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A Colorado doctor accused of illegally prescribing anti-depressants to a Stanford student who later committed suicide has been convicted of practicing medicine in California without a license.
Christian Hageseth, 76, faces up to a year in county jail, San Mateo County Chief Deputy District Attorney Steve Wagstaffe said.
Hageseth had entered a surprise no-contest plea to the felony charge on Feb. 24 in San Mateo County Superior Court.
Hageseth prescribed fluoxetine hydrochloride, a generic form of the anti-depressant Prozac, over the Internet to John McKay, a 19-year-old Stanford student and Menlo Park resident in June 2005. Two months later McKay committed suicide by carbon monoxide poisoning, inhaling car-exhaust fumes at his mother’s home.
The case was precedent-setting because it questioned the legality of online prescriptions to out-of-state patients. San Mateo County prosecutors maintained “telemedicine” breaks the law by prescribing drugs to a patient in California if the practitioner is not licensed to practice medicine in the state. Hageseth had a license in Colorado but surrendered it in 2005 after Mr. McKay’s death, according to his attorney, Carleton Briggs of Santa Rosa, Calif.
“This is the first case, as far as I can tell in my research, in the English-speaking world. That’s why it’s such an important case; that’s why it’s such a critical issue.
“It’s not illegal, per se, to get drugs over the Internet. From studies that I’ve read, very large numbers of people do it. It just cries out for federal regulation, and I’m very leery about an individual state purporting to control interstate commerce,” he said.
Wagstaffe agreed the case was important and will have a bearing on future cases. “It establishes that if a patient is receiving care in California, that a doctor better be licensed in California,” he said.
According to reports, Hageseth tried to get the case dismissed, claiming the state courts lacked jurisdiction to try him under California law. But Court of Appeals justices ruled that California statutes apply to an offense that occurs within the state by a defendant outside the state “regardless of whether the agent or other means employed was within the state at the … time.”
A federal law dating back to 1911, Strassheim vs. Dailey, also backs the state law in that a state can exercise jurisdiction over criminal acts that are committed outside the state but do harm within the state, justices said.
Hageseth’s attorney in part argued that the Internet undermines the role of territorial boundaries, but the appeals court rejected that claim, according to court papers. The case was later returned to San Mateo County Court for prosecution.
Briggs said Hageseth pleaded no contest for health reasons.
“He just had open heart surgery; he really can’t continue with all the litigation,” Briggs said.
Wagstaffe said the plea and conviction ends a 3 1/2-year prosecution for the district attorney’s office.
Hageseth, who is free on bail, will be sentenced on April 17 at 9 a.m. Briggs said his client has returned to Colorado until sentencing.
Wagstaffe said the district attorney’s office will consult a pre-sentencing report to assess Hageseth’s health status and level of remorse before deciding on whether to ask for incarceration.
The physician who knows the long term continuous care patient has better knowledge of the a patient in many cases than one who has seen a patient only once . Add to this the extreme difficulty in finding adequate care at short notice and I would say that tis is very selective prosecution. Many out of state physicians provide continuous care over the phone in situations where an in state attending physician could not. For example, if the patient had extensive testing in order to diagnose an ailment and needs to change a medication in an emergency when on vacation in California no California physician will prescribe exactly what the patient needs without time consuming diagnostic tools. By then it might be too late…
Even pharmacists and optometrists will fill out of state prescriptions, for good reason.
I do not know the details of the case, but tele-medicine is part of the solution to our health care mess.
There is no good reason not to have a license that applies across the US, this already applies to “good samaritan” care, eg on a plane.
Many routine Dx and monitoring tasks could be off-shored with current and future IT.US patients X rays are currently reviewed in Singapore, there have even been cases of remote surgery by internet 2 and 3 by SRI and leading medical centers.
Prozac is not a drug of abuse nor particularly poisonous, it is not clear from the report if the young man killed himself with prozac or some over the counter pills or some other way.
The MD is in his late seventies, has heart disease and is at the end of his life– was this worth while to prosecute?
Correction- I see he killed himself with CO, not drugs, even less reason to prosecute the MD, there have been moves to make prozac an OTC drug
Prozac and other, much more dangerous drugs can be purchased on the Internet from foreign countries without any prescription or consultation. I’m not sure that this prosecution is really facing today’s reality.
This article incorrectly states that he is 76. He is only 68, and was only 64 when he was making lots of money with his lucrative internet precription practice. He did not even have a license to write new prescriptions in the state wehre he lives, because he lost it through unethical behavior and malpractice. Save your sympathy.