HHS Secretary Robert F. Kennedy, Jr.’s recent hiring of David Geier to reinvestigate possible associations between vaccines and autism gives ample cause to review Mr. Geier’s history as a consultant to vaccine-injury claimants, and as a prolific co-author with his father, the late Dr. Mark Geier, of studies, reviews, letters, and magazine articles that support their disability causation claims.
That history begins at a point when Dr. Geier’s output of scientific journal articles had slowed. During the 1970’s, he had co-authored a dozen papers in the fields of genetics and biochemistry; however, during the 1980’s, only a few papers bore his name. The 1990’s saw a handful of new publications, all on genetic testing save for a letter discussing the rubella vaccine.
In spite of this uptick, near the end of the century Dr. Geier’s career was not so much about conducting studies and publishing scientific papers as it was about running a genetics and obstetrics practice, testifying in vaccine injury cases, and offering commentary on vaccines at public committees and conferences. However, judges and Vaccine Injury Compensation Program (VICP) special masters had grown increasingly critical of the quality of his speculative, often irrelevant testimony. (I discuss this subject in my previous post, “A Checkered History in Vaccine Court: Mark Geier at the VICP, 1988-2003.”)
A Dwindling Store of Evidence
Although the VICP does not strictly adhere to rules of evidence that apply in civil courts, the VICP special masters are nonetheless inclined to apply the principles outlined in Daubert v. Merrell Dow to cases in that venue. Daubert requires that expert opinion be supported by peer reviewed research, but peer reviewed research to support Dr. Mark Geier’s idiosyncratic, litigation-driven opinions on vaccine injury and disease causation was scarce, and the few academic sources upon which he relied were increasingly out of date.
One approach to filling the evidence gap was to DIY. Although during the 1970’s Dr. Geier had published several papers on endotoxins in vaccines, his only other vaccine-related contributions to the scientific literature consisted of two otherwise-unpublished statements made at public meetings of the Institute of Medicine. However, in 1999, he acquired a new apprentice with whom he could jointly generate studies and reviews to buttress his opinions in court, and with whom he could jointly address public meetings and conferences to broadcast those opinions worldwide.
A Pair of Wiser Minds
In 1998, Mark Geier’s son David Geier was a freshman at the University of Maryland-Baltimore County (UMBC); he would eventually choose a major in biology and a minor in history. Although he described himself at least once as a pre-med student, he appears to have taken few pre-med courses. During his college years, David Geier was granted a journalism internship and became a frequent contributor of opinion pieces to the UMBC student weekly, The Retriever. He advocated for gun control and for restricting voting rights to those with demonstrable educational achievement; he predicted interstellar settlement and a new civil war; he recommended that eligible citizens be legally required to vote, and that the United States consider purchasing parts of Canada.
In a September 19, 2000 Retriever editorial, “Americans should take vaccines more seriously,” young Mr. Geier—like his father had before him—donned the mantle of vaccine expert in the absence of any formal education or clinical experience in immunology, neurology or vaccine development, and adopted his father’s “expert” opinions as his own. He characterized prevalent methods of vaccine distribution as a careless business and counted himself and his father among the “wiser minds [who] have begun to truly question the safety and efficacy of such a slipshod method of vaccination, especially considering the fact that vaccines can cause some extremely disastrous side effects in recipients.” He called attention to “my recent research with Dr. Mark Geier in the Journal of Clinical and Experimental Rheumatology” as evidence that the Hepatitis B vaccination often caused “serious immunological disorders,” and cited to a “recent analysis by Mark Geier and myself” as evidence that influenza vaccines are only marginally effective. Mr. Geier opined—like his father had in numerous vaccine-injury cases—that pharmaceutical companies were incapable of adequately testing flu vaccines for efficacy and safety. Like his father had before him, Mr. Geier accused “healthcare professionals and industries” of painting a “wonderful rosy picture” of vaccine safety and encouraged his readers to “know the whole truth” about vaccines.
The essay ended with the biographical note, “David Geier is a junior majoring in biology,” but failed to disclose that the author had also recently become President of a firm offering consulting services to vaccine injury attorneys—a President who was either self-appointed, or, more believably, was elevated to that role by his father.
The Expert’s Apprentice
On August 1, 1999—shortly before David Geier’s sophomore year commenced, and a year before he penned his vaccine editorial—Clifford Shoemaker—a vaccine injury attorney and close professional associate of Mark Geier—prepared the Articles of Incorporation of MedCon, Inc., a Delaware corporation established to “provide medical consulting and other such litigation support for personal injury attorneys.” MedCon’s Directors were identified as Mr. Shoemaker, David Geier and his mother, early childhood educator Anne Geier, and the firm’s principal office as the Geier family home in Silver Spring, Maryland. Although ostensibly a medical consulting firm, MedCon’s Board of Directors did not include anyone with a medical education. The name of Dr. Mark Geier—the only member of the Geier household even remotely qualified to offer medical services—appeared nowhere on the document.
For the next quarter-century, Mark and David Geier presented themselves as one mind and spoke as one mind. From 2000 onward, nearly every paper published by Mark Geier named his son as a co-author; their written output focused primarily on vaccines and vaccine injury. On public forays, they often gave the impression of unanimity. A 2003 profile in Seed Magazine noted that David “finishes his father’s sentences and jumps in to correct him when a detail is omitted during one of the numerous presentations they make together,” and that father and son “live in the house where David grew up and work most nights and weekends on side-by-side computers in the study.” Nearly a decade later, their work-life situation was much the same; as one judge noted, David Geier and Dr. Geier “live in the same home and are together nearly all the time.”
An Instant Professional Affiliation
But even as Mark and David Geier lived their private life at each other’s side and cultivated a unified public image, they also sought to convey the notion that they were intellectually independent from each other. Although David Geier lacked his father’s M.D. and Ph.D.—and until mid-2002, lacked even a Bachelor’s degree—he did have one credential he could display to create an impression of expertise, authority, and intellectual independence: his made-to-order professional affiliation as “President of MedCon, Inc.”
From 2000 through 2005, David Geier would identify himself—or not identify himself, as convenience mandated—as “President of MedCon, Inc.” Every paper co-authored by David Geier and Mark Geier between 2000 and 2005 gave David Geier’s affiliation as “President of MedCon, Inc.,” and Mark Geier’s affiliation as principal or President of his obstetrics and genetics practice, Genetic Centers of America. In none of the Geiers’ published papers did Mark Geier ever disclose any affiliation with MedCon. These disclosures, and the lack thereof, served to convey the unwarranted impression that David Geier’s professional life was somehow separate from his father’s.
This was hardly the case. In fact, MedCon, Inc. served as a vehicle for an ambitious effort to transform David Geier from an average college student to the very picture of a full-fledged contrarian scientist, qualified not by post-graduate education and research or clinical experience, but by apprenticeship to his father, a self-styled expert on vaccine injury and professional purveyor of results-oriented testimony. MedCon, Inc. also served as a made-to-order employer; on his resumes, Mr. Geier included “Researcher at MedCon, Inc.” and “President of MedCon, Inc.” as examples of his scientific employment, notwithstanding the fact that he was purportedly the firm’s founder and President.
In the eyes of those not already wedded to the conclusion that vaccines cause autism, Mark and David Geier’s effort to boost the latter’s status to that of an instant expert was doomed to fail.
New Research & New Clients
David Geier’s new role as Mark Geier’s amanuensis and “President of MedCon, Inc.” enabled Dr. Geier to dramatically boost his output of publications, and to transform the royal “we” into the collective “we” in his papers and public testimony. In their early work together, Geier père et fils would turn their attention first to the hepatitis B and pertussis vaccines, then to vaccines for rubella, anthrax and Lyme disease. They published a series of analyses of data from the Vaccine Adverse Events Reporting System (VAERS), a database of adverse event reports submitted by both professionals and laypeople, consistently finding associations between vaccines and whatever might be the topic of their analysis. Then, beginning in 2003, they would shift their focus again, to the mercury-based preservative thimerosal in vaccines.
The Geiers’ reorientation coincided with their new role as consultants to petitioners in the Omnibus Autism Proceeding (OAP), which consolidated growing numbers of VICP claims alleging that children had been rendered autistic by either the MMR or thimerosal-containing vaccines. At the November 2002 3rd International Conference of the National Vaccine Information Center, Mark and David Geier gave a presentation on adverse vaccine reactions and became acquainted with Lyn Redwood, co-founder of SafeMinds, a parent-led organization that promoted the thimerosal-causation hypothesis and advocated for collective litigation. Shortly thereafter, they were solicited by attorneys from the OAP Petitioners’ Steering Committee to evaluate data about thimerosal-containing vaccines. In September 2003, Mark Geier entered into a formal agreement with the PSC to consult and potentially offer expert testimony, at rates ranging from $250 to $500/hour. One year later, that agreement was expanded to include David Geier, with payment of fees to be deferred until the conclusion of the six OAP test cases.
Mark Geier, David Geier and petitioners’ attorneys spent the next few years seeking authorization to access data in the Vaccine Safety Datalink (VSD), which is comprised of anonymized patient information from participating Managed Care Organizations (MCOs). After many complaints about the inconvenience of passing the scrutiny of the MCOs’ Institutional Review Boards, and many requests to the court to order MCOs to grant petitioners’ “independent experts” unfettered access to patient records, Mark and David Geier were eventually allowed to study the VSD, only to find their permission withdrawn after they attempted implement a plan that (according to Mark Geier) was devised by David “to put their … seven different data bases together to make one.” In 2006, following more appeals by petitioners’ attorneys, a second attempt by the Geiers to analyze multiple datasets simultaneously led to yet another suspension. (I describe these events in greater detail in my post, Senator Hassan Sets Secretary Kennedy Straight.)
In the meantime, Mark and David Geier continued publishing analyses of VAERS data, now in relation to thimerosal-containing vaccines.
Cultivating Litigants & $$$
David Geier’s MedCon, Inc. engaged in both the business of generating evidence to support the claims of vaccine-injury petitioners and soliciting clients for vaccine-injury attorneys. In a 2005 announcement on autismfliers.tripod.com, David Geier encouraged parents of autistic children to file VICP claims by way of his firm:
75 cents from every vaccine goes into $2 Billion dollar program which pays for your child’s lawyer & medical experts. Contact David Geier and the medical-legal consulting firm, MedCon, 301-989-0548. Must file suit within 3 years of diagnosis.
In a 2005 defamation action against the authors of an article that criticized their work, both Mark and David Geier claimed that compensation for services to litigants represented a significant portion of their income, presumably eclipsing Dr. Geier’s income from his obstetrics and genetics practices.
(T)he Geiers dedicate a substantial amount of their time and resources to their role as expert witnesses. … (T)he Geiers are dependent upon the compensation they receive as expert witnesses as a significant source of income.
Where that income was coming from—especially income presumably paid to David Geier—is left to the imagination. Many VICP decisions evaluate Mark Geier’s bills to the court, and either outright deny or reduce his compensation. Although only a handful discuss David Geier, those that do shed abundant light on his lack of qualifications to offer expert research and opinion on medical matters, as well as a willingness to soak the court for personal expenditures that can fairly be called audacious.
An Anonymous Invoice
In her June 18, 2008, fees and costs decision in Carrington v. HHS (Case No. 99-495V)—the first VICP ruling to mention MedCon, Inc.—Special Master Denise Vowell scrutinized a request for nearly $100,000.00 in fees submitted by petitioners’ counsel Clifford Shoemaker, and determined that bills from MedCon were not compensable, due in part to the firm’s appearance as an alias for Mark Geier, and due in part to the fact that while MedCon purported to provide consulting services, the faceless entity delivered no work product to the court.
Perhaps the most difficult matter in this fees and costs application is the amount of compensation requested for Dr. Mark Geier and MedCon, Inc., a combined total of $3,800.00. I am concerned both by the lack of specificity in the bills submitted, as well as the use of medical consultants when no reports or other documents are filed with the court reflecting what role the consultant played in the case.
Invoices from both MedCon and Dr. Geier were submitted with the fees and costs application. The bill format of MedCon is identical to the format of the bills submitted by Dr. Mark Geier as a Medical/Legal Consultant, with the exception of an entry over the heading reflecting Dr. Geier’s name. The bills for Dr. Geier and MedCon are aggregated in the Synopsis of Fees and Costs submitted with the Application for Fees and Costs. I thus conclude that MedCon is a business that is in some way connected with Dr. Geier. [emphasis added]
Given that David Geier’s name appears nowhere in the Carrington decision, Special Master Vowell appears not to have been informed that bills from MedCon pertained to work performed by Mark Geier’s son.
A Hidden Relationship
The special master then expressed her concern that Mark Geier and Mr. Shoemaker had preexisting business relationships by way of a nonprofit organization they had recently founded, the Institute for Chronic Illnesses:
When a client is billed for such consultation, the client is entitled to know what the consultant did, what hourly fee or flat rate of compensation was charged, and why the consultant was required. […] Under fee-shifting statutes, the general rule is that an attorney may not bill the government (or the opposing party) for fees that would not be billed to a private client.
When there are indications that the arrangement between consultant and attorney is not entirely at arm’s length, the issue of consultant fees becomes even more problematic. Public records reflect that petitioner’s counsel is an officer or director of the Institute for Chronic Illnesses, Inc., a charitable organization. One of Dr. Geier’s many published articles identifies his organizational affiliation as the Institute for Chronic Illnesses, Inc.
In light of Special Master Vowell’s expression of concern over Dr. Geier’s and Mr. Shoemaker’s shared membership on a nonprofit board, it is likely that she would have been equally concerned to learn that Mr. Shoemaker was a director of the for-profit MedCon consultancy when he submitted MedCon’s bills to the court.
Bills and time records from Mark Geier and the anonymous MedCon gave Special Master Vowell little indication of the work being performed and the identity of the individual who performed it, and bore little relationship to time records submitted by Mr. Shoemaker.
In the case of Dr. Geier/MedCon, Inc., the situation is complicated by the frequency in which such services are utilized, when little or no information is ultimately filed with the court documenting what was actually done… The invoices in this case are insufficient to explain the relationship of the costs to the prosecution of this petition. … The bill dated March 2, 2002, submitted from MedCon, Inc., claims $400.00 for what is labeled ‘Research’ in one column and ‘Lawyer Consultation’ in another. I have carefully examined the attorney time records submitted, and find only one entry involving this case for any attorney in this firm in all of 2002.… Given the lack of specificity for this bill and the lack of any attorney entry reflecting consultation with MedCon, Inc., or Dr. Geier in the same year, I will not authorize compensation for this $400.00.
The Evidence Fails to Persuade
Although the President of MedCon enabled his father to produce a pile of litigation-driven journal articles, he was unable to enhance their quality. In his February 2009 ruling in Cedillo v. HHS (Case 98-916V), Special Master George Hastings offered his take on studies by the Geiers submitted in support of the contention that autism could be caused by the MMR vaccine.
As noted above, all of the studies that have addressed the MMR/autism causation issue published since the Wakefield article in 1998 have found no association between MMR vaccination and autism, with two exceptions. Both exceptions were studies published by the research team of Dr. Mark Geier and his son David Geier….
After careful consideration, I conclude that the Geiers’ studies cannot be given any weight. Those studies were considered by the Institute of Medicine (IOM) committee that fully studied the entire MMR/causation issue in 2004, and that committee concluded that the studies were so flawed as to be “uninterpretable” and to contribute nothing meaningful (“noncontributory”) concerning the causation issue. The committee noted that the studies were based on databases that themselves had “significant limitations,” and that the studies’ methodologies had “serious methodological limitations.” The committee added that the Geiers’ articles describing the analytical methods were “not transparent” and omitted “important details,” so that it was impossible to evaluate the studies. Other specific points of deficiency in the studies were also discussed. In addition, Dr. [Eric] Fombonne analyzed the Geier studies, and found them to be “seriously flawed in several respects.” None of the expert witnesses for the petitioners vouched for the reliability of the Geier studies. [emphasis added]
In her simultaneously-published decision in the test case, Snyder v. HHS (Case No. 01-162V), Special Master Vowell came to much the same conclusion regarding the Geiers’ 2003 report, A Case-Control Study of Mercury Burden in Children with Autistic Spectrum Disorders, presented to support the argument that autism is a consequence of vaccine-induced thimerosal poisoning. After noting numerous methodological and statistical problems with the study, Special Master Vowell wrote:
Petitioners have failed to demonstrate that children with autism have difficulty excreting mercury, and thus there is no reliable evidence of a mercury efflux disorder or a hypersusceptibility to mercury in children with an ASD diagnosis
It didn’t help that two of the study’s co-authors were already poorly regarded by the court:
I note that two of the co-authors of this study were Dr. Mark Geier and Mr. David Geier. This is not the first occasion in which other researchers have been unable to verify the validity of the Geiers’ statistical analysis. … A number of judges have had similar concerns about Dr. Geier’s work.
In his March 2010 decision in the test case King v. HHS (Case No. 03-584V), Special Master George Hastings had another opportunity to comment on the value of Mark and David Geier’s thimerosal studies. His observations were similar to those in Cedilloregarding their studies of the MMR vaccine:
As explained above, most of the epidemiologic studies that have addressed the thimerosal/autism causation issue have failed to find any association between thimerosal-containing vaccines and autism, but there have been certain exceptions. Those exceptions were studies published by the research team of Dr. Mark Geier and his son David Geier.
After careful consideration, I conclude that the Geiers’ studies cannot be given any weight. A number of those studies were considered by the Institute of Medicine (IOM) committee that fully studied the entire thimerosal/autism causation issue in 2004. … Other specific deficiencies in the studies were also discussed, including the fact that the Geiers incorrectly used several epidemiologic terms and measures
Further, petitioners’ own expert witness concerning epidemiology, Dr. [Sander] Greenland, agreed with the criticisms of the Geier articles, acknowledging that those studies are “deficient in methodology.” And none of the expert witnesses for the petitioners vouched for the reliability of the Geier studies.
In summary, I conclude that all of the Geier epidemiologic studies are not reliable, and cannot be accorded any weight. [emphasis added]
Unfamiliar & Unqualified
Whereas in Carrington, MedCon lost out on only $400 in billables, in Riggins v. HHS (Case No. 99-382-V)—another VICP case in which Clifford Shoemaker served as petitioner’s counsel—David Geier and his father were far more presumptuous. In his June 2009 Fees and Costs Decision in that case, then-Chief Special Master Gary Golkiewicz discussed Mr. Geier’s qualifications and his bills to the court and found both inadequate.
The undersigned is quite familiar with Dr. Mark Geier, but far less familiar with his son David Geier. Petitioner has requested approximately $37,543.75 in costs associated with fees to be paid to David Geier. The undersigned finds petitioner’s request for fees and costs associated with activities performed by David Geier unsubstantiated, and thus unreasonable, and denies the request in total.
The court observed that David Geier had no relevant credentials and no expertise to offer.
As an initial matter, David Geier is not qualified to serve as a consultant on the medical issues presented in the Vaccine Program. To the undersigned’s knowledge, David Geier has not been compensated as a consultant in any prior Program case, and petitioner has not cited any such prior Program compensation. David Geier does not possess any advanced medical or scientific degrees. The only degree David Geier possesses is a Bachelor of Arts in Biology. According to his CV, he has taken graduate level coursework, but does not appear to have finished any program, nor does he appear to be currently enrolled in any graduate program. While David Geier is named as co-author in numerous vaccine related papers with his father, Mr. Geier possesses no advanced degrees or credentials to qualify him for work as a Vaccine Program consultant. The issues in this matter concern medical causation for which Mr. Geier does not have the requisite background and credentials. On this basis alone, petitioner’s request for compensating David Geier is denied. [emphasis added]
Although David Geier sought to buttress his claim for reimbursement with a retainer agreement between a Chicago attorney and MedCon, the court was not impressed.
The undersigned notes that attached to David Geier’s affidavit, as “Exhibit B” is a retainer agreement signed by an attorney in Chicago and David Geier in which the attorney client appears to be retaining the services of MedCon, Inc. (of which Mr. Geier is president) to perform research “involving thimerosal litigation and other related matters” at a rate of $250 an hour. The undersigned does not find this agreement establishes David Geier’s qualifications to serve as a consultant in Program cases. At most, this agreement may demonstrate that someone has agreed to pay MedCon, Inc. to perform research “involving thimerosal litigation and other related matters” at a rate of $250 an hour.
The court was also unmoved by Mr. Geier’s employment history (which at the time consisted primarily of summer jobs and positions at enterprises established by or employing his father).
David Geier, also lists as “scientific employment” his positions in various consulting and research organizations. However, holding these positions alone does not give Mr. Geier the background necessary to qualify him for work as a Vaccine Program consultant.
Two for the Price of One?
Mark Geier and Clifford Shoemaker characterized David Geier’s employment as a consultant in Riggins as something of a bargain.
Petitioner argues David Geier is a qualified consultant and petitioner saved funds by employing David Geier. (“In his consultation with Counsel Dr. Geier would enlist the assistance of David Geier, his son, at a greatly reduced rate than his own, an action which resulted in further savings to counsel, and subsequently, the Program.”)
However, the court determined that both father and son were performing essentially the same work, at the same number of hours.
However, even assuming arguendo that David Geier was qualified to serve as a Vaccine Program consultant, the work performed in this matter by Mr. Geier is duplicative of the work performed in this matter by his father, Dr. Mark Geier. To state that counsel is saving the Vaccine Program money by employing David Geier is simply not established nor is it a credible statement. For virtually every single request for costs for work or travel performed by Dr. Geier, an identically described request is made by David Geier (albeit at a lower rate than his father).
Mr. Shoemaker’s insistence on his right to be compensated for every “expert” he might happen to hire was unavailing.
Petitioner attempts to justify this unreasonable submission for fees and costs for the services of both Dr. Mark Geier and David Geier by arguing “that it is counsel’s prerogative to determine how to prosecute his case.” Within certain bounds, including ethical and reasonableness, that is true, however, it is not counsel’s “right” to be compensated simply because counsel says a charge is reasonable. Attorneys retained by paying clients are not able to make any expenditure they desire. In private litigation, the client’s oversight constrains expenditures. Likewise, petitioners in the Program are not given a “blank check to incur expenses” to be paid by the Vaccine Trust Fund.… The undersigned finds a hypothetical client would find counsel’s request for consulting fees paid to David Geier unjustifiable as he is unqualified, his costs constitute over-billing as they duplicate his father’s charges, and thus the charges are entirely unreasonable. Therefore, fees and costs associated with David Geier are denied in their entirety. [emphasis added]
“An Extreme Example of Error in Billing Judgment”
The Geiers’ bills in Riggins included a preposterous request for nearly $44,000 spent on father-son jaunts to France and Italy in 2005 and 2006, as well as their time in the air.
Another extreme example of counsel’s error in billing judgment is the request by counsel for fees and costs billed by Dr. Mark Geier and David Geier for trips to France and Italy in the summer of 2005 and winter of 2006 respectively, and for Mr. Shoemaker to travel to France with the Geiers in the summer of 2005. These requests represent a complete abdication of billing judgment.
Dr. Geier and Mr. Geier together billed a total of over $20,000.00 to travel along with Mr. Shoemaker to France and meet with various doctors and lawyers to discuss adverse events following the hepatitis B vaccination. Dr. Geier, in his affidavit, and counsel in Petitioner’s Sur-Reply, allege … that this information could only be obtained in “face-to-face” discussions. In addition, Dr. Geier and Mr. Geier together billed $23,690.00 to travel to Italy to attend the 5th International Conference of Autoimmunity.
The undersigned finds petitioner has failed to explain why it was reasonable for the Geiers (and Mr. Shoemaker) to travel to France and Italy, billing and spending in excess of $44,000.00, including $19,175.00 billed as travel time, to talk to other doctors and lawyers about their experiences and research “face-to-face.” … These fees and costs requested for these trips are excessive and not compensable.
The court looked askance at the Geiers’ failure to submit receipts for their travel, and at their commingling of expenses.
Additionally, the Geiers provided absolutely no supporting documentation, such as receipts, to evidence the $9,399.68, they allege they incurred in costs for airline tickets, other transportation costs, parking, hotel, “daily expenses,” food, and conference fees during these trips. By itself, this failure justifies not awarding these costs.… The undersigned notes David Geier’s “costs” while on travel are intermingled with the travel costs of Dr. Geier.
The court found Mark and David Geier’s bills even more unreasonable due to their lack of qualifications to serve as experts in a case involving the hepatitis B vaccine.
Further, there is no explanation of why the Geiers, who are not qualified experts, were taken to engage in conversations with these foreign experts as opposed to qualified experts counsel had retained to opine in [Shoemaker & Associates’] hepatitis B cases…. It is completely unreasonable and extremely inappropriate to bill the Vaccine Fund for the costs of the Geiers traveling to Italy and attending a professional conference that the Geiers were invited to attend as researchers.… Thus, the request is denied.
It appears that the Geiers in this matter incurred significant costs with no oversight…. In summary, the undersigned finds the costs for David Geier’s efforts to be obviously unreasonable as Mr. Geier is not qualified to address the medical issues involved in the Program and his work was duplicative of the efforts by Dr. Geier. Thus, the undersigned denies the request for costs for David Geier in its entirety. [Emphasis added]
Dr. Geier would be awarded only $10,000 for his services as a consultant to the petitioners in Riggins, and David Geier would receive nothing. The decision was eventually affirmed by the United States Court of Appeals for the Federal Circuit, which held that “the Special Master’s reduction in the fees awarded for the work of Dr. Geier and refusal to award fees for David Geier was not arbitrary, capricious, or an abuse of discretion.”
Unjustified, Unreasonable & Unobjective
Following the conclusion of the test case King v. HHS (Case 03-584V), the Geiers sought $197,000 in compensation for researching and writing Thimerosal exposure in infants and neurodevelopmental disorders, an article commissioned by the PSC; co-author Heather Young sought $248,636 for her contributions, and collaborator Dr. Robert Hirsch sought $41,000 for his. However, in his December 2010 ruling on fees and costs, Special Master George Hastings concluded that it would not be reasonable for the Program to compensate anyone for any work on the study. He noted that although Dr. Geier had acknowledged his intent “to produce a legitimate scientific work product that would withstand peer review and be published in a scientific journal… even absent the Vaccine Act litigation,”
[Mark and David Geier] already had a long track record of producing data analyses and articles supportive of the theory that vaccines can contribute to causing autism. The mere fact that the PSC lawyers contributed or promised monetary support for another article co-authored by the Geiers, concerning the topic of whether thimerosal-containing vaccines can cause autism, is itself strong evidence that the article was litigation-driven.
He observed that the article “did not add any value to the petitioners’ causation presentation in this case,” citing to the testimony of Dr. Michael Rutter and Dr. Eric Fombonne, both of whom criticized the study’s statistical manipulations and wholesale invention of data. The petitioners’ epidemiology expert Dr. Sander Greenland did not help the Geiers’ credibility with his testimony that their work was “deficient in methodology.”
The special master concluded:
No rational hypothetical paying client of the PSC would have agreed to pay for the production of such a flawed study.
The special master then gave his rationale for not covering the cost of producing an article co-authored by the Geiers, referring to Mark Geier’s custom of offering testimony outside his medical specialty, and citing to his colleagues’ rulings on “the credibility, credentials, honesty, or other aspects of the testimony or opinions of Mark Geier,” and their conclusions that he “is not an honest, candid witness.’” One cited decision noted that “such expressions by special masters were common even in the earlier years of the Program, so that even by the year 2002 it should have been clear that to retain Dr. Geier as an expert was ‘unreasonable.’”
The court held that it would be particularly unreasonable to pay Mark and David Geier to produce yet another study intended to demonstrate a causal association between vaccines and developmental disorders, given the severe criticism of their work by the Institute of Medicine and by both petitioners’ and respondents’ expert witnesses.
Dr. Geier’s attempts at epidemiological studies in this area were so poorly executed that they are completely useless in analyzing the general causation issues.… I find that the fact that Mark Geier and David Geier are two of the three co-authors of the Young-Geier article is another very strong reason for concluding that it would not be reasonable for me to compensate the PSC for the cost of producing that article.
As demonstrated above, the prior epidemiologic efforts of the Geiers in the area of the alleged vaccine causation of autism clearly demonstrate that the Geiers are the very opposite of independent, objective researchers. As also demonstrated, the Geiers do not have appropriate expertise to author epidemiologic studies. And as further demonstrated, adding Drs. Young and Hirsch to the project did not salvage the situation. Given the Geiers’ history, it was quite unreasonable for the PSC to agree to fund a research project with the Geiers as co-authors, even if Drs. Young and Hirsch did have appropriate expertise themselves. And the resulting study in fact turned out to be severely flawed, in ways very similar to the deficiencies of the Geiers’ previous studies in the vaccine-autism area. [emphasis added]
In addition to billing $197,000 for their work on Thimerosal exposure in infants and neurodevelopmental disorders, Mark and David Geier billed approximately $167,000 for general work performed for the PSC between 2003 and 2008. Most of this was also deemed unreasonable. The special master expounded at length about David Geier and his lack of qualifications to render services to the court, either as an “expert” or a consultant, or to bill $200-250/hour for those services.
I am not persuaded that it would be reasonable to provide any compensation for the claimed services of David Geier. His only academic degree is a Bachelor of Arts with a major in biology. He has no medical degree or other graduate degrees. It is the petitioners’ burden to demonstrate that it would be reasonable to pay David Geier at his claimed hourly rates of $200 or $250, or at any other rate, but they have failed to demonstrate that he is qualified to provide valuable expert or consultant services to the PSC…. The petitioners have not pointed to any Vaccine Act case in which a special master has awarded compensation for services provided by David Geier.
As in Riggins, the court smelled the unseemly aroma of double-billing.
Further, I note that in Riggins, the special master concluded, after studying the Geiers’ billing records, that for many meetings or consultations, Mark Geier and David Geier seemed to have billed the same hours; the master found that this amounted to unjustified duplication of effort. I have detected the same phenomenon again and again in the billing records submitted in this case, and I find it to be another reason to deny compensation for the hours billed by David Geier.
Finally, I note that the petitioners have failed completely to offer any evidence as to what might be a reasonable hourly rate for David Geier’s services. This is yet another reason for denying compensation for his services.
In short, it is the petitioners’ burden to demonstrate that it would be reasonable to compensate then for the services provided by David Geier, but they have failed to shoulder that burden in this case.
Special Master Hastings then analyzed invoices submitted by both Mark Geier and MedCon and determined that each pertained to the work of both father and son.
I have closely studied the part of Petitioners’ Application that contains the billing documentation pertaining to the Geiers… A summary of payments made to, or bills received from, “Mark Geier,” totaling $355,431.05, shows disbursements to “Medcon, Inc.,” totaling $9,165.00. “Medcon” seems to be an alternative billing vehicle for the Geiers, under which work by either Geier may be billed. The PSC in its billing records intermingled bills for “Mark Geier” and “Medcon.” Both the bills from “Mark Geier” and the bills from “Medcon” bill the PSC for the work of both Mark Geier and David Geier. [emphasis added]
Faced with nearly a third of a million dollars in invoices from Mark Geier, David Geier and MedCon, Inc., the court awarded $33,130.35—about a tenth of the total bill—to Dr. Geier, and nothing to his research assistant.
A Litany of Unprofessional Conduct
In the Spring of 2011, the Maryland Board of Physicians summarily suspended Mark Geier’s license to practice medicine and charged David Geier with the unlicensed practice of medicine; the decisions were reaffirmed the following summer. The Geiers nonetheless persisted in their efforts to extract compensation from the VICP for their services. In her August 2012 decision in Arango v. HHS (Case 09-318V), Special Master Dee Lord made note of the disciplinary actions that disqualified the Geiers from having any role in the case:
David A. Geier, co-author of [An evaluation of serious neurological disorders following immunization], does not possess any advanced medical or scientific degrees.… On May 16, 2011, the Maryland State Board of Physicians (the ‘Board’) charged David Geier with practicing medicine without a license. On July 30, 2012, the Board concluded that David Geier practiced medicine in Maryland without being licensed and imposed a $10,000 civil fine for the violation.
David Geier is the son of Mark R. Geier, M.D., the other co-author of [An evaluation of serious neurological disorders following immunization]. On April 27, 2011, the Board summarily suspended Dr. Geier’s license to practice medicine in Maryland on the grounds that the public health, safety, or welfare imperatively required such action. Six other states, including California, Indiana, Kentucky, New Jersey, Virginia and Washington subsequently suspended Dr. Geier’s license to practice medicine, pending the outcome of the discipline in Maryland. The State Medical Board of Ohio initiated similar action with respect to Dr. Geier’s pending licensure application based on Maryland’s licensing board suspension, concluding:
[T]hat the public health, safety, and welfare imperatively required emergency action based on the determination that doctor’s treatment for autistic children included exposing children to needless risk of harm resulting from misdiagnoses, failing to conduct adequate physical examinations prior to starting treatment, and treating with therapies not supported by evidence-based studies.
On March 22, 2012, following a lengthy appeals process, the Maryland Board upheld the suspension of Dr. Geier’s license to practice medicine.
I do not give probative weight to any evidence based on the work of the Geiers because they lack appropriate medical credentials and have been found by competent authorities to have engaged in unprofessional conduct. Their work product is not reliable.
The Geiers vs. the PSC
Although Mark Geier and David Geier AKA “MedCon, Inc.” had entered into agreements with members of the Petitioners’ Steering Committee to conduct research that would support their clients’ autism causation arguments, there was no guarantee that the court would compensate them. After the six OAP test cases had closed without Dr. Geier being called upon to testify, the Geiers billed the PSC for nearly $600,000. After their bills were rejected by the court and went unpaid by any of the petitioners’ attorneys, the Geiers filed suit, alleging breach of contract, malpractice and civil conspiracy for fraud.
In her February 2012 ruling in Geier v. Conway, Homer & Chin-Caplan, District Court Judge Rosemary Collyer dismissed the case for lack of jurisdiction and failure to state a claim. Her ruling contained much discussion of Dr. Geier’s amply-documented history as a testifying expert in vaccine cases. With respect to the doctor’s apprentice and President of MedCon, Inc., the court noted that:
The special master declined to provide any compensation for the work of David Geier because he was not qualified to serve as a consultant on medical issues.
Judge Collyer concluded:
Given the reaction of Vaccine Court to the Geiers it is doubtful that the Law Firms were particularly benefitted by the Geiers’ services. … The Court takes judicial notice of the orders by which the Vaccine Court determined the value that the Geiers generated to the Vaccine Court petitioners and compensated the Geiers. The Geiers received compensation for the benefit they conferred.
That benefit was considerably less than they had envisioned.
Shocking & Disreputable
In his 2017 fees and costs decision in Hooker v. HHS, Chief Special Master George Hastings expressed his amazement that the petitioners and their attorney, the ubiquitous Clifford Shoemaker, would offer both Mark and David Geier as experts following the disciplinary actions taken against them.
The court noted that Dr. Geier’s expert report was prepared in November 2007, about 5½ years before it was filed; that it was prepared prior to completion of the OAP test cases; that it expounded autism causation theories which had already been extensively litigated and roundly rejected; and that Dr. Geier’s license to practice medicine had been revoked.
With respect to the petitioners’ expert reports—including one by petitioner Brian Hooker himself, one by David Geier, a supplemental report by Mark Geier, and reports by Janet Kern, Boyd Haley and Dr. Stephen Smith—Special Master Hastings wrote:
I found that the Petitioners’ experts were very poorly qualified, sometimes scandalously so, and very unpersuasive in their reports. I found that Respondent’s expert reports were quite persuasive. I found that Petitioners’ theory of causation, that SRH was injured by the mercury contained in the thimerosal ingredient of one or more of SRH’s vaccinations, was exactly the same theory rejected at extreme length and detail in the petitioners’ “second theory” “test cases” in the OAP. In short, I found absolutely no merit in any of Petitioners’ causation evidence advanced in this case.… I conclude that Petitioners’ entire presentation of expert reports, medical literature, and the filings of Dr. Hooker himself, were so defective that their presentation was, in essence, frivolous. [emphasis added]
Special Master Hastings went on to discuss Mark Geier’s license revocation, and the Maryland Board of Physicians’ findings about the quality of his patient care—patient care in which David Geier participated.
The first expert report filed was that of Dr. Mark Geier, and it was shocking to me that in 2013 any Vaccine Act attorney would rely on Dr. Geier, for several reasons.
First, in King v. HHS, I found that it would be unreasonable for the Vaccine Program to compensate counsel for paying Dr. Geier and his co-authors for writing a medical article.… Further, exhibits filed in this case show that the Maryland State Board of Physicians (“Board”) suspended Dr. Geier’s license to practice medicine on April 27, 2011, and then revoked that license on August 22, 2012. Even more disappointingly, when Petitioners’ counsel filed a curriculum vitae of Dr. Geier on October 4, 2013, the fact that his medical license had been suspended and later revoked was not mentioned.
Further, those exhibits also showed that the Board, in fact, based its actions against Dr. Geier specifically on a review of Dr. Geier’s medical care for multiple patients afflicted with ASDs. Among the many reasons given by the Board for revoking Dr. Geier’s medical license were: a) his failure to meet basic medical standards for evaluating patients and keeping adequate records; b) his prescriptions of risky “chelation” therapy to patients who did not need chelation; c) his administration of medications not approved by the Food and Drug Administration, without obtaining adequate informed consent, and his failure to properly monitor the outcome of such treatments; and d) his willful falsification of his professional credentials. The Board concluded that Dr. Geier had displayed “an almost total disregard of basic medical and ethical standards,” and that, “in plain words, Dr. Geier exploited these patients under the guise of providing competent medical treatment.”
Further, while Dr. Geier has published many medical articles concerning ASDs, the Institute of Medicine has evaluated a number of these articles and concluded that they are riddled with problems, and thus are essentially without any value whatsoever in terms of contributing to the study of the causation of ASDs.
After Special Master Hastings discussed disciplinary actions taken against Dr. Stephen Smith, David Geier took his turn on the rotisserie:
Petitioners’ counsel also submitted as an “expert” report a report from Mr. David Geier, the son of Dr. Mark Geier. However, David Geier, according to his own curriculum vitae, lacks any sort of medical education or training. In fact, his most significant qualification is a Bachelor of Arts degree, with a major in biology. Further, David Geier was a co-author with his father on most of the medical articles described above, found by the Institute of Medicine to be worthless. I also note that in Riggins v. HHS, Special Master Golkiewicz found that David Geier was “not qualified to serve as a consultant on the medical issues presented in the Vaccine Program.” I reached the same conclusion in King v. HHS.
It was shocking to me that Petitioners’ counsel even filed the reports of Dr. Mark Geier, Dr. Stephen Smith, and David Geier, in light of the above-described rejection by the Institute of Medicine of the works of the two Geiers, the complete lack of qualifications of David Geier, and the condemnations of both Dr. Geier and Dr. Smith by the medical boards of their respective states. [emphasis added]
Special Master Hastings noted that the petitioners’ allegations were “strongly contradicted” by their child’s medical records and admonished them that he had already warned that they risked not being compensated if they continued with “their flawed, rejected, and discredited causation theory.” Ultimately, he disallowed most of the fees and costs application—not only the cost of commissioning expert reports by Mark and David Geier, but any time Mr. Shoemaker spent interacting with Dr. Geier.
I will make no award for fees and costs incurred after [August 2011], except for a small amount awarded for filing the fees and costs application…. I will also disallow most of the hours counsel spent interacting with Drs. Geier and Megson. Based on my discussion of Dr. Geier above, I find that all hours spent dealing with that disreputable individual are per se unreasonable. [emphasis added]
Questionably Competent & Scientifically Unreliable
A dwindling number of post-2017 VICP decisions mention either Mark or David Geier. A January 2022 ruling in America v. HHS (Case 17-542V) disparages a citation made by a petitioner’s expert to the Geiers’ 2017 VAERS study, Quadrivalent Human Papillomavirus Vaccine and Autoimmune Adverse Events, and cites to numerous VICP decisions critical of their research.
In his July 2022 decision in Chambers v. HHS (Case 19-140V) current Chief Special Master Brian Corcoran noted with disapproval the inclusion of studies by the Geiers in a meta-analysis of studies of vaccines and autoimmune conditions, commenting both on their methodological failings, and on their authors’ reputation:
I nevertheless note that the Geiers have repeatedly, and over a lengthy period of time, been deemed to be questionably-competent and scientifically-unreliable experts in the Vaccine Program—casting significant doubt on any studies they have authored.
In his January 2024 ruling in Stricker v. HHS (Case 18-56V), Special Master Christian Moran found that the Geiers’ analysis of VAERS data in their 2015 paper, A case-control study of quadrivalent human papillomavirus vaccine-associated autoimmune adverse events “was questionable and its authors were not trustworthy.” (The special master’s ruling was later affirmed by Judge Richard A. Hertling.)
Shell Game by-the-Sea
Beginning in 2006, David Geier replaced the statement of affiliation in his publications from “President, MedCon, Inc.” to the much more humanitarian-sounding “Vice-President of the Institute of Chronic Illnesses.” Although he would never disclose his affiliation with MedCon, Inc. in any other peer-reviewed publication, Mr. Geier’s consultancy remains a going concern. Tax filings of the Institute of Chronic Illnesses indicate that beginning in 2011—the year Dr. Geier’s license to practice medicine was suspended, the year that David Geier was charged with the unlicensed practice of medicine, and the year the Geier family relocated to Florida— père et fils frequently moved funds between their personal and tax-exempt accounts.
Between 2011 and 2023, over $2,670,000 in donations to the Institute from Mark Geier, David Geier, Anne Geier, and their enterprises MedCon, Genetic Centers of America, ASD Centers, and DAP Pharmaceuticals, were counterbalanced by nearly $1,500,000 in Institute disbursements to Mark Geier, David Geier and MedCon for both “professional consulting” and “medical consulting” services. (ICI’s expenses also included a one-time payment of $355,000 to Anne Geier for “professional consulting”; over $176,000 in rent for the nonprofit, which is located in the Geier family’s oceanside palazzo; and $20,000 to the LLC which holds title to the home.)
In early 2020, MedCon, Inc. board member Clifford Shoemaker was disbarred for embezzling funds from a disabled client’s bank account, first by the Virginia Bar Association, then by the U.S. Court of Federal Claims. With Mr. Shoemaker now in enforced retirement, and with Dr. Geier deceased, it is unlikely that David Geier, B.A. will ever seek validation as an “expert” in a vaccine injury case again. But that is, perhaps, a minor issue now that the unqualified, disreputable HHS Secretary Robert F. Kennedy, Jr. has elevated his equally unqualified, disreputable friend to a paid position at HHS in order to (as Senator Maggie Hassan aptly put it) “relitigate and churn settled science,” or (as sources at the CDC put it), to “prove corruption” at the CDC, or (as I see it) to carry on his unqualified, disreputable father’s mission of sowing unjustified fear and outrage among parents of disabled children and unwarranted suspicion about vaccines.
