NC Medical Board Dr. Rashid A. Buttar Transcript - Page 10 of 16
keep a concise method of documenting this information so that I can go back and refer to it quickly and see how they're developing. This is one of those sheets.
QAnd what does that sheet show with regard to Patient C?
AThe normal reference rate for lytic units for Natural Killer Cell levels is 20 to 50 lytic units. And when the patient presented to us, it was 8.6 lytic units with the Natural Killer Cell Activity per cell of 5.3.
So that I can perhaps explain this a little bit better. Natural Killer Cell Activity would be how strong your army is. Natural Killer Cell Activity per cell would be how functional each individual soldier is. So if you have a high Natural Killer Cell level, but you have a low Natural Killer Cell Activity per cell, that would mean that you're Natural Killer levels are there, but the soldiers are apathetic and they're not really doing what they're supposed to be doing.
Versus if you have a Natural Killer Cell Activity that's say low, that means your army is small, but your Natural Killer Cell Activity cell ‑- per cell being high would mean that each one of your soldiers is like a supersize soldier.
So a 5.1 would be ‑- on the Natural Killer Cell Activity per cell -- 5.1 would be he bare minimum for Natural Killer Cell to be considered functional and 10 would be the high end of normal.
When the patient came to us, his Natural Killer Cell Activity per cell was down to 5.3.
And I can look through the rest of it if that's what you want me to do or ‑-
QOkay. Well, what significance is this to you as far as the efficacy of the treatments?
AWell, by the ‑- by the third time we did the test and actually this is the last one, right? One of the last ones we did which was in May, we had increased his Natural Killer Cell Activity to 20.8 bringing him into the normal range and we had taken his Natural Killer Cell Activity per cell and from his previous test which was the middle test, more than ‑- more than doubled that, so he was at 7.9.
His ‑- I can tell you all the specifics here. There were a number of things that were pertinent in this. his Natural Killer Cell Activity in 2.5 months went up 150 percent. Natural Killer Cell Activity went up more than ‑- more than 100 percent. His NKHT3 plus cells -- we did that with competency -- and there's different levels of competency of these Natural Killer Cells. The NKHT3 plus immunocompentency cells increased from 15 percent to 19 percent.
His lymphocytes increased from 6400 to 10,400, so his counts -- they were ‑- they were still normal, but they were increased without giving way to demargination or -- (inaudible) -- like with infection or anything, but it's basically is an indirect measurement that his immune system was becoming more palliative.
His CD2 counts went up from 863 to 1,005. His CD3 increased from 849 to 1,034. His T helper cells CD4 went from 446 to 612. His CDHT, the suppressors cells went from 381 to 393. His CD19 and CD20 which are the B cells which are the ones that basically do the ‑- create the antibodies where the body went from 141 to 233. His CD15 and 56 went up from 163 to 262. His diapeptidal pepsase increased from 337 to 597. His cell cycle improved significantly before treatment and after treatment as is documented with the results. That's ‑-
QSo ‑-
AThat's what that showed.
QSo do you believe that the results show a positive impact from your treatments?
AThis person was told at this point that he could take a break from treatment and I was more concerned about another issue that was going on with him, but his immune system was coming up. I mean, I couldn't have asked for a better profile.
QOkay. And when you told him you wanted to take a break from treatment, what was his reaction?
AHe had a friend also ‑- I mean, renal cancer is very rare -- but he had a friend also that had renal cancer and they had both planned in seeking treatment and his friend had gone to Europe to a place that I had actually suggested to Patient C also that I thought was a good place and his friend died at that time. And his friend's disease wasn't as extensive as his ‑- as Patient C's was and so he felt ‑- I think he was scared and he felt that he needed to continue.
QAnd so did he continue then and for how long ‑- how many weeks of treatment?
AWell, I wanted him ‑- I wanted him to get out of this environment because there was another issue going on with him and I was pushing him to take a vacation, but he continued treatment and then followed up with my recommendation sometime in June.
QOkay. And in June did he take a break from your treatment?
AWell, he ‑- it wasn't that I wanted him to take a break from my treatment, I wanted him to get out of his environment and I wanted him to find a place that he could continue getting maintenance.
QWhy did you want him to get out of his environment?
AThe most potent form of oxidative stress is stress which would mean that the most potent form of antioxidant therapy may be prayer, he was very stressed. He was under a tremendous amount of duress.
This man, when he was done with his treatments would not go home, he would stay in the clinic and sometimes wait until the last employee would leave.
On two separate occasions I walked into the exam room and there was screaming inside the exam room and I would walk in with some concern and he would turn to me and apologize and shut his phone.
There was just ‑- this was a very, very sweet man. He was in the process of writing a book and creating a web site to tell the world about what he was experiencing and how he was improving with our treatment, but he was under a lot of stress.
And my concern so much at that time was ‑- it was obvious his immune system was coming up. We had been debulking him from his toxic load and he was responding very well to treatment, but his face you can see he was ‑- he wasn't ‑- I mean, he was gaining weight and his color was good, but you could see stress. You could seen the frown on his ‑- on his ‑- I mean, between his eyes. He was just stressed and he just did not want to go home.
And even when I told him that he was ready to stop treatment and just go on a maintenance program he said, no, I'm not ready. And he said, I like ‑- I like being here. And I said, this is a clinic. I mean, go to the park or, you know, go watch a movie or do something with your kids and he was actually doing things with his kids, but he just didn't want to go home. And ‑-
QAnd so did a plan arise for him to leave the country?
AYes. I had actually discussed with him going to Dr. Tony Menez in Mexico who is a colleague of mine who's an oncologist who uses the same therapies that I do. And Dr. Menez basically couldn't take him because Dr. Menez was leaving on a missionary trip to South Africa. But Dr. Menez used to work at the Issles Clinic, I don't know how to pronounce that, but he recommended that that may be where Mr. XXXXX, excuse me, where Patient C would perhaps want to go. And that happened to be the same place that he had looked at before, so he was very agreeable with that.
QGetting back to Dr. Peterson's criticisms and if you could just briefly react to EDTA chelation therapy has no benefit in treating cancer and bear in mind we have ‑- you discussed extensively why you believe it is.
AI wasn't treating this cancer with EDTA therapy.
QWhat were you treating with EDTA therapy?
AI was treating his ‑- his metal load which is in here somewhere. I'm not sure ‑-
QIt's not in that notebook, I think. No, it's in the patient regular notebook.
ACan I use it a minute?
QSure.
AIs it this one? I mean, I was treating his metal load is what I was treating, but, I mean, I can tell you the metals, but I don't remember offhand.
PRESIDENT RHYNE: I would like to see that.
WITNESS: Yes, ma'am. Is it the big one?
MS. GODFREY: Yeah, the big one.
PRESIDENT RHYNE: You can go ahead.
WITNESS: I'm sorry, ma'am.
PRESIDENT RHYNE: You can go ahead if there's another question.
MS. GODFREY: Okay. What I was going to try to do is just give him Patient C's chart. How about ‑- yeah, it would be easier to do with this.
MR. KNOX: I'll tell you what --
MS. GODFREY: No, we can find out --
PRESIDENT RHYNE: I would like to see that.
WITNESS: I'll be able to find it faster.
PRESIDENT RHYNE: Okay.
WITNESS: Are all the labs together?
AOkay. I was treating him for a burden, an elevated burden of mercury and lead, as well as elevated levels of arsenic and tin. Because he had been diagnosed with cancer, he was, by my definition, a non-excreter so his metal levels were ‑- I mean, he had the inability to excrete, but yet he was still excreting elevated levels.
He had documented levels of arsenic, antimony, cadmium, lead, mercury, nickel, thallium, thorium, tin and tungsten, but the ones that were elevated were mercury and nickel. As far as I'm concerned, any level in the body of these substances is not safe, but the ones that were considered elevated were mercury, nickel and arsenic.
QDr. Buttar, those results are from a urine test ‑- urine challenge test; is that fair?
AYes, ma'am, they are.
QAnd what lab performed that?
AThis particular one is performed by Doctor's Data which is a Medicare provider, certified with the American Board of Pathology approved laboratory.
QOkay. Do you own any interest in that lab?
AI wish I did.
QOkay. But you don't?
ANo, ma'am, I do not.
QOkay.
AAnd just as a side note, this urinary testing that Dr. Peterson said was bogus is done by Quest Diagnostics, it's done by LabCorp, is done by Nichols Laboratory which is all ‑- all the big research that's done is done through Nichols. The Center for Disease Control uses it. In both my visits to the Center for Disease Control they do urine as well as blood, fecal and they actually ‑- the most accurate method is actually biopsy samples, but as Dr. Wilson mentioned, that's not conducive to the practice of medicine by doing multiple site biopsies. That's someone difficult to get a patient to consent to and obviously I'm being a little facetious. But toenail clipping levels of mercury, that's been shown in multiple studies.
In fact, the New England Journal of Medicine reported a study where they showed a direct correlation of mercury levels and myocardia infarction and -- (inaudible) -- organic acid.
But there are many labs that do this. Great Plains Laboratory, Geneva Labs, right here in North Carolina, there's numerous labs that do urinary metal profiles. Metametrics does this and they're all government ‑- and they are all Medicaid certified laboratories.
QOkay. With regard to Dr. Peterson's other criticisms, he says that the labs that you've drawn have no clinical relevance such as urine toxic which you've just discussed. Stelocryte?
ASteatocrit.
QSteatocrit.
AThat has nothing to do with metals. That's looking at the gastrointestinal system which a lot of these patients have problems that resulted in digestion of the nutrients in their ‑- you know, they think that it's normal to have a bowel movement every four days which is ridiculous and we have been able to establish a balance there.
QOkay. And so you believe those labs are necessary. What about labs?
AYeah, these are just ‑- he just pulled like some lab ‑- he just pulled some levels out of this complete diagnostic urinalysis that we do, but, yes, they're all ‑- they're all pertinent. I mean, if they're normal that's great, but many times they are not normal so we have to help the body get into a state of balance.
QNow, he says that the standard of care would be to treat with chemotherapy such as -- (inaudible) -- or enrollment in a clinical trial versus palliative -- (inaudible).
AI think that he's mistaken because from what I understand it ‑- again, I'm not an oncologist, I don't know. I refer this to an oncologist. But I believe that chemo was not an option for him.
QAnd ‑-
AHe had adrenal cancer which I think even ‑- I'm not sure, but I don't believe adrenal cancer is usually responsive, but I could be wrong, but ‑-
QAnd, finally, if you'll turn to Exhibit 18 which is your ‑- which is your progress notes for this patient, can you respond to Dr. Peterson's criticism that no physician contact was documented?
AOn June ‑- I'm sorry, excuse me, on February 16th, I conducted an exam myself and wrote a detailed note, a progress note, SOAP note.
On March 24th, I conducted an exam and wrote a detailed note.
On April 7th, I conducted an exam and wrote a detailed note.
On April 7th, I also had a second ‑- a second note in there. On May 4th, I conducted an exam and did a note.
On May 25th, I examined the patient and wrote a note.
On June 9th, I did a progress note.
On March 15th, I performed IRRs on the patient.
On March 23rd, I performed IRRs on this patient.
On March 30th, I performed IRRs on this patient.
On April 6th, I performed IRRs on this treatment ‑- on this patient, excuse me.
On April 14th, I performed IRRs on this patient.
On April 20th, I performed IRRs to treat the patient.
On April 27th, I performed IRRs on this patient.
On April 28th, I performed IRRs on this patient.
On May 4th, I performed IRRs on this patient.
On May 11th, I performed IRRs on this patient.
On May the 18th, I performed IRRs on this patient.
On May 25th, I performed IRRs on this patient.
On June 1st, I performed IRRs on this patient.
And on June 9th, I performed IRRs on this patient and it's all documented in the chart.
And that does not include my post signatures and any notes that was done by anybody else.
QAnd the IRRs were, again, to relieve what?
AWell, Dr. Wilson gave a great history of IRRs, but what I have found it actually ‑- because the patients that have cancer, they are in a greater state of -- (inaudible) -- metabolism.
And most of these patients are in respiratory distress and you document that a respiratory reserve is noted on pulse oximetry before and after treatment and there is an immediate, sometimes less than 30 second improvement in ventilation of these patients with ‑- with an improvement in respiratory reserve that sometimes exceeds 200 percent with a pulse oximetry that generally goes up anywhere from 3 to 5 percentage points.
And these patients ‑- I mean, this is ‑- these patients literally want to get up and give you a hug and thank you. I've seen patients with tears in their eyes because they can all of a sudden breathe better.
So I'm actually just trying to improve oxygenation. That's the reason I do hyperbaric, to improve oxygenation in these patients because cancer is anaerobic metabolite. It is an -- (inaudible) -- anaerobic metabolite, so my goal is to increase that anaerobic metabolism in the system thereby using oxygen as beneficial.
First year of medical school we're taught that the ‑- in fact, I'm an ACLS instructor, ATLS instructor, I'm a PALS instructor and I've kept up with all these certifications as an instructor to continue to teach for the last 15 years.
And the first line of drug ‑- in ACLS -- the first line of drug -- this is a question you always ask people, what is the first line of drugs. The answer is oxygen. So we use oxygen to help increase the airway state of the body.
QAnd in your observation of Patient C, did he ‑- did he object ‑- physically get better under your care?
AI mean, it's documented throughout the note that his ambulation increased. I mean, the guy when he came had a hard time walking and was able to start walking, he was able to start playing the drums again. He was a drummer.
He ended up selling his business and started working on these web sites. He was a programmer. In fact, on one specific occasion he had a gentleman that met him at the office while in his treatments to discuss doing some projects for this gentleman. He was able to start going to his kids' games.
He -- on one occasion when I asked him what he was still doing in the clinic -- it was like 5:30 and he was still there and his treatment had finished at 3:00. I had a talk with him because I thought he wasn't feeling well. He said, no, I feel great, I was just waiting for my kids' game to start and I'm going to meet him there.
And I said, why don't you just go home and he didn't respond, but he hugged me and thanked me and said, just the fact that I can go to my kids' games is something that I'll never ‑- never forget. And so that ‑- that was something that I remember because it's something that's just hard to forget.
QOkay. With regard to Patient C's conventional course, after he returned from Mexico there is a note and it's Exhibit 21 that is a note from his oncologist. And I believe the date on that is August 10, 2004.
AAugust ‑- yes, ma'am.
QAnd was he under your care or was Patient C under your care at that point?
AI didn't see Patient C after June. I know that he was still in touch with the office and there was, you know, communication, but I didn't see him coming in for ‑- as ‑- I didn't see him come in to see me as, you know, no office visit or anything, so in August I did not see him. At least if I did, there was no note, but I don't ‑- because there would be a note.
QOkay.
AI think the last time he was seen in our office was before he left for Mexico.
QOkay. And as of August of 2004, he was beginning to have some edema in his distal extremities, is that correct?
AYes, ma'am, he did.
QAnd I think the ‑- he's also having problems talking.
AYes, ma'am. He ‑- he had some problems with breathing early on in his treatment course with us and that's one of the reasons that I did a little bit more IRRs than I normally would because he had such a benefit.
But before he left for Mexico there was nothing abnormal about his breathing. I mean, it was, you know, consistently responding to treatment and he was actually ‑- we were proud of that -- he was ‑- the duration of how much he felt improvement would last longer. Sometimes ‑- the initial time, it may only last, you know, a day or so, but he was seeing longer residual.
QAnd as of ‑- as of August, does the note say that he's still receiving immune therapy from Mexico?
AYes, ma'am.
QAnd what's the recommendation of the oncologist with regard to that?
AContinue it.
QOkay.
AThis ‑- this patient's biggest issue was that he was under a lot of emotional and psychological duress.
QAnd then did you become aware that Patient C passed away?
AI did.
QAnd are you aware of the ‑- of ‑- I think we have his death certificate, if I'm not mistaken.
AYes, ma'am.
QIf we could look for that. Exhibit 33, if you'll turn to that.
AYes, ma'am.
QIs that a ‑- I'll represent to you that's a death certificate for Patient C.
AYes, ma'am.
QWhat are the listed causes of death?
AAtherosclerotic heart disease, adrenal cell carcinoma and pulmonary emboli.
QOkay.
AAs I understand it, he presented with a pulmonary ‑- his symptomatology was acute pulmonary emboli.
QOkay. With regard to Patient D, I'm going to cover her with your ‑- with your nurse practitioner, Ms. Garcia in ‑-
AYes, ma'am.
Q‑- in detail. But you never saw Patient D; is that correct?
AI did not examine Patient D or see her.
QAnd is that a normal occurrence in your practice for a patient that presents with ‑- with metal toxicity issues?
AAbsolutely. It's ‑- I mean, she was not a compromised patient. She had ‑- I mean, it was a very clear cut case. It would be like ‑- it's a very basic thing and Jane is more than qualified to handle something that was, you know, like that or even -- I mean, it was just ‑- I see the charts like I see all the patient's charts and I, you know, co-signed the notes and there was no issue when we went through ‑- I mean, I covered it in a regular weekly meetings that we have.
QOkay. And so you were aware and monitoring this patient's treatment?
AAbsolutely and everything was fine.
QOkay. In response to a question by Mr. Jimison in your deposition, were you asked to gather information about your office costs for providing certain IV treatments?
AYes, ma'am.
QAnd did you gather that information from your accounting records and from your accountant?
AIt was a tremendous burden, but, yes, we did, ma'am.
QOkay. And turn, if you will, to Exhibit 26.
AYes, ma'am.
QAnd, Dr. Buttar, is this a document that you yourself produced?
ANo, ma'am.
QOkay. How was it produced?
AWell, I helped format it because I do a lot of stuff in Excel, so I helped them format it because they couldn't get it in the right format. But it was done between my accountant and my financial officer in my office.
QOkay. And what ‑- what was the purpose of ‑- of collecting this information?
AI believe Mr. Jimison was saying that I was charging outrageous fees or something to that extent.
QOkay. And did he just ask you to provide cost information for five of your IV treatments that you do?
AActually, he asked for four. I must have misunderstood him because I've provided five. But I believe he only asked ‑- because I don't think he asked for five but I put that in there, but I must have misunderstood him.
QOkay. And are all these IV treatments that were provided to the patients in this case?
AThese particular five, all those patients got -- (inaudible) -- I mean, everybody gets different depending on what their issue is, but for instance -- (inaudible) -- we would not do it, if somebody had a liver issue or something like that. But these five all ‑- all the patients in question ‑- well, A through C, not D.
QOkay. And what does this show with regard to your ‑- well, first of all, I know we're looking at a period of time here from ‑- I think the first patient was in '04 and the last patient might have been in '06.
AYes, ma'am.
QWhat does this show with regard to how much money you were collecting for IV and can you explain that first as opposed to charging per IV?
AWell, we collect ‑- it was $115 per IV, we collected in March 2005. That was a question that was brought up sometime. I don't know if there's an adjustment on these patients' charts. We were collecting $115 per IV from 2000 to 2005.
From 2005 to 2007 our overhead had increased and we started charging ‑- I'm sorry, excuse me, we started increasing what we were collecting $125 and after June 2007, we started collecting $135.
QAnd does this then show ‑- for example, the first IV is EDTA, does it show all of your costs in providing that IV to the patient?
AYes, ma'am.
QOverhead, what does that include?
AIncludes everything from nursing staff, administrative staff, rent, electric, malpractice, CME, dealing with investigations of the Medical Board and costs of all these different things. I mean, it's just ‑- it's everything that it costs me to have my clinic functional so I can see patients.
QAnd then the other things listed there, are they direct ‑- what are they?
AThose are the direct hard costs of what it costs us to do any of these particular IVs. That's ‑- the way our accountant has that, that's under cost of goods sold and the rest of it is under overhead which is all the other things.
QAnd ‑- and so are you able then to calculate what kind of profit you're making on the IVs that you're giving?
AWell, they were able to calculate, yes, ma'am.
QOkay. And is that shown in this exhibit?
AIt is.
QFor ‑- for which IVs?
AFor EDTA currently ‑- do you want me to read these?
QWell, you can. Currently for EDTA, what kind of profit are you making?
A$1.78.
QPer IV?
APer IV.
QAnd how long does it take to provide EDTA IV to a patient?
AIt depends on the patient and what dose they're getting. It's usually giving one gram per hour, so their full dose of treatment, it will take two and a half to three hours. If it's an initial dose, .75 grams will take about 45 minutes.
QAnd the next one is DMP ‑- DMPS.
AYes, ma'am.
QAnd what kind of profit are you currently making on a DMPS IV?
A$7.68.
QAnd, again, is that ‑- how long does it take to administer one of those?
ADMPS is actually done over 20, 25 minute IV drip.
QGlutathione?
AGlutathione?
QThion, sorry.
AYes, ma'am. $2.83.
QAnd how long does it take to administer one of those?
AThat can be done at a number of various methods. It can actually be done over a five-minute push, it could be done over an hour drip and it all depends on the status of the patients and what other things they are getting and also whether they've been, you know, there's other issues that we look at, but could be done, you know, a five-minute IV push which the nurse is there the whole time for the five-minute push or a drip over an hour and a half or so.
QOkay. And ‑-
AIt's also depending upon dose.
QThe next one is hydrogen peroxide.
AYes, ma'am.
QAnd how much are you currently making off of hydrogen peroxide IV?
A$7.22.
QAnd how long does it take to administer one of those?
AHydrogen peroxide, about an hour and a half. Since we've been doing ozone, we don't do much hydrogen peroxide now, but when we do that, that's an hour and a half maybe.
QOkay. And a vitamin C IV?
AA vitamin C IV again, if it's 25 grams versus 100 grams it all depends how ‑- how much we're doing. We start the patient actually at 35 grams, they go up to 50 and they go 75. By the third IV they're at 75 and then I usually keep them there or we'll take them higher.
QOkay. And how long does it take to administer a vitamin C IV?
AAgain, it's based on the -- (inaudible) -- and based upon the problems with the patient, but it can take up to two hours.
QAnd the profit per IV you're currently making on vitamin C?
AI think this is actually wrong because it's ‑- each vial -- it's $9.41, but we don't charge anything more for your treatment.
QOkay. Now, lastly, I'd like you to turn to Exhibit Number 27 and tell the Board what that is.
AThat's a sign that's in our front and it's also something that we have ‑- we used to have it in the front office in my old office. In the new office, it's just at the check-out place and it's framed, setting up so all patients could see it when they're leaving when they pay.
QAnd is that something that you did ‑- well, why did you post that sign?
ABecause the Medical Board wanted to make sure that my patients knew that this was being done for profit the last time when they investigated me, whatever you want to call it.
QAnd ‑- and is that why the sign is then posted in your office?
AYes. Actually, this was ‑- this was ‑- this isn't actually the ‑- this says, last revised January 18th, but it was revised again after 2003, but this was actually ‑- I think after the second visit in ‑- maybe the first visit in 1999 that the Medical Board had and we put this up.
And then in 2003, this last revised obviously isn't ‑- isn't right because in 2003, we put this notice posted for all patients in order to be fully compliant with the policies of the North Carolina Medical Board.
QAnd did you play a role in the legislative effort of the North Carolina Society for Integrative Medicine ‑-
AYes, ma'am.
Q‑- lobbying the Legislature for a change in the Medical Board statutes?
AYes, ma'am, I was.
QExplain to the Board Members what role you played in that?
AI'm the president of the North Carolina Integrative Medical Society. We felt that integrative doctors were being singled out for the practice of medicine. We testified in front of the House. Our bill was 886, Due Process for Physicians ‑- for all physicians, not just integrative physicians, but every physician.
The House was 78 percent against us, 22 percent for us. And after my testimony the vote went 116 to 6 in our favor. It was presented to the Senate and it went 40 to 7 in our favor. 40 Senators voted for us, 7 against us. Of the 7 that voted against us, they represented all the doctors that were on the Medical Board of Dentists.
And it was interesting because it didn't make any sense why a doctor would be opposed to a bill called Due Process for Physicians. There were extensive meetings between Mr. Mansfield and myself and Mr. Henderson and the past president of the Medical Society, Dr. Kanof at the legislature. There were press releases done.
We ‑- we changed the law, actually, from what I understand the fastest law that's ever been changed in North Carolina. And I was still under the impression that ‑- that the Medical Board is doing the best that they can and I'm not so sure any more.
MS. GODFREY: I don't have anything further.
MR. JIMISON: I don't know if the Board wants to break for lunch.
PRESIDENT RHYNE: How long is your cross-exam going to take?
MR. JIMISON: Twenty to thirty minutes and I can't guarantee, but I think it would be about twenty, thirty minutes.
PRESIDENT RHYNE: Let's go ahead and take a break because some of the Board Members are indicating they need to take a break. So we'll ‑- we'll just go ahead and do lunch and then ‑- can you be back by 12:50? Does that not ‑-
MS. GODFREY: 12:50?
PRESIDENT RHYNE: ‑- give you enough time?
MS. GODFREY: That's ‑- that's fine.
(11:58 A.M. - 12:55 A.M. RECESS)
PRESIDENT RHYNE: Okay. We'll go ahead and proceed then.
WITNESS: Yes, ma'am.
PRESIDENT RHYNE: You can have a seat, thank you, sir.
WITNESS: Okay.
PRESIDENT RHYNE: Mr. Jimison, I think that it's your time to cross-examine.
MR. JIMISON: Thank you.
CROSS-EXAMINATION BY MR. JIMISON:
QDr. Buttar, let's start off with some things that I think we can agree on. You have no medical training of oncology, correct?
AOther than what I did in my year in a residency, no, sir.
QBut you're not ‑- you didn't do a residency solely devoted to oncology ‑-
AI did not.
Q‑- or cancer?
ANo, I did not.
QYou're not board certified in oncology?
ANo.
QYou're not an oncology surgeon?
ANo.
QYou're not a radiation oncologist?
ANo.
QAlso, as to Patients A, B and C, but I think we can agree on this, they all came to your office with metastatic cancers, correct?
AThey came to me all with end-stage metastatic cancer, yes, that's correct.
QAnd for each of these Patients A, B and C you ‑- you treated them with essentially with similar therapies, correct?
AWell, it's interesting that you brought this up because my ‑- my goal of therapy is to debulk them and debulk them from their toxic load to stimulate their immune system.
And the techniques that I have at my disposal with that I have so far learned are the same techniques whether ‑- no matter what it is, whether it's a person's toxic and they've got cardiovascular disease or cancer, I'm using the same treatment to debulk the toxic load.
QI mean, we can agree that they all got hydrogen peroxide therapies?
AYes, they did.
QAnd we can agree that they all got ozone therapies?
AIn these three cases, I believe that's correct.
QWe can all agree that they all got some form of chelation?
AIn these three patients, that's correct.
QAnd we can agree that all of them got vitamin C?
AIn these three patients, that's correct.
QAnd they all got assorted minerals and vitamins?
AThat is correct.
QThey all got IRR injections?
AThese three patients, yes, they did.
QAnd they all got vitamin C?
AI believe in these three patients, yes, they did.
QOkay. And ‑- and everything I just listed from the hydrogen peroxide down to vitam C ‑- what about the glutathione, did they all get glutathione?
AI would have to look back at the chart, but I'm quite certain they all three got glutathione, yes.
QAnd maybe some got hyperbaric chambers, but not all got hyperbaric chambers but they could have got hyperbaric chambers down in South Florida?
AThat's correct, if I had it they would have definitely gotten it, yes.
QIf you had it. Now, each one of those things I mentioned, hydrogen peroxide, ozone, chelation, vitamin C, minerals, IRR, biofeedback, glutathione, hyperbaric chambers, none of those things have been shown to work for cancer in any clinical trial, correct?
AThere have been clinical trials that have been done on various modalities of treatment. If you're asking me in the United States, I'm not aware of anything that combines all those treatments together.
QSo Dr. Peterson would not have been incorrect saying that none of these therapies are within prevailing treatment for cancer, correct?
AWell, if you look at the individual IVs for instance at the University of Kansas right now they're conducting trials of vitamin C.
The trials that Dr. Peterson was talking about versus what we're talking about, Dr. Peterson is talking about, those trials are to determine safety because you're giving a toxic substance. These treatments are not toxic, so there's nothing to determine as far as Phase I which is usually to determine toxicity and safety. There is no issue with toxicity or safety with any of these treatments.
QBut I'm just trying to stay on what we can agree with and I'm just trying to get ‑- you can answer yes or no and then explaining the answer and you can ‑-
MR. KNOX: Objection. He says -- may I just speak. He doesn't have to answer yes or no.
PRESIDENT RHYNE: He can explain his answer.
MR. JIMISON: If it's possible. I'm just trying to see if there's areas of agreement.
PRESIDENT RHYNE: No. Go ahead.
Q(By Mr. Jimison) These hydrogen peroxide, ozone and chelation, vitamin C, minerals, IRR, glutathione, hyperbaric chambers, those are not within the prevailing and acceptable medical practices for the treatment of cancer in this country, is it?
AThat is incorrect.
QWhy is that incorrect?
AThe American Cancer Centers right now or Cancer Centers of American use these modalities in their seven different hospitals throughout the United States that are using many of these modalities.
QFor cancer?
AYes, for cancer, that's why it's called the American Centers for ‑- I just said it, Cancer Centers for America. They're advertising all the time on TV. They use this in conjunction with other therapies, conventional therapies such as chemo, radiation, but they are giving these treatments that we just mentioned, yes.
QWhen Patient C went to ‑- I'm sorry, Patient A.
When Patient A went to M.D. Anderson which is a pretty progressive cancer center and you said you even got some training there.
AYes, absolutely.
QThey spoke about getting oxygen therapy after they basically said there's nothing more that we can do for you here, correct?
AThat's correct.
QAnd ‑- and the doctor there said, well, there's not any legitimate clinical trials at all of these therapies being offered at M.D. Anderson, correct?
ADr. Garth Nicholson from M.D. Anderson has sent me patients, so I'm not sure what you're ‑- if that doctor didn't know, he didn't know. Is that what you're asking me?
QYeah. Mainly I'm just saying, is that a fair statement on his notes?
AFrom that note, yes, you're correct, that's what he said.
QAnd so M.D. Anderson according to this doctor with his knowledge of what was going on there, they weren't doing oxygen therapies?
AThat's correct.
QAnd you're familiar with the American Cancer Society, correct?
AAbsolutely.
QAnd they've recommended that oxygen therapy not be given to patients, correct, with cancer?
AI am not aware of that.
QIf you can turn to the thin notebook.
MS. GODFREY: Which notebook?
MR. JIMISON: The thin one, the Board's thin notebook.
MS. GODFREY: What exhibit?
MR. JIMISON: Number 19.
Q(By Mr. Jimison) I'm going to read you something at the bottom of that from ‑- from Memorial Sloan- Kettering Cancer Center.
AWhat page, I'm sorry?
QThe first page.
AYes.
QThe last sentence says: the American Cancer Society urges cancer patients not to seek treatment with hydrogen peroxide, ozone therapy or other hyperoxygenation therapies. Oxygen therapies should not be recommended.
AYou know, if you're going to ask me to make a statement -- that statement -- line right above it, it says: because of the blood-borne viruses such as hepatitis C and HIV reported after treatment with contaminated autohemotherapy devices.
That's exactly what it says here. And obviously with any treatment that you do with contaminated autohemotherapy device, you are going to have a risk, so I would ‑- I would agree with the statement.
QWell, I read that statement correctly, correct?
AYou only read part of that statement. You took it out of context.
QOkay, here at 21.
AI'm sorry, which page?
QThe first page.
ADoes it have page 22 on it? The first page is 19.
QExhibit 21. Exhibit 21, page 1.
AOh, sorry. Okay.
QAnd this is from the American Cancer Society.
AI do not believe it is.
Qwww.cancer.org?
AThat is not the American Cancer Society to the best of my knowledge.
QOkay. Well, let me just read the statement at the top under Overview from this document. It says: Available scientific evidence does not support claims that putting oxygen-releasing chemicals into a person's body, as described here, is effective in treating cancer.
MS. GODFREY: Well, unless the source can be identified, we're going to object to it being read into the record.
AYou could have read this ‑- I have no idea what it ‑-
MR. KNOX: Wait a minute, Doctor. Wait until she gets through.
MS. GODFREY: Again, my objection is, Dr. Rhyne, that unless the source can be identified and I believe under the Rules of Evidence in order to cross-examine somebody with a journal article you have to show first that they rely on that particular journal or publication and I don't think that foundation has been laid by Mr. Jimison's question.
MR. JIMISON: Actually, this may be a good point. I want to go fast, but I do want to make this point of law and I've got so many documents. I know the Board Members have the Motion in Limine, if you all could turn to that and ‑-
MS. GODFREY: The Motion in Limine?
MR. JIMISON: Yeah, the Motion in Limine.
PRESIDENT RHYNE: We've got a lot.
MS. GODFREY: If you can move that up.
PRESIDENT RHYNE: This is the one I think, Ms. Godfrey ‑-
MS. GODFREY: That I filed, yeah. And it has the rules of ‑- the hearsay exceptions attached. It's 803‑18.
MR. JIMISON: It says: To the extent called upon to the attention of an expert witness upon cross-examination or relied upon by direct examination statements contained in published treatises, periodicals or pamphlets on the subject of history, medicine or other science of law are all established as reliable authority by the testimony or admission of the witness or by other expert testimony or by judicial notice -- meaning that you folks can take judicial notice -- If admitted, the statements may be read into evidence, but not received as exhibits.
So all we're doing is reading it into evidence. You can take judicial notice of it, if you like. It's not contingent upon the witness. There's three different ways that it can be done. The witness can verify it, another expert witness can verify it, or you this Medical Board can take judicial notice of it.
MS. GODFREY: Well, unless the source is identified, how can they take judicial ‑-
MR. JIMISON: Well ‑-
MS. GODFREY: ‑- notice of it?
MR. JIMISON: I'll identify the source by the ‑- by the URL.
DR. McCULLOCH: Are we talking about Exhibit 19?
MR. JIMISON: Exhibit 21.
PRESIDENT RHYNE: No, I think you're talking about 21.
DR. McCULLOCH: He's talking about 21, I'm sorry.
MR. JIMISON: And that is from the ‑- at least at the bottom of the ‑- the bottom is from www.cancer.org?
MS. GODFREY: Right.
WITNESS: Ma'am, I'd like to make a comment on this document, if possible.
MR. KNOX: Wait until ‑-
PRESIDENT RHYNE: Go ahead. Go ahead, sir.
WITNESS: The reference at the back of this document, one of the references is an organization that is called -- and this is on page 4, ma'am -- it is the, two, three, four, five, six, seventh reference down is an organization called quackwatch.org. They've already been found to have their references and their information that's been ‑- and presented in the courts of California and Wisconsin to be biased and unreliable. And so anything with a reference to that organization to me is fraudulent.
Q(By Mr. Jimison) Are you familiar -- are you familiar with www.cancer.org as the American Cancer Society web site?
ANo, I am not. The American Cancer Society's web site that I'm aware of is ACS.org.
QWell, are you familiar with Duke or the UNC programs?
AI am.
QDo they have integrative programs?
AThey do.
QDo any of those programs use oxygenation therapy for cancer?
ANo. They send those patients to me.
QDo you refer patients to Duke?
AYes, I have.
QOn the integrative programs?
AActually, not only for the integrative programs. I'm not sure if it's with the integrative program or not, but I have had patients sent to me from Duke.
QFor oxygen therapy?
AYes.
QAnd who are those oncologists?
AThey're not oncologists. I didn't say they were oncologists.
QWho will send you the patients then?
AI would have to go back and pull those charts to find out the names of those doctors, but there have been two different doctors that have sent me patients from Duke.
QSo I'm talking about ‑- you say you didn't know whether it was from the integrative medicine program?
AI do not.
QSo you don't have any knowledge that the integrative medicine program at Duke has ever sent you patients?
AYou asked me if Duke has sent me patients. The answer is yes.
QWhat I meant was that integrative program?
AI'm not familiar whether any of those doctors had a position in the integrative department. The integrative department doesn't have exclusive appointees. They usually serve on some ‑- in some specific division and they also have a physician on the integrative faculty. They have an interest in it from what I understand.
QAnd isn't it true that their curriculum does not include ‑- does not include teaching oxidation therapy?
AI'm sorry, I'm not familiar with the curriculum.
QWhat about UNC, do you know of their curriculum?
AI've lectured. I've been invited to come and lecture at UNC Chapel Hill. I've had their medical students rotate through my office, but I'm not familiar with their curriculum.
QAre ‑- or have they ‑- do they teach oxidation therapy ‑-
ALike I said, I'm not familiar with their curriculum.
QYou testified on direct examination that you've never done anything standard in your life, correct?
AWell, my goal has always been to be above the standard. I'm sure I failed sometimes and hit the standard.
QSo what is the standard for end-stage cancer as you understand it?
AI think that, Mr. Jimison -- and I'm not sure if I understand this question -- but I think every person is going to have a different definition of what their standard is. My standard is can I look at the patient in the eye and can I look at myself in the mirror and that's what my standard is. If I can't, then I've done something short of doing the best that I can for my patient.
QOkay. You heard Dr. McCulloch ask a question earlier about the National ‑- I think it was the NCCAM. Are you familiar with that organization?
AThe National Council of Complimentary and Alternative Medicine. I'm not sure who Dr. McCall is. Oh, I'm sorry, Dr. McCulloch, that's right. I'm sorry. Sorry.
WITNESS: My apology, sir.
DR. McCULLOCH: It's not a problem.
Q(By Mr. Jimison) Have they taken the position on oxygen therapy, if you know?
AI had actually met with ‑- I met with the National Council for Complimentary and Alternative Medicine when the previous of -- HHS, he had set up an appointment for me to go meet and they actually ‑- during our meeting there was a discussion on what types of things that they are ‑- what type of therapies and what type of treatments they openly promote.
And the assistant head of NCCAM at that time said that this is a very politically volatile time and they have to be very conscious of which ways to make inroads. And anything that would be construed as being more than controversial, they would have to keep on the lower priority and use those types of modalities that have been more widely accepted to promote and get inroads with integrative medicine and complimentary and alternative medicine.
QSo they do not promote oxygen therapy?
AI am not familiar with what they do and do not promote because I do not use them as a reference, but that was what I was told during my last meeting at NCCAM.
QNow, we go ‑- let's go to Patient C's record.
APatient C?
AUh-huh (yes). Well, let me ask a question this way, are there other doctors in North Carolina practicing oxygen therapy for cancer patients by itself?
AI use oxygen therapy -- the correct name is oxidative therapies -- for various number of issues in the patient's body and those patients may present with symptoms of other diseases. They may have cardiovascular disease, they may have cancer. There are doctors that are using oxidative therapies in North Carolina besides myself, yes. For what purpose, I am uncertain.
QOkay. And so ‑- but to your knowledge you're the only one using it for patients with end-stage cancer?
AI'm not using it with patients with end-stage cancer. I'm using it to debulk their bodies. It just so happens that patients come to me that have end-stage cancer.
QOkay. So when Patient A, B and C presented to you, they didn't present to you for looking for you to help their cancer?
AThey came to me because they wanted to live.
QDid they look to you ‑- were they presenting because they wanted you to help them get rid of their cancer?
AThey came to me because they wanted to live. My patient, the one that you saw testify, I asked her did she have an issue, if she has cancer for the 50 years if she is still alive and she said no. But cancer is not what I'm going after.
QAre you familiar with the document Innovative Protocols for Treating Chronic Disease, Cancer, Cardiovascular and Neurodegenerative Disease?
AYes, I am.
QOkay. Just wanted to flip through it and see if that is familiar to you.
AYes, it is. It was an ACCME approved course that I give.
QOkay. Turn to page ‑- I believe it's --
MS. GODFREY: Do you have a copy of that for us?
MR. JIMISON: I don't, but I'll ask him if this is just a fair statement of his own materials.
Q(By Mr. Jimison) Who ‑- who made this up?
ASome marketing people.
QBut you read over it and approve it, correct?
AI think that my operations manager or somebody must have reviewed it. I've reviewed it, but probably not, you know, in a very detailed manner. I mean, I've gone through the content that's pertinent to the course, but the marketing stuff, I'm ‑- I really don't really look at it. I know there's nothing they are claiming from what I know.
QIs this a page with your sort of information? Could you read the first sentence?
MS. GODFREY: Well, Marcus, can ‑- can we just see that because you haven't ‑-
MR. JIMISON: Yeah, well, before he reads it, you can show it to your counsel, if you want.
AYes, that ‑- that line said ‑-
MR. KNOX: Did you hear what he said?
WITNESS: I'm sorry, sir, I did not.
MR. KNOX: Well, hand it over to me before ‑-
WITNESS: Oh, I'm sorry, excuse me.
PRESIDENT RHYNE: Can you make copies ‑-
MR. JIMISON: Yeah. I'm sorry.
PRESIDENT RHYNE: ‑- for us, also? Thank you.
MR. KNOX: I'm sorry.
MS. GODFREY: Yeah, we just wanted to see that exhibit, if that's okay.
WITNESS: Want me to give that back to you or ‑-
Q(By Mr. Jimison) Well, if you could read the first sentence of the second paragraph.
ADr. Buttar practices in Charlotte, North Carolina where he's the Medical Director of Advanced Concepts in Medicine, a clinic specializing in the treatment of cancer, heart disease and other conditions ‑- chronic conditions in patients who have tried conventional treatments with a special emphasis on the relationship between metal toxicity and insidious disease process.
QOkay. So it says your clinic specializes in cancer, correct?
AAgain, Mr. Jimison, I will try to be as succinct as I can, but the World Health Organization in 1998 and 1999 stated that 8 out of 10 people in the industrialized world die of either cardiovascular disease or cancer. When you add neurodegenerative disease to it, it's 92 percent. It is 92 percent of causes of all death which means homicide, suicide, all natural disasters, wars, all chronic disease together 8 out of 10 people are dying of heart disease and cancer.
So the reason that says chronic disease, cancer, cardiovascular disease and neurodegenerative disease is because it represents 92 percent of causes of all death.
QIf you can turn to your ‑- the thin notebook that I think you might have in front of you.
AThis one?
QUh-huh (yes). To your deposition which is 12, I believe.
A12, yes, sir.
QIf you can turn to page ‑- I believe it's 51.
APage 51. Is that the ‑- is that the first number at the bottom or was it the ‑- I have the pages.
QNo, I'm sorry, do see the pages of four?
AYes.
QBeginning line 10, I asked you whether vitamin C is a treatment for cancer.
And then you said it is a treatment that we use for the immune system. Nothing that I'm doing is addressing cancer.
I asked you directly and then you answered the following. What's your answer?
ABecause cancer is a symptom, so I'm not going to address it directly, so I'm trying to direct it to the underlying immunosuppression and the issue of toxicity.
QSo when these patients come to you and they're coming to you because ‑- I mean, let's go ‑- Patients A, B and C came to you because they had been referred to hospice?
AThat's correct.
QAnd ‑-
ABut I think actually that Patient C had not been ‑- he was not in hospice, A and B were in hospice.
QOkay. And what ‑- did you see them initially ‑- all initially?
AI saw all three initially, but I did not scribe the note. In these three patients I saw them all initially, yes.
QWhat do you tell them?
AI don't really tell them much of anything, I'm listening to them most of the time because I get their history, what they've gone through, what they've been exposed to, what their, you know, history has been that led them to that point.
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