Pill Mill Monitor : Personal Injury Lawyer & Attorney : Kay Van Wey Law Firm : Prescription Drug Overdoses & Pharmaceutical Abuse

On its seventh day of deliberations, a federal jury on Thursday, June 24 found Kansas  doctor Stephen Schneider and his nurse wife Linda Schneider guilty of conspiring to profit from illegally prescribing painkillers to patients, many of whom later died. The jury also found the Schneiders guilty on five counts of unlawfully writing prescriptions and on 11 health care fraud counts. The jury found Linda Schneider guilty of 15 money laundering charges.

Assistant U.S. Attorney Tanya Treadway prosecuted the case, which consumed eight weeks of trial. In a 34-count indictment, the Schneiders were charged with conspiring to illegally distribute prescription drugs that contributed to 21 deaths, fraud, and money laundering. The prosecution put on evidence of 176 overdoses and 68 deaths related to the pill mill.

This was a case of “money before medicine,” Tanya Treadway said. According to the prosecution, about half of the 10,000 patients treated at the Schneider Medical Clinic received pain medication. The clinic was open 11 hours a day every day, had 14 exam rooms and  scheduled patients 10 minutes apart.  Prosecutors allege the clinic made $7 million in a little over four years through health care fraud. The Schneiders pocketed about $1.5 million. The prosecution put on evidence of 176 overdoses and 68 deaths related to the pill mill.

Dr. Schneider’s attorney, reportedly supported by the advocacy group Pain Relief Network that advocates for the right to pain treatment, argued that Dr. Schneider acted “with a pure heart.” He said that “what [Dr. Schneider] did with his patients, he did so innocently, he did so honestly, and he did so courageously.”

Curiously, Dr. Schneider chose to drive a bright yellow hummer emblazoned with skull and crossbones to and from the pill mill on a daily basis. I wonder what kind of message he was trying to send? Was he  in a state of deep denial or did he have  so little fear of ever being prosecuted for his pill peddling that he felt bulletproof? We will probably never know, but I am sure the vehicle represents to the victims everything that was wrong with the Schneiders and their so called medical practice.

Sentencing has not yet been set. The Schneiders could face up to a life sentence.  The Schneiders also will stand trial in several civil wrongful death lawsuits which have been filed against them.
 

 We applaud the courage of Tanya Treadway in stepping up to the plate to prosecute this case.  It takes hard work and effort to bring persons such as these to justice.  Prosecutions such as these must continue to happen. Pill mill operators need to go to jail  just like persons who peddle street drugs go to jail. Pill mill operators must also be held liable for monetary damages for the devastation that they are causing while lining their pockets with blood money.Hopefully, the combination of vigorous criminal and civil prosecution will stem the tide of prescription drug overdose deaths.
 

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The Houston Chronicle recently reported a story of  alleged pill mills (S&G Medical Clinic, Texas Medicine Direct, and Uptown Medical Clinic) which stand accused of distributing large quantities of Vicodin, Xanax and Soma without a valid medical purpose.

Dr. Nancy Sellars of Houston has been charged with engaging in organized crime and practicing medicine without a license at S&G Medical Clinic at 9110 Jones Road.  See a copy of the Complaints [PDF]. Non-licensed personnel were allegedly filling out pre-signeded medical prescriptions for a variety of medicines, the majority of which were the commonly abused "cocktail" of Vicodin, Soma and Xanax.  Dr. Sellars was disciplined by the Texas Medical Board in 2001 after pleading guildy to fraudulenty prescribing controlled substances.  See a copy of the Agreed Order [PDF]. 

A non-physician , Barry Ransom, 51, the owner of Texas Medicine Direct on Interstate 10, has been charged with engaging in organized crime through knowingly delivering a prescription for other than a valid medical purpose in the course of professional practice.  See a copy of the Complaint [PDF].  According to public records, Ransom has numerous prior convictions, including a conviction for possession of a weapon (1981), controlled substance felony convictions (1983, 1986), a conviction for possession of marijuana (2007), and a charge for driving while intoxicated, dismissed because Ransom was convicted on another count (1981).  In April, he was charged with yet another drug offense.

 According to the complaint against Dr. Sellars,

• The "cocktail" Vicodin, Soma and Xanax are the most commonly abused narcotics in the houston area.

• Vicodin abuse has surpassed the illcit use of marijuana in the Greater houston area.

• The Harris County Medical Examiner's Office has directly attributed 111 deaths from June 2009 to December 2009 as related to the overdose of the narcotics included in the "cocktail."

• At least two of the deaths have been directly linked to prescription sissued by Dr. Christina Clardy (Medical Director of S&G Clinic and Uptown Medical Clinic).

   

Dr. Clardy, 61, who lives in West University, was charged in March with engaging in organized crime at S&G Clinic and the Uptown Medical Clinic.  See a copy of the Complaint [PDF].

According to the Complaint against Dr. Christina Clarda,

• Christina Clardy admitted that she knew that the prescription forms that she signed for uptown Medical Clinic were not used for medical purposes

• During the 11 days the Uptown Medical Clinic was open, they had seen 171 patients

• The patients came from all over the country, including New York, Arkansas, Louisiana, Wisconsin and Texas

• Over 95% of the patient's diagnosis was "lumbar"

• There were no refills cirlced on the prescriptions which creates a monthly client for the clinic, which is not typical for a therapeutic medical purpose

• The clinic did not accept medical insurance, Medicare or Medicaid and only accepted cash as a form of payment, which is a common scheme for a clinic operating for purposes of illicit distribution of prescription drugs to stay off the radar and prevent being shut down by the Dexas Department of Public Safety who regulates such businesses

According to authorities, the clinics were responsible for illegally distributing more than 3 million tablets of Vicodin, Xanax and Soma in 2009, and before they recently shut down, they were on pace to distribute 5 million this year.  The two operations grossed over $1.4 million last year alone, according to Deutsch.

We are relieved to see that law enforcement is addressing the rampant pill mill problem which exists in Houston and throughout Southeast Texas. 

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A pill mill is a doctor's office or medical clinic whose purpose is not to treat sick or injured patients, but instead to reap enormous profits through the illegal diversion of prescription drugs. Law enforcement estimates that there may be tens of thousands of these pill mills currently operating in the United States.

While not all pill mills look alike, they can often times be spotted by the crowds of people gathering in their parking lots or the makeshift banner advertising "pain management" or "pain clinic". Pill mill doctors rarely have any pain management credentials, usually do not have hospital privileges, see 80-100 patients per day and typically only accept cash.

Pill mills work in conjunction with shady pharmacies and unethical pharmacists who are willing to turn a blind eye to apparent non-therapeutic prescribing practices.  Remember, the prescriptions are only worth the paper they are written on until a willing pharmacist agrees to dispense the drugs.

Some pill mills may have the appearance of a legitimate medical practice. However, the encounter will typically be very brief. Oftentimes, there will be very little medical history, little or no physical examination, no laboratory or diagnostic studies performed.  Some pill mills routinely write prescriptions for a drug cocktail, which is a combination of Lorcet or Vicodin, Soma and Xanax. This combination of drugs is commonly referred to as a "party pack", "Holy Trinity" or in some parts of the country a "Las Vegas Cocktail".

A legitimate pain management practice may also dispense narcotic pain medications, but only after a thorough physical examination, detailed understanding of the patient's medical history, and diagnostic tests. Typically, medical treatment such as physical therapy, injections, surgical procedures and psychotherapy are provided in conjunction with the prescription. 

Some pill mill operators have become smarter about flying under the radar screen and have adopted ways of looking more like legitimate medical practices.

Partially gathered by the CBS Evening news and myself, here are some tell tale signs of a typical pill mill:

• It accepts cash only
• You may or may not be seen by a physician
• No physical exam required or performed
• No medical records or X-rays are needed
• Prior medical records not required
• You ask for the medications rather than the doctor deciding what you need
• The same drugs and combinations of drugs are prescribed over and over to most patients
• There is scant medical documentation
• You’re directed to "their” pharmacy
• They treat pain with pills only
• They give you a set number of pills and tell you specific date to come back for more
• Huge quantities of drugs are prescribed at one time
• They may have security guards
• They may have a line of people outside or in the waiting room
• They may accept out of town or out of state patients
• Patients may arrive in carloads

Again, pill mills come in all shapes and sizes and some are better at hiding their true colors. However, there are a staggering number of pill mills that are operating right under the noses of law enforcement, medical licensing boards and other government regulatory agencies. Law enforcement is well aware of these types of clinics, but little has been done to eradicate them.  Meanwhile, enormous fortunes are being made and people continue to die from prescription drug addiction.

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