Doctor cleared over breast cancer patient's treatment

A US doctor has been cleared of allegations of professional misconduct over the provision of a non-conventional treatment to a woman who died from breast cancer after refusing chemotherapy at Cork University Hospital.

A fitness-to-practise committee of the Medical Council decided to make no findings in the case, as it ruled none of the allegations against Professor Dana Flavin could be proven beyond reasonable doubt.

Prof Flavin had been accused of failing to clearly advertise on her website that her immune support treatment should be undertaken in addition to conventional therapy for breast cancer and not as a replacement for it.

The committee said it had also not been proven that the website, collmed.org, had failed to clearly state the risks and potential side effects of the therapy offered by Prof Flavin or that it was not based on large-scale "Phase III" clinical trials for new medical treatments.

A medical inquiry yesterday heard evidence that a woman in her 50s, identified only as Patient A, had died from curable breast cancer after telling doctors at CUH that she wanted to try an alternative treatment to chemotherapy.

The allegations related to a period between September 2021 and April 2023 during a period when Prof Flavin, who was based in the UK at the time, was understood to be involved in providing care to Patient A.

Announcing the committee's ruling today, the inquiry chairperson, Jill Long, said the committee had heard no direct evidence that Patient A had received treatment from Prof Flavin, while only limited screenshots from the website had been provided.

The website also contained a disclaimer that receiving a consultation or reading its content did not create a physician-patient relationship.

The inquiry's legal assessor, Ronan Kennedy SC, had cautioned the fitness-to-practise committee that large elements of the evidence were based on hearsay in the absence of Patient A.

Ms Long said there was a "very significant evidential deficit" in the case.

She said the committee also made no findings about the allegation that Prof Flavin had failed to adhere to Medical Council guidelines which require doctors to ensure any information published about their medical services is true and verifiable.

Council for the Medical Council, Hugh McDowell BL, had argued that information published by Prof Flavin on her website had the potential to raise unrealistic expectations on the part of patients.

Mr McDowell contended that all the allegations against Prof Flavin, who is also a qualified pharmacologist and biochemist, constituted both professional misconduct and poor professional performance.

A separate allegation that Prof Flavin had provided immune support treatment to Patient A in circumstances where it was inappropriate as it was neither evidence-based nor in the patient’s best interest was withdrawn during the hearing yesterday.

Patient regret

A consultant oncologist at CUH, Seamus O'Reilly, gave evidence to the inquiry that Patient A had rejected "time sensitive" chemotherapy treatment as she had chosen "a radical detox for 12 weeks."

Prof O'Reilly said he understood that Prof Flavin was involved in the provision of such care, with Patient A informing him that she was taking about 40 tablets per day.

The consultant admitted he had found it "troublesome" that he had never been contacted about the patient by Prof Flavin.

While he had tried unsuccessfully to get Patient A to change her mind about chemotherapy, Prof O'Reilly acknowledged that she had "an element of medical mistrust" and noted she had not been vaccinated against Covid-19.

The oncologist, who made a formal complaint about Prof Flavin to the Medical Council, said he had found Patient A's death from breast cancer "very upsetting."

He also observed that the patient appeared regretful about not undergoing conventional treatment as she approached the end of her life.

Prof Flavin, who now lives in Germany, did not attend the hearing.

The inquiry heard she had told Prof O'Reilly after he contacted her about Patient A that: "I never reject conventional medicine. I only support it."

She also wrote: "I applaud the discoveries of my colleagues. Your therapy is imperative."

Although registered with the Medical Council since February 2018, Prof Flavin claimed the regulatory body had no jurisdiction over her as she had never practised in Ireland and did not intend doing so in the future.

In reply to the complaint, she told the Medical Council that she had been researching cancer since 1970 and believed specific nutrients and off-label drugs could enhance the efficacy of conventional medicine for treating cancer.

An expert witness, Ray McDermott, told the inquiry that he believed that while Prof Flavin was advising patients to still seek standard medical treatment, she was also offering them "snake oil-type remedies."