An internationally recognized researcher on drug toxicology told jurors that it's impossible to say why patients of a former Haysville doctor died.
Steven Karch testified Monday that the deaths of patients of the Schneider Medical Clinic might have resulted from serious maladies they suffered from, not just overdoses of drugs prescribed to them.
Karch, a medical doctor from Berkeley, Calif., is the author of the "Drug Abuse Handbook" and "Postmortem Toxicology of Abused Drugs."
Those books have been used as a reference by doctors and scientists at the Sedgwick County Regional Forensic Science Center, whose work Karch criticized in a federal courtroom in Wichita.
Karch was testifying in defense of Stephen Schneider, a former doctor. Schneider and his wife, licensed practical nurse Linda Schneider, are charged with contributing to the deaths of dozens of patients.
The Schneiders are accused of illegally prescribing painkillers that resulted in the deaths of 68 patients. The couple are charged with directly contributing to the deaths of 21 patients.
Medical examiners and the chief toxicologist of Sedgwick County determined those patients died of mixed drug intoxication.
Karch said the patients also suffered from other medical conditions that could have killed them. He said one of the Schneider patients had such profound heart disease he's going to include it in the next edition of his textbook.
Karch testified he has conducted research for years, trying to find ways to determine how drugs contribute to deaths. But he says no one has found a way to accurately draw conclusions about drug levels found in a person's body after they die.
Karch said the research shows drug levels in the blood after death are not telltale signs of an overdose. Drugs stay in the body, Karch explained, even after it starts to deteriorate after death, causing the levels to rise dramatically.
"It doesn't tell me about the cause of death because I don't know what the number was when they died," Karch said under direct questioning by defense lawyer Lawrence Williamson.
Assistant U.S. Attorney Tanya Treadway pointed out on cross-examination that Karch's testimony contradicts what he has said in other cases.
Karch's testimony helped convict English doctor Harold Shipman of killing 15 patients through overdoses of lethal drug mixtures.
Treadway also pointed out that despite Karch's books on drug pathology, he is not a board-certified pathologist.
Karch said he found three Schneider patients he could say died of accidental drug overdoses. But none of them, Karch said, died of prescription medicines but rather illegal street drugs.
One man had a heart condition likely exacerbated by smoking marijuana, which Karch said speeds up the heart rate. Another man had high levels of methamphetamine, and another woman had ingested cocaine.
All interacted with other medical problems the people had, Karch said.
Karch said the other patients couldn't be conclusively called overdoses.
"The confusing factor is the presence of large amounts of drugs" in the patients, Karch said of one man. "There is no way to tell whether the multiple drugs or heart disease did it."
Karch said autopsies could have narrowed down the causes by doing drug hair tests that might show the presence of drugs. Such test had been shown to determine a person's tolerance for drugs.
But Karch said such tests are expensive — about $1,200 a hair — and are cost prohibitive for publicly funded crime labs.
"Without that, it's just a guess," Karch said.
Jurors will have the ultimate decision of which witnesses to believe. But there will only be 11 of them deciding the verdict.
Alternates chosen at the beginning of the trial, which entered its seventh week Monday, had been released from duty for various reasons during the trial. Another was dismissed Monday morning by U.S. District Judge Monti Belot.
No reason was publicly given but both sides have agreed to go on with 11 jurors. Another juror loss could result in a mistrial.
"Be safe," Belot told the jury as he dismissed them for the afternoon.
The trial continues Thursday. Belot said he hopes to be able to deliver the case to the jury early next week.