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Inmates sue Arkansas doc, jail after unknowingly taking dangerous doses of ivermectin

Tablets of ivermectin.
Enlarge / Tablets of ivermectin.

Detainees at an Arkansas jail were given ivermectin without their knowledge or consent, a new lawsuit alleges. As early as November 2020, Dr. Robert Karas, the jail’s doctor, told inmates who had contracted COVID that he was giving them a cocktail of vitamins, antibiotics, and steroids when in fact he was administering dangerously high doses of the dewormer. Ivermectin is not authorized by the FDA to treat or prevent COVID, and the agency has repeatedly told people not to take it outside its approved use as an anti-parasitic. 

“At no point were Plaintiffs informed that the medications they were consuming included Ivermectin,” the lawsuit says. “Further, Plaintiffs were not informed of the side effects of the drug administered to them or that any results would be used for research purposes.”

Four detainees are suing Dr. Karas and his company, the Washington County sheriff, and the Washington County Detention Center and 10 of its employees, alleging that they violated the inmates’ rights to informed consent. The ACLU of Arkansas filed the lawsuit on their behalf. The plaintiffs are seeking medical evaluations by independent providers and an injunction preventing Dr. Karas from administering ivermectin to COVID patients.

“No one—including incarcerated individuals—should be deceived and subject to medical experimentation. Sheriff Helder has a responsibility to provide food, shelter, and safe, appropriate care to incarcerated individuals,” Gary Sullivan, legal director of the ACLU of Arkansas, said in a statement.

Lack of informed consent

The four men who brought the lawsuit say that if they had been told what they were being given and made aware of its side effects, they would have refused to take it.

“It is both customary and legally required in all medical settings, both within Arkansas and beyond, that patients be given complete, accurate, and truthful information to enable them to make an informed decision as to whether to proceed with medical treatments,” the lawsuit says. “As medical providers, [Dr. Karas and his colleagues] undoubtedly knew this.”

At least two of the inmates were given incredibly high doses of the drug, according to the lawsuit. For its use as an anti-parasitic drug, the FDA has approved 0.2 mg per kilogram of body weight in a single oral dose. If necessary, second doses are only given three to 12 months after the first. One 72 kg inmate, though, received 48 mg over four days, or 3.4 times the approved dose. Another, who weighed 87 kg, received 108 mg over four days, or 6.3 times the approved dose.

As a result, these men experienced diarrhea, bloody stools, stomach cramps, and vision problems, the lawsuit says, all of which suggest ivermectin poisoning. “To add insult to injury, Plaintiffs were subject to the payment of fees for medical examinations they sought after suffering side effects from the Ivermectin treatment.”

“COVID protocols”

As the pandemic took hold, Dr. Karas began “publicly and privately espousing the virtues” of ivermectin, the lawsuit says, and “began conducting research as to its efficacy” against COVID. He has publicly posted about the “virtues” of ivermectin, including detailed dosing as part of his “COVID protocols.” In one Facebook post, made on December 24, 2021, he said that he was dosing inmates at the jail higher than those in his private practice. Karas’ “protocols,” which he says he has used with his family members, have caught the attention of the Arkansas Medical Board, which has opened an investigation.

For providing medical services at the jail, Dr. Karas’ company, Karas Correctional Health, of which he is the sole member, receives $1.4 million annually. Plus, his contract allows him to buy drugs wholesale and sell them to the jail, which is “obligated to pay the costs for all prescription medications prescribed to WCDC detainees,” the lawsuit states.

The ivermectin problem isn’t limited to jails, of course. People around the world have latched onto the idea that the dewormer can both prevent COVID infection and fight it off. Early in the pandemic, a petri dish study suggested that the drug may have some antiviral qualities but at doses that would be 100-times higher than what had been approved in humans. Fringe members of the medical community have pushed the false narrative, and certain politicians continue to do so.

The widespread misuse of the drug has led to spikes in demand, and, according to a new study in the Journal of the American Medical Association, a surge in insurance reimbursements, too. Despite the fact that they should be incentivized not to cover ineffective treatments, private health insurers are spending around $130 million a year, the study’s authors estimate.

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