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May 12, 1999

Legal Implications of Practicing Alternative Medicine

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(18):1698-1699. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-18-jac90004

To the Editor: Notwithstanding the conclusions by Dr Studdert and colleagues,1 the following 2 cases should be a source of concern to physicians who plan to use herbal and homeopathic remedies.

In Meza v Southern California Physicians Insurers Exchange,2 an osteopathic physician injected tea-tree oil, an herbal salve, into a wart on the plaintiff's finger. The tip of the finger subsequently had to be amputated. A lawsuit commenced, but the insurance company refused to cover the damages of the physician's care, stating that its policy contained a clause excluding coverage from the use of any drug not approved by the Food and Drug Administration. The physician argued that it was not a drug, since the manufacturers and its distributors made no claim as to its therapeutic effects. The insurance company's decision was appealed, but the lower court agreed with the carrier regarding the legality of the clause. The court found a definition of a drug based on its usage in the US Food, Drug and Cosmetic Act, as well as in a dictionary. The Appellate Court upheld the lower court's verdict. The ramifications of this decision indicate that a "drug" is defined by a physician's intent rather than the properties of the substance itself whether or not it is called an herb, supplement, or the like.