Lancaster doctor: 'I lived for 13 months thinking I had... killed my son' by slapping a Fentanyl patch on his back
May 23, 2016 1:06 PM
William A. Carter, 65, of Lancaster, could not save his son with CPR the day after he applied a fentanyl patch to ease pain from surgery. Though he lived for a year in fear that he would be charged in the death, he developed opinions that the patch did not kill his son. He now practices only cosmetic medicine.
By Rich Lord / Pittsburgh Post-Gazette
When firefighters showed up at a Lancaster home to answer a cardiac arrest call, they found a father performing CPR on his son, repeating, “Oh my God, oh my God, oh my God.”
Asked what was happening, the father told a medic, “You have an accidental narcotic overdose due to his incompetent father.”
The death of Connor Carter, at 14, and those words, uttered in a moment of desperation in 2008, changed every aspect of William A. Carter’s life.
“I lived for 13 months thinking I had accidentally killed my son” by slapping a Fentanyl patch on his back, Dr. Carter said in an interview. “I came so close to blowing my brains out during those 13 months, I couldn’t tell you.”
Now, he said, “I don’t think [pain medicine] had anything to do with it.” But as a result of his son’s death, he is no longer allowed to prescribe controlled substances, relegating him to cosmetic treatments and the role of, as he put it, “a second-class doctor.”
Dr. Carter spent his entire medical career in Lancaster County, starting with his residency in 1979. He shifted from family practice, to rehabilitative medicine for brain and spinal injuries, to a mix of family and cosmetic medicine. He said he prescribed opioids infrequently.
Connor, the only child of his second marriage, was an athletic boy who weighed 190 pounds as a high school freshman but nonetheless could ride a unicycle. He played through the 2008 football season without incident, but then tore a ligament in gym class. He underwent knee reconstruction surgery on Dec. 16, 2008, and was prescribed 5 milligrams of oxycodone every three hours -- a low dose.
The pain medicine didn’t help, and by the evening of Dec. 17, Connor was aching, sleepless and nauseous, Dr. Carter said. The doctor had a few expired fentanyl patches that had been prescribed to a deceased patient. He placed one on his son’s back.
When Dr. Carter took a patch prescribed for one person and gave it to another, he broke a federal law, he admitted.
The next morning, he found his son in a chair, warm and pale with foam dripping from his mouth. He screamed for his wife to call 911, while starting CPR.
“When the police showed up with the ambulance, I was so distraught I just kept saying, over and over again, ‘I killed my son,’” Dr. Carter recounted. “And that hung me.”
The autopsy was handled by Lancaster County Coroner Stephen Diamantoni, M.D. Dr. Carter said that he worked for Dr. Diamantoni’s medical practice years prior, but the two disagreed about contract terms and sanitary practices in the office.
The autopsy remained under wraps for a year, during which Dr. Carter continued his practice while wondering what his future held. He heard secondhand that his son’s body had “sky-high” narcotic levels. “I knew that I was under the gun,” he said.
The report came back. Cause: multiple drug toxicity. Manner: homicide.
The district attorney promptly charged Dr. Carter — but not with homicide. He instead faced a felony count of administration of a controlled substance outside of normal medical practice, and a misdemeanor count of recklessly endangering another person. He agreed to help to educate other physicians and, importantly, give up forever his license to prescribe powerful painkillers.
Without full prescribing privileges, insurance companies would not include him in their networks. His practice dwindled from 2,000 patients to 50, he said. Increasingly, he doubted he’d killed Connor.
He sent the autopsy report to three experts. One noted a thickening of the ventricular wall, sometimes called “Athlete’s Heart,” which could — combined with pain and sleep deprivation — stop the heart. Another noted “exceedingly low” levels of oxycodone and fentanyl, below the levels found in any fatal overdose “ever published.” Finally, a year after the release of the autopsy report, a forensic pathologist from Louisville, Ky., found six “possible causes of death” — three related to the heart, two from the medicines, and the last a blockage in the lungs.
“I don’t think [the fentanyl patch] had anything to do with it,” Dr. Carter said. “I think it was a cardiac event.”
Dr. Carter’s attorney negotiated a deal with the Board of Medicine under which he could not practice for six months, and then was on probation with the threat of another two and a half years of suspension if he failed physical and mental examinations.
He settled into a life of cosmetic medicine, fixing the bags under eyes, providing fuller lips and eliminating wrinkles.
He said the increasing heat on physicians who prescribe narcotics has unintended consequences. “Doctors are afraid they’re going to get hammered for trying to be compassionate,” he said.
As for him, he’s 65, going through a second divorce, and — having burned his retirement savings defending himself — bending over faces despite an achy neck. “I’m not going to ask anyone for a prescription,” he said.
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