10/03/08 (GA):
Medical Expert Testifies In Patient Deaths Case
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Suspended physician Spurgeon Green Jr. provided sub-standard care, including prescribing and dispensing powerful narcotics, that led to the death of three patients, a medical expert testified today in federal court.
Dr. Barry Straus of the North Georgia Pain Clinic testified for a second day in federal court about the deaths of three more of Green's patients, bringing the total to 13 alleged to have died under Green's care in about an 18-month period. The expert's testimony over two days included allegations that Green failed to check medical histories or verify patient prescriptions, did not conduct generally accepted exams, failed to document patient history, ignored red flags of prescription abuse or diversion, failed to offer alternative treatments to narcotics for pain management and altered patient records.
Green, physician's assistant Dorothy Mack and Jack Joseph, a pharmacist whose business was located near the doctor's office, are accused of conspiring to distribute drugs "not for a legitimate medical purpose and outside the usual course of professional practice."
Green is accused of distributing medication that led to the deaths of seven people as well as serious bodily injury to six other people who died - and in which the drugs prescribed were a contributing factor.
Mack is implicated in three of the death charges and two of the serious bodily injury charges, while Joseph is implicated in four of the death charges, according to the 118-count indictment.
When going over the medical file of one of the patients who died after alleged serious bodily injury, Straus testified Friday that it was yet another example that Green did not document the reason for prescribing the powerful narcotics.
The patient's records included a urine test that registered positive for methadone, a drug Green had not prescribed, and negative for the medications he had prescribed, the expert testified.
But in spite of this red flag that the patient may have been diverting her medication, she continued to receive the potent drugs, the witness said.
"The crossing guard was down, the train was coming and we paid zero attention to it," Straus told jurors.
The patient's medical file included a notation that her addicted sister had sold her drugs, another red flag, Straus said.
There were multiple accidents reported in the patient's medical file, which when combined with the other notations should have raised suspicions, he said.
Also, the medical record indicated the patient reported a 10 for pain on a scale of 1 to 10 with 10 the worst. That meant, Straus told jurors, that she was supposedly experiencing the "most horrible, excruciating pain - worse than child birth. Yet, she's comfortably sitting there."
On a subsequent visit, the pain scale indicated that the patient was experiencing no pain, yet her prescription of OxyContin was doubled in potency from 40 to 80 milligrams by the doctor.
Such a dosage, along with the other mixture of medications prescribed, can cause users to pass out or fall into a drugged stupor in which the person may vomit and drown in one's own vomit, Straus testified.
Taking twice the normal dosage is enough to accidentally kill yourself, he said.
Straus testified that Green's treatment, which included the prescribing of narcotics, caused the woman's death.
© X-Pro 2008
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