Pubdate: Wed, 07 Mar 2001
Source: Bergen Record (NJ)
Copyright: 2001 Bergen Record Corp.
Contact:  150 River St., Hackensack, NJ 07601
Fax: (201) 646-4749
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Website: http://www.bergen.com/
Author: Linda A. Johnson, Associated Press

CLAIM REJECTED IN RAPID DETOX SUIT

TRENTON -- A state appellate court panel has rejected a malpractice claim 
against an addiction treatment specialist the state is investigating, but 
allowed a former patient to proceed with other claims a Bergen County judge 
previously dismissed.

The three-judge appellate panel, in a decision distributed Tuesday, wrote 
that the 32-year-old recovering heroin addict could pursue three claims 
against Dr. Lance L. Gooberman concerning possible breach of contract, 
product liability, and assault -- for allegedly not informing her of a 
procedure's risks.

Gooberman performed a procedure called rapid detoxification, widely used in 
Europe but relatively new in this country, to break the woman's addiction 
while she was under anesthesia in his Merchantville office four years ago.

"I feel confident that we did everything properly," Gooberman said in a 
telephone interview. "I explained it to the patient and the patient signed 
[a consent form]. That's informed consent."

The five-page consent form explains the procedure and its risks in detail. 
Gooberman continued to use it until the state barred him from doing the 
procedure in his office pending its investigation of the sudden deaths of 
seven people, out of more than 2,300 rapid detox patients, over a four-year 
period.

Gooberman said he had not seen the court's decision but was leaning toward 
appealing it.

"We obviously have options, including taking this up to the [state] Supreme 
Court," said his attorney, John Talvacchia.

The female patient, identified in court documents by the fictitious name 
Jane Darwin, still has some pain and a minor disability in her right arm, 
according to her attorney, Dennis J. Cummins Jr.

The woman underwent rapid detoxification in Gooberman's Camden County 
office on Dec. 17, 1996. After being put under general anesthesia, 
Gooberman and his assistants gave her a series of drugs that rapidly 
flushed the heroin from her brain and greatly reduced the pain, diarrhea, 
and other discomfort of narcotic withdrawal.

Gooberman also implanted a pellet containing the drug naltrexone in the 
woman's arm. The pellet remains in the body for a few months, blocking the 
effects of heroin or any other opiate drugs taken to help the recovering 
addict avoid temptation.

The drug is widely used in pill form for treating recovering addicts, but 
has not been specifically approved as an implantable pellet -- the basis of 
the woman's product liability claim.

Her lawsuit claims she knew little about the procedure beforehand, felt 
horrible when she awoke, and suffered nausea, diarrhea, and pain in her arm 
afterward. She claimed she had the pellet surgically removed but that it 
left "a lingering infection, pain, and scarring."

Two years later, after media accounts began appearing about some of 
Gooberman's patients dying, the woman sued.

In a 20-page ruling, the state appellate panel agreed with a Superior Court 
judge in Hackensack, saying the woman could not sue for malpractice because 
she never filed the required affidavit from a doctor stating there was 
substantive evidence of malpractice. That requirement was set by the state 
Legislature to limit frivolous malpractice suits.

Cummins said he and the woman believed evidence from the state's 
investigation of Gooberman would meet that requirement.

Cummins said he was pleased with the rest of the decision.

The appellate court said the product liability and assault claims were not 
barred by the expert affidavit requirement, but it split hairs on the final 
claim, that Gooberman did not obtain informed consent.

Such a claim, it wrote, would amount to negligence and thus would be barred 
by the affidavit requirement. But if the woman could prove Gooberman had no 
consent at all to proceed, the judges wrote, "this is an 
assault-and-battery case, not a negligence case, with no affidavit needed."

Gooberman and his former employee, Dr. David Bradway, are in the middle of 
a lengthy civil trial in which lawyers for the state board that regulates 
doctors are trying to convince an administrative judge that the two 
physicians should be fined and their medical licenses revoked.

Lawyers for Gooberman and Bradway argue that the doctors did nothing wrong 
in the cases of the seven patients who died, and say there is evidence most 
of them took drugs after the procedure despite strong warnings of the dangers.

At least a dozen other U.S. addiction specialists perform a similar 
procedure, at about twice the fee Gooberman charges, but do it in a 
hospital and require an overnight stay.
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