Liz Szabo

USA TODAY

Fans of Houston doctor Stanislaw Burzynski love him for defying the medical establishment and offering alternative therapies to terminally ill patients.

The latest charges against Burzynski by the Texas Medical Board, which has tried and failed to take away his license for more than two decades, paint a very different picture.

Burzynski has long lured patients from around the world to his Texas clinic by promoting his unapproved drugs as safe, effective and available from nobody else. Yet Burzynski knew that most patients were ineligible for the experimental therapy, according to a 200-page complaint that describes problems with the care of 29 patients.

Desperate patients have sought out Burzynski because of his claims about antineoplastons, drugs that he invented and patented. Although they haven't been approved by the Food and Drug Administration, the FDA has allowed Burzynski to dispense them through a clinical trial. The FDA put that trial on hold after the 2012 death of a 6-year-old boy, but gave Burzynski the green light to resume the trial last month.

Once patients arrived at Burzynski's office, the board says, he misled them in several ways:

• By making patients pay a retainer before receiving any diagnosis or treatment.

• By performing unnecessary tests and "non-therapeutic treatment" with no potential to help them.

• By imposing "exorbitant charges" for drugs and lab tests, without telling patients that he also owned the pharmacy and lab being used.

• By allowing unlicensed staff to treat patients, while describing the staff as doctors.

Burzynski also prescribed unapproved combinations of highly toxic chemotherapy in ways that caused harm to several patients, the board says.

Burzynski — who was the subject of a USA TODAY investigation last year — broke Texas law, the board says, through "unprofessional and dishonorable conduct that is likely to deceive or defraud the public."

Oncologist Howard Ozer, who reviewed the board's case, said the charges against Burzynski are medically sound. For example, the board says Burzynski tested one patients' blood oxygen levels eight times in two weeks — at $35 a test, in addition to a $4,500 monthly case management fee. While these oxygen tests are common for patients in intensive care, they aren't used for patients receiving outpatient treatment, Ozer says.

In Burzynski's case, "these tests seem to me to be simply for generating extra revenue," says Ozer, a professor at the University of Illinois Cancer Center.

Several of Burzynski's critics praised the board's decision.

"Burzynski should not be practicing medicine. Period," says Ronald Lindsay, president and CEO of the Center for Inquiry, an advocacy group that promotes evidence-based medicine. "The Center for Inquiry hopes that this case will be pursued vigorously and promptly, and that Burzynski will no longer be able to exploit patients."

Burzynski's attorney, Richard Jaffe, says his client hasn't broken any laws. Jaffe says that it's common for doctors to order blood tests or dispense cancer drugs from their own pharmacies.

Jaffe notes that the unlicensed employees singled out in the complaint — Tolib Rakhmanov, Larisa Tikhomirova, Sheryll Acelar and Lourdes DeLeon — all earned medical degrees abroad. Although they don't have licenses to practice medicine in Texas, Jaffe says they are all skilled doctors. He said they mainly performed tasks such as checking in on patients by phone after patients returned home from Houston.

But the board charges that Burzynski led patients to believe these employees were licensed doctors, and that they performed a number of medical roles, including evaluating patients, diagnosing them and making recommendations about their treatments.

Wayne Merritt, a former Burzynski patient, says he didn't know that Burzynski used unlicensed employees. Merritt and his wife, Lisa, say they hope the board "is able to do something to stop him this time."

Burzynski last battled with the medical board in 2012 about the care of several patients. He was cleared of charges at that time, after a judge found that the care in question had been provided by Burzynski's employees, not him.

The board has since filed charges against two employees.

Physician Robert Weaver, a former Burzynski employee, was formally reprimanded in May in relation to a patient treated in 2008 to 2009. The board found that Weaver failed to meet the standard of care while working for Burzynski, "who implemented multiple therapies, which had insufficient evidence of clinical efficacy and high probability of additive toxicities."

The board also found that while Weaver signed the order, he consulted with Burzynski on the patient, whose care was a "team effort." The board found that the patient should not have been charged for treatment related to the clinical research, and that the patient was "inappropriately billed" for study-related lab work.

The board has charged a current Burzynski employee, physician Zanhua Yi, with failing "to practice medicine in an acceptable professional manner" while caring for a cancer patient in 2011. That case has not yet been decided. Jaffe, who spoke on behalf of Yi, said that doctor's care was appropriate.

Jaffe says the board, which put Burzynski on probation from 1994 to 2004, is "under tremendous pressure to take away Burzynski's license" because of negative publicity that Burzynski has received in recent years.

Jaffe predicts that this would be the last time that Burzynski, 70, will tangle with the medical board.

"One way or another, this is the last time that this is going to happen," Jaffe says. "Either they are going to take away his license or the board is going to be humiliated, because we are going to ask a judge to decide whether this treatment works better."