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PUBLISHED WEDNESDAY, FEBRUARY 13, 2002
Witness:Treatment not unorthodox
Expert faults Graves for record- keeping
Monica Scandlen @PensacolaNewsJournal.com
A defense expert said Tuesday the only change he would have made in treating some of Dr. James Graves' patients is keeping better records.
Dr. Daniel Handel, a pain medicine and palliative-care specialist at the National Institutes of Health, reviewed medical records of some of Graves' patients from the Pace doctor and other doctors.
He testified he found nothing unusual about Graves' prescriptions for OxyContin, Lortab, Xanax and a sleeping medicine such as Ambien or Soma.
"I found (Graves) practiced within the bounds of the standard of care in the United States," Handel said of each of four of Graves' patients who overdosed and died.
Yet, he added several times: "I think we have a physician who is severely lacking in documentation."
Graves, 55, is accused in the deaths of the four patients who overdosed on the medications he prescribed. The prosecution contends he illegally prescribed the powerful combination of medications to dozens of other patients.
Graves maintains the patients were addicts who lied to him to get the drugs and he is not responsible for how his patients took their drugs once they left his office.
Handel agreed.
"A doctor has no control over any of what our patients do," Handel said.
Under cross-examination by Assistant State Attorney Russ Edgar, Handel admitted that once patients started dying, he would have "reassessed" some cases.
The four patients fatally overdosed within seven months of each other: between November 1999 and June 2000.
Also, Handel said the fact that other patients came back early for their prescriptions over and over again would have raised "a red flag." But, he said, that is not always a sign of addiction or a sign the doctor should stop prescribing medication.
It could be a sign that the patients' pain is undertreated or they are selling or giving away their medication.
"I'd want to know why that's happening," Handel said.
Edgar also questioned Handel about his role as part of the speakers bureau for Purdue Pharma, the company that makes OxyContin, and two other pharmaceutical companies.
The defense case is expected to continue today.