Cancer doctor faces lawsuit By Francis X. Gilpin Montgomery Advertiser Pauline Novak went in for a routine checkup and was told her breast cancer had returned. Montgomery oncologist David Gay Morrison prescribed chemotherapy. The 65-year-old Novak later got a second opinion at the world's oldest and largest cancer hospital, Memorial Sloan-Kettering Cancer Center in New York. There, a doctor wrote on her chart: "I do not feel the patient has any evidence of recurrent breast cancer." Novak is suing Morrison for malpractice, and Alabama regulators have found 19 other patients allegedly mistreated or misdiagnosed by the cancer specialist. The state claims some patients were needlessly or excessively exposed to toxic cancer-fighting agents that endangered their health. For now, Morrison still is practicing. The state briefly suspended his license in June, but his attorneys got it reinstated. The legal battle over his license provides a rare look inside Alabama's process for deciding which medical practitioners need to be put out of business. As the Morrison case illustrates, those calls aren't always easy. More than 20 of Morrison's other patients have written letters to the state Board of Medical Examiners, passionately defending the board-certified oncologist and hematologist. "I would not be here today if it were not for Dr. Morrison," Marie C. Hoffman stated unequivocally. Hoffman went on to say she has never seen a doctor "so dedicated to his calling." A dozen fellow physicians also have stepped forward to write letters of support for Morrison, 48, who graduated from Baylor University's medical school and did his residency at Tulane University's health sciences center. "It is my intention to continue to request his skills and expertise for which I have been so grateful," wrote Allen R. Dupre, a Montgomery obstetrician and gynecologist whose daughter has been one of Morrison's 800 patients. "I would trust his care to any patient, as I trusted him with the care of my daughter." Lawyers for Morrison trace the investigation to 2002. Morrison moved from Montgomery Cancer Center, where he was research director, to the Cancer Care Center of Montgomery, an affiliate of Southeast Cancer Network PC. After the move, described as voluntary by Morrison's lawyers, they contend Montgomery Cancer Center began reviewing his patient charts and eventually asked for the state investigation. Though Morrison's legal team doesn't ascribe a motive to the request, some of Morrison's patients and at least one colleague do. Radiation oncologist Thomas E. Beatrous said Montgomery Cancer Center instigated an investigation against him, too. Now a Morrison colleague at the Cancer Care Center, Beatrous told medical board Executive Director Larry D. Dixon in a letter that he was investigated after turning down a job at Montgomery Cancer Center. The inquiry resulted in no action against Beatrous. In his letter, Beatrous estimates Montgomery Cancer Center has lost 25 percent of its daily radiation revenue as his practice at the competing clinic has grown. Morrison patient Janet A. Gulley also points to money. "I was shocked to learn of the charges brought against Dr. Morrison by three of the physicians at Montgomery Cancer Center," Gulley wrote to the medical board. "I am deeply disturbed that the Board is choosing to overlook the obvious attempt by MCC to eliminate their competition." Two detailed voicemail messages left with the Montgomery Cancer Center's Terry Lynn Jeffcoat were not returned. The state medical board, made up of all physicians, spent more than two years scrutinizing Morrison. Last October, the board found probable cause to believe Morrison had engaged in malpractice by repeatedly performing unnecessary medical procedures. The medical board's associate counsel, William F. Addison, told a Montgomery County judge earlier this year that his office is still taking complaints. "There are also cases where he diagnosed cancer where it wasn't present and put them through chemo," Addison said. In addition, the medical board has accused Morrison of violating a federally approved protocol for a clinical trial at Montgomery Cancer Center in the late 1990s. The board claims Morrison enrolled patients who were inappropriate candidates for an experimental cancer drug. One of Morrison's lawyers, Frank M. Wilson of Montgomery, refused to discuss the allegations in detail with the Montgomery Advertiser. "The Legislature has established the process and procedure for the medical profession to regulate itself," Wilson said. "That is the process that we are in and we will work through in defending Dr. Morrison against these claims." The two sides tried to negotiate a settlement earlier this year. The state insisted that Morrison stop practicing for a year but later tentatively agreed to a three-month suspension of his license, according to court records. Then the medical board received five more complaints, including one about Pauline Novak, and forwarded the records to Mobile oncologist Michael W. Meshad. Meshad already had reviewed 27 of Morrison's case files and told the board in a letter that the doctor had a "cavalier" diagnostic approach that "resulted in great harm physically, emotionally and financially to a number of patients." After reviewing the five new files, Meshad wrote: "Nothing has changed." The medical board received Meshad's letter in late June and obtained an emergency suspension of Morrison's license. A day later, Morrison's lawyers were in court. They questioned why regulators were so quick to pull the license when the state had acted so slowly until then.Addison defended the medical board's deliberate approach. He told the court that Morrison's lawyers had led regulators to believe their client had learned from past mistakes. But Meshad's letter ruined any chance of a negotiated resolution, he said."Once that letter was received, it changed the complexion of everything," Addison said. Wilson argued summary suspensions like the one imposed on Morrison have historically been reserved only for dire situations, like a surgeon showing up drunk. Circuit Judge Charles Price ultimately stayed the suspension partly because Morrison hadn't been sued for medical malpractice. Within two weeks of the ruling, Novak filed her lawsuit. Wilson said Morrison will contest it. State regulators since have agreed to let Morrison continue seeing patients, pending a January hearing before the Alabama Medical Licensure Commission, the final administrative authority over his license. Wilson pointed out there are frequent differences of medical opinion about the proper treatment of simple ailments, let alone a life-threatening disease. "We are dealing with the diagnosis and management of cancer," he said. "The old saying goes that if you get five oncologists in a room and present a case to them, you will get six different opinions."