Com. v. Scott, V.

CourtSuperior Court of Pennsylvania
DecidedSeptember 27, 2018
Docket55 WDA 2018
StatusUnpublished

This text of Com. v. Scott, V. (Com. v. Scott, V.) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Com. v. Scott, V., (Pa. Ct. App. 2018).

Opinion

J-S38034-18

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37

COMMONWEALTH OF : IN THE SUPERIOR COURT OF PENNSYLVANIA, : PENNSYLVANIA : Appellee : : v. : : VAN EDWARD SCOTT, : : Appellant : No. 55 WDA 2018

Appeal from the PCRA Order November 29, 2017 in the Court of Common Pleas of Lawrence County Criminal Division at No(s): CP-37-CR-0000516-2010

BEFORE: BOWES, NICHOLS, and STRASSBURGER,* JJ.

MEMORANDUM BY STRASSBURGER, J.: FILED SEPTEMBER 27, 2018

Van Edward Scott (Appellant) appeals from the order entered

November 29, 2017, denying his petition filed under the Post Conviction

Relief Act (PCRA), 42 Pa.C.S. §§ 9541-9546. We affirm.

We provide the following factual and procedural history. Appellant was

sentenced to an aggregate term of 9 to 18 years’ imprisonment following his

convictions relating to the improper prescribing of narcotic drugs and to

disposing of frozen or seized assets.

Appellant is a medical doctor who ostensibly engaged in a pain management practice. As a central part of that practice, [A]ppellant prescribed large dosages of narcotic opiate drugs to his patients. During [A]ppellant’s trial, the Commonwealth presented testimony from some of [A]ppellant’s patients who ____________________________________________

* Retired Senior Judge assigned to the Superior Court. J-S38034-18

typically described office visits as lasting five minutes or less and consisting of a brief, perfunctory examination, followed by the prescribing of large dosages of controlled substances.

*** The Commonwealth [] presented expert medical testimony [ from Stephen Thomas, M.D.] to the effect that [A]ppellant’s prescribing of controlled substances was outside of accepted treatment principles.

Commonwealth v. Scott, 121 A.3d 1121-22 (Pa. Super. April 6, 2015)

(unpublished memorandum at 2-3) (citations to record omitted).

To rebut the testimony of the Commonwealth’s expert, Appellant

presented the testimony of Frank Fisher, M.D., as an expert witness. Dr. Fisher maintains a physician’s and surgeon’s license in the State of California. Dr. Fisher received his undergraduate education from University of California-Berkeley[,] graduating with a degree in anthropology[,] and graduated from Harvard Medical School. He had several articles published and peer reviewed relating to the area of pain management. Dr. Fisher also performed several speaking engagements concerning the topic of pain management.

On direct examination, it was revealed that Dr. Fisher was charged with … murder, drug trafficking and conspiracy in the State of California in February of 1999, arising from his prescribing of opioids. Those charges were eventually dismissed by the Attorney General’s office on the first day of trial according to Dr. Fisher. Following the dismissal of the criminal charges, the Board of Medicine of California raised issues regarding Dr. Fisher’s ability to practice medicine. A resolution was reached in which Dr. Fisher agreed to three years of probation concerning his license to practice medicine, continuing medical education courses and he would undergo evaluations at the University of San Diego for mental and medical competency. Dr. Fisher was able to complete the three years of probation and evaluations without issue. At the time of trial, Dr. Fisher maintained an unrestricted license to practice medicine in California.

Dr. Fisher was admitted as an expert witness at trial. He testified that titration to optimal therapeutic effect for pain

-2- J-S38034-18

management consists of gradually raising the dosage to where it is most effective and that method is necessary to effectively treat chronic pain. He disagreed with Dr. Thomas’s testimony that [Appellant’s] initial prescriptions to his patients containing large dosages failed to comply with the standards in the reasonable medical community as Dr. Thomas was basing his opinion from the total daily dosage as opposed to the dosage at each use. For example[,] Dr. Thomas stated that [] one patient received an initial dosage of 180 milligrams daily, which actually consisted of doses of 30 milligrams to be taken six times per day. Dr. Fisher deemed that starting point to be a safe and reasonable initial dosage. Moreover, Dr. Fisher felt that it was “nitpicking” for Dr. Thomas to criticize [Appellant] for failing to document every increment in the titration process. He also determined that Dr. Thomas’s assessment that patients with chronic pain should start with a 5 milligram dosage of Oxycodone and be titrated to 10 milligrams by stating his belief that a patient with chronic pain would be undertreated by that dosage. Dr. Fisher ultimately opined [Appellant’s] starting dosages and increments in titration complied with the standard of care in the area of pain management.

In Dr. Fisher’s opinion, the dosages prescribed by [Appellant] were expected dosages and fell within the standard of care for treatment of individuals suffering from chronic pain. Dr. Fisher explained chronic pain can be a deadly disease if not properly treated, which was in direct conflict to Dr. Thomas indicating pain will not kill a patient, but addiction will.

Dr. Fisher’s opinions were supported by a monograph written by Dr. Perry Fine at the University of Utah and Dr. Russell Portenoy at the Sloan Kettering Cancer Institute in New York City, which, he opined, is the best synopsis of the standard of care concerning the treatment of patients with chronic pain. According to Dr. Fisher, Dr. Fine and Dr. Portenoy state the elements of the standard of care for chronic pain are diagnosis and effective treatment reached through titration of medication to optimal therapeutic effect. Dr. Fisher explained [Appellant] complied with the standard of care in treating patients suffering from chronic pain with appropriate dosages of opioids.

Dr. Fisher further opined that [Appellant] was not engaged in diversion of prescription medications based upon the medical records from [Appellant’s] practice and his removal of a patient

-3- J-S38034-18

from treating with him for engaging in diversionary activities. Dr. Fisher recalled [Appellant] utilized a pain management contract with his patients to educate them about the type of treatment they would be receiving and the repercussions they faced if it is determined they are engaged in diversion of their prescription drugs.

On cross examination, Dr. Fisher indicated that he did not perform a residency or fellowship prior to entering the practice of medicine. Moreover, Dr. Fisher did not practice long term pain management from 1982 through 1992 as he was practicing general medicine. His license to practice medicine was suspended from 1999 until 2006 while his criminal charges were pending as a condition of his bail. Furthermore, in the decision and settlement with the Medical Board of California, Dr. Fisher admitted there was an evidentiary basis to discipline his license for gross negligence, repeated negligent acts and incompetence as stated in Section 2234 [of the] Business and Professions Code in California regarding his treatment of numerous patients. Counsel for the Commonwealth then engaged in a line of questioning concerning quotations issued by Dr. Portenoy indicating he was incorrect in the method of prescribing opioids for chronic pain and the risk of addiction for patients who receive long term treatment of opioids for pain management. Dr. Fisher responded to those quotes by explaining that Dr. Portenoy did not change his opinions he rendered concerning [Appellant’s] treatment of his patients. However, Dr. Fisher explained that only 20 to 30 percent of his patients require pain management.

PCRA Court Opinion, 11/29/2017, at 6-9.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Commonwealth v. Johnson
966 A.2d 523 (Supreme Court of Pennsylvania, 2009)
Commonwealth v. Springer
961 A.2d 1262 (Superior Court of Pennsylvania, 2008)
Commonwealth v. Marinelli
810 A.2d 1257 (Supreme Court of Pennsylvania, 2002)
Commonwealth v. May
31 A.3d 668 (Supreme Court of Pennsylvania, 2011)
Hinton v. Alabama
134 S. Ct. 1081 (Supreme Court, 2014)
Commonwealth v. Perry
128 A.3d 1285 (Superior Court of Pennsylvania, 2015)
Commonwealth v. Benner
147 A.3d 915 (Superior Court of Pennsylvania, 2016)
Thompson, T. v. Thompson, A.
187 A.3d 259 (Superior Court of Pennsylvania, 2018)
Commonwealth v. Heilman
867 A.2d 542 (Superior Court of Pennsylvania, 2005)
Commonwealth v. Washington
927 A.2d 586 (Supreme Court of Pennsylvania, 2007)
Commonwealth v. Chmiel
30 A.3d 1111 (Supreme Court of Pennsylvania, 2011)
Commonwealth v. Johnson
51 A.3d 237 (Superior Court of Pennsylvania, 2012)
Commonwealth v. Rivera
108 A.3d 779 (Supreme Court of Pennsylvania, 2014)

Cite This Page — Counsel Stack

Bluebook (online)
Com. v. Scott, V., Counsel Stack Legal Research, https://law.counselstack.com/opinion/com-v-scott-v-pasuperct-2018.