Angels doctor testifies he ‘had no idea’ how addictive opiates he prescribed Eric Kay were

SANTA ANA, Calif. — The Los Angeles Angels team physician acknowledged in testimony on Wednesday that he prescribed Eric Kay 600 opioid pills over a three-plus-year span, stating that he didn’t fully grasp how addictive the medication was at the time.

Dr. Craig Milhouse, who has worked for the Angels for 31 years, prescribed Kay, the team’s former communications director, to take up to six Vicodin pills a day, as well as the opiate NORCO at different times spanning 2009 through 2013.

He stopped providing the prescriptions just months before Kay, according to testimony from his ex-wife, had a breakdown in the Yankee Stadium press box and told Angels team officials that he’d developed a Vicodin addiction.

Kay is serving 22 years in federal prison for providing the pill that Angels pitcher Tyler Skaggs ingested, leading to his death on July 1, 2019. Skaggs’ family filed a wrongful death lawsuit against the team, arguing negligence.

“I thought they were safer,” Milhouse testified, saying he wasn’t fully aware of the addictiveness of opiates until some time around 2014. He also noted that he didn’t always re-review a medication’s fact sheet before prescribing it.

“I was not aware of how quickly someone could become addicted to them. We knew that there was this potential, we were always told that. But I had no idea just how addictive they were.”

Skaggs attorney Daniel Dutko argued that Milhouse’s prescriptions of the opioids spurred Kay’s addiction, utilizing Milhouse’s testimony to make their case. At the outset of his testimony, he agreed that taking five opioid pills a day would be a “full-blown addiction.”

Milhouse testified that he refers patients to pain specialists if they are suffering from chronic pain, which is pain lasting longer than three months. His opioid prescriptions for Kay extended for 44 months, or 214 prescription days, according to Kay’s Controlled Substance Utilization Review and Evaluation System (CURES) report.

Dutko also highlighted a text exchange between Milhouse and Kay, where Kay requested Viagra pills for a player. The texts were used to showcase both Kay’s role as a drug liaison for players and the team doctor’s alleged laxity regarding a medical professional’s legal and ethical standards for issuing medication.

The text messages showed a friendly conversation between Kay and Milhouse. After Kay requests and reminds Milhouse multiple times about the pills, Milhouse asks Kay, “What is your reward for this?” He also provided instructions to relay to the unnamed player: “100 mg tabs, he should take 1/2 tab.”

However, Milhouse testified that he also called and chastised Kay before these texts, saying it wasn’t appropriate for him to be asking for those pills. Milhouse testified that he also evaluated the player in person and provided the same instructions to them, also in person.

“I told (Kay) that’s not how it works,” Milhouse said. “I’m not going to give medications for him to give to someone.”

When asked about the legality of the action by Dutko, Milhouse said, “It would be illegal on my part to prescribe a medication to someone to give to somebody else.”

Dutko responded by asking, “Is it a violation of company policy to ask you to do something illegal,” referring to Kay’s conduct. Milhouse responded, “I suppose yes.”

“Did you report it?” Dutko asked, to which Milhouse said, “No.”

There were other lengthy, contentious back-and-forths in Dutko’s questioning of Milhouse. Central to the Angels’ case is that Kay was receiving treatment from Dr. Erik Abell, who leads the Angels’ Employee Assistance Program. Skaggs lawyers have contended that the Angels did not follow MLB policies by neglecting to report Kay’s drug abuse to MLB, as required by MLB guidelines — and that Abell’s psychiatric treatment was not adequate, and did not follow league rules.

Milhouse testified that he believed that Abell, as part of the EAP, was a liaison with the league. And that Kay’s seeing Abell would satisfy the league’s requirements of reporting his drug use.

“In my mind, the EAP is an arm of MLB,” Milhouse said, while noting that he’s never had anyone with the Angels voluntarily self-report drug abuse.

Dutko questioned where in MLB’s policy it stated that, and Milhouse was unable to find specific examples, but maintained his stance. The back-and-forth led to Dutko objecting to Milhouse’s answer as “non-responsive.”

The league’s policy says that the league’s Drug Policy Oversight Committee, made up of four MLB-determined specialists, creates the treatment program, and that an EAP, such as Abell, could be one of multiple entities that helps oversee that treatment. But the EAP’s role only comes after the drug use is reported to the Commissioner’s office. After lengthy questioning and a long sidebar with the judge and attorneys, Milhouse acknowledged the league’s DPOC role in establishing the treatment.

Angels attorney Todd Theodora’s questioning of Milhouse largely centered around establishing him as a credible doctor, highlighting his history working for multiple teams and conducting his private practice. He also suggested that the 600 opiate pills prescribed could be misleading, and that the overall number of milligrams prescribed was a better barometer, which came out to 24.5 milligrams per day.

Theodora had hoped to question Milhouse on specifics related to Kay’s treatment — arguing on Tuesday that Kay had recently waived his doctor-patient confidentiality. Dutko said it would be “sandbagging” — meaning that it would be prejudicial to their side for this evidence to come in during trial, and not during discovery. Angels attorneys asserted that privilege during Milhouse’s deposition.

The judge asked both sides to file short briefs — with the Angels filing an affidavit from Kay’s attorney that he waived his privilege. Kay’s attorney is funded by the Angels, according to trial testimony. The judge sided with the Skaggs attorneys.

Before Milhouse took the stand on Wednesday, ex-Angels clubhouse attendant Vince Willet testified that he personally witnessed Kay snort pills during spring training in 2016 or 2017. He said that Kay asked him to stand guard on both occasions.

“He pulled a pill out … kind of had me stand by the door to make sure no one walked by,” Willet said. “He crushed it up on the counter with what looked like a room key or credit card.

“Then I saw him snort it.”

Willet, who worked for the Angels from 2009 through 2017 and then briefly again in 2019, interacted with Kay on a daily basis in spring training, where they developed a cordial relationship. He was not represented legally by the Angels, and said on cross-examination that he hoped the plaintiffs would win the lawsuit.

During his time in spring training, Willet said, he witnessed behavior he believed to be a product of Kay’s drug use. This included sitting in a chair in the Angels clubhouse, laughing at nothing, becoming agitated and talking to himself.

Angels attorney Stephen Ladsous pressed Willet on why he signed disclosure forms in 2016 and 2019, stating he hadn’t witnessed drug use. Willet said he was never educated on the purpose of the forms and believed they were related to players and steroid use. He also testified that he didn’t believe it was his responsibility to report Kay, since he was in a different department. Another ex-Angels clubbie, Kris Constanti, testified the same on Tuesday.

Willet also said he was concerned about his own job security, and that people might think he participated in taking drugs, which he said he did not.

“I felt that if he were to be reported,” Willet said, “it should be by employees in his own department.”

The Athletic has reached out to the Angels on Milhouse’s status with the organization and will update if and when they respond.