Pain-Racked Patient Dies in Peace, but Doctor Faces Murder Charge

Rosario Gurrieri was a 70-year-old retired bank guard who had just learned that the crippling aches in his bones were caused by lung cancer that had spread undetected through his body. His doctor gave him weeks to live.

Dr. Ernesto Pinzon was the young physician on call two weeks later when Gurrieri, hospitalized in terrible pain and gasping for breath, begged his nurses and his family again and again for something to make it bearable.

By telephone, Pinzon ordered a nurse to give the man a large shot of morphine. The nurse refused. So in the evening hours of Oct. 6, Pinzon went to Highlands Regional Medical Center and administered that drug and Valium.

Then, sitting at Gurrieri’s bedside with the man’s family hovering around, Pinzon injected potassium chloride into his patient’s vein. Within an hour, the man was dead.

Weeks later, a grand jury accused Pinzon of committing “willful, premeditated and unjustified murder” by using potassium chloride--a drug sometimes used for executions.

He was charged with first-degree murder, punishable in Florida by a life prison term or the electric chair.

As the 36-year-old doctor awaits trial, set to begin May 12, a Florida judge and U.S. Supreme Court justices are deciding in separate lawsuits whether terminally ill patients have the right to ask their physicians for drugs to help them die.

Although Pinzon and his prosecutors want to remove his case from the debate about physician-assisted suicide, advocates on both side of that issue say it illustrates their arguments.

Advocates of assisted suicide argue that easing or even ending a dying patient’s suffering has long been part of a doctor’s job, and arguments against it are far removed from the reality of watching someone die an agonizing death.

Opponents counter that doctors need to learn how to ease pain, rather than speed death, and legalizing assisted suicide could lead to elderly or helpless patients being pushed to needlessly hasty deaths.

“It is very scary for us to see how many people are advocating murder to avoid pain,” says lawyer Luis Gonzalez, who represents Gurrieri’s widow and three adult children.

“Those last hours, those last days, the last time a terminally ill patient has with his family is extremely precious. My clients were deprived of that. And that is not what they wanted.”

The investigation into Gurrieri’s death began when a nursing supervisor filed a complaint with the hospital, saying there was no medical reason to inject the potassium chloride. Hospital administrators reported the doctor to police two days later.

State medical regulators later issued an emergency order to suspend Pinzon’s license. Pinzon told the regulators that his intent in using the potassium chloride was to slow Gurrieri’s heart rate and breathing, making his final moments more bearable.

Although Pinzon refuses to discuss specific details about his actions with reporters, his partner as well as Gurrieri’s primary doctor, Dr. Fabio Oliveros, say Pinzon made a caring and medically sound treatment decision.

Gurrieri’s case was complicated, Oliveros says, because he was not only in the final stages of lung cancer, but also suffered from heart disease and was going into respiratory failure.

“What we are talking about, this is a very compassionate act. If I was the physician to be called at home on a Sunday night by a nurse saying, ‘Mr. Gurrieri is dying, he is in pain,’ I would say, ‘I know that. I know his death will be extremely painful. Just let it happen.’

“But here this guy, who knew that the man was dying, he still wanted to face the family. He wanted to help. He wanted to do something about the dying. And now he is caught up in this.”

Pinzon, who remains free on $100,000 bond, is widely supported in Sebring, a small town about 80 miles southeast of Tampa. His case is also drawing strong support from Puerto Rico, where he had lived since childhood and completed his medical training.

In Sebring, hundreds of people rallied on Pinzon’s behalf the day the grand jury announced its charges. His court hearings overflowed with doctors, nurses and patients wearing purple ribbons, including his estranged wife and two children who traveled from Chicago to support his release on bond.

In San Juan, doctors and medical staff at the Veteran’s Administration Hospital where Pinzon trained are holding fund-raising drives and raffles to help with his defense.

“Ernesto is not an evil-intentioned person,” says Dr. Carlos Rosado, one of Pinzon’s former teachers. “Whatever took place that night, I can only guess that it occurred by compassion, taking into account whatever was going on with the patient.”

But to Dr. Herbert Hendin, a New York City psychiatrist who founded the American Foundation for Suicide Prevention, that misses the point.

“People say that all the time when they put people to death,” says Hendin, who examined the medical board’s investigation into Gurrieri’s death. “What they really mean is, ‘I didn’t know what to do.’ ”

Hendin says Pinzon failed to administer drugs that could have helped manage the pain.

“There is just incompetence all through this case,” he says. “They justify it in the name of compassion, but what you’re really talking about is incompetence, and compassion is not a substitute for competence.”

Pinzon initially planned to hire Geoffrey Feiger, the lawyer for euthanasia advocate Dr. Jack Kevorkian, to fight the charges, but decided against it. His supporters say Pinzon is not a crusader for euthanasia.

The doctor defended his reputation as a good and caring doctor.

“It is true that I am a very compassionate physician,” he says. “I love my patients. I love my career. I am a good physician.

“I am sure that I am not a criminal.”