Utah physician Ina Amber called 911 at 2:16 a.m. Her husband, she told dispatchers, was dead.

Next to Rustin James Orr’s body, Cottonwood Heights officers found a bottle of Gatorade mixed with vodka, along with pill bottles. A 30-pack of beer — 14 cans still left in the box — was on the floor near the recliner where Orr had died.

Amber told police on that September morning in 2014 that her husband of nearly 20 years had been drinking a fifth of vodka each day, along with some beer.

A medical examiner would later find that Orr’s blood alcohol level at his death was 0.32. But it wasn’t the liquor alone that killed the lifelong alcoholic at the age of 54, authorities say.

It was a combination of alcohol and Librium — a drug intended for short-term use by alcoholics to lessen the more severe symptoms of detoxing.

And he got the Librium from his wife, an infectious disease specialist.

Now, Salt Lake County prosecutors have charged Amber with second-degree felony manslaughter, alleging she was reckless. They argue that as a doctor, she should have known her husband couldn’t take the detox drug, while he continued to drink.

She is also charged with aggravated abuse of a vulnerable adult, a felony. If convicted of either crime, she could spend up to 15 years in prison.

Her attorneys, however, say Amber is a victim herself — for years, she was the subject of her husband’s verbal and physical abuse that often escalated when he drank. She did her best and shouldn’t now be facing charges for his death, they say.

Amber is expected to enter a plea to the charges Monday.

‘A 25-year relationship of lies and manipulation’

She first met her future husband while skiing in 1990. She was 38 years old, Orr eight years her junior.

He was tall — she barely came to his shoulder — with sandy blond hair and blue eyes. He was charming and witty. He told her he had a college degree, and worked as a professional ski coach, specializing in teaching women. He often guided wealthy families around Utah’s resorts, he said.

Amber, who had recently divorced, was smitten.

But she would later learn that nothing Orr told her during their first encounter was true, according to an expert report provided to The Salt Lake Tribune by Amber’s defense team.

“Thus, began a 25-year relationship of lies and manipulation,” wrote forensic psychologist Mindy Mechanic, “as well as physical, psychological and emotional abuse.”

The couple married in 1996.

(Photo courtesy of Brown, Bradshaw & Moffat law firm) James Orr and Ina Amber in 1998.

Amber would later describe Orr as a “Dr. Jekyll/Mr. Hyde”-type person, Mechanic wrote in her report.

When sober, he was charming. But when he drank, Orr became angry and sometimes violent.

He would yell at his wife, friends testified at a May preliminary hearing, hurling insults and calling her names if she would not give him alcohol. He often left the house while intoxicated to find more booze.

There was a time in 2013 when Orr became so enraged after Amber poured alcohol down the drain that she locked him in their basement because she was worried for her safety. He broke through the door, came upstairs and yelled at her through a locked door that he had an ax “and she better watch it,” a Cottonwood Heights police officer wrote in a report.

“He also told her it was her responsibility to supply him with alcohol,” the officer wrote.

A year later, the police were called again. This time, Orr threatened a family friend with a loaded shotgun after she would not help him find the alcohol he believed his wife had hidden.

(Photo courtesy of Brown, Bradshaw & Moffat law firm) Cottonwood Heights police took this photo of a shotgun that James Orr allegedly used to threaten a family friend in 2014.

“He wanted what he wanted and he was going to get it,” testified Barbara Sukkari, an employee of Amber’s who often cared for Orr. “[He was] worse than a child with a tantrum.”

Orr also insisted that his wife be his primary healthcare provider, according to the defense expert report. He wouldn’t let Amber buy him health insurance, the report reads, believing it would “jinx” him and trigger health problems.

Orr tried to get sober on many occasions, and, over the years, Amber estimated that she spent tens of thousands of dollars for inpatient care for her husband.

Sukkari testified that when Orr went through withdrawals on those times when he stopped drinking, he was often angry.

His hands would shake so severely, Amber later told police, that he couldn’t put the Librium pills in his mouth. She would do it for him — but the physician insisted to police that she never gave him both alcohol and Librium at the same time. (Prosecutors allege she did mix alcohol and the pills together.)

But the treatment was never successful.

Orr always went back to alcohol or drug use.

His final days

In the months before Orr’s death, a friend he had met at Alcoholics Anonymous meetings frequently visited him.

Lex Madsen testified at Amber’s preliminary hearing that he was concerned for his friend, and wanted to make sure Orr was sober enough to attend court hearings after he was charged for making threats with the shotgun.

Madsen noticed Orr was frequently in a near-comatose state and couldn’t walk. He recorded several cellphone videos.

One video shows Orr lying in a recliner in early June 2014, his eyes squinting as he says he has been given too much medication. A bottle of orange Gatorade mixed with vodka is within arms’ reach.

“Too much medicine?” Madsen asks.

“Way too much,” Orr murmurs.

“It’ll kill you,” the friend says.

“I don’t think it’s going to kill me,” Orr responds, his voice low and gravelly. “All I’m saying is Ina is giving me too goddamn much.”

In a later recording, his friend suggests he take less of the medication, perhaps only a single pill if his wife offers two.

“If I don’t take it, I will drink,” Orr says. “And drinking is way worse than those damn pills.”

Amber’s defense team believe Orr was lying to his friend about taking the pills to hide the fact that he was drinking alcohol. Prosecutors say Orr was taking Librium and drinking alcohol simultaneously.

(Photo courtesy of Brown, Bradshaw & Moffat law firm) Rustin James Orr in 2014.

During those final months, Amber had hired someone to stay with Orr during the day, to make sure he was eating and to be a companion for him.

That caregiver, Kimberlie Rock, testified that Orr would spend the day drinking a mix of vodka and Gatorade and a few beers. Amber controlled how much he was allowed to drink, Rock testified, but there were some days when Orr was “persistent” and his wife would allow him to have another can of beer.

Orr spent much of his final days lying down, watching the History Channel, Rock said. He was too intoxicated to walk, and he’d often stumble or crawl to the bathroom.

They talked to each other often, Rock said, recalling a conversation she had with Orr just before he died where he told her he regretted becoming an alcoholic.

“He just went on and on about how much he loved and adored Ina for what he’s put her through,” Rock testified, her voice shaking with emotion. “He just kept saying he wants to get sober and he doesn’t know where to start. And I just kept telling him, ‘It’s up to you. We can’t do anything for you.’ ”

He replied that he wanted to get better.

His death

Orr died a few days later on Sept. 11, 2014.

Rock said she was surprised by his death, because the day prior had been so typical. He drank, but he didn’t seem any more or less intoxicated than he normally was.

“It was a shock to me,” she testified.

Utah Chief Medical Examiner Erik Christensen determined Orr’s cause of death was a lethal combination of alcohol and the detox drug Librium. Orr also had underlying heart disease.

The medical examiner testified that he found high levels of Librium metabolite in Orr’s body, which indicated to him that it had probably been “quite some time” since the man had taken the medication. Christensen said it was unlikely that the alcohol alone would have been enough to kill Orr, since he had drank heavily for so much of his life.

But the two combined, Christensen said, could have caused Orr to become dizzy, disoriented and sedated. He would have likely had trouble breathing before his death.

Once a victim, now accused

An expert hired by prosecutors testified at Amber’s preliminary hearing that it’s common knowledge among physicians that alcohol and Librium should never be mixed.

“All physicians are taught that central nervous depressants can have additive effects,” psychiatrist Michael Crookston testified. “I can’t imagine a physician not being aware of the fact that mixing those two are dangerous.”

Crookston testified he believed Amber’s treatment of her husband was “medically reckless.” She shouldn’t be writing prescriptions for her husband, he said, and she should not have given Librium to someone who was still drinking. And, she should have sought other medical help when it became clear her treatment plan wasn’t working, he said.

Prosecutors filed criminal charges more than a year after her husband’s death. Deputy Salt Lake County District Attorney Robert Parrish told The Tribune officials believe Amber’s home treatment contributed to her husband’s death. She is also charged with aggravated abuse of a vulnerable adult — a charge that Parrish said stems from Amber allegedly giving Orr both alcohol and Librium together, which “put him in a kind of comatose state at times.”

Amber’s defense attorneys, Mark Moffat and James Bradshaw, say their client’s decisions through the years to write him prescriptions or give him alcohol were because of Orr’s manipulation and threats of violence.

“She was the victim,” Bradshaw said, “not the perpetrator.”

Parrish called the defense team’s claims of domestic violence “overblown.” Even the Cottonwood Heights police reports detailing Orr’s violent outbursts don’t contain the whole story, the prosecutor said. He declined to provide any further detail.

“We think we know what the situation was,” he said, adding that Orr “certainly didn’t present any risk to anybody” during the final weeks of his life.

That decision may soon rest with a judge and jury.