## American Society of Regional Anesthesia Targets Cardiac Anesthesiologist With C&D Over Free Guidelines Reference App
The American Society of Regional Anesthesia (ASRA) has sent a cease and desist letter to Dr. Rishi Kumar, a cardiac and ICU-trained anesthesiologist, demanding he shut down a free mobile application he developed based on the society's publicly available anticoagulation guidelines for regional anesthesia procedures. The dispute centers on guidelines governing the timing of anticoagulant medications before and after interventional pain procedures—a critical safety reference for anesthesiologists and pain specialists nationwide.

ASRA historically offered its official mobile reference app for a one-time fee of approximately $5-6, marketed as a lifetime subscription. Roughly a year ago, following publication of updated guidelines, the organization transitioned to a $7 annual subscription model. Notably, this change applied even to users who had previously purchased lifetime access. According to reports, individuals who reached out to ASRA's administrative staff were offered either a one-year access voucher or a refund. Dr. Kumar subsequently developed an independent free application, funded entirely out of pocket for hosting costs, synthesizing the same publicly available guideline information.

The cease and desist raises questions about the intersection of publicly accessible medical guidelines and commercial access models. ASRA's guidelines, while developed through a professional society process, are positioned behind a paywall in their official digital distribution channel. The legal basis for restricting a third party from independently presenting public information in a different format remains unclear. The case has drawn attention within medical communities for its implications on guideline accessibility, physician-developed open resources, and the financialization of clinical reference materials that practitioners argue should prioritize patient safety and clinical utility over subscription barriers.
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- **Source**: r/medicine
- **Sector**: The Lab
- **Tags**: ASRA, medical guidelines, cease and desist, regional anesthesia, anticoagulation
- **Credibility**: unverified
- **Published**: 2026-05-15 00:48:21
- **ID**: 83246
- **URL**: https://whisperx.ai/en/intel/83246