Michael Ledtke, MD is a doctor in Saginaw, MI and a member of the pseudoscience group ILADS. In 2009, he pleaded no contest to serious charges of negligence and incompetence with regard to his treatment of a 36 year old woman known as J.R..
The Michigan Medical Board found that Ledtke “prescribed J.R. medications in such a combination and dosage as to have potential lethal effects.” The Board laid out the charges against Ledtke (“Respondent”) in a 2008 Administrative Complaint.
The story
J.R. suffered from many worrying symptoms, 21 of which were listed in the Complaint. She went to a number of doctors, but eventually ended up at Ledtke’s office. A document dated 2015 on Ledtke’s site states that initial consultations “range from $240 to $600.” The Complaint’s description of J.R.’s initial consultation is disturbing:
At her first appointment with Respondent on March 29, 2007, J.R. informed Respondent of her prior treatment history and stated that she was currently taking Effexor XR (150 mg per day), Lyrica (50 mg, 3 times a day), Wellbultrin SR (150 mg, 2 times a day), Zantac (300 mg per day), Zyrtec (10 mg per day), and Mobic (75 mg, 2 times a day).
At this appointment, Respondent opined that J.R. suffered from a tick borne disease and that she had chronic Candidiasis for many years. He also suspected J.R. suffered from Babesia and irritable bowel syndrome secondary to the Candida.
Without ordering any blood tests or performing any other diagnostic exam, Respondent recommended the following treatment plan at the first appointment according to his notes:
First, I am going to treat the Babesia. I will do this with BIAXIN and MALARONE, following up with DIFLUCAN and NYSTATIN, and after two weeks add in DOXYCYCLINE. I will have her avoid milk and ice cream, and taper off the Pepsi and regular coffee. She will drink more water. I gave her BIAXIN XL 500 #6 one daily for three days, and then repeat in a month, MALARONE 250 #24 four daily for three days, and then repeat in a month. I gave her a B-12 INJECTION in the left deltoid, and 3 cc 25-guage 5/8″ syringe needle #30 with two refills, B-12 1,000/cc #30 cc one cc per dose with two refills. I also gave her DOXYCYCLINE 100 #90 one t.i.d. with one refill, DIFLUCAN 200 #30 one daily with one refill, NYSTATIN 500,000 #120 one q.i.d. with one refill. I gave her Candida followup, Lyme follwup, injection B-12, water, Raynaud’s, headache diet, fibrocystic breast, and cerumen impactation sheet. I put down Dr. Flora’s number for neck and shoulder chiropractic. I spent 85 minutes. See her in a month.
The diagnoses and drug cocktail were appallingly irresponsible. There were five different anti-microbials including drugs with antibiotic, anti-malarial, and anti-fungal properties. There was no good reason provided for the B-12 injection. Dr. Steven Novella has explained that chronic candidiasis is a “popular fake illness”.
Babesia is rare or non-existent in Michigan, and needs to be confirmed with established diagnostic procedures. Given a patient with non-specific symptoms in a location with few Lyme cases, a Lyme diagnosis would also need to be confirmed with testing. Only 51 confirmed Lyme cases from Michigan were reported to the CDC in 2007. All too often, we see “Lyme literate” doctors make dubious diagnoses based on the flimsiest of evidence.
In the rare cases of Babesia-Lyme coinfection, both infections can be treated simultaneously. If a patient has both infections, it could be considered malpractice to withhold treatment to “first” treat one infection.
After the appointment, J.R. began to experience debilitating adverse events, which are described in detail in the Complaint. It’s unclear to what extent these adverse events may have been caused by the many drugs prescribed to J.R.. Nevertheless, at the next appointment, Ledtke inexplicably continued to prescribe a bizarre regimen of antimicrobials.
Discipline
In 2009, Ledtke reached an agreement with the Michigan Board of Medicine in which he would be disciplined. According to the agreement, the Disciplinary Committee of the Board found that:
- The allegations of fact contained in the Complaint are true;
- Ledtke violated the Michigan Public Health Code for his negligence; and
- Ledtke violated the Michigan Public Health Code for his incompetence.
The agreement stipulates:
Respondent does not contest the allegations of fact and law in the complaint. Respondent understands that, by pleading no contest, he does not admit the truth of the allegations but agrees that the Disciplinary Subcommittee may treat the allegations as true for resolution of the complaint and may enter an order treating the allegations as true.
Sadly, Ledtke’s punishment was only a $5000 fine.
Was this predictable?
A 2004 study found that ILADS, LymeDisease.org, IgeneX, Lyme Disease Association, and many organizations with “Lyme” in their names spread inaccurate information about Lyme disease.
Dr. Henry Feder, coauthor of the 2004 study, later noted that the ideology of ILADS “is testimonial-based, not evidence-based.” He also stated:
Following the recommendations of Stricker and the ILADS of using prolonged antibiotic therapy for presumed Lyme disease has been shown to be harmful and even fatal.
Raphael Stricker is a former ILADS president who was found guilty of scientific misconduct by the NIH and UCSF. Stricker was also fired by UCSF. In 2019, the Medical Board of California issued an accusation against Stricker that included charges of Gross and Repeated Negligence, but the accusation was later withdrawn.
In an effort to legitimize themselves, ILADS members released so-called guidelines in 2004. In 2010, the Healthcare Protection Agency of UK issued a lengthy report that contained scathing conclusions about these guidelines:
- The ILADS guidelines are not evidence-based and are poorly constructed.
- Application of the ILADS guidelines’ poorly defined case definitions will result in a very high risk of misdiagnosis.
- Use of ILADS guidelines’ vague treatment recommendations, including prolonged use of antibiotics, has potentially serious consequences.
- Patients misdiagnosed with Lyme disease risk losing opportunities for diagnosis and treatment of other conditions. They also risk serious physical, psychological social and financial adverse events.
Documents
Michigan Board of Medicine: Michael Ledtke Complaint
Michigan Board of Medicine: Michael Ledtke Consent Order