Sex With Patients Termed ‘Mental Illness’ : Ex-Psychiatrist Should be Eligible for Insurance, His Lawyer Tells Jury

When Costa Mesa psychiatrist George Prastka was kicked out of the medical profession in 1979 for having sexual relationships with female patients and telling them it was part of their therapy, he claimed insurance benefits for his lost livelihood.

But his claim--for $3,200 monthly--was denied, so he sued his insurance company.

On Thursday, Prastka’s attorney told an Orange County Superior Court jury that mental illness caused Prastka to have sex with his patients, led to the loss of his medical license and destroyed his ability to earn a living.

“The evidence will show that Dr. Prastka was mentally ill to the extent that he was not able to practice psychiatry with any assurance of safety to the public,” Mark Edwards, Prastka’s lawyer, told the jury as the trial began Thursday morning.

“He has a narcissistic disorder . . . a grandiose sense of self-importance,” Edwards said. “He exaggerated his talents and engaged in sexual relationships with his patients . . . with no empathy to his patients and no knowledge of the problems they were in. Sex with his patients was a blatant sign of psychological disturbance.”

Prastka is suing Massachusetts Casualty Insurance Co. for his policy benefits, an unstated amount of general and special damages, and $500,000 in punitive damages.

According to Edwards, Prastka’s problems began in 1976 when he was placed on five-year probation by the California Board of Medical Quality Assurance for over-prescribing drugs to patients.

Three years later, the board began another investigation into Prastka’s practices, after at least three woman patients complained that he was over-prescribing the sedative Quaalude and engaging in individual and group sexual encounters with them while they were still his patients, Edwards said.

When confronted with his patients’ written statements, Edwards said, Prastka confessed to the misconduct and agreed to give up his medical license.

Audrey Chanley, now 33, sued Prastka for $1 million in punitive damages, claiming that he told her that having sex with him was part of her therapy. During her 1982 trial, Chanley told the court that sex with her was Prastka’s idea and that their sexual relationship began in 1974, when she was still his patient.

Prastka testified then that he fell in love with Chanley after she encouraged him and that he did not get involved with her sexually until she suggested it. He claimed that their intimate relationship did not begin until 1976, after their doctor-patient relationship had ended.

He also testified during that trial that between 1976 and 1979, he billed Medi-Cal for office visits by a woman patient for the purpose of sex. He billed Medi-Cal, he said at the time, only to hide his affair from his wife and office staff. A Superior Court jury ruled in Chanley’s favor and awarded her $89,150.

Marsha Seligson, another former patient, also sued Prastka, but instead of going to trial, the psychiatrist agreed to a mandatory settlement last spring, according to Barbara McDonald, Seligson’s attorney. McDonald refused to reveal the amount of the settlement.

To Massachusetts Casualty, Prastka’s misconduct was not caused by mental illness but was a matter of choice, a blatant disregard for medical ethics. The psychiatrist, the company contends, therefore does not deserve to receive disability benefits.

“Dr. Prastka chose to break some rules,” said David Chodos, attorney for the insurance company. “The evidence will show that Dr. Prastka may have just been trying to satisfy his own sexual desires.

‘Violated Ethics’

“When patients have opened themselves up to you . . . they are extremely vulnerable, and it is unfair, unethical and destructive to have sex with them,” Chodos said. “What he did violated the ethics of his profession. Dr. Prastka at all times had free will.”

Although Seligson’s suit was settled several months ago, her attorney said that Prastka has yet to pay her client. Chanley also has yet to receive her $89,150 award, said Robert Schwartz, her attorney. Prastka filed for bankruptcy, but the federal bankruptcy court ruled that he still had to pay Chanley’s award.

“It’s ironic,” Schwartz said in a telephone interview. “He destroyed her life, and she never received the money awarded her. If he gets this money, maybe he’ll pay her. Here’s a doctor who’s now suing an insurance company for disability benefits, when he ruined the life of a poor little girl who never got anything.”

Prastka’s trial is expected to last three weeks.