Opinion ID: 613517
Heading Depth: 2
Heading Rank: 7

Heading: Webb's Trial Evidence

Text: Webb's first trial witness was Dr. Richard L. Rauck (Dr. Rauck). Dr. Rauck, an expert in anesthesiology and pain management, testified that Webb was writing prescriptions appropriate for his patients' conditions, and that his prescribing practices were within the professional bounds of medical practice. Dr. Rauck stated that in cases where he has testified for the Department of Justice that other doctors conducted themselves outside the bounds of medical practice, it was his experience that the accused doctors did not treat infections and other conditions. In Dr. Rauck's opinion, Webb's prescribing patterns did not fit with those of other doctors prosecuted for inappropriately prescribing controlled pain medications. Dr. Rauck further testified that opioids can appropriately be prescribed for patients with drug abuse histories. Dr. Rauck testified that Webb did refer patients to pain management clinics for treatment. In his review of Webb's files, Dr. Rauck did not see any intent on Webb's part to get his patients addicted to narcotics. Dr. Rauck testified specifically on each of the three patients in whose deaths Webb was implicated. He opined that Terri Morris had an extraordinary level of fentanyl in her system when she died, and that such a high level could not have come from a prescribed dose. He also noted that Webb did not prescribe fentanyl for Terri, but only for her husband, and testified that it was not unusual for Webb to have prescribed OxyContin to treat Morris's headaches. As to Gena Ortega, Dr. Rauck testified that she had been on stable doses of hydrocodone, so one would not have expected that to have caused her death. He stated that the levels of hydrocodone found in her blood at death should not have been lethal. Dr. Rauck also found it compelling that Ortega had a sixty percent lesion of one coronary artery and a forty percent lesion of another coronary artery, which he posited was a possible reason for a cardiac event that could have caused Ortega's death. Dr. Rauck also reviewed Victoria Ross's file, which he said demonstrated narrowing in [the] coronary arteries that could possibly have caused her death. Dr. Rauck opined that Ross clearly had sustained a miocardial [sic] infarction rather acutely within days or hours before her ultimate death. He also testified that if Ross took her OxyContin as prescribed it would be hard for [him] to understand that that would be the cause of death. Dr. Rauck disagreed with the medical examiner that acute oxycodone intoxication was likely the cause of Ross's death, concluding that her heart condition was a more likely cause. Webb testified in his own defense. He stated that he took patients other doctors were unwilling to see, and that he is very frustrated by his arrest and trial. He also never intended to defraud anyone. Webb did not know that Victoria Ross was going to other doctors to get medicine, and was not treating Ross for her heart problems. Webb prescribed Ross Oxy-Contin shortly before she died, but did not realize how desperate her situation was. As to Ortega, she would not have died if she had taken the amount of drugs Webb prescribed her. Webb never prescribed fentanyl to Terri Morris, and when he found out that she and her husband were sharing drugs, he would have had a very significant conversation with them (although he did not claim to remember such a conversation specifically). After the defense rested, the district court instructed the jury on all counts.