Noble Brigham ‘20
This year’s Mock Trial case addresses the underlying issue of the opioid crisis, which has taken the United States by storm. Pain lies at the root of the issue- pain, which takes such a personal connotation for different individuals. Some have a high endurance for it, but some become dependent on or addicted to opioids in order to cope. Nicole Chaikin, Upper School Psychologist, says, “There are different neural pathways for pain, and we also try to differentiate a pain threshold versus a pain tolerance. For example, some chronic pain would have a lower threshold, but they would have a higher tolerance because they’ve been living with it for a long time.” Over the past seven years, a large number of rogue doctors have irresponsibly prescribed opioids to injury patients in pain. Malpractice has developed into the third wave of a crisis called the Opioid Epidemic that has ravaged America since the 1990s, when opioids were mistakenly thought to have a low risk of addiction. This year’s Mock Trial case involves an alleged “pill mill doctor,” a doctor who has prescribed high numbers of unnecessary painkillers in disregard to medical protocol. Kris Aldridge, Class of 2020 Form Dean and EA Mock Trial advisor, says, “It’s a case that is stripped from the newspaper. It’s a tale of someone becoming ultimately addicted to opioids and dying as a result.”
Philadelphia has seen a number of these cases in recent years. Psychiatrist Alan Summers turned a legitimate practice into a drug dealing operation from 2001 to 2014, according to the Philadelphia Inquirer. He amassed millions of dollars and frequently allowed as many as 100 people to line up at his office on S. Broad Street in Philadelphia. He made the mistake of detailing his “Ten Year Financial Plan” on a word document, in which he described the financial necessity of superfluous and irresponsible prescriptions. Instead of individual therapy sessions, he would speak to a crowd of patients, give them a brief examination, and then write prescriptions. Dr. William J. O’Brien III, similarly, was sentenced to 30 years in prison for running a “pill mill.” According to the Philadelphia Inquirer, he used a motorcycle gang to help him run his office and solicited patients for sex in exchange for prescriptions. At his trial, he chose to represent himself, made lewd comments, and asked a witness to read The Cat in the Hat to prove their literacy.
Mock Trial advisor and US teacher Jennifer Maier has personal legal experience with drug addiction. Before becoming a teacher, Maier was a civil lawyer and did her pro-bono work for the Support Center of Child Advocates. Some of her cases related to the parental rights of opioid-addicted guardians. Maier says, “I was able to see the toll that drugs take on families.” Often, these cases were long and frustrating. Maier states, “A lot of times, the parents wouldn’t even be able to show up at the hearing without taking a drug test.”
This year’s fictitious but believable Mock Trial case features, as its defendant, Dr. Rae Shafer. This character operated a pain-management practice called Pain Away. Aldridge says, “[Shafer’s] business was originally an alternative medicine kind of business where people would pay to pursue options like acupuncture and more Eastern Medicine options. That business ultimately goes bankrupt, in large part because of bad mismanagement of the nurse, who is now going to be a witness for the prosecution.” The practice initially won national attention, but it shifted toward prescribing painkillers after a financially ruinous flood. The case centers on the death of Hadley McAdoo, a former star athlete and high school coach, who suffered unidentifiable pain. Although she had several simultaneous perscriptions for the same strong painkiller, it was Shafer’s medication that she ultimately overdosed on. Combined with prescription Xanax, it caused her respiratory arrest. According to the Mock Trial case materials, the jury must consider whether Shafer’s treatment of McAdoo was “an act of mercy to a local hero” or illegal behavior “by someone driven to desperation by financial and reputation ruin.” Shafer is pleading not guilty. Lynne Hay comments, “There’s a lot of self serving… everybody’s looking at the situation through the lense that best fits them.”
In her witness statement, Shafer blames the nurse-turned-office manager Fran Kelsey for many of the problems with the practice. Shafer’s statement is that Kelsey “pushed” Shafer to expand the practice, which created serious financial problems after the flood. Shafer claims ignorance about McAdoo’s multiple pre-existing prescriptions because Kelsey did not check the database, an encouraged but non-required step in the prescription process. Cat Spellman ‘19, who portrays Kelsey, says, “Fran is rude, manipulative, and generally unlikeable. We plan to use this to our advantage as it allows the character of Fran to bluntly assert her opinion that Dr. Shafer was not acting in good faith while prescribing Hadley McAdoo opioids.” The defense side’s three witnesses are Dr. Shafer, Sal Abbott, friend of McAdoo and Shafer, and Ry Haight, an expert witness funded by an anonymous benefactor. According to case materials, the defense claims it was not yet required to check the prescription database at the time of her patient’s death. The defense emphasizes the abnormality of pain and the impossibility of completely understanding a patient’s feelings. According to Haight, McAdoo had pain without an apparent cause, but it was still real pain for which she was seeking treatment. Haight also argues that Shafer had such a large clientele because she was the only area doctor who would treat their pain, not because she was a drug dealer.
The prosecution argues that Shafer was running a “pill mill,” prescribing opioids only for personal financial gain. Fran Kelsey, and another former friend of McAdoo’s, JJ Teva, a local bank employee who helped Shafer obtain loans, are both testifying for the prosecution. So is Royal Copeland, an investigator who admits that his/her motivation for testifying is to obtain a better job. They argue that Shafer’s reckless and selfish operation of her practice caused McAdoo’s death. Grace Smith ‘19, the lawyer questioning Copeland, says, “Both sides have flawed, biased witnesses. My lawyer’s witness, for example, is looking to get a pay raise and promotion out of successfully finishing the case; however, I will try to swing that motive in a positive tone.” However, the defense has a different perception of McAdoo’s death. Hay said “We even were toying with the idea could it have been a suicide…[due to] the fact that the victim was found with an empty liquor bottle—she knew that you weren’t supposed to drink when you were taking these drugs—and that there were several trophies all around her on the floor where she was found.”
Ultimately, this case covers a very current and nuanced topic: the debate about appropriate pain management. Aldridge said “Maybe there’s a certain level of pain that is just part of life…I do worry a little bit that we’ve become almost cavalier with pain medication prescriptions.”