At last, someone has died – after (possibly) taking HCQ for COVID

By Jane M. Orient, M.D.

Many medical authority figures have warned people not to take hydroxychloroquine (HCQ), lest they die or go blind – if they take it for COVID-19. If patients need it for lupus, or rheumatoid arthritis, or malaria, we must not allow use for COVID to create a shortage of their essential remedy.

Thousands of patients have defied the experts and taken HCQ anyway. Now, a patient who obtained a prescription from a telehealth doctor has died. His family is suing the doctor, and the case is getting prominent media coverage.

I am not acquainted with the physician, Dr. Medina Culver. Some people seem to disapprove of her because she has long hair, a flamboyant personality and a large following on social media, none of which seem relevant or newsworthy to me. Neither does her membership in America’s Frontline Doctors (AFLDS) – which is also being sued for allegedly promoting the drug improperly.

The plain facts are that the patient had a telemed appointment with Dr. Culver in August 2021, at which time Dr. Culver reportedly prescribed hydroxychloroquine and/or ivermectin for COVID-19 treatment or “preventative therapy.” Dr. Culver never performed a physical examination of Mr. Parker – it was a telemed visit, remember.

According to the lawsuit, the patient developed cold-like symptoms in late January 2022. His body was found Feb 3, 2022. The Washoe County, Nevada, coroner listed the cause of death as “sudden in the setting of therapeutic use of hydroxychloroquine.”

The news article does not report whether the patient took the HCQ that had been prescribed six months earlier, whether he had COVID, whether he took any other drugs, or what he died of. Nevertheless, a retired medical school professor was able to opine that the patient’s death might have been prevented “if Dr. Culver had performed a more thorough evaluation including a physical exam to evaluate his heart function, a blood pressure measurement, and an EKG to ensure he did not have an abnormality” – six months earlier.

The dreaded EKG abnormality that can occur with HCQ or numerous other medications, including erythromycin and related drugs (e.g., Z-pak), Cipro and related drugs, and a long list of psychotherapeutic drugs, is a prolonged QT interval. That’s a delayed repolarization of the conduction system. A premature beat falling in a vulnerable spot could trigger a dangerous arrhythmia called torsades de pointes. The number of cases of this rhythm reported in seriously ill hospitalized COVID patients who received HCQ? Zero.

Do doctors screen patients for congenital prolonged QT before prescribing any of these drugs? They do not. Or do they do periodic EKGs during therapy? That would probably be disallowed as “unnecessary.”

The retired professor made the oft-repeated statement that the FDA has not specifically approved HCQ for COVID. It has also not approved the indications for which one out of five doctors’ prescriptions are written. Once approved for safety, as HCQ was in 1955, doctors are free to use a drug for any indication for which they believe it is useful. If a drug company wants to advertise that use, it can spend years and millions of dollars to get it approved. Approval doesn’t make the drug safe – listen to the long list of adverse effects in the TV ads.

HCQ has been used by hundreds of millions of people worldwide, is available without prescription in many places and is safer than many over-the-counter drugs such as Tylenol.

Telehealth is touted as a great answer to physician shortages and difficult access to care – despite the inability to do a physical examination. Unless it involves an “off-label” prescription for COVID.

People die, often after taking a treatment. If it happens after a COVID vaccine, correlation doesn’t prove causality, and beware of the post hoc, ergo propter hoc (“after this, therefore because of this”) logical fallacy. But different rules apply to early, officially disparaged COVID treatment.

More than 1 million U.S. deaths have been attributed to COVID. Very few of those patients probably received early treatment with a repurposed drug. More than 34,000 deaths have been reported in association with COVID vaccines, but causation has not been proved.

Finally, someone is suing because a patient was given HCQ or ivermectin, instead of because a hospital denied a patient ivermectin. Doctors who prescribe a potentially life-saving drug despite vilification by authorities, hospitals and medical associations had better take notice: malpractice attorneys may target you. Ditto for entities that organize telehealth services and/or provide favorable information on a repurposed drug.

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