NC Medical Board Dr. Rashid A. Buttar Transcript - Page 6 of 16
ANo. All that a patient does it's called granulate -- (inaudible) -- immune factor. It does one thing and one thing only. It brings up the -- (inaudible). It doesn't do anything to hemoglobin, it doesn't do anything to T-cell -- (inaudible) -- to bring the white cells up which tends to reduce the incidence of the -- neutra -- (inaudible). It does not -- (inaudible) --to your immune system.
QWell, let me read what you said. You said, the only two drugs that have been shown to work in melanoma is ‑- (inaudible) -- and Interleukin. Chemotherapy is almost worthless. Okay.
AWhat was that? I couldn't ‑- was that about adrenal cell cancer -- and what was it? I couldn't hear the first part of what you said.
QI'm sorry. The only two drugs that have been shown to work in melanoma ‑-
ARight.
Q ‑- are the Interferon and Interleukin and chemotherapy you said was almost worthless.
But the next question was, but the mechanism of those treatments is to boost the immune system of the patient with melanoma. And you said, that's the idea, yeah.
AYeah. Well, the idea is to ‑- you're trying to turn this into an alternative medicine therapy. It isn't to boost the immune system, it's to trigger the immune system to react to the cancer cells.
QI'm not trying to turn it any way, I'm just reading you what you said. Did you say that, yes or no?
MR. JIMISON: Well, objection. At some point I think if he's going to quote Dr. Peterson's deposition perhaps we should all be following along and give Dr. Peterson a copy of his deposition to see exactly what he said.
MR. KNOX: Well ‑-
MS. GODFREY: It's in the ‑- it's in the book.
MR. JIMISON: I know, but if you could turn to us and guide us to the page you're reading from ‑-
MR. KNOX: It's on page 18, Doctor.
MR. JIMISON: What exhibit?
MR. KNOX: Of his deposition.
MS. GODFREY: Dr. Peterson's deposition is our Exhibit Number ‑- it's number ‑-
MR. JIMISON: Actually it is 15 in our notebook.
MS. GODFREY: 51.
MR. JIMISON: Actually, let me ask you to go to ‑-15 of in the thin notebook and they can turn to page ‑- turn to page 18 and there are quarter pages.
WITNESS: And there's all kinds of numbers and books. It's very confusing.
MR. JIMISON: So you want to look at the top right-hand corner.
WITNESS: Yeah.
MR. JIMISON: And then you want to go to page 18.
WITNESS: Is page 6 on the transcript. Okay?
MS. GODFREY: Yes.
WITNESS: All right. Yeah, I'm with you all.
MR. JIMISON: Okay.
Q(By Mr. Jimison) So under line 10, okay. But the mechanism of those treatments is to boost the immune system of the patient with melanoma? And your answer was ‑-
AYeah, that's the idea. But I didn't make the statement, Mr. Knox, you did, I just responded to the question. I wasn't -- (inaudible).
QWell, do you think ‑-
PRESIDENT RHYNE: Pardon me. Can you tell me again where you were in the transcript?
MR. KNOX: I'm on page ‑-
MS. GODFREY: 18.
MR. KNOX: ‑- 18.
PRESIDENT RHYNE: And is that in your book or in ‑-
MR. KNOX: It's in the thin book.
PRESIDENT RHYNE: It's in your book or Marcus'?
MS. GODFREY: It's in both. It's ‑-
PRESIDENT RHYNE: In both.
MS. GODFREY: Yeah, 51 in our book.
PRESIDENT RHYNE: Okay.
MS. GODFREY: And there's page 18.
Q(By Mr. Knox) And then in the very next line, line 21: (sic) So taking the vaccine is intended to do what? And what did you say?
AThat's not what I said.
QDo you see the answer on page 21.
AOn page 21.
QI'm sorry, line 22. I'm going too fast.
MR. JIMISON: Page 21?
AI hope he's taking Megace to stimulate their appetite.
What cancer are we talking about here?
MR. JIMISON: Colon.
AColon cancer vaccine trial.
QYes. And you said that was done to boost immune systems.
AYeah, that was probably a poor choice of words. The more specific would be to prevent colon cancer antigens the immune effective cells hoping that they will trigger the immune system to react to the colon cancer -- (inaudible) -- added on to the vaccine.
QNow, I believe you said the National Institute of Health has printed that there are thousands of trials out there of things to do to build up their immune system for cancer patients; is that true?
AI don't think I said thousands. There's thousands of trial, but they're not all for the immune systems. Some are for chemotherapy, some are for antibodies, some are for pharmaco-biologic targeted therapies, some are anti -- (inaudible) -- trying to attach mutations. I don't recall saying there were thousands of ‑-
QWell, go to page 23, line 2. Are you with me?
AYeah, there's thousands of trials out there.
QMay I ask the question, please?
ASure.
QCan you think of any other cancers where there are studies that you aware of that are treating it to boost their patient's immune system. And what did you say?
AIf you look at the web site at the National Institute ‑- the NIH, there's thousands of trials out there. I'm sure, if I looked, there will be all kinds of immune trials out there, but they're all Phase I and none of them are successful. But I did not say there's thousands of new trials. It says there's thousands of trial out there. Period.
QOkay.
AAnd I want to be clear about that. I did not say that.
QBut you said people are still trying it and you said sure, correct?
AAbsolutely they're trying it, but ‑- but I don't get to do that in my office. That gets done in a setting, a controlled trial where they are collecting data and some of the patients get -- where they are looking for toxicity and efficacy and it's monitored and it's in a randomized fashion so we can tell if it's actual fact.
That's not the same as me just making up a vaccine in my backyard and giving it to patients because, oh, I think it'll help your immune system.
MR. KNOX: Well, objection, being unresponsive.
MR. JIMISON: I think it was quite responsive.
MR. KNOX: Well, I made an objection to the doctor.
PRESIDENT RHYNE: Your objection ‑-
MR. KNOX: My objection that that was not a responsive answer, but a voluntary speech.
MR. JIMISON: It's his question. The witness is more than ‑- more than entitled to explain his answer on cross-examination. There ‑- I mean, he's entitled to explain his answer.
PRESIDENT RHYNE: You can ask then, perhaps when you cross-examine, you should give him an opportunity to explain.
Q(By Mr. Knox) Then on page ‑- page 21 again at the top you look at it starting at line 10 and you said that they're trying to use the immune system all the time. I just -- somebody I sent to Duke for a vaccine for colon cancer, but as a trial, correct?
AThat is correct.
QThat's ‑- the idea is to treat the immune system.
ANo, again, you keep trying to say that. I don't know how many times I have to go over this. No, it does not say treat the immune system. That sentence does not say treat the immune system.
It says use of the vaccine to treat the cancer and the vaccine is not to change or boost the immune system. It's to trigger an immunologic response to specific colon cancer patient.
QYou may be right, but go to line 22. See that? So taking the vaccine is intended to do what? And you said -- read it.
AWe hope it will boost the immune system to fight the cancer, but it wasn't ‑- that answer was not given in context that you're asking me now. It is ‑- you're trying to imply that these vaccines sometimes ‑-
QI want --
A‑- sometimes make your immune ‑- you asked a question, I'm going to answer it.
MR. KNOX: Well, I object to your speaking. Answer the question.
PRESIDENT RHYNE: Just answer the question.
AThe answer is the vaccines are not to boost the immune system. The immune system is already very functional. The idea is to see if you can trigger an immunological response to specific cancer antigens. It is not the same thing as saying boost the immune system.
QDoes chemotherapy decrease the immune system?
AThe majority of it does, yes. Some of the biologic there just do not, but some of the -- (inaudible) -- antibodies do not.
QAnd there are times when you give people certain minerals and vitamins to help them with ‑- to build back up their immune system?
ANo.
QYou don't do that at all?
ANo.
QOkay. You don't give anybody vitamin C even if it shows that their vitamin C is low when you treat a cancer patient?
AI've never seen a low vitamin C level, and if I did, I'm sure I'd give it to them. But, again, it wouldn't be to boost their immune system, it would be to treat vitamin C deficiency which is not the same as an immune depression.
QLet's move forward. You said when asked about Dr. Buttar's treatments that they were below the standard of care. Yet, you told Mrs. Godfrey you didn't know what an IRR was, did you?
AI'd never heard that acronym.
QAnd you didn't know whether he had actually seen any one of these cancer patients and had injected them with IRR or another procedure?
AI didn't understand that question.
QYou didn't know that he had seen or had done a procedure on all three of these cancer patients?
ANo, I didn't see it in the records, so I didn't know about that. I did not know.
QYou have used an ET ‑- EDTA as a chelated agent for chronic lead toxicity, haven't you?
AYes, I have.
QAnd you still do that, correct?
AYes. And that's standard medical therapy.
QAnd that's used in conventional medicine?
AThat's correct, yes. But, of course, for a specific diagnosis.
QYou did not know what EMPS was, did you?
ANo.
QBut yet you said it was below the standard of care to use it, didn't you?
AThat's correct.
QNever heard of it before, right?
AThat's correct.
QOne of the things you read out there when the lawyer asked you the question about the other procedures and drugs used, GHS ‑- GSH, an antioxidant, you didn't know what that was either, did you?
AYou know, I know from the deposition, I believe it's glutathione something along -- I can't remember but that is back with my biochemistry days. If I remember right --
QBut you had ‑- I'm sorry, are you through?
AI didn't recognize the acronym, but it's glutathione.
QBut you had no problem to say it's below the standard of care because the doctor used it, am I right?
AThat's absolutely right because it ‑- it is not a therapy for any cancer. I don't have to ‑- there's lots of ‑- there's tons of chemicals out there. I don't pretend to know all of them. There's probably, who knows, millions of chemicals. I don't pretend to know what they all are, but I know the ones that are related to cancer and GSH is not one of them.
QBut you have heard of it being used as an antioxidant?
ANo.
QWell, go down and look at page 42, line 6. Have you ever heard it as being an antioxidant? And you said, yeah, actually I've heard that, yeah. Is that correct?
AI don't see it.
MS. GODFREY: Page 42.
AI guess I also heard it at one time, but I don't remember it now.
QDid you say that?
AI'm sure I did say that.
QAnd then over, do you believe that proper nutrition would help a person in the fight of cancer; is that correct?
AYes.
QAnd there's ‑- I believe you said, it's a whole section in the Journal of Clinical Oncology that talks about giving people supportive care to keep their nutrition up.
AIs that a statement or a question?
QI'm asking you.
AWhat was the question?
QYou had indicated that there were whole articles in the Journal of Medical Oncology called supportive therapy ‑- supportive care. Do you find that supportive care is essential to cancer patients?
AI think it's important, yes.
QAnd do you give any type of minerals to anybody that ‑- that may be deficient that you've treated with chemotherapy?
AWhat do you mean by a mineral?
AWell, any type of minerals that you might think might build up your ‑- the ‑- the body of the system of the individual that's very sick from both the cancer and the chemotherapy?
ANo.
QOkay. You then say you believed in biofeedback; is that correct?
AI don't recall saying I believed in it. I said I was aware of it.
QWell, do you use biofeedback with your patients?
ANo.
QNot at all?
ANo.
QYou never sat down and talked to them about the stress level?
ASure, I do, but I don't call that biofeedback. I call that the practice of medicine.
QThe practice of medicine?
AYes.
QAs a matter of fact, you keep a couple of dogs in there to help people deal with stress, am I correct?
AI do, but I don't bill for the dogs.
QWell, I understand, that's good and I appreciate that. The point is you're giving intravenous injections in your office, correct?
AWhat has that got to do with the dogs again?
QWell, may I just finish. You're giving intravenous injections in your office you say because it takes a long time and people get stressed out and the dogs help reduce their stress; is that true?
AOh, I think they probably enjoy the dogs. Does it reduce their stress? It might.
QLet's go through where you ‑- you filled out your form, if I can find it. You filled out the form on your patients and so if you will turn to those.
MS. GODFREY: They're ‑- they're number 8 in our book.
MR. KNOX: And briefly, do you have ‑-
PRESIDENT RHYNE: Tab 8.
MS. GODFREY: Tab 8 in our book.
Q(By Mr. Knox) Okay. Just look at your expert sheet and just on Exhibit ‑-
MR. KNOX: What's that exhibit?
MS. GODFREY: It's our Exhibit 8.
Q‑- our Exhibit 8. You reviewed Patient A, B and C, all cancer patients, right?
ARight.
QPatient D who had ‑- depending on what you say, either polyps or constipation or whatever that you diagnosed, correct?
AI didn't diagnose anything. I just reported what I saw in the chart.
QAnd you wrote in this letter, of course, this was two hours of time. Thank you, John Peterson, M.D.
AActually my office manager wrote that, but that's right. That's right.
QAnd you sent that to the North Carolina Medical Board?
ARight.
QNow, Dr. Peterson, if I could, what did you understand your role to be when this was sent down there?
AWell, they just asked me to look at some charts and see if I thought the standard of care was met, so I reviewed them and gave them my opinion.
QAnd you had no idea that you would ever be called to testify at a Medical Board hearing to take somebody's privileges to practice medicine, did you?
ANo, I didn't at that time.
QAnd had you known that, would you have spent more time?
AProbably not. It wasn't that hard. I mean, most of these charts are just labs, there's very little progress notes. There's almost nothing in the way of x-ray studies to look at.
QAre you telling this panel that you went through 10,000 ‑- 1,000 pages in two hours?
AAs I just said, the vast majority were just acts of labs reports. It wasn't thousands of pages of medical records. In terms of patient care records, there's ‑- I don't know how many there were, but there were less than 100.
QAnd ‑- and you wrote down on Patient C ‑- Patient A that ‑- did I get it right -- that the diagnosis was in the standard of practice, correct?
AIt's probably ‑- mine aren't labeled A, B and C, so you're going to have to read them again.
MS. GODFREY: She's the one who begins with a W.
ACervical cancer?
MS. GODFREY: Yes.
QCorrect.
AYeah.
QAnd you wrote down the maintenance of the records were within the standard, correct?
AThat's right.
QAnd ‑- and down at the bottom you put, no physician contact documented; is that correct?
AThat's was my ‑- I could not see it, that's correct.
QAnd do you know that Dr. Buttar actually did an examination on the patient?
AWell, he may have, but I don't have him. I have the records and the records didn't reflect it.
QOkay.
AIt doesn't mean it didn't happen. I'm just saying it wasn't in the records.
QNor did you learn that he had done the three IRR procedures on the patient?
AAgain, I only had the records. If it's not documented in the records, it's not possible for me to know that.
QDo you know if these records were written in a different handwriting from the nurse assistant?
AI can't remember, I'd have to look at the records.
QAll right. Let's go to the next one. Patient ‑- Patient B.
MS. GODFREY: 51-year-old with ovarian cancer.
QAll right. You got that?
AYeah, I've got that.
QAnd you indicated that he made a diagnosis within the standard of care, correct?
AYeah.
QBut you found that his records were below the standard of care, correct?
AThat's what I marked, yeah.
QAnd do you know ‑- are you able to say whether or not Dr. Buttar actually did a physical exam and wrote the information in the chart?
AIt was ‑- my recollection on the records, I couldn't see that he did.
QOkay. And ‑- and there again you said there had been no physician contact with the patient ‑-
ANot that ‑-
Q‑- documented. I'm sorry.
ARight, documented. You know, all I can say is what I saw in the records. I didn't see it in the records.
QWell, would it affect your opinion in any way to know that he spent time with this patient on more than one occasion and he did an exam, that he did the three IRR ‑-
MR. JIMISON: Objection, it's assuming facts not in evidence.
AYeah, I have no idea if any of those things happened.
QWell, if it ‑- if he had seen her that many times, would that affect your decision?
AWell, it would depend on what he did. I mean, there's no documentation. I mean, he could have had a phone conversation in the hallway and called that a physician visit.
QSo you don't know whether he did touch the patient, talk to the patient or called from the hallway, is that what ‑-
AWhat I know is what was in the record. And I didn't see any history and physical performed by Dr. Buttar in the record.
QWell, the way you describe this, the standard of care in each one of these cases is just to refer the patient down to hospice without any care, give them some pain medicine; isn't that correct?
AWell, I think you're ‑- it's not exactly what I said. What I said was at this point, this patient has two choices. One is that of hospice for care.
Two is going for experimental therapies, Phase I trials, if she so chose and could do so. Most of the patients opt not to at this point because the efficacy of Phase I trials is so poor and when you're this far down and you're this sick, it usually doesn't do any good. Most patients elect to go to hospice instead.
QThey can't do Phase I trials without a protocol, can they?
AWell, if they can go -- we've got universities and in Charlotte, they've got very sophisticated oncology care down there. There's clinical trials in the private practices in Charlotte.
QBut they don't fit into the precise setting that were mentioned to be treated, do they?
AI don't know, it depends on trials that are open.
QWell, there are some trials ‑- you indicated that there was a couple of patients. You had one from Chapel Hill and one from Duke that went through their protocols and they were sent out and terminated the treatment and they came down to you and you elected to treat them further, didn't you?
AThat's correct because they were still responsive to standard chemotherapy.
MS. GODFREY: Did he try to treat them with experimental ‑-
QDid you treat them with experimental drugs or ‑-
ANo, I treated them with standard chemotherapy.
QSo I guess my question is, if Patient A had been to Indiana or something and said no further, your acknowledged standard of care would have been, said, go home, take some pain medication and talk about it with hospice; is that correct?
AThat's what I would have advised him to do, yes.
QAnd so it's your decision that ‑- your opinion that if a patient wants to ‑- elected ‑- elect and have freedom of choice to go to a doctor of their choice to seek further treatment, that's below the standard of care for a doctor to treat them; is that correct?
AIt is below the standard of care to do ineffective therapy. These are emotionally, desperate, scared patients and taking advantage of them under the libertarian argument that it's a free country and aiding them into this is bogus. We're not talking about the patient's side, we're talking about the doctors side.
QWell, didn't you say that if a patient wanted to go for further treatment, it was up to them and their freedom of choice?
AIt's up to the patient, that's right, but not my freedom of choice as a physician if I would start giving bogus treatments. I don't have the right to do that. The patients can do whatever they chose. I cannot do whatever I chose.
QWell, who do you think brought these patients down to see Dr. Buttar other than themselves?
AI understand what the patient did. It's not what the patient did. We're talking about what the doctor did.
And once again, I am not free to do whatever I want in my office. I'm a regulated entity of the State of North Carolina and I cannot give ineffective therapy just because the patient wants it. Your argument would be you go to thoracics ‑-
QI'm not interested in my argument.
AYou asked the question, I think I can answer this.
MR. JIMISON: Just a moment.
PRESIDENT RHYNE: Oh, you can answer.
MR. KNOX: I mean, I'm sorry if he's offended, but ‑-
ABut you're not listening to me. I got to tell you, this is going to drive me nuts. There we go, it's working. (Referencing microphone)
You cannot walk in a thoracic surgeon's office and demand open heart surgery just because you want it. That surgeon cannot perform surgery unless it's effective. And he cannot go to coronary and get a completely unnecessary procedure because the patient wanted it.
QIf I walk in after I've been through analysis, I have major heart problems, I'm going to die in 30 days, you mean to tell me I can't go to a medical doctor and say, Doctor, is there something you can give me that will help ‑-
AAbsolutely. But what I'm trying to point out and if I can is what he gave him didn't help them and there's no evidence that it will. If he had something to help them with, that's fine.
QAnd you don't know what it is, do you?
AI know it doesn't work. And there's ‑- and here's how we know. It's not my job to prove it doesn't work, it's his job to prove that it does. First, you have to prove it's effective before you can give it.
QI think it's the Board's job to prove it.
ANo, it's not the Board's job. It's the FDA's job to prove it.
QLet's go to the next one. These people that you've treated from Duke and Carolina have been through their protocol, right? And they ‑- they failed for some reason or their protocol didn't match?
AI'm not ‑- what are you talking about?
QI thought you said you had saved somebody that was sent away from one of the hospitals that didn't meet their protocol.
ANo, that's not what I said. What I had was ‑- I've had patients that were -- this is most interesting.
This was a patient with metastatic ovarian cancer who had been treated by the oncology service at UNC. And Dr. Van Lee called me and said, you know, we've tried three different regimens, she's progressed to -- (inaudible) and we want to send her to you, we don't think there's much else we can do.
And when I got all the records and proceeded to look through it, it was quite clear to me that she actually had very obviously chemo responsive disease. Part of the reason being she was a GYN oncologist and she's not a medical oncologist.
And all I did was go back to the first treatment she used carbo/Taxol which is really quite responsive and she lived another seven and a half years and worked full-time for seven out of those seven and a half years.
QSo your treatment saved her life at least some period of time?
AIt prolonged it, but I gave, once again, standard chemotherapy that was with FDA approved drugs.
QAnd that was after they told her that it was over and it was over for her, didn't they?
AWell, they were a research institution and they really aren't interested in treating chronically ill patients for years and years. Once they've done what they can do, it's not unusual for them to refer them out to a private practitioner for ongoing care. They're really not in the business to do what I do.
QOkay. Let's go to the last patient, Patient D. And I think we can move through this. Patient D. I believe you indicated that the doctor had treated this patient with chelation therapy for constipation; is that what ‑- that's what you wrote on your sheet, isn't it?
AYeah, and I got that from the ‑- from the ‑- from the record. That was what I understood from the records that were given to me.
QOkay. It says, 46-year-old female with constipation and essentially ‑-
AColonoscopy.
Q‑- other than polyp was treated by Dr. Buttar for EDTA chelation for heavy metals and constipation.
ARight.
QYou ever heard of that in your life?
ANo.
QAnd you know now that that's incorrect?
AWell, I'm not sure. I couldn't tell from the record what they were doing.
QHave you read Patient D's deposition where she acknowledged when she came to the doctor, she ‑-
MR. JIMISON: Objection, just ask him if he read Patient D's deposition.
AI have not read Patient D's deposition.
QWell, if the testimony is that she had a prior lead drug analysis and she came to Dr. Buttar asking for treatment of the lead problem, that certainly wouldn't be consistent with treatment for constipation, would it?
ANo, it wouldn't.
QOkay. So do you think you were a little quick on that opinion?
ANo. I ‑- all I had was the records. I ‑- I can't do anything except what the records reflect and if that was in there, I could not find it and I didn't see any serum lead levels. If you're doing EDTA chelation, you do serum lead levels to make sure it's working. I didn't see that.
QAnd you didn't see the test that she brought, did you?
ANo.
QOkay.
AI'm assuming it wasn't in the records I was given.
QAnd you believe it was below the standard of practice because the diagnosis was improper, didn't you?
ACorrect.
QOkay. But you said that the maintenance of the records were in the standard of care.
AFor the records I saw, I thought they were, yeah.
QAnd then you said that the doctor should have not treated her with chelation therapy; is that correct?
AThat's correct.
QNow, Doctor, as I understand it, you basically believe that the standard of care for treating any cancer are the three modalities that you use and unless that is used any other experimental drugs has to be in a controlled environment like at Duke or Chapel Hill or someplace like that; is that correct?
AIt doesn't have to be Duke or UNC. It has to be in a controlled clinical trial. Now, I don't do them in my office because my office is too small, but there's lots of private practices that have clinical trials. Certainly in Charlotte there's one.
QThere's a Dr. White in Charlotte that does that?
AI'm not sure which -- Richard White?
QI believe you said there was a Dr. White that ‑-
AOh, well, I'm ‑- yeah, there's a Richard White in Charlotte.
QHave you read that the doctors at CM Hospital at Charlotte, I keep forgetting the name -- Carolina Memorial Hospital ‑-
AYes.
Q‑- is now treating people with microwaves for tumors?
AOh, sure. We've been doing it at UNC and Duke, yeah, but those are only trials.
QBeen doing it how long?
AI don't know, sir. I don't do it, but I know that they do it ‑-
QHow about ‑-
A‑- radio frequency ____.
QI'm sorry. How about with radio waves? Are you familiar with any of those procedures?
AWhat do you mean radio? You mean, opposed to radiation?
QYes, radio waves.
ANo, I'm not.
QHave you read anything about that the Harvard people says it's the most innovative thing to ‑-
AOnce again, that's not approved therapy and it's going on under a trial. It's not ‑-
QWell, I'm asking what you know.
AWhat I've read in the newspaper, that's all I know. It's not ‑- it's not an FDA approved treatment. It may be some day.
QYeah. Do you agree that CA 125 is ‑- is a measure of cancer cell growth?
AIt's a very ‑- it can be, but it can also grow with endometriosis. We use it when somebody has been diagnosed with ovarian cancer and it might respond to treatment.
QWhat's your understanding that ‑- what's the highest level of CA 125 that you've seen?
AOh, I'm going to say over 10,000.
QAnd what's the ‑- what's the formula for what it's supposed to be?
AIt's supposed to be under 20, depending on the lab they use, but supposed to be under 30.
QOkay. And ‑- and I take it from that that you looked at Patient D and saw that her labs went from 10,000 down to about 6200? Do you remember reading that?
ANo, I don't remember reading it.
QSo you never saw that?
AWell, I looked at these six, seven months ago. I don't remember it.
QI understand. But if that were to occur, would that be an improvement?
ANot necessarily. The tumor mercury can fluctuate and you can see tumor mercurys go down and CAT scans get worse is why we don't rely entirely on tumor markers. We monitor them so we put them through so many CT scans. We always follow them up with CAT scan to be certain that the tumor marker reflects what's actually going on.
QFinally, you have said that in your review of the records, you can see no place that Dr. Buttar had done harm to his patients.
AWell, not ‑- yeah, he's done harm. He's scheduled them in his office 40 hours a week and took thousands of dollars from dying patients for no good reason.
QWell, and today you said that the treatment did not provide a risk --
AI don't ‑- I don't ‑- well, first of all, I don't know what provides risks because these things haven't been put through clinical trials. I don't think it looks dangerous.
QHang on just one minute. Let's go if you would please, sir, to 77 ‑- no, I'm sorry, 119. Okay?
PRESIDENT RHYNE: Where is it on 119?
MS. GODFREY: In his deposition. Tab 51 to our ‑-
WITNESS: Well, where's the deposition one?
MR. JIMISON: 15 in the thin notebook.
MR. KNOX: I got it.
AWhich page?
Q(By Mr. Knox) 119, line 21.
AOkay.
QWhat about physically? Do you see any evidence that they were physically harmed by Dr. Buttar's treatment and what did you say?
AI said: No, but, you know, I wasn't there to examine them or talk to them. And the people doing the documentation were the people giving the bogus treatments, so I doubt they are going to write things down that are going to make them look bad.
QLet's go down to the next line. So there's nothing in your review that shows any visible harm whether they occurred or not, you don't know?
AThat's right.
QAnd I believe you said today at your earlier testimony that you didn't find any risks of the alternative treatment that he was giving these patients?
ANot that I'm aware of.
MR. KNOX: Okay. That's all.
PRESIDENT RHYNE: Before we do ‑- before we redirect, let's take a break.
MR. JIMISON: Oh, sure.
PRESIDENT RHYNE: I think everybody would like to take say a ten-minute break and we'll convene back and 4:10 and then we can continue.
MR. KNOX: We might can see if he doesn't have any questions ‑-
MR. JIMISON: No. I have questions.
PRESIDENT RHYNE: Let's just take a break.
(4:00 P.M. - 4:20 P.M. RECESS)
PRESIDENT RHYNE: Okay. Are you ‑- thank you very much on that.
Mr. Jimison, are you ready to go ahead and resume with redirect at this time?
MR. JIMISON: Sure.
REDIRECT EXAMINATION BY MR. JIMISON:
QDr. Peterson, I want to try to go through this very quickly. I know we've gone very long.
AExactly.
QAnd the therapies that Dr. Buttar provided, the hydrogen peroxide, the ozone, are any of those therapies indicated to boost their immune system?
ANo.
QAre you aware of any clinical trials that show they have an effect on boosting the immune system?
ANo.
MR. KNOX: Objection, asked and answered earlier.
PRESIDENT RHYNE: The objection is sustained.
Q(By Mr. Jimison) Well, I just ‑- if it actually was truly asked ‑- you know, answered earlier about how clinical trials have an effect of boosting the immune system, I think I might have asked about cancer. But the answer is you're not aware of any ‑-
ANo.
QThat was your previous answer.
And the ‑- the therapies that were being offered, did you see from your review of the records whether the patients indicated that they were consenting to any research?
ANo.
QAny ‑- that they were consenting to experimental therapies?
ANo.
MR. KNOX: Objection, been ‑-
MR. JIMISON: No, this was a different witness.
MR. KNOX: May I just make an objection. Give me a chance to say something. He asked all the questions about experimental and ‑- and whether the patients were placed in experimental on direct.
MR. JIMISON: I think these are different questions and ‑- and I think the objections are actually more long than the questions are, so if I could just keep going.
PRESIDENT RHYNE: Go ahead. I think as I recall without looking at the transcript, it was about cancer and not about the immune system.
MR. KNOX: Okay. I'm sorry.
Q(By Mr. Jimison) The ‑- the ‑- is there anything in the records that show that these patients were part of ‑- of an experiment or research that were being supplied by an Institutional Review Board?
ANo.
QIs cancer just a symptom of a faulty immune system?
ANo.
QIf you were to hear the phrase "cancer is just a symptom", what would you take that to mean?
ANonsense.
MR. JIMISON: Okay. I have no other questions.
PRESIDENT RHYNE: Ms. Godfrey and Mr. Knox, do you want to redirect?
MR. KNOX: No, ma'am. We're through.
PRESIDENT RHYNE: Okay. Any Board Members have any questions?
EXAMINATION BY THE PANEL MEMBERS:
DR. McCULLOCH: Now at this point, Dr. Peterson, would you ‑- would you agree that in each of these patients, traditional therapy, as you would describe chemotherapy, etcetera, had failed these patients?
WITNESS: Yes.
DR. McCULLOCH: Is it your opinion that there was any physical harm done to these patients by this other treatment at this point?
WITNESS: Other than 40 hours sitting in a chair, no.
DR. McCULLOCH: Right.
WITNESS: No.
DR. McCULLOCH: But I guess the point I'm trying to get to, would there have been any ‑- would they have been improved at all by staying in traditional therapy?
WITNESS: No.
DR. McCULLOCH: Okay. Thank you.
DR. WALKER: Are you aware of any toxicities from EDTA or from hydrogen peroxide that maybe you read in the newspaper or from any other sources?
WITNESS: Not hydrogen peroxide. The only problem with EDTA and I don't know how far you want me to push it, but it does, in fact, pull lead and heavy metals out of your system similar to -- (inaudible).
I mean for instance, we now prescribe -- (inaudible) -- to prevent prostate cancer and put prostate cancer patients on, so I really don't know what you are saying when you just start pulling out the metals.
I mean, you are supposed to have heavy metals. I mean, you're supposed to have copper and lead in your system. I mean, you're not supposed to deplete them. I mean, iron deficient ‑- iron is a heavy metal and iron deficiency -- (inaudible), so I don't know that it's necessarily safe to deplete it.
PRESIDENT RHYNE: Any other questions? Thank you very much, Dr. Peterson.
MR. KNOX: Unless you ask one, I won't.
WITNESS: Okay.
MR. JIMISON: Thank you.
WITNESS: Thank you.
MR. JIMISON: That concludes the Board's case, Dr. Rhyne.
PRESIDENT RHYNE: Thank you, Mr. Jimison.
Mr. Knox or Ms. Godfrey, do you have any evidence that you wish to present on behalf of Dr. Buttar?
MS. GODFREY: We do. We need to ask the Board about your timetables. We were originally told that Mr. Jimison would be finished by about 2:00 of the afternoon of the first day and we've run over about two and a half hours.
We have doctors that are supposed to be here first thing tomorrow morning to testify as expert witnesses and then we have one doctor who is testifying via videotape as an expert witness. Her videotaped deposition is an hour and 24 minutes. What we would like to do is get her in today, but we realize that would take the Board about until 6:00.
PRESIDENT RHYNE: That ‑- that'll be fine.
MS. GODFREY: Is that okay with you?
PRESIDENT RHYNE: That is okay.
MS. GODFREY: That would be ‑- now is the best time for us to sit and watch a video, I think.
PRESIDENT RHYNE: Okay. Just ‑- just for my information, so we'll have her and then how many witnesses do you anticipate tomorrow?
MS. GODFREY: We have ‑-
MR. KNOX: Let me ask you, what time are you going to start in the morning? We have one by phone at 8:30.
PRESIDENT RHYNE: Well, it depends on what you tell me because we can start at 7:30 or earlier. It depends ‑-
MR. KNOX: Well ‑-
MS. GODFREY: We make ‑- we're doctors, we make rounds at 7:00 or 6:30, so.
MR. KNOX: We have Dr. Wilson and Dr. Biddle and then of course we'll have Dr. Buttar and Jane Garcia. We have ‑- on video we have Dixon Hewitt. We hope to have a telephone conference and ‑- and we have another party. And one of the people is Michelle Reid who worked with Dr. Buttar and Ms. Kennedy testified about.
MS. GODFREY: We have some videos of patient ‑- patients of Dr. Buttar's that I think altogether take about a couple of hours, but we can work them in tomorrow.
MR. KNOX: We will have a full day.
PRESIDENT RHYNE: So we'll have a full day ‑- well, I will ‑- we will be happy to start at what time you would like, 7:30, 7:00, whatever.
MS. GODFREY: Whatever time you want to start.
PRESIDENT RHYNE: How long do you think it will take you to get through your ‑-
MR. KNOX: I don't know, but I would, like you, want to get back and so the earlier the better for me because I go about 6:30 every morning, they think I'm a doctor, so.
PRESIDENT RHYNE: That's fine. How about ‑- does anybody have any conflict. Barbie, do you have any problems starting say at 7:00? We'll start at 7:00 sharp.
COURT REPORTER: I'm at your pleasure.
MR. KNOX: Maybe 7:30. I mean, I'll do whatever you say, but ‑-
MS. GODFREY: 7:00 a.m.
PRESIDENT RHYNE: Let's start at 7:00.
MS. GODFREY: We can play videos.
MR. KNOX: That's fine. We'll put videos on if we don't have the doctors.
DR. WALKER: Oh, but you can't put the videos on and go to sleep now.
MS. GODFREY: No. Actually ‑- actually, our docs will be here because I believe they're coming in tonight and they'll spending the night, so they would be more than happy to get ‑- get in and out, I'll bet.
PRESIDENT RHYNE: Okay. So we'll start at 7:00 then.
MR. KNOX: Okay.
PRESIDENT RHYNE: Okay. You want to proceed then?
MR. KNOX: Your Honor, we're calling Dr. Ripoll by video conferencing. This is his deposition and we have agreed that she can be sworn by the court reporter in Charlotte and the transcript would be used at this hearing. Correct?
MS. GODFREY: And her CV is in our exhibits at ‑- at 31, I believe. And I think the only other exhibit that we used in her video deposition was Dr. Peterson's notes that I think they're already familiar with and I think that's Exhibit 8.
Didn't we use that? Oh, you weren't there, okay.
I think those are the two, but I do identify them by number during the video deposition, so if you'll just grab our book, then ‑-
PRESIDENT RHYNE: Okay.
MS. GODFREY: ‑- that's the easiest way.
PRESIDENT RHYNE: Okay. Do you need help with ‑- are you ready?
MS. GODFREY: We're ready, I guess.
The transcript of this deposition is also in your exhibit book at Number 48.
PRESIDENT RHYNE: I'm sorry, number 40?
MS. GODFREY: 48.
PRESIDENT RHYNE: Thank you.
----------------------------------------------------------
(WHEREUPON, THE VIDEOTAPE DEPOSITION
OF EMILIA RIPOLL, M.D. TAKEN ON APRIL 21, 2008,
WAS PLAYED AND IS HEREBY ATTACHED
IN ITS ENTIRETY AS EXHIBIT 48)
----------------------------------------------------------
PRESIDENT RHYNE: Can somebody turn on the lights? Okay. Do you have anything more to add? Are you ready to ‑-
MR. KNOX: I have a gentleman here who can testify and it might take ten minutes or so.
PRESIDENT RHYNE: Okay.
MR. KNOX: Let's go get Mr. Hewitt.
WHEREUPON,
RICHARD DIXON HEWITT,
being first duly sworn,
was examined and testified
as follows:
DIRECT EXAMINATION BY MR. KNOX:
QWould you tell the Panel your name please, sir?
ARichard Dixon Hewitt.
QAnd, Mr. Hewitt, where do you live?
AAnderson, South Carolina.
QAnd who lives with you?
AMy wife, Deana, three children, a boy, boy, girl; 12, 10 and 5.
QOkay. And what do you do?
AI'm a human resources director for Clareton Mills, a towel manufacturer in Delta in South Carolina.
QAnd how long have you been with them?
AAbout 17 years.
QAnd is your wife employed outside the home?
AShe is. She is a physical therapist.
QNow, you've had the occasion to take one of your children up to see Dr. Buttar, correct?
AThat's correct.
QAnd what's that child's name?
AHunter.
QAnd how old is Hunter?
AHe will be 13 next month.
QAnd tell the Board just a little bit about Hunter and how he did prior to going to see Dr. Buttar.
AAt the age of two and a half, three, Hunter was diagnosed and given a label of autism. And we bounced around from physician to physician, doctor to doctor, and he ‑- like I say, he's about 13, next month, and he's ‑- he's come along way.
He ‑- you know, he was taken out of preschool because he was not verbal and ‑- and ‑- and would strike out and would possibly create a danger to himself and others, so you know now he's, at times, in a regular education classroom, so.
QYeah. Was he diagnosed by a family doctor ‑- a family practice doctor that he was autistic?
AHe was. He was diagnosed by our family pediatrician, Dr. Keith Hart.
QAnd did he have certain lead toxicity tests before he went to see Dr. Buttar?
ANo, sir.
QAnd went you went up to see Dr. Buttar, did you see Dr. Buttar?
AI saw ‑- my wife and I, our original appointment was with Dr. Buttar.
QOkay. And tell this Panel what kind of doctor he was and how much time he spent with you?
ADr. Buttar in the first visit spent, I'm guessing, an hour to an hour and a half that first visit.
QOkay. And did he explain to you whether or not he could cure autism or whether he could help Hunter or what did he tell you?
ADr. Buttar felt like there was ‑- there was a possibility ‑- a very strong possibility Hunter ‑- Hunter had a toxicity issue and if that was the issue, that there was some help for him. And he outlined his treatment plan, what that would consist of. There was not any guarantee made.
He did feel as though that if the toxicity wasn't even an issue, he felt very strongly we could help him. And so it made sense to ‑- all of our research and ‑- and it made sense for us to try that treatment and therapy.
QAnd I'm trying to move along. Will you explain the policy of payments, whether insurance may or may not apply and the method of payment for the treatments?
AWe just paid for it. There was no guarantee of insurance assistance and we just, you know, put it on a credit card and hoped it would work out in the end, you know, with the ‑- you know, we paid on a cash basis.
And we knew ‑- again, I knew what I was getting into before I even walked in the door. I had called and ‑- and spoken with his staff on, okay, well, if we did this, what is it going to cost? If we did this, what's it going to cost? And so, I mean, I knew that going in.
QAre you satisfied now that Dr. Buttar's treatment of Hunter has been beneficial ‑-
MR. JIMISON: Objection, leading. It's leading.
MR. KNOX: I know. It's 6:30, I'm sorry.
QAll right. Tell me ‑- go ahead and tell us ‑- explain to the Panel what your observation is.
AMy current observation is ‑- is Hunter has got a long way to go, but he's ‑- he's come so very far. It's ‑- his ‑- his ‑- his toxicity was an issue. It was his amounts were grotesque. It was just ‑- it was toxic.
And so, you know, we cleaned him up, began the hyperbaric oxygen therapy and ‑- and he can do things. He has a quality of life now that before, there's no question he wouldn't have had. You know, when you get ‑- when you receive a phone call from your physician, physical education teachers that hasn't seen him over the course of the summer and he tells you what's ‑-
MR. JIMISON: Objection ‑-
A‑- what's going on ‑-
MR. JIMISON: ‑- that's hearsay.
PRESIDENT RHYNE: I couldn't ‑-
MR. JIMISON: That's what ‑- what the teacher said.
AI received ‑-
MR. JIMISON: Objection as to what the teacher may have said.
AI received a phone call from the teacher.
PRESIDENT RHYNE: Go ahead and proceed.
AAnd the teacher asks what's going on with Hunter. I mean, he's ‑- he's ‑- his fine motor skills, gross motor skill is remarkably different and better, what's ‑- I mean, what's going on. That tells you all you need to know as far as how far he's come and whether he's benefited from the treatments.
And my observation is I'm an ecstatic parent because the quality of life my son ‑- I see for my son versus what he had is not parallel.
QOkay. How many drugs was he on at the time he came to Dr. Buttar?
AFive ‑- at the time he walked in the door, he was on five medications. It might ‑- at one point in time it was seven and started out at one, but when he walked in the door he was on five medications.
QAnd how about now?
AHe's not. He's ‑- he's on vitamins and minerals and ‑- that's ‑- that's what he's on.
MR. KNOX: All right.
PRESIDENT RHYNE: Yeah. Mr. Jimison, do you want to cross-examine.
MR. JIMISON: No.
PRESIDENT RHYNE: Any Board Members?
EXAMINATION BY THE PANEL MEMBERS:
DR. McCULLOCH: You said your son was toxic and I'm happy for your ‑- for his improvement.
WITNESS: I mean, there's things you're going to hear about.
DR. McCULLOCH: You said he had toxic levels of something.
WITNESS: Yes, sir. Mercury, lead, zinc.
DR. McCULLOCH: And ‑- and those toxic levels were based on what?
WITNESS: We did labs ‑-
DR. McCULLOCH: I guess my ‑- my question is, your description of him being toxic is based on which ‑- what was ‑-
WITNESS: What my understanding of ‑- of a high ‑- abnormally high level was.
DR. McCULLOCH: And where did you get that understanding?
WITNESS: From my research, from the laboratory results ‑-
DR. McCULLOCH: And from Dr. Buttar's office?
WITNESS: Yes, sir. There were three parts. The lab gave you results, Dr. Buttar gave you results and I came up with what I thought were my own results.
DR. McCULLOCH: Thank you.
PRESIDENT RHYNE: Were these blood, urine, hair samples or what, and from the same lab.
WITNESS: Fecal, blood, urine. It was a lot of them.
PRESIDENT RHYNE: Were the labs done in Dr. Buttar's office?
WITNESS: No. No, independent labs.
DR. WALKER: Did you have any of your other children tested?
WITNESS: No, sir. None of them displayed symptoms or were characteristic of ‑- you know, gave us any reason for concern. We did hesitate as far as vaccination with our five year old knowing what we, you know, knew, but we still went through with it, so. But we haven't had any of them tested, no, sir.
DR. WALKER: Do you have any ideas from your research why one child might have had toxic levels for what is presumably environmental contamination and nobody else did?
WITNESS: Yes, sir, I do and that's kind of what Dr. Buttar ‑- some information that he gave me was that, you know, perhaps Hunter has some type of genetic problem to where he just can't rid himself of ‑- of the metals. And if this was the case, then it's building up in his system to mimic the characteristics, you know, described in autism.
DR. WALKER: You know, most insurance companies will pay for treatment of metal toxicity. Did you ever try to get reimbursement from the insurance company?
WITNESS: Oh, yes, sir, we did. And we did receive some, but it was ‑- I would be willing to bet 95 percent of it was turned down.
DR. WALKER: Has your son ‑- I assume that at the beginning of this ordeal that you've been through that he went through the usual developmental testing that the psychologists do on kids who are having learning problems or other problems. Would that be true? I didn't mean to upset you. I realize that ‑-
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