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Pain Doctor's Trial: Local Links

<ro><b>Only Support System</b>

<lst>Susan Cruz said she learned a lot about compassion for patients from defendant Dr. William E. Hurwitz.

Cruz, a nurse practitioner who lives in Herndon, worked in Hurwitz's office in McLean from the summer of 2000 until he shut down his practice in 2002.

"They have a huge, huge notebook full of letters from patients that said they got their life back because of this treatment," Cruz said, following her testimony on Nov. 30. "We cared about them, we were told by many patients that we were their only support system."

Outside of the courtroom, Cruz said 90 percent of Hurwitz's patients were legitimate pain patients needing treatment, not like the patients testifying against him in court.

"I feel very strong that pain management patients don't get adequate treatment. Things like this [trial] aren't making it easier," Cruz said. "We were helping people in pain — most will not get relevant treatment from anyone else."

DURING HER TESTIMONY, Cruz, a witness who testified for Hurwitz's defense, recalled how Hurwitz reacted when he found a patient had a positive drug screen.

"He was upset," Cruz testified. "He would say, 'What's happening here? You've got to stop using these drugs.’"

Hurwitz then monitored such patients more frequently and told patients they needed to work together so they would stop using, according to Cruz. "There were definitely some that were discharged," she testified.

But a small group in the practice were patients Cruz testified that she could not trust. "I thought they were creepy or seedy characters. It was more just a feeling that I wasn't sure if I trusted them."

Hurwitz sent Cruz to workshops on pain management and addiction at NIH. Cruz and Ann Wierbinski, another nurse in the office, recommended that Hurwitz refuse to continue treating some of the "problem" patients.

"I know I didn't want to see them in my office," she said.

Hurwitz's response, Cruz testified, was that her reaction might be social bias against this group. "We don't have direct evidence against people, they are innocent until proven guilty," she said he told her.

On cross-examination, Eugene Rossi, Assistant U.S. Attorney, asked Cruz to explain how she would have run the practice. "So if a person like Bret McCarter fails one, two, three, four, five drug tests, they should be terminated?"

"They should be terminated," Cruz said.

<sh><b>6 Seconds from Death</b>

<bt>Carl Shortridge, a patient of Dr. Hurwitz's was six seconds away dying of an overdose at the Vienna Wolf Trap Motel in Vienna on Feb. 28, 2001, according to testimony from Sandra Caple, from the Fairfax Fire and Rescue Service.

"The medication prescribed … had potential for being lethal," testified Dr. Michael Ashburn, the prosecution's 28th witness in its case against Hurwitz. "This should have been a dose that cost him his life."

Shortridge's medical treatment was within the bounds of medicine and for legitimate medical purpose, testified defense witness Dr. C. Stratton Hill Jr., founder of the pain management clinic at The University of Texas, M. D. Anderson Cancer Center.

<ro><b>More Like Agony</b>

<lst>Following an operation due to pancreatitis, a doctor told Gemevra Webster that she was probably never going to be completely out of pain.

"The migraines were bad, that was a lot of pain; the intercystal cystitis was extremely painful because I would get urinary tract infections, the pancreatitis was more like agony," said Webster, 49, of Springfield, who is a past patient of Hurwitz. "Pancreatitis feels like you've put a spear with barbs on it into your stomach and try to pull it back out."

Webster, who calls herself a "medium to high-dose" patient "depending on what's happening with my body," has a detailed calendar, reminding her when to take certain medications and the correct day to change her pain patch. One month, during a time she changed insurance companies, she ended up paying $5,000 for a month’s supply of her medications.

"It's not easy being a chronic pain patient, having people look at you like you're a raging addict. If you have a cold, you take cold medicine, if you have pain, you take pain medicine," said Webster, an artist who gave up teaching students with disabilities because of her medical condition.

"I miss Dr. Hurwitz because I think he is dedicated, he works even harder with you," said Webster, who is married and has two grown children. "He seems to be passionate about his work, his patients and pain management."

"It seems as if they are trying to make law enforcement part of medicine," Webster said. "I hope doctors like Dr. Hurwitz and Dr. Joseph Statkus [her current doctor] aren't pushed out of the system because they really help people with chronic pain."

<sh><b>Stolen Prescription Pad</b>

<bt>James Longo, a patient with chronic pancreatitis, stole Dr. Archibald Green's prescription pad and tried to forge Green's signature at a local pharmacy.

"He was looking bad, he wanted more pain medication," testified Green, who works at Falls Church Medical Center in Arlington. Earlier that month, Green recommended him to a gastroentologist. "I told him I wouldn't give him more until he made an appointment. He became belligerent and demanded Dilaudid."

Green, who was the government's 37th witness in its case against Hurwitz, treated Longo from February to May 1999. Longo "seemed to exhibit addictive behavior," requesting early refills and making excuses about lost prescriptions, testified Green. "He certainly needed treatment for his addiction, be committed to detox and have his pain controlled somehow."

Longo then became a patient of Hurwitz. When told of the prescriptions Hurwitz issued for Longo — 2,000 Dilaudid every 30 days — Green testified "that would far exceed my comfort level for anyone to receive that amount of medication."

Green said if Hurwitz had contacted him, he would have told Hurwitz that Longo had chronic pain, was difficult to treat and exhibited addictive personality, in addition to the incident with the prescription pad.

Green's testimony also revealed that it is sometimes difficult for a doctor to know exactly what to do in certain situations. Once, when Longo lost a prescription, Green admitted, "I gave him the benefit of the doubt on that one and gave him medication. If I was certain he was an addict, I probably would not have."

<sh><b>Two Links to Centreville</b>

<bt>Paula Jane Farmer's husband John died of an overdose on July 10, 2004, well after Dr. Hurwitz closed his practice.

When her husband was terminated from the Dulles Pain Management Center after testing positive for cocaine in June of 1999, their friend Kevin Fuller, recommended Dr. Hurwitz. By that time, the Farmers were already snorting and injecting OxyContin.

"He could get you just about anything you want," Farmer said Fuller told them.

Farmer testified that her husband's prescriptions peaked to 3,000, 80-milligram OxyContin pills and 10,000 Dilaudid pills per month.

"We had to have more and more and more," Farmer testified. "My teeth started falling out.…It messes with your body."

"We made a lot of money , we were selling half of them," Farmer said. "At times, we had $20,000 in cash."

Dr. Lenore Day, a family physician at the Family Center for Clifton/Centreville, treated Robert Woodson on April 2, 2002.

"He came in for back and neck pain and asked for refills for the medicine he had been on," Day testified.

She issued Woodson 80-milligram OxyContin pills to take three times a day and a small amount of Xanax.

"He had a rash, exfoliation, he said that was from a dog," Day said. "It didn't look like a type of allergic reaction, but I had no reason to disbelieve him."

The next day, she received a call informing her that Woodson had been arrested for attempting to sell the pills she had prescribed.

"I discharged him from the practice," Day testified. She said she wrote a letter to be included in Woodson's files alerting all physicians in the practice not to issue any narcotics to Woodson if he came back.

Woodson is one of the prosecution's key witnesses against Hurwitz.

<sh><b>Robinson's Sneak Preview</b>

<bt>Robert Woodson, who was sentenced to 97 months for conspiracy to distribute OxyContin, told Robinson High School students a year ago that OxyContin is "the pill made by Satan himself. Miracle drug? Far from it. With that pill, you'll wake up and find yourself doing things you've never done before."

OxyContin was the subject of a November 2003 town meeting, "OxyContin: Miracle Drug or Medical Disaster," organized by Robinson students in the DECA program, an Association of Marketing Students.

At that time Woodson, who had already been cooperating with the government in its investigation of McLean pain doctor, Dr. William E. Hurwitz, spoke to students under the fictitious name, Bob Smith. "I tried to quit probably a thousand different times. I got to the point where I'd rather be dead than in the position I was in," said Woodson.

Woodson was the prosecution's 60th witness who testified in the trial against Hurwitz on Nov. 29, 2004. Woodson is one the key figures in the government's case against Hurwitz. At peak times, Woodson profited $40,000 to $60,000 a month selling portions of Hurwitz's pills.

He wore a wire to his doctor's office on May 29, June 10, June 18, July 2, July 30 and Aug. 28, 2002.