Two South Florida doctors involved in a pill mill operation that collected $40 million and dispensed more than 20 million pain pills within two years are facing charges in the deaths of nine people, federal prosecutors said Friday.
Officials say the physicians — Cynthia Cadet, 42, of Parkland, and Joseph Castronuovo, 72, of Key Largo — worked as vital tools in the Broward- and Palm Beach County-based operation that distributed oxycodone pills to addicts without any regard for their health.
Both face the possibility of life in prison if convicted.
In a 34-page indictment filed Thursday, investigators attributed the deaths of nine people to oxycodone parceled out at the pill mills.
It appears most of the overdose victims, such as Shawn Michael Harper, 22, of West Virginia, traveled thousands of miles to South Florida for the pain medications.
“I didn’t know until his death that he was going down [to South Florida] many times for the drugs,” Harper’s father, David, said from his home in West Virginia. “The doctors belong in prison like other drug dealers.”
The two doctors were among 32 people arrested last year on multiple charges ranging from racketeering to fraud and illegal drug sales. The arrests were the result of a multi-agency investigation called Operation Oxy Alley.
Twenty-eight of those arrested have already entered guilty pleas and been sentenced in connection with the August 2011 indictment, said Annette Castillo, spokeswoman for the U.S. Attorney’s Office for the Southern District of Florida, in Miami.
Richard Merlino, an attorney representing Cadet, thinks the latest charges against his client were filed because she refused to enter a guilty plea like the others. Cadet’s trial is set for later this year.
“She is not surprised by this. We knew it was coming, and we continue to look forward to the trial,” Merlino said.
The attorney said he plans to use his own experts to show that the doctor’s actions were within bounds of standard medical care and that there was no direct connection between the prescriptions and the deaths.
Castronuovo and his attorney could not be reached for comment late Friday.
According to officials, the doctors were cogs in a scheme by the clinic’s owners, Palm Beach Gardens twins Jeffrey and Christopher George. The clinics were shut down in 2010.
The doctors performed minimal physical examinations in an attempt to make the brothers’ operation seem legitimate, according to the indictment. They were paid in cash for each patient they saw, and helped the operation maintain large inventories of pain medication, according to prosecutors.
Between 2008 and 2010, Cadet received from various pharmaceutical wholesalers 876,200 dosage units of oxycodone while primarily working at the brothers’ American Pain clinic in Boca Raton.
Castronuovo worked at the operation’s Executive Pain clinic in Wilton Manors, and received 388,600 doses of oxycodone within 13 months starting in 2009.
Federal prosecutors said the doctors prescribed large quantities of the drugs to people without legitimate medical reasons, and failed to prescribe alternative medications or implement treatment plans.
“And instead would prescribe a standard cocktail of [the drugs] in violation of medical practice in order to generate as much income as possible,” says the indictment, signed by U.S. Attorney Wifredo Ferrer.
The indictment alleges the doctors often relied on preliminary radiology reports in prescribing large quantities of drugs, and knew that many of their patients came from outside Florida, where stricter controls of the pills were in place.
Cadet is charged with dispensing oxycodone and other controlled substances that resulted in the deaths of seven patients, each count punishable by up to life in prison.
Castronuovo is charged in the deaths of two people, for which he also could face up to life in prison on each count, and with conspiracy to distribute oxycodone to persons under 21, punishable by up to 40 years in prison.
The doctors are to be arraigned on the new charges in West Palm Beach next week.
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