MEDICAL MALPRACTICE: Second-Degree Murder Trial Begins in Lakeport
Opening arguments began yesterday in Lakeport a criminal case against a doctor that has "sent tremors through the medical community." The Los Angeles Times reports that Dr. Wolfgang Schug, who practiced at the Redbud Community Hospital, is being charged with second-degree murder, involuntary manslaughter and willful injury to a child in the case of 11-month-old Cody Burrows, who died after Schug transferred him by car to another hospital. The Times reports that the case against Schug is the first charge of second-degree manslaughter against a physician prosecuted by the state attorney general. The case has raised concern with state and national medical organizations, "which oppose punishing doctors criminally for mistakes made in the care of patients."
For The Prosecution
In his opening remarks, Deputy Attorney General Vernon Pierson said Schug kept the baby in the emergency room at Redbud Community for eight hours before realizing that the child was seriously ill. Pierson said that Schug tried to conceal the illness "out of concern for his professional reputation." Pierson said, "This is a case about the last few days and, more importantly, the last few hours of an 11-month-old infant. And the issues are credibility, ego and details." According to Pierson, the baby "desperately needed fluids," but Schug, who was the only physician on duty, "waited too long to try to insert an IV and refused to summon help from an on-call surgeon because he did not want to admit he had misjudged the boy's condition." Schug eventually told Cody's parents to take him to Santa Rosa Community Hospital, but the trip took over an hour and the child stopped breathing before they arrived.
In His Defense
Medical experts testifying for Schug are expected to say that the baby's "weight loss indicated only mild dehydration" and blood tests did not indicate a "medical emergency." In addition, experts will testify that the baby "suffered from kidney failure, and if Schug had tried to give him fluids intravenously at Redbud, the baby probably would have died there" (Dolan, 2/4).
The California Medical Association plans to file an amicus brief in support of Schug. In an interview with NPR's "Morning Edition," Dr. Jack Lewin, executive vice president of the California Medical Association, said, "It's never okay when a mistake or error occurs in medicine. But when a physician is practicing with the best of intentions ... this is not something for which criminal acts should be applied, ever." According to Georgetown University Law Professor Lawrence Gostin, what should separate criminal from civil charges is the "intention to do harm." He said, "Criminal charges are only appropriate if the person had evil intentions. That is, if they had the knowledge that their act would cause harm or they had a specific intent to cause harm. ... You would need either knowledge or intent to harm or some purposeful neglect" to prosecute a doctor for a criminal act. Lewin said applying criminal charges to Schug's case could have ramifications for other doctors. He said, "If we decide to apply criminal charges to errors in judgment ... doctors who practice in rural areas ... won't take critically ill patients who they don't know ... they won't take very serious medical cases." And according to Dr. Lucian Leape, professor of health policy at Harvard University, the "process should be preventive, not punitive." He said that, as with other industries, the medical community needs to "find out why the errors were made and then correct the system," including creating an environment in which mistakes are routinely "reported and analyzed without fear of retribution."
Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, said that doctors should not be immune from criminal charges, particularly since very few patients injured by medical malpractice ever sue and because state medical boards do not take strong action against doctors. According to Wolfe, criminal charges send the message that doctors should be "accountable for their actions" even if they do not plan to do harm ("Morning Edition," NPR, 2/3).