The Florida Medical Board has reprimanded and fined a physician whose patient — a toddler — died soon after being given a dose of amygdalin (also known as laetrile) to treat her advanced eye cancer. Amygdalin — whose active component is believed to be cyanide — is not approved by the US Food and Drug Administration (FDA) and is controversial, given its unproven effectiveness and potential for deadly side effects.
Martha Grout, MD, agreed to give up her Florida license and pay a $2,500 fine. The Florida board took action against Dr Grout more than a year after the Arizona Medical Board reprimanded her for her role in the March 2013 death of the 18-month-old girl.
Dr Grout, medical director of the Scottsdale-based Arizona Center for Advanced Medicine, is still licensed in Arizona and Hawaii.
The Florida reprimand was not surprising, given the censure in Arizona, said Stephen Myers, a Phoenix, Arizona, attorney who represented Dr Grout in her proceedings with the Arizona Medical Board and the Arizona State Board of Homeopathic and Integrated Medicine Examiners.
Dr Grout was required under Florida law to report, within 30 days, the disciplinary action in Arizona, but did not. As a result, the Florida state health department instituted proceedings against her in February 2015...
Dr Grout was licensed in Arizona by both the Arizona Medical Board and the Arizona State Board of Homeopathic and Integrated Medicine Examiners. Only the allopathic board reprimanded her; the homeopathic board cleared Dr Grout in what Myers called a thorough investigation.
According to the August 2014 reprimand from the Arizona Medical Board, the child, Mercy Maynard, had retinoblastoma. She had an eye removed by oncologists in her home state of Maine in February 2013. The biopsy confirmed spread to surrounding orbital tissue. The oncologist urged the Maynards to follow up with a spinal tap for tumor staging, but they instead sought Dr Grout's care in Arizona.
The father signed a consent form with Dr Grout's clinic "that indicated that the safety and efficacy of many homeopathic medicines have not been established in controlled studies to the satisfaction of the FDA and many conventional physicians," according to the state medical board.
Dr Grout gave the child 3.4 milliliters of amygdalin on March 13, 2013. Amygdalin, found in fruit pits, raw nuts, and some plants, is used primarily in Mexico. According to the National Cancer Institute (NCI), amygdalin has not been shown to be effective in any controlled studies. The drug was popular in the US in the 1970s, but it also had the potential to be extremely toxic — mimicking cyanide poisoning — especially in the pill form, said NCI.
Twenty-four hours after Mercy received the amygdalin dose, Mr Maynard told Dr Grout that the child was having shortness of breath and bloating. He was told to come back to the clinic. Mercy almost immediately went into cardiorespiratory arrest and could not be revived, even by paramedics called to the scene by Dr Grout. Mercy died less than 3 hours after her symptoms began.
The hospital contacted the police, who began a child abuse investigation.
The Maricopa County Office of the Medical Examiner concluded that Mercy died from cyanide poisoning, as a result of the amygdalin dose. "This case represents toxicity occurring in the setting of an alternative medical regimen," according to the autopsy report.
The medical examiner concluded that there was "no apparent or stated intent to cause injury or death."
The Arizona Medical Board ruled that Dr Grout deviated from the standard of care by not making sure that the patient had tried all forms of accepted allopathic treatment and not ensuring that the amygdalin would pose no harm.
Dr Grout agreed to accept a reprimand for "unprofessional conduct."
Separately, the Arizona State Board of Homeopathic and Integrated Medicine Examiners conducted "an exhaustive investigation," executive director Chris Springer told Medscape Medical News. The board concluded that Dr Grout had acted within the scope of the laws that govern the practice of homeopathic medicine.