Welcome to the newest edition of Investigative Roundup, highlighting a few of the very best investigative reporting on healthcare each week.
UCSF Regrets A long time-Old, Unethical Experiments on Incarcerated People
UCSF has apologized after an internal investigation found that two faculty members on the institution performed unethical experiments on incarcerated people within the Sixties and Seventies, based on a report from the San Francisco Chronicle.
Two UCSF dermatologists — Howard Maibach, MD, and William Epstein, MD — experimented on a minimum of 2,600 people incarcerated on the California Medical Facility, a jail hospital in Vacaville. The experiments didn’t appear to have approval from the UCSF committee that was purported to authorize studies on human subjects, and informed consent documentation from the research subjects was sparse, the inner investigation concluded.
Epstein died in 2006, but Maibach, 93, continues to be a part of UCSF’s dermatology department.
The interior report was conducted as a component of UCSF’s newly created Program for Historical Reconciliation, which goals to “reply to questions and concerns raised by our community about UCSF’s history,” the Chronicle reported.
UCSF’s report cited just a few experimental methods used on the prison subjects, including the topical application of herbicides and pesticides, placing small cages with mosquitoes near the arms of human subjects, and even placing the cages directly onto the skin to look at how the insects bit an individual.
Reviewing publications from 1960 to 1980, UCSF found that nearly all of studies conducted by Maibach and Epstein lacked documentation for informed consent, although this documentation was required as early as 1966.
“What I think to be ethical as a matter in fact forty or fifty years ago isn’t considered ethical today,” Maibach wrote in a Dec. 12 letter to his colleagues, addressing the report. “I regret having participated in research that didn’t comply with contemporary standards.”
Mystery of Doc Lost at Sea
In October, Marvin Moy, MD, a Manhattan physician, and his friend left on a ship from Long Island for a day-long fishing trip. Greater than 2 months later, Moy has yet to be found.
The disappearance of Moy, a physician from a humble background who then became the topic of a criminal investigation, has develop into a mystery. An investigation from the Latest York Times details the events leading as much as the day Moy was lost at sea, and the sparse evidence indicating his whereabouts now.
Almost a 12 months before the fishing trip, Moy was charged with insurance fraud in federal court in Manhattan. The federal government accused Moy and others of orchestrating a scam that involved bribing emergency responders and hospitals to send automotive crash victims to his pain management clinic. A conviction could have sent him to prison for years, the Times reported.
Along with the court case, Moy was within the midst of a divorce from his wife of 14 years. The divorce had already dragged on for five years, and was stuffed with fights over custody of Moy’s 12-year-old daughter in addition to disputes over money. The physician went through several lawyers, and still owed one firm nearly $70,000, based on a lawsuit obtained by the Times.
On Oct. 12, Moy and his friend Max Wong, a nurse in Queens, left early morning to travel 6 hours to their destination. Around midnight, alarms indicated that the doctor’s boat was in distress, and the Coast Guard dispatched rescue teams off the coast of Fire Island to locate him. However the Coast Guard saw only an oil slick, a floating cooler, and one man — Wong.
“Look, who knows what happened?” Roland G. Riopelle, a lawyer representing one other person accused alongside Moy within the insurance fraud case, told the Times. “As I sit here now, I don’t have any reason to know someway whether he died in a boating accident or cleverly created a situation that looked like a boating accident and fled.”
Hundreds of Patients Get Ketamine Online — And It’s Legal
Scott Smith, MD, a family medicine doctor from South Carolina, obtained medical licenses in 45 states within the last 2 years, all to prescribe ketamine via telehealth. But while Smith has been in a position to construct a wholly virtual ketamine practice through the pandemic, the expiration of public health emergency rules may disrupt his ability to prescribe the substance online, based on the Washington Post.
Smith is considered one of several doctors and tech start-ups providing ketamine via telehealth through the pandemic, made possible by the general public health emergency declaration that waived the requirement for providers to prescribe controlled substances to patients in person. He said the principles have made it possible for him to supply the drug to greater than half of his 3,000 patients. “Persons are beating a path to my door,” Smith said in an interview with the Post.
Ketamine, which has shown some potential to treat depression and anxiety, has typically been administered under strict protocols endorsed by the FDA. But Smith prescribes generic lozenges online, which patients can take at home.
Not less than eight corporations have began to supply ketamine via telehealth for the reason that start of the pandemic, the Post reported. Between Smith and two of the more well-known start-ups — Nue Life and Mindbloom — greater than 10,000 patients have received ketamine of their homes.
While ketamine telehealth corporations and providers say that they’re removing barriers to care, some psychiatrists are concerned about patients taking ketamine without physician supervision.
Ketamine has been utilized in hospitals for anesthesiology — and abused recreationally — for years. The FDA approved the nasal spray esketamine (Spravato) in 2019 under strict protocols, including that doctors needed to be with patients for 2 hours after they took the medication due to its potential to change consciousness and cause hypertension.
“I’m very concerned about treatments that deviate too removed from the usual recommendations given by the FDA,” Gerard Sanacora, MD, PhD, director of the Yale Depression Research Program who led a team that pioneered ketamine to treat depression, told the Post. “I actually do imagine that it’s considered one of the most important advances of psychiatry prior to now half-century,” he said of ketamine, “but we’ve to be very careful to proceed to develop this responsibly.”
