Pietr Hitzig once called himself "the father of fen-phen" and was known nationally as a vocal proponent of the drug therapy that he claimed could not only help people lose weight but also cure other ills, ranging from drug addiction to gulf war syndrome.
The Timonium doctor drew attention for one other claim, as well. Hitzig said he didn't need to see patients in person or administer physical exams before prescribing drugs, and he set up a booming online business that he described as a progressive "telemedicine" practice but that federal authorities said put patients at risk.
Yesterday in U.S. District Court in Baltimore, the once-famous Internet diet doctor went on trial on charges of illegally prescribing medicine to patients around the country during the late 1990s. Federal prosecutors have charged the Ivy League-educated Hitzig in a 34-count indictment involving 12 patients, two of whom died after following his drug protocol.
Hitzig, 58, contends that the charges are an unfair attack on experimental medicine. But prosecutors told jurors in opening statements yesterday that the allegations focus narrowly on whether Hitzig had acted outside the bounds of professional medical practice by medicating patients he had never examined.
"It's not about the legitimacy of his theories or suppositions, but about the legitimacy of his clinical manner in treating these patients," Assistant U.S. Attorney Christine Manuelian said.
The trial, expected to last five weeks, is something of a last stand for Hitzig. His career, which began after he graduated from Columbia University's medical school in 1969, crumbled when he surrendered his medical license to the Maryland Board of Physician Quality Assurance in 1999 and acknowledged sexual misconduct with patients.
His longtime marriage ended in divorce, and he moved out of his family's 7-acre estate in Monkton, where court records indicate he frequently entertained patients during the 1990s as he began narrowing his practice to fen-phen.
The treatment - a combination of the prescription drugs fen- fluramine and phentermine - was banned by the U.S. Food and Drug Administration in September 1997 after studies linked it to heart-valve damage.
Hitzig, who was critical of the ban, had advocated the drug combination for treatment of a variety of illnesses. In court yesterday, his attorney said Hitzig believed the drugs could help patients whom other traditional medicines had failed, and he pointed to research that showed other physicians were exploring the same possibilities.
"This is not some kind of fantasy that Dr. Hitzig dreamed up to attract patients and rake in the money and make himself some kind of god in the medical and scientific community," said Barry Coburn, a Washington attorney representing Hitzig.
But that is exactly the motive government investigators have ascribed to the man who once told a patient: "I don't believe in a God, but if there is one, I'm it," according to court records.
In court yesterday, the prosecution described a system in which telephone or Internet patients would pay $350 to begin Hitzig's fen-phen treatment. Patients would pay another $450 for an introductory group session that one patient likened to a "sales pitch," according to Manuelian.
Court records describe Hitzig's Timonium office during the period covered under the indictment - roughly 1996 to 1998 - as a frenzied distribution center where patients would often be given handfuls of orange and blue pills and told to begin taking them immediately in the waiting room.
Some patients ended up in the hospital, Manuelian said. One patient in Arizona with a history of psychiatric problems shot himself several weeks after he stopped taking Hitzig's treatment, she said.
Another patient, David McGill, died at his home while under Hitzig's care. Autopsy results showed that McGill, whose wife, Susan, also was a patient of Hitzig's and was involved in a romantic relationship with the doctor, suffered from phentermine intoxication, Manuelian said.
Coburn said Hitzig was not responsible for the deaths. He said the doctor might have been eccentric and inappropriate in his personal life, but he always had his patients' best interests in mind.