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On May 4, 2021, MedPage Today first reported on an Illinois judge's order for a hospital to give ivermectin to a comatose COVID-19 patient. As part of our review of the year's top stories, we look back on what has happened since this decision and the numerous cases that followed in its wake.

At the beginning of 2021, the anti-parasitic medication ivermectin took off in popularity as a treatment for COVID-19 after a campaign from the physicians at the helm of the Front Line COVID-19 Critical Care Alliance (FLCCC) touted its efficacy. Despite lack of evidence and recommendations against its use from the CDC, FDA, and NIH, some doctors and family members of COVID patients have taken the issue to court, suing hospitals that have refused to administer ivermectin in serious COVID cases.

New York

The first of these cases cropped up in January 2021, when a judge in Buffalo, New York, to give ivermectin to 80-year-old Judith Smentkiewicz. She had been on a ventilator battling COVID-19 when her family members pleaded with one of the hospital's physicians to try ivermectin. Smentkiewicz received her first dose before another doctor at the hospital refused to continue the treatment.

Smentkiewicz's family maintained that even the first dose of the experimental drug made rapid improvements to her condition, which subsequently declined after the second dose was refused. The hospital insisted that doctors -- not the courts -- should be at the forefront of these decisions. State Supreme Court Judge Henry Nowak, however, went the way of Smentkiewicz's family members.

It is reported that Smentkiewicz recovered after resuming her treatments, but the connection between ivermectin and her turnaround remains unclear. Some clinicians have argued that patients might just be getting better, with or without this particular drug.

Illinois

The same was seen in May 2021, when Judge James Orel, of DuPage County, Illinois, ordered Edward-Elmhurst Hospital to allow 68-year-old Nurije Fype to receive ivermectin as a treatment for her acute COVID illness.

Fype's daughter, Desareta, learned of the drug after reading about Smentkiewicz's situation months prior. When her own mother was placed on a ventilator, she sought out ivermectin. Doctors refused, given the drug's experimental status for COVID-19 and , including nausea, vomiting, diarrhea, sudden drops in blood pressure, and liver injury.

Bending to the judge's orders, the hospital granted internist Alan Bain, MD, credentials to give Fype ivermectin. According to , she was discharged from the hospital after her condition improved. Still, whether ivermectin was what prompted Fype's recovery has yet to be proven.

In September 2021, the American Medical Association (AMA) issued a statement the use of ivermectin to treat COVID-19, adding that "calls to poison control centers due to ivermectin ingestion have increased five-fold from their pre-pandemic baseline."

Not all of the legal battles against hospitals in the fight for ivermectin have been successful, though. In September, MedPage Today reported that a judge sided in favor of Memorial Medical Center in Springfield, Illinois, which stood firmly against allowing ivermectin treatments for COVID patients. Anita Clouse, wife of 61-year-old Randy Clouse, took to the courts to force Memorial Medical Center to give her husband ivermectin.

Randy Clouse, who wasn't vaccinated against COVID-19, was on a ventilator and dialysis as a result of his COVID infection, the reported. But in a legal response, the hospital said that Clouse's condition was improving at the time of their filing and he no longer had an active COVID diagnosis.

Chicago internist Bain had prescribed ivermectin to Clouse and testified in a hearing for the case. The lawyer representing the Springfield hospital maintained that Bain did not properly review Clouse's medical history before prescribing the drug and that he refused to acknowledge the widespread medical advice regarding the use of ivermectin for COVID-19 patients.

Attorney Ralph Lorigo, who represented Clouse and a number of other patients, told MedPage Today that, as of Nov. 3, Clouse was taken off the ventilator and later discharged from the hospital.

Lorigo also represented Man Kwan Ng, the daughter of 71-year-old Sun Ng, in a case against Edward Hospital in Naperville, Illinois. Sun Ng ended up on a ventilator with COVID-19 in mid-October, the . Despite the hospital's refusal to turn to ivermectin -- citing the same safety and efficacy concerns as health officials -- a DuPage County Judge ruled that Bain, who is unvaccinated, could prescribe Ng with ivermectin.

According to the , Lorigo said Ng removed his breathing tube himself after 5 days of ivermectin treatment. The lawyer for Edward Hospital, however, said Ng was improving before the treatment even started.

Ohio

At the beginning of September, what at first looked like a win for ivermectin proponents turned out to be a loss in the case of Julie Smith, who filed suit against West Chester Hospital, located near Cincinnati, to allow the use of ivermectin after her husband, Jeffrey Smith, 51, was placed on a ventilator and diagnosed with a secondary infection, the .

Although a Butler County judge originally ruled in favor of the Smith family against the hospital's wishes, the ruling was later by a different judge after physicians told the court that ivermectin was not helping Smith get better, NPR reported.

Fred Wagshul, MD, who is affiliated with the Front Line COVID-19 Critical Care Alliance, had prescribed ivermectin to Smith before the hospital's refusal. At the follow-up hearing, Wagshul testified that he wasn't sure if the drug would help Smith, ultimately convincing the judge to reverse the order.

"After considering all of the evidence presented in this case, there can be no doubt that the medical and scientific communities do not support the use of ivermectin as a treatment for COVID-19," Judge Michael Oster .

According to , Smith died a few weeks later.

Kentucky

In a similar decision from mid-September, Jefferson Circuit Court Judge Charles Cunningham overruled a previous ruling from a different judge, ultimately permitting a hospital to deny the prescription of ivermectin to a COVID patient.

Angela Underwood had filed a suit against Norton Brownsboro Hospital in Louisville, Kentucky, claiming that the hospital prohibited one of its physicians from administering ivermectin to her husband, Lonnie, 58, despite a previous agreement.

"[The internet] is rife with the ramblings of persons who spout ill-conceived conclusions if not out-right falsehoods," Cunningham said, according to a . "If [Angela Underwood] wants to ask the Court to impose her definition of 'medically indicated' rather than the hospital's, she needs to present the sworn testimony of solid witnesses, espousing solid opinions, based on solid data."

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