A physician who saw a hospitalized patient of Dr. Zannos Grekos in 2010 was surprised to learn bone marrow had been aspirated from the patient and injected into her circulatory system and brain, according to testimony Wednesday in a state hearing.
"I was quite shocked. My first comment was 'You did what?'" Dr. Richard Roland said, recounting his conversation with Grekos. "His response was 'Yes, we have been having good luck with this procedure.'"
Roland, a critical care physician, is one of several physicians testifying in a state administrative hearing this week. The state Department of Health filed a complaint against Grekos that says he committed medical malpractice in his care of 69-year-old Domenica Fitzgerald.
Roland saw the patient at NCH Downtown Hospital where she was admitted on March 25, 2010, for brain damage. That was a day after Grekos performed a stem cell procedure with her, using her own blood.
A cardiologist by training, Grekos was developing a following with patients who saw stem cell therapy as a last-ditch effort against debilitating illnesses. He sent some patients to the Dominican Republic for infusion of stem cells after their blood is spun to filter out unwanted particulate.
Fitzgerald had gone to Grekos, in hopes the procedure would remedy numbness and tingling in her feet caused by earlier chemotherapy for breast cancer. Instead of sending her to the Dominican Republic, he treated her in his practice.
The state restricted Grekos' license and ordered him not to do anything with stem cells and patients after she was taken off life support and died. But this past March, the state suspended his license when investigators found he had done a similar procedure on another patient, a 77-year-old Indiana man. That patient suffered a cardiac arrest at the doctor's practice and died at a local hospital.
Grekos elected to have a hearing before an administrative law judge to contest the state's complaint in hopes of getting his license reinstated to good standing. The state is seeking further discipline and possible license revocation.
Roland said he called the Collier County Medical Examiner's Office after seeing the patient in the hospital and learning of the bone marrow procedure.
"The reason I contacted the medical examiner was because of my concern this situation was more than just a medical or civil (matter)," Roland said. "I had concern this was criminal."
Dr. Manfred Borges, deputy chief medical examiner in Collier County who performed the autopsy, testified the bone marrow infusion caused oxygen to be cut off to the left side of the brain. The brain damage was the cause of death.
Grekos defense attorney, Richard Ozelie, questioned Borges if a cerebral angiogram, imaging of blood vessels in the brain, plaque or spasms can cause brain damage.
"In the realm of possibility, I believe so," Borges said.
The defense attorney asked if the patient's brain damage could have been due to trauma. A couple hours after being home following the procedure, she was in an unresponsive state and fell forward from her chair and her face landed forward on the floor, her husband, John "Jack" Fitzgerald, had testified Tuesday.
Borges responded to the defense questioning that she had not suffered a "hard fall, she just slid down."
The defense attorney, nevertheless, pointed out that Borges had spoken by phone to the state health department prosecutors in June 2010.
"They told you there was no fall," Ozelie said.
The defense attorney also asked Borges if he had seen an EMS report from the paramedics who had responded to the Fitzgerald home on March 25, 2010.
The EMS report said the patient had gotten up to use the bathroom and had struck her head on the couch, the defense attorney said. The EMS report also said her mouth had swelled after hitting the couch, he said.
The administrative hearing continues in court room 4-D in the Collier County Courthouse, and is expected to wrap up Friday. The administrative law judge will issue a recommended order for the state Board of Medicine to act. An outcome may be months away.