Last December, Joey Rovero and a couple of pals from Arizona State University set out on a road trip to Southern California.
They weren't headed to Hollywood or some other spot likely to attract a trio of rowdy frat boys out for a good time. Their destination was a clinic in a mini-mall off the 60 Freeway.
After a short visit with Dr. Lisa Tseng, the young men left with a handful of prescriptions and headed back to ASU. Nine days later, Rovero, a muscular former high school football star, was dead of an overdose. He was 21.
Rovero was one of at least six men in their 20s who have died of overdoses since 2007 after making the trek to Tseng's office in Rowland Heights, a Times investigation has found. Two others died after getting drugs from patients who got them from Tseng, authorities said.
Though Tseng is a general practitioner without a specialty, some patients drove from San Clemente, Palm Springs and places even farther away to see her.
Many who died were white men in their early 20s from Orange County. As kids, they played baseball and soccer and went surfing. They had nice homes and loving parents. Several shared a mischievous streak or bad-boy edge that led them to experiment with drugs.
Friends and family members of some patients described their loved ones as addicts who used old injuries — a once-shattered ankle from riding motocross, a sore knee from a snowboarding mishap or a stiff back from a car accident — as excuses to score drugs.
Tseng prescribed an array of painkillers, muscle relaxants and anti-anxiety medications, according to records. Sold under the brand names OxyContin, Vicodin, Soma and Xanax, these drugs are widely abused by teens and young adults who increasingly are ending up in detox centers, emergency rooms and county morgues.
Last week, after investigating Tseng for nearly three years, the U.S. Drug Enforcement Administration deemed her "an imminent danger to public health and safety" and suspended her license to prescribe drugs prone to abuse.
Since then, law enforcement officers have received calls from more parents alleging that their children had overdosed after getting prescriptions from Tseng.
Hsiu-Ying "Lisa" Tseng graduated from Michigan State University's College of Human Medicine with an osteopathic degree in 1996. Her California medical license remains in good standing, according to state records. She has no reported malpractice judgments against her or settlements of note and has not been charged with any crime.
Complaints about her practice from parents are another matter. Tseng, 40, of Arcadia, said she gets them "every day."
"They call me all sorts of names … drug doctor, drug-dealing doctor," Tseng said, adding that their anger was misplaced.
"I prescribe based on what I know and what I feel and what I see," Tseng said. "If it is a new patient, there is no way for me to determine … if they are legitimate or not."
Tseng spoke to The Times last week as DEA agents and state medical board investigators were inside her office seizing patient files and financial records. They raided the Rowland Heights facility as part of an ongoing probe into whether she was prescribing OxyContin and other drugs to patients with no legitimate medical need.
Tseng said those patients who died had not followed her dosing instructions.
"I never intended to kill anybody," she said.
The drugs Tseng prescribed, although addictive, can provide much-needed relief to patients in pain. The law gives doctors broad latitude to make diagnoses and treatment decisions, but requires that they conduct physicals and document a patient's medical history.
Experts say such measures should help physicians tell the difference between a patient with real pain and an addict shopping for his or her next high. Among the most obvious signs of abuse are patients willing to drive long distances to see a doctor; patients asking for a specific medication in its most potent dosage; and patients going to multiple pharmacies to have their prescriptions filled.
Tseng said she had noticed that some of her patients drove long distances to see her. She said she asked them why and was told that they had been referred by friends or relatives — an explanation she accepted.
Asked whether she believed that she had been duped into giving drugs to any patients who didn't need them, she replied: "Yes."
Tseng said she eventually noticed that "a lot" of pharmacies were questioning her prescriptions or refusing outright to fill them. Prompted by this concern and by media reports about celebrities overdosing on prescription drugs, Tseng said, she stopped writing new prescriptions for OxyContin last year.
"Now," she said, her patients "understand that they can't come in here and get anything they want."
Cases against doctors are fraught with the difficulties medical and legal authorities face in drawing the line between legitimate medicine and drug dealing.
"If somebody is selling heroin or coke on the street, one undercover buy and they are going to prison," said Steve Opferman, a Los Angeles County sheriff's detective who specializes in medical fraud. "With doctors, it's a whole other matter. You need overwhelming evidence."
Matt Stavron was happiest soaring through the air on his Yamaha dirt bike after hitting a jump on the various motocross tracks throughout Southern California that he would visit with his dad and little brother.
Landing wasn't always so much fun. Stavron was 13 when he suffered a compound leg fracture in the mid-1990s — the first of many injuries. He was hospitalized and given morphine for the pain. His parents think that's when he started on the road toward addiction.
Over the next decade, Stavron was in and out of rehab, battling an addiction to painkillers. As much as his son loved competing in motocross and hoped to turn pro, Bruce Stavron said, it got to the point where he began to wonder whether Matt was crashing his bike on purpose to get drugs.
In 2007, however, things began to look up. Stavron spent the summer in rehab and this time, his parents said, it appeared to be taking. He had been clean for three months and was engaged to be married.
"He was the best we'd seen him in years," Bruce Stavron said in an interview in the family's home in San Clemente.
That September, Stavron's fiancee broke her neck and, rather than continue with his rehab in Long Beach, he stayed home to take care of her.
He relapsed about two weeks later.
His mother, Kelle, found him curled up in the fetal position on the bathroom floor, dead at age 24. Pills — large white ones, small bluish green ones and rectangular bars — were strewn about: There was OxyContin, Soma and Xanax — all traced back to Tseng, more than 50 miles away in Rowland Heights, according to Orange County coroner's records. She prescribed 80 milligrams of OxyContin — the maximum strength — intended for people in extreme pain and favored by addicts. Of the 30 tablets Tseng prescribed just two days earlier, four remained.
Stavron's parents said they had never heard of Tseng and didn't know how their son had met her. What they did know, they said, was that he had no legitimate injury requiring the sort of medication he was given.
Kelle Stavron said she knows her son could have died after scoring drugs on the street, "but the truth is this doctor gave him those pills, and he died," she said. "She's gotta live with that."
Ryan Latham was 21 when he overdosed in 2008. He died of the combined effects of hydrocodone, Xanax and Soma — the same drugs prescribed by Tseng less than a week earlier, according to records.
The coroner ruled his death a suicide, noting, among other things, that Latham had grown depressed after breaking up with his girlfriend about a year earlier. His mother, Tina, said her son was particularly upset because his ex-girlfriend was about to get married.
Handsome and gregarious on the surface, Latham was "pretty sensitive, emotional" underneath, his mother said. He struggled with drugs for years, but had been clean for about six months before he started seeing Tseng.
Tina Latham said her son was born with a mild case of spina bifida and had suffered a broken jaw in a fight a year or so before his death. Neither was causing him any pain, she said. In fact, Latham said, her son confided to her that Tseng, given some pretext — "an old X-ray, whatever," would prescribe "all the drugs you want."
Ronnie Wiessbrod, one of Ryan Latham's roommates when he died, recalled his friend sending him a text message from Tseng's waiting room in which he talked about other patients laughing about the things they were planning to tell Tseng to get drugs.
"She wouldn't really ask any questions," Wiessbrod, a UCLA student, recalled his friend telling him.
Jeffrey "Neil" West did not die of an overdose. But his mother says she believes Tseng played a role in his death.
In the two weeks before West fatally shot himself in July 2009, Tseng wrote him seven prescriptions totaling 325 pills — Adderall, Xanax, Soma, hydromorphone and 80-milligram tablets of OxyContin, coroner's records show. At one point, she wrote him overlapping prescriptions for Soma — 90 tablets on July 8 that should have lasted a month, then another 45 a week later.
Asked about this, Tseng said West, 23, must have lost his pills. She said she recalled treating him for back pain.
By July 20, the day West killed himself, all but the Adderall were gone.
There were no drugs of the type Tseng had prescribed in his system when he died. But his mother, Mary, said she believed it was his inability to break free of his addiction that killed him.
"He hated, hated, hated it," she said. "It took over his body, his brain, his soul — his everything."
She said her son was a surfer and roller hockey enthusiast who was "the sweetest, most loving kid. He always had a smile on his face."
Upon learning after his death that Tseng had been prescribing such powerful drugs to her son, she blamed the doctor for fueling his addiction.
"I don't know how a doctor can do this and be able to look at herself in the mirror," Mary West said.
Tseng, asked whether she felt responsible for Neil West's death or any of the others, replied:
"That's a double-edged sword. If I say 'yes,' it means I'm admitting wrongdoing. If I say 'no,' it means I have no remorse."