Doctor can be tried for out-of-state prescription in suicide case

from the San Mateo Daily Journal

A Colorado doctor who filled an online Prozac prescription for a 19-year-old Stanford student who later committed suicide can be tried in San Mateo County for practicing medicine without a license, an appellate court ruled.

The decision means psychiatrist Dr. Christian Ellis Hageseth III, 65, can be extradited from his Colorado home back to San Mateo County where he has a $500,000 arrest warrant. The court’s ruling dissolved a stay of Hageseth’s prosecution, paving the way for prosecutors to pick up where they left off last August.

Judge Carl Holm refused to dismiss the case on grounds California has no jurisdiction to try Hageseth under state law but defense attorney Carleton Briggs appealed. Briggs argued prosecuting Hageseth opens the door to trying thousands of out-of-state physicians who participate in so-called telemedicine and beyond.

“The key seems to be if the practitioner knew the patients resided in California but the decision doesn’t seem to limit it just to telemedicine,” Briggs said. “There are potentially thousands of practitioners who can be affected.”

The court held that Hageseth is liable if found to commit a crime “in whole or in part” within the state, according to the opinion by Presiding Justice J. Anthony Kline.

Hageseth should have known state authorities would not take lightly his filling a California prescription without a license, Kline said.

But Briggs said the ruling is creating new law, meaning there was no way for Hageseth to know previously about the responsibility.

Hageseth is charged with one felony count of practicing medicine without a valid California license. A conviction can carry up to three years in prison.

In June 2005, John McKay, a freshman at Stanford University and former student at Menlo-Atherton High School, purchased 90 capsules of generic Prozac via credit card at the online pharmacy site USAnewRX.com which was then shipped from the Mississippi-based Gruich Pharmacy Shoppe.

Online sites like the one used by McKay do not require a physical examination prior to receiving a prescription. Instead, the buyer fills out an online questionnaire which a doctor is supposed to review before signing off on the drugs.

According to previous news reports, McKay requested the drug to treat moderate depression and adult attention deficit disorder. He reportedly wrote on his application that he had taken the drug before and was not suicidal.

Hageseth reportedly signed off on the prescription of flouxetine without a consultation. On Aug. 2, McKay committed suicide by carbon monoxide poisoning, reportedly with alcohol and flouxetine in his system.

The following February, McKay’s parents, David and Sheila, filed a federal lawsuit against Hageseth and the pharmacies, alleging negligence and wrongful death.

Meanwhile, the Medical Board of California launched its own investigation and the San Mateo County District Attorney’s Office filed criminal charges last May.

At the time of McKay’s online purchase, Hageseth had a restricted medical license at the time because of an unrelated relationship with a patient he later married and was not allowed to fill prescriptions. He currently does not have a Colorado medical license because it was suspended after the charge, Briggs said.

The McKay’s federal lawsuit is still pending but it along with the criminal case is being watched by online pharmacy critics who believe it is poorly regulated.

Hageseth shouldn’t have filled a prescription without a good-faith examination, Briggs conceded, but that is not the issue at hand.

“The charge is practicing without a license. What he did was write a prescription and from beginning to end the entirety of the act occurred in Colorado,” Briggs said.

The State Attorney General’s Office filed a brief on behalf of the Medical Board noting it receives a number of complaints about Internet prescriptions filled by out-of-state doctors and has tried limiting the activity, according to the appeals court.

Briggs said he and Hageseth will decide in the next few days first if they’ll fight the decision in court and, if not, if he will wait for extradition or come voluntarily to California.

Briggs is hopeful local authorities will allow Hageseth to remain in Colorado on his own recognizance.