Since at least April 2021, the Montana medical licensing board has had evidence, including thousands of pages of patient files and medical reviews, that Dr. Thomas C. Weiner, a popular Helena oncologist, had hurt and potentially killed patients, ProPublica and Montana Free Press have learned. Yet in that time, the board renewed his medical license — twice.

Weiner directed the cancer center at St. Peter’s Health for 24 years before he was fired in 2020 and accused of overprescribing narcotics, treating people who didn’t have cancer with chemotherapy and providing substandard care. Weiner, who has denied the allegations, was the subject of a December ProPublica investigation, which revealed a documented trail of patient harm and at least 10 suspicious deaths. Many of the records cited in the story had been in the medical board’s custody for nearly four years, St. Peter’s recently confirmed.

The Board of Medical Examiners renewed Weiner’s medical license in March 2023 and this month, authorizing him to treat patients and prescribe drugs. While lawyers for the state agency that oversees the medical board collected records from the hospital under subpoena, including medical reviews that criticized Weiner’s care, that inquiry languished at the staff level, according to one current and one former board member. It’s unclear why Weiner’s case was not elevated to the governor-appointed board members.

Sam Loveridge, a spokesperson for the Department of Labor and Industry, the board’s umbrella agency, did not answer a list of emailed questions, including whether the records provided by the hospital were reviewed by members of the board.

Kathleen Abke, a lawyer representing St. Peter’s, told ProPublica and Montana Free Press that the hospital initially surrendered to the licensing board 160,000 pages of documents relating to the care of 64 patients; the state received those records in early 2021, just months after Weiner was fired.

As part of the subpoena, St. Peter’s supplied the medical records of Scot Warwick, whom Weiner diagnosed with Stage 4 lung cancer in 2009. Even though there had not been a lung biopsy to confirm that Warwick had the disease, Weiner proceeded to give him chemotherapy and other treatments for 11 years. After Warwick died in 2020, an autopsy — which St. Peter’s said it gave to the medical board — found no evidence of cancer. Weiner maintained the patient had terminal cancer for 11 years and said a pathologist and post-mortem medical examiner missed the disease.

Lisa Warwick, Scot’s widow, sued St. Peter’s for his wrongful death and settled for an undisclosed amount. Warwick learned from ProPublica and Montana Free Press this month that the state had her husband’s records and other evidence for years. She called the situation “appalling.”

“I would just like to know what information they’re reviewing that sways their determination to renew this man’s license,” she said. “Because if they are truly doing their job and are reviewing these things and looking at all the cases that have been brought forth — the people who have died, the circumstances under which they died — there is no way they can justify renewing this man’s license.”

Anthony Olson, another Weiner patient who inappropriately received chemotherapy for nearly a decade, expressed shock when he learned Montana regulators had information about his case as early as 2021. Three biopsies confirmed that Olson never had cancer, according to court and medical records. That chemo created severe health complications for Olson.

“So they just really don’t care?” Olson asked. “It gives me the shakes. My heart’s racing, and I literally don’t know what to feel right now.”

Weiner blamed other doctors for Olson’s misdiagnosis but acknowledged he received toxic treatments “needlessly.”

In Montana, medical licenses are up for renewal every two years. A few months after the board renewed Weiner’s license in 2023, its staff subpoenaed the hospital for additional records. Abke said St. Peter’s provided the board with thousands more internal documents and medical reviews. Yet, she said, no one from the hospital was called by the board to testify about Weiner’s practices.

St. Peter’s confirmed that the second tranche included the medical records of Nadine Long, a 16-year-old girl who, court and medical records show, died in 2015 shortly after Weiner ordered the injection of a large amount of phenobarbital, a powerful sedative. Weiner has denied wrongdoing in the case. Maintaining that the girl’s condition was terminal, he said he was providing comfort.

St. Peter’s also reported Weiner’s removal to the National Practitioner Data Bank and alerted the federal Drug Enforcement Administration to his alleged narcotics practices, according to records and interviews.

“We provided information to every entity that had the ability to do something about this,” Abke said. “St. Peter’s took these allegations extremely seriously.”

Dr. James Burkholder, a member of the medical licensing board from 2016 to 2023, told ProPublica and Montana Free Press that Weiner’s name “never came up” during board deliberations. Burkholder, a retired family doctor from Helena, said he’s certain the case didn’t reach the board level because he knows Weiner professionally and would have recused himself. He also served on the screening subcommittee that would have first reviewed the state’s investigation into Weiner and passed it up to the full board to be adjudicated.

Dr. Carley Robertson, a current board member, said she’s never heard of Weiner.

It’s unclear how many complaints have been filed against Weiner, as the medical board keeps information about cases that weren’t substantiated secret. ProPublica and Montana Free Press confirmed that at least one licensing complaint against Weiner, filed in 2021, was pending for three years before being dismissed in December.

A few months after reading local news reports about Weiner being fired by St. Peter’s, Marilyn Ketchum decided to act on concerns about her husband, Shawn Ketchum, who died back in 2016 while under Weiner’s care. After reviewing his medical records, she told the board that Weiner altered her husband’s code status without permission. If his heart stopped, he wanted to be a full code, she said, meaning he wanted to be resuscitated. Instead, when he was rushed to the hospital, Weiner maintained that Ketchum was a DNR/DNI — do not resuscitate and do not intubate — his medical records show. Ketchum died without intervention soon after, according to the records.

In its internal reviews of Weiner’s care, St. Peter’s alleged that unilaterally changing patients’ code status was a “standard practice” of his, which it called “a serious violation of the standard of care and medical ethics.” Weiner did not respond to questions about Ketchum’s case and has denied that he ever changed a patient’s status without permission.

Ketchum, who now lives in Arkansas, said a state employee did not interview her until two years after she made a complaint against Weiner’s license. “I was on their ass to do something about it,” Ketchum said, emailing or calling someone from the labor department “every couple of weeks.”

In a letter sent in late 2024, the board provided no explanation for why it had dismissed her complaint.

Weiner has said he’s not currently treating patients because he can’t get malpractice insurance.

Following the ProPublica investigation published in December, the Montana Department of Justice launched a criminal inquiry into Weiner, according to three people with direct knowledge of the case. Weiner has not been charged with a crime. In separate cases last year, the U.S. Department of Justice sued Weiner and the hospital, alleging they defrauded federal health care programs. The hospital settled for $10.8 million. Weiner has denied the allegations through an attorney and petitioned the court to dismiss the case.

Last month, Weiner lost an appeal of a yearslong court battle over his firing. The Montana Supreme Court ruled that the hospital’s actions were “reasonable and warranted due to the quantity and severity of Weiner’s inappropriate patient care.”

Still, since Weiner’s firing, many Helena residents continue to defend him, including by funding billboards that proclaim “WE STAND WITH DR. WEINER.” Weiner’s supporters, often citing his renewed medical license, have accused the hospital of orchestrating a smear campaign against a dedicated oncologist. Since the winter of 2020, they’ve held protests outside of the hospital.

Abke said many St. Peter’s employees are exhausted by the blowback from Weiner’s supporters and are working to regain trust in Helena. Asked about concerns that the hospital unfairly targeted Weiner, Abke said, “No hospital would want to take the financial, the PR, the personal hit for no reason.”