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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--

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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