SALT LAKE CITY — Deliberations over the fate of a Brigham City doctor accused of illegally prescribing painkillers to his patients, including one who died, will begin Wednesday.
After closing arguments, U.S. District Judge Dee Benson will hand the case to a 12-member jury to decide whether Dewey MacKay had a legitimate medical purpose for dispensing narcotics to 12 patients identified in an 85-count indictment. The defense and the prosecution rested Tuesday after four weeks of testimony.
MacKay, an orthopedic surgeon who runs a small pain management clinic, took the witness stand on his own behalf for the second day in a row. He testified that he never prescribed medication that he didn't think was needed, necessary or helpful.
"It is not in my nature to do anything differently," he said.
Under cross examination, federal prosecutor Richard Daynes painted MacKay as a doctor who carelessly prescribed high volumes of painkillers without ascertaining patients' medical or personal histories. He also said MacKay ignored information that some of his patients were abusing or addicted to drugs.
"I don't work with addicts," MacKay said.
For one patient, Scott Blanscett, MacKay wrote six prescriptions totaling 450 pills in 37 days after his first visit. Daynes asked MacKay why he did not check a state database that would have shown Blanscett was getting narcotics from multiple doctors at the time.
"I trusted him because he was my patient and I was his doctor. I knew him from the community. I had no reason to doubt him," MacKay said.
The doctor testified that he took patients at their word when they told him they'd lost their prescriptions or ran them through a washing machine.
Another longtime patient, David Wirick, went to MacKay for painkillers when his family doctor was out of town. MacKay testified that he and the family doctor had previously agreed that MacKay would no longer manage Wirick's chronic back pain.
But MacKay testified that it was "totally appropriate to step in and help this one time" because he knew from his seven-year relationship with Wirick that he suffered chronic back pain. The doctor prescribed Lortab, Percocet and Soma.
"Certainly from a medical standpoint it was totally justified," MacKay said.
Wirick died three days later after a drug binge.
The state medical examiner earlier testified that Wirick had pneumonia at the time. Daynes asked MacKay if he checked Wirick's vital signs or heart and lungs.
"I don't take temperatures. I didn't notice that he was coughing," MacKay said. "I gave him the exact thing I'd given him a hundred times before."
MacKay's attorney, Peter Stirba, argued the evidence does not show that the doctor prescribed the drugs for a reason other than a legitimate medical purpose or that the drugs caused Wirick's death.
Prosecutor Michael Kennedy contends the purpose was "simply to feed Mr. Wirick's need for pills." MacKay, he said, should have been aware of Wirick's binging.
Stirba wants the judge to remove two charges related to Wirick from the indictment. Benson said he's inclined to believe there is evidence to support the charges but would take the argument under advisement and let the case to go the jury Wednesday.