Review Upholds License Revocation
of Warren Metzler, M.D.
Stephen Barrett, M.D.
In 1992, the New York State Board of Professional Medical Conduct revoked the license of Warren Metzler, M.D. based on his management of four patients, one of whom died as a result of lack of appropriate treatment. Metzler testified that he practiced "constitutional homeopathy" using homeopathic remedies to "treat the entire person" rather than treating diseases. He also testified that illness is the result of a restricted spirit, there is no such thing as an incurable illness, and that it was necessary to do standard diagnostic testing or repeated physical examinations. The board sustained charges of gross negligence, negligence on more than one occasion, and failure to maintain records. Metzler requested an administrative review in which he asserted that practicing a field of medicine that differs from the weight of medical authority does not constitute negligence. As noted below, however, the review board said there was no separate standard for homeopathic medicine.
STATE OF NEW YORK : DEPARTMENT OF HEALTH
STATE BOARD FOR PROFESSIONAL MEDICAL CONDUCT
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IN THE MATTER
WARREN METZLER, M.D.
ADMINISTRATIVE REVIEW BOARD DETERMINATION AND ORDER
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A quorum of the Administrative Review Board for Professional Medical Conduct (hereinafter the "REVIEW BOARD"), consisting of ROBERT M. BRIBER, MARYCLAIRE B. SHERWIN, EDWARD C. SINNOTT, Mr. AND WILLIAM A. STEWART, M.D,1 held deliberations on October 14, 1992 to review the Professional Medical Conduct Hearing Committee's (hereinafter the "HEARING COMMITTEE") August 12, 1992 Determination revoking Dr. Warren Metzler's license to practice medicine in New York State. Doctor Metzler requested the review through a Notice of Appeal received by the Board on August 23, 1992. JAMES F. HORAN, ESQ., served as Administrative Officer to the Review Board. David M. Ettinger, Esq. submitted a brief en behalf of Doctor Metzler and David W. Smith submitted a brief en behalf of the Department of Health.
1At the time at which the Administrative Review Board met to deliberate this case, the New York State Senate had confirmed only four members of the five member Administrative Review Board that was created pursuant to Chapter 606 of the Laws of 1991
SCOPE OF REVIEW
New York Public Health Law (PHL) Section 230(10)(i), Section 230-c(1) and Section 230-c(4)(b) provide that the Review Board shall review:
- whether or not a Hearing Committee determination and penalty are consistent with the Hearing Committee' s findings of fact and conclusions of law; and
- whether or not the penalty is appropriate and within the scope of penal ties permitted by PHL Section 230-a.
PHL Section 230-c(4)(b) permits the Review Board to remand a case to the Hearing Committee for further consideration.
PHL Section 230-c(4)(c) provides that the Review Board's determinations shall be based upon a majority concurrence of the Review Board.
HEARING COMMITTEE DETERMINATION
The Department of Health charged Doctor Metzler with practicing medicine with gross negligence, with negligence on more than one occasion and with failing to maintain adequate records. The charges involved the Respondent's care for four patients, whom the charges designated as patients A through D.
The Hearing Committee in this case determined that the Department had met its burden of proof in establishing that the Respondent was guilty of gross negligence in his treatment of patient A, of negligence on more than one occasion in his treatment of patients A through D and of failure to maintain records for patients A through D.
The Hearing Committee voted unanimously to revoke Doctor Metzler's license to practice in New York. The Committee found that the care the Respondent rendered to patients A through D failed to meet the minimum standards of acceptable medical practice. The Committee found further that Doctor Metzler does not recognize the existence of disease, did not consider any disease incurable and did not recognize the necessity for laboratory tests or diagnostic studies or the need for repeated physical examinations.
The Respondent's brief argues that the proceeding against Doctor Metzler was actually targeted against the school of homeopathic medicine which Doctor Metzler practices. Respondent raises six points in challenging the Hearing Committee's determination:
1. The Hearing Committee did not judge Doctor Metzler's treatment by the proper standard of care.
2. The Department's witness was not a qualified expert in homeopathic medicine.
3. That practicing one field of medicine that differs from the weight of medical authority does not constitute negligence.
4. That the physicians on the Hearing Committee were prejudiced against the Homeopathic School of Medicine.
5. That the Administrative Law Judge acted as an adjunct of the Hearing Committee rather than as an independent arbitrator on questions of law.
6. That the Hearing Committee's findings as to patients A through D were inconsistent.
The Respondent urges that the findings of the Hearing Committee can not be grounds for the revocation of Doctor Metzler's license to practice medicine in New York State and that the Committee's determination must be reversed.
REVIEW BOARD DETERMINATION
The Review Board has considered the entire record from this hearing, together with the Briefs which each party has submitted, in reaching this Determination.
We find that the issues which the Respondent raised in his Points 4 and 5 concerning bias by the Hearing Committee and a lack of independence by the Administrative Law Judge are issues which are beyond the Review Board's jurisdiction.
The Respondent's Points 1 and 3 allege that the Hearing Committee did not judge the Respondent by the proper standard of care and that practicing a field of medicine that differ from the weight of medical authority does not constitute negligence. The Review Board believes that the Hearing Committee judged Doctor Metzler's treatment of patients by the correct and only standard of care which applies to the profession of medicine in New York State, that being whether he had the skill and knowledge of the ordinary medical practitioner in New York State. We believe further that the Department's expert, Doctor Chester, was familiar with that standard of care. There is no separate standard for physicians who practice homeopathic medicine. Addressing the Respondent's Point 2, We find that Doctor Chester was qualified to testify as an expert in the practice of medicine.
The Respondent states in his final point that the Hearing Committee' s Determination about Patients A, B, C and D are inconsistent. The Review Board finds that the Hearing Committee weighed each charge against the Respondent and examined the medical charts for each patient carefully. The Board finds that the difference in findings among the patients resulted from the separate review of each charge. The Review votes unanimously to sustain the Hearing Committee's Determination finding Doctor Metzler guilty of gross negligence, negligence on more than one occasion and failure to maintain adequate records. The Determination is consistent with the Findings of Fact and Conclusions of Law and is supported by the expert testimony by Doctor Chester and by the Respondent's records in evidence.
The Review Board votes unanimously to sustain the Hearing Committee's Determination revoking Doctor Metzler's license to practice medicine in New York State. The Determination is consistent with the Hearing Committee's conclusions and findings that the Respondent is guilty of gross negligence and negligence on more than one occasion and the penalty is appropriate under PHL Section 230-a.
NOW, based upon this Determination, the Review Board issues the following Order:
1. The August 12, 1992 Determination by the Hearing Committee on Professional Medical Conduct is hereby sustained.
2. The Hearing Committee's Determination revoking the license of Warren Metzler, M.D., to practice medicine in the State of New York is sustained.
ROBERT M. BRIBER
MARYCLAIRE B. SHERWIN
EDWARD C. SINNOTT, M.D.
WILLIAM A. STEWART, M.D.
This page was posted on January 30, 2009.