Dr. Lisa Tseng was nowhere near the Taco Bell parking lot in Laguna Niguel where a drug dealer handed 19-year-old Zack Jones a pill that would later kill him.
Nor was she in the Irvine home where Grant Pieson injected himself with a lethal cocktail of drugs.
Yet authorities are investigating whether the Rowland Heights doctor indirectly played a role in both men's deaths, according to law enforcement records and interviews.
The alleged dealers suspected of providing drugs to Jones and Pieson were among an undetermined number of Tseng patients who authorities believe sold medications she prescribed —extending her reach beyond her patient base and complicating the task of determining how many deaths and overdoses might be linked to her practice.
Tseng is under investigation by the U.S. Drug Enforcement Administration and the state Board of Osteopathic Medicine for allegedly prescribing potent painkillers to patients who had no legitimate medical need. Since 2007, at least eight of her patients have died from overdoses of the same type of drugs she prescribed to them, according to coroner's files and interviews.
Tseng, 40, has said she has done nothing wrong and should not be held accountable for patients who do not following dosing instructions.
Mark Mermelstein, one of several lawyers representing the physician, said "Dr. Tseng cares deeply about all her patients and looks forward to her opportunity to vindicate herself in court."
Among her patients are at least three people who have been charged with dealing drugs and a fourth who is suspected by police of doing so. In interviews with The Times, two others admitted dealing drugs prescribed by Tseng, and the family members of several deceased patients said they suspected their loved ones sold some of their prescription pills to finance their habits.
A heavy prescription drug habit can cost $400 a day at drugstore prices, which users can finance by selling a handful of their pills at up to $80 each on the black market.
"It's an expensive addiction," said Kham Vang, a Fountain Valley police narcotics detective who is not involved in the Tseng case.
Grant Pieson had been vomiting blood all night before he finally passed out. His friends hauled him into the shower around 5 a.m. in an effort to revive him, according to coroner's records. He died of an overdose — caused by a mix of prescription and illicit drugs — in the emergency room of an Irvine hospital on April 12, 2009.
Police questioned two young men who were with Pieson the night before he died, according to an affidavit filed in support of the warrant used to search Tseng's office. One of the men, Ryan Carry, acknowledged being a patient of Tseng's, according to the records.
Asked where the drugs came from, Carry pointed to his backpack, according to the search warrant affidavit. Inside, police found vials of oxycodone, hydromorphone and alprazolam — all prescribed by Tseng — along with syringes and the type of small colored balloons that are used to hold drugs.
Carry, 29, has not been charged in Pieson's death. However, he was charged with felony possession for sale of oxycodone — stemming from the drugs in his backpack the day Pieson died. Carry has pleaded not guilty and his case is pending in Orange County Superior Court, records show.
In a statement provided by his attorney, Carry said, in part, "Prescription drugs took me and people around me into an ugly world of addiction that destroyed many of our lives and, in some cases, took lives. Stopping doctors who illegally prescribe drugs will save lives and stop the destruction many go through in their addiction. However, prescription drugs prescribed by Lisa Tseng were not a part of Grant's death."
The attorney, Lloyd Freeberg, declined to answer questions about Carry's statement or case, citing ongoing settlement talks with the district attorney.
Carry's father, Rich Carry, said that Pieson was already intoxicated before arriving at his son's home and that any suggestion that Ryan provided Pieson with drugs is "completely erroneous." Carry added that his son has completed a drug rehab program and has been clean and sober for nearly a year.
Zack Jones was not a drug addict, his mother, Julia, said. But he was a risk-taker, one of those "yeah, I'll try it" kind of kids.
On Oct. 21, 2008, Jones tried a drug called oxymorphone, a potent painkiller sold as Opana and popular among young prescription drug abusers.
That night, Jones had been painting his new apartment with some friends and decided to go score some drugs with a man he'd met in an alcohol education class after a drunk driving conviction a year earlier, according to Julia Jones.
The friend from the class led Jones and several other friends to a Taco Bell parking lot where they met another young man who sold Jones two and a half pills of oxymorphone for about $100, according to Julia Jones, who has been briefed on the case by police.
That man, Laguna Beach police said in a news release, "had been prescribed the pain medication by Dr. Tseng."
Police declined to identify the man, who they said remains under investigation.
The man was apparently aware of the potency of the drugs he was selling, according to an investigative summary in Jones' coroner's file.
He told Jones: Just "do a little bit" because the drug is so strong, a friend who witnessed the transaction told police.
Jones, who stood 6 feet 2 and weighed 228 pounds, boasted to friends that he was a "big guy" who could handle more than most people, his girlfriend told police. She said she watched Jones grind up and snort part of one pill and believed he did the same with the remaining one and a half. Julia Jones said the girl has since confided to her that she and others snorted some of the pills as well, limiting the amount her son could have ingested.
Zack Jones suffered from sleep apnea, a condition characterized by irregular gaps in breathing during sleep, which can be exacerbated by drugs like oxymorphone, his mother said.
After taking the drug, Jones snored loudly all night and did not wake up when it was time to go to work the next morning. His girlfriend called 911 when she saw bloody foam coming from his mouth.
Julia Jones rushed to the emergency room, where she said her son momentarily opened his eyes to look at her before dying minutes later.
Jones, a born-again Christian, said she prayed for her son in the hospital and is praying for Tseng now.
"It is unimaginable to me that she did not know what she was doing and what she was contributing to, so my prayer for her is, Lord have mercy," Jones said.
John Mata believes his son Nicholas — who died of an overdose in May — resorted to selling some of the prescription drugs Tseng prescribed to him in order to finance his addiction.
In an interview, Mata said that about six months before his son's death, he discovered six bottles of prescription drugs in a coffee table drawer at the family's Huntington Beach apartment. All were prescribed by Tseng, Mata said. He said his son had no medical reason for the prescriptions.
"Nobody gets that kind of a prescription for medication all at the same time. Nobody," Mata said.
Around the same time, Mata said, he found more than $9,000 in his son's pocket.
"When you see a 22-year-old unemployed kid and $9,000 or $10,000 in his pocket, what does that tell you?" he said. "I asked him if he was selling drugs. He says, 'Pop, what do you think?'
"I said, 'You are going to end up dying. You have to stop what you are doing,'" Mata recalled. "I threatened to call the police or go see that doctor. But he would never tell me where the doctor was."
In February, Mata said, his son was arrested for disorderly conduct in the parking lot of a Huntington Beach drugstore, where he had just filled a prescription from Tseng. Mata said he believed his son had been drinking. He had previously been arrested for drug possession and several outstanding traffic violations. The latest arrest violated his probation and landed him in jail until May 14, his father said.
Upon his release early that morning, Nicholas was given back his possessions, including his prescription. He was dead within 12 hours.
Mata said he knows his son had problems and bears responsibility for his death. But, he said, Tseng deserves some of the blame as well.
"There is nothing wrong with the kid, and he gets a 'scrip," he said. "That's like putting a gun to the kid's head. It's wrong."