As early as 2007, Al Bussam was identified as one of the top prescribers of painkillers and other abused drugs in the L.A. area. A subsequent search of a state database at the request of authorities investigating the doctor revealed that he was the No.1 prescriber of such addictive medications in the entire state over a three-year period beginning in January 2008.
The deaths reviewed by The Times involved people ranging in age from 30 to 49. They were known by friends or loved ones to have abused prescription drugs, illegal narcotics or both. Several had previous drug overdoses or drug-related arrests.
It's unclear why authorities did not discover the patient deaths as part of their investigation. When asked about the deaths, prosecutors declined to comment.
Debbie Evert, whose brother, Gregory Barcus, died of an overdose in his Orange apartment after being prescribed a painkiller and a muscle relaxant by Al Bussam in 2008, said it would have been obvious to anyone that he was an addict.
She said neighbors would routinely find him so drugged up, "he couldn't walk or talk.... He was just a mess."
Ryan Thompson, 30, died on the doorstep of his younger sisters' Costa Mesa home a day after being prescribed methadone pills by Al Bussam, records show. His sisters cared for him while he suffered through a withdrawal, throwing up so often his vomit was streaked with blood. He wanted to kick his methadone habit and had been sober for weeks when he got his last prescription, family members say. Al Bussam wrote him a prescription for 100 methadone pills to be taken three at time three times daily, records show.
Thompson's sister Hailey said he came home obviously high that evening. Upset and saddened by his relapse, she told him they would discuss it in the morning.
When Hailey found her brother sitting cross-legged outside her front door, a friend began CPR, but it was too late. Toxicology tests later revealed methadone, as well as morphine and oxycodone, in his body. The coroner ruled his death an accidental overdose.
Thompson's mother, Niki, said a coroner's investigator told her that if her son had resumed taking methadone at the amount he was used to before kicking the habit, it could have killed him.
"If you know someone is an addict, why in the world would you hand them a bottle of pills and say, 'Here, take three at a time,'" Niki said.
Gluck, Al Bussam's attorney, said he did not believe that Thompson was a patient of his client. Coroner records list Al Bussam as his doctor and show that Al Bussam's office provided medical records to an investigator.
Others who, according to coroner records, died after being prescribed drugs by Al Bussam or while in possession of drugs he prescribed are:
• Christopher Vargas, 47, who overdosed in his Echo Park apartment in May 2007 on a cocktail of prescription drugs, including a commonly abused muscle relaxant sold under the brand name Soma, which had been prescribed by Al Bussam 26 days earlier, according to coroner's records. Vargas had multiple drug-related arrests, the records state.
• Terry Ridgeway, 42, who family members said had been a crack cocaine abuser but had been clean for seven years before developing a prescription drug habit. He was found dead on the kitchen floor of his Santa Monica apartment in December 2008. A pill bottle containing an anti-anxiety drug prescribed by Al Bussam was found in his bedroom. That drug was one of three that caused his death, coroner's records show. The vial bearing Al Bussam's name had a partially torn label, which law enforcement officials say is a sign of illegally traded drugs. Gluck said he did not believe that Ridgeway was a patient of Al Bussam.
• Lisa Vanzandt, 49, who was an aspiring nurse and primary caretaker of her elderly mother, according to coroner's records. Vanzandt had several medical problems, including back pain, her mother said. She was fond of walking along the cliffs of the Palos Verdes Peninsula near where she grew up in Redondo Beach. A friend told coroner's investigators that the family lost their home and that Vanzandt had always dreamed of moving back. The friend said Vanzandt had a prescription drug problem and speculated that she fell off the cliff while intoxicated. Prescription bottles bearing Al Bussam's name were found in Vanzandt's purse. The same drugs as he prescribed — a painkiller and anti-anxiety medication — were among a cocktail of drugs found in her body, coroner's records show. The labels on both bottles were torn. The death was ruled an accident.
Photos: Dr. Nazar Al Bussam