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Should you be allowed to take a medicine your doctor prescribes for you? This seems like a silly question. If your doctor prescribes it and it is FDA-approved, why wouldn't you?

What if you are dying in a hospital with only days left to live, and you want to try an FDA-approved drug because it might save your life? What if your doctor reviews studies that show it is effective for your illness and proceeds to prescribe that drug as an off-label treatment for you? What if, despite all that, the hospital refuses to allow it?

That is what happened to Jami Howitt.

A 51-year-old mother, grandmother, daughter and sister from Oxford, Michigan, Jami came down with COVID on April 12, 2021. She called her primary care doctor, an internist, who told her to stay home to recover, offered no treatment other than rest and directed her to go straight to the hospital if her condition worsened and she could not breathe. Just over a week later, on April 21 when Jami's lips turned blue, her son rushed her to the hospital. Jami was admitted, and within 24 hours she was ventilated due to her severely low oxygen levels.

Once at the hospital, her treatment consisted mainly of remdesivir, an expensive treatment with troublesome side effects and an uneven track record.

After two weeks with no improvement, the doctors told Jami's family that she had, at most, two weeks to live if she did not turn around. The only thing they offered was the very complicated extracorporeal membrane oxygenation treatment, a complicated and difficult-to-obtain treatment with mixed results. And that was only if a spot opened up at a local hospital. 

The family, searching for options, learned about ivermectin. Ivermectin is a generic FDA-approved anti-parasitic drug that, since 1975, has been used safely over 4 billion times around the world to treat parasites in humans and animals. Since May 2020, it was showing promise in treating COVID. A team of five frontline COVID-treating doctors who were treating COVID patients daily formed an alliance (the Frontline COVID-19 Critical Care Alliance, or FLCCC) early on in the pandemic to compare notes on what worked and what did not. These doctors soon discovered the anti-viral properties of ivermectin and its efficacy in treatment of COVID, ideally when taken early.

Observations of their own patients, together with their review of many quickly accumulating studies, revealed a clear signal that ivermectin was a promising treatment for COVID. After reviewing several studies, Jami's family wanted to try ivermectin as a last hope to possibly save her life.

With the dire news that Jami had just days left to live, Jami's family asked the doctors to prescribe ivermectin. They refused. The family shared the studies and pleaded again. The doctors still refused. The family did not give up but instead asked Jami's primary care doctor to prescribe ivermectin. He also refused. They then spent hours calling countless doctors — explaining their grim situation with a loved one on death's door — and not one doctor was willing or able to take on Jami as a patient and prescribe ivermectin.

Eventually, after much discussion, intense pleading and outright begging, Jami's primary care doctor relented. He acknowledged ivermectin is a safe drug, it cannot hurt, the situation is grave and Jami had nothing to lose. He agreed to prescribe ivermectin, and the family was relieved! However, when he called the hospital pharmacy to order it, the pharmacy refused to fill his ivermectin prescription for Jami. Unbelievable!

They pressed the hospital further and even offered a full liability waiver. The hospital did not budge. The family had one option left. Desperate to get Jami ivermectin, her family took the extraordinary route of hiring attorneys to assist them in this struggle. They contacted Ralph Lorigo and Jon Minear, two New York attorneys who had successfully handled several hospital ivermectin cases, who in turn contacted me. As a Michigan-based attorney following this issue, I was eager to help when I was asked by Ralph and Jon to serve as local counsel to file suit against the hospital.

With the hospital and its doctors holding steadfast against ivermectin, we pressed on through the courts. The court hearing for an order to compel the hospital to administer the prescribed ivermectin was set for a Monday morning at 10 a.m.

Saturday night I could barely sleep; I knew each hour mattered, and I prayed Jami would hold on for another two days.

Sunday morning, I heard a text at 7:30 a.m. My heart sank. It was Jami's sister, letting me know Jami had just died that morning — Mother's Day. I was devastated and immediately overcome by a mix of outrage, sadness and helplessness. It was very unfair for Jami to have been denied a chance to live.

Now, to help other families avoid this tragic denial of treatment, Jami's family graciously allowed their story to be told.

At the heart of the story is the mystery of why the prescription was not filled. Prior to filing suit, in discussions with hospital personnel, I was told that ivermectin was not part of the hospital's COVID protocol mainly because of the FDA's general position against ivermectin use for COVID. (To my knowledge, the FDA has never — until ivermectin — taken a stance against a specific potential treatment option.)

In an FDA consumer update on ivermectin issued on March 5, 2021, the FDA stated to "please beware" and that it had "received multiple reports of patients who have required medical support and been hospitalized after self-medicating with [the animal version of] ivermectin." It continues, regarding human use, that "ivermectin tablets are approved at very specific doses for some parasitic worms." The agency called ivermectin "dangerous" to take in "large doses" and stated in its update that the "FDA has not approved ivermectin for use in treating or preventing COVID-19 in humans."

Even though that statement appears definitive, it is nevertheless true that doctors are legally permitted to prescribe drugs for off-label uses, i.e., uses not specifically approved by the FDA. In a separate update on off-label uses, the FDA stated in February 2018 that sometimes there are situations where "you may have tried all approved treatments without seeing any benefits. In situations like these, you and your health care provider may talk about using an approved drug for an unapproved use to treat your disease or medical condition." Bottom line: a doctor may prescribe any drug for any legitimate medical purpose, including, as is commonly done, an off-label use. And doctors do — quite often, with no trouble from the FDA — until ivermectin.

In addition, Michigan law supports a dying patient's right to try treatment outside the standard protocol. Michigan's Right To Try Act allows a terminally ill patient to try an investigational non-FDA-approved drug that is currently in clinical trials. Allowing already FDA-approved ivermectin for a dying COVID patient, while not within the letter of the Act, is certainly within its spirit and intent. Notably, proposed legislation is attempting to ensure and leave no doubt that doctors are protected and able to prescribe off-label medicines in dire situations. Let's hope this passes very soon. Nevertheless, the hospital pharmacy — despite a full liability waiver — refused to fill Jami's doctor-prescribed ivermectin.

Now, if they qualify, COVID patients would likely be prescribed Paxlovid — but even the Centers for Disease Control and Prevention has admitted this antiviral drug has proven to be problematic, especially in the vaccinated and in young people.

So the important lesson for any potential hospitalized COVID patient is this: The hospital treatment protocol for COVID by the hospital doctors takes precedent over any protocol your primary care doctor elects. Knowing this becomes helpful in pre-planning your options.

According to the FLCCC and other frontline doctors, early treatment is key to helping avoid the hospital altogether. And early treatment has been available with the safe generic ivermectin (and other generic drugs) since at least December 2020.

Still, only a few (2–5%? But growing!) of the probable 4,000 or so frontline COVID-treating Michigan doctors — mainly internists, family physicians or pulmonologists — will offer proven-safe generic drugs, like ivermectin, for early treatment. Why so few? Because state and federal medical licensing boards have threatened to investigate doctors who prescribe ivermectin for COVID. It's that simple.

But the evidence of ivermectin's value and safety is overwhelming. Doctors should not be maliciously threatened and effectively prevented from prescribing ivermectin as a viable and proven COVID treatment option. And patients should not have their access to this off-label treatment blocked surreptitiously. Early treatment of COVID with safe, generic drugs should be available to all COVID patients. Hospital treatment with those same safe generic drugs should be available too. No one should have to resort to hiring legal help to force a hospital to administer a doctor-prescribed medicine to try to save a life.

So prepare ahead of time:

It might save your life or the life of someone you love.

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