A Rowland Heights doctor accused in the prescription- drug-overdose deaths of three men spent only minutes with some patients before prescribing powerful opiates, a prosecutor said Monday, but a defense attorney claimed the doctor lacked the street smarts to know drugs like oxycodone might be abused.
Hsiu-Ying “Lisa” Tseng, 45, is charged with three counts of second- degree murder in the deaths of Vu Nguyen of Lake Forest and Steven Ogle of Palm Desert, both 25, and Joseph Rovero III, a 21-year-old Arizona State University student from San Ramon, between March and December 2009. Tseng is also facing 20 counts of unlawfully prescribing controlled substances and one count of fraudulently prescribing a controlled substance.
Deputy District Attorney John Niedermann said there were plenty of “red flags” to alert Tseng, an osteopathic doctor, of the dangers of prescription drugs. Three other Tseng patients in their 20s — Matthew Stavron, Ryan Latham and Naythan Kennedy — overdosed between September 2007 and September 2008. Their deaths, all just days after seeing Tseng and walking out with prescriptions for multiple drugs, prompted calls to the doctor’s office from the Orange County coroner’s office.
She “repeatedly had patients overdose and die, the defendant was repeatedly notified” and “the defendant’s practice of prescribing did not change at all,” the prosecutor said in his opening statement.
Niedermann said medical experts will testify that Tseng “departed from the standard of care in an extreme degree” and was “not acting in good faith.”
He also said the doctor should have seen the signs of drug-seeking behavior, Niedermann told jurors.
Rovero “drove 361 miles to go see the defendant at Rowland Heights” and overdosed 10 days later, the prosecutor said.
The prosecutor said pharmacists will testify that they “became alarmed” at the profile of patients looking to fill Tseng’s prescriptions. Many were between 18 and 26 years old and paying cash for expensive brand-name pharmaceuticals designed to help patients with chronic pain or cancer.
Some visits by undercover agents to Advance Care AAA Medical Group, where Tseng ran a practice with her husband, “lasted barely minutes,” Niedermann said. No physical examinations were made, no medical histories were taken and agents walked away with prescriptions for Vicodin, Suboxone and Xanax, he told jurors.
Tseng created a fake chart for one patient’s husband so the woman could “double-dip on her prescriptions … getting up to 400 pills a week.”
Defense attorney Tracy Green told jurors her client, who went to medical school at Michigan State University, was “a soft touch … she was not street smart. She was nerdy … (and) didn’t have a full appreciation of what was going on out there.”
As for the victims leading to the murder charges, “all three of them had taken large amounts of drugs … far in excess of what was prescribed,” Green said.
She told jurors that if Tseng were “acting like a pharmaceutical drug dealer” she would have had an in-house pharmacy or deal with a pharmacy. It was patients who shared information about where they could find a “soft- hearted doctor” and get their prescriptions filled without questions being asked, Green said.
Responsibility for picking up on red flags when handing out potent narcotics “rests as much on the pharmacist as it does on the doctor,” Green said. Other doctors also prescribed medications that may have led to the men’s deaths, but prosecutors never interviewed pharmacists or other prescribing doctors, according to the defense attorney.
“These are sad, tragic things … but it’s difficult to place all of the responsibility on Lisa Tseng,” the defense attorney said.
Patients “feigned illnesses (and) lied” to Tseng, who would have no idea, for example, that Rovero drove from Arizona, since he used his parents’ California address, according to Green. “He was partying and made this trip for partying,” she said.
“The prosecution in this case has overcharged,” Green said. They’ve “taken a medical board case … and decided to make a murder case out of it.”
Her client was just in “over her head,” Green said. “She wasn’t a pain management or addiction specialist … she wasn’t being callous or indifferent.”
Tseng surrendered her license to practice in 2012 and has settled civil cases with several families in an effort to “take responsibility where she can.”
“The evidence will show that she just happened to be the last stop” for men who “had struggled for many years,” Green said. “She acted as a doctor, not a drug dealer.”
Larry Eisenberg, a plaintiff’s attorney who handled several civil cases against Tseng was also in court Monday. He said she was responsible for about 15 deaths and called her clinic a “pill mill.”
— Wire reports