A doctor accused of giving a toddler a fatal dose of an unapproved drug was declared “very, very dangerous” at a meeting of the Florida Board of Medicine on Friday. But she escaped serious discipline by agreeing to go away and stay away.
Dr. Martha Grout, medical director of the Arizona Center for Advanced Medicine in Scottsdale, Ariz., agreed to give up her Florida license voluntarily within 10 days of receiving the final order from the board. In return, the order imposed merely a “letter of concern” and a $2,500 fine.
Several board members said Grout should have her license suspended or revoked for her actions in the Arizona case. Dr. Nabil el-Sanadi called her a “public threat” and “very, very dangerous.”
But most voted in favor of the deal, they said, in order to keep Grout from ever returning to Florida, where she practiced for several years in the 1990s.
Arizona’s standards are different from Florida. It licenses doctors who practice “homeopathy” and other alternative treatments that are not legal in this state.
Grout said most of her practice involves homeopathy, which dates back more than 200 years. It involves giving a person a diluted dose of a substance that would be harmful if given full-strength. The National Center for Complementary and Integrative Health says “there is little evidence to support homeopathy as an effective treatment” for any illness.
Grout’s attorney, Allen Grossman of Tallahassee, told the Florida board that it could not punish his client for actions that were legal in Arizona. The Arizona Board of Medicine gave her only a reprimand – no suspension, no probation, not even a fine.
The Arizona Board of Homeopathic and Integrative Medical Examiners dismissed the case. Florida and most other states do not have such a board.
The case presented a dilemma for the Florida board, which met Friday near Orlando. It tests the question of whether Florida, which filed a complaint against Grout because of the disciplinary action imposed in Arizona, could go further than Grout’s home state in meting out discipline. Department of Health prosecutor Yolanda Green told the board DOH felt it could not legally press for more serious discipline.
According to the “findings of fact” by Arizona authorities, the case involved an 18-month-old girl in Maine who was suffering from a rare form of eye cancer, called retinoblastoma. After her doctors in Maine removed her right eye in February 2013, they suggested follow-up tests and chemotherapy. Instead, her parents took her to Grout’s center in Scottsdale, the Arizona Center for Advanced Medicine.
In medical board records in Arizona and Florida, the child was called MM, by her initials. But she was identified as Mercy Maynard of Dexter, Maine, several months ago in an online article “Deadly Medicine” by Emilia David. The writer, who was then a graduate student in journalism at City University of New York, has now graduated.
Arizona medical board records say Grout gave the child 3.4 milliliters of amygdalin orally on March 13, 2013 at 3 p.m. as a homeopathic treatment for the cancer. Around 5:15 p.m., Mercy’s father called, saying she was crying, bloated and short of breath. Grout told them to return to the clinic.
But soon after they arrived, the records say, Mercy went into cardiorespiratory arrest. Grout called paramedics and provided cardiopulmonary resuscitation to the child, records say, but had no pulse when paramedics arrived. Aggressive resuscitation at the hospital failed and Mercy was pronounced dead shortly before 8 p.m.
Mercy’s father refused consent for an autopsy, but the Scottsdale Police Department overruled him. The autopsy report said the cause of death was undetermined, but a medical consultant to the state later concluded that Mercy died of cyanide poisoning as a result of the amygdalin that Grout gave her.
In its Aug. 8, 2014, letter of reprimand to Grout, the Arizona Medical Board said she violated the standard of care because she hadn’t tried all the currently accepted mainstream medical treatments before trying amygdalin. Also, the board said she should have made sure that the substance would not harm the patient.