Psychiatrist Held Patients Against Their Will? Patent Games; Abortion Paper Battle

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Psychiatrist Allegedly Held Patients Against Their Will

An Arkansas psychiatrist is being sued by more than 25 patients and has been eyed by that state’s attorney general for his role in an alleged scheme that involved holding patients against their will for days or weeks, according to NBC News.

Brian Hyatt, MD — who until recently was also the chairman of the Arkansas State Medical Board — allegedly held patients against their will far longer than the 72 hours allowed under state law. A longer hold would require consent from a judge, according to the story.

One of those patients is William VanWhy, whose partner had to work with a lawyer to get a court order for VanWhy’s release. A sheriff enforced the court order.

VanWhy’s lawyer, Aaron Cash, had previously represented patients with similar experiences with Hyatt.

“I think that they were running a scheme to hold people as long as possible, to bill their insurance as long as possible before kicking them out the door, and then filling the bed with someone else,” Cash told NBC News.

Another patient described feeling imprisoned while under Hyatt’s “care.”

The state attorney general’s office accused Hyatt of scamming Medicaid by claiming to treat patients he rarely saw and then billing for the highest severity code possible, though he has not been charged with a crime. Over 2.5 years, Medicaid paid $800,000 to Hyatt’s facility, the article stated.

“I will continue to defend myself in the proper forum against the false allegations being made against me,” Hyatt wrote in a letter reported by NBC News.

Patient Harm from HIV Drug Delay?

Back in 2004, Gilead executives were reported to think an updated version of tenofovir would be less toxic to patients’ kidneys and bones, yet the company halted its development, allegedly for intellectual property reasons, the New York Times reported.

Internal Gilead documents referred to a “patent extension strategy,” which is common in the industry, the Times reported. One method is product hopping, where pharmaceutical companies ride out their drug patents until near the end when generics could be available. Then, they switch patients over to an updated formulation that has a new patent. It’s a method of extending patent monopolies right before generics become available, according to the Times.

Those company documents, turned up by lawyers suing Gilead on behalf of patients, suggest that executives knew the new formulation was promising because it was less toxic — but they also imply that some thought the formulation was very similar to the one on the market.

“The patent system actually encouraged Gilead to delay the development and launch of a new product,” Christopher Morten, an expert in pharmaceutical patent law who has brought cases against Gilead, told the New York Times.

Gilead faces state and federal lawsuits representing 26,000 patients who took older HIV drugs and whose bones and kidneys were allegedly harmed as a result. One plaintiff is David Swisher, who took emtricitabine/tenofovir (Truvada) for 12 years starting in 2004 and developed kidney disease and osteoporosis.

Abortion Paper Controversy

A controversial paper published in 2011 in the British Journal of Psychiatry is still being used in legal cases against abortion rights, and efforts to have the paper retracted have been stymied, according to a joint investigation by the BMJ and the BBC.

The original paper, by Priscilla Coleman, PhD, concluded that women who have had abortions were at a much higher risk of developing mental health problems.

At the time of publication, the journal received letters questioning the paper’s methodology and calling for its retraction. One of the letter writers told the BBC the paper was “a very serious lapse of scientific integrity.” The Royal College of Psychiatrists, which owns the British Journal of Psychiatry, also found issues with the paper’s results and conclusions, yet the paper was not retracted.

After ongoing questioning of the paper’s value and an increasing number of legal cases using the research to influence women’s healthcare, the journal in 2022 formed an independent panel to investigate complaints against the paper. That panel also recommended retracting the paper, which hasn’t happened.

Some panel members raised concerns that legal threats may have influenced that decision. When the journal told Coleman it wanted to place a notice on the article raising awareness of a possible problem, her lawyers said that would cause “serious harm and direct damage to her reputation.” A second legal letter sent a month later allegedly repeated that threat, according to the BBC article.