Over-prescribing blamed in woman’s death

Molly Ball

Wednesday, March 9, 2005 | 10:52 a.m.

Dr. Gary Lutz knew his patient was suicidal, but he kept prescribing her narcotic medications -- drugs Rae Anne Distasi would later use to kill herself, prosecutors told the state Board of Osteopathic Medicine on Tuesday.

Lutz, a doctor of osteopathy, faces charges of malpractice and excessive prescribing in the case, which could lead to his license being revoked. The hearing continues today.

Distasi was 34 when she was found dead in January 2004. The coroner ruled that her death was a suicide, caused by an overdose of the drugs amitriptyline and alprazolam, also known as Elavil and Xanax.

"Dr. Lutz engaged in unprofessional and unethical conduct in the excessive prescribing of controlled substances," Chief Deputy Attorney General Charlotte Bible told the board.

Lutz is also accused of excessively prescribing drugs to three other patients.

But Lutz's attorney, John Spilotro, portrayed Distasi as a troubled woman who was in constant pain as a result of brain surgery. Her suicide could have resulted from "multiple problems" in her life, he said.

In trying to treat his patients' chronic pain, Lutz "might have gone over his head...which he probably should not have done," Spilotro said.

But that doesn't change the fact that Lutz was "a doctor trying to do the best for his patients that he could under the circumstances," Spilotro said.

In his medical records, Lutz noted that Distasi had expressed suicidal thoughts and attempted suicide unsuccessfully once while he was treating her. But he did not adjust her prescriptions or refer her to a mental health professional, as he should have, said Dr. Robert Kessler, a Boulder City pain-management specialist who testified for the prosecution as an expert witness.

"If they are depressed enough to express suicidal ideology, then something's not working," Kessler said.

In addition, a physician who knows his patient is suicidal should not prescribe large amounts of potentially lethal drugs, Kessler said.

The other three patients referenced in the complaint against Lutz were also prescribed large amounts of drugs.

One patient, referred to only as Patient B to protect his privacy, was at various points prescribed a laundry list of drugs that included OxyFast, Lortab, OxyContin, Norco, morphine, methadone, Soma, Dilaudid and Dexedrine.

Kessler testified that Lutz never performed the thorough examinations, such as a neurological exam, that should have been prerequisites for such prescriptions. Lutz increased the patient's prescribed dosages rapidly, even though the patient said he was feeling fine, according to testimony.

The patient was taking a dose of methadone that was 10 times what recovering heroin addicts normally take, and the amounts of Tylenol-based drugs were enough to cause liver damage, Kessler said.

Another patient was prescribed 24 times the usual starting dose of Klonopin, a drug used to treat panic, and was given 100 times the recommended starting amount of Actiq, a fentanyl lollipop that is an extremely powerful narcotic.

And the fourth patient named in the complaint against Lutz was prescribed medications containing more than three times the toxic dose of Tylenol, Kessler said.

Family members of Distasi who attended the hearing said they blamed Lutz for her death.

"She went to him for help, and it took eight short months for him to turn her into a zombie and kill her," said Andrea Fisher, Distasi's younger sister.

Once a vivacious, outgoing woman, Distasi lost her job and stopped speaking to her friends and family while under Lutz's care, Fisher said.

"He killed her, that's how I see it," she said. "I don't care if they ruled it a suicide."

Lutz also has a history of misbehavior.

In 2001, the Nevada board placed Lutz on probation after a complaint accused him of inappropriately touching a patient. A psychological evaluation found that he had "boundary issues," said Trey Delap, the board's deputy executive director.

Lutz reached a settlement with the board that required him to attend counseling, Delap said.

Previously, Lutz was twice convicted of misdemeanors in Ohio for giving a 13-year-old patient copies of Penthouse magazine on two separate occasions, according to the Ohio State Medical Board.

Lutz was the team doctor for the child's football team, according to the Ohio board's citation. Lutz's Ohio medical license was suspended in 1998, and he was ordered to undergo psychiatric treatment and enroll in a sex-addiction program.