Witness for defense defends prescriptions written by Chua

William Morton, a pharmacist and professor emeritus who teaches medical students about psychiatric drugs at the University of South Carolina, began his testimony for the defense about 4:55 p.m.

After explaining his professional background, Morton said pain medications were part of his expertise but he is not a toxicologist.

He said he has testified at least 35 times as an expert witness in trials throughout the Southeast.

But Stephen Kelley, one of the prosecuting attorneys, objected to questions about his evaluation of drugs prescribed because Morton is not a medical doctor.

After the jury was sent back to their chambers, Judge Amanda Williams said she would not allow Morton to answer questions about the drugs Chua prescribed to Carter.

"I am not going to let him talk like he is a doctor," Williams said. "He doesn't even have M.D. behind his name. I don't care what he teaches. He's not a doctor."

Defense attorney Donald Samuel said he would preface every question with a disclaimer that Morton is not a medical physician.

While the jury was out of the courtroom, Morton said he reviewed Carter's medical records and concluded drugs prescribed by Chua were "rationally prescribed" for tretment of headaches.

Morton said hydrocodone is an appropriate medication for a patient with Carter's symptoms. He listed the many pain medications prescribed by other doctors to treat Carter's headaches.

Morton said physicians contact him when they have questions about the drug and dosage to treat a patient's medical condition.

A nasal spray prescribed for pain relief was also an appropriate medication to treat Carter's problem, he said. A patch that slowly releases medication into the skin, fentanyl, was also a useful drug to treat Carter's symptoms.

"You always weigh that good effects often outweigh the bad effects," he said.

He said it's not unusual for a doctor to change a patient's medications to find a drug that effectively treats an ailment.

Morton said he reviewed the drugs found in Chua's house and some of the medications were not prescribed by Chua.

The morphine given to Carter in the hospital and the Demerol given to him shortly before his release were also appropriate, Morton testified.

Demerol is "not one of my favorite drugs" to prescribe because it's difficult for a patient to absorb.

"My experience is people do not have a good response," he said.

The oxycontin and percocet prescribed to Carter simultaneously is also acceptable medical practice by many physicians, he said.

One of the problems with the drugs is the potential for abuse, he said.

The methadone prescribed to Carter on Dec. 9, but it has less likelihood to get someone high, he said.

There aren't that many people searching for methadone for illicit purposes because the drug takes days to build in a person's system.

The levels of methadone found in Carter's system at the time of his death were at medically acceptable therapeutic levels, he said.

It did not appear Carter took excessive amounts of methadone, Morton said.

He said it was inappropriate to use other narcotic pain killers in combination with methadone, however.

Morton said other alternative therapies such as acupuncture are also acceptable ways to treat headaches. Carter was referred for the treatment the day before his death, medical records show.

During cross examination, prosecuting attorney Stephen Kelley questioned Morton about different controlled substances. Some of the drug Chua prescribed Carter such as hydrocodone, morphine, Demerol and methadone are among the most dangerous, addictive prescription drugs, he said.

Morton told jurors many of the drugs prescribed to Carter could still have been in his possession at the time of his death because some of them were prescribed to be taken as needed by the patient.

Morton said all medications prescribed to patients should be charted in a patient's medical records. At least four drugs were prescribed to Carter by Chua with no explanation in his medical records, Morton testified.

He said when he first reviewed Carter's medical records, his first response was "it looked like he was way over-prescribed."

But after a more careful analysis, he reversed his opinion.

If there was evidence that Jamie Carter was a drug abuser, Morton said he would change his opinion.

Chua should have prescribed methadone to Carter earlier because oxycontin has a higher risk of addiction, Morton said.
But Morton said Chua was "not grossly over-prescribing" medications to Carter.

Testimony is scheduled to resume 9 a.m. Thursday, with the remaining witnesses for the prosecution and additional testimony by witnesses for the defense.