 Robert Weitzel attends his trial on charges stemming from the deaths of five patients.  Jeffrey D. Allred, Deseret News |
Dr. Sharon Weinstein said hospital charts showing the vitapulse and
respiration rates and the blood pressure of the five individuals, along with
records regarding the times they received medications, show that the drugs did
not produce signs of an overdose — sleepiness and a slow decline in pulse,
respiration and blood pressure.
"The morphine did not cause or contribute to the death of this
patient," Weinstein testified about each individual during questioning by
defense attorneys. Additionally, she said the psychotropic drugs given to four
of the patients, either alone or in combination with the morphine, also did not
kill them. Instead, she said these patients suffered from severe dementia when
admitted to the geropsychiatric unit that Weitzel supervised.
"These patients were terminal," she said.
Weinstein is a neurologist at the University of Utah who supervises pain
management care and palliative (comfort) care at the Huntsman Institute. She
also is associated with the Veteran's Hospital, has published several articles
about the effects of medications and pain, and has participated in clinical
research trials.
Weitzel is charged with two counts of second-degree felony manslaughter and
three misdemeanor counts of negligent homicide in connection with the deaths of
the five, which occurred in late 1995 and early 1996 at Davis Hospital and
Medical Center in Layton.
Dr. Kerry Cranmer, a geriatrician who works in Oklahoma City, also testified
that Weitzel medicated the patients appropriately — which was not always the
case in 1995-96 when less was known about pain in elderly people with dementia.
Cranmer is treasurer of the American Medical Directors Association, belongs to
many other professional organizations, and has a three-page typewritten list of
articles he has published that focus primarily on treating elderly patients.
He testified that doctors traditionally have undertreated pain in older
patients, especially those who cannot verbalize what is wrong. Weitzel's
approach to these five individuals was certainly within the standard of care at
the time, Cranmer testified.
"To be honest with you, he was probably ahead of his time," Cranmer
said. "Morphine is probably the most geriatric-friendly medication you can
use."
Without the morphine they received, these patients probably would have died
"a bad death" of physical suffering rather than a death of
"comfort and dignity," according to Cranmer.
Cranmer rejected contentions raised by prosecutor Melvin Wilson that the
patients were overmedicated and there was a greater risk of organ damage because
of that. "Those organs are affected by increased agitation and
anxiety," which morphine can calm, Cranmer said.
Keela Herr, a professor of nursing at the University of Iowa who has published 60 articles in peer review publications and taken part in 15 research projects involving pain in elderly patients, also said Weitzel did nothing wrong. She said geriatric patients who are mentally impaired often are not properly diagnosed or treated for pain even though they may show non-verbal signs of it. "All five (of these patients) had a very high probability they were in pain."