Lisa Scottoline and Adam Dunn“No, I didn’t base it on a real case. I never base anything on real cases. I never do any ripped-from-the-headlines stuff.”

So states bestselling, Edgar Award-winning crime novelist Lisa Scottoline during a breathless interview between parking lot and podium, where she will expound upon her latest thriller Every Fifteen Minutes (St. Martin’s Press). In the book, a psychiatrist’s tenacious refusal to breach doctor-patient confidentiality lands him in the crosshairs of a homicide investigation into a young girl’s murder.

Right there the author’s initial statement boomerangs. The scenario posed in Scottoline’s novel is reminiscent of Tarasoff v. Regents of the University of California (1976), in which a young male patient undergoing psychiatric treatment divulged threatening intent towards a young woman who had rejected his advances, which was not reported to authorities by the treating therapist. Subsequently, when the patient successfully carried out his intent to kill the woman, her parents sued the therapist, whose claim that he had no duty to the victim since she was not his patient was rejected by the state supreme court. Since then, the ruling has been modified twice (in 1985 and 2005), with the center of gravity moving further and further from the importance of a certified mental health professional’s role in determining the validity of a threat and its reportage to authorities.


Readers familiar with Scottoline’s work should recognize her penchant for using legal dilemmas as plot thickener. (Neophytes be advised the author is a former trial attorney with a JD from the University of Pennsylvania—cum laude!) In her defense, when pressed on whether the specific scenario she outlines in Every Fifteen Minutes is based on an actual case or individual doctor grappling with the question of To Tell Or Not To Tell, she declares: “I’ve written 23 novels in 24 years, and a lot of people ask me the same thing. I would never breach anything. I have the secrets that I have, and I always will have them. I take confidentiality very seriously.

Every Fifteen Minutes“For me as a mother, the situation posed here is your basic Tarasoff dilemma, a guy threatening a young girl. Every mom in the world would go, ‘TELL!’ But I wanted to develop the other side of this, which is, what is the harm [done] once you tell. Because when you tell, you lose that person to therapy. So you create a more dangerous person who’s at large and not receiving treatment. The argument for telling is easy. Anything can trigger the duty to warn. The question is, do you really want to, given that you’re going to lose this person. And I ran it by my experts.”

Those included three practicing psychiatrists, including one treating prison inmates, to create what the author deemed “a consensus” for her novel. The author prides herself on her research, which turned up an interesting detail that wound up being a major plot device. (Non-spoiler alert!) It’s a classic case of macro serving micro: in the book, a Big Pharma drug maker is suspected of cutting corners in order to push a new, expensive cardiac drug to hospitals (the author goes so far as to detail the enormous expense of a single regimen of the new drug.)

Cue second boomerang. In 2014, the Connecticut AG initiated a probe into price spikes for a cardiac drug called digoxin, manufactured by American drug makers Impax Laboratories and Lannett Co., Inc., as well as a Swiss company, Covis Pharmaceuticals.[2] The price tag for digoxin, a generic drug used to treat patients with irregular heart rhythm, had tripled between 2013 and 2014, with wild price spikes shooting from $50 to $1000 for a single regimen.[3] Shortly after the state’s investigation began, things went Federal, with the Department of Justice opening its own probes into both companies (which included both antitrust and grand jury subpoeanas).[4] As of March of this year, an unnamed third generic drugmaker was drawn into the Federal probe, which showed no signs of stopping.[5]

It’s been said that life imitates art. Seems like the reverse also holds true, at least where the ducats are concerned.

[1] “Tarasoff reconsidered” by Charles Patrick Ewing, JD, PhD, American Psychological Association vol. 36 #7, July/August 2005.

[2] “Rising heart drug price pulls Impax into Connecticut AG investigation” by Ron Leuty, San Francisco Business Times, July 16, 2014.

[3] “Rapid price increases for some generic drugs catch users by surprise” by Elisabeth Rosenthal, New York Times, July 8, 2014.

[4] “Justice Department probes generic companies after price hike reports” by Ed Silverman, Wall Street Journal, November 10, 2014.

[5] “Update on the DOJ’s criminal investigation into generic pharmaceuticals” by Jeff VanHoorweghe, Jeff Bank, and Brendan Coffman, Wilson Sonsini Goodrich & Rosati alert, March 24, 2015.[/fusion_text]