the notice of hearing. An agency member may communicate with other members of the agency and may have the aid and advice of the agency staff other than the staff which has been or is engaged in investigating or prosecuting functions in connection with the case under consideration or a factually-related case. This section does not apply to an agency employee or party representative with professional training in accounting, actuarial science, economics or financial analysis insofar as the case involves financial practices or conditions.
Marcus and Thom told us that in the opinion of their outside counsel, the communications between Doctors Kirby and McCulloch did violate the above statute.
Legal Analysis
In the case of Mission Hospitals, Inc. v. N.C. Department of Health and Human Services, 658 S.E. 2d 277 (Ct. of App. March 18, 2008), the Court addressed the prohibition on ex parte communications in the Administrative Procedure Act (APA). Mission Hospitals involved a decision by the Director of Division of Facilities Services of NCDHHS (Agency) to grant a “no-review” Certificate of Need to Asheville Hematology and Oncology Associates. Mission Hospital petitioned for a contested case hearing before the Agency. The ALJ who heard the case issued a recommended decision affirming the original Agency decision. After a hearing before the Director of the Agency, the decision was reversed.
It came to light that counsel for the Mission Hospital had some ex parte communications with the Director prior to the issuance of his decision. Asheville Hematology appealed and the Court of Appeals held:
(1) Director of Agency violated the Administrative Procedure Act (APA) by engaging in ex parte communications with hospital immediately before reversing ALJ's recommended decision;
(2) Director's actions prejudiced treatment center's substantive rights; and
(3) Agency's decision violated the APA by not stating specific reasons for not adopting certain findings of fact by the ALJ.
658 S.E. 2d 277. The Court found that the ex parte communications in violation of the statute (in this case NCGS 150B-35) constituted an error of law under NCGS 150B-51 (b). This error of law effected the outcome because it denied the opposing party the right to cross-examine witnesses or evidence offered to the decision maker in the case. As the Court reasoned:
N.C. Gen.Stat. § 150B-29 provides rules of evidence for agency proceedings. In relevant part, it states:
Evidence in a contested case, including records and documents, shall be offered and made a part of the record. Factual information or evidence not made a part of the record shall not be considered in the determination of the case, except as permitted under G.S. 150B-30.
N.C. Gen.Stat. § 150B-29(b) (2005). The referenced exception in N.C. Gen.Stat. § 150B-30 allows for official notice of certain facts provided that:
The noticed fact and its source shall be stated and made known to affected parties at the earliest practicable time, and any party shall on timely request be afforded an opportunity to dispute the noticed fact through submission of evidence and argument.
N.C. Gen.Stat. § 150B-30 (2005).
658 S.E. 2d at 283.
The remedy for this violation was to reverse and vacate the decision and remand the matter to the Agency for a new hearing. Id. The Court specifically refused to adopt the appellant’s suggestion that Court adopt the original decision in favor of the appellant.
Another recent decision that should be considered in this case is Faber v. NC Psychology Board, 153 NC App. 1, 569 S.E. 2d 287 (2002). In this case, a psychologist appealed the decision of the Psychology Board suspending his license for engaging in a romantic relationship with a patient.
Just as with the Medical Board, the Psychology Board received a patient complaint and assigned a staff psychologist (Dr Yardley). to investigate. Dr. Yardley presented a report to the Board on whether there were sufficient grounds to bring formal charges against Dr. Farber. Prior to the formal hearing, Dr. Faber filed a petition and asked that certain Board members be disqualified because they had received information from Dr. Yardley that may have prejudiced them in hearing evidence at the formal hearing. The Board denied the petition and all members heard the case in the formal hearing. They issued a decision suspending Dr. Faber’s license.
On appeal to the Wake County Superior Court the decision was vacated on the grounds that Dr.Yardley’s ex parte communications improperly commingled the investigative and adjudicative functions of the Board.
The Court of Appeals reversed the Superior Court on the grounds that the ex parte contact in this case did not specifically violate NCGS 150B-40 (d) because it took place before the Notice of Hearing on the formal charges was issued. NCGS 150B-40 (d) specifically limits the prohibition on ex parte communications to the period after the time of the Notice of Hearing.
In the Buttar matter, the ex parte communications clearly took place after the Notice of Hearing was issued. Thus, our case is distinguishable from Faber on its facts and reasoning in the Mission Hospitals case should apply.
Conclusion
Based on the facts of this case and the law cited above the possible remedies for the violation of NCGS 150B-40 (d) are:
(1) A new hearing before the full Medical Board – with the 3 members who sat on the Panel that heard the case in April excluded from the hearing and all deliberations; or,
(2) Under NCGS 150B-40 (e), if the Board determines that it can not hear the case, the Board can apply to the Office of Administrative Hearings to appoint an administrative law judge to preside over a new hearing.
BEFORE THE NORTH CAROLINA MEDICAL BOARD
In re: Rashid Ali Buttar, D.O.,
Respondent.
RESPONSE TO NOTICE OF CHARGES AND ALLEGATIONS
NOW COMES the Respondent, Rashid All Buttar, D.O., and responds to the charges and
allegations served on him on January 8,2008, as follows:
1. Paragraph 1 is an allegation of law and not of fact and is, therefore, denied.
2-4.. Admitted.
5. Concerning the allegations of paragraph 5, it is admitted that Patient A presented to the Respondent with a diagnosis of cervical cancer which had metastasized to her liver and lungs at the time she started treatment with him.
6. Concerning the allegations of paragraph 6, it is admitted that Patient B was diagnosed with ovarian cancer in 2002 which, at the time of surgery, had spread throughout her abdomen and liver. In 2002 and 2003, she underwent chemotherapy which was unsuccessful and, in April 2004, was directed to the Respondent by her family doctor.
7. Concerning the allegations of paragraph 7, it is admitted that Patient C had a diagnosis of adrenal carcinoma which had metastasized to his lungs.
8. Concerning the allegations of paragraph 8, it is denied that Patient D presented to the Respondent for treatment of colon polyps. Rather, she was referred by her mother for treatment of heavy metal toxicity (which had been diagnosed by hair analysis) and treatment of pain in her lower left side.
9. Concerning the allegations of paragraph 9, the Respondent states that, at the time of Patients A, B and C's deaths, he was not treating them and has no personal knowledge as to their causes of death. The Respondent is informed and believes that Patients A and B succumbed to their cancer, and that Patient C died of a pulmonary embolism.
10. Denied. With regard to Patient A, the Respondent's records do not reflect how she was referred to him for treatment. However, the Medical Board's investigation states that Patient A's daughter referred her mother to the Respondent for treatment of cervical cancer which had metastasized to the lung and liver, and for which conventional medical treatment had been discontinued due to lack of efficacy. Patient A signed a consent to treatment (which was witnessed) that specifically admitted that no claim from the Respondent to cure cancer with therapies had been made. With regard to Patient B, the Respondent's records reflect that this patient was referred to the Respondent by her family physician and, prior to beginning treatment with the Respondent, Patient B signed a consent to treatment that specifically admitted that no claim from the Respondent to cure cancer with therapies had been made. With regard to Patient C, it appears that he was self-referred to the Respondent through a web search. He also signed a consent to treatment in which he specifically agreed that no claim to cure cancer with the Respondent's therapies had been made to him.
11. Denied. The Respondent will present scientific evidence before the Board of the efficacy of all treatments rendered in his practice to Patients A, B and C. Further, N.C.G.S. $ 90- 14(a)(6) specifically states that: "The Board shall not revoke the license of or deny a license to a person solely because of that person's practice of a therapy that is experimental, nontraditional, or that departs from acceptable and prevailing medical practices unless, by competent evidence, the Board can establish that the treatment has a safety risk greater than the prevailing treatment or that the treatment is generally not effective,"
12. Concerning the allegations of paragraph 12, the first sentence is con~pletely and totally denied. Concerning the allegations in the second sentence regarding the costs of treatment for individual patients, the billing statements for each of the patients vary and the total amount billed for each patient is reflected thereon. Concerning the third sentence of this allegation, it is specifically denied that the Respondent ordered therapies in an attempt to drive up billings. Rather, he ordered therapies as were necessary (in his judgment) to the treatment of the patients. In addition, it is specifically denied that he ordered tests and lab work with no rational medical relationship to the patients' cancer diagnoses. Rather, he ordered tests and lab work which were (in his professional opinion) necessary to the treatment of these patients. Finally, with regard to the allegations of the fourth sentence of paragraph 12, it is specifically denied that the tests and lab work ordered by the Respondent were never adequately justified or linked to the patients' diagnoses and clinical conditions or, in some cases, never interpreted. All tests and lab work were necessary in the judgment of the Respondent to the treatment of the patients, and all were used in connection with the treatment of these patients, Furthermore, all rationale used to treat above-mentioned patients has been taught in an ACCME accredited, AMA Category 1 CME approved course.
13. The allegations of all of the sentences of paragraph 13 are specifically denied. All testing and lab work was, in the opinion of the Respondent, necessary for the treatment of his patients.
14. The allegations of all sentences of paragraph 14 are specifically denied. Patients A, B and C all clinically showed efficacy of treatment and objective evidence of improvement.
15. The allegations of paragraph 15 are specifically denied. Patients A, B and C were seen at least once per week by the Respondent and, on many occasions, more than once per week.The Respondent and his nurse practitioner, together, often saw these patients and notes would be taken by the nurse practitioner. All patient treatments and decisions were made by the Respondent. All the instances when the nurse practitioner saw patients, her notes were reviewed and countersigned by the Respondent. The Respondent followed all Medical Board standards and guidelines for the supervision of his nurse practitioner, who was fully qualified to perform all tasks and duties that she undertook at the direction of the Respondent.
16. Concerning the allegations of paragraph 16, it is specifically denied that the Respondent ever promised Patient C that his treatments had a " 100% success rate." With regard to the amounts of the charges for Patient C, the Respondent's billing records have been submitted to the Medical Board and speak for themselves. It is admitted that, prior to his death, Patient C attempted to pay a final bill by check, and it is admitted that Patient C's spouse stopped payment on that check. It is further admitted that the Respondent's staff witnessed numerous angry phone conversations between Patient C and his wife, who was not supportive of the Respondent's treatment. Patient C specifically related to the Respondent on two separate occasions that he was depressed over the fact that his wife cared more about her financial status than his life.
17. Concerning the allegations of paragraph 17, it is admitted that, after Patient C's spouse stopped payment on a check that Patient C had written to the Respondent, Patient G's account (after his death) was referred to a collection agency.
18. Denied. The billing statements for Patient B have been submitted to the Medical Board and they speak for themselves. Patient B was seen on at least a weekly basis, if not more
often, by the Respondent. All of the notes written by the Respondent's nurse practitioner were reviewed and countersigned by the Respondent. Moreover, the Respondent personally examined this patient, and his notes reflect evidence of clinical improvement over the course of her treatments.
19. Concerning the allegations of paragraph 19, the billing statements for Patient B (which have been submitted to the Medical Board) speak for themselves. It is admitted that the Respondent's practice did seek collection from Patient B's estate for a balance outstanding at the time of her death. Except as specifically admitted, the remainder of the allegations of paragraph 19 are denied.
20. Concerning the allegations of paragraph 20, the billing statements for Patient A have been submitted to the Medical Board and speak for themselves. Both as to the dates of treatment and amount of charges, it is admitted that Patient A received treatment for approximately one month, and that she came to the Respondent with advanced cancer after conventional treatments had failed. The Respondent's treatment of Patient A was not limited to the administration of hydrogen peroxide. A complete list of treatments administered by the Respondent is contained in the billing statements for this patient. It is admitted that Patient A paid $360.00 by credit card for her initial office visit and made an advance payment of $12,000 against which other tests and treatments were credited. The total number of office visits for this patient is documented in the billing records, as is additional billing amounts. It is admitted that, at the conclusion of her treatment, certain items were returned which resulted in a credit and refund. The Respondent saw Patient A on a number of occasions without charging her. It is admitted that the Respondent's nurse practitioner made notes of office visits at which the Respondent and the nurse practitioner were in attendance. On occasions in which the nurse practitioner examined Patient A independently, her notes were reviewed and countersigned by the Respondent, All diagnoses and treatments were reviewed and ordered by the Respondent. Except as specifically admitted, the remainder of the allegations of paragraph 20 are denied.
21. Concerning the allegations of paragraph 21, it is specifically denied that the Respondent treated Patient D for colon polyps. In fact, Patient D presented with a complaint of heavy metal toxicity, and that was specifically the condition for which she sought treatment. The Respondent did not personally meet with Patient D. However, she was treated by a nurse practitioner under the direct supervision of the Respondent. The nurse practitioner's notes were reviewed and countersigned by the Respondent. The Respondent authorized and supervised all treatment of Patient D, which was appropriate. Patient D was eventually discharged from the practice due to the fact that, after paying by credit card for services rendered, on numerous occasions she attempted to reverse credit card charges claiming that she never received the services that had, indeed, been rendered. This did result in an ongoing dispute with Patient D because she attempted to obtain services from the Respondent without intending to pay for those services. Except as specifically admitted, the remainder of the allegations of paragraph 21 are denied.
22. The allegations of paragraph 22 are specifically denied. Under N.C.G.S. Â 90- 1A(3), "integrative medicine is a diagnostic or therapeutic treatment that may not be considered a conventionally accepted medical treatment and that a licensed physician in the physician's professional opinion believes may be of potential benefit to the patient, so long as the treatment poses no greater risk of harm to the patient than the comparable conventional treatments." The Respondent is an integrative medicine physician. In addition, under N.C.G.S. $ 90-14(a)(G), "the Board shall not revoke the license of or deny a license to a person solely because of that person's practice of a therapy that is experimental, nontraditional, or that departs from acceptable and prevailing medical practices unless, by competent evidence, the Board can establish that the treatment has a safety risk greater than the prevailing treatment or that the treatment is generally not effective." The allegations of the Board's complaint against the Respondent do not state that the Respondent's treatments posed a safety risk greater than the prevailing treatment, nor do they show that the Respondent's treatment was generally not effective. In fact, the Respondent's treatment was documented in some individual patient files as being more effective than the standard treatment of those individual patients and the Respondent will supply medical and scientific proof that the treatments used by him on patients are effective in treating various conditions.
23. The allegations of paragraph 23 are denied. The Board has presented no allegations or proof that the Respondent's treatments are a safety risk greater than the prevailing treatment, nor any proof that they are generally not effective.
24. The allegations of paragraph 24 are denied. The Respondent did not directly solicit any of the patients cited in the Medical Board's charges. In fact, patients arc routinely referred by other patients or their physicians to the Respondent. All patients, and particularly cancer patients, sign a statement recognizing that the Respondent does not make any specific representations about his treatments or their effect on cancer. All patients also sign clear financial policies which state that patients are directly responsible for all charges.
WHEREFORE, the Respondent respectfully requests:
(1) That the charges and allegations against him be dismissed;
(2) That the Board take no disciplinary action against him after hearing the evidence on
the charges presented.
FOR THE FIRM:
Knox, Brotherton, b o x & Godfrey
Post Office Box 30848
Charlotte, N.C. 28230-0848
Phone: (704) 372- 1 360
Fax: (704) 372-7402
CERTIFICATE OF SERVICE
I, Lisa G. Godfrey, Attorney for Respondent, certify that I have this day served a copy of the
foregoing RESPONSE TO NOTICE OF CHARGES AND ALLEGATIONS on the following
individual, a copy of same via e-mail, addressed as follows:
VIA E-MAIL Marcus.JimisonOPCMEDBOARD. ORG
Mr. Marcus B. Jimison
North Carolina Medical Board
Post Office Box 20007
Raleigh, NC 276 19-0007
This the day of February, 2008.
BEFORE THE NORTH CAROLINA MEDICAL BOARD
In re:
Rashid Ali Buttar, D.O., Respondent
NOTICE OF CHARGES AND ALLEGATIONS; NOTICE OF HEARING
The North Carolina Medical Board (hereafter, Board) has preferred and does hereby prefer the following charges and allegations:
1. The Board is a body duly organized under the laws of North Carolina and is the proper party to bring this proceeding under the authority granted it in Article 1 of Chapter 90 of the
North Carolina General Statutes.
2. Rashid Ali Buttar, D.O. (hereafter, Dr. Buttar), is a physician licensed by the Board on or about May 20, 1995, to practice medicine and surgery, license number 95-00528.
3. During the times relevant herein, Dr. Buttar practiced medicine in Cornelius, North Carolina.
4. Patients A through C presented to Dr. Buttar with a diagnosis of cancer.
5. Patient A presented to Dr. Buttar with a diagnosis of cervical cancer.
6. Patient B presented to Dr. Buttar with a diagnosis of ovarian cancer.
7. Patient C presented with a diagnosis of adrenal cell cancer.
8. Patient D presented to Dr. Buttar with a history of colon polyps.
9. Patients A, B and C would eventually succumb to their cancer.
10. Patients A, B and C, desperate for any hope to combat their disease, came to Dr. Buttar because of Dr. Buttar's representations that the therapies he offered would be effective in their battle against cancer. Dr. Buttar's representations were false, and were made by Dr. Buttar with full knowledge of their falsity.
11. Dr. Buttar provided therapies to Patients A, B and C that were unproven and wholly ineffective. The therapies consisted primarily of intravenous administration of a variety of substances, none of which has any known value for the treatment of cancer. The substances included EDTA (ethylenediaminetetraacetic acid), chromium, certain vitamins, and hydrogen-peroxide.
12. Dr. Buttar charged exorbitant fees for his ineffectual therapies. The total cost of the intravenous injections and other therapies for these cancer patients at times ranged in the thousands, sometimes tens of thousands, of dollars. Not only would Dr. Buttar order and have administered unproven and ineffectual therapies for Patients A, B and C in an attempt to drive up his billings, he would also order numerous tests and lab work for these patients that had no rational, medical relationship to the Patients' cancer diagnosis. Moreover, many tests and lab work that were ordered by Dr. Buttar were never adequately justified in the medical records of the patients, were never linked to the patients' diagnoses or clinical condition, and in some instances never interpreted.
13. There is no evidence that any of the extensive and expensive laboratory data obtained on Patients A, B, C and D were used for treatment decisions. In essence, the medical records indicate that the extensive testing and lab work for Patients A, B, C and D were not ordered for any medical or clinical purpose, but were instead ordered in an attempt to drive up costs.
14. Patients A, B and C seemed to be treated on an indistinguishable or arbitrary protocol regardless of their individual diagnosis. None of the Patients (A – D) showed any evidence of response or benefit to the treatments they received at Dr. Buttar’s office. All Patients received frequent, expensive treatments that had no recognized scientific evidence of any validity whatsoever on almost a daily basis without any evidence of sustained improvement.
15. The medical records of Patients A, B, C and D also do not indicate that Dr. Buttar ever examined or followed any of the patients. All four patients were seen and treated mainly by Dr. Buttar's nurse practitioner. Despite having little, or no personal interaction with Patients A, B, C and D, Dr. Buttar nonetheless charged thousands of dollars to each patient for his services.
16. Dr. Buttar charged Patient C over $32,000.00 for treatments he knew to be ineffectual. Immediately prior to his death, Patient C sent a check to Dr. Buttar, for partial payment, in the amount of $6,700.00. Before Dr. Buttar could cash the check, Patient C's widow cancelled the check because she felt that Dr. Buttar's treatments were useless even though Dr. Buttar had promised her and her husband that his treatments had a "100% success rate."
17. After Patient C's widow cancelled the $6,700.00 check, Dr. Buttar referred Patient C's account to a collection agency. The amount that Dr. Buttar sought from Patient A's widow exceeded $25,000.00, which included the unpaid portion of Patient C's bill, interest, and a 25% collection fee.
18. Patient B was treated by Dr. Buttar for a period of two months, from April 2004 to June 2004. During this two month period, Dr. Buttar charged Patient B in excess of $30,000.00 for
ineffectual therapies that included injections of intravenous vitamins and other substances, chelation therapy with DMPS (Dimercapto-propane sulfonate) and EDTA, Philbert Infra Respiratory Reflex Procedure and Ondamed biofeedback. All of Patient B's clinical notes were written by his nurse practitioner, and for an extended period of time, Dr. Buttar's nurse practitioner exclusively saw and treated Patient B.
19. Prior to her death, Patient B paid Dr. Buttar $10,258.00. Dr. Buttar has sought collection from Patient B's estate the remaining $19,765.00 of his charges.
20. Patient A was treated by Dr. Buttar for one month beginning in July, 2006. Patient A came to Dr. Buttar after a radical hysterectomy, chemotherapy and radiation therapy all failed to halt the spread of her cancer, which by July 2006 had spread to her liver and lungs. Dr. Buttar's treatment of Patient A was to administer hydrogen peroxide intravenously. Patient A paid $12,360.00 to Dr. Buttar for an initial fee. Over the next month, Patient A would have nineteen (19) other office visits with Dr. Buttar and pay an additional $18,000.00, for a total of $27,820.00 (Patient A's family received a refund of $2,540.00). The average cost of Patient A's office visits for Dr. Buttar (to receive IV hydrogen peroxide) was $1,464.00. All examinations and office visit notes for Patient A were written by Dr. Buttar's nurse practitioner. Although Patient A was billed for "physician attendance and supervision," it is unclear from Patient A's medical record whether Dr. Buttar ever examined Patient A or provided much of any supervision to his nurse practitioner.
21. Patient D presented to Dr. Buttar with a history of colon polyps. Dr. Buttar initiated chelation therapy for Patient D without ever seeing the patient or establishing a diagnosis. Patient D was seen only by Dr. Buttar's nurse practitioner and not on all visits. Most of the documentation regarding Patient D has to do with billing issues. There is no diagnosis, no treatment plan defined, and no repeat evaluation of Patient D directly. Patient D's clinical notes consist of six (6) pages, but her financial and laboratory related items consist of some sixty (60) pages. In sum, there is no documented history or examination on repeat visits for Patient D, no stated working diagnosis, and no rationale for the treatment plan. However, there is extensive diagnostic testing without medical justification or indication.
22. Dr. Buttar's treatment of Patients A, B, C and D constitutes unprofessional conduct, including, but not limited to, departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession, irrespective of whether a patient is injured thereby, within the meaning of N.C. Gen. Stat. § 90-14(a)(6), and grounds exist under that section of the North Carolina General Statutes for the Board to annul, suspend, revoke, or limit his license to practice medicine and surgery issued by the Board or deny any application he might make in the future.
23. Dr. Buttar's treatment of Patients A, B, C and D constitutes unprofessional conduct in that he provided a therapy, whether it be characterized as experimental, nontraditional, or a
departure from acceptable and prevailing medical practices, that nonetheless has a safety risk greater than the prevailing treatment or that the treatment is generally not effective within the meaning of N.C. Gen. Stat. § 90-14(a)(6), and grounds exist under that section of the North Carolina General Statutes for the Board to annul, suspend, revoke, or limit his license to practice medicine and surgery issued by the Board or deny any application he might make in the future.
24. Dr. Buttar's conduct in regard to Patients A, B, C, and D constitutes Dr. Buttar providing services to a patient in such a manner as to exploit the patient within the meaning of N.C. Gen. Stat. § 90-14(a)(12), and grounds exist under that section of the North Carolina General Statutes for the Board to annul, suspend, revoke, or limit his license to practice medicine and surgery issued by the Board or deny any application he might make in the future, and furthermore, upon a finding of the exploitation, the Board may order restitution be made to the payer of the bill, whether the patient or the insurer, by the physician, provided that a determination of the amount of restitution shall be based on credible testimony in the record.
NOTICE TO DR. BUTTAR
Pursuant to N.C. Gen. Stat. § 90-14.2, it is hereby ordered that a hearing on the foregoing Notice of Charges and Allegations will be held before the Board, or a panel thereof, at 8:00 a.m., on Wednesday, February 20, 2008, or as soon thereafter as the Board may hear it, at the offices of the Board, 1203 Front Street, Raleigh, North Carolina, to continue until completed. The hearingwill be held pursuant to N.C. Gen. Stat. § 150B-40, 41, and 42, and N.C. Gen. Stat. § 90-14.2, 14.4, 14.5, and 14.6. You may appear personally and through counsel, may cross-examine witnesses and present evidence in your own behalf. You may, if you desire, file written answers to the charges and complaints preferred against you within 30 days after the service of this notice.
The identities of Patients A through D and the date and place of treatment of these patients are being withheld from public disclosure pursuant to N.C. Gen. Stat. § 90-8. However, this information will be provided to you upon your request.
Pursuant to N.C. Gen. Stat. § 150B-40(c)(5), it is further ordered that the parties shall arrange a pre-hearing conference at which they shall prepare and sign a stipulation on pre-hearing conference substantially in the form attached hereto. The prehearing stipulation shall be submitted to the undersigned no later than seven days prior to the hearing date.
The right to be present during the hearing of this case, including any such right conferred or implied by N.C. Gen. Stat. § 150B-40(d), shall be deemed waived by a party or his counsel by voluntary absence from the Board’s office at a time when it is known that proceedings, including deliberations, are being conducted, or are about to be conducted. In such event the
proceedings, including additional proceedings after the Board has retired to deliberate, may go forward without waiting for the arrival or return of counsel or a party.
This the 20th day of November, 2007.
NORTH CAROLINA MEDICAL BOARD
By: ____________________________
Janelle A. Rhyne, M.D.
President
Dr. Buttar Truth Quotes
“Whoever undertakes to set himself up as a judge of Truth and Knowledge is shipwrecked by the laughter of the gods.”
—- Albert Einstein
“Truth is generally the best vindication against slander.”
—- Abraham Lincoln
"All truth passes through 3 phases: First, it is ridiculed. Second, it is violently opposed, and Third, it is accepted as self-evident."
—- Arthur Schopenhauer
"There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success than to take the lead in the introduction of a new order of things because the innovator has for enemies all those who have done well under the old conditions and lukewarm defenders in those who may do well under the new."
—- Machiavelli, The Prince