By Michael Donoghue
Vermont News First
BURLINGTON — A Chittenden County jury has cleared the University of Vermont Medical Center against claims of medical malpractice and negligent undertaking in the 2020 overdose death of the adult son for a world-renowned doctor based at the Burlington hospital.
Dr. David N. Krag as executor of the estate of Peter M. Krag had sued the UVM Medical Center claiming the medical care provided by Dr. Halle G. Sobel was substandard and led to the death of the well-known local jazz musician from Shelburne five years ago.
The jurors, after a one-week trial, deliberated about 90 minutes before the foreman sent a note to Vermont Superior Court Judge Megan J. Shafritz that they had a verdict Friday afternoon.
Burlington lawyer Nicole Andreson, the lead defense lawyer, declined comment and referred comments to the UVM Medical Center, which finally issued a statement late Saturday afternoon.
“University of Vermont Medical Center respects the outcome of this case, which centered on the tragic death of a patient and member of the Burlington community,” Annie Mackin, a spokeswoman said in an email to Vermont News First.
“We appreciate the work of the jury and stand by the compassionate and competent care that our teams provide to patients struggling with opioid use disorder,” Mackin said.
The hospital was asked to make a member of its administration available to discuss the case or answer follow-up questions, but still had not responded as of Sunday afternoon.
The lawsuit questioned whether Dr. Sobel, an adult primary care internal medicine physician, had properly treated Peter Krag, who died in May 2020 at age 34. Peter Krag had started using opioids, including heroin and fentanyl, when he was 27 until his death, the lawsuit noted.
Peter Krag’s treatment – or lack thereof – was the center of the lawsuit that has drawn considerable internal interest within the state’s largest medical center and within the medical community in Vermont and beyond. It is rare for a medical doctor to sue his hospital and take on a colleague in open court over the treatment for a patient.
Dr. Krag had maintained Dr. Sobel had failed in her medical care for his son.
He cited Dr. Sobel’s own email to him on Oct. 31, 2019 in which she promised to keep Dr. Krag and his wife advised about their son. “Hate to go around his back, as he is an adult, but he did give permission to communicate with you and Jesusa … and I feel if he is not making good decisions, I need to reach out to you.”
Dr. Sobel said relied on the parents to convey information to the patient “and the parents were relying on Sobel, based on this promise, to keep them apprised of developments in Peter’s care,” the lawsuit said and his lawyers argued.
Sobel, who comes from a well-known South Burlington family, was not named as a defendant in the civil case, only the UVM Medical Center was sued. Sobel was seated throughout the trial at the defense table with the lawyers representing the UVM Medical Center.
“Peter Krag’s death is a tragedy,” Andreson had told the jury in her opening statement. “This is not a case of medical malpractice. She (Sobel) provided proper medical care.”
Andreson said it was more a case of a 34-year-old man losing his battle with addiction and Sobel had done all that she could do.
Sobel broke down a couple of times while testifying during the trial. She had developed a strong bond with the younger Krag.
The jury had been asked to consider awarding possibly $9 million in damages during the closing argument by Shelburne lawyer Mary Kehoe. She represented Dr. Krag, along with Burlington attorney Thomas J. Sherrer.
The jury of eight women and four men began hearing opening arguments and testimony last Monday at the historic courthouse on Main Street. The testimony wrapped up Friday morning with an expert witness for the hospital, who said he was being paid $40,000 for the case.
Closing arguments by the lawyers followed that morning and Judge Shafritz explained the relevant law to the jurors, who got the case just before noon.
Once in the jury room, most of the jurors quickly agreed Dr. Sobel had completed the proper standard of care for Krag, according to one juror, who spoke to Vermont News First anonymously.
The jurors took an initial vote upon entering the jury room to get a feeling on how they stood, the juror said. A woman on the jury collected the secret ballots and the tally was 11-1 leaning in favor of the hospital.
The jurors then discussed the evidence as they lunched over pizza and salads the court had ordered for them from Leonardo’s.
Some court exhibits, including items covering the proper standard of care, were reviewed in the jury room, the juror said.
Following more discussion the vote eventually became unanimous and a note was sent to the judge. The jurors had to wait about a half hour until the court could round up all the lawyers, parties and court staff for the jury’s findings to be announced and the signed verdict form submitted.
Judge Shafritz excused the jurors but before letting them leave the courthouse she met with them in private to thank them for their work and to discuss the trial and answer questions from them.
Most of the claims by Dr. Krag were based in part on a consent Dr. Sobel obtained from Peter Krag to discuss his care and treatment with his parents, David and Jesusa Krag of Shelburne. In one email exchange, “Dr. Krag tells Dr. Sobel that absolutely 100 percent Peter cannot control himself and needs medical assistance to deal with his opiate addiction and Dr. Sobel agreed.”
Krag’s parents had been authorized to work with Dr. Sobel and get regular updates on their son to help fight his addiction, the lawsuit said. Between 2013 and 2020 with the help of his parents and others, Krag participated in multiple inpatient and outpatient treatment centers, court records note.
At one point in 2018 his parents, David and Jesusa Krag, took him to North Carolina for an attempted intervention because his heroin/fentanyl use had become increasingly destructive, the lawsuit said.
Dr. Krag testified that Peter Krag gave up and went to the Wilmington, N.C. airport to fly back to Burlington. The family intercepted him before his flight and said that was the final straw. He was told “you are on your own” if he left. Instead Krag opted to work with his parents on his addiction, Dr. Krag told the jury.
Peter Krag was considered an intelligent, artistic and caring young man, who graduated with a 3.6 GPA from the University of Vermont in 2008 while majoring in music, his father told the jury. He said besides playing music, his son also taught it. Krag was well-known for his keyboard playing with a handful of popular musical groups. His father said he also made many CDs.
The jury got to hear a recording of Peter Krag and his father performing together and also watched a music video of Peter Krag.
Dr. Krag testified that he was counting on his colleague, Dr. Sobel, to report any issues about his son’s treatment, but she failed to follow through on her email promise. Dr. Krag said after his son’s death he went to his apartment near the family home in Shelburne on July 2, 2020 to organize his possessions. He testified he found a letter from the UVM Medical Center on a table and he opened it. He said he was shocked. It had medical records that said Krag had told Dr. Sobel on May 13, 2020 that he had stopped taking his oral naltrexone.
It was nine days later that he was found alone, slumped over in a car outside 345 Malletts Bay Avenue near Morehouse Drive on the west side of Winooski. Winooski Police and St. Michael’s College Rescue responded to a 911 call shortly before 10 a.m., but Krag was dead.
“His son died because his medication was cancelled,” Kehoe said in her 16 minute opening statement.
Kehoe noted Krag initially was getting his treatment by shot each month and it was working. When it switched to an oral ingestion, there was the potential for the treatment to fail if the medication was not taken.
“The death was preventable,” Kehoe said.
Andreson, in her 28-minute opening statement, had said “his addiction was severe.” She said he had a 10-to-20 bag a day habit for heroin at one point.
Krag resorted to selling drugs and stealing from his family to support his addiction, she said.
Sobel, who began working with Krag in 2016, had warned him to never use drugs alone and to always have Narcan available to reverse the effects of an opioid overdose and to extend a life. He did not follow those rules, said Andreson, a former state prosecutor.
Dr. Sobel’s bio from UVM Health says “she cares for patients with opioid use disorder and helps those individuals in their recovery from the chronic disease of addiction.” It also notes she is an associate professor of medicine for UVM’s Robert Larner College of Medicine, where she works with and does mentoring for trainees.
Dr. Krag, as an academic, holds the S.D. Ireland Family Professorship in Surgical Oncology at UVM. He is known world-wide for his cancer work.
The lawyers in April had picked a 14-member jury, including two alternates, but by the time the trial started last Monday, two were excused. Both were for medical reasons, including one juror that was sent to the emergency room the day before the trial began, the judge said.
One other juror was initially a no-show on Monday and apparently had asked the court to excuse her because she was starting a new job that day. There was some misunderstanding at the court over the request, but she soon arrived when contacted.
The judge had questioned the lawyers in the interim how they would feel if the jury ended up dropping below 12 people.
Krag’s lawyers said their client was willing to have the case proceed, but the Medical Center lawyers said their client was inclined to stick with 12 jurors. That might have meant the sheriff would need to go out onto the streets and find somebody to fill the seat. In the end it wasn’t needed.
The defense also objected to the jury verdict form that a series of questions to hear the jury in their work. In the end it didn’t matter.