A pain management specialist testified Monday that he met with a Kansas doctor now accused of running a "pill mill" that led to dozens of deaths at the urging of a concerned drug company representative in 2004.
Dr. Graves Owen told jurors that he met with Dr. Stephen Schneider and his staff for about an hour that December over concerns about the high number of fast-acting drugs being prescribed from his Haysville clinic. Owen said he advised Schneider that painkillers giving an immediate, euphoric effect were more likely to lead to addiction than longer-acting medications.
Owen, a paid prosecution expert, said he told Schneider about how to recognize and treat addiction but that a later review of clinic records showed that Schneider did not take his advice.
Schneider and his wife, Linda, are charged with health care fraud, money laundering and unlawfully prescribing drugs in a scheme that prosecutors believe led to more than 100 emergency room visits for overdoses and 68 deaths. The couple is being tried together.
Owen called the clinic's overdose rate "unprecedented" and said his review of medical records found no corrective action taken to address the problems.
If convicted of unlawfully prescribing drugs leading to death, the Schneiders could face up to life in prison.
Defense attorneys deny that the couple, arrested in December 2007, caused any deaths. They said the general practitioner and his wife were devoted health care professionals whose state-of-the-art clinic provided medical services the community needed.
Owen, a Texas doctor also working for plaintiffs in a medical malpractice lawsuit against the clinic, was repeatedly asked Monday by prosecutors about several specific overdose deaths. Owen said he believed that the doctor, not the patients, was to blame.
In his own 15 years as a pain management specialist, Owen has had two overdose deaths and changed his practices after them, he said.
But unlike Schneider's clinic, Owen's practice does not accept Medicaid patients, who Owen said are more likely to abuse prescription drugs and more difficult to refer for additional medical care. Defense attorneys said Schneider was a compassionate doctor who took in patients nobody wanted because Medicaid reimburses doctors less for those patients.
Medical records of Schneider's patients indicated warning signs of addiction, such as early refills, but were ignored, Owen said. Owen also found that patients were rotated to other drugs without any medical rational or prescribed two drugs that did the same thing. Doses also became more generous as time went on.
"They were excessive because they weren't producing any therapeutic benefits," Owen testified. "Patients were getting worse over time."
Owen said he believed that Schneider was not prescribing the drugs for a legitimate medical purpose, a key factor that would make the allegations criminal rather than civil.
But on cross examination, Owen acknowledged that his testimony in the criminal case was the first time he had given such an opinion painting Schneider as a drug dealer despite his numerous depositions and opinions in the civil malpractice case.
He also acknowledged that he has been paid between $30,000 and $40,000 for his expert testimony in the malpractice cases plus at least $4,500 and expenses for his testimony in the criminal case. He also said he began advertising his services offering expert testimony in the wake of the Schneider malpractice lawsuits.
Defense attorney Lawrence Williamson also pressed Owen to acknowledge that he only reviewed a few medical records provided to him by attorney Larry Wall, who has filed most of the malpractice lawsuits.
Owen testified on cross examination he never came across any evidence that showed Schneider had prescribed controlled substances outside of his medical practice or wrote prescriptions outside of the clinic. He also acknowledged it wasn't against the law to prescribe controlled substances to a person who may be addicted.
Owen choked up and cried as he talked about how the doctor continued to "give these dangerous drugs without a therapeutic benefit" that resulted in so many deaths.
The dramatic exchange prompted the defense to later sarcastically ask whether he had also cried when he turned away Medicaid patients. He said he had not.