Dr. Kooshian vs. the Gay Community

Can Charles Bouley II sue Stephen Kooshian? Should others follow suit?

A return to the airwaves may have been part of the reason Howard continued to celebrate even after the Gay Pride festival ended on his final night. According to notes from a Los Angeles County Coroner's investigator, the HIV-positive host had consumed eight glasses of wine and five shots of tequila in a five-hour-period.

At 2 a.m., Bouley was asleep in the couple's bedroom. Howard was in the living room, happily dancing to Abba songs. Thirty minutes later, he woke Bouley. "The room is spinning," Howard said before vomiting. By 4 a.m., the pain had shifted.

"Andrew never talked about pain," said Bouley. "So when he told me that he felt severe chest pain, I knew something was wrong."

At 4:44 a.m., with Bouley by his side, Howard walked into the emergency room. If national longevity statistics were any guide, he should have had 44 more years to live. Howard had 92 minutes left.

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Drug use is rife at dance parties, especially at Gay Pride festivals. One of the more popular if highly toxic drugs is gamma hydroxybutyrate (GHB)—the so-called "date rape drug." In addition to creating energy to dance for hours, some men also believe it heightens sexual passion. GHB can also make a user unconscious. Many alcohol-free partygoers who end up vomiting, incoherent and in the ER have overdosed on GHB. Officials at Long Beach Memorial Medical Center declined to confirm the number of drug-abuse emergencies they handled during the Gay Pride festival, but it was likely more than a few.

That sad scenario may have worked against Howard. When he and Bouley arrived early in the dark on Monday morning and complained of vomiting and acute chest pains, nurses demanded to know about their drug use. The pair acknowledged alcohol use and insisted that Howard had not used illegal substances. (Blood tests would later confirm their truthfulness.) But the nurses appeared disbelieving and apathetic, Bouley asserted in court records.

"Over and over, they asked about illegal drugs," he said. "They refused to listen to us. The whole time, they were not treating his chest pains."

Then Howard suffered a seizure and vomited blood. Standing nearby watching was one nurse who continued to "casually unroll an oxygen hose" while two other nurses chatted about "scheduling and who was going to be getting time off," said Bouley. "They were sauntering around."

After the patient was transported to a bed, the questions about drug use continued, nurses "fumbled around" for a seizure kit, and "further critical time elapsed . . . more than 15 minutes" before a doctor arrived for a quick examination, Bouley alleges. At 5:21 a.m.—almost 40 minutes after their arrival—an EKG carried this alarming note: "Borderline first-degree AV blockage—Abnormal."

If Howard was afraid, he didn't show it. "I grabbed him and said, 'I love you,' and he told me that if I was going to be a big baby to go wait in the hallway," said Bouley. "It was just like Andrew."

While his lover's condition worsened, Bouley asked about the EKG. He was assured the problem was tachycardia—simply an unusually fast heartbeat. "They did not take what was happening to Andrew seriously," he said.

Minutes later, Bouley heard Howard scream. He had a second seizure. "I begged a nurse for help and was told, 'Oh, he is just snoring.' I said, 'You bitch! Get someone now!' There were nurses sitting around again. . . . The next time I saw Andrew, he was dead. He had gone from making jokes and walking into the hospital to being on a slab. What the hell happened? They had no real explanation."

The ER staff tried unsuccessfully to revive Howard. Officials said he died at 6:16 a.m. from a "pulmonary embolism" or the sudden obstruction of a blood vessel.

That determination wasn't exactly right. Two days later, an autopsy proved that Howard had suffered a massive heart attack thanks to untreated arteroscelorotic cardio vascular disease. But even that finding was unusual: a 34-year-old white American male has a greater chance of dying in a homicide than from a high cholesterol count. Howard had suffered "complete blockage" of one coronary artery.

* * *

If Bouley and Howard's parents are correct, the death was preventable. In court records, they blame the hospital for emergency-room negligence and accuse Dr. Kooshian—Howard's primary physician—of recognizing the potential heart condition but "doing nothing to treat it" for more than a year. Indeed, a series of Kooshian's laboratory tests as early as mid-2000 showed alarmingly high levels of cholesterol and triglyceride. The coroner reported that Howard's death had been "years" in the making.

An official at Long Beach Memorial Medical Center declined to speak on the record about the case, but in court pleadings, the hospital's attorneys have denied errors. Kooshian said he was "deeply saddened by the untimely passing of Andrew," which he called "a tragedy." The doctor described his treatment as competent and caring. 

"There is no aspect of the medical care which I rendered to him which was inappropriate or below the standard of care," he said. "The nature and degree of coronary artery disease suggested by the autopsy report for this patient was truly extraordinary and unexpected."

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