Marik Sues Sentara Over COVID-19 Treatment Ban

Paul Marik

by James A. Bacon

Paul Marik, director of Sentara Norfolk General’s ICU, has sued the hospital to reverse a ban on a treatment protocol he uses to treat critically ill patients. That protocol includes the administration of ivermectin and fluvoxamine.

In the lawsuit Marik claimed that the Sentara restrictions may have contributed to the deaths of four of his patients. “It’s the physician who determines what’s the best treatment for the patient, not nameless bureaucrats sitting in an office,” Marik said, according to WTKR-TV. “I had to stand by idly watching [my patients] die because I was not allowed to do what I’m meant to do.”

“I think it’s criminal. It’s immoral, and it’s illegal,” he added. “Can you understand the toll that that takes that I have young patients — young patients in the 30s and 40s, who I had to watch die — while the hospital prevented me from giving them the treatment I thought was in their best interest?”

Sentara contends that the use of ivermectin, an inexpensive and widely available anti-parasitic drug, has not been proven effective in randomized, double-blind clinical trials, the scientific gold standard. Furthermore, the hospital contended that Marik based his claim to have cut mortality rates in half, published in the Journal of Intensive Care Medicine, upon inaccurate information. The journal has since retracted the article.

The controversy highlights a fundamental question: who decides — and how they decide — what COVID-19 treatments are permissible.

Marik is a leading member of Front Line COVID-19 Critical Care Alliance (FLCCC), a group of physicians who have developed what it calls the MATH+ protocol based on their experience treating the disease. The physicians developed the protocol based upon first-hand experience, using scientifically guided trial and error (akin to battlefield medicine) to find out what works. By contrast, the Centers for Disease Control insists that treatment protocols follow time-consuming, expensive, randomized, double-blind studies. The virtue of the FLCCC approach is that it’s faster and more adaptable in response to experience. The virtue of the ponderous CDC approach is that it is more scientifically rigorous.

That’s not to say that the MATH+ protocol is not informed by science. As the FLCCC website explains, MATH+ identifies three pathophysiologic processes associated with severe COVID-19 cases — severe hypoxemia, hyperinflammation, and hypercoagulability — and treats each condition “with a use of single agents or in synergistic actions.”

“All component medicines are FDA-approved, inexpensive, readily available and have been used for decades with well-established safety profiles,” states the FLCCC website. The group added ivermectin as a core medication in October 2020. The use of ivermectin has become highly politicized, widely ridiculed in the media, and a marker in U.S. culture wars. Ivermectin is used widely in other countries such as India where COVID vaccinations are not universally available.

Key questions are how effective is the MATH+ protocol, and how does one measure the effectiveness? Marik and FLCCC contend that several small-scale trials have demonstrated the efficacy of ivermectin. Marik also claimed in the Journal of Intensive Care Medicine that the mortality rate among 191 patients at Norfolk General for the year ending July 20, 2020, was 6.1% compared to hospital mortality rates reported in the literature ranging from 15.6% to 32%.

However, Sentara countered that Marik’s data were inaccurate. After conducting a “careful review” of its COVID-19 patient data, it found the mortality rate to be 10.5% rather than 6.1%. Additionally of those 191 patients, only 38% had received any of the four MATH+ therapies, and their mortality rate was 24.7%. Patients who had received all four therapies had a mortality rate of 28%.

Stated Sentara in a communication with WTKR-TV:

Sentara generates treatment guidelines by engaging multi-disciplinary groups of clinicians to review literature, care standards and provide expert advice. In most situations, physicians are able to deviate from guidelines to individualize care for patients. However, in some scenarios, treatments that may potentially harm patients or that are widely considered to be outside the standard of care may be limited.

To that end, COVID-19 treatment guidelines at Sentara have been consistently communicated to all medical staff throughout the pandemic using usual channels. The most recent guidelines generated by the multi-disciplinary group of clinicians did include, but were not limited to, guidance on the use of ivermectin. All members of the medical staff receive the same guidelines.

Marik’s lawsuit claims that he and his FLCCC colleagues pioneered innovations in COVID-19 treatment that now define the standard of care, including the use of high-dose steroids and the use of the blood thinner Heparin. One of Marik’s FLCCC co-founders, Joseph Varon, asserts that use of the protocol has reduced the mortality of hospitalized COVID-19 patients by “at least 50% below the national average” — a fact made all the more remarkable by the fact that in the Houston area where he practices, his hospital treats the most acutely ill patients.

Marik’s lawsuit, filed in Norfolk Circuit Court, does not ask the court to reach a scientific judgment. Rather, it claims that Sentara’s ban “violates patients’ right to informed consent, because it contravenes Virginia’s Health Care Decisions Act, and because it flies in the face of Virginia public policy as expressed in its Right to Try statute.”

In Virginia (as elsewhere), informed consent requires that patients be told of, and permitted to choose among, existing alternatives to a proposed course of treatment. Health care providers violate patients’ informed consent rights if they “fail to disclose … the existence of alternatives if there are any, thereby precluding the [patient] from making an informed decision about whether to undertake a particular procedure or course of treatment.

Moreover, under Virginia’s Advance Directive statute, hospitalized individuals have the right not only to specify in advance what treatment they choose not to receive in case of incapacity, but “to specifically direct” the treatment they are to receive so long as that treatment is “medically appropriate under the circumstances as determined by their attending physician.” …

The statute does not say that such medicines must be recommended or endorsed by a patient’s hospital.

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30 responses to “Marik Sues Sentara Over COVID-19 Treatment Ban”

  1. Deborah Hommer Avatar
    Deborah Hommer

    He’s not alone in that assessment. Many doctors have complained of this exact thing happening to them. Just another element of this pandemic that doesn’t add up. has more information on all this.

  2. LarrytheG Avatar

    Pretty easy to see here how a hospital could get sued by patients and family members if things go south.

    And pretty sure, you don’t want the State mandating to the hospitals medical standards and care….

    Is this yet another case of the “elites” talking down to the “little people”?

    1. DJRippert Avatar

      It’s not the state being sued, it’s the hospital. And the Sentara BigHealth conglomerate is hardly “the little people”.

      1. LarrytheG Avatar

        Doesn’t have to be the state to be accused of being “elites”

        The hospital has some level of liability for treatments that beyond what standard protocols are and may also cause insurance providers to not reimburse for that treatment.

        The fact that some doctors want to not be restricted by rules and protocols is their call but so are the consequences…

        The hospital is going to stand on standard protocols no matter what and they’re going to have substantially more legal resources unless this guy is going to find a pro-bono Conservative group willling to run with that ball.

      2. Nancy Naive Avatar
        Nancy Naive

        So when did you become anti-business? Just because they’re big doesn’t mean they ain’t also right.

        1. Matt Adams Avatar

          “Nancy Naive DJRippert • 3 days ago
          So when did you become anti-business? Just because they’re big doesn’t mean they ain’t also right.”

          If you believe your employer has wronged you, you have a right to sue them. Your strawman about being “anti-business” is just your standard retort.

  3. Stephen Haner Avatar
    Stephen Haner

    Soon enough the Merck and Pfizer anti-viral pills will be widely available and all this other shot-in-the-dark nonsense becomes moot. Of course, there are those dumb enough to refuse those and stick with Ivermectin….

    1. Nancy Naive Avatar
      Nancy Naive

      What I like is this guy conducted his own “studies”. Double blind? Do you sppose his patients knew there was a chance they were receiving a placebo in place of horse paste?

  4. tmtfairfax Avatar

    What if the facts were a religious hospital refused to allow a doctor to perform sex organ removal surgery on a patient or an under-age-of-consent patient? Would penumbras and emanations allow for a different result? Pardon my cynicism but there are a lot of lawyers who gave up following the law decades ago.

  5. Nancy Naive Avatar
    Nancy Naive

    So he shoots ’em full of horse paste, they die anyway, and instead of one lawsuit by a quack, they have 4 or 5 by patient relatives. Can’t win for losing.

    The correct expression is “playing god” and it doesn’t apply to the hospital… this time.

    1. LarrytheG Avatar

      just imagine ANY Doc wanting to vary from standard protocols – which, no matter how “good” – risk liability exposure as well as insurance companies refusing to reimburse.

      That’s what Mexico is for…..

      1. Nancy Naive Avatar
        Nancy Naive

        House,… Gregory House.

        1. LarrytheG Avatar

          a looooooooonngg wiki on the character:

          I never came to admire the character… he never seemed to have much empathy for others, even his own patients…

          1. Nancy Naive Avatar
            Nancy Naive

            They saved it for the last episode.

  6. walter smith Avatar
    walter smith

    I have refrained from commenting on this issue for a long time, mostly because people are locked in on their OPINIONS.
    Here are facts – all the COVID “vaccines” administered to date are EUA. The federal statute dealing with EUA products requires informed consent and the patient has the right to accept or refuse. Federal laws preempt State laws.
    All hospital systems have some version of a Patients Rights policy, and all of those policies have some form of informed consent.
    Here is Sentara’s –
    Patients also have the right to choose to die.

    I’m glad everyone here knows more than Dr. Marik, including the application of patient care and the Hippocratic oath. Professionally, lawyers and doctors have sold their souls (even more than lawyers did before) by not standing up for professional standards.

    More facts – if anyone claims they KNOW something here about the efficacy of the non vax vax, they are lying. We still don’t know. Were you told it would fade in six months? Boosters? Warned of side effects? How come VAERS numbers are far higher than what we would historically accept? It is simply far too early to speak with confidence on the ultimate safety and efficacy of the experimental jab, jab, jab…

    Unknowns – is natural immunity better (that seems proven, but I’m being nice)? Does vax on top of surviving harm overall immune response?

    Is it possible that choosing to live life and get COVID if you get it and survive it a rational decision with a better outcome? (Hint – yes. And many people choose that. This is akin to climate change – it is ridiculous to think we can control the climate and it is ridiculous to think we can control a virus. The virus will do what it does without care. What we do know is certain people are at real risk.)

    Do I trust any statistics in the news? No. There is too much room for manipulation. Is this a COVID death? From or with? What period is being measured? And let’s not forget that the CDC keeps changing the definition of vaccine and being vaxed under COVID. I guess right now with the boosters and many not having gotten it, the CDC could say the deaths are of the unvaccinated (but previously deemed vaccinated). Why did the CDC quit reporting breakthroughs and breakthrough deaths? How come we don’t have the daily case numbers running across the TV screens with the death totals (with the deaths under Biden now exceeding under the Bad Orange Man)?

    Why are you critics so against therapeutics? What is the morality of confirming COVID and telling people to go home and go to the hospital if it gets worse? Particularly when aggressive treatment greatly improves outcomes? Is vaccination only strategy wise? Why not a federalism approach? How come the ivermectin miracle of Uttar Pradesh India is not widely known?

    So why the hate for Dr. Marik? Wouldn’t it be good news if what he says (with a number of other doctors and there are plenty of studies indicating lots of therapeutics have efficacy) helps?

    Seriously everybody – get a grip. COVID is risky to some people and not much of a risk to huge swaths, the vast super majority. Protect those people. All people – Lose weight. Get some sunshine. Build up your immune system. Treat aggressively with therapeutics instead of letting it progress.

    My OPINIONS – natural immunity is better. The shots are not as safe or as effective as advertised. No one under 30 should get the shots unless they have particular medical conditions where COVID is particularly dangerous to them. The vaccinating everyone, even those not really at risk, causes the virus to mutate quicker, and could cause all people to have the same vulnerability to a future variant (in other words,preserving genetic diversity protects mankind). The mandates, besides being illegal, are unConstitutional and will ultimately be found so. Masks don’t work. Plexiglass was counterproductive. Lockdowns didn’t work. (There are studies on all of these saying I am right, but I’ll allow the science isn’t settled.) The vaccine mandates are a crime against humanity because the drugs are all EUA. Any person vaxed without WILLING consent has been forced into a medical experiment.
    Now think about the morality and scientific rationale. Which is more of a risk to a 40 year old – COVID or poverty from losing a job? This is not about science – it is about power.

    Enjoy the gas prices, food shortages and suffering to come under this corrupt government. How come Hunter hasn’t been charged? Any problem with the Project Veritas raids? With the J6 prisoners being held in solitary? Calling parents terrorists? And you trust these people? You might want to read Martin Niemoller’s poem…they’ll be coming for you one day…

    1. LarrytheG Avatar

      You kinda give your politics away at the end. Even before then, you’re citing things that simply are not true with regard to COVID and vaccines – the kind of stuff that is explicitly pointed out as not true by authoritative and credible medical sources.

      Billions of people have received the vaccine around the world – and they are just as effective as prior vaccines for things like smallpox and polio and yet there are always those that disbelieve for any number of reasons , a lot of which ends up being associated with politics rather than science, and in fact science itself distrusted and claimed to be political also!

      Hunter Biden has absolutely nothing to do with Covid and Vaccines except in the minds of those who someone see a link on that and a whole bunch of other stuff.

      From that point on, the whole ball of was is a conspiracy theory of sorts.. for some folks.

    2. Nancy Naive Avatar
      Nancy Naive

      “Is it possible that choosing to live life and get COVID if you get it and survive it a rational decision with a better outcome? (Hint – yes. …”

      So, you know that? You know the outcome is “better” without the vaccine?

      And, yes. You also have the right to die. Everyone does. Everyone will. If only this were also a disease of choice then there’d be no issue. But, it’s not.

      It’s contagious and it’s mutatable. This makes you what every American refuses to believe — you’re not ruggedly independent — you are a cog in the machine, a link in a chain, and yes, responsible for more than just you.

      1. walter smith Avatar
        walter smith

        And here is the great divide. I don’t owe you squat.
        I should not be mandated to do something for you because you want it, otherwise I could mandate things for you because I want it.
        But it’s a public health emergency!
        Everything in totalitarian world is a public health emergency – GUNS! CLIMATE CHANGE! COVID! See a pattern?
        In the normal world you and I were born into, somehow, we went to college where there was no very basic vaccine requirement…and we all lived! Oh, the danger. Woodstock happened in the midst of a huge epidemic. Syphilis and crabs were probably bigger problems at that super spreader event.
        When our illustrious legislators decided to impose a vaccine requirement for colleges in 1986, do you really think it has done anything other than cause lost hours filling out forms never to be used and then even more forms for those who claimed a medical or religious exemption? It was needless. Why was it needless? Because far and away most people choose to get vaccinated with the basic vaccines because they work and we know the side effects are extremely rare. So, even though the law was really overkill, even then the legislators allowed exemptions on a name it and claim it basis, and that is why the requirement was never challenged. It was balanced. It also was established in a normal legislative process and signed into law – not an imperial decree.
        In this case, our illustrious overlords are mandating a Nuremberg crime – a forced medical experiment for something that is an inconvenience for 99% of the people. And there is strong evidence (I’m being nice – everyone not a political hack knows this, including researchers at the Pharma companies) that natural immunity is far more complete and better than the induced antibody response of the experimental mRNA therapeutic injection, which has far worse side effects than any other medical product previously allowed for emergency use.
        So which is the better societal outcome? Mandate everyone get a shot to protect you, possibly endangering all of mankind, or let most of mankind develop natural immunity? The answer is obvious. And, as people like you clamor for more and more social control, the water in the pot gets hotter and hotter without you even noticing…but your frog legs will be mighty tasty!
        So the ultimate policy answer is liberty – enlightened self-interest. And beyond that, perhaps a little bit of wisdom, a little bit of humility, to realize man cannot control a virus. So, encourage healthy behavior, educate people (instead of daily manipulation of stats and spreading fear) and find what works best so we reduce it to an inconvenience for all as much as we can…and even so, some people will die. Oh, and why was Dr. St. Fau(x)ci, the Mendacious Midget, funding gain of function research in Wuhan? Asking for a friend…

        1. Nancy Naive Avatar
          Nancy Naive

          So? Can we assume your money is in your mouth and you’re nit vaccinated?

          1. LarrytheG Avatar

            think of it as a law that says even though it’s legal to drink , if you choose to do it in certain circumstances, like driving a vehicle, there is an additional requirement to assure you are not a danger to others.

            Maybe something similar to working in close contact with others and you could being carrying a disease that would infect them…

            Or you have to stop at a red light no matter how safe a driver you are and never been charged and no traffic coming.

            But if you don’t trust govt, nor science nor most media – where are you getting the “truth” from that you cite and rely on?

          2. Nancy Naive Avatar
            Nancy Naive

            I think it is more of a case of “bottled courage” in a 30 ml bottle.

  7. walter smith Avatar
    walter smith

    It is no one’s business whether I am vaccinated or not. When did you stop beating your wife?
    It does not matter if I have a political view or not. Everyone has a worldview which informs their political views.
    The facts remain facts – the mandated shots are not legal without willing, informed consent.
    Government does rely on consent of the governed. It helps to build consensus if you are not lying. Fool me once, shame on you. Fool me twice, shame on me. Corrupt liars lying does not help one trust the corrupt liars aren’t lying about their good intentions in mandating an experimental therapy that 99% don’t need… Why look, even Andrew Sullivan…not exactly a conservative has noticed a pattern…
    Here is a coffee talk (think SNL) question to discuss amongst yourselves – How come the liberal journalists pointing out media deception and advocating for free speech are often gay (Greenwald, Sullivan, Weiss)?

    Leftists will not personally act like Christ, but love to demand that others do it for them when it fits their needs. Look at charitable giving.

    This is true of most people, Left and Right, we want justice when others transgress, but mercy for ourselves. Wokism is a religion without forgiveness. It is a horrible way to live, practiced by horrible, hypocritical people. (John McWhorter made the religion without forgiveness observation and it is brilliant.)

    1. LarrytheG Avatar

      Like it or not, there ARE “mandated” rules when behaviors and activities can endanger others.

      When you approach a traffic signal -you are “mandated” to do something – no matter your own views political or otherwise – someone else has decided that you WILL stop because of the potential danger to others if you do not.

      Life is full of such rules… where your own personal activities are restricted by laws and regulations that purport to protect health and safety of others.

      Even Conservatives support such rules for a wide variety of behaviors.

      Conservatives even believe in stopping and frisking individuals who MAY constitute a threat to others so they are stopped on that basis.

      When a cop pulls you over and decides you have been drinking, he can order you to be tested or suffer the consequences of not being tested.

      When kids enter school, they are “mandated” to get shots.

      When you travel abroad, you can be “mandated” to get shots.

      your “liberty” is not unrestricted. Your “rights” are predicated on others rights also.

      If your behavior and activities imposes threats and risks to others – what is their right?

      I’m amused by the dicotomy between doctor’s offices and WalMarts these days.

      Lots of unmasked folks in Walmarts – virtually zero in the doctors offices that I’ve been to and admonitions to those who don’t to mask up or leave.

      What does that “mandate” mean? The unmasked at Walmarts don’t generally see doctors or they “compromise” their beliefs and rights when they go to the doctor of hospital?

      I had a friend who went to a funeral for a co-worker who died of Covid. He was the only one wearing a mask – all the others at the funeral not only did not have masks, but they chewed on him for wearing one! Since that time, guess what happened to some of the others? It’s hard to understand.

      1. tmtfairfax Avatar

        Larry, how do you square your belief that the government can make people receive a COVID-19 vaccination with the Supreme Court case that have held the decision whether to have an abortion or make other choices about reproductive health is a personal matter? Either personal decisions concerning health care are personal or they are not.

        And again, the Virginia Code provides exemptions for school-required vaccinations based on religious and medical grounds. A child with a religious or medical exemption who is not vaccinated for a particular disease may catch it and, depending on whether it is contagious or not, spread it to other children or adults.

        And the 5th Circuit just struck down OSHA’s rule for mandatory vaccinations for employees of employers with more than 100 employees, which was adopted without notice and comment.

        Are we a nation governed by law or not?

        1. LarrytheG Avatar

          I consider abortion to be a bit of a special case where there clearly is a right of the mother and disagreements about what constitutes a human (baby) with rights.

          That so different from comparing two human beings with right – coexisting in a world where we must have rules to keep some folks from harming others – even not on purpose but ignorantly without care for others.

          On exemptions – there is a tension between what it takes to achieve herd immunity – i.e. what percentage of the population needs to be immunized versus how many can remain immunized and where that point is where not enough are immunized and everyone including and especially the unimmunized are at much greater danger from not only existing variants but new ones that can mutate if infections spread even among the immunized.

          In fact, mutations can occur in the immunized that become even more resistant to vaccines and the vaccines no longer effective.

          That happens right now with the flu and with the use of antibodies…

          It’s not govt or science “forcing” others to do something – it’s the diseases itself and it’s propensity to morph and mutate into even deadlier and more contagious variants. That is a clear risk that many seem to be either unaware of or don’t believe… until it happens…

          We’ve seen so many people DIE because they did not believe this virus could kill them, that it was hoax and they were convinced by lies and disinformation to not get vaccinated and argue about “rights” and liberty as they went to their deaths AND infected others who could not get vaccinated or had exemptions.

          A lot of this is predicated on ignorance… plain and simple.

          1. tmtfairfax Avatar

            Larry, you don’t get to consider. This is a matter of constitutional law. We don’t have different constitutional rights based on whether we are male or female, our race or ethnic background. That’s what equal protection is all about. Law isn’t about special cases. That’s what the centuries of efforts to get to equal protection is all about.

            What you are saying is that a woman can decide to have an abortion but cannot decide whether she wants to receive a COVID-19 vaccine. Only a journalist would think that makes sense. The right of an adult to make decisions about health care is a right to make decisions about health care.

            I’m not arguing against vaccination. I’ve had three pokes. I wear masks when required. I respect people who wear masks in other situations where I don’t. But I respect the law more.

          2. LarrytheG Avatar

            I’m not saying that. I’m saying the courts have to date.

            So, yes they HAVE made a distinction when it comes to abortion.

            It’s not the same as fully developed humans and rights.

            Until we decide when a fetus is a full developed human with all rights, we’ll continue to debate it.

            That’s not the same as fully developed humans and their right a they affect each other not only IMHO but the courts because the Constitution never really anticipated the issue or made clear how it was to be handled much less how society changes when such issues evolve.

            But you guys that have gotten the pokes and at the same time have argued against the science and govt agencies like the FDA and CDC puzzle me to no end.

  8. Eric the half a troll Avatar
    Eric the half a troll

    “Marik also claimed in the Journal of Intensive Care Medicine that the mortality rate among 191 patients at Norfolk General for the year ending July 20, 2020, was 6.1% compared to hospital mortality rates reported in the literature ranging from 15.6% to 32%.

    However, Sentara countered that Marik’s data was inaccurate. After conducting a “careful review” of its COVID-19 patient data, it found the mortality rate to be 10.5% rather than 6.1%. Additionally of those 191 patients, only 38% had received any of the four MATH+ therapies, and their mortality rate was 24.7%. Patients who had received all four therapies had a mortality rate of 28%.”

    Wow, so the hospital has a 10.5% mortality rate yet Mario’s patients have a 25-28% mortality rate. It is not difficult to see what is going on here. Marik is filing his lawsuit as a preventative defense against the lawsuits headed his way from patients’ family members.

    1. LarrytheG Avatar

      but, but… it’s the “elites” squatting on the “little people”… once again… they just can’t catch a break……. 😉

  9. Amazing that the key idea here is missed as you move down the list. Patient rights are being ignored because of political and social reasons. Ivermectin is not the issue of the suit. However, Ivermectin has received a raw deal in the US. I lived in Africa for awhile where Ivermectin is considered a wonder drug used in humans to treat a myriad of issues of which mostly are parasitic. Because of the low COVID-19 infection and death rates in some African countries, studies have been conducted like the COVID-19: Ivermectin Covid Enigma that used data from an WHO existing program to reduce to and Onchocerciasis invection, that ivermectin has in vitro effects against SARS-CoV-2. Look it up and read it yourself. Ivermectin was used widely in India during their outbreak of COVID-19 Delta and there are professional per reviewed papers on the subject that show efficacy in it use as well as those who disagreee. Also, you cannot look that statistics here in this article and make any real inference regarding mortality rates. The 191 patients could not have had identical symptoms and responses. There is just not enough information. If you look at the MATH+ information as I just did. You will see that there is a plethera of medicines aimed at reducing the hyper-inflammation in the lungs that ultimately lead to death. Up until recently there is little offered to patients to help fight COVID-19. I know of several patients that were sent home and told to come back to the ICU if there oxygen levels dropped to low. I know several people that died and they were given little treatment other than oxygen and hydration based on their families reports. Methylpredinosone, thiamine, zinc, vitamin D, and heparin show any promise in reducing the critical symptoms and if the ivermectin studies from Africa and India show any level of efficacy, why not allow it and who are you to intervene in a doctor patient privilege. Just sayin…

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