Little Rock 'Pill mill' signs drew eye of DEA, officer testifies

The telltale signs that a "pill mill" might be operating in Little Rock in 2014 were captured on surveillance cameras set up by a federal Drug Enforcement Administration task force after several pharmacists reported being asked to fill a flurry of similar prescriptions from patients of Artex Medical Clinic, a task force officer testified Tuesday.

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Lawrence "Mike" Wellborn, a Little Rock police officer assigned to the DEA task force, spent a full day on the witness stand as the second day of a federal jury trial unfolded for three health-care professionals.

Dr. Felicie Wyatt, nurse practitioner Kristen Raines and physician assistant Aaron Paul Borengasser are accused of conspiring to distribute controlled substances -- mainly the painkiller hydrocodone and the anti-anxiety medication alprazolam, commonly known as Xanax -- without a legitimate prescription, on behalf of clinic owners and managers aimed at making big profits by catering to the illicit drug market.

They are the only three of 20 original defendants in the case who didn't plead guilty or otherwise agree to cooperate with authorities in exchange for charges being dropped. The other defendants included Anthony King, an owner of KJ Medical Clinic, which opened in October 2014 at the same Hermitage Road location where the Artex clinic closed on July 16, 2014; two doctors, one of whom has since died; another nurse; clinic employees; and customers.

Prosecutors say the clinic worked in conjunction with the nearby Bowman Curve Pharmacy, where several other people were indicted in a related case that hasn't yet gone to trial.

Wellborn testified that pill mills originated in Florida and are now believed to be operating in every state. He said the DEA focused on Artex because the initial observations suggested it was "one of the biggest" pill mills in Arkansas, and as such, the best place for the task force to focus its resources.

Among the common characteristics of a pill mill detected in the initial surveillance, he said, were the large number of vehicles, especially vans, in the clinic parking lot; numerous passengers in each vehicle; armed security guards at the clinic entrance; a restriction on the number of people allowed to enter the clinic at a time; cash payments required before an exam; and the existence of only "bare bones" equipment and staff.

He said the task force soon sent in confidential informants and undercover officers disguised as patients to record activity inside the clinic, which was started by Stanley James and Christopher Ware, who in 2013 owned and operated several pill mills in Dallas.

Wellborn testified that Raines and Borengasser were trained in Dallas to ensure that they followed the correct protocol in Little Rock, which included an emphasis on certain drugs and dosages that they were to prescribe under the supervision of Wyatt, the required supervising physician who visited the clinic once or twice a week to review records and verify the prescribed treatment.

Attorneys for Wyatt, Borengasser and Raines say the three had no idea when applying for medical positions at the clinic that it was a pill mill.

Jurors on Tuesday watched Borengasser's videotaped interview with a DEA agent after his arrest May 20, 2015, at a Cabot clinic where he worked after just three weeks of employment at Artex.

Borengasser told the agent, Shelli Chupik, that he came across an advertisement on a jobs website when he was desperate for work, after seven months without an income as a result of his physician-assistant license being suspended -- though he didn't say why his license had been suspended.

He said the ad led him to believe a physician assistant was needed for a family practice, which was his desired specialty, noting, "It did not say it was a pain management clinic."

He said he contacted the recruiter, and the next day he received a call from James, who hired him after a telephone interview and immediately scheduled him for training in Dallas.

Borengasser told the agent that he only worked at the clinic for three weeks because he quickly began feeling "uncomfortable" about the number of "pain patients" he was seeing and the quantity of pills he was supposed to prescribe. He said he wasn't given a quota, but saw about 40 patients a day. He said the "protocol" was to prescribe 120 hydrocodone pills to each pain patient on the first visit, and then 90 pills on follow-up visits. He said he was encouraged to prescribe a "trinity" of drugs that included hydrocodone, Xanax and a muscle relaxer or anti-inflammatory drug -- which prosecutors say is common at pill mills.

Borengasser told the agent that he passed on his concerns about the clinic to the Arkansas State Medical Board, telling an investigator when he quit that "I really would rather have no employment than this job."

Borengasser said he found a much better job at a Cabot medical clinic, where he was still working 11 months later when DEA agents showed up to arrest him after his indictment in connection with his stint at the Artex clinic.

He said the Artex job paid a "pretty standard" wage for his position, and, "I didn't feel like I was paid to do inappropriate things," but he nevertheless stopped working there because he felt uncomfortable treating the influx of patients who complained of chronic pain.

During the interview, when he insisted upon knowing why he had been indicted, Chupik told him, "You've admitted to me that you knew it was wrong," yet he continued working at the clinic.

The trial resumes at 9 a.m. today before U.S. District Judge James M. Moody.

Metro on 08/03/2016

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