Vice President Mike Pence's physician privately raised alarms within the White House last fall that President Donald Trump's doctor may have violated federal privacy protections for a key patient -- Pence's wife, Karen -- and intimidated the vice president's doctor during angry confrontations over the episode.
The previously unreported incident is the first sign that serious concerns about Ronny Jackson's conduct had reached the highest levels of the White House as far back as September -- months before White House aides furiously defended Jackson's professionalism, insisted he had been thoroughly vetted and argued allegations of misconduct amounted to unsubstantiated rumors.
The episode -- detailed in three memos by Pence's physician -- is also the first documentation that has surfaced involving a specific allegation of medical misconduct by Jackson. It adds to a series of significant allegations leveled by unidentified current and former colleagues, including that he casually dispensed prescription drugs.
Jackson and the White House have continued to deny allegations of misconduct, and Jackson's defenders in the White House said Monday that the episode involving Mrs. Pence was simply a dispute between two doctors with a strained relationship and that he had acted appropriately.
According to copies of internal documents obtained by CNN, Pence's doctor accused Jackson of overstepping his authority and inappropriately intervening in a medical situation involving the second lady as well as potentially violating federal privacy rights by briefing White House staff and disclosing details to other medical providers -- but not appropriately consulting with the vice president's physician.
The vice president's physician later wrote in a memo of feeling intimidated by an irate Jackson during a confrontation over the physician's concerns. The physician informed White House officials of being treated unprofessionally, describing a pattern of behavior from Jackson that made the physician "uncomfortable" and even consider resigning from the position.
After Mrs. Pence's physician briefed her about the episode, she "also expressed concerns over the potential breach of privacy of her medical condition," the memo said. Karen Pence asked her physician to direct the vice president's top aide, Nick Ayers, to inform White House chief of staff John Kelly about the matter. Subsequent memos from Pence's doctor suggested Kelly was aware of the episode.
A White House official said that Ayers informed Kelly and White House deputy chief of staff Joe Hagin about the situation and they said Pence's doctor should report the matter through the appropriate medical and military chains of command.
Alyssa Farah, press secretary for the vice president, said Pence's physician "brought the issue to Mr. Ayers, who appropriately referred the matter to the proper channels."
Jackson, who had been Trump's lead physician and was also Trump's pick to head the Department of Veterans Affairs, withdrew his nomination last week after allegations surfaced of professional misconduct. Trump and Jackson have furiously denied the allegations, calling them an attempt to smear the reputation of a Navy rear admiral and respected White House physician.
"He served 3 presidents," Trump said of Jackson Saturday evening at a Michigan rally, decrying "vicious rumors" against him. "President Obama said he was fantastic. President Bush said he was fantastic. I say he's fantastic."