After all the bad news that I’ve been blogging about, it’s a pleasure for me to end the week with a bit of very good news, very good news indeed. That news came in the form of an article published in the Orange County Register with the glorious title Dr. Bob Sears faces medical board discipline in recommendation not to vaccinate.
Dr. Bob Sears, the Capistrano Beach pediatrician who is an outspoken critic of mandatory vaccination laws, faces possible state Medical Board discipline after he recommended that a 2-year-old patient forgo immunizations, according to legal documents made public Thursday.
The board accuses Sears of committing “gross negligence” in 2014 when he wrote a letter excusing the toddler from future vaccinations after the child’s mother described an adverse reaction as an infant.
The documents say Sears failed to obtain a detailed medical history documenting the unidentified boy’s prior vaccines and reactions, which was necessary for making an evidence-based decision. Sears’ recommendation left the patient and “his future contacts at risk for preventable and communicable diseases,” the documents say.
Sears declined to comment Thursday.
If the board finds Sears negligent, he could face discipline ranging from a public reprimand to revocation of his medical license.
My first thought when I saw this story was: Excellent. It’s about time! Personally, like some of you, I consider Dr. Bob to be an antivaccine quack. That is my opinion, but it is one that I can give quite a few evidence-based reasons for and have been doing for years now. Given Dr. Bob’s history of opposing SB 277, the new California law that eliminated nonmedical exemptions to school vaccine mandates and his willingness to give paid seminars teaching parents to avoid the requirements of SB 277 and even outright selling nonmedical exemptions, I consider him a menace to public health, particularly that of children in California and beyond. Physicians who betray public health and the health of their patients by not only failing to vaccinate but actively seeking to subvert SB 277 (not oppose, which is Sears’ constitutional right, but to actively subvert it now that it’s passed by writing what I consider to be dubious medical exemptions based on bogus antivaccine pseudoscience), a law designed to maintain high rates of vaccination, do not deserve their medical licenses, as they are not practicing anywhere near according to the standard of care. I thus view the Medical Board of California’s action with strong approval, strong approval indeed.
That is my opinion of Dr. Bob and what he deserves. Now the Medical Board of California is actually acting against him.
When I read this story, I also couldn’t help but wonder initially if this action was over an incident that a reader reported to me, complete with letters signed by Dr. Sears recommending exemptions from school vaccine mandates based on what I considered to be bogus medical reasons based on the mother filling out an online application and paying a fee. It rapidly became clear that it wasn’t when the news story stated that the incident resulting in this complaint occurred in 2014. The legal filing by the State of California tells the tale, the tale being about a young boy named J.G. (for purposes of court hearings):
On April 3, 2014, two-year-old J.G. presented to Respondent for the first time. He was seen by Respondent for what medical records describe as a “two year.” The visit of this date includes a summary of the patient’s history with a brief description of J.G.’s prior vaccination reaction, as described by the patient’s mother. Her description included, “shut down stools and urine” for 24 hours with 2 month vaccines and limp “like a ragdoll” lasting 24 hours and not himself for up to a week after 3 month vaccines.
Respondent wrote a letter dated April 13, 2014 excusing patient J.G. from all future vaccinations. The letter indicates that the patient’s kidneys and intestines shut down after prior vaccinations and that at three months the patient suffered what appears to be a severe encephalitis reaction for 24 hours starting approximately ten minutes after his vaccines, with lethargy.
The letter dated April 13, 2014 was not maintained in patient J.G.’s medical chart in Respondent’s office.
There’s more, including other visits to Dr. Bob. I wonder what Dr. Bob’s antivaccine fans would think if they learned that he actually administered the dreaded Tamiflu to J.G. later (January 2015) for a case of what appeared to be influenza. Be that as it may, Dr. Bob also saw the child in June 2014 for headache with a history of being hit on the head with a hammer by Dad two weeks prior to visit. According to the Board, there was also a mention of a split lip prior to the hammer incident. However, the physicial examination indicated “no residual marks now.” The Board also noted that no additional physical examination, including the all-important neurological examination (in cases of head trauma), was performed and no assessment with plans recorded. I used to do trauma, including pediatric trauma, and I know that this is a grossly inadequate evaluation for what might be a concussion, based on symptoms and timing, after having been hit in the head with a blunt object. One also has to wonder if child protective services was involved somehow or whether Dr. Bob reported the incident as possible child abuse, as the law requires a pediatrician to do when he suspects possible child abuse. I suspect that most pediatricians, upon seeing a child reportedly hit on the head with a hammer by his father, even if it was reportedly accidental, would report the incident, particularly if there were reports or signs of other injuries, like the split lip.
[Note: Since I posted this, it’s been pointed out to me by commenters that the reference to “An Emergency Response Notice of Referral Disposition” in the complaint likely indicates that Dr. Bob did think enough of the story to report the incident, as it is also mentioned that it also had a notation of “Allegations cannot be substantiated—case closed.” Of course, that Dr. Bob believed the story enough to have reported it makes his failure to do a proper neurological examination all the more egregious a failure.]
Be that as it may, the bottom line is that Dr. Bob did see J.G. a few times for various medical issues. One of those issues was how he dealt with the child’s head injury. The other issue that drew the attention of the board was this:
The standard of care requires that a physician evaluating a patient for a possible reaction to vaccines obtain a detailed history of the vaccines previously received as well as the reaction/reactions that occurred. Based on that information, the physician should provide evidence-based recommendations for future immunizations.
Respondent was grossly negligent and departed from the standard of care in that he did not obtain the basic information necessary for decision making proior to determining to exclude the possibility of future vaccines, leaving both patient J.G, the patient’s mother, and his future contacts at risk for preventable and communicable diseases.
Based on Dr. Bob’s granting of the medical exemption to vaccinations for J.G. and his failure to do a neurological examination of the child when he presented with persistent headaches after head trauma, the Board listed the first cause for disciplining Dr. Bob as gross negligence. The second cause for discipline was repeated negligent acts, given that there were two instances of gross negligence included in the complaint. The third cause for discipline was failure to maintain adequate and accurate medical records.
The complaint calls for:
- Revoking or suspending Physician’s and Surgeon’s Certificate Number A60936 issued to Robert Sears, MD;
- Revoking, suspending, or denying approval of his authority to supervise physician assistants, pursuant to section 3527 of the Code;
- If placed on probation, ordering him to pay the Board the costs of probation monitoring;
- Taking such other and further action as deemed necessary and proper.
The complaint is dated September 2, the Friday before the Labor Day weekend. Not surprisingly, now that the Board’s complaint is public, the merry band of antivaccine loons at Age of Autism is up in arms, and other antivaccine sites are, predictably, referring to the Board’s disciplinary action as a “witch hunt.”
When I saw the news story, I must admit that I was surprised. This incident occurred before the passage of SB 277. Why did Dr. Bob write a letter supporting a medical exemption to school vaccine requirements for J.G.? He didn’t need to. The mother could have just gotten a personal belief exemption. So why did Dr. Bob do it? Why did the mother ask him for an exemption? Didn’t she know about personal belief exemptions? At this time, I just don’t know. The other issue that puzzles me is why the board chose this case. True, it’s pretty egregious not to have examined J.G. properly when his mother brought him in with persistent headache after head trauma. (Very sloppy doctoring there, Dr. Bob.) It’s also pretty questionable to have written a letter supporting a medical exemption based on J.G.’s history and such dubious reasoning. As bad as these lapses were, normally a state medical board would probably not bother with them, as underfunded and outmanned as they usually are. Yet California is going after him. Like Steve Novella and Reuben, I definitely approve of the Board’s willingness to take this risk.
I suspect that the Board wants to make an example out of Dr. Bob, which to me is also a good thing. He’s a high profile antivaccine doctor whose Vaccine Book is widely read by parents and supports an “alternate vaccine schedule” that is based on fear mongering rather than science, and lately he’s been opining on how the measles isn’t that bad while laying down a lot of other antivaccine misinformation. If the Board is successful it will make other antivaccine docs think twice about writing exemption letters based on a questionable history of vaccine reaction and non-evidence-based reasons. It’s also risky, too. Dr. Sears has become an instant martyr to the cause among antivaccine activists, and his family’s celebrity will make it easy for him to grab the limelight and portray himself as wrongly “persecuted” for his “vaccine safety” views. That makes the Board’s action a high-risk strategy to send a message. If it loses, Dr. Bob and those who want to sell medical exemptions to circumvent SB 277 will be emboldened.
I only hope that the Board has the opportunity to add to Dr. Sears’ charges. After all, his selling bogus medical exemptions after the passage of SB 277 using an online form is far more egregious than the incident that the Board is going after Sears for. I suspect that, given Sears’ history, there’s a lot more to be found. I really hope that the father who sent me the letters that Dr. Bob Sears generated based on an Internet form has contacted the Medical Board of California. Now would most definitely be an excellent time to do so.
I’m also expecting all manner of conspiracy theories to flow once the antivaccine movement latches on to this news. Believe it or not, I had nothing to do with this. I will be honest, though. I wish I had.