Medical and legal professionals have been waiting with baited breath for the landmark decision that came in last Friday night that convicted Dr. Hsiu-Ying “Lisa” Tseng of murder for fraudulently, and recklessly prescribing drugs that resulted in the overdose death of three of her patients. The decision is so critically important because it sets a standard—doctors can be convicted of murder for illegally or carelessly prescribing pills. Many cases have tried this, but no one ever has been found guilty.
Until now, under the Health & Safety Code 11173, and Health and Safety Code 11153 (the Wobbler offense), the only penalties a prosecutor could charge for California Prescription Fraud were a misdemeanor or a felony. Charges were based on the kind of allegations made, or if the defendant has a criminal history. Best-case scenario, if convicted of a misdemeanor, the doctor serves one year in county jail and a fine up to $1,000. Worst-case scenario, if convicted of a felony, the guilty faces 16 months to three years in jail and a fine of up to $20,000. The convicted doctor might also get their license suspended, or in rare occasions, revoked.
I looked up a list of legal defenses that one reputable law firm in California put on their company website as the defenses they use for a medical professional when he, or she, is charged with prescription fraud. While I’m never to say anything is impossible, these are a stretch. Doctors who like to write phony scripts, regardless of the consequences, have won their cases with defenses like, entrapment, pressure, flattery, threats, and the ever-useful insanity plea. But now, things have changed.
Dr. Lisa Tseng is the first doctor to be convicted of murder for irresponsibly and negligently writing scripts for narcotics. This is a game changer. It means doctors are vulnerable if they don’t follow the rules. Now the medical community is all a flux that this conviction will put restrictions on doctors who have legitimate needs to prescribe these drugs, and that will interfere with their ability to properly treat patients. Sure, there will always be someone who tries to game the system and blame an innocent doctor for a death or overdose they had nothing to do with. But, it’s always been that way. That’s why doctors have insurance and lawyers. Doctor’s who comply with regulations and treat patients properly and safely have nothing to worry about. Giving a terminal cancer patient an oxy so he can have five minutes of relief from agonizing pain is clearly different than providing a teen, or twenty-something, with an indefinite supply of narcotics there’s no legitimate, medical reason for. Particularly, if the patient exhibits drug-seeking behavior, or admits to addiction issues.
The 2014 Medical Board of California has very strict guidelines for prescribing controlled substances for pain. Doctors must first perform a psychological evaluation then examine medical history, family histories and use screening tools before a patient can even be considered a candidate. Once a patient is deemed fit for pain management treatment, the doctor is supposed to discuss risk strategies, treatment plans and objectives, counsel patients on overdose dangers, and sometimes start with an opioid trial. Then, there must be ongoing patient assessment, drug testing, pill counting and a plan for discontinuing narcotic therapy. The Medical Board of California also provides many suggestions for alternative therapeutic options, suggested treatments plans, and strategies for weaning the patient off pain drugs. These rules and regulations are very clear. An image from the 2014 official guidelines acknowledges the new dangers of overdose deaths from prescription medications, and notes that there have been revisions made to help physicians prevent abuse or overdose from prescription drugs.
But Dr. Tseng ignored all of this. Now that we understand doctor’s who comply with the rules have no real risk of penalty for performing their job correctly, let’s get to the point, which is there are too many doctor’s peddling scripts for financial gain, with no regard to the law, or the lives of their patients. That’s what the medical defense lawyers are worried about. Big pharm is huge business. Like billions and billions, and with any business, where the temptation of money can throw morality out the window, doctors are not exempt. To the public, if you have a good, reputable doctor, don’t worry. To the good, well-respected doctors, don’t worry. To the doctors towing the line, or crossing it, watch out, because statute has been made. Reckless prescribing can now send you to jail for murder just like reckless driving.
But, back to the conviction of Dr. Tseng. Let’s paint the full picture—First, Dr. Lisa Tseng was notified nine times by authorities about overdose deaths of her patients, with drugs she prescribed in their systems. Nine calls in under three years. It’s surprising she wasn’t investigated then, isn’t it? Endless claims were filed about a variety of Dr. Tseng’s medical infractions, but the three convictions of murder are the real tragedy. The victims were 21, 25 and 28 years old, respectively. They had no legitimate need for the prescriptions she was prescribing them. In fact, she was found guilty of more than a dozen counts of illegal prescribing. Prosecutors told of students who came from over 300 miles to get their drugs from Dr. Tseng’s clinic, then sold some to finance their own habits. Several patients admitted to dealing drugs they got from Tseng, and several of Tseng’s patients have been charged with dealing drugs over the years.
It gets worse. Dr. Tseng ignored warnings she got about the way she prescribed drugs after a patient in her clinic died of an overdose. Even crazier, an undercover agent came to see her as a patient, admitted to being a drug addict, but Dr. Tseng prescribed narcotics anyway. Then she did no follow-up whatsoever. She never did follow ups. Dr. Tseng is the most dangerous kind of drug dealer we have in this country because she has a medical degree, a prescription pad, and no conscience. She knowingly prescribed the exact drugs drug-seeking ‘patients’/addicts came in, told her they were addicted to, but needed. Add to this, it came out one grandmother called the office demanding she stop prescribing narcotics to her addict grandchild. That request was ignored and business went on as usual.
Dr. Tseng is the kind of doctor people, well addicts, ‘doctor shop’ for. She’ll prescribe anything with no discretion, couch it in some insane justification, but the real motive here is money. Her clinic brought in five million dollars over the last few years. Come in, give me money and I’ll write you a script for any drug you want, knowing you don’t need it and it’s harming you, just make sure you bring cash. If that’s not a straight up drug dealer, I don’t know what is.
While her mother and defense attorney claimed she was helping, and informing these ‘patients’ of the risks by continuing to use these very addictive drugs, she still wrote those scripts like it was her job. That’s the opposite of her job. The correct thing to do is to immediately send these patients to the kind of detox or rehab they probably all desperately needed, but instead she enabled them and kept them coming back for more, and for that she deserved to be punished.
A doctor makes an oath to protect their patients. A doctor is meant to be trusted and moral. Dr. Tseng broke that oath, betrayed the trust of parents and patients, and was so devious and greedy, or maybe crazy, she knowingly involved her business with dozens, maybe hundreds of addicts, and many died because of it.
Dr. Tseng is appealing her case. Good luck with that, people don’t like doctors who kill young people and peddle drugs to addicts. And, good luck in prison because without that prescription pad, it’s not going to be very pleasant. Kudos to the jurors and judge who convicted this woman, I won’t dignify her by calling her a doctor because she’s not she’s a criminal with a medical degree.