Part 4: Dr. Meryl Nass' Hearing Testimony with the Maine Medical Board
Chat Messages, All LIVE Courtesy of CHD.TV
After one member dropped off the call, a break was called. Sorry for any typos, etc because I literally typed this as they were speaking.
CHAT NOTES ARE IN BOLD, WITH TIME STAMP
DoNotComply 11:16am“Neuropsychiatric evaluation” — who in the world will conduct THAT?
KarenT 11:17amThink this is all about scaring other doctors into compliance
Abi11:17amThey are being exposed! All they care about is the money! As a doctor myself, I'm ashamed of my "professional" colleagues! 🤮
Scott Rn 11:17amFirst time watching a kangaroo court. Why are they not doing this in person,
I.M. Nottaborg11:17amAnother persecuted doc pointed out he wouldn't have received 5 letters right away from his hospital if he had killed people with remdesevir
Dino11:17amI was shocked when I saw that none of them had masks on.
Someone11:18am@Dr T 😂
KarenT11:18amAnyone know where we can leave notes of encouragement forDr.Nass? Maybe her sub stack is best?
Ayse Deniz11:18amYes, massive attack on patients' privacy.
CatM11:18amHow is this hearing serving the people of Maine? I see a witch hunt. No more no less.
Apologies for name misspellings.
Assistant Atty. General Seigleman: A question had been asked if Patient 1 give permission to have her son speak on her behalf. Atty asked again if Dr. Nass asked permission, and Dr. Nass answered,
No, because I didn’t need it.
Q: Do you think Patient 1’s medical record was adequate? When asked why, he further explained it was persuant to Medical Board rules.
Asked if her medical record included an informed consent, all phone calls. Dr. Nass explained she was told by the family that she was “doing okay” so she took them at their word. Every time there was an indication someone in the family was severely ill, she made a phone call back; these were not office visits.
Q: What is your understanding of the difference of a telemedicine vs in-office care? She cited her years of experience, stating her records are essentially adequate. When asked if her medical record Patient 1 includes all relevant aspects of symptoms, full basis for diagnosis, Dr. Nass reiterated she was only seeing her for COVID, and that her record was adequate. During phone appointment when she was healthy, she believed her documentation was adequate.
Q: Was your informed consent adequate? Was your risk/benefit analysis adequate?
Defense Atty: Informed consent in writing is only required for invasive procedures, and does not apply for ivermectin prescriptions.
Sorry for the blurry screen shot of the LIVE Hearing.
Q: Was your medical record for Patient 1 adequate for risk/benefit analysis for telemedicine? Her lawyer objected, stating there was no telemedicine requirement needed for ivermectin prescriptions. Dr. Nass stated that her patients were provided an incredible amount of time for questions, she does describe risks and benefits, she doesn’t specifically document informed consent was done, but her patients will confirm it.
Patient 2 on September 22, 2021 with year ending 60 per birth date: Exhibit Pagenation 21, Exhibit 227, Page 1, then Page 232 or PDF Page 233: A discussion of pages and exhibits occurred. Telephone consult confirmed, while Patient 2 was healthy. Dr. Nass stated she never met Patient 2 in person.
Dr. Nass verified medications, non-prescription supplements, with both being already taken by patient prior to appointment.
Q: “CC” is blank for this appointment, correct?”
A: Yes
Assessment Plan: the patient was “high risk” of having a severe case of COVID, if he eventually got it. # 85, #16 and 17 tabs - referred to the initial ivermectin prescription.
Blood pressure, pulse, oxygen saturation: Dr. Nass agreed vitals and physical exam were left blank.
In the Assessment Portion, it says, “High Risk” and “ivermectin” and she confirmed there was no reference to “COVID”. She verified the same dose/ quantity were prescribed as written on her note.
Next contact was in December 11, 2021, page 232 with her standard form.
CHAT:
Jean11:49amThey are phishing. He doesn't know what he is doing.
Were you in direct contact with Patient 2, or with someone else? Dr. Nass stated she thinks, according to her recollection, that she was in contact with his wife.
Page 234, text messages show she is touch with his wife; Dr. Nass confirmed. On December 15, 2021, this was also Patient 2 she is directly texting. Dr. Nass confirmed seeing four texts on the next page 235 about Patient 2, showing pulse oximeter dropped to 82%, chills, no energy, and asked if she received permission from a third party to discuss the patient with his wife? Dr. Nass described the standard of care was they were both on the phone together, and talking with one is talking with the other. She described both had COVID at the same time, the wife was in better condition than the husband, and she did all the talking. She spoke to both while healthy during the initial ivermectin prescription. Dr. Nass stated she did not need Patient 2’s repeat permission to speak to his wife, as she already had permission. She was surprised this is something “shocking” to the Board.
A question was asked that she just testified that Patient 2 agreed that Dr. Nass could speak to his wife regarding his own care. She said he effectively did it by being present together in the same room. She stated one patient may be more competent than the other, and the Board Member asked if she documented that permission.
Objection: What statute or rule requires such documentation? To which there was no answer.
Dr. Nass was asked to answer the question, to which she replied that she was not required to have such a written documentation of said permission.
Q: She is in text contact in September 2021 then in December. Asked if that was her only contact, she had extra contact with them. They were unable to fill, and Dr. Nass described she facilitated the ivermectin prescription dispensed with a compounding pharmacy in New York, something the Medical Board perhaps helped make difficult.
Q: Your record does not talk about COVID.
Objection: Requested he would yield if someone showed him the rule.
The content was allowed; the question was repeated. She was the patient’s COVID doctor, the patient had COVID, but there is no record of “COVID” in her medical record.
CHAT:
concerned grandma11:52amMy husband always goes to doc visits with me when I want him there.
Objection: The same. The attorney was told not to keep objecting, as his objection is noted.
A: Dr. Nass stated that COVID was specifically discussed with the patient’s hospitalist, as well as his differential diagnosis; the chart was in a place where only COVID charts were. There was no need for her to specify COVID unless he got it, then that is what she treated in December 21, 2021.
Q: Did Patient 2 get a COVID Test?
A: Dr. Nass stated this “box” was a “note for a phone call” and the only reason the patient would call her was for COVID, so it was “pretty obvious” that this was about COVID.
Q: To your knowledge, did Patient 2 get a COVID Test from a practitioner?
A: The chart does not reflect this, so I do not know…. Let me tell you a little bit about diagnosing in medicine. Some you can make on the phone, and in the case of COVID, tests don’t always give the answers and you wouldn’t need a doctor. In this particular care with this Patient, it is complicated because he has multiple conditions that put him at high risk. That’s why he was given a phone call, she documented the most relevant matters, she diagnosed and treated him properly, and told him at the original visit to tell her if he got COVID. She wanted to be sure he got the maximum treatment possible with ivermectin and hydroxychloroquine. She was not allowed to prescribe HCQ ahead of time, which was why he was to contact her if he got sick.\
CHAT:
Ayse Deniz11:54am You spoke to the man's wife, so we'll suspend your diploma!
Q: Two pages prior to that, a phone call, Page 230: Documents a phone call with Patient 2 on December 15, 2021 - she confirmed.
Patient had a fever, oxygen saturation of 89%, and Dr. Nass confirmed. It lists symptoms including colored sputum, sweating and chills; Dr. Nass confirmed.
CHAT:
Bahmi11:55amThe Maine board has been shown to be taking orders from higher ups. Who gave them that right to lodge absurd charges against this fine doctor?
Zumi11:56am Did they give her a transcript without page numbers on purpose?
At the end of the memo, it says, “Get CXR and let me know the result” to which Dr. Nass confirmed CXR is a chest x-ray.
Q: Do you agree that oxygen saturation below 90% requires emergency care? Dr. Nass said, “No.”
Q: Saturation of 89 or even 88%, did you advise the patient to go to the Emergency Room?
A: “I advised him to go to an Emergency Room or an Urgent Care to get a chest x-ray, yes.”
Q: I’m sorry, I’m not following. The note says to get a chest x-ray, right?
A: YEs, it does.
Q: Your testimony is that you advised patient through his wife to either get a chest x-ray or go to the Emergency Room? You left it up to the patient?
A: The patient can’t go by themselves and get an x-ray. A doctor has to order it. I didn’t order it. That requires another doctor to order it. The way you get that is to go to an ER or to an Urgent Care. Unless you have a primary care doctor who will order it for you…”
Q and A. Okay. Can you please go to the page before, the Board has this marked as Page 229? And that’s the last name of Patient #2, is that right? She confirmed. December 17, 2021 was the confirmed treatment date, two days after the original phone call. The top half is for the wife and the bottom half is for Patient 2. Dr. Nass confirmed this is correct. Below the patient date, is the names of both patients and “advice regarding hospitalization”. Dr. Nass confirmed.
CHAT:
Scotter 12:01pm They're just trying to find ONE stitch in the beautiful garment of her experience they can legally object to, with NO questions about her professional expertise.
CAS12:03pmI am praying that the truth wins here. Why it is so obvious to us and not the medical board is astounding. This never should have happened to Dr. Nass
Q. Now the patient is in the hospital. Moving 10 pages forward, page 239, A Dr. Welch at Midcoast Hospital. Did you ever speak to Dr. Welch? She confirmed.
Now back to page 228. December 19, 2021, page 2. Was this a Consult with Dr. Welch regarding Patient 2?
A. This was the two of us talking about a mutual patient, at the request of the family. The top half she received from Dr. Welch, the bottom half were thing she wanted her to consider, because she didn’t have a specific diagnosis besides COVID sickness and she encouraged her to consider additional issues, which is what Internal Medicine doctors are supposed to do.
Q and A. Was the patient on oxygen? Yes. The top of the page says he was on BiPAP.
Q. Did you have an opportunity to talk to the patient in the hospital?
A. No, it’s kind of hard to speak to patients on oxygen in the hospital.
Q. Did the patient give you permission to talk to Dr. Welch?
A. The patient’s wife gave permission for me to talk to Dr. Welch.
Q and A. Past email, Board Exhibit 244, same format as before. Patient 2, December 23, 2021. Dr. Nass confirmed he was doing better, now from oxygen 90’s to 42 - regarding oxygen delivery, not %. On a feeding tube. His wife didn’t know how much pressure support he was on. PC with Angela.
Q. Going back to Page 242, a text message, Exhibit 21. Starts on December 23, 2021 on the page before, the December 24 and 25th. Summarized that in late December 2021, the hospital successfully treated Patient 2, and he was subsequently released?
A. Dr. Nass elaborated, after permission granted, that yes, the hospital treated him after admission and he was successfully released. However, he had to extubate himself in order to facilitate his release.
Q. Regarding your record-keeping on PAtient 2: Does your medical record, in your opinion, document informed consent for the patient?
Objection: same objection raised to ask for a requirement or rule that stipulates Dr. Nass is required to write this. Same Board member said she understands the objection, she overrules it, and he does not have to keep making it. The question was asked again.
A. This was two questions, 1. There is no document of informed consent. 2. She did everything else for free, held his wife’s hand, made them okay with going to the hospital, spent maybe 3 to 4 hours with this patient and while there was only one telephone call three months earlier.
Q. Is there a different standard of care depending on your level of care?
A. Yes. It is different for Medicare. You have to document different things depending on the level of care.
I took a break at this time.
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