Smith verdicts will resonate for doctors, patients

LOS ANGELES - September 27, 2010

She appears on a huge video screen above the heads of three of her friends, who sit in a courtroom because of their relationships with her.

The woman is Anna Nicole Smith, a one-time Playboy model who died in 2007 of a drug overdose. Those on trial are her former lawyer-boyfriend and two doctors, all charged with conspiring to give her excessive prescription drugs while knowing she was an addict.

The prosecution is expected to rest its case Monday.

The trial's approaching outcome is sure to reverberate among doctors and pain management patients whose need for drugs is at the heart of California laws under which the defendants are charged.

Superior Court Judge Robert Perry has harshly criticized the prosecution for "overreaching" and indicated he will bar some charges from going to the jury.

"I'm very concerned about the way this case is charged and being prosecuted," he told Deputy District Attorney Renee Rose. "If you're going to accuse someone, you should have some evidence."

Now, Perry has presented both sides with a 15-page document he labeled "Thoughts," asking 50 different questions about the charges.

His first question was: "What evidence shows that Anna Nicole Smith took drugs to get high or obtain a euphoric state and not to relieve pain?"

The one defense witness, pain management expert Dr. Perry G. Fine, clearly impressed the judge. Fine testified that even if Smith was prescribed 1,500 pills in one month for pain, it did not mean she was an addict - that clinical factors had to be considered as well as her high tolerance for opiates and sedatives.

Perry sees this as central to the case and advised jurors: "The number of pills is not a determinative factor in this case. Please keep that in mind."

He spoke after Rose spent two hours having an investigator enumerate thousands of pills found in Smith's homes after she died. Much of the prosecution's case has been a laundry list of powerful medications, including Methadone, Dilaudid, Demarol, Valium, Xanax and Chloral Hydrate. Pharmacists testified about being shocked at the number of medications prescribed and one said he refused to fill a request that he felt was "pharmaceutical suicide."

Witnesses testified that Smith suffered from chronic pain syndrome, seizures, fractured ribs, migraine headaches, insomnia and severe back pain, as well as depression after the death of her son, Daniel.

Defendants Howard K. Stern, Dr. Sandeep Kapoor and Dr. Khristine Eroshevich have pleaded not guilty to an array of charges, including conspiracy to provide excessive controlled substances, prescribing to an addict, and obtaining drugs by fraud - some prescribed under false names. The three are not charged with causing Smith's death.

Their defense team - veteran lawyers Steve Sadow, Ellyn Garafalo and Brad Brunon - recently made a surprise announcement that they will call no further witnesses after the prosecution rests. They say the case against their clients has not been proven.

The three attorneys intensely cross-examined every prosecution witness and the judge said they succeeded in destroying the credibility of several, including two nannies flown in from the Bahamas. Sadow accused one of them of outright perjury.

The prosecution summoned up Smith's video images to suggest she was addicted - showing her at the American Music Awards slurring her words.

The defense answered with its own videos of Smith speaking clearly and still photos showing her smiling and engaged.

Prosecutors used photos of Smith naked in a tub with Eroshevich and pictures of Kapoor kissing Smith after riding with her in a gay parade to show that the doctors blurred the line of their professional relationship with Smith.

Perry scheduled arguments Monday on dismissal motions, but indicated some charges "will likely survive in some form."

He wants arguments to be limited to two issues: whether Smith was an addict and whether prescriptions were obtained under false names.

If false-name charges stand, he asked whether nine prosecution witnesses should be considered accomplices and jurors should be warned to treat their testimony with caution. These included pharmacists and doctors who prescribed to Smith under pseudonyms, a common practice with celebrities.

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