Pubdate: 1 Oct 2003
Source: Times-Dispatch (VA)
Author: BILL MCKELWAY
Conditions for doctor's bond set
Charges involve pain medication
BY BILL MCKELWAY
TIMES-DISPATCH STAFF WRITER
Oct 1, 2003
ALEXANDRIA- A federal magistrate opened the way yesterday for the release on bond of a well-known doctor whose arrest last week on drug and prescription-fraud charges has raised protests among patients with intractable pain.
But U.S. Magistrate Barry R. Poretz stayed provisions of a strict bond regimen that would essentially place Dr. William E. Hurwitz under house arrest.
Poretz gave federal prosecutors until tomorrow to decide if they will appeal the ruling, which could make family members and supporters of Hurwitz liable for $1 million in bond money if he flees.
"He would wipe out the family finances if he flees," said Poretz, noting that he was "spreading the risk" among Hurwitz' 22-year-old daughter, his 86-year-old mother, a brother, his former wife and her husband.
Each of them must guarantee the bond. In addition, Hurwitz would be under 24-hour electronic surveillance and would be obligated to stay in the Washington area. He could not practice medicine or give medical advice.
Referring to Hurwitz as "mister" rather than "doctor," assistant U.S. Attorney Mark Lytle described Hurwitz as a man who has minimal ties to the Northern Virginia community, has sold his home and is unemployed.
He questioned if any set of conditions would prevent him from fleeing.
Hurwitz, 57, faces a life sentence if convicted of charges issued in a 49-count indictment last week that followed a two-year federal investigation.
The indictment alleges Hurwitz conspired with patients to prescribe large doses of addictive drugs that were then sold on the street. Three patients listed in the indictment died; some were not properly assessed by him; Hurwitz allegedly knew some were drug dealers; and, he failed to consult with other doctors, according to the indictment.
Lytle has described Hurwitz as a man whose white coat and pen served as a license to deal drugs; he has sought to distance the doctor's prosecution from the notion that this is merely a malpractice case or a matter of bad judgment.
But the executive director of a national organization focused on drug issues and medical care said yesterday that Hurwitz's prescription methods and patient care have always been closely monitored by the Virginia Board of Medicine.
"If he was doing something so wrong, they could have yanked his license and stopped him instantly," said Dr. Jane Orient, of the Arizona-based Association of American Physicians and Surgeons.
When the state medical board took up many of the same issues in May that are now addressed in the federal indictment, the board put Hurwitz on probation and set up provisions he needed to meet to re-open his office.
Hurwitz had closed his practice in McLean last year in August after a raid by federal agents. He learned he was the target of a federal criminal investigation in February last year.
Orient described Hurwitz as "a national leader at the vanguard" of offering treatments for people suffering unbearable pain; she blasted the federal government's efforts to prosecute Hurwitz and other doctors around the country involved in heavy-dosage medication.
"We're getting calls every day from doctors who see what's happening to Bill Hurwitz and are scared to proceed with their own patients," Orient said.
Hurwitz's lawyer, James Hundley, said yesterday that Hurwitz treated each of his patients with care and concern and said that patient conduct that was illegal was beyond his control.
But the indictment alleges Hurwitz clearly knew of the illicit activities carried out by some of his patients and he continued prescribing medicines for them.
Outside the federal courthouse yesterday, Leigh Anne Franklin, a Hurwitz supporter who traveled to Alexandria from North Carolina, described Hurwitz, dressed yesterday in a black-and-white striped jail uniform, as a saint.
"He saved my life and my sister's life when doctor after doctor had turned us down," she said, describing her severe pain from kidney stones and a sister's back problems.
"Now that he's been arrested, my doctors back home are really having doubts about what to do. They're terrified."
Contact Bill McKelway at (804) 649-6601 or [email protected]
Doctor Hurwitz Indicted In OxyContin Scheme
By Josh White
Washington Post Staff Writer
Friday, September 26, 2003
A McLean pain doctor was indicted by a federal grand jury yesterday on charges that he led a broad conspiracy to illegally distribute prescription narcotics across the nation, resulting in the deaths of at least three patients.
In a 49-count indictment, William E. Hurwitz, 57, was charged with drug trafficking resulting in death and serious injury, engaging in a criminal enterprise, conspiracy and health care fraud. Hurwitz was arrested yesterday morning at his ex-wife's home and was ordered held without bond until a hearing Monday. Should Hurwitz be convicted of the most serious charges, he faces life in prison.
The indictment in U.S. District Court in Alexandria grew out of a wide-ranging federal investigation into doctors, pharmacists and patients suspected of selling potent and addictive painkillers on a lucrative black market. More than 40 people have been convicted in the ongoing probe.
Hurwitz's attorney, James Hundley, said the charges come from overaggressive prosecutors trying to scare doctors from prescribing painkillers. Hundley said Hurwitz says he was practicing good medicine.
"Dr. Hurwitz is a legitimate medical doctor with expertise in the area of the management of intractable chronic pain," Hundley said. "He was doing nothing but providing appropriate medical care. The government has come in and taken a medical issue and attempted to apply horribly twisted logic to it through criminal statutes."
The indictment signals an aggressive push by federal prosecutors to hold doctors accountable for what happens to the drugs they prescribe. It also highlights the complexities of proving criminal culpability in cases of licensed and reputable physicians prescribing a legal painkiller. Hurwitz is one of a few doctors across the country who have been indicted on charges of over-prescribing drugs, and he is among the first to be charged with orchestrating a widespread conspiracy.
The illegal sale of OxyContin and drugs such as methadone and Dilaudid has fueled an epidemic of abuse that has affected small towns throughout Appalachia, authorities said. Over the past few years, the abuse and sales have crept into suburban and urban areas, bringing associated crimes such as theft, fraud and homicide, authorities said.
OxyContin is a government-approved pill that releases its main ingredient, oxycodone, slowly over time to patients who need strong levels of pain relief. It is hailed as a miracle drug by cancer patients and others with intractable pain, but it is decried by local, state and federal authorities for its potential for abuse and lethal overdose.
"The indictment and arrests in Virginia demonstrate our commitment to bring to justice all those who traffic in this very dangerous drug," Attorney General John D. Ashcroft said. "We will continue to pursue vigorously physicians, patients and others who are responsible for turning OxyContin from a legitimate painkiller to a vehicle of addiction and death."
Patient advocates have said the prosecutions are troubling for those who need help for pain but are finding it increasingly difficult to convince doctors to treat them. "It's a terrifying turn of events that the medical community ought to look at carefully," Hundley said.
U.S. Attorney Paul J. McNulty said yesterday that Hurwitz was a "major and deadly drug dealer" who used the cover of medical pain management to dispense "misery and sometimes death."
According to the indictment, Hurwitz's Northern Virginia pain practice was at the heart of a conspiracy to distribute the painkillers for profit. The grand jury alleges that Hurwitz prescribed "countless prescriptions for excessive doses" of controlled drugs with the goal of hooking his patients, getting them to pay him a monthly fee and encouraging illegal sales.
Assistant U.S. Attorneys Gene Rossi and Mark Lytle alleged that Hurwitz wanted "to make as much money as possible" and wanted the drugs to be resold throughout Northern Virginia, southwest Virginia, Tennessee and Kentucky.
The most serious charges -- that the conspiracy caused fatal overdoses -- focus on patients Rennie Buras Sr. of Louisiana, who died on Oct. 9, 1999, and Linda Lalmond, who died in Fairfax County on June 1, 2000.
Bryan Slaughter, a Charlottesville lawyer, represented Lalmond's family in a civil lawsuit against Hurwitz that was settled earlier this year in Fairfax. He said Lalmond died days after first meeting Hurwitz and taking high doses of morphine. "Dr. Hurwitz's treatment was so far outside accepted medical practice that the result was certainly foreseeable in Linda's case," Slaughter said.
The indictment also mentions the death of Mary Nye in Prince William County on Nov. 4. Hurwitz is charged with causing Nye serious bodily injury by prescribing her large amounts of OxyContin and methadone.
"Dr. Hurwitz got her hooked on narcotics and took advantage of her," said Manassas attorney Amy Ashworth, who represents Nye's widower, Paul.
Hurwitz has been under scrutiny before. He lost his medical license for over-prescribing painkillers and was most recently placed on probation in Virginia in May. His marketing practices, authorities said, allowed him to keep patients in all parts of the country and Canada. The indictment alleges that Hurwitz prescribed medications in as many as 39 states, issuing the prescriptions with little or no physical examination and sometimes over the phone, fax, or the Internet.
Prosecutors allege that Hurwitz made large profits by charging an initiation fee of $1,000 for each patient and then $250 a month for maintenance. They said Hurwitz had about 470 patients in his clinic over the past five years, accounting for millions of dollars in profit.
Hurwitz shut his offices last year because he feared an indictment and wanted to give his patients time to find new doctors.
'OxyContin Network Believed Extensive
Federal Probe Nets 41 Convictions'
Note: OxyContin Network (link above) by Josh White (Post) prompted Ms. Reynolds of the Pain Relief Network to comment:
"This guy, Josh White, at the (Washington) Post is trying to make a reputation in this Oxycontin area. I have spoken with him, and have been in e-mail communication with him on many ocassions, attempting to show him that his work is killing people, to no avail. He is half-bright and an easy gull for Rossi and the DEA.
I and others have pointed out that this Oxycontin firestorm was started by DEA, that the "deaths" have been debunked, etc. that these charges are disingenuous (the DEA and Justice know perfectly well that Drs. Hurwitz and Statkus were practicing medicine in good faith) and that this is essentially a campaign for funding, cynically run by DEA. White is having too much fun presently, playing reporter. The man is dangerous.
This sort of thing indicates that Statukus and Hurwitz may indeeed be put through a show trial like the Comprehensive Care case in South Carolina. Fortunately, they don't appear to have the equivalant of a Dr. Woodward in Northern Virgina so they will have to rely on the razzle dazzle of having patients say they lied to the doctors and using this as proof that the doctors were in bad faith.
I know its hard to understand how jurors would fall for such a thing but they do. Such a hysteria has been drummed up around opioids that even intelligent doctors such as Dr. Define, for example, can be manipulated into pointing the finger at a medication she knows has no special chemical properties or an added evil molecule. And yet, we see her saying here that it's bad because of what it has "done" to people. Clearly, confusion reigns. And it does so because the government is actively inciting riot of this kind. And the press, unfortunately, has been cooperating.
The story is lurid. It's man bites dog, so why not! It's easy for a guy like Josh White to pretend to be a reporter when he covers such a "dramatic" story in this way. There is nothing we can do about people like Josh White. The time will come when we will need to denounce him but we have a lot of hard work to do in the meantime.
The government is inciting a mob reaction against the pain profession, pointing to the doctors as though they were some kind of vampires and telling the mob that the doctors are the evil ones. Of course the mob can be counted on to gather round, torches blazing. I don't know about all of you, but I find the situation extremely dangerous.
This will not confine itself to "little guys" like the fifty or so doctors around the country facing this. Dr. Hurwitz is high profile. It could happen to any one.
Dr. Bordeaux was the test case to see if they could prosecute a totally innocent doctor and keep her collegues from running to her defense. It worked, so on they went.
I and my collegues have formed PRN to actively oppose what's happening here. We have been working on this thing full time since South Carolina.. We will soon be announcing our mission and outlining our essential plan."
All The Best,