Suing DAN! practitioners for malpractice: It’s about time

Now that’s what I’m talking about! This is what we need to see more of! A father whose child underwent the quackery that is the Defeat Autism Now! (DAN!) protocol is suing the doctors who administered it for malpractice:

The father of a 7-year-old Chicago boy who was diagnosed as a toddler with autism has sued the Naperville and Florida doctors who treated his son, alleging they harmed the child with “dangerous and unnecessary experimental treatments.”

James Coman and his son were featured last year in “Dubious Medicine,” a Tribune series that examined risky, unproven treatments for autism based on questionable science.

The defendants — family-practice physicians Dr. Anjum Usman of Naperville and Dr. Daniel Rossignol of Melbourne, Fla. — are prominent in the Defeat Autism Now! movement, which promotes many of the alternative treatments the Tribune scrutinized. Both have spoken to groups of parents at autism conferences and trained other physicians in their methods.

Coman alleged in Cook County Circuit Court that Usman and Rossignol prescribed “medically unnecessary and unjustified” chelation treatments, designed to force the body to excrete toxic metals, even though the child did not suffer from heavy metal poisoning. The treatments carry a risk of kidney failure, the lawsuit alleges.

“This is a big business, and there are a lot of people who are willing to put aside the safety of children to make money off of scared, desperate parents,” Coman said in an interview.

I’ve uploaded a copy of the complaint in PDF format for your perusal here.

Indeed it is big business to be bilking the parents of autistic children of considerable sums of money to use pseudoscientific “treatments” based largely on the scientifically discredited idea that autism is some form of “vaccine injury” or “toxicity” due to a combination of vaccines and environmental “toxins” (almost always vaguely defined or completely undefined). As a result, children are subjected to potentially dangerous treatments like chelation therapy, which can kill when it goes wrong, designed to “detoxify” the heavy metals that are supposedly causing the child’s autism. Coman alleges a whole host of unscientific and unsupportable “tests” by Doctor’s Data and “therapies” by Drs. Usman and Rossignol that, in their totality, are truly horrifying. Get a load of just a fraction of what’s in the complaint:

25. During the same period of time from late December 2006 through mid-October 2007, Defendant ROSSIGNOL continued his telephone consultations with A.J.’s mother and diagnosed, without ever seeing or examining A.J., and although he diagnosed a myriad of conditions, including Minamata disease and encephalopathy (2/7/2007), toxic effects of mercury and its compounds and inflammation of the brain (6/1/2007), toxic effects of mercury and its compounds, encephalopathy, autoimmune disease, and nutritional deficiency (6/19/2007), toxic effects of mercury and its compounds, encephalopathy, and autoimmune disease (10/2/2007), ROSSIGNOL did not diagnose autism.

26. During the same period of time from late December 2006 through mid-October 2007, and based on his diagnoses, Defendant ROSSIGNOL prescribed Methyl B-12 injectable medication (2/9/2007), Ferrous sulfate elixir (2/9/2007), DMPS suppositories for rectal chelation, Spironolactone (6/1/2007), NAC transdermal (6/1/2007), DMPS suppositories (5/5 and 6/4/2007), Vitamin C injectable vials (10/2/2007), NAC injectable vials (10/2/2007), EDTA injectable vials (10/2/2007), Nystatin (10/2/2007), oral Spironolactone (10/2/2007), Glutathione injectable vials (10/2/2007), and DMPS injectable vials (10/2/2007), some of which medications were manufactured, distributed, and/or sold to A.J.’s parent by Defendant CREATION’S OWN.

[…]

28. On or about October 24, 2007, Defendant USMAN commenced IV chelation therapy upon A.J. (based on her diagnosis of heavy metal toxicity) and following a protocol developed by Defendant ROSSIGNOL (based on his diagnosis of heavy metal toxicity). At Defendant USMAN’s direction and under her supervision, chelation therapy was performed on A.J. using EDTA as the chelating agent combined with Vitamin C, GSH (a drug approved only for the treatment HIV) and DMPS (a non-FDA approved drug), on November 7, 2007, November 28, 2007, December 5, 2007, December 19, 2007, January 2, 2008, January 9, 2008, January 23, 2008, January 30, 2008, February 13, 2008, February 28, 2008, March 11, 2008, March 27, 2008, April 3, 2008, April 10, 2008, April 17, 2008, April 24, 2008, April 30, 2008, May 8, 2008, May 14, 2008, May 21, 2008, May 29, 2008, June 5, 2008, June 11, 2008, September 17, 2008, October 1, 2008, October 8, 2008, October 16, 2008, October 22, 2008, October 30, 2008, November 6, 2008, November 12, 2008, November 19, 2008, December 11, 2008, December 17, 2008, January 5, 2009, January 19, 2009, February 5, 2009, February 16, 2009, March 4, 2009, March 19, 2009, and April 2, 2009.

All of this occurred without Dr. Rossignol ever seeing or examining the patient. It should be noted that Mr. Coman and his son were one of the parents and children featured in Trine Tsouderos’s excellent expose on autism quackery last year entitled Autism treatments: Risky alternative therapies have little basis in science, which I blogged about when it was first published. Basically, Coman opposed all the dubious treatments, correctly viewing most of them as quackery, and his wife was the one subjecting Coman to them. The dispute erupted into a bitter custody battle. When Coman was interviewed for the previous story, he struck me as a reasonable man in a very bad situation:

James Coman says he is so concerned about the possible long-term effects of his son’s treatments, including chelation, that he filed complaints with state medical boards against the boy’s two Defeat Autism Now! doctors, Dr. Anjum Usman of Naperville and Dr. Daniel Rossignol of Melbourne, Fla.

“I worry very much,” Coman said as his son played nearby with his younger brother and a neighbor’s children. “There may be latent physical harm,” he said. “We don’t know.”

Coman said he thinks his son, now a playful, funny and outgoing 7-year-old, would have progressed developmentally without any medical treatments.

His wife declined to be interviewed but has said in court documents that she believes the boy’s many alternative therapies benefited him. She argued that her son’s treatment must continue on a regular basis. “Abruptly halting medications (he) has been on for years will do great harm to the child,” she said in court documents.

But the boy has stopped some of his treatments, according to court records, and Coman says he has not regressed.

I can’t imagine being in such a situation, with my wife insisting on dubious DAN! protocols and me knowing that there is no science behind them and that some of them are likely to be potentially harmful. It’s not clear to me how Coman can sue Rossignol and Usman, though, unless he has custody of his son. As far as I can tell, the bitter divorce proceedings are continuing, and I wonder how that will impact the malpractice suit. Certainly, Coman can expect no help from his wife in pursuing it. Quite the opposite, it’s not unreasonable to expect that she will oppose it–fight it tooth and nail, even.

However Coman’s custody battle affects his attempt to sue DAN! practitioners, there’s one thing I’ve never been able to figure out, it’s why more victims of physicians using potentially dangerous treatments with no scientific basis to support them don’t sue for malpractice. I realize that I’m a physician and thus a member of the tribe. I detest frivolous malpractice suits as much as any physician. Like most physicians, I fear them as well. However, unlike some physicians, I accept that there are legitimate malpractice lawsuits. When a physician goes so far astray from the standard of care and behaves as alleged in this lawsuit, given that state medical boards seem powerless to shut down even the most egregious of quacks (like Dr. Rashid Buttar, who charged cancer patients tens of thousands of dollars for useless quack therapies and “pioneered” what he calls “transdermal” chelation therapy–or, as we like to call it, Buttar’s butter), all that leaves is a malpractice suit.

However, for a malpractice suit to succeed, usually there must be a demonstrable injury, the more dramatic, the more likely the suit is to succeed. Although I have no doubt that there really was injury to Coman’s son in the form of pain and suffering due to bein forced to undergo treatments that had no chance of helping him. However, such injury is not going to be obvious or easy to demonstrate to a jury. I certainly hope Cosman’s lawyers can do it, though, because I have little doubt that subjecting an autistic child to such interventions, forcing him to swallow supplements, administering a diuretic to him for no reason, and the other DAN!interventions described in the complaint. More compelling and likely to succeed, in my admittedly “not a lawyer” opinion, is the charge of lack of informed consent, one of which reads:

On or about April 19, 2004, and continuing thereafter through April 2, 2009, in purported treatment of A.J.’s undiagnosed medical condition, Defendant USMAN negligently failed to disclose to A.J.’s parent the inherent and substantial risks involved in the administration of chelation therapy treatments, including but not limited to, infection, renal failure, and blood diseases, and negligently failed to obtain the informed consent of A.J.’s parent for chelation therapy on the dates identified herein in light of the undisclosed risks.

Also alleged is misrepresentation, both intentional and negligent, in which the defendants are alleged to have misrepresented Cosman’s son’s condition, stating that he had all sorts of “toxic” conditions that he did not, in fact, have. No kidding!

Perhaps the loveliest aspects of this lawsuit will be the the discovery and testimony. Granted, it’s rather unlikely that this lawsuit will ever make it to trial. Most likely there will be some sort of settlement; Rossignol and Usman can’t help but fear being put on the stand, particularly given Usman’s role in the death of Tariq Abubakar Nadama. I’d really love to see it, too, even though I realize that it’s unlikely that the case will come to that. At the very least, discovery will be a bitch, though.

As an advocate for science-based medicine, I remain appalled at how easily physicians practicing modalities that are clearly so far outside the standard of care that they might as well be in another solar system–heck, sometimes, it seems, another universe!–can somehow continue to do so unmolested by state medical boards. In general, it takes truly horrific offenses to motivate a medical board to do anything. We’re talking substance abuse by a physician resulting in obvious impairment that causes medical misadventures causing injury or near-misses or blatantly illegal behavior, such as running a narcotic prescription mill. I’ve said it before and I’ll say it again now: Part of the problem is an attitude among doctors that seems to consider a medical license to be a right, rather than what it really is: an incredible privilege bestowed upon us physicians and surgeons by society that takes an equally incredible commitment and skill to be allowed to continue to keep. It was noted in both stories that Cosman had filed complaints against Usman, but thus far nothing appears to have happened. Unfortunately, that makes a lawsuit perhaps the last chance to send a message and obtain some measure of recompense for his son’s ordeal.