NC Medical Board Dr. Rashid A. Buttar Transcript - Page 1 of 16

  IN THE MATTER OF                   )  TRANSCRIPT  OF  THE
  RASHID ALI BUTTAR, D.O.,           )        HEARING
                    Respondent.      )    


                  PANEL MEMBERS OF THE BOARD


          Janelle A. Rhyne, M.D., President
H. Arthur McCulloch, M.D.
William A. Walker, M.D.


April 23 2008, 9:30 a.m. - 6:15 p.m.
April 24, 2008, 7:00 a.m. - 8:48 p.m.
1203 Front Street
Raleigh, North Carolina


For the North Carolina Medical Board:
                       Mr. Marcus Jimison
                       Ms. Katherine Carpenter
                       Mr. Thomas Mansfield
                       1203 Front Street
                       Raleigh, North Carolina 27609


For the Respondent:    Mr. H. Edward Knox
                       Ms. Lisa G. Godfrey
                       817 East Trade Street
                       Charlotte, North Carolina 28202


               T A B L E  O F  C O N T E N T S
Description                                     Page Number
Motion in Limine                                       15

Opening Statement by Mr. Jimison                       18
Opening Statement by Mr. Knox                          28

Direct Examination by Mr. Jimison                      41
Cross-Examination by Mr. Knox                          58
Redirect Examination by Mr. Jimison                    78
Recross Examination by Mr. Knox                        85
Examination by the Panel Members                       87

JERRY MESSINA, sworn (telephone testimony)
Direct Examination by Mr. Jimison                      90
Cross-Examination by Ms. Godfrey                      105
Redirect Examination by Mr. Jimison                   109
Recross Examination by Ms. Godfrey                    115

XXXXXXXX XXXXXX, Mother of Patient E, sworn (telephone
Direct Examination by Mr. Jimison                     119
Cross-Examination by Mr. Knox                         129
Redirect Examination by Mr. Jimison                   139
Recross Examination by Mr. Knox                       141
Examination by the Panel Members                      142
Further Recross Examination by Mr. Knox               145

Direct Examination by Mr. Jimison                     148
Cross-Examination by Ms. Godfrey                      160
Redirect Examination by Mr. Jimison                   169
Examination by the Board Members                      170

Direct Examination by Mr. Jimison                      171
Cross-Examination by Ms. Godfrey                       179
Redirect Examination by Mr. Jimison                    183

Direct Examination by Mr. Jimison                      186
Cross-Examination by Mr. Knox                          229
Redirect Examination by Mr. Jimison                    274
Examination by Panel Members                           276  

Videotape Deposition of Emilia Ripoll, M.D.            282

Direct Examination by Mr. Knox                         283
Examination by Panel Members                           288
Continued Direct Examination by Mr. Knox               293
Examination by Panel Members                           293
Cross-Examination by Mr. Jimison                       294
Examination by Panel Members                           295
        Adjournment at 6:15 p.m. on April 23, 2008
        Reconvene at 7:00 a.m. on April 24, 2008
JOHN L. WILSON, JR., sworn
Direct Examination by Ms. Godfrey                      299
Cross-Examination by Mr. Jimison                       317
Redirect Examination by Ms. Godfrey                    335
Examination by Panel Members                           338

Videotape Deposition of Erlene Thomas                  357

Videotape Deposition of Ned M. Jarrett                 358

Direct Examination by Ms. Godfrey                      359
Cross-Examination by Mr. Jimison                       463
Examination by Panel Members                           526

Videotape Deposition of William John Hewitt            558

Direct Examination by Mr. Knox                         572
Cross-Examination by Mr. Jimison                       581
Examination by Panel Members                           582
Redirect Examination by Mr. Knox                       582

Videotape Deposition of Ellen Hinshaw                  583

JANE GARCIA, N.P., sworn
Direct Examination by Ms. Godfrey                      583
Cross-Examination by Mr. Jimison                       608
Direct Examination by Ms. Godfrey                      614
Examination by Panel Members                           616
Recross Examination by Mr. Jimison                     632
Further Examination by Panel Members                   633


Examination by Mr. Mansfield                            633

Closing Statement by Mr. Godfrey                        658
Closing Statement by Mr. Jimison                        679

Executive Session   -   Decision                        713
Phase II
Statement by Ms. Godfrey                                714
Statement by Mr. Jimison                                718
Statement by Mr. Knox                                   724
Comments by Dr. Buttar                                  727

Executive Session   -   Decision                        728


 1 - Medical Records and Billing of Patient D (76 p)
 2 - Medical Records and Billing of Patient C (267 p)
 3 - Medical Records and Billing of Patient B (191 p)
 4 - Medical Records and Billing of Patient A (158 p)
 5 - Medical Records and Billing of Patient E (110 p)
 6 - Expert Review documents from John L. Peterson, M.D.
     (9 p)
 7 - Curriculum Vitae of John L. Peterson, M.D. (4 p)
 8 - Curriculum Vitae of Rashid Ali Buttar, D.O. (12 p)
 9 - Collaborative Practice Agreement for Jane D. Garcia,
     N.P. (4 p)
10 - Documents regarding the cost of certain treatments
     administered by Dr. Buttar (3 p)
11 - Curriculum Vitae of Jane D. Garcia, N.P. (2 p)
12 - Deposition of Rashid Ali Buttar, D.O. (34 p, 2 sided)
13 - Deposition of James Robert Biddle, M.D. (17 p, 2 sided)
14 - Deposition of Dennice H. Herman, M.D. (19 p, 2 sided)
15 - Deposition of John L. Peterson, M.D. (32 p, 2 sided)
16 - Deposition of Emilia Ripoll, M.D. (11 p, 2 sided)
17 - Deposition of John L. Wilson, Jr., M.D. (19 p, 2 sided)
18 - Article from the New England Journal of Medicine (1 p)
19 - Article from Memorial Sloan-Kettering Center (5 p)
20 - Article from Canadian Interactive Cancer Therapies,
     Association (5 p)
21 - Article from American Cancer society (4 p)
22 - Complaint Form regarding Patient C (4 p)
23 - Complaint Form regarding Patient B (3 p)
24 - Complaint Form regarding Patient A (2 p)
25 - 3/24/2008 E-mail from Dr. Buttar re NCMB Hearing
     (1 p)
26 - HOUSE DRH70244-LU-71 (03/20) Bill,
     Due Process of Physicians (6 p)
27 - Session Law 2003-366, House Bill 886, amended,
     8/1/2003  (3 p)

 1 - CV of Rashid A. Buttar, D.O. (12 p)
 2 - CV of Jane Garcia, N.P. (2 p)
 3 - 1/30/2004 Correspondence from David Henderson (1 p)
 4 - 3/11/2004 Correspondence to Thomas Mansfield (1 p)
 5 - Collaborative N.P. Practice Agreement (4 p)
 6 - Patient A Consent Forms (3 p)
 7 - 8/12/2006 Letter from John Clements, M.D. (1 p)
 8 - Review Sheets from John Peterson, M.D. (9 p)
 9 - Patient A Progress Notes (18 p)
10 - Patient A IRR Sheets (3 p)
11 - Patient A 7/13/2006 Ralph Freedman, M.D. note (1 p)
12 - Patient B Consent Forms (2 p)
13 - Patient B Progress Notes, Physical Exam (18 p)
14 - Patient B Lab reports (27 p)
15 - Medical Dictionary given to Dr. Buttar by Patient B
     (retained by Dr. Buttar) 
16 - Patient B Estate File (12 p)
17 - Patient C Consent Forms (4 p)
18 - Patient C Progress Notes (21 p)
19 - Patient C, Lab report (27 p)
20 - Patient C Medical Records and CT scan (19 p)
21 - Patient C Past Treatment Medical Record (1 p)
22 - Patient D Consent Form (2 p)
23 - Patient D Progress Notes (7 p)
24 - Patient D Urine Toxic Metal Labs (12 p)
25 - 3/30/2006 Letter to Patient D (2 p)
26 - Cost of Selected IVs (3 p)
27 - Copy of Sign from Waiting Room (1 p)
28 - E-mails from Patient C to Nina Wall (12 p)
29 - CV of John Wilson, M.D. (5 p)
30 - CV of James Biddle, M.D. (3 p)
31 - CV of Emilia Ripoll, M.D. (6 p)
32 - E-mail from Patient E's Mother (1 p)
33 - Patient C's Death Certificate (1 p)
34 - Abstract from New England Journal of Medicine (2 p)
35 - CV of John Peterson, M.D. (4 p)
36 - Affidavit of Alan Lintala, M.D. and Janet Lintala, M.D.
     (3 p)
37 - Affidavit of Greg Provenzano (1 p)
38 - Affidavit of Rosi Arrondo (2 p)
39 - Affidavit of Margaret C. Hewitt (2 p)
40 - Affidavit of Anne Phelps (2 p)
41 - Affidavit of Joe Phelps (2 p)
42 - Affidavit of Michelle Reed (2 p)
43 - Deposition Transcript of Elrene Thomas, M.D.
     (7 p, 2 sided)
44 - Deposition Transcript of Ellen Hinshaw (6 p, 2 sided)
45 - Deposition Transcript of Ned Jarrett (7 p, 2 sided)
46 - Deposition Transcript of Francis Allen (6 p, 2 sided)
47 - Deposition Transcript of John Hewitt (11 p, 2 sided)
48 - Deposition Transcript of Dr. Ripoll (19 p, 2 sided)
49 - Subpoena to Stephanie Kenny (1 p)
50 - Deposition Transcript of Patient D (17 p, 2 sided)
51 - Deposition Transcript of John Peterson, M.D.
     (32 p, 2 sided)
52 - Deposition Transcript of Dennice Herman, M.D.
     (19 p, 2 sided)
53 - Deposition Transcript of Martha Biddix (5 p, 2 sided)
54 - Deposition Transcript of Stephanie Kenny
(16 p, 2 sided)
55 - Summary of Patient B's charges at Forsyth (1 p)


     PRESIDENT RHYNE:  Good morning.  Today is Wednesday, April 23, 2008.
     In accordance with Governor Easley's Executive Order Number 1, it is the duty of every Board Member to avoid both conflicts of interest and appearances of conflict.  Does any Board Member have any known conflicts of interest or appearance of conflict of interest with respect to any matter coming before the Board today?  If so, please identify the conflict or appearance of conflict and refrain from any undue participation in the particular matters involved. 
     Thank you.
     PRESIDENT RHYNE:  I'm Dr. Janelle Rhyne, President of the North Carolina Medical Board and I'll be presiding at this hearing.
     We're here today for a hearing in the matter of Dr. Rashid Ali Buttar who is charged pursuant to the North Carolina General Statute 90-14(a)(6) and 90‑14(a)(12) based upon allegations that he practiced below the acceptable standards of medical practice in the matter of which he treated Patients A through D and that he provided services in a manner that exploited patients.
     Board Members present to my left are Dr. Arthur McCulloch and to my right, Dr. William Walker. 
     Counsel for the Board is Mr. Marcus Jimison and Ms. Katherine Carpenter. 
     Counsel for Dr. Buttar is Mr. H. Edward Knox and Lisa G. Godfrey. 
     Mr. Jimison, are you ready to proceed?
     MR. JIMISON:  Yes, ma'am, Madam President.
     PRESIDENT RHYNE:  And the preliminary matters, have we got that --
     PRESIDENT RHYNE:  I don't believe there are preliminary matters at this point.
     MS. GODFREY:  Well, we have a Motion in Limine.
     MR. JIMISON:  I think we can deal with the Motion in Limine as we come to it during the hearing, but if you want to do it for now.  I haven't seen the Motion in Limine.
     MS. GODFREY:  Okay.  Well, I was just going to hand out copies of it.
     MR. JIMISON:  Oh, okay.
     PRESIDENT RHYNE:  Oh, that's all right.
     MR. JIMISON:  Well, we don't have problems passing out copies.
     MS. GODFREY:  Madam President, this is a -- a Motion in Limine is a motion brought prior to the beginning of the hearing for a pre-hearing ruling on certain matters of evidence.  And we believe that three of the witnesses that the Medical Board plans to call will be testifying primarily to hearsay.  And attached to the motion are copies of the North Carolina Rules of Evidence that deal with hearsay. 
     As you may know, hearsay is an out-of-court statement used to prove the truth of the matter asserted.  In our case, two of the complaining witnesses in this case never met ‑- or actually all ‑- none of the complaining witnesses in this case ever met Dr. Buttar. 
     The two that are listed here, Dr. Herman and Mr. Messina, everything they know about Dr. Buttar and his treatment they know through conversation with other people and that is why we bring the motion to have anything that they would have to testify to, that they do not have direct personal knowledge of, not be allowed to be heard by the Board.
     In the case of Dr. Herman, the Board has subpoenaed a witness, Ms. Marie Church, who does have personal knowledge and we ‑- we contend whatever evidence she has to give is a better quality of evidence and not hearsay evidence.
     With regard to Mr. Messina, he is a witness that has never been to North Carolina to our knowledge.  He lives in Los Angeles and everything he knows about Dr. Buttar he learned either from his aunt who is deceased or his mother who lives in Pennsylvania and that he has no direct personal knowledge of anything with regard to Dr. Buttar's practices.  And anything that he would have to testify to, particularly on that witness, we say would be hearsay.
     And so I just wanted to preview that from the Board because we will be objecting to the testimony of these witnesses and I just wanted to give you a heads-up, so to speak, as to why and as to why we feel the hearsay evidence is inappropriate. 
     I have the law for you and I'm not going to belabor the point.  I'm not asking you necessarily to exclude or include these witnesses at this point, but what I do want to do is highlight for you the reasons we will be ‑- be objecting to their testimony in hopes that we can move this along.
     PRESIDENT RHYNE:  Thank you, Ms. Godfrey. 
     Did you want to respond to that, Mr. Jimison?
     MR. JIMISON:  Yes.  And, you know, per our standard practice, if it's okay with the Board President I'll remain seated, but I'll stand if you like.
     PRESIDENT RHYNE:  No, please do remain seated at this time for all counsel.
     MS. GODFREY:  Okay, but I'm used to standing.
     MR. JIMISON:  There ‑- there are ‑- I don't want to take but just a few moments.  But the most important thing Ms. Godfrey says that hearsay is defined as an out-of-court statement as being asserted for the truth of the matter asserted.  If it is being asserted for some other reason, such as corroboration or impeachment or ‑- or basically just to show knowledge, it is not being asserted for the truth of the matter. 
     There is a whole slew of exceptions to the hearsay rule that would cover certain things.  And, frankly, I think when we get to these certain ‑- when we get to certain questions, you know, you'll find out what's the purpose of the question and ‑- and then you can make a decision.
     I don't think we need to make a decision right now, but there are exceptions.  One of which is a dying declaration.  Statements made by people who are deceased, who are dying.  And as the Board's witnesses will show, these people were dying, that ‑- you know, that's an exception ‑- not necessarily an exception to hearsay, it's defined as non-hearsay.
     So, you know, if it's not being asserted for the truth of the matter, if it's being asserted to corroborate what another witness has said, then it's asserted for purposes of corroboration.  It's being done to show some ‑- you know, some flaw with the witness's testimony for impeachment purposes, it's defined as non-hearsay.
     So ‑- but I think it would be best if we just deal with those matters as they come out during the hearing and not right now preliminarily.
     PRESIDENT RHYNE:  We will deal with that as they come up. 
     Now, we'll have the opening statements. 
     Mr. Jimison, would you like to make an opening statement?
     MR. JIMISON:  Yes, Madam President. 
     And for the purpose of, perhaps, Dr. Walker, because I know I've made this speech before for Dr. Rhyne and Dr. McCulloch, but the purpose of an opening statement, Dr. Walker, Members of the Board, is that it's basically showing a road map of what the evidence is going to show during the course of this hearing. 
     This is sort of like ‑- what I actually prefer analogizing to is a story, an outline of a story.  What you're going to hear is a story of patients who are dying of cancer and their experience with Dr. Buttar.  And the purpose of the opening statement is we basically provide you sort of a sense of what the evidence is going to show.
     There are four patients, A through D that the Board has charged Dr. Buttar with.  I'll be focusing mostly on just the first three, Patients A, B and C, all who had cancer.  And there's also what we call the pattern of practice witness, Patient E, who will be testifying as to certain things that happened with her experience with Dr. Buttar that would seem, you know, in the Board's theory of the case to lend credence to what some of the other people will be saying.  So that's the purpose of an opening statement and this is mine. 
     The Board's evidence will show the following: Patient A, a young, beloved wife and mother.  She is diagnosed with cervical cancer, her cancer will spread, she is dying and soon she will die. 
     Patient B is a young, beloved sister and aunt.  She is diagnosed with ovarian cancer.  Her cancer will metastasize and spread throughout her body, she is dying and soon she will die. 
     Patient C, a young, beloved husband and father who was diagnosed with adrenal cell cancer.  It will later spread to his liver and lungs.  He too is dying and he too will soon die.
     All three of these patients are holding on to life, tumors are spreading throughout their body, surgery, radiation, chemotherapy have all failed to halt the progression of this insidious disease.  The question is not whether the cancer will kill them, the question is when. 
     In these darkest of hours, Patients A, B and C will search for some hope, some glimmer of hope to stave off the inevitable march of their disease.
     They will all find their way to Dr. Buttar.  They came to him because of some of information somewhere that led them to believe that Dr. Buttar could do something about their cancer.  They came with hope, they came with optimism, they came in desperation.
     The evidence will show that Dr. Buttar, and many times his nurse practitioner, told these patients that they could help.  They can treat them, help them fight their cancers, help them beat back their cancer.  The evidence will show that this was nothing more than an empty sales pitch.
     What Dr. Buttar sold these five patients, these dying moms, sisters, aunts, husbands and fathers, was false hope, hope that he knew to be false.  The hope consisted of providing therapies that were not only not an indicator of cancer, but had no basis whatsoever in science or any evidence that it would be effective against cancer. 
     Patients A, B and C all had Stage IV metastatic cancer. 
     Cancer is somewhat of a misnomer as you may know.  It is a single term that describes hundreds of thousands of different types of malignancies and diseases.  Cancer is a disease with an energy in molecular biology that has baffled the leading scientists and researchers of the 20th and 21st Centuries.  Billions of dollars going into research, thousands of the best and brightest minds dedicated to its eradication and yet despite significant strides made in the war against cancer, these many diseases with a single name still persists.  It still persists robbing us of our loved ones, our parents, our children, our brothers and sisters. 
     The Board's evidence will show that despite the fact that cancer has baffled the world's best and brightest, Dr. Buttar and his nurse practitioner have the answers.  The answer, hydrogen peroxide.  But not just hydrogen peroxide, the common household solution, but also therapy such as ozone, intravenous vitamins and minerals, trigger point injections, chelation therapy and hyperbaric chambers.
     These therapies are given to patients over the course of an eight to ten hour day, five days a week for weeks on end.  And these therapies will beat back cancer that has defied surgery, radiation, chemotherapy ‑- chemotherapy and the latest experimental drugs.  And they work ‑- and they will work for all cancers, even though it can take years of research dedicated to the development of a single drug to fight a single cancer.
     These therapies administered by Dr. Buttar's nurse practitioner and nurses given eight hours a day, five days a week for weeks on end work ‑- will work where the best of modern medicine has failed or at least, according to Dr. Buttar's nurse practitioner. 
     However, in reality, the Board's evidence will show that these therapies will not fight cancer.  They have no effect on cancer whatsoever.  None.  They are not effective.  They are science or evidenced based therapies.  They have not been subjected or proven to work at any clinical trial. 
     They have not been found to have any effect singularly or in combination with any other therapies provided by Dr. Buttar on cancer.  They are useless and ineffective.  The only real effect is to rob these dying patients of their precious remaining days and their precious resources.
     Dr. John Peterson, a double ABMS board certified physician in oncology and hematology, will testify that the treatments that Dr. Buttar provides are not only useless and ineffective, they are nothing more than rank fraud.
     And the evidence will show that these fraudulent therapies have been enormously profitable to Dr. Buttar.  Dr. Buttar's therapies are administered to patients while he's out of the office by his nurse practitioner and nurses because he is out of his office and quite frequently, costs in excess of $1,000 a day.
     Patients A, B and C will all have paid in excess of tens of thousands of dollars to Dr. Buttar before they died.  And when Patients B and C became disaffected with the care they received from Dr. Buttar and stopped paying him, Dr. Buttar turned over their accounts to collection agencies even after they died.
     In the case of Patient C, Dr. Buttar will refer a $6,700 balance to a collection agency who in turn proceeded to collect in excessive of $20,000 from Patient C's estate.  Dr. Buttar proceeded to collect in excess of $19,000 from Patient B's estate.
     The records of all five patients will show a distinct pattern.  Patients are not examined or followed by Dr. Buttar.  All five patients, not just the cancer patients, were seen primarily in some instances exclusively by Dr. Buttar's nurse practitioner.
     Dr. Buttar would order numerous tests and lab work that had no rational medical relationship to the patient's cancer diagnosis.  Many tests and labs that were ordered by Dr. Buttar were never adequately justified, never linked to the patient's diagnosis or clinical condition. 
     There is no evidence that any of the extensive tests and lab work were used for treatment decisions.  And despite the fact that cancer is a heterogenous disease, Patients A, B and C were treated with an indistinguishable arbitrary protocol as if one size fits all.
     Patient E is a pattern-in-practice patient.  Patient E is an eight-year-old school girl who is severely autistic.  Her mother contacted the Board after receiving a solicitation from Dr. Buttar to support him in this matter. 
     Like the ‑- like the cancer patients, Patient E's mother came across information that Dr. Buttar could help her child's autism.  And without ever seeing the doctor, without ever traveling to North Carolina, Patient E was sent a kit to ‑- to basically self-administer a chelation therapy on her own daughter.
     And when things started going ‑- deteriorating for Patient E, Patient E's only interaction with Dr. Buttar was through his nurse practitioner or other staff members in his office. 
     And the nurse practitioner who essentially, from the medical records, as you will see, made all decisions about the treatment and diagnosis of this child's autism across state lines without personally seeing the patient, has no formal training in autism or oncology, much like Dr. Buttar who does not have any formal training in oncology or autism.
     Yet, nonetheless, they convinced Patient E's mother to take the child off of her medication so that he can apply a transdermal chelation cream on the child.  A cream, not so coincidentally, that is developed and invented and sold directly by Dr. Buttar to his patients. 
     The mother did as instructed and took her daughter off her medication and applied Dr. Buttar's transdermal chelation cream.  Her daughter began to deteriorate.  The child began to have violent tantrums.  She couldn't leave the house or attend school.  During the weeks and months as the child deteriorated, Dr. Buttar never followed the child. 
     And when the mother did not get a satisfactory responses to her concerns, she called the office, made an appointment to see Dr. Buttar and drove her family to North Carolina.  However, when she got to North Carolina, she did not see Dr. Buttar, only the nurse practitioner. 
     And the result of that meeting was that the nurse practitioner attempted to convince the patient ‑- the patient's mother that the child needed to be converted to a more aggressive intravenous form of chelation therapy.
     The evidence will show that Patient E's situation mirrors that of the other patients.  Little or no physician involvement with the patient.  Patients are seen primarily, if not exclusively, by the nurse practitioner.  The patients have serious illnesses and Dr. Buttar and his nurse practitioner have no formal training in those illnesses.
     The patients are prescribed expensive treatments that come straight out of their pocket because insurance does not pay for the treatments.  The treatments are arbitrary, one size fits all.  They have no basis or evidence of science.  The therapies are ineffective and not been subjected to clinical trials and are potentially unsafe.
     Patients are deprived of their remaining days and significant amounts of money before they tragically and inevitably pass away.  And at least in the cases of two patients, after they passed away, Dr. Buttar stays a presence in their life of their surviving loved ones by seeking to collect thousands of dollars from their estates through collection agencies.
     In sum, the Board's evidence will show that Dr. Buttar prays on people in the darkest hours at a time when they are most desperate.  He provides therapies to dying patients that have not been shown to be effective and charges thousands of dollars a day for what he knows will not work and he does this with a North Carolina medical license hanging on his wall.
     Thank you.
     PRESIDENT RHYNE:  Mr. Knox or Ms. Godfrey, would you like to make an opening statement?
     Mark Twain once said that the stories of my death are grossly exaggerated.  If that was the evidence, I will tell you, it's been embellished.  It looks like as you indicated yesterday you would take ten minutes to make this argument and that's been over extended.
     I do want to say this to the Board.  Dr. Buttar is here with me this morning.  He is a bright, intellectual, capable, good doctor.  He loves his patients.  He believes in the fact that we don't have to give up on everybody because traditionally they say it's time to give up.
     He is a strong person who desires to be as innovative as he can to help people with their immune system as alternative methods.  He believes strongly in the freedom of choice for people to have this type treatment.
     He's lectured across the world.  He's testified before the United States Congress.  He's published many articles and wrote books.  He's a leading authority on autism and treating the immune system.
     As a side note, in 2003 Dr. Buttar, President of the North Carolina Alternative Society, went before the legislature to talk about changes and what an integrative doctor was. 
     Notwithstanding that Mr. Buttar is not going to testify -- he will testify less than three weeks later he received a report from this Board saying, come to Raleigh and talk to us about your practice.  That would have been fine, but at the bottom of this, though, it says you are advised of your Miranda rights and anything you tell us might be used against you.
     Now, he's going on.  Dr. Buttar is here to talk about these three cases and this has been a moving target.  Mrs. XXXXXX (Mother of Patient E) was added in the last eight to ten days.
     MR. JIMISON:  Objection.  At this point I'd like to just remind everyone that we refer to patients as A, B, C, D or E.
     MR. KNOX:  She is not a patient.
     MR. JIMISON:  Well ‑-
     MR. KNOX:  I'm sorry. 
     PRESIDENT RHYNE:  Let's still use --
     MR. KNOX:  Okay.  I understand. 
     The burden of proof in this case is not on Dr. Buttar.  He doesn't have to say a word.  The burden is on Mr. Jimison to prove to you that Dr. Buttar has failed to follow the standards of the alternative doctor, not an oncologist as their expert is.
     Their expert has testified there's been no harm to any of these patients, physical harm.  So the test for you is going to be the efficacy of this treatment, does it have merit. 
     The North Carolina General Statutes specifically says ‑- it defines integrative medicine as a diagnostic or therapeutic treatment that may not be considered a conventionally accepted medical treatment and that a licensed physician, in the physician's professional opinion, believes -- the word believes -- may be a potential benefit to the patient, so long as the treatment poses no greater risk of harm to the patient than the comparable conventional treatments.
     As I indicated, the expert says there's been no physical harm.  So the test for you is going to be what is the standard of an integrative doctor. 
     Now, there were four cases, Patient A, B, C and D.  There of these patients are cancer patient and Patient D was a person treated for heavy metal toxicity who came to Dr. Buttar as a latter patient with a pre-diagnosis of lead toxins and was asked to be treated with chelation therapy.
     Dr. Buttar did not see her.  She only took chelation therapy.  But the end result is, she was upset about her bill and I won't go into the circumstances of the bill, but that's what brought her charges to the Board.
     Now, after I took her deposition, they ‑- they sort of dismissed her as a part of this case and reached out to get one more person, Patient E, to help build up the case.  This case is not about the patient.  It's not about the patient's complaint.  It's about beneficiaries who are unhappy that they got bills and were taking money out of this estate.
     Dr. Buttar will offer three doctors, alternative doctors.  And one doctor, Dr. Ripoll, who is a neurologist/oncologist, an alternative medicine doctor, will testify that he met the standard of care in the treatment of these patients. 
     The timing of the treatment and acting on the complaints is highly important for you to consider.  For example, Patient A was last treated in June of '06.  Neither the patient nor her daughter who went with her to every visit complained about the treatment by Dr. Buttar.
     The daughter coincidentally works for Dr. Herman who is a complaining witness who never ever told her employee, by the way, I'm going to file some complaint to the Medical Board.  She's down the hall and never asked her about the treatments and then called her as a witness when she doesn't want to be involved.  The point I make is, in that instance, it's about people who objected outside of the patient or the daughter who was there.
     Patient B is treated for her immune system.  She was an ovarian cancer patient.  She was only treated about three weeks by Dr. Buttar and she was discharged for non-compliance. 
     Now, the Board's attorney wants to use not what she said about the treatment rendered by the doctor, but they want to use a heir, a nephew who is the sole heir of Patient B's estate who never saw Patient B during the treatment.  Patient B died five months later after the treatment. 
     And the boyfriend who came with her to every treatment, they never sought him out as a witness, but he and Patient B never complained to Dr. Buttar.
     Patient C is an adrenal cancer patient who had undergone extensive surgery and took 16 of 28 radiation treatments in February of '04, over four years ago.  The sole complainant is his wife, the sole beneficiary of his estate. 
     Now, when this patient was going to Dr. Buttar, he paid and every one of these pages signed ‑- patients signed a consent.  We don't get insurance, that's between you, we'll keep our family doctor involved.  Dr. Buttar does not grant ‑- guarantee anything about the therapy and they all signed written consents acquiescing that they knew exactly what they were doing.
     Now, Patient C's wife, after he left Dr. Buttar, had went to Mexico for further alternative treatment, called up and canceled a $5700 check which the patient had written to Dr. Buttar and which he had not complained about.  The patient stopped treatment with Dr. Buttar in June of '04, almost four years. 
     We think he was as happy a patient -- he went from being nauseated and vomited and fatigued, unable to do anything after the radiation, and Dr. Buttar built him up where he was walking two miles a day, going to his games and his vitality improved.  And we say that the therapies was what helped him.
     The wife incidentally is complaining about the bill and she never drove up to see this doctor.  She did not go to the radiation treatments and she did not go to Mexico even though she admitted that there was nothing to keep her from doing that.  It's all about the money that may have come out of the estate.
     Now, someone once said a river never rises higher than the street.  And interesting enough, the Board employed Dr. Peterson in October of 2007 to review the Board cases.  He's a traditional hematologist and oncologist.  And that may be when I say traditional -- a pretty fair representation because Dr. Peterson believes that if you don't use surgery, you don't do chemotherapy or radiation, the next step is to take pain medication and get palliative care and give up.  Dr. Buttar does not believe you give up.
     Dr. Peterson will testify and has testified in his deposition that he's not able to define what an integrative doctor is according to this statute.  He will testify that the standard that he applies is that of an oncologist.  We say that is not the test.  The test is, was the treatment in accordance with an integrative doctor.
     Not only has there been this two to four year delay to proceed on the charges, they all are subject to a number of visits by the staff to Dr. Buttar's office and every time he has cooperated with them.  I don't know how many times a doctor could anticipate somebody coming in to their office from the Medical Board.
     Dr. Peterson billed that he took hours to review approximately a thousand pages.  He said he wasn't sure why he was called, but he went through them and wrote down some information.  We think his ‑- for lack of understanding about what his role was going to be and lack of time to review -- he was at -- his investigation and his opinions were not well thought out.
     For example, he said Patient D was treated with chelation therapy for constipation.  We took Patient D's deposition.  She admitted she came with a lead diagnosis and she asked to be treated with chelation therapy.  No one ever treated her for constipation, but somehow that was his diagnosis of what Dr. Buttar did.
     In Patient C, he indicated that Dr. Buttar had no contact with the patient.  The records are full of information signed by Dr. Buttar where he did the physical at times that he gave his patient IRRs.  He gave every one of these cancer patients an IRR injection, three times, so he did see the patient.
     Dr. Buttar had no notes of a thousand pages that he wrote or if he did, he tossed them away. 
     MS. GODFREY:  Dr. Peterson.
     MR. KNOX:   ‑- Dr. Peterson. 
     The point I make is, this is a serious matter that he's been asked to investigate and to write a report.
     I'm going to ask you to do this, you're all doctors and I'm sure good doctors.  I'm going to ask you to listen to this evidence.  The Board has the burden of proving to you that he's failed to follow an alternative standard of care. 
     And then I want you to listen as they bring forth the expert and the information.  I want you to weigh their credibility on what the people say and what is their motive for this.  Why didn't it come earlier?  Why this wasn't part of ‑- not 2004, 2005, 2006, but in 2007? 
     The lawyers change medical science they got.  And doctors are people that promulgate and bring about change and that's why we're here.  We have a doctor that believes you go look ahead.  But you can't always just say, go home and die.  Thank you.
     PRESIDENT RHYNE:  All right.  Now, we're ready to hear the evidence.  Mr. Jimison, I'll call on you to present the evidence.  
     MR. JIMISON:  Thank you, Madam President, and just for counsel, and typically the practice before the Medical Board with these quality of care cases are just to go ahead and stipulate into the record the medical records and at this point I'd like to just go ahead and stipulate into evidence the medical records of Patients A through E.
     MS. GODFREY:  Well, we're going to object to the medical records of Patient E.  I'm sorry, I keep getting up, it's just a force of habit.  I have to do that in court. 
     Patient E is not in the complaining charges.  The complaint came in, I think, about a month ago.  The Medical Board has not ‑- not investigated it.  There are no formal charges involving Patient E and we would object to the wholesale consideration of those records in this proceeding. 
     If the Board wants to bring a formal complaint about Patient E, that's fine.  If there are particular portions of the records that might be relevant to the testimony of Patient E's mother, that would be fine.  But the wholesale admission of the patient in these records, I think is inappropriate at this time.
     MR. JIMISON:  This matter was as you may recall, Dr. Rhyne, was in ‑- was addressed in a pre-hearing conference.  You allowed her as a pattern to practice witness.  The medical records as the Board is very familiar with and is ‑- is the best evidence of what's happened with that patient. 
     You're not precluded from introducing medical records or patient testimony just because it's not part of the charges if it's part of the pattern to practice.  Ms. Godfrey has not cited any Rules of Evidence or any law that would prohibit you from considering the medical records when Patient E testifies if she's testifying as part of the pattern of practice. 
     So, therefore, it's the best evidence.  She's going to be talking about the care that her daughter received and the best evidence of the care that her daughter received, that this Board has historically and traditionally been aware of, is part of the medical records.  Many times when patients testify on behalf of the doctor, we ask that they bring their medical records in.  So it's not uncommon and there is no rule of evidence or statute that would prevent the Board from considering it, nor did Ms. Godfrey cite one.
     MS. GODFREY:  Since the rule isn't whether or not they are at all relevant, there's no expert witnesses to examine the records and give any conclusion.  It's just simply the mother has to testify about whether she heard --
     PRESIDENT RHYNE:  I think we will allow the records.
     MR. JIMISON:  And also without objection, but we can do it during the hearing, but I would like to amend and stipulate into evidence Exhibit 7 through 11.  Those are basically just CDs about documents I received from Dr. Buttar's office and I would like to go ahead and refer 7 and 11 through ‑- into evidence.
     PRESIDENT RHYNE:  I'm sorry.
     MR. JIMISON:  Exhibit 7 through 11, the Board's Exhibit 7 through 11.
     PRESIDENT RHYNE:  Exhibits 7 through 11?
     MS. GODFREY:  Seven.
     MR. JIMISON:  Do you have the list?
     MS. GODFREY:  I have those, yes.
     PRESIDENT RHYNE:  Is that one of our notebooks?
     MR. JIMISON:  This one.
     MS. GODFREY:  The second notebook.
     MR. JIMISON:  In the second notebook.
     PRESIDENT RHYNE:  In the second one.
     MS. GODFREY:  It's a little smaller.
     PRESIDENT RHYNE:  Okay.  They will be admitted.
     MR. JIMISON:  And I will deal with Number 6 when we call Dr. Peterson.
     MR. JIMISON:  Okay.  At this ‑-
     MS. GODFREY:  You got one for me.  Do I need it?
     MR. KNOX:  Okay.  I'm sorry.  We're okay.
     MS. GODFREY:  I just wanted to keep school.
     MR. JIMISON:  We would now like to call Stephanie Kenny to the stand.
          being first duly sworn,
          was examined and testified
          as follows:
     MR. JIMISON:  Actually, before we get started, Dr. Rhyne, may Ms. Godfrey and I consult?
QWill you introduce yourself to the Medical Board.
AMy name is Stephanie Kenny.
     PRESIDENT RHYNE:  Can you turn on the microphone.
     MR. KNOX:  I'm sorry and I apologize, but if you're sitting that close to her and you're that soft, I'm not going to ever hear you.  Do you have your microphone on?
     MR. JIMISON:  I have my microphone on.
     MR. KNOX:  Okay. 
Q(By Mr. Jimison)  Ms. Kenny, do you mind testifying publicly about this matter?
QOkay.  So I'll refer to you as Ms. Kenny when we refer to the Patient C. 
     Ms. Kenny, where do you live?
AMy address?
QUh-huh (yes). 
A2801 Redfield Drive in Charlotte.
QAnd could you describe your family to us?
AI have three children.
QWho are they?  Well, you can just give me their first names and ages or gender.
AWhen I agreed to do -- to go public, I didn't agree to involve --
QOkay.  Do you have boys?
AI have two sons and a daughter.
QOkay.  And how old are they?
A17, 16 and 8.
QOkay.  Were you married?
QAnd were you married to Patient C?
QAnd how long were you married?
ASeventeen plus years.
     MR. KNOX:  I'm sorry, I'm still having trouble hearing you.
     WITNESS:  Seventeen years.
     MS. GODFREY:  We're all having trouble hearing her.
     MR. JIMISON:  If you could kind of pull up a little closer to the mike.  All right.  Maybe that will help.
Q(By Mr. Jimison)  At some point was your husband diagnosed with cancer?
QAnd tell me about when you originally learned about your husband's cancer diagnosis.
AIt was in September of '03.
QAnd what type of cancer was it?
QAnd how old was your husband when he was first diagnosed with cancer?
AForty-two, yes, sir.
AAnd what happened after he was diagnosed with adrenal cancer?
AThen came a plan for surgery and after the surgery, radiation.
QSo he had the surgery?
AHe did.
QHe started radiation?
QDid he finish the radiation?
ANo, he did not.
QAnd why not?
AHe just couldn't tolerate it.
QAnd what did your husband do after that?
AHe ‑-
QWhat happened after he stopped the radiation?
AHe appeared to be doing well.  I mean, it took him a while to get over it, but then he ‑- he was doing better and he was back to work full-time.  He looked much better and had the energy, but then it was rediscovered in another scan in February of '04.
QFebruary of '04? 
QAnd what happened after that?
AWell, at that point, the scan showed a spinal tumor and a speck in the lung, but his oncologist ‑- his oncologist said that operating fails at that point.  He just encouraged him to look at quality of life.
QAnd so the ‑- would it be fair to say his cancer was metastatic?
AYes, at that point, yes, it was.
QAnd it spread through the liver and his lungs?  And your husband's oncologist did not ‑- did not recommend further surgery?
QDid he recommend further chemotherapy or radiation?
QAnd what did your husband do after he basically had that conversation with his oncologist?
AHe didn't want them to biopsy it and went to alternative care.
QAnd did he ever meet ‑- did he ever decide to go to Dr. Buttar?
AHe did.
QAnd how did he hear of Dr. Buttar?
AJust through research.  He was looking at this at night and just researching on‑line and he seen him in some article.
QOkay.  And did he ‑- did he ever have a chance to meet Dr. Buttar, your husband?
APrior to becoming a patient?
QYeah.  Well, I mean, did he ever go see Dr. Buttar at his office?
AYes.  I'm sorry about that.
QWere you there?
AI was.
QOkay.  Was that the first meeting?
AIt was.
QAnd describe that meeting that you were present at.
AWell, we brought all his records.  He said he was not concerned with the type of cancer, that he had a 100 percent success rate, that he would be able to turn his body chemistry around to fight the cancer, so it didn't matter what kind it was.
QOkay.  And did ‑- did Dr. Buttar make any representations about how successful his therapy would be?
     MR. KNOX:  Objection, asked and answered.  She just answered.
QAgain ‑-
AHe did give ‑- he said that he had a 100 percent success rate.
QHow did you take that?  How did you personally take that?
ATo mean that he had a 100 percent cure rate.
QAnd ‑- and after that meeting, what did you and your husband decide to do?
AHe chose to become a patient as opposed to -- (inaudible).
     PRESIDENT RHYNE:  Excuse me.  Chose to go where?  We couldn't hear.
     MR. JIMISON:  Yeah, I'm having a hard time hearing her.  Please speak up a little louder.
     WITNESS:  He chose to continue alternative care with Dr. Buttar as opposed to going to the Issles Clinic in Mexico at that time.
     PRESIDENT RHYNE:  Thank you.
Q(By Mr. Jimison)  The treatments were ‑- did the treatments, were they explained to you by Dr. Buttar during the first meeting what he would do?
ANot in great detail.  He talked about the nutritional aspect and the supplements he would have to take, the changes in diet and he said that, you know, ozone and that kind of thing, but it weren't discussed in detail.
QOkay.  And when did your husband start going for treatments?
AI think it was sometime in late February or early March.
QAll right.  Okay.  And how long would the treatments last per day?
AAll day, just like a job.
QDescribe that day.  When did your husband leave the house?
AWell, he would leave between 7 and 7:30, I believe it was, and it was about a 45 minute drive.
QOkay.  And when would ‑- sorry.  And when would he return home at night?
AAbout 6.
QAbout 6:00?
AUh-huh (yes). 
QSo he was there from basically 8:00 to 5:00?
QFive days a week?
QAnd what was his therapy, to your knowledge?
AOzone treatments, sauna treatments -- (inaudible) -- some medication.  There were two different base lines that you made -- (inaudible).
QAnd did your husband, did he talk about IV therapies that he got?
AYes, chelations all the time.
QAnd so he would go to these therapies for eight hours a day?
QFive days a week?

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Dr. Buttar Truth Quotes

“Whoever undertakes to set himself up as a judge of Truth and Knowledge is shipwrecked by the laughter of the gods.”
—- Albert Einstein

“Truth is generally the best vindication against slander.”
—- Abraham Lincoln

"All truth passes through 3 phases: First, it is ridiculed. Second, it is violently opposed, and Third, it is accepted as self-evident."
—- Arthur Schopenhauer

"There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success than to take the lead in the introduction of a new order of things because the innovator has for enemies all those who have done well under the old conditions and lukewarm defenders in those who may do well under the new."
—- Machiavelli, The Prince