Disciplinary Actions against Charles C. Mary, M.D.
Stephen Barrett, M.D.
Charles C. Mary, III, M.D., who operates the Mary Medical Clinic in Metarie, Louisiana, has been disciplined four times by the Louisiana State Board of Medicine.
The Mary Clinic Web site states that the clinic was founded in 1973 by Mary's father (Charles C. Mary, Jr., M.D.), who , after attending lectures by Linus Pauling and others, decided to administer IV vitamin C to his patients. Charles III eventually took over the clinic and in recent years has offered chelation and many other types of IV treatments.
- In 1998, the board concluded that Dr. Mary suffered from dependency on alcohol and had previously undergone treatment for addiction to controlled drugs. The board issued a consent order under which Mary was placed on probation for five years and required to obtain treatment. In 2003, the board concluded that he had complied with the 1998 order and reinstated his unrestricted license.
- In 2009, the board found Mary guilty of unprofessional conduct in connection with his management of five patients. Its opinion and order (shown below) concluded that Mary had administered intravenous (IV) hydrogen peroxide treatments to a woman with rheumatoid arthritis without documenting an adequate treatment plan or adequately informing her that effective standard treatment options were available. The document also noted that a review of four more of his cases revealed the same deficiencies. The board fined Mary $3,000 and placed him on probation for five years, during which he was required to have his practiced monitored by another doctor and take specified continuing education courses.
- In September 2010, the board noted that Mary and failed to engage a monitor and suspended his license until he did so. Three months later, after he engaged a monitor, he was permitted to resume practice.
- In July 2014, the board summarily prohibited him from administering IV hydrogen peroxide to any patients.
BEFORE THE LOUISIANA STATE BOARD OF MEDICAL EXAMINERS
IN THE MATTER OF:
CHARLES CALLAN MARY, M.D. (Certificate NO. 023420)
OPINION AND ORDER
This matter comes before the Board pursuant to an Administrative Complaint and Supplemental and Amending Administrative Complaint, which charge Respondent Charles Callan Mary, III, M.D., with a number of violations of the Medical Practice Act, R. S. 37: 1261 et seq. The matter was heard before a panel consisting of Kim Edward LeBlanc., M.D., Ph. D., Mark Dawson, M.D., Robert E. Dawson, M.D., Cynthia G. Montgomery, M.D., Melvin G. Bourgeois, M.D., and Linda Gage-White, M.D., Ph. D., President.
In the Administrative Complaint, Respondent is charged with continuing conduct which fails to satisfy the prevailing and usually accepted standards of medical practice in this state, which is indicative of professional and medical incompetency with respect to his clinical judgment, diagnosis, and treatment, in violation of R. S. 37:1285A(12) and (14). He is further charged with violation of the Board's rules regarding Integrative and Complementary Medicine, which may be found in La. Admin. C. Title 46, Section 7101 et seq., and R. S. 37:1285A(30), which proscribed violation of the Board's rules and regulations. These charges arise out of his treatment of one patient, who shall be referred to herein as B.B.
Dr. Mary is a graduate of Louisiana State University Medical School, and, after graduation, he completed an internship and a residency in internal medicine at Charity Hospital in New Orleans. He went immediately into private practice, and has never attempted to become board certified.
B.B. first consulted Dr. Mary on November 29, 2006, complaining of pain and swelling in various joints, which were affecting her quality of life. She filled out three forms, including an "Informed Consent," which was general as to Integrative and Complementary Medicine, but not specific as to B.B.'s condition or as to her treatment. Since it is dated November 29, 2006, it was completed before any diagnosis was made. Dr. Mary examined her, and ordered a number of tests, and, on receipt of the test results the next day, arrived at a correct diagnosis of rheumatoid arthritis.
The chart kept by Dr. Mary on B.B. does not show that he discussed her condition with her, or that he advised her as to conventional therapies for her disease. B.B. testified that she was unaware that she was going to receive alternative therapy, and that she had not read the "Informed Consent" form referred to above. Respondent ordered a course of hydrogen peroxide infusion therapy, which B.B. took for about three weeks, beginning December 4, and ending December 28, 2006. During that period she had six infusion treatments, with only minimal improvement. She did not return to Dr. Mary's clinic after that date. During this period, Dr. Mary saw B.B. only informally, speaking to her in the infusion room, or in passing. Nothing that took place during these encounters is documented in the chart. Dr. Mary testified that she told him she was feeling better when he asked her how she was.
Section 7107 of the Board's Rules for Integrative and Complementary Medicine provides, in part, as follows:
"A. 3. Treatment Plan. A treatment plan by which progress or success can be evaluated with stated objectives shall be formulated by the physician which is tailored to the individual needs of the patient and documented in the patient's medical record. Such plan shall include documentation of:
"a. whether conventional or complementary methods of diagnosis or treatment for the current complaint or condition have been considered, are being undertaken or have been attempted without adequate or success or a statement that the patient has refused such methods;
"b. Consideration for the need for conventional testing, consultation, referral or treatment when indicated;
"c. the intended role of integrative or complementary medicine within the overall plan; and
"d. whether integrative or complementary medicine offered or utilized could interfere with any ongoing conventional therapy.
"4. Informed Consent. A physician shall inform a patient or his guardian of each of the following, which discussions shall be noted in some form in the patient's record:
"a. His education, experience and credentials regarding any integrative or complementary medicine which is recommended; and
"b. the risks and benefits of both conventional medicine and integrative or complementary medicine incorporated within each treatment plan.
"B. A physician shall inform the patient that his recommendation for the use of a particular drug, substance or medical device for diagnosis or treatment of the patient's illness, disease or condition is investigational, experimental, new, unconventional or unproven."
Dr. Mary stated that he had never read the Board's rules 100%, but that he thought he was practicing good medicine.
Brobson Lutz, M.D., testified as an expert in Internal Medicine for the Complainant. He testified that the treatment afforded B.B. by Respondent did not meet the standard of care for an internist. He pointed out that conventional therapies for rheumatoid arthritis are extremely effective, even "miraculously so." He was of the opinion that to administer alternative therapy to a patient with rheumatoid arthritis, without explaining or discussing the conventional therapies, falls below the standard of care for an internist. He was also of the opinion that to have an informed consent executed before there is a diagnosis, is also a violation of the standard of care.
We further note from the record that, on January 11, 2007, she was seen by Dr. Robert J. Quinet at the Ochsner Clinic. He instituted a conventional course of treatment, which was quite successful, and the rheumatoid arthritis was controlled within a matter of weeks.
We do not believe that the treatment of one patient can constitute "continuing or recurring medical practice which fails to satisfy the prevailing and usually accepted standards of medical practice in this state," in violation of R. S. 37:1285A(14). However, we are of the opinion that to institute an unproven treatment of a patient for a condition which is readily controlled by conventional means, without first consulting with the patient and clearly explaining the treatment options, is indicative of professional or medical incompetency in violation of R. S. 37:1285A(12). We therefore find respondent guilty of the latter charge.
With respect to the alleged violations of the Board's Rules on Integrative and Complementary Medicine, we first note that Dr. Mary, by his own testimony, is not familiar with those rules. Second, in the case of B.B., we find no treatment plan in her chart which comes close to satisfying the requirements of Section 7107A(3) of the rules, quoted above, particularly subsection (a), which requires documentation of the consideration of conventional therapies. Neither does he document consideration for the need of conventional testing consultation, referral, or treatment when indicated, as required by subsection (b), nor the intended role of integrative or complementary medicine within the overall plan, as required by subsection (c).
There is no informed consent in the chart. The document titled "Informed Consent" does not satisfy the requirements of Section 7107 A (4), in that it does not contain the information relative to the physician's education and experience, and does not document the risks and benefits of conventional and integrative or complementary medicine included in the treatment plan.
Finally, Section 7107 B requires that the patient be advised that the course of treatment recommended by the physician is investigational, experimental, new, unconventional, or unproven. The chart is devoid of any suggestion that this was done in this case. In fact, B.B. testified that she did not know that the treatment given her by Respondent was alternative medicine.
We therefore find that Dr. Mary is guilty of multiple violations of the Board's Rules for Integrative and Complementary Medicine.
In the Supplementary and Amending Administrative Complaint, the charges relative to B.B. are reiterated, and Dr. Mary is further charged with violations of the Board's rules regarding Integrative and Complementary Medicine, supra, and R. S. 37:1285A(30), supra, for alleged deficiencies in his treatment of four other patients, A.S., B.O., R.R., and M.M.
We have examined the charts of these patients, and have heard the testimony of Dr. Mary as to those charts. Without going into detail, we can say that the same deficiencies exist in these cases as did in the case of B.B. We therefore find Dr. Mary guilty of the charges in the Supplementary and Amending Administrative Complaint.
We therefore impose the following sanctions:
The license of Respondent Charles Callan Mary, Jr., M.D., to practice medicine in the State of Louisiana, as evidenced by Certificate No. 023420, is hereby suspended for a period of three years, effective immediately, but the said suspension is hereby stayed, subject to the following terms and conditions:
First, the license of Respondent Charles Callan Mary, Jr., M.D., to practice medicine in the State of Louisiana, Certificate No. 023420, is hereby placed on PROBATION for a period of five years, subject to the General Conditions of probation heretofore adopted by the Board, a copy of which is attached hereto as Exhibit A, and subject to the following special conditions:
1. Within the first year of his probationary period, Respondent shall enroll in and successfully complete a course of training in medical record keeping, pre-approved by the Board, and shall furnish to the Board a certificate attesting to the successful completion thereof.
2. Within thirty (30) days of the effective date of this Order, Respondent shall enter into a contract with a physician or other entity determined by the Board, for the development and implementation of a monitoring program. The monitoring physician shall monitor Respondent's medical practice for the duration of the probationary period and shall submit quarterly reports to the Board. The monitoring physician shall meet with Respondent and review no less than 25 medical records per quarter. The monitor is responsible to determine that Respondent is practicing in accordance with the generally accepted standards of medical practice, and furthermore, is in compliance with the Board's Integrative and Complementary Medicine Rules. Any and all fees, costs or expenses incurred in connection with this monitoring requirement or any other expenses necessitated by compliance with this Order shall be borne by Respondent.
3. Respondent shall furnish to the Board, within thirty days of the date of this opinion, an affidavit that he has read, understands, and will abide by the Board's Rules on Integrative and Complementary Medicine.
4. Respondent shall provide to the Board, within thirty days of the date of this opinion, an informed consent form, which shall be satisfactory to the Board.
5. Respondent shall enroll in and satisfactorily complete a course in Integrative and Complementary Medicine, satisfactory to the Board, for each year of his probation, and shall furnish to the Board a certificate attesting to his satisfactory completion of each course.
6. Within six months of the date of this opinion, Respondent shall enroll in, and satisfactorily complete, a ten day course in Internal Medicine, satisfactory to the Board, and shall furnish to the Board a certificate attesting to his satisfactory completion of said course.
7. Respondent shall pay a fine of $3000.00, and all costs of this proceeding since the filing of the Administrative Complaint.
Any violation or failure of the probationer to abide by each of the general terms ands special conditions of probation shall be considered a violation of probation, and shall constitute sufficient cause for the revocation, suspension, or further disciplinary action against the license of the probationer, including but not limited to, the immediate imposition of any sanctions which may have been stayed, in whole or in part, upon the license of probationer, as if such cause were enumerated in R. S. 37:1285A.
NEW ORLEANS, LOUISIANA, this 14th day of December, 2009.
LOUISIANA STATE BOARD OF MEDICAL EXAMINERS
LINDA GAGE- WHITE, M.D., PH. D., PRESIDENT
The following general conditions are imposed on all persons placed on supervised probation by the Louisiana State Board of Medical Examiners:
- The probationer is required to report, in person to his probation officer, within 48 hours of receipt of notification that the opinion of the Board is final and executory.
- The probationer is required immediately to complete all forms, fully and carefully, when received, and to present these to his probation officer at the first meeting.
- The probationer is required to report to his probation officer, in person, at such times as may be directed.
- The probationer is required to allow such access to his home or office, as well as all medical and/or psychiatric records, and substance abuse records, as may be necessary to his supervision.
- Upon request of the Board's probation officer, the probationer shall immediately execute and provide, as may be necessary, such authorization and/or medical releases as may be requested to obtain photocopies of medical treatment records of probationer, including but not limited to substance abuse, alcohol, psychiatric or other records which may otherwise be protected by any state or federal law.
- Upon request of the Board's probation officer, the probationer shall immediately execute and provide, as may be necessary, authorization to obtain any and all peer review records pertaining to probationer of any hospital, institution or other health care entity where probationer has had or has privileges.
- Probationer shall submit to alcohol or drug screens through a urine, blood or hair specimen, at the request of the probation officer without prior notice, to determine chemically through laboratory analysis that probationer is free or prohibited drugs and/or alcohol. Probationer shall pay for the costs of such chemical analysis.
- The probationer is required fully to conform to accepted standards of professional conduct, and with all civil and criminal laws, rules and regulations.
- The probationer is required to submit to such medical or psychiatric examinations, or both, as may be directed by the Board.
- The probationer is required immediately to report to his probation officer any and all investigations, inquiries, charges, convictions, or disciplinary actions taken by any local, state, or Federal agency, or any institution or facility.
- The probationer is required to fulfill all special conditions of probation.
- The probationer shall immediately notify the Board's Probation and Compliance Officer of any change in his current home and professional addresses and telephone numbers, and he shall direct all matters required pursuant to this Order to the attention of the Probation and Compliance Officer, with whom he shall cooperate on all matters and inquiries pertaining to his compliance with the terms, conditions and restrictions of this Order.
- Should the probationer at any time during the period of probation ordered herein be absent from the state of Louisiana, relocate to and/or take up residency in another state or country for a period of thirty (30) days or more, he will so advise the Board in writing. In such instance, the probationary period ordered herein and all terms and conditions thereof shall be deemed interrupted and extended and shall not commence to run until the probationer notifies the Board in writing that he has returned to, relocated in and/or taken up residency in the state of Louisiana. In such instance, the probationer shall not receive credit toward completion of the probationary period for the time during which he was absent from the State of Louisiana.
- At least sixty (60) days prior to the conclusion of the probationary term imposed herein, the probationer shall provide the Board with an executed affidavit certifying that he has complied with each of the terms of probation imposed upon him by this decision, and he shall contact the Board and arrange for a personal appearance before the Board, or such other committee as may be designated by the Board, at its meeting preceding the expiration of the probationary term ordered herein.
- For each year of the probationary term the probationer shall pay the Board a probation monitoring fee of Three Hundred ($300.00) Dollars. Payment of the initial fee shall be done not later than sixty (60) days from the date of this Decision. All subsequent annual payments shall be due on or before the anniversary date of the initial fee payment.
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