A new report by investigative news nonprofit ProPublica centers on allegations of misconduct by one of Montana’s most influential doctors. Oncologist Thomas Weiner saw thousands of patients at St. Peter’s Health in Helena for two dozen years before the hospital fired him in 2020.
ProPublica reporter J. David McSwane says he obtained sealed court documents from a dispute between Weiner and the hospital that outline years of billing malpractice and 10 “suspicious” deaths of patients under Weiner’s care.
McSwane joined MTPR’s Austin Amestoy to talk about his two-year investigation.
Austin Amestoy: David, tell us about who Thomas Weiner is and what these court filings reveal about his decades of work as an oncologist.
J. David McSwane: Well, Dr. Thomas Weiner is a oncologist at St Peter's Health in Helena, Montana, who had been basically the only option for cancer patients for 24 years from 1996 to 2020. And in that time he had amassed a great influence within the hospital and within the community. And he's beloved by many, many patients. And all the while, within the hospital there were suspicions that he might be hurting people.
Austin Amestoy: You spoke with families of three patients for this story who died under Weiner's care. Court documents and your piece indicate there were at least 10 who seemingly died of overprescription or maybe improper prescription by Weiner, according to that report. What commonalities did you find in these cases?
J. David McSwane: Well, yeah, those are the cases that we can substantiate with court records and that I have asked the doctor and the hospital about. Seven of them are what were referred to within the hospital and in court records as the phenobarbital cases. These are folks who seemingly at end of life or hospice or palliative care, whatever you want to call it, were given large doses of a drug called phenobarbital, which is a barbiturate that is most commonly used for alcohol withdrawal and seizures, and they died shortly thereafter.
Within the hospital, there was pretty intense concern that this drug either hastened their deaths or caused it. And, you know, that's been publicly disclosed.
There was also great concern as to his narcotics prescribing, including the case of a woman named Sharon Dibble, who very clearly, according to court records and medical reviews, died just after he doubled her morphine from 30mg twice a day to 60[mg]. That equaled a potentially lethal dose. And her daughter, unfortunately, found her unresponsive. That's relevant because in the hospital's own internal review, they had found that his narcotics were, "a greater danger to the community than Coronavirus."
In the case of Scot Warwick — some of this has actually made it into the press, though I don't know if his name has been identified. This is a patient who Dr. Weiner diagnosed with stage-four lung cancer, which is a very advanced and terminal disease, most people die pretty quickly: Months, maybe, maybe more, if you're lucky. He lived for 11 years, and in those 11 years received chemotherapy and other experimental treatments, and ultimately died in 2020. The autopsy and a biopsy just before he died found that he actually didn't have cancer that entire time, which, of course, was incredibly traumatic for that family.
So. the thing that I think we've identified in the records, and this story shows, is Weiner had just an incredible patient load. He logged as many as 70 patient contacts a day. And while doing so, you know, there were many instances of people being misdiagnosed, mistreated, over treated. And there were some pretty gruesome outcomes as a result, according to records and interviews.
Austin Amestoy: Weiner's story has been sort of coming in and out of the press in Montana for a few years now. But, of course, it's these sealed discovery documents that you obtained from this wrongful termination suit going on between Weiner and St. Peter's [hospital] that sort of had blown this story open through your report. This information, though, of course, is not public. So I'm hoping for our listeners' sake here, and my own curiosity, if you could tell us a little bit about how you and your team went about verifying facts for this story.
J. David McSwane: I came upon this story while I was working on an entirely different story during COVID that brought me to Helena, and there were obviously whispers, and I heard some things. I was already kind of poking around. I had talked to current and former staff members and was really reporting, and just happened to be able to obtain some of these things because I asked the right question, I guess. And those records, obviously, inform what is a huge mystery within the community. I mean, there are people who really stand by the doctor, as evidenced by — there's billboards or signs everywhere. He's beloved by many — and then others, not so much, because they've had a little bit more of a window into what's going on. So, I felt we really just needed to gather up the evidence, ask the hospital, ask the doctor, try to get to the bottom of it and explain what happened for this community, that I think is really awash in conspiracy theories and confusion. The hospital has to protect its own interests, obviously, and just hasn't been able to clarify some of these things.
Austin Amestoy: I think if folks, you know, turn to your story, one of the things I noticed was not only are you pulling out information from these discovery documents, but you're often going and talking with the folks who are subject of the information and the discovery documents and sort of corroborating the material that's in there with the families of patients and other doctors at the hospital. So, I thought that was very interesting. But, you know, you mentioned there that you have put some of these questions to St. Peter's and to Dr. Weiner. How have those, you know, the hospital and the doctor responded to your investigation?
J. David McSwane: Well, the hospital really hasn't refuted anything. You know, they gave me a statement that broadly declines comment, citing litigation, but they have not pushed back on our findings, because they're documented and I've confirmed them and we try and do it as best we can, including, as you said, going to some of the families and asking for their medical records. And, you know, it was very involved.
As for the doctor, we have a rule in the news business. We don't surprise people. So, he's had a chance to look at everything that I'm reporting here and has responded to it. And basically. he denies any wrongdoing. He stands by his work, very confident about it. There was this moment where I'm talking to him and I finally asked, 'are you killing your patients?' And he says, 'Well, no, I'm not,' but he kind of hesitated. And I asked him, 'Why did you hesitate?' He said, 'Well, it depends on what you mean by killing them.' And ultimately, what he's referring to is this principle of double effect in medicine. Essentially, if a doctor prescribes something that kills someone, it's considered ethically okay or morally okay if the intent was to provide comfort, not to, necessarily, kill them. That was sort of a byproduct of the intent to provide someone comfort. And he really sticks to that.
Austin Amestoy: David, before I let you go, I did want to ask you one more thing here. Could you update us on the status of Weiner's wrongful termination suit and whether or not there are any other lawsuits or investigations ongoing that you know of?
J. David McSwane: Yeah, it's a little bit of a black box, because law enforcement, their default is to provide no comment. But, Dr.. Weiner sued Saint Peter's for wrongful termination and defamation. That case was thrown out in district court and he's appealed to the state Supreme Court. There is a separate issue where he sued one of his former colleagues who had raised questions about patients, and that continues. He's also, since in August, I believe, he was sued by the U.S. attorney's office for, essentially, fraudulent billing — prescribing more narcotics and treatments than were necessary or needed. And he has, through his attorney, filed a motion to dismiss that case and has said the federal government has no basis.
Austin Amestoy: Once again, J. David McSwane is a reporter for ProPublica. His report on Dr. Thomas Weiner is available at propublica.org. David, thanks for your time.
J. David McSwane: Thanks so much for having me.
In a statement, a spokesperson for St. Peter’s Health said the hospital is “focused on moving forward,” and remains “committed to providing the great care and experience our community deserves.”
Attorneys for Weiner did not respond to a request for comment by deadline.
