HELP — HELP — HELP

Posted on July 9, 2021 by Pharmaciststeve

Every week, sometimes multiple of times a day… I get emails, FB messages, phone calls from chronic pain pts that are being denied care and their medically necessary medication… sometimes from a prescriber, some from a pharmacy/pharmacist, insurance/PBM.

I am about to take on the task of being CFO for the non profit American Pain & Disability Foundation, so there is going to be one more alligator in my swamp…and I am getting tired/bored with giving out the same/similar advise over and over… hopefully after I finish this post they will read it first and/or if they don’t read it first.. I can just answer their question with referring them to this post first with a hyperlink.

FIRST THE PHARMACY/PHARMACIST

I often get some cryptic message about them being denied their medication – and I am suppose to fill in the blanks and come up with a recommendation. Often, I am just replying with the same/similar words that I have routinely typed to other pts.

If the pt is going to a chain store… and you have been getting your meds without problem for months or years and all of sudden they are getting stonewalled.. Most likely, there has been a change in the staffing in the Rx dept of that store or they have encountered a “floating pharmacist” that is working there for a day or week… covering a sick employee, a vacation, a pregnancy leave. Often these Pharmacists don’t know your prescriber, don’t know you and won’t bother to look at your Rx records at the store… JUST SAY NO…

They know that the pt calls HQ, they will be told that they stand behind their pharmacist’s decisions – can’t make a pharmacist to fill a Rx… probably get the same answer from the board of pharmacy. They could ask the Pharmacist to provide the clinical information that they made their decision on… but.. that would create a virtually Tsunami of paperwork.

Another “reason” … “I’m not comfortable”… maybe the pt should ask the pharmacist what clinical information that he/she is not comfortable about ? – IMO “I’m not comfortable” is an EXCUSE not based on few if any FACTS.

Then there is a “we are out of stock”… what the Pharmacist hopes that the pt doesn’t know that the DEA requires that every pharmacy keep a hard copy PERPETUAL INVENTORY… Maybe the pt should document the date/time of being told that the pharmacy is out of stock and send a request to the pharmacy board to ask the pharmacy to provide a copy of the perpetual inventory sheet for the particular medication/strength for the particular day/time… Does the Board of Pharmacy consider LYING TO PTS UNPROFESSIONAL CONDUCT ? If the Board won’t go as far as getting this information – then they apparently don’t.

The pt will probably be told that the Pharmacist has a “corresponding responsibility” which is in the control substance act of 1970… Just have to make sure that the medication is being prescribed for valid medical reason… IMO, corresponding responsibility should be a “two way street” … make sure that medication does not get into the hands of someone that really doesn’t have a valid medical necessity and make sure that the medication gets in the hands of someone that does have a valid medical necessity.. But Pharmacists don’t have access to the pt’s medical records – other than the Rxs they have filled at the store and/or pulled a state PDMP report… Pharmacists don’t have the legal right, nor training, nor physical space, nor time to do a physical exam… If they have not called and talked to the prescriber.. the information that the Pharmacist has is fairly limited… so many use the term “corresponding responsibility” to JUST SAY NO. They turn this term into a ONE WAY STREET TO JUST SAY NO !!!

Other than the state of Alaska, I know of no pharmacists that have experienced any bad consequences for JUST SAYING NO !!

Perhaps, a pt – being denied their medication… share this chart with the Pharmacist… this chart shows the comorbidity complication of under/untreated pain and if a pt is intentionally thrown into cold turkey withdrawal those complications will come on very quickly and probably very intensively… Think hypertensive crisis, stroke, death… how would that affect the pharmacist’s license ?

The quickest path for a pt to get their medication is to find a independent pharmacy … where the pt will be dealing with the Pharmacist/owner who tend to be less judgemental.. here is a website to locate one by zip code https://ncpa.org/pharmacy-locator

DENIAL FROM A PRESCRIBER

More and more prescribers are no longer in a private practice. Their practice has been sold to large hospital system and they are just an employee of that corporation and what they will/won’t prescribe is more likely being dictated by their corporate employer.

It is best if chronic pain pts are proactive when they are first told that they are going to participate in a involuntary forced reduction in their meds. IMO… waiting until you are way down the path of reducing their doses… it is probably too late to back things up Here is a post that I did a few months ago that should give the pt some direction of actions that they may be able to take http://www.pharmaciststeve.com/?p=35002

Insurance/ PBM problems/denials

Many insurance company will hire a PBM ( Prescription Benefit Manager) to handle the adjudication of Rx claims… they provide you the “drug card”. There are a handful of PBM’s that control the lion’s share of the market place.

If your insurance is thru your employer.. abt 50% of large employers are self insured that is referred to as an ERISA prgm – over seen by the Fed Labor Dept and insurance company is just an administrator to pay out your employer’s money for health claims for their employees and their families. If you have this sort of “insurance” and you get denied…someone at your employer can just call up the insurance company and tell them to pay for your medications as your prescriber wrote for… after all it is your employer’s money that they are paying out.

If you are on Medicare or Medicaid… then you are probably dealing with a Part D Rx prgm… they have a three level appeal process.. they don’t have to tell you about the process unless you ask and then they have to give you the process in writing- today that is probably a website. Be sure to meet the time limits of making the appeals… expect to get denied the first time because the same system/people that already denied it … is the one handling the appeal.. because a fair percent of pts getting denied will give up… after three denials there is a Administrative Law Judge (ALJ) again they have to tell you the process is writing… the very fact that you KNOW ABOUT the ALJ appeal level… may be enough to get them to cave… because they know that at least 50% get to this level will get approved. Doesn’t cost the pt anything, and now a days… it is probably a ZOOM type meeting.. the pt doesn’t need an attorney… just needs to state way they need what was denied … it is a pretty straight forward process.

It is also good if the pt calls 800-MEDICARE or www.cms.gov and file a complaint against any provider for denying you care.

Any other kind of health insurance… you just have to ask what their appeal process is and if they don’t offer… ask for the details in writing… the more times you appeal … the more likely the pt will get a YES/APPROVED.

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I reserve the right of editorial censorship

Posted on January 30, 2020 by Pharmaciststeve

It looks like the political “mud slinging” has already started – IMO – worse than the national election two years ago… I am taking a stand – in particular – against “slanderous name calling” directed toward specific politicians, particular political parties and/or specific people. I don’t mind political debate – based on FACTS… when the debate drifts off the road based on FACTOIDS, FAKE NEWS, opinions stated as FACTS.. is where I am going to draw the “line in the sand” and delete comments that go down that path.

While personally, I am not a big fan of our political/bureaucratic system.. IMO.. it is too self serving… Admittedly, politically I tend to lean to the POLITICAL RIGHT but that is because the Libertarian party is seemingly always kept in their place by our dominating “two party system”.

I have belonged to a national pharmacy association for 35 yrs… that promotes the saying “get into politics … or get out of pharmacy ..” If you don’t attempt to influence politicians… someone else will…. and IMO this saying applies to those in the chronic pain community and/or pts who are dealing with subjective diseases. Legislatures, bureaucrats are doing things that are adversely effecting the quality of life of those pts. As long as those being affected continue to lack unity and/or a large segment chooses to stand on the sidelines, whoever is successfully “bending the ear” of these politicians … they will continue to do so because they have little/no concern about the consequences and/or collateral damage that they cause to those suffering and dealing with subjective diseases.

I am sure that the vast majority of my readers will understand and cooperate…those who try to challenge this policy… It is THREE STRIKES and you are out/banned… and WORDPRESS gives me your IP ADDRESS attached to your comment(s)… Once banned, just posting under a different name – WILL NOT WORK ! Everyone needs to “play nice “

Lastly, please do not post anything promoting a particular vendor or any entity or person selling a product/particular service. Because some may perceive/believe that they have my endorsement which may or may not be the case. Anyone posting a link to a professional selling a product/service will be edited out

Filed under: General Problems | 24 Comments »

Financially attempting to taking out one chain pharmacy at a time over the opiate crisis

Posted on January 16, 2022 by Pharmaciststeve

Delaware top court says Rite Aid can’t get insurance coverage for opioid cases

https://www.reuters.com/legal/litigation/delaware-top-court-says-rite-aid-cant-get-insurance-coverage-opioid-cases-2022-01-10/

Delaware Supreme Court rules for Chubb in coverage lawsuit by Rite Aid
Court says Rite Aid only entitled to coverage in personal injury cases

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The Delaware Supreme Court on Monday ruled that insurance company Chubb Ltd is not required to provide coverage and defend Rite Aid Corp in lawsuits accusing the pharmacy chain operator of fueling the opioid epidemic.

The ruling came in one of several disputes nationwide involving pharmaceutical companies, drug distributors and pharmacies suing insurers in order to recoup the costs of defending against and settling thousands of opioid lawsuits.

A lower-court judge in 2020 found that various Chubb subsidiaries were required to defend Rite Aid against bellwether lawsuits by two Ohio counties in the federal multidistrict litigation over the epidemic.

But Delaware’s top court reversed, concluding that policies covering personal injury cases did not require Chubb to defend Rite Aid against lawsuits seeking only economic damages.

Rite Aid and its lawyer, Gerald Konkel of Morgan, Lewis & Bockius, did not respond to requests for comment. Chubb and its lawyers, including Jonathan Hacker of O’Melveny & Myers, had no comment.

More than 3,000 lawsuits have been filed nationally by largely state and local governments seeking to hold the companies responsible for an opioid abuse crisis that has led to hundreds of thousands of overdose deaths.

The lawsuits accuse Rite Aid of negligently distributing addictive prescription pain pills. The company denies wrongdoing, and in 2019 sued Chubb to recover the costs of its defense and future settlements.

In Monday’s ruling, Chief Justice Collins Seitz, said that for Rite Aid to receive coverage, the lawsuits needed to be brought by people injured by opioids – individuals suing on their own behalf or anyone who cared for or treated them.

But in the case of Ohio’s Summit and Cuyahoga counties, which brought opioid claims similar to other local governments, they specifically said they were not seeking recovery for any residents’ personal injuries, Seitz said.

They instead sued to recover for injuries the counties suffered by being saddled with the economic burden of higher demands for medical treatment and impacts on their criminal justice systems, Seitz wrote for the 4-1 court.

“This claim is not directed to an individual injury but to a public health crisis,” Seitz said.

Justice James Vaughn dissented, saying Chubb’s policy language should be interpreted broadly to cover all damages an organization could bring against Rite Aid for the care, loss of services or death of someone due to opioid addiction.

The case is ACE American Insurance Co, v. Rite Aid Corp, Delaware Supreme Court, No. N19C-04-150.

For Chubb: Jonathan Hacker of O’Melveny & Myers

For Rite Aid: Gerald Konkel of Morgan, Lewis & Bockius

Pharmacy chains including CVS helped fuel opioid epidemic, U.S. jury finds

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Another GIFT from the BIDEN ADMIN: At home-covid tests won’t be covered by Medicare

Posted on January 16, 2022 by Pharmaciststeve

At home-covid tests won’t be covered by Medicare

https://www.msn.com/en-us/money/personalfinance/at-home-covid-tests-wont-be-covered-by-medicare/ar-AASFCPH

But millions of people—including the uninsured and those on Medicare—are not eligible to get tests reimbursed under this latest measure.

Medicare won’t cover at-home covid tests

Under the plan announced yesterday, people covered by private insurance or a group health plan will be able to purchase at-home rapid covid-19 tests for free or submit receipts to their insurer for reimbursement. US president Joe Biden’s administration also wants to incentivize insurers to work with preferred pharmacies and retailers to cover the costs of the tests up-front, rather than require patients to pay out of pocket.

It’s no secret that healthcare costs have skyrocketed in recent years. Between rising insurance premiums and a lack of pricing regulation for everything from lab work to prescriptions, medical costs have soared. Fortunately, there are some ways to cut medical costs before they send you into debt.

The new measure doesn’t include the estimated 31.1 million uninsured people living in the US, nor most of the 61.5 million (pdf) Americans enrolled in Medicare, the federal health insurance plan for seniors and people with disabilities. For now, they will have to rely on other types of covid testing covered by the government. Some Medicare Advantage plans, which are more comprehensive, may cover the cost of at-home tests.

Over the past two years the US government has offered covid-19 laboratory testing to most individuals—including the uninsured (pdf) and those on Medicare—at no cost. But even as more pharmacies began stocking rapid at-home covid tests, the federal government was slow to make them widely available. Though frequent testing is seen as an effective measure to contain coronavirus spread, rapid at-home covid tests in the US typically cost anywhere from $9 to $24, and have been going for as high as $80 as pharmacies battle supply-and-demand issues.

More people in the US should have access to free at-home rapid tests later this month, when the Biden administration has said it will make 500 million test kits available to anyone who wants them. The Department of Health and Human Services also says it’s providing up to 50 million at-home tests to community health centers and Medicare-certified health clinics to distribute to patients free of cost.

By the time these tests reach everyone who needs one, though, the first wave of the omicron variant will likely have already peaked. But at the very least, manufacturers and public health officials may now be better prepared for the next coronavirus variant.

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Another victim of the war on pts/drugs ?

Posted on January 15, 2022 by Pharmaciststeve

from Shasta

It is with great sadness that I have to share with all of you that our good friend and fellow activist, Lisa Pray has passed on. I was asked to let everyone know.
Lisa was always such a fun person to talk with, had a wonderful spirit and cared so very much about our community. Even though she struggled with her health, she never stopped working to raise awareness. She loved making her videos on TikTok and many of us learned so much from her. Her quest for the truth and her joy for activism was a joy to be around. I always appreciated her for giving us all a voice in her room she created “The Painful Truth”. She stood by her friends and her passion really shined through.

I miss you Lisa Pray. I can’t believe that I will never hear your voice again. Thank you for always being such a good friend to me.

RIP Gravestone

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very interesting video on gov surveillance on Medicare disabled people

Posted on January 15, 2022 by Pharmaciststeve

Barb is no longer on Medicare disability – she is just OLD NOW !… so this video is of no real interest to me… but this appears to be made by -maybe – an attorney firm DISABILITY RESOLUTION, PA

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OPERATION WARP SPEED: the horror stories are starting to see the light of day

Posted on January 15, 2022 by Pharmaciststeve

As far as I can tell the Astra Zeneca version of a COVID-19 vaccine was never approved by our FDA. Because of the “bum’s rush” (operation warp speed) to get a COVID-19 vaccine to market – as I remember – the USA ordered 300-400 million doses prior to that vaccine even getting a FDA EUA (Emergency Use Authorization). I remember hearing that we sent hundred of millions of doses to India or Pakistan when they had a huge outbreak.

Back in 2020-2021, I remember questioning putting a new medication on the market with < one year of clinical trials – a new med typically takes 10+ yrs to get thru all the appropriate clinical trials and on to the market place..

As part of this “operation warp speed”, Congress indemnified everyone involved in getting these vaccines to market – that they could not be sued for any harm/damages that these vaccines could/would cause.

This video suggests that there was not only some harm to many pts getting these vaccinations, but there may have been some sort of purging of “bad data” and pts with adverse events and the woman in this video read a “suicide letter” from one such pt who experienced such bad outcomes that life was no longer worth living.

I am sure there will be more coming to light in the near/far future.

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American Medical Association is asking for your denial of pain management stories

Posted on January 15, 2022 by Pharmaciststeve

American Medical Association is asking for your stories. We If you have had problems obtaining proper or any dose of opiate pain medicines. AMA wants to know.

If you have had limitations on your pain medications by pharmacists, insurance companies, ER’s, after surgery or by any doctors NP’s or who ever trying to limiting opioid pain medications including tapering and being cut off.

send your BRIEF story to AMA to be counted. see email address below

Yes, I retired but one last video, it wore me out, back to my canoe

Your report needs your name (or the name of a representative, if you are shy), city, state, zip, no address or phone. plus – your primary diagnosis, just 1, what happened to you 1-3 sentences and what medicines were involved( if just a denial to treat AT ALL put “opiate pain medicine”) add the insurance company if they were a problem and thats all. Make it brief they are just counting. Maybe add “suspend cdc guidelines” if u want. Tell friends. spread the word!

EMail report to:
opioidtaskforce@ama-assn.org

They have said they want to hear from as many as possible. JUST DO IT! easy, they are primarily counting

Help get others do this, it is ok if if the sick person cannot do it.

Speak up, someone is listening, doctors not the government.
National Pain Council supports this effort
National Pain Council.org

Filed under: General Problems | 3 Comments »

PBM’S: Going to make it rough for people to get new antiviral meds

Posted on January 14, 2022 by Pharmaciststeve

The feds are providing this medication at NO CHARGE to community pharmacies and apparently the PBM’s have established a pharmacy reimbursement to fill these medications for pts at a ONE WHOLE DOLLAR. Years ago, when I was actively practicing pharmacy it was claimed that the business overhead in providing/filling a Rx for pts cost abt $12 EACH. But I retired in 2013, and part of that $12 cost would be the cost of carrying and insuring inventory, so that cost would/could be subtracted from that $12 cost, but NINE YEARS have passed since I last practiced, so nearly a TEN YEAR inflation, would most likely pushed that $12 cost back in 2013 would be much above that $12 dollar figure today. Just last month the current inflation for Dec 2021 was pushing TEN PERCENT on a annualized basis. Of course, the PBM industry has always fought financial transparency and if the numbers on this program are eventually leaked…I would not be surprised to see the PBM’s administration cost could be $20- $30 per Rx – charged back to the federal program. I would not be surprised that many pharmacies will just “be out of stock” of these two new anti-viral… I doubt that pharmacy software drug to drug interactions system will not be fully updated and I suspect that there is going to be a lot of drug-drug interactions that were not uncovered under the brief clinical trials under the EUA (Emergency Use Authorization). The Pfizer anti-viral version is known to have many serious drug to drug interactions and possible many undocumented drug to comorbidity health issues and the Pfizer med is reported to be nearly 3 times more effective than the Merck version.

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reporter from KSDK is looking for pharmacy employees to speak out anonymously about hazardous working conditions.

Posted on January 14, 2022 by Pharmaciststeve

Saint Louis region (MO / IL)

Please feel free to pass this along to any pharmacy employees, Rphs, etc you may know. A local reporter from KSDK is looking for pharmacy employees to speak out anonymously about hazardous working conditions. Her name is Allie Corey with KSDK and she can be reached via @alexandracorey on FB.

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Everyday: are you putting your health/life into healthcare providers who are “NOT AT THEIR BEST ” ?

Posted on January 14, 2022 by Pharmaciststeve

Wednesday was National Pharmacist Day, and one Georgia pharmacist described the feelings of burnout many in her profession are feeling.

https://www.13wmaz.com/article/news/health/coronavirus/pharmacist-burnout-covid-19/85-d8902656-da59-4576-afd9-2b202543757d

ATLANTA — COVID-19 brought a wave of burnout among physicians and other health professionals – while nurses and doctors are feeling the elevated stress and staffing shortages in the wake of the new omicron variant, they’re not the only ones feeling overwhelmed.

Pharmacists were seeing high burnout levels from their profession long before the COVID-19 pandemic. As the pandemic has continued, the situation has only worsened.

“Pharmacists have been dealing with this for a long time and COVID just took it to another level,” said Shirin Zadeh, pharmacist and president of the Atlanta region at the Pharmacy Association of Georgia.

In 2017 pharmacists reported higher rates of burnout in practice than surgeons, oncologists, and emergency-medicine practitioners. Right before the start of the pandemic, a 2020 study found 75% of pharmacists reported burnout.

The stress pharmacists are under can lead to mistakes in prescriptions, which can cause hospitalizations or even cost somebody’s life, said Zadeh.

The Pharmacy Association of Georgia, a pharmacist union, currently has 1,500 pharmacists and 537 pharmacy technicians.

Of those, 301 pharmacists and 88 of the technicians are under Zadeh’s supervision in the Atlanta region.

“I have so many pharmacists coming to me saying, ‘I just need a new job. I don’t care if I’m a pharmacist anymore. This is just not what I want to do with my life, because basically, I don’t have a life anymore,'” said Zadeh.

According to the U.S Bureau of Labor Statistics, about 11,300 openings for pharmacists are projected each year, on average, over the decade. All of these openings are expected to result from the need to replace workers who transfer to other occupations or exit the labor force, such as to retire.

The pharmacists under Zadeh in the Atlanta region feel like it’s impossible to get anything done and they come to her with these concerns. COVID-19 has forced them to quickly adapt to ever-changing regulations and practices.

“Hey, if we get these new guidelines every day, we get all these things that we need to do. Every news station says, ‘Oh, go to your pharmacy and get your immunization.’ Then we wake up and they say, ‘Oh, you have to do this many shots today.’ We go to work and how am I supposed to finish everything that I was doing. And top of that do immunizations,” said Zadeh.

Pharmacists are thinking about their patients’ safety when they decide to leave the field, according to Zadeh.

“Not only do they tired feel, but they feel unsafe for their patients. They think this is somebody’s mom, this is somebody’s dad, this is somebody’s kids and I’m not 100% and I don’t have time to look at their profile, go to their medication history because I’m the only one here and I have so many things to do,” said Zadeh.

It’s better for pharmacists to leave before someone gets hurt, she added.

The mindset, Zadeh said, is: “I’m going to get my license and I don’t want to kill someone, so I’m just going to leave.”

Zadeh wants everyone to know and value their pharmacist for the services they provide, both during the pandemic and under normal circumstances.

‘Pharmacists are the most trusted health care workers, they are everybody’s first phone call, the first person that the patient goes to ask for medical advice is their pharmacist. They’re just available, accessible all the time,” said Zadeh.

Filed under: General Problems | 2 Comments »

Mayo Hospital FL: things are done OUR WAY – even if alternative treatment could save the pt’s life.

Posted on January 14, 2022 by Pharmaciststeve

Just imagine your loved one has been on a vent for over TWO WEEKS and the hospital (MAYO) that the pt is in .. is playing “hardball” because the hospital’s policy disagrees with another prescriber that is willing prescribe Ivermectin for this pt… and the family’s fight is CRAWLING thru our court system – while the pt gets closer and closer to death and judge A-HO …declared …“An individual’s right to privacy is one of self-determination, the right to accept or refuse. It is not a right to demand a particular treatment. It is not a right to substitute one’s judgment as to which treatments must be made available by others. There is no right, constitutional or otherwise, of a patient to substitute one’s judgment for a medical professional.” And chose to pick one mediical professional’s opinion over another – as to what medication the pt can receive. AND if this pt dies – waiting for our laboric judicial system to come to a final decision… after it was determined that the LEGAL PROCESS NEEDS TO BE EXPEDITED. Aren’t we all grateful that when someone goes into a hospital’s Emergency Dept and critically ill that their “expedited process” takes weeks ? If this pt dies, is anyone going to be held responsible for all the “FEET DRAGGING ” and the pt’s death ?

Florida Family Fighting For Ivermectin: Appeals Court Expedites Case

https://www.zerohedge.com/covid-19/florida-family-fighting-ivermectin-appeals-court-expedites-case

Florida’s First District Court of Appeal has expedited the process to decide a lawsuit filed by the family of a COVID-19 patient on a ventilator at a Jacksonville hospital

Attorneys for Mayo Clinic Florida have until 10 a.m. Jan. 13 to respond to the appeal filed by the family of 70-year-old Daniel Pisano.

Then the family’s attorneys will have until Jan. 14 to file additional arguments. At that time, a three-panel judge could be appointed to decide the case.

Mayo Clinic has said Pisano, who has been on a ventilator 22 days, has a slim chance of survival.

But an outside doctor, who is not affiliated with Mayo Clinic, testified in an emergency hearing Dec. 30 that there’s still a good chance to save him—although there’s no time to delay, the physician said.

Chris and Lauren Pisano were elated when his parents Daniel and Claudia decided to move from North Carolina to Florida in early December, and bought a lot where they planned to build a home nearby to be close to their only two grandsons.
In a desperate attempt to save their loved one, the Pisano family has begged Mayo Clinic to try a protocol widely used by independent physicians around the country and developed by the Front Line COVID-19 Critical Care Alliance.

Mayo Clinic officials have refused and attorneys have fought the family’s wishes vigorously in court.

Claudia Pisano, Daniel Pisano’s wife of 51 years, and their son, Chris, have power of attorney and legally have the right to ask for the treatment of their choice, their attorneys have argued. But Daniel Pisano is declining fast and running out of time, they say.

The family’s trusted doctor, Dr. Eduardo Balbona of Jacksonville, testified that in order to save him the hospital must quickly allow treatment—with ivermectin and other drugs and supplements—he’s used to help dozens of critically ill COVID-19 patients recover.

Being on the ventilator is doing harm to Pisano and other patients fighting COVID-19, Balbona testified.

After considering the testimony in the three-hour hearing, Judge Marianne Aho, of Florida’s Fourth Judicial Circuit, denied the family’s plea to force Mayo Clinic doctors to step aside and let Balbona treat their dying loved one.

Aho wrote, “An individual’s right to privacy is one of self-determination, the right to accept or refuse. It is not a right to demand a particular treatment. It is not a right to substitute one’s judgment as to which treatments must be made available by others. There is no right, constitutional or otherwise, of a patient to substitute one’s judgment for a medical professional.”

The family disagrees saying the Florida Patient’s Bill of Rights gives them the right to choose between treatment options and they’ve offered to release Mayo Clinic from all liability in following through with that care. They filed an appeal Jan. 9.

After Mayo Clinic submits a response by Jan. 13, attorneys for the family will have until 3 p.m. on Jan. 14 to add to their arguments.

Meanwhile, on Jan. 12 Daniel Pisano clung to life in a drug-induced coma, on a ventilator, and on his sixth day of dialysis for kidneys that have shut down.

Doctors monitoring his chart for the family through an online portal say his lab work suggests internal bleeding, says attorney Nick Whitney, of the AndersonGlenn law firm in Jacksonville.

For days, Chris and Claudia Pisano have begged Mayo Clinic to do a CT scan to identify the cause of the bleeding.

“Mayo has refused, saying the CT scan is not medically appropriate,” Whitney says.

Mayo Clinic officials have not responded to requests for comment. Attorneys for the hospital have asked for their filings in the case be sealed from pubic view, citing privacy concerns.

The Mayo Clinic logo at Mayo Clinic Square, Minneapolis, Minn., on June 24, 2018. (Tony Webster via Wikimedia Commons)
The family’s search to find a hospital able to take Daniel Pisano has led only to dead-ends, Whitney said.

Still the Pisanos hope to continue raising money through donations to keep their legal fight going and to be able to pay$40,000 to $50,000 for air ambulance transport.

As of Jan. 12, 142 donors had given more than $28,000 toward the effort.

Since news of the case began spreading other families facing similar heartbreak have reached out to Whitney and to Jeff Childers, of Childers Law in Gainesville, another attorney on the Pisano legal team.

And on Jan. 12, a patient was driving from Chicago to Florida to meet with Balbona.

Whitney said it’s not easy for patients to find a doctor like Balbona willing to step up and make an alternative treatment plan for a patient hospitalized with COVID-19. And that’s the first step, he’s told those who have contacted him.

Families desperate for help say they don’t know where to turn, he said.

When they reach out for help through independent doctors, they’re told that the person can’t take on more cases, he added.

“The bottleneck, in my opinion, is that physicians who are willing to do this are overwhelmed,” Whitney said. “There’s a need for intensive care physicians to come forward and say they’re willing to treat with ivermectin.”

The U.S. Food and Drug Administration has posted strict warnings against using ivermectin to treat COVID-19.

More than 90 peer-reviewed studies have been published, which supporters say demonstrates the drug’s efficacy at treating patients suffering from COVID-19.

Claudia Pisano is fighting to try to save the life of her husband of 51 years, Daniel, by asking a judge to order Mayo Clinic to allow treatment with ivermectin. (Photo courtesy of Chris Pisano)
Part of the frustration families face when they’re seeking alternative treatments for COVID-19 surrounds the Right to Try Act signed into law May 30, 2018.

It gives patients access to some unapproved treatments, if they have been diagnosed with life-threatening diseases or conditions, have tried all approved treatment options, and are unable to participate in a clinical trial to access certain unapproved treatments, according to the FDA.

But ivermectin and other drugs used as part of the FLCCC protocol for treating COVID-19 have already been approved by the FDA for some uses, so they don’t qualify to be used under the Right to Try Act.

“Right to Try only applies to experimental medications,” says Childers. “It says nothing about FDA-approved meds like fluvoxamine, ivermectin, or hydroxychloroquine.”

The Mayo Clinic is a nonprofit American academic medical center employing more than 4,500 physicians and scientists and 58,400 other staff members across campuses in Florida, Minnesota, and Arizona.