The doctor linked to 1,500 deaths

Authorities in Germany Friday arrested a respected hospital physician in what is being called the biggest criminal medical investigation in post-war German history — possibly involving 1,500 morphine deaths.

Investigators in Hanover say Dr Mechthild Bach is being held in connection with the deaths of eight patients under her care at a pain clinic at the well-known Paracelsus Hospital in suburban Hanover.

But they acknowledged that they have also confiscated the records of 76 clinic patients who died under unusual circumstances. And unconfirmed reports meanwhile speak of more than 250 cases in the past four years and hundreds more dating back to the early 1980s.

Dr Bach, herself, has gone on national television to deny any wrongdoing. The primly-dressed, soft-spoken 54-year-old practitioner says the allegations against her are hurtful and they are misguided.

“I love all my patients,” she told RTL television. “I am devoted to them. I often say they are my children since, you see, I long ago opted to have no children of my own.”

While stressing that she would never harm a patient, she has however also told interviewers that she would go to great lengths to alleviate their suffering. That, she insists, is the whole purpose of the pain clinic she heads at Paracelsus Hospital.

*quote1*“It is wholly false to say that what I am involved in doing is helping people to die,” she told RTL. “I see myself as helping people in the process of dying.”

Hospital staff alerted authorities after noting an alarming death rate among patients under Bach’s care.

“She never wanted to kill her patients, but rather only wanted to ease their pain and suffering,” said Bach’s attorney, Klaus Ulsenheimer.

“This could be construed as assisting in the dying process, or assisting dying people, which is not punishable,” he said. “But it cannot be construed as actually terminating people’s lives.”

German authorities have meanwhile confirmed they are investigating a number of further suspicious deaths connected to the physician, who is in custody on manslaughter charges.

While many patients in the chronic pain ward are suffering from terminal illnesses, several were there for relatively routine operative procedures or ailments which ordinarily do not result in death.

One elderly female patient reportedly was admitted for therapy to alleviate pain after suffering broken bones in a fall. The patient died after a few days.

Once the allegations became public, more suspicious incidents were brought to the attention of investigators.

“We’ve had a number of calls in recent days from relatives saying that in retrospect the death of a relative under Dr Bach’s care seemed unusual,” said Thomas Klinge, a spokesman for the chief prosecutor’s office in Hanover.

Insurance investigators have been on the case for some time.

*quote2*“It was only a matter of time before this whole affair blew sky- high,” said Klaus Altmann, an investigator for AOK health insurance company.

He said AOK has been looking into “incidents of false billing and registration” and that many more cases will likely come to light.

Authorities have confiscated records of 76 patients under Dr Bach’s care who died between December 2001 and May 2003.

“At this point it remains to be seen whether we will submit all 76 files to forensics experts, depending on where the course of investigation leads us,” said Klinge.

As head of the pain clinic, Bach signed all death certificates for patients who succumbed in her wards. That is standard procedure at most clinics in Germany, according to Hanno Kummer, spokesman for the VdAK insurance group. His company has been pressing lawmakers for years to require more than one physician’s verification of cause of death.

Klinge said there is no evidence at this point to support reports that hundreds of cases might be involved.

However, Der Spiegel news magazine referred to the investigation Friday as “one of the biggest criminal probes” in German post-war history.

Der Spiegel says Bach could be linked to 251 patient deaths between January 2000 and last July, and to as many as 1,500 deaths since 1982.

Klinge cautioned against such speculation, saying, “The suspect correctly treated many terminally ill cancer patients with morphine, we know that. And there is no evidence indicating that the number of unsolved deaths is any where near 1,500 – at this point.”

So far, records of 11 patients have been studied by investigators. In eight of those deaths, the patients were not terminally ill but allegedly were nonetheless prescribed high doses of morphine.

Morphine is one of the most effective drugs known for the relief of severe pain and remains the standard against which new analgesics are measured.

But morphine is also highly addictive and, in large doses, can result in death.

DPA

March 2004

Subject: German News