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Thursday, June 11, 2009 | 2 a.m.
Sun Coverage
Lingering Questions, seg. 1
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Entertainer Danny Gans died from a toxic reaction to a powerful painkiller according to the Clark County Coroner. How did Gans, who had a history of heart problems, obtain a drug that could endanger his health? Face to Face talks with pain management and addiction specialist Dr. Mel Pohl and Las Vegas Sun reporter Marshall Allen.
Lingering Questions, seg. 2
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Entertainer Danny Gans died from a toxic reaction to a powerful painkiller according to the Clark County Coroner. How did Gans, who had a history of heart problems, obtain a drug that could endanger his health? Face to Face talks with pain management and addiction specialist Dr. Mel Pohl and Las Vegas Sun reporter Marshall Allen.
Lingering Questions, seg. 3
Viewing video requires the latest version of Adobe's Flash Player
Entertainer Danny Gans died from a toxic reaction to a powerful painkiller according to the Clark County Coroner. How did Gans, who had a history of heart problems, obtain a drug that could endanger his health? Face to Face talks with pain management and addiction specialist Dr. Mel Pohl and Las Vegas Sun reporter Marshall Allen.
Sun Topics
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The cause and manner of death of Las Vegas entertainer Danny Gans was released Tuesday afternoon.
Audio Clip
- A press conference was held Tuesday, June 9, 2009 regarding the cause of death of entertainer Danny Gans.
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Sun Archives
- Coroner: Gans’ death was accidental; health problems a factor (6-9-2009)
- Encore Theater packed one last time for Gans (5-21-09)
- As Danny Gans is remembered, we’re reminded to grasp the moment (5-21-09)
- Band member: Gans in ‘top form’ at final show Wednesday (5-2-09)
- Danny Gans was a gifted, unique figure in Las Vegas entertainment history (5-1-09)
- Death of headliner Danny Gans creates gap at Encore (5-1-09)
Related Blog
- The Kats Report: Gans epilogue: Entertainer was not nearly as healthy as he appeared
Beyond the Sun
The explanation for what killed Danny Gans raises more questions than it answers, medical experts said Wednesday, opening the door to speculation about the entertainer with a squeaky-clean image.
Clark County Coroner Mike Murphy announced Tuesday that Gans died because of toxic levels of hydromorphone — best known as Dilaudid — in conjunction with other medical conditions. Murphy termed it an accidental death with no indication of drug abuse.
But the lack of details by the coroner is allowing questions of drug abuse to be raised. And four independent medical experts interviewed by the Sun question the coroner’s explanation of Gans’ death, which could be verified if the family authorizes the release of additional information.
“There are too many gaps in the information” to support the coroner’s explanation, said Dr. Jim Marx, a Las Vegas pain specialist. “The bottom line is: The guy died of an overdose.”
Dr. Andrea Trescot, a Seattle pain specialist who has written national guidelines on prescription narcotics, said hydromorphone toxicity means the drug was either prescribed incorrectly or not properly taken.
“Either he took more than was prescribed, in which case it’s an accidental overdose, or it was prescribed in an inappropriate dose, and that makes it potential malpractice,” Trescot said.
Addiction specialist Dr. Mel Pohl said he does not understand how Gans could have suddenly died if the drugs were prescribed responsibly and taken as the doctor ordered. The coroner said Gans suffered from chronic pain syndrome.
“The key thing is: How come it happened that night?” Pohl said. “You’ve got to figure he took more than he usually takes to cause this reaction.”
The 52-year-old impressionist, who headlined at the Encore, was an evangelical Christian who held prayer meetings before shows. He died in his sleep early in the morning of May 1 at his Henderson home, after his wife called paramedics saying he was having trouble breathing.
Gans’ death is the highest-profile example yet of a growing problem in Clark County — deaths in which prescription painkillers are a contributing factor.
A Sun analysis in 2008 showed that more deaths in Las Vegas were associated with prescription drugs — at least 258 in 2007 — than street drugs or automobile crashes. The rate of fatal prescription drug overdoses more than doubled between 1998 and 2007.
Gans’ family is not making further inquiries about the cause of his death — even though it knows neither the levels of Dilaudid found in Gans’ blood nor whether he was legally prescribed the drug, said Chip Lightman, the entertainer’s manager and representative of the family.
“They are at peace to go with what the coroner told them,” Lightman said.
Lightman said in a separate interview with the Associated Press that he is haunted by the question: “Who gave him that prescription?”
The family can learn who prescribed Gans the drug through the Nevada Board of Pharmacy’s prescription drug database. It tracks every prescription for narcotics written in the state by doctor and patient name.
Publicly releasing that information and other details, including the amount of the drug in his blood, could answer lingering questions about the celebrity’s death and, if necessary, bring accountability to the doctor who prescribed the medication.
The coroner, who is bound by patient-privacy considerations, would not say whether Gans was prescribed the highly potent medication and, if so, how much; the amount of the drug that was in his system; or whether any other drugs or alcohol were in his system.
“We have an issue involving Mr. Gans’ health and the hydromorphone, and as a result of the combination of those issues, Gans succumbed,” Murphy said in his news conference.
A 2008 Sun analysis of Drug Enforcement Administration data found that Nevadans ranked seventh nationally for per-capita use of hydromorphone in 2006, the latest year statistics are available. (For that same year, Nevada ranked first and fourth nationally for per-capita use of hydrocodone, better known as Vicodin and Lortab, and oxycodone, best known as OxyContin.)
Hydromorphone is at least three times more potent, milligram for milligram, than morphine, experts said. It’s rarely prescribed — an average of 4.47 milligrams was consumed per Nevadan in 2006 — compared with hydrocodone, which was consumed at an average of 242.6 milligrams per Nevadan, according to government data.
Hydromorphone is not commonly prescribed, doctors said, not only because it is extremely potent but because it’s short-acting, lasting only a few hours.
Marx, the pain specialist, said he can’t remember the last time he wrote a prescription for hydromorphone, but that doesn’t mean it’s inappropriate. Any drug that’s not used properly can have unintentional consequences, he said.
Usually, other factors — such as alcohol, or the anxiety remedies Xanax and Valium — are involved in deaths involving prescription narcotics, Marx said. He said he’s skeptical that the single drug caused Gans to stop breathing.
“It’s not like he took an extra pill and stopped breathing, particularly if he took them in the past,” Marx said.
The coroner said the effect of the drug was magnified by Gans’ hypertensive heart disease and a condition called polycythemia, which thickens the blood, decreasing the amount of oxygen flowing to the body.
Marx said he would label the death an overdose because it sounds like it was the drug that caused him to stop breathing.
Las Vegas pain specialist Dr. Michael McKenna said the take-away message should be that such drugs should be taken with caution, according to doctors’ orders. McKenna said there seems more to the story than the coroner’s explanation.
“Given no other changes in his medical condition and that he was taking the same dose he normally took it’s unlikely that the medication would cause him to die,” McKenna said. “Under excellent medical care, with excellent monitoring and compliance by the patient, this type of thing should not happen.”
The answer to whether Gans took too much Dilaudid would be found in the amount of the drug in his blood, and that’s not publicly known, McKenna said. And knowing the dosage he was taking would answer whether the drugs were properly prescribed, he said.
“There may be a combination of things that led to this unfortunate outcome,” McKenna said. “But without the details we can’t state whether his care was appropriate or inappropriate.”
Sun reporter Alex Richards contributed to this story.
If Danny Gans was a layed off Casino worker the coroner's report would simply say, Cause of death. "overdose of Didaudid". If he would have been screened for drug use when he was hired by Encore like any other employee, He could have got help and might be alive today!
Even the photos make him look more and more like Elvis every day.
Hey all. On today's Face to Face, we are discussing the conditions Danny Gans suffered from, the drug that eventually killed him, and whether doctors are doing enough research on the medical histories of their patients before prescribing powerful medications. That's today (June 11) at 5:30pm, 6:30pm, and 8:00pm on Las Vegas ONE, Cox Cable Channel 19.
The Las Vegas Sun seems to be very willing to trash the names of individuals such as Gans - just ask Darling, the guy who was hit by the police offier going 110 mph. Too bad the Sun doesn't show the same sense of investigative journalism towards Metro. Maybe if someone in Las Vegas actually questioned the behavior of the police we might see fewer instances of illegal actions by them.
The truth will come out. It does no good making Gans out to be some kind of saint if indeed he was nothing more than a druggie local celeb. I will give him the benefit of the doubt for now.
What is the differance between Hydromorphone & Oxymorphone ? Thanks
Dr. Mel Pohl of the Las Vegas Recovery Center will be hosting a Q&A session on chronic pain syndrome on Twitter, so please feel free to ask any questions (cut and paste link below):
http://www.twitter.com/PainRecovery
This may all be the result of a crappy email program with weak spam filtering.
He was a good Christian.
Let him rest in piece & the family heal.
This is a general comment.
Any opiate prescibed should be done by one Doctor dealing with one pharmacy only with frequent blood and urine samples to make certain that the person is not abusing the drug and is in compliance (agreement in writing signed by the patient). It produces intense euphoria (this is one of salient reason for the abuse of opiates)and a decrease in respiration. pulse and blood pressure.
For those of you who never have gone for pain management you have no idea what Danny went through. If you knew you would not be making rash judgements. Going for pain management does include drug testing. For those of you that are perfect and never taking your meds wrong keep your comments to yourself. All your doing with your nasty comments is hurt the Gains family. Isn't it enough that they lost Danny without you throwing stones. He's gone and its not for us to judge.
I have never seen a coroner go so out of there way to not say that someone died of a drug overdose, accidental or otherwise, when it is obvious that is what happened.
spell check people..their means belonging to someone. there means over there. arrrgh. this is for gettocard..it's healthy, not healty, suddenly, not suddendly.
So Danny Gans was an evangelical christian drug addict? The contradiction does not surprise me one bit.
To spellcheck freak:
I am so with you! It takes a special kind of thesaurus to get through some of these comments.
***it is "rest in peace", not "rest in piece";
***it is "laid off", not "layed off";
***it is "hurtful to the family", not "hurt the family";
***it is the "Gans" family, not the "Gains" family.
elvis all over again - afraid to put the words in print??? Drug overdose - give me a break
The reason the family doesn't want to know more is because they know. And maybe the insurance wouldn't pay? This is not right all men are created equal, if he used drugs don't cover it up and the DA needs to look to see who gave him this drug, before it kills somebody else.
People need to know the truth. When you put things out there like "he was a good christian" or "he was a good guy and a pilar in the community" which may be well and true. He may also have been a drug addict. These things are not mutually exclusive of each other. People, especially kids need to know that. No one is immune to the addictive effects of drugs, perscription or otherwise.
Dr Michael McKenna SHOULD NOT BE Saying anything here... This Supposed Dr. messed me up. I was in an Auto accident told him my mid back was hurt. He did an MRI of the upper back, and didn't notice the Broken Thoracic vertebrae. Further more he told me he would only give me Basically a Strong Aspirin for the pain. Later well after the fact New Dr noticed the Broken vertebrae. TOO Late to fix it Even though I had Complained for years. I should have Sued both For Obvious Malpractice. But Especially Dr.McKenna. And yes I have Proof of all I have posted here...
Maybe it wasn't an accidental overdose.
Exhibit 1: Danny Gans tells Alicia Jacobs several days before his death that the best story she will write will be his obituary.
Exhibit 2: Danny is not happy with his recent deal with Steve Wynn where he's lost the exclusivity of the showroom at Wynn.
Exhibit 3: During Danny's memorial gathering, Danny's daughter mentions that "my Dad told me to keep THIS speech short so I don't lose the attention of the audience".
Exhibit 4: Danny plays golf with his priest on the last day of his life.
Danny has suffered from years of chronic pain--achilles tendon, back, and especially his shoulder, he had trouble sleeping, and he had a heart condition. Perhaps he was just too tired to continue. R.I.P.
By the way, being in pain management does not require bloodwork or even an MRI, depending on your pain management doctor's greed factor. I have a pain management doctor who no longer hands you your prescriptions; the doctor sends all the prescriptions through 'his' pharmacy--you have no choice of where to have your prescriptions filled. This cuts out the independent pharmacist (WalMart, CVS, etc.) who might raise a red flag. I assume that the more prescriptions the doctor writes, the more money he makes. And you must see the doctor every 30 days for your refills; and the office visits cost $250-$300 plus a couple of hours of wait time. If you've ever been in the waiting room of a "pain management" doctor, it's overflowing with newly-created junkies. Pain management is just a really expensive form of drug dealing. The Nevada Medical Board should take a second and third look at the easy availability of drugs via "Pain Management Doctors" in our city and state. Pain management is often the last resort for chronic pain sufferers, but their chronic pain is nothing compared to the hellish care and side effects they are about to be subjected to. And that's a crying shame for the patient who is truly seeking relief, not drugs.
If we believe the TV commercials, we'd all be taking one pill or another...
One thing that isn't clear to me in the various accounts is if he was taking blood pressure medication. It said that he had high blood pressure and advanced heart disease from it. Did blood pressure medication play a part in this or maybe the lack of taking blood pressure medication?
Come on, you know when a Dr. Is a Drug Dealer. Usually by their waiting room ( as you stated). People complain about Drs. & even blame them for their addiction, but they know when they are taking 5 or 6 Lortabs instead of 1 that they aren't supposed to be. And they know the Dr should be calling them on running out early. So, patients have their part in it, also. As for Danny Gans, no one is a saint, Christian or not. But, apparently, the law says we have to respect he & his family's privacy *shrug*
As for Mr. Ms. Spellcheck up there, with the invent of iPhones & such (I am typing on an iPhone now) keyboards have changed & typos have increased, a lot! I noticed several of your spelling errors were probably typos. As for the grammer, it's horrid.