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Board correctly took emergency action against MD in egregious case

A state medical board's decision had merit and it did not abuse its discretion in the disciplinary proceedings that ultimately led to the revocation of a physician's license, the Court of Special Appeals of Maryland held May 29 (Geier v. Maryland Board of Physicians). 

Since 2011, Mark Geier, a former licensed physician, had his licensed suspended or revoked in every state in which he held a license.

Geier’s misconduct allegations include irresponsible treatment methods involving autistic patients, lying to patient’s parents regarding the treatment plan, and falsifying his credientials to the Maryland Board of Health.

In April 2011, the Maryland State Board of Physcians initiated an “emergency action” to suspend Geier’s license over concerns that he was endangering autistic patients. The board found that Geier’s methods did not hinge on any proven scientific data or research and that he misdiagnosed countless patients.

The board found that Geier lied to patient’s parents that he was administering an approved drug for chelation therapy when he was, in fact, administering an unapproved drug. Geier also lied about his credentials by telling the board he was a certified geneticist and epidemiologist.

In August 2012, the Board issued a Final Decision and Order, and Geier’s license was revoked. The primary finding by the board was that Geier treated his patients with Lupron, a drug only approved by the FDA for use on adults, not on children “in the absence of precocious puberty.” Geier also did not perform adequate examinations to reach a conclusion if his patients did, in fact, have precocious puberty.

Geier petitioned for judicial review in three jurisdictions: the Circuit Court for Baltimore City, the Circuit Court for Baltimore County, and the Circuit Court for Montgomery County. Geier voluntarily dropped his petitions in Baltimore, and the Maryland Board moved to dismiss. The Circuit Court of Montgomery County denied the Board’s motion to dismiss, but affirmed the Board’s decision on the merits.

On appeal, Geier posed numerous questions to the Maryland Court of Special Appeals (which the court consolidated). The questions included if there was substantial evidence that Geier engaged in professional misconduct, if evidence and testimony was properly given to the court, and if the court abused its discretion in denying Geier a motion to stay.

The Special Appeals Court found that the board and the lower courts neither abused their discretion nor made judgments on insufficient evidence.

The court highlighted evidence found by the board that Geier falsified documents, misled parents regarding the treatment of their children, and failed to give proper examinations to his patients.

“Geier treated Patient I for nine months without any physical examination and in fact without seeing him and without even documenting this patient’s height and weight. He treated Patient B for almost three years without a physical examination and before ever seeing him, and he also treated Patient G without first physically examining him or even seeing him in person,” the court stated.

Notably, Geier did not deny diagnosing patients with precocious puberty, nor did he deny not conducting physical examinations of his patients. Instead, Geier argued that he was “not required to diagnose his patients with precocious puberty or conduct a physical examination before administering Lupron ‘off-label’ to treat autism.”

However, the court found that claim too, to be a lie, citing the board’s findings, “Geier explicitly documented that he was using Lupron to treat precocious puberty, the ‘on label’ use for Lupron for children. The fact is Dr. Geier diagnosed his patients with precocious puberty, but he never performed the evaluations necessary for the diagnosis, and then he treated his patients with Lupron under that diagnosis.”

The board also found that Geier prescribed chelation therapy to patients who “failed to display the need for chelation.” Geier would then begin the therapy without proper documentation or adequate evidence of informed consent.

The board concluded and the special appeals court concurred that Geier “displayed… an almost total disregard of basic medical and ethical standards by treating patients without properly examining or diagnosing them, continuing treatment without properly evaluating its effectiveness, and providing “informed consent” forms that were misleading and in at least one case blatantly false.”