this May 19, 2013, file photo, Prince performs at the
Billboard Music Awards at the MGM Grand Garden Arena
in Las Vegas. Itís not clear if any doctor could
have averted the fentanyl overdose that killed Prince
in April 2016. But his death may offer evidence for
how the special treatment often afforded the rich and
famous can result in worse health care than ordinary
delivered test results to Prince's home. Another sent his
son, who wasn't a physician, on a cross-country flight to
bring medication to the music star.
clear if any doctor could have averted the fentanyl overdose
that killed the singer in April. But his death may offer
evidence for how the special treatment often afforded the
rich and famous can result in worse health care than
ordinary Americans receive. It's a pattern identified in
medical literature as early as 1964 and it has a name:
agree that doctors treating Michael Jackson and Joan Rivers
lost their bearings and made fatal mistakes in the glare of
their patients' fame. Eleanor Roosevelt is another example.
are a number of red flags that go up," said Dr. Robert
Klitzman, who directs Columbia University's bioethics
master's program. "Prince was one of the wealthiest
musicians alive. Did he get appropriate care? VIP Syndrome
may have been involved."
described by Dr. Walter Weintraub of the University of
Maryland School of Medicine in a 1964 paper, VIP Syndrome is
shorthand for how the influence of wealth and the allure of
fame can cause doctors to veer into risky territory when
they cater to the demands of a star or his entourage.
reject medical advice or demand ineffective or harmful
treatments. Star-struck doctors may order unnecessary tests
or not enough tests. Hospital administrators may meddle in
decisions if the patient is a potential financial donor.
personal doctor, Conrad Murray, spent two years in prison
after his involuntary manslaughter conviction in the King of
Pop's 2009 death. Jackson had requested a surgical
anesthetic, propofol, to help him sleep, calling it his
"milk," according to trial testimony. Prosecutors
said Murray supplied the drug and didn't notice when Jackson
to please apparently pushed Murray far beyond the boundaries
of reasonable treatment, said Dr. Stephen Dinwiddie of
Northwestern University Feinberg School of Medicine.
doctor took a cellphone photo of Joan Rivers on the
operating table, according to a recently settled malpractice
lawsuit. That's a clear sign of clouded judgment, Dinwiddie
comedian's family accepted an undisclosed amount to settle
the complaint in her 2014 death following a routine
endoscopy. The family alleged doctors performed an
unauthorized medical procedure and failed to act as Rivers'
vital signs deteriorated.
Roosevelt may have been misdiagnosed because of VIP
Syndrome, said New York University School of Medicine's Dr.
Barron Lerner, who published a paper based on his review of
her medical record.
lady died in 1962 of tuberculosis, which could have been
caught earlier if she'd had a bone marrow biopsy in time,
Lerner said. Instead, she was misdiagnosed with aplastic
anemia and treated with steroids, which may have reduced her
body's ability to fight infection.
of doctors were involved, and no one was specifically in
charge," Lerner said, citing one hallmark of VIP
Syndrome. "She was an opinionated patient, and that
made it more challenging to take care of her."
timeline of events surrounding Prince suggests missed
opportunities, experts said, including a close call less
than a week before he died on April 21.
15, Prince's private plane made an emergency stop in
Illinois on a flight from Atlanta back to Minnesota. The
Associated Press and other media organizations, citing
anonymous sources, reported that first responders gave him
an antidote commonly used to reverse suspected opioid
think someone would say, 'Let's get him into
treatment,'" Klitzman said. Instead, a week passed
before Prince's associates called a California addiction and
pain specialist, Dr. Howard Kornfeld.
have not said whether he had a prescription for the fentanyl
and, if not, how he obtained it.
the musician's care remains unknown. Was Prince ó who
reportedly suffered from hip and knee pain related to years
of athletic stage performances ó already seeing doctors
well-versed in the risks of opioids? If he became addicted
to painkillers, did anyone consider referring him to a
nearby and highly regarded treatment option, Minnesota's
Hazeldon Betty Ford?
sent his son Andrew in an effort to persuade Prince to seek
long-term care at his Recovery Without Walls center in Mill
Valley, California, according to William Mauzy, the
Kornfelds' attorney. Andrew Kornfeld carried a small dose of
buprenorphine, which is used to ease withdrawal symptoms and
cravings, Mauzy has said.
Kornfeld arrived too late. He was among those who discovered
not respond to the AP's questions regarding Kornfeld's
approach to celebrity care.
of Dr. Michael Todd Schulenberg, a Minnesota family
physician, are also under scrutiny.
saw Prince on April 7 and 20, the day before he died. He
told investigators he prescribed medications for him, but a
search warrant did not specify which drugs. Schulenberg
arrived "on the death scene" at some point,
according to the warrant. He told a detective he was there
to drop off test results.
call suggests VIP Syndrome, Klitzman said.
attorney, who would not comment specifically about Prince,
said the doctor has made periodic house calls ever since he
was in residency, when he was trained to do them.
visits, he carries only a stethoscope and "does not
administer medications or perform any type of procedures in
a patient's home," attorney Amy Conners said in an
email to The Associated Press.
against VIP Syndrome, the Cleveland Clinic published nine
principles of caring for VIPs in 2011. The document warns
doctors against bending the rules.
In the end,
doctors must monitor a tendency toward any unusual
practices, said Lerner, author of "When Illness Goes
Public: Celebrity Patients and How We Look at
you're contemplating superhuman or very heroic, unorthodox
behavior in your zeal to help a famous patient," Lerner
said, "that's where you've got to take a deep breath