SALT LAKE CITY -- A jury began deliberating Wednesday in a federal case against a Brigham City doctor charged with running a massive pill mill operation, illegally prescribing painkillers to thousands of patients without evaluating their conditions.
Prosecutors in U.S. District Court in Salt Lake City argued that Dewey C. MacKay turned from doctor to drug dealer to pad his wallet after he no longer could work as an orthopedic surgeon because of health issues. MacKay's defense lawyers however suggested the case against their client was flimsy.
"They've taken 12 of 500 (patients) and the worst of the worst and are trying to sell that as a criminal indictment," Peter Stirba said in his closing argument.
MacKay was charged last year with 130 felonies in what prosecutors at the time said might be the largest such indictment ever handed down in the state. They have since dropped 45 counts.
Prosecutors contend MacKay was seeing up to 120 patients a day, spending as little as 3 1/2 minutes with each and refilling prescriptions without evaluating their history or providing basic examinations. MacKay said in testimony this week that number is a gross exaggeration.
State records show MacKay issued more than 37,700 prescriptions for hydrocodone and oxycodone between June 2005 and October 2009, totaling more than 3.5 million pills.
Assistant U.S. Attorney Michael Kennedy said MacKay even filled prescriptions when patient relatives begged him to stop because their loved ones were addicted or selling the pills on the street for a profit.
MacKay, 64, has pleaded not guilty to the charges, including two that involve the death of David Leslie Wirick, a 55-year-old Ogden man who was working as a rocket scientist.
If convicted on those charges alone, MacKay could spend 35 years in prison and be ordered to pay $2.5 million in fines.
Kennedy told jurors Wirick went on a binge with drugs supplied by MacKay when he couldn't get them from other doctors. Wirick died three days after getting the two prescriptions, on May 6, 2006.
Attorneys blamed the death on different causes, with prosecutors maintaining the mixture of oxycodone and hydrocodone caused severe respiratory problems and swelling of the brain.
The defense said the medical evidence showed Wirick died of pneumonia, and that there were only high therapeutic levels of the drugs -- not toxic levels -- in his system at the time of death.
The jury is deliberated late into Wednesday evening and was scheduled to return Thursday morning.
Before deliberations began, Stirba told jurors that the case against MacKay was not medical malpractice or negligence but a criminal matter, and they couldn't find him guilty simply because his record-keeping was sloppy.
"If he was prescribing pain meds for pain, he is not guilty because doctors legitimately prescribe medications for pain," Stirba said.
Stirba said all but two of the patients who testified were in chronic pain when they went to see MacKay. The others, he said, were undercover operatives who lied, one trying to avoid a lengthy prison sentence.
MacKay took the stand in his own defense Monday and Tuesday and maintained that he had no reason to doubt his patients when they came to him in pain. He testified that the drugs were appropriate medicine.
Prosecutors tried to show that had MacKay checked a state database that tracks controlled substances, especially after he had been warned certain patients were "doctor-shopping," he would have discovered some patients had seen a dozen different medical providers to obtain drugs.
A defense expert testified, however, that less than 8 percent of doctors in Utah checked those state reports in the past two years.
Stirba also told jurors that MacKay's patients testified that they are still in chronic pain and are still getting pain meds similar to what MacKay was prescribing -- only from other doctors or pain clinics.
He said MacKay helped many of these patients function so they could work and make a living, including Wirick.
MacKay's supporters packed the courtroom this week to support the doctor.
"You don't have that kind of support if you're not a good doctor, not a good guy and a drug dealer," Stirba said.
Kennedy, however, said drug dealers aren't only those operating in the shadows or the corners of parks. He said they can be pillars in the community.
"That's exactly what this doctor was, a drug dealer," Kennedy said in closing.