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SALT LAKE CITY (AP) -- The state Division of Occupational and Professional Licensing is trying again to yank psychiatrist Robert Weitzel's medical license.
To the disgraced doctor, it seems like shooting the wounded.
Acquitted after two state trials on multiple homicide charges that his treatment of five elderly patients' pain led to their deaths, Weitzel is now serving a short federal sentence on prescription fraud.
He's been in the Nellis Air Force Base prison camp near Las Vegas, Nev., since Dec. 9.
The state sent notice of the license action by certified mail Dec. 17, not to the prison but to Weitzel's former Salt Lake City address. The signature on the return receipt was illegible.
Hearing of this for the first time during a telephone interview last week, Weitzel was surprised and angry. By then, he had a single day left to meet the 30-day response deadline.
"They're screwing me while I'm here," he said.
Some influential Utah doctors agree. They want to know more about Occupational and Professional Licensing's role in the Weitzel prosecutions, starting with this latest move.
"I would think there's a process by which the person needs to be notified. They know where he is," said physicians licensing board member Dr. Sharon Weinstein, chief of pain management and palliative care at the Huntsman Cancer Institute. "It looks like a witch hunt."
Dr. Gary Lower, past president of the Utah Medical Association, said he and others want further explanations from the licensing agency.
"I'm concerned that what happened to Weitzel could happen to other physicians," he said. "It may be the law gives them that power. But how that power is used is a question mark. It raises issues." -------- Weitzel's three years of prosecution in state and federal courts started with the licensing division, familiarly known as DOPL, pronounced "dopple." It is part of the state's commerce department.
In 1999, DOPL received an anonymous tip that Weitzel was a drug user. Some suspect the tipster was a California woman who sued Weitzel for malpractice in 1992, citing "boundary violations." Weitzel and the woman, a former psychiatric patient, had a two-year relationship that he ended.
The federal prescription fraud charges came in mid-September 1999; the state filed five first-degree murder charges a week later.
Weitzel was accused of overdosing with morphine five elderly, demented patients admitted to the Davis Hospital geriatric-psychiatric ward in December 1995. The five died over a period of 16 days. All had been administered morphine over their last few days of life.
DOPL first tried to take Weitzel's license on Aug. 24, 1999, because he refused an order issued two weeks earlier to check into the Menninger Clinic in Topeka, Kan., for treatment of "malignant personality disorder."
There is no such malady listed in the psychiatric Diagnostic and Statistical Manual of Mental Disorders.
Department of Commerce spokesman Scott Thompson said it's not known who made the diagnosis, nor is there any apparent record of the original order.
Menninger, known for its two- to three-week "professionals in crisis" therapy programs, is expensive: $725 dollars per day, plus several thousand dollars per week for various assessments.
Weitzel would have been on the hook for the bill; he needed to pay legal bills. His attorney in the first state trial, Peter Stirba, told the board Weitzel couldn't go to Menninger because he was in the middle of a criminal prosecution. DOPL suspended his license. -------- The first trial lasted six weeks -- the longest in Davis County history -- and ended in July 2000 with guilty verdicts for manslaughter and negligent homicide.
Second District Judge Thomas L. Kay nullified the verdict the following January, ruling prosecutors had failed to disclose the exculpatory testimony of University of Utah anesthesiologist Dr. Perry Fine.
A nationally recognized expert on pain management and end-of-life care, Fine told prosecutors who'd hired him as a consultant that while Weitzel's was a bumbling doctor in need of remedial training, giving morphine to his patients to ease their pain wasn't criminal.
But Davis County Attorney Mel Wilson and other prosecutors didn't care what Fine had to say about the law, because he's a doctor, not a lawyer.
"It's not for him to decide," said Assistant Attorney General Charlene Barlow.
After the trial nullification, prosecutors alleged Kay was biased in Weitzel's favor and demanded he be recused. Second District Judge Brent West reluctantly replaced Kay. In a blistering ruling, West accused Wilson of unethical behavior bordering on prosecutorial misconduct during and after the trial.
Kay's replacement, Judge Rodney Page, presided over the second trial that ended this past November with innocent verdicts on manslaughter and negligent homicide. Wilson estimates the two trials put his budget $192,000 in the red.
Between the state trials, Weitzel pleaded guilty to two counts of federal prescription fraud. He was sentenced to begin a one-year, one-day prison term 10 days after the resolution of his second state trial or Jan. 1, whichever came first.
------ It's possible that if a spurned lover hadn't pursued him -- if he'd had the sense to realize medical ethics were at issue when he decided to date a former patient -- Robert Weitzel wouldn't be in prison.
If he hadn't grown up in the 1970s, maybe he wouldn't have been so cavalier about drugs. If he'd just had one nurse-witness watch him when he squirted excess morphine down the sink at his shared West Valley City clinic, as he claimed he had, he wouldn't have broken federal drug laws.
If he hadn't been so high-handed with nurses who differed with him on the patients' treatment.
If he'd bothered that Christmastime in 1995 to explain to the patients' families why he thought the patients too ill and demented to speak for themselves were suffering intractable pain.
If he'd just taken more time with the patients themselves. But he didn't.
"He was brusque, abrupt, rude and sometimes crass with off-color jokes," said attorney Walter Bugden, who defended Weitzel the second trial. "It was clear to (the nurses) he didn't like them or respect them."
Weitzel agrees. In an interview a few days before he reported to prison, he admitted he was openly derisive of Mormons, flamboyant and dismissive. From prison, he said it again: "I was stupid and arrogant. An arrogant guy putting down nurses -- I'd never do that again."
Dr. Wallace Ring, a retired anesthesiologist and UMA member concerned that the Weitzel prosecutions were attempts to criminalize legitimate medicine, said Weitzel's character flaws fed his prosecution and made him an attractive target for DOPL.
"Weitzel had a reputation that proceeded him that was questionable, even distasteful," Ring said. "He was a bachelor, out on the make. He was fairly promiscuous, rode about in a red Porsche, picked up a lot of women and made no bones about it. That lifestyle sticks out like a sore thumb in Utah."
Ring pointed to a frequently cited 1998 survey of the growing number of cases against doctors who allegedly gave patients lethal doses of pain medication found that most criminal prosecutions occurred in small towns or rural counties.
The study's author, Ann Alpers, a University of California, San Francisco medical school professor who also has a law degree, found that many of those prosecuted were "outsiders" -- either newly arrived, members of racial or ethnic minorities or living "alternative lifestyles."
-------- Whether Weitzel's license will be reinstated is up to DOPL, whose standards say revocation is possible if a licensee pleads guilty to a crime.
Weitzel knows he's been spat out of Utah. But he wants to work as a prison psychiatrist, perhaps offer hospice care to inmates. He has to get his Utah license back before he can reinstate his Texas license, suspended amid the trials.
The recommendation will come from the Physicians Licensing Board, one of the professional boards that make up DOPL.
Making such decisions "is highly subjective. They are done on an individual basis," said DOPL spokesman Thompson. "The boards have a wide latitude, from a slap on the wrist to revoking their license."
Bugden wants to make sure Weitzel is treated no differently than other doctors who've gotten in trouble.
"I'm pretty sure we're going to find many, many doctors who have substance problems who are put on probation," Bugden said.
In fact, Dr. Michael Crookston, one of the prosecution's expert witnesses, in 1990 lost his medical and controlled-substance licenses for five years for using drugs he illegally prescribed to himself.
He wasn't allowed to practice anesthesiology for the same period. Crookston completed his probation in 1995 and is now fully licensed in Utah.
-------- The Federal Bureau of Prisons Web site lists Weitzel's anticipated release date as April 16, just 18 weeks into his one-year, one-day sentence.
When Weitzel heard that last week, he was surprised -- and wary.
"They make mistakes," he said.
(Copyright 2003 by The Associated Press. All Rights Reserved.)