A Mountain View woman appeared in court Monday to face charges for allegedly prescribing large quantities of highly addictive painkillers and anti-anxiety pills to multiple patients -- one of whom is now dead of an apparent overdose -- without conducting proper examinations or checking medical records, a county official said.
Dr. Jasna Mrdjen was arraigned May 14 on multiple charges related to the "pill mill" she is accused of running out of a small Los Gatos office with "virtually no medical equipment," said James Sibley, supervising deputy district attorney for the narcotics unit of Santa Clara County.
Prosecutors allege that Mrdjen knowingly prescribed opiates and other sedatives to addicts, who sought the medications for purely recreational purposes. One of these patients died of an apparent overdose, after taking a fatal cocktail of both types of medication, Sibley said.
Mrdjen had been operating the Pain Management Clinic, located at 14125 Capri Dr. in Los Gatos, for about two years when agents with the Santa Clara County Special Enforcement Team served her with a search warrant on May 11, Sibley said.
Sibley said undercover agents with the enforcement team -- a multi-jurisdictional task force overseen by the California Department of Justice -- had visited Mrdjen's clinic many times over the course of a year in order to see how many and what kind of pills they could get the doctor to prescribe, and what they had to claim in order to get their hands on the drugs.
In one instance, an undercover officer visited her office complaining of pain in his foot, Sibley said. According to the officer's report, Mrdjen touched the outside of his boot without asking him take it off, and sent him away with a prescription for 210 oxycodone-containing pills.
Oxycodone is a "semi-synthetic narcotic analgesic and has historically been a popular drug of abuse," according to a Drug Enforcement Agency fact sheet. It is similar to other opiate-based drugs, such as heroin and morphine.
It is prescribed by doctors in the treatment of moderate to severe pain, according to the DEA. In addition to offering relief from pain, the medication can produce feelings of euphoria, "which explains its high potential for abuse." The drug can also cause physical dependence and in high doses can be fatal.
In addition to being accused of prescribing oxycodone and other opiate-based medication, such as Vicodin, Mrdjen is accused of prescribing benzodiazepines -- a kind of sedative used to treat alcohol withdrawal, anxiety and muscle spasms, Sibley said.
This class of drug also carries a potential for abuse, due to the "intoxicated state" it can produce in users, the DEA states. Brand names associated with benzodiazapines include Xanax and Valium.
Benzodiazepines can be lethal in high doses, or in combination with alcohol, and are also dangerous when users quit suddenly, as they can lead to physical dependence and withdrawal symptoms can be severe, according to the DEA.
Sibley said the accusation that Mrdjen was prescribing both kinds of medications is particularly troubling. "They both depress the central nervous system and respiration, and they have a synergistic impact," he said. "They magnify each other." Both work together to suppress the respiratory system, Sibley added, and benzodiazepines eliminate the body's ability to metabolize opiates.
Though the autopsy of the patient who died has not yet been completed, Sibley said toxicology reports show that the individual had taken opiate- and benzodiazepine-based drugs before dying.
Pill mills are a growing problem throughout the country, as is prescription medication abuse and addiction, Sibley said. "It's definitely one of the fastest growing areas of drug abuse."
Addicts were not the only ones visiting Mrdjen, he said. Drug dealers were also using her clinic to stock up on pills that they sold on the street, where users will often pay as much as a dollar per milligram and some pills go for $50 each, if not more.
According to Sibley, it is not uncommon for recently retired doctors to open up practices like the one Mrdjen was alleged to have been running, as a way to make quick money before they retire. He said doctors figure that if they get caught, the most that will happen is their medical license will be taken away, and that the risk justifies the reward.
Mrdjen fits this profile, Sibley said. Records show Dr. Jasna Mrdjen operated a physical medicine and rehabilitation practice in Los Gatos for about 40 years. Sibley said he wasn't sure what Mrdjen did before, but he knew that she had closed a prior practice before opening the Pain Management Clinic. At her new clinic, Mrdjen only accepted cash from her customers, he said. She allegedly charged $240 for a first visit and $100 per visit after that.
She was arraigned on a 12-count felony complaint, which alleges she conspired to sell controlled substances by helping drug dealers obtain narcotics; she is also accused of "issuing prescriptions outside the usual course of professional treatment" and "prescribing controlled substances to an addict."
If she is convicted of all the charges, Mrdjen could be sentenced to up to 12 years in prison.