EAST ST. LOUIS — A judge Thursday sentenced an Alton doctor to a year in prison for dispensing dangerous drugs from a “pill mill,” even though the doctor was warned some of his patients were ending up in emergency rooms or dead.
Chief U.S. District Judge David Herndon said Dr. Viwathna Bhuthimethee, 69, of Alton, was not directly responsible for any deaths, but his dangerous prescription practices “didn’t help.”
The judge said there was little doubt the doctor knew that some of his patients were “out of control,” yet he continued to prescribe dangerous pain medications to them. Used in combination with other drugs, some of them died, Herndon pointed out.
“Some of his patients died. He certainly didn’t help. He may not have contributed directly to their deaths, but he didn’t help. He helped patients’ addictions. He certainly had a wrong-headed approach,” Herndon said.
The one-year sentence was in line with the recommendation of Assistant United States Attorney Michael Quinley, who argued that Bhuthimethee was warned by a fellow physicians that “this patient is out of control.” Other patients ended up in local emergency rooms, and pharmacists also warned him, Qunley argued.
A panel of the Illinois Department of Public Aid, which oversees Medicaid, also warned him, Qunley argued.
“However, there was no change in the doctors practice. He called in more prescriptions for hydrocodone,” Quinley told the judge. “Some of his patients were in the emergency room with overdose. They nearly died,” Quinley argued.
He took exception to the argument of defense attorney Bill Lucco of Edwardsville, who said the doctor was trying to take care of his poor, disadvantaged patients in the face of changing ways of managing pain.
Quinley said that after being kicked out of the Medicaid program in 2012, the doctor would see patients on a cash-only basis.
“If you don’t pay, you don’t get to see the doctor,” Quinley said of Bhuthimethee’s practice at 654 Broadway, which is also his home.
The doctor pleaded guilty Feb. 14 in federal court to one count of healthcare fraud and 15 counts of illegal distribution of controlled substance. Eight of the counts were for illegal distribution of hydrocodone, a morphine-like pain medication, and five counts of distribution of alprazolam, a sedative, often used on the streets to trade of heroin or to enhance the effects of the illegal drug.
The indictment charged the doctor prescribed the drugs “outside the usual course of professional conduct and without legitimate medical purpose.”
Some mornings, people would be lined up outside the office, waiting to get in. Quinley said the state should have done a better job of regulating the practice, and society is partly to blame because people should have noticed the long lines and reported something suspicious.
Quinley said the doctor “didn’t start out on a plan to become a pill mill but fell into it.”
Yet, the doctor is still subject to the law, Quinley argued and discipline is on order. He recommended a one-year sentence out of a maximum of 10 years in prison. The doctor’s license to dispense controlled substances was suspended on Oct. 11, 2012 after Alton police and the federal Drug Enforcement Agency visited the office and asked him to turn the license over.
Lucco argued that the doctor committed his crimes in an environment of “new attitudes in pain management and pharmacology.” He said the doctor was subject to a lack of training and guidelines in the use of the pain drugs. Perhaps Bhuthimethee did not fully understand the implications of his conduct, Lucco suggested.
The definition of “usual course of professional conduct without legitimate medical purpose” has become vauge, he argued.
The judge, however, interrupted Lucco during his defense of his client.
“Your client pleaded guilty to knowlingly and intentionallly prescribing drugs outside the usual course of professional conduct and without legitimate medical purpose,” the judge said.
Herndon noted that he was taking into consideration that the guilty plea was an indication that the doctor had accepted responsibility for his crimes.
“What you are saying sounds very contrary to that (accepting responsibility),” the judge said. “Are we not backing away from accepting responsibility?”
“It doesn’t sound lilke he agrees that he knowingly and intentional was acting while outside the usual legitimate practice of medicine,” Herndon said to Lucco.
Lucco admitted to being flustered by the apparent contradiction. “This has been one of the most tormenting cases of my career,” he told the judge.
The doctor told the judge he was doing the best he could for his patients. He also noted that he had retired.
Sanford Schmidt can be reached at firstname.lastname@example.org