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Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Malone Harassed Doc Who Reported Him to Medical Board

Robert Malone, MD, who made waves by promulgating a controversial theory on Joe Rogan's podcast earlier this year, was reported to the Maryland state medical board for other alleged misinformation activities recently. Malone countered by stalking and harassing the physician who reported him and filing a complaint to another state medical board about this accuser,

After Malone spoke at rallies opposing vaccine mandates in Hawaii, Michael Patmas, MD, a medical director at Maui Health, reported Malone's actions to the Maryland board late last year. He noted they dovetail under Federation of State Medical Board (FSMB) guidelines concerning pandemic misinformation issued over the summer. (Malone, who calls himself a consultant and former pathology and surgery professor and lists a Virginia address on his website, has an active license with the Maryland board.)

Malone then sent cryptic messages to Patmas via his LinkedIn profile, aired his grievances on his popular Twitter feed and Rogan's podcast, and filed a complaint against Patmas with the Hawaii Board. Patmas later received public complaints at his workplace and online.

The Hawaii Board later dropped Malone's complaint.

The Maryland Board also dropped the complaint against Malone. It did not explain why in a letter Malone shared with The Scientist.

The inaction mirrors a national trend. Only 12 of 58 complaints to state boards led to any discipline through the end of 2021, according to FSMB.

Patmas is aghast that the Maryland Board dropped his complaint. "Retaliation for a complaint -- if that's allowed to stand, then other physicians are going to be reluctant to hold one another accountable," he says. "If doctors who do that get their head cut off, well, you're going to let doctors get away with bad things. It's unethical and it's morally wrong."

The Maryland board declined to discuss Malone's investigations, but said a doctor under investigation should not contact, threaten legal action against, or otherwise harass a complainant. Such actions could be grounds for further investigation, if noted in a written submission. Patmas says he did email the board multiple times in December and January, but did not receive a response.

Fact-checkers have repeatedly called Malone's comments false or misleading. His Twitter and LinkedIn accounts were suspended at the end of last year.

Pain Clinic Fraud Scheme

Kaiser Health News a shuttered California pain clinic network accused of administering dozens of possibly unnecessary procedures, offering providers bonuses based on volume and certain procedures performed, and other tactics designed to juice revenue.

Lags Medical Centers was a large system of clinics serving about 20,000 mostly working-class patients reliant on government insurance in California's Central Valley and Central Coast.

Centers closed suddenly in May when the California Department of Health Care Services suspended state Medi-Cal reimbursements to 17 of the chain's 28 locations, citing "potential harm to patients" and an ongoing investigation by the state Department of Justice into "credible allegations of fraud."

KHN interviews with former patients and employees, and analyses of Medicare and Medi-Cal billing data and other court and government documents, suggest the clinics operated based on "a markedly high-volume and unorthodox approach to pain management." The clinics regularly conducted skin biopsies unusual for pain specialists and very high rates of other procedures, including nerve ablations and high-end urine tests that screen for a large list of drugs.

Those procedures generated millions of dollars over recent years for this network of clinics owned by the Francis Lagattuta, MD -- most funded by public insurers.

A few nurse practitioners and physician assistants performed most of the procedures, often dozens daily, with minimal remote supervision from the clinic's doctors.

Via his attorney, Lagattuta declined to speak with KHN, citing an ongoing state lawsuit. He is still seeing patients in California, according to his deposition.

CDC Not Sharing COVID Data

The CDC was not sharing much of the data it collected on pandemic measures, including information on vaccine boosters, hospitalizations, and wastewater analysis. That's according to from the New York Times.

When the CDC published the first major data on booster effectiveness among people under 65 earlier this month, for example, it omitted numbers for 18- to 49-year-olds.

CDC only recently hosted a wastewater database on its website, to provide potential early signs of oncoming COVID surges -- even though some states and municipalities had been sending their wastewater data to the CDC since the start of the pandemic.

A CDC spokesperson said the agency has been slow to release data because its "priority when gathering any data is to ensure that it's accurate and actionable" and because it fears the information might be misinterpreted by the public.

A deputy director said the pandemic exposed that CDC and state data systems are outdated and not able to handle large volumes of data. The CDC has also been held up by bureaucratic delays; it often shares data with states and partners before publicizing them.

The CDC has been building the wastewater system since September 2020 and its data presentation capacity over the past few months. States have had access to the data since inception.

Overall, CDC has received $1 billion to modernize its data systems.

Public health officials were surprised to learn that such information even exists. "We have been begging for that sort of granularity of data for two years," said Jessica Malaty Rivera, MS, an epidemiologist who helped run COVID Tracking Project, which compiled pandemic data until March 2021. A detailed analysis, she said, "builds public trust, and it paints a much clearer picture of what's actually going on."

"Tell the truth, present the data," said Paul Offit, MD, of Children's Hospital Philadelphia. "I have to believe that there is a way to explain these things so people can understand it." Knowing which groups of people were being hospitalized, which other conditions those patients may have had, and how vaccines affected other variables would have been invaluable.

Does Major League Baseball Have a Painkiller Problem?

Is there a hidden painkiller crisis in Major League Baseball (MLB)? That is the question the -- inconclusively -- following the conviction of a team employee who issued opioids to several players, including one who died as a result.

Tyler Skaggs, a pitcher for the Los Angeles Angels, died in 2019 after communications director Eric Kay issued him fentanyl-laced oxycodone. Former teammates testified during Kay's recent trial that they were also given opioids to help them manage pain through a season that stretches as long as 8 months for pitchers and catchers, while another player said it is common for Major Leaguers to use Tylenol and oxycodone.

But MLB's drug testing has not caught any players positive for unapproved opioids via more than 12,000 tests over the last two seasons, while only 12 minor-league players have violated opioid or opiate guidelines among more than 95,000 tests over seven years. In addition, players told the Post that they are unaware of opioid abuse in their clubhouses.

Skeptics wondered why the court showed little interest in tracing the lethal painkiller Kay supplied.

"There's no question the MLB system is broken," assistant U.S. attorney Errin Martin said during her closing statement. Players "have to do whatever it takes to play."

The potential pratfalls with painkillers in MLB has drawn attention given the league's steroid crisis in the late 20th and early 21st centuries, and cocaine abuse by several prominent players in the 1970s and 1980s.

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