CONTENTS
- 1. What Is Etomidate?
- - The Ministry of Food and Drug Safety's Narcotics Designation and Strengthened Regulation
- 2. Doctor Who Illegally Administered Etomidate: Four Years' Imprisonment
- - Summary of the Issues
- - The Standards of the Supreme Court's Determination
- - The Structure of the Sentence Reduction
- 3. Key Points for Medical Practitioners' Response Regarding Etomidate
- - If You Need Assistance
1. What Is Etomidate?
Etomidate is an intravenous drug used to induce general anesthesia, originally a medication used in medical procedures such as surgery to rapidly lower a patient's level of consciousness.
However, because of its relatively rapid onset and recovery characteristics, it began to be misused at some medical institutions for the purpose of inducing sleep, which became a social problem.
In particular, it is used in a manner similar to propofol, and its non-medical use increased to the point that it came to be called the "second propofol."
Such misuse is problematic because it carries a high risk of harming patients' health beyond merely deviating from legitimate medical practice, and because it may become subject to criminal punishment when combined with repeated administration and monetary transactions.
The Ministry of Food and Drug Safety's Narcotics Designation and Strengthened Regulation
Etomidate was originally managed as a "drug subject to concerns over misuse and abuse," but as cases of illegal administration continued to occur, the need for regulation was raised.
Accordingly, the Ministry of Food and Drug Safety designated etomidate as a psychotropic drug, incorporating it into the framework of the Narcotics Control Act.
This means that the entire process, from importation to distribution and administration, was converted into a structure controlled by the State.
In particular, once it was designated as a controlled narcotic, a reporting obligation was imposed on every stage of handling, and the government became able to monitor usage in real time, establishing a basis for the early detection of abnormal administration or misuse.
This strengthened regulation is regarded as a preemptive response to the increase in cases of etomidate being used illegally as a substitute for propofol.
2. Doctor Who Illegally Administered Etomidate: Four Years' Imprisonment
A doctor in Seoul who illegally administered etomidate to patients recently received a final sentence of four years' imprisonment.
The doctor, who operated an internal medicine clinic in Gangnam, Seoul, was indicted on charges of administering etomidate to 75 patients a total of more than 5,000 times from 2019 to 2024 and earning profits of approximately 1.2 billion won.
In the course of this, at the patients' request, a method of having a nurse aide inject the drug was used, which was at issue as a violation of the Medical Service Act, along with violations of the Pharmaceutical Affairs Act and the Act on Control of Public Health Crimes.
This case came to light when the police obtained the clinic's CCTV footage while investigating another case, and the footage confirmed scenes of etomidate being repeatedly administered to numerous patients.
Summary of the Issues
In this case, the following legal issues, along with the question of whether the administration was illegal, were treated as central.
• The unlawfulness of repeatedly administering etomidate for purposes such as inducing sleep
• Whether administration through a nurse aide violated the Medical Service Act
• Whether the CCTV footage obtained during the search and seizure was admissible as evidence
• The scope of criminal liability depending on whether illegally obtained evidence was excluded
The Standards of the Supreme Court's Determination
The Supreme Court upheld the judgment of the second instance as it stood and confirmed the sentence of four years' imprisonment.
Repeated and Profit-Driven Administration Is Illegal
The Supreme Court found that repeatedly administering etomidate for convenience-oriented purposes, such as inducing sleep rather than for treatment, and thereby earning profits cannot be regarded as legitimate medical practice.
In particular, the fact that the administration was carried out through auxiliary personnel who were not medical practitioners also served as a factor reinforcing the unlawfulness.
Application of the Exclusionary Rule for Illegally Obtained Evidence
The most important determination in this case concerns the admissibility of evidence.
The investigative authorities additionally reviewed CCTV footage unrelated to the existing warrant, and the court regarded this as an unlawful investigation.
The Supreme Court set out the following standards.
• When information unrelated to the purpose of the warrant is discovered, the additional search must be stopped
• Continuing to review without a separate warrant is unlawful
• Illegally obtained evidence cannot be admitted as evidence
Accordingly, some of the CCTV footage and the facts of administration based on it were excluded from the evidence, and that portion was found not guilty.
The Structure of the Sentence Reduction
In the first instance, a sentence of six years' imprisonment was imposed; however, in the second instance, as the illegally obtained evidence was excluded and some of the criminal facts were not recognized, the sentence was reduced to four years' imprisonment.
The Supreme Court likewise found this determination to be proper and dismissed the final appeal.
3. Key Points for Medical Practitioners' Response Regarding Etomidate
Taking together this case and the trend of strengthened regulation regarding etomidate, one can see that the purpose and method of administration, along with its repetitiveness, serve as key criteria for the determination.
First, administration for convenience-oriented purposes, such as inducing sleep rather than for treatment, is difficult to recognize as a medical practice, and the likelihood of criminal punishment increases significantly, particularly when it is carried out repeatedly and accompanied by monetary consideration.
In addition, where a medical practitioner does not perform the procedure directly but entrusts administration to auxiliary personnel such as a nurse aide, a violation of the Medical Service Act may additionally be at issue, so caution is required.
Meanwhile, in criminal cases, not only the unlawful act itself but also the lawfulness of the evidence-collection process serves as a very important variable.
Indeed, in this case as well, the unlawfulness of the search-and-seizure procedure was recognized, some evidence was excluded, and this led to a reduction of the sentence.
If You Need Assistance
Accordingly, in cases involving drugs subject to strengthened regulation, such as etomidate, a review of the method of securing evidence, the strategy for responding to the investigation, and the legal issues must be carried out together from the earliest stage, and missing the appropriate time to respond can lead to an unfavorable outcome.
In particular, after designation as a controlled narcotic, even violations of management and reporting obligations may be at issue, so medical institutions and related personnel need to thoroughly comply with the legal standards governing the entire process of handling the drug.
Daeryun Law Firm LLP has numerous attorneys experienced in medical matters and in narcotics matters, through whom it provides professional and systematic legal support across the entire process, from assessing the lawfulness of medical practitioners' treatment to legal issues related to narcotics control, response to investigations, and criminal defense.
If you are in a situation where related assistance is needed, you are welcome at any time to 🔗Schedule a Legal Consultation With an Attorney Experienced in Medical Matters to entrust your case to us.
