Monday, May 29, 2006

Pittsburgh doctor's "drugs for sex" prescription fraud case analyzed in Pittsburgh City Paper

The case of Bernard Rottschaefer, M.D. is discussed in the latest Pittsburgh City Paper. His case was profiled by John Tierney in the New York Times last January. The doctor has lost his appeal in the U.S. Court of Appeals for the Third Circuit on April 27, in 3-0 opinion. The appeal was brought by the heroic Eli Stutsman of Oregon. But on its face, the Court's opinion is convincing. The valiant Pain Relief Network has the briefs for Rottschaefer, whom they call a "healer & hero," and the government on its website.

The case is salacious. The government said that Dr. Rottschaefer traded sex for drugs for five women. While the case was pending, one of the women, Jennifer Riggle, sent hundreds of pages of letters to her also imprisoned boy friend saying that she was lying about the sex, and urging her boyfriend to burn the letters. After she broke up with the boyfriend, the letters were obtained by Rottschaefer's attorney. Four other women also testified that they had sex with the doctor in exchange for drugs.

The third circuit says that even if there were no sex involved, the prescribing was for "no legitimate medical reason."

Rottschaefer has asked the U.S. Supreme Court to reverse his conviction.


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7 comments:

Anonymous said...

I’m not sure how you find the court’s decision convincing. The “no legitimate medical reason” argument has no basis if the sex did not occur. Per the Controlled Substance Act, which Dr. Rottschaefer supposedly violated, all medical and scientific matters must be deferred to the Associate Director of the Health and Human Services Department. Within this agency, the FDA is responsible for dictating appropriate medications for ailments, and if Dr. Rottschaefer was prescribing for appropriate indications (which he was) there is no crime. The only way a crime occurs is if the Dr. was not acting in the patient doctor relationship (such as sex for drugs).

As for the letters, the courts interpretation that a witnesses hand written correspondence would receive the same weight as that of a jailhouse snitch is concerning. Also, the use of the letters to supposedly back up the “no legitimate medical reason” is concerning. The diagnosis of pain is a very subjective one which requires the doctor to rely on the patient’s subjective comments. For soft tissue ailments, there is no diagnostic tests. Its sad to see three judges take the word of a known perjury and use them to disregards Dr. Rottschaefer’s thirty five year history within the medical field. Anyways, these types of arguments are usually handled within the civil arena where it is appropriate.

Overall, this case is ugly to say the least. The prosecution’s office has been twice told by the courts that their lead witness committed outright perjury, yet they refuse to take any action. When Ms. Buchanan is so quick to go after members of her political opponents for perjury and others with less evidence, one must ask why not in this case?

The fact that all five women claimed no sex between them and the doctor occurred initially is something to be said. The women changed their statements in relation to the sex only after getting assistance from the lead prosecutor, Mary M. Houghton, in the form of plea deals and such. After two witnesses changed their statements, their state drug distribution charges were consolidated at a federal level and they were released from prison. Three months after the trial, these individuals (one of which wrote the letters) received probation for their crimes. Another witness was incarcerated for armed robbery, yet after she changed her testimony in relation to the sex charge, the charges were dropped and she was released from jail.

Lastly, the notion that Dr. Rottschaefer’s own records prove the prosecution’s charge is absurd. The prosecution’s office had Dr. Rottschaefer’s records in their possession for three years since their initial raid. During that time, three separate grand juries were held and only during the third grand jury (when two individuals entered their statements concerning sex for drugs) was an indictment rendered. If it was as truly cut and dry as Ms. Buchanan notes, why did two other grand juries refuse to indict? Why did only ¾ of the charges come back with a guilty verdict?

Anonymous said...

You have some factual errors on within this article.

Jennifer Riggle was one of the four individuals who claimed sex for drugs. As the city paper noted, all four women altered their intial statements to the investigators to include sex. In fact, the same investigator was the one who always recorded the changes in these people's statements.

Another individual participated as a witness for the government, yet never claimed sex.

Also, the case was not related to fraud. No fraud charges were ever brought against the doctor. The charge was that Dr. Rottschaefer violated the CSA act for prescribing for "no legitimate reason".

Anonymous said...

You have some factual errors on within this article.

Jennifer Riggle was one of the four individuals who claimed sex for drugs. As the city paper noted, all four women altered their intial statements to the investigators to include sex. In fact, the same investigator was the one who always recorded the changes in these people's statements.

Another individual participated as a witness for the government, yet never claimed sex.

Also, the case was not related to fraud. No fraud charges were ever brought against the doctor. The charge was that Dr. Rottschaefer violated the CSA act for prescribing for "no legitimate reason".

Anonymous said...

Sir,

Please read the city paper and/or the court documents. Your statement that the government stated Dr. Rottschaefer traded sex for drugs for five women is incorrect. The government stated that 4 out of 5 women made these accusations. Jennifer Riggle is within these four people.

I think it is appropriate for you to correct this information within your article instead of boldin incorrect facts.

Anonymous said...

The charges were based on the testimony of five women, four of whom said Rottschaefer gave them unnecessary prescriptions for painkillers in exchange for sex in his office

EXACT QOUTE FROM PAPER.

Anonymous said...

New information has surfaced on the Rottschaefer case.

The doctor’s legal team has recently filed a motion which details that all five of the prosecution witnesses lied about their diagnosis and need for the medications during the criminal trial. The new evidence consists of these individuals own statements in civil proceedings which contradicts the statements these individuals made in their trial testimony.

In addition to this new information, the doctor’s legal team uncovered that the prosecution and witnesses mischaracterized the plea agreements/deals they received for their testimony in front of the jury.

The new evidence also shows that the patients were receiving the same medications that the doctor was prescribing from other physicians prior to Dr. Rottschaefer assuming their care, during the time Dr. Rottschaefer cared for them, and even today. To add to this issue, the evidence shows that the patients were getting stronger dosages of these medications from these other physicians who were not their PCP. Neither Dr. Rottschaefer or the other physicians would have been aware of these patients deceptions due to privacy of information and such.

see posts:

http://www.pittsburghcitypaper.ws/archive.cfm?type=News%20Briefs&action=getComplete&ref=6772

http://www.pittsburghlive.com/x/pittsburghtrib/news/east/s_470417.html

http://www.pittsburghcitypaper.ws/archive.cfm?type=News%20Feature&action=getComplete&ref=6603

http://www.pittsburghcitypaper.ws/archive.cfm?type=Main%20Feature&action=getComplete&ref=6202

Anonymous said...

Dear Blogger,

I wish to inform you that the third circuit entered a new opinion on February 13th, 2007 in the Rottschaefer case that contradicts their previous ruling on the case. When the court was confronted with newly discovered evidence in the form of the five patients' sworn civil depositions in malpractice cases that they (the patients) confirmed they had the medical ailments the medications were meant to treat, that they (the patients) received medical benefit from the medications in coping with their medical ailments, that they (the patients) required the medications in order to continue to cope with their medical ailments, that they (the patients) retracted all their prior claims of alleged addiction, and that they (the patients) had concealed during the trial of Dr. Rottschaefer that they continued to seek treatment for the same medical ailments and receive the same medications at question (often in stronger dosages) from other physicians. The court held that the new evidence proved that Dr. Rottschaefer clearly prescribed for a legitimate medical reason when he issued the medications, yet the court held the conviction on the sex allegations alone.

So in the first appeal opinion, the court stated that the sex allegations were not required to be proven in order to substantiate the guilty of Dr. Rottschaefer and that in many counts it is not even questionable that the sex allegations did not occur. In the first appeal the conviction is held on a view that Dr. Rottschaefer failed to demonstrate the medications were issued for a legitimate medical purpose.

In the second appeal opinion, the court ruled that Dr. Rottschaefer demonstrated he prescribed the medications for a legitimate medical reason, yet the court holds the conviction based on the sex allegations alone.

If you don’t want to take my word, go to these article links:

http://www.reason.com/blog/show/124984.html

http://www.post-gazette.com/pg/08048/858161-56.stm

Or you can take the prosecutor’s written word on the case as follows:

“The government said they (the medications) were written in exchange for oral sex, although prosecutors argue that didn't have to prove that claim. They (the prosecutors) only had to show that the OxyContin was not prescribed for a legitimate medical purpose.”

Or take the appeals court opinions:

1ST Appeals Court Opinion
"The crime for which Rottschaefer was convicted was not, as he claims, trading drugs for sex," wrote Judge Marjorie Rendell in an earlier appellate decision. "Rather, he was convicted of unlawfully distributing controlled substances outside the course of professional practice.” Later in the same opinion the Judge Rendell pens that “outside the course of professional practice” equates to “prescribing for no legitimate medical reason” and that for the prescriptions to be legal, Dr. Rottschaefer has to demonstrate that the medications were written for a legitimate medical reason/purpose.

2nd Appeals Court Opinion

The court writes “the recent deposition testimony of his former patients proves that some of them had been suffering from medical conditions that merited the treatment that he provided.” Yet the court held the convictions based on a view that the crime was not prescribing for no legitimate medical reason and was instead one of “unlawful distribution of a controlled substance based on his practice of over-prescribing painkillers until his patients became addicted, and then demanding sexual favors in exchange for subsequent refills.”

Am I the only one that sees a contradiction within these rulings?