Structural Biology Prof. David McKay is continuing to pursue a wrongful death claim against the physician and pharmacy groups who prescribed his son Prozac over the Internet prior to his suicide.

In August 2005, Stanford freshman John McKay ‘08 committed suicide, dying of a combination of alcohol and carbon monoxide poisoning. At the time of McKay’s death, traces of the antidepressant Prozac were found in his system.

Prozac is one of a number of medications that carries a “black box” warning from the Food and Drug Administration (FDA) about its potential for increasing suicidal thoughts and behavior. Prior to McKay’s death, the online pharmacy www.usanetrx.com supplied him with the medication.

Prof. McKay claimed that the online pharmacy acted negligently and illegally in providing his son with the medication. He said that the pharmacist who wrote the prescription via the Web site knew nothing about his son’s health history and, in fact, had never seen him prior to diagnosis.

“The key problem is unscrupulous, professionally negligent Internet physicians who blindly approve prescriptions for patients they know nothing about, with no regard for the risks or consequences, just to make some quick and easy money,” McKay wrote in an email to The Daily. “Such individuals should not be allowed to engage in the practice of medicine.”

In February 2006, McKay filed the civil case with San Francisco Federal Court against three parties: physician Christian Hageseth of Fort Collins, Colo., who wrote the prescription; pharmacist Frank Gruich of Biloxi, Miss.; and the pharmacy JRB Health Solutions, which operates out of Austin, Tex. A summary judgment has since been given in favor of the pharmacist on the grounds that the suicide could not be directly attributed to the Prozac, a judgment which McKay and his attorneys are considering appealing.

McKay claimed that his primary concern with this case is drawing attention to the issue of online pharmacies and pharmacists.

“Our main goal is to hold them responsible for their actions,” he said, “with the goal of shutting them down and bringing attention to the issue of drugs being prescribed without proper diagnosis on the Internet.”

As the civil case against the respective parties remains ongoing, a criminal case against Hageseth, whose restricted license made it illegal for him to prescribe the medication to John McKay, has resulted in Hageseth being extradited to San Mateo Country and held on a $250,000 bail. On Dec. 4, Hageseth entered a “not guilty” plea.

According to McKay, the pharmacy was unaware at the time that Hageseth’s license was restricted. After John McKay’s death, Hageseth fought extradition as long as he could, until a warrant was finally put out for his arrest.

“His attorney argued that he couldn’t be tried in California because everything he did was in Colorado,” McKay said. “It was ruled that California did have jurisdiction over him.”

While the circumstances of the criminal case against Hageseth are made simpler by the fact that he was working with a restricted license at the time of the prescription, the civil lawsuit against him and the other two parties is much more complicated — both by the nature of their operation and an overall ambiguity surrounding legal issues of this kind.

“One of the facts is there’s no explicit law and very few precedents dealing with the Internet and things of this sort,” McKay said.

He added that the case also becomes “very complex with jurisdiction,” given that the defendants reside in three different states and the case has been filed in California.

As both the civil and criminal cases progress, McKay hopes to see lawmakers address this issue more closely to prevent future incidents.

“It would help to have a set of legal requirements that are uniform across state lines,” he said.