EXPERT: SUICIDE, NATURAL CAUSES POSSIBILITIES IN LUYAO DEATHS

FORT PIERCE -- Prosecutors say a suspended Port St. Lucie doctor's
excessive prescriptions led to the accidental overdose deaths of six
of her patients, but an expert medical examiner who testified in her
defense said Friday he could not rule out natural causes in two of
the deaths or the possibility of suicide in some of the others.

Dr. Ronald Wright did not perform any of the autopsies in the patient
deaths for which Asuncion Luyao is charged with manslaughter, but he
reviewed the autopsy reports and other files at the request of
Luyao's attorney. The former chief medical examiner for Broward
County was one of two expert witnesses expected to testify on Luyao's
behalf after prosecutors rested their case Friday morning.

Prosecutors are trying to convince a jury that Luyao aimed to keep
patients addicted to powerful painkillers in order to continue to
collect an $80 office fee required for monthly refills.

Those prescription practices, they say, caused the six deaths.

But her attorney, Joel Hirschhorn, said Friday he doesn't believe the
state proved its case, and he attempted to plant reasonable doubt in
the jury's mind about linking the deaths to Luyao. He says she was a
caring physician who did not act with a reckless disregard for her
patients' safety.

Wright testified that he believes patient Robert Gustaf, 40, of
Jensen Beach died from pneumonia and that Julia Hartsfield, 52, of
Fort Pierce, died from heart disease.

The Treasure Coast Medical Examiner's Office determined Hartsfield's
official cause of death was a drug overdose and Gustaf died from an
combination of an overdose and pneumonia.

"Just because Mr. Gustaf had pneumonia doesn't mean the methadone
didn't kill him," Assistant State Attorney Erin Kirkwood said of the
drug Luyao had prescribed.

Wright said patient Bradley Towse, 23, of Palm Beach Gardens,
probably died of an overdose. But, Wright said, because the medical
examiner who conducted his autopsy only tested blood taken from him
at a hospital before his death, it's impossible to know exactly what
drug he really overdosed on.

Towse had taken methadone, which Luyao had prescribed for him the day
before he died, but Hirschhorn has argued that he was released from
the hospital, and no one knows if he took other drugs before he died.

Wright also said Towse would have had a much better chance of
survival if he had not been released from the hospital.

Towse's mother testified earlier in the trial that her son did not
take any other drugs in the hours after he was released from the
hospital and before his death.

Wright said in at least two cases, Tina Smith, 27, of Sebastian and
Janice Byers, 41, of Vero Beach he could not rule out the possibility
of suicide.

The doctors who performed their autopsies had testified earlier they
did not see any tell-tale signs of a suicide.

Hirschhorn argued that patient Rona Kay, 35, of Broward County, had a
history of taking gamma hydroxybutrate, or GHB, and it's impossible
to know if she had taken it the day she died because it clears out of
the body so quickly.

"While drugs may have been a factor, I suggest it wasn't drugs Luyao
prescribed, and even if it was, they were prescribed in good faith,"
Hirschhorn said.

Kirkwood said Friday she's confident "the links have all been
established" between Luyao's prescriptions and the six deaths.

The defense will continue to present its case on Monday, and the jury
is expected to begin deliberations on Tuesday.