Thursday, April 26, 2018
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Ninth Circuit Affirms Conviction of Participant In Massive Drug Conspiracy
By a MetNews Staff Writer
The Ninth U.S. Circuit Court of Appeals yesterday affirmed the conviction of a medical assistant for participating in a major dope peddling conspiracy by prescribing a controlled substance without a medical reason which would then be sold on the streets.
A three-judge panel, in an opinion by Judge Ronald M. Gould, rejected the contentions by David James Garrison, who had been a physician’s assistant at the Los Angeles-based Lake Medical Group, that there was insufficient evidence of his guilt and that late disclosures by prosecutors to the defense required reversal.
Garrison was one of 16 persons arrested in connection with the conspiracy which involved prescriptions for more than 1 million OxyContin pills, which Gould described as “a powerful opioid pain reliever.”
Runners Used
Homeless persons and others of meager means were recruited as “patients,” runners took them to pharmacies where the prescriptions were filled had the prescriptions filled, the runners brought the pills to the clinic administrator, who had the pills sold illicitly. The cost at the pharmacies was about $6 per pill, which were sold for about $25 each.
Medi-Cal and Medicare paid about $6 million for unnecessary medical services and for the pills.
At the time of the arrests on October 2011, then-United States Attorney (now District Court Judge) Andre Birotte Jr. of the Central District of California declared:
“With a medical clinic and doctors to lend it legitimacy, the organization not only flooded the streets of Los Angeles with an extremely dangerous narcotic, it also bilked a government-run program designed to help the poor and elderly.”
Not Close Case
In yesterday’s opinion, Gould said:
“We do not consider this to be a close case on sufficiency of evidence. As to the underlying violation, there was expert testimony that Garrison acted outside the scope of usual medical practice and that he participated in distributing OxyContin in an alarmingly high volume and strength for no legitimate medical purpose. Further, Garrison pre-signed prescriptions, filled out pre-signed prescriptions, and wrote OxyContin prescriptions for people neither he nor anyone else at the clinic had ever examined. He also lied to an investigator about his standard practices. Inconsistencies or lying can lead a jury to infer intent….This evidence was sufficient to allow a reasonable jury to draw the inference that Garrison was prescribing OxyContin with the intent to do so for no legitimate medical purpose.”
He added:
“Here, Garrison had much more Than a slight connection with the conspiracy. He was a major actor in it.”
Gould agreed with the defendant that evidence which prosecutors were obliged to share with the defense was not provided as early as it should have been. However, he said dismissal was not required, explaining:
“All of the late disclosed evidence…was given to the jury. And the district court gave a jury instruction telling the jury that the government had disclosed evidence late and that the jury could draw adverse inferences from that late disclosure. From the instruction it is clear that the jury was empowered to exonerate Garrison because of the government’s misconduct, if it chose to do so. But the jury instead found Garrison guilty, hi light of The extensive evidence against Garrison, we cannot conclude that any prejudice stemmed from the late disclosure.”
The jurist observed:
“There is now an epic crisis of deadly opioid abuse and overuse, hi 2016. roughly 11.5 million people in The United States misused prescription opioids….That same year, 116 people on average died every day from opioid-related drug overdoses….And in 2017, the Acting Secretary of Health and Human Services declared the national opioid abuse epidemic a public health emergency….
“In the midst of this crisis, we trust doctors and healthcare professionals to be conscientious gatekeepers to these dangerous and potentially fatal chugs. But unfortunately some medical professionals betray then duty to do no harm as healthcare providers and abuse then prescription pads. This is exactly what happened at the Lake Medical Group clinic…, where Garrison worked as a licensed physician’s assistant from summer 2009 until the Clinic was closed in February 2010.”
The case is United States v. Garrison, No. 15-50137.
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