Deseret News, Tuesday, November 19, 2002

Defense experts back Weitzel's care of patients

By Linda Thomson
Deseret News staff writer

FARMINGTON — Psychiatrist Robert Weitzel appropriately medicated five patients who died, he did not deviate from a commonly accepted standard of care, and all five died from natural causes and not morphine overdoses, according to two experts testifying for the defense in Weitzel's trial.

Weitzel is charged with two counts of second-degree felony manslaughter and three counts of misdemeanor negligent homicide in connection with the deaths of five patients at Davis Hospital and Medical Center's geropsychiatric unit in late 1995 and early 1996.

Prosecutors allege he overdosed them with morphine, while defense attorneys claim he was providing "comfort care" to people with physical medical problems.

The first expert to testify in the trial's fourth week was Dr. Lesley Blake, who is director of geriatric psychiatry at Northwestern University Medical School, runs the geropsychiatric unit and has published several scholarly articles about drug treatment of elderly psychiatric patients.

Blake testified that her review of the five patients' records shows Weitzel properly switched some patients from medications that are not good for elderly patients to other drugs and increased dosages because their agitation was not abating.

Given the symptoms that nurses charted in their records, Blake also found Weitzel's use of morphine acceptable.

Blake rejected prosecutor Charlene Barlow's suggestion that the patients were overmedicated. One patient, Judith Anderson, received 28 shots in the last 24 hours of her life, Barlow noted. "You try to give the next injection before the pain breaks through," Blake said.

"I do not feel those drugs contributed to these patients' deaths," Blake said. "I think it was entirely appropriate for him to treat pain in those patients."

Blake said the goal of treating elderly psychiatric patients is not to sedate them but to control their behavior, which often requires some trial-and-error use of medications to see what combination works best. But people who are seriously ill upon admission to a hospital probably will not survive, and these five patients were all in bad shape.

"A certain portion of patients who come into the hospital are going to die," Blake said. "They (the five Weitzel treated) were in the terminal phases of dementia. No matter what anybody did, they were going to die."

Dr. Bader Cassin, a forensic pathologist for two Michigan counties, testified that all the individuals who died did so from natural causes.

Cassin said patient Ellen Anderson, 91, died from a combination of arteriosclerosis (chronic hardening and thickening of the arteries) that had an effect on her heart, along with emphysema and bronchopneumonia.

Cassin testified that Judith Larsen, 93, died from advanced arteriosclerosis. He said Mary Crane, 72, died from hypertension, a stroke and advanced arteriosclerosis.

Cassin said Lydia Smith, 90, died from advanced arteriosclerosis. And Cassin testified that Ennis Alldredge, 83, died from severe arteriosclerosis, hypertension and acute bronchopneumonia.

Cassin said all five patients had other serious physical health problems that contributed to their deaths.

He disagreed with questions posed by prosecutor Steve Major suggesting that morphine overdoses killed the patients by depressing respiration, producing problems with swallowing that could lead to fluid in the lungs or other side effects of morphine use.

"I don't think morphine caused their deaths," Cassin said.

Instead, Cassin testified that Weitzel's use of morphine for these individuals probably gave them a more peaceful natural death than they otherwise would have had.

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© 2002 Deseret News Publishing Company