The administrative trial to determine whether former USC medical school dean Carmen Puliafito should be allowed to continue practicing medicine wrapped up Friday, ending a days-long hearing that recapped in dramatic fashion his double life of hard drug use.
In her closing argument, Deputy Atty. Gen. Rebecca Smith said Puliafito’s medical license should be revoked. She cast Puliafito as a man who cared only about himself and recounted the chaos of Puliafito’s last few years, placing the blame squarely at his feet as images of the ex-dean consuming drugs were projected onto a white screen for the judge to see.
He disregarded his duties as a dean and physician, smoked methamphetamine and heroin and inserted himself repeatedly into dangerous situations, Smith said. He provided drugs to a young prostitute and her underage brother, and misled authorities about her condition and history of drug use when that woman overdosed in his Pasadena hotel room, she argued.
An attorney for Puliafito, Peter Osinoff, said the former dean, a Harvard-trained ophthalmologist considered a titan in his field, was plagued by a bipolar disorder and “hypomanic” state that poisoned his judgment and skewed his understanding of how his behavior would be viewed by others. Osinoff argued that Puliafito has been in recovery about a year and should be allowed to practice medicine under supervision.
“Decisions in life involve taking acceptable risks and balances. Dr. Puliafito was out of balance because he was ill,” Osinoff said, adding that it was time to put the physician “back to work for society.”
Throughout the case, Puliafito and his attorneys have argued his mental disorder was exacerbated by his relationship with Sarah Warren, the young woman Puliafito was infatuated with and who he claimed conned him into spending hundreds of thousands of dollars on jewelry, clothes, food, housing and trips to places as far-flung as Switzerland.
It was Warren who first introduced Puliafito to methamphetamine, and the physician smoked the drug mainly to be close to her, Puliafito, his lawyer and experts testifying on his behalf argued. They also alleged Warren’s parents shook him down for tens of thousands of dollars by threatening to make Sarah available for interviews to reporters, blackmailing Puliafito into writing checks and taking Warren’s mother out on expensive clothes-shopping trips at his expense.
An attorney for the Warrens declined to comment. Paul Warren, Sarah's father, denied Puliafito's shakedown allegations to The Times last week.
Puliafito also disputed that he misled authorities about Warren’s condition in the Pasadena hotel, saying he mistakenly believed that she was only drinking alcohol.
Both Smith and Osinoff accused USC of looking the other way as Puliafito spiraled out of control. Smith also accused USC of paying Warren and her family so they wouldn’t testify, and earlier in the trial questioned whether the settlement included a “gag order” imposed on the Warrens. A spokesman for USC did not return a request for comment Friday.
Puliafito’s rehabilitation came into question Thursday when, in a surprise twist in the case, Smith openly accused Puliafito of perjury.
Under examination by Smith, the doctor insisted his relationship with a convicted drug dealer had ended in late 2016. But Smith then produced what she said was a summary of a dozen recorded phone calls that Puliafito supposedly had with prisoners in jail, including the drug dealer.
“He sat there and told us he had no conversations with Kyle V., and yet while he is in recovery he’s having conversations with Kyle V.,” Smith said, alluding to the drug dealer Puliafito previously associated with. “He was not honest and perjured himself on the stand.”
Smith ultimately withdrew the introduction of new evidence after Administrative Law Judge Jill Schlichtmann wanted to delay the hearing so a Sheriff’s Department official could authenticate the recorded phone calls for the court. Smith said that might not be possible because they were obtained as part of an ongoing investigation by the department, and opted instead to finish the trial on Friday. Schlichtmann admonished Smith for what she said was a violation of Puliafito’s right to review that evidence during discovery.
He has not been charged with perjury, and the hearing will determine only whether he keeps his medical license.
Experts testifying on Puliafito’s behalf said they would be concerned if Puliafito continued to associate with the unsavory characters of his past. His addiction expert, Dr. Gregory Skipper, said continuing those relationships could trigger a relapse.
Osinoff attacked the state’s evidence, particularly the three witnesses in the case who testified to some of Puliafito’s most egregious behavior, including providing drugs to other people. He pointed out that on the first day of the trial, Sarah Warren and her brother were excused from testifying after their attorney cited their 5th Amendment right against self-incrimination. They provided declarations with their allegations to the court.
Another witness for the state, karaoke deejay Don Stokes, repeatedly gave conflicting accounts, veering during the same testimony from denying he ever saw Puliafito smoke methamphetamine to acknowledging it. In an audio interview played for the court, Stokes said Puliafito was the source of drugs at several parties he attended. He testified he had been drinking before the interview and before he gave the state a sworn declaration, and said he couldn’t recall Puliafito providing drugs to others.
Puliafito testified for hours on Thursday, apologizing to his colleagues, students and family for harming them. He also said he was sorry for damaging the reputation of USC’s Keck School of Medicine, and the integrity of the medical profession.
And he apologized to Sarah Warren for enabling her addiction through his financial support, even though during his mania he believed he was rescuing her from a life of drugs and prostitution, his attorney said previously.
“I was supposed to be a beacon of morality and judgment, and I fell flat on my face after decades of doing the right thing,” Puliafito said. “I’m not placing blame on anyone except myself. At the core of this I forgot that I was a physician 24/7. I failed to recognize that and did things outside the workplace that were wrong.”
Puliafito’s medical board trial occurred nearly a year after The Times detailed his drug use and partying with a circle of criminals and addicts, prompting the state’s investigation and its accusation that the former dean used methamphetamine and heroin, smoked methamphetamine within hours of seeing patients and provided drugs to Warren and her brother. During the proceeding, Puliafito denied supplying street drugs to them.
A tip about the former dean’s involvement in the hotel incident led The Times to investigate. Less than a month after the overdose, Puliafito stepped down as dean. But USC allowed him to remain on the faculty and continue practicing medicine until The Times’ story broke 16 months later.
The judge is expected to issue a ruling within 30 days. The state medical board can accept the judge’s decision or offer a different order.