Two doctors violated their responsibility to protect Anna Nicole Smith by prescribing massive amounts of drugs with the connivance of her lawyer-boyfriend, even though they knew she was addicted to painkillers, a prosecutor argued Wednesday.
The contention by Deputy District Attorney Renee Rose came during opening statements at the conspiracy trial of Dr. Sandeep Kapoor, Dr. Khristine Eroshevich and Howard K. Stern, who are accused of providing hundreds of pills — including powerful opiates and sedatives — for the Playboy model under multiple names.
“None of it could have happened without Mr. Stern,” Rose added during her two-hour presentation in Superior Court.
Smith’s mother, Virgie Arthur, was in the courtroom with other relatives.
Stern and the doctors have pleaded not guilty to conspiracy to furnish the drugs. Each could face more than five years in prison if convicted, and the doctors would lose their medical licenses.
They are not accused of causing Smith’s 2007 overdose death at age 39 — a fact that Judge Robert Perry has stressed to jurors.
He previously told panelists they must not confuse the trial with the issues in the case of Michael Jackson’s doctor, who is charged with involuntary manslaughter.
“What we are trying is a legality of prescribing medication case,” Perry said.
Lawyers for the doctors and Stern have suggested they were desperately trying to save the doomed model during a period when she gave birth to a daughter and lost her grown son to a drug overdose.
During her opening statement, Rose displayed pictures on a courtroom screen of prescriptions for hundreds of pills, including Dilaudid, a drug known as “hospital heroin,” and methadone in pill, liquid and injectible form.
“Anna Nicole Smith took a lot of methadone for pain and she took Dilaudid on top of that,” Rose said.
Jurors also were shown pictures of Eroshevich with Smith following the 2006 birth of the model’s daughter, Dannielynn.
Rose said they had become close friends and the psychiatrist kept no medical records of her treatment, even though she was prescribing several drugs.
Rose also argued that Kapoor filled Smith’s prescriptions, even though another doctor warned that she was an addict.
The prosecutor said Smith went to Cedars-Sinai Medical Center in 2006, where doctors advised weaning her from drugs because of her pregnancy.
But as soon as she was released, Kapoor immediately began prescribing drugs for her again, Rose contended.
The prosecutor quoted from a diary kept by Kapoor that spoke of the “mesmerizing” effect of being with a celebrity and added: “Can she ruin me?”
Smith died of what was ruled an accidental overdose of at least nine medications at a Florida hotel.
During pretrial hearings, Rose battled to inject details of Smith’s final days into the trial. But the judge wasn’t persuaded.
Recently, Rose made a surprise move to add Smith as a coconspirator in the case, saying that without her craving for drugs the prescriptions would not have been written.
Kapoor’s lawyer, Ellyn Garafalo, has told the judge the trial’s outcome could have serious consequences for doctors and patients everywhere.
“Criminalizing a doctor’s efforts to help a difficult patient is problematic,” she said. “A doctor’s even poor judgment is not criminal. Good faith is involved.”
Authorities claim that 44 different medications were prescribed for Smith under a number of other names, including Stern’s.
Dave Kettel, a former federal prosecutor who handled prescription drug cases, and is now a defense attorney, said the case may be difficult to prove because of the multiple defendants. He said prosecutors could have a hard time showing the doctors knew they were acting improperly and that one knew what the other was doing.
He also said prosecutors may have erred by naming Smith as a coconspirator.
“Despite her personal problems, people liked her,” he said. “The last couple years of her life were so sad. I don’t think anyone wants to blame her.”