Jurors got a glimpse into the inner workings of a former "pill mill" through the testimony Friday of several former employees of the KJ Medical Clinic in Little Rock, which federal agents shut down in a May 2015 raid.
A doctor and a physician assistant who worked at the clinic's predecessor, Artex Medical Clinic, and a nurse practitioner who worked at both clinics are on trial in a Little Rock federal courtroom on charges of conspiring with one other, with clinic operators and with drug dealers to distribute the controlled substances hydrocodone and Xanax between June 2014, when Artex opened, and the raid.
Defense attorneys contend that neither Dr. Felicie Wyatt, who was the supervising physician at Artex for about two months of its four-month existence; physician assistant Aaron Paul Borengasser, who worked at Artex for three weeks; nor Kristen L. Raines, a nurse practitioner who worked at Artex and KJ, knew that the clinic, housed in a modern red-brick building at 11215 Hermitage Road, was an illegitimate medical clinic.
Prosecutors say Artex was owned by Stanley James and John Christopher Ware, who prosecutors say also operated pill mills in the Dallas area. The men closed Artex on Oct. 6, 2014 -- the day hydrocodone was reclassified as a Schedule II narcotic instead of a Schedule III narcotic, making it harder for nonphysicians to write prescriptions for it.
Prosecutors say Ware and Anthony King then opened the KJ Clinic in mid-November 2014 at the same location -- in a suite inside the building, which is occupied by a variety of health care professionals.
King pleaded guilty to a conspiracy charge shortly before the trial began, and 16 other former employees and patients who were indicted have either pleaded guilty or signed cooperation agreements in exchange for the dismissal of their charges.
One of them was Christopher Manson, 33, who testified Friday that James brought him to Little Rock from Las Vegas to manage Artex, and that Ware later hired him to manage the KJ Clinic, as well.
Manson told jurors that he had never worked at a medical facility before, and only gradually came to sense that the clinic wasn't legitimate. Among the tip-offs, he said, was the increasing refusal of pharmacies in the area to fill prescriptions issued by the clinic, which another employee later testified resulted in frustrated patients being given refunds of the $150 to $200 cash they'd paid upfront to be seen at the clinic.
Manson testified that Ware assured him that the KJ clinic "was going to be a family practice" that would include kidney dialysis and physical therapy.
"We were going to change everything we were doing at Artex," he said.
But Manson said there were few changes, and prescriptions for both hydrocodone and Xanax continued to be issued to a steady stream of patients each day. Often a noncontrolled substance, such as a blood pressure medication or a cough medicine, was added to give an air of legitimacy to the controlled-substance prescriptions.
Manson said that from his perspective, only about 15 percent of the patients at Artex, and 20 percent of the patients at KJ, seemed to be truly in need of pain or anxiety medication. He said that despite his gradual awareness that the Artex clinic wasn't legitimate, he felt that he had "no option" but to continue working at KJ after moving his family to Little Rock and suddenly finding himself unemployed when Artex was closed.
But when he experienced back pain, Manson said, he went to another unrelated clinic in the building so he could receive "very thorough" treatment, including X-rays. He noted that neither Artex nor KJ had X-ray or other diagnostic equipment.
Manson's co-manager of the KJ clinic, Randy Chane, testified that his brother, Ware, persuaded him to give up a good job at a liquor distributorship in Houston to move to Little Rock and manage the clinic.
"Since he'd had those clinics in Dallas for going on 11/2 years, I figured everything was okay," Chane said.
He said he was surprised to find that patients, who often rode together in a vehicle driven by a clinic "regular," would start arriving in the parking lot as early as 6 a.m., an hour before the clinic opened. "Some people spent the night" to try to be first in line when the clinic opened, he said.
Chane testified that only three patients at a time were allowed into the clinic, and all were screened for weapons by armed guards. On a single day, he said, one nurse would see from 30 to 60 patients, and the clinic would take in $8,000 to $10,000 cash. He said he was paid $1,500 a week in cash, and everyone who worked in the clinic was paid in cash. He said that included Raines, who received $2,000 a week in cash.
Raines' attorney contends she was paid by check and made only $13,000 through her work at both clinics.
Chane's wife, Densheo Lorraine Davis, testified that she worked at KJ as a nursing assistant, and realized after about two months that it wasn't a professional operation. She told jurors that many of the patients appeared to be poor or homeless -- the type of people that prosecutors say recruiters paid to pose as patients. The phony "patients" would get their prescriptions filled and then turn them over to their driver, said officer Mike Welborn, who investigated the case as part of a Drug Enforcement Administration task force.
Stella Osei Green, a nurse practitioner, testified that she started working for James and Ware in Texas, and moved to Little Rock at Ware's insistence when he started up the KJ Clinic. She said the prescription-writing protocol was the same at the clinics in both states, where she wrote maximum dosage prescriptions for pain and anxiety medication on pads that had been pre-signed by doctors.
Green said that while in Little Rock, she lived in a hotel paid for by Ware, and "I was making $5,000 a week," an arrangement that made it impossible to quit even after realizing the clinic was illegitimate.
The trial resumes Monday morning and is expected to end sometime next week.
Metro on 08/06/2016