STATE OF MAINE

BOARD OF LICENSURE IN MEDICINE

IN RE: )
MERYL J. NASS, M.D. ) ORDER OF IMMEDIATE
CR21-191, CR21-210, AD21-217, ) SUSPENSION
AD21-220, and AD22-1 )

On January 11, 2022, the Maine Board of Licensure in Medicine (“the

Board”) met and reviewed complaint and investigation materials regarding
Meryl J. Nass, M.D. (“Dr. Nass”). On the basis of its review of these materials,
the Board concludes that the continued ability of Dr. Nass to practice as a
physician in the State of Maine constitutes an immediate jeopardy to the health
and physical safety of the public who might receive her medical services, and
that it is necessary to immediately suspend her ability to practice medicine in
order to adequately respond to this risk.

This suspension is issued pursuant to 5 M.R.S. § 10004(3). Dr. Nass’s

ability to practice medicine will be suspended effective immediately upon
issuance of this Order for a thirty (30) day period ending on February 11, 2022,
at 11:59 p.m., pending further Board action at an adjudicatory hearing, which
will be scheduled shortly. A formal notice of hearing will be transmitted, which
will outline the issues and procedures for that hearing.

PRELIMINARY FINDINGS

Specifically, the Board preliminarily finds for purposes of this Order and
pursuant to the materials reviewed as follows:

1. Dr. Nass was first issued a license to practice medicine in Maine on

August 22, 1997 (license number MD14575). Dr. Nass specializes in internal
medicine in Ellsworth, Maine.

2. On December 19, 2021, the Board received a report pursuant to 24

M.R.S. § 2505 from a physician. The physician reported that she had admitted
Patient 1 to her hospitalist service on that day and that the patient had for two
weeks had dyspnea, cough and fatigue. The physician reported that the
patient told her that Dr. Nass diagnosed the patient “over the phone” with
COVID and prescribed 5 days of Ivermectin which is not indicated for
treatment of COVID. The physician reported that the patient was unvaccinated
and was hospitalized requiring supplemental oxygen for COVID-19 pneumonia.

3. In response to a Board subpoena requesting the medical records for

Patient 1, Dr. Nass provided handwritten pages and copies of phone texts. Dr.
Nass initially sent phone text messages regarding Patient 2 as phone text
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messages related to Patient 1. In an email dated January 4, 2022, Dr. Nass
stated that Patient 1’s son “texted [her] regarding himself and his two parents,
all of whom had Covid at the same time and all three wound up eventually in
the hospital. The texts are intermingled for all three patients.” The medical
records provided by Dr. Nass for Patient 1 included a copy of a written
prescription for Ivermectin for Patient 1 dated September 28, 2021 and an
associated progress note that contains a brief additional note almost two
months later dated December 17 “[j]ust beginning to turn a corner Day 11.
Doesn’t need additional rx.” The September 28, 2021 progress note contains
no patient medical history, no physical examination, no chief complaint, no
coordination of care or set follow-up care, no medical decision-making, no
diagnosis, no patient informed consent, and no assessment and plan other
than identifying Ivermectin 27 mg/d x 5, Zinc 30 mg/d, Vitamin C 500 mg/d,
and aspirin 325 mg/d. A December 19, 2021 handwritten note on notebook
paper references the patient’s admission to the hospital and multiple
“conversations” but no substantive notes associated with the conversations
including who the conversations were with or what they were about. The
medical records did not include patient authorization for Dr. Nass to disclose
information to any other person(s).

Text messages produced in response to the medical record subpoena are

associated with Patient 1’s son and include December 10, 2021
communications regarding his treatment with Ivermectin and
hydroxychloroquine. Patient 1’s son texted Dr. Nass on December 15, 2021
that his father was “borderline delirious. He moans on every exhale and he
says snippets of things that don’t make any sense. He’s coherent once he’s
awake and in a conversation.” Dr. Nass did not respond to the text directly.
Patient 1’s son next texted Dr. Nass on December 17, 2021, “Dr. Nass my
parents aren’t doing very well. My dad’s breathing is very shallow and when he
tries to breathe deeply he begins to cough violently. I don’t see any signs of
improvement. When do I need to consider taking him to the ER? Should we be
taking more ivermectin?” Dr. Nass did not respond to the text directly. On
December 19, 2021 at 1:20 pm, Patient 1’s son texted Dr. Nass, “I think it
might be time to take my parents to the ER. They are getting very weak. I don’t
see any symptoms improving. Can you talk?” Dr. Nass responded, “My son’s
family is just getting ready to leave. Can we talk at 2 PM?” The text messages
included references to Dr. Nass receiving a Board subpoena for Patient 1’s
medical records.

4. The records for Patient 1’s hospitalization in December 2021 were

consistent with the physician report.

5. On December 11, 2021, Dr. Nass emailed Board staff and stated “one of
my complex, high risk patients for Covid just got Covid. The patient [Patient 2]
and I wanted him treated with hydroxychloroquine. I reviewed his dozen or so
medications and discussed all potential drug interactions and how to
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ameliorate them, and we decided to proceed. But the problem was finding a
pharmacist willing to dispense the drug. I was eventually forced, when the
pharmacist called a few minutes ago and asked me for the diagnosis, to provide
misinformation: that I was prescribing the drug for Lyme disease, as this was
the only way to get a potentially life-saving drug for my patient.” Dr. Nass
posted her communication to Board staff on her website/blog. In addition, Dr.
Nass referred to her interaction with a pharmacist during a ZOOM meeting
with members of the Maine State Legislature. She stated, “I lied and said the
patient had Lyme disease and so the pharmacist dispensed the medication only
because I lied … .”

6. In response to a Board subpoena requesting the medical records for

Patient 2, Dr. Nass provided handwritten pages and phone texts. In her email
producing the records Dr. Nass stated “This is the gentleman for whom I
prescribed hydroxychloroquine and was forced to inform the pharmacist was
for a non-Covid diagnosis. That is because I was following the ethical
principles of the AMA and other ethical codes of my profession.” Dr. Nass
produced: a) a copy of a handwritten prescription for Ivermectin dated
September 2, 2021 for Patient 2; b) a handwritten progress note dated
September 2, 2021 for Patient 2 that identifies 21 medications and
supplements, but contains no patient history, no physical examination, no
chief complaint, no medical decision-making, no diagnosis, no patient informed
consent, and no assessment and plan other than “High Risk” and a reference
to the Ivermectin script which was mailed. In the middle of the September 2,
2021 progress note and outlined by hand is another note dated December 11,
2021-“[Patient 2] is high risk + needs HCQ rx. Must [decrease] diltiazem and
watch for hypoglycemia” and notes the prescribing of azithromycin and
hydroxychloroquine, with “call in 3 wks”; c) a handwritten telephone note dated
December 1, 2021, of a conversation with Patient 2’s spouse regarding Patient
2 stating “Day 9” symptoms including a temperature of 102.9 and oxygen
saturation at 89%, refers to ordering a prednisone taper, Aldactone, and
Avodart, but holding off and get chest x-ray and let her know the result; d) a
handwritten progress note dated December 17, 2021, referencing Patient 2 and
his spouse and “advice re hospitalization”; e) a handwritten note on notebook
paper dated December 19, 2021, referencing a phone call discussion with
another physician regarding Patient 2 and his hospitalization; and f) a
handwritten progress note dated December 23, 2021 of a telephone call from
Patient 2’s spouse that Patient 2 was doing better in the hospital and including
a note about the spouse’s own nausea. The medical records did not include
written patient authorization for Dr. Nass to disclose information to any other
person(s).

Text messages produced in response to the medical record subpoena are

associated with Patient 2’s spouse and include texts from September 7 and 8
referencing a pharmacy in New York. On December 11, 2021, Dr. Nass texted
Patient 2’s spouse “The pharmacy called me back and question [sic] me for the
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reason for the prescription and I told him Lyme disease.” Patient 2’s spouse
replied “Thank you for letting us know. We picked up the medication.” Dr.
Nass texted back “Good. And I wrote a letter to the board of medicine telling
them they had forced me to miss inform [sic] a pharmacy today in order to get
a life-saving medicine to a patient. Let’s see what they do with that”. There are
a series of texts between Patient 2’s spouse and Dr. Nass dated December 15,
2021 discussing various medications for Patient 1, then asking for a pharmacy,
and Dr. Nass texts “I cannot remember your name, town, and date of birth. I do
remember lying to the pharmacy. Please send me that information. Texting
does not provide me names.” Additional texts were provided including texts
associated with Patient 2’s hospitalization during December 2021.

7. Hospital records for Patient 2 indicate that he was admitted through the
hospital emergency department on December 16, 2021. Patient 2 presented
with 9 days of symptoms and had completed the “ivermectin protocol” with his
“Covid specialist physician’s office”. Patient 2 was unvaccinated and presented
with multiple diagnoses including diabetes, hypertension, obstructive sleep
apnea, obesity, and a known heart murmur. The patient refused antiviral
treatment initially and requested that the ED physician speak with his COVID
doctor, Dr. Nass. The ED physician noted that he tried to contact Dr. Nass but
she did not answer her phone. The records noted that Patient 2 had tested
positive for COVID by home test on December 7, 2021. The patient was
admitted on December 16, intubated on December 18, self-extubated on
December 30, 2021, and discharged on January 4, 2022.

8. On December 31, 2021, the Board received a report pursuant to 24

M.R.S. § 2505 from a Certified Nurse Midwife (“CNM”). The CNM reported that
earlier in 2021 one of her pregnant patients became ill and tested positive for
COVID. The patient [Patient 3] contacted the CNM office on September 22,
2021, for advice about COVID-19 care and told the CNM that she was on
hydroxychloroquine. The CNM reported that she was shocked. Patient 3 told
the CNM that the hydroxychloroquine had been prescribed by Dr. Nass. The
CNM reported her concern that Dr. Nass prescribed a medication which was
not an approved or recommended treatment for COVID-19 and did not consult
with the obstetric/midwifery practice prior to doing so.

9. In response to a Board subpoena requesting the medical records for

Patient 3, Dr. Nass provided two pages: 1) one page with a copy of two
handwritten prescriptions dated September 21, 2021 for Patient 3 for
hydroxychloroquine and a “z-pak” with a note indicating that they were faxed
to Walmart; and 2) a handwritten progress note for the patient “28 yo 6 mos
pregnant”, referencing a positive test at urgent care and identifying in the
assessment and plan “stop montelukast, HCQ, Z-pak, fluids, rest”. The
progress note contains no patient history, no physical examination, no medical
decision-making, no patient informed consent, no coordination of care, and no
recommended follow-up.
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10. On June 15, 2020, the United States Food and Drug Administration
(“FDA”) revoked the Emergency Use Authorization for chloroquine phosphate
(CQ) and hydroxychloroquine sulfate (HCQ) based on information that the drug
may not be effective to treat COVID-19 and that the drug’s potential benefits
for such use do not outweigh its known and potential risks.

11. The FDA has not authorized or approved the use of Ivermectin for use in
preventing or treating COVID-19 in humans.

12. The American Medical Association Code of Medical Ethics contains

standards of professional behavior established for the practice of medicine and
include in Principle II that a physician be honest in all professional
interactions. Opinion 1.2.11 Ethically Sound Innovation in Medical Practice
provides, in part, that when a physician offers “existing innovative diagnostic or
therapeutic services to patients” they must “recognize in this context informed
decision making requires the physician to disclose (i) how a recommended
diagnostic or therapeutic service differs from the standard therapeutic
approach if one exists; (ii) why the physician is recommending the innovative
modality; (iii) what the known and anticipated risks, benefits, and burdens of
the recommended therapy and alternatives are; (iv) what experience the
professional community in general and the physician individually has had to
date with the innovative therapy; and (v) what conflicts of interest the physician
may have with respect to the recommended therapy.”

13. Board Rules Chapter 6 establishes Telemedicine Standards of Practice.

Physicians using telemedicine in providing health care will be held to the same
standards of care and professional ethics as those providing traditional care.
§§ 1(3), 3(3). Chapter 6 sets forth practice guidelines associated with obtaining
a medical history and physical examination § 3(7), informed consent § 3(9),
coordination of care § 3(10), follow-up care § 3(11), medical records § 3(13),
privacy and security § 3(14), disclosure and functionality § 3(16), patient
access and feedback § 3(17). Absent a valid physician-patient relationship, a
licensee’s prescribing to a patient based solely on a telephonic evaluation is
prohibited. § 20.

14. On October 26, 2021, the Board received a complaint alleging that Dr.
Nass was engaging in the public dissemination of “misinformation regarding
the SARS CoV2 pandemic and the official public health response calling for
vaccinations” via a video interview and on her website, and that the
information that Dr. Nass was disseminating was a “danger to the public.” Dr.
Nass’s comments in the interview and on her website include, but are not
limited to:

a) she “did not intend to comply with masking and vaccine orders”;

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b) that the federal government “won’t let us find out” how many people are
immune from less severe or asymptomatic COVID cases and the federal
government has “basically prohibited the use of normal tests of immunity,
normal antibody, T-cell tests, etc., or some pattern of those”, and “instead we
all have to be vaccinated” and that “doesn’t make scientific or medical sense”;
c) “the more doses of vaccine, the more shots you get the greater the risk of
adverse reactions”;
d) “if you’re going to get myocarditis over 80% get it after the second dose, not
after the first dose” and “people who got it after the first dose, many of them
had already been infected with COVID”;
e) “if we are doing this for people’s health it would be very important to identify
how many people are immune and they don’t have to worry about masks …
they don’t have to worry about distancing, they don’t have to worry about
vaccination. They are immune. We know so far that those people have broad
and very durable long-term immunity. As best we know … they’re very
immune a year after they had the infection”;
f) “so the FDA was forced to issue a license for the Pfizer vaccine for certain
people and yet there is no comirnaty vaccine in the United States, so there are
no vials of licensed Pfizer vaccines in the United States. The FDA did a bait
and switch”;
g) “why is the federal government so interested in getting everyone vaccinated?
It seems that one probable reason is unless you get people vaccinated and you
have to give them boosters every so often there is no logical justification for
vaccine passports … which is probably going to be your electronic ID, and
probably will mediate your financial transactions, will identify where you are
any time, etc., you know will have broad uses for increased control and
surveillance. There may be other reasons. I mean there may be things in these
vaccines that the government wants to inject in us”;
h) “but obviously vaccinating people who are already immune and have much
better immunity than you would get from these vaccines that are extremely
weak an short lived in what they give you, and dangerous with many potential
serious side effects, and 14,000 deaths reported to the federal VAERS system
in the 8 to 10 months we have been vaccinating people, not quite 10 months,
the vaccines are a problem”;
i) “we’re vaccinating for a virus that is gone. We have no benefit from the
mRNA, we have only problems from it”;
j) “the vaccines don’t work very well, so there are loads of people who are
getting infected who’ve been vaccinated almost at the same rate as the
vaccinated”;
k) “the governments seem to think they own our children because they are
vaccinating children age 12 and up without parental permission in many parts
of the United States”;
l) “children have the worst side effect profile, and they get the least benefit from
the vaccines. So you are either vaccinating them to try and, you know, stop it
spreading in children so adults don’t get it, because if children are getting a

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cold, you don’t vaccinate kids against colds, we never have before, or you are
vaccinating them for some other nefarious reason”;
m) “the DNA from the adenovirus could potentially become a part of our DNA …
the human beings we’re the guinea pigs for these vaccines”;
n) “there are drugs like Ivermectin, hydroxychloroquine, chloroquine,
mefloquine, and others that are quite effective against this virus, that will kill
off the virus the first week you have it when virus is still growing”;
o) Operation Warp Speed is the result of an agenda that “seems to be the same
one that has been in play since 2001, you know, the 9/11. Which is increased
surveillance, right, increased central control, and some blurring of national
borders and national sovereignty, which we haven’t seen much of yet but the
close collusion of many countries with the same program indicates that there is
international collusion going on at high levels”;
p) “the people who are not getting vaccinated are tending to be the most
educated, the wealthiest”; and
q) “if you did not know that the CDC was a criminal agency by now, this ought
to get you going. Remember COVID vaccines are associated with high rates of
miscarriages.”

15. On November 7, 2021, the Board received a complaint that Dr. Nass was
spreading COVID and COVID vaccination misinformation on Twitter, which
included a link to an interview with Dr. Mercola, and include, but are not
limited to:

a) that a patient informed consent form for hydroxychloroquine used at a

hospital was a form “designed to scare patients from using a safe drug that
works well for COVID by making false claims. The form therefore can only
result in injuries and possibly deaths”;
b) “you’re the guinea pigs, and they’re not collecting the data. Nobody should
have these shots”;
c) a “large number of Americans are recovered and have very durable long-
lasting immunity, much stronger that what you would achieve from the
vaccine, which is limited only to immunity against spike, wears off over the
next few months, may, in fact, permanently limit the kind of immune response
[you] would make were you to be infected with COVID again. So there is
absolutely no reason -- no good reason to vaccinate someone who is recovered,
and several bad reasons. You can harm them. There’s a higher rate of injury in
the recovered if you vaccinate them and you may damage – potentially damage
their immune response later”; and
d) cities are vaccinating 12-15 year-olds without parental permission.

In response to the complaint, Dr. Nass stated that “[e]verything that I say in
public is accurate.”

16. AMA Code of Medical Ethics Opinion 2.3.2 Professionalism in the Use of
Social Media includes that physicians should ensure that the personal and
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professional information on their own sites is “accurate and appropriate” and
must recognize that their actions online and content posted “may negatively
affect their reputations among patients and colleagues, may have
consequences for their medical careers, and can undermine public trust in the
medical profession.”

For the purposes of this Order of Immediate Suspension and subject to holding
the aforementioned full adjudicatory hearing on this matter to determine if any
violations have actually occurred, the Board finds that the actions of Dr. Nass
constitute immediate jeopardy to the health and physical safety of patients
who might receive her medical services and that delaying imposition of a
suspension until holding a hearing would not adequately respond to this
known risk. It is of great concern that Dr. Nass admittedly lied to a pharmacist
in order to have the pharmacist dispense a medication that was not FDA
approved for use in the treatment of COVID-19, she blamed the Board and the
Maine Board of Pharmacy for her decision to deceive another medical
professional, that she involved the patient in the deception, and that the
medical records for that patient do not reflect that she followed Board rules
regarding telemedicine standards of practice; that all three patient medical
records produced by Dr. Nass reflect that she failed to comply with Board rules
regarding telemedicine standards of practice which were designed to protect
public health and safety; and that two of the patient medical records produced
by Dr. Nass included phone text messages that occurred with persons who
were not the patient, without written authorization to do so from the patient,
and included her admission in one that she did not know who she was texting
with.

A. 32 M.R.S. § 3282-A(2)(A) by engaging in the practice of fraud, deceit or

misrepresentation in connection with services rendered within the scope
of the license issued.

B. 32 M.R.S. § 3282-A(2)(E)(1) by engaging in conduct that evidences a lack

of ability or fitness to discharge the duty owed by the licensee to a client
or patient or the general public.

C. 32 M.R.S. § 3282-A(2)(E)(2) by engaging in conduct that evidences a lack

of knowledge or inability to apply principles or skills to carry out the
practice for which the licensee is licensed.

D. 32 M.R.S. § 3282-A(2)(F) by engaging in unprofessional conduct by

violating a standard of professional behavior, including engaging in
disruptive behavior, that has been established in the practice of
medicine. For purposes of this paragraph, “disruptive behavior” means
aberrant behavior that interferes with or is likely to interfere with the
delivery of care.

E. 32 M.R.S. § 3282-A(2)(H) by violating a rule adopted by the Board.

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 ORDER OF IMMEDIATE SUSPENSION

The Board ORDERS as follows:

Dr. Meryl J. Nass, M.D.’s license to practice medicine in Maine is

suspended immediately and she may not practice medicine upon
issuance of this Order for a thirty (30) day period ending on February
11, 2022, at 11:59 p.m. pending further Board action at an
adjudicatory hearing, which shall be scheduled shortly.

Dr. Nass may not practice medicine in the State of Maine during this
suspension.

January 12, 2022

_____________________________________
MAROULLA S. GLEATON, M.D.,
CHAIR