Doctor defends his treatment of patients who died
- From: rpautrey2 <rpautrey2@xxxxxxxxx>
- Date: Mon, 27 Oct 2008 20:47:13 -0700 (PDT)
Posted on Sat, Oct. 18, 2008
Doctor defends his treatment of patients who died
By Becky Purser
Suspended Perry physician Spurgeon Green Jr. testified Friday that if
his patients had taken their medications as he had prescribed, there
would have been no risk of serious bodily injury or death.
Green, physician's assistant Dorothy Mack and pharmacist Jack Joseph
are on trial in federal court in Macon on charges of conspiring to
distribute drugs "not for a legitimate medical purpose and outside the
usual course of professional practice" from January 2000 to July 2003.
The 118-count indictment charges that Green distributed medications
that led to the deaths of seven people as well as serious bodily
injury to six other people, who died in instances 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 indictment.
Green, 69, testified Friday that the medications he prescribed for his
patients were appropriate for their medical condition at the time as
he understood it and that his treatment was within the bounds of
legitimate medical purposes and the standard of care.
The physician, who took the stand for a second day in his own defense,
was the only witness to testify Friday.
Prosecutors have not yet had an opportunity to question Green.
Testimony is expected to resume Monday with another defense witness
because of a scheduling issue, though the doctor is subject to being
recalled to the witness stand for further questioning.
During several hours of testimony, O. Hale Almand Jr., a Macon
attorney representing Green, took his client through the medical
records of more than a dozen patients in defense of the care he
provided. The questioning was similar in method to that of the
government when prosecutors took their key medical expert through
Green's patient files to suggest substandard treatment of patients.
Green defended his diagnoses, noting what previous history he may have
relied on, what medical tests may have been previously done to help
him decide how to treat a particular patient and why he didn't think
alternative forms of treatment would have worked.
Here are excerpts from Green's testimony from Thursday and Friday:
Green testified that he was never advised of a call to his office from
Barbara Martin, the mother of David Barbari, 40, of Jesup, one of 13
patients who died during an 18-month period. The doctor is accused of
distributing medications that led to Barbari's death.
Martin had testified that she called Green's office and told the
person answering the phone that her son was an addict and should not
be taking the drugs Green was prescribing for him.
"I thought that would be it and it would be stopped," Martin had told
jurors.
In his testimony, Green denied that he had seen a handwritten note
from Barbari's friend Judy Maiolo Thompson, who pleaded for the doctor
to stop prescribing the medication, graphically described what the
narcotics did to him and pointed out that Barbari responded well to
non-addictive drugs.
Houston County sheriff's Sgt. Wayne Franklin previously testified that
during the criminal investigation of the doctor he retrieved from
Green's office trash not only the original note but also a copy of it
with holes punched along the side - as if it had been part of a
medical file.
Green testified his office kept an adverse drug file separate of the
medical records, for confidentiality. Any records that would have been
discarded would have been destroyed, the doctor told jurors.
"We shredded everything," he testified. "How it got into the trash, I
don't know."
Thompson had testified that Green was handed the note but that he
tossed it. Green countered that was impossible because he was always
in the back of the clinic, in patient examination areas - and not up
front near the reception area.
Green also commented on a photo shown to jurors of a passed out
Barbari. Thompson testified she had taken the picture after Barbari
had taken drugs he continued to get from Green.
"I know there were some other medications that did that, that had
nothing to do with pain," Green told jurors.
The doctor testified that he could not discuss a patient with a third
party, by federal law, even if it were "Barbari's mother" or "a
pastor."
"My hands are tied," Green said.
A pastor from Jesup had told the jury he had called Green's office out
of concern that addicts who received counseling at his church were
getting drugs from the doctor.
Green testified that if he did get a call or a letter about a patient,
he would have talked to the patient about the concerns, but noted that
the patient could deny it and that the patient was a grown adult.
Green told the jury his office policy was for his staff to verify
which drugs patients indicated they were already taking when they
filled out a patient history upon first visiting his clinic. Green
said he couldn't say if that always happened, but that was the office
policy.
If prior prescriptions could not be verified, the doctor said, he used
his "best medical judgment" in treating the patient and prescribing
medications.
"I have to believe the patient," Green said. "If I don't believe the
patient, I don't need to treat that particular patient."
Former patients had testified that all they had to do to get the
narcotics they wanted was to fill out the patient history form, list
the drugs and they'd get their pills.
But Green said the only medications he dispensed were for legitimate
medical purposes based on a patient's diagnosis.
http://www.macon.com/197/story/496119.html
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