Prisoner, doctor who treated him, both had drug arrests

Sunday, September 27, 1998
By Andrew Skolnick Special to the Post-Dispatch and Kim Bell of the Post-Dispatch
Copyright 1998 St. Louis Post-Dispatch

Joseph Super was an auto mechanic. David S. White was a doctor. They had one thing in common: Both got arrested for marijuana possession.

Super, caught with five pounds of marijuana, received a six-year prison sentence in 1992 for his crime. Dr. White, a former specialist in treating drug and alcohol addiction, got two years' probation in 1990 for driving under the influence.

Missouri's medical licensing board revoked the doctor's license for a week and put him on probation for five years.

The troubled doctor found new work at the Central Missouri Correctional Center, where he eventually would treat Super. Super died several months later. His widow claims in a wrongful death lawsuit that White was partly to blame. White said the care was proper.

The case is scheduled for trial in November in Kansas City.

White is one of nine prison doctors in Missouri working for Correctional Medical Services who have been disciplined by licensing boards. CMS has 35 physicians here. That means nearly one in four of its doctors in Missouri have been disciplined for misconduct. In contrast, about one in 40 of the nation's 689,000 doctors has been disciplined.

Police reports, court documents, interviews and White's disciplinary agreement with the State Board of Registration for the Healing Arts tell the following story:

In 1990, White was arrested in Ashland, Mo., for driving while intoxicated and possessing marijuana and drug paraphernalia. He pleaded guilty to DWI and got probation.

The doctor signed an agreement with the medical licensing board that he would not drink any alcoholic beverage during his five-year probation. But on Sept. 28, 1994, Lake Ozark police arrested him for drunken driving, a violation of his medical probation. White's blood alcohol level was 0.21 percent, more than double Missouri's legal limit.

By that time, Super, who owned a salvage yard near Columbia, was well into his second term. He previously served two years for burglary and drug possession.

When Super entered prison in 1992, he tested negative for tuberculosis. But a test by CMS two years later showed that his body had been exposed to TB germs in prison. To prevent him from developing and spreading the disease to others, Super was ordered to begin six months of therapy with Isoniazid, an antibiotic widely used to treat patients who test positive.

Isoniazid packages warn doctors that the drug can cause serious and even fatal liver damage and should not be given to anyone with liver disease. That is probably why, on Nov. 28, 1994, CMS ordered a liver test before starting Super on the drug. That test showed he had an inflamed liver. On Dec. 2, 1994, he was started on Isoniazid anyway.

After a month on the drug, Super went to see White with complaints of chronic pain in his right side. This was three months after White's second DWI arrest. Super's pain came and went but got worse when he coughed. White ordered no tests or follow-up. He allegedly prescribed an over-the-counter medication for intestinal gas.

The warning label for Isoniazid tells doctors to closely monitor the patient's side effects and monthly liver function tests. Super never got those tests, then or after he was transferred to the Kansas City Honor Center on Jan. 25, 1995. He complained to his caseworker that the medication made him sick. She instructed him to continue taking it.

At the Swope Parkway Health Center, Super was continued on the medication, allegedly without being examined.

Over the next five months, Super's symptoms worsened. On June 5, 1995, after vomiting blood, he was admitted to the University of Missouri-Columbia Hospital. He died 11 days later. An autopsy showed that Super, 42, died of cirrhosis of the liver, gastrointestinal bleeding, and complications.

Super's wife, Karen, and daughter, Jacqueline Dawson, filed a wrongful death suit in Jackson County against White, Correctional Medical Services and others.

"He was a very caring, very loving man," said Karen Super, his wife of 11 years. "He liked to go boating but wouldn't fish, because he didn't want to kill an animal."

White declined to discuss the case. "In general," he said, "all of the treatment provided the patient was well within commonly accepted standards of care."

On July 19, 1997, the medical licensing board disciplined White for violating probation with the second DWI arrest. The board gave him probation again -- this time, for seven years, but made it retroactive to his arrest on Sept. 28, 1994.

White said his arrests "did not occur at a time when I was seeing patients. It was off-hours. It has absolutely no affect whatsoever on patient care." He said he is a good physician and the public should feel safer with doctors like him, who most undergo rigorous and random drug tests.

"As far as I'm concerned," White said, "physicians who are under a disciplinary agreement with the board of healing arts are probably the most certifiably unimpaired physicians in the state, because you know we're not out there using drugs and alcohol."

White currently works for CMS at the Tipton Correctional Center.