by Medical Justice | Mar 20, 2019 | Blog
I have never understood why some women spontaneously become pen pals and virtual lovers with violent felons currently incarcerated. Some even marry the object of their desire.
This behavior is not dissimilar to a recent Facebook group launched in support of Dr. Johnnie Barto, a Johnstown, Pennsylvania pediatrician.
Dr. Barto was recently sentenced to 79 to 158 years in prison. The prosecutor asked for a sentence of 31 to 63 years in prison. Dr. Barto is currently 71 years old.
So, what did he do?
Barto pleaded guilty in December 2018 to sexually abusing two family members.
He also pleaded no contest to sexually assaulting 31 children, most of them patients. Many were now adults. By pleading no contest, he did not admit guilt, but he did accept the punishment.
Barto’s wife included her own victim impact statement:
“He has been lying to me about everything for all of the 52 years I have known him. … He spent his whole sinister life lying and sneaking around, so he could carry on his abuse uninterrupted,” she said. She said her heart was heavy for the victims.
Other victims spoke their mind:
Erika Brosig (who was 13 when abused) said she can still feel Barto’s cold hands and hear the exam table paper crinkling underneath her body. “The sound of you moaning will haunt me until the day I die,” she told Barto.
One victim said that because of what Barto did to her, she rarely sees a doctor and is terrified of taking her children to one. Another told the court she showers in the dark because she’s ashamed of her body.
Many spoke of lifelong struggles with depression, anxiety, panic attacks and distrust of men. “I’ve lived my life in pain, hopelessness and despair,” a woman said in her statement.
The prosecutor argued that Barto became a pediatrician so he’d have a ready supply of victims – typically prepubescent girls; one was an infant.
Guess what? In 2000, Barto appeared before the Pennsylvania Board of Medicine on administrative charges he molested two young girls in the 1990s. The regulators concluded the charges were incongruous to Barto’s reputation and allowed him to continue practicing medicine. This break likely even emboldened him.
During his tenure as Johnstown’s beloved pediatrician, he served as an elected school board member. Ribbons of support were distributed and worn at a high school football game as he worked to keep his license.
The judge presiding over the case summed up his feelings of disgust:
“All I can say is that the justice system is not perfect, but it worked the second time.”
Apparently, there’s a word for the psychology behind prison pen pals – “hybristophilia” – a paraphilia or condition in which one feels sexual arousal or has an affinity for people who do reprehensible things.
These negative acts range from “small” offenses like cheating or lying to terrible crimes such as serial murder and assault. The condition is different than someone who may be physically attracted to a criminal despite their crimes; a person with hybristophilia is drawn to the person because of the crimes they committed. Those who identify as having hybristophilia often become pen pals, start fan sites, and form relationships with the accused — some have even married criminals while the inmates are still incarcerated. Famously, some serial killers have inspired fan clubs and groupies, consisting primarily of women who are drawn to their extreme bad-boy aesthetic.
While hybristophilia may explain the Facebook support group for Dr. Barto, the simpler explanation is just plain denial. It’s horrifying to think that a parent could be duped into allowing their vulnerable child to be examined by a predator.
What do you think?
ABOUT THE AUTHOR
Jeffrey Segal, MD, JD
Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.
Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.
Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.
If you have a medico-legal question, write to Medical Justice at infonews@medicaljustice.com.com.
by Medical Justice | Mar 5, 2019 | Blog
C. difficile is a thorny problem for hospitalized patients because physicians have generously prescribed progressively stronger broad spectrum antibiotics, killing off good bacteria, making it easier for the bad bacteria to proliferate.
The condition affects 500,000 Americans each year and takes 30,000 lives.
When yogurt and standard probiotics don’t stop the diarrhea (and there is evidence to suggest they may be good first line treatments), some have turned to fecal matter transplants (FMT) to rebuild the good bacteria.
How does it work?
The treatment transfers fecal matter from healthy donors to the bowels of sick patients. Transfer can be via mouth or colonoscopy. Before you judge, the treatment by mouth requires processing to make it palatable.
The question before the FDA is whether fecal microbiota should be considered a drug. Or are fecal microbiota analogous to organs, tissues, and blood products transferred from the healthy to the ill?
Let’s go back in time. In 2013, the FDA announced a draft decision to regulate FMT as a new drug. They stated they would study the matter. Almost 6 years later, a decision is expected soon.
Some entities, such as practicing gastroenterologists and patient groups, want the FDA to butt out. Others (such as biotechnology and pharmaceutical companies) want the FDA to regulate. The conflict is turning into a s*%tstorm.
In a summary of the conflict, the NY Times reported:
Dr. Alexander Khoruts, a gastroenterologist at the University of Minnesota, said he feared the F.D.A. was favoring the interests of what he calls the “poop drug cartel,” a group of companies seeking approval for new ways to deliver the active ingredients in transplanted feces. Three of the companies, Rebiotix, Seres Therapeutics and Vedanta Biosciences, have raised tens of millions of dollars from investors and they recently formed an association to advance their interests with the F.D.A.
“An obscene amount of money is being thrown around by companies trying to profit off of what nature made,” said Dr. Khoruts. “I don’t think there are clear villains here, but I worry that the regulators are not caught up on the latest science and that the interests of investors may be exceeding those of patients.”
“The first principle of medicine is do no harm, and at the moment we don’t have a long-term track record of F.M.T.’s adverse effects,” said Dr. Sahil Khanna, an associate professor of gastroenterology at the Mayo Clinic who has conducted industry-funded clinical trials on fecal transplants. “We also need to move away from transferring poo from one person to another.”
Experts in the field of bioethics and many doctors are pressing the F.D.A. to come up with a new regulatory category that reflects the groundbreaking nature of microbiota therapies.
In 2012, around the time the FDA released its draft, a microbiologist at MIT, Mark Smith, founded OpenBiome as a non-profit stool bank. That entity now supplies the lion’s share of fecal matter for transplants in the US. Since its founding, tens of thousands of patients have been treated and cured with FMT. Some patients feel relief within hours of being treated.
The FDA is in a holding pattern and has adopted a wait and see approach for FMT for patients who have failed conventional treatments for C. difficile. Desperate patients has resorted to taking shortcuts with a relative’s stool , saline, and an enema.
Ms. Duff, the head of the C. diff patients group, credits her own recovery from the disease to a homemade concoction her husband created with his own stool in the kitchen blender.
I hope that blender was thoroughly washed before being used again. The larger point is that the number of effective treatments are few; and FMT is so effective. The FDA should make it easier to obtain access.
Insurance companies are also in a holding pattern waiting for FDA guidance. Until the FDA decides, most carriers are not reimbursing for FMT.
So, what does farm to table (or, more accurately, bench to bedside) look like:
The organization (OpenBiome) produces 900 to 1,000 monthly treatments, most of them bottled liquids that are packed in dry ice and sent overnight to clinics across the country. Any unpleasant odors are confined to an airtight production facility, where employees in white hazmat suits gingerly handle clear plastic bags filled with a mud-colored slurry.
The material comes from donors who earn $40 a pop and must pass intensive screenings and regular medical checkups. “It’s harder to become a stool donor than it is to get into M.I.T.,” said Carolyn Edelstein, who runs the organization.
From the pharmaceutical companies’ perspective, if patients can buy a treatment directly from OpenBiome for a modest sum, then no one will enroll in a clinical trial. They are arguing that they have invented a novel means of delivering FMT and they should be able to extract a premium price if it passes formal regulatory approval.
Who knows how this will come out in the end? Let us know your thoughts. And if you’ve found yourself in a medico-legal bind, use the form below to connect with us.
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ABOUT THE AUTHOR
Jeffrey Segal, MD, JD
Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.
Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.
Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.
If you have a medico-legal question, write to Medical Justice at infonews@medicaljustice.com.com.
