Archive: Physicians Under Fire: The Case of William Hurwitz MD

Virginia Physician William Hurwitz Sentenced To 25 Years In Federal Prison

Virginia pain specialist William Hurwitz, MD, was sentenced to 25 years in federal prison in April 2005. The Richmond Times-Dispatch reported on April 15, 2005 ( “Pain Doctor To Serve 25 Years”) that “A prominent doctor convicted of using his pain clinic as a front for drug trafficking and prescribing massive amounts of opiates to patients was sentenced to 25 years in prison yesterday. William E. Hurwitz, 59, whose pain clinic in McLean drew patients from more than 39 states, was convicted in December on 50 counts, including drug trafficking resulting in the death of a patient, health-care fraud, and illegal drug distribution.”

According to the Times-Dispatch, “Hurwitz attracted a national following as an aggressive advocate of high-dose opioid treatment for patients, once touting his theories on ’60 Minutes.’ About 100 of Hurwitz’s supporters packed the federal courtroom in Alexandria, and several testified that Hurwitz saved them from debilitating pain that other doctors were unwilling to treat. ‘I was sick as a dog. I was 90 pounds soaking wet, and I wanted to die. If not for that man, I would be dead’ said Eyssel Gurganus of Goldsboro, N.C., pointing to Hurwitz. ‘I had been to 36 doctors, and every doctor is afraid of prosecution.’”

Physician William Hurwitz Convicted

Dr. William Hurwitz, a northern Virginia physician, was convicted on several counts in a federal court in December 2004 in a case which has sent shockwaves through the medical community. As Jacob Sullum wrote in the Washington Times on Dec. 27, 2004 ( “Chilling Conviction”), “I have to admit I’m impressed by the achievement of the federal prosecutors who call McLean, Va., pain doctor William Hurwitz “a major and deadly drug dealer.” Though the evidence at his trial made it clear Dr. Hurwitz was not a drug trafficker, they still managed to get him convicted. The prosecutors did not dispute Dr. Hurwitz had helped hundreds of patients recover their lives by prescribing the high doses of opioids they needed to control their chronic pain. Instead they pointed to the small minority of his patients – 5 to 10 percent, by his attorneys’ estimate – who misused the drugs, sold them illicitly, or both. The prosecutors did not claim Hurwitz, who could receive a life sentence, got even a dime from illegal drug sales. Instead they cited his physician income, which they said was boosted by fees from patients faking or exaggerating their pain. The prosecutors did not allege Dr. Hurwitz had any explicit arrangement with those patients. Instead they described a “conspiracy of silence,” carried out by “a wink and a nod.” The evidence was, unsurprisingly, ambiguous at best, with plenty of room for reasonable doubt. Yet prosecutors got the jury to overlook their case’s obvious weaknesses and convict Hurwitz, in essence, of trusting his patients too much. That verdict sends a clear message to doctors that it’s better to err on the side of suspicion. Knowing they could be prosecuted for believing a patient who turned out to be an addict or a dealer, doctors will be even less inclined to take the risk, compounding the already appalling problem of people in needless pain because physicians are afraid to help them.”

Sullum noted that “More to the point, the jury was not supposed to decide if Hurwitz was a good doctor; that’s an issue for the state medical board. The jury was supposed to determine if Hurwitz intentionally fed the black market in opioids. The evidence indicates he prescribed in good faith, intending to treat pain, and so his drug trafficking conviction is a chilling precedent. Writing in USA Today during Hurwitz’s trial, Karen Tandy, head of the Drug Enforcement Administration, said, ‘Doctors acting in good faith and in accordance with established medical norms should remain confident in their ability to prescribe appropriate pain medications.’ Notice that ‘good faith’ is not enough to keep the DEA at bay. Doctors also have to prescribe ‘in accordance with established medical norms,’ as determined by the DEA, and prescribe only those medications and dosages the DEA deems ‘appropriate.’ With reassurances like that, who needs warnings?”

Hurwitz Case Goes To Jury

The federal criminal prosecution of northern Virginia physician Dr. William Hurwitz went to the jury in early December, 2004. As reported by the Richmond Times-Dispatch on Dec. 9, 2004 ( “NVA Jury Set To Get Painkiller Case”), “A federal jury was asked yesterday to decide between two widely disparate descriptions of a prominent Northern Virginia doctor accused of fueling a black market in potent prescription drugs. Did Dr. William E. Hurwitz, as prosecutors alleged in closing arguments, look the other way when he learned some of his patients were selling and abusing the medications he prescribed for them? Or, as defense lawyers contended, is Hurwitz a caring, courageous physician who was duped by a small number of patients enrolled in a practice that helped hundreds of other people deal with their chronic pain? After a six-week trial and hearing from more than 75 witnesses, the jury is to begin deliberations this morning on a 62-count indictment against Hurwitz. If convicted of the most serious charges, the McLean doctor could be sentenced to life in prison.”

The Times-Dispatch noted that “The charges against Hurwitz stem from a two-year federal investigation into doctors, pharmacists and patients who allegedly marketed in potent prescription drugs, primarily OxyContin, a widely abused and highly addictive painkiller.”

In a story published Dec. 7, 2004 ( “Pain Doctor Accused Of Drug Trafficking Testifies”), the Times-Dispatch reported that “William E. Hurwitz, on trial in U.S. District Court, acknowledged that he prescribed massive amounts of opiates for some of his patients but said he always had a medical reason for doing so. Hurwitz testified that he knew some of his patients were drug abusers who were illegally taking cocaine or abusing his prescriptions. But he said he felt compelled to continue treating them with drugs such as OxyContin – or at the very least to refrain from abruptly canceling their prescriptions – because of the withdrawal they would suffer after taking such high doses. ‘Abrupt termination of these medicines is tantamount to torture,’ Hurwitz testified. Hurwitz frequently prescribed 100 tablets or more of OxyContin for his patients as they developed tolerance to lesser doses. Court testimony during the trial indicated that at least one patient received a prescription for 1,600 pills a day.”

According to the Times-Dispatch, “Some of Hurwitz’s patients were using the prescriptions they received to deal drugs; many have struck plea bargains and testified against him at trial. Prosecutors have played audiotapes to the jury that they say are proof that Hurwitz knew these patients were dealing drugs and that he turned a blind eye. Hurwitz testified that he did not know any of his patients were dealing drugs. Expert witnesses have testified for both prosecutors and the defense, differing on whether Hurwitz’s prescriptions were medically justified. Among the doctors to testify on Hurwitz’s behalf was Russell Portenoy, chairman of the pain management department at Beth Israel Medical Center in New York and considered one of the world’s leading experts on pain management. Hurwitz treated nearly 500 patients from 39 states in the late 1990s through 2002, receiving a $1,000 initiation fee and monthly fees of up to $250 for each patient in the practice.”

In addition, as the Times-Dispatch reported in a Dec. 8, 2004 story ( “Pain Doctor’s Pay Entered At Trial”), “They also charge that two patients who came to him seeking legitimate pain treatment were prescribed such massive amounts of drugs that he is to blame for their overdose deaths. Hurwitz’s lawyers contend those patients died of other causes. They acknowledge that at times Hurwitz prescribed massive amounts of opiates to the patients enrolled in his clinic, but say it was part of an emerging medical trend that encourages high-dosage opiate treatment for pain management.”

The case has repercussions in the policy world as well. The Washington Post reported on Oct. 21, 2004 ( “DEA Withdraws Its Support Of Guidelines On Painkillers”) that “Advocates for aggressive pain management said the DEA’s decision appears to have been triggered when defense lawyers tried to introduce the guidelines in the upcoming drug-trafficking trial of William Hurwitz, a McLean physician. In late September, Hurwitz’s defense team sought to introduce them as evidence. Several weeks later, the DEA took the document off its Web site and said it was not official policy. Twelve days after that, U.S. Attorney Paul J. McNulty, who is prosecuting Hurwitz, filed a motion in the case asking that the guidelines be excluded as evidence, again saying that they do ‘not have the force and effect of law.’ ‘It seems pretty clear that they felt they had to try to get rid of the guidelines because they supported so many parts of our case,’ said Hurwitz’s defense attorney, Patrick Hallinan. ‘If the Justice Department followed the guidelines, there would be no reason to arrest and charge Dr. Hurwitz.’” is a project of the Real Reporting Foundation. Post last updated February 11, 2024 by Doug McVay, Editor.