Wednesday, Oct. 15, 2008 | 2 a.m.
Barbara Baile’s death was both agonizing and avoidable, leaving her husband of 50 years painfully lonely.
Don Baile remembers her wry humor, the joy of traveling together and how, during a brutal winter in Montana, she gave every coat in their house to a needy family.
She wouldn’t be dead, Baile said, if only Dr. Kevin Buckwalter had properly addressed a side effect — constipation — of the narcotic pain medicines he was prescribing to his wife.
Barbara Baile, 69, started seeing Buckwalter in April 2004, complaining of pain in her hips and back. What Buckwalter did for her is unclear. In her medical file, he did not detail her medical history or a treatment plan or list the drugs he was prescribing her or their effectiveness.
Buckwalter declined to comment for this story.
Pharmacy records show Buckwalter put her on heavy doses of narcotics and other medications, a regimen that continued until she died. Buckwalter prescribed hydrocodone, oxycodone, fentanyl patches and many more drugs, records show. Don Baile says she was disabled for the final four years of her life, addicted to narcotics, bedridden, and living in constant pain from sore hips.
Dr. Andrea Trescot, a pain specialist in Florida, said any doctor who prescribes narcotics must monitor for constipation, one of the most common side effects of the drugs. Remedies start with over-the-counter options but may include prescription drugs and a rectal exam and manual removal of the blockage, she said.
Baile says his wife suffered from constipation the whole time Buckwalter was prescribing her narcotics. Sometimes she would go for two weeks without moving her bowels, he said. Baile said his wife complained many times to Buckwalter about the constipation. Baile said Buckwalter never explained that Barbara’s constipation could be caused by the narcotics.
If Buckwalter had monitored for constipation, as Trescot says is required of doctors, it would not have mattered whether she complained. But Baile said he does not remember Buckwalter’s ever examining his wife or offering any prescription remedy to soften her stool and move her bowels. Buckwalter merely suggested the over-the-counter treatments that she was already using, Baile said.
The problem reached a crisis in February. Barbara had not moved her bowels in more than three weeks. Frantic, Don bought everything he could at the drugstore. Nothing worked.
“I’m not trying to say that I shouldn’t have been smarter than I was,” Don Baile explains. “I loved her. When I saw her in pain — she’d get these tears in her big blue eyes — I’d run all over the world to get her something to take it all away.”
On Feb. 10, recognizing she was addicted to narcotics, Barbara Baile — in horrible pain from the constipation — entered a detox facility. On her first night in rehab, Barbara’s bowels ruptured and she was rushed to the hospital. In the ensuing weeks, doctors performed multiple surgeries in unsuccessful efforts to clean her body of massive amounts of fecal contamination and repair her intestines. Baile’s body was poisoning itself. After an agonizing 10 weeks fighting sepsis, she died April 27. Don Baile blames Buckwalter.
“He should not even be allowed to practice medicine,” Baile said. “I don’t think he even knew what to do for Barbara. I don’t think he took it seriously.”
Experts who reviewed Baile’s medical records say Buckwalter’s charts are so inconsistent and incomplete that they do not mention complaints of constipation.
“These are just horrible, horrible, horrible records,” Trescot said. “Medicare requires so much more than this. I don’t know of any insurance company that would have accepted these as records.”
The fact that Buckwalter didn’t address the constipation issue could constitute malpractice, said Trescot and three other experts who reviewed the records.
Baile is consumed with guilt over his wife’s death. He questions why he did not know better, and why he never took his wife to another doctor until it was too late.
“The last sound I ever heard her make was screaming when I walked out of that hospital and that’s a terrible thing I have to live with,” he said.