HTTP/1.0 200 OK Content-Type: text/html Panhandle Doctor's OxyContin Conviction To Send Message
Pubdate: Wed, 20 Feb 2002
Source: Denver Rocky Mountain News (CO)
Copyright: 2002, Denver Publishing Co.
Author: Bill Kaczor Associated Press Writer
Bookmark: (Oxycontin)


A doctor's manslaughter convictions for overdose deaths from the painkiller 
OxyContin should make physicians more cautious about their prescribing 
practices, a federal drug official said Wednesday.

The prosecution of Dr. James Graves, convicted Tuesday in the deaths of 
four patients, was part of a national crackdown on the abuse of 
prescription drugs. He was convicted in state court in nearby Milton.

"It's going to send a very strong message to the medical community that 
they treat these very potent drugs _ to include OxyContin but there are 
others _ with respect," said Laura Nagel, head of diversion control for the 
Drug Enforcement Administration.

Graves, 55, of Pace, was the first doctor in the nation convicted of 
manslaughter or murder for deaths from OxyContin. He is facing a maximum of 
15 years in prison on each of four counts of manslaughter and five counts 
of unlawful delivery of controlled substance. He also faces 30 years for 

At least two other doctors are facing charges of causing the deaths of 
patients who took OxyContin. Dr. Frank Fisher is set for trial next week in 
Redding, Calif., on three manslaughter counts, and Dr. Denis Deonarine of 
West Palm Beach, Fla., could face a death sentence if convicted of 
first-degree murder in an overdose death. No trial date has been set for 

Dr. Theodore Parran, a specialist in internal and addictive medicine who 
testified against Graves, expects more manslaughter prosecutions.

"My impression is that prosecutors have generally felt unwilling to push 
the manslaughter side of this because of not really having a game plan on 
how to make a manslaughter charge stick," he said.

The Graves case gives them a "roadmap," said Parran, who is on the medical 
school faculty at Case Western Reserve University in Cleveland.

In most cases doctors accused of overprescribing have been charged with 
crimes such as insurance fraud or illegal distribution.

The DEA, working with state law enforcement agencies, in recent years has 
focused more attention on prescription drugs partly because of OxyContin. 
The agency blames OxyContin alone for 117 deaths in the past two years and 
suspects it is the likely cause in 179 others.

"It cannot be ignored," Nagel said. "People are dying."

Nagel said most physicians have nothing to worry about.

"Doctors that are operating and doing everything appropriately, they'll 
never see us," she said.

Parran agreed, saying "This isn't going to have a chilling effect on 
anybody except for felons." He characterized Graves as a rare "dishonest 
doc" out to make money from addicted or dependent patients by keeping them 
coming back for more prescriptions.

Dr. William Hurwitz, a pain management physician in McLean, Va., has a 
different view and is worried that legitimate doctors also have reason to 
worry because of the verdict.

"There's almost a standard of strict liability for any mistakes that are 
made or deviations in proper behavior by patients," Hurwitz said. "That has 
a chilling effect and should have a chilling effect on primary care 
physicians to sort of venture tentatively into managing pain."

Graves, a Kentucky native, was a general practitioner but began 
specializing in pain management a couple years before he was arrested in 2000.

Hurwitz said pain management doctors should protect themselves by keeping 
meticulous records and closely monitoring patients. Some may avoid young 
and lower-class patients because they are more prone to being drug abusers, 
he said.

Timothy Bannon, a spokesman for Purdue Pharma, which makes OxyContin, 
declined comment on the Graves case but said the Stamford, Conn.-based 
company, is vigorously defending itself against lawsuits prompted by 
overdoses and deaths.

"We believe them to be baseless and motivated in many cases by money," 
Bannon said. "We also feel that these cases can threaten the appropriate 
care given to patients by their physicians."

The company has cited the voluntary withdrawal of three suits in 
Mississippi, Maine and North Carolina over the past couple months.

Bannon said Purdue Pharma also is committed to spending $100 million by the 
end of the year on developing an abuse-resistant alternative to OxyContin.

Addicts defeat OxyContin's 12-hour time release mechanism and get a 
heroin-like high by chewing the tablets or crushing them and then snorting 
or injecting the drug.
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