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Date Posted: 09:43:57 12/20/03 Sat
Author: Peter Mesen
Subject: Despite troubles, doctors retained licenses for years
In reply to: Billy 's message, "Online drugs a health risk, officials warn" on 03:29:51 12/16/03 Tue

Despite troubles, doctors retained licenses for years

By Leslie Berestein
UNION-TRIBUNE STAFF WRITER

December 20, 2003



NELVIN CEPEDA / Union-Tribune
Francine Haight's 18-year-old son Ryan died in February 2001 from a deadly combination of drugs, some of which had been purchased over the Internet.

In December 1983, a young doctor in Texas was in deep legal trouble.

Robert Ogle had been sentenced to three years in a federal penitentiary for prescribing Quaaludes, a hypnotic sedative. With prison looming, he surrendered his medical license.

But he got it back.

More than 17 years later, La Mesa teenager Ryan Thomas Haight was found dead in his bed at his parents' house on Feb. 12, 2001, the victim of a drug overdose. Hoping to catch just the right buzz, he had mixed numerous pills, including the powerful narcotic hydrocodone.

In his room, investigators found an empty bottle of hydrocodone with a label from Main Street Pharmacy, an Internet operation based in Oklahoma.

The prescribing doctor, according to medical board documents, was Dr. Robert Ogle. By this time Ogle had been to prison twice, the second time for theft. But he still had his license.

Ogle, now 56, was one of three Texas physicians who wrote prescriptions for the online pharmacy, prescribing dangerous drugs to people they had never met. All of them, records show, had been disciplined by their state medical board for drug offenses in the past.

Two of the doctors, including Ogle, had previously lost their licenses for illicit prescribing. But in the Internet age, they found their niche.


Online pharmacy
Main Street Pharmacy started out as Friendly Pharmacy in Garland, Texas, in spring 1999, when a young supermarket pharmacist named Clayton Fuchs partnered with physician Stephen Thompson to sell prescriptions online.
Thompson had a history of substance abuse. In 1986, Georgia put severe restrictions on his medical license due to his "intemperate use of alcohol or drugs," according to medical board records. Texas did the same in 1990.

But both states eventually lifted the limitations, and by 1993, Thompson's Texas license was "free and clear of any restrictions."

Six years later, Thompson's medical office became the home of Friendly Pharmacy. At first, the online pharmacy sold lifestyle drugs, such as Viagra, for sexual dysfunction, and Propecia, for baldness.

In late 1999, Fuchs and Thompson diversified.

"They wanted to make money," said Daniel Guess, an assistant U.S. Attorney in Dallas who eventually prosecuted both men and their associates. "They started selling controlled substances, and that is when their business took off."

They primarily sold hydrocodone, which is generic for Vicodin and Lortab. According to Guess and medical board records, they sold quantities of 100 pills with two refills at $240 per prescription.

In August 2000, they began hiring help. Thompson recruited an elderly physician named Kenneth Speak to write prescriptions for $500 a week.

According to disciplinary records obtained from the Texas State Board of Medical Examiners, Speak's license was suspended in 1991 for administering drugs for nontherapeutic purposes to 19 patients.

Speak was ordered to complete a mini-residency and take an exam to get his license back, but in July 1992 his license was returned "free and clear."

That same month, Ogle joined the team. He had gotten his license back shortly after his release from prison in 1985. The Texas medical board tried to take it away again after his 1991 conviction for theft but was unsuccessful.

Dr. Donald Patrick, executive director of the Texas State Board of Medical Examiners, said the three doctors were able to keep practicing because at that time the medical board was struggling with funding, a short-staffed legal department and a soft attitude toward fellow physicians who erred.

Teaming with Fuchs was a sweet deal for Ogle. He was paid $42.50 for each prescription he approved. According to court records, he allegedly approved 5,866 prescriptions from August 2000 to Feb. 8, 2001.


On the honor roll
In the summer of 2000, Ryan Haight was 17 and an honor roll student at Grossmont High School. He had a fondness for tennis, snowboarding and baseball cards.
He also was drawn to the rave party scene and had begun experimenting with drugs.

That May, Ryan joined an online chat forum, bluelight.nu. The forum advocates "harm reduction" among drug users, but participants freely post accounts of their drug experiences.

Ryan experienced his first rave during his junior year in high school, according to a post by "Doctor Love," who considered Ryan one of his best friends. In March 2000, Ryan took Doctor Love to his first rave in Pomona.

"This was another big step in our lives, our newly found drug life," Doctor Love wrote. "We experienced 2cT7, morhpine (sic), mushrooms, ativan, ketamine, and many other drugs with each other (JD, Ryan and Myself) for the first time. Summer of 2000 had to be the funnest point in my entire life ... "


Feeling the heat
In September of that year, a Texas pharmacy board inspector dropped by Friendly's headquarters for a routine check. The inspector saw that the pharmacy was selling online and expressed concern.
Before the board could follow up, Fuchs skipped across the state line.

Main Street Pharmacy opened in October 2000 in Norman, Okla. All business was conducted online via its Web site, nationpharmacy.com.

The pharmacy cranked out orders, processing 1,684 prescriptions within one week that fall. Investigators would learn that both Fuchs' pharmacies earned $5.6 million from January 2000 to March 2001.

Fuchs was living large. According to court documents, he spent $92,650 on a Mercedes, bought a 1.735-carat diamond ring and spent more than a million dollars on real estate. He bought his mother and stepfather, Eugene Gonzales, a $28,039 minivan and moved $70,000 into their bank account.

Fuchs also brought in a new doctor to help him in Oklahoma, Ricky Joe Nelson, who had already been prescribing for numerous online pharmacies.

Then shortly before Christmas, a compliance officer from the Oklahoma state pharmacy board crashed the party. Cindy Hamilton was only making a routine inspection at Main Street Pharmacy. What she found in the storage room left her slack-jawed.

"There were cases of hydrocodone in this small room stacked waist-high," Hamilton said. "It was all around this little room, probably an 8-by-8-size storage room."

She learned that several other agencies, including the Oklahoma medical board and the federal Drug Enforcement Administration, were interested in Main Street Pharmacy and its predecessor.

But by the time Hamilton discovered the boxes of hydrocodone in Oklahoma, some of those same pills had already been delivered COD to a house in La Mesa.


'A bright future'
Meanwhile, Ryan had been sending out college applications.
"He really had a bright future," his mother, Francine Haight, said. "I think if he really understood the damage he was doing, he would have never done this."

On Dec. 6, 2000, Ryan placed an order for hydrocodone to nationpharmacy.com, according to court documents.

On Feb. 13, an autopsy showed that Ryan, 18, died from a mix of hydrocodone, morphine, Valium and Oxazepam, an anti-anxiety medication. The morphine also had been purchased online; no one knows how he got the other pills.

Around the time Ryan died, Ogle was getting paid. On Feb. 7, he received $39,482 for authorizing 929 prescriptions, according to court documents.

He received an additional $70,805 from the pharmacy on Feb. 16 for 1,666 prescriptions.

Less than a month later, on March 5, 2001, Main Street Pharmacy was shut down and its drug supply seized about 98 percent of it controlled substances.

One by one, the doctors and pharmacists involved lost their licenses. Nelson, who also held a license in California, was convicted last year in Oklahoma on charges of money laundering and conspiracy to distribute controlled substances over the Internet. He is in federal prison.

Last December, the U.S. Attorney's Office in Dallas indicted Fuchs, Thompson, Ogle, Speak, Gonzales and pharmacist Waldrick Lemons on criminal charges including conspiracy to illegally distribute a controlled substance and money laundering. Thompson and Ogle each pled guilty to two criminal counts and face maximum sentences of 25 years; Speak pled guilty to one count and faces a five-year sentence.

Fuchs and Gonzales, who worked for his stepson in the pharmacy, were convicted on similar charges in October, along with Lemons. Fuchs faces life in prison.

Sentencing hearings begin next month.

A San Diego Superior Court judge earlier this month ordered Ogle to pay $2 million to Ryan's parents; they settled with Fuchs in September.

Ogle was the last of the physicians to lose his license. It was revoked last week.

If he wants it back, he must reapply to the medical board.

Jill Wiggins, a spokeswoman for the Texas medical board, doesn't think Ogle could get his license back with the ease he did the first time.

"It's a different era now," Wiggins said. "There is much more accountability now, and he has much more history."

But he can still reapply.

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