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March 9, 2005 - The Washington Post (DC)

Life Sentence Sought For VA Pain Doctor

Defense Attorney Calls Federal Prosecutors' Request 'Insane' And 'Obscene'

By Jerry Markon, Post Staff Writer

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Federal prosecutors urged a judge yesterday to send William E. Hurwitz to prison for life, saying the prominent former pain doctor repeatedly lied on the stand during his narcotics-trafficking trial last year.

In a memo filed in U.S. District Court in Alexandria, prosecutors said Hurwitz's "criminal behavior was simply disgraceful" and "blatantly violated his Hippocratic oath" to help patients. Hurwitz was convicted of running a drug conspiracy out of his McLean office and trafficking in narcotics that caused the death of one patient and seriously injured two others. He is scheduled to be sentenced April 14.

Hurwitz's attorney, Marvin D. Miller, called the government request for a life sentence "absolutely insane and way beyond the realm of rationality." Portraying Hurwitz as a caring doctor who wanted only to help his patients, Miller said, "This is obscene."

Miller said U.S. District Judge Leonard D. Wexler should give Hurwitz a sentence of less than 25 years in prison.

The contrasting views of Hurwitz set up what promises to be an explosive sentencing hearing in a case that already has generated a lot of heat.

As cancer patients and others in chronic pain became increasingly vocal about access to treatment, Hurwitz became a symbol in a nationwide debate. Advocates for patients with chronic pain portrayed him as a licensed doctor prescribing legal drugs to patients in dire need with nowhere else to turn; prosecutors said he took advantage of that hope.

Adding to the uncertainty about Hurwitz's sentence, a recent U.S. Supreme Court decision made "advisory" federal guidelines that had been mandatory for judges. Hurwitz's is one of the first major cases to come up for sentencing in federal court in Alexandria since that decision.

The government accused Hurwitz of prescribing excessive amounts of dangerous drugs - in one instance 1,600 pills a day - to addicts and others, some of whom then sold the medication on a lucrative black market.

The case capped a three-year investigation, part of a broader federal crackdown, into doctors, pharmacists and patients suspected of selling potent narcotics and fueling an epidemic that ravaged Appalachia.

Nationally, most other convicted pain-management doctors have received sentences much shorter than the one recommended in this case, law enforcement officials said yesterday, though one doctor convicted in Florida last year was sent to prison for life.

A federal jury in December convicted Hurwitz of 50 counts of the 62- count indictment, including conspiracy to distribute controlled substances. Jurors acquitted him of nine counts and deadlocked on three.

Patient advocates have portrayed Hurwitz as a heroic figure who helped patients nobody else would treat. Advocates reacted with shock to the government's call for a life sentence.

"That's really something. That's unbelievable," said Russell Portenoy, chairman of pain medicine at Beth Israel Medical Center in New York. "Such an extreme sentence sends the message to the medical community that the government will continue to go after doctors."

The government memo lays out numerous examples of lies that allegedly were told by Hurwitz when he testified and that prosecutors cite in calling for a tougher sentence. In one example, the memo says, Hurwitz lied when he blamed the prescription of 1,600 pills a day to one patient on a "clerical error."

Prosecutors quoted from letters sent to the judge by relatives of Hurwitz's victims. One was from Mary Meyer, mother of Linda Lalmond, who died of a drug overdose in Fairfax County in 2000 shortly after meeting Hurwitz. She wrote that her daughter "left home hopeful and smiling, had 2 visits with Dr. Hurwitz and was returned home in a container."

"I request that Dr. Hurwitz be sentenced to the fullest extent of the law," Meyer wrote.

March 11, 2005 - The Drug War Chronicle (US Web)

Federal Prosecutors Ask Life Sentence for Dr. Hurwitz

Federal prosecutors are seeking to send nationally-known Virginia pain specialist Dr. William Hurwitz to prison for life. In a memo filed in US District Court in Alexandria, Virginia, Tuesday, prosecutors argued Hurwitz deserved a life sentence because he "blatantly violated his Hippocratic Oath," his "criminal behavior was simply disgraceful," and he lied on the witness stand. But while prosecutors portrayed him as craven drug dealer, many supporters believe he is unjustly convicted and many patients, including some who testified at his trial and others who came hundreds of miles to attend in moral support, see him as a humane, life-saving physician.

Hurwitz is the prominent, cutting edge pain specialist who was convicted in federal court in Alexandria in December of over-prescribing opioid pain medications and conspiracy to distribute controlled substances in a trial that put the clash between the imperatives of drug law enforcers and those of medicine, and pain management in particular, in stark relief. Relying on the testimony of a group of related Hurwitz patients themselves facing drug charges, who never testified that Hurwitz conspired with them, as well as expert medical testimony that has since been discredited, prosecutors convinced a federal jury that Hurwitz' medical practice was beyond the pale.

Hurwitz's defense attorneys, supporters, medical associations, and pain relief experts expressed nearly uniform dismay, anger, and shock at the prosecutors' request. The request is "absolutely insane and way beyond the realm of rationality," Hurwitz defense attorney Marvin Miller told the Washington Post. "This is obscene."

It is not surprising that Miller would stick up for his client, but expressions of concern are also coming from leading pain relief experts. "That's really something. That's unbelievable," said Russell Portenoy, chairman of pain medicine at Beth Israel Medical Center in New York. "Such an extreme sentence sends the message to the medical community that the government will continue to go after doctors." Portenoy was one of a group of academic pain specialists who worked with the DEA for years in an abortive effort to arrive at pain pill prescribing guidelines that would satisfy both law enforcement and medical imperatives.

The American Academy of Physicians and Surgeons (AAPS), a 60-year-old organization representing private doctors, also weighed in calling for lenient treatment for Hurwitz even before prosecutors announced they were seeking a life sentence. A life sentence for Hurwitz would be "a travesty," AAPS said in a February letter to presiding Judge Leonard Wexler.

"He is someone who took his professional obligations to his patients very seriously and did his utmost to help the most ill among us. He published his work in the medical literature and shared his experiences and research results by speaking at medical conferences, including ours. He is certainly not a drug dealer to be incarcerated for nearly the rest of his life. Dr. Hurwitz is someone we all admire, the criminal actions of a tiny percentage of his patients notwithstanding."

Citing false expert testimony by prosecution witness Dr. Michael Ashburn -- his testimony has been authoritatively challenged by a group of past presidents of the American Pain Society -- the AAPS challenged the validity of his conviction. "A conviction based on this false medical testimony should not stand, and, respectfully, sentencing should not rest on it," the group wrote under the signature of its president, Dr. Jane Orient.

Dr. Hurwitz is scheduled to be sentenced April 14. Given the controversy that has only increased as he was hunted, indicted, tried, and convicted, that hearing could be highly contentious.

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