Ivermectin: Wife of York County man on 'death's doorstep' from COVID sues UPMC to use drug

On Nov. 10, Keith Smith, a 52-year-old structural engineer, was diagnosed with COVID-19.

Nine days later, he was admitted to UPMC Memorial.

Despite treatment with steroids and antibiotics – following the medical center’s protocols – his condition deteriorated, and on Nov. 21 he was transferred to the intensive care unit, placed on a ventilator in a medically induced coma.

His wife of 24 years, Darla, was understandably terrified. “He is the love of my life, and I am completely lost and empty without him,” she wrote in an affidavit. The couple, who live in Manchester Township near the Out Door Country Club, has two sons, 21 and 17, and she wrote, “They love their father dearly and pray for his full recovery. Keith is the rock of our family.”

Keith Smith, a vice president of Providence Engineering, headquartered in Lancaster, is a 1992 graduate of Penn State and, like many alumni, he is a huge fan of the Nittany Lions and loved going to Beaver Stadium in the fall. In 1994, he appeared in Sports Illustrated’s special edition commemorating the football team’s perfect season. Among the exhibits attached to the complaint is a photo of him and his wife at a Penn State game, Beaver Stadium looming in the background. He was active, his wife wrote. He loved skiing and woodworking.

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And now, she wrote, he “is on death’s doorstep.”

The doctors told Darla Smith that no further treatment options existed and that “his situation is truly ‘wait and see,’” she wrote in her affidavit.

“At this point, there is nothing more the (hospital) can do, or will do, for my husband,” she wrote. “However, I cannot give up on him, even if the (hospital) has. ... Running out of options, I began researching other COVID-19 treatment options.”

That research led her to a doctor who has advocated the use of the controversial drug ivermectin to treat COVID-19.

The hospital, though, refused to administer the drug. It isn’t part of the hospital’s COVID-19 protocols.

So she sued the hospital.

'His wife and sons don't want him to die'

Her lawsuit, filed in York County Court, asks a judge to compel the hospital to treat her husband with ivermectin, seeking an emergency injunction to force UPMC Memorial to administer the drug.

“As a 52-year-old male placed on a ventilator,” the complaint states, “Mr. Smith’s chances of survival have dropped to less than 30 percent. At this point, there is nothing (UPMC) can do, or will do, for Mr. Smith. (UPMC) has exhausted its course of treatment and COVID-19 procedure in treating Mr. Smith which is unacceptable to Mrs. Smith.”

The complaint states, “Mr. Smith is on death’s doorstep; there is no further COVID-19 treatment protocol for (UPMC) to administer to Mr. Smith; his wife and sons do not want to him die, and they are doing everything they can to give him a chance.”

'A Hail Mary'

Darla Smith’s research led her to news stories that described four different instances in which patients’ families have successfully sued to force hospitals to use the controversial drug, ivermectin, each resulting in a patient who had been placed on a ventilator recovering from the disease.

She cited a a story in the Buffalo News that described how the family of an 80-year-old woman on a ventilator, like Keith Smith, “on death’s doorstep,” was able to obtain a court order to force the hospital to treat her with ivermectin in “a Hail Mary attempt to save her life,” Darla Smith wrote. Within 48 hours, she wrote, the woman’s condition improved, and she was transferred out of the ICU. Two weeks later, the woman was released from the hospital.

Her research also led her to the Front Line COVID-19 Critical Care Alliance, a group that promotes the use of ivermectin headed by a doctor named Pierre Kory.

Studies over effectiveness are disputed

How ivermectin was elevated from an obscure anti-parasitic into what Kory described as a “wonder drug” in COVID-19 treatment begins with Kory, a former critical care specialist at the University of Wisconsin medical center.

Kory and the co-founder of the Front Line COVID-19 Critical Car Alliance, Dr. Paul Marik, chief of critical care at Eastern Virginia Medical School, have been described by Business Insider as “fringe doctors (who have) created the myth that ivermectin is a ‘miracle cure’ for COVID-19.”

Their work is cited in Darla Smith’s complaint, as are the studies cited by Kory in defense of using ivermectin to treat COVID-19. The petition filed by her lawyers cites 65 studies, including 32 randomized trials, described as “the gold standard in medical studies.”

Kory has been the most visible advocate for the use of ivermectin, testifying before a U.S. Senate committee about its supposed efficacy in treating COVID-19, touting the drug as “miraculous” and a “wonder drug.”

His conclusions, though, were found to be based on what experts say could be flawed studies. Some of the studies were based on data that doesn’t exist and others cherry-picked information, leaping to conclusions that Business Insider described as making “ivermectin sound more effective against COVID-19 than it is.” An Egyptian study, described as one of the largest ivermectin studies in the world, was found to be based on data that didn’t exist. An Argentinian study found that ivermectin could prevent all COVID-19 infections, but an investigation by BuzzFeed News revealed that some of the hospitals cited in it never participated. Two scientific papers co-authored by Kory have been retracted after objections to their use of data and “bias issues” were raised, according to RetractionWatch.com.

The National Institutes of Health issued a statement earlier this year stating that most studies claiming to show benefits of ivermectin in treating COVID-19 are based on “incomplete information and significant methodological limitations, which make it difficult to exclude common causes of bias,” concluding that “there are insufficient data . . . to recommend either for or against the use of ivermectin for the treatment of COVID-19.” The U.S. Food and Drug Administration has not authorized the use of the drug in treating COVID-19, noting that “currently available data do not show ivermectin is effective against COVID-19.”

Still, the notion that ivermectin is a “miracle drug” has spread rapidly, so much so that the demand for the drug, according to the U.S. Centers for Disease Control and Prevention, has spiked, making supplies scarce. Some have turned to veterinary-grade versions of the drug, leading to a flood of calls to poison-control centers and prompting the FDA, in August, to tweet, “You are not a horse. You are not a cow, seriously, y’all. Stop it.”

In the summer of 2020, Kory left the University of Wisconsin because, as he explained in a Zoom call to doctors in Malaysia, “they would not let me doctor.” He later worked for a few months for Aurora Health Care in Milwaukee, leaving there because he believed his employer was stifling his right to free speech.

This past summer, Kory contracted COVID-19, which he described during an August webinar as “a mild case.”

He had been taking ivermectin weekly as a prophylactic.

The hospital refuses to give him the drug

Darla Smith asked UPMC to administer ivermectin to her husband. She told hospital staff that her husband asked to be given the drug before he was placed on a ventilator. (The voluminous court file, which contains more than 600 pages, does not indicate whether Keith Smith was vaccinated.)

The hospital declined. Use of the drug, according to UPMC, is not part of its COVID-19 treatment protocols. She offered to sign a waiver, “relinquishing the (hospital) of any liability.” The hospital refused the offer.

So, through Front Line, she got in touch with Dr. Tarik Farrag, described in the petition as “my husband’s physician.”

Farrag, who supports the use of ivermectin and is a member of Kory’s Front Line organization, practices at Southern Bone and Joint Specialists in Ozark, Alabama, according to WebMd.com. He also serves as a medical advisory board expert for eDrugstore.com, a website that specializes in dispensing erectile dysfunction drugs, according to its website. (Attempts to reach Farrag were unsuccessful.)

In her affidavit, Darla Smith wrote that Farrag “is familiar with my husband’s past and current medical condition; Dr. Farrag would not prescribe ivermectin if he believed it was unsafe.”

Then, through Front Line, she got in touch with Ralph Lorigo.

'The hospital is out of bullets'

In January, Lorigo, whose practice is in West Seneca, New York, was approached by the family of an 80-year-old woman who had contracted COVID-19 and was on a ventilator, asking him to compel the hospital to administer ivermectin.

He won the case.

The woman survived.

Since then, Lorigo, who serves as chairman of the Erie County Conservative Party, has taken on numerous similar cases, filing suits around the country seeking to compel hospitals to treat COVID-19 patients with ivermectin.

“For the kind of people that are contacting me, there’s no real alternative, the hospital is out of bullets,” he told Bloomberg Law, which reported that Lorigo declined to respond to “questions about who is paying for the suits, how successful his cases have been, or how many he has brought.”

Lorigo did not return a phone call seeking his comment.

In the complaint filed on behalf of the Smiths, he argues that UPMC failed “to provide proper medical care and has breached its collective obligation and oath to ‘do no harm.’” He further argues that the hospital “violated Pennsylvania and federal law by denying Mr. Smith his legal right to make rational decisions and choices, individually, and through his legal representative, Mrs. Smith."

In its response to the petition, UPMC Memorial’s lawyers argued that the complaint “is deficient as a matter of law” and that the Smiths’ lawyers “failed to allege the elements necessary to demonstrate an entitlement to injunctive or emergency relief.”

'Positively horrible medicine'

Lorigo told the Associated Press that doctors “are not gods because they wear white jackets. I take issue with their stance.”

Physicians and hospitals take issue with Lorigo’s stance, arguing that it’s dangerous to permit lawyers and judges to dictate medical care.

“The way medicine works is, they are the experts, the doctors and ... the hospitals,” Arthur Caplan, professor of bioethics at New York University’s Grossman School of Medicine, told the Associated Press. “When you go there, you’re not going to a restaurant. You don’t order your own treatments.”

“You can’t have a medical field that’s subjected to having to practice according to patient demand backed up by court orders. That is positively horrible medicine.”

'He has no other options'

None of that matters to Darla Smith. She is just trying to save her husband’s life.

“My husband is on death’s doorstep; he has no other options,” she wrote in her affidavit. “With absolutely nothing to lose, with little to no risk, and with the (hospital) likely to begin palliative care, there is no basis for it to refuse Dr. Farrag’s order and prescription to administer ivermectin to their mutual patient.”

She wrote, “It is respectfully submitted that this court give my husband a fighting chance.”

Columnist/reporter Mike Argento has been a Daily Record staffer since 1982. Reach him at mike@ydr.com.

This article originally appeared on York Daily Record: Lawsuit could force UPMC Memorial to treat COVID patient with ivermectin