Regulatory Actions against Robban Sica, M.D.

Stephen Barrett, M.D.

Robban A. Sica, M.D., who operates the Center for the Healing Arts in Orange, Connecticut, is facing charges that could result in revocation of her medical license. In 2003, she was charged with improperly using chelation therapy to treat cardiovascular disease, failing to obtain adequate consent for such treatment, and failing to properly manage many of these patients whom she said were suffering from heavy metal toxicity. Sica was charged with violating the standard of care, as follows:

STATE OF CONNECTICUT
DEPARTMENT OF PUBLIC HEALTH
BUREAU OF HEALTHCARE SYSTEMS

In re: Robban Sica, M.D.

Petition No. 2002-0306-001-043

STATEMENT OF CHARGES

Pursuant to the General Statutes of Connecticut, §§19a-10 and 19a-14, the Department of Public Health (hereinafter "the Department") brings the following charges against Robban Sica, M.D.:

FIRST COUNT

1. Robban Sica, M.D. of Orange, Connecticut (hereinafter "respondent") is, and has been at all times referenced in this Statement of Charges, the holder of Connecticut physician and surgeon license number 026453.

2. Respondent treated patient E.M at various times between May 2000 and May 2001. E.M. had a history of atherosclerosis, hypertension, and hypercholesterolemia. Respondent diagnosed mercury and nickel poisoning. Respondent treated patient with IV infusions of EDTA from on or about October 9, 2000 until on or about April 26, 2001.

3. Respondent's care for E.M. violated the applicable standard of care in one or more of the following ways:

a. she treated coronary artery disease with EDTA;
b. she failed to make a differential diagnosis of the patient's symptoms;
c. she diagnosed mercury and nickel poisoning without adequate supporting laboratory data;
d. she treated for mercury and nickel poisoning by giving IV infusions of EDTA;
e. she failed to identify a source of mercury and nickel and abate it;
f. she failed to perform follow-up tests on the diagnosis of mercury and nickel toxicity;
g. she administered excessive quantities of EDTA;
h. she failed to order kidney function tests to ensure the safety of the long-term administration of EDTA; and/or
i. she failed to obtain adequate consent from the patient to treat with IV infusions of EDTA.

4. The above described facts constitute grounds for disciplinary action pursuant to the General Statutes of Connecticut, §20-13(c)(4).

SECOND COUNT

5. Paragraph 1 of the first count is incorporated herein by reference as if set forth in full.

6. Respondent treated patient I.M at various times from June 6, 2002 through August 27, 2002. I.M. had a history of hypertension, hypercholesterolemia, adult onset diabetes, and erectile dysfunction. Respondent diagnosed copper and lead poisoning. Respondent treated patient with IV infusions of EDTA from on or about June 10, 2002 until August 27, 2002.

7. Respondent's care for I.M. violated the applicable standard of care in one or more of the following ways:

a. she diagnosed and treated for heavy metal toxicity at least three occasions before she received the laboratory analysis of the patient's blood;
b. she diagnosed and treated for heavy metal toxicity without identifying a source of exposure or prescribing measures to abate the exposure;
c. she continued to diagnose and treat for heavy metal toxicity even though the laboratory values were within normal limits for all tested metal toxins;
d. On August 27, 2002, she determined that I.M. no longer had toxic levels of metal, without any laboratory evaluation;
e. she administered IV infusions of EDTA without following any standard protocol for such administration;
f. she treated hypertension with EDTA;
g. she administered excessive quantities of EDTA;
h. she failed to order kidney function tests to ensure the safety of the long-term administration of EDTA; and/or
i. she failed to obtain adequate consent from the patient to treat with IV infusions of EDTA.

8. The above facts constitute grounds for disciplinary action pursuant to the General Statutes of Connecticut, §20-13(c)(4).

THIRD COUNT

9. Paragraph 1 of the first count is incorporated herein by reference as if set forth in full.

10. Respondent treated patient J.A. on various occasions from January 30, 2002 through April 25, 2002. J.A. had a history of acute atrial fibrillation in September 2001, hypertension controlled by medication, and hyperthyroidism. J.A. presented specifically for treatment of arteriosclerosis and requested EDTA chelation. A laboratory analysis of J.A.'s red blood cells dated February 8, 2002 reported an elevated level of antimony and slightly elevated levels of manganese. Respondent administered IV infusions of EDTA on fourteen visits from January 31, 2002 through April 2, 2002.

11. On March 11, 2002, during an IV infusion of EDTA, J.A. became lethargic and incoherent and developed rales in her chest.

12. Respondent's care for J.A. violated the applicable standard of care in one or more of the following ways:

a. she failed to validate the laboratory result for elevated trace elements;
b. she treated ateriosclerosis with EDTA;
c. she treated a diagnosis of non-lead metal toxicity with EDTA;
d. she failed to identify or abate a source of exposure to antimony and/or manganese;
e. on March 11, 2002, she failed to recognize the severity of J.A.'s potentially fatal condition, and failed to hospitalize J.A.;
f. she administered excessive quantities of EDTA; and/or
g. she failed to order kidney function tests to ensure the safety of the long-term administration of EDTA.
h. she failed to obtain adequate consent from the patient to treat with IV infusions of EDTA

13. The above facts constitute grounds for disciplinary action pursuant to the General Statutes of Connecticut, §20-13(c)(4).

FOURTH COUNT

14. Paragraph 1 of the first count is incorporated herein by reference as if set forth in full.

15. During the period of January 1, 2002 through the date of this Statement of Charges, respondent has administered and/or prescribed EDTA chelation therapy for coronary and/or vascular diseases and for diagnoses of various metal toxins in approximately 40 patients.

16. Respondent's care for every such patient has violated the standard of care in one or more of the following ways:

a. she has treated coronary and/or vascular diseases with EDTA;
b. she has treated metal toxicity, other than lead toxicity, with EDTA;
c. she has exceeded accepted dosing limits of EDTA;
d. she has failed to identify and abate a source of exposure to the diagnosed toxic metal; and/or
e. she has failed to perform kidney function tests to assure that the EDTA has not damaged the kidneys.
f. she has failed to obtain adequate consent from the patient to treat with IV infusions of EDTA

17. The above facts constitute grounds for disciplinary action pursuant to the General Statutes of Connecticut, §20-13(c)(4).

THEREFORE, the Department prays that:

The Connecticut Medical Examining Board, as authorized in §§19a-17 and 20-13(c), revoke or order other disciplinary action against the physician and surgeon license of Robban Sica, M.D. as it deems appropriate and consistent with law.

Dated at Hartford, Connecticut this ______ day of 2003.

Stanley K. Peck, Director, Legal Office
Bureau of Healthcare Systems

Chelation therapy is a series of intravenous infusions containing EDTA and various other substances. It is falsely claimed to be effective against cardiovascular disease and many other diseases and conditions. Chelation has valid use in some cases of heavy metal poisoning. However, chelationists often diagnose it in patients with no history of toxic exposure and use treatment protocols that differ from standard protocols [1].

When Sica learned that the Connecticut Bureau of Health Care Systems was investigating her, she filed a 48,000-word lawsuit and founded the Protect Healthcare Freedom Association to appeal for financial and political help. The suit, which charged that she was being denied due process, targeted the State, the Connecticut Department of Public Health, the Commissioner of Public Health, the individual board members, and a medical consultant [2].

Federal courts do not intervene in ongoing state regulatory matters unless a plaintiff can demonstrate that the state's action was brought in "bad faith" or involves "extraordinary circumstances." Sica charged that she was being unfairly persecuted and that the state's system for physician regulation was severely flawed. However, in October 2004, after considering the meager evidence she presented, a federal judge ruled that the state board procedures would provide Sica with ample opportunity to defend herself and that her argument that Connecticut's regulatory framework was globally flawed was "frivolous." [3] It appears to me (and I suspect that it was obvious to the judge) that the lawsuit was an attempt to persuade state government officials that pursuing her will take more effort than the state can afford to spend.

In February 2005, Sica and the Connecticut licensing authorities signed a settlement under which she agreed to: (a) serve a year of probation, (b) stop using DMPS as a chelating agent, (c) stop using a provoked test to diagnose heavy metal toxicity, (d) use a patient consent form which states that chelation therapy has not been scientifically substantiated, and (e) have her practice monitored by an independent consultant. The agreement also contained stringent recordkeeping and reporting requirements and a provision that Sica could not own shares or serve as an officer of any professional corporation or other form of medical practice in which she does not render a substantial amount of patient care [4].

Other Dubious Practices

In addition to chelation therapy, Sica offers other questionable services, the most notable of which is "electrodermal screening" with the Listen System, which Sica says can "help identify patterns of environmental sensitivities." However, the device merely measures skin resistance to a low-level electric current. According to a proponent's patent application:

The LISTEN system is a modified computer-based system which, in addition to determining electrical resistance at specific conductance points, can be used to administer radio frequency signals corresponding to specific compounds, such as homeopathic dilutions of growth factors. These signals are generated by digital codes pre-programmed into the system by the manufacturer. The patient to be evaluated holds a source electrode, or brass bar, covered with wet gauze in one hand. The practitioner holds a second brass electrode, or probe, like a pen and touches a specific conductance point in the other hand or in a foot with the probe while firmly supporting the finger or toe [5].

All the device actually measures is how hard the practitioner presses the probe against the patient's skin [6]. Sica's Web site states that she usually charges $380 for her initial "comprehensive wellness assessment," $150 to $275 for subsequent office visits, and $420 for electrodermal screening [7].

Previous Problems

Sica has had other legal problems. In 1999, Allstate Insurance Company filed two suits against 258 individuals suspected of participating in staged accident rings in Camden and Perth Amboy, New Jersey. A third suit targeted chiropractors, medical doctors, and related medical and business corporations who allegedly created a dummy medical corporation to misrepresent a chiropractic facility as a physician-owned medical center. One of the suits accused a chiropractor of setting up a phony medical corporation in order to circumvent a New Jersey health-care regulation that limits chiropractors' scope of practice and regulations designed to reduce health care costs. The chiropractor entered into the alleged illegal arrangement with Sica to create the appearance that the clinic was owned by Sica. The suit alleged that Sica had suspected ownership interests in at least 14 other similar corporations in New Jersey. The chiropractor was introduced to Sica through a seminar run by a California chiropractor named Daniel Dahan, who operated a medical management consulting firm called "Practice Perfect." Dahan located the MD-for-hire and also supplied the instructions and paperwork to set up the bogus corporation. In testimony to Allstate, the chiropractor admitted that he never personally met Sica and that she had never visited the facility, invested in the corporation, or treated or supervised patients [8]. In 2001, a judge ruled that the scheme "to be suspicious and indicative of a sham ownership." [9] Sica settled her part of the lawsuit in 2004 in an agreement with undisclosed terms.

In 2000, Allstate sued Sica and 108 other defendants for fraud and racketeering in New York State. According to an Insurance Times report:

Included as defendants are 47 medical professional corporations, 15 medical doctors, one former medical doctor, 26 chiropractors, five lay persons and 15 management companies. The complaint alleges claims for relief under the federal Racketeer Influenced and Corrupt Organization (RICO) Act, the state consumer fraud act, the state anti-self-referral statute, under theories of common law fraud and unjust enrichment. Collectively, the companies seek in excess of $60 million in damages plus undetermined additional punitive damages.

The lengthy investigation by Special Investigations Units (SIUs) from the four insurance companies revealed five medical doctors and one former medical doctor as the main perpetrators of the scam. The complaint charges that Alan Cohen, M.D., Swapnadip Lahiri, MD, Robban Sica, MD, George Battaile, Robert Mallela, MD, and John Grauerholz, MD were willing to sell their names and licenses to anyone willing to pay their fees. Cohen was identified as the principal perpetrator with 29 of the named phony PCs linked to his name. . . .

A doctor such as Cohen agreed to sell the use of his name and license for a yearly fee of approximately $4,000 to any lay person or non-physician interested in establishing one or more phony medical PCs. The transaction was completed through a complex series of contracts and agreements that purported to absolve Cohen from responsibility for anything associated with the phony PC, including providing any genuine medical services.

By requiring them to sign over their stock certificates in blank at the time the phony PC was formed, the real owners of each PC made sure that Cohen and the other nominal owners could never seek to take control of the PC. The real PC owners could then assume ownership by filling in the blank stock certificates with the dates and the names of any individuals they chose. The real PC owners could then continue to control and operate the phony PCs [10].

Sica's part in this lawsuit was also settled with a confidential agreement [2].

The third lawsuit involved sham ownership by Sica in five New Jersey corporations [11].

In 2001, New York State licensing authorities charged Sica with "professional misconduct by reason of directly or indirectly receiving or agreeing to receive a fee or other consideration from third party in connection with the performance of professional services." [9]. The State alleged that between 1995 and 1999:

It is against New York state law for anyone other than a licensed practitioner to own a medical professional corporation that delivers services covered under the practitioner's license. Sica settled the charges with a consent agreement under which she promised to dissolve the corporations and to permanently give up her right to renew her license [12]. In 2002, in a separate consent agreement, Sica agreed to dissolve one of the clinics, Bellmore Physical Medicine and Rehabilitation, P.C. (formerly known as Bellmore Medical Services). [13]

New Charges (2010)

DMPS is not a legal drug [14]. In 2010, Sica was charged with violating the 2005 order by prescribing it for 11 patients [15]. In 2012, the board fined her $700 per patient, suspended her license for 30 days, and ordered close monitoring of her practice for two years [16].

References

  1. Barrett S. Chelation therapy and insurance fraud. Quackwatch, May 11, 2000.
  2. Sica v. State of Connecticut et. al., Civil Action 3-04CV0023.
  3. Garfinkle WI. Findings of fact re: alleged exceptions to Younger abstention. In Sica v. State of Connecticut et al. U.S. District Court, District of Connecticut, Civil Action No. 3:04-CV-23(MRK), Oct 8, 2004.
  4. Consent order. In re: Robban Sica, M.D. Petition No. 2002-0306-001-043, Feb 15, 2005.
  5. Brewitt B. Homeopathic dilutions of growth factors. U.S. Patent Number 5,629,286, May 13,1997.
  6. Barrett S. Quack "electrodiagnostic" devices. Quackwatch, revised April 26, 2004.
  7. Welcome package. Center for the Healing Arts Web site, accessed, May 4, 2004.
  8. Barrett S. Allstate sues to recover many more millions. Chirobase, Dec 30, 1999.
  9. Allstate Insurance Company v. Northfield Medical Center, Practice Perfect, Daniel H. Dahan, Robert Borsody, et al., Superior Court of New Jersey, Law Division, Morris County, Docket No. MRS-L-3228-99, decided April 27, 2001.
  10. Insurers allege fraud In $60 million lawsuit against NY doctors. Insurance Times, March 28, 2000.
  11. Denial of summary motion to dismiss. Allstate Insurance Company et al. v. Harry Schick, D.C., 328 N.J.Super. 611, 746 A.2d 546, Nov. 23, 1999.
  12. Consent agreement and order. In the matter of Robann A. Sica, M.D. New York State Board for Professional Medical Conduct, BPMC No. 02-10.
  13. Consent agreement and order. In the matter of Bellmore Physical Medicine and Rehabilitation, P.C., f/k/a/ Bellmore Medical Services, P.C. New York State Board for Professional Medical Conduct, Oct 28, 2002.
  14. Barrett S. DMPS is not a legal drug. Chelation Watch, Jan 25, 2010.
  15. Statement of charges. In re: Robban Sica, M.D. Petition No. 2007-0227-001-030, March 19, 2010.
  16. Memorandum of decision. Robban Sica, M.D. Petition No. 2007-0227-001-030, June 19, 2012.

This page was revised on July 30, 2012.