Comment By Dr. Jane Orient of AAPS, with respect to letter of Carolyn Smith Buhman   AAPS website>>

I have read several letters asserting, in effect, that Dr. Weitzel must be guilty because 
there were "too many" deaths in a short period of time when Dr. Weitzel was attending 
patients on that unit. Well, there were other persons on that unit too: nurses, orderlies, 
ward clerks, etc. Shouldn't they all be under suspicion, since in fact the precise cause 
of death remains undetermined in all cases? Maybe somebody injected a bolus of potassium 
chloride or air.
 

All physicians in practice probably remember "clusters." One week seems to be GI bleeding 
week, another cardiac failure week, and so on. It is also observed that deaths from all 
causes tend to increase around the holidays. 
 

Most clusters turn out to be statistical artifacts. They are a reason to investigate (as 
the hospital did), but are not proof of anything, certainly not of criminal misconduct.
 

All physicians have probably also had the experience that patients and families seem to 
change their stories.  You may think that you are communicating well and being understood, 
only to have a very different picture emerge later. There can be a very ugly "he said/she 
said" type of disagreement. The specific allegations made by Mrs. Buhman contradict the 
medical record. Lots of people are responsible for what is in that record, not just Dr. 
Weitzel. If the record misrepresents the situation, they are all accomplices. If the nurses 
objected, it was their responsibility to file an incident report. Where are those reports?
 

If Dr. Weitzel is not innocent, then the prosecutor is derelict in his duty for not 
indicting other people for being accessories to the crime. And the hospital, and the 
accreditation agency, and the nursing licensure board are likewise at fault.
 

Doctors everywhere will probably conclude that caring for elderly patients, especially 
demented ones with serious underlying medical illnesses, is a highly dangerous and 
thankless occupation. The care of patients will not be improved by what appear to be 
demands for revenge.
 

It is not as though new evidence has emerged of a killer stalking the halls doing 
clandestine deeds with a sinister motive. The case hinges on controversy about the medical 
judgment of the physician as reflected in events openly recorded in the medical records.
 

Jane Orient, MD

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