Patient cannot force hospital to treat with Ivermectin

Daniel and Claudia Pisano

Screenshot via WJXX/WTLV.

A Florida appeals court has ruled that families of COVID-19 patients cannot force a hospital to treat a patient with ivermectin, melatonin or other treatments against the hospital’s will. Citing state law, the judges decided that the patient had the right to refuse treatment or choose between treatment options, but did not force the healthcare provider to provide any specific treatment. any.

A consensus per curiam idea by a panel of three judges at the First District Court of Appeals – yes, proper names are singular – rejected the family’s plea and upheld a trial court’s decision. The lower court refused to grant an emergency restraining order to force Mayo Clinic Florida to carry out a process that included “specific doses of Lovenox, aspirin, Famotidine, Dexamethasone, Fluvoxamine, Doxycycline, Vitamin C, Vitamin D3, Zinc, Melatonin and ivermectin” for Daniel Pisano, A 71-year-old man is being treated at the Mayo Clinic for COVID-19.

According to the opinion, issued on January 14 but published on January 27, Pisano was admitted to the clinic on December 11, 2021, and his condition rapidly deteriorated. Within a week, he was on a ventilator and a medically induced coma in the intensive care unit. His family, including his wife Claudia Pisano and son Christopher Pisano, was told by doctors at the hospital that they had run out of possible treatments and estimated his chance of survival to be between 0-5%.

An outside doctor, Dr. Ed Balboa, who proposed an alternative treatment including ivermectin and other treatments, and Pisano’s family asked the Mayo Clinic that administers this approach, requesting to sign a disclaimer for the patient. hospital if they do.

The Mayo Clinic, like most hospitals, has a “closed staff” and allows only its own approved doctors to treat patients in its facility. In addition to not being an employee of or under contract with the Mayo Clinic, Balbona failed to meet several of Mayo’s requirements for physicians treating patients in their ICUs, including being “board certified on both critical care medicine and the primary field of physicians,” noted Opinion.

The hospital will not allow Balbona to treat a patient under its care, and no internal staff member is willing to carry out the complete process supported by the patient’s family. Some are available for certain medications, but are given in lower doses than Balbona would like. Ivermectin specifically objected, and no one at Mayo agreed to give that drug to Pisano:

In particular, no one on the staff of the Mayo Clinic is willing to prescribe or administer ivermectin. According to the Mayo Clinic, there is no evidence that ivermectin is as effective in treating end-stage COVID-19 patients as Mr. Pisano, it has not been approved by the FDA to treat COVID-19 and has no national or Internationally recommends its use for COVID -19. The Mayo Clinic prohibits employees from prescribing or administering off-label use drugs that are not supported by medical documentation and approved through the Mayo Clinic’s approval procedures.

Dr. Pablo Moreno Franco, Chair of the Department of Intensive Care at the Mayo Clinic, countered Balbona’s assertion that ivermectin is an effective treatment for COVID-19. He noted that the hospital has “created a multidisciplinary COVID-19 treatment review board to review substantial amounts of information to make recommendations and guidelines for the management of COVID-19 patients” and that the panel declined to recommend or approve ivermectin as a treatment for COVID-19. Specifically, as Franco stated in an affidavit, there is no credible medical evidence to support the use of ivermectin in terminally ill COVID-19 patients like Pisano.

Franco also raised other objections to Balbona’s regimens, stating that the recommended dose and frequency of ivermectin is higher than the standard dose for approved uses and that there are concerns. Concerned about side effects, including bleeding and interactions with other Pisano medications.

On December 29, 2021, Claudia and Christopher Pisano filed an urgent petition for relief of the restraining order in Duval County Circuit Court, and a hearing was held the following day, December 30. Pisanos argued. that Florida Probate Rule 5,900, allowing for rapid judicial intervention regarding medical procedures, allowing them to be relieved to order the Mayo Clinic to administer Balbona’s regimen, including ivermectin, and to submit research health and information about Balbona’s treatment of other COVID-19 patients to support their case.

The Mayo Clinic counters that no Florida appeals court has interpreted the 5,900 Probate Rule to operate in a way that forces a hospital to provide a specific treatment against a medical judgment by its own doctors. surname. The clinic also argued that Pisanos also failed to demonstrate sufficient legal authority to compel the hospital to implement the desired treatment regimen and failed to establish the essentials for ordered palliation.

Balbona testified at the hearing. He believes that ivermectin is helpful and has helped his other COVID-19 patients in the past. After being re-examined by attorneys for the Mayo Clinic, Balbona acknowledged several problems and criticisms with an ivermectin protocol for COVID-19:

On cross-examination, Dr. Balbona confirmed that he had never been authorized to use ivermectin in a hospital except in one case by court order. That patient died, not from COVID-19, but from bleeding. Moreover, no other COVID-19 patient he has treated according to his regimen is using a ventilator like Mr. Pisano. Some of his COVID-19 patients were hospitalized and treated by doctors who wanted to put them in intensive care or on ventilators, but they discharged themselves so Dr. Balbona could treat them. Balbona claims no hospital in Jacksonville allows ivermectin, although there are hospitals in South Florida. . . . He acknowledges that some major health organizations are either neutral in using ivermectin to treat COVID-19 or oppose it. The FDA has opposed it. He agrees that no major medical organization supports it.

Based on Jacksonville, Fla. TV stations WJXX and WTLV, Attorney at Mayo Clinic Ed McCarthy “Agreeing to the plea of ​​the family of Pisano who passed away due to ‘a very, very difficult circumstances’, but said that asking the hospital to provide a medical treatment was opposed by his doctor. would set a dangerous precedent.”

“The legal remedy they seek,” McCarthy argued at the hearing, “while well-intentioned, is asking the Court to replace its judgment with that of medical professionals, and says would, quite frankly, undermine the integrity of medical practice. ”

The trial court denied Pisanos’ claim of merit, finding that they had failed to demonstrate the ability to succeed on merit and could not establish that they were entitled to a preliminary order. The court order recognizes that the Mayo Clinic is a closed hospital and will not be required to allow an unlicensed outside physician at the Mayo Clinic to treat patients there. The court also ruled that a patient’s right to privacy is the “right to accept or refuse,” not including the “right to request a particular treatment.”

“There is no right, constitutional or otherwise, of a patient to substitute one’s judgment for a medical professional,” the trial judge wrote, citing another case just months earlier. (Case, Drock v. Medical Center Palm Beach Gardens, decided by the 15th Circuit Court of Florida on October 16, 2021.)

On appeal, the First District Court of Appeals dismissed some of Pisanos’ arguments as they were not raised and reserved it suitable for appeal. The opinion explains, remaining issues in court are whether Probate Rule 5,900 or a patient’s right to privacy and self-determination includes being able to compel the hospital to provide a certain treatment. and whether the trial court was correct in ruling that Pisanos failed to respond to the relief requests ordered.

On both of these issues, the intermediate appeals court ruled in favor of the Mayo Clinic.

Rule 5,900, the court noted, arose in 1990 Florida Supreme Court Case states that “a medical representative or designee may exercise a constitutional right of privacy to terminate life-saving treatment for an incompetent person if the person expresses such a wish while still having authorization.” The state’s highest court encouraged the Probate and Guardianship Commission to develop procedures to expedite judicial proceedings for these matters, and Rule 5,900 resulted.

Pisanos’ interpretation of Rule 5,900 attempted to stretch it too far, the court held:

As they argue, it does not “require” the court to intervene in medical treatment, but rather creates a expedited mechanism for limited medical disputes. The rule only requires the trial court to make a decision. It is silent on the extent of relief a petitioner is or may be entitled to under the basic law..

The appellants framed the issue as whether Mr. Pisano had a “right to choose life”, but that framing omits the legal dispute in question. No one disputes Mr. Pisano’s “right to choose life”. The question before this Court is not whether ivermectin or any other specific treatment is effective or reasonable. The answer to that question is clearly of paramount importance to Mr. Pisano and his family. But the petition before us raises a completely different, yet unrelated, legal question. The question here is not whether Mr. Pisano (or his deputies) can “choose life”; that is whether Mr. Pisano has determined the legal right to compel the Mayo Clinic and its doctors to perform a treatment they do not wish to provide. The answer is no.

The case law provides “no legal basis to appropriate the medical judgments of the treating physicians and compel them to perform medical treatment against their will,” the court wrote.

“Rule 5,900 does not provide a substantial legal basis for forcing a hospital, physician, or healthcare worker to perform treatment based on their perceived medical or ethical judgment. We agree with the trial court that the Appellants did not respond to the request for relief of the restraining order. Accordingly, the court’s rejection of the urgent petition is CONFIRMATION”.

Cases like WJXX and WTLV report, “One of dozens of countries in which families want to force hospitals to allow Ivermectin treatment and at least a third in Jacksonville.”

Daniel Pisano passed away last week, the family attorney said, after suffering a brain hemorrhage.

[image via WJXX/WTLV screenshot]

Is there a trick we should know? [email protected] Patient cannot force hospital to treat with Ivermectin

James Brien

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