Pubdate: Thu, 09 Dec 2004
Source: Richmond Times-Dispatch (VA)
Copyright: 2004 Richmond Newspapers Inc.
Contact:  http://www.timesdispatch.com/
Details: http://www.mapinc.org/media/365
Author: Paul Bradley

N.VA. JURY SET TO GET PAINKILLER CASE

ALEXANDRIA - A federal jury was asked yesterday to decide between two 
widely disparate descriptions of a prominent Northern Virginia doctor 
accused of fueling a black market in potent prescription drugs.

Did Dr. William E. Hurwitz, as prosecutors alleged in closing arguments, 
look the other way when he learned some of his patients were selling and 
abusing the medications he prescribed for them?

Or, as defense lawyers contended, is Hurwitz a caring, courageous physician 
who was duped by a small number of patients enrolled in a practice that 
helped hundreds of other people deal with their chronic pain?

After a six-week trial and hearing from more than 75 witnesses, the jury is 
to begin deliberations this morning on a 62-count indictment against 
Hurwitz. If convicted of the most serious charges, the McLean doctor could 
be sentenced to life in prison.

The charges against Hurwitz stem from a two-year federal investigation into 
doctors, pharmacists and patients who allegedly marketed in potent 
prescription drugs, primarily OxyContin, a widely abused and highly 
addictive painkiller.

Assistant U.S. Attorney Gene Rossi said Hurwitz was a reckless doctor whose 
therapies hooked some of his patients on drugs and resulted in the deaths 
of at least two of them.

"The defendant was a key factor in making [patients] addicts, sellers and 
diverters," he said. "He gave them the keys to their own destruction."

Rossi added: "The defendant's pain practice was out of control. For many 
patients, the defendant ran a pill mill."

Rossi said Hurwitz repeatedly ignored "red flags and loud gongs" - signs 
that his patients were abusing illicit drugs, such as the appearance of 
needle tracks on their arms. Rossi said Hurwitz was indifferent upon 
learning that some patients had been arrested on drug charges.

Hurwitz, who earned a reputation as an unconventional pioneer in the use of 
potent drugs to combat chronic pain, has run afoul of authorities before. 
He has been disciplined by medical boards in Virginia and the District of 
Columbia for improperly treating pain patients.

Hurwitz has acknowledged that he prescribed massive amounts of painkillers 
to some patients, but insisted he always did so for sound medical reasons.

Defense lawyer Patrick Hallinan said any mistakes Hurwitz has made should 
be handled by those civil boards, rather than in criminal court.

"What this case is about is the question of who sets the medical standards 
for people in this country," he said. "Is it the clinicians, or is it law 
enforcement?"

Hallinan said Hurwitz fell victim to his own conviction that all patients 
with chronic pain are entitled to treatment, even those who have had 
brushes with the law or have drug problems.

A small number of patients abused the doctor's trust by selling or abusing 
legitimate prescriptions, Hallinan said. They later were enlisted as 
informants by the Drug Enforcement Administration as it investigated 
Hurwitz, he added.

Hurwitz "gave these people a credibility they didn't deserve," Hallinan 
said. "His belief in his ethical duty was the key to the door to these 
predators, these thieves. Dr. Hurwitz, unfortunately, was the perfect mark 
for these people."

"He never wrote a prescription that he didn't believe was going to be used 
by that patient to relieve his pain," Hallinan said.

Rossi, noting that Hurwitz has medical and law degrees while most of his 
patients never went to college, implored the jury to reject defense 
assertions that Hurwitz was duped.

"This defendant has a mind like a steel trap," he said.

Hurwitz treated about 300 patients from across the country from the late 
1990s to 2002, receiving a $1,000 initiation fee and monthly fees of up to 
$250 for each patient enrolled in the practice. Much of the evidence 
presented at his trial came from former patients who struck plea deals and 
testified against him.
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