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2 doctors accused of murder by poor treatment face trial 

Originally Posted at:http://www.press-enterprise.com/newsarchive/1998/02/01/886317964.html

2 doctors accused of murder by poor treatment face trial 

By Raymond Smith
The Press-Enterprise

On Tuesday, a doctor in Riverside and another in Northern California will go to court, each accused of murdering a patient with poor medical treatment.

The coincidence is a rarity in an arena where murder charges against doctors are as common as specialists who make house calls.

The unrelated cases point to a growing concern among some doctors that prosecutors have nosed too far into medical decision-making. The specter of criminal charges could discourage doctors from accepting high-risk cases and developing innovative new treatments, they argue.

But a Los Angeles County prosecutor says some doctors are exploiting the attention given to a few high-profile cases to hammer home their message: Doctors should almost never face criminal charges for their deadly mistakes.

On Dec. 13, 1996, Sharon Hamptlon of Barstow was five months' pregnant when she went to A Lady's Choice Women's Medical Center in Moreno Valley for an abortion. Dr. Bruce Saul Steir completed the procedure and Hamptlon left the clinic about 5:45 p.m.

Hamptlon's mother drove her home but could not wake her when they arrived in Barstow around 8 p.m. The family called paramedics, but Hamptlon was dead before she reached Barstow Community Hospital.

An autopsy determined she bled to death after her uterus was perforated during the abortion.

Steir is scheduled Tuesday for a preliminary hearing in Riverside County Superior Court. The doctor, whose license was revoked by the California Medical Board in March, said in an interview soon after the death that he would have gotten treatment for Hamptlon had he known about the perforation.

When Hamptlon died, Steir was on probation because of a string of problems in previous abortions and was practicing without a mentor physician, required under terms of his probation. The case is one of three pending in California in which doctors are charged with murder.

In Lake County, opening statements are scheduled to begin Tuesday in the trial of emergency room doctor Wolfgang Schug.

Schug was charged in the death of an 11-month-old boy he treated for several days in February 1996. After deciding the child needed to be hospitalized, Schug had the parents drive the boy to a hospital with a pediatrics unit more than an hour away. The boy died the next day from a massive infection.

In Los Angeles County, Dr. Patrick Chavis is accused of botching a liposuction procedure, killing a 43-year-old woman. The doctor left his office to check on another patient who suffered complications after a liposuction the previous day, said Deputy District Attorney Brian Kelberg, who is prosecuting the case.

While Chavis was gone and a nurse was in charge, the patient at his office went into cardiac and respiratory arrest and later died, Kelberg said.

In Orange County, prosecutors decided in December not to file criminal charges against Dr. W. Earle Matory Jr. A woman under his care died in March following 12 hours of liposuction.

In San Bernardino County, an unlicensed physician was charged with murder after a Rancho Cucamonga woman died in June from a liposuction procedure that Guillermo Falconi performed in her home. 

Neither prosecutors nor groups such as the American Medical Association track the number of criminal charges filed against doctors. But the recent spurt indicates to some doctors that prosecutors are looking closer than before at patients' deaths.

Dr. Michael Sexton, a San Rafael emergency room doctor and a California Medical Association board member, said some prosecutors may think "they should be the arbiter or protector of patients." That attitude may spring from distrust of a health care system that has gravitated from the traditional doctor-patient relationship to the managed care concept, he said.

"I think there's less trust in the system," he said.

But Sexton said criminalizing the medical decision-making process is proper only in extraordinarily rare cases.

"To the extent that we're seeing over the last few years an increase in these kinds of filings, I think that's inappropriate," he said.

Sexton cannot think of a single case that should have drawn criminal charges against a doctor in his 24 years in emergency medicine. He argued that the California Medical Board's review of doctors and the civil law system, where malpractice is litigated, works well.

"The criminal system is designed to punish people who do things wrongly with intent," he said. "Who's going to want to take care of someone who has a serious illness with a high potential for a bad outcome?"

And fear of prosecution could scare doctors away from developing innovative new procedures that might be second-guessed, he said.

Dr. Ronald Bangasser, medical director of the Redlands-based Beaver Medical Group, has been a physician more than 20 years and is involved in peer review of doctors' work. Even in that capacity, he said, "I don't think I've ever seen . . . anything that comes even close to being murder."

That includes cases in which doctors did things they should not have or went beyond their expertise. Bangasser, who has no direct knowledge of any of the pending cases, said he could envision murder charges being filed against a doctor who abandons a patient without proper care.

Riverside County Deputy District Attorney Kennis Clark, who is prosecuting the Steir case, said doctors should not have a special standard when it comes to murder charges. A murder allegation does not require that someone intends to kill another person, she said.

Clark used the analogy of a construction worker who saws through a support beam while building a house. The worker realizes what was done, knows the danger, and then covers up the mistake and hopes everything will be fine. If the house falls down and kills someone, she said, that is murder.

"Someone does not have to say to themselves, `I'm going to kill at this moment,' " she said. The key is implied malice: Did a person consciously disregard a potential danger that they knew existed because of something they did?

"That's what we have here," she said, referring to the Steir case.  

Employees in the Moreno Valley clinic said Steir made comments that showed he knew he had perforated Hamptlon's uterus, Clark said. One employee, Nancy Myles, said in an affidavit that she saw a look of surprise on Steir's face during the operation. Steir then said, "I think I pulled bowel."

With that statement, Steir knew or should have known about the danger to Hamptlon because bowel tissue would indicate a perforation, she said. Other employees also said Steir left the clinic before Hamptlon was released so that he could fly home to San Francisco.

Steir's attorney, Doron Weinberg, said his client made mistakes, but the case is malpractice at worst, not criminal.

Clark does not believe prosecutors are overzealous with doctors.

"Of all the people that die in the hands of doctors, how many murder charges or even involuntary manslaughter charges have been filed?" she asked.

Prosecutors and medical associations said they do not keep statistics on the numbers. Kelberg, the Los Angeles County prosecutor, heads a special unit that reviews deaths in which allegations are made about extremely poor care, euthanasia and physician-assisted suicide. Of hundreds of cases reviewed, the office has filed criminal homicide charges against five doctors and two dentists since 1984, he said.

Recent cases have generated publicity that the California Medical Association and other doctors' groups want to exploit, he said. 

"You take one well-publicized case and an organization like the American Medical Association or the California Medical Association might try to galvanize public support," he said. "To use one case as kind of a whipping boy for the position is, I think, a mistake.

"There are in fact some very dangerous doctors out there who kill people," Kelberg said, and their punishment should not be limited to losing their licenses and facing civil lawsuits.

Julie D'Angelo Fellmeth said she does not know if the recent cases are an anomaly or if increased prosecution can be expected. She is administrative director of the Center for Public Interest Law at the University of San Diego law school.

Doctors may be feeling pressured because they are being questioned more, Fellmeth said. The California Medical Board has beefed up administrative review of doctors since the late 1980s, she said. Managed health care has created a great deal of dissatisfaction among patients, who now might be asking more questions and making more complaints. 

The new attitude among patients, she said, is: "We're not going to take whatever our doctors say at face value and swallow it and go on with our lives."
 

Published 2/1/1998



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