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Kentucky Hospital Can Deny Ivermectin to COVID Patient, Says Judge

— Patient's wife sued after demanding the controversial drug be used

MedpageToday
Photos of Norton Brownsboro hospital, Ivermectin tablets, and Jefferson Circuit Judge Charles Cunningham
Jefferson Circuit Judge Charles Cunningham

A Kentucky hospital does not have to treat a COVID-19 patient with ivermectin, a circuit court ruled this week, following a demand from the patient's wife -- who said she is an RN -- that it use the controversial drug.

Jefferson Circuit Court Judge Charles Cunningham overruled an earlier decision, noting that the court "cannot require a hospital to literally take orders from someone who does not routinely issue such orders," and that the Kentucky Supreme Court "only allows admission of scientific evidence based on sufficient facts or data."

Lonnie Underwood, 58, was admitted to Louisville's , part of the Norton Healthcare network, earlier this month, according to reports. With Underwood on a ventilator in intensive care, his wife, Angela Underwood, demanded that the hospital treat him with ivermectin and intravenous vitamin C. When her demand was ignored, she filed a lawsuit alleging that the hospital refused to treat him in this way, the .

"As a registered nurse, I demand my husband be administered ivermectin whether by a Norton physician or another healthcare provider of my choosing including myself if necessary," she wrote in the complaint, according to the Post. She requested that the court designate ivermectin as "medically indicated" to treat COVID. "The studies and research does show the effectiveness of the medication when given to those patients in the trial," she added.

While Angela Underwood found a doctor to craft an emergency privileges order for ivermectin, the hospital said that this physician "refused to come see his patient." She accused Norton Brownsboro of prohibiting Rafael Cruz, MD, based in Indiana, from treating her husband.

However, Cruz did not have privileges at a hospital "providing care for critically ill COVID patients," Cunningham stated. "Frankly, even a doctor who was in the trenches in 2020 fighting hand-to-hand against the virus, is probably not up-to-date with what works and what fails in late 2021 because the virus has mutated and our responses and therapies have evolved with it."

ľֱ found seven records for a Rafael Cruz on Indiana's medical licensing board in Logansport and Jeffersonville. Some are active, some have expired, and one was superseded. Only the Jeffersonville licenses are active, pertaining to the practice just across the Ohio River from downtown Louisville. Cruz was certified by the American Board of Emergency Medicine from 1997 to 2017, according to on the practice's site.

Circuit Court Judge Judith McDonald-Burkman initially ruled on Tuesday that Norton Brownsboro had to treat Lonnie Underwood with ivermectin and vitamin C, "if medically indicated and ordered by an appropriate physician," and issued an emergency injunction to administer intravenous vitamin C, .

But Norton Healthcare asked the court to reconsider the case. Cunningham, filling in for a booked McDonald-Burkman, then issued his ruling.

"[The internet] is rife with the ramblings of persons who spout ill-conceived conclusions if not out-right falsehoods," Cunningham said, according to the Washington Post. "If [Angela Underwood] wants to ask the Court to impose her definition of 'medically indicated' rather than the hospital's, she needs to present the sworn testimony of solid witnesses, espousing solid opinions, based on solid data."

Angela Underwood is now trying to find a hospital that "believes in the efficacy of these therapies," according to reports.

"This is impractical because it is likely that no such hospital in the United States, or certainly in this region, agrees with [her]," Cunningham stated. "Moreover, her husband's medical circumstances may make such a transfer unjustifiably risky."

It would be a "Herculean task" for Underwood to show evidence that ivermectin and intravenous vitamin C were "relatively safe and efficacious" enough to overrule the court, Cunningham added.

Lonnie Underwood remains on a ventilator, according to reports.

Ashley Butler, reportedly Angela Underwood's attorney, did not immediately return a call Friday. ľֱ found an active RN license for an "Angela Gail Underwood" in both Kentucky and Indiana; the license expires October 31 in both states.

Norton Healthcare declined to comment. "Our thoughts and prayers are with this patient and family in this very difficult situation. Out of respect for the family, we ask that you refer to the court documents for information on the situation," a spokesperson wrote in an email Friday.

The Kentucky decision follows in Ohio. A judge there reversed an order demanding that a hospital treat a COVID patient with ivermectin after the patient's wife and the doctor who prescribed it failed to provide "convincing evidence" that the drug could substantially help the patient, according to reports.

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    Ryan Basen reports for MedPage’s enterprise & investigative team. He often writes about issues concerning the practice and business of medicine, nurses, cannabis and psychedelic medicine, and sports medicine. Send story tips to r.basen@medpagetoday.com.