Pubdate: Sat, 18 Nov 2006 Source: Abbotsford News (CN BC) Copyright: 2006 Abbotsford News Contact: http://www.abbynews.com/ Details: http://www.mapinc.org/media/1155 Author: Trudy Beyak JUDGE RENDERS SWANNEY DECISION FRIDAY Christena Constible died of a drug overdose due to the reckless disregard of Dr. James Swanney to protect her life, said Crown lawyer Wendy Dawson on Wednesday. Dawson said Swanney is guilty of criminal negligence causing death as she concluded the case against the former Abbotsford doctor. Justice Brenda Brown is set to render her decision on Friday (Nov. 24). The family physician apologized to the family after she died on May 12, 2000 and acknowledged that he probably shouldn't have given her a second vial of methadone to take home with her, according to testimony given by John Constible, her dad, in B.C. Supreme Court in New Westminister Dawson said this criminal case is not about trying to discourage physicians from prescribing methadone, but is solely about evaluating the standard of medical care given by Dr. Swanney. She recounted evidence given by various medical experts in the courtroom during the six-week trial. Defence lawyers, meanwhile, claimed that Swanney cannot and should not be held responsible for Constible's death (as published in Thursday's Abbotsford News). Swanney is charged with criminal negligence causing death after Constible died due to respiratory depression from a mixed drug overdose of methadone, chloral hydrate and venlafazine. Dawson reminded the judge of the overwhelming evidence of criminal negligence in this case. She said Swanney, as a skilled practicing methadone physician in Abbotsford, should have known that giving a 20 year old woman the starting dose of 40 mg of methadone on May 11, 2000 in combination with the fact that she was abusing other prescription drugs, would have been lethal. Either Dr. Swanney was "minimally informed" or "willfully blind," Dawson said. He should have conducted a urine analysis test to determine if she was abusing other drugs, before he put her on methadone, Dawson said. In addition, he should not have given his patient used methadone that had been returned to him by another patient, she said. Dawson painted a picture of a young woman spiraling into a desperate downward cycle after she went off methadone on March 17, 2000. She ended up in MSA General's psychiatric ward from April 4 to April 8 and again on April 16 for another 10 days. At this point, Swanney must have known that the methadone Constible had previously taken would have been totally out of her system, Dawson said. Meanwhile, he prescribed various anti-depressant and anti-anxiety drugs to Constible. On May 11, when Christena Constible and her mom Carolyn came to his office to see him, they were both shocked that Swanney decided, abruptly, to put Christena back on methadone, according to the mother's testimony. Swanney made a unilateral decision, Dawson said, without consultation with Christena or doing a urine analysis. He gave her 20 mg of methadone that afternoon and another 20 mg to take home with her. This, said Dawson, was in contradiction to the opinion of respected experts who testified that it is always advisable "to go slow and to go low" on the beginning dosages of methadone. Several medical experts testified that the starting dose of methadone for Constible should have been in the range of 10 mg. The amount of methadone Swanney gave to Constible was significant, Dawson said, adding that the evidence throughout the trial implicated that the starting dose was the problem and the cause of her death. On another matter, Dawson said the judge should not give much weight to the testimony of another Abbotsford doctor, Dr. James Zacharias, who spoker earlier in the trial. He is biased and a friend of Swanney's, Dawson said. "He criticized anyone who dared to criticize Dr. Swanney," she said, noting his hostility on the stand. In addition, she said that Zacharias had also been under investigation by the College of Physician and Surgeons for his prescription practices. In fact, Zacharias was so bold that he said he would be non-compliant and defy the guidelines set by the college, Dawson said. n In 2004, the B.C. College of Physicians and Surgeons removed Swanney's name from the medical registrar, barring him from practicing medicine in B.C. The College also imposed a fine of $13,500 after two patients - Constible and Mission RCMP Const. Don King - died in 2000 due to prescription drug overdoses. Meanwhile, Swanney still owes money to the B.C. Securities Commission (BCSC). He was fined $35,000 in 2002 for perpetrating fraud on an investor in a scam involving a failed private surgical hospital. Swanney was the director of Specialized Surgical Services Inc, a company that the BCSC said made misrepresentations in soliciting more than $1.3 million from local investors for a proposed private surgical hospital in Coquitlam. The fine remains unpaid, according to BCSC. Swanney moved to Scotland earlier that year to practice medicine at the Portree Medical Centre on the Island of Skye. - --- MAP posted-by: Elaine