AMERICAN PAIN (45 page)

Chris met with the prosecutors in early July 2011, just after Dianna gave birth to their son. Derik went in a week later.

The day before his meeting, Derik called Cadet, who was still holding out, insisting she was innocent. Derik said she should meet with the feds too and take a plea bargain. No sense in fighting at this point. He said he would try to explain to them that she hadn’t known about his past and the bad things he’d done at the clinic, that he believed she was less to blame than the other doctors. Maybe they’d cut her a break.

At the meeting, Paul Schwartz and the others were much less aggressive. They didn’t try to make him cop to selling pills. They said they just wanted a general understanding of the operation. He told them all about it. They seemed to be hoping for more direct evidence to offer about the doctors’ culpability. Derik tried to explain: It hadn’t been like that. Even he and Chris hadn’t talked about it openly most of the time. They thought it was legal, more or less.

Schwartz looked disappointed but seemed to accept Derik’s version of events. The only thing that appeared to ruffle him was when Derik tried to explain that Dr. Cadet was probably the least culpable of the doctors. Schwartz said Derik didn’t want to finger Cadet because he liked her and she’d been nice to him.

The next day, Derik called Cadet to tell her how it went.

Derik said: They don’t like you at all. Once I mentioned your name, they got angry and didn’t want to hear it.

Footnotes

* At Cadet’s trial, Chris said he earned about $40 million in revenue from the pain clinics, but less than 25 percent of that was profit. In a November 18, 2009, conversation with his father, Chris agreed to see a contact about a Swiss bank account in Belize. Chris says he never set up the account.

* South Florida Pain opened in February 2008, but July 2008 was the earliest that any of the doctors under investigation worked at the George clinics. Dr. Gittens and Dr. Joseph left the clinics before the federal investigation began, and they were not targets.

* Forty-three percent of the prescriptions went to patients from Kentucky; 20 percent to patients from Florida; 18 percent to patients from Tennessee; and 11 percent to patients from Ohio.

* Harvard Drug Group eventually paid a $6 million fine for “failing to have in place an effective system designed to identify suspicious orders of controlled substances, and to report suspicious orders of those substances to the DEA.”

* However, Gittens soon thereafter closed the clinic and returned home to New York, where she went to work for a nonprofit health organization that offered, among other services, treatment for addiction. She did not respond to multiple phone calls and letters asking for an interview for this book.

11

A month after Chris George and Derik Nolan agreed to cooperate, the US Attorney’s Office issued a 123-page indictment that detailed the operation of not only the pain clinics but the steroid clinic and Jeff’s timeshare scam.
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The indictment named thirty-two people, including thirteen doctors, eleven of whom worked either full- or part-time at either American Pain or Executive Pain. Two of the doctors were in their sixties, four in their seventies.

“The significance of today’s takedown is that we have dismantled the nation’s largest criminal organization involved in the illegal distribution of painkillers,” said John Gilles, special agent in charge for FBI Miami. “Up until today, efforts focused on the demand by targeting individual users. Today, we attacked the source and choked off the supply.”

The indictment included Derik Nolan, the George brothers, their mother, and Chris’s wife, Dianna. Most of the lower-level employees and part-time doctors at American Pain were not indicted. State officials also charged Jeff George with felony second-degree murder in the overdose death of Joey Bartolucci, the case that prompted Jeff’s infamous Lamborghini quote. The state attorney in Palm Beach County said he believed it was the first time a pain clinic owner who wasn’t a prescribing doctor had been charged with murder in an overdose case. He’d also threatened to charge Chris George with murder, but backed off when Chris agreed to plead guilty to federal charges.

Schwartz made sure the indictment was longer than usual and full of juicy details. He wanted to bring as much news media attention to the pill mill problem as possible, and the newspapers and TV stations lavished attention on the piles of cash, the doctors carrying guns, the expensive cars. As usual, Jeff captured more than his share of the spotlight. The brothers were portrayed as equal partners, never mind that Jeff’s clinics were only a small fraction of the size of American Pain. Though the whole thing had been his idea initially, Jeff was essentially just another of the hundreds of clinic operators who followed in the wake of American Pain.

Those other clinic operators also paid close attention to the indictment. Two Pompano Beach firemen who owned a chain of six pain clinics and one pharmacy studied public records associated with the American Pain case, authorities said, allegedly using details from the indictment to figure out how to run a pill mill without getting busted.
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Only one drug wholesaler was indicted—Steven Goodman, owner of Medical Arts Inc. Goodman had ignored the DEA’s warning that American Pain was a pill mill and lied to the DEA about the number of pills he’d sold to the clinic. Other wholesalers who’d supplied American Pain escaped indictment; they hadn’t done anything quite that blatant.

Everyone had agreed to cooperate, except for Cadet. The other defendants were allowed to turn themselves in. Cadet was arrested at her home in Parkland and taken to jail in handcuffs. Her lawyer told Paul Schwartz that the doctor was willing to submit to an FBI-administered polygraph examination, but Schwartz refused.

At a detention hearing, Schwartz told a magistrate judge that investigators were still trying to determine how many of Cadet’s patients had died.

“There are over fifty-three overdose deaths that we have been able to identify with this case alone, just in Florida,” Schwartz said. “Again, we don’t know how many kids died behind barns in Tennessee, Ohio, Kentucky, and West Virginia.”

That fall, an FBI agent named Kurt McKenzie was given the task of tal-lying Dr. Cadet’s death toll. McKenzie had a background in forensic science, and as a former DNA analyst, he understood evidence-handling procedures. McKenzie ran patient names through the Social Security Administration and medical examiners offices in other states and came up with a number. Fifty-one of the four thousand patients Dr. Cadet had seen at American Pain had died.

Probably others had died from drugs she’d prescribed, because many of the pills were sold on the street. But even if McKenzie could have tracked down those deaths, it would have been a stretch to charge the doctor with them, so McKenzie didn’t work those cases. Many people also died in pill-related car accidents, but in poor rural jurisdictions in Kentucky, those cases were typically classified as accidents and potential evidence was destroyed.

So McKenzie built a database of the fifty-one deaths and worked to determine how much time had elapsed between when Dr. Cadet wrote the prescription and when the patient died. It wasn’t pragmatic to charge the doctor with an overdose death that occurred months after she’d last written that patient a prescription, so he threw those deaths out. He also threw out cases in which the patients had seen other doctors or didn’t have lethal amounts of oxycodone in their systems. Mc- Kenzie gathered toxicology reports, autopsy reports, and police reports. He and other members of the task force traveled to Kentucky to interview dozens of local police, toxicologists, coroners, and family members. The fast-talking agents and lawyers stood out in rural Kentucky, especially McKenzie, who didn’t see another black man during his time in Harlan County.

McKenzie ended up with a list of ten deaths he believed they could take to court, and the prosecutors further narrowed the list to seven: six overdoses and one car crash. The trail of death stretched up the East Coast and into Appalachia.

In Ashland, Kentucky, a fifty-year-old woman’s heart stopped in an ambulance headed to King’s Daughters Medical Center. She survived for six hours on life support before multiple organs shut down. Two days earlier, Cadet had written her a prescription for oxycodone and Xanax.

At a truck stop in Fort Pierce, Florida, a fifty-year-old woman from Lexington, Kentucky, died in her car. Two days earlier, Cadet had written her prescriptions for oxycodone and Xanax.

In Mount Sterling, Kentucky, a thirty-eight-year-old man died on his couch, an American Pain appointment card in his wallet and a pill bottle with Cadet’s name on it next to his body. Two days earlier, Cadet had written him prescriptions for oxycodone and Xanax.

Near Daytona Beach, Florida, a thirty-four-year-old man died on the floor of a house, blood oozing from his mouth. Ten days earlier, Cadet had written him prescriptions for oxycodone and Xanax.

At a Quality Inn in Boca Raton, a forty-two-year-old man from Hamblen County, Tennessee, died, blue-faced, on the floor of Room 265. Pill bottles with Cadet’s name were found near the body. Two days earlier, Cadet had written him prescriptions for oxycodone and Xanax.

Just south of Jonesville, North Carolina, a twenty-two-year-old man from Racine, West Virginia, died at 4:45 a.m. when his 1989 Camaro smashed into a pickup truck on Interstate 77.
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He was high on oxycodone and no skid marks could be found. Pill bottles bearing Cadet’s name were in his pocket. The day before, Cadet had written him prescriptions for oxycodone and Xanax.

And of course there was Stacy Mason, the first Cadet-related death of the group, and the first one they’d unearthed.

In Kentucky, Alice Mason knew nothing of the events unfolding in Florida. It had been almost three years since Stacy had died. People said things would get easier. Alice couldn’t say she agreed with that.

She prayed every day that someone would do something about that lady doctor in Florida. During the summers, she kept track of how many times she mowed the pasture around Stacy’s grave. Each November, on Stacy’s birthday, the
Mount Vernon Signal
ran a poem Kevin had written about his brother. When December rolled around, Alice couldn’t bear thinking about turning the calendar to January and seeing the date of Stacy’s death, so she’d just turn the calendar a couple months ahead. Kevin was the only one Alice could talk to about Stacy. Her husband still barely spoke about his dead son.

In December 2011, Alice was feeding the game roosters when a police cruiser pulled up the long gravel drive of the farm on Hummingbird Lane. Barry Adams was driving. Alice knew who he was, but she’d never met him. Adams had been a deputy sheriff of Rockcastle County, but now he was assistant chief of police in Mount Vernon. There were two others in the car: a tall blonde woman and a broad-shouldered man. Alice couldn’t imagine what these strangers wanted with her.

The Mason farm was so remote that even Barry Adams had a hard time finding it. Adams parked the car and turned to speak to Jennifer Turner and Mike Burt.