SALT LAKE CITY — A Brigham City doctor accused of illegally prescribing painkillers took the witness stand in his own defense Monday, saying he honestly tried to ease people's chronic pain.
Dewey C. MacKay testified in U.S. District Court that all the drugs he prescribed were "medically justified" to help people function and improve their quality of life.
"I wanted to do something that relieved that suffering," he said of the people who came to his small pain-management clinic. "I felt that I had provided a great service for patients."
MacKay, an orthopedic surgeon, is charged with 85 counts of illegally prescribing pain medication. Federal prosecutors contend he prescribed millions of pills without a legitimate medical purpose. Their case is built around 12 of MacKay's patients, including one who died after going on a hydrocodone binge.
Between January 2005 and October 2009, Mackay wrote 20,612 prescriptions for hydrocodone products, totaling more than 1.9 million pills, prosecutors say. Between Jan. 1, 2005, and June 5, 2008, they say he had the highest volume of prescriptions for hydrocodone in the state and the fourth-highest volume for oxycodone prescriptions.
Earlier in the trial, now in its fourth week, prosecutor Richard Daynes said MacKay did little or no evaluation of patients who claimed to be in pain.
MacKay testified Monday that he never checked a patient's pulse, blood pressure, weight, heart or lungs because there's "not one orthopedic clinic in the world that takes routine vital signs. … I don't think it's terribly relevant."
The doctor said he conducted "focused exams" aimed at addressing their pain.
Defense attorney Peter Stirba had MacKay describe how and why he treated each of the patients named in the case. The doctor said he had them sign a "controlled substance contract." He also said he monitored their compliance, behavior and well-being through regular office visits.
He said if he found out patients were abusing or selling drugs or getting painkillers from multiple doctors, he stopped seeing them, though he conceded "I certainly tended to give patients the benefit of the doubt."
MacKay started practicing in Brigham City in 1981. For a long time, he was the only orthopedic surgeon in town and saw some patients monthly for years. He testified that he routinely visited patients' homes to do exams, remove casts, give cortisone shots or drop off prescriptions. He also gave money to some who were poor.
"I knew them, and they knew me," he said.
MacKay testified that one young woman, Kerri Dritlein, made 70 visits to his office over four years. He described her as difficult to work with because she constantly called to change her appointments or get her medication early.
But he said he felt sorry for her because she was a domestic violence victim. He gave her money twice for Christmas and once for her son's birthday, a gesture he said was "not unusual" for other patients as well.
"People have needs. If I have more than someone else, I'm willing to share that. I've had a good life," he said.
At one point, he said he found out Dritlein was getting drugs from several doctors and dropped her as a patient until she came into his office crying and promising to follow the rules.
"I was honestly just trying to help her," MacKay said. He said he didn't find out until after he ultimately terminated her prescriptions that she'd been lying to him about her drug use.
MacKay is expected to conclude his testimony Tuesday, then face cross examination from the prosecution.