THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Monday, August 12, 1996 TAG: 9608120060
SECTION: LOCAL PAGE: B5 EDITION: FINAL
SOURCE: BY PETER FINN, THE WASHINGTON POST
LENGTH: 83 lines
After the longest hearing in its history last month and 12 hours of deliberation behind closed doors in Richmond Saturday, the Virginia Board of Medicine has revoked the medical license of William Hurwitz, the controversial physician who prescribes large doses of powerful narcotics to treat people suffering from intractable pain.
Hurwitz has built up a national practice of around 300 patients from across the country. He prescribed large doses of powerful painkillers, such as morphine and dilaudid, to treat pain in patients with nonmalignant conditions. It is a controversial branch of medicine that draws federal and state scrutiny because of the numbers of pills involved and the potential for abuse.
The Virginia board said that it would stay the revocation in three months if Hurwitz meets a number of conditions. He would be banned from prescribing certain narcotics for one year and would be required to take approved medical courses in prescribing narcotics, pharmacology, psychiatry, addiction, medical record-keeping and pain management, his specialty.
A board panel found that Hurwitz, a McLean, Va., resident with offices in the District of Columbia, routinely prescribed excessive amounts of narcotics to patients whom he failed to properly screen and monitor. The board noted that some of Hurwitz's patients had a pattern of drug abuse that should have been evident to him.
Moreover, the board said in its findings, Hurwitz inadequately evaluated and treated two patients who died from drug overdoses from narcotics he had prescribed.
``I'm flabbergasted,'' Hurwitz said Saturday night. ``The Board of Medicine has told my patients, ``Drop dead.' ''
Of past drug abuse among some of his patients, Hurwitz said: ``The fact they saw that in the records shows I was not blindsided by it. This was information I gathered.''
Hurwitz said he plans to appeal the ruling to the state or federal courts or both.
The decision outraged Hurwitz's patients, 50 of whom traveled to Richmond to support him.
``The board has made no provision for the patients,'' said Laura Cooper, an Arlington, Va., resident and legal consultant for the National Multiple Sclerosis Association, who suffers from pain associated with multiple sclerosis and is treated by Hurwitz. ``If I can't get medicine, I'm going to die the next time I get sick, and that's not histrionics. Some of us are candidates for suicide now.''
Even before the Virginia ruling Saturday night, Hurwitz's future in medicine was becoming increasingly uncertain.
He also is licensed in the District, where his office is located, and the D.C. Board of Medicine is investigating his practice separately. Hurwitz has been on administrative probation in the District since 1991, after an investigation that found he had violated the law by writing prescriptions for controlled substances for people with whom he had not established a doctor-patient relationship. D.C. officials said last week they can use the Virginia finding to take immediate action against Hurwitz.
Hurwitz said his medical malpractice insurer has canceled his coverage because of lawsuits stemming from the deaths of the two patients, a move that he said will all but end his ability to practice.
The Virginia board suspended Hurwitz's license on an emergency basis May 14, alleging that he was a ``substantial danger to public health and safety,'' for excessively prescribing controlled substances to drug-dependent patients. The board's action was triggered by the two deaths in January, both allegedly from overdoses of prescribed drugs.
Hurwitz argued that one patient had committed suicide by taking 10 times the recommended dose, something he could not control, and that the other patient had died from intestinal hemorrhaging, not an overdose.
But the board found that Hurwitz failed to screen either patient even though both had histories of drug abuse.
A patient in Vienna, for instance, was prescribed 81,784 pills from November 1993 to June 1995, about 150 pills a day, according to the board.
The case against Hurwitz, which drew national attention, was viewed by Hurwitz supporters as pitting a radical and relatively new treatment against the ingrained conservatism of regulatory bodies.
Pain specialists from leading U.S. hospitals and medical schools reviewed Hurwitz's treatment protocols and came to his defense. ILLUSTRATION: ASSOCIATED PRESS
Dr. William Hurwitz, right, said of his license revocation hearing
last week that his patients' needs were being ignored.
KEYWORDS: DOCTOR VIRGINIA BOARD OF MEDICINE LICENSE
REVOKE by CNB