FARMINGTON — After five weeks of anguished testimony tempered by an exhaustive review of medical records, the trial of Robert Allen Weitzel peaked Thursday when Weitzel categorically denied he killed five patients.
Weitzel, a psychiatrist, testified in 2nd District Court that he believed he acted appropriately when he prescribed morphine and other sedative medications to five patients at the Davis Hospital and Medical Center's geriatric-psychiatric unit in December 1995 and January 1996. He also countered prosecutors' accusations that he was derelict in his care of patients and intentionally caused their deaths.
"I followed these patients every day," Weitzel said. "I used my best judgment with regard to medications. I felt they were appropriate."
Weitzel said the drugs were prescribed to treat the patients' psychological problems and alleviate the suffering he believed they experienced. He said he attempted to treat the medical problems that four of the five patients developed during their stay at the hospital, but that the patients' own medical directives prohibited him from aggressive medical interventions.
The fifth patient, 91-year-old Ellen Anderson, died the day after she was admitted to the Layton facility. Weitzel testified he was "curious" to know what caused her death but did not believe the 20 milligrams of morphine played a role.
When Mary Crane, 72, developed a potentially infectious medical condition, Weitzel said he requested that an internal medicine specialist outline treatment options. But when prosecutor Mel Wilson asked him why he did not prescribe antibiotics as a gynecologist had recommended, Weitzel said, "The gynecologist recommended broad-spectrum antibiotics. I didn't know which one to use."
Though Weitzel later did prescribe an antibiotic after he discovered the internist "was kind of missing in action," he testified Crane's infection had become septic. And since she had a medical directive preventing life-prolonging measures, Weitzel said his hands were tied. He denied prescribing medications that contributed to her death.
"I don't see how there's any way these medications caused sepsis," Weitzel said.
When all the patients, except Anderson, became terminally ill, Weitzel said he met with family members to discuss treatment options. He testified it was his policy to tell them they could transfer the patient to the hospital's intensive care unit.
But, he said, family members voluntarily accepted his offer to provide end-of-life care, which included morphine and sedatives.
"All of these families were on board with me, understanding what was going on and wanting their loved ones to be comfortable," Weitzel said. "I did what I thought was right. The medications were meant to help them."
Pain management expert Bradford Hare, the state's first rebuttal witness, testified physicians have an ethical obligation to alleviate pain and suffering, even if they foresee the comfort measures may hasten death.
However, he said Weitzel's decisions to administer medications intra-muscularly and to discontinue intravenous fluids and medications for a patient whose medical directive permitted IVs did not conform to his understanding of comfort care.
Rather, Hare said several patients showed signs of morphine toxicity, while his review of records revealed few pain complaints justifying the administration of morphine.
The prosecution will continue its presentation of rebuttal witnesses Friday. Closing arguments are expected Monday, after which the case will go to the jury.