Global Courant
A San Jose doctor has been convicted of illegally prescribing and distributing large amounts of opioids without a legitimate medical purpose, including to a person who died of an overdose, federal prosecutors announced Friday.
Donald Siao, 58, a family physician, was convicted Tuesday by a federal jury of 12 counts of distributing the controlled substances oxycodone and hydrocodone outside the usual course of his medical practice during a 12-month period between 2016 and 2017. prosecutors at the United States Attorney’s Office said in a press release.
After identifying Siao in a separate prescription fraud investigation, investigators found that Siao had written 8,201 prescriptions for drugs containing controlled substances in just the one-year period from May 2016 to May 2017, prosecutors said. Over the course of the investigation, Siao increasingly prescribed opioids to four separate undercover officers posing as patients, though in some cases they admitted to sharing the drugs with colleagues or friends.
Each of the 12 charges against Siao carry a maximum prison term of 20 years. Ismail J. Ramsey, U.S. Attorney for the Northern District of California, announced On Friday he would try to have Siao’s medical license forfeited.
Calls to the US attorney’s office and to Siao’s attorney were not immediately answered.
Eight of the 12 charges against Siao involved a mother and son identified in court documents as EJ and AJ, respectively.
Both mother and son claimed to have lost or stolen pills, and Siao continued to respond with prescriptions, according to court documents.
Siao also ignored a warning from an insurer about possible fraud related to EJ and a report that AJ had previously been arrested for selling pills, prosecutors said in the press release.
AJ overdosed twice, but still got prescriptions from Siao, according to court documents. AJ died of an opioid overdose in December 2019. In addition, Siao failed to comply with requests for medical records from the coroner following AJ’s death.
The last four charges against Siao were related to an operation conducted by an undercover interagency task force.
The California Department of Justice Bureau of Medi-Cal Fraud and Elder Abuse, or BMFEA, was one of several agencies investigating Siao in 2017, according to court documents. In May of that year, the agency searched a state controlled substance database and found that Siao had written more than 8,000 controlled substance prescriptions.
Many of those prescriptions called for 30 milligrams of oxycodone, which is on the high end of the dosage strength. The National Library of Medicine statesfor example, that immediate-release oxycodone tablets start at 5 mg and end at 30.
Along with oxycodone, Siao issued prescriptions for combinations of opioids, muscle relaxants, and benzodiazepine, often known as the “Holy Trinity,” according to court documents. The Justice Department has said that together, the trio “depresses the central nervous system and the ability to breathe”.
The drug task force conducted an investigation from February to May 2018. Four officers visited Siao’s office multiple times to request prescriptions for controlled substances.
In one case, an agent known as AM posed as a retired football player complaining of pain in his shoulder, arm and elbow. He saw Siao three times, each visit ending with a recipe.
During his third appointment with Siao in July 2018, AM admitted to sharing a portion of a previous dosage of 60 tablets and 30 mg of oxycodone, a potentially addictive controlled substance used for pain management, with a colleague. The agent asked if Siao could increase the amount of pills to compensate for the borrowed cache.
Siao obliged, increasing the total to 75 pills during an appointment that lasted about two minutes, according to court documents.
Another agent, identified only as ET in court documents, sought Siao for a prescription of Norco, a combination of hydrocodone and acetaminophen used for pain management.
The agent said he bought Norco at work earlier for $10 a pill. Siao said, “That’s crazy,” court documents said. The doctor then added, “I’m not going to say anything. Some people are trying to turn that into a business; say it like this.”
The doctor then prescribed 45 10 mg tablets after a first visit in April 2018, according to court documents.
Siao eventually increased the number to 60 tablets on ET’s second visit, prosecutors said. At the agent’s request, he also prescribed a cannabinoid, Marinol. The officer told Siao that he was a marijuana user and had to show his employer that any cannabis found in his bloodstream through random testing was due to another drug.
Siao replied “gotcha” and filled the prescription, prosecutors said.
