Jerry N. Mixon, M.D., who founded the Longevity Medical Clinic in Kirkland, Washington, in 1999, has been disciplined twice by the state’s Medical Quality Assurance Commission. In 2002, he was charged with unprofessional conduct in connection with administering “anti-aging” treatment to a woman with whom he was also having sexual contact. The case was settled with an agreed order that required him to pay a $5,000 fine, take an 18-hour ethics course, and serve at least three years of probation, during which he was required have a chaperon present when examining a disrobed female patient, undergo a psychological evaluation, cooperate with monitoring, and make annual compliance appearances before the Commission. The probation was terminated in 2006 after a hearing in which he said he was not providing direct clinical services to patients and did not intend to resume doing so.
In 2012, he was charged again with unprofessional conduct in connection with his management of four patients whom he improperly diagnosed and treated for growth hormone deficiency. The Statement of Charges (shown below) noted that his clinic Web site had advertised “comprehensive hormone supplementation” as an anti-aging remedy. The case was settled with an agreed order that prohibited him from prescribing growth hormone and required him to (a) pay a $10,000 fine, (b) serve at least three years on probation, (c) take an approved ethics course, and (4) submit to semi-annual practice reviews.
STATE OF WASHINGTON
DEPARTMENT OF HEALTH
MEDICAL QUALITY ASSURANCE COMMISSION
In the Matter of the License to Practice
STATEMENT OF CHARGES
The Disciplinary Manager of the Medical Quality Assurance Commission (Commission) is authorized to make the allegations below, which are supported by the evidence contained in file number 2009-140485. The patients referred to in this Statement of Charges are identified in the attached Confidential Schedule.
1. ALLEGED FACTS
1.1 On March 24, 1986, the state of Washington issued Respondent a license to practice as a physician and surgeon. Respondent’s license is currently active. Respondent is board certified in General Family Medicine.
1.2 During a time frame that included November 11, 2009, Respondent advertised the “Longevity Medical Clinic” on a website which offered to consumers the use of “Comprehensive Hormone Supplementation” as an anti-aging remedy. Respondent is and was at all pertinent times the governing person of Longevity Medical Clinic.
1.3 Respondent provided a long term regime of growth hormone supplementation for adult patients to treat age-related decline in growth hormone production for patients without abnormally deficient hormonal levels, Respondent acknowledged he did not perform IV (or IM) stimulation testing to determine whether or not a patient had a deficiency before prescribing human growth hormone. These activities occurred after Federal law specifically banned the use of growth hormone as an “anti-aging” therapy or for any use other than the treatment of a disease. These activities occurred after Federal law further limited the use of growth hormone therapy to those medical conditions specifically authorized by the Secretary of Human services, Since 1989 Washington State law prohibits the use of growth hormone to manipulate hormones to increase muscle mass, strength or weight or to enhance athletic ability. The only legitimate use of growth hormone prescriptions for adults is treatment of the disease of adult growth hormone deficiency. The use of growth hormone is particularly contra-indicated in patients with an active malignancy because it may accelerate the growth of cancer cells. The use of growth hormone is contributory to carpal tunnel syndrome and other diseases.
1.4 The standard of care for diagnosing adult growth hormone deficiency requires:
1.4.1 The physician must have a high index of suspicion that the patient has growth hormone deficiency, Consideration for growth hormone deficiency in adults is indicated in patients with pituitary or brain disease, tumors or irradiation; patients who have suffered traumatic brain injury; patients with Acquired Immunity Deficiency Syndrome (AIDS) wasting syndrome or rare patients with short bowel syndrome. In addition, adults who had childhood onset growth hormone deficiency should be considered for continued growth hormone therapy as adults.
1.4.2 The diagnosis of growth hormone deficiency must be achieved by obtaining an insulin-like growth factor (IGF-1) level and then performing the provocative (or stimulation) test. The stimulation test is required unless the patient has deficiencies in at least three other hormone levels or the patient has a history of childhood growth hormone deficiency. A simple measurement of IGF-1 level is not sufficient to make the diagnosis, except in patients also diagnosed with panhypopituitarism.
1.4.3 If growth hormone deficiency is determine by this standard, then the physician must look for the underlying cause.
1.5 Patient A, born in 1938, was treated at Respondent’s “Nonage Longevity Medical Clinic” between October 2001 and March 2010, There was no indication Patient A had a condition that would indicate a work-up for growth hormone deficiency. Patient A’s hormone level was in the low normal range. Patient A was prescribed growth hormone therapy by Respondent and his colleagues at Longevity Medical Clinic from 2002 through 2009. The growth hormone was prescribed to raise growth hormone levels which had naturally declined as part of normal aging. Respondent did not perform stimulation testing on Patient A. Respondent did not record regular monitoring of lGF-1 levels. Respondent’s initiation and maintenance of human growth hormone regime for Patient A was below the standard of care and created an unreasonable risk of harm to Patient A.
1.6 Patient B, born in 1936, was treated at Longevity Medical Clinic by Respondent and others from March 2001 through June 2002. Patient B was started on growth hormone in approximately March 2001. Respondent continued growth hormone replacement therapy for Patient A, who subsequently developed uncontrolled diabetes. Growth hormone at any dose can exacerbate a diabetic condition. There was no evidence of growth hormone stimulation testing. Baseline IGF-I level was normal. There was no notation that the patient had any condition that would indicate a work-up for growth hormone deficiency. Respondent’s initiation of prescribing growth hormone to Patient B and Respondent’s maintenance of growth hormone therapy for Patient B was below the standard of care and created an unreasonable risk of harm to Patient B. Patient B reported stopping the human growth hormone after admission to Intensive Care Unit for diabetes while taking a cruise in Australia in March 2002.
1.7 Respondent treated Patient C, born 1937, between November 2000 and September 2003 at Nonage Longevity Medical Clinic with “comprehensive hormone supplementation”. Patient Cos stated goal was to stop the aging process, Respondent prescribed growth hormone for Patient C, without conducting growth hormone stimulation testing, There was no notation that the patient had any condition that would indicate a work-up for growth hormone deficiency, Respondent’s initiation of a growth hormone regime for Patient C and Respondent’s maintenance of HGH therapy for Patient C was below the standard of care and created an unreasonable risk of harm to Patient C.
1.8 Respondent saw Patient D between November 2000 and August 2001. Respondent prescribed human growth hormone for Patient D although the patient’s laboratory tests were within normal range, Respondent did not conduct growth hormone stimulation testing. There was no notation that the patient had any condition that would indicate a work-up for growth hormone deficiency. Patient D’s stated goal was increased stamina. Respondent’s initiation of and maintenance of a human growth hormone regimen for Patient C was below the standard of care and created an unreasonable risk of harm to Patient C.
2. ALLEGED VIOLATIONS
2.1 Based on the Alleged Facts, Respondent has committed unprofessional conduct in violation of RCW 18,130.180 (4), (7); RCW 69.41,320, WAC 246-919-610, and 21 U.S.C.A. § 333 (e) which provide:
RCW 18.130.180 Unprofessional conduct. The following conduct, acts, or conditions constitute unprofessional conduct for any license holder or applicant under the jurisdiction of this chapter:
(4) Incompetence, negligence, or malpractice which results in injury to a patient or which creates an unreasonable risk that a patient may be harmed, The use of a nontraditional treatment by itself shall not constitute unprofessional conduct, provided that it does not result in injury to a patient or create an unreasonable risk that a patient may be harmed;
(7) Violation of any state or federal statute or administrative rule regulating the profession in question, including any statute or rule defining or establishing standards of patient care or professional conduct or practice;
RCW 69.41.320 Practitioners—Restricted use—Medical records. (1)(a) A practitioner shall not prescribe, administer, or dispense steroids, as defined in RCW 69.41.300, or any form of autotransfusion for the purpose of manipulating hormones to increase muscle mass, strength, or weight, or for the purpose of enhancing athletic ability, without a medical necessity to do so.
(b) A person violating this subsection is guilty of a gross misdemeanor and is subject to disciplinary action under RCW 18.130.180.
(2) A practitioner shall complete and maintain patient medical records which accurately reflect the prescribing, administering, or dispensing of any substance or drug described in this section or any form of autotransfusion Patient medical records shall indicate the diagnosis and purpose for which the substance, drug, or autotransfusion is prescribed, administered, or dispensed and any additional information upon which the diagnosis is based.
WAC 246-919-610 Use of drugs or autotransfusion to enhance athletic ability. (1) A physician shall not prescribe, administer or dispense anabolic steroids, growth hormones, testosterone or its analogs, human chorionic gonadotropin (HCG), other hormones, or any form of autotransfusion for the purpose of enhancing athletic ability.
(2) A physician shall complete and maintain patient medical records which accurately reflect the prescribing, administering or dispensing of any substance or drug described in this rule or any form of autotransfusion Patient medical records shall indicate the diagnosis and purpose for which the substance, drug or autotransfusion is prescribed, administered or dispensed and any additional information upon which the diagnosis is based.
(3) A violation of any provision of this rule shall constitute grounds for disciplinary action under RCW 18.130.180(7). A violation of subsection (1) of this section shall also constitute grounds for disciplinary action under RCW 18.130,180(6),
21 U.S.C.A. § 333 (e) Prohibited distribution of human growth hormone (1) Except as provided in paragraph (2), whoever knowingly distributes or possesses with intent to distribute, human growth hormone for any use in humans other than the treatment of a disease or other recognized medical condition, where such use has been authorized by the Secretary of Health and Human Services under section 355 of this title and pursuant to the order of a physician, is guilty of an offense punishable by not more than 5 years in prison, such fines as are authorized by Title 18, or both.
(2) Whoever commits any offense set forth in paragraph (1) and such offense involves an individual under’ 18 years of age is punishable by not more than 10 years imprisonment, such fines as are authorized by Title 18, or both.
(3) Any conviction for a violation of paragraphs (1) and (2) of this subsection shall be considered a felony violation of the Controlled Substances Act [21 U.S.C.A. § 801 et seq.] for the purposes of forfeiture under section 413 of such Act [21 U.S.C.A. § 8531.
2.2 The above violations provide grounds for imposing sanctions under RCW 18.130,160.
3. NOTICE TO RESPONDENT
The charges in this document affect the public health, safety and welfare. The Disciplinary Manager of the Commission directs that a notice be issued and served on Respondent as provided by law, giving Respondent the opportunity to defend against these charges. If Respondent fails to defend against these charges, Respondent shall be subject to discipline and the imposition of sanctions under Chapter 18.130 RCW.
DATED: March 13, 2012.
STATE OF WASHINGTON
DEPARTMENT OF HEALTH
MEDICAL QUALITY ASSURANCE COMMISSION
KRISTIN G. BREWER WSBA#38494
ASSISTANT ATTORNEY GENERAL
This page was posted on February 26, 2015.