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The battle between a physician and hospital continues over a COVID-19 treatment protocol involving ivermectin.

After Paul Marik, MD, filed suit against Sentara Healthcare over its ban of certain COVID treatments, a judge in Virginia granted in part Sentara's motion to dismiss the case, but allowed one of Marik's claims against the health system to proceed, in an .

At the same time, the judge denied Marik's motion for a temporary injunction to stop Sentara from enforcing its ban.

"The court finds that Marik has third-party standing to bring an informed consent claim on behalf of his patients but that he lacks standing to bring a claim under Virginia's Health Care Decisions Act," the judge . "The court further finds that, for purposes of a temporary injunction, Marik has failed to prove that he is likely to succeed on the merits of his informed consent claim."

Marik's "position that physicians should be able to demand that hospitals support their alternative treatments, even if the hospital has reasonably determined those treatments to be unsafe, does not appear to be consistent with Virginia's informed consent law and arguably could set a dangerous precedent against established medical standards," the judge continued.

The ban on certain COVID-19 treatments has had a direct impact on the use of Marik's MATH+ Hospital Treatment Protocol, which includes ivermectin. Marik, a vocal proponent of the drug and founding member of the Front Line COVID-19 Critical Care Alliance, the same day that the Journal of Intensive Care Medicine (JICM) that Marik co-authored on the MATH+ protocol.

Though a spokesperson for Sentara previously told 番茄社区app that it did not seek the retraction, JICM noted that the retraction followed receipt of communication from Sentara Norfolk General Hospital "raising concerns about the accuracy of COVID-19 hospital mortality data reported in the article pertaining to Sentara."

Last week's order signals that the back-and-forth between Marik and Sentara isn't over yet.

Fred Taylor, JD, a partner at the Virginia law firm Bush & Taylor who is representing Marik in the lawsuit, told MedPage Today in an email that, "Right now, we are weighing options as far as how we are going to proceed on the claim that was dismissed (via the Virginia Health Care Decisions Act)."

Marik's complaint against Sentara had argued in part that, under the Virginia Health Care Decisions Act, "individuals have a right to execute an advance medical directive specifying what treatment they are to receive under certain circumstances."

"Other than that, we will be moving forward with trial now on the claim regarding informed consent, and remain confident that the law is on the side of Dr. Marik and other doctors across the Commonwealth of Virginia who wish to treat their patients without restrictions," Taylor added.

Counsel for Marik that Marik had arrived to work at the Sentara Norfolk General Hospital ICU 2 days after a November 18 court hearing to find an unexpected note from Sentara on his desk. The note allegedly stated that Marik's hospital privileges had been suspended for 14 days.

At the hearing, "Sentara expressly represented to this court that it would not discipline Dr. Marik in any way for informing his COVID patients that Sentara was preventing him from giving them alternative treatments that are, in his medical judgment (and based on unrefuted evidence), safe, potentially life-saving, and medically appropriate for them," legal counsel for Marik wrote in the letter. "Yet Sentara has now done exactly that."

A spokesperson for Sentara told 番茄社区app in an email that, in accordance with state statutes and consistent with hospital policies, Sentara cannot comment on any medical staff proceedings.

"We are appreciative of the court's ruling on Dr. Marik's request for preliminary injunction regarding Sentara Healthcare's COVID-19 protocols. Sentara Healthcare is committed to delivering the highest quality of care to all patients at Sentara facilities. We understand some community members might see conflicting articles based on misinformation available online, but we want to assure our patients and community members that our treatment guidelines are extensively reviewed by multi-disciplinary groups of clinicians using the latest medical literature, care standards and expertise available," the spokesperson said in a statement. "Patients are safe in our care and health care professionals working in Sentara facilities follow evidence-based protocols as recommended by trusted agencies including the CDC, NIH, FDA and WHO."

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