The grieving father needed answers, and his medical mind sought them in the reams of records that had come to represent his son’s bitter end. He cataloged drug tests, checked them against the son’s medications, pored over research and emails and office-visit notes to the point of memorization.
Each time Dr. David Krag set the papers down, he arrived at the same painful conclusion: Peter should not have died. Krag decided that his son’s fatal drug overdose amounted to medical malpractice and that he would seek redress.
And so it was that the elder Krag sat in a Burlington courtroom last week as a jury heard his lawsuit against the University of Vermont Medical Center — the very place where he has worked for decades as a cancer surgeon. It was a fellow physician there, Dr. Halle Sobel, whose medical judgment would ultimately be on trial. Sobel, a primary care physician, had treated the younger Krag, a prominent musician in the Burlington area, for addiction long before his death five years ago at age 34. The family charged that her decision to allow Peter to stop taking a proven medication without objection and failure to spot signs of an impending relapse — all without notifying his family — led to his death, charges that the hospital had consistently denied.
The five-day trial presented an uncomfortable scene: A respected doctor suing his own employer over the care that an experienced colleague had provided his son. The UVM physicians sat feet apart at separate tables, surrounded by their attorneys, and rarely glanced at each other as a jury heard the regrettable details that led the parties to legal confrontation.
During days of testimony, Krag and his wife, Jesusa, would recall Peter as a quiet, inquisitive boy who grew into a brilliant but troubled musician. Sobel, too, would testify, at times tearfully, about her relationship with Peter, and expert witnesses would clash over whether she had erred in his care.
At issue were complex questions about a doctor’s responsibility to the patient — and their family members — during what is often a tortuous path through addiction treatment.
The jury’s eventual answer would have possible implications for Vermont’s innovative, sprawling system of addiction care amid an ongoing crisis and many good intentions. And when word of a verdict came last Friday, after just 90 minutes of deliberations, the two doctors braced to learn how this wrenching chapter of their lives was going to end.
‘Key Helpers’
It began with a loud knock on the door. A sheriff’s deputy asked Krag to get Jesusa, then broke the news: Peter had been found dead in his car from an apparent overdose. It was May 22, 2020.
Krag had lived in fear of this day ever since another son found needles in Peter’s car seven years before. But recently, Peter seemed to be doing quite well. He was living out of a music studio he’d helped build on his parents’ Shelburne property and was teaching piano to children.
Most importantly, Peter was on medication: Vivitrol, a long-lasting injection of a drug known as naltrexone intended to reduce his opioid cravings and, in turn, his risk of overdose. As long as Peter kept taking the monthly injections, Krag thought he would be safe.
Krag was also confident about the experienced colleague overseeing Peter’s care. Sobel, a South Burlington native, had completed medical school at UVM and chose primary care because she believed getting to know her patients would make her a better doctor. She was intrigued by the many chronic illnesses primary care doctors confront — a list that, by the early 2010s, prominently featured opioid addiction.
But Sobel was frustrated by the limited number of options she had for treating addicted patients. She recalled a mother with young children who was 800th on a waiting list for the methadone clinic.
So when Vermont health authorities put out a call for primary care practices to start prescribing addiction medications, Sobel jumped at the opportunity. She became an early participant in the “hub-and-spoke” treatment system.
Created around 2013, the model is designed to integrate addiction treatment into the normal medical system by using primary care practices — “spokes” — to care for stable patients who do not need more intensive services offered at “hubs.”
While some doctors were reluctant to take on this difficult work, Sobel saw the benefits and would go on to teach young doctors how to better care for this vulnerable population.
In fall 2016, Peter applied to be in UVM’s intensive drug-treatment program. First, he needed a primary care doctor to oversee his treatment. He chose from a list at random, according to his family, and wound up with Sobel, who choked up on the stand last week when describing Peter’s first visit.
“His head was down. He didn’t make any eye contact. He looked so sad,” she recalled.
The two developed a rapport as Sobel joined the constellation of people trying to keep Peter clean. They talked about using meditation and music to quiet his mind. She encouraged him to block the phone numbers of drug dealers and to never use drugs alone.
Peter, typically quiet and reserved, began to open up. “He trusted me,” Sobel said, “and he came back to me.”
But his struggles continued, and between 2016 and 2019, he managed only a few months of sobriety at a time.
Over the course of his addiction, Peter came into contact with every part of Vermont’s treatment system. He checked into residential treatment centers, only to leave early, against medical advice. He was kicked out of a sober house for testing positive for drugs. He tried all three of the main addiction medicines — methadone, buprenorphine and Vivitrol — but always ended up using street drugs. Nothing clicked, and by summer 2019, he was off medication and shooting up several bags of fentanyl daily.
That September, Peter landed in the emergency department for another detox.
By then, Peter had signed a release form allowing Sobel to communicate with his family about his care. She called his father and learned that Peter was headed to Howard Center to restart Vivitrol injections. Sobel said she’d be happy to prescribe the medication herself and scheduled a visit with Peter for the following day.
On October 31, 2019, Sobel and her patient’s father exchanged emails that would become a key point of contention in the trial.
“Hate to go around his back as he is an adult but he did give permission to communicate with you and Jesusa,” Sobel wrote. “And I feel if he is not making good decisions I need to reach out to you.”
Krag responded that communicating with a patient’s “key helpers” was an approach supported by research. He stressed the importance of keeping Peter on the Vivitrol. “His track record is absolutely 100% he cannot control himself,” Krag wrote. “He knows this and wants to get better,” but if there is a window of time that he is off medication, “he will absolutely use.”
“Agree he cannot help it,” Sobel responded.
Sobel would later maintain that she was agreeing to keep Krag updated only during this chaotic time in Peter’s life, not forever. “Peter was my patient,” she testified, not his family members.
Krag saw it differently. “A promise does not have an expiration,” he said during his six hours on the stand.
Peter showed up for his first Vivitrol shot, then several others. By May 2020, he was consistently testing clean for fentanyl. Krag felt hopeful that his son could conquer this disease.
What the elder Krag didn’t know was that his son had stopped taking Vivitrol three months earlier, in February — with Sobel’s consent.
That month, Peter emailed his doctor to say he wanted to stop the injections because they were giving him a rash. He said he was in a good place, with no desire to use, and wanted to take a once-daily, oral version of naltrexone, the active ingredient in Vivitrol.
He had an upcoming appointment with Sobel for his next injection. “But if it is OK to stop taking the Vivitrol, I would be comfortable not coming,” he wrote.
Sobel responded that she supported his decision. She warned him, though, that missing doses would be dangerous if he were to use fentanyl again, because his tolerance would be low.
A few weeks later, COVID-19 arrived and Sobel was enlisted to provide end-of-life care at a Burlington nursing home. She would not see Peter again until a telehealth visit on May 13, 2020, during which he revealed that he had not been taking the pills she’d prescribed.
He’d also been drinking more, resulting in the second of two DUIs over a short span. Peter told Sobel that he was getting connected with a counselor and that his drinking was under control. She encouraged him to be safe and to call her if he needed anything.
Nine days later, Peter was dead.
Krag and Jesusa did what they’d always done when Peter got in trouble: They brought him home. With the town’s permission, they buried his body about 50 yards from their house, near a small grove of bushes. They invited people to visit their son and would often look out the window to see someone standing by the grave. Sobel even came by with a colleague to leave flowers.
Jesusa, an artist, would hang colorful luminaries in the music studio where Peter had been living. They were meant to help him find his way in the afterlife, she’d say at trial. She also placed a small bronze statue on top of his grave that she had sculpted when he was a little boy. It depicted a young Peter in rain boots, hair spilling over his ears, his knees slightly bent — her “little puddle jumper.”
A Verdict
Six weeks passed after Peter’s death before Krag worked up the courage to enter the music studio again. That’s when he found an envelope from the UVM Medical Center among Peter’s belongings.
It contained a summary of his May 13, 2020, telehealth visit, during which he told Sobel that he was no longer taking any medication.
“I was just stunned,” Krag recalled on the witness stand. “I couldn’t actually get my brain around that.”
Krag emailed Sobel for clarification. She responded immediately. Peter had asked to get off the injections, she wrote to Krag, and she told him it was a “bad decision” because it would leave him without a “life jacket.” She was distraught over Peter’s death and said she regretted not pushing him to stay on the medication.
But Sobel’s decision making was within the standard of care, Dr. Joshua Lee, an addiction specialist at New York University’s Grossman School of Medicine, testified on Sobel’s behalf. She was under no obligation to inform the Krags about Peter’s decision, Lee said. And oral naltrexone, while certainly not recommended in every case, can be prescribed safely under certain circumstances.
“All she had to do was call his lifeguard, his father. She didn’t. And Peter is dead.” Mary Kehoe
Experts summoned by Krag’s attorneys vehemently disagreed. Oral naltrexone is not recommended for treating opioid-use disorders over time, they argued, because it does not activate the brain’s opioid receptors, unlike methadone or buprenorphine. That means people end up losing their tolerance to opioids, which, in turn, makes missing even a single dose dangerous should someone start using again.
The experts said oral naltrexone may be useful for patients under strict observation, such as in prison. Sobel, however, switched Peter onto the less effective medication via email and then failed to follow up for two months, those experts said.
“It’s completely inappropriate, and it violates the standard of care,” said Dr. Melissa Weimer, a physician at Yale University.
Sobel acknowledged under questioning that she could have told Peter that she did not support his choice or talked him through the decision during an appointment. She conceded that she could have called his father.
“This is a case, and this is a result, that has nothing to do with Dr. Sobel. This is not her fault.” Nicole Andreson
But Sobel wanted to meet Peter “where he was at,” she said. His written message showed that he had made up his mind, and she worried that pushing would scare him away.
“Your patient asked you if it was OK to go off medicine,” said Mary Kehoe, one of Krag’s attorneys.
“It was a statement,” Sobel replied.
“It was a question.”
“It was a statement, based on my relationship with him.”
During closing arguments, Krag’s attorneys said Sobel acted irresponsibly. She should have urged her patient to continue his medication and viewed his drinking as a cause for serious concern. They drew on Sobel’s own words to make the point.
“She saw that her patient — without a ‘life jacket’ — was drowning,” Kehoe said. “All she had to do was call his lifeguard, his father. She didn’t. And Peter is dead.”
The hospital’s attorneys argued that Peter was a competent adult who had a right to change — or stop — treatment at any time.
“This is a case about a 34-year-old man who lost his long, difficult battle with addiction,” said Nicole Andreson of the Burlington law firm Dinse. “This is a case, and this is a result, that has nothing to do with Dr. Sobel. This is not her fault.”
The parties concluded their arguments shortly before noon last Friday. Less than two hours later, the jury reached a verdict. The four men and eight women filed back into the courtroom and took their seats.
A hush settled over the courtroom, and the bailiff read the verdict aloud: UVM was cleared.
Sobel embraced one of her attorneys, while a member of Krag’s legal team rubbed Jesusa’s arm. A few people watching the proceedings wiped away tears as the judge thanked the jury for its service. Sobel quickly left. Jesusa lingered, hugging friends and family who had shown up to support her all week. David Krag wasn’t there; he had fallen sick and missed the final three days.
The parties emerged from the courthouse to a steady rain and the distant notes of music — a performance not far away at Burlington’s annual jazz festival. Peter could have been there himself, watching or playing keyboard, had his life turned out differently.
Correction, June 13, 2025: Dr. Halle Sobel was not a defendant in the lawsuit. A headline in an earlier version of this story contained an error.
The original print version of this article was headlined “A Question of Care | A Vermont surgeon sues a colleague — and his employer — over son’s fatal drug overdose”
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This article appears in Jun 11-17, 2025.
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