DR. JONES' HEARING SYNOPSIS
(DAY SIX)
November 2006
Approximately 150 people were present, to witness Day
6 of Dr. Jones' hearing. Dr. Jones' next witness,
Brian Fallon, MD, was called to testify.
Dr. Fallon's testimony began with his advising the
panel regarding his credentials, going into some
detail regarding his background, as well as the
current scope of his work. Dr. Fallon mentioned his
testimony before federal boards and committees, his
long history of Lyme disease research, as well as his
recently-completed chronic Lyme disease study, and his
position heading the Lyme Disease Research Center,
soon to open at Columbia University. As he cited his
background, and his interest in Lyme disease research,
he stated that he's "appalled at how it hits
children."
Dr. Fallon also testified regarding his familiarity
with Dr. Jones' work, the two doctors sharing
patients, as well as both doctors serving as
presenters at medical conferences. In addition, Fallon
cited a fellowship for medical students at Columbia,
named after Dr. Jones. Selected students spend time in
Dr. Jones' office in the summer, and Dr. Fallon
testified that they are invariably impressed with the
thoroughness of Dr. Jones' examination of his
patients.
Regarding Lyme disease, Fallon noted the assumptions
made about Lyme disease that are not true. These
erroneous assumptions include 1/ that Lyme disease is
easily treated, 2/ that it does not cause serious
problems, 3/ that it doesn't cause psychiatric or
cognitive problems, and 4/ that there will be current
joint involvement, if Lyme presents as neurologic. He
also pointed out that not all EM rashes conform to the
bulls-eye configuration, when, in fact, an EM rash is
present.
Dr. Fallon noted that there is controversy regarding
the spectrum of the disease. He sees the narrow
definition (meeting CDC criteria) as useful for
surveillance, but a broader definition is needed for
diagnosis and treatment. The broader definition would
include chronic fatigue symptoms, encephalopathy, and
exposure in a Lyme-endemic area (that would be defined
as having 2 or more cases of Lyme reported). Other
areas of controversy include the number of courses of
antibiotics, and duration of treatment.
Fallon pointed out that most of the research done on
Lyme disease has addressed early Lyme.
Neuropsychiatric aspects may be more prominent in
chronic Lyme, and blood tests are most problematic in
chronic Lyme. Although he certainly considers blood
tests when screening patients for his research, Fallon
said we don't use blood tests to determine whether
people need treatment. It only measures immunological
response.
The symptoms of chronic Lyme can be very profound, at
times including severe neuropsychological
manifestations, according to Fallon. He includes
fatigue, increased need for sleep, headaches, sensory
hyperarousal, peripheral neurologic symptoms and mood
problems (including irritability, depression, anxiety,
and personality problems), AD/HD symptoms,
particularly inattentive type, in the list of possible
symptoms. Also cognitive problems can manifest,
particularly in children. Again, Fallon stressed that
Lyme disease can be very serious, citing a child blind
from Lyme as an example, and he said "You don't want
to miss it.
In support of his observations about the affects of
Lyme disease in children, he cited Felice Tager's
published research, indicating symptoms that were
moderate to severe in children, including attention
problems, confusion, and even suicidal ideation.
(Note: Tager's article is available on the Lyme
Disease Association website--
www.lymediseaseassociation.org/Tager.pdf)
In addition to citing study results to support his
testimony, he pointed to flaws in the design of other
studies that had previously been published, studies
often cited by those who challenge the existence of
chronic Lyme. These studies, Fallon pointed out, were
based on assumptions that would erroneously influence
the outcome. His testimony was very, very compelling.
Dr. Fallon was questioned, and cross-examined
extensively regarding neuropsychiatric Lyme disease
symptoms, and again his testimony demonstrated his
considerable knowledge in the field, and ability to
express it. Responding to a question on
cross-examination, specific to the case under
investigation, Dr. Fallon said, In this case, the
neuropsychological testing did show significant
deficits, consistent with Lyme, and AD/HD, inattentive
type. ? Also specific to the question of Lyme disease
present in these children, Fallon cited multi-system
symptoms as being consistent with Lyme, and the
importance of not using the CDC 5-band WB criteria to
substantiate Lyme.
Following direct and cross-examination, the panel
asked some questions. Many of us were shocked when
Munchausen's by Proxy was brought up. This would
assume that the children's mother was making the
children ill, in order to gain attention for herself.
Fallon said that Munchausen's by Proxy is very, very
rare. However, he has seen the allegation coming up in
cases involving divorce and custody, particularly
coming from fathers against mother sa number of
times?.
(Note: Dr. Jones' early testimony indicated that the
children's father had called and asked that Dr. Jones
support the father's allegation of Munchausen's by
Proxy against the mother, and the mother's testimony
also indicated that her ex- husband had threatened to
have her declared mentally ill. After Dr. Jones
refused to collude with the father, the father filed
the complaint against Dr. Jones with the health
department. One might question whether the health
department should have investigated the source of the
complaint, the father, and his underlying reason for
the complaint, before taking action against Dr.
Jones.)
Fallon was asked by the panel his opinion regarding
monitoring of the treatment. Fallon indicated that
monitoring was done, citing the mother's considerable
experience as a nurse, her telephone updates, Dr.
Jones' ordering blood work, and the mother's inability
to find a medical professional who would monitor (in
light of her ex-husband's threats to the local
doctors). Regarding evidence that Dr. Jones
considered other possible illnesses in the
differential diagnosis, Dr. Fallon indicated that the
records showed that Dr. Jones had, in fact, done blood
work to test for other causes of the children's
symptoms.
Regarding the results of Dr. Fallon's study, one of
the panel members pointed out that the study results
were not yet out in 2004, when these children were
treated, possibly leading to the question of the
relevance of Dr. Fallon's study results, in this case.
On re-direct testimony, Fallon indicated that his
pilot study was, in fact, completed by that time, the
information therefore available to physicians, clearly
showing that his results were, in fact, relevant.
---
(Note: Dr. Fallon's testimony, supported by his
considerable research, was consistent with the
testimony of Steven Phillips, MD, who also testified
on Dr. Jones' behalf. Both Drs. Fallon and Phillips
cited numerous studies, to back their research
findings. Their testimony challenged the earlier
testimony of Eugene Shapiro, MD, who had testified
against Dr. Jones, and the transcripts of the hearing
will show that Dr. Shapiro failed to present data to
substantiate his claims.)
Following Dr. Fallon's testimony, the hearing was
adjourned until January.
Sandy Berenbaum, LCSW, BCD
Family Connections Center for Counseling
Brewster, New York
(845) 259-9838 ***
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