Chua v. the State.
| Decision Date | 31 May 2011 |
| Docket Number | No. S11A0051.,S11A0051. |
| Citation | 289 Ga. 220,710 S.E.2d 540 |
| Parties | CHUAv.The STATE. |
| Court | Georgia Supreme Court |
OPINION TEXT STARTS HERE
Garland, Samuel, Loeb, Donald Franklin Samuel, Atlanta, for appellant.Jacquelyn Lee Johnson, District Attorney, Thurbert E. Baker, Attorney General, Paula Khristian Smith, Senior Assistant Attorney General, Benjamin Henry Pierman, Assistant Attorney General, for appellee.HINES, Justice.
Noel Chua appeals his convictions for felony murder and violating the Georgia Controlled Substances Act, in connection with the death of James B. Carter.1 For the reasons that follow, we affirm in part and vacate in part.
1. Carter died of drug intoxication brought about by a self-inflicted combination of morphine, oxycodone, and methadone. Chua, a physician, wrote prescriptions for Carter for these, and other, drugs. At the time of his death, Carter lived in Chua's home and did some work in Chua's office; it was in the home that Chua discovered the body. Chua asserts that the evidence was insufficient to authorize the jury to find him guilty of: (a) violating the Georgia Controlled Substances Act (“VGCSA”) by distributing controlled substances; (b) felony murder; and (c) VGCSA by keeping a dwelling for the purpose of using controlled substances.
When this Court reviews the sufficiency of the evidence, it does not re-weigh the evidence or resolve conflicts in witness testimony, but instead it defers to the jury's assessment of the weight and credibility of the evidence. [Cit.] Our role is to examine the evidence under the standard of Jackson v. Virginia, 443 U.S. 307, 99 S.Ct. 2781, 61 L.Ed.2d 560 (1979). [Cit.]
Greeson v. State, 287 Ga. 764, 765, 700 S.E.2d 344 (2010).
(a) The jury found Chua guilty of multiple counts of distributing controlled substances by prescribing them in a manner that was not “in the usual course of his professional practice,” and was not “for a legitimate medical purpose,” in violation of OCGA § 16–13–41(f); 2 specifically, he was found guilty of distributing methadone and oxycodone on unspecified dates, distributing OxyContin and Percocet (both oxycodone drugs) on November 28, 2005, and distributing methadone on December 9 and December 12, 2005.
As part of the State's effort to show that Chua's acts of prescribing the drugs to Carter were not in the usual course of his medical practice and not for a legitimate medical purpose, the State argued that an inappropriate relationship beyond that of physician and patient had developed between Chua and Carter. Construed to support the verdicts, the evidence showed that Chua, a physician, became acquainted with Carter on September 22, 2005, when Carter, then 19 years of age, sought treatment for pain, mostly from headaches. Chua's notes of the initial visit indicate that Carter was “afraid of being labeled a drug seeker”; under “Social History,” Chua noted, “[d]enies smoking, no illicit drugs, denies alcohol abuse....” On that day, Chua gave Carter a prescription for 60 pills of hydrocodone; his record carries the notation: “advised about abuse potential.” The next day, at 7:19 p.m., Chua called Carter from his cell phone; his next cellular telephone call to Carter was November 2, 2005, at which point cellular telephone and text contact between the two men increased, sometimes numbering more than 20 instances a day.
Carter's second office meeting with Chua was on October 14, 2005; Chua's notes regarding that appointment contain no mention of Carter's fear of being labeled a drug seeker, and the “Social History” notation is simply: “denies smoking, no alcohol abuse.” The record of that visit also shows: “given refill of lortab ...,” which is a brand name for a hydrocodone drug. Chua also obtained copies of Carter's previous medical records, which showed a history of painkiller use. Over the next several weeks, Carter had several other visits at Chua's office, and received several different prescriptions, for a variety of painkillers. There were several other office visits in the ensuing weeks. Chua's notes regarding these visits do not contain any mention of Carter as a drug seeker, a user of illicit drugs, or a drug addict.3 Chua never billed Carter's insurance company for any of the office visits Carter made.
Carter moved from his father's home in early November; a month earlier, Carter told a different physician that his parents supervised the taking of his hydrocodone prescription and were controlling the pills. After Carter moved, on at least one occasion, Chua took the unusual step of visiting a pharmacy to write a prescription for drugs for Carter, while in the company of Carter. On a pharmacy visit on November 28, 2005, when Carter was alone, a pharmacist noticed that Chua had prescribed two opiates for Carter on the same prescription slip, and placed a notation on the prescription to the effect that he told Carter that this was excessive, and that Carter had responded that Chua was destroying previous prescriptions as they were not working; at that time, Chua had prescribed six pain medications in the last twenty days. A psychiatrist who had treated Carter, and who reviewed Chua's medical records opined that, from November 8, 2005 forward, it was “Katy-bar-the-door” as far as Chua's prescriptions were concerned, which he considered excessive.
In early November, Chua attended a party accompanied by Carter; there, Carter said that he was “shadowing” Chua, including making rounds with him at the hospital while dressed in “scrubs”; although Chua had previously acted as a mentor to young people interested in medical careers, it was unusual for a student to go on rounds with him. During November, or December, Carter, while attending a nearby college, appeared about to faint and had slurred speech. He had a prescription bottle with Chua's name on it, but Carter told college personnel that they did not need to telephone Chua because they were “partners”; Carter said, While Carter was in a laboratory class with an instructor who was a former mentee of Chua, Chua sent a text message to Carter to tell the instructor to give him an “A” in the class.
Chua had Carter admitted to a hospital on November 17, 2005 on Chua's diagnosis of acute gastroenteritis and severe headache. Carter told a nurse that the intravenous morphine he was being given was not proving effective, and asked her for Demerol. He also asked the nurse to administer the Demerol by injecting it “faster and in the lowest port possible,” so that he could “feel it.” When the nurse told Chua of this episode, and expressed her concerns that Carter was displaying signs of being an addict, Chua responded that if Carter was an addict, they would “find out soon enough”; Chua approved the use of Demerol, including the administration of an additional intravenous dose just before Carter's discharge, an unusual procedure. When Carter was discharged, Chua drove him away from the hospital. An expert who examined the records concerning the hospitalization concluded that the diagnosis of gastroenteritis was “a fabrication to make the hospitalization look more legitimate,” and that the true cause of Carter's nausea was opiate withdrawal.
At a Thanksgiving gathering with his family on November 24, 2005, Carter arrived late, accompanied by Chua. He could not carry on a conversation and was shaking such that he had difficulty keeping food on his fork. Later that day, Carter and Chua were alone at the home of Carter's mother; when Carter's sister arrived, she found Carter asleep in his bed, and Chua lying on top of the bed next to him. After Thanksgiving, Chua and Carter took a trip to New York City. Before the trip, Chua had a lab report done on Carter's blood that included testing for the presence of HIV; Chua's records did not contain any consent from Carter for such a test.
Just before a final examination in a college class on December 6, 2005, Carter entered the classroom stumbling, as though drunk. He was unable to take the exam without assistance as his vision was blurred and he could not hold a pen. A student drove Carter's pickup truck, with Carter in the passenger seat, to Chua's residence; another student followed in a separate vehicle. On the drive, Carter took some pills from a prescription bottle and swallowed them. At the gate to Chua's residential community, Carter took over driving his pickup truck and the other students were left outside the gate. The students discussed the situation during the drive back to the college, and one returned to the gated community. There, through the intercom system at the gate, the student stressed to Chua his concerns regarding Carter's condition, and informed Chua that Carter had taken additional pills during the trip to Chua's, which Carter had said were pain medications; Chua's only response to this information was
Chua again had Carter hospitalized on December 8, 2005; Carter was incoherent and obviously under the influence of drugs. Chua again ordered Demerol, and Carter was discharged on December 9, 2005. Chua's records show that Carter visited Chua's office on December 9, 2005, and state that Carter would be given methadone; Chua's record of this visit does not mention any hospitalization, which would be the normal practice when a hospitalization had just been completed. That day, Chua gave Carter a prescription for 60 methadone pills; on December 12, 2005, he gave him a prescription for an additional 30 pills, which Carter filled at a pharmacy different from the one used on December 9, 2005. Chua did not make any office record of the December 12, 2005 prescription, which is unusual in medical practice; some prior prescriptions for controlled painkillers were also not recorded, and not mentioned later in Chua's records concerning whether drugs were proving effective for Carter.
Carter's fatal drug ingestion was on December 15, 2005. Numerous pill bottles, loose...
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