Doctors claim drug dilution hastened cancer patient's death

KANSAS CITY, Mo. -- For the first time, federal prosecutors say they have proof that rogue pharmacist Robert R. Courtney's dilution of chemotherapy drugs hastened -- perhaps even caused -- a cancer patient's death.

That won't lead to murder charges against Courtney, who has already pleaded guilty to diluting two cancer drugs out of greed. However, prosecutors hope the independent findings by two cancer specialists will result in the former pharmacist receiving the stiffest possible sentence.

But attorneys for Courtney, who could receive 30 years without parole when sentenced Dec. 5, have countered with experts who said no link can be proved between Courtney's actions and the death of Evelyn Coates, 53, of Kansas City.

"He's the one who has to live with what he did," Coates' husband, Steven Coates, said Friday night. "I don't know if he has any conscience, but if it were me, that would be sentence enough."

In Friday's filings, prosecutors presented reports prepared independently by two oncologists. Both said Coates' death in August 2001 from complications of ovarian cancer came sooner than it would have had she received full doses of her chemotherapy drugs.

"It is even possible she could have been cured if she had received the ... chemotherapy treatments in the strengths prescribed by her treating oncologist," wrote one of the doctors, Mark J. Ratain, a professor of medicine and chairman of the committee on clinical pharmacology at the University of Chicago.

'It is too speculative'

One defense expert, however, said he believed Coates' cancer was far more advanced when she was diagnosed than her treating physician realized.

"This patient had a poor-prognosis ovarian cancer from the time it first caused symptoms," wrote Kenneth Dawson Bagshawe, emeritus professor of medical oncology at the University of London. "It is too speculative to suggest that bigger doses of the drugs than those she received would have prolonged her life."

Courtney, 49, pleaded guilty in February to 20 felony counts of tampering with, adulterating and misbranding the cancer drugs Gemzar and Taxol. Under terms of the plea agreement, Courtney's sentence is to range between 17 1/2 and 30 years in prison, without parole.

Courtney should avoid the maximum sentence because of his guilty plea and subsequent cooperation with authorities and federal prosecutors, his attorneys wrote.

"Mr. Courtney does not blame anyone for his conduct but himself," the defense response read in part. "However, a sentence of 17 1/2 years sends a stern message yet fairly recognizes his sincere remorse, his acceptance of responsibility, and his meaningful efforts to end this tragedy without needless litigation."

Defense attorney J.R. Hobbs also objected to the government's depiction of Courtney's actions as "heinous" and "cruel."

"Here, the conduct of Mr. Courtney was wrong," Hobbs wrote. "He has admitted that his conduct was unlawful. However, his conduct cannot equate to torturing or brutally attacking a person."

In his plea agreement, Courtney admitted diluting the expensive cancer drugs Taxol and Gemzar for 34 patients on 158 separate occasions between March and June 2001.