The Medical Board of California has called for a hearing to suspend or revoke the medical license of David Chao, the former San Diego Chargers team doctor with a long history of medical malfeasance. The Medical Board is specifically investigating Chao's treatment of his former patient and close friend, Junior Seau, who committed suicide in 2012.
According to the complaint, Chao negligently prescribed Seau the powerful sleep aid drug Ambien without the proper supervision, care, or even the most basic due diligence, in the months and years leading up to his death. This accusation comports with Chao's documented history of cavalier prescription medication dolling.
As the complaint against Chao states, "The use of Ambien is associated with increased incidence of impaired driving and completed suicide. It should be prescribed with caution in patients suspected of having depression or suicidal thoughts, and in the lowest effective dose."
Seau checked off all those warning boxes. In 2010, he drove his car off the road, an incident he always said was due to him falling asleep at the wheel. Yet, Chao wrote Seau another prescription for Ambien three days after the crash.
According to the complaint, Chao told an investigator that he, Seau, and other close friends engaged in a "pact" after a mutual friend committed suicide. Under this pact, they would report any suicidal thoughts to each other, an illustration of their close friendship. Chao claimed he had no knowledge of Seau's depression. Yet, Seau was exhibiting enough depressive symptoms that many of his relatives noticed: a lawsuit filed by Seau's relatives after his death stated that he had been suffering from "severe depression."
Despite all these warning signs, in the 18 months prior to Seau's death, Chao wrote 14 prescriptions of Ambien for Seau, a total of 375 pills, most at the double strength of 10mg. Seau was taking this medication until the day he died. Deadspin reported that Ambien was found in Seau's toxicology report: "The level of Zolpidem in Seau's body was consistent with ingestion fewer than 90 minutes prior to his death."
Seau did indeed have a history of insomnia, but it seems he was never referred to an expert in the field. Instead, Chao, who treated Seau since he came into the league in 1990 until his death, gave Seau Ambien for decades. It is unclear why Chao, an orthopedic surgeon, felt he was qualified to diagnose a sleep disorder and prescribe medication for it.
Chao's alleged medical malpractice here extends beyond shoddy record-keeping, failure to properly examine a patient and track his response to prescription medication, all of which Chao is accused of. There is something far more severe at hand which affects many other former football players, too: a basic lack of medical due diligence to investigate and treat the root causes of their symptoms, in favor of prescribing painkillers, antipsychotics, and other mood disorder medication that carry severe side effects, particularly in populations with increased rates of depression.
Seau was in pain from the second he suited up for the Chargers until the day he died, a common state of existence for former football players. After his retirement, Seau complained of crippling headaches. Likewise, he had relationship difficulties, lost close friends, and had difficulty adjusting to a change in profession; normal issues for men in their forties. Each of these required separate and specific treatment, drugs or otherwise. None of them were likely due to the commonly misdiagnosed issue of sleep disorders. It's possible Seau had that, too, but a responsible doctor would have never given him fistfulls of Ambien knowing these underlying issues which were never solved, to say nothing of referring him to a sleep specialist.
After his suicide, Seau's brain was found to have CTE, the degenerative brain disease increasingly found in former football players, which is associated with mood and behavior disorders and confirmed to many that his depression and suicide was due to the lasting effects of playing a violent sport. But it was likely not that simple. Yes, a lifetime of head trauma likely contributed to extremely unpleasant physical and emotional symptoms that made life difficult on a day-to-day basis. When Seau sought relief for one of them, his doctor let him down and gave him a dangerous drug to mix with those symptoms.
What led Seau to kill himself is not reducible to a single word like "football" or "depression" or "malpractice." Like most suicides, it was a confluence of factors that can never be truly understood, and focusing on a single one won't solve any of them. While head trauma is a serious issue, proper treatment for its symptoms remains a largely undiscussed one.
In Deadspin's thorough documentation of Chao's history, Chao's attorney responded to inquiries regarding his prescribing of Ambien to Seau by saying, "Of the few people Seau noted in his Chargers Hall of Fame speech he mentioned Dr. Chao. He publicly and with great passion thanked Dr Chao many times for keeping him healthy. The issue you raise seems ridiculous."
This "ridiculous" issue will likely cost Chao his livelihood. He will have to live the rest of his life wondering if it cost him his friend, too.