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About Us

Who We Are
Concerned pain physicians, other physicians, and midlevels engaged in the treatment of chronic pain.
What We Do
Develop standards for ethical behavior of both patients and physicians in the realm of pain, and provide single website source
The Board is composed of pain physicians practicing more than 50% full time pain but cannot serve more than 2 years as chair.
Where We Are Going
Working to define pain regulation preemptively, malpractice/substance abuse patient accountability and research facilitation
Contact Us
Email: algosdoc1@yahoo.com Telephone: APM 812-342-8300

Hot Button

CRNAs = MD Pain Docs

Nov 2, 2012 In an unprecidented diminishment in quality of care, the CMS in one fell swoop has elevated the entire CRNA profession to that of BC fellowship trained physicians for the sake of "patient access".


Doctors in Trouble

Doctors Charged or Convicted of Drug Crimes.... Because of the increasing numbers of physicians charged with crimes associated with the practice of pain medicine, this article is continually updated with newspaper articles and investigative reports nationwide regarding this growing issue.


IN Supreme Court

Victory for Physicians over Trial Lawyers in Plank Case: Battle is Won But the War Is Not Over In January 2013, the Supreme Court ruled unanimously that the statute of limitations to file a challenge to the constitutionality of the Indiana...


Meningitis Outbreak

INDIANA PAIN SOCIETY PRESS RELEASE 11/1/12 QUESTIONS ABOUT EPIDURAL STEROID INJECTIONS Recently Indiana became one of the many states involved in a large-scale series of meningitis infections occurring due to epidural steroid injections using contaminated vials of methylprednisolone acetate obtained from...


Opting Out/Disenroll




Department of Veterans Affairs Issues Interim Final Rule on Providing Information to PDMPs In what will be viewed as welcome news, The Department of Veterans Affairs today issued interim final rules allowing the sharing of prescription information...


Medical Malpractice:  Intrinsic Factors and Outcomes-  A US Systemic Analysis of Risk

MLWhitworth, MD    April 2011 

Medical malpractice litigation rates and paid claims rates are evaluated in this Indiana Pain Society research paper.  There are significant variations in the dollar value paid per state, number of claims filed, number of claims paid, and the overall payouts for malpractice per state.  Although medical malpractice claims represent only a small fraction of the tort claims filed each year in the US, they create significant consternation for the involved physician, cost an average of $22,000 to defend without a trial, and $100,000 to go to trial.  Only about 1:10 significant physician errors result in medical malpractice claims, ostensibly because at least some of the population believe in the concept of personal responsibility for risk when given informed consent.  Plaintiff's lawyers would like to see a much higher rate of litigation and actively encourage this through billboard advertising and TV advertising, however these are product liability advertisements primarily.  In the realm of physician litigation, there is rarely any mass litigation however when it does occur, as in the case of Marc Weinberger, an Indiana ENT surgeon accused of malpractice who then left the country and disappeared, the litigation lawyers descended in mass at this appearance of impropriety, and the Indiana tort system has been jammed for years with over 300 claims against this one physician.  There are several intrinsic factors that are present within state laws that affect the medical malpractice climate and payouts of awards.  Both these factors are analyzed and discussed in this paper, and a malpractice model with ranking of relative intrinsic risk of litigation state by state.  

Nationwide, malpractice litigation risk depends on several issues according to the Pacific Institute, a think tank that creates data driven reports on various subjects.  The US Tort Liability Index 2010 is their latest foray into the arena of tort law with specific discussions on the effects of various state laws on medical malpractice and what drives up litigation/payment costs.  This report, that evaluates all tort law claims through intrinsic factors (input) and output (payments) is quoted extensively below.  US Tort Liability Index 2010 evaluates some 42 intrinsic variables that affect tort law.  In our report, the variables were reduced to the 12 that most affect medical malpractice (given that many of the 42 variables in the Liability Index focus on general tort law).  Specifically, the following factors affect medical malpractice litigation rates and award rates:

1.  Caps on non-economic-damage awards in medical-malpractice lawsuits. There are significant variations in the state by state non-economic caps in medical malpractice litigation.  This variable tracks whether a state has limits on non-economic-damage awards in medical-malpractice lawsuits, or has increased the negligence standard required to find medical providers responsible for malpractice.  For instance, North Dakota has a $500,000 limit. West Virginia has a limit that can vary from $250,000 to $500,000 depending on the severity of the injuries. Utah’s limit is adjusted for inflation.  It was also found that limits on medical-malpractice damages lessen liability pressures on physicians and lead to reduced medical expenditures as reported by Daniel P. Kessler and Mark McClellan, who found that direct malpractice reforms limiting the amount of awards reduce reliance on defensive medicine procedures such as ordering unnecessary tests or referrals.  These reforms led to a reduction of 5 to 9 percent in medical expenditures without significant negative effects on mortality or increased medical complications. Limits on damage awards are the most direct way to reduce medical-malpractice awards. Additionally, damage-award caps also lower premiums for medical-malpractice insurance. In a study by Meredith L. Kilgore, Michael A. Morrisey, and Leonard J. Nelson, the effect of new state damage caps on physician malpractice-insurance premiums from 1991 through 2004 found that a new damage cap reduced malpractice premiums for internal medicine, general surgery, and obstetrics/gynecology by 17.3 percent, 20.7 percent, and 25.5 percent, respectively. Lowering damage caps by $100,000 reduced premiums by 4 percent. Punitive damages are contrary to tort law, which is intended to compensate, not punish however plaintiff lawyer groups continue to push for elimination of damage caps.  In Indiana in 2012, arguments have been slated to be heard before the state Supreme Court to eliminate the damage caps present since 1975.  State laws limiting malpractice awards also affect where physicians decide to practice medicine. An analysis by Fred J. Hellinger and William E. Encinosa, conducted for the U.S. Department of Health and Human Services, found that states with malpractice damage caps had about 12 percent more physicians per capita than states without damage caps.  By comparison, in 1970, before the implementation of any state malpractice caps, the supply of doctors per capita across states was indistinguishable.  Of states with malpractice caps, those with lower dollar limits had a greater supply of physicians.

2.  Caps on punitive-damage awards in medical malpractice lawsuits.  Some states have limits on punitive-damage awards in medical-malpractice lawsuits. Washington State does not allow punitive-damage awards contrasted to Alaska that limits the award to $500,000 or three times compensatory damages.  Delaware, on the other hand, has no limits on punitive awards, but permits punitive damage awards only when there was malicious intent to injure or willful or the commission of wanton misconduct.  Caps on punitive awards reduce excessive awards, thus lowering insurance losses and premium rates as was demonstrated in a report by Albert Yoon, who found that such caps reduced the average medical-malpractice recovery by $20,000 in Alabama.  Yoon showed that when the Alabama Supreme Court ruled caps unconstitutional and removed them, average plaintiff awards approximately doubled.  Another study, by Kenneth E. Thorpe, showed that punitive-damage caps lower physicians’ insurance premiums.  Thorpe found that insurance premiums in states that capped awards were more than percent lower than in states with no caps. Punitive-award caps lower medical-liability premiums.

3. Does the state generally use a contributory,comparative, or modified-comparative standard for negligence? This variable tracks each state’s negligence standard for recovery of damages in civil-liability cases but may be germain to discussions about medical malpractice. Negligence standards fall into four categories: pure contributory negligence, pure comparative fault, modified comparative fault at 50 percent, and modified comparative fault at 51 percent. Pure contributory negligence prevents the recovery of any damages if the plaintiff is in any degree at fault. Four states use this standard. Pure comparative fault allows a plaintiff to recover an award that is reduced by the percentage of his fault. If he is 25 percent at fault, the award is reduced by a quarter. Modified comparative fault prevents the recovery of damages if the plaintiff is at fault above a certain percentage, but allows a proportionally reduced award when his fault is below that threshold. If the threshold is 50 percent, a plaintiff cannot recover damages if he is 50 percent or more at fault.  If he is less than 50 percent at fault, he can recover, although recovery is reduced by his degree of fault. Iowa, for example, bars the recovery of damages when the plaintiff is 51 percent or more at fault, but allows a reduced award when fault is less than 51 percent.   States with a comparative-negligence standard have larger legal payouts than states with alternative standards. Daniel P. Kessler found that settlement amounts in states applying comparative negligence exceeded those in states applying contributory negligence.  He concluded: “This is consistent with conventional wisdom about comparative negligence: it compensates a wider variety of claimants, and it compensates them more generously than contributory negligence.” Stuart Low and Janet Kiholm Smith looked at 9,610 auto-injury accident claims and found that a comparative-negligence standard provides stronger incentives to hire an attorney and file a lawsuit, and is associated with higher dollar awards. The joint probability of representation and filing is 12.5 percent in contributory-negligence states but 21.2 percent in comparative-negligence states. States with a comparative-negligence standard have larger legal payouts than states with alternative standards. Alternatives to a pure comparative-negligence standard, especially a contributory-negligence standard,  reduce the number of attorneys hired and lawsuits filed, the amounts of damages awarded, and settlement amounts agreed to by both parties.

4.  Rules on joint and several liability.   Joint and several liability allows a plaintiff to recover all damages from any one defendant in a multiple-defendant lawsuit regardless of that particular defendant’s proportion of fault. For example, under a so-called 1 percent rule, a co-defendant found to be only 1 percent at fault could be stuck paying 100 percent of the plaintiff ’s damages. This is particularly important in deep pocket arguments in medical malpractice cases.  The apportionment of blame lies with the jury in some cases, or in others, one defendant may be completely dismissed from a claim even though the defendent was clearly at fault in order to have the defendant testify against the other parties in the claim.  Frequently the application of this rule leads to the plaintiff's lawyer naming everyone involved with the case, and in Indiana has extended to naming people on a call schedule that were not at all involved in the patients care.  This stacking the deck with as many defendents as possible in order to recover joint liability is a travesty.  Reforms either limit or bar application of the rule of joint and several liability, and generally define liability according to share of responsibility.  This is called proportional liability.  Florida, for example, abolished joint and several liability in 2006.  As of 2012,  46 states have retained joint and several liability with only four enacting reforms.  

5. Rules on early offers of settlement.  Most states have adopted a variation of Federal Rule 68, stating that if a defendant offers a plaintiff a pretrial settlement but the offer is rejected, and the plaintiff does not subsequently win a trial judgment greater in value than the offer, the plaintiff must pay trial costs accrued since the offer, minus attorney fees. This has the effect of lowering medical malpractice costs through penalizing plaintiffs that do not accept an offer to settle, but decide to proceed to trial, and effectively gain less than would be acquired via the offered settlement.  Other states have variations of Rule 68 that include in the penalty the payment of attorney fees and/or make the provisions applicable to both the defendant and the plaintiff. Some states, such as New Jersey, include provisions that allow for interest to accumulate on offers rejected by a defendant when the trial judgment is either equal to or greater than the settlement offer, starting from the date the offer was made. These arrangements such in Federal Rule 68 encourage pretrial settlements, saving all parties the costs associated with going to trial. An analysis by Kathryn E. Spier noted that “broadening the definition of costs to include attorneys’ fees and extending the rules to offers made by either litigant will increase their effectiveness in encouraging settlement.”   These settlements result in lower litigation costs and, as a result, lower liability-insurance rates. They also save taxpayers money that would otherwise be spent on court administration costs.

6. Jury-service rules.  To help resolve the problem of losing representative juries, some states have adopted rules addressing ignored jury summonses, the financial imposition on jurors, and increased administrative costs. Colorado’s jury-service rules set stricter criteria for excusal from jury service and provide protections for small businesses that might suffer financially from a temporary loss of employees. Maryland increased juror compensation from $15 to $50 per day after the fifth day of service in order to reduce the number of residents who ignore jury summonses. Changing the rules of jury service to increase participation strengthens the constitutionally protected right to a representative jury of one’s peers.  Harry F. Mooney argued that removing exclusions from jury service creates socially diverse and representative juries that are fair and desirable for defendants. Such juries, in turn, lend additional credibility to the jury verdicts rendered. The financial impact of this is unclear since attorneys have the ability to strike potential jurors via a process called preemptory challenge.  It is extremely unlikely a plaintiff attorney would allow any physician to serve on a medical malpractice jury, and it is also very uncommon to permit nurses to serve in a similar capacity.  Therefore the financial implications of having a socially and representative jury is frequently torpedoed via preemptory challenges by attorneys that absolutely do not want a physician with education in the medical field to influence the remainder of the jury, and effectively define the standard of care.  However, requiring jury service for all and making it extremely difficult to be excused from jury duty at least populates the pool with a number of educated individuals which may overwhelm the ability of plaintiff's attorneys to stack the deck with preemptory challenges. 

7.  Medical malpractice: Attorney-fee limits. This variable tracks whether a state limits attorney fees in medical-malpractice cases. States use a variety of methods to regulate attorney fees. New York, for example, uses a sliding scale: 30 percent is allowed for the first $250,000 of an award; 25 percent for the second $250,000; 20 percent for the following $500,000; 15 percent for the subsequent $250,000; and 10 percent above $1.25 million. Washington courts, on the other hand, must approve attorney fees for each party based on their perceived reasonableness.  
Daniel Kessler concludes "A state’s regulation of attorney fees in medical-malpractice lawsuits increases the supply of physicians in that state." He found  the adoption of tort reforms, including attorney-fee limits, increased the supply of physicians by 3.3 percent after three years, controlling for other factors.  Indiana has a set limit of attorney fees of 15% of patient compensation fund payments.  This has the effect of making the litigation a shared risk and not a windfall profit for attorneys.  
 The researchers also noted that the reforms had a greater effect on retirements and entries than on movement between states. More physicians enter the job market and remain in practice longer after adoption of tort reforms such as attorney-fee limits. This benefits patients by retaining high quality physicians that seek out a low litigation state defined by tort reform. 

8.  Medical malpractice: Pre-trial screening or arbitration.  Some states require pre-trial screening or arbitration for medical-malpractice lawsuits. Pre-trial screenings are preliminary hearings to determine the validity of a case whereas arbitration is an alternative to trial that relies on an impartial third party for resolution. Both methods of dispute resolution are intended to reduce a state’s medical-malpractice caseload and also place extra screenings for case validity prior to litigation in a court.  Indiana and Nebraska accomplish these goals by mandating a review of malpractice claims by a medical-review panel before the case may proceed to trial. Oregon, on the other hand, requires all parties to participate in dispute resolution within 270 days
from when the action is filed, unless the case has already been settled or all parties voluntarily waive mediation or arbitration. Pre-trial screening and arbitration reduce the number of meritless cases that clutter courthouses. Pretrial screening allows a panel of medical professionals to determine the validity of a malpractice claim, instead of passing that burden to jurors who might lack necessary medical knowledge. A report by Claudia E. Lavenant et al. found that pre-trial screening cut the number of physicians who received medical-malpractice sanctions by filtering out cases in which injuries were not caused by physician negligence.  Albert Yoon found that screening panels in Nevada have reduced the percentage of medical-malpractice claims that go to trial. However, to balance the effect of this additional step, anyone can sue a physician without an attorney for $5 and filling out an on-line form.  This suit generally must go through the medical malpractice panel, but if the plaintiff does not ask for one or does not provide information to the panel about the specifics of the case, then the suit (considered litigation) remains on the physicians public record for many years, requiring a court order and attorney fees paid by the physician to have their name cleared.  This permutation of the system actually encourages the filing of frivolous lawsuits, but the medical panel stops most of these from progressing.  If the medical panel decides for the plaintiff, there is a 2/3 chance of successful litigation but if the medical panel decides for the defendant, there is only a 5% chance of prevailing in court in Indiana. 
 Like pre-trial screening, arbitration keeps a number of malpractice cases out of courtrooms; in addition, arbitration can lead to settlements that are agreeable to all parties.

9.  Are state-supreme-court justices appointed or elected?  Some state’s supreme-court justices are appointed while others are elected. In Arizona, the governor appoints supreme court justices, who must subsequently seek the voters’ confirmation in retention elections. Rhode Island justices are nominated by the governor and must be confirmed by both the state House and
the state Senate. And in Nevada, there are statewide nonpartisan elections for state-supreme-court justices. Other methods include merit selection by committee, legislative appointment, and partisan elections by district. Whether a state appoints or elects its supreme-court justices is significant because litigation awards tend to be larger in states where judges are elected, especially if they are elected in partisan elections. Put another way, the appointment of justices is associated with lower awards and a more business-friendly climate. Alexander Tabarrok and Eric Helland found that awards are larger in states with an elected judiciary. The researchers argued that this result is driven by the need for elected judges to buy votes—which they do by redistributing money from out-of-state defendants (nonvoters) to instate plaintiffs (voters)—and to satisfy trial lawyers, many of whom not only vote but also fund judges’ election campaigns. Perhaps Richard Neely, a retired West Virginia Supreme Court judge, said it best in a moment of extreme candor:As long as I am allowed to redistribute wealth from out-of-state companies to injured in-state plaintiffs, I shall continue to do so. Not only is my sleep enhanced when I give someone’s else money away, but so is my job security, because the in-state plaintiffs, their families, and their friends will reelect me. . . . It should be obvious that the instate local plaintiff, his witnesses, and his friends, can all vote for the judge, while the out-of-state defendant can’t even be relied upon to send a campaign donation. In the case of medical malpractice cases, this effect is obviously less since the physician businesses are in-state, but with increasing ownership of physician practices by hospitals that may be part of national corporations, the litigation against physicians may be levied in effect against out of state concerns. 
In addition, different supreme-court selection methods are associated with differences in judicial quality. Russell S. Sobel and Joshua C. Hall found that states that select judges through appointment have better average rankings in measures of judicial quality than those that elect judges, primarily because of the partisan nature of elections. The researchers found that differences in party control of the judiciary in states that elect judges are associated with differences in outcomes generally considered to be related to judicial quality, including use of eminent domain. These findings reinforce the conclusion that judicial quality is enhanced when states use a non-partisan appointment method of judicial  When judges act as politicians in robes, the civil-justice system is further eroded.  Some evidence suggests, however, that state-court litigation rates are higher where judges are appointed—up to 40 percent more cases litigated than in the average elected court.  Insulating judges from political influence, therefore, could come at the price of more litigation but bring fairer outcomes.  Finally, supreme court judges and appellate court judges do not simply interpret the constitutionality of the law:  they create law through precident.  The effect of appointed judges tends to make a more stable set of created precidents than elected officials that may only be in office for a few years.  The hodgepodge of laws created through elected supreme court justices judicial activism at the state level lends itself to more radical interpretations of law by lower courts and potentially leading to higher awards and more constraints on defendant protections. 

10. What is the standard for scientific review of evidence by expert witnesses?  States fall into one of four general categories: those that have adopted Daubert v. Merrell Dow Pharmaceuticals(509 U.S. 579, 1993), those that use a modified version of Daubert, those that use Frye v. United States (293 F. 1013, D.C. Cir. 1923), and those that use an alternative state standard. California is one of the states that use the Frye standard, which holds that new scientific evidence is permissible in court if the method has gained “general acceptance” in the relevant field. Mississippi, on the other hand, has adopted the stricter Daubert standard, which requires that expert testimony reflect a method that is not only generally accepted, but also supported by “good grounds.”  Awards in California’s more favorable counties average $3 million more than in less favorable counties. Daubert raises the bar for expert review of evidence and testimony, and it reduces the influence of interest groups on the content of testimony. Jeffrey S. Parker elaborated on these effects, arguing that Daubert is more economically efficient than alternative standards. In addition, Parker found that proposals that allow for more judicial supervision or impose external constraints are both “unnecessary” and “socially undesirable.” There is also evidence that Daubert is a “gun that kicks as hard as it shoots.” Brian Beckcom notes that he and other plaintiffs’ lawyers have successfully used Daubert to disqualify scientific expert witnesses called by defendants. Both defendants and plaintiffs are relying on Daubert, and the end result is a fairer and more science-based civil-justice system that works better for both parties. For these reasons, Daubert is the preferred, stricter standard for scientific review of evidence by expert witnesses.

11.  Conditions on the use of expert witnesses in medical-malpractice lawsuits.  Expert-witness rules vary in strictness from state to state. Minnesota, for example, requires
that medical-malpractice claimants sign an affidavit whenever an expert has been consulted. Michigan, on the other hand, requires that expert witnesses be licensed and board-certified in
a specialty similar to that of the defendant, be in active practice, or have been engaged in teaching medicine during the year
preceding the action. Rules governing the use of expert witnesses in medical-malpractice cases increase the likelihood that fair decisions will be rendered. This is because, under these
rules, courts are forced to require that testimony be based on accepted professional opinion, rather than novel approaches. Walter K. Olson, in an article for Fortune, noted that judges are often expected instinctually to validate expert testimony on their own, but he argued that this should not be the case, as judges often lack sufficient medical knowledge to do so.  Olson also showed that the sale of expert witnesses is big business, as certain firms specialize in maximizing jury awards through expert-witness testimony. There are several internet sites where plaintiff lawyers may find lists of expert witnesses in various fields.  Many of these are physicians in or near retirement or are on university faculty attempting to supplement their income through doing expert witness testimony.  Unfortunately, these are simply guns for hire, and often will adopt positions that are contrary to accepted scientific standards, and frequently testify about medical issues with which they have no personal knowledge, experience, or recent experience.  Tough validation criteria disallow expert views outside the mainstream and keep defendants accountable to accepted medical standards in their field.
12. Statute of limitations on medical-malpractice lawsuits   Indiana, for example, sets its medical-malpractice statute of limitations at two years from the alleged harmful act, omission, or neglect. Kentucky sets its statute of limitations at one year from the alleged act or reasonable discovery, but no more than five years after the act. 
A reasonable statute of limitations lowers litigation rates while ensuring that cases are tried when actions and incidents are more easily recalled and causation is more apparent. As the time lengthens between when the alleged injury, or discovery, took place and when the claim or lawsuit is brought, a fair trial becomes more difficult, as witnesses move away, get sick, or die; documents are lost; and memories fade.  Such limitations ultimately reduce medical-malpractice litigation by eliminating older cases, thus lowering legal costs for physicians. David M. Studdert et al. also found that such limitations cut medical costs. Looking at Pennsylvania physicians, the researchers found that the practice of defensive medicine was highly prevalent among doctors who paid the most for liability insurance. Nearly all the doctors the researchers asked admitted to avoiding certain procedures and patients perceived to have higher litigation rates in order to reduce their insurance costs. By restricting eligible cases, limitations reduce legal and insurance expenses and reduce the need for costly defensive medicine.

13. Size of juries in general-jurisdiction courts multiplied by the percentage of jurors needed to reach a verdict.  Alabama civil trials require a unanimous decision by 12 jurors to reach a verdict. Pennsylvania also mandates juries of 12 people; however, agreement by only 10 jurors is required for a verdict.  Requiring more people to reach a verdict helps guarantee fairer trials for defendants and maintains good faith in court operations. The American Bar Association’s House of Delegates agrees. In February 2005, it adopted a set of principles calling for a return to 12-person juries and unanimous verdicts. Terry Carter, a senior writer for the American Bar Association Journal, argued in favor of these principles in a feature story on jury reforms.  Carter noted that non-unanimous juries often neglect to consider the potentially helpful opinions of some jurors if they have already reached the necessary majority for a verdict.

Indiana Supreme Court Decisions 2006-2012  

M.D. Related 

01/12/12 Keith M. Ramsey, M.D., The Methodist Hospitals, Inc. v. Shella Moore  Effectively the Supreme Court holds the 180 day requirement to submit material to the medial review panel simply doesn't apply even though stated in law, and the trial judge can elect to disregard the law as written by the legislature. 45D04-0903-CT-83
08/10/11 Howard Regional Health System d/b/a Howard Community Hospital, Charles G. Marler, M.D., and Community Family Health Center v. Jacob Z. Gordon b/n/f/ Lisa Gordon The hospital lost some of the records associated with the case prior to turning them over to the plaintiff, and the plaintiff attempted to split off a claim of "spoilation" from the medical malpractice act.  The Supreme Court rejected this argument.  The malpractice case could go ahead without a separate "spoilation" cause of action. 34D02-0609-CT-782

12/18/09 Mercho Roushdi Shoemaker Dilley Thoraco Vascular Corp. v. James W. Blatchford, III, M.D., and Eve G. Cieutat, M.D. The Supreme Court reversed lower court decisions and found non-compete clauses are indeed enforceable.  84D01-9912-CP-1990
11/30/09 Ava McSwane, et al v. Bloomington Hospital and Healthcare System and Jean M. Eelma, M.D. The Supreme Court found that a victim that left a hospital voluntarily with a person that shot her dead, after denying any abuse issues, was negligent for her own care and caused her own death.  53C04-0602-PL-337
06/16/09 Brenda Spar v. Jin S. Cha, M.D.  The Supreme Court ruled the trial court erred in their instructions to the jury regarding "incurred risks" but that informed consent had been adequately provided.  45D10-0402-CT-20
12/09/08 John C. Roberts, M.D. v. Community Hospitals of Indiana, Inc. In this case, a very poorly performing resident doctor was terminated from the residency program and hospital contract.  During the preliminary hearing, the trial judge used an arcane law from 1970 to consolidate all arguments, and make a final judgement.  The supreme court affirmed that this process is permissible under Indiana law.    49D02-0605-CT-022328
11/13/08 Victor Herron v. Anthony A. Anigbo, M.D. The plaintiff fell at home rendering himself quadruplegic, and had emergency surgery for cervical decompression.  Another doctor later alleged the care by the first doctor led to continuing difficulties, but the plaintiff even after this had 4 months remaining to file a medical malpractice claim, yet failed to do so within the 2 year window.  The Supreme court affirmed in a split decision that the trial court was correct in not allowing a claim due to expiration of the statute of limitation time. 45C01-0503-CT-40
04/08/08 Daniel H. Raess, M.D. v. Joseph E. Doescher In this case the Supreme Court established that a surgeon screaming and swearing while advancing towards a perfusionist is assault and this singular event is worth $325,000 in damages.  There was no physical contact.  The Supreme Court concluded the person being assaulted would be considered the victim of assault if the beleived he were to be assaulted physically.  This chilling decision means demonstration of mere anger can be punished with massive dollar fines in Indiana.  49D01-0206-PL-1116
02/21/08 Chi Yun Ho, M.D. v. Loretta M. Frye In this case the trial court refused the motion of the plaintiff for summary judgement , then heard the evidence before a jury that decided in favor of the physician defendant.  The plaintiff filed a motion that there was an error in not responding to the summary judgement request, and the trial court ordered a new trial.  The appellate court reversed the order for a new trial and found for the plaintiff, and ordered payment of damages by the physician, effectively jettisoning the entire trial court's decision.  The Supreme Court ruled no new trial need be conducted, and that the original jury was correct in their decision for the physician.  This represents excessive activism by the appellate court that signifies  incorrect interpretation of law by that court that could be damaging to physicians.  67C01-0210-PL-349
01/15/08 Sandra and Mark Brinkman v. Anne P. Bueter, M.D., James F. Dupler, M.D., and Women's Health Partnership, P.C. The initial lawsuit was filed 5 years after the initial event of preeclampsia and eclampsia during pregnancy, and was as a direct result of allegations of prior substandard care made by Dr Dawn Zimmer, a high risk OB doctor.  The statute of limitations had run out long ago and the Supreme Court affirmed that the plaintiffs did not need to be directly told of malpractice to trigger the 2 year statute of limitations, and that they had the option of seeking a second opinion long before.   29D01-0410-CT-872
09/19/07 Eusebio Kho, M.D. v. Deborah Pennington, et al.  The Supreme Court effectively gave physicians unfairly accused due to the carpet bombing approach of naming individuals in a lawsuit that had nothing to do with there care a cause of action.  The plaintiff bypassed the medical review board process and named specifically Dr Kho as a treating physician that caused the death of the plaintiff, but Dr Kho was simply on call for the ER as a family physician and never saw or gave any care to the decedent.  Dr Kho subsequently countersued for errantly being named in a lawsuit and for the pain and suffering, and embarrassment to his practice.  The Supreme Court affirmed Dr Kho could counter sue for damages. 72C01-0301-CT-4
02/22/06 Marsha Ledbetter v. Robert Hunter, M.D., Lawrence Benken, M.D., and Ball Memorial Hospital The Supreme Court affirmed the constitutionality of the medical malpractice act statute of limitations for minors, and found for the physician, once again overruling the judicial activism of the appellate court that found it unconstitutional. 49D02-9409-CT-384
12/30/05 L. Thomas & Norma Sue Booth v. Robert G. Wiley, M.D., Ronald K. Norlund, O.D., and Midwest Eye Consultants, P.C. The Supreme Court reversed the trial courts summary judgement for the physician defendents and remanded back to the trial court.  They determined there was not sufficient investigation by the trial court as to whether summary judgement should have been granted based on the statute of limitations. 


D.O. Physician Related

11/13/08 Lloyd Overton v. Marshall Grillo, D.O., et al. The statute of limitations had run out before the filing of the lawsuit and the plaintiff knew of the alleged malpractice at least 9 months before the end of that period, yet failed to file during the statuatory time.  The Supreme Court found in favor of the defendent physician.  J. Dickson dissented.64D02-0110-CT-8838


Hospital (Without Physician Named as Principle) Related

12/13/11 Steven Spangler and Heidi Brown v. Barbara Bechtel, Expectations Women's Health and Childbearing Center, and St. Vincent Randolph Hospital 49D03-0306-CT-1120
09/01/10 Suzanne Eads, et al. v. Community Hospitals 45C01-0802-CT-14
08/27/08 Christopher R. Brown, D.D.S., Inc. v. Decatur County Memorial Hospital C-159326
05/02/07 W. Ruth Mullins and Johnce Mullins, Jr. v. Parkview Hospital, Inc., et al 02D01-0212-CT-508


Appellate Court Decisions 2008-2012

M.D Related

03/15/12 Irmina Gradus-Pizlo, M.D., and Select Specialty Hospital Indianapolis, Inc. v. Donald Acton 49D04-1004-CT-19137
02/29/12 Thomas Pine, Individually and as Admin. for the Estate of Helen Pine, Deceased v. Stirling Clinic, Inc., Albert C. Lee, M.D., and Indiana Neurology Specialty Care (NFP) 49D03-0712-CT-52890
02/22/12 Chuck W. Adams v. Mauro Chavez, M.D., Prison Health Services, Gil Kaufman, Craig Underwood, Dean Reiger (NFP) 49D13-1005-CT-22119
2/30/11 Mary Alice Manley and Gary Manley v. Ryan J. Sherer, M.D., and Sherer Family Medicine 59C01-1007-PL-320
12/20/11 Derrick D. Jeter, M.D. v. Medical Licensing Board of Indiana (NFP) 49D02-1007-MI-32536
12/15/11 Theresa L. Trensey and Louis L. Roth, Sr. v. Garland D. Anderson, M.D., Parkview Medical Group, and Unnamed Hospital, Inc. d/b/a Unnamed Hospital (NFP) 02D01-0907-CT-281
12/07/11 Ivelisse Martinez v. Jung I. Park, M.D., and St. Margaret Mercy Healthcare Centers, Inc. 45D11-0612-CT-222
12/02/11 Dr. Kurt Kessler, M.D. v. Memorial Hospital and Health Care Center, a/k/a Little Company or Mary Hospital of Indiana, Inc., and Dr. Joseph Munning, M.D. (NFP) 51C01-0807-PL-308
11/29/11 Natalie A. Miller, Individually and as Administratrix of the Estate of Alexis J. Ritch; and Daniel J. Ritch v. L. Barrett Bernard, M.D., the Bethany Circle of King's Daughters Hospital & Health, et al 39C01-0304-PL-182
11/02/11 Janet Greenwell v. Gregory J. Loomis, M.D. and Matthew B. Kern, M.D. (NFP) 82C01-0503-CT-228
10/25/11 Victor Jeffrey and Lynell Jeffrey v. The Methodist Hospitals, Paul Okolocha, M.D., Okolocha Medical Corp., and Okolocha Medical, Pain and Weight 45D11-0905-CT-102
10/19/11 Mark S. Weinberger, M.D., Mark S. Weinberger, M.D., P.C., Merrillville Center for Advanced Surgery, LLC and Nose and Sinus Center, LLC v. William Boyer 45D11-0904-CT-66
09/19/11 Judy Fratter, et al. v. Stanley Rice, Larry Ratts, M.D. 53C06-0811-CT-2833
08/25/11 John Fiederlein, M.D. v. Alex Boutselis, M.D. and Steve Jones, M.D. 79D01-0802-PL-12
07/27/11 Tomika Johnson, et al. v. David Sullivan, M.D., et al. 82C01-1001-MI-55
07/21/11 Jacqueline Wisner, M.D., and the South Bend Clinic, L.L.P. v. Archie L. Laney 71D04-0708-CT-135
07/20/11 Marianne Jackson v. Thomas Trancik, M.D. 29D02-0911-CC-1421
06/08/11 Donna Gibson v. G. David Bojrab, M.D., et al. 02D01-0901-CT-47
05/31/11 Joan Mazurkiewicz, et al. v. George Hodakowski, M.D., et al. (NFP) 45D11-0812-CT-189
04/13/11 Claudette Mee, et al. v. George Albers, M.D., et al. (NFP) 03C01-0710-CT-1989
02/10/11 Christine and Ivan Kolozsvari v. John Doe, M.D., Jane Doe, R.N., Kelley Branchfield, R.Ph., and Hook SuperX, LLC 32D02-0902-CT-4
12/22/10 Tracey L. Beswick and Ruthie Beswick v. Edward E. Bell, M.D., and Floyd Memorial Hospital & Health Services 22D01-0603-CT-89
12/15/10 Keith M. Ramsey, M.D. v. Shella Moore 45D04-0903-CT-83
11/09/10 Paul Arlton v. Gary Schraut, M.D., and Lafayette Retina Clinic 79C01-0503-CT-10
09/15/10 Alexander Gatzimos, M.D. v. Boone County and State of Indiana 06D02-0901-MI-107
08/20/10 Kurt Retrum, M.D., et al. v. Sarah Tinch (NFP) 48D02-0904-PL-362
07/27/10 Term. of Parent-Child Rel. vo M.D.; M.C. v. I.D.C.S. (NFP) 34C01-0906-JT-17
06/23/10 Mary Ann Dandino v. Luisito C. Gonzales, M.D., and Elkhart Clinic, LLC (NFP) 20D02-0106-CT-410
06/09/10 Rickey D. Miller and Jennifer Miller v. Art Duncan, M.D. (NFP) 22C01-0703-CT-155
04/26/10 Spine, Sports, and Pain Medicine, P.C. v. Daniel H. Nolan, M.D. (NFP) 02D01-0903-PL-71
04/16/10 Term. of Parent-Child Rel. of G.P., J.P., M.A.D.; M.D. and A.P. v. IDCS (NFP) 76C01-0901-JT-8; 76C01-0901-JT-12; 76C01-0901-JT-9
04/14/10 Term. of Parent-Child Rel. of M.D.; M.D., et al. v. IDCS (NFP) 46C01-0903-JT-21
04/13/10 M.D. v. Review Board (NFP) 09-R-4313
03/18/10 Alexander Miller, M.D. v. Mary Knight (NFP) 45D01-0511-CT-234
01/20/10 Spine, Sports, and Pain Medicine, P.C. v. Daniel H. Nolan, M.D. (NFP) 02D01-0903-+PL-71
12/18/09 David Jayakar, M.D. v. Kirk A. Pinkerton and Pinkerton & Friedman, P.C. (NFP) 45D11-0806-CT-75
11/10/09 Dharam Bhatia v. Anuradha Kollipara, M.D. 02D01-0703-CT-128
11/10/09 Marvin Jay Miller, M.D. v. Tiffany Brook Yedlowski, et al. 49D04-0305-CT-873
10/26/09 Kimberly Mosley, et al v. Ibrahim S. Zabaneh, M.D., et al (NFP) 45D05-0808-MI-25
10/08/09 Linda Spaulding, et al v. Erinn Harris, M.D., and Health & Hospital Corp. of Marion County d/b/a Wishard Memorial Hospital 49D07-0606-CT-23761
10/08/09 Douglass S. Hale, M.D. v. Melissa Phelps (NFP) 49D14-0803-CT-12313
08/18/09 Myers Blaker v. Ronald Young, II, M.D., and Indianapolis Neurosurgical Group 49D01-0704-CT-15142
07/21/09 Term. of Parent-Child Rel. of M.D., et al; J.D. and M.F. v. IDCS (NFP) 49D09-0703-JT-10166
06/30/09 Helene C. Uhlman v. Rodrigo R. Panares, M.D., et al 45D01-0706-PL-54
06/22/09 James Ashburn and Lynette Ashburn, et al v. Memorial Hospital of South Bend, Dr. Jeanne E. Ballard, M.D., et al (NFP) 71D05-0504-PL-151
05/26/09 Bertram Anthony Graves, M.D. v. Bingham McHale, LLP (NFP) 49D11-0806-CC-26365
04/08/09 Ruben Vargas v. Elian M. Shepherd, M.D. 45D04-0701-CT-21
04/07/09 Priscilla Perkins, Admin. of the Estate of Rosella Perkins v. Surendra Shah, M.D. and Adel Sandouk, M.D. (NFP) 45D10-0505-CT-99
02/26/09 Charles E. Perkins v. Michael Mitcheff, M.D., and Karla Foster (NFP) 46C01-0702-CT-59
02/05/09 Mercho-Roushdi-Shoemaker-Dilley-Thoraco Vascular Corp. v. James W. Blatchford, III, M.D. and Eve G. Cieutat, M.D. 84D01-9912-CP-1990
01/30/09 Wendy Byers, M.D. v. Linda Jean Quillen (NFP) 29D02-0710-PL-1233
12/23/08 Niles D. Schwartz, M.D. v. Parker Shelton (NFP) 02D01-0510-CT-461
11/26/08 Patricia Popovich v. John R. Danielson, M.D. 64D02-0706-CT-5102
10/07/08 Mary J. Ziobron v. Madalyn Kell Squires, M.D., Women's Health Partnership, et al 29D03-0310-CT-979
09/29/08 Ray A. Haas, M.D. v. Donald H. Bush, Rep. of the Estate of Elaine M. Bush 30D01-0507-CT-526
09/23/08 Charles N. Pollack, M.D. v. Sisters of St. Francis Health Services, Inc., et al (NFP) 49D13-0407-PL-1352
08/14/08 Lori Caldwell v. Adolphus A. Anekwe, M.D., et al (NFP) 45D01-0212-CT-297
07/21/08 Jeffrey L. Cain, M.D. v. Richard and Suzette Back 20C01-0305-CT-32
07/18/08 Ralph D. Millsaps, M.D. and Julio A. Morera, M.D. v. Ohio Valley Heartcare, Inc. (NFP) 87D02-0604-PL-159
07/17/08 Monica Joyner-Wentland, M.D. v. Pamela J. Waggoner 49D05-0504-CT-15613
06/27/08 Surjit Singh, M.D. v. Diane Lyday, Betsy Calderhead, and Cara Nichols 84D01-0407-CT-7291
06/03/08 Michael A. Linton, M.D. v. Lawanda Davis 45D01-0403-CT-69
04/14/08 Patrick A. Cleary, M.D., and Ball Memorial Hospital v. Konnie A. Manning, on Her Own Behalf and as the Personal Representative of Paul Manning, Deceased 18C01-0612-CT-60
04/11/08 Morgan County Hospital, Richard J. Eisenhut, M.D., Unity Physicians, et al v. Maria Upham, et al 55D01-0211-CT-605
03/12/08 Ava McSwane, Danielle Hays v. Bloomington Hospital and Healthcare System, Jean M. Eelma, M.D. 53C04-0602-PL-337


DO Physician Related

12/15/11 P. Bryan Lilly, D.O. v. Tammy Meserve, as Natural Guardian of Samantha Jo Aders, Darien Aders, and Mason James Aders, minors (NFP)
02/16/11 James M. Thompson, D.O. v. Amy Gerowitz, et al. 49D10-0609-CT-38531


Hospital Related (without physicians named primary)

02/16/12 Raymond Dale Berryhill v. Parkview Hospital 02D01-0908-SC-17061
01/26/12 Diana Bible v. St. Vincent Hospital (NFP) C-187474
01/26/12 Ruth Dishman, Personal Rep. of the Estate of Julie A. Etchison v. Community Hospitals of Indiana, Inc., Medcheck Anderson, Troy Abbott, M.C., and Stephen Robertson (NFP) 48D03-1012-PL-4041
12/12/11 Natosha Canfield, Individually, and Next Best Friend of D.C., Minor v. Clarian Health Partners, Inc. d/b/a Methodist Hospital (NFP) 49D03-1007-CT-30250
10/25/11 Timothy W. Plank, Individually and as Personal Representative of the Estate of Debra L. Plank, Deceased v. Community Hospitals of Indiana, Inc. and State of Indiana 49C01-0311-CT-3130
04/04/11 Elkhart General Hospital v. Doris Williams (NFP) 20D02-0308-CT-505
03/28/11 Cynthia Taylor v. Community Hospitals of Indiana, Inc. 49D13-0907-PL-1559
01/25/11 Frank J. Akey, Personal Rep. of the Estate of Wayne Akey v. Parkview Hospital, et al. 02D01-0909-CT-346
11/24/10 St. Joseph Hospital v. Richard Cain 02D01-1003-PL-95
11/22/10 William Delk and Sandra Delk v. Reid Hospital & Health Care Services, Inc., et al. (NFP) 89D01-0904-CT-8
10/08/10 Richmond State Hospital, et al. v. Paula Brittain, et al. 49D11-0108-CP-1309
06/11/10 Larz A. Elliott v. Rush Memorial Hospital 70C01-0902-MI-36
04/14/10 Constance Renee Nasser v. St. Vincent Hospital and Health Services 49D12-0703-CT-8451
03/15/10 Kevin and Nancy Green v. Community Hospitals of Indiana, Inc. (NFP) 49D11-0801-CT-1973
01/26/10 Anonymous Hospital v. A.K., et al. 45D05-0605-CT-94
11/30/09 G.Q. v. Caleb Branam and Bloomington Hospital an dHealthcare System 53C07-0902-MH-4
08/07/09 Terry Dennie, Sr., et al. v. Methodist Hospitals, Inc. (NFP) 45D05-0501-CT-17
07/23/09 Suzanne Eads and James Atterholt v. Community Hospital 45C01-0802-CT-14
05/15/09 Tracy Lynn Weston, et al v. Fayette Memorial Hospital, et al (NFP) 21D01-0701-PL-080
02/16/09 David Bradley Drawbaugh and Cynthia Sue Drawbaugh v. Methodist Hospital, et al. (NFP) 45D01-0609-MI-31
11/05/08 The Health and Hospital Corp. of Marion Co. d/b/a Wishard Memorial Hospital v. Phyllis Long (NFP) 49D11-0509-CT-38383
10/23/08 David Bradley and Cynthia Sue Drawbaugh v. The Methodist Hospital, Inc. and Dr. Paul J. Stanish (NFP) 45D01-0609-MI-31
06/24/08 Aurelia Watts v. Health and Hospital Corp. of Marion Co. d/b/a Wishard Memorial Hospital (NFP) 49D13-0110-CT-001588
06/18/08 Procare Rehab Services of Community Hospital v. Janice S. Vitatoe
04/10/08 H.D., John and June Doss v. BHC Meadows Hospital, Inc. 53C06-0511-PL-2132
03/20/08 Edward J. Allison and Henry Charles Safford v. Union Hospital and Wabash Valley Anesthesia, P.C. 77C01-0511-CT-400

Guy David Dyer was sentenced Wednesday.

By _Brian  Freskos_ (http://www.starnewsonline.com/personalia/bfreskos

Published: Wednesday, March 14, 2012 at 5:51 p.m.

Dr. Guy David Dyer, whose name has become synonymous with the illegitimate  
pain clinic he once ran in Wilmington, pleaded guilty Wednesday to charges 
that  he exploited his standing as a doctor to sell prescriptions for cash 
out of his  former office on Shipyard Boulevard. 

He was sentenced to three years  probation.  
The plea, entered in New Hanover County  Superior Court, ended the case 
that began two years ago and included undercover  visits to Dyer's office by a 
state law enforcement agent as well as a month of  physical and electronic 
surveillance of his dealings.  
As the owner and operator of the  Wilmington Pain Clinic, Dyer was accused 
of furnishing prescriptions to addicts  and described by law enforcement as 
a drug dealer hiding behind a medical  license.  
Superior Court Judge Jack Jenkins  sentenced Dyer to probation after the 
doctor pleaded guilty to four counts of  attempting to traffic opiates and 
three counts of prescribing controlled  substances without a legitimate medical 
Because he had no criminal history, Dyer  was ineligible for active prison 
time under North Carolina's sentencing  requirements. If he violates the 
conditions of his probation, however, he could  serve nearly nine years behind 
bars, according to the New Hanover County  District's Office. He had been 
scheduled to go to trial in April.  
Calling its action a step to protect  patient health and safety, the N.C. 
Medical Board took the rare move of  suspending Dyer's physician's license 
soon after his arrest in May 2010,  foregoing the usual practice of waiting to 
see whether the doctor was convicted  of criminal charges. The medical 
board's website on Wednesday still listed his  license as inactive.  
While authorities did not begin exploring  the possibility of leveling 
criminal charges until 2010, the medical board began  receiving complaints the 
year prior from pharmacists concerned that Dyer was  prescribing to patients 
who exhibited drug-seeking behavior.  
Several also raised alarms that Dyer was  prescribing a significant amount 
of powerful drugs like Oxycodone, an oft-abused  painkiller.  
Dyer's business operated as North  Carolina ? and the rest of the country, 
for that matter ? witnessed a steady  climb in the number of fatal overdoses 
attributed to prescription drugs. The  trend prompted the federal 
government to label prescription abuse an epidemic,  and White House Drug Czar Gil 
Kerlikowske called it "the nation's  fasting-growing drug problem."  
One of those who fell victim to the  scourge was Shelia Stukes, a 
46-year-old mother of 10 who was found unresponsive  by her boyfriend in January 
2010. She died in her Houston Moore home from taking  too much Oxycodone, which 
her family said in an interview last year with the  StarNews was prescribed 
in unsafe quantities by Dyer.  
The criminal inquiry into Dyer's practice  started when one of his former 
receptionists told investigators that the doctor  had asked her to fudge 
patient charts and that patients paid $100 per visit and  got a prescription for 
whatever they wanted.  
Investigators used informants, including  Dyer's landlord, and an 
undercover State Bureau of Investigation agent to build  their case against the 
doctor. The agent posed as a patient and went to Dyer's  office twice seeking a 
prescription, and both times walked away with one for  Percocet in exchange 
for cash. 


California Doctor Charged With Murder in Multiple Patient Deaths


On March 1, 2012  Dr. Hsiu-Ying “Lisa” Tseng, 42, was arrested on a felony complaint filed by the Los Angeles County District Attorney’s Office charging her with second-degree murder and other crimes. The three patients of hers who died of drug overdoses are: Vu Nguyen, 29, of Lake Forest, on March 2, 2009; Steven Ogle, 25, of Palm Desert, on April 9, 2009; and Joseph Rovero III, 21, a University of Arizona student from San Ramon, on Dec. 18, 2009. All were patients of Tseng who were prescribed a myriad of drugs. If convicted as charged Dr. Tseng faces a possible maximum state prison term of 45 years to life.


Besides the murders, Tseng is charged with one felony count of prescribing drugs using fraud, and 20 felony counts of prescribing drugs without a legitimate purpose. Three of the prescription counts involve two of the patients who died. The remainder of the prescription counts involves victims who survived, or prescriptions written for undercover officers.


Dr., 3 others charged in 'pill mill' bust at DeBary  clinic    *  DEBARY, Fla. 

Mar 13, 2012 

Four Central Florida residents were charged with prescription drug  
trafficking and operating a _pill mill_ 
(http://www.wftv.com/s/news/florida-pill-mills/)  after  investigators busted the Florida Family Health Care clinic on 
Spring Vista Drive  in Debary, according to the Florida Department of Law 
Neighbors said they saw law enforcement officers remove boxes of papers and 
files from the clinic. 
"The hustler, if you would, the guy who picked those indigents up off the  
street, would be waiting in the car and that guy or lady would keep that 
bulk of  the prescription," said neighbor Jack Lower. 
According to investigators, Anthony Joseph Paradyse, 27, of Deltona, owned  
and managed the center. They said he hired Dr. Jean-Luc Michel, 56, of 
Boynton  Beach, as its physician. 
A confidential informant tipped off state agents about the cash-only  
business. The center was charging patients $700 to $800 for each visit. 
Agents said Paradyse was charged with knowingly operating an unlicensed 
pain  clinic, trafficking in oxycodone and obtaining a controlled substance by 
fraud.  The charges are felonies, investigators said. 
Authorities said Michel was arrested for knowingly operating an unlicensed  
pain clinic, which is a third-degree felony.  
FDLE agents said this is one of the most bizarre pain pill busts they've 
made  because Michel was hired through Craigslist to work at the clinic. 
Michel responded to an ad to work at the clinic. The two owners did not 
have  a license to practice medicine, so they needed the doctor to write the  
"It's kind of disconcerting if your doctor is found on Craigslist," FDLE  
agent Jack Massey said. 
FDLE agents served a search warrant last year, then Michel later resigned.  
Agents said not only was the facility not licensed, but the doctor is not  
allowed to practice in Debary. 
Massey said Michel only allowed to practice in Boynton Beach, but they have 
found him working in Vero Beach and Fort Lauderdale too. 
The clinic has now been shut down, but Michel still has his license. It is  
now up to the Department of Health to figure out next steps regarding his  
license. Michel faces up to 45 years in prison. 
Office manager, Jermaine Lydell Johnson, 34, of Deltona, was charged with 
one  count of knowingly operating an unlicensed pain clinic, investigators 
Medical assistant Alexandra Jane Grech, 23, was charged with trafficking in 
oxycodone and obtaining a controlled substance by fraud, said authorities. 

Agents said Paradyse was booked into the Orange County jail, Michel was 
taken  to the Indian River County jail and Grech was booked into the _Volusia 
County_ (http://www.wftv.com/s/news-voulsia-county/)  jail, but Johnson 
remains at-large.  
The _Volusia  County_ (http://www.wftv.com/s/news-voulsia-county/)  Sheriff?
s Office and the Florida Department of Health partnered with  FDLE during 
the investigation, which they say is ongoing.  
The Office of the State Attorney, 7th Judicial Circuit said it  will 
prosecute the case.


More Than Four Life Sentences for Doctor Whose Drugs Resulted in Four Deaths


On February 14, 2012  Dr. Paul H. Volkman was sentenced in U.S. District Court to more than four terms of life imprisonment for illegally prescribing and dispensing pain pills outside the scope of a legitimate medical practice. As a consequence of his actions four people died between 2003 and 2005.


Evidence presented during the trial showed that Volkman prescribed and dispensed millions of dosages of various drugs including diazepam, hydrocodone, oxycodone, alprazolam, and carisoprodol. Volkman operated out of three locations in Portsmouth, Ohio and one location in Chillicothe before task force investigators, led by DEA Diversion investigators, shut him down in 2006.


 Attorney for doctor in Daytona pill raid says indictments coming  

By LYDA LONGA, Staff writer  (mailto: This email address is being protected from spambots. You need JavaScript enabled to view it.
 March 8, 2012 12:05 AM  
Posted in: 

DAYTONA BEACH -- An attorney representing the South Florida doctor linked 
to  a Daytona Beach clinic raided last year said his client was in the 
process of  "parting company" with chiropractor Joseph Wagner just days before the 
offices  of both men were searched by state and federal agents.  
The attorney, Allan Hoffman, also said he expects that his client Dr. John  
Peter Christensen and others connected to his case will be indicted by a 
grand  jury. Hoffman said a grand jury had been empanelled this week in 
Daytona Beach.  
State officials did not confirm information about a grand jury Wednesday.  
Joseph Wagner and his son John Wagner -- also a chiropractor -- are under  
investigation on allegations of insurance fraud and prescription pill  
distribution. According to state investigators, the father and son -- with  
Christensen's authorization -- prescribed pain pills and other drugs to patients  
at the Wagner Chiropractic & AcupunctureClinic, 542 N. Ridgewood Ave.  
The prescriptions were issued in Christensen's name despite the fact that 
he  never evaluated the patients, investigators said.  
John Wagner, meanwhile, was placed on probation by the state's Board of  
Chiropractic Medicine in April 2011, records show, because he erroneously  
diagnosed a patient.  
The FBI, the Florida Department of Law Enforcement and other law 
enforcement  agencies raided the Wagner clinic on Aug. 4. Patient records were 
The seizure of records was in connection to Christensen, FDLE officials 
said;  two other clinics were busted that day, as well -- one in West Palm 
Beach and  one in Port St. Lucie.  
The 60-year-old Christensen's license was suspended by the state the same 
day  as the raids. Wagner's license was suspended a week later on Aug. 11. 
Wagner  later relinquished his license to avoid any more scrutiny by the state 
Department of Health, documents show.  
Wednesday, Hoffman said Christensen did authorize Joseph Wagner to 
prescribe  medications to some of the local chiropractor's patients; however Hoffman 
said  Joseph Wagner prescribed more pills than Christensen authorized.  
Joseph Wagner also prescribed medications to chiropractic patients who were 
never seen by Christensen, state documents show.  
That fact was underscored in the Department of Health's emergency order  
against Joseph Wagner last August after the clinics were searched.  
"Dr. Christensen was in the process of parting company with Dr. Wagner just 
a  few days before the office was raided," Hoffman said. "He (Christensen) 
found  out what was going on (at the Wagner Clinic)."  
The 62-year-old Wagner did not return a message left Wednesday.  
But his clinic on Ridgewood is no longer open for business and his name and 
another physician's have been covered with white paint. The name "Wagner" 
on a  blue and white sign atop the structure is the only vestige that the 
business  existed inside the two-story building.  
The former chiropractor lost the structure -- where he remained ensconced  
days after the raid -- to his former wife, Carolina Duarte Wagner. The 
latter  filed for divorce in late December and was awarded the building in the 
divorce  settlement. Joseph Wagner got to keep the couple's house in 
What Joseph Wagner will not be getting is the $1,000 a month he wanted his  
ex-wife to pay him after the divorce. In the divorce papers, Joseph Wagner  
stated that his only income these days are the Social Security checks he  
receives each month.  
Christensen, meanwhile, reached at his residence in West Palm Beach on  
Wednesday morning, said he is waiting to see how the investigation unfolds. He  
has not relinquished his license to practice medicine.  


 Posted: Thursday, March 1, 2012 4:30 pm 
_Chandler plastic surgeon accused of running prescription drug  ring_ 
hop/article_5a804a98-63f6-11e1-8b02-001871e3ce6c.html) TribuneEast Valley 
Tribune | _0  comments _ (http://www>

A former Chandler plastic surgeon is among a group of four colleagues 
accused  of running a prescription drug ring that used and sold pain pills. 
Dr. James Lawrence Robrock and the three others were indicted on forgery 
and  drug trafficking-related offenses for obtaining fraudulent prescriptions 
for  drugs such as oxycodone, oxycontin and other controlled substances by 
using  aliases to obtain the drugs, Arizona Attorney General Tom Horne 
announced on  Thursday. 
Other doctors named in the indictment were: Christopher Ryan Chilton, 
Matthew  Anthony Thierbach and Jonathan Laine Zaletel. 
They each were charged on seven counts, including forgery, possession of a  
narcotic drug for sale and identity theft.


 Date: Mon, 27 Feb 2012 10:08:54 -0500 (EST)

Doctor who worked at St. Mary gets 6 1/2 years in  prison in pill mill ring

WEST PALM BEACH ? A doctor who  worked at St. Mary's Medical Center was 
sentenced Friday to 6 1/2 years in  prison for his role in a massive illicit 
prescription drug network organized by  Wellington twins Jeff and Chris 

Fatigue pushed Dr. Beau Boshers, 48, to accept a job at one of the 
brothers'  so-called pain clinics, his wife wrote U.S. District Judge Kenneth Marra. 

Having graduated from medical school in his 40s, Boshers didn't have the  
stamina to be a doctor at the hospital, wrote his wife Deborah Bennett 
"Nights, weekends, 24 hours at a time," she wrote of his schedule. "It was  
very stressful for someone 45 years old, not 30 like others in the group." 
When he went to work at the clinic in Fort Lauderdale, life was good. He  
worked just a day or two a week, she said. And, she added, the pay was good.  
Although Boshers only worked sporadically, he was busy, federal prosecutors 
said. He wrote prescriptions for more than 3.6 million pills  of oxycodone 
and other powerful narcotics without checking to see if there was  any 
medical justification for them, they said.  
Boshers, who moved from Jupiter to Georgia after his indictment in August, 
is  among 14 doctors and 32 people overall who were charged in connection 
with the  multi-million-dollar operation in Palm Beach and Broward counties 
that is blamed  for more than 50 deaths. Twenty-six have been sentenced. Like 
10 other doctors,  Boshers pleaded guilty to money laundering instead of 
more serious drug  distribution charges.  
Also on Friday, Zachary Horsley, 25, of Royal Palm Beach, was sentenced to  
five months in prison on one count of racketeering conspiracy.  
In a surprise move Friday, an attorney for Dr. Joseph Castonuovo, 72, of 
Key  Largo, told Marra his client had decided not to accept the plea deal he 
had  agreed to last week.  
Castronuovo and former Parkland Dr. Cynthia Cadet, who now lives in Ocala,  
are to be tried in August. Dr. Gerald Klein, 77, of Palm Beach Gardens, is  
awaiting trial on a first-degree murder charge in state court. Two elderly  
doctors died after they were indicted


Nov 24, 2011 NEW YORK (AP) — A pain management doctor whose patients included a man who killed four people in a pharmacy robbery made a practice of peddling prescriptions to addicts and drug dealers, and at least 10 of his patients went on to die of overdoses, authorities said Monday.
From a Queens weekend clinic where patients lined up in front of his door and as many as 120 were seen a day, Dr. Stan Li wrote more than 17,000 prescriptions — mainly for oxycodone and other highly addictive painkillers — in the last 2 ½ years, city Special Narcotics Prosecutor Bridget G. Brennan's office said as Li was charged with selling prescriptions to one patient even after the man repeatedly overdosed. An overdose ultimately killed him.
Li's lawyer, Aaron M. Wallenstein, said the doctor denies the allegations, had acted responsibly and "wants to fight this to the end." Li, 57, was being held on $500,000 bail after pleading not guilty to prescription sale and reckless endangerment charges. While they currently all relate to one patient, prosecutors said more charges were expected.
While some doctors unwittingly prescribe drugs to addicts, Li is accused of intentionally writing prescriptions for unneeded narcotics in return for cash, Brennan noted in a statement.
His conduct, she said, "is just another form of drug dealing."
Li, who was born in China, has been a U.S. citizen since 1999, his lawyer said. Li now lives in Hamilton, N.J., and works full time as an anesthesiologist at a hospital there, running his Medical Pain Management clinic on Saturdays and occasional Sundays since January 2009, prosecutors said.
Investigators found some patients selling drugs right outside the clinic, and inside they found a sign setting out his fees, prosecutors said: $100 a visit for a "low-complexity" patient, or $150 for a "high-complexity" case, including someone seeing more than one doctor, someone seeking more than three prescriptions in one visit or someone with a history of drug abuse. Li took cash and sometimes billed government health programs for the visits, prosecutors said.
Investigators also discovered at least 10 fatal overdoses among his patients, prosecutors said.
Michael Cornetta got prescriptions monthly from Li for oxycodone, the anti-anxiety drug alprazolam — sometimes sold under the trade name Xanax — and fentanyl, a potent pain medication that comes in the form of a patch, prosecutors said. Li went on prescribing the drugs even after Cornetta overdosed and was hospitalized in January 2010 and again that May, prosecutors said. An emergency room doctor called Li about the January overdose, they said.
Cornetta was 40 when he died of a deadly dose of fentanyl, anti-anxiety drugs and cocaine in November 2010, three months after getting his last prescription from Li, prosecutors said.
Meanwhile, Li also provided 24 prescriptions filled by David Laffer, who went on to kill four people during a Long Island pharmacy robbery in June, Newsday has reported. Laffer's wife, Melinda Brady, admitted driving the getaway car. He's serving a life sentence; she's serving 25 years.
Laffer indicated at his Nov. 10 sentencing that he had "shopped" for doctors willing to prescribe painkillers with few or no questions asked.
Wallenstein said Li had refused to keep treating Laffer, Brady and Cornetta, though he wasn't sure when. The attorney declined to detail the reasons, but he said the physician had made use of a database designed to combat painkiller abuse by tracking patients who seek prescriptions from multiple doctors.
"He followed the rules. He did what he had to do," Wallenstein said.
Brennan, however, said the lawyer's characterization of Li's use of the database "is wholly inaccurate."
Meanwhile, Suffolk District Attorney Thomas Spota told Newsday on Sunday that he was seeking a special grand jury to investigate "doctor shopping" and possible criminal conduct by physicians in prescribing painkillers.


Nov 18, 2011 Massachusetts. Pain Mismanagement: Plaintiff Victory Attributed to Problems with Poor Record Documentation and Inconsistent Prescribing Practices

The Case
A middle-aged female patient was referred to pain management by her primary care physician (PCP) for treatment of chronic pain in her lower back and left lower extremity. The patient also had a history of psychiatric problems, including anxiety, depression and bipolar disorder, and was under the care of a psychiatrist.
For six years, pain management consistently prescribed Oxycontin, Lortab, Norco and Durgesic in different combinations. During this time the patient exhibited signs that she was abusing the medications. Staff had threatened to discharge her from the practice on numerous occasions. One day the patient again reported that she had been robbed of her drugs, but the police officer who completed the report doubted the patient's truthfulness. It was this concern that prompted another physician to switch the patient from pills to a transdermal system. The patient was prescribed five Duragesic patches 100 mcg with breakthrough medications, and was instructed to wear one patch for three days. Thus, a pack of five patches would last her two weeks. She returned two weeks later as part of the probation protocol that had been implemented at her previous visit. The probation protocol consisted of 1) switching the patient to a less readily divertible agent; 2) a urine drug screen every two weeks; and 3) no further "inconsistencies" with respect to drug screens.
The patient seemed to be doing well with the patch and adhering to the probation protocol, so the physician prescribed her another pack of five patches to be used over the next two weeks. When the patient returned to the office, she refused to submit to a urine drug screen and was terminated from the practice. Her children testified later that they did not hear their mother speak much of the termination, only that she had patches she did not know how to use. Her children believed that their mother was confused and, thus, applied two patches, instead of one.
On Christmas Eve, the patient was found dead in her bedroom. The EMTs who responded reported finding two Duragesic patches on her body, one on each arm. An autopsy revealed the cause of death was an acute intoxication of Fentanyl.
The allegations were that the Defendants:
Ignored the information contained in the Black Box warning for the Duragesic patch, which states it is contraindicated for patients diagnosed with depression.
Failed to routinely monitor the patient for signs of misuse, abuse and addiction to the Duragesic patch, especially in consideration of the patient's psychological problems.
Ignored repeated demonstrations of noncompliant and drug-seeking behavior, and thereby continued to prescribe the Duragesic patch.

This case was settled for a moderate amount.

Risk Management Commentary

Three experts gave negative standard of care reviews. The reviewers had concerns that: 

The patient had a history of using her opioid pain medications inappropriately, along with her history of psychiatric disorders and psychiatric admissions. Pain management appeared not to take into account the propensity for patients with psychiatric disorders to abuse the opioid meds and/or to become suicidal.
The physicians talked about referrals, but never followed through to make sure the patient was seeing the recommended physicians.
It should have been foreseeable to a prudent physician that the patient had the ability to abuse all the medications, as well as the Duragesic patches. There were clear indications the patient was diverting her medications and /or abusing them.
The X-rays were negative for degenerative changes in the back, no radiculopathy, etc. There was nothing to indicate that the patient needed to be on all of these medications.
The practice would take repeated steps to terminate her, but would take her back, and provide her with more opioids.
Some of the urine drug screens came up positive for medications that were not prescribed by pain management, but there was no documentation of where the patient may have obtained these drugs. These drugs included Methadone, Dilaudid and Oxymophone/Opana. At one point, the patient was receiving Methadone from pain management, but those drug screens were done at a time when Methadone was not being prescribed for her. The psychiatrist denied prescribing any of these drugs.
The pain management practice was conducting a pain management fellowship program. As a result, the patient tended to see different physicians each visit, which is problematic from a continuity of care standpoint.
The EMR contained dictated notes that appeared to be "copied" from visit to visit over a number of months. These medical record entries gave the reviewers the impression that the treating physicians were not really spending much time evaluating, monitoring, talking to the patient, appropriately documenting the visits, and developing the physician/patient relationship.
Even with possible causation arguments on the side of pain management, the poor medical record documentation, along with inconsistent prescribing and management practices, severely decreased the credibility of the physicians involved in this patient's care.


Nov 5, 2011 Tampa, FL -- A Land O' Lakes doctor was arrested Wednesday after an investigation into a Tampa pain clinic.
According to detectives, 75-year-old Dr. Albert Ford, of the Busch Pain Clinic, was found to be operating out of the standard level of care.
Cases reviewed by Florida Board Certified Pain Management Doctors found he was significantly overstating the patient's level of pain and impairment, conducted inadequate medical exams and falsified medical records to justify the prescribing of Oxycodone. 
The clinic was investigated during the months of June and July 2011, when undercover officers and a confidential informant posed as patients.
The investigation resulted not only in Ford's arrest but two other employees as well. 50-year-old Maria Hernandez Abella and 30-year-old Daniel Corcino were arrested on July 7, 2011.
Ford is being charged with Writing a Prescription for Controlled Substance through Deception, Untruthfulness or Fraud.



Nov 1, 2011 SPRING HILL --
Lynn Hutchinson kept her head down for most of the short walk to the deputy cruiser.
At one point after she was led out of her pain-management clinic in handcuffs, she glared and barked at photographers who were snapping photos.
Television cameras and reporters swarmed around her and the two deputies who were escorting her.
"Get out of my face," Hutchinson blurted to one photographer standing less than 5 feet in front of her.
Moments later, she tried to appear more peaceful.
She said "God is good" to the group of reporters after she got in the car.
Dr. Harold Edward Sleight, 70, was brought out more than 30 minutes later by more deputies. He refused to make eye contact and said nothing as he ducked under a strip of yellow tape and got into the backseat of the second cruiser parked near the front entrance.
The Hernando County Sheriff's Office responded shortly after 9 a.m. Tuesday to Hope Pain Management Group at 1250 Mariner Blvd. to execute a search warrant. Deputies also searched Hutchinson's home at 3256 Gulf Wind Circle the same day, said Cpl. Wendy McGinnis, a sheriff's spokeswoman.
Both Hutchinson and Sleight were interviewed throughout the day along with several employees.
Hutchinson, 46, was charged with myriad felonies, including unlicensed practice of a health care physician, unlawful practice of medicine and fraudulent representation of a practitioner to obtain a controlled substance.
Sleight was charged with principal to unlicensed practice of a health care physician and principal to unlawful practice of medicine. He is accused of writing blank prescriptions and giving them to Hutchinson.
Deputies conducted an 18-month investigation, which was called Operation No Hope by the sheriff's office's narcotics unit.
Several undercover detectives and confidential informants took part in the operation, said McGinnis.
Those who work at nearby businesses said they expected Tuesday's arrests to happen sooner or later. The clinic attracted its share of scruffy and strung-out people, they said.
"I knew it every time one came in here," said Karen Gigante, who works at a neighboring business. "They come in here wanting to use the bathroom."
A few customers defended Hutchinson and her employees. Milton Van Sandt, of Spring Hill, never suspected they were doing their jobs unethically.
He pulled into the parking lot that morning hoping to pick up a prescription. He looked bewildered after he realized the business had been shut down.
"I'm completely shocked," he said. "The doctors there are always (saying), 'Don't break the law at all.' They have a bunch of signs up."
He described how sensitive they were with patients with debilitating conditions. They would contact authorities whenever they encountered someone suspicious, he said.
"They were like family all the way," Van Sandt continued. "They were very nice. I'm just shocked."
He also said he was under the impression Hutchinson was a doctor.
Sgt. John Cameron, a sheriff's spokesman, emphasized Hutchinson was not legally permitted to practice medicine.
"She has never been licensed to be a doctor in Florida," he said.
Hutchinson was arrested three years ago on a charge of concealing information from a practitioner to obtain a prescription. It was eventually dropped, according to court records.
In her mug shot from 2008, she had "Dr. Lynn Hutchinson" embroidered on her scrubs.
"The (detectives and informants) were sent for MRIs without ever seeing the doctor," said McGinnis. "They were also given physical exams and issued prescriptions for pain medicine."
McGinnis said Hutchinson performed the MRIs and exams while Sleight "condoned these practices and did nothing to curtail" them.
"I didn't think I had to be worried about anything at this doctor, so it kind of concerns me about the treatment that I've been receiving here," said a disheveled Dana Nelson, who arrived Tuesday morning for a prescription.
Her sweatshirt was on backward.
Employees at nearby businesses said the clinic was busiest on Tuesdays — the first day of the week it opened. Customers would pick up prescriptions at the clinic and often would go to the pharmacy next door to obtain medicine.
The pharmacy and its employees were not part of the investigation, said McGinnis.
Patients who arrived Tuesday learned their medical records were seized and would not be released by the sheriff's office until Monday.
That frustrated Van Sandt, who said he needed his medication for the chronic pain from the injuries inflicted following a car accident 10 years ago. He's also had two brain surgeries. He pointed to the two visible scars on his head.
"They've been perfect," Van Sandt said of Hutchinson and her employees. "There's no jacking around. That's why I liked coming here. I just can't believe it."
McGinnis said more charges could be filed against Hutchinson and Sleight as the investigation continues.
Lisa Listowski, who works at a business in the same plaza, was among those who expected to see deputies swarming the area.
"Not having them here is probably a good thing," she said of the clinic's customers. "They actually hurt our business in a way, so I guess it's a relief."
She acknowledged Hutchinson made an effort to at least lessen the flow of customers each morning.
"She changed it more to an appointment-based system," Listowski said. "Before that, they would be standing in line in the parking lot waiting."


A federal indictment unsealed Thursday charges five Jacksonville doctors, the owner of three pain clinics where they worked and seven other employees in a multimillion-dollar pill mill operation that led to at least one death, records obtained by the Times-Union show.
The three-count grand jury indictment accuses the 13 defendants of scheming to profit off patients to whom they sold painkiller prescriptions from December 2009 until late July 2010. The buyers of highly addictive oxycodone and Xanax came primarily from Ohio, Kentucky and Tennessee. Many returned home to sell the drugs at a profit for themselves.
Several of the doctors involved have been practicing for decades. The now-closed clinics where they worked were Jacksonville Pain and Urgent Care at 1395 Cassat Ave.; Duval Wellness at 203-9A W. 48th St.; and First Coast Pain and Urgent Care at 5834 Normandy Blvd.
Pipeline of Pain: Review Times-Union coverage of pill mills and learn how they develop
The daily bank deposits from the clinics were routinely between $40,000 and $60,000, with some days well over $100,000. Doctors sometimes earned as much as $12,000 a week, records show.
The indictment, unsealed in federal court in Jacksonville, followed a nearly two-year investigation by the DEA, FBI and Jacksonville police that had already led to charges against two doctors and two other people.
Those indicted were clinic owner Zachary Timothy Rose, 27; doctors Eldon Dale Brandt, 74, Donald W. Hall, 79, Todd Perla, 52, Anthony Posca, 43 and Marc Tafflin, 62; clinic mid-level managers Ryan A. “Nubby” Young, Yevgeny Drubetskoy, Theodore J. Enquist, Brian D. Goldberg and Jason C. Votrobek; pharmacy technician Teresa Faulkner; and Krystopher Legg, an Ohio man accused of bringing patients from Ohio to Jacksonville to buy the drugs.
Read how court records show a pain clinic's transformation into a pill mill
The group is charged with conspiracy to distribute narcotics not for legitimate medical purposes and not in the usual course of professional medical practice. All but Brandt, Posca, Faulkner and Legg are also charged with money laundering.
Rose, Hall and Legg also are charged in the April 2010 death of Robert Lee Johnson, 25, who overdosed on oxycodone in a Jacksonville motel. Investigators said he obtained the drug at Duval Wellness, where Legg transported him and others weekly from Ohio to Jacksonville. The actual charge in the indictment is aiding and abetting oxycodone distribution resulting in death.
In 'top 100’ pill buyers
All seven doctors were on the DEA’s list of the nation’s top 100 practitioners when it comes to ordering units of oxycodone, records show. They are listed as prescribing physicians at the clinics.
Arrest warrants were issued Thursday, though its unclear who had immediately been taken into custody. At least some initial court appearances are expected to be held today.
U.S. Attorney Bobby O’Neill said the investigation should serve as a warning to corrupt doctors in Florida.
“All law enforcement on all levels in this state are looking to go after the unscrupulous doctors,” O’Neill said. “That one percent who are violating their own practices and standards need to have their licenses revoked and taken out of the medical field.”
Tafflin’s attorney, David Barksdale , said Tafflin expects to mount a vigorous defense to the charges.
“Dr. Tafflin has a long record of providing compassionate and quality medical care in Jacksonville,” Barksdale said.
Rose’s attorney, Dave Bogenschutz , said his client also plans to defend against the charges. Known attorneys for the other defendants couldn’t be reached to comment.
Florida Attorney General Pam Bondi, who’s made battling illegal pill mills a cornerstone of her campaign to fight crime statewide, praised the investigation.
“I commend the DEA, FBI, and Jacksonville police for their perseverance in this case, which will help end drug tourism to our state,” Bondi said. “Today’s indictment is a perfect example of how collaboration among various levels of government protects Floridians.”
Thursday’s charges supersede a federal indictment in January that charged Legg with conspiracy and aiding in Johnson’s death. Also previously arrested were doctors Thomas Holland, 60, and Elio Madan, 66, and clinic manager Jenna Crawley, who have all pleaded guilty.
Pipeline of customers
Court records said Rose moved from South Florida to Jacksonville in December 2009 and opened Jacksonville Pain to compete with clinics in South Florida. The move purposely cut the drive time for people Rose knew were customers farther south. He used patient rosters obtained from a competitor in Miami to spread the word about the savings, records said.
Most of those patients, complaining of back pain, were uninsured and routinely paid up to $1,000 a month to see a doctor, get an MRI and then get a prescription. The prescriptions were given without any legitimate medical purpose, records said.
Doctors treated as many as 140 patients in one day. Madan told investigators that if he didn’t prescribe the medications to virtually all the patients he saw, the owner would replace him, records show.
Rose was evicted from the Cassat Avenue business in March 2010 due to neighborhood complaints of out-of-state people congregating in the parking lot to buy the drugs. He then opened the other two clinics.
Investigators used confidential informants to make recordings of Rose, doctors and clinic managers, records said. They also made undercover buys and recovered other evidence.
Court records note that a potential expert government witness in internal medicine determined that the sales made to the undercover officers alone could have killed them if taken as prescribed.
Duval Wellness and First Coast Pain were closed after police raids in July 2010, in which agents served 40 search warrants. Authorities seized $3.4 million in bank accounts as well as cars and property.
Several pain clinics owned by Rose are also under investigation in Tennessee, police said. In an interview with the Times-Union last year, Rose said he saw nothing wrong with his business practice.
“We [he and other owners] have 56 clinics in Jacksonville,” he said at the time. “What made those two illegal and the other 54 legal?”
After the police raids, a number of the other clinics closed or left town voluntarily.


Oct 14, 2011 LARGO — For the second time in five years, health officials have taken emergency action to stop a Pinellas County doctor from writing excessive prescriptions for powerful painkillers.
Authorities say Dr. Ty Anderson, an osteopathic family physician, prescribed "potentially lethal quantities" of widely abused narcotics such as Roxicodone and Percocet, often without so much as a physical exam.
He also permitted an assistant — a nurse who was his girlfriend — to illegally sign prescriptions when he took a leave from practice, state health officials say.
Similar charges netted Anderson, 46, a previous suspension in 2006. In that violation, he was fined $12,500 but allowed to return to practice.
In recent years, Anderson, who could not be reached for comment Wednesday, has been treating patients at Anderson Medical Clinic, a pain clinic at 10333 Seminole Blvd., Suite 4, in Largo.
An employee told investigators he was instructed to recruit new patients by promising they would leave the clinic with at least 240 oxycodone pills, as well as other prescription medications popular as street drugs.
Two patients said the clinic knew they were illegally going from doctor's office to doctor's office to shop for drugs.
Still, Anderson refilled their prescriptions.
One was a 41-year-old man, identified as K.P. In an 8-month period, he left the pain clinic on 10 occasions with prescriptions from Anderson on each visit for 690 pills, mostly narcotics.
At one point, the patient told Anderson that he was worried about being overmedicated and asked to change his treatment.
But K.P. was informed that his prescriptions were pre-signed and couldn't be changed — at least not without a $25 charge.
The Florida Department of Health announced Wednesday the emergency suspension of Anderson's medical license.
The St. Petersburg Times has written repeatedly about Anderson's troubled medical record.
In 2006, he was the medical director of Doctors Urgent Care, a St. Petersburg walk-in clinic advertising easy access to Vicodin, Percocet and other drugs.
The Pinellas County Sheriff's Office raided the clinic and arrested one of its doctors, as well as the clinic's owner and two physician's assistants.
But Anderson wasn't charged. Detectives said he was rarely there.
Instead, he signed stacks of blank prescriptions and sent them by courier from his main office in Seminole.
Outside of his medical work, Anderson has been arrested multiple times, most recently in 2009 on cocaine charges.
In other action, state health officials suspended the license of Dr. James Paul Oakes, a Treasure Island osteopathic physician who pleaded guilty in August to a felony drug trafficking charge involving oxycodone.


Oct 13, 2011 A South Florida doctor who was arrested Monday on charges of operating an unlicensed pain management clinic and trafficking in oxycodone was seeing a large number of Northeast Florida patients, according to the Florida Department of Law Enforcement.
Mark K. Sachs of Palmetto Bay, Fla., was selling and dispensing medications to people without a medical need at his Miami office, according to the FDLE. The case was developed in part because of all the patients from the Jacksonville region who traveled to see him, said Travis Smith, resident agent in charge at the agency's Jacksonville Regional Operations Center, St. Augustine field office.
"Agents in this office developed numerous sources who were going to see Dr Sachs," Smith said. "They would pay cash, go through little to no exam, and leave with a lethal cocktail of oxycodone and other prescription pills."
Some of the patients never even saw the doctor, Smith said.
"They would tell the doctors staff what they wanted, pay cash, get the prescription, and walk out the door," he said.
The Jacksonville interviews sparked the investigation into Sachs, whose medical license was suspended on Oct. 7 by the Department of Health in an emergency proceeding.
We had people from Putnam, Flagler, St. Johns, Duval, and Clay counties all traveling to see this doctor," Smith said. "He was known as an open prescription writer ... you got a lethal dose simply by going down there."

Read more at Jacksonville.com: http://jacksonville.com/news/crime/2011-10-11/story/doctor-charged-oxycodone-trafficking-miami-saw-significant-number#ixzz1afSbr5qz


Oct 10, 2011 LOS ANGELES -- A Southern California doctor was sentenced to seven years in prison Wednesday for illegally selling tens of thousands of painkiller and sedative prescriptions to patients he never examined.
Dr. Nazar Al Bussam, 72, of Newport Beach, was ordered to no longer practice medicine and forfeit roughly $450,000 in personal funds prosecutors say he pocketed from his prescription-for-cash scheme. Al Bussam, who was remanded into custody, also must pay $125,000 fine.
Federal prosecutors argued that Al Bussam should be sent to prison for nearly 20 years to act as a deterrent for other physicians who think about flauting the law. However, U.S. District Judge S. James Otero said that was too harsh and showed Al Bussam some leniency given his age.
Otero did not take into account a report published by the Los Angeles Times on Wednesday that said three patient deaths have been linked to Al Bussam. Had the article played a factor, Al Bussam may have been given the sentence prosecutors recommended, Otero said.
Authorities say Al Bussam made more than $1 million a year by selling prescriptions for cash. He was worse than a street drug dealer, prosecutors said, because he abused his position as a doctor and knew the negative effects of prescription drugs when taken regularly or in large amounts.
Al Bussam typically raked in $3,000 per day in cash and was the top prescriber of controlled substances in California between January 2008 until his arrest last October, according to court documents. He would often give Percocet or the sedative Xanax to patients but would try to avoid prescribing the powerful painkiller Oxycontin because he thought it would draw the attention of law enforcement, records show. Al Bussam pleaded guilty in July to 18 conspiracy and drug counts. On Wednesday, he apologized for his actions, saying he was filled with shame.
"I can only hope to be given some opportunity to redeem myself, so help me God," he said in court.
Two others died - one from an overdose and the other by falling off a cliff - with drugs in their systems and pill bottles bearing Al Bussam's name in their possession.
Defense attorney Benjamin Gluck said in court that information in the article was "demonstrably wrong."
Several of Al Bussam's patients were later arrested for illegally selling drugs that he prescribed, authorities said.


Oct 10, 2011 Rowland Heights doctor accused by state and federal officials of overprescribing narcotics has agreed to pay $500,000 to settle two lawsuits blaming her for the overdose deaths of twoyoung men.
Embattled doctor Lisa Tseng will pay $275,000 to the parents of Joey Rovero and $225,000 to the family of Nicholas Mata, according to the Osteopathic Medical Board of California.
Attorneys in the cases declined comment, saying that the settlements were confidential.
Tseng (right) is under investigation by the U.S. Drug Enforcement Administration, which yanked her ability to prescribe addictive drugs following a raid on her business in August 2010. The Osteopathic Board is attempting to strip Tseng of her license to practice, citing allegations that she operated a “pill mill” for drug addicts at her storefront clinic. A hearing before an administrative law judge is set for January.
Joey Rovero, 21, an Arizona State University student, made the six-hour trip with friends to the California clinic to buy drugs on Dec. 9, 2009, according to congressional testimony by his mother, April. Rovero received prescriptions for more than 100 tablets of Roxicodone, Soma and Xanax, which he filled at a Huntington Beach pharmacy 35 miles away as directed by Tseng, said his mother.
Rovero died nine days later after a night of partying. A member of the Dean’s List, Rovero was only five months from graduation. He died from a deadly mix of Xanax, Roxicodone and alcohol.
April Rovero of San Ramon went on to found the National Coalition Against Prescription Drug Abuse.
Nicholas Mata, 22, of Huntington Beach died May 14, 2010 from drugs that he received from Tseng, according to his family’s personal injury lawsuit, filed in Los Angeles County Superior Court.
The suit alleged Tseng used her clinic as a front for illegal drug prescriptions. Federal officials say she wrote more than 27,000 prescriptions over a three-year period.
There are at least six other lawsuits against Tseng in Orange County court.


Sept 18.2011 SALT LAKE CITY (AP) — A federal jury found a Brigham City doctor guilty Thursday of illegally prescribing painkillers that resulted in the death of a Utah scientist.
Dewey C. Mackay, 64, was convicted of a total of 40 out of 86 charges related to running a massive pill operation.
The convictions include two charges of distributing a controlled substance leading to the 2006 death of David Leslie Wirick, 55, of Ogden, who was working as a rocket scientist.
The other convictions were for three counts of using a communication facility to commit a drug offense and 35 counts of distribution of a controlled substance. But he was not convicted on 46 counts of distribution of a controlled substance.
Mackay faces a possible prison sentence of 35 years for the two charges related to Wirick's death, with one of the charges carrying a mandatory minimum sentence of 20 years because he prescribed oxycodone. Sentencing is set for Oct. 23.
Prosecutors in U.S. District Court in Salt Lake City argued during the trial he turned from doctor to drug dealer after he no longer could work as an orthopedic surgeon because of health issues.
U.S. District Attorney Carlie Christensen said Mackay was seeing as many as 120 patients a day, but many of those were simply given prescription refills without being evaluated.
State records show MacKay issued more than 37,700 prescriptions for hydrocodone and oxycodone between June 2005 and October 2009, totaling more than 3.5 million pills.
Following the verdict, Christensen said they were pleased because it was "clear that the narcotics were not being prescribed for a medical purpose."
Defense lawyers didn't comment following the verdict. During the trial, Peter Stirba said MacKay tried to ease the chronic pain of his patients, many of whom are now being treated by other doctors with similar regimens.
Stirba told jurors during closing arguments Mackay might have kept sloppy records, but he didn't commit any criminal acts.
All but two of the patients who testified were in chronic pain when they went to see MacKay, Stirba told jurors. The others, he said, were undercover operatives who lied, including one trying to avoid a lengthy prison sentence.
Defense attorneys also contended that Wirick died of pneumonia, and there were not toxic levels of hydrocodone or oxycodone in his system. Prosecutors, however, claimed Wirick died from heart problems and swelling of the brain caused by the drugs.

Read more: http://www.ctpost.com/news/article/Utah-doctor-guilty-in-prescription-case-death-2122609.php#ixzz1YHFy0R3P


Sept 6, 2011 SALT LAKE CITY (AP) — A federal jury found a Brigham City doctor guilty Thursday of illegally prescribing painkillers that resulted in the death of a Utah scientist.
Dewey C. Mackay, 64, was convicted of a total of 40 out of 86 charges related to running a massive pill operation.
The convictions include two charges of distributing a controlled substance leading to the 2006 death of David Leslie Wirick, 55, of Ogden, who was working as a rocket scientist.
The other convictions were for three counts of using a communication facility to commit a drug offense and 35 counts of distribution of a controlled substance. But he was not convicted on 46 counts of distribution of a controlled substance.
Mackay faces a possible prison sentence of 35 years for the two charges related to Wirick's death, with one of the charges carrying a mandatory minimum sentence of 20 years because he prescribed oxycodone. Sentencing is set for Oct. 23.
Prosecutors in U.S. District Court in Salt Lake City argued during the trial he turned from doctor to drug dealer after he no longer could work as an orthopedic surgeon because of health issues.
U.S. District Attorney Carlie Christensen said Mackay was seeing as many as 120 patients a day, but many of those were simply given prescription refills without being evaluated.
State records show MacKay issued more than 37,700 prescriptions for hydrocodone and oxycodone between June 2005 and October 2009, totaling more than 3.5 million pills.
Following the verdict, Christensen said they were pleased because it was "clear that the narcotics were not being prescribed for a medical purpose."
Defense lawyers didn't comment following the verdict. During the trial, Peter Stirba said MacKay tried to ease the chronic pain of his patients, many of whom are now being treated by other doctors with similar regimens.
Stirba told jurors during closing arguments Mackay might have kept sloppy records, but he didn't commit any criminal acts.
All but two of the patients who testified were in chronic pain when they went to see MacKay, Stirba told jurors. The others, he said, were undercover operatives who lied, including one trying to avoid a lengthy prison sentence.
Defense attorneys also contended that Wirick died of pneumonia, and there were not toxic levels of hydrocodone or oxycodone in his system. Prosecutors, however, claimed Wirick died from heart problems and swelling of the brain caused by the drugs.

Read more: http://www.ctpost.com/news/article/Utah-doctor-guilty-in-prescription-case-death-2122609.php#ixzz1YHFy0R3P


Sept 9. 2011 NJ Pediatric surgeon charged with murder by drugs Allegedly prescribed more than 300,000 pain pills
A doctor who for decades practiced in Monmouth County has been arrested on murder-by-drug charges in Florida in what officials deem a landmark case in the prosecution of prescription pain pill traffickers.
Pediatric surgeon Dr. Gerald Joseph Klein, 77, who according to New Jersey state records has been licensed to practice medicine in the Garden State since 1963, has been charged with first-degree murder by Florida in the death of a West Palm Beach man who died hours after Klein prescribed him hundreds of pain pills.
Authorities said Klein had written prescriptions for more than 300,000 oxycodone pills, a powerful narcotic, in 18 months. Klein was arrested Aug. 23.
Klein, a founding doctor at East Coast Pain Clinic, West Palm Beach, “was one of the highest-dispensing pain pill doctors” at the clinics, Florida State Attorney Michael F. McAuliffe said.
The indictment charges that on Feb. 27, 2009, Klein prescribed East Coast Pain Clinic patient Joseph Bartolucci, 24, a total of 210 pain pills, which he filled the same day.
Bartolucci died later that night or early the next day, according to the indictment.
The clinic was one of four pain clinics in South Florida owned by twin brothers Jeffrey and Christopher George. Jeffrey George, charged with drug-trafficking and second-degree murder in the death of Bartolucci, last week pleaded guilty to the drug and murder charges, McAuliffe said. He will be sentenced at a later date.
Klein, meanwhile, who had medical offices in Eatontown and Oakhurst, on Friday had bail set at $360,000 in Florida. The doctor is under house arrest in Palm Beach Gardens, Fla., and has been barred by the judge from practicing medicine, according to court records.
Reached at home Wednesday, Klein through his wife declined to comment on the charges against him.
McAuliffe said this is the first indictment of its kind charging both a prescribing doctor and pain clinic owner with murder in a state where prosecutions of “pill mills” have been aggressive in recent years.
The indictment against Klein, Jeffrey George and others came as part of a sweeping multiagency investigation dubbed Operation Prescription for Death, according to the state attorney.
That probe was part of an even larger investigation by the state attorney, Palm Beach County Sheriff’s Office, U.S. Attorney for the Southern District of Florida, FBI and federal Drug Enforcement Administration. It resulted in an indictment of 32 people on drug charges that also fall under Florida’s racketeering statues, officials said.
Investigators found that from January 2009 through June 2010, Klein dispensed more than 300,000 oxycodone prescription pain pills alone, the state attorney said.
In addition, George and an office manager diverted thousands of pain pills to drug dealers in exchange for thousands of dollars, according to the indictment. All the pills were purchased under the clinic physicians’ DEA dispensing licenses, primarily Klein’s, the indictment stated.
McAuliffe said his office pursued its investigation of Bartolucci’s death as a homicide from the start.
“With this case, we called it for what it is — murder,” the state attorney said.
The pain pill mills were lucrative operations, he noted.
“In general, this is a cash-basis business ... with the veneer of legitimacy,” McAuliffe said, because prescription pain medicines can be legally prescribed to treat specific conditions.
But for doctors such as Klein, involvement comes “as greed takes over,” he added. “My office is actively pursuing murder charges against prescribing physicians.”
According to New Jersey records, Klein was a pediatric surgeon during the years he practiced medicine in New Jersey.
His medical license status was changed from active to “retired-paid” in June 2011, according to the New Jersey Health Care Profile Web site maintained by the Division of Consumer Affairs in the Attorney General’s Office. That means Klein is at least 65 years old and not affiliated with a hospital or HMO.
He pays a reduced fee every two years when he renews his license, a spokesman for the DCA said.


Aug 28, 2011http://online.wsj.com/article/SB10001424053111904009304576530823247047508.html?KEYWORDS=3m#articleTabs=article
Florida has been plagued by these clinics over the last few years, with oxy/benzo overdoses resulting in over 3,500 deaths in 2010 in the state. Certainly, many more deaths in other states can be traced back to oxycodone and xanax originating from these Florida based pill mills. The state legislature has finally make major progress in stemming the illegal activities by tougher regulations, including limiting physician dispensing of narcotics. Hopefully, we've seen the end of South Florida serving as the capital of "Oxy Alley."
Just FYI, none of these docs were board certified pain management specialists. They were all employed by one of four clinics owned by the infamous George twins, who earned over $40 million in two years operating these pill mills. The clinics were responsible for dispensing over 20 million oxy pills. The 30 year old George twins are felons who had previous convictions for drug crimes and were somehow allowed to own and run these clinics and affiliated pharmacies. They paid their physician employees ~$35,000 per week with bonuses for the highest performers.
The physician charged with murder was a retired pediatric surgeon. The others charged include three general internists, one FP, two general surgeons, two anesthesiologists , one plastic surgeon, one ER doc, one cardiologist (age 70), one nephrologist (age 72), and one radiologist (age 76).


June 3, 2011A US Supreme Court on Tuesday affirmed the conviction of a Filipino-American doctor found guilty of overdosing and eventually causing the death of his patient. He was sentenced to life imprisonment.

The Georgia State Supreme Court in Atlanta said Dr. Noel Chua violated Georgia’s Controlled Substance Act after prescribing painkillers and other drugs to Jamie Carter III. 

The drugs led to Carter’s death 10 days before Christmas in 2005, according to Georgia’s highest state court. 

Court records showed Chua prescribed 10 narcotics to Carter between September and December 2005. In particular, police said Chua was prescribed methadone for treatment of Carter’s persistent headache six days before the latter’s death. 

On one prescription in November 2005, a certain pharmacist wrote Carter was receiving too many painkillers. Carter replied that his doctor was destroying the old medications, according to the pharmacist’s note.

Chua himself wrote that Carter willingly returned old medications and feared being labeled a drug seeker.

But according to the Composite State Board of Medical Examiners, Chua wrote several prescriptions without examining Carter, and in November alone prescribed four different painkillers in escalating amounts.

The board said Carter was seen with syringes and bags of drug samples and bragged to friends he could get them any drug they wanted if they visited Chua.

Prosecutors also listed other instances where Chua signed black prescription forms, prescribed drugs without examining the patient, and engaged in other irregularities between 2003 and August 2006, eight months after Carter’s death.

Chua, an alumnus of Far Eastern University’s medical school, excelled in his class which landed him in the 11th spot of the 1992 Philippine medical board exam.

He worked for a time as a Christian missionary doctor in Palawan before flying off to the US to get his master’s degree in health care policy and management from the Carnegie Mellon University in Pittsburgh, Pennsylvania. He received the highest honors in his graduate studies. — Joseph Lariosa/JE, GMA News


May 22, 2011 The Florida Department of Health has suspended a Southwest Florida doctor accused of running a pill mill at her Lehigh Acres and Pinellas Park offices.
The emergency suspension order was signed by the Florida Surgeon General May 18.
The Emergency Suspension Order is the result of an investigation conducted by the Department of Health after allegations Dr. Jacinta Gillis was operating "pill mills" out of her two office locations.
Investigators say Gillis prescribed pain pills after performing only cursory exams and failing to check the patient's medical history.
The state claims Gillis' behavior poses an "immediate, serious danger to the public health, safety or welfare."
Gillis' offices were closed after a raid in October. In April 2011, Lee County deputies arrested the 41-year-old doctor on charges of money laundering and trafficking controlled substances.
We went by her Fort Myers home, but received no response.
She did speak to us by phone. She maintains her innocence and says she did not break any laws.
In an interview last October, Gillis said she was victimized by the war against drugs.
Gillis has 30 days to appeal the department's findings.

Specific allegations from the emergency suspension order:
A 38 year old male patient was given only a cursory physical exam on August 27, 2008 and received a prescription for 90 Percocet pills.
A 42 year old male was given a cursory exam on August 4, 2008 and was prescribed 120 Oxycodone 30 mg pills. On August 27, 2008 he was again prescribed 120 Oxycodone 30 mg pills. Although the patient stated he had a pain level of zero, the Oxycodone pills allowed the patient to relax, according to Dr. Gillis' records.
A 25-year old male went to see Dr. Gillis on June 23, 2008. She prescribed 60 Xanax 1 mg and 210 Oxycodone 30 mg pills. Between July and November 2008, Gillis prescribed an additional 920 Oxycodone 30 mg pills to the patient.
A 28 year old female patient was prescribed 150 Oxycodone 30 mg pills and 20 Zoloft 50 mg pills on June 20, 2008. On June 27, the doctor prescribed 60 Xanax pills 1 mg and 60 Soma 350 mg. July 16, the doctor prescribed 180 Oxycodone 30 mg pills and 30 Zoloft 50 mg pills. The patient also received 180 Oxycodone 30 mg pills on September 29th and 200 Oxycodone 30 mg on October 28.
Patient MG first began seeing Dr. Gillis on December 19, 2008 for pain related to a car accident in November 2007. From January 2009 to December 2009, MG was prescribed a total of 3,400 pills:
720 pills of Oxycontin 40 mg
1920 pills of Oxycodone HCL 30 mg
40 pills of Oxycodone APAP (10-650mg)
390 pills of Oxycontin 60 mg
180 pills of Diazepam 10 mg
150 pills of Alprazolam 2 mg
Dr. Gillis is accused of performing only cursory examinations on the patients and failed to perform an adequate review of each patient's medical history. She also is accused of failing to develop plans for the treatment and management of the patient's pain. She is also accused of failing to take urine samples or monitor her patients to ensure they were taking the medication prescribed to them and were not abusing, overusing or diverting the medication to someone else.
Undercover officers posing as patients visited her clinic eleven times from February 2009 to May 2010. They received prescriptions for a total of 1,260 Oxycodone 30 mg tablets.
A former employee told investigators Dr. Gillis began using a web cam to see patients in 2010. The employee said 33 different patients received prescriptions from unlicensed personnel after the web cam sessions.
After Gillis surrendered her DEA license, which allows her to prescribe controlled substances, she hired another doctor to write prescriptions for her patients.
The doctor told investigators she worked for only a few days and left when she suspected Dr. Gillis was using her to operate a pill mill, according to documents released by the state.


Mar 2011 A Monroe doctor was charged in federal court with fraud for reportedly writing prescriptions for more than 5 million doses of narcotics during a two-year period and reportedly fraudulently billing Medicare for more than $5.7 million. 

Federal, state and local officials raided the office of Dr. Oscar Linares in a strip mall on LaPlaisance Rd. Wednesday following a 15-month investigation. Dr. Linares, 53, was arrested and charged with unlawfully distributing prescription drug controlled substances, including OxyContin. He also was to be charged with health care fraud, according to U.S. Attorney Barbara L. McQuade.

Drug Enforcement Agency officials said between April 1, 2008, and March 24, 2010, Dr. Linares prescribed more than three million doses of narcotics. He then increased his prescribing activity, they said, prescribing an additional 2 million dosages of drugs between June and October, 2010.

Local drug-free advocates applauded the move on the clinic, which was closed indefinitely.

"It was common knowledge that (the federal government) was watching him," said April Corie, coordinator of the Monroe County Substance Abuse Coalition. "I'm pleased they took action."

Outside the clinic Wednesday, many patients milled around, some waiting to get inside even with numerous marked police cars parked in front of the clinic. They said they supported Dr. Linares and his practices. Robert Greer, 61, of Toledo said he suffers from four herniated discs in his back and he has been a patient of Dr. Linares for three years.

"He's a wonderful doctor," said Mr. Greer, who was prescribed Percocet for his pain. "He's the only one who helped me."

"I support him 100 percent," added Carmen Darnell, a patient from Toledo who suffers from neck pain. "I don't understand this."

But investigators said Dr. Linares ran what they described as a prescription mill that he allegedly called an untouchable empire, according to a federal affidavit.

"This investigation and the arrest of Dr. Linares should serve as a warning to any medical professional that if you unethically prescribe medication for personal gain, you will be prosecuted to the fullest extent of the law," Robert L. Corso, special agent in charge of the DEA's Detroit Field Division, stated in a press release.

In addition to the raid at the clinic at the strip mall near I-75, federal officials searched at least two other locations, including Dr. Linares' Monroe home. 

Federal officials also seized assets in four banks accounts, seven luxury vehicles and two boats, which they believe were paid for with proceeds from his illegal activities, agents said.

In the affidavit, federal authorities describe an operation for which thousands of patients came from surrounding states and would wait hours for prescriptions, often never seeing a physician.

Surveillance officers described the parking lot being so full of vehicles that an attendant had to direct traffic. On a daily basis, patients came to the clinic two or three in one vehicle and left the clinic with prescriptions and documents.

Many paid cash, up to $200 for an office visit and $250 more for tests that were described as rudimentary. The clinic generated millions of dollars in office visits alone, the affidavit said.

Investigators also allege that some patients were selling their prescriptions in the parking lot, but the doctor refused to do anything, stating that he was "not the police."
Efforts to reach Dr. Linares or his attorney were unsuccessful. According to its website, the Monroe Pain Center was founded by Dr. Linares in 2006 and calls itself one of the premier pain management facilities in the U.S.

Dr. Linares, a licensed physician since 1987, had two former practices, one as a geriatric physician and he ran another office in Flat Rock. Neither is in use, officials said.


March 12, 2011 Vinita, OK State board suspends Vinita doctor

He prescribed more than 1,000 narcotic pills to a patient who later died.

By SHEILA STOGSDILL World Correspondent
Published: 3/12/2011 2:30 AM
Last Modified: 3/12/2011 6:55 AM

VINITA - A Vinita doctor who prescribed more than 1,000 narcotic pills to a nursing instructor who died with toxic amounts of the drugs in her system has been suspended by the Oklahoma Board of Medical Licensure and Supervision for 30 days and fined $25,000, a spokeswoman said Friday.

Dr. Mickey Ray Tyrrell, 38, appeared before the medical board Thursday for more than three hours, said Janet Swindle, secretary for the investigations department.

Tyrrell also was suspended for an additional 30 days but is allowed to practice obstetrics, she said. The suspension was effective Thursday.

Swindle said Tyrrell also must perform 200 hours of community service.

Tyrrell is accused of prescribing excessive amounts of narcotics to Tammy Dawn Daniels, 35, of Vinita, who died Sept. 5, 2009, of acute combined drug toxicity from forms of the painkiller Demerol, according to an autopsy report.

Phone calls to Tyrrell's home and office and to Daniels' family were not returned.

Daniels, who worked as a nursing instructor at the Northeast Technology Center, was being treated by a Tulsa urologist for interstitial cystitis, a recurring pain in the bladder and pelvic region, when she started seeing Tyrrell for pain management.

Pharmacy records from June 2 through Sept. 2, 2009, show that Tyrrell prescribed 990 Demerol pills and 120 OxyContin pills to her.


March 7, 2011 (CNN) -- A Massachusetts doctor and his nurse face charges that they conspired to distribute controlled substances, a practice that authorities claimed led to the deaths of six patients, according to a criminal indictment released Thursday.
Dr. Joseph Zolot and Lisa Pliner -- both of whom practiced in Needham, about 15 miles southwest of Boston -- appeared in a federal court Thursday. They will be charged with one count of conspiracy to distribute methadone, oxycodone and fentanyl, as well as seven counts for the distribution of controlled substances.
Dennis Dillon, Jeffrey Campbell, Thomas Dunphy, James Curley, Christopher Bartoloni and Scot Poulack died between February 2004 and September 2006 after overdosing on methadone prescriptions they received from Zolot and Pliner. The men ranged in age from 26 to 49 at the times of their deaths, according to Zolot and Pliner's indictment.
Many of the prescriptions were given despite indications that the patients were abusing, misusing or illegally distributing drugs, the indictment alleges. Prosecutors further contend that the distribution of the drugs led to the addiction, deteriorated health, overdoses and -- ultimately -- deaths of the men.
Zolot and Pliner issued the prescriptions to make money, rather than for legitimate medical purposes, the indictment claims.
Individuals were billed $300 for their initial visits to the nonsurgical orthopedic clinic, and $100-$150 for subsequent visits, the court document states. Patients visited the offices at least once every month to receive prescriptions.
Approximately 40 to 50 people a day would frequent Zolot's office four days a week, according to the indictment. Zolot and Pliner did not adequately give physical examinations during those visits, which tended to be very brief, according to the court document.
Zolot's attorney David Meier maintains that his client is innocent. He said that the doctor has been aware for years that these charges may be forthcoming, and looks forward to defending himself in court.
"At all times, Dr. Zolot acted in good faith as a practicing physician," Meier said. "His intent was to do good as a doctor, it was never his intent to cause harm, never mind death."
Zolot voluntarily surrendered his medical license in 2008 following a preliminary FBI investigation into his medical practice that began the previous year, his attorney said.


February 27, 2011 Berea Kentucky doctor’s medical license revoked
By Bill Robinson Senior News Writer The Richmond Register Sun Feb 27, 2011, 07:00 AM EST
BEREA — The state Board of Medical Licensure in December revoked the license of a Berea physician who came to Kentucky and was licensed in 1994, despite a history of being disciplined by medical authorities in Colorado and serving time in federal prison for drug offenses.

Dr. Mary Margaret Miller had practiced family medicine in Berea for about 10 years before losing her license, according to members of the local medical community. Her last office was at 125 Clay Dr., near the intersection of Ellipse Street and Richmond Road.

Her license was revoked, according to board records, based on the findings of Paula York of the agency’s Drug Enforcement and Professional Practices Branch, who described Miller as a “‘generous’ prescriber of narcotics, benzodiazines and diet pills ….”

The investigation was launched after a pharmacist questioned Miller’s prescribing of narcotics, the revocation order states.

Miller failed to perform “due diligence in her evaluation compliance” and “did not take detailed past histories, social histories or history of drug abuse to assess risk of (patients’) drug abuse,” the investigator reported.

Miller’s patients at times were “over-sedated” and “sleeping all the time from massive doses of narcotics,” according to York. Even after observing those symptoms, Miller did not decrease the patients’ doses, the investigator stated.

The doctor should have performed drug-screening tests to patients for whom she prescribed narcotics, York told the board. In a June 28, 2010, letter to York, Miller wrote that “she has not needed to do ‘random urines’” to test her patients, a statement that York characterized as “at best naïve, given the rest of the red flags noted in the medical records.”

Pharmacists also reported that Miller had prescribed “toxic doses of Tylenol” in combination with vicodin and Percocet, York reported. The doctor also allowed “early refills and too-generous quantities” and suggested that patients “try others’ medicines (implicitly allowing ‘sharing’ of medicine), which is illegal.”

The order states the Kentucky board will not consider re-instating Miller’s license for two years, something the Colorado board did, even after Miller was convicted of federal drug offenses.

In 1984, Miller served 10 months in prison and four months in a halfway house and paid a $75,000 fine when she was convicted by a federal jury in Colorado for “illegal distribution of scheduled drugs.”

According to the Kentucky revocation order:

In December, 1986, Colorado’s board of licensure re-instated Miller’s medical license but required her to work under another doctor’s supervision and prohibited her from prescribing scheduled drugs.

In April, 1990, she completed a four-month voluntary commitment to a professional health program in Hampton, Va.

In September, 1990, Colorado revoked her medical license for “habitual intemperance.”

Even with that history, the Kentucky board in 1994 granted Miller a one-year limited license for “institutional practice” at the University of Louisville Medical School.

About 13 months later, Kentucky licensed Miller for a five-year probationary period, but stipulated she could prescribe controlled substances only with the signed approval of another physician.

That limitation on prescribing controlled substances was removed in September, 1997, but Miller was required to maintain a log of such prescriptions and allow review of it on request.


Feb 25, 2011 MIAMI — Drug Enforcement Administration agents and other law enforcement officials on Wednesday raided six South Florida pain clinics accused of illegally dispensing potent prescription drugs across the United States. Twenty-two people, including five doctors, were arrested on state and federal drug trafficking charges.
The one-year undercover inquiry, dubbed Operation Pill Nation, focused on storefront clinics in Miami-Dade, Broward and Palm Beach Counties that the authorities say have become a national clearinghouse for illegal prescription drugs and highly addictive painkillers like oxycodone. Investigators described the operation as the federal government’s most aggressive effort to shut down the so-called pill mills they say have contributed to sharp increases in overdoses and addiction.
South Florida has long been a place where prescription drugs could be obtained easily and cheaply. In recent years, such pill mills have flourished in strip malls from Miami to Palm Beach Gardens, with the highest concentration of rogue clinics in Broward and Palm Beach Counties, officials said.
“This is a completely profit-driven operation that has no medical regard for anyone,” Mark R. Trouville, the special agent in charge of the Miami field office for the D.E.A., said in an interview. “These clinics have nothing to do with the welfare of the community.”
Mr. Trouville said that since the operation began a year ago, a task force had taken action against 66 doctors at 83 locations and seized more than $25 million worth of property.
Wednesday’s raids came several weeks after Gov. Rick Scott announced his intention to halt a planned state database for tracking the sale of prescription drugs. Mr. Scott, a Republican, has said the database is an invasion of privacy and a waste of money, drawing criticism in Florida, even from some fellow Republicans, and from two Democratic senators, Charles E. Schumer of New York and Joe Manchin III of West Virginia.
More than 20,000 people a year die of prescription drug overdoses, including an estimated seven a day in Florida, according to the Centers for Disease Control and Prevention.
Among those arrested on Wednesday was Dr. Zvi Perper, who owns Delray Pain Management in Delray Beach. Dr. Perper, whose father is Dr. Joshua Perper, the Broward County medical examiner, had no comment as he was led away in handcuffs and beige medical scrubs.
The authorities said they seized more than $2.5 million worth of homes, property, luxury cars and boats belonging to doctors and clinic owners on Wednesday.
In the last year, undercover agents, posing as patients without legitimate medical ailments, were able to easily obtain powerful narcotics like oxycodone and hydrodone, law enforcement officials said.
Mr. Trouville said addicts, driving cars with out-of-state plates, camp out most nights and wait for clinics to open at 10 a.m. “When we go into these clinics, there is a gun in there,” he said. “How many times have you gone into your doctor’s office and there’s an armed guard outside? They don’t take insurance. This is a facade that these clinics provide a service to the community.”


Feb 1, 2011 NIAGARA FALLS, N.Y. (WIVB) - Federal agents have arrested a Niagara Falls doctor accused of writing illegal pain prescriptions.
Uniformed officers with automatic weapons stand guard outside of Dr. Pravin Mehta's medical office in Niagara Falls. His patients were turned away.
One patient said, "I was just pretty shocked. Go see my doctor just to see all these police."
Dr. Mehta is accused of issuing pain killer prescriptions to patients without a proper medical exam. The investigation, which began about a year ago, involved undercover agents posing as patients.
U.S. Attorney William Hochul said, "On some occasions weren't asked any questions at all about their particular medical condition."
Authorities believe some of the painkillers prescribed by Mehta wound up being sold on the streets illegally, and they point to a recent narcotics bust.
Niagara Falls Police Superintendent John Chella said, "16 out of the 38 bottles that we seized. 16 of them were illegal controlled substances. 16 of these had Dr. Mehta's name on them."
Besides Mehta, 13 others, including current and former employees of Mehta's medical practice, are charged in connection with the prescription drug probe.
"Some of the defendants sold these pills, which they obtained from Dr. Mehta's office, on the streets of our community for between $30 and $50 a pill," said Hochul.
The 73-year-old physician, who authorities say was known on the street as "Dr. Feel Good," appeared before a judge in federal court.
"Today I can say proof positive that we did get the head of the snake, and boy did we get the supplier," said Chella.
Hochul says in 2009, Dr. Mehta prescribed almost twice as many pills as all the other prescribers of Niagara County combined.


2 doctors charged in federal indictment

Local physicians accused of operating pill mill

November 18, 2011 08:56:49 PM

_CHRIS OLWELL / News Herald Writer_ 

PANAMA CITY ? Two doctors have been charged in federal court with more than 
100 criminal counts for allegedly operating a pill mill-like practice out 
of a local clinic and one doctor?s Youngstown home, according to an 
indictment unsealed Friday. 
Rudolfo B. Torres, 76, of Youngstown, appeared Friday afternoon in slacks 
and a blue doctor?s smock before Magistrate Judge Larry Bodiford at the U.S. 
District Courthouse to plead not guilty to the charges in the 109-count, 
29-page indictment. He promised to appear at future hearings and surrender 
himself if he is sentenced in this case. 
We are not seeking Dr. Torres detention. We do not believe he is a 
flight risk,? Assistant U.S. Attorney Gayle Littleton said in court. ?When he 
could no longer dispense controlled substances, he ceased being a danger 
to the community.? 
Torres declined to comment on his way out of the courtroom. He faces 70 
counts in all, and a maximum sentence of life in prison for one count of 
dispensing a controlled substance resulting in the death of an individual 
identified in the indictment as ?F.R.? He also is charged with eight counts of 
health care fraud, each of which carries a possible 10-year sentence, and 61 
counts of unlawful dispensing of controlled substances. 
Abdul Salman, 66, did not appear in court Friday and a warrant for his 
arrest is outstanding. He was charged with 33 counts of unlawful dispensing of 
controlled substances, one count of dispensing a controlled substance 
resulting in the death of an individual, identified in the indictment as ?R.T.,?
and five counts of health care fraud. 
According to self-reported information on the Department of Health?s 
website, Salman received much of his medical training in Iraq and in 2010 settled 
a dispute with the Florida Agency for Health Care Administration about 
overpaid Medicaid claims. He was fined $3,000. 
Both doctors are accused of prescribing narcotic painkillers in large 
quantities between 2005 and 2009 to patients who were addicted or already had 
overdosed without a legitimate purpose and despite information that patients 
were selling, sharing or otherwise abusing the medications. In some cases, 
medication was prescribed without an examination and without a documented 
medical justification, the indictment alleges. 
Salman operated the Gulf Coast Medical Clinic on 15th Street where Torres 
also practiced before moving his practice to his home in Youngstown. Both 
doctors voluntarily surrendered their license to prescribe controlled 
substances in 2009, authorities said. The latest crime alleged in the indictment 
occurred in February 2009. 
Bodiford set Torres trial for the week of Jan. 23, 2012. 
State Health Department records indicate that Torres medical license will 
expire Jan. 31, 2012. Records state that Salmans license expired in 
January and that he is retired.


Oct 27, 2011 Doctor indicted in prescription sales at coffeehouses [Los Angeles Times]

Oct. 27--An Orange County doctor who authorities said brazenly sold prescriptions for pills as potent as heroin out of Starbucks coffeehouses was arrested late Tuesday after being indicted on federal drug charges.
Dr. Alvin Ming-Czech Yee, 43, of Mission Viejo routinely wrote prescriptions for oxycodone, sometimes referred to as synthetic heroin, to his patients, a third of whom were 25 or younger, authorities alleged in court papers.
Yee sold the prescriptions for cash after cursory examinations that were often conducted in coffeehouses and other unusual locales, court documents state. He once took out his prescription pad in a Las Vegas casino to generate more cash for gambling, according to a search warrant affidavit filed in U.S. District Court in Santa Ana.
On another occasion, he met a patient in the showroom of an Irvine Toyota dealer where Yee was buying a new car, according to the affidavit written by Drug Enforcement Administration Agent Mark Nomady. After a few minutes of talking and laughing with Yee, the patient left with a prescription.
Yee pleaded not guilty Wednesday during a hearing in front of U.S. Magistrate Judge Robert Block. His bond was set at $500,000.
Yee's attorney, Shepard Kopp, declined to comment because he had not yet reviewed the 56-count indictment with his client.
At least one of Yee's patients, a 21-year-old woman from Huntington Beach, died of a drug overdose in August after he prescribed drugs for her, according to a preliminary finding by the Orange County coroner's office, the affidavit states. From November 2010 to August 2011, the woman received 28 prescriptions from Yee, according to the documents.
Several other overdose deaths in which Yee may have played a role are under investigation, the affidavit states.
Investigators have seized large quantities of commonly abused drugs linked to Yee from suspected drug dealers and others in Seattle, Phoenix and Detroit, the affidavit states. One man was arrested twice in Seattle on charges of trying to sell hundreds of tablets of the painkillers OxyContin and Roxicodone prescribed by Yee, court records state.
A medical expert who reviewed Yee's practice for federal prosecutors called it "a front for drug dealing."
Federal prosecutors say Yee met up to a dozen people almost every evening between 7 p.m. and 11 p.m. in Starbucks stores throughout Orange County. Yee allegedly charged as much as $600 for meetings in exchange for prescriptions for drugs such as OxyContin, Vicodin, Xanax and Adderall, according to the affidavit.
Yee's examinations lasted about a minute and consisted of checking patients' blood pressure and pulse, and asking them to bend over to touch their toes, the affidavit states. Yee laughed and joked with patients -- and undercover DEA agents -- and told them business was good, prosecutors allege.
Several area pharmacists refused to honor prescriptions written by Yee because of the large number and high dosages of his narcotic prescriptions, according to court documents.
The patients aroused suspicions, in part, because they were between 25 and 30, came in groups and paid cash, said one pharmacist cited by the affidavit.
Yee said some pharmacies started "freaking out" when they saw his patients with multiple potent medications on the same prescription sheet, the affidavit states.
"They are giving me the reaction like I'm the devil or something," Yee allegedly told a source assisting the DEA.
Assistant U.S. Atty. Ann Luotto Wolf, who is prosecuting Yee, said the problem of doctors prescribing medications without a legitimate medical purpose is a significant one.
"I think it is becoming more recognized, and certainly more indictments like that of Dr. Yee will make the public more aware of what's occurring," Wolf said.
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Tampa Pharmacy Owner Charged
10/13/11 | SOURCE: TBO.com

The owner of New Tampa Pharmacy on West Waters Avenue - along with two pharmacists there - illegally distributed oxycodone, according to the U.S. Attorney's Office.

The office announced today the unsealing of an indictment charging pharmacy owner Retsidistswe Griffith, 32, of Tampa, with one count of conspiracy to possess with intent to distribute oxycodone and one count of acting outside the scope of professional practice by dispensing and distributing oxycodone.

Pharmacists Brian C. Weiler, 52, and Treshena L. Dixon, 41, face the same charges.
The United States also intends to forfeit the trio's Drug Enforcement Administration registrations.

As part of the case, 10 others were charged with conspiracy to possess with intent to distribute oxycodone.
They are: Joshua Shane Barber, 25, of Tennessee; Nelson Garcia, 44, of Pasco County; Derrick Choate, 24, of Tennessee; Robert Clawson, 41, of Pasco County; Michael Saunchgrow, 39, of Pasco County; Misty Key, 29, of Pasco County; Eric Trabucco, 29, of Tennessee; Megan Barber, 29, of Tennessee; Michael McBroom, 27, of Tennessee; and Edward Desimone, 28, of Pasco County. Choate and Garcia also were charged with one count of possession with intent to distribute and distribution of oxycodone.

The defendants face a maximum of 20 years in federal prison for each count, according to the U.S. Attorney's Office.

In a separate indictment, 48-year-old Sanjeev Grover of Tampa - a physician practicing in Tampa - was charged with five counts of illegally distributing or causing the distribution of oxycodone, a U.S. Attorney's Office release states today.

Grover illegally prescribed oxycodone five times between April 12 and June 9, the indictment states. If convicted, Grover faces a maximum of 20 years in federal prison on each count. The United States also intends to forfeit Grover's Drug Enforcement Administration registration.


Oct 20, 2011 Michigan A family medical practice in Macomb Township has closed its doors 
permanently after an investigation has accused its primary physician of writing 
illegal prescriptions. 
The Macomb Family Medical Center, located on 24 Mile Road, was served 
primarily by Dr. Alan Peter, 40, who, according to court documents obtained by 
_Local 4 News_ (http://www.clickondetroit.com/news/29543439/detail.html) , 
is alleged to have written 50-100 prescriptions for patient Grant Schwartz, 
39, and Schwartz' two children. 
Schwartz, the son of a retired Macomb County Circuit Court judge, is 
alleged to have used his father's insurance card to fraudulently obtain $18,000 
worth of prescriptions at local pharmacies, according to the warrant against 
Investigators told Local 4 they believe Schwartz profited from the sale of 
the prescriptions, which means Schwartz could face felony charges of 
delivery and manufacture of a controlled substance and conspiracy to commit 
health care fraud. Peter is facing a charge of controlled substance possession, 
according to Local 4 reports. 
Peter has surrendered his license to practice medicine.


Oct 9, 2011 Admitted drug dealer sues doctor who prescribed him painkillers, seeks $43 million in damages [York Daily Record, Pa.]

Oct. 09--YORK, Pa. -- A York man who pleaded guilty to illegally selling prescription drugs is suing the doctor who prescribed the painkillers to him for medical malpractice and medical negligence.
Lionel "Beans" Sease is serving a six-to-16-year sentence for possession with the intent to deliver drugs and cocaine delivery.
Sease led authorities to Dr. Michael Dobish in January 2010 after Sease was investigated for obtaining large amounts of prescription painkillers from area pharmacies.
Dobish, of Spring Garden Township, pleaded guilty in August 2010 to illegally dispensing drugs and Medicaid fraud. He was sentenced to three to six years in prison and ordered to serve 27 months before becoming eligible for probation.
He also was ordered to pay $73,787 in restitution to Medicaid and lost his medical license for 10 years.
The doctor denied making a financial profit from the prescriptions he wrote for Sease, one of his patients.
Sease now is suing Dobish and his former medical practice, Dallastown Medical Associates, alleging that Dobish's "malpractice" resulted in his becoming "highly addicted and or dependent" on Vicoden, Percocet and Oxycontin.
He said the addiction made him "dysfunctional and engage in bizarre, uncivil and harmful behavior."
Sease, who is seeking $35 million in punitive damages and $8 million in compensatory damages, claims the drugs caused "irreparable loss" to his "mental stability and emotional well-being."
Sease also named Dobish's former practice and medical associates as defendants for alleged negligent supervision of Dobish.


Oct 17, 2011 HOUSTON (KTRK) -- More than a dozen people have been charged and several businesses have been shut down. Investigators say they were pill mills -- places where people could easily get their hands on prescriptions written illegally.

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We first told you about the story Thursday night on Eyewitness News at 10pm. Among those charged are a doctor and a Houston police officer.

The operation shut down four businesses operating in November 2010, spread out across Harris County -- on West Parker, Federal Road, Long Point, and in Highlands on Main Street.

What was once a so-called pain clinic is now shuttered. The 'IMed' sign has been tossed carelessly next to a a large trash bin. But neighboring business owner Donald Huynh always suspected something.

"Yes, weird, and trash, and that was everywhere," said Huynh.

He was right on. IMed is one of four main clinics shut down by investigators. This week, the District Attorney's Office charged 13 people, including at least one doctor and an HPD officer, for operating a massive pill mill ring.

"It's all cash, and what happens is you can go to one of these places, and pay 100 bucks and see a 'doctor,'" said Assistant District Attorney Ryan Patrick. "You see the doctor, and then you get the prescription, then you go to a pharmacy that's related, and then you get all your pills. That's how it works."

Patrick says clinics like IMed and Umat would dispense prescriptions for pain pills to just about anyone. Since state law requires clinics to be owned by doctors, prosecutors say Dr. Akili Graham pretended to own all four, when in reality HPD Officer Danny Muhammed owned two, and two other defendants owned one clinic a piece.

Some of those charged in this investigation face accusations of prescribing medication like hydrocodone. Essentially, they were practicing medicine without a license. But according to prosecutors, that's not where the problems end.

"Other times, the problem is with ownership in the pain clinics. You have to be a licensed medical doctor to have an ownership interest. Several of these people were not licensed doctors and still had ownership shares in the business and actually helped operate the businesses," said Donna Hawkins with the Harris County District Attorney's Office.

"In this investigation, there were 13 people, and the grand jury handed down 19 indictments," said Patrick.

Prosecutors say these pill mills are a growing problem.

"As of today, there are 321 pain management clinics in the state, and of those, 40 percent are in Houston," said Patrick.

Steve Symeonidis is relieved to hear the news. His company managed the property where the Umat clinic was located and now he understands why it's been impossible to collect back rent.

"In May, no later than June, they defaulted and they haven't paid rent since. And we've been trying to find them," said Symeonidis. "I think they did something shady; obviously for the government to step in, they must have done something wrong."

We're told 11 of the 13 people have been arrested and charged. Here is a list of those facing charges:

Akili Henry Graham, 44
Gladys Ngumezi, 55
Christian C. Nnabuffie, 38
Juan E. Rojas, 60
Jacqueline Nicole Hendry, 39
Vanessa Sepulveda, 28
Angeline Prince, 52
Kenneth Hopkins, 44
Durce Muhammad, 49
Isaiah Muhammed 
Jacqueline Weil 
Danny Muhammad (not in custody)
Tamu Muhammad (not in custody)
For now, prosecutors say Danny Muhammad has not turned himself in. HPD says he has been on administrative leave since December 2010 while both an Internal Affairs and a criminal investigation are ongoing. He is a 14-year veteran of the police department.


Oct 20, 2011 A Manhattan doctor was arrested by federal agents Wednesday on charges he was supplying thousands of prescription pills to a drug gang that then sold them on the street.

Drug Enforcement Agents and U.S. marshals raided the Washington Heights offices of Dr. Felix Rodriguez and arrested him at his home in the early morning.

DEA officials said Rodriguez, an internal medicine doctor, wrote hundreds of prescriptions for designer drugs like Oxycodone for the drug gang. Gang members then allegedly sold the drugs on the street for as much as $30 per pill.

Nearly 50,000 pills were allegedly sold; investigators said Rodriguez pocketed more than $500,000. Investigators said the crew referred to pills as "jelly beans" during cell phone conversations.

DEA agents questioned Rodriguez in February after he made an apparent delivery in his Mercedes along Gun Hill Road in the Bronx. Prosecutors said Rodriguez claimed he was addicted to painkillers and that he writes prescriptions to patients, who then return the filled prescriptions to him in exchange for free medical care.

“Dr. Felix Rodriguez hid behind his white jackets while overseeing and facilitating an Oxycodone distribution ring in the Bronx,” said DEA Acting Special Agent in Charge Wilbert Plummer.

Officials said Rodriguez worked with at least five others who helped store the drugs in a Bronx safehouse.

Cocaine was also allegedly sold on the streets by members of the crew. Authorities found ledgers that contained names of customers and amounts; Rodriguez was named as a cocaine customer, prosecutors said.

The others involved are charged with drug trafficking counts. If convicted, the suspects could face a minimum of 10 years in prison and up to $4 million in fines.

Abuse of prescription drugs is now second behind marijuana the list of drugs abused by Americans, DEA officials said. 

Investigators said the drug gang sold Oxycodone on the black market across Westchester and the Bronx.

More than five kilos of cocaine was also sold during the course of the investigation, prosecutors said. 

Oxycodone is a painkiller that can be highly addictive.

In June, four people were shot and killed in a Long Island pharmacy where the suspects were allegedly trying to steal painkillers to feed their addiction. Across the nation, pharmacies have increasingly been targeted for hold-ups as criminal gangs and addicts try to get their hands on several kinds of prescription medications.

Attempts to reach Rodriguez’s attorney were not immediately successful. A woman outside his office declined to give her name but said the doctor was a caring man and she is shocked by news of his arrest.


Oct 25, 2011 INDIALANTIC, Fla. — A Brevard Co. doctor bonded out of jail Tuesday night, following his arrest for a sex-for-drugs trade, and WFTV has learned that this isn't the first time Gayden has been arrested for this crime.

Dr. John Gayden of Indialantic is one of the top pain pill prescribers in the county, prescribing more than 250,000 oxycodone pills in eight months, according to investigators. That amount is enough to nearly top the number of pills distributed in the entire state of California last year. 

Investigators said they had the evidence they needed for the charges involving the underage teen Gayden is accused of having sex with, and prosecutors could still add drug charges after reviewing the case. 

Gayden has been down this road once before. A little more than two years ago, he was arrested after sheriff's deputies said he had sex with a minor and gave the girl drugs. 

But prosecutors dropped the charges after they had problems with the evidence and key witnesses changed their stories. 

Authorities said they have been investigating him in part because he is known for writing more prescriptions for pain medications than any other doctor in Central Florida. More oxycodone pills are distributed in Florida than all the other 49 states combined. Officials said 98 of the top 100 doctors in the country who dispense the powerful drugs are in Florida. Prescription drugs are the number one killer of middle-aged Floridians.

Police said they have also been investigating prescription abuse accusations made as far away as Winter Park, where the doctor recently bought a $1 million condo.
Neighbors in Indialantic said his clinic was bringing down the community. 

"Everyone was kind of aware of what was going on here for a long time, so I think it's good," said neighbor Judy Walton. 

But a woman who declined to give her name said she has seen the doctor several times, and said the doctor was prescribing pain pills when people needed them. 

"When they come to you with a legit MRI, what are they supposed to do? I've seen people with neck braces and back braces," she said. 

Meanwhile, the state has taken away Gayden's medical license, and he won't be able to write any more prescriptions, but his patients can still fill the prescriptions he already wrote them.
Previous story: Brevard County doctor arrested


Oct 18, 2011 Putnam County Indiana A 57-year-old physician in Putnam County was arrested today on 12 felony counts of unlawful dispensation of a controlled substance and three felony counts of furnishing false or fraudulent information, authorities said.

Dr. Ray D. Howell, identified in court documents as owner and sole practitioner of Tri-County Family Medical Clinic, Roachdale, was arrested at his home by an investigator with the Putnam County Prosecutor's Office and agents from the U.S. Drug Enforcement Administration, according to county Prosecutor Tim Bookwalter.


DEA officials arrest Sebastian doctor and co-owners of Treasure Coast Pharmacy

September 2nd, 2011 by TCPalm.com
By Jonathan Mattise

Drug Enforcement Administration officials arrested 13 people Thursday connected to a sprawling steroid and pain pill ring, including a Sebastian doctor and the father-son co-owners of Treasure Coast Pharmacy on Jensen Beach Boulevard — a facility the Department of Health called one of the country’s largest steroid supplier operations before shutting it down in June.

Treasure Coast Pharmacy’s Peter Dominic DelToro , 38, of the 700 block of Southwest Squire Johns Lane in Palm City, Richard R. DelToro, 60, of the 2000 block of Southeast San Jeronimo Road in Port St. Lucie, and Jaclyn Rubino, 31, of Stuart were taken into custody at Palm Beach County Jail on Thursday.

Peter and Richard DelToro are listed by Department of State records as Treasure Coast Pharmacy’s co-owners. Rubino also helped operate the pharmacy, according to a U.S. Attorney’s Office for the Southern District of Florida release.

Dr. Timothy Sigman, 40, of the 6000 block of 110th St. in Sebastian, also was arrested, in addition to a chiropractor and four more doctors, including one from California, the release said.

In what officials dubbed “Operation Juice Doctor 2,” the 42-count indictment states the defendants conspired to and distributed steroids, human growth hormone and oxycodone, and attempted to import steroids from China, the release said.

If convicted, the arrested parties can face up to 10 years in prison on the steroid charges, five years on the HGH and additional steroid charges, and 20 years on the oxycodone charges, the release said.

With Peter DelToro as top pharmacist, Treasure Coast Pharmacy dispensed almost 11,000 steroid and human-growth hormone orders and 3,700 other addictive prescriptions, such as oxycodone, from October 2010 to March 31, according to a Department of Health emergency suspension order. Peter DelToro filled more than 84 percent of those prescriptions, according to the order.

The DEA raided the pharmacy in late June, and seized boxes of patient records before pulling the pharmacy’s license to deal controlled substances. The Department of Health later ordered the facility closed, and suspended Peter DelToro’s pharmacist license.

The indictment said the pain, anti-aging and hormone replacement therapy clinics hired doctors to sign off on prescriptions written by the clinic operators and salespeople.

Doctors received the prescription orders, which were largely placed online, and signed off without in-person patient exams or regard for the orders’ quantities or dosages, according to the order. The signed prescriptions were sent to Treasure Coast Pharmacy through a third party, and then shipped to patients nationwide and as far internationally as Finland and Guam, according to the order.

Treasure Coast Pharmacy also had ties to distributing steroids to celebrities and athletes, according to court documents. The pharmacy started filling prescriptions between 2005 and 2007 for operations owned by Anthony Forgione, a fired Boca Raton police officer. Forgione is serving a 20-month federal prison sentence followed by three years of supervised release.

Forgione, who started selling anabolic steroids and human growth hormone in South Florida gyms in 2005, first used Dr. Gary Brandwein of Boca Raton to sign off on the prescriptions for a commission. After a 2007 raid on Forgione’s clinic, Infinity Longevity Inc. in Delray Beach, Forgione said during a 2008 guilty plea in an Albany, N.Y. court that each prescription was filled by Treasure Coast Pharmacy, court records show.

Forgione said Brandwein funneled steroids to rappers and athletes, including Chris Benoit, a pro wrestler who killed his wife and son and committed suicide in 2007. Brandwein pleaded guilty to New York drug charges in March 2008.

Forgione returned to Florida on probation, and used Delaware doctor Rodney Baltazar and new business partner Scott Lofquist from Kansas to continue the online steroid sales.

Treasure Coast Pharmacy filled each of their steroid orders, Forgione said when he pleaded guilty in April 2010. Forgione, Baltazar and Lofquist each received a 20-count indictment in April 2010 after selling steroids to undercover federal agents, according to federal reports.

Peter DelToro worked as manager of the Martin Memorial Health Systems pharmacy from 2002 to 2007, and left on his own terms, said Martin Memorial spokesman Scott Samples. Peter DelToro graduated from University of Florida’s College of Pharmacy after attending the University of Connecticut for undergraduate studies, according to Martin County records.

Richard DelToro, his father, worked as a police officer in Stamford, Conn., in the 1980s, according to court documents.

The Department of Health still lists Sigman’s doctor license as clear and active, and states he practices at 1515 U.S. 1 in Sebastian. He’s board-certified in internal medicine, graduated from the American University of the Caribbean and completed a residency in Memphis, Tenn.


Nov 2, 2011 Tampa, FL -- A Land O' Lakes doctor was arrested Wednesday after an investigation into a Tampa pain clinic.

According to detectives, 75-year-old Dr. Albert Ford, of the Busch Pain Clinic, was found to be operating out of the standard level of care.

Cases reviewed by Florida Board Certified Pain Management Doctors found he was significantly overstating the patient's level of pain and impairment, conducted inadequate medical exams and falsified medical records to justify the prescribing of Oxycodone. 

The clinic was investigated during the months of June and July 2011, when undercover officers and a confidential informant posed as patients.

The investigation resulted not only in Ford's arrest but two other employees as well. 50-year-old Maria Hernandez Abella and 30-year-old Daniel Corcino were arrested on July 7, 2011.

Ford is being charged with Writing a Prescription for Controlled Substance through Deception, Untruthfulness or Fraud.


Jul 11, 2011 Florida. Port Orange doctor arrested on pain-pill trafficking charges
Dr. Ataur Rahman was arrested on Tuesday after a lengthy investigation into his practice, officials said.
July 26, 2011|By Jeff Weiner, Orlando Sentinel
A Port Orange doctor and several others who investigators say took part in a large-scale pain-pill trafficking ring were arrested and charged on Tuesday, officials said.

The arrests were the result of an extensive investigation into the medical practice of Dr. Ataur Rahman by Port Orange police, the U.S. Drug Enforcement Administration and other agencies.

Authorities say that Rahman and his co-conspirators were involved in illegally distributing powerful pain medication through several Florida counties and outside the state.

In September, investigators searched Rahman's practice, on Swallow Tail Drive in Port Orange, as well as his home and banks where he held accounts.

He was arrested on Tuesday, charged with trafficking in illegal drugs, racketeering, conspiracy to commit racketeering and money laundering.

Also arrested in the sting were Maranda Francis of New Smyrna Beach; Bettie Gordon of Port Orange; and Sean Reynolds ofOrmond Beach.

A fourth person charged, Rick Roush, already was incarcerated in a West Virginia federal prison on unrelated charges, according to Port Orange police.

The alleged co-conspirators were described as patients or employees of Rahman, who authorities said participated in the trafficking activities with his knowledge.

"Today's five arrests for charges related to prescription drug trafficking are a perfect example of how we are working together to eradicate Florida's pill mills," Attorney General Pam Bondi said in a statement.

Authorities said the arrests are the culmination of a year-and-a-half long investigation involving undercover operatives, surveillance and information from pharmacies and concerned citizens.

According to state records, Rahman previously practiced pediatrics and family medicine in New York. His current specialty is listed as family medicine.

Records show Rahman was licensed to practice medicine in Florida in 2006. His medical licensing is currently under suspension in Florida, New York and Pensylvania, records show.

The Florida Department of Health filed a complaint against Rahman last year, accusing the doctor of prescribing an excessive amount of narcotic pain pills to an undercover department investigator.


Nov 4, 2011 Bakersfield, CA Three weeks after federal agents raided a Bakersfield medical clinic to examine the prescribing records of a local physician, that doctor has been arrested.

Gonzalo Flores Ruiz, 47, of Bakersfield, is accused of knowingly prescribing addictive prescription painkillers for "no legitimate medical purpose," according to the U.S. Attorney's Office. The drug at issue was hydrocodone, a controlled narcotic marketed under the brand names Vicodin, Vicoprofen, Lortab, Lorcet and Norco, among others.

Between April 2009 and October 2011, Ruiz prescribed and distributed the painkiller without medical justification and outside the usual course of professional practice, according to the 21-count indictment issued Thursday but sealed until Friday.

The doctor's former employer, Central Valley Occupational Medical Group, said the clinic was "shocked" by the allegations.

"What he's accused of, if it's all true, was done without our knowledge and was completely outside the scope of practice at Central Valley," said Barry Adelman, administrator of the clinic at 4100 Truxtun Ave. "We have 12 licensed medical providers who are all disgusted that he was apparently doing what he was doing. He has betrayed the trust of his colleagues, and the consequences for that betrayal should be his, alone."

Agents from the Federal Bureau of Investigation and the U.S. Drug Enforcement Administration who went to the clinic Oct. 17 were investigating Ruiz's "prescribing practices," Adelman said at the time.

Ruiz worked for the clinic part-time and was terminated after about a year of employment. Central Valley opened 11 years ago and has about 40 employees, Adelman said.

"The agents told us they were looking at a physician who is no longer employed here, not at the clinic or its owner," Adelman said last month. "They asked our staff not to see patients and to stay off of computers while they looked at some records, and of course we complied."

Central Valley Occupational Medical Group treats work-related injuries and provides pre-employment drug and alcohol screening, among other services.

Adelman declined to say when Ruiz was terminated or why, but did say that his employment ended before the federal raid.

No one responded to a message left at the last known telephone number for Ruiz.

The doctor was arrested in the Los Angeles area, and will remain in custody over the weekend, said Lauren Horwood, a spokeswoman for the U.S. Attorney's Office.

He is scheduled to appear before a magistrate judge there Monday, she said.

If convicted, Ruiz faces up to 10 years in prison for each of the 21 counts.

The case was the product of a joint investigation by the FBI, the DEA, the California Department of Health Care Services Investigations and the Medical Board of California.

Assistant U.S. Attorney Laurel Montoya is the assigned prosecutor.

Montoya, the FBI and the DEA all declined to comment Friday.

Ruiz has a valid California medical license that was first issued in 1992 and expires in November of next year, but he has a history of disciplinary action against him, according to public records on file with the Medical Board of California.

Ruiz was cited in 2010 for "abetting the unlicensed practice of medicine," for which he was required to pay a $2,500 fine.

Also, in 2000 he had sexual relations with a friend who also was a patient while she was passed out at her apartment after drinking, according to public records. Ruiz was disciplined for sexual misconduct and gross negligence and placed on seven years' probation, according to public records. He also was ordered to reimburse the cost of the investigation into the accusations and the administrative law proceedings against him.

It was unclear whether the federal case had led to yet another medical board investigation.

The medical board does not confirm or deny pending investigations into practicing doctors, a spokeswoman said.


Former Western Slope doctor arrested in Florida on fraud charge
POSTED: 08/11/2011 01:00:00 AM MDTBy Felisa Cardona
The Denver Post
Dr. Eric Peper was arrested Wednesday morning at his home in Florida, a day after his indictment on charges of health care fraud and dispensing painkillers that resulted in the deaths of four patients.

Peper, a former Western Slope physician, was arrested without incident and appeared in federal court Wednesday morning in Key West, Fla.

His co-defendant, Dr. Sam Jahani, is already in custody in Texas, where he last resided.

An indictment against both doctors alleges they defrauded Medicaid, Medicare and Rocky Mountain Health Plans by prescribing painkillers to patients outside the scope of professional practice, then billing those services to the health care benefit plans.

Some services were never rendered, the indictment says.

Four patients died after being prescribed high doses of painkillers such as Oxycontin.

Jahani operated three medical clinics called Urgent Care Inc. in Delta, Montrose and Grand Junction. Peper was an employee of the Delta and Grand Junction clinics.

The two doctors are expected to be transferred to Colorado, where the case will be heard.

If convicted of dispensing controlled substances resulting in death, they could be sentenced to life in prison.


Doctor arrested for prescription fraud
Couple faces two to 10 years if convicted

Updated: Tuesday, 15 Nov 2011, 4:41 PM CST
Published : Tuesday, 15 Nov 2011, 4:41 PM CST

KERRVILLE, Texas (KXAN) - A physician who operates Med Express in two locations, Kerrville and Ingram, was arrested Monday, accused of prescription fraud. His wife is also charged in the crime.

Dr. Richard DeBendetto and Tina DeBenedetto have been the subjects of a seven-month long investigation by Kerrville Police Department, the 216th District Attorney's Office, Kerr County Sheriff's Office Narcotics Unit, Drug Enforcement Administration Diversion Group, Federal Bureau of Investigation Medicare Fraud Unit and the Texas Attorney General's Medicaid Fraud Control Unit.

Officials have charged Richard DeBendetto with six third-degree felony counts of unlawfully prescribing pharmaceutical controlled substances, including the drug hydrocodone. His bond was set at $475,000 and he was taken to jail after the arrest.

Tina DeBendetto has been charged with two third-degree felony counts. Her bond was set at $125,000. She was already in the Kerr County Jail on unrelated charges.

Search warrants were executed at both Med Express locations.

If found guilty of the charges, the couple faces confinement of not more than 10 and not less than two years each, and a fine of up to $10,000 on each count.


June 14, 2011 A Boca Raton doctor connected to a number of pain clinics raided last week was arrested Monday at a $3,200-a-month Jewish senior life center in Michigan, authorities said.

Dr. Arnold H. Aaron, 75, was booked into the Oakland County Jail in Michigan on $250,000 bond, and Florida agencies are beginning the process of bringing him back to the state.

U.S. Marshal David Say said task force officers were led to believe that Aaron was in extremely poor health, but discovered that information to be inaccurate.

Aaron had been staying at the West Bloomfield, Mich., retirement home since April and was scheduled to check out June 21, Say said.

He was arrested on a Clay County warrant, where he is accused of operating an unlicensed pain clinic.

Aaron was aware of the charges against him, Say said.

"He said, 'I figured you guys would come looking for me since all the other doctors in Florida were arrested,'" Say said.

Aaron is also linked to an operation that resulted in the arrests of five people after authorities raided clinics in Palm Beach County last week.

Aaron took over as sole manager of clinics in Palm Springs, Boca Raton, Margate, Orlando and Orange Park, according to documents signed days before tougher pain clinic restrictions took effect on Oct. 1.

Last week's arrests came after a yearlong investigation dubbed Operation "Blue Spoon."

Arrested on charges ranging from operating an unlicensed pain clinic to trafficking in contraband prescription drugs were: Pasquale Gervasio, of Parkland; Richard McMillan, 38, of suburban Delray Beach; Boca Raton clinic manager Adelard LeFrancios, 41, of suburban Boca Raton; pharmacist Mark Donegan, 51, and Dr. Sherri Pinsley, 65, of suburban Delray Beach.


Nov 17, 2011 Two Palm Beach County doctors were among 10 who had their licenses suspended Wednesday by the Florida Department of Health.

Dr. Donald B. Bletz, of Boca Raton, and Dr. Cesar Augusto DeLeon, of Boynton Beach, both received emergency suspension orders, according to a statement released Wednesday.

Bletz is accused of inappropriately prescribing controlled substances, failing to adequately keep patient medical records and failing to practice medicine without the level of care recognized in general law.

According to the statement, DeLeon acknowledged violating state statutes when he pleaded guilty this year to knowingly and intentionally distributing oxycodone without a legitimate medical purpose.


Oct 31, 2011 WEST PALM BEACH — The infamous George brothers, their mother and one of the Wellington twins' wives now share something more than family ties.

All are now felons.

In the course of an hour today, Chris George, his wife Dianna Pavnick George and his mother Denice Haggerty all pleaded guilty to single charges for their role in what prosecutors say was one of the biggest illegal drug networks in the nation.

Like his 30-year-old twin did last month, Chris George pleaded guilty to conspiracy to commit racketeering. He faces a maximum 20 years in prison and $250,000 fine when he is sentenced Feb. 3.

His 27-year-old wife and 58-year-old mother stood side-by-side before U.S. District Court Judge Kenneth Marra, and each pleaded guilty to one count of conspiracy to commit wire fraud. Both face possible five-year prison terms and $250,000 fines when they are sentenced next year.

At their attorneys' request, Marra delayed an actual finding of guilt. As convicted felons, Haggerty and Dianna George wouldn't be able to visit Christopher George at the Palm Beach County Jail where he has been held since last fall on a weapons charge. Dianna George wouldn't be able to bring to the jail the couple's 4-month-old daughter, who has never seen her father wearing anything other than prison blues.

Marra granted the request after being assured it was just a technicality and wouldn't have any impact on the two women's guilty pleas.

The three members of the George family were among seven scheduled to appear in federal court today to acknowledge their guilt in connection with the wide-ranging scheme that is blamed for more than 50 deaths. In addition to George family members, the following people also pleaded guilty to helping turn pain clinics to prescription drug mills:

Dr. Roni Dreszer, 36, of Sunny Isles Beach, pleaded guilty to conspiracy to commit money laundering. In return, prosecutors dropped two other charges against him, including one which could have landed him in prison for as long as 20 years. He faces a maximum 10 years in prison and $250,000 fine when he is sentenced Feb. 3.
Dr. Daniel Hauser, 61, of Hollywood, who is board certified in internal and emergency medicine, pleaded guilty to conspiracy to commit money laundering. He faces a maximum 10 years in prison and $250,000 fine when he is sentenced Feb. 3.
Dr. Augusto Lizarazo, 71, of Boca Raton, who practiced at one of the pain clinics in West Palm Beach, and Zachary Horsley, 25, of Royal Palm Beach, were to plead guilty later this afternoon.
Since the indictments were handed up in August, 27 of the 32 charged have pleaded guilty. In addition, Jeff George pleaded guilty to second-degree murder in state court in connection with the overdose death of one of the client of his pain clinics. Palm Beach Gardens Dr. Gerald Klein, 77, also faces a charge of first-degree murder in state court.


June 20, 2011 Deputies arrest two in Palm Springs pain clinic sting
Palm Beach Post Staff Writer
Updated: 10:05 a.m. Monday, June 20, 2011
Posted: 12:36 p.m. Friday, June 17, 2011
Two men were arrested Friday morning after authorities raided a second pain clinic in Palm Beach County in as many weeks.

After a five-month investigation, the Palm Beach County Sheriff's Office Multi-Agency Diversion Task Force concluded that the Southern Care Pain Management and Wellness Center on South Congress Avenue was illegally prescribing hundreds of powerful narcotics as an unregistered pain management clinic.

Authorities arrested Dr. Marvin Reich, a 62-year-old Boca Raton ophthalmologist, and 57-year-old Glen Smith, the Lake Worth owner/manager of the clinic. They accused of not properly registering the clinic.

Reich, who was mentioned in a 2009 Palm Beach Post investigative series on suspected pill mills, also was arrested Friday for prescribing controlled substances at a non-registered pain clinic.

According to probable cause affidavits, the Southern Care probe began in November when the task force was tipped off that Reich was "prescribing pain medication outside his scope of practice" at Southern Care.

During Friday's raids, the task force - in conjunction with the Palm Beach County State Attorney's Office and Florida Department of Health - seized several boxes of medical and financial records.

Scott Mizrahi, who manages an auto parts business in the plaza, said he'd see "shady people" going in and out of the clinic daily.

"It seemed like their clientele might've been questionable," he said. "Didn't seem like what you would see at a regular doctor's office."

With the help of two pharmacies, investigators documented how from July 2, 2010 through Jan. 4, one patient referred to as "L.V." received more than 1,300 tablets of methadone.

From March 31 through May 12 of this year, one of two undercover agents received a medical check and dosage instructions for reported lower back pain. The agent was prescribed 84 tablets of Roxicodone, along with 21 tablets of Amitriptyline and 42 Soma tablets. The agent was told to return to the clinic in 21 days.

Lt. Bruce Hannan, of the sheriff's office narcotics division, said on Friday that the investigation into the clinic is ongoing and that future arrests could be forthcoming.

In addition to Reich and Smith, state Division of Corporation records also name Shan Graham as a registered manager of the clinic. Graham is also named in the affidavit, but had not been arrested as of Friday afternoon.

"We're trying to do our best to shut these clinics down," Hannan said.

Indeed, last week, authorities raided another Palm Beach County pain clinic operation, along with several others in Broward.

"The latest raids, arrests and charges reinforce the clear message to illicit pain clinic owners and physicians that we are bearing down on them," State Attorney Michael McAuliffe said Friday. "This community has much to gain or lose in this fight."

A Brief History of the Treatment of Pain

For millinea pain has been treated with various methods including cold, distraction, electrical stimulation (electric eels and electric fish, then later galvanic electrical stimulation devices), and medications.  The most widespread treatment for pain throughout time has been opium, derived from the opium poppy.  It is a latex containing up to 12% morphine, codeine, and a variety of other agents.  For centuries it was used as the powder but was difficult to dissolve in water, therefore was difficult to take orally.  In the 16th century Paracelsus found dissolving the opium powder in alcohol was much more readily accomplished, and this combination (in addition to several other added ingredients) was called Laudanum.  Later paragoric was created by mixing camphor with opium.  These three preparations of opium (powder, laudanum, paragoric) were used from the 1500s on to treat virtually any medical condition, and although the addictive properties were known, the benefits were thought to outweigh concerns over addiction.   In the US, these drugs were frequently used in the 18th and 19th century for treatment of pain, diarrhea, menstrual cramps, and sleep disturbances.  The only other major treatment available for pain was willow bark (containing salicylic acid, a precursor to aspirin) but this was very hard on the digestive system.  Morphine was extracted from opium in 1817 but it did not become commonly manufactured before the 1830s and 40s and could only be given orally.  The Civil War brought the invention of the hypodermic needle and the syringe, and injected intramuscular morphine was used liberally during the civil war to treat the injuries from battle and as an anesthetic for surgery.  Many  soldiers coming home from the war were given laudanum long term afterwards leading to uncontrolled, unmonitored usage.  Morphine was found as an impressive substitute to opium and especially was useful in treating opium addiction.  The use of opium itself significantly decreased when morphine (available in several different salts initially) became available, but the addictive properties of morphine were not appreciated until after the civil war when 400,000 soldiers returned home completely dependent physically and psychologically on opioids.   Morphine and opium in the mid to late 1800s however were commonplace in society and were readily available up until 1914 in grocery stores, drug stores (without a physician's prescription), via mail order, or as a component in patent medicines.  Most families of the late 1800s had a supply of morphine at home used to treat various maladies from teething to diarrhea to hunger, and it was used liberally.  Morphine was less expensive than food and was used in the late 1800s to quiet the starving children of the industrial revolution to take away hunger pangs.  Patent medications containing morphine were plentiful and used to treat everything from the common cold to cardiac diseases.  These patent medicines proiferated in the 19th century, most contained alcohol, and the ingredients were secret.  The term "patent medicine' is a misnomer since most patent medicines were trademarked, but not actually patented in part  to avoid revealing their contents to the public (may frighten them into not purchasing such medicine), in part due to attempting to avoid taxation as an alcoholic drink.  Patent medications were available virtually everywhere by 1900 and made claims of amazing cures of venerial diseases, cancer, heart disease, etc with their use supported by fake testimonials that were published.  did not have their contents made available to the public and contained mysterious and often crackpot components based on myth or on rural medicine corn doctors.    
    Another drug class, the barbiturates, was introduced as an alternative to the bromide based (toxic) treatment for headaches and stress.  In mid to late 1800s, physicians frequently misdiagnosed women with stress disorders, termed female hysteria.  Fully 25% of women were thought to have this condition and were treated with some rather unusual physician treatments employed including electrified beds, pelvic massage, and extensive rest.  Chloral hydrate was introduced in 1869 to assist with sleep and the bromides were used as a powerful tranquilizer.  The toxicity of the bromides was not known until much later (finally withdrawn from the market in 1975) but their bitter taste made them less palatable.  However, many women used up to 6 glasses a day of this drug.    Barbituate was invented in 1903 and became very popular nearly at the outset to a great degree due to the lack of a rebound headache and the bitter taste of bromides.  
   The addictive nature of opium was known from ancient times and became much more public in the mid 1800s with the publication "Confessions of an Opium Eater" , that extolled the virtures of opium as well as lamented its addictiveness.  Morphine, not widely appreciated as being an extract of opium, was thought to be more "pure" and less addictive than opium, however by the 1870s the medical community became increasingly concerned about its addictive properties.  But since the medical community did not control the supply of morphine (available via mail, grocery stores, etc), they had little effect in curbing the appetite of society for the drug.  Heroin was invented in 1874 but did not begin production until 1898 and quickly began to replace morphine.  It was actually touted as a non-addictive substitute for morphine and was marketed by Bayer in that manner.  However, overdose deaths began to occur and the potency of the drug as well as its addictiveness that appeared to exceed morphine brought the attention of both the medical community and Congress.   By 1900, approximately 5% of the population was characterized as being "addicted" to the opioids.  There were several forces at play during the 1890s and early 1900s that demanded action to curb addiction and unregulated patent medicines.  The Women's Christian Temperance Union and the General Federation of Women's Clubs worked tirelessly as potent consumer groups to affect change.  Articles written by Samuel Collins Adams in the influential Collier's Magazine provided an expose on patent medicines and advertising fraud, and lastly was Theodore Roosevelt's outrage after reading "The Jungle" by Upton Sinclair in 1905 (detailing the meat packing industry filth and processes).  The combination of these forces spurred the passage of the very controversial bills, the Pure Food and Drug Act and Meat Packing Act, both on the same day in 1906.  The Pure Food and Drug Act was established " For preventing the manufacture, sale, or transportation of adulterated or misbranded or poisonous or deleterious foods, drugs, medicines, and liquors, and for regulating traffic therein, and for other purposes." .  This sweeping bill established the Bureau of Chemistry Department of Agriculture as the mechanism to determine whether adulteration or misbranding of patent medications had occurred.  Adulteration was defined as when "standard of strength, quality, or purity" of the active ingredient was not either stated clearly on the label or listed in the United States Pharmacopoeia or theNational Formulary".    Ultimately the Bureau of Chemistry was transformed into the Food, Drug, and Insecticide Organization in 1927 then into the Food and Drug Administration in 1930.  
Congress passed the Pure Food and Drug Act in 1906 that required certain drugs be obtained only by prescription by a physician, establishing the gatekeeper role of physicians.  The FDA was established by the act to test and regulate all foods and drugs meant for human consumption, partially due to Theodore Roosevelt's horrified reaction to the meat industry expose in the book "The Jungle".  The act also was the death knoll for patent drugs since it required warning labels placed on all habit forming drugs.  The FDA established a chief chemist that effectively oversaw the certification of drugs, and most patent medicines (called nostrums) failed to achieve FDA certification at that time.  Some of the patent medicines such as Coca Cola (ironically claimed to treat morphine addiction) had responded by progressive removal of dangerous drugs from its product, but went to court with the US when the US wanted to force the company to remove caffeine from the patent medicine.  Coca Cola prevailed in court, but the Pure Food and Drug Act was expanded in 1912 to require dangerous ingredients be listed on the label, and caffeine was declared a dangerous drug that required labeling.  The Hague Opium Convention Treaty was signed by the US in 1910 ironically in China, the site of the opium wars in which the British forced the Chinese to buy opium from them in trade for silk.  This treaty was an international treaty used to control the spread of narcotics becoming increasingly problematic throughout the world.  The Harrison tax act of 1914 was the next tool employed by the US to control opioids and dangerous drugs through taxation.  In 1919 two landmark US court cases limited the prescribing of narcotics by physicians and permitted regulation of narcotics that they cannot be prescribed to addicts.  The Bureau of Narcotics and Dangerous Drugs was established in 1930, and on repeal of prohibition in 1933, former bootleggers turned to the narcotic trade which caused a spike in opioid use prior to World War II.  
Several semisynthetic and synthetic opioids were created from 1898-1960 giving doctors other options in pain control. The initial drug synthesis years for these are heroin (1897), oxymorphone (1914), oxycodone (1916), hydrocodone (1920), hydromorphone (1921), methadone (1937), meperidine (1939), pentazocine (1958), and fentanyl (1959).  Many other opioids were created and never released into the market, for example 23 derivatives of morphine and codeine were never released.  There were hundreds of other semisynthetics that never were released to the market.  Some opioid medications were released but later withdrawn.  
Amphetamines were introduced into the US in 1933 and used extensively in World War II by both side's soldiers.  
      In 1906, the Pure Food and Drug Act placed the responsibility for medical Because opioids were controlled by the medical community, the federal government began regulating the amount of medication that would be permitted to be manufactured, and because of fear of addiction, the use of morphine and other opioids declined, being relegated for the treatment of primarily acute post surgical pain from the 1940s-70s.  

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