L.A. doctor who gave daughter propofol sees license suspended

Propofol is prepared at a lab. Dr. Steven Shafer, an anesthesiologist who specializes in propofol, said it is Â?extremely uncommonÂ? for the drug to be used in the home.
(Los Angeles Times)

A Northridge doctor’s license was suspended Thursday after medical authorities found that he had been injecting his daughter at home with propofol, the same drug that killed pop star Michael Jackson.

Robert S. Markman, a retired anesthesiologist, constructed a treatment area in his adult daughter’s “filthy” house, in a bedroom she rarely left, the Medical Board of California alleged in a ruling on an interim suspension order made public Thursday.

Markman, according to the board’s order, injected his daughter, referred to only as L.M., with the surgical anesthetic about 500 times over five years.

“It is clear the Medical Board of California moved to protect the health and well-being of Dr. Markman’s daughter,” said Dan Wood, a board spokesman.

Markman, 66, administered the drug every three days to treat the severe genital pain his daughter had experienced for years, according to the order.

Markman began treating his daughter after her efforts failed to find treatment from numerous doctors and medical centers proved unsuccessful, according to a declaration by Markman cited by the board. Markman said the propofol gave his daughter the longest-lasting pain relief she had ever had.

“This is a tragic case of a woman who has suffered excruciating pain for 17 years and had not been able to get relief,” said Mitchell J. Green, an attorney for Markman. “The medical board’s reaction has been, in a word, medieval. If the medical board had been around in the Middle Ages, we would still be operating without anesthesia.”

Interim suspension requests and decisions by the board are rare and sought only when it is believed a doctor could cause harm before a formal decision can be made in his or her case, Wood said.

Markman turned over more than 1,200 pages of his daughter’s medical records to the board, saying he kept detailed records in treating her, according to the order.

Dr. Steven Shafer, an anesthesiologist who specializes in propofol, said it is “extremely uncommon” for the drug to be used in the home. Shafer testified on behalf of the prosecution in the trial of Dr. Conrad Murray, who was convicted in November of involuntary manslaughter in the death of Michael Jackson.

Shafer, who wrote a declaration to the board in regard to Markman’s case, said it is reasonable to try propofol for chronic pain as a last resort.

“Although the use of propofol in the management of chronic pain is not established, given the complexity of chronic pain, and our limited therapeutic options, a trial of propofol is a reasonable therapeutic option for patients refractory to conventional pain treatments,” he wrote.

Though he has not seen Markman’s daughter’s medical records, Shafer has spoken with Markman multiple times by phone and believes he was trying to help his daughter.

“What happens if a parent feels they are a physician of last resort?” Shafer said. “I truly believe that both he and the California Medical Board are absolutely genuine in that their primary concern is the care of the daughter.”

A hearing on the interim suspension order is scheduled for April 18.

In December 2011 an investigator for Los Angeles County’s Adult Protective Services, suspecting possible dependent abuse, tried to visit the daughter’s home, according to the board’s order. Markman did not allow the investigator to meet her or enter the home and allegedly threatened the investigator.