Telemedicine startup Cerebral Inc. had a goal of prescribing stimulants to 100% of its ADHD patients and engaged in other practices that prioritized growth over patient safety, a lawsuit filed by a former executive claims.
Matthew Truebe, who was vice president of product and engineering for about one year starting in February 2021, sued the company for wrongful discharge after he says he was fired for challenging the company on its practices.
The lawsuit, first reported by Bloomberg Law, was filed in California Superior Court in April 27. Truebe is seeking unspecified damages.
San Francisco-based Cerebral offers mental health services and diagnoses and writes prescriptions for ailments like depression, anxiety and ADHD via its telehealth app. Treatments can include controlled substances like stimulants and benzodiazepines.
Truebe's lawsuit claims the company tracked retention rates of ADHD customers and found that those who received prescriptions for stimulants were more likely to continue using the service, while those that were denied prescriptions for controlled substances were less likely to continue using it. The directive, the lawsuit alleges, came from the chief medical officer.
"Mr. Truebe told the CMO that this was not safe or legal, and that stimulants, which are addictive, should not be prescribed for purely business reasons, such as to increase Cerebral’s customer retention," the suit states.
The company denied the claim in an email, saying that it does not set any target prescription percentages for its clinicians or clients and uses a comprehensive approach for assessing prescriptions with safety measures that "even surpass practices at certain brick-and-mortar clinics across the country."
Cerebral, founded in 2019, said the claims are without merit. "We intend to vigorously defend this matter," a spokesperson said in a statement provided to the Business Times.
Truebe also claimed in the suit that the company had 2,000 duplicate shipping addresses for prescription accounts, which could imply that patients are creating more than one account to receive double the prescribed medication. He says when he brought the issue to Cerebral CEO Kyle Robertson he was told it was a low priority, his lawsuit states.
Cerebral says it tracks, monitors and deletes all duplicate accounts and has automated safeguards to prevent this problem.
The lawsuit also alleges that Robertson told Truebe to put all of his technological resources behind customer acquisition and retention, and none behind compliance with state and federal laws. The former VP alleges in his suit that the company's leadership declined to take action when he alerted them that there was a data breach of tens of thousands of sensitive patient records, his suit claims.
Patient safety incidents like overdoses and suicidal ideation were often not followed up on in a timely matter or not at all, the suit claims.
Truebe claims he was put on administrative leave after refusing to sign a document that would amend his employment contract, retroactively reduce his stock options and bar him from speaking out about practices inside the company. He says he was later fired by the CEO one day before his stock vested.
Cerebral has raised over $460 million to date and has a valuation of $4.8 billion. Last year the company hired Olympic gymnast Simone Biles as its "chief impact officer," a vaguely defined role startups often give to celebrities to be the face of their brand. The company heavily markets on social media sites like TikTok, Instagram and Facebook to grow its customer base that pay subscriptions to access prescribers, therapists and other mental health services.
We previously wrote last month about Cerebral and other telemedicine startups sprouting up around the Bay Area and how their business model of high growth and aggressive marketing may be blurring ethical lines surrounding patient care, especially concerning controlled substances like stimulants.
