The Arkansas State Medical Board voted to take no action at this time against a physician embroiled in a federal lawsuit over prescribing Washington County jail inmates ivermectin, an anti-parasitic medication some doctors have given as an off-label treatment for covid-19.
During an April Medical Board meeting, board members told Dr. Robert Karas that a state investigator was unable to find consent forms in all but one of the inmate medical records that were reviewed.
Four inmates are suing Karas, his health care company, the jail and the Washington County sheriff after they say they were unknowingly given "incredibly high doses" of ivermectin after contracting covid-19 last summer, according to court documents.
The state Medical Board has not taken a stance on the off-label use of ivermectin as a treatment for covid-19. Instead the Board's investigation of Karas centered on informed consent and whether the detainees knew they were being given the de-wormer as part of a medication regimen for the virus.
Several health agencies, including the U.S. Food and Drug Administration, advise against using ivermectin for the prevention and treatment of covid-19.
"This is not about the chosen drug. This is about doing the right thing," Dr. Edward Garner, a board member, said during the April 7 meeting. "It is about permission."
"I am surprised that our simple informed consent that we use on everybody and have for years, how that is getting missed on that many people," Karas said before the board in April.
He added that after state and national media attention last year, he "did do a more thorough informed consent with all the medications and have them [detainees] sign specifically for each medication they were getting.
"Thanks for not having an emergency suspension [of my medical license] or anything like that," Karas told the state Medical Board in April.
Board members Thursday told Karas, who appeared with his attorney, Kyle Unser, that the physician had provided the information needed to clear up questions about consent.
"There were some questions regarding the consent forms, the general consent to treat forms on some of these patients," Dr. Sylvia Simon, board chairman, said. "We've since gotten copies of those with explanations for why some of them actually appeared to be signed and some of them appeared to be more typed with covid regulations."
"I think he has given us what we asked him to give," Simon said. "We had questions about the consent forms previously. We have got them now."
During his roughly three-minute appearance Thursday, Karas said for "public record" he wanted to talk about the Washington County jail.
"We have had 1,200 cases plus of covid there that we have documented with electronic medical records," he said. "We have a case fatality rate of zero percent. We have one hospital admission for two days on a patient who refused his meds. I tell people it is the safest place in the world to get covid."
The lawsuit, filed by the American Civil Liberties Union of Arkansas on behalf of the four inmates in January, contends they were given ivermectin as early as November 2020 and didn't become aware of what the treatment was until last July. The lawsuit states they were told the treatment consisted of "vitamins," antibiotics," and/or "steroids," court documents said.
It is unclear whether the federal lawsuit will move forward as both sides wait on a ruling by the judge on whether to dismiss the case. That decision could come as early as next week when a hearing is scheduled to discuss whether the case is moot because the inmates are no longer being held at the Washington County jail, said Gary Sullivan, ACLU of Arkansas legal director.
Attorneys representing the plaintiffs are amending their claim to seek damages in lieu of injunctive relief as well as seeking to consolidate lawsuits with a fifth detainee also claiming no informed consent was given for ivermectin, Sullivan said.
"Our best option would be the court ordered them to get informed consent from the detainees before they take ivermectin," Sullivan said. "We believe informed consent should include a clear statement that the use of ivermectin to treat covid is not sanctioned and also that the FDA has warned against its use. A person should be informed of that."