Editor:
What was accomplished by defending Eleazar Kadile under the excellent counsel of attorneys Frank Recker and Ray Roder, with the advisory team of Tim Bolen, Bob Waters, and Terry Chappell, and with the financial backing of Wally Simons and many others? A settlement was reached. The initial statements of each section are the terms and conditions that Kadile's previous attorney strongly urged him to accept. The Outcome statements list what actually happened.

I. Accused of substandard treatment of several patients due to use of thyroid replacement, environmental medicine, and chelation therapy. There were no patient complaints. Outcome: all allegations related to patient care were dropped.

II. Chelation therapy was not accepted by the Board as an appropriate treatment for any of four patients in question. In fact, according to the prosecutor, Arthur Thexton, the Board's position was that chelation therapy was both ineffective and dangerous. Outcome: The Board made no findings or comments on the use of chelation therapy. In fact they stated that they had no position on the use of chelation therapy. Thexton's statement was found to be inaccurate.

III. The Board contended that Robert Baratz, as state's expert, was qualified to give admissible testimony on all aspects of the charges, including his broad-brushed indictment of CAM. Outcome: This finding was deleted. Although the judge did not dismiss Baratz altogether, during cross-examination, Baratz was discredited on many points (see section XVIII below). His testimony is now public record and can be used against him wherever he surfaces as an "expert" witness in the future.

IV. The Board accused Dr. Kadile of "unprofessional conduct" relating to the treatment of several patients using chelation therapy, natural thyroid replacement and environmental medicine. Outcome: The Board reprimanded Dr. Kadile for minor advertising statements made almost 10 years ago. No mention of unprofessional conduct nor any of these therapies was made.

V. In order to treat patients, Dr. Kadile was to be ordered to first inform all other primary care physicians and cardiologists in writing of his diagnosis and treatment plan. Outcome: Provision was deleted.

VI. Dr. Kadile was to be forbidden from prescribing any drugs for uses not FDA-approved (i.e. off-label drug use was forbidden). Outcome: Provision was deleted.

VII. Dr. Kadile was to be forbidden to prescribe any compounded drug or drug product. Outcome: Provision was deleted.

VIII. Dr. Kadile was to be forbidden from ordering any laboratory test from commonly used laboratories in Complementary and Alternative Medicine (CAM) without full disclosure that the test was experimental and found to be inappropriate and possibly dangerous by the Medical Board (there was no evidence that the Medical Board had made these determinations). Outcome:Provision was deleted.

IX. Dr. Kadile was to be forbidden to sell any goods or article for other than actual cost without a detailed informed consent that the patient is purchasing the article voluntarily and is aware that he or she can purchase it elsewhere. Outcome: Provision was deleted.

X. Dr. Kadile was to be forbidden to use any unconventional treatment, including chelation therapy, natural thyroid replacement, and environmental medicine without a detailed informed consent that included a statement that the Board had examined the therapy in question and found it to be inappropriate and possibly dangerous (another incorrect statement). Outcome: this provision was deleted, except that a mutually agreed upon informed consent will be required for treating a patient with chelation therapy. It was also agreed that a patient would have a three-day waiting period prior to receiving chelation therapy, unless the patient had received it elsewhere. The Board stated that it had no policy against the use of CAM. After Tim Bolen met with Sandra Rowe, the new chief of enforcement in Wisconsin, she told him that they no longer were going to go after CAM docs. She agreed to work with Bolen on resolving the 13 cases in Wisconsin that he was working on. Rowe admitted that they had a significant problem with two prosecutors in her department and stated that in the future they would be closely supervised.

XI. Dr. Kadile was to be required to hire an outside monitor to review his medical practice on a regular basis for at least three years. Outcome: this provision was deleted.

XII. Dr. Kadile was to be reprimanded for stating in the newspaper that he had been certified by the Board of Environmental Medicine, when the actual name of the Board is the American Board of Environmental Medicine and he was told that he must specify that this Board is not recognized by the American Board of Medical Specialties (most are not). Outcome: this provision was deleted but was mentioned by the judge in his decision on costs.

XIII. Dr. Kadile's wife, Genia, continued to be attacked by prosecutor Thexton for using a title of certified nutritionist because she was not certified by Wisconsin, although she was indeed certified by the state of New York. Thexton continued his attacks on Genia even after the settlement of Dr. Kadile's case. Outcome: another judge then threw out the case. Initially, Thexton objected, but the next day he told the judge that he had been ordered to withdraw his objections.

XIV. The news media was highly critical of the Department of Licensing and Regulation for its prosecution of Dr. Kadile. Tim Bolen put a tremendous amount of pressure on the DORL, asking all sorts of embarassing questions. He also exposed that the prosecutors were under direction of the National Council Against Health Fraud. Outcome: The Medical Board called a special session to settle the Kadile case with only a minor reprimand, and a medical school evaluation that would not address the use of CAM. The worst that could happen is that Dr. Kadile would be required to take a CME course on record keeping or another topic. The Madison newspaper carried a story after the settlement with a headline that stated, "Board Allows Chelation Therapy: Medical Examining Board agrees to let Green Bay doctor offer the heart disease treatment." The DOLR agreed to work with Bolen to minimize the need for Legislation, although Tim and others are still working actively with the Legislature. Because prosecutor Thexton may have violated the Judge's instructions and tried to prejudice the University of Wisconsin about Dr. Kadile prior to his evaluation, Dr. Kadile filed a formal complaint to void the evaluation requirement. This was later withdrawn as part of the cost settlement.

XV. Thexton openly stated that his next target after Dr. Kadile was Dr. Waters (for chelation) and then he was going after the other doctors who do environmental medicine in Wisconsin. Outcome: Almost immediately after the settlement of Dr. Kadile's case, Thexton was removed as prosecutor in the investigation of Dr. Waters, and then the investigation of Dr. Waters was dropped altogether. During the Kadile case, Thexton was admonished by the judge that he was trying to make his own rules for physicians as he went along. Thexton tried to defend himself by stating that the reason he did this was because he could not get the Medical Board to make the rules he wanted! The desired rules are of course the agenda of the NCAHF. These efforts by Thexton were later repudiated by his supervisor.

XVI. As a result of the public outcry over the injustice to Dr. Kadile led by Tim Bolen and Dr. Kadile's patient support group, legislation was introduced into the state legislature and moved to the floor that would officially sanction chelation therapy in Wisconsin. Several other pieces of legislation are contemplated due to the abuses of the DORL in this case and others.

XVII. In late January, 2004, there was a hearing by the administrative law judge on who was to pay the costs of this proceeding. It was revealed in the media that Baratz had charged almost $100,000 in expert witness fees, more than all the other expert witnesses for the Medical Board combined over a two year period. Thexton demanded that Dr. Kadile pay more than $75,000 in costs. Outcome: The Administrative Law Judge ordered Dr. Kadile to pay $15,000 of costs, primarily to cover his time in hearing the advertising part of the initial complaint that was sustained. He was not ordered to pay any of the costs related to Baratz's testimony or any issues related to CAM. Dr. Kadile agreed to do this to avoid considerable more expense that would be required to object to this decision.

XVIII. Baratz was initially disqualified as a witness on chelation therapy because he had no experience with the therapy and did not meet the AMA qualifications as an expert witness. The judge later reinstated him because Thexton threatened to start over with another member of the National Council Against Health Fraud, who is also a professional witness. In the end, the defense and the judge successfully pressured Thexton to delete any mention of Baratz as a recognized expert for any pertinent field in this case. None of the medical procedures that Baratz testified about were included in the settlement. They were all deleted. Medical Board members throughout the country will be made aware of the need for true peer review in evaluating emerging technologies, as well as several other issues from this case.

XIX. Unfortunately, Dr. Kadile was not given the best legal advice initially in the case. When he changed attorneys, he did much, much better. He and Dr. Waters both used some common law advice that was very helpful but not decisive in their cases. ICIM raised more than $80,000 to help pay the bills of attorneys Frank Recker and Ray Roder. Wally Simons contributed in a major way to expenses and with his timely payment for Recker's fees. AAEM raised $11,500 for a defense fund. Dr. Kadile himself paid more than $73,917, and he has been billed $89,000 more from his previous attorney. He still owes $107,500 to Attorneys Recker and Roder. Negotiations on the latter two amounts are in progress. Outcome: Dr. Kadile still owes massive legal bills, even with all the help that he received from colleagues, pharmacists, patients and suppliers of CAM products and services. His previous attorney might have jeopardized his claim to fees by siding with the prosecuting attorney against Dr. Kadile in one of the pre-hearing issues after the attorney had been dismissed. At that time the Judge suggested to Dr. Kadile that he should consider filing a complaint against previous counsel for not releasing his records of the case. Between the DOLR and Dr. Kadile, the total cost of the proceedings was about half a million dollars. Tim Bolen is taking the initiative to try to work with the Medical Board to insure that such a horrible waste of money, time and effort does not happen again, as a result of an out-of-control prosecutor linking up with a special interest organization with an agenda.

Dr. Kadile has been vindicated. The Board has evaluated all the details of his CAM practice and has determined that it is acceptable for him to practice CAM like he did before, except for a little caution with his advertisements and a pending evaluation of his medical records by University of Wisconsin. He might have to take a CME course if his evaluation by the University of Wisconsin recommends it. To some degree this process gives him protection against future actions by the Board. The Board certainly seems to have completely changed direction on CAM due to his case, and they have assured us that their prosecutors will be much more closely supervised in the future. If Dr. Kadile had accepted the advice of his previous attorney, the settlement offered would have made it impossible for him to attract new patients or practice medicine using any CAM techniques. Further, the13 cases in Wisconsin and many others across the country would be at a much higher risk due to this case setting an awful precedent. He made a courageous stand, at great personal and financial sacrifice, to defend the type of practice that many of his CAM colleagues utilize on a daily basis. Because of his victory, many others will be able to practice freely and in the ways they can best help their patients, with much less fear of unjust harassment from their medical boards.

Further contributions toward helping Dr. Kadile pay his outstanding legal bills (more than $100,000 is still owed to Attys. Recker and Roder) can be sent to:
ICIM Advanced Medicine Legal Fund
P.O. Box 248
Bluffton Ohio, 45817 USA
or
Kadile Defense Fund
American Academy of Environmental Medicine
7701 E. Kellogg, Suite 625
Wichita, Kansas 67207 USA

Terry Chappell, MD

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