Mark Geier built a medical practice in Rockville and a national reputation for propagating the discredited theory that vaccines cause autism. The Maryland Board of Physicians suspended his license seven years ago because he was treating autistic children with a drug considered dangerous for young people and not known to alleviate symptoms of the disorder.
But the regulators who stripped Geier's credentials are now in the hot seat, ordered to each personally pay tens of thousands of dollars in damages by a judge who says the board abused its power in an attempt to humiliate the doctor and his family.
The board posted a cease-and-desist order on its website in 2012 alleging that Geier had improperly prescribed medication for himself, his wife and his son while his license was suspended. In an unusual move, the order named the drugs in question. Online critics of Geier took notice, mocking the doctor and his family in blogs and comments for their use of the medications.
The Geiers say the state publicized those details for vengeance, to punish a doctor with unconventional ideas. State officials say it was an honest mistake.
But Montgomery County Circuit Court Judge Ronald B. Rubin sided with the Geiers, awarding them $2.5 million in damages. He called the order a significant breach of medical privacy and accused the board and its staff of failing to preserve emails related to the case and pleading ignorance about the order on the witness stand.
"If their testimony were to be believed, which the court does not, it is the worst case of collective amnesia in the history of Maryland government and on par with the collective memory failure on display at the Watergate hearings," Rubin wrote in a December opinion.
He ordered 14 board appointees, the board's lead attorney and the lead investigator on the Geier case to pay half of the damages out of their own pockets, between $10,000 and $200,000 apiece, depending on their net worth.
A spokeswoman for the state health department, which oversees the board, says the agency tries to balance privacy with a responsibility to inform the public of risks.
The defendants, who are appealing the decision, mostly declined to comment or did not respond to interview requests. Three of them told The Washington Post that the judge's version of the facts was wrong, and accused him of coming down too hard on volunteers who were donating their time.
"I felt Judge Rubin had a bone to pick with the Board of Physicians. Some of the stuff he came up with is outlandish," said Jonathan Lerner, who left the board last year. "He set the tone for the future that no one else would want to serve on a board."
Raquel Coombs, a spokeswoman for the Maryland Attorney General's Office, which represents the board, said of the ruling: "We believe there are serious errors in both the facts and the law and will vigorously pursue those on appeal."
Controversial views
Mark Geier developed a national following — and drew widespread criticism — for espousing his belief that thimerosal, a mercury-based preservative formerly used in childhood vaccines, contributes to autism.
Multiple medical groups and judges dismissed his research as seriously flawed, and the vaccine-autism link has been repeatedly debunked. But a growing movement that sees vaccine requirements as an intrusion on parental rights has taken hold in California, Texas and other states, emboldened by President Trump's embrace during the 2016 campaign of the discredited vaccines-and-autism link.
Public health experts consider "anti-vaxxers" a grave threat to one of the most significant medical developments in human history. Some Facebook users share Geier's videos to urge against flu shots, even amid the worst flu outbreak in nearly a decade.
But it was Geier's treatment of autistic children that caught the attention of the Board of Physicians in 2006.
Geier believed mercury from vaccines caused early puberty, aggression and symptoms of autism, and that suppressing testosterone with the drug Lupron — which is approved to treat prostate cancer, endometriosis and fibroids, but also is also used to chemically castrate sex offenders — would reverse those effects.
No credible medical research showed this treatment to be effective for autism, the Board of Physicians noted. The board suspended Geier's medical license in 2011 and revoked it the next year, citing his methods and saying he had misrepresented his credentials. Several other states also revoked Geier's medical license, and regulators targeted his son for practicing medicine without a license.
Maryland officials continued to track Mark Geier's activities, according to the lawsuit the Geiers filed in 2012.
Many of the case records remain under seal. But Rubin's order shows that board staff were tracking blogs and news articles chronicling Geier's downfall, mocking him and his son in emails and reveling in their humiliation.
When they got a tip that Mark Geier may have still been prescribing medication, they vowed to look into it. Before holding an evidence hearing, board attorney Victoria Pepper drafted the cease-and-desist order.
Rubin described the decision to name the drugs in the order as an extraordinary breach of privacy for an agency that should know better than anyone else the importance of confidentiality in the medical profession. He pointed to emails sent later on during the probe as evidence of the board's motivation to embarrass the Geiers.
Pepper referred derisively to the Geiers as "Daddy G" and "Baby G" in emails to Josh Shafer, the board investigator leading the probe of the Geiers.
"Maybe we can help make it a bad month" for the Geiers, Shafer wrote back, using a derogatory reference to the drugs they were using.
Timeline
April 27, 2011: Maryland Board of Physicians suspends Mark Geier's license
Jan. 25, 2012: Board posts order accusing Geier of prescribing drugs to himself and his son while his license was suspended, naming the drugs in question.
Feb. 5, 2012: Attorney for Geiers sends board letter objecting to publication of private medical information
Feb. 22, 2012: Board removes private information from Geier order, but original still accessible online.
Dec. 29, 2012: Geiers file lawsuit against Maryland Board of Physicians
July 11, 2013: Board removes original order from website
Dec. 7, 2017: Montgomery County judge awards $2.5 million to the Geiers
At trial, Pepper said she knew the Geiers' private medical information would be online as a result of the order, but didn't think it would be embarrassing. She said she named the drugs to clarify that they weren't dangerous controlled substances and named the recipients to clarify that Geier wasn't prescribing the medication or juveniles.
The judge called those reasons "fabrications," adding that "Pepper viewed Dr. Geier and his practice to be so abhorrent that she was willing to do 'whatever it took' to tarnish his reputation."
Pepper, who still works for the board, did not return repeated emails seeking comment.
All but one member of the Board of Physicians who voted to approve the cease-and-desist order on Jan. 25, 2012 later told the judge they didn't actually read it.
"It is sort of like looking out an airplane window watching the pilot walking around kicking the rubber and pulling on the metal. I don't have to go behind him and pull it. I trust the pilot to do his job," testified Paul Elder, an anesthesiologist from Anne Arundel County who was appointed by former governor Robert L. Ehrlich (R) in 2003 and chaired the board at the time of the Geier investigation. "I trust the Board staff to do their job and construct a document that was ready for signature."
Elder, who is no longer on the board, did not return repeated messages left at his medical practice.
A legal battle
The Geiers were horrified when they saw their private business was now available for the world to read. Their then-lawyer Jay Schwartz sent the board a letter calling the disclosure of private medical information illegal, and confronted Elder after an unrelated hearing in Annapolis to underscore his point.
The board uploaded a new version of the order, with the personal information removed. But the original could still be found by a simple Google search, and was uploaded online by a local television station covering the board's probe of Geier.
The order stayed online even after an administrative law judge decided the allegations it was based on were without merit — Mark Geier didn't prescribe the drugs, his son David did— and the family threatened to sue.
It was not taken down until July 11, 2013, a day after Rubin held a hearing in the lawsuit.
Mark Geier's wife Anne, who died in October 2014, said during a deposition a few months earlier that she was "humiliated" by the contents of the order.
"How would you feel if somebody put your medical records up and then they laughed at you and made fun of you?" she said. "They humiliate you. The whole thing has just ruined my life."
Mark and David Geier, who moved to Florida in 2012, declined to comment.
Several board members acknowledged in court that posting private medical information was inappropriate, but said they didn't take any steps to make sure the order was taken down from the website. In what Rubin dubbed "colossal amnesia," some board members also said they barely knew Mark Geier — who had been the subject of one of their most high-profile cases.
"The Board of Physicians is not an ornamental office. It is a serious public trust. It was breached horribly in this case," Rubin wrote in his opinion. "They knew, the court finds, that the problem had not been fixed. The court finds they simply did not care."
Lerner, one of the former board members, said the reason they didn't follow up was far simpler.
"We trusted the staff member and IT staff members when they said it was taken down," he said. "I don't think I'm responsible to go do a Google search."
Rubin also criticized the board for failing to turn over key emails about the case, many of which were apparently lost when the agency changed email servers in 2012 or overlooked because officials didn't properly search their private accounts.
"The negative and unprofessional tone and tenor of the few preserved e-mails is manifest," Rubin wrote. "It is not believable that other e-mails, had they been preserved, would fare better."
Only one of the 14 board members ordered to pay the Geiers still serves on the board: Beryl J. Rosenstein, who did not return a message left at his medical practice.
Jim Love, an attorney for the Geiers, suggested his clients were targeted for a simple reason.
"Everyone hates the Geiers because they say bad things about vaccines," Love said. "I don't know why it's so personal."