Pubdate: Thu, 04 Jan 2001
Source: Bergen Record (NJ)
Copyright: 2001 Bergen Record Corp.
Contact:  150 River St., Hackensack, NJ 07601
Fax: (201) 646-4749
Feedback: http://www.bergen.com/cgi-bin/feedback
Website: http://www.bergen.com/
Author: Linda A. Johnson, The Associated Press
Related: http://www.mapinc.org/drugnews/v00/n1950/a07.html

DETOX MALPRACTICE TRIAL OPENS

Choking back tears, the mother of a 44-year-old heroin addict testified 
Wednesday during a malpractice trial that her son died several hours after 
undergoing a new medical procedure called rapid opiate detoxification in a 
Merchantville doctor's office.

The woman, identified only as Mrs. J, said her son Michael, a heroin addict 
on and off for 20 years, began vomiting profusely, sweating, and having 
trouble breathing within hours of being discharged from Dr. David Bradway's 
care.

"He died in my arms," before paramedics arrived, said the Gwynedd Valley, 
Pa., woman, whose son had earned about $83,000 annually working in the 
family's suburban Philadelphia dental laboratory business.

As the civil trial began in Hamilton Township near Trenton on Wednesday, 
Deputy Attorney General Douglas J. Harper said Bradway and his former 
employer, Dr. Lance L. Gooberman, are responsible for the deaths of seven 
patients within days of them undergoing rapid detoxification. Harper said 
dozens of other patients needed urgent medical care.

The physicians face the possible loss of their medical licenses. They argue 
they followed accepted medical standards and did not cause any patients' 
deaths. One defense expert believes most of the patients died because they 
took drugs after the procedure or had undetectable heart damage caused by 
drug abuse.

But Harper said there was "either a direct causal relationship or a 
contributory relationship" between the patients' deaths and the rapid 
detoxification procedure.

"Had these people been monitored longer," Harper said, "they would be alive 
today."

Rapid opiate detoxification, developed in Europe in the late 1980s, uses 
medications to flush drugs out of addicts' bodies rapidly and ease 
withdrawal symptoms such as diarrhea, cramps, and tremors.

Patients are under anesthesia for about four hours. Gooberman and Bradway 
also implant a pellet of an opiate-blocking drug in the patient's abdomen 
that prevents them from "getting high" if they take drugs over the next two 
months.

Gooberman says his business, U.S. Detox Inc., has successfully detoxified 
about 2,350 patients addicted on heroin, morphine, methadone, and 
prescription painkillers and guided them into long-term recovery programs.

On Wednesday, relatives or friends who accompanied three of the patients 
who died to Gooberman's clinic testified they did not receive sufficient 
warning about the procedure's risks. But some conceded they recalled 
specific warnings from the doctors, and the witnesses and the patients each 
signed a five-page consent form that clearly details those risks, 
highlighting in boldface, underlined type that taking heroin or cocaine 
afterward could kill them.

The relatives and friends, who cared for the patients after the procedure, 
each testified the addicts were too groggy to walk when they were wheeled 
out of the clinic. They also said they did not see the addicts take any 
illicit drugs afterward.

Jessica Martirano, 21, of Newark said she helped her cousin, Anthony 
Reggio, care for his girlfriend, Lisa Flowers of Elizabeth, after she 
underwent rapid detoxification on June 26, 1999. Martirano, who said 
Flowers began taking opium after her infant daughter died, described 
Flowers' face turning blue and her eyes rolling in the back of her head 
hours after she was discharged from Gooberman's clinic.

"I saw her the whole time," and nobody gave her any drugs, Martirano said.

But Gooberman's attorney, John S. Sitzler, said after Wednesday's testimony 
that the day after Flowers died, Reggio told Gooberman's staff Flowers had 
taken 12 bags of heroin after the procedure. Sitzler said toxicology 
reports show heroin was in Flowers' bloodstream many hours after the 
procedure had flushed it out of her body, and that the narcotic painkiller 
Fentanyl was in her stomach.

Sitzler said that indicates that Flowers either ate or licked the narcotic 
from a transdermal patch Bradway affixed to her back to ease remaining 
withdrawal symptoms after the $3,000 procedure.

"These people suffered with this addiction to the same extent that the 
addicts did, and they need someone to blame for a lifetime of addictive 
behavior," Sitzler said.

The trial, before Administrative Law Judge Jeff Masin, resumes this morning 
and is expected to run through the end of February.

Masin then will recommend whether the doctors' licenses should be revoked, 
permanently or temporarily. The state Board of Medical Examiners, which 
regulates physicians, will make a final decision based on Masin's 
recommendation and the board's own expert witnesses.

The doctors' attorneys tried unsuccessfully Wednesday morning to have Masin 
bar testimony for the state from two of those expert witnesses, arguing 
that poses a huge conflict of interest.
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