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Another Lawsuit To Suppress Legitimate Criticism – This Time SBM

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I suppose it was inevitable. In fact, I’m a bit surprised it took this long. SGU Productions, the Society for Science-based medicine, and I are being sued for an article that I wrote in May of 2013 on Science-Based Medicine. My SBM piece, which was inspired by an article in the LA Times, gave this summary:

The story revolves around Dr. Edward Tobinick and his practice of perispinal etanercept (Enbrel) for a long and apparently growing list of conditions. Enbrel is an FDA-approved drug for the treatment of severe rheumatoid arthritis. It works by inhibiting tumor necrosis factor (TNF), which is a group of cytokines that are part of the immune system and cause cell death. Enbrel, therefore, can be a powerful anti-inflammatory drug. Tobinick is using Enbrel for many off-label indications, one of which is Alzheimer’s disease (the focus of the LA Times story).

The claims and practice of Dr. Tobinick have many of the red flags of a dubious medical practice, of the sort that we discuss regularly on SBM. It seems that Dr. Tobinick does not appreciate public criticism of his claims and practice, and he wants me to remove the post from SBM. In my opinion he is using legal thuggery in an attempt to intimidate me and silence my free speech because he finds its content inconvenient.

Of course, we have no intention of removing the post as we feel it is critical to the public’s interest. This is what we do at SBM – provide an objective analysis of questionable or controversial medical claims so that consumers can make more informed decisions, and to advance the state of science in medicine.

We also feel it is critical not to cave to this type of intimidation. If we do, we might as well close up shop (which I suspect the Tobinicks of the world would find agreeable). Defending against even a frivolous lawsuit can be quite expensive, but we feel it is necessary for us to fight as hard as we can to defend our rights and the work that we do here at SBM.

An interesting wrinkle of this suit is that Tobinick is claiming that my blog post is an “advertisement.” This is a legal maneuver as the threshold for forcing someone to remove an advertisement is much lower than the threshold for suppressing their free speech. I can only assume that he and his attorneys are not bothered by the fact that blog posts on SBM are blatantly not advertisements.

In the case of the Enbrel article he had to make the absurd claim that the post (which does not mention my own practice) was an advertisement for my neurology practice at Yale, designed to attack a “competitor.” He would have us believe that Yale neurology in Connecticut is concerned about a distant clinic. Further, Yale Neurology is an academic practice. Our problem is too many referrals and long wait times, not competitors. To see how desperate the claim is, he argued that because I use Botox, which can be used to treat symptoms following stroke, that his treatments for stroke represent a competitor. However, I don’t use Botox to treat stroke patients. I mostly use it to treat migraines, as I am a headache specialist.

Perhaps he feels that my 18-year career promoting science, critical thinking, and science-based medicine is just a cover so I can occasionally attack distant tangential “competitors.”

In any case, the fight is on. Here is a review of the salient points of my criticism of Tobinick:

Tobinick is not a neurologist, and yet he feels it is appropriate for him to treat multiple neurological conditions with an experimental treatment. It is generally considered unethical for physicians to practice outside of their area of competence and expertise. He is trained in internal medicine and dermatology and is certified in those specialties. He has never completed a neurology residency nor is he board certified in neurology.

Despite his lack of formal training and certification, he feels he has ushered in a “paradigm shift” in the treatment of Alzheimer’s disease – a disease that has proved challenging for actual neurologists for decades.

His treatment of choice is perispinal etanercept (Enbrel), which basically is an immunosuppressant drug. He is using this treatment for not only Alzheimer’s disease, but neurological deficits following stroke, traumatic brain injury, and pain resulting from vertebral discs. He therefore claims that the neurological deficits in these various conditions result from active inflammation (specifically tumor necrosis factor – TNF) and by inhibiting TNF “rapid improvement” in neurological function is possible.

These claims are highly implausible, and in my opinion reflect his lack of training and expertise as a neurologist. Strokes cause ischemic damage to the brain – brain cells in severe stroke die. Inflammation following stroke is incidental, not causative. Yet Tobinick claims that 10 years following a stroke, long after any neurological recovery would have occurred, patients can improve by inhibiting TNF.

He makes the same claim for Alzheimer’s disease, despite the fact that this is a neurodegenerative disease resulting in loss and destruction of brain cells. An anti-inflammatory drug is not going to bring back dead brain cells, yet he claims “rapid improvement” is possible.

The simplest explanation for the apparent response to his treatments is simply placebo effects. Stroke neurologists, for example, are acutely aware of the so-called “cheerleader” effect. Take a patient with chronic deficits, get them off the couch, give them any treatment and tell them it will make them better, and they will likely demonstrate increased functionality simply because they are making an effort they had not made for a while.

The only way to really know if the treatment itself is having any neurological benefit is with careful double-blind placebo-controlled clinical trials. Tobinick, however, has not produced such evidence. He has a long list of publications – all case series, observational studies, pilot studies, case reports, and reviews. I could not find a single double-blind placebo-controlled trial establishing the efficacy of his treatment for any of the conditions I listed above. (There are small studies for disc herniation showing conflicting results.)

At best his treatment should be considered experimental. I think the plausibility of the effects he is claiming is extremely low. It’s possible that an anti-TNF effect may be of some use, but given the type of evidence we have it is likely we are seeing mostly (if not completely) placebo effects.

Despite the preliminary nature of his evidence, the “paradigm shift” such claims would represent, and his lack of formal training in neurology, Tobinick has obtained a number of use patents for his treatments. Use patents for medical procedures are still legal in the US, although they have been banned in many other countries, and many consider them unethical. The AMA has this to say:

The intentional withholding of new medical knowledge, skills, and techniques from colleagues for reasons of personal gain is detrimental to the medical profession and to society and is to be condemned.

The case highlighted in the LA Times story involved Ken Chiate, who brought his wife who was suffering from Alzheimer’s disease to Tobinick’s clinic for 165 injections of Enbrel over four years, at a cost of $800 each (that’s $132,000). During that time there were questionable subjective effects from the treatment, typical of placebo-only effects. Meanwhile his wife’s condition continued to relentlessly progress, as is typical of the disease, until she finally died in 2011.

I am not the only one to have concerns about Tobinick’s practices. The Medical Board of California filed an accusation in 2004, amended in 2005 and 2006, stating:

  • From about 2000 to 2002, Tobinick, owned and operated a medical practice under the name “Institute for Neurological Research” in Los Angeles and Newport Beach.
  • During those years, Tobinick promoted and advertised a new off-label use for an FDA-approved drug, etanercept (Enbrel). He referred to his drug as DiskCure® [sic] and advertised it as “a new and innovative approach for back or neck pain without surgery,” and as a “breakthrough” in the treatment of disc-related back and neck pain.
  • Enbrel is a genetically engineered protein and immune response modifier approved by the FDA for treating several types of arthritis but not for back pain. Tobinick’s treatment involved injecting it near the spine.
  • Until May 2002, there had been no published, peer-reviewed, scientific studies showing the effectiveness of the treatment for back pain in humans. Nor had there been an approved, pending, or investigational drug application for this use of etanercept.
  • Tobinick’s advertisements for DiskCure constituted unprofessional conduct under the California Business and Professions Code.
  • Tobinick had also failed to obtain a fictitious name permit for the Institute for Neurological Research as required by law.

Tobinick agreed to serve one year on probation during which he was required to complete courses in ethics and prescribing practices and have his practice monitored by another physician or complete a professional enhancement program.

But now he is not only up to his old tricks, but he has greatly expanded the scope of his Enbrel claims and practice. He has his own “Institute for Neurological Recovery” in which he shows videos of select patients to promote his patented treatments.

This is all, unfortunately, a far too common pattern, one with which we at SBM are very familiar. There is definitely a need here to provide critical analysis of such extraordinary medical claims. That means, also unfortunately, that we will occasionally need to spend our time and resources defending our right to do so.

 

 

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Leave a Comment (152) ↓

152 thoughts on “Another Lawsuit To Suppress Legitimate Criticism – This Time SBM

  1. Bob Blaskiewicz (@rjblaskiewicz) says:

    Where do we send our checks?

    1. Jeff Clegg says:

      That was my first response too. Opening up the virtual wallet now…

    2. BobbyGvegas says:

      My first thought.

  2. Thanks for the offer, Bob. We certainly would welcome support. You can donate to SBM at the button above, or to SGU Productions (http://www.theskepticsguide.org/support).

    Just tag the donation with “legal defense fund.”

    Or if you want to send a physical check, e-mail me directly and I will send you an address.

    1. dandover says:

      Done!

      1. Kevin says:

        I don’t get this asking for money stuff, can you not just win, then recover costs from the guy bringing the suit? it’s a pretty clear cut case tbf…

        1. Peter S says:

          Not under the American system, unless the defendant can convince the judge the suit was brought in bad faith and — a very high hurdle.

      2. Stefano G Jorge says:

        Done !

  3. This is called a SLAPP lawsuit (strategic lawsuit against public participation), and is explicitly against the law in 28 states and DC, including California. California, in fact, permits an accelerated anti-SLAPP motion. If he has filed his suit in California, I urge you to retain counsel and file a CCP 425.16 motion forthwith. If you win, he has to pay reasonable attorney’s fees.

      1. Peter S says:

        From a quick search, Florida’s anti-SLAPP statute appears to apply only to governmental plaintiffs.

  4. Peter S says:

    It seems a stretch, to say the least, to have brought this claim under the Lanham Act.

    1. Peter S says:

      To clarify, the Lanham Act applies to commercial advertising or promotion. This site hardly seems that.

  5. Unity says:

    Time to contact Ken White and get him to send up the Popehat signal – http://www.popehat.com

  6. Stefan Harders says:

    This is one of the times I’m glad to practise and publish in Europe. That guy, Tobenick, sounds exactly like another one of those assholes doing experiments on severely ill patients for money, thereby displaying a severe lack of empathy, and I’m free to say so without the risk of a pending lawsuit. Fight on!

  7. Frederick says:

    WOW, That guy’s record is not really good and he think suing will help him?

    Maybe a judge will reject his complaint, it is frivolous after all. The whole Advertisement angle is ridiculous. Your article is not a smear campaign either. You demand better evidence, which he does not have. I really hope you get a good judge that will see that it is ridiculous and That it is a slapp. Here In Quebec we now have a anti slapp law now ( loi anti poursuite bâillons we call it). The fact that he patented he “use” is quite weird, he want to be sure nobody else use that, Or test it. It is a sign i guess that it is dubious.

    Extraordinary claims demands extraordinary evidence. In which language can we right that so he understand? he does not only need a double blinded placebo, but also a independently replicated experiment after his own. Than if it work, he’ll be famous. What wrong about that?

    Anyway Let us know how the case is going. I’m already a Member of the SGU, My budget is limited, But I will certainly help SM as much as I can. Lucky for SBM there’s a Super good Lawyer on the staff!

    But being Sued by a guy like him kind is evidence that you are doing you job right.
    Bonne chance!

    1. Frederick says:

      I want to had, As I express in another comment, I really don’t like cranks who make money out of patient with neurological disorder. So kick his ass.

    2. Mike says:

      A common tactic among quacks (e.g. Burzynski) is to use their patents as evidence for efficacy, but a patent office review typically only looks for novelty and non-obviousness, and not whether the invention described in the patent application works. It is probably easier to get a patent on a treatment that doesn’t work because it’s easy to come up with quackery that it novel and non-obvious.

      Still, receiving a patent says little to nothing about whether or not a treatment is effective, so no, just knowing that Tobinick has patents is not evidence that his treatments are dubious.

  8. Nell on Wheels says:

    Related article from 2008: Breakthrough or False Hope? Etanercept Case Report Draws Scrutiny

    Most media reports presented the work as a “UCLA study.” Tobinick lists a UCLA e-mail address on the manuscript, and the private medical group where he works full-time is located in a building at UCLA’s medical plaza. According to the UCLA media office, Tobinick is a voluntary assistant clinical professor with UCLA’s Division of Dermatology. The office stated that his etanercept study did not go through the UCLA IRB. Greg Cole, associate director of the UCLA Alzheimer Disease Center (ADC), said that the center had nothing to do with Tobinick’s etanercept work.

    Amgen, the maker of etanercept, distanced itself from the study… “This study was not supported nor endorsed by Amgen. While Amgen and others have long recognized the potential for TNF inhibitors to have an effect on neurological conditions, we have carefully examined this study and believe that at this time there is insufficient scientific data to support the use of a TNF inhibitor as a means of treating Alzheimer’s disease.”

  9. goodnightirene says:

    I’ve already donated to Dr Barrett’s fund, a case which seems to never be resolved, and is just as absurd in its obvious intent to get revenge for being exposed as a questionable practice or practitioner. Nevertheless, I will contribute what I can.

  10. Ed Whitney says:

    Actually, etanercept has been tested in randomized trials for lumbar herniated disc and spinal stenosis; there is uncertainty about its benefits but at least some decent scientific work is being done in this area. Freeman and Ohtori reported a therapeutic effect but Cohen did not; however, Cohen used a smaller dose (4 mg) than the other authors used. This is all recent work and does not justify Tobinick’s using it in 2002. But it is not in the same league as trying it out for Alzheimer dementia.

    Ohtori S, Miyage M, et al. Epidural Administration of Spinal Nerves With the Tumor Necrosis Factor-Alpha Inhibitor, Etanercept, Compared With Dexamethasone for Treatment of Sciatica in Patients With Lumbar Spinal Stenosis. Spine 2012 ; 37 : 439 – 444

    Cohen SP, White RL, et al. Epidural Steroids, Etanercept, or Saline in Subacute Sciatica A Multicenter, Randomized Trial. Ann Intern Med. 2012;156:551-559

    Freeman BJC, Ludbrook GL, et al. Randomized, Double-blind, Placebo-Controlled, Trial of Transforaminal Epidural Etanercept for the Treatment of Symptomatic Lumbar Disc Herniation. Spine 2013;38:1986–1994

  11. Ed – these are small studies (less than 50 participants) with conflicting results, so hardly sufficient to establish efficacy, but I added a small addition to clarify.

  12. NotADoc says:

    Dr. Novella, you should take offense at his allegation that you are engaged in advertising at SBM. As a frequent reader, I knew you were in neurology, but didn’t know you were at Yale or that you specialized in headaches until reading this post. If you were indeed trying to advertise, I sincerely hope you would be a little bit better at it.

    Good luck deflecting this. Hope you’re rid of this guy quickly.

  13. daedalus2u says:

    You might want to look at this paper

    http://www.jci.org/articles/view/75073

    It shows clinically significant effects in Parkinson’s due to a placebo treatment.

    They knew it was a placebo effect because it was done in a double-blind placebo controlled trial.

    The Etanercept results may or may not be placebo, because there has been no trial measuring them against placebo. I suspect that the very prompt acute effects may be due to the effects of Etanercept reducing inflammation, but that reduction in inflammation is only acute. It does not lead to resolution of whatever is causing the inflammation.

    My hypothesis is that while Etanercept may acutely and temporarily improve things like Alzheimer’s by acutely reducing inflammation, it would very likely accelerate progression because physiology will respond and upregulate inflammation to compensate for the perturbation of Etanercept.

    Each dose likely “ratchets” the state of neuroinflammation a little bit higher. If there are periodic MRIs, you could probably see the progression accelerate.

    Since they have sued you, in discovery you should be able to get the records of the patients used for the case studies and so determine if they are likely placebo responses or not

  14. R.w.Foster says:

    May I reblog your original article? The one that knucklehead wants pulled down? Naturally, you’ll be sourced, Dr. Novella. Unless you happen to lose, then I suppose we could credit it to Dr. Scratcheenseiff…

  15. Bravo! Fantastic. I doubt Tobinick has a clue just how much of a Streisand Effect he’s in for. If he thought Google’s search results were unkind to him before, he hasn’t seen anything yet!

    I love the toughness and ethical clarity of this response. Having endured my own legal incident a few years ago (after provoking the wrath of chiropractors), I know how surreal and stressful these kinds of threats can be. A firm decision to fight for the right to criticize is a perfect demonstration of why I’m proud and humbled to be involved with ScienceBasedMedicine.org. I’ll be doing my bit to help get that Streisand effect going. And munching my popcorn…

    1. Windriven says:

      His Wikipedia entry could use some editing :-)

      1. ernesto says:

        It needs editing badly. Guess it’ll come with the Streissand effect.

  16. smh says:

    You are familiar with anti-SLAPP laws? He hasn’t got a chance. Make sure your lawyer is not a complete idiot.
    http://en.wikipedia.org/wiki/Strategic_lawsuit_against_public_participation

    1. smh says:

      Don’t forget to sue for attorney’s fees.

  17. This is an outrage!
    I’m already donating to the SGU every month as a damned dirty ape, but I’ll make sure to send a bit more your way this month, every little bit helps!

    /Mikael

  18. thetentman says:

    Good luck with the lawsuit. Nobody on Yelp likes him either.

    http://www.yelp.com/biz/tobinick-edward-md-los-angeles

    1. Windriven says:

      Neither do his reviewers at Healthgrades where he earned 2.9/5, below the national averages on every measure (except wait time where he was at the national average).

      We all know the problems with these subjective reviews. But it is striking that there are quite a number of internists close by with similar numbers of reviews and much higher marks.

      It would seem like the doctor is quite the entrepreneur, dabbling in hair removal and neurological research. I guess the two are related. There is hair on most heads. And there’s a lot of neurological stuff inside most heads. So … yeah, I can see that.

      1. Reese Vaughn says:

        Wish there were a “like” button for your comment about hair and the brain.

  19. CrankyEpi says:

    I realize this is off the main topic and rather trivial, but I feel you (Dr. Novella) are being overly kind by saying that “at best his [Dr. Tobinick's] treatment should be considered experimental.” Outside of the usual scientific connotation of the word “experimental,” I would think of a patient who has a bad disease and who has responded poorly or not at all to all other standard, science-based treatments. Not that the patient would be expected to be cured or respond really well, but rather that you don’t see at least the minimally acceptable improvement from standard treatments in this patient that you would see in others. So in an effort to help the patient, who may have certain peculiarities about his case, the physician might try an unusual treatment (“experimental”) and carefully observe whether the patient responds. I am describing a relatively rare scenario. Without this connotation I worry that non-science based people will interpret “experimental” to mean “let’s try it!” without qualifiers.

    Okay, I did not read the LA Times article but it does not sound like this is Dr. Tobinick’s approach.

  20. Doug Attig says:

    Attorneys who take cases like this should be disbarred, IMO.

    1. Peter S says:

      It will be interesting to me to see their argument how they have satisfied the “commercial advertising or promotion” element of a Lanham Act claim. I fail to see it.

  21. Peter Kaplan says:

    Might I suggest crowdsourcing the cost of defending against the lawsuit? Adam Carolla and other podcasters are using this strategy to finance a defense against patent trolls who are suing them for bogus patent infringement. As of 7/23, they are closing in on half a million dollars (https://fundanything.com/patenttroll?locale=en).

  22. SMH mentioned Anti-SLAPP laws above. California has one of the stronger ones: California Anti_SLAPP Law

    Anti-SLAPP laws are designed to provide a remedy against “Strategic Lawsuits Against Public Protection” (SLAPPs), often lawsuits with little merit but designed to intimidate and silence. See Public Participation Project

    1. Windriven says:

      One suspects that Tobinick filed in FL rather than CA because of less restrictive SLAPP laws in FL.

      1. smh says:

        Florida!? Ruh roh. You can pretty much just shoot people in the face there, right? ;)

        1. Windriven says:

          Only if they’re wearing a hoodie.

          1. WilliamLawrenceUtridge says:

            Only if the’re black and wearing a hoodie. :(

  23. Mike says:

    I wish you the best of luck in getting this lawsuit dismissed. Since neither you nor Dr. Tobinick are Florida residents, it would seem that he did some forum shopping to find a state without an anti-SLAPP law.

    However, as a former patent practitioner, I strongly disagree with your statements about the patent system, which is a completely separate topic from this quack’s actions.

    You write:

    Use patents for medical procedures are still legal in the US, although they have been banned in many other countries, and many consider them unethical.

    This argument sounds very similar to a Non-GMO Project statement on GMOs:

    Most developed nations do not consider GMOs to be safe. In more than 60 countries around the world, including Australia, Japan, and all of the countries in the European Union, there are significant restrictions or outright bans on the production and sale of GMOs.

    The basis for the U.S. patent system is enshrined in article 1, section 8 of the Constitution, which states:

    The Congress shall have power … To promote the progress of science and useful arts, by securing for limited times to authors and inventors the exclusive right to their respective writings and discoveries;

    The modern patent system institutes a quid pro quo, whereby an inventor is required to publicly disclose how to make and/or use the invention in return for receiving a 20 year monopoly on practicing that invention. Because the patents are published online, a patent by definition cannot constitute “intentional withholding of new medical knowledge, skills, and techniques from colleagues.”

    According to U.S. statute, a patentable invention must be novel and non-obvious at the time of the invention. Thus there is (at least in theory) a high bar to obtaining a patent, and a patent should not preclude people from using existing techniques. Patents are especially important in the pharmaceutical industry, where it can cost $1 billion to create the first pill, and a penny to create the second pill. Patents are an important tool for incentivizing drug and medical device development because they can help recover the large research and development costs. Thus, “use” patents are pursued in pharmaceutical and medical device patents all the time.

    The WMA makes several distinctions between physicians and companies where that do not apply. For example, aren’t uses of medical devices and drugs considered medical procedures? The WMA seems to acknowledge the importance of patents but states that physicians are special because they “already have incentives [e.g. professional reputation] to innovate and improve their skills.” Well, under the same logic, physicians should never charge for care because any such charges might stop patients from getting the medical care they need and not charging would improve physicians’ professional reputations. Similarly, medical schools should not charge for teaching doctors, and doctors should not charge for training other doctors. Why are not all medical school teaching materials and lectures freely available online?

    Basically, the WMA seems to just be coming up with reasons why doctors shouldn’t have to pay for development of novel medical techniques, while making excuses for why it’s ok to pay for (and not steal) pharmaceuticals and medical devices. The WMA also seems to dramatically understate the costs involved in developing new medical procedures.

    Furthermore, even if one thought the use of patents on medical procedures to make money was unethical, merely holding a patent on a medical procedure and not enforcing the patent (as Elon Musk recently pledged to do for Tesla’s patents) costs the public nothing, so can not be considered unethical.

    Is it possible to unethically assert a patent? Perhaps, by refusing to allow anyone to practice a life saving invention at any price or at a price considered to be too high, but such discussions are not because medical procedure patents are, by themselves, unethical. The WMA statement also discusses possibly problematic conflict of interests, but, again, this problem is irrelevant to whether medical procedure patents themselves are ethical or not. This debate is really about the costs of healthcare in general. Of course the costs of medical care are an important topic to debate, but a particular type of patent should not be singled out as unethical over any other cost involved in providing healthcare in the 21st century.

    1. Peter S says:

      “I wish you the best of luck in getting this lawsuit dismissed. Since neither you nor Dr. Tobinick are Florida residents, it would seem that he did some forum shopping to find a state without an anti-SLAPP law.”

      According to the Complaint, Tobinick is a Florida resident. Paragraph 4.

      1. Mike says:

        Thanks for the correction.

  24. KillCurve says:

    What a slimeball! So thrilled to see you fight!

  25. papertrail says:

    Donating now. I also didn’t know you specialized in headaches. Cool! I never heard of this guy before. I hope this frivolous lawsuit doesn’t take time away from your important work.

  26. Matthew says:

    Maybe I missed it, but on the donation page there is no way to send a memo with the donation earmarking the money for the legal defense.

    1. tmac57 says:

      Actually,you can(at least I was able using my PayPal account. You should see a “thank you for your donation” or something similar,with a plus sign next to it.When you click the plus sign,a drop down box lets you enter a memo.

  27. Kiiri says:

    You are right Dr. Novella, it was only a matter of time before someone thought to sue. Best of luck and keep fighting the good fight. Will be looking into making a contribution to the defense.

  28. Waydude says:

    Would this guy be open to posting his rebuttal on SBM or having a debate similar to the Truther?

    1. WilliamLawrenceUtridge says:

      Why bother? The issues are already laid out – anecdotes aren’t data, no matter how many you accumulate, selling treatment before it is proven effective is unethical, and suing to supress dissent makes you an asshole and effectively demonstrates your inability to support your practices in any meaningful way.

      There’s no debate, Toberdick will just cite anecdote after anecdote, Dr. Novella would say “anecdotes are not data” an equal number of times, and nobody accrues any benefit. Bar Toberdick getting more publicity, thus turning this site into an advertisement for him, a small irony given the contents of the suit.

  29. Peter Jones says:

    Tobinick bringing a lawsuit based on claim of Novella advertisement. Time for a reality check for Tobinick.

    Here is a Radio Advertisement for strokebreakthrough.com, created by Dr. Edward Tobinick, Dermatologist. This advertisement was broadcast on radio in the Los Angeles area. Tobinick promotes in his videos and publications, only the use off-label of Etanercept (Enbrel). In the State of California ( and I expect in the other States), the promotion and advertising of off-label drugs is prohibited. Perhaps, after you have listened to Tobinick’s Strokebreakthrough.com advertisement, you good folks could do your bit and bring Tobinick’s violation to the Medical Board of California.

    Link to Dan O’Day Talks About Radio. To hear the Radio Advertisement, Open webpage and Click on Audio Link:

    http://danoday.com/blog/2012/02/radio-strokebreakthrough-com/

    MONDAY RADIO COMMERCIAL SMACKDOWN: Institute of Neurological Recovery
    by DAN O’DAY on FEBRUARY 13, 2012
    First, the terrible radio commercial…complete with terrible opening line.

    The opening line of your radio commercial is the commercial for the commercial.

    When your first words are, “Announcing, at last…” the audience expects to hear an announcement they long have been waiting to hear.

    But no listeners have eagerly been awaiting “a brand new medical breakthrough for victims of stroke.”

    Yes, many stroke victims and their loved ones would love to hear about something that can improve the lives of stroke victims — something that can mitigate some of the many possible effects of a stroke.

    But that’s what those people want to hear about: the results that “at last” are available, not a meaningless, unsupported declaration about a “breakthrough.”

    “Just published from medical doctors”

    Huh? Is your Weasel Words alarm going off? In those five words, they manage to alert us twice that they’re deliberately not telling us anything.

    “Just published” — Y’know what? If this “breakthrough” was published in, say, the New England Journal of Medicine, they would’ve said, “just published in the New England Journal of Medicine.”

    If it was published as an advertisement in, let’s say, the Pennysaver, then maybe they’d forget to mention who “published” it.

    And whatever it was that was published, wherever, was “by medical doctors.” Once again, the alarm bells ring.

    Does being told that unnamed “medical doctors” published something somewhere (which, apparently, says something although we’re not told what it does say) really cause you to trust this advertiser?

    This new treatment “is exclusively available only at…” — Thank you, from our Department of Redundancy Department.

    They tell is it’s “exclusively available (only at)” before they tell us what the heck they’re talking about. Hint: Tell us what you’re selling before you tell us where we can get it.

    But to be fair, they never do tell us what the heck they’re talking about.

    They tell us the advertiser’s name, address, and Web address. And then they invite us to schedule a free visit…by calling them on the phone. Or by going to their website. (Here’s that URL again).

    Why should we schedule a free visit? Sorry, they just didn’t have time in this 60-second radio advertisement to give us a reason. After all, they had to tell us the advertiser’s name, physical address, URL, and phone number a total of 11 times.

    “Results can vary”

    Umm…I’m sure they can. But WHAT RESULTS ARE YOU TALKING ABOUT?

    Schedule your visit “at absolutely no cost to you.”

    “Hey, Hon! I have no idea WHY we should visit them, but if we do it’ll be at absolutely no cost to us!”

    “Sounds great! What’s that number/name/address/website again…?”

    1. Xplodyncow says:

      Big Pharma companies cannot promote off-label, but I have no idea whether that also applies to individuals who are not affiliated with a pharma company.

      1. Peter Jones says:

        Individual Medical Doctors cannot promote the use of Off-label drugs.

      2. Peter S says:

        As I understand it, it’s the manufacturer. There is actually no express ban on off label promotion, rather, it’s considered false or misleading labeling, which is prohibited.

      3. Peter S says:

        There has been some recent law too suggesting the ban violates the First Amendment right to free speech.

  30. EBMOD says:

    I think that this excerpt from yelp is spot on:

    “After showing a video and asking 5 questions regarding my mom’s history, an assistant (not a Doctor) said my mom was “the perfect candidate” for the treatment. I asked several times what was the cost but I was told the treatment was so unique to each patient they could not tell me the cost without having the neurologist make a personal diagnose for my mother.

    After paying $400.00 the doctor came in the room and asked questions about where we lived, our profession, employment status (they seemed more interested in our income than my mom’s health history!!!!). Then, after five minutes without even touching my mother or checking her vital signs, Dr. Tobinik said she was the “perfect” patient and that each shot costs $4,000.00.

    $400. too much for five minutes trying to inquire about our finances; $4,000.00 same price for all stroke patients, never got the “personalized” diagnostic; the whole experience “a thief wearing a doctor’s scrub” with total disregard for the hope of ill people and the families… HE SHOULD BE DISBARRED!!!”

    What a despicable practitioner. As long as the cash continues to roll in, he clearly DGAF about the profession or his patients…

  31. This is why I started a subscription donation a while back. It was going to happen.

  32. Windriven says:

    A little digging and I found that Tobinick is represented by Tripp Scott / Ft. Lauderdale and his lead attorney is one Peter G. Herman, a “director” at Tripp Scott and a most interesting individual. Mr. Herman “was found to have “defrauded” creditors in his personal Chapter 7 bankruptcy by concealing” a $10 million fee.

    As of this writing, Herman appears to have filed (March 26, 2013) an appeal. He appears to be on the hook for $4.5 million in a failed real estate deal.

    You just can’t make this stuff up.

    1. AdamG says:

      I grew up in Boca/Ft. Lauderdale, and it’s sad to me how normal this story seems. It’s where the most successful quacks and fraudsters go to retire on their piles of money.

    2. Peter S says:

      $10 million here, $10 million there, pretty soon you’re talking about real money.

  33. tmac57 says:

    Donation sent!
    The only thing I hate worse than a bully,is a bully with a lawyer.

  34. Peter Jones says:

    TOBINICK DOWN UNDER

    There are four video recordings from April 2014 and one from 2011, which feature Linda Lumbra undergoing off-label Etanercept treatment by Dr. Edward Tobinick at his practice in Boca Raton, Florida. The videos Reverse Stroke Part 1 and Part 2 were aired primetime on Channel 9 Australian TV. Two other videos are what the call ‘Extra Minutes’ which contains further interviews with patient Linda Lumbra, but they were not aired on TV, but are made available in the 60 Minutes Video Library. The 2011 video is from 2011 when this same station 60 Minutes, produced a new Alzheimer’s treatment, again featuring Dr. Tobinick and the off-label use of Etanercept. I would like you all to view these videos and appreciate the effect they had on Stroke patients and families in Australia and New Zealand.

    Click on Link, Type in STROKE in video search. I invite you to view Austalian TV 60 Minutes , (leading current affairs documentary program) from April 2014, the story of LInda Lumbra

    http://sixtyminutes.ninemsn.com.au/videoindex.aspx

    Reverse stroke Part 1
    The controversial and incredible new therapy that can reduce the effects of a stroke in just three minutes. 27 Apr 2014

    Reverse stroke Part 2
    The controversial and incredible new therapy that can reduce the effects of a stroke in just three minutes. 27 Apr 2014

    Stroke: Cured in minutes!
    Watch the incredible moment Linda Lumbra is cured after being paralysed by a stroke three years ago. 27 Apr 2014

    Stroke: Extended interview with Linda Lumbra
    “It’s a miracle and should be available for all stroke patients” – Linda Lumbra describes her incredible experience with this controversial new stroke therapy. 27 Apr 2014

    Stroke: Rewind: A new shot of life (2011)
    They call it “the long goodbye” and it’s the most heartbreaking journey imaginable. Alzheimer’s robs its victims of their memory and their dignity, erasing their personalities until all that is left is the shell of their bodies.

    1. Windriven says:

      Wonderful, heartwarming stories. I’m happy for Ms. Lumbra and the others. But surely you understand that every quack and snake oil salesman has a raft of testimonials and anecdotes.

      The fact that this therapy is being humped on 60 Minutes before it has been carefully studied in RCTs suggests extreme caution.

      RCTs with sufficient power will tell a lot. But before it even gets to that point, what is the magic with perispinal delivery? Why not epidural or intrathecal? Etanercept is a huge effing molecule. How is it getting to the target in the brain? How is it doing it in a couple of minutes? Why has Amgen not embraced this research?

      Just wondering.

      1. Nell on Wheels says:

        How is it getting to the target in the brain? How is it doing it in a couple of minutes?

        As described below, the patient is turned upside down, “allowing the medicine to travel into the brain.” ;)

    2. Nell on Wheels says:

      Don’t know if this makes a difference., but there appears to be some confusion about whether Ms. Lumbra suffered a stroke or a seizure. According to the local news A Medical Miracle: Linda’s Story

      Three years ago, Linda Lumbra of Sebec suffered a violent seizure. Unable to walk, unable to speak, she felt trapped in her own body… on one school day, something terrible happened.

      “Basically, the last thing I remember is I had a reading recovery lesson with a child,” said Linda. “That child left the room and I didn’t feel very well, which is not totally uncommon before a seizure.”

      Linda was found seizing on the classroom’s bathroom floor an estimated 45 minutes later. After ten days in the hospital, Linda was diagnosed with an acute brain injury, her case was moderate to severe.

      It’s my understanding that a traumatic brain injury can predispose someone to a stroke, but they are not the same thing. And that particular article never mentions stroke.

      In a follow-up article, Dr. Tobinick describes the process:

      It’s injected into the back of the neck. The medicine is then absorbed by an interconnected system of veins in the spine and Brain called the cerebrospinal venous system. The patient is then tilted backwards, allowing the medicine to travel into the brain.

      1. Windriven says:

        That DOES make a difference, a huge difference. A seizure and a stroke are very different events.

      2. Peter Jones says:

        A Medical Miracle: Linda’s Story
        Written by Lindsey Mills 04 February, 2014
        SEBEC – It’s a medical breakthrough. A first of it’s kind treatment for stroke and traumatic brain injury patients that helps them return to living a normal life.

        Three years ago, Linda Lumbra of Sebec suffered a violent seizure. Unable to walk, unable to speak, she felt trapped in her own body. That was, until exactly two weeks ago, Tuesday.

        Linda Lumbra is a wife, daughter, mother, and mammy, as she’s known by her grandchildren. She was a teacher for more than two decades. But on one school day, something terrible happened.

        “Basically, the last thing I remember is I had a reading recovery lesson with a child,” said Linda. “That child left the room and I didn’t feel very well, which is not totally uncommon before a seizure.”

        Linda was found seizing on the classroom’s bathroom floor an estimated 45 minutes later. After ten days in the hospital, Linda was diagnosed with an acute brain injury, her case was moderate to severe.

        “I couldn’t shower… you’re life totally changes because you’re not independent anymore.”

        Even after months of therapy, she was weak.. and walked with a limp. Her speech, slow and hard to understand. The reality had settled in… and Linda felt defeated. But that all changed, one December day.

        “Had my mom not seen this article, we would have no idea about Doctor Tobinick.”

        Linda and her family found Doctor Edward Tobinick at the Institute of Neurological Recovery in Boca Raton, Florida. He developed a breakthrough treatment for stroke and traumatic brain injury patients.

        One single injection, and a 4 minute wait.

        “Wow! It’s bright in here!”

        With those five words, Linda Lumbra had her life back.

        Her husband Benny, had his Linda back.

        “I hadn’t heard that voice in three years!” said Benny.

        Linda says Gabby Giffords was her inspiration, the entire journey.

        For more information on Dr. Edward Tobinick and the Institute of Neurological Recovery, visit http://www.strokebreakthrough.com.

        Lindsey Mills
        Lindsey Mills
        Anchor/Reporter/Producer
        lmills@wvii.com
        Lindsey joined the WVII ABC7 and WFVX FOX Bangor news team in January of 2012. Raised in Arlington, Mass., Lindsey graduated from Endicott College located in Beverly, Mass. where she majored in Communication. While attending college on the North Shore Lindsey ran the campus newspaper, the Endicott Observer, lead the Endicott Gulls field hockey team as Captain in the 2009 & 2010 seasons, and played for the women’s club hockey team.

        For two years Lindsey worked at WCVB Channel 5 News Boston as an ENG producer and writer, while also filling in for various positions in
        Chronicle, the station’s nightly news magazine. Additionally, Lindsey contributed to the production of two MDA Labor Day telethons.

        When she’s not in the field she can be found on the ice. Lindsey helps out with Brewer’s Youth Hockey Learn to Skate & Learn to Play program and plays on a men’s league team. She also helped to establish Brewer’s first youth under-12 girl’s hockey team.

        octor Behind “One Shot Away” Explains Linda’s Medical Miracle
        Written by Lindsey Mills 05 February, 2014
        BOCA RATON, FL – Last night we brought you the story of Linda Lumbra, a Maine teacher who had to give up the career she was so passionate about after suffering a violent seizure that left her weak and barely able to speak.

        Tonight, we’re learning more about that breakthrough treatment, developed by Doctor Edward Tobinick of the Institute of Neurological Recovery.

        Just minutes before Linda’s treatment, she had trouble counting to ten. She had been living like this for three years.

        Now, it’s no problem for Linda to count to ten. It’s all thanks to a single injection of a drug called Etanercept.

        It’s FDA approved to treat some autoimmune diseases like arthritis. You may recognize it from a commercial for ENBREL featuring pro golfer, Phil Mickelson.

        But how it was used on Linda, is not FDA approved. It’s being used in an “off label use.”

        Since 2010 Dr. Tobinick has been using it to help hundreds of stroke and traumatic brain injury patients.

        “The stoke treatment evolved naturally from our use of this technique and this medicine for treating patients with Alzheimer’s and other forms of brain dysfunction,” says Dr. Tobinick.

        It blocks tumor necrosis factor, or TNF. It’s a chemical produced by the body to help with the healing process after suffering some sort of brain trauma.

        “When the concentration of TNF becomes elevated, becomes too high, then brain function is perturbed, it’s disturbed. There’s brain dysfunction.”

        By applying the TNF blocker, Dr. Tobinick says he’s demonstrated that TNF is actually not good for the healing process.

        Here’s how it works. It’s injected into the back of the neck. The medicine is then absorbed by an interconnected system of veins in the spine and Brain called the cerebrospinal venous system. The patient is then tilted backwards, allowing the medicine to travel into the brain.

        “Some patients stay better for months. Some patients, it wears off rather quickly but the medication can be repeated, if necessary.”

        It is still an experimental treatment at this point, but it’s already made an amazing impact on people like Linda Lumbra.

        1. Nell on Wheels says:

          Waste of space posting entire articles that have already been linked to above, especially since they add nothing new to the conversation. Do we really need to know that “While attending college on the North Shore [the reporter] ran the campus newspaper, the Endicott Observer, lead the Endicott Gulls field hockey team as Captain in the 2009 & 2010 seasons, and played for the women’s club hockey team.”

          Did you have a point?

          1. Peter Jones says:

            yeah, I agree, it was a bit long and should have been trimmed. From my point of view, I wanted to show what ‘patient’ Linda Lumbra said to the reporter , and what Dr. Tobinick said to the reporter. If you want my opinion……… the Linda Lumbra treatment / recovery is a work of fiction created by Tobinick, and should be properly investigated by the proper authorities.

        2. AntipodeanChic says:

          As (another?) Australian – I’d like to point out that “60 Minutes” is generally considered to be a low-rent (yet unfortunately high-rating) tabloid-style program.

          Nearly every week they seem to promote some “exotic” Quackery, frequently using the refrain: “If only the Australian Medical Establishment would step in line with the rest of the World – but no, those pesky Ethics Committees just don’t want ‘Aussie Battlers’ to live/thrive”. [Naturally I paraphrased...] It is certainly no “Four Corners” or “Insight”, for example.

    3. Peter Jones says:

      It is my opinion that Linda Lumbra, featured as a Stroke patient in the Tobinick created videos, was never a Stroke patient and that what you are seeing in these videos is an act of deception perpetrated by Dr. Edward Tobinick for the sole purpose of extracting vast sums of money from Stroke families with the promise of a very high success rate. This is nothing more than exploitation of the vulnerable.
      Dr. Edward Tobinick is a snakeoil salesman. Dr. Edward Tobinick and the Linda Lumbra Stroke claims demand an immediate investigation by the Medical Board of California, the Florida Health Board and the Civil authorities. How many more stories do we have to read of Australian and New Zealand Stroke patients with family members and carers, running fundraisers to pay for the travel fares, the 3 weeks accommodation and the exhorbitant fees charged by Tobinick. Dr. Edward Lewis Tobinick, Dermatologist is a charlatan, a purveyor of fraudulent claims and acts for the purpose of enrichment.

  35. Peter Jones says:

    TOBINICK DOWN UNDER :

    http://www.thechronicle.com.au/news/Reverse-stroke-treatment-family-tears-joy/2326054/

    The Chronicle Toowoomba Newspaper, Australia 23 July 2014

    Reverse stroke treatment has family crying tears of joy

    Stuart Cumming | 23rd Jul 2014 6:00 AM

  36. Peter Jones says:

    TOBINICK DOWN UNDER.

    http://hope4joel.wordpress.com/

    Further to Stroke patient Joel Shepherd and Family. As this is a fluid situation, as on Monday 21st July, 2014, Stroke patient Joel Shepherd was administered his first injection of off-label Etanercept (a Black Boxed Warning drug) by Dr. Edward Tobinick. The family report in their updates on their WordPress HOPE4JOEL that they have an appointment next Monday 28th July 2014, at Dr. Tobinick’s Institute of Neurological Recovery in Los Angeles. The family of Joel Shepherd report in the WordPress diary, record how they were affected by the 60 Minutes “Reverse Stroke” story. I invite you to read this diary. This is happening NOW!!!

    Related Joel Shepherd Article.
    [ http://www.thechronicle.com.au/news/Reverse-stroke-treatment-family-tears-joy/2326054/
    The Chronicle Toowoomba Newspaper, Australia 23 July 2014
    Reverse stroke treatment has family crying tears of joy ]

  37. charles minus says:

    I hope you get a savvy lawyer. That is probably more important than anything else. I have watched a few of these lawsuits against Quackwatch and the usual tactics are to bog the legal case down in motions, amendments, substitutions and other legal hurdles attempting to get the defendant to just give in and pay off the plaintiff. I hope that doesn’t happen to you in this case. Good lluck.

  38. Windriven says:

    @Peter Jones

    Now you’re being a dick. Spamming us with lots of anecdotal stuff doesn’t make your guy look good, it makes him look like a quack. How about bellying up with some first rate, high quality research? Something that has broad applicability?

    1. goodnightirene says:

      Or…the plural of anecdote is not evidence.

    2. Xplodyncow says:

      If this is the same Peter Jones as in comment #30, I don’t think he is defending Tobiniak. At least I hope not.

      1. Windriven says:

        Peter Jones is a shill. I’ve watched his video links and read his articles. If he isn’t a shill then his humor is as dry as the Gobi. I believe that 30 was written to entice people to listen to the radio spot, not the hard scientists here so much as the lurkers. You can read the whole long comment or you can listen to the ad for yourself. The ad is well done and the address it directs listeners to is 100 UCLA Medical Plaza, an address sure to dispel concerns that this is a quack.

        1. Peter Jones says:

          Tobinick had a practice in offices at 100 UCLA Medical Plaza. His dermatology practice was called Institute of Laser Medicine ( basically, hair removal). The dermatology MDs and staff from Tobinick’s Dermatoloy practice where the same people Tobinick used as Institute for Neurological Research which later was changed to Institute of Neurological Recovery. Tobinick never employed any staff with neurological experience. Tobinick used the location at UCLA Medical Plaza, to dupe people to thinking that Tobinick was part of UCLA Medical Hospital Campus / University.

          1. Windriven says:

            Yes, I thought it was masterful the way they wove that into the script making it sound as if this was a UCLA-related therapy.

      2. Peter Jones says:

        The last thing I want to do is defend Tobinick. I want to expose Tobinick for the 15 years of exploitation of the most vulnerable in our society – the sick and the elderly, by giving them false hope in areas of medicine with high unmet need such as Alzheimer’s and Stroke, not forgetting Tobinick’s first claim in the off-label use of Etanercept for disc related pain which he called DiskCure. Here we are, 15 years later, still unable to make Tobinick accountable for his actions. Next Monday 28th July 2014, young man Joel Shepherd and family , all the way from Toowooba, Australia to Dr. Tobinick’s Los Angeles practice, will attend Tobinick’s Institute of Neurological Recovery for a 2nd injection of Off-label Etanercept ( a Black Boxed Warning drug). If you want the truth, go speak to Neurologists.

        1. Windriven says:

          Well Peter, I deeply apologize. I totally misread you. Your comments other than 30 seemed … complimentary.

          1. Peter Jones says:

            Windriven, Thanks for the feedback. I know from experience just how hard it is to unravel fact from fiction when it comes to Dr. Edward Lewis Tobinick.

            1. Frederick says:

              You should have made a disclaimer under you comments, I was confused too. It,s good that you want to help But with that said, try to spam a little less, I know now you meant well. But as skeptic, we must try not to become troll and spammer ourselves.

              I remember a guy spamming comment on Facebook. His comments were for “our side” but he was spamming, like 20 comment in a row, so in the end, he just looked bad.

              But still, thanks for all the info.

            2. Nell on Wheels says:

              Sooooo… I’m going to go out on a limb here and hazard a guess that you have had perhaps… shall we say… a more direct or personal experience with the dear doctor than the rest of us have?

      3. WilliamLawrenceUtridge says:

        It seems like Peter Jones might be playing the “I was skeptical, look at all these (unrelentingly and uncritically positive) stories and make up your own mind (based on my biased sample.”

        Hard to tell because he throws in the occasional quasi-skeptical or tangent. It would be nice if he were to simply be a giant dick to clarify the issue.

        1. WilliamLawrenceUtridge says:

          Or perhaps not.

    3. Peter Jones says:

      I challenge all the claims and practices of Dr. Edward Tobinick.

  39. Jamin Rak says:

    Keep up the good fight Novella! You guys are doing an awesome job of keeping us all very well informed. I’m honestly surprised that you haven’t had more backlash from other, more sue happy people, like Carrick! You, Hall, Ingraham, and all the rest have helped me question my long standing beliefs for the betterment of my practice. It has fundamentally changed my perspective of medical science and has enlightened me to my biases prompting me to continue researching all things “factual”. Everyone should donate, not just towards fighting this pathetic lawsuit, but to ensure that you all continue in this most dignified quest! Thank you!

  40. Derek says:

    This here lawyer will be making a donation to your defence fund since I’m not called in the US, but I certainly hope the many American lawyers that follow SBM and the SGU will consider volunteering some coordinated pro bono assistance to your legal counsel to mount a solid response and to keep the costs down.

  41. Rex Browne says:

    First time I have visited SBM website. As primary care practitioners, we are in need of this sort of objective analysis of complementary medicines.
    Bravo for defending reason and honesty.

  42. Trond says:

    Most of this is stuff that is beyond me, but the legal parameters seem simple enough. If this goes to court, force a double blind study to be done on the subject. If he is right, then no harm done as his claims will show results. In fact I dare say that he will gain more fame for doing so, but he would have done it the right way.
    If however it doesn’t, then it will show that he is basically doing fraud against innocent people, robbing them of money and he should be shut down and maybe even have his license suspended for a while. I would not say permanently as he is still a doctor which is something we need more of, not less, but maybe the time off from practicing medicine will teach him that patients welfare comes first, not his wallet or search for fame.

    1. WilliamLawrenceUtridge says:

      I’m pretty sure courts wouldn’t force a double-blind study. Which is too bad, since that would be a rad (but expensive) way to resolve a lot of the cases. Here, Burzynski, homeopathy, etc.

      On the other hand, you’d probably end up doing a lot of double-blind studies for stupid things like homeopathy, or dangerous things like giving a stroke victim a TNF-A inhibitor.

      1. KayMarie says:

        I worked on a project once where the funding was part of a settlement between the state and an industry. Part of the money the industry paid in the settlement was earmarked for a study which could then inform future regulations on the industry. Then the state solicited grant applications and the usual so on and so forth commenced.

        So there is some precedent for research to be borne out of a lawsuit, but someone has to have deep enough pockets that you get big enough settlements to then pay for the study in addition to any other things the money may be for.

        1. WilliamLawrenceUtridge says:

          Heh, neat. Gosh, wouldn’t it be a shame if a court-mandated requirement for a double-blind study completely emptied out a quack’s bank account?

          Who was the mobster sent to jail for mail fraud?

  43. Julie says:

    He sounds a bit desperate. You and a decent lawyer should be able to rip him apart.

  44. Escargot says:

    Tobinick seems a clever bugger with a plan. Note how he intentionally provokes a complaint against him for patent interference.

    http://patentlawcenter.pli.edu/2014/05/20/cafc-sends-dismissed-interference-back-to-board/

    I would not underestimate this guy.

  45. Escargot says:

    Check out the LinkedIn “also viewed” for Tobinick’s bff, Hyman Gross MD:

    https://www.linkedin.com/pub/hyman-gross/35/512/36

    Dr William Reed, BS, DC, DACNB
    Functional Neurologist at Doctors’ Choice Chiropractic Center

    Charlie Hester
    chiropractic neurologist at henry chiropractic

    Richard Matthews DC DACNB FACFN
    Chiropractic Neurologist, Functional Neurologist

    I guess you can’t control who looks at your LinkedIn. But it is interesting that people interested in chiropractic neurology are looking at Dr. Gross’ page.

    1. Peter S says:

      A chiropractic neurologist sounds like a contradiction in terms to me because neurologist implies a real doctor?

      1. R Miller says:

        You are correct, a neurologist is by definition a physician.

        Thus, naturopathic practioners (and some chiropractors) simply add the term “functional” or other such modifiers in front of the title; this gives them the ability to con patients who do not understand the difference, while also providing legal wiggle room. As long as they don’t explicitly state they are an MD/DO without credentials, they are free to pretend to be as long as they are extremely careful with the language. It’s basically the health professional version of how you label health benefits of food – you go to jail if you say your can treat Alzheimer’s Disease, but if you say the food “boosts mental health, mood, and cognition” you’re perfectly fine.

  46. Reese Vaughn says:

    Has anyone verified Tobinick’s credentials? Thinking here of the people who attend a summer institute at Harvard and then claim on their vitaes to have been “educated” at Harvard.

    1. Peter Jones says:

      Tobinick’s Credentials………..how about Tobinick’s Scheme to Defraud.
      Scroll down to Page 15 onwards.

      http://www.casewatch.org/board/med/tobinick/davoodifar.pdf

      1. Reese Vaughn says:

        Thanks

  47. Aaron Wright says:

    It’s times like this I wish I was a lawyer. If I were, I would gladly contribute my services to bring down quacks like the guy coming after you. People who want to silence free speech just make me want to scream. I’ll send a bit of money your way to help out. Best of luck!

  48. daedalus2u says:

    The thing to do is to hit them with discovery that will uncover criminal and/or fraudulent and/or unethical activity.

    What they have to be afraid of is a class-action lawsuit by the patients they (may) have defrauded.

  49. Peter Jones says:

    The Tobinick Con Job
    Date: January 21, 2014
    Location: Institute of Neurological Recovery, Boca Raton, Florida.
    Tobinick has invited two Neuroscience Laboratory Researchers, Ignatowski and Spengler, to observe the initial and post assessments, the first injection of off-label Etanercept to patient Linda Lumbra, who, it is claimed, suffered acute brain injury 3 years ago in September 2010. Based on events that day , the two visiting researchers, Ignatowski and Spengler, along with Tobinick, Arthur Levine ( Osteopathic Physician) and Rodriguez (Nurse Practitioner), would be named as authors of an article in the medical journal Clinical Drug Investigation, with the title:
    Immediate Neurological Recovery Following Perispinal Etanercept Years After Brain Injury http://link.springer.com/article/10.1007/s40261-014-0186-1

    Hard to argue when you have two experienced Neuroscience Laboratory Researchers amongst your co-authors. I am sure this made an impression on the ‘peer reviewers’.

    Tobinick had cameras at all angles to record the events of the day. This video would be later used by Australian 60 Minutes TV and be posted on Tobinick’s various websites as promotional material. Nice to have two neuroscience laboratory researchers on board. It is my opinion that Ignatowski and Spengler where at all times unaware of this fraudulent act, and are therefore innocent.
    So what about stroke patient Linda Lumbra. My research shows that Linda Lumbra has some sort of association with epilepsy be it as patient or just a supporter. Linda Lumbra, as stated was a school teacher at Brownville Elementary School and retired end of term 2012. I can find no information to support a claim of Linda Lumbra being a Stroke patient. Based on my years of researching the claims and practices of Dr. Edward Lewis Tobinick, it is my opinion that Linda Lumbra never had an acute brain injury and that her behavior along with the actions of Dr. Tobinick and his staff warrant immediate investigation by medical and civil authorities.
    I invite you to view the two videos at the link below. They are from one of Dr. Tobinick’s websites.
    1. Published version: Length: 10:58

    2. Scientific Version: Length 45:32

    http://www.nrimed.com/a-new-life/

    1. Windriven says:

      What the fLick is your deal, Jones? You continue to post links to propaganda videos from Tobinick’s site. You make specious claims about the influence of a couple of PhDs and a radiologist on ‘peer reviewers.’ And you couch it all in supposed skepticism.

      But all that is bullwaddle, the links and the faux skepticism. PhDs and radiologists may be wonderful at what they do but, with some exceptions for the radiologist, they are not competent to make diagnoses of neurological defects and their causes.

      The bottom line is that there needs to be a large trial, double blinded, with carefully screened patients and a firmly pre-established end point. That can start the conversation. All the rest of this is speculative. “Perispinal”* Embril might be the best thing since sliced bread or it might be laetrile in a pretty new dress. We are never going to know on the basis of fluff and case studies reported by a guy charging a couple grand for a $150 dose of the drug.

      Tobinick’s practice looks like quackery whether it is or it isn’t because he has chosen to put marketing wa-a-a-a-ay before science.

      I for one am done giving you the benefit of the doubt. You are not adding anything to this conversation now, you’re just spamming with anecdotes.

      Buckle up Sparky, from here on out you’re in for a rough ride.

      1. Windriven says:

        *Perispinal is such a bullsh!t word. Depending on how didactic one chooses to be, perispinal means ‘in the neighborhood’. So is this homeopathic Embrel that somehow ‘knows’ where its needed and goes there?

      2. Peter Jones says:

        Windrivin, my reference to the PHds and Peer Reviewers was to demonstrate Tobinick’s need to seekk them out to add legitimacy to his fraudulent claims and acts. Stop seeing me as some Tobinick cheerleader…….I am Tobinick’s nemisis. I appreciate the difference between PHds and Neurologists. I should have emphasized the importance of their different roles. It is a very important point you raise. I shied away from stating it earlier, but it is my opinion that Tobinick would not get away with such a stunt with Neurologists.

        1. KayMarie says:

          Perhaps that is the problem. In becoming a nemesis in some kind of epic battle you’ve circled back around where it is hard to distinguish you from his cheerleaders.

          You really don’t have to work so hard to convince people here to be skeptical of him, so why work so hard to make sure all sort of links to all his propaganda get posted all over this page.

          Kind of that old be careful when you fight monsters chestnut. Because so far you seem to be the only one here trying ever so hard to get us to see his propaganda and the more places that have links to his propaganda the more likely it is he will push the criticism off the top of the google search. So either you don’t care you are working as one of his marketers trying to effect the google rankings (or other SEO ploy), or you are deliberately working as one of his marketers. I hate to think this is some kind of false flag operation as I hate to be that conspiratorially minded, but you keep at it in a way that makes me wonder.

          Back to old chestnuts, “I think you doth protest too much”. Or you are like Sheldon Cooper and need to have an enemies list.

        2. Windriven says:

          Taking you at your word, something I am increasingly disinclined to do, the links still add nothing to the discussion. We’ve all been to the website. We’ve all read the Medical Board actions against Tobinick and his protegees. We all understand the emotional appeal of Tobinick’s marketing. We all have had a look at the available literature.

          The issues remain the paucity of RCTs in the scientific literature and the puzzling suit against Novella, et alia.

      3. Nell on Wheels says:

        I’m beginning to believe that Mr. Jones is sincere, if perhaps inept, in his zeal to discredit Tobinick. Assuming he’s the same Peter Jones, check out his comments in his 2008 transcriptt of an AlzForum webinar discussing “Targeting Tumor Necrosis Factor—A Therapeutic Strategy for AD,” where he employs the same strategies and almost the identical language to try to get the panelists to refute Tobinick:

        Peter Jones: Is it appropriate to use etanercept on AD patients, as it does not cross the BBB yet lowers the immune system?

        Peter Jones: Do you have an opinion on CSVS as a way past the BBB?

        Peter Jones: Does any scientist here support Dr. Tobinick?

        Peter Jones: I am stating here, after much research I challenge Dr. Tobinick in his claims with the use of etanercept for Alzheimer’s and all the other diseases he has claimed in the past. The entire works are fiction. The AD caregiver community is vulnerable to this because of the dearth of therapies in AD. There may be some truth to inflammation as a causation in the pathology in AD, but to come out with this magic potion. It is time that the AD research community regrouped. Dr. Tobinick is a dermatologist. Any person from neuroscience willing to challenge Dr. Tobinick?

        Peter Jones: I am sorry to intrude in your discussion, but Dr. Tobinick has entered into your domain and is messing with your research and AD patients.

        Peter Jones: Dr. Tobinick should be discounted completely; he is delaying the advances in this area. He has nothing to offer.

        Fran Shaller: If he has “nothing to offer,” then my eyes are lying to me.

        Gabrielle Strobel: Let’s move on. Does anyone have further questions or ideas regarding Yong’s and Malu’s research?

        Peter Jones: I apologise for my interference. Please, scientists, Google Tobinick and see what comes up. You will all advance with real science.

        Cynthia Lemere: Sorry, I have to go now. Thanks everyone!

        It’s hard not to feel his frustration. And that goes back to 2008.

        I also took a close look at the case he referenced earlier (http://www.casewatch.org/board/med/tobinick/davoodifar.pdf). There are references to a patient, M.J., and certain items related to patient M.J. are underlined. I repeat my earlier suspicion that Peter Jones is personally invested in his crusade against Tobinick, but is not terribly adept at making it clear.

        1. Windriven says:

          I also found something that seems to link a Peter Jones with P2D Bioscience, an outfit that among other things, is doing work on TNF inhibitors for treatment of dementia and obesity. It would appear that P2D does actual research before jumping to translational efforts. What a concept.

  50. Windriven says:

    What the fuck is your deal, Jones? You continue to post links to propaganda videos from Tobinick’s site. You make specious claims about the influence of a couple of PhDs and a radiologist on ‘peer reviewers.’ And you couch it all in supposed skepticism.

    But all that is bullwaddle, the links and the faux skepticism. PhDs and radiologists may be wonderful at what they do but, with some exceptions for the radiologist, they are not competent to make diagnoses of neurological defects and their causes.

    The bottom line is that there needs to be a large trial, double blinded, with carefully screened patients and a firmly pre-established end point. That can start the conversation. All the rest of this is speculative. “Perispinal”* Embril might be the best thing since sliced bread or it might be laetrile in a pretty new dress. We are never going to know on the basis of fluff and case studies reported by a guy charging a couple grand for a $150 dose of the drug.

    Tobinick’s practice looks like quackery whether it is or it isn’t because he has chosen to put marketing wa-a-a-a-ay before science.

    I for one am done giving you the benefit of the doubt. You are not adding anything to this conversation now, you’re just spamming with anecdotes.

    Buckle up Sparky, from here on out you’re in for a rough ride.

  51. Greg says:

    Donation complete – good luck with your defence!

  52. Nell on Wheels says:

    For anyone who’s interested and has the time, the response to the complaint can be found at http://www.scribd.com/doc/234904906/Novella-Reponse, and the link to the original 118 page complaint can be found at the bottom of that page or at http://www.scribd.com/doc/234904706/Tobinick-Complaint-Against-Steve-Novella

    1. Peter S says:

      Just to be technical, the first document is Dr. Novella’s opposition to a motion filed by plaintiffs for an injunction, not his response to the Complaint which presumably will be in the form of a motion to dismiss. I would be shocked if this motion is granted.

      1. Nell on Wheels says:

        Thanks for the clarification. Now, just to be technical, can you clarify “this motion”? Are you referring to the plaintiffs motion for an injunction or to Dr. Novella’s presumed motion to dismiss?

        1. Peter S says:

          The motion for injunction is the one I meant to refer to. I don’t believe Dr. Novella’s legal team has filed yet, but I expect theirs will be a strong motion given the issues I see with the Lanham Act claim, namely the absence of any “commercial advertising or promotion.”

  53. Homunculus says:

    After the suite, request his lawyer be examined by the bar for abuse of process. If the state in which the case is being heard allows it, ask that they be investigated for barratry. Part of the problem, a big part, is that there are many lawyers willing to ignore their proper duty to clients and to the courts, and they use the legal system as a tool for harassment and intimidation. These lawyers need to be, at least censured, but preferably disbarred.

    1. Windriven says:

      Yeah … good luck with that in this country.

  54. Jopari says:

    I honestly don’t see the point in getting mad over Peter Jones, he does seem sincere but slightly misguided in his presentation.

    There just ain’t no point but to tell him what he’s doing wrong, getting mad over it ain’t gonna help you or him. He probably doesn’t understand what is expected, that or he’s stubborn, still no-brainer.

    No salary, sorry. However you have my full support.

  55. BJ says:

    Best of luck with taking this guy down. The saddest part is desperate folks from the other side of the planet are raising money to get treated by this quack. 60 Minutes has a lot to answer for too.

    http://www.stuff.co.nz/manawatu-standard/news/10227329/Stroke-patient-seeks-relief-in-US-clinic

    1. Peter Jones says:

      Here are others from Australia and New Zealand, one remortgaging the house to fly half way around to world to Tobinick’s clinics at Los Angeles and Boca Raton, Florida, and these are the few we read about in newspaper articles. How many more Stroke patients and their caring families are being duped by Tobinick. I call for an immediate investigation into the claims and practices of Dr. Edward Tobinick by the medical and civil authorities in the USA, Australia and New Zealand.

      http://www.cessnockadvertiser.com.au/story/2262327/stroke-treatment-could-give-kurri-family-their-life-back/?cs=457

      http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11294688

      http://www.thechronicle.com.au/news/family-hopes-reverse-stroke-treatment-will-help-th/2265742/

  56. Sawyer says:

    Good luck Steve! Sent my normal Christmas donation early this year. I hope Tobinick realizes that the only thing he has accomplished is to draw more attention (and funding) to those that defend the reality based worldview in medicine.

  57. Peter Jones says:

    The Australian 60 Minutes TV program who brought you the 2014 Stroke story featuring Linda Lumbra, previously carried an earlier Tobinick Alzheimer’s story in 2011. Shame on Australian 60 Minutes, which promotes itself as ‘Australia’s leading current affairs program, celebrating 35 years of excellence in 2014′.

    A New Shot at Life
    Friday, November 4, 2011

    http://sixtyminutes.ninemsn.com.au/stories/8360210/a-new-shot-at-life

  58. Peter Jones says:

    December 6, 2001 Photolysis HR threatens legal action

    http://www.hairfacts.com/websites/photolysis-hr-threatens-legal-action/

    Threatening legal letter from: We are counsel to Institute Research Associates, A Medical Group, Inc., and the Institute of Laser Medicine

    Response to threatening letter : Andrea James, hairfacts.com

    1. Peter Jones says:

      02/28/04 Consult and Price Quote Dr. Tobinick’s Institute of Laser Medicine, LA, CA ( same offices, doctors and staff employed by Tobinick as Institute for Neurological Research, later renamed Institute of Neurological Recovery ).

      Consult and Price Quote Institute of Laser Medicine, LA, CA

      http://www.hairtell.com/forum/ubbthreads.php/topics/12010/Consult_and_Price_Quote_Instit.html

      1. Peter Jones says:

        Institute of Laser Medicine, Los Angeles. YELP Reviews

        ( Picked out this little nugget posted recently 2/3/2014, where sheds a little light on the promotional actions of Tobinick’s staff. Tobinick was never part of Faculty atUCLA. He was many years ago an Associate Professor (a voluntary appointment where he was available to help a student with their lessons). Tobinick would use this title in self authored papers and promotional material, along with a UCLA email address with the intention to mislead the general public, to the frustration of the Board at UCLA, who discussed his misuse of the name UCLA and sought to take measures to dismiss him of any association or use of the name UCLA.

        http://www.yelp.ie/biz/institute-of-laser-medicine-los-angeles
        2.0 star rating 2/3/2014
        This is the most professional-seeming laser hair removal place I’ve ever been to. They put some kind of gel on your face as they do it, they have air blowing on you to cool the skin as they go. It’s a very medicalized environment and feels super legit. ‘their associated doctor is on faculty as UCLA’. This was typical Tobinick fraud. Tobinick would

        It’s also the most expensive. Like two and three times what other places cost. Presumably because (they say) they have all the patents, they have the latest technology, their associated doctor is on faculty as UCLA (I’ve never actually fact-checked this).

        1. Peter Jones says:

          Example of Tobinick’s intentional misuse of UCLA name, in this case, Tobinick’s use of UCLA Email address in submitted and published paper.

          http://www.ncbi.nlm.nih.gov/pubmed/14512134

          Clin Ther. 2003 Aug;25(8):2279-88.
          Targeted etanercept for treatment-refractory pain due to bone metastasis: two case reports.
          Tobinick EL.
          Author information
          Institute for Neurological Research, Los Angeles, California 90095, USA. etmd@ucla.edu

          1. Peter Jones says:

            in 2008, Tobinick’s practice has turned into a ‘Department of Medicine’

            http://www.ncbi.nlm.nih.gov/pubmed/18184433

            J Neuroinflammation. 2008 Jan 9;5:2. doi: 10.1186/1742-2094-5-2.
            Rapid cognitive improvement in Alzheimer’s disease following perispinal etanercept administration.
            Tobinick EL1, Gross H.
            Author information
            1Department of Medicine, Institute for Neurological Research, Los Angeles, USA. etmd@ucla.edu

  59. Peter Jones says:

    In 2010, Tobinick claims the title: David Geffen School of Medicine at UCLA and the continuation of the use of the UCLA email address.

    Expert Rev Neurother. 2010 Jun;10(6):985-1002. doi: 10.1586/ern.10.52.
    Perispinal etanercept: a new therapeutic paradigm in neurology.
    Tobinick E.
    Author information
    David Geffen School of Medicine at UCLA, 100 UCLA Medical Plaza, Suites 205-210, Los Angeles, CA 90095, USA. etmd@ucla.edu

  60. Peter Jones says:

    2006, under Author information, Tobinick claims the title, David Geffen School of Medicine, University of California. This paper authored by Tobinick sets out his claims for what he names Cerbrospinal Venous System CSVS. It sets out to claim how a biologic drug such as Etanercept can access the brain. Tobinick is not just your ordinary quack, he is your extraordinary quack.

    http://www.ncbi.nlm.nih.gov/pubmed/16915183

    MedGenMed. 2006 Feb 22;8(1):53.
    The cerebrospinal venous system: anatomy, physiology, and clinical implications.
    Tobinick E1, Vega CP.
    Author information
    David Geffen School of Medicine, University of California, Los Angeles, USA.

    1. Peter Jones says:

      2009 Tobinick Author Information: claims title – Medicine at University of California and the continued misuse of the UCLA email address

      http://www.ncbi.nlm.nih.gov/pubmed/19330170

      Drug News Perspect. 2009 Mar;22(2):119-25. doi: 10.1358/dnp.2009.22.2.1303818.
      The value of drug repositioning in the current pharmaceutical market.
      Tobinick EL.
      Author information
      Medicine at the University of California, Los Angeles, CA, USA. etmd@ucla.edu

  61. Peter Jones says:

    2008 Tobinick Author Information: claims title University of California also misuse of UCLA email address.

    http://journals.lww.com/anesthesiology/Fulltext/2008/02000/A_Critique_of_Intradiscal_Administration_for.29.aspx

    Anesthesiology:
    February 2008 – Volume 108 – Issue 2 – p 334
    doi: 10.1097/01.anes.0000300072.56020.10

    Correspondence
    A Critique of Intradiscal Administration for Treatment of Radiculopathy
    Tobinick, Edward L. M.D.

    Author Information
    University of California, Los Angeles, California. etmd@ucla.edu
    (Accepted for publication October 5, 2007.)

  62. Peter Jones says:

    Based on Tobinick’s misleading Author Information in so many of his submitted papers, one must reach the conclusion that the content in the Tobinick papers are highly suspicious and should therefore be deemed as spurious claims.

  63. Jeremy says:

    I suggest you lodge a complaint about his legal council with the Florida bar.

    The over all code is here : https://www.floridabar.org/DIVCOM/PI/WebNodes.nsf/Nodes/CAB70A7265C39112852577E000485BCA

    The Florida bar now appears to support a formal complain process : http://www.floridasupremecourt.org/decisions/2013/sc13-688.pdf
    A formally written complaint is always best – while it is unlikely anything will come of one complaint, it is a black eye and might make this practice think about its approach.

    The creed is very clear about conduct that brings the legal profession into disrepute:
    “I will further my profession’s devotion to public service and to the public good.”
    “I will exercise independent judgement and will not be governed by a client’s ill will or deceit”

    Call this a SCALE (strategic complaint against legal ethics), you can initiate it here :https://www.floridabar.org/tfb/TFBConsum.nsf/0a92a6dc28e76ae58525700a005d0d53/dbac6623cf5c015f85257a3f0060b781!OpenDocument#How%20to%20File%20a%20Complaint%20Against%20a

  64. Peter Jones says:

    So why does Tobinick author so many papers. Over the years, Tobinick has targeted different chronic conditions with high unmet need such as chronic back pain, Alzheimer’s and latterly, Stroke and Traumatic Brain Injury. I showed evidence where Tobinick submitted these papers to print medical journals and to these online medical publications. Tobinick would use the papers published as promotional material on his numerous websites, show to potential clients attending at initial consultations at Tobinick’s practice , also display the papers like a certification of validation, framed and hanging on the walls at his practice in Los Angeles and Boca Raton , Florida.
    Here is an example of Papers appearing on the walls of Tobinick’s Institute of Neurological Recovery, Los Angeles. See 2nd picture in article with papers framed hanging on the wall. This Australian family will return Monday 28th July, 2014 for a 2nd injection of off-label Etanercept, a black boxed warning drug, administered by Dr. Edward Tobinick.

    http://www.thechronicle.com.au/news/Reverse-stroke-treatment-family-tears-joy/2326054/

  65. Peter Jones says:

    Dr. Edward Tobinick back in 1998. Do you recognise a certain pattern!

    http://news.google.com/newspapers?nid=2457&dat=19980821&id=5QxbAAAAIBAJ&sjid=SU4NAAAAIBAJ&pg=1293,1667433

    The Los Angeles Times 1998

    America’s ‘hairest man’ collects prize: surgery

    Extracts from article were Tobinick mislead the public:

    1. misleading the public by using the UCLA logo in his address.
    2. misleading the public with his false claim that his procedure was recently approved by the Food and Drug Administration.

    ‘Young heard a syndicated radio talk-show host tell last summer of a new breakthrough in hair removal, pioneered by Dr. Edward Tobinick of UCLA’s Institute of Laser Medicine.’

    ‘ Tobinick, whose procedure was recently approved by the Food and Drug Administration.

  66. Jopari says:

    Peter Jones,
    I retract my statement from July 25. There is a difference between being earnest and being bloody stubborn. You come off as a person who simply is unable to realise that the methods you are employing are incorrect. All that’s happened now is simply you hogging the comments section.

    After many have told you to tone it down you have failed to do so. This only shows a dogmatic clinging to a single point despite criticism, in fact, this temperament is one which I for one, strongly disagree with.

    Enough is enough.

    1. Nell on Wheels says:

      AMEN! AMEN! AMEN!

      He;s completely negated any good will or benefit of the doubt that some of us were willing to consider for him. Although no one’s reading anything he’s posting anymore anyway.

      Too bad this system doesn’t have a way to collapse/ignore a particular poster to avoid having to scroll through all that spam. The “Recent Comments” link does help in navigating to the most recent relevant comments, though.

  67. Peter Jones says:

    Looks like Dr. Edward Tobinick, dermatologist, old habits go back a long long time, like this ‘INSTITUTE’ gem from 1987 .

    Warning: Fry Now, Pay Later Melanoma Is Caused By A Serious Sunburn From Childhood
    By JENNIFER LOWE, Los Angeles Daily News
    POSTED: May 20, 1987

    “You can’t have people in not stay out of the sun,” said Dr. Edward L. Tobinick, a Beverly Hills dermatologist and medical director of the Skin Cancer Institute, a private skin-care clinic.

    http://articles.philly.com/1987-05-20/entertainment/26165214_1_skin-cancer-screening-malignant-melanoma-squamous-cell-carcinomas

  68. andrews says:

    Florida’s SLAPP statute is indeed fairly useless in this sort of case, especially where ptf is not a government entity. However, you may find some comfort in the Offer of Judgment statute. See FS 768.79, also Fla.R.Civ.P. 1.442 for information.

  69. Nancy says:

    Steve, don’t you and SGU/SBM have a liability insurance policy which would defend you against defamation/libel allegations?

  70. NeilC says:

    Despite your country’s inability to spell defence, my PayPal donation is winging its way to your legal defence fund as I write. Keep up the good work and may these people end up regretting their decision to take on the rationalist community by incurring huge costs themselves.

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