Part 2: Meryl Nass, MD Testimony before the Maine Medical Board
Courtesy of LIVEstream CHD.TV
This is a continuation of Meryl Nass, MD’s Hearing before the Maine Medical Board today. Pardon blurry photos, name spellings and other limitations as I literally took notes as the hearing was LIVE. Thank you, CHD.TV for an amazing window!
Attorney and Third Amendment to Hearing, CR 22-4, Concerning 1,2,3: This was the first time they heard of it, awaiting Asst. Atty. General after the hearing, to address this concern.
Dr. Meryl Nass Testimony:
Asked to raise her hand, swore not to receive assistance during her testimony by looking at notes or documents; will at all times expose who is in the room with her during her testimony, other than Atty Levy; and to tell the truth, the whole truth during this proceeding. She said YES. Atty Levy confirmed no one else was in the room with him during this time, as well.
Board Member: Asked Dr. Nass to view Exhibit 9, Patient #1’s chart; Staff Exhibit 16 marked as page 105. and conform this is Patient #1. She stated some records were related to family members living in same home as Patient #1. She confirmed it is part of the medical record and was asked to deny there were additional records relevant to this case. She agreed they were missing records, as they had text messages but not medical notes. When asked again, she clarified they are missing medical records. The Board admitted it was missing some records.
Exhibit 9: 1st page is an email and the rest of Exhibit 9 was being sent to the court. It is a couple pages: Rx, treatment note, a piece of line paper. Dr. Nass agreed it seemed to agree but they clarified she has NO pagination on the bottom right corner of her document, so it appeared they may be looking at two separate documents. When asked why her pages have no pagination on the bottom, a person stated Exhibits used by Board Staff were reduced from 5 to 1 documents, using a chart provided by Board Staff (not board numbers), but all pages were identical. They said to agree to proceed but in the future, everyone needed to have paginated documents.
Dr Nass: Asked to verify Exhibit 9 has 3 pages, Exhibit 16 has text messages she sent. Dr. Nass clarified they were texts she both sent and received. When asked if there were additional records, she stated NO. Dr. Nass’ attorney was asked not to intervene with Dr. Nass’ answering questions. Dr. Nass asked for 15 minutes to review additional text messages.
Started with Exhibit 8, Name is Patient #2. Dr. Nass stated that what she wrote in this email was that “these were texts regarding Patient 1”. The Board said, OK, asking as going through it, there are additional text messages, to which Dr. Nass confirmed. More conversation about the page numbers on the bottom right serial numbers of each page; asked to view 0041. Gray text on the left is Patient 2, confirmed. Recap: Email is patient 1 by name, but it is regarding Patient 2.
Exhibit 10. Similar text messages with slightly different transmittal to Board, which Dr. Nass confirmed.
Exhibit 20. Cover email was chart for Patient 2, confirmed by Dr. Nass.
Exhibit 21. More documents on Patient 2, confirmed.
Exhibit 22: Cover email, Patient 2, confirmed also by Dr. Nass.
Having reviewed Exhibits 8, 20, 20, 21, and 22, Dr. Nass was asked if there are additional records to these on Patient 2. She stated she was “happy to make the assumption” this is complete, but admitted to not exactly knowing if it is complete. Looking at Exhibit 22, Dr. Nass asked to review the Exhibit numbers to which she did not see a prescription that was part of his record, so she was “not sure” this is a complete record. Then she found a prescription, and stated, “as far as I know, these are complete.”
Exhibit 28: Transmission email to Board staff regarding Patient 3 is confirmed by Dr. Nass. She was asked to look at its two pages as the entire patient record, confirmed by Dr. Nass.
Patient 1, Exhibit 9: Atty Steigleman. Confirmed this is a 69 year old female. Page 3: confirmed this is PAtient #1’s name; he asked if the date September 28, 2021 was the date of treatment? She said no, the date was not a “treatment visit” and described the meeting was an initial encounter while the patient was well, how she would be treated if she was sick. All healthy patient visits left the patient with the option with how they wanted to be seen, by telemedicine or in-office. The patient agreed to do a telemedicine visit by phone. She had one telemedicine visit on 9/28/21, charged for one visit $60 for 30 minutes to have all their questions answered. He reasked the question,
“Did you ever meet with the patient in person?”
She said NO, it was a telephone visit.
Going back to the document, Patient 1’s name is on top of the document, dated 09/28/21 and there’s a date ending with 52, which Dr. Nass clarified was a birth date. When asked where the form originated, Dr. Nass stated it was from the Board of Internal Medicine. When asked 1/3 down the page if there was a “CC”, Dr. Nass said,
“That is what it stands for”,
to which she was interrupted and he asked if it was written,
“Unvaccinated, has HCQ at home.”
The attorney stated that she gets to answer the question, which was repeated. PAtient' 1’s Chief Complaint was that she was “unvaccinated”? Dr. Nass said No. When asked if “HPI” stands for “History of Present Illness” to which was affirmative. Then “sister getting very sick”
Attorney asked not to speak to client unless he asks for a break.
Under HPI, blanks for blood pressure, pulse oximeter, and he asked if it was left blank, which Dr. Nass affirmed. She stated that the telemedicine visit was such that she was unable to do vital signs. When asked if this was for prophylactic treatment, she denied the use of the term “prophylactic”. More review of her note showed a list of prescription, “IVM”, affirmed as being ivermectin. Also: zinc, vitamin D, acetylsalicylic acid. Asked if one prescription, three recommended supplements were written as a treatment plan? She said, No, the 30-minute discussion did not explain everything that was discussed. She admitted the not did not tabulate everything that was discussed, this was not a primary care visit, and was just a consult using an unmodified form that was later updated to reflect a modified form. She admitted the modified form was not in evidence.
Page 47 or PDF form page 48: Guessed that they were referring to a prescription, which was confirmed, as Patient 1 with same birthdate, same note date of an ivermectin prescription which was verified by Dr. Nass. After this date, she was asked if the next date of contact was about December 15, 2021. Then they turned to Exhibit 16, text messages of December 10th, Exhibit 16, with a family member talking about ivermectin. Dr. Nass admitted that no exact reference was made to the Patient 1. At the bottom of the page, December 15, 2021 text said,
“We are all suffering a lot…”
and goes to the next page of text to December 17, 2021. Dr. Nass admitted texts were between Dr. Nass and Patient’s 1 adult child, in reference to Patient 1’s husband. When asked if Patient 1’s husband was also a patient, she asked if it violated HIPPA regulations? She stated yes, both were patients, both Patient 1’s husband and son.
Exhibit 9: Third page, marked as page 48 with pagenation of September 28, 2021. The right side of note said, 12/17 and “just beginning to turn a corner, doesn’t need a new Rx”. Dr. Nass confirmed Patient 1 was turning a corner on having COVID. When asked about looking at the note, how do we know the patient was beginning to turn the corner about COVID? Dr. Nass replied re: this particular patient, she was told on two phone calls that the patient did not require additional attention. The Board member said a future reviewer would have to “guess” this was about COVID. Rephrasing, he asked if there was an indication that Patient 1 had COVID? She replied,
“Not from this page, but from the rest of the chart, you would know that she had COVID.”
Next page: Other than the prescription form and note, looking at a binder paper. Asked if she would know the patient had COVID on this date, Dr. Nass said this note was a phone call, and it was clear that she was only a patient for COVID, not primary care, and these were brief note. After this phone call where the patient was advised to go to the ER despite her not wanted to do so, she did go. All three patients in the same family were corresponded with for three consequetive days. The son was doing most of the talking for the family by phone call or text, all regarding the care of all three patients. Re-confirmed the correspondence was to/from the adult son. Asked if Patient 1 gave express permission for Dr. Nass to discuss her care with the adult son, she replied,
“…three people were living in the same home, everyone agreed” he would be the spokesperson.”
One person was noted to be missing from the table, to the hearing was dropped. Later, she said her internet went out.
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