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LAS VEGAS HEADLINER: Gans' death ruled accidental

Coroner: Painkiller exacerbated health risks







Impressionist Danny Gans' death last month was caused by a combination of heart and blood diseases and a powerful prescription painkiller used to treat chronic pain, the Clark County coroner said Tuesday.

The death was ruled accidental.


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  • "Mr. Gans' health conditions placed him at greater risk for heart irregularities, and the hydromorphone was a factor that exacerbated those risks," Coroner Mike Murphy said at a news conference.

    The official cause of death was acute hydromorphone toxicity because of chronic pain syndrome. Hydromorphone is a strong synthetic opioid commonly known as Dilaudid.

    The contributing factors were hypertensive cardiovascular disease, which causes high blood pressure and thickening of the heart muscle, and polycythemia, a thickening of the blood caused by too many red blood cells.

    "It want to be very clear that this is not an issue of drug abuse," Murphy said. "What I'm trying to be clear about is that we have an issue involving Mr. Gans' health and the hydromorphone, and as a result of the combination of those issues, Mr. Gans succumbed to his health conditions in conjunction with that hydromorphone issue."

    Murphy would not reveal how much hydromorphone was in the 52-year-old's system, how long he had been taking it or whether it was prescribed to Gans.

    He said that the coroner's office worked with Henderson police to obtain all of the records they had available, including medical records from Gans' physicians.

    The entertainer died May 1 in the bedroom of his Henderson home. His wife had called 911 about 3:45 a.m. because he was having trouble breathing.

    Gans' manager, Chip Lightman, said Gans had been dealing with "terrible pain" in his shoulder since 2006.

    He had surgery in November, after his Mirage show closed, and another procedure in March.

    "He was in terrible pain again in March from the shoulder stuff, so they went in again and got rid of some scar tissue and did some cleanup from the original surgery," he said.

    Lightman said Gans might have been prescribed the hydromorphone after his surgeries, but he said he couldn't see Gans using it in large amounts.

    "It would just be very odd for Danny to take too much pain medicine because it would dry his vocal cords out," he said. "He wouldn't really do that because it would hurt his voice."

    Gans discussed some of his physical issues during an interview in February 2006, when he was about to reopen his show at The Mirage after a three-month break for surgeries on his right rotator cuff and left hand.

    He said the cumulative wear and tear from years of baseball, golf, martial arts and the physicality of his nightly show caught up to him. At the time, Gans couldn't lift his right arm over his head.

    "I had a lot of bone spurs in there (the shoulder) and a lot of scar tissue from hurting it -- little tears -- and I continued to perform," he said. "Maybe it would take four to six weeks to fix the tear that maybe I started three years ago. I said, 'Oh, you know, I'll just take more Tylenol and I'll be OK.'"

    The pain eventually disappeared, but Gans said he would reaggravate the shoulder now and then.

    "I'd swing a golf club or something, 'Ow! OK. I'll take more Motrin tonight. I've got a show I don't want to miss.' Because I had that one period in 2003, I missed a ton," he said. "That was a really bad year. I lost both my parents. I had an automobile accident. It was just a really rough time."

    David Graham, a pastor who golfed with Gans at the Dragon Ridge Country Club on the last day of the performer's life, said Gans did not complain about any pain that day and never mentioned taking Dilaudid.

    "He certainly was not an addict of any kind. He hated drugs," Graham said. "The only thing you could say about him taking pain medicine was he just had surgery."

    Lightman said he knew the game exacerbated the pain.

    "I know he was feeling pretty good, (but) he was exhausted from not sleeping the night before. Then he had his massage that he usually has on Thursday, then went to take a nap. Period. Nothing out of the ordinary."

    Dr. Todd Schlifstein, a nationally recognized expert in pain management who practices at the New York University Medical Center, said hydromorphone is a commonly used pain medication that is four times stronger than morphine.

    Schlifstein said Gans' cause of death, acute hydromorphone toxicity, meant his breathing was suppressed.

    "He would have a hard time breathing," he said. "He would be gasping for air. When he tries to gasp for breath, he just can't do it."

    He said it was "definitely unusual" that Gans died that way, "especially if Dilaudid is not new to him, if he's not opiate naive."

    Usually a patient and doctor know how the patient responds to the drug over time, he said.

    Schlifstein said that someone using the drug for pain management must use more of it over time to get the same effect, and the danger rises with increasing doses.

    Dr. Mel Pohl, medical director of Las Vegas Recovery Center, which has a program that deals with chronic pain management, said the listing of polycythemia as a factor in Gans' death indicated that the condition could have played a critical role.

    The disease thickens the blood, which slows circulation and lowers oxygen levels. Coupled with depressed breathing from the hydromorphone, and "you could have a potentially lethal brew."

    "For him to take enough to stop breathing is a significant event," he said.

    The question that Pohl said he has to ask is, "What was different on the night he died?"

    Both Pohl and Schlifstein said it is very difficult to speculate on Gans' death without knowing his medical history.

    "If the drug is prescribed and an individual follows a doctor's order, there shouldn't be any negative connotation regarding those who use pain medication," Schlifstein said.

    "Not everyone who uses pain medication is a junkie or drug addict. Many people are now afraid to even tell people they use pain medication because it's got a bad rap after some people abuse it. People are much too quick to judge in this area."

    Contact reporter Brian Haynes at bhaynes@reviewjournal.com or 702-383-0281. Contact reporter Mike Weatherford at mweatherford@reviewjournal.com or 702-383-0288. Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

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    Well wrote on June 11, 2009 05:53 PM: If he's a Christian, it couldn't have been an overdose.


    PK Smith wrote on June 11, 2009 02:43 PM: dear Gans Fan,

    Danny Gans was probably all of the wonderful things you say. that does not mean he couldn't have been addicted to drugs, or at least abusing them (the definition of abuse is using them in any way other than prescribed way). addiction does not discriminate. we are all eligible. it has nothing to do with character, status in life, money, fame or any of the rest of it.
    I speak from experience. I am a teacher, a good citizen and 21 years sober. I got to be an alcoholic despite all the good things about me.
    hopefully this old myth of addiction being a character flaw can be dispelled a bit more by this incident.
    on another note, many of us who have written about this are not judging Mr Gans. rather we are disgusted with the coroner for thinking we are all so gullible as to fall for his medical explanation. take a lesson from the Sheriff in the recent tragic car accident. he manned-up and when the facts were in, he told the truth.


    Gans Fan wrote on June 11, 2009 02:12 PM: It is a sad commentary on the state of our society that people cannot believe that someone as good as Danny could have had a reaction to a medication that caused his death. Why are so many of you trying to make him out to be a drug addict that overdosed? Why can't you accept the fact that he was a decent, loving Christian person who was incredibly talented. Why try to make him out to be a drug addict. And to Norm Clark, I am surprised & disappointed that you made the comparison to Elvis who we all know had a drug problem. Please leave Danny's memory and family alone. Enough is enough.


    Well wrote on June 11, 2009 08:48 AM: Lookie, the Sun has some balls! Even more logic right here: http://www.lasvegassun.com/news/2009/jun/11/report-raises-questions-pain-specialists/

    Physician says "He overdosed. Plain and simple."

    It's ok to love the guy BUT HE OVERDOSED.


    RickyBobby wrote on June 11, 2009 08:10 AM: He overdosed on skullpoppers. So sad.


    Well wrote on June 11, 2009 01:41 AM: If you don't have cancer and you are taking cancer medicine (that's 5x more powerful than morphine) and you die it's an OD. ALL UNAUTHORIZED PHARMACEUTICAL DEATHS ARE ACCIDENTS. But let's call a spade a spade. Danny died from doing something he wasn't supposed to do.

    For those of you trying to scold people for making this point, back up your opinion with logic. Great person or not, he died from misuse of a type 2 narcotic.


    SRK wrote on June 10, 2009 09:28 PM: Thank you Steve T.. well said Mr Gans has done so much for Vegas and does not deserve these type of comments. I guess they are building up their own shortfalls by trying to knock down someone who has done some good for us as a community. Idiots


    Steve T wrote on June 10, 2009 04:15 PM: To all you self righteous jerks with your rants about what you claim is a fact that he ODed, all I can say is have you done as much for the community as he did? Sure it doesn't make a wrong right (if there is even a wrong there), but we all have feet of clay and can stumble. You have no clue how he got to where he was. A wise man said take the board out of your own eye before you try to take the dust speck out of someone else's eye.


    Ken wrote on June 10, 2009 03:19 PM: Does it really matter, Kevin, if people put IMHO before their rant on Gans overdose? If anyone believes for a minute that there is any point of reference behind these comments then they are troubled. Especially if they need IMHO to be written so they can say, "Oh, it's just their opinion."

    Oh and Jennifer, it does come out of our pocket. Insurance rates rise for everyone when people make claims for benefits they are not entitled to.

    Gans may have been a great person but he messed up big time and insurance should not be paid if it is determined that he recklessly popped pills. The coroner tried to put a positive spin on it but I guarantee the insurance company won't.


    vegas resident wrote on June 10, 2009 03:17 PM: While I am sad for the family, I have to ask myself, Was Danny thinking of them or himself???

    What he was taking is a comfort drug for cancer patients in their last days, not golfers at 3am home alone. Unless he was (it appears he wasnt) trained and very knowlegable about the use of opiates he wouldnt have used too much of it or any for that matter the are better alternatives.

    No matter how nicely they word it the facts are the same, he used a drug that was related to his premature death. Was his pain that bad that nite? It dosent appear that he called for his wife to help him before he ingested the drugs and was having difficulties with his breathing.

    I'd love to see the toxicology report and see how close he was to the "LD 50" levels of Dilaudid in his blood were. The term refers to the LD50 or median lethal dose, a pharmacology term meaning the dose amount of a medicine required to kill 50% of a tested population. If we knew that number then there would be a basis to determine weather Mr. Gans Od'ed or if it was as they described it so nicely in the media. (cough cough).


    Its a terrible loss either way, and there is a lession to be learned, lots of lessions, but sadly they wont. Elvis (remember him) had a liking for Dilaudid 40 years ago, things people do...

    just another voice in the vally that will go unnoticed....my best to the family....


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