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SALT LAKE CITY — A lawyer for a Brigham City orthopedic surgeon who at one point allegedly dispensed more hydrocodone than any physician in the state described him as an upstanding man just doing his job.
"This case is about a caring and compassionate doctor," defense attorney Peter Stirba told a federal jury. "He's accused irresponsibly and wrongfully of acting as a drug dealer."
Dr. Dewey C. MacKay went on trial Wednesday facing 85 counts of illegally prescribing painkillers from 2005 to 2009. Prosecutors dropped 45 counts Monday, saying the weight of the remaining charges would not affect any sentence he might receive if he is found guilty.
Daynes said MacKay did little or no evaluation of people who came to him with chronic pain, sometimes handing repeat patients a prescription as they walked into his office.
The doctor, they contend, dispensed millions of pills without a legitimate medical purpose.
Prosecutors intend to build their case around 12 of MacKay's patients, all but one of whom will testify during what is expected to be a five-week trial.
"You will not be hearing from David Wirick in this case," assistant U.S. attorney Richard Daynes told jurors. Wirick, a rocket scientist at ATK who had Munchhausen syndrome, died after going on a hydrocodone binge, he said. The syndrome causes people to feign illness or hurt themselves to get attention.
Daynes said MacKay did little or no evaluation of people who came to him with chronic pain, sometimes handing repeat patients a prescription as they walked into his office. He saw 80 to 120 patients a day who were lined up out the door of his small clinic.
Shawna Olsen, a former receptionist for Mackay who gave testimony, said he prescribed pain killers even to patients who told the orthopedic surgeon their pills had been lost or stolen.
When asked by KSL if she thought MacKay was guilty, Olsen said "Absolutely."
Between January 2005 and October 2009, MacKay wrote 20,612 prescriptions for hydrocodone products, totaling more than 1.9 million pills, prosecutors say. Between Jan. 1, 2005, and June 5, 2008, they say MacKay had the highest volume of prescriptions for hydrocodone products in the state and the fourth-highest volume for oxycodone prescriptions.
Stirba said there is no recognized medical standard of how to treat people with chronic pain. "There is no upper limit" for how much medication can be prescribed. There is only one criteria: is it effective, he said.
MacKay changed his practice from surgery to pain management after a coronary bypass and diabetes caused numbness in his hands. Stirba said the doctor determined that surgery doesn't always work and treatment with painkillers could improve patients' quality of life.
"This is his community," said peter Stirba, noting MacKay was named citizen of the year in 2004. "This is where he lives."
Wirick, who endured four failed back surgeries, was such a patient, he said. MacKay prescribed opioids such as methadone as a way to keep Wirick functioning and working at his "important" job at ATK.
MacKay started practicing in Brigham City in 1981. Stirba said he knows his patients and that affects how he treats them.
"This is his community," said Stirba, noting MacKay was named citizen of the year in 2004. "This is where he lives."
Howard Anderson was one of several people who showed up to support MacKay. He said MacKay has treated his wife for 25 years and performed one of her two back surgeries. He said MacKay would write her a prescription for the painkiller, Percocet, every month, due to chronic pain in spite of the surgeries.
"He never over prescribed," Anderson said. "No."
Anderson says he doesn't believe the allegations against his long-time friend.
"He's been wronged. He'll probably lose everything he's got fighting this, that he's worked for all his life and it's a sad way to end a career," he said.