Associated Press Writer

SAN ANTONIO (AP) An Air Force nurse charged with giving lethal doses of medication to the terminally ill took an aggressive approach to treating end-of-life patients and felt he cared best for them, friends and hospital workers testified Wednesday.

Capt. Michael Fontana, 35, is charged with killing three patients at Wilford Hall Medical Center, the largest hospital in the Air Force. Doctors testified that unusually large amounts of morphine were given to one stroke victim, who also received an anti-anxiety drug that was allegedly never prescribed.

Fontana wore his blue Air Force uniform at a Lackland Air Force Base military court and quietly took notes during the Article 32 hearing, which is similar to a civilian grand jury proceeding.

"He said the doctors and nurses were mad at him because he knew more about comfort care than they did," said Air Force Staff Sgt. Jessica Telles, one of Fontana's friends.

Fontana hasn't commented since being charged in March.

Doctors and nurses from Wilford Hall said Fontana was regarded as capable and professional, even while giving other testimony favorable to military prosecutors.

No motive has been offered. The purpose of the hearing, which will continue Thursday, is to determine if there is enough evidence to send the case to court-martial.

Fontana worked as an intensive care nurse at Wilford Hall, which primarily serves military personnel and retirees but provides emergency and trauma care to some civilians.

None of the alleged victims were active duty. Prosecutors focused their questions Wednesday on two patients, who both died Aug. 5 and whose families had given doctors permission to cease life-sustaining care.

One was a 74-year-old stroke victim who received large doses of the painkiller morphine and the anti-anxiety drug Ativan, according to hospital records. Several doctors testified Ativan was never prescribed.

A nurse's chart showed that Dorothy Marie Gray received 70 milligrams of morphine in a span of 70 minutes, and 16 milligrams of Ativan. Doctors described the doses as very dangerous.

"A very high dose for someone like Mrs. Gray," said Dr. Joshua Sill about the Ativan dosage. "That could be lethal."

Maj. Donald Stracener, another nurse at the hospital, said Fontana told him that a doctor had given a verbal order to give Gray the anti-axiety drug. Stracener said Fontana told him the woman had discomfort.

"Is Capt. Fontana a good nurse?" asked Maj. Michael Cojo, one of Fontana's attorneys.

"You bet he is," Stracener answered.

Lt. Lewis Carver, another nurse at the hospital, testified he had overheard Fontana tell a co-worker that some people "disagree with his aggressive approach" with end-of-life patients.

Telles, Fontana's friend, said she worked with investigators by letting recording devices be put in her car before going out with Fontana and filing reports afterward about their conversations.

Fontana also faces one count of conduct unbecoming an officer for altering medical records. He faces prison if the case moves forward and Fontana is convicted.

Fontana, who previously worked as an EMT nurse in Austin, has been in the Air Force since 2006 and served a tour at the military hospital in Balad, Iraq, from August to December 2007. The Texas Board of Nursing lists Fontana as a registered nurse since 2000.

Copyright 2009 The Associated Press.