A medical clinic that opened in Little Rock in June 2014 may have looked like any other doctor's office from the outside, but its sole purpose was to churn out illegitimate narcotics prescriptions in exchange for lots of cash, federal prosecutors said Monday as a trial for three health care professionals began.
The three professionals -- Dr. Felicie Wyatt, nurse Kristen Raines and physician's assistant Aaron Paul Borengasser -- are accused of conspiring to distribute hydrocodone, Xanax and a muscle relaxer without a legitimate medical purpose through a "pill mill" at 11215 Hermitage Road -- first called Artex Medical Clinic and later called KJ Medical Clinic.
The clinics were a spinoff of pill mills in the Dallas area that were owned by the same people, Assistant U.S. Attorney Allison Bragg told the four women and eight men on the jury who are expected to hear about two weeks' worth of testimony in the Little Rock courtroom of U.S. District Judge James Moody Jr.
Pill mills have sprung up across the country in response to the growing demand for prescription drugs, mostly opioids, that are sold on the street at much higher prices than if filled at a pharmacy, testified officer Lawrence "Mike" Wellborn of the Little Rock Police Department. Wellborn is part of the Drug Enforcement Administration's local tactical diversion squad, which focuses on stopping the diversion of prescription narcotics into the marketplace for illicit street drugs.
Attorneys for Wyatt, Raines and Borengasser told jurors that while the three worked at the clinic on Hermitage Road, they had no idea at the time that the clinic was a "pill mill."
Borengasser was arrested simply because he worked at Artex for three weeks, from June 16, 2014, through July 9, 2014, defense attorney Darren O'Quinn of Little Rock told jurors.
He said Borengasser considers himself a family practitioner and believed that's why he was recruited by the clinic.
But after a few weeks of treating only pain patients, O'Quinn said, Borengasser "was wondering, 'Where's the family practice?'"
O'Quinn said Borengasser questioned the clinic owners about it but was reassured that it was just taking a while to get the family practice part of the clinic up and running.
Not wanting to wait around, Borengasser found a new job at the Cabot Medical Clinic, which O'Quinn noted is a legitimate clinic.
He said that months later, Borengasser was surprised one day when gun-toting DEA agents showed up in the middle of a staff meeting at the Cabot clinic to arrest him in connection with prescriptions he had written at Artex.
O'Quinn said the agents handcuffed the stunned Borengasser and escorted him out of the office, in front of patients in the waiting room, before taking him to jail.
O'Quinn told jurors that all prescriptions Borengasser wrote at Artex were for a "legitimate medical purpose" and were done in the normal scope of his practice, as a defense expert who has reviewed the record will testify.
Debby Ferguson, who along with attorney Charles Hicks of Little Rock is representing Raines, said Raines grew up in Russellville and "loves taking care of people, so became a nurse."
After becoming a more-skilled nurse practitioner in 2008, which allowed her to write prescriptions under the supervision of a doctor, Raines was recruited to work at Artex to take Borengasser's place, Ferguson said. The attorney said Raines wrote legitimate prescriptions for pain, under Wyatt's authority, until shortly before Wyatt quit in September 2014.
Raines didn't resume writing prescriptions until another doctor was hired to replace Wyatt, Ferguson said. She said Raines left the clinic primarily to help care for her ill mother-in-law, who had recently moved into her and her husband's home from Texas.
Like Borengasser, Raines had been gone from the clinic for several months when she was indicted, Ferguson said.
Wyatt, of Memphis, came to Artex in response to what appeared to be "a legitimate ad," her attorney, Arkie Byrd, told jurors. Byrd said Wyatt agreed to be a consultant to the clinic on a limited basis, which involved reviewing patient charts and providing any necessary feedback about prescriptions Raines wrote on Wyatt's prescription pad.
"For doing just that, she was indicted," said Byrd, who is representing Raines along with attorney Richard Mays of Little Rock. But, Byrd said, "she knew nothing about that aspect of the clinic. ... The medications [she reviewed and approved] were appropriate for what was presented to her."
Byrd questioned why Wyatt would "get involved in a so-called criminal conspiracy" after working hard to graduate at the top of her high school and college classes, then spending eight years caring for military veterans and their families.
"She has a lot at stake," Byrd said. "It makes no sense that someone with her achievements would throw that all away."
Bragg, the prosecutor, told jurors that patients regularly went to the clinic by carloads and, after paying $150 to $200 cash apiece for a cursory examination, "came out with identical prescriptions" for all three drugs referred to in the charges. The similarity and number of the prescriptions began to catch the attention of pharmacists, whose concern prompted the federal investigation, Bragg said.
Bragg said jurors will hear from confidential informants who posed as patients at the clinic while recording video of the exams and conversations with the prescribers. She said the informants will describe how they were met at the door of the clinic by an armed guard, were made to pay cash before being examined and were urged to fill out sheets rating their pain level above five, on a chart ranging from 1 to 10.
Bragg said jurors will also hear from staff members who "quickly recognized" that the clinic wasn't legitimate, and they will come to see that all three defendants knew the clinic was a "pill mill" and that the prescriptions they wrote or authorized would be filled only to be sold on the streets.
The trial resumes at 9 a.m. today.
Metro on 08/02/2016