The prosecutor who took the rare step of charging a doctor with murder in the prescription drug overdose deaths of three patients said Friday that the case should serve as a warning to unethical physicians who become pill pushers.

 

Los Angeles County District Attorney Steve Cooley said his office will continue to prosecute greedy and unethical doctors after charging Dr. Hsiu-Ying “Lisa” Tseng, 42, with second-degree murder and 21 other felony counts. If convicted of all the charges, she faces a maximum sentence of 45 years to life in prison.

 

“This case was beyond anything else we have ever seen,” said Cooley, who stressed that these types of cases must be carefully researched before the extreme charge of murder is filed.

 

Tseng made her first court appearance Friday, wearing a pink sweatshirt and looking glum. Her arraignment was postponed until March 9, when her bail, currently $3 million, also will be reviewed.

 

Her lawyers declined to comment after the hearing.

 

Tseng is one of just a few doctors nationwide to be charged with murder related to prescription drugs. Authorities have been cracking down on drug deaths, which fueled by prescription drug overdoses now surpass traffic fatalities.

 

But the murder charges could be hard to prove because the victims played a role by seeking out and taking the drugs.

 

Tseng, a licensed osteopath, and her husband, also a physician, set up a storefront office in the Los Angeles suburb of Rowland Heights in 2005. Three years later, she was under investigation by the Drug Enforcement Administration and the California Medical Board for prescription irregularities reported by a pharmacy. Patient deaths were linked to her in 2009, according to authorities, but not all led to murder charges.

 

Tseng wrote more than 27,000 prescriptions over a three-year period starting in January 2007 — an average of 25 a day, according to a DEA affidavit. DEA agents swept into her office in 2010 and suspended her license to write prescriptions.

 

She was arrested this week after voluntarily surrendering her license to the Osteopathic Medical Board of California. Her husband continues to run their clinic.

 

The case highlights a murky region of medicine as patients hooked on prescription drugs seek out a source for their addiction. Prosecutors have charged many doctors with dispensing prescription drugs illegally, arguing they wrote prescriptions outside the normal course of practice and for no legitimate medical purpose.

 

There are about 880,000 doctors nationwide who are registered to write prescriptions, and federal agents investigate somewhere between 200 and 300 suspected dirty physicians every year, said DEA spokesman Rusty Payne.

 

But filing a murder charge against a doctor in a case where a patient dies from an overdose is extremely rare.

 

In 2008, Harriston Bass was convicted of second-degree murder in Nevada for the death of Gina Micali, 38, who died after taking the pain reliever hydrocodone. Bass was sentenced to 25 years to life.

 

A Georgia doctor was sentenced to life in prison in October 2007 for the drug overdose death of his patient and housemate. Noel Chua was found guilty of felony murder and violating the state’s controlled substances act in the death of Jamie Carter III, who died of multi-drug intoxication. Among the prescriptions Carter received from Chua were oxycodone and methadone.

 

In Florida, Dr. Sergio Rodriguez faces three counts of first-degree murder in the overdose deaths of three patients. His case is still pending.

 

The second-degree murder charges that Tseng is facing rely on the theory of “implied malice.” Authorities said Tseng knew that her prescriptions could have a deadly result because others in her care had died before the three alleged murder victims named in the criminal complaint.