Bud Dickman
2004-12-28 16:46:08 UTC
Some past patients say Dr. William E. Hurwitz saved their lives.
Before he found Hurwitz on the Internet, Sylvester Boyd testified
Friday, Dec. 3 that he suffered 12 years with "constant, nagging,
unrelenting pain just pain, pain, pain it nearly destroyed my
life."
"I was at the end of my rope. It gets to a point where shockingly
suicide is not an option you're willing to dismiss," testified Boyd,
50, who suffered bone fractures, muscle and cartilage tears in his
back during a fall at an ice skating party he held for his daughter
about 15 years ago.
Boyd was not the only grateful patient.
"Dr. Hurwitz saved my wife's life, said Charles Barnhart, of New
Mexico, following his wife Molly Shaw's testimony last Thursday. "I
hope she got to the jury; I know every time she talks about it, it
gets to me."
[Top of Page]
PROSECUTORS DON'T DISCOUNT the care some patients received from
Hurwitz, 59.
But the 1,879,677 pills prescribed by Hurwitz to 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 J. Rossi and Mark D. Lytle.
Kilee Hoskin's uncle, Rennie Buras of New Orleans, died in 1999, under
treatment by Hurwitz. "This man built planes and boats and things with
his bare hands," testified Hoskin, 25, during the third week of
Hurwitz's trial, which began Thursday, Nov. 4. "[Paramedics] thought
he was retarded, that's how the pills affected him."
Prescriptions Hurwitz wrote for OxyContin, including the 68,700 total
pills he prescribed for Bret McCarter and the 63,530 pills Hurwitz
prescribed for Kevin Fuller, led to illegal drug sales in Manassas,
other parts of Virginia and Tennessee, according to prosecutors.
More than 15 convicted felons, most from Manassas and many related to
each other, testified against Hurwitz.
"I think he enjoyed it. I think he lived vicariously through us,"
testified Timothy Urbani, 34, who faces 20 years in federal prison for
charges including conspiracy to distribute OxyContin and robbery of
OxyContin from a pharmacy. "At the time, I thought [the pills] were
helping me, but I'm in all this trouble now. I wasn't there for my
kids for three to four years, now I won't be there for a long time."
Hurwitz's defense attorneys Patrick S. Hallinan, Kenneth H. Wine and
Marvin D. Miller called the convicted dealers "predators" who abused
the doctor's trust, lying about or exaggerating their pain to obtain
drugs from the nationally-known doctor who specialized in high-dose
opioid therapy for people with unrelenting chronic pain.
[Top of Page]
FOLLOWING 19 DAYS of testimony, from 63 witnesses for the prosecution
and nine witnesses for the defense, Hurwitz took the stand on Monday,
Dec. 6, in the United States District Court for the Eastern District
of Virginia before Senior Judge Leonard D. Wexler.
Hurwitz testified Monday that he showed all potential patients
literature suggesting that "opioid treatment is not for everyone."
"It was an attempt to discourage people from opioid therapy unless
they have exhausted other options," Hurwitz testified. "I wanted
patients to understand that treatment with opioids was a complicated
practice with risks."
Hurwitz, who closed his practice in December 2002, faces a 62-count
indictment, including charges of conspiracy to traffic in controlled
substances, drug trafficking resulting in death, drug trafficking
resulting in serious bodily injury, drug trafficking distributions,
engaging in continuing criminal enterprise and health care fraud.
Still posted on Hurwitz's Web site is a request to patients,
foreshadowing the possible 20 years in jail or more that he faces for
each count of the indictment.
"More than in most clinical circumstances, the failure of patients to
act intelligently, responsibly and honestly can lead to disaster,"
reads the Web site. "For all of these reasons, patients who undertake
opioid maintenance therapy should behave in a way that is beyond
reproach or suspicion in all matters relating to their use of
medications. Patients who are unwilling or unable to do so jeopardize
not only their own health and safety, but the health and safety of
other patients with chronic pain."
Advocates for patients with chronic, severe pain are watching the
trial closely. The treatment of pain is a human rights issue, said
Mary Baluss, director of the Pain Law Initiative, who has attended
most of the trial.
"I'm worried that high-profile trials will have a negative impact on
the treatment of pain," said Dr. Steven Passik after serving as a
witness for the defense.
[Top of Page]
THROUGHOUT THE TRIAL, prosecutors Rossi and Lytle emphasized that
Hurwitz deliberately ignored obvious "red flags" of abuse and
distribution, giving examples of patients who:
* Gave frequent excuses about lost or stolen prescriptions
* Ran out of medication early
* Tested positive for illicit narcotics
* Tested negative for medications Hurwitz prescribed
* Injected medications, which should have been taken orally
* Had track marks and ulcers on arms
* Showed cocaine rashes on skin
* Reported current or past addiction
* Were arrested for distributing Hurwitz's medications or illicit
substances.
Bret McCarter, whose street name was "Mav," testified that he smoked
crack before visits to Hurwitz so "I could look straightened out when
I made an appearance."
McCarter paid $15,000 to $20,000 a month to fill prescriptions for
OxyContin, Dilaudid and Methadone, he testified, and said Hurwitz
called him a "high-risk patient."
"At the end, he would always continue writing the prescriptions,"
McCarter testified.
Hurwitz testified that McCarter was one of his high-dose patients who
was treated for pain resulting from failed back surgery. McCarter's
mother wrote Hurwitz a letter saying she was subsidizing her son's
treatment, Hurwitz testified.
[Top of Page]
HURWITZ'S TESTIMONY was scheduled to continue Tuesday with prosecutor
Rossi's cross-examination, after The Connection's presstime. Defense
attorneys plan to introduce a few more expert witnesses, after
Hurwitzs testimony concludes.
After closing arguments by the prosecution and defense, the jury is
expected to begin deliberations later this week.
Hurwitz's attorneys say he is not guilty of any of the charges, that
he cared for patients who could not get adequate care elsewhere.
ABOUT 50 PEOPLE including Hurwitz's two daughters, mother and two
brothers watched his testimony Monday.
"Imagine the feeling of betrayal," said his brother Kenneth Hurwitz,
senior associate with Human Rights First. "He has gone out of his way
to help people and give people the benefit of the doubt.
"It all seems so incredibly unjust. If he made mistakes, they were
mistakes that were out of his good faith and his attempt to help
people," Kenneth Hurwitz said.
From 1998-2002, Hurwitz, who has remained free after posting a $2
million bond, treated more than 400 people for chronic pain. He
testified that he terminated treatment for 17 patients, but sometimes
continued treatment for problematic patients that he thought he could
help.
"I believe all the patients have pain," Hurwitz testified.
[Top of Page]
--------------------------------------------------------------------------------
SIDEBAR: Doctor's Story
Dr. William E. Hurwitz, of McLean, took the stand at his trial on
Monday, Dec. 6, at 10:45 a.m. Following questions from his defense
attorney Marvin D. Miller, of Alexandria, Assistant U.S. Attorney
Eugene J. Rossi's cross-examination of Hurwitz began at 4:50 p.m.
Rossi's cross examination continued Tuesday, Dec. 7, after The
Connection's press deadline. Hurwitz faces a 62-count indictment.
Closing arguments in his trial are expected to be presented this week.
ALEXANDRIA, VA, 10:45 A.M., MONDAY, DEC. 6
Dr. William E. Hurwitz began by answering questions from his attorney
about how he came to specialize in pain treatment and the difficulties
he had with it over more than a decade.
Hurwitz was sanctioned by the Washington, D.C. Board of Medicine in
1991. Trouble for Hurwitz occurred, he testified, after he prescribed
medication to one of his patients whose wife was dying of breast
cancer and provided a stock bottle of Percocet to a doctor in
Paraguay.
"The experience before the D.C. Board introduced me to literature
about pain as well as to people who were involved with pain research,"
testified Hurwitz, who volunteered as the medical director for Peace
Corps Brazil in the 1970s and practiced internal medicine in
Washington, D.C. from 1978-1991.
By that time, Hurwitz, who treated his first patient with chronic pain
in 1978, had five chronic pain patients.
"Having a patient with a problem focuses your attention," he
testified.
The number of patients he treated for chronic pain grew to 200 as his
understanding of treatment with opioid therapy grew, he testified.
"There is no clinical limit to what a patient may require to
experience relief," he said, addressing the very high doses of pain
medications he prescribed for many of his patients. "Opioid exposure
appears not to cause any damage."
But in 1996, Hurwitz's license was revoked by the Virginia Board of
Medicine and he was required to complete continuing medical education
in the pharmacology and physiologic actions of drugs, psychiatry and
addictionology and in record keeping and practice management.
When he resumed a practice specializing in opioid therapy in 1998, he
required patients to fill out a consent agreement form, letting
patients know they would be terminated if they abused medication,
illicit drugs, sought prescriptions from other doctors or sold drugs
that he prescribed.
"This gave me the flexibility to discharge a patient," he said.
Hurwitz testified that he counseled patients, alerting them to the
dangers of opioid therapy and the associated social complications and
financial burdens.
Hurwitz said his $1,000 initiation fee and his monthly fee, which
ranged from $125 to $250 during the course of his practice, covered
the cost of all visits no matter how many. "I wanted patients to talk
to me, and not to worry if they could incur further charges. I wanted
them to have open access to me."
He also trusted patients to monitor their own pain relief. "Pain
fluctuates from patient to patient, I believed my approach with
patients should be to give them freedom to control pain," he
testified.
By the fall of 2001, Hurwitz said he started ordering drug screens of
patients when he said he realized a percentage of his patients were
abusing cocaine and his prescribed medications.
"I didn't have a concept of red flags, I had concept of aberrant or
problematic behaviors."
"I was aware of the investigation of me beginning in early 2002,"
testified Hurwitz, who said he was "shaken up" by a number of his
patients' positive urine screens for cocaine use.
"I was wrestling with this issue, trying to reconcile how to deal with
these patients," Hurwitz said.
But abrupt termination was never a reasonable option, only tapering
patients down from high doses, he testified. "[Abrupt stoppage of
medication] subjects people to a form of torture."
Hurwitz announced the closure of his practice on Sept. 1, 2002.
4:50 P.M., MONDAY, DEC. 6
Prosecutor Rossi greeted Hurwitz on the stand.
"Good afternoon, Dr. Hurwitz."
"Good afternoon, Mr. Rossi," Hurwitz replied.
Rossi then referred to the 1996 order by the Virginia Board of
Medicine, which revoked Hurwitz's license in 1996.
"Stephen Bresko passed away on Jan. 15, 1996 in Pigeon Forge,
Tennessee. Is it true that he was a patient of Dr. William Hurwitz?"
Rossi asked.
"True," Hurwitz replied.
Rossi repeated this process for one other patient mentioned in the
Virginia order and with two of Hurwitz's patients who died between
1998-2002.
"From January 1996 to February 2001, you were prohibited from
practicing for 23 months. So in 39 months you had four patient deaths
and a patient come near death," Rossi said. "You averaged a death
every eight or nine months, true?"
"The charges in this court order are eerily similar, if not identical
to many of the things we heard from patients and their records in this
trial, true?" Rossi asked
"The charges appear similar," Hurwitz said.
Before he found Hurwitz on the Internet, Sylvester Boyd testified
Friday, Dec. 3 that he suffered 12 years with "constant, nagging,
unrelenting pain just pain, pain, pain it nearly destroyed my
life."
"I was at the end of my rope. It gets to a point where shockingly
suicide is not an option you're willing to dismiss," testified Boyd,
50, who suffered bone fractures, muscle and cartilage tears in his
back during a fall at an ice skating party he held for his daughter
about 15 years ago.
Boyd was not the only grateful patient.
"Dr. Hurwitz saved my wife's life, said Charles Barnhart, of New
Mexico, following his wife Molly Shaw's testimony last Thursday. "I
hope she got to the jury; I know every time she talks about it, it
gets to me."
[Top of Page]
PROSECUTORS DON'T DISCOUNT the care some patients received from
Hurwitz, 59.
But the 1,879,677 pills prescribed by Hurwitz to 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 J. Rossi and Mark D. Lytle.
Kilee Hoskin's uncle, Rennie Buras of New Orleans, died in 1999, under
treatment by Hurwitz. "This man built planes and boats and things with
his bare hands," testified Hoskin, 25, during the third week of
Hurwitz's trial, which began Thursday, Nov. 4. "[Paramedics] thought
he was retarded, that's how the pills affected him."
Prescriptions Hurwitz wrote for OxyContin, including the 68,700 total
pills he prescribed for Bret McCarter and the 63,530 pills Hurwitz
prescribed for Kevin Fuller, led to illegal drug sales in Manassas,
other parts of Virginia and Tennessee, according to prosecutors.
More than 15 convicted felons, most from Manassas and many related to
each other, testified against Hurwitz.
"I think he enjoyed it. I think he lived vicariously through us,"
testified Timothy Urbani, 34, who faces 20 years in federal prison for
charges including conspiracy to distribute OxyContin and robbery of
OxyContin from a pharmacy. "At the time, I thought [the pills] were
helping me, but I'm in all this trouble now. I wasn't there for my
kids for three to four years, now I won't be there for a long time."
Hurwitz's defense attorneys Patrick S. Hallinan, Kenneth H. Wine and
Marvin D. Miller called the convicted dealers "predators" who abused
the doctor's trust, lying about or exaggerating their pain to obtain
drugs from the nationally-known doctor who specialized in high-dose
opioid therapy for people with unrelenting chronic pain.
[Top of Page]
FOLLOWING 19 DAYS of testimony, from 63 witnesses for the prosecution
and nine witnesses for the defense, Hurwitz took the stand on Monday,
Dec. 6, in the United States District Court for the Eastern District
of Virginia before Senior Judge Leonard D. Wexler.
Hurwitz testified Monday that he showed all potential patients
literature suggesting that "opioid treatment is not for everyone."
"It was an attempt to discourage people from opioid therapy unless
they have exhausted other options," Hurwitz testified. "I wanted
patients to understand that treatment with opioids was a complicated
practice with risks."
Hurwitz, who closed his practice in December 2002, faces a 62-count
indictment, including charges of conspiracy to traffic in controlled
substances, drug trafficking resulting in death, drug trafficking
resulting in serious bodily injury, drug trafficking distributions,
engaging in continuing criminal enterprise and health care fraud.
Still posted on Hurwitz's Web site is a request to patients,
foreshadowing the possible 20 years in jail or more that he faces for
each count of the indictment.
"More than in most clinical circumstances, the failure of patients to
act intelligently, responsibly and honestly can lead to disaster,"
reads the Web site. "For all of these reasons, patients who undertake
opioid maintenance therapy should behave in a way that is beyond
reproach or suspicion in all matters relating to their use of
medications. Patients who are unwilling or unable to do so jeopardize
not only their own health and safety, but the health and safety of
other patients with chronic pain."
Advocates for patients with chronic, severe pain are watching the
trial closely. The treatment of pain is a human rights issue, said
Mary Baluss, director of the Pain Law Initiative, who has attended
most of the trial.
"I'm worried that high-profile trials will have a negative impact on
the treatment of pain," said Dr. Steven Passik after serving as a
witness for the defense.
[Top of Page]
THROUGHOUT THE TRIAL, prosecutors Rossi and Lytle emphasized that
Hurwitz deliberately ignored obvious "red flags" of abuse and
distribution, giving examples of patients who:
* Gave frequent excuses about lost or stolen prescriptions
* Ran out of medication early
* Tested positive for illicit narcotics
* Tested negative for medications Hurwitz prescribed
* Injected medications, which should have been taken orally
* Had track marks and ulcers on arms
* Showed cocaine rashes on skin
* Reported current or past addiction
* Were arrested for distributing Hurwitz's medications or illicit
substances.
Bret McCarter, whose street name was "Mav," testified that he smoked
crack before visits to Hurwitz so "I could look straightened out when
I made an appearance."
McCarter paid $15,000 to $20,000 a month to fill prescriptions for
OxyContin, Dilaudid and Methadone, he testified, and said Hurwitz
called him a "high-risk patient."
"At the end, he would always continue writing the prescriptions,"
McCarter testified.
Hurwitz testified that McCarter was one of his high-dose patients who
was treated for pain resulting from failed back surgery. McCarter's
mother wrote Hurwitz a letter saying she was subsidizing her son's
treatment, Hurwitz testified.
[Top of Page]
HURWITZ'S TESTIMONY was scheduled to continue Tuesday with prosecutor
Rossi's cross-examination, after The Connection's presstime. Defense
attorneys plan to introduce a few more expert witnesses, after
Hurwitzs testimony concludes.
After closing arguments by the prosecution and defense, the jury is
expected to begin deliberations later this week.
Hurwitz's attorneys say he is not guilty of any of the charges, that
he cared for patients who could not get adequate care elsewhere.
ABOUT 50 PEOPLE including Hurwitz's two daughters, mother and two
brothers watched his testimony Monday.
"Imagine the feeling of betrayal," said his brother Kenneth Hurwitz,
senior associate with Human Rights First. "He has gone out of his way
to help people and give people the benefit of the doubt.
"It all seems so incredibly unjust. If he made mistakes, they were
mistakes that were out of his good faith and his attempt to help
people," Kenneth Hurwitz said.
From 1998-2002, Hurwitz, who has remained free after posting a $2
million bond, treated more than 400 people for chronic pain. He
testified that he terminated treatment for 17 patients, but sometimes
continued treatment for problematic patients that he thought he could
help.
"I believe all the patients have pain," Hurwitz testified.
[Top of Page]
--------------------------------------------------------------------------------
SIDEBAR: Doctor's Story
Dr. William E. Hurwitz, of McLean, took the stand at his trial on
Monday, Dec. 6, at 10:45 a.m. Following questions from his defense
attorney Marvin D. Miller, of Alexandria, Assistant U.S. Attorney
Eugene J. Rossi's cross-examination of Hurwitz began at 4:50 p.m.
Rossi's cross examination continued Tuesday, Dec. 7, after The
Connection's press deadline. Hurwitz faces a 62-count indictment.
Closing arguments in his trial are expected to be presented this week.
ALEXANDRIA, VA, 10:45 A.M., MONDAY, DEC. 6
Dr. William E. Hurwitz began by answering questions from his attorney
about how he came to specialize in pain treatment and the difficulties
he had with it over more than a decade.
Hurwitz was sanctioned by the Washington, D.C. Board of Medicine in
1991. Trouble for Hurwitz occurred, he testified, after he prescribed
medication to one of his patients whose wife was dying of breast
cancer and provided a stock bottle of Percocet to a doctor in
Paraguay.
"The experience before the D.C. Board introduced me to literature
about pain as well as to people who were involved with pain research,"
testified Hurwitz, who volunteered as the medical director for Peace
Corps Brazil in the 1970s and practiced internal medicine in
Washington, D.C. from 1978-1991.
By that time, Hurwitz, who treated his first patient with chronic pain
in 1978, had five chronic pain patients.
"Having a patient with a problem focuses your attention," he
testified.
The number of patients he treated for chronic pain grew to 200 as his
understanding of treatment with opioid therapy grew, he testified.
"There is no clinical limit to what a patient may require to
experience relief," he said, addressing the very high doses of pain
medications he prescribed for many of his patients. "Opioid exposure
appears not to cause any damage."
But in 1996, Hurwitz's license was revoked by the Virginia Board of
Medicine and he was required to complete continuing medical education
in the pharmacology and physiologic actions of drugs, psychiatry and
addictionology and in record keeping and practice management.
When he resumed a practice specializing in opioid therapy in 1998, he
required patients to fill out a consent agreement form, letting
patients know they would be terminated if they abused medication,
illicit drugs, sought prescriptions from other doctors or sold drugs
that he prescribed.
"This gave me the flexibility to discharge a patient," he said.
Hurwitz testified that he counseled patients, alerting them to the
dangers of opioid therapy and the associated social complications and
financial burdens.
Hurwitz said his $1,000 initiation fee and his monthly fee, which
ranged from $125 to $250 during the course of his practice, covered
the cost of all visits no matter how many. "I wanted patients to talk
to me, and not to worry if they could incur further charges. I wanted
them to have open access to me."
He also trusted patients to monitor their own pain relief. "Pain
fluctuates from patient to patient, I believed my approach with
patients should be to give them freedom to control pain," he
testified.
By the fall of 2001, Hurwitz said he started ordering drug screens of
patients when he said he realized a percentage of his patients were
abusing cocaine and his prescribed medications.
"I didn't have a concept of red flags, I had concept of aberrant or
problematic behaviors."
"I was aware of the investigation of me beginning in early 2002,"
testified Hurwitz, who said he was "shaken up" by a number of his
patients' positive urine screens for cocaine use.
"I was wrestling with this issue, trying to reconcile how to deal with
these patients," Hurwitz said.
But abrupt termination was never a reasonable option, only tapering
patients down from high doses, he testified. "[Abrupt stoppage of
medication] subjects people to a form of torture."
Hurwitz announced the closure of his practice on Sept. 1, 2002.
4:50 P.M., MONDAY, DEC. 6
Prosecutor Rossi greeted Hurwitz on the stand.
"Good afternoon, Dr. Hurwitz."
"Good afternoon, Mr. Rossi," Hurwitz replied.
Rossi then referred to the 1996 order by the Virginia Board of
Medicine, which revoked Hurwitz's license in 1996.
"Stephen Bresko passed away on Jan. 15, 1996 in Pigeon Forge,
Tennessee. Is it true that he was a patient of Dr. William Hurwitz?"
Rossi asked.
"True," Hurwitz replied.
Rossi repeated this process for one other patient mentioned in the
Virginia order and with two of Hurwitz's patients who died between
1998-2002.
"From January 1996 to February 2001, you were prohibited from
practicing for 23 months. So in 39 months you had four patient deaths
and a patient come near death," Rossi said. "You averaged a death
every eight or nine months, true?"
"The charges in this court order are eerily similar, if not identical
to many of the things we heard from patients and their records in this
trial, true?" Rossi asked
"The charges appear similar," Hurwitz said.