A Las Vegas doctor who prescribed deadly amounts of painkillers to a patient over a five-year span was arrested on a murder charge Wednesday in connection with her death.
Richard Sy Teh, 49, an internist at Sun City Medical Group in northwest Las Vegas, was arrested by a DEA Task Force officer and booked at Clark County Detention Center on Wednesday afternoon. A hearing was set for Friday morning.
Murder charges against doctors are almost unheard of, with discipline more likely to come through suspension or loss of medical licenses in cases in which patients die because of their actions. However, pain management specialists have come under increasing scrutiny by federal authorities in recent years.
According to an arrest report, Teh prescribed Lisa Blythe massive amounts of narcotics, including Demerol, Oxycontin and Valium, from February 2001 to February 2006 to combat migraines, though other doctors described her symptoms as "stable."
Blythe, 39, died in January 2007 from multiple drug intoxication, as well as acute renal failure and an enlarged heart, which can be caused by drug abuse.
Although the death was deemed suspicious at the time, the Nevada Department of Public Safety closed its initial investigation in April 2007 because it lacked resources to investigate Teh's records, the report said.
But Stuart Wilhoite, Blythe's husband, received a $400,000 civil settlement from Teh in 2009 for the doctor's "failure to properly monitor the patient's narcotic drug use" resulting in overdose and death, according to records of the Nevada Board of Medical Examiners.
As part of the malpractice suit that led to the settlement, Wilhoite's attorney, William Brenske, had several doctors examine Teh's records. Brenske provided their testimony to police, who reopened the criminal investigation.
Brenske's experts concluded that Teh failed to meet the minimal standard of care while treating Blythe's symptoms with inappropriate doses and quantities of narcotics, and also failed to coordinate with Blythe's other doctors or defer to their expertise.
"None of Ms. Blythe's diagnoses required the massive amounts of controlled substances Teh prescribed," one doctor wrote.
According to the police report, Blythe first sought treatment from Teh on Feb. 9, 2001, for minor medical issues such as swelling, dry mouth and fatigue. Teh prescribed Ambien, Soma and Paxil.
But by October 2001, Teh had prescribed Blythe Demerol for migraines, though a neurologist was already treating her. Teh never consulted the neurologist before he wrote the prescriptions, and the following month he added Dilaudid and Oxycontin to her prescription.
In February 2002, Teh diagnosed Blythe with "chronic pain syndrome" without explanation and began prescribing large quantities of narcotics, including injections of Demerol.
In the following months, Teh prescribed Percocet and Valium to Blythe, despite receiving a letter from an allergist noting Blythe's previous addiction to cocaine and history of addiction to habit-forming drugs.
In 2003, Teh referred Blythe to Dr. Daniel Kim, a pain specialist who recommended Blythe cut back on medications. But police say Teh ignored Kim's recommendations and increased her doses.
By 2006, Teh noted that Blythe was dependent on Demerol after two years of unsupervised home injections, prescribed by him.
Wilhoite told Teh he was concerned about Blythe's drug abuse and wanted her to undergo detoxification.
Teh agreed but continued treatment with Demerol in attempts to wean her off the drug, the report said. Records showed that Teh wrote 19 prescriptions of injectable Demerol for a total of 38,000 milligrams in 2006 -- even after Wilhoite expressed concern.
In January 2006, after she stopped seeing Teh, Blythe sought counseling at Montevista Hospital for drug dependence, telling hospital officials she needed "to get off my current meds to find a clean base to find correct treatment."
A year later, she was dead.
Dr. Ivan Goldsmith, a Las Vegas internist who knew Teh professionally, described him as a doctor very interested in patient wellness and longevity.
"He always seemed to be on top of his game," Goldsmith said. "He was always trying to add new things to his practice."
Goldsmith added that when Teh made up his mind on a subject, it was "his way or the highway."
According to the Board of Medical Examiners, Teh received his medical degree from Far Eastern University, in the Philippines, in 1987. He completed his residency at Cook County (Illinois) Hospital in 1993 and his fellowship in 1994. He was licensed in Nevada in 1997.
The Board of Medical Examiners has not formally charged Teh and declined to comment.
Review-Journal staff writer Paul Harasim contributed to this report. Contact reporter Mike Blasky at mblasky@ reviewjournal.com or 702-383-0283.