FORT PIERCE, Florida — An undercover agent who walked into the office of Dr. Asuncion Luyao complaining of phony hip and back pain, and left with prescriptions for powerful and addictive painkillers after a short exam, was among the first witnesses called on the stand to testify against the Filipino-American doctor charged with continuing a criminal enterprise, six counts of trafficking in oxycodone, and six counts of manslaughter in connection with the death of six patients.

The undercover agent’s visit at the office was the start of an investigation that would end in charges against the Port St. Lucie physician.
Undercover agent Thomas Watterson, who works with the state attorney general’s office, described an office where visits never took longer than 15 minutes, pain prescriptions freely were dispensed, and the doctor was seen carrying a large wad of cash in her lab coat.

He said he visited her office in the former Village Green shopping center six times between June 2001 and October 2001, and those visits are the source of the trafficking charges against her now.

During his first visit, he told jurors he complained of hip and back pain and she gave him the prescriptions he asked for — including OxyContin and Xanax — after a brief physical exam and review of his medical history. On his next five visits, Luyao listened to his heart with a stethoscope, but made no other physical examination.

She never talked about other ways to deal with his pain or about specialists or others who might help him find the source of his pain. Luyao also never talked about the dangers of OxyContin addiction, he said.

On one visit, he said he might have to postpone a visit, which she cautioned him against.

“She said, ‘You’ll run out of dope,’” Watterson testified.

That conversation and others were captured on tape using a microphone Watterson had hidden in his beeper, and some of those tapes were played in court.

After his first visit, Luyao asked Watterson to bring in medical charts to back up his story about back and hip pain, but he instead brought her charts that described a heart condition. She continued to give him OxyContin and other drugs, and never mentioned medical records again, he said.

During opening arguments earlier in the day, Assistant State Attorney Lev Evans described Luyao as “a drug dealer with a prescription pad” who recklessly prescribed “unconscionable” amounts of OxyContin to her patients in a greedy effort to get more money. He gave details about the six patient deaths prosecutors say she is responsible for, and told jurors how family members, pharmacists and detectives increasingly became concerned about her practice.

Her attorney Joel Hirschhorn countered she was a responsible doctor who broke no laws in prescribing painkillers to her patients, and had all of them sign agreements saying they would not abuse drugs. She did treat drug addicts, but there is no law against it, and she used reasonable care in handling those patients, he said.

“Dr. Luyao made a conscientious effort to treat her clients. She treated them all with respect and dignity. As a physician she is entitled to rely on what the patient tells her,” Hirschhorn said. “It’s unfortunate that the state has decided to target Dr. Luyao.”

The case is tentatively scheduled to last three weeks.