Alexander DeLuca, M.D.
In a trial full of second opinions and second guesses, Dr. Paul Heberle said he would have done nothing differently.
The Erie osteopath retook the witness stand Thursday and testified he did all he could to understand the patients to whom he was prescribing powerful painkillers.
Heberle said he used a personal approach in dispensing drugs such as OxyContin and fentanyl.
"Every patient is unique," he said during two and one-half hours of testimony.
With each patient, Heberle said, "there was a medical purpose" for prescribing the painkillers.
"I'm not about giving people things that can be a problem without checking it out."
Heberle was the final witness in a trial that started with testimony May 9. Closing arguments start in the courtroom of Erie County Judge William R. Cunningham at 8:30 a.m. today.
Heberle on Thursday tried to counter the prosecution's allegations that he illegally overprescribed painkillers to 15 patients between August 2003 and April 2005.
Heberle was practicing at Southeast Medical Center, 1306 East 38th St., during most of that time. He also worked in the emergency room at Millcreek Community Hospital.
Heberle testified most of his patients had been previously prescribed painkillers, including a class of drugs known as opioids, which include OxyContin. Heberle said he accounted for the patients' medical histories as he prescribed drugs to help them alleviate back pain and pain from other chronic conditions.
Referring to the 15 patients, Heberle said, "Everybody on that list had previous experiences with these medicines. They were not naive, they had tolerance."
Heberle, 40, of Edinboro, is accused of 15 counts of violating state drug laws and 13 counts of Medicaid fraud. He was trained in internal medicine and later specialized in pain management. Heberle is not currently practicing medicine.
The jury for much of the trial heard from expert witnesses for the defense and prosecution. They gave their opinions on whether Heberle followed proper procedures in prescribing drugs.
A number of patients testified as well. Heberle during his testimony responded to the experts' views and reviewed the cases of 15 patients one by one.
The defense and prosecution focused many of their questions to Heberle on the case of Lisa Stallard, 42, who died of an overdose of fentanyl in January 2005. Heberle was treating Stallard, a delivery-truck driver, for severe work-related back pain.
Stallard's death prompted the Pennsylvania Attorney General's Office to launch its investigation of Heberle, who was trained in internal medicine but built up a pain-management practice for about 300 patients.
Most of Heberle's patients were on Medicaid, and Heberle said the federal program limited the type of painkillers he could prescribe.
Stallard was not on Medicaid. The lead prosecutor, Douglas Wright, a senior deputy attorney general, suggested that situation would have given Heberle more leeway in how he chose to treat Stallard.
But Heberle said the painkillers and dosages he prescribed to Stallard were appropriate under the circumstances. He said he was trying to wean Stallard off fentanyl when she died.
"I feel terrible about it," he said of her death. "But I still don't understand it."
Wright is alleging Heberle should have known better than to prescribe the drugs to Stallard and the other 14 patients. He has tried to show Heberle acted illegally by writing the prescriptions without fully evaluating the patients' respective medical histories.
Wright on Thursday was critical of Heberle's testimony that Stallard had told him she had taken opioid drugs while under the care of another physician.
Stallard's medical file contains no written documentation of that conversation. Heberle said the conversation occurred.
Wright asked Heberle if he accepted the medical axiom that if "it's not in your chart, it didn't happen."
Heberle replied, "You'd have to carry a movie camera on your shoulder to record everything that way."