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Involuntary manslaughter was one of nine charges included in an indictment an Orange County grand jury issued last week against donor Kareem Ahmed and two associates. The indictment accused Ahmed, the president and CEO of a company called Landmark Medical Management, of masterminding an alleged multimillion-dollar insurance kickback scheme involving the manufacture and prescription of profitable topical pain creams to workers' compensation patients. The other charges against Ahmed include conspiracy and insurance fraud. As TPM reported in 2012, Ahmed was one of the biggest financial backers of Obama's re-election efforts, despite years of suspicions about his business practices from officials and workers' compensation experts in California.
The indictment, which also named pharmacist Michael Rudolph and physician Andrew Jarminski, described the manslaughter charge only in general terms, saying that on Feb. 3, 2012, Ahmed and the two other men "unlawfully and without malice [killed] Andrew G. (a minor), a human being, in the commission of a lawful act which might produce death, in an unlawful manner and without due caution and circumspection."
But on Monday, TPM obtained Los Angeles County coroner's department documents that offer more details about the death.
The documents indicated that at 8:05 a.m. on Feb. 3, 2012, a five-month old child named Andrew Gallegos was declared dead at Los Angeles County-USC Medical Center. Gallegos' mother, Priscilla Lujan, told a coroner's department investigator she had woken up at 7 a.m. that day and found the baby not breathing, according to the documents. A subsequent autopsy determined that Gallegos died of "multiple drug intoxication," and ruled his death a homicide. The autopsy report said lethal levels of the drugs tramadol and dextromethorphan, as well as a high level of amitriptyline, were found in Gallegos' stomach and liver, and that "residue" of the cream which contained the three drugs was found in one of Gallegos' baby bottles.
"There is medication residue found in one of the baby bottles tested which supports an ingestion route also," Louis Pena, the deputy medical examiner, wrote in the autopsy report, which is dated July 4, 2012. "The story from law enforcement investigation is inconsistent with the lethal levels found. A-6-month-old baby cannot manipulate the tube where these 3 medications were together in a cream form. The levels obtained in the baby's blood are not possible from incidental skin absorption or passive transfer."
It remains unclear from the available record how the infant's ingestion of drugs as reported by the coroner led to the manslaughter charge against Ahmed, Rudolph, and Jarminski in the insurance fraud case.
The Orange County District Attorney's office on Monday declined to comment on the manslaughter charge, saying it could not address the case until 10 business days after defense attorneys had been granted access to grand jury transcripts. Court documents obtained by TPM last week indicated that Gallegos' mother was one of the witnesses who appeared before the grand jury that issued the indictment against Ahmed. TPM's attempts to reach Lujan and Gallegos' father, Camilo Gallegos, on Monday were unsuccessful.
In a telephone interview with TPM on Monday, one of Ahmed's attorneys maintained his client's innocence, and said he expects Ahmed to be "fully exonerated." On the manslaughter charge in particular, attorney Edward Feldman said that extending criminal responsibility to a physician who ordered the cream, the pharmacist who manufactured it, and the management company that handled the finances was "clearly beyond what the law anticipates." (An attorney for Jarminski declined to comment to TPM. Attempts to reach Rudolph's attorney were unsuccessful.)
"The death of the five-month-old is obviously a horrific tragedy," Feldman said. "To bring manslaughter charges, though, does need to comport with what the law requires, in terms of attributing criminal responsibility, it must conform to what the law requires. There has to be some nexus between the death and the people who are charged."
A second indictment issued last week brought 35 additional charges against another dozen of Ahmed's associates, including a number of physicians and chiropractors and former Landmark Medical Management Vice President Bruce Curnick. That indictment accused the defendants of conspiring with Ahmed, who is not charged in the second case, and the counts included insurance fraud, kickbacks for patient referrals, and false claims. The doctors allegedly accepted millions of dollars from Ahmed between 2010 and 2013. In a statement emailed to TPM on Friday, Landmark Medical Management human resources manager, Ladonna Hieber, said that Ahmed and his staff "are innocent of all charges that have been alleged. The charges are meritless and we expect full exoneration of any wrongdoing."