Geier v. Maryland State Board of Physicians
116 A.3d 1026
Md. Ct. Spec. App.2015Background
- The Maryland State Board of Physicians revoked Dr. Mark R. Geier’s medical license after finding he prescribed Lupron and chelation therapy to children with autism without adequate evaluation, monitoring, informed consent, or appropriate IRB oversight; the Board found false credential statements on renewal applications.
- Administrative hearings included a prior summary suspension proceeding; the ALJ recommended revocation on multiple grounds (unprofessional conduct, false records, failure to meet standards, inadequate records), and the Board adopted the ALJ’s recommendation.
- Geier filed petitions for judicial review in three Maryland circuit courts, dismissed two voluntarily, and pursued review in Montgomery County; the circuit court affirmed the Board’s decision and denied the Board’s motion to dismiss the Montgomery petition as barred by Md. Rule 2-506(c).
- Key factual findings: Geier often treated patients without face-to-face physical exams or required diagnostic testing (e.g., bone age/Tanner staging), used DMPS (not FDA-approved) while providing consent forms stating DMSA, and represented that a purported IRB approved protocols though the IRB was composed largely of affiliated members.
- The Board concluded Geier’s conduct violated HO §§ 14-404(a)(3)(ii) (unprofessional conduct), (a)(11) (willful false report/record), (a)(22) (failure to meet quality-of-care standards), and (a)(40) (inadequate records); it revoked his license.
Issues
| Issue | Geier's Argument | Board's Argument | Held |
|---|---|---|---|
| Whether substantial evidence supported violation of HO §14-404(a)(22) (quality-of-care) | Geier: He could lawfully prescribe Lupron "off-label" and was not required to diagnose precocious puberty or perform the physical exams the Board faulted him for | Board: Record shows Geier documented treating for precocious puberty, failed required diagnostic evaluations, and treated patients who did not meet his own off-label profile | Affirmed: substantial evidence supports finding Geier failed to properly evaluate, obtain informed consent, monitor, and document care, violating §14-404(a)(22) |
| Whether substantial evidence supported violation of HO §14-404(a)(3)(ii) (unprofessional conduct) | Geier: Board erred in finding IRB was a sham; no requirement to have an IRB if not conducting human research | Board: Consent forms misled parents about IRB approval; other egregious practices (using non-approved drug, falsified consent, treating without exams) independently support unprofessional conduct finding | Affirmed: even if IRB issue were unresolved, other undisputed findings (false consent, non-approved drug use, failure to examine) suffice to support unprofessional-conduct violation |
| Whether substantial evidence supported violation of HO §14-404(a)(11) (false reports/records) | Geier: He was certified by ABMG as a genetic counselor in 1987; specialty listings on renewals were not false in context | Board: Renewal applications listed ABMS-recognized specialties he was not certified in; evidence supports finding of false credential statements | Affirmed: substantial evidence that Geier falsely reported ABMS board certifications, violating §14-404(a)(11) |
| Whether Board/ALJ erred in admitting/excluding evidence, expert qualification, peer-review proof, supplementation, and stay | Geier: Challenged admission of Board expert Dr. Grossman, exclusion of two exhibits, failure to admit two peer-review reports, denial to supplement record with late ABMG letter, and denial of stay for additional discovery | Board: Expert was qualified; exhibits were untimely; pre-charge peer-review defects cannot be raised now; the late ABMG letter was irrelevant and untimely; stay was properly denied | Affirmed: Court found no abuse of discretion in admitting Dr. Grossman; exclusion of untimely exhibits proper; alleged peer-review defect precluded from collateral attack; denial to supplement and denial of stay not an abuse of discretion |
Key Cases Cited
- Paolino v. McCormick & Company, 314 Md. 575 (procedural limits on raising issues not appealed by a party)
- Joseph H. Munson Co. v. Secretary of State, 294 Md. 160 (appellee may not attack trial court judgment without cross-appeal where attack would reverse judgment)
- Bd. of Physician Quality Assur. v. Levitsky, 353 Md. 188 (role and limits of pre-charge peer review; scope of challenge under statutory bar)
- Blackwell v. Wyeth, 408 Md. 575 (standard of review for admissibility of expert testimony)
- Kim v. Maryland State Bd. of Physicians, 196 Md. App. 362 (deference to administrative credibility findings)