Opinion ID: 613517
Heading Depth: 2
Heading Rank: 6

Heading: Death of Patient Gena Ortega

Text: Webb's patient Gena Ortega (Ortega) was a dental hygienist who had successfully completed a drug rehabilitation program in 2001. According to Ortega's sister-in-law, after she got married Ortega was a very professional person, loved her job and neat in her appearance, ... and ... seemed to be just in good general spirits. After Ortega began seeing Webb, she became moody, had little energy, and could not hold down a job. Ortega had burn marks on her legs and on the furniture in her home from where she allowed the cigarettes she was smoking to drop from her mouth and smolder. Webb treated Ortega for back pain intermittently from July 2004 until her death in April 2007. Ortega's husband testified that he drove her to two of her appointments with Webb, during which she was in Webb's office for less than 15 minutes and went directly to the pharmacy afterwards. In December 2004, Ortega told Webb that she had taken too many pills and therefore had run out of her prescription ten days early, and Webb phoned in a new prescription for her. On March 23, 2005, Webb noted that Ortega `requests some medication to unwind at the end of the day,' so Webb prescribed her what Dr. Parran described as a whopping 1 mg dose of Klonopin. Dr. Parran opined that [u]nwind at the end of the day is not a diagnosis, and is certainly not a legitimate medical purpose for a Schedule IV benzodiazepine to be prescribed. Ortega obtained an early refill from Webb in April 2005 and Webb sent her for a pain consult in May 2005. After a five-month absence, Ortega came back to Webb in October 2005, and Webb prescribed her Klonopin and Lortab at the same levels as before. According to pharmacy databases in the area where Webb practiced, Webb continued to prescribe Lortab for Ortega on a monthly basis until April 19, 2007. That same day, Webb also prescribed generic Soma and Endocet. Ortega died on April 22, 2007. Among other things, Ortega's toxicology report showed the presence of hydrocodone and alprazolam, which resulted in a synergistic effect. The medical examiner concluded that the cause of Ortega's death was toxic effects of hydrocodone and other drugs, which essentially caused her to accidentally choke on her own vomit. Dr. Parran testified that Webb's prescribing appeared to be inconsistent with the usual course of medical practice and appeared to have been for other than legitimate medical purpose and was a contributing factor to [Ortega's] death. At the close of the government's evidence, Webb made a motion for acquittal, which the district court denied. Webb did not renew this motion at the close of the evidence.