As public demand for alternative products has grown, so has the potential for mishaps to occur.
Posted in Case Studies on Friday, February 27, 2026
Tim Stone, 58, sought treatment from Sue Reese, ND, for back pain, memory loss, headaches and upper-body soreness. Two years earlier, Mr. Stone had been diagnosed with prostate cancer and his Prostate Specific Antigen (PSA) count was 10 nanograms per milliliter (ng/ml), compared to the normal range of 0 to 4 ng/ml.
Mr. Stone began a course of radiation treatment, and after two months, his PSA count was 1.6. His count continued to be normal until the time he first visited Dr. Reese.
Dr. Reese provided Mr. Stone with pre-dehydroepiandrosterone (pre-DHEA) to treat his headache, memory loss and body soreness. The steroid hormone dehydroepiandrosterone, or DHEA, is a chemical synthetic cousin of testosterone and estrogen, while pre-DHEA is a dietary supplement manufactured from an extract of wild Mexican yams. As a nutritional substance, pre-DHEA’s use is not regulated by the FDA.
Some medical studies have demonstrated a link between high levels of testosterone and prostate cancer. Although some dispute this link, it is generally accepted. Since natural DHEA precursors would normally increase testosterone levels, it is not usually considered advisable to take precursor supplements if one has an inherent risk of prostate cancer.
Dr. Reese placed monthly orders for pre-DHEA and other nutritional supplements. In turn, her office became a retail outlet for the products.
The Allegations
Three months after Mr. Stone began taking pre-DHEA, his PSA level shot up to 9.5. Mr. Stone alleges that Dr. Reese responded by telling him not to worry about his PSA count.
As time passed, Mr. Stone’s PSA level continued to rise. Once it reached 21, Mr. Stone’s medical doctors conducted further testing and diagnosed a recurrence of prostate cancer. He was advised by his medical doctor to discontinue taking pre-DHEA and undergo chemotherapy immediately. After four months, Mr. Stone’s PSA count was 1.4.
Mr. Stone contended that the recurrence had caused him to become impotent and greatly weakened. He sued Dr. Reese for malpractice, alleging that pre-DHEA caused his cancer to recur.
The Defense
The defense team for Dr. Reese was adamant that there wasn’t a scientifically proven link between DHEA and prostate cancer, and more importantly, that Mr. Stone was taking pre-DHEA, not DHEA.
An oncologist/hematologist was retained for the defense. This specialist discovered that Mr. Stone’s PSA level two months prior to his first treatment with Dr. Reese was elevated to 4. This expert stated that patients with PSAs of 4 or more two years after receiving radiation therapy are probably going to face a recurrence. So, in the specialist’s opinion, it was not significant that Mr. Stone took DHEA or pre-DHEA.
The pre-DHEA was sent to a lab for testing, which detected only very minute amounts of DHEA. The doctor there indicated that one millionth of DHEA is claimed in the product itself. He explained that in order to induce androgen elevation, one must administer at least 50 milligrams of DHEA. This is equivalent to 15 million nanograms. The product that Dr. Reese gave to Mr. Stone included only 13 nanograms. The doctor who performed the tests was of the opinion that virtually no physiological effect can be elicited with that dose.
The Outcome
Mr. Stone demanded $850,000 to settle the case, and the case went to mediation. After lengthy deliberation and diligent efforts by the NCMIC defense team, the case settled for $19,000, with $6,500 paid on behalf of Dr. Reese and $12,500 paid by the manufacturer of the pre-DHEA. The doctor’s legal fees totaled $44,350.
What Can We Learn?
Know When to Refer
Physicians must recognize when treatment for a patient’s condition is beyond their professional expertise and know when to refer the patient to another provider. In this case, Dr. Reese did not truly examine the patient with the intent of forming an actual diagnosis. In a malpractice trial, issues dealing with qualifications to treat, competence to treat and proper examination will be part of the total equation.
Be Cautious About Product Recommendations
Doctors must employ the utmost caution in using products with questionable or unknown benefits. Manufacturers often make exaggerated and unsupported claims about the efficacy of their products. Doctors who encounter products that are unfamiliar or are inadequately labeled should exercise great caution in dispensing or utilizing those products. A conscientious doctor will duly investigate a company’s quality control before purchasing a product.
Know the Most Common Malpractice Allegations
It is helpful to be mindful of the most common allegations in these types of malpractice cases. The most common include failure to diagnose, failure to refer in a timely manner, treating beyond the statutory scope of practice, failure to provide informed consent, and practicing medicine without a license.
Review Patient History
Information obtained from initial case histories is very important in the overall management of patients and their complaints. Knowledge of prior cancer, heart attacks, stroke, diabetes and other family health history can be indicators to monitor and evaluate the patient’s progress or lack of progress. The knowledge and proper co-management of the patient’s conditions will play an important role in the event of a malpractice allegation.
Be Thorough in Your Case Management
Request copies of lab reports. Clarify your interest in staying closely apprised of any developments. In a case like this, an ND has options of supplementation which would have no such risks involved.
Expert Witnesses Provide Value
In this case, the doctor could be defended by an expert who reviewed the records and discovered the elevated PSA. Had there not been an elevation prior to the commencement of treatment, the outcome may have been different. The potential for an excellent plaintiff’s attorney to build a case for greed, lack of quality in product distribution and a poor outcome by the patient all make for a case that’s difficult to defend.
Listen to Your Patients
How many times have you known of medical doctors who just tell a patient to keep taking something even when the patient has a concern? Dr. Reese failed to respond to her patient’s concern, thus damaging the relationship. Good relationships and listening to patients are both critically important in limiting the likelihood of legal action.
Although this case study is based on a real case, names, dates and details have been changed to protect patient and doctor privacy.