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11 Articles in Volume 16, Issue #2
Gender and the Pain Experience
Sex and Gender Differences In the Pain Experience
Medical Management of Diabetic Neuropathy
Comorbid Substance Use Disorders: Primer for Pain Management
Marijuana Use Disorder: Common and Often Untreated
Acupuncture: New Approach for Temporomandibular Disorders
Opioid-Maintained Patients Who Require Surgery
Natural Protein Points to New Inflammation Treatment
Lessons from the Murder Conviction of Dr. Hsiu-Ying “Lisa” Tseng
Zohydro vs Hysingla: What is the Difference in These Extended-Release Agents?
Letters to the Editor: Opioid Calculator, Testosterone for SCI

Lessons from the Murder Conviction of Dr. Hsiu-Ying “Lisa” Tseng

Editor's Memo from March, 2016
Page 1 of 2

For many years, I’ve had my two local papers, The Los Angeles Times and San Gabriel Valley Tribune, delivered to my door early each morning. The San Gabriel Valley is just east of downtown Los Angeles and consists of two-dozen bedroom communities.

Doctor convicted of murder after prescribing deadly combination of medications.Both newspapers delivered a shock on the morning of March 2, 2012. The front-page headline read, “Rowland Heights Doctor Faces Murder Charges for Prescription Drugs.”1,2 On February 5, 2016, Hsiu-Ying “Lisa” Tseng, DO, was sentenced to 30 years to life in prison for the murder of 3 young men who fatally overdosed while under her care.3

The murder conviction of Dr. Tseng for prescribing a deadly concoction of medications is a first in the United States. Due to this landmark event, Practical Pain Management wants all pain practitioners to know the sorry facts and lessons about this case. Above all, this case does not reflect the legitimate practice of medicine and the prescribing of opioids and other controlled drugs to bona fide pain patients.

Since I live and practice in the community of West Covina, which abuts Rowland Heights to the south, and Dr. Tseng’s trial and sentencing were held in Los Angeles, I’ve been able to follow this case and collect the news reports that it has generated.

Dr. Tseng, 46, who was a general practitioner, is among a small but growing number of doctors charged with murder for prescribing opioids that killed patients. A Florida doctor was acquitted of first-degree murder in September, 2015.3

The Charges

Dr. Tseng was officially charged with murder of 3 young, single men: Vin Nguyen, 29, of Lake Forest, California; Steven Ogle, 25, of Palm Desert, California; and Joseph Rovero, III, 21, an Arizona State University student from San Ramon, California.

Dr. Tseng was reported to have written more than 27,000 prescriptions over a 3 year period, starting in January 2007. She saw patients at a rate of about 25 a day, and wrote prescriptions primarily for alprazolam (Xanax), oxycodone (Oxycontin), hydrocodone/acetaminophen (Vicodin), and amphetamine/dextroamphetamine (Adderall)—all highly abused medications. She initially came to the attention of authorities when some pharmacies noted non-standard prescriptions being presented by questionable patients.

Accompanying the original 2012 news report was this statement by Los Angeles District Attorney Steve Cooley: “There were deaths directly as a result of her prescribing medication that was probably not needed at all, to feed someone’s habit. Her incredible greed was exhibited by prolific dispensing of literally thousands upon thousands of dangerous drugs.”4

I was impressed by Cooley’s statement as I have personally known him for many years and even testified as an expert witness in some of the DA’s cases. He’s not a prosecutor with a vendetta against physicians or pain patients, so I knew his statement represented that something bizarre was happening.

The Doctor

Dr. Tseng was 42 years of age when she was arrested. She graduated from Michigan State University of Osteopathic Medicine, and was licensed in 1997. In 2005, she opened her clinic in a strip mall on Fullerton Boulevard, a very busy street, in Rowland Heights. The clinic’s name was Advanced Care AAA Medical. She surrendered her medical license in 2012 after her arrest and incarceration.

Incredibly, at the time of her arrest, Dr. Tseng was affiliated with 14 hospitals in the Greater Los Angeles area. Almost all the hospitals ranked her in the “top 25%” of physicians. An interesting questions is why did she have all these hospital affiliations and what did she do to receive such positive ratings? Did any of these hospitals bother to check her practice?

She has two young children and expressed this opinion in a public letter before her sentencing: “I now realize that personal problems—undiagnosed depression, hoarding, and difficulty juggling work and children—interfered with her abilities to be a good physician.”3

The Practice

Between 2007 and 2010, Dr. Tseng’s tax returns showed that her practice took in $5 million. According to court documents and press reports, she kept few records, and seldom performed a physical examination. Prescriptions of medications were issued pretty much on the patient’s request, which undercover law enforcement agents documented.

Even though Dr. Tseng was convicted of murder of only 3 young men, other deaths occurred in her practice. Three young men under age 30 overdosed and died in 2007 and 2008: Mathew Stavron, Ryan Latheau, and Nathan Kenney. It appears that her practice catered to young people who were clearly abusing and misusing medications.

During the trial, it became evident that these patients drove long distances to her clinic and apparently all paid cash for prescriptions. She rarely performed a physical examination or documented a bona fide need for opioid analgesics and other drugs. Most clinic visits resulted in prescriptions for at least
2 of these 4 drugs: Oxycontin, Adderall, Xanax, and Vicodin.

She received numerous reports from families, pharmacists, and coroners about her patients abusing and selling drugs. She was even notified about patient deaths before the 3 fatalities of which she was convicted. Apparently, she ignored all or at least the majority of these 3rd party reports of inappropriate use of her prescriptions.

The Community Setting

This case has been particularly perplexing to the pain practitioners who function in close proximity to Rowland Heights. I personally had never heard of Dr. Tseng and was shocked that she could essentially run a “pill mill” for so long.

Why? Pain practitioners in my city know each other. In my town of West Covina, no physician could possibly operate a storefront prescribing Oxycontin and other medications for illegitimate purposes for very long. Physicians and our surrounding medical establishments would not tolerate such behavior and would immediately notify law enforcement, including our local police department.

Unfortunately, an objective analysis of Rowland Heights is one of the sorry messages in this debacle. Rowland Heights is a new, unincorporated conclave of a tight knit Asian-immigrant community. There is no police department, city hall, hospital, or mayor.

Besides the Dr. Tseng matter, this community recently made national headlines for a different, but equally tragic event. Three teenagers from China were sentenced to prison for brutally beating 2 teenage girls. The beating included burning their breasts. The apparent motive was that the girls didn’t show “proper respect.”5 The 3 teenagers were called “parachute kids,” which refers to young people sent alone by their parents to America to attend school.

Perhaps I sound defensive, but I do not believe Dr. Tseng could have carried out her practice in any of the communities that surround Rowland Heights. I truly believe that a normal, incorporated city would have stopped Dr. Tseng long ago.

Last updated on: March 15, 2016
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