Federal court case involving unlicensed health care practice

This federal court case involving unlicensed health care practice sheds light on some CAM testing methods.

Many of these testing methods lie in a legal gray zone, and our law offices advises physicians and others incorporating novel CAM diagnostic methods.

This federal case shows how courts might view such tests. Of course, the particular factual circumstances must be taken into account - among other things, that the case involved someone practicing naturopathy in a state where it was not specifically licensed.

The court said this about live blood cell analysis:

The live blood testing, although a common thread, was, the court said, part of the larger "scam perpetrated by the Defendant in bringing people into his office and then telling them they were very sick people who needed his services." And there was evidence at trial that Curran, not being a doctor, was not authorized by state law to perform or evaluate such a test, as well as that it was rare for parasites to be found in anyone's blood. Curran's test results were described by one doctor as "gibberish."

Here is the court's background summary:

Curran held himself out falsely as a medical doctor although his only training in the healing arts was in naturopathy, a system of treatment relying on natural remedies. The wire fraud and money laundering charged in the twenty-three-count indictment rested upon his posing as a doctor so as to entice patients into his office where he conducted expensive "diagnostic" tests he was not licensed to perform and frightened patients into purchasing dubious, overpriced treatments. Two counts were dismissed at trial, and the jury convicted Curran on the remaining counts after eight days of testimony and the admission of several hundred exhibits. The district court sentenced Curran to 150 months in prison, in the middle of the Guideline range, stating that Curran was a "menace" who "took advantage of [the patients'] worst fears" and "preyed" on them for reasons of "greed" as he undertook "a scam of the worst kind." In calculating Curran's base sentence, the court included substantial enhancements based upon the dollar value of the losses suffered by the victims of his fraud and their number, using as the measure of loss the fees his clients had paid him. The court also ordered Curran to pay restitution of these fees, totaling $ 1,425,061.62.

Again, the case involves unlicensed medical practice, but there is interesting language about the use of certain diagnostic tests including one involving 'biomeridians':

Curran, a high school graduate who had previously run a carpet cleaning business, became a practitioner of naturopathy in 1998. He had trained under a practicing naturopath for two years and completed a two-week program at a college of naturopathic medicine in Arkansas. He maintained an office first in Cranston, Rhode Island and then in nearby Providence. Although he had never attended medical school and did not have a license to practice medicine, he held himself out to clients as being a medical doctor as well as a naturopath. Rhode Island law prohibited Curran from holding himself out as a licensed physician and from diagnosing disease or treating it.

At his office, which gave the illusion that it belonged to a medical professional, Curran wore a lab coat with a name tag reading, "John Curran, N.D., M.D., Ph.D." In the printed materials he passed out to clients, including business cards, prescription pads, and pamphlets, Curran referred to himself as an "M.D.," "N.D.," "physician," "doctor," and a medical school graduate. Just as he had not earned an M.D., he had also not earned a Ph.D. The sign on Curran's office door read, "Dr. Curran's Office." The nameplate on his desk said, "John Curran, ND, MD, Board Certified Naturopath." Diplomas and certificates bearing his name were framed on the walls, including one from an unaccredited medical school Curran had never attended, and one referring to the purported Ph.D. In a written statement describing the mission of his office, he said, "GET THEM IN THE DOOR! (w/o looking like a huxster [sic])." Curran claimed he had cured people of, inter alia, cancer, liver failure, hepatitis C, paralysis and infertility. Staff were instructed to tell prospective clients that the office had an eighty percent success rate.

When new clients came to see him, Curran would perform a preliminary consultation in which he explained his services. Curran and his staff would ask what he called "open ended diagnostic sounding questions" to emphasize the allegedly medical nature of the discussion. Curran would then charge $ 950 for a "full-body assessment," which consisted of measuring the client's body heat using a thermal imaging device, hooking each one up to a "BioMeridian Stress Assessment Device" which Curran claimed evaluated the client's internal organs but which is not approved for diagnosing disease, and finally, testing the client's blood by using a microscope attached to a computer. State and federal authorities had warned Curran that he was not allowed to perform such blood tests because he lacked the proper credentials, and Curran had promised in writing to stop using the procedure. He did not do so. Curran testified at trial that while before the warning he had performed a one-to-two hour live blood analysis, after the warning he switched to performing a shorter, fifteen-minute "live blood demonstration" he felt he was permitted to conduct. He conceded that he had not confirmed such authorization with the Rhode Island Department of Health.

There was testimony by former patients that, after doing the tests, Curran told them that they were in very ill health. He said to them that they had blood abnormalities including live parasites, double-headed parasites, worms, holes, big eggs, green- tinted cells, red crystals, dying cells, "dormit cells," severely reduced blood cells, and/or no white blood cells. He also purported to diagnose deficient body functions or immune systems, "fungus on the liver," defective lungs and kidneys, or "organs in distress." On occasion he indicated the existence or possibility of the existence of a life-threatening illness like cancer. One doctor testified that Curran's records of the results of some of these tests were "gibberish." A doctor testified at trial that while parasites can on rare occasions be found in the blood, such cases are extremely unusual.

There was evidence indicating that Curran's technique included scaring his clients, telling one young woman that "at the rate she was going, she wouldn't live until 25," and telling another woman that her "immune system was completely shot" and that "within a couple of months [she] could be dead." Having scared the clients, Curran offered expensive treatments to them, telling them, "You can't put a price on health." Curran offered "green drink," which he claimed was a nutritional supplement he had invented, containing "a synergistic blend of all natural compounds that support and promote the body's overall ability to fight and prevent diseases." Though Curran sold this item in buckets priced at $ 600, $ 1,000, and $ 2,000, it was a commercially produced liquid that usually sold for only a small portion of Curran's mark-up.

Another one of Curran's proposed "cures" was "Specially Energized water," which he said had the "same Synergistic healing properties as the water in Lourdes, France." The water was actually distilled water Curran ran through a blender. He also sold therapies named hydrotherapy massage, SpectraColor spa, hyperbaric chamber, ionic cleaner, massage capsule, and personal sauna.

Though Curran began his practice as early as 1998, the government's evidence at trial emphasized the years 2003-4, during which period Curran "treated" 340 clients. In each case, Curran performed at least one live blood exam, which in turn led to the diagnosis of one of the invented ailments listed supra. Each client bought one or more of Curran's treatments for a cost in some instances of more than $ 10,000. In those two years, Curran made $ 1.4 million in income doing this kind of evaluation and "treatment" of his clients. Urged by one of his former naturopathy teachers not to pretend to be a medical doctor, Curran responded, "Some people will think I'm a medical doctor, some people won't. I don't care what they think as long as they give me money." He continued, "I'm tired of being broke. I want to make as much money as medical doctors."

As part of his ongoing fraud, Curran made interstate wire transmissions, including a fax to a company which printed one of Curran's misleading pamphlets; an email about the purchase of one of his Ph.D. diplomas; a faxed sales agreement to buy a BioMeridian machine; a faxed application for a line of credit in the name of a parent of one of his clients; and related credit card and credit line transactions involving client payments.

In his defense, Curran testified to believing in all of the methods and products he used and denied any intent to mislead clients about his credentials. He admitted to telling clients "you can't put a price on your health" but also claimed that he regularly told clients that he was a naturopath who had later earned "honorary" and "academic only" M.D. degrees. At sentencing, Curran's counsel submitted letters from fifty-six of Curran's former clients saying they were happy with Curran's work and/or had not been victims of fraud.

There are some emerging diagnostic procedures that might receive legal protection if within an appropriate practitioner's scope of practice, and framed by a well-drafted informed consent that documents a robust consent process, where the medical literature supports the approach. But the above case suggests what can go awry especially when combined with issues of unlicensed medical practice.