Former Chargers doctor gave Ambien to Junior Seau, experts say he should not have had it

SAN DIEGO - Team 10 has exclusively obtained pictures of pill bottles inside Junior Seau’s home the night he committed suicide, and a nationally-known expert is raising serious concerns about Seau's doctor.

Dr. David Chao prescribed Ambien to the former Chargers star, despite warning signs like insomnia and depression.

Team 10 also found out Dr. Chao allegedly partied with the football star.

Seau killed himself in May 2012.

Team 10 reviewed the medical examiner’s photos of pill bottles found inside Seau's home, and the toxicology report, which found zolpidem tartrate, commonly known as Ambien, in Seau's blood.

The drug maker’s instructions say the sleeping pill should be used with caution by patients "exhibiting signs or symptons of depression."

His family described signs of depression exhibited in Seau before his death in an interview with Nightline in 2013.

“I think there are so many symptoms we all witnessed, um, the mood swings, the depression, the insomnia was terrible,” said ex-wife Gina Seau.

The photos show there were two Ambien bottles found in his home. They were for prescriptions of 10mg, and each bottle had 30 pills.

One vial was empty, and the other bottle was missing pills.

The second vial was prescribed 15 days before Seau's suicide.

Nineteen pills were missing in 15 days.

On that 15th day is when Seau killed himself.

Seau’s family claims he was depressed in a lawsuit filed against the NFL and helmet makers.

The lawsuit says Seau had wild mood swings, irrationality, forgetfulness, insomnia and depression that got progressively worse over time.
 
“There were mood swings that came randomly (and) they started to get worse,” said Seau's son, Tyler, in the Nightline interview.

“I will never forget what he said," said Gina. "He said,’Gina, I am so low... It’s so dark right now… I can’t pick up my surfboard and get in the water.”

The family donated Seau’s brain to the National Institutes of Health.

NIH research showed definite signs of Chronic Traumatic Encephalopathy, or CTE.
 
It is the result of violent head trauma.

Numerous medical experts say CTE leads to depression.

"In a case as in Junior Seau, who is suffering from a variety of problems manifested by confusion, depression, improper atypical behavior... you don't prescribe a drug like Ambien," said Dr. Cyril Wecht, a nationally recognized as an expert in forensic pathology.

"You may be placing that patient at greater risk to doing something to himself, such as committing suicide," Wecht said.



Two years before his suicide, Seau drove his car off a cliff. At the time, Seau said he simply fell asleep.

His former girlfriend told media it was a suicide attempt.

“Studies show that people who take sleeping pills are anywhere from two to 18 times more likely to commit suicide,” said Dr. Dan Kripke, a professor emeritus at Univeristy of California at San Diego.
 
Kripke is a psychiatrist who has studied the effects of sleeping pills, and is considered one of the pre-eminent medical experts on the subject by his peers.

“It is clear that these drugs in normally prescribed amounts cause trouble,“ Kripke said.
 
"That prescription for that period of time was, in my opinion, improper and it was medically negligent," Wecht said.

The former Chargers doctor prescribed the Ambien to Seau, years after Seau left the team.

Chao started with the Chargers in 1995. Seau left the Chargers in 2002.

Multiple sources refused to be interviewed on camera, but told Team 10 they saw Chao and Seau partying at San Diego bars in the years after Seau left the Chargers, and also after Seau retired from the game in 2010.
 
The medical examiner’s report also states Chao was Seau’s doctor at the time of his death.

Wecht said given their relationship, Chao should have known to not prescribe Ambien to Seau in that quantity for two months.

"He should have been aware of some degree of depression," Wecht said.
 
Team 10 asked both doctors if Seau's suicide had anything to do with the Ambien prescriptions.

"In my opinion, the prescription of Ambien to Junior Seau was a significant contributing factor,” Wecht said.

"I don't know," Kripke said. "He is not my patient."

“I think it is unwise for physicians to prescribe sleeping pills ever,” Kripke said, “in particular it’s unwise to prescribe them for people who are depressed or have brain damage… but it is still accepted practice.” (*See editor’s note at the end of the article.)

"Who commits suicide? People who are depressed right?" Wecht said. "You don't have to be a physician to know you are pushing the patient towards suicide."



Chao, through his attorney, declined an on-camera interview. His attorney, Robert Frank, provided this statement:

Statement of Dr. David Chao, through his attorney, Robert Frank, of Neil, Dymott, Frank, McFall & Trexler APLC:

Junior Seau was found to have a form of CTE on study of his brain by Dr. Russel Lonser, NIH chief of neurosurgery and lead scientist who studied the brain. Dr. Lonser concluded, "physicians are unable to diagnose CTE in a living person.” The connection between symptoms of CTE and CTE is "poorly understood."
 
Per the San Diego County Medical Examiner, who performed the autopsy and studied the cause of death, Dr, Craig Nelson said Junior Seau "had no known suicidal ideation or confirmed attempt," as of the time of his death.  According to Dr. Nelson's autopsy report and the death certificate, Junior Seau's episodic short term use of use of Ambien was not a factor contributing to his death.
 
USCD trained forensic psychiatrist and former California Medical Board consultant, Dr. Clark Smith, reviewed the facts surrounding the death, including the short term use of Ambien prescriptions. He saw "nothing out of the ordinary.”  He confirmed that "Ambien is an FDA approved medication commonly prescribed  by physicians to treat sleeplessness associated with depression."  
 
That Junior Seau considered Dr. Chao to be one of his best friends is well-known.  The Seau family recognized this by having Dr. Chao as a pallbearer at the funeral just over two years ago. Dredging up the past with inaccurate insinuations and innuendo is uncalled for now.  Seau's family, friends, and fans that loved him have been through enough. 

Chao's medical license is currently on probation with the California Medical Board for what the board called "gross negligence" against patients and “dishonesty or corruption.” Despite the probation, the board just renewed Chao's medical license last month.

However, the medical board in the state of Illinois decided not to renew Chao's license. A spokesperson told Team 10, "Illinois refused to renew his license ... after learning of the action taken against his license in California.”

Team 10 spoke with Dr. Smith, who was referenced in Chao’s attorney’s statement about the story.

Dr. Clark Smith said if there was a history of chemical dependency, like  drugs and alcohol, Ambien should be used with caution, or not at all.  

Dr. Smith reviewed the same medical examiner records that Team 10 provided to Chao’s attorney and the experts interviewed for this story.  After reviewing the documents, Dr. Smith told Team 10 he felt 42 pills in two months “did not represent abuse of Ambien.”   

When asked about Junior Seau’s issue with chronic insomnia, Dr. Smith said he would have recommended non-addictive medications.

(*Editor’s note: The headline states, “Former Chargers doctor gave Ambien to Junior Seau, experts say he should not have had it”. The quote with the asterisk was added to the story after initial publication to clarify the headline and quote both experts who told 10News Seau should not have been taking Ambien.)

Timeline for David Jee Wei Chao, M.D., and Junior Seau

1990 – 2002: Junior Seau plays for the San Diego Chargers

April 1994: California Medical Board issued Physician’s and Surgeon’s Certificate to David Jee Wei Chao, M.D.

1995: Chao employed at Oasis Sports Medical Group, Inc. The principal owner is Dr. Gary Losse, who also is the San Diego Chargers head doctor.

1995: Chao is arrested and pleads guilty to a “wet reckless” charge related to driving while under the influence of alcohol. (Editor’s note, an earlier version of the timeline contained an error on Chao’s two cases involving drinking and driving, which are only misdemeanors.)

November 1995: Doctors Losse and Chao perform surgery on San Diego Padres pitcher Greg Harris.

December 1997: Harris sues Losse.

September 1998: A Chargers news release says Losse was relieved as the team’s physician. Chao becomes assistant team physician for the Chargers.

March 1999: The jury finds in favor of Harris. The verdict in case number 716706 said Losse was medically negligent and Harris won a $6 million verdict in 1999.

March 1999: SeaWorld performer Jeff Warner sued Chao after his ACL surgery. Allegations in the third amended complaint in case number 729388 state Warner went in for ACL surgery, but instead Chao performed “PCL” surgery – or surgery on his posterior cruciate ligament, instead of his anterior curciate ligament. (The suit was later settled under confidential terms.)

October 1999: Abby Rueckert files a lawsuit against Chao accusing him of a botched shoulder surgery.

August 2000: Losse’s client files a lawsuit that alleges Chao wrote narcotics prescriptions to Losse with no oversight. Chao was later cited and fined by the California Medical Board. Citation No. 10-2001-127021 states Chao “failed to maintain adequate and accurate medical records of a patient/colleague that was treated by you…” The fine was for $1,000.

2001: Chao is named head physician for the San Diego Chargers, and his name and picture are published in the team’s media guide in subsequent years.

February 2002: Abby Rueckert wins her lawsuit against Chao and is awarded $500K. In case number GIC736923, Chao testified, “… there was a dissection of the artery, it required a graft.”

Around March 2002: Chao gives his consent to settle the Warner case, and the terms are confidential. This was not revealed until a video deposition in a later case, Engler vs. Chao, GIC 870982, in 2008. Under oath, Chao stated, “A type of consent was given,” to settle the Warner case. (Editor’s note: Chao’s attorney, Robert Frank, of Neil, Dymott, Frank, McFall & Trexler, APC, stressed his client did not pay anything to settle and that he was dismissed from the lawsuit.)

2003 – 2005: Junior Seau left the Chargers to retire, but later changed his mind and went to play with the Miami Dolphins.

March 2003: A class action lawsuit is filed against Chao and others. In part, the suit accuses Losse of practicing in an “impaired state.” (Filed by attorney Marc Stern, case GIC806908 is still pending 11 years later.)

May 2003: Chao performs surgery on 15-year-old Whitney Engler. (She later sued for medical negligence.)

2006 – 2009: Junior Seau plays with the New England Patriots.

August 2006: Chao arrested after Chargers banquet for driving under the influence. It is his second arrest for DUI. He would later plead guilty to misdemeanor charges. (Editor’s note, an earlier version of the timeline an error on Chao’s two cases involving drinking and driving, which are only misdemeanors. Chao’s attorney, Robert Frank, said this case has been expunged.)

January 2007: Lawsuit filed against Seau by two women over an alleged incident in a bar. Chao was present. The case was later settled. 

February 2007: Thomas Fagan has knee replacement surgery by Chao. Fagan says the surgery resulted in the loss of his leg, and he sued Chao the next year.

February 2007: A patient identified by “M C” had knee replacement surgery by Chao, who accuses him of medical negligence. Medical Board records say Chao “failed to monitor” the diabetic patient.

May 2007: A patient identified as “E A” had hip surgery by Chao. Medical Board records say Chao committed a negligent act in his care and treatment of the patient.

May 2007: A patient identified as “K A” had hip surgery by Chao. Medical Board records say the patient “exhibited a laceration of the common femoral artery and vein and copious blood loss.”

November 2007: Chao’s patient David Egan claims the doctor cut off the blood supply to his leg during hip surgery. Medical Board records say Chao “committed repeated negligent acts in his care and treatment” of the patient, which resulted “in significant blood vessel lacerations.”

May 2008: In a court filing, Dr. Losse said he had addiction problems and was receiving prescriptions from Chao without any examination by the doctor. Losse’s declaration for cases GIC806902 & GIC806908 states he “repeatedly received opioids, as well as Ambien, from the Oasis ‘in-house pharmacy’.”  (Oasis is the name of the business where Chao practices medicine.) Losse’s declaration also states he “received prescriptions for opioids from other physicians, Dr. Chao (and another doctor), without undergoing any examination by those physicians.”

2008: In his first deposition in the Fagan case, Chao says he could not return to Scripps Memorial Hospital to care for his patient. Court records in case number 37-2008-00077411 quote Chao as saying he was “driving to Los Angeles” to see his mother. He later contradicts this testimony.

May 2009: Chao’s attorney provides redacted receipts that show Chao was at a nightclub named “Belo” and bought a bottle of vodka the night Fagan needed a doctor following his surgery. Court records related to case number LC090723 (a different lawsuit in 2010), show Chao and his assistant, Anthony Durfee, were offered a settlement by Fagan’s attorney, so the unredacted receipts could be kept confidential.

June 2009: Fagan settles with Scripps Hospital for $1.395 million. Fagan’s attorney made settlement offers of $250,000 each to Chao and his physician’s assistant, Anthony Durfee.   The offer was eventually accepted by Durfee, and court records show Chao did not give his consent to settle (Case No. LC090723).

December 2009: The California Medical Board accuses Chao of alcohol abuse and unprofessional conduct.

2010: The consulting psychiatrist for the San Diego Chargers, Steven Sobel, M.D., evaluates Chao for the Scripps Memorial Well Being Committee, according to Medical Board records. The records show Sobel determined Chao, still the Chargers head doctor, “does not abuse alcohol and that he is not an impaired physician.” The 2010 evaluation is described as an update to an evaluation in 2008, according to the board’s records.

July 2010: A patient identified as “M E” has knee replacement surgery by Chao. Medical Board records show the surgery was for the right knee. 

October 18, 2010: Junior Seau drives his Escalade over a Carlsbad cliff. 

November 6, 2010: A patient identified as “D E” had hip surgery by Chao, and had blood loss of 1800cc, according to Medical Board records. Chao “either failed to properly place the retractor or improperly utilized the capsular scissors… resulting in significant blood vessel lacerations,” the records say. (Nearly the same language was used by the Medical Board to describe patient David Egan post-surgery in November 2007.) 

November 10, 2010: “M E” has knee replacement surgery by Chao on the left knee. Medical Board records show between November 10, the day of the surgery, and November 15, Chao’s “whereabouts are unknown.” The records state there are no notations in Chao’s records or hospital records on which doctors should have covered his patient’s care in his absence.

November 19, 2010: Medical Board records show “M E” had a “definite pseudoanuerysm,” or a hole in the artery following the surgery with Chao nine days earlier. (*Editor’s note: the original timeline did not have the correct medical term, which is now directly quoted from the documents.)

December 2010: The California Medical Board amends first complaint to add “dishonesty or corruption” to allegations of gross negligence by Chao in the care of patients. The board says Chao failed disclose his convictions of driving under the influence of alcohol when he applied to be a Qualified Medical Evaluator (QME) for the Division of Worker’s Compensation.

January 2011: Arbitration awarded to Kathleen Adams of $2.2 million in a highly publicized case.

March 2011: Chao settles with Adams for confidential amount.

July 2011: Medical Board holds a hearing on dishonesty and corruption accusations regarding Chao’s QME application disclosures.

February 13, 2012: Chao prescribes Zolpidem Tartrate (Ambien) 10mg, 30 tabs for Seau.

April 7, 2012: Chao prescribes Ambien, 10mgs, 30 tabs for Seau.

May 2, 2012:  Seau commits suicide at his Oceanside home. Chao identifies himself as Seau’s physician to the medical examiner. (The autopsy report would later show the Ambien in Seau’s blood concentration was “consistent with therapeutic use.”)

July 2012: Jury awards Engler more than $5 million and later adds punitive damages of $500,000.

Summer 2012: Scripps Mercy and Scripps Memorial recommend revoking Chao’s hospital privileges.

June 2013: Chao and hospitals reach an agreement, and Chao relinquishes his privileges.

May 9, 2013: Medical Board publicly reprimands Chao for not disclosing his two convictions on QME applications for Division of Worker’s Compensation. “Respondent did not understand the wording of the application required that he disclose either conviction” for drinking and driving, the records say. The board also says it had already accused Chao of doing this twice, when he did it a third time on his 2010 application.

August 2013: Illinois Medical Board refuses to renew Dr. Chao’s medical license in that state. A spokesperson told Team 10, “In the case of Dr. Chao, Illinois refused to renew his license on 8/13/2013, after learning of the action taken against his license in California.” It would be several months before Chao’s license was placed on probation in California.

April 2014: Chao placed on probation by the California Medical Board but can continue to practice medicine.

Read the medical board documents here: http://bit.ly/1ko3Tv0

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