“…The overturning of Chevron’s deference also significantly impacts physicians charged with unlawful distribution under 21 USC 841 and the interpretation of 21 CFR 1306.04. These statutes make it unlawful for physicians to prescribe controlled substances outside the scope of professional practice or not for a legitimate medical purpose. Historically, the DEA has had broad discretion in interpreting these terms...”
ron chapman esq
TURTLES ALL THE WAY DOWN
NORMAN J CLEMENT RPH., DDS, NORMAN L. CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC.T. SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., WALTER F. WRENN III., MD., JULIE KILLINGWORTH, LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., IN THE SPIRIT OF LEROY BAYLOR, JAY K. JOSHI MD., MBA, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
BIG BROTHER HAS TRULY ARRIVED
Fifteen years ago, an “anonymous” person contacted the federal authorities and said that Dr. Richard Paulus, a prominent cardiologist, was committing fraud by placing coronary stents in arteries that didn’t need them. I am always skeptical of anonymous tips from the authorities.
Court records show that the federal government is not above having a member of its task force call in complaints so they will have “probable cause” to open an investigation into a citizen.
Many anonymous calls to authorities come from disgruntled employees, angry patients, jealous competitors, and exes who often qualify for all three adjectives.
All such calls should be vetted carefully to ensure that law enforcement does not become a weapon against anyone we don’t like. This problem can be an epidemic in police states and during witch hunts. Literal and figurative witch hunts.
The Stasi in East Germany employed 91,000 agents, one in thirty citizens, and maintained over 500,000 informants, who readily identified five million of the sixteen million population of neighbors, colleagues, friends, and relatives as enemies of the state.
Much of the oppression was overt, as any government trying to control its populace will know that what can’t be accomplished by law can be enforced by fear. A form of “legal” terrorism. Depending on whether you have a constitution and if rights are protected.
“..For instance, in United States v. Moore (1975), the Supreme Court upheld the conviction of a physician for distributing controlled substances outside the usual course of professional practice, emphasizing that registered physicians can be prosecuted under 21 USC 841 when their activities fall outside professional norms..”
“..With the end of Chevron deference, courts will no longer defer to the DEA’s interpretation of what constitutes “legitimate medical purpose” and “usual course of professional practice.” This could lead to several significant changes..”
It’s important to remember that every witch hung or tortured to death for confession at Salem had a trial. A trial that satisfied all the laws and rules of that day. Thirty of two hundred of the accused at Salem were convicted, fifteen percent.
A dismal failure by modern American federal standards, where the conviction rate has risen from 75% in 1972 to today when 0.4% of accused citizens are acquitted at trial.
A technically correct trial does not assure justice, as Navalny would confirm if he were not on the ground. This brings up an important point. What is said on paper is unimportant if it does not control what happens on the street.
In Dr. Paulus’s case, it seems that the government immediately assumed his guilt and invested a lot of money to prove it—your money, by the way.
But don’t weep for the government. They can almost always seize or coerce enough assets to come out on top. In this case, the medical center where Paulus worked was forced to give up 41 million dollars in civil proceedings.
“..With Chevron deference no longer in play, what can we expect for the DEA? The DEA will face increased judicial scrutiny, as courts will now independently interpret ambiguous statutes rather than deferring to the agency’s expertise. This could lead to more litigation, as parties challenge the DEA’s interpretations more frequently. We might also see the DEA becoming more conservative in its rulemaking, relying on clearer statutory mandates to avoid legal challenges..”
ron chapman esq
Dr. Paulus was indicted in 2015 on charges of falsifying medical records and performing unnecessary procedures to defraud insurance companies. This last is essential, as federal law enforcement has been essentially rented out to insurance companies as a private police force to target physicians and force those companies to give up some income for their beneficiaries’ medical treatment.
In May of 2019, Dr. Paulus went to trial and faced the government’s expert witness. These witnesses are paid much money to agree with the prosecutor’s argument.
“..The overturning of Chevron’s deference also significantly impacts physicians charged with unlawful distribution under 21 USC 841 and the interpretation of 21 CFR 1306.04. These statutes make it unlawful for physicians to prescribe controlled substances outside the scope of professional practice or not for a legitimate medical purpose. Historically, the DEA has had broad discretion in interpreting these terms..”
THE GLORIFICATION OF STUPIDITY
The evidence indicated that Dr. Paulus had carried out unnecessary procedures, exaggerating medical conditions and making it appear that interventional stenting was needed when it was not. They also accused him of falsifying medical records to get the insurance companies to pay for it. A serious crime if it were true.
After an analysis of patient records by the FBI, DHHS, and the Attorney General-Medicaid Fraud and Abuse Control Unit from 2008 to 2013, the jury was told that Dr. Paulus had placed seventy-one stents in patients who suffered from blockages of less than seventy percent, the standard for intervention.
“.. OVERNIGHT SENSATIONS THESE GUYS DON’T LOSE, BUT THEY LIE AND EXAGGERATE..”
The government said that Paulus recorded these patients as at or near seventy percent and that a reviewing expert found only one out of eighteen random samples medically necessary.
The government did not say that the prosecution had selected those records after a previous reviewer found that most of the sampled procedures were medically necessary. This potentially exculpatory information was withheld, which is a violation of law, but who has the power to arrest an assistant US attorney?
They would have to essentially arrest themselves in an environment where winning, equated with conviction, is everything. Withholding becomes a standard operating procedure.
Dr. Paulus was convicted and sentenced to five years in prison. An appeal was filed, asking the court to throw out the conviction for lack of evidence of criminal intent and with the argument that the government’s case had been “cherry-picked” and exculpatory evidence withheld.
Cherry picking is a term often applied to scientific research where it is found that the investigator carefully selected “evidence” to confirm their preconceived conclusion, ignoring anything to the contrary.
Also, understand that reading angiograms is not an exact science, and opinions on interpretation can differ. At least before AI takes over. And an acceptable error rate is 5 to 10% (JACC 2010).
Another study published in 2013 found a 15% error rate when compared against intravascular ultrasound. A rate of 71 mistakes out of that fifteen hundred would be 4.7%.
That would mean that Dr. Richard Paulus was prosecuted and convicted, not for being a criminal but less than perfect.
Indeed, it would mean that he was prosecuted despite being better than the average cardiologist, which seems to indicate that once they target you, no amount of contrary evidence will keep them from pursuing a conviction.
And if they need to hide a few records to convict someone, that’s “part of the game,” as a defense attorney once told me. I responded that this is no game; a person’s life is at stake. He just smirked and walked away. Luckily, Dr. Paulus’ attorneys did not see it this way.
MOTION FOR A NEW TRIAL
A motion for a new trial was filed on appeal, and US District Judge David Bunning granted it. Judges, as members of the judiciary branch instead of the executive branch, are the citizens’ last hope for justice when the latter breaks the rules.
The checks and balances created by the founders of this nation. The judge didn’t think it stood to reason that a physician who spent decades becoming a doctor would risk everything to earn the hospital or himself a few percent extra.
The government came back to try again in 2023. Now understand this means Dr. Richard Paulus has, to this point, spent time in federal prison and eight years of his life fighting these charges, costing him his life savings, reputation, livelihood, and over a million dollars taken by the government at the start.
In the second trial, the government argued that emails celebrating Dr. Paulus’s “astronomical procedure volume” and associated financial rewards were not indicators of a hard-working physician but a crime.
“..Winning” against the federal government is like surviving the attack of a great white shark, whose capacity for compassion probably exceeds some prosecutors. Even if you survive, it’s going to cost you horribly..”
The defense, now armed with an accurate evaluation of Dr. Paulus’s work, was able to show that his accuracy had outperformed physicians at the Mayo Clinic.
The prosecution tried to admit statements that the doctor had once fallen asleep in the cath lab, but this was excluded at trial.
I have personally seen surgeons fall asleep standing up during trauma rotations when they were waiting for a procedure to be prepared. This is a good use of time for an exhausted physician whose skills are critical to someone’s survival.
So, a physician’s records are combed through for outliers. Scan two hundred records; any expert can find an average of twenty equivocal. Send those to a different expert to review, and they could easily see that, in their opinion, eighteen of those twenty don’t cut.
That eighteen of twenty is then presented to the jury as a 90% rate of false interpretation by the defendant. Clear evidence of wrongdoing by the standard applied to citizens; knew, should have known, or was willfully blind to.
That brings us to the deluge of prosecutions of physicians treating pain and addiction, where the government will comb through tens of thousands of medical records looking for complicated or compromised patients who need individualized care, then feed those to a state medical board to get them to panic.
They will usually throw in a few “deaths associated with the doctors’ practice” to make sure the doctor’s ability to continue his profession and fund a defense is destroyed.
It is important to note something here. From my personal clinical experience as a physician, it has come to my notice that most people die from something at some point in their lives.
Indeed, it is a medical fact that sick people die more often than healthy ones. And most doctors treat sick people. I have even seen where the case of a patient shooting was presented to a medical board as an “opiate-related death.” Doctors have been given life sentences based on these “facts.” Just ask Dr. Steven Hensen.
Pain and addiction doctors usually see patients every month and long-term. That means every patient’s death is within thirty days of a prescription, post hoc ergo propter hoc. A single negative drug screen will also be held up as PROOF of diversion, ignoring the possibility of a false negative, as-needed dosing with a good day, a medication holiday to reset receptors and tolerance, or a rapid metabolizer. And don’t you dare order a genetic test to see if the person is a rapid metabolizer? Genetic tests are a red flag.
Dr. Paulus’ was acquitted of one charge, and the jury could not reach a unanimous verdict on another at the second trial.
The government then finally threw in the towel, begrudgingly, in their mercy, deciding not to put him through a third trial, but telling the public they were still sure of his guilt, and essentially that if it hadn’t been for those pesky constitutional rights, they would have convicted him, which is almost certainly true.
OR SEND
TO CASH APP:$docnorm
ZELLE 3135103378
So, Donate to the “Pharmacist For Healthcare Legal Defense Fund,
The doctor’s defense attorney, Ms. LoCicero, said of Dr. Paulus, “He dedicated his life to helping sick patients and always acted in their best interests. There was substantial evidence at trial that established this. Essentially, the case boiled down to legitimate disagreements between experts in a complicated field of medicine.
After a five-day trial before District Judge Brian A. Jackson on December 9, 2022, the jury unanimously convicted Lamartiniere of 20 counts of distribution of controlled substances. As the evidence at trial demonstrated, from in or about March 2015 through January 2016, Lamartiniere, in exchange for cash, wrote medically unnecessary prescriptions for large quantities of Adderall, fentanyl, hydrocodone, methadone, oxycodone, and oxymorphone.
The government’s attempts to criminalize such disagreements among doctors were unjustified. Doctors frequently disagree, and there was never any proof of wrongdoing.”
This profound statement could be said of so many physicians who are still behind bars for treating pain or addiction. Dr. William Bauer comes to mind. As does Dr. Ruan. Yes, he’s still in prison.
This included rational polypharmacy, including opioids and non-narcotic medications. DME, physical therapy, injections, urine drug screens, opioid agreements, pill counts, referrals to other specialists, including addiction medicine and surgical consultations. All of these things that they claimed were a conspiracy and fraud scheme. When it was broken down and presented to the jury, the prosecution’s narrative melted like an ice cube in the Arizona desert. They had no answers for an actual medical defense. We took them to the pool’s deep end, where they couldn’t swim.
Dr. Paulus will celebrate with his family for a few days. Then he will sit down, eight years older and having lost everything he dedicated his life to building, and he will ask himself. Was it worth it?
L.J.PARKER, MD
“..Is practicing medicine in the United States of America today, with the criminalization of differing medical opinions, worth it? I will tell you what I said about a brilliant young family member considering medicine. Think long and hard before you swim in those waters. It’s not safe..”
“..The overturning of Chevron deference in Loper Bright Enterprises v. Raimondo marks a pivotal change for the DEA, physicians, and DEA administrative decisions..”
ron chapman esq
FOR NOW, YOU ARE WITHIN
THE NORMS
