A Doctor in Danger : Physician Says He Has Healed Himself, but Past Drug Use Imperils His Career

The night his girlfriend died in his bed of a massive cocaine overdose, Dr. Stan Azen’s long affair with drugs finally capsized his life.

The veteran emergency-room physician later was arrested and convicted of possessing cocaine. His $400,000 home was seized under federal anti-drug laws. And he admitted in a public hearing that he was an addict who had abused drugs for 20 years.

Yet Azen managed to cling to his career. He swore off cocaine, enrolled at the Betty Ford Center and passed numerous random drug tests. Meanwhile, he worked at two San Fernando Valley hospitals that serve many low-income people, earning high praise from colleagues.

“He is definitely one of the best ER physicians I have ever known. . . . He is a kind, compassionate physician in the best sense,” said Dr. Jonathan Serebrin, emergency room chief at the Medical Center of North Hollywood, where Azen worked for nine years.

But late last month, nearly four years after his girlfriend’s death, the Medical Board of California opened trial-like hearings that could cost Azen, 42, his license to practice. The board charges, among other things, that he gave his girlfriend cocaine the night she died, that he was under the influence of drugs and alcohol when he tried to resuscitate her and that he continued to buy, sell and use drugs after her death.

Azen denies the allegations. And in an unusual twist, he is drawing vocal support from other doctors who believe he is clean and sober and should be allowed to keep caring for poor and minority patients.

“It seems inappropriate to remove a . . . board-certified, American-trained physician from a population that rarely has access to such quality of care and competence,” said Dr. Val Warhaft, who heads emergency care at Pacifica Hospital of the Valley, a Sun Valley facility that treats many poor Latinos and where Azen worked until recently.

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Azen’s case poses a dilemma for the medical board, which must decide how severely to punish an admitted one-time drug abuser who also is seen as dedicated to helping a clientele often underserved by medical professionals. The board can revoke Azen’s license, suspend it or place him on probation.

Azen says he has not touched drugs in three years and no longer desires to. He insists that his years of drug abuse never affected patients. And he is angry the board is trying to punish him, rather than place him in a diversion program.

Since his girlfriend’s 1990 death, Azen has been buried under an avalanche of legal and personal problems.

His former Westside home and his Jeep Cherokee were seized under asset-forfeiture laws, although the Jeep was later returned.

In March, the U.S. Drug Enforcement Administration revoked his certificate of registration, a crucial permit for emergency room physicians to prescribe pain-killing narcotics such as codeine.

The agency said in a written decision that it was “inconsistent with the public interest” to let Azen keep his certificate because of his history of drug abuse, including his admitted use of cocaine with his girlfriend on the night she died.

The revocation cost Azen his job at Pacifica Hospital, which he had held since September, 1991. Before that, his arrest and ensuing legal difficulties had cost him jobs at the Medical Center of North Hollywood and at Westside Hospital.

In hearings last year that led to the loss of his DEA license, Azen, who now lives in Sherman Oaks, testified that he began experimenting with marijuana and cocaine in the 1970s and became a regular cocaine user in the 1980s.

A graduate of Loma Linda University medical school, Azen was hired in 1982 at Medical Center of North Hollywood.

By 1987, he was working up to 90 hours a week, earning $240,000 a year. And there was a romantic bonus: He had met a hospital auditor, Donna Lynn Miller, who soon moved in with him.

But with a fat paycheck and a high-stress job, Azen also had become a serious cocaine user, snorting up to two grams a day, according to his DEA testimony.

Azen denied taking drugs on the job. But a friend told state investigators the physician had a “high tolerance” for cocaine and used it to stay awake during his long hours at work.

After Miller moved in, Azen’s house became a gathering spot for several of their friends who often barbecued, played volleyball and used drugs together “for days on end,” Azen testified. He said he supplied some cocaine for the parties. “We were kind of like a little family together,” he testified.

Then came the night of Sept. 20, 1990.

After he came home from work, Azen said, he and Miller snorted cocaine, smoked marijuana and had a couple of drinks apiece. Then they made love and went to sleep.

Azen told police that Miller later got up and went to the bathroom. But when she returned to bed, she had two seizures and lost consciousness.

Azen said he performed cardiopulmonary resuscitation on Miller, but she did not respond. He later dialed 911. By the time paramedics arrived, Miller, 28, was dead. A pathologist estimated that she had ingested 20 times a fatal dose of cocaine.

In an interview, Azen described Miller as an addict who had “a death wish” and once tried to kill herself. At the time of her death, he said, she was drinking heavily.

Azen said that although he and Miller had used cocaine together in the past, he did not supply her drugs on the night she died.

No criminal charges were filed against Azen in connection with Miller’s death. But in April, 1991, he was arrested for allegedly selling cocaine to her sister. Police said they searched his home and turned up 61 grams of cocaine.

Azen later was convicted of possessing cocaine. He was sentenced to six months in jail and three years probation, requiring him to submit to random drug tests.

Shaken by Miller’s death and his legal problems, Azen said he decided to stop using drugs. He enrolled in a Los Angeles outpatient clinic of the Betty Ford Center.

A county probation officer testified at the DEA hearing that from December, 1991, to December, 1992, Azen passed 22 random drug tests. Azen said he has since passed more.

But state officials argue that the issue is not whether Azen is drug-free now, but whether he broke drug laws and made serious errors of medical judgment in the past.

State Deputy Atty. Gen. Robert McKim Bell, who is prosecuting Azen, said he was negligent in not seeking help for his addiction and for continuing to treat patients while addicted.

He said Azen broke the law by providing drugs to Miller and others. And by giving cocaine to Miller, who had a history of seizures, Azen risked her health because the drug has seizure-inducing properties, Bell said.

Bell also said Azen performed CPR on Miller while impaired by drugs and alcohol, and waited 30 minutes after she stopped breathing before dialing 911 for help.

Azen said he had eaten dinner and slept before Miller’s seizure and was sober. He said he did not call 911 because the phone was in the kitchen, several rooms away. Getting to it would have meant stopping CPR, which is not supposed to be interrupted, he said.

Only days before the medical board hearings began, Azen lost his third job when he was terminated at Pacifica Hospital because he did not have a DEA license.

Although the DEA revoked his permit March 3, he continued to practice at the hospital without it until May 15. Azen said patients were not endangered because he still could get narcotic medications from the hospital pharmacy, which has its own DEA certificate.

Pacifica Executive Director Ermanno Mariani said Azen was dismissed because he could not do his job properly without the license. But he added that Azen was a good doctor whom he would take back if his legal problems are resolved--a sentiment echoed by others at the hospital.

Located in a mostly Latino neighborhood, Pacifica is a small community hospital and may be best known as the place Rodney King was treated after he was beaten by police.

The area is a poor one, and Pacifica’s busy emergency room could double as a set for “St. Elsewhere.” More than 1,400 sick people are seen there each month. Among them are a hefty share of gang members with bullet or knife wounds.

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Unlike their colleagues who practice in more leisurely surroundings, ER doctors describe what they do as “gut medicine”--making snap decisions in life-or-death situations. And among Pacifica’s ER physicians, Azen is known as a gut-medicine star.

“I’ve heard other doctors call him a doctor’s doctor,” said Warhaft, Azen’s former boss.

“He’s probably one of the 10 or 20 best clinicians in the country,” said Dr. Rick Key, another Pacifica ER physician.

Key recalled one Azen patient who had overdosed on digitalis, a heart stimulant. The man’s heart was beating in a rapid, uncoordinated way, a potentially lethal condition.

Azen tried the standard treatment, electroshock paddles, but the man’s heart kept convulsing wildly. Switching strategy, Azen injected him with a big dose of potassium, stopping the heart. Then, using a pacemaker, Azen restarted it, and its beat returned to normal.

“That’s as brilliant as you’ll ever see in medicine, to do that on the spot,” said Key.

Key and Warhaft said they never saw Azen impaired at work and would love to see him return. The medical board action against him, they said, does not make sense.

“The government is spending bread in the six figures to, if they succeed, remove a very good doctor from doing good work in a charity area,” said Key.

“Stan liked working in a third-world hospital and doing things for people who otherwise would never have the chance . . . That’s what makes this even worse.”