Doctor who put non-cancer patient through extensive chemo ordered to pay close to $73K

An Ontario family physician who claimed he was being targetted unfairly by the Ontario College of Physicians and Surgeons has been ordered to pay $72,590 in investigation and hearing costs and banned—for the second time—from practising medicine after being found incompetent in his care of two patients. Dr. Akbar Nauman Khan, founder and director of Toronto-based Medicor Cancer Centres—which promotes “allopathic plus naturopathic” cancer therapy—misdiagnosed one patient with pancreatic cancer and put her through extensive chemotherapy she didn’t need, according to a case document issued by the Ontario Physicians and Surgeons Discipline Tribunal. With a second patient, who had thyroid cancer, Dr. Khan discontinued T4 therapy provided by the patient’s oncology team, causing the development of profound hypothyroidism and risking the proliferation of cancer cells. Dr. Khan already had his licence revoked last year in a separate case, which also included an order to pay $197,030 in college costs. At the start of Dr. Khan’s penalty hearing, his lawyer compared his client’s situation to the “historical persecution of a Jewish man who had been accused of slaughtering a Christian child,” according to the case document. Even though this particular man was ultimately acquitted, the court still stated that “Jews are capable of doing such things,” the lawyer told the hearing. He had previously also criticized one of the college’s experts—a veteran clinical endocrinologist who has also held high-level academic positions—calling him a swindler who acts like a member of the Nazi Gestapo, Chinese Red Guards or the Inquisition. Both Dr. Khan and his lawyer left before the penalty hearing, which was conducted virtually, was fully underway. Read: Doctor who used unproven cancer treatments stripped of licence and hit with almost $200,000 in costs In addition to its ruling on quality of care, the tribunal also found Dr. Khan had fraudulently billed the Ontario Health Insurance Plan 68 times for palliative care that he did not provide to the first patient, who was not terminal when she was in his care for cancer she didn’t have. Dr. Khan’s lawyer suggested this was simply a case of inadvertently using the wrong billing code, but the tribunal found this implausible given that Dr. Khan billed for palliative care almost weekly when he did not see the patient as frequently. The tribunal also found it unlikely that a billing code error could be made 68 times over a 15-month period. In the case of the first patient—a New Brunswick resident—Dr. Khan ignored the assessment of another doctor, whose clinical assessment and review of an endoscopic ultrasound concluded the patient had intraductal papillary mucinous neoplasm (IPMN), a precancerous condition requiring no aggressive therapy. This doctor recommended follow-up ultrasounds to ensure stability. Instead, Dr. Khan based his diagnosis and treatment on two ONCOblot tests—ordered by a naturopathic doctor—which found the patient positive for pancreatic cancer. He put her on the chemotherapy drug carboplatin, which a college oncology expert said is not used to treat IPMN or pancreatic cancer. The tribunal cited a conflict of interest with the use of the ONCOblot tests. Dr. Khan’s company, Medicor, is the sole distributor of these tests in Canada. The naturopath who ordered tests for the IPMN patient was billed by Medicor $1,460 for one test and presumably received a similar invoice for the second test (Medicor in turn pays the ONCOblot test owner and representative US$700 for each test). Dr. Khan admitted to talking to the naturopath about the test but denied recommending them—an assertion the tribunal did not accept. The patient’s platelet levels subsequently dropped to as low 72,000. Yet, Dr. Khan recommended eight more cycles of chemotherapy, even though carboplatin should not be used when platelet levels are below 100,000, the expert testified. Read: Faster, better, less agonizing: How one college is building a more efficient, less punitive complaints process Dr. Khan also prescribed mesna and phenylbutarate, drugs that the college expert questioned. For one, the use of phenylbutarate in oncology has been limited to testing in the lab and, as far the expert knew, there had been no human trials. An ultrasound ordered by Dr. Khan about seven months after the patient started chemotherapy showed the pancreatic lesions had increased in size. However, he told the patient that one tumour was dead and the other was dying. A complaint filed with the college by the patient’s daughter stated the patient had paid out almost $100,000 for various blood tests, chemo- and other therapies, plus the cost of flights and accommodations to receive the treatments. In the case of the second patient with thyroid cancer, Dr. Khan told the college’s expert witness that he didn’t follow Cancer Cancer Ontario guidelines because he’s not actively engaged in conventional cancer care and assumed the patient’s other physicians followed these guidelines. He said he doesn’t use recommended thyroid-stimulated hormone (TSH) targets for ongoing management of thyroid cancer and paid little attention to TSH levels even though the hormone is a growth factor for thyroid tissue and thyroid cancer. The tribunal described Dr. Khan’s dealing with this patient as evidence of a “lack of knowledge, skill or judgment or disregard for (the patient’s) welfare of a nature or to an extent that demonstrates Dr. Khan is incompetent and unfit to practise. In his emails to (the patient) regarding his thyroid replacement, it is apparent that Dr. Khan did not understand even the basics of thyroid physiology.” Dr. Khan, who admitted to the college’s expert that he has little experience with thyroid cancer, also said he chose not to join the patient’s circle of care because specialty physicians were either uninterested or opposed to his approach. “As a result, (the patient’s) cancer specialists did not know that Dr. Khan had changed their treatment regime and they did not have the opportunity to intervene quickly to correct the harm that resulted from Dr. Khan’s care,” wrote the tribunal. Dr. Khan has appealed the penalty decision. This latest action will not, however, stay the decision pending the outcome of the appeal. Read: I flunked my CPSO peer review

Doctor who put non-cancer patient through extensive chemo ordered to pay close to $73K

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