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Va. Doctor's Misconduct Left Trail of Broken Lives

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By Sandra G. Boodman and Patricia Davis
Washington Post Staff Writers
Sunday, September 28, 2003; 12:00 AM

Anita Kratzke hadn't been feeling well in the days before she died. Her body was still in bed, tucked under her comforter, and there were no signs of violence.

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So when the Fairfax County detective who had been called to the Reston home to investigate Kratzke's sudden death spotted several bottles of pills near her bed, she called the doctor who had prescribed them.

Martin H. Stein said he was Kratzke's doctor and would sign the 49-year-old woman's death certificate, police reports said. No autopsy was performed.

Police said Stein never explained that he was a psychiatrist treating her primarily for back pain, not for any life-threatening condition.

"Cardiac arrest," Stein wrote on the death certificate. He did not examine the body, nor had he documented a visit with her in eight months.

Stein, once listed among the region's best psychotherapists in Washingtonian magazine, would say later in court papers that he had no idea what killed Kratzke.

More than 21/2 years after Anita Kratzke's death on March 19, 2000, the Virginia Board of Medicine ruled that Stein was a danger to public health and that his signing of the death certificate without proper investigation was part of a pattern of negligence. The board's 22-page order details ethical breaches, misdiagnoses and the inappropriate and excessive prescribing of drugs, including narcotics, in the treatment of 10 patients Stein saw between 1991 and 2000.

The board found that Stein had sexual relations with a patient, treated children even though he is not a child psychiatrist and was responsible for the deterioration of several people under his care. Despite the severity of the violations, Virginia's medical board did not revoke Stein's license. Instead, the 63-year-old board-certified psychiatrist signed a consent order last Oct. 11 agreeing to surrender his license for at least a year. He can apply for reinstatement next month. The D.C. Medical Board issued an emergency suspension based on Virginia's order and revoked Stein's license July 9.

Stein's story provides a rare, unusually detailed examination of the failures of a flawed system that purports to protect the public. His case raises questions about the speed and adequacy of discipline meted out by medical boards -- a slow process enveloped in secrecy that critics say harms vulnerable patients by allowing bad doctors to keep practicing -- and about the medical profession's ability to police itself. This report is based on more than 100 interviews with former patients and their families, physicians, hospital officials, lawyers and medical board and law enforcement authorities, and on thousands of pages of documents filed with two medical boards and courts in the area.

Among the patients cited by the board were Anita Kratzke, her husband, Robert, and their youngest son, Chris, whose simultaneous treatment the board called a "clear conflict of interest." The board found that Stein's treatment of Robert Kratzke caused him irreparable brain damage that forced him to retire on disability from his GS-15 engineering job at the Department of Energy. Chris Kratzke got so sick under Stein's care that he was committed to psychiatric hospitals for more than a year. The board also cited Stein for not properly managing more than a dozen medications, including powerful narcotics, he prescribed to Anita Kratzke.

"He totally wiped out my family, and we had to start over," said Robert Kratzke, 52, who pulled up three decades of roots to build a new life in Honolulu for his sons. "Our life was totally destroyed."

Beyond the Kratzkes, the board found that Stein "engaged in sexually intimate behavior" for more than two years with a patient to whom he rented a room in his Arlington office for $100 a day and charged her $200 an hour to go on shopping trips and visit her home. Stein flew with the 35-year-old woman to her home town in Illinois -- at her expense -- to "evoke memories of childhood abuse." Other documents submitted to the board say Stein encouraged the woman to "remember" that her father had been active in a satanic cult that sexually abused her and forced her to kill and eat a baby. The report concluded that Stein misdiagnosed and drugged her 4-year-old son, once binding the boy's ankles with electrical tape after his mother said he was out of control. None of the patients was named in the board's order.


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