Pubdate: Thu, 16 Dec 2004
Source: McLean Connection (VA)
Copyright: 2004 Connection Newspapers
Author: Ken Moore
Bookmark: (Chronic Pain)
Bookmark: (Oxycontin/Oxycodone)


Jury Finds McLean Pain Doctor Guilty On 50 Counts.

After hearing 21 days of testimony, 76 witnesses and exhibits from 31
notebooks containing thousands of pages of documents, an Alexandria
jury of seven men and five women convicted Dr. William E. Hurwitz, 59,
of 50 of the 62 counts charged against him. The jury deliberated more
than 30 hours to determine whether prescriptions Hurwitz wrote for
chronic pain patients, some who turned out to be criminal drug
dealers, some addicted to opioids including OxyContin, warranted
locking the McLean 'pain doctor' in federal prison. Most counts carry
a possible 20-year sentence, meaning Hurwitz faces the rest of his
life in prison.

He will be sentenced in February or March of 2005, and his attorneys
have until Feb. 1 to file their appeal. "There will be an appeal, no
question about that," said Senior Judge Lenord D. Wexler, who presided
over the case.

"I was engaged morning, noon and night in my practice. I bent over backwards
in terms of being available to my patients as much as I possibly could
have," Hurwitz said Monday, Dec. 13, as the jury deliberated over his fate.
"I felt I was doing the best I could as a doctor to relieve pain." Many past
patients came to the United States District Court in Alexandria to offer
support the last six weeks of his trial. "I know, in my mind, I did
everything in good faith to help people," Hurwitz said.

Hurwitz, who closed his practice in December 2002, faced a 62-count
indictment, including charges of conspiracy to traffic in controlled
substances, drug trafficking resulting in death and serious bodily
injury, drug trafficking distributions, engaging in continuing
criminal enterprise and health care fraud.

The jury found him guilty of all types of charges except for health
care fraud. Hurwitz's trial was not the typical case involving someone
charged with conspiracy to distribute drugs. The prosecution never
claimed that Hurwitz directly profited from illicit drug sales. His
attorney Patrick Hallinan told the jury that Hurwitz's salary -
$286,000 in 2001 and $317,000 in 2002 - was hardly extravagant for a
Washington area physician, and small when compared to the amounts of
money some former patients, now facing jail time, said they made
selling the pills he prescribed. "What in the devil is the motive in
this case?" said Hallinan, during closing arguments on Wednesday, Dec.
8. "What did Tim Urbani get, he made $3 million [selling Dr. Hurwitz's
pills,] Robert Woodson made $750,000 in two years. Where's the split?

Where's the conspiracy? Where's the motive?"

The 1,879,677 Pills Hurwitz prescribed for just 24 of the 400-plus
patients he treated from 1998-2002 led to drug addiction, drug
dependency and death, according to Assistant U.S. Attorneys Eugene
Rossi and Mark Lytle. Because Hurwitz continued to prescribe
medication to addicts who turned out to be selling many of their
pills, and because he prescribed high doses without properly
monitoring patients, he posed such a great a danger that he should be
convicted as a drug dealer, argued the prosecutors. "It is about
reality, about the patients becoming hopelessly addicted and the
reality of the patients selling the pills," Rossi said during closing
arguments Wednesday, Dec. 8. Rossi and Lytle presented 63 witnesses
during the first 15 days of the trial, which included police officers,
police detectives, forensic toxicologists, pain doctors, emergency
rescue paramedics, emergency room physicians, Medicaid officials,
benefit managers, patients convicted of selling prescribed pills, past
patients who became addicted, and loved ones who watched the impact
pain killers had on their family's lives. "We are here because Linda
Lalmond and Rennie Buras are not," Rossi said in closing statements,
referring to two patients who died during treatment by Hurwitz from
1998-2002. More than 60 people came to the courtroom to hear to
Rossi's closing argument, including David Lalmond, Linda Lalmond's
husband, Rennie Scott Buras II, 24, the son of Rennie Buras, and Paul
"Andy" Nye, the husband of Mary Nye, whose daughters have filed a
civil wrongful death suit against Hurwitz. All three men sat next to
each other during Rossi's closing arguments. Lalmond and Nye both cried.

Prosecutors acknowledged the care Hurwitz provided to many patients,
including Molly Shaw, Sylvester Boyd and Dr. William Fleischaker - who
say Dr. Hurwitz saved their lives. But the trial, according to Rossi,
was about ruined lives, lives that could have been saved if Hurwitz
recognized the "red flags" or warning signs of abuse, and terminated
such patients, as the government's expert witness Dr. Michael Ashburn
testified Hurwitz should have done. Hurwitz was sanctioned by the DC
Board of Medicine in 1991 and the Virginia Board of Medicine in 1996.
Some of the cases in the 1996 order were similar in nature to the
charges covered in the trial.

Lives would also have been saved if Hurwitz followed the lessons he
learned in the 1996 course, "The Drug Seeking Patient," taught by Dr.
William Vilensky, Rossi said. The Virginia Medical Board ordered
Hurwitz to take Vilensky's course after his license was revoked.

Hurwitz scored the highest on the examination at the end of the
course, but when Hurwitz went back from the classroom to the doctor's
office, he didn't translate the lessons learned, prosecutors said.
Bret McCarter, 39, for example, requested 45 early refills for
prescriptions, and testified that he used women's make-up on his arms
to cover track marks from injecting medications. "At the end, he would
always continue writing the prescriptions," McCarter testified.
"Regulatory authorities bent over backwards to try to get the
defendant to do the right thing and every time he came to the fork in
the road, he did the wrong thing and he did it time and time again,"
Rossi said.

Approximately 15 former patients convicted of conspiracy to distribute
OxyContin prescribed by Hurwitz, most from Manassas and many related
to each other, testified against their former doctor. Cindy Horn, 43,
testified that her life improved when she went to jail for selling
pills and was forced into detox from OxyContin. "After I got off the
pills, I felt like I was 18 again," Horn testified. Many blame
Hurwitz, such as Timothy Urbani, 34, who is sentenced to 20 years in
prison. "I wasn't there for my kids for three to four years, now I
won't be there for a long time." One patient, Kevin Leroy Fuller, 42,
called Hurwitz naive, but a doctor who was always concerned; Fuller
still calls Hurwitz his friend. All said they had fooled doctors in
the past to get OxyContin and other pain pills. "These are pros and
Dr. Hurwitz never had a chance," said Hallinan. Prosecutor Rossi had a
different interpretation. "You let all those patients jeopardize your
entire practice, true?" Rossi asked during his cross-examination of
Hurwitz, when the doctor took the witness stand Dec.6-7. "True,"
Hurwitz said. "The effects were foreseeable, true?" Rossi asked. "No,
I didn't foresee it," said Hurwitz.

Pain doctors who don't get duped once in a while, probably aren't
treating pain aggressively enough, according to Dr. Steven Passik, an
expert witness for the defense, following his testimony.

Passik is the director of Symptom Management and Palliative Care at
the Markey Cancer Center in Lexington, Ky. But about 10 percent of
Hurwitz's patients, according to his former nurses Susan Cruz, of
Herndon, and Ann Wierbinski, were problematic patients who they wanted
out of the practice.

Cruz testified that Hurwitz told her they might be exhibiting a social
bias against these patients; Wierbinski testified that Hurwitz thought
he could treat their pain while also treating their addiction.
"Predators," say Hurwitz's attorneys Hallinan, Marvin Miller and
Kenneth Wine. Although certainly not saints, these patients were
"human beings [who] didn't deserve the treatment they received," Rossi

Doctors, pain patients and pain advocates across the country expressed
outrage over the conviction of the Northern Virginia doctor's case.
"Doctors have been given the notion that you, as a physician, will be
held criminally responsible if a patient turns out to have a substance
abuse problem or addiction," said Siobhan Reynolds, president of Pain
Relief Network. "How are they supposed to know? The Drug Enforcement
Agency seems to be requiring for physicians to drug test all potential
patients, to do background checks, and look at fixable income to
assure to protect themselves, if they were crazy enough to treat
chronic pain patients." The damage, Reynolds says, will ultimately
harm the legitimate patients with chronic pain, which the Association
of American Physicians & Surgeons estimates to be 50 million people.
"The more they scare off the doctors, what happens to the millions
like me?" said Sylvester Boyd, a past patient, after testifying in
support of Hurwitz on Dec. 2. Molly Shaw flew from New Mexico to
Northern Virginia to see Hurwitz because doctors in her state were too
fearful to prescribe Dilaudid to her control migraines, she testified.
Dr. William Fleischaker, a retired physician, flew from Arizona to be
treated by Hurwitz. "Look what happens when law enforcement sets the
standards," Hallinan said. "What's the matter with medicine?"
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MAP posted-by: Larry Seguin