Pain Management

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Two South Florida doctors faced life in prison and fines up to $2 million each because nine (9) of their patients allegedly died of drug overdoses, according to the Drug Enforcement Administration (DEA). However, on July 30, 2013, a jury acquitted Cynthia Cadet, M.D., and Joseph Castronuovo, M.D., of causing the deaths of their patients. The doctors were convicted of money laundering for their role in a conspiracy involving the chain of pain clinics they worked at, according to the DEA. The doctors still face up to ten (10) years in jail for the money laundering charges, as well as forfeiture of the money made while working at the clinics. Sentencing for the doctors is set for November 4, 2013, according to the DEA.

Click here to read the press release from the DEA.

The two doctors were arrested as part of a four (4) year operation targeting a string of South Florida pain clinics. The operation, also known as “Oxy Alley,” resulted in racketeering charges against 32 people in 2010.

Defense Attorneys Argued Doctors Appropriately Examined and Diagnosed Patients.

In the case against the two doctors, prosecutors depicted the pain management clinics where the two doctors worked to be pill mills for addicts. According to an article on Reuters, prosecutors stated that addicts and distributors would come from all over the country and pay cash to be prescribed hundreds of prescription pills at a time.

Defense attorneys argued both doctors were unaware of the conspiracy and were practicing medicine in line with state standards, which allows licensed physicians to distribute opioid pain pills without fear of punishment. An expert on pain management testified that specifically Dr. Cadet’s files showed no evidence of misconduct

According to Reuters, the two clinics where the doctors worked disbursed more than 20 million oxycodone tablets between 2008 and 2010.

To read the entire article from Reuters, click here.

Legal Tips to Manage Pain Patients.

I have represented a number of physicians who have been accused of “overprescribing.” Some of these were criminal investigations by local law enforcement authorities, such as a county sheriff’s office. Some were investigations by the DEA. Some were investigations by the state licensing agency such as the Florida Department of Health (DOH).

In several cases the investigation began when the patient died of a drug overdose (in several of these cases it was unclear whether it was a suicide by the patient or an accidental overdose). In each of these cases, there was an angry, upset family member who blamed the physicians for the patient’s death. In each case, the physician I represented had no idea what the patient was going to do.

Anytime there is a death that may have been drug related, local law enforcement authorities will usually do a thorough investigation and will usually seize any prescription medications for the patient that they can find. This may result in the prescribing physician becoming the target of a homicide investigation.

To read a previous blog listing some ideas on how physicians might protect themselves from drug-seeking patients, click here.

Florida Ranks Eleventh in Nation for Prescription Drug Abuse Deaths.

Despite the aggressive “war on prescription drugs,” the stings on pill mills and Florida’s prescription drug monitoring program, the Sunshine State reportedly ranks eleventh highest nationally in drug overdose deaths. According to an article in the Orlando Sentinel, in 1999, the number of drug-overdose deaths, most from prescription drugs, was 6.4 deaths per 100,000 Florida residents. In 2013, that number is reportedly 16.4 deaths per 100,000 Florida residents.

According to the Orlando Sentinel, states were ranked by investigating ten (10) different strategies that appear effective in curbing prescription drug abuse. Florida was found to be using seven (7) of the ten (10) strategies. The article did not list the strategies that were reviewed.

Click here to read the entire article from the Orlando Sentinel.

Contact Health Law Attorneys Experienced with DEA Cases.

The attorneys of The Health Law Firm are experienced in handling DEA cases. If you are currently being investigated or facing other adverse action by the DEA contact one of our attorneys by calling (407) 331-6620 or (850) 439-1001. You can also visit our website for more information at www.TheHealthLawFirm.com.

Comments?

Do you think Florida’s war on prescription drug abuse is working? Please leave any thoughtful comments below.

Sources:

Jameson, Marni. “Florida Ranks 11th in Nation for Prescription-Drug Abuse Death.” Orlando Sentinel. (October 10, 2013). From: http://www.orlandosentinel.com/features/blogs/vital-signs/os-prescription-drug-abuse-florida,0,2078034.post

Drug Enforcement Administration. “Jury Convicts Two Doctors of Conspiracy to Commit Money Laundering Resulting from Pill Mill Operation in Broward and Palm Beach Counties.” Drug Enforcement Administration. (August 1, 2013). From: http://www.justice.gov/dea/divisions/mia/2013/mia080113a.shtml

Fagenson, Zachary. “Florida Pain Doctors Convicted of Money Laundering.” Reuters. (July 30, 2013). From: http://www.reuters.com/article/2013/07/31/us-florida-pillmills-doctors-idUSBRE96U01D20130731

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.