Pubdate: Sun, 12 Aug 2001
Source: Palm Beach Post (FL)
Copyright: 2001 The Palm Beach Post
Contact:  http://www.gopbi.com/
Details: http://www.mapinc.org/media/333
Author: Noah Bierman, Palm Beach Post Staff Writer
Bookmark: http://www.mapinc.org/find?186 (Oxycontin)

INDICTED DOCTOR: OXYCONTIN DEATH CHARGES 'A TRAVESTY'

Before he was charged with murder last month, Dr. Denis Deonarine 
made $650,000 a year, five times the average family practitioner's 
income.

"I am a workaholic," he said. "I work my . . . (backside) off, to put 
it mildly."

Patients said they endured hours sometimes in a crowded waiting room 
to see him. He took weekend rounds at the Veterans Affairs Medical 
Center for nearly a year, arriving at 8 a.m. and leaving at midnight. 
Some of his sickest patients say he gave them his home number for 
emergencies, saw them any time of day and, in some cases, made the 
difference between life and death.

By his own "modest estimate," he admitted 11,000 patients to 
hospitals since he opened his Jupiter practice four years ago. That's 
more than seven patients a day, assuming no time off for weekends or 
holidays. That number includes some, but not all, of the 3,000 to 
4,000 patients he saw in his office.

Deonarine said he missed his own son's wedding in Georgia this year 
- -- a wedding he paid for -- because he failed to find another doctor 
to take his calls. "What does that tell you?" he asks.

Some patients told authorities there was another reason Deonarine 
made so much money -- he made it easy for recreational drug users to 
get prescriptions for powerful narcotics.

Now Deonarine's work habits are drawing national attention.

He's only the second doctor in the country charged with murder 
because a patient for whom he prescribed OxyContin died from an 
overdose. Charges against the other doctor, a San Francisco man, were 
later reduced to manslaughter.

A Palm Beach County grand jury indicted Deonarine last month, 
charging him with first-degree felony murder in the overdose death of 
a 21-year-old patient, Michael Labzda, of Jupiter. Prosecutors apply 
the felony murder charge when a homicide occurs during the commission 
of another felony -- in this case, prosecutors say, drug trafficking 
by Deonarine. If convicted, Deonarine would face at least life in 
prison.

Deonarine's lawyer, Richard Lubin, accuses prosecutors of getting 
sucked into a national hysteria. The drug, which critics have dubbed 
a legalized heroin, has been blamed for hundreds of overdose deaths 
across the country. National magazines and newspapers have 
dramatically chronicled its rise and its patients' falls.

Labzda's friends told police he was snorting crushed OxyContin pills 
and drinking beer and rum before he died in February, according to 
investigators' reports. An autopsy found high levels of oxycodone, 
the active ingredient in OxyContin; the tranquilizer alprazolam 
(Xanax); and marijuana. The cause of death was multi-drug poisoning, 
the autopsy report said. OxyContin, which many patients use safely 
and legally to relieve severe pain, is not supposed to be snorted or 
mixed with other drugs.

Labzda's family's civil lawsuit includes Deonarine but targets 
drugmakers Purdue Pharma and Abbott Laboratories for marketing 
OxyContin.

Deonarine, 56, also prescribed OxyContin for three others who later 
died from overdoses, prosecutors have said. Prosecutors have not 
charged Deonarine in those deaths but say the cases are still under 
investigation, state attorney's office spokesman Mike Edmondson said 
Friday. In the meantime, Deonarine faces 79 other drug-related 
charges from his family medicine practice.

Police say they found Deonarine hiding in the closet of his Jupiter 
home July 27 when they arrested him. Since then, the doctor has lost 
his affiliation with Palm Beach Gardens Medical Center. Jupiter 
Medical Center has suspended his staff privileges. State regulators 
suspended his medical license July 30.

Before it all unraveled, Denis Deonarine's identity was so married to 
his medical practice that his patients became his employees; his 
employees became his lovers and his family members became distant.

'I Have Good Intentions'

Deonarine sat in his attorney's office last week, five days after 
bonding out of jail.

"I'm not here to kill anybody. I have good intentions," he said, 
having exchanged his awkward blue jail outfit for a stylish dark 
business suit. He looked befuddled and hurt that anyone -- 
prosecutors, patients, the public -- would think he is anything but a 
caring and dedicated doctor. He vehemently denied accusations from 
some former patients and staff that he dispensed prescriptions freely 
or took drugs while on duty.

The oldest of 10 children born in Trinidad and Tobago, he had built a 
lucrative career. He bought a $400,000 house in Jupiter and two 
Jaguars, a red 2000 model and a topaz 2001 model, with checks from 
his office and offshore bank accounts, Lubin said during a bond 
hearing. None of the medical boards in the five states that have 
admitted him had ever disciplined him before the criminal charges 
began.

He said he has faith his attorney will prevail over this "saddest 
travesty of the American justice system."

The Palm Beach Post used a patient list from an unsuccessful 
Medicaid-fraud case against Deonarine to find and interview nine 
former patients. Additional information about patients and former 
staff members came from criminal and family court records and 
testimony at Deonarine's bond hearing.

Todd Shea, 31, described tipping Deonarine $100 to $300 while in the 
examination room by placing the money into his patient file after he 
got his OxyContin prescription, according to an investigator's sworn 
affidavit used as evidence in Deonarine's bond hearing. Shea, the 
account continues, also brought other patients to Deonarine, told 
them what to say and at times went into the examination room with 
them.

Shea's medical file lacked the appropriate tests or documentation to 
justify his prescription, the investigator said in the affidavit.

State records show Shea has been arrested eight times since 1992 on 
charges that include weapons and narcotics possession. He pleaded 
guilty to possession of heroin and possession of drug equipment in 
March and was sentenced in 1993 to three years' probation after 
pleading guilty to selling marijuana and possessing a weapon during 
the commission of a felony, but adjudication was always withheld, 
according to court and state records. His most recent charges include 
a June 1 domestic battery and violation of probation.

Christina Brown, another patient for whom Deonarine prescribed 
OxyContin and other painkillers, worked in the office and was 
pregnant at the time, according to the same investigator's affidavit. 
Brown's patient file included no information suggesting she had been 
informed of the risks to her unborn child, the affidavit says.

Deonarine dropped another patient, Jennifer Coates, after she tried 
to get him to help her control her addiction rather than continue to 
prescribe her OxyContin and Diazepan, the affidavit said.

Fraud Probe Dropped

Deonarine, under his attorney's advice, declined to answer questions 
about specific allegations, but he said of them generally:

"Not true. I listened to my patients, and there was a shared degree 
of trust between the patient and the doctor."

Lubin, the attorney, said he has not seen most of the evidence that 
the government cites. He says generally that Deonarine never offered 
inappropriate care, that he always made sure his patients understood 
the proper use of their medications and that he refused to see 
patients who abused their prescriptions. And, specifically, he points 
to the criminal charges Shea faces as a motive for possibly lying 
about the doctor.

Lubin also had another doctor, Douglas Baird, of Largo, review 
several of the government's charging documents. Baird signed an 
affidavit saying Deonarine's medical care of Labzda met professional 
standards.

When Medicaid fraud investigators sent a wired undercover agent to 
get OxyContin from Deonarine, it wasn't easy. A transcript created 
from two visits to Deonarine's office in April and May indicates 
Deonarine asked detailed questions about the supposed Vietnam war 
injury to the undercover agent's knee. He asked the undercover agent 
to retrieve old X-rays and magnetic resonance imaging tests or agree 
to order new ones. The agent resisted, offering several excuses. 
Deonarine eventually agreed to prescribe a temporary supply of 
OxyContin, but insisted that the patient order new tests.

The government has since dropped the Medicaid fraud charges, which 
were separate from the murder and drug trafficking charges that 
Deonarine now faces.

Deonarine said he feels deep compassion for sick people in pain. He 
said watching his mother give birth to nine other children in his 
Caribbean homeland made him upset with the lower standard of care 
there. Later in his career, when he worked at a Veterans Affairs 
hospital in Tennessee, he saw former soldiers with limbs amputated 
and said it devastated him.

He said he knew at 14 that he wanted to be a doctor so he could make 
a difference.

He graduated with honors from the University of the West Indies in 
Jamaica in 1973, officials there confirmed. When Deonarine pursued 
his residency at Queen Mary's Hospital in London in 1974, he was the 
first person of color from the British colonies in the gynecology and 
obstetrics department, he said.

Deonarine speaks proudly of his British education and his experience 
at the hospital.

In 1976, Deonarine flew back to Trinidad to deliver his second child, 
his daughter, Michelle.

'Booming' in the '70s

By the late 1970s, Deonarine was living well, by his own estimation. 
His gynecology practice in Trinidad was "booming, booming." He had 
affiliations with five private hospitals.

"That's where I made my millions," he said.

He had a $1 million home at the end of a cul de sac with no mortgage 
and two extra lots he would one day use for his children's homes, he 
said. Deonarine would work until 2 a.m., fall asleep with the 
television on and a plate of uneaten food in front of him. The phone 
would wake him two hours later, and he'd run out to deliver a baby, 
he recalled.

He wanted his children to have it easy, no shifts at Burger King and 
Dunkin' Donuts while they went through school.

But his wife had another vision.

"I wanted to live here in the States," said Irene Deonarine, who now 
lives in Atlanta.

Her mother and four sisters lived in New York and Florida, and she 
wanted to be closer to them.

Deonarine's wife arranged for the family to get legal U.S. residency. 
She and the two children moved to New York.

"I think they were disgusted with the fact that my work was ruling 
me," he said.

He followed his wife there briefly, but they separated in 1983 and 
divorced in 1987. In between, in 1985, he had his third child, with a 
Trinidad woman whom he did not marry, Deonarine said.

Irene Deonarine said he's always been there financially for her and 
the children, but he spent most of his time with patients.

"That was his life and it still is his life," she said. "His patients 
love him dearly."

In the 1980s and 1990s, Deonarine moved back and forth between the 
United States and the Caribbean, starting and stopping his medical 
practice. Moving to the United States presented a problem, because it 
meant he would have to complete another medical residency. Deonarine 
felt he'd already been trained well in England.

So he tried a few other options: a public health degree from Columbia 
University in 1982 and a paralegal certificate from Nova Southeastern 
in Davie in 1992. He has lived continuously in the United States 
since 1992.

In 1993, Plantation police charged him with stealing shampoo, 
conditioner, dental floss, a cleansing mask and deodorant from an 
Albertson's grocery store, according to Broward County court files 
from that case. He pleaded no contest to petty theft, a misdemeanor. 
A judge withheld adjudication, which means the conviction does not go 
on his record.

The charge apparently did not affect his plan to train as a family 
practitioner in the United States. Deonarine, who had been a 
gynecologist, switched specialties to reduce the amount of training, 
which, by this time, seemed redundant to him, Lubin said.

Employer and Boyfriend

In 1992, he began a new residency in Nashville, at Meharry Medical 
College, and spent another year at the Veterans Affairs hospital in 
Murfreesboro, Tenn.

There, he had another child, Oliver. Deonarine lost parental rights 
to the child as part of a March court settlement that allowed the 
child to move with his mother back to Tennessee and allowed Deonarine 
to quit paying child support. Deonarine, however, said he continues 
to support the 6-year-old boy and speak with him once a week, though 
he is legally bound to do neither.

Oliver's mother, Gabriel Wood, did not return phone calls. Records 
from the paternity suit indicate she knew Deonarine as both a 
boyfriend and an employer, a pattern that would be repeated at least 
twice more.

By the time Oliver was 2 years old, Deonarine had left Tennessee and 
begun working for a practice in Port St. Lucie. In June 1997, he set 
up his own practice in Jupiter.

He also married one of his nurses that year, Jeannine Garner Hopson, 
according to court records. The marriage lasted 14 months.

The third woman who would know Deonarine as both boyfriend and 
employer started as a patient and now ties her fate to Deonarine's: 
Wayna McCullom, his co-defendant on some of the drug trafficking 
charges that shattered his practice this year, met Deonarine when she 
came to his office as a patient in January, according to Medicaid 
fraud investigative records. Deonarine stopped treating her 
officially two weeks later when the romantic relationship began, 
according to her medical records.

But investigators seized several subsequent OxyContin prescriptions 
signed by Deonarine for McCullom. And at midnight on Feb. 24, before 
rushing to catch a flight to Jamaica, the couple stopped at a Hobe 
Sound pharmacy to pick up 120 OxyContin pills, according to a 
complaint the pharmacist wrote to the Agency for Health Care 
Administration. The order was so large, the pharmacist told Deonarine 
they did not have enough stock to fill it.

"I believe Dr. Deonarine is not having a doctor-patient relationship 
with the patient," pharmacist James Longo wrote.

 From Patient to Worker

Several other patients also became employees and, in one case, ran 
into legal problems.

Careen McCray, charged in March with fraud and three counts of 
forging prescriptions from Deonarine's office, had been working in 
his office, according to a Jupiter police report. McCray said she 
came to Deonarine first as a patient. The report says Deonarine 
prescribed painkillers for her, and she said she became hooked. 
McCray told police she used blank signed prescriptions she got from 
Deonarine and filled in her mother's and her husband's name to save 
money on insurance co-payments, according to arrest records.

Another patient who testified at Deonarine's bond hearing last month 
said she also answered phones in her doctor's office one day when 
Deonarine's regular employee unexpectedly quit.

Becky Davenport, a retired teacher, said at a hearing that she agreed 
to answer the phones because Deonarine needed her and he had shown so 
much compassion during her husband's illness.

"I called him one night at 11:30 and talked with him for an hour," 
she said, explaining the kind of support available from Deonarine.

Indeed, many of Deonarine's former patients -- several of whom were 
contacted by The Post without Deonarine's knowledge -- say they came 
to him because of his hard work and dedication, not for prescriptions.

"To me, he was the best doctor I ever had," said Karin Bowden of 
Jupiter, who saw Deonarine for high blood pressure and digestive 
problems. "I'm not a kid. I'm 58 years old.

"When people abuse the medication, it should not be his problem," Bowden added.

Bowden said Deonarine was a doctor who would sit down and listen, 
then order appropriate tests.

"If there's a problem, he will explain the problem with you. He's not 
just in and out," said Grady Tatum, 49, of Jupiter.

That contrasts with the picture one former employee painted for investigators.

Barbara Groseclose told authorities she began working for Deonarine 
last July after two or three months as his patient. She quit in April 
out of frustration, she said, because she became frustrated with his 
prescribing narcotics to patients who came to the office for that 
purpose alone, according to a Food and Drug Administration 
investigative report.

She told investigators Deonarine pre-signed his prescription pads, 
the report said.

"She said that Deonarine is also taking the drugs and she recalled 
one patient . . . told her that Deonarine fell asleep on her," the 
FDA report said.

Deonarine said the allegations that he was taking drugs are "absolutely false."

He said he's spent the days since bonding out of jail getting himself 
mentally and physically stable. He's reevaluating his priorities. In 
the past five years of practice, he took two one-week vacations. He's 
never been fishing. He doesn't sail, dive or golf.

His adult children, Dennis and Michelle, stand by him. Although they 
didn't see him more than a few times a year growing up, they say he 
wrote them cards and called and paid for everything.

"It is very unfair that a man would dedicate his whole entire life to 
helping people, and then (for authorities) to turn around and say 
these things . . . ," said Michelle Deonarine.

If he's acquitted, which he said he fully expects, he wants to get 
his medical license back. If he can't, he said he'll use his legal 
background to work as a malpractice consultant. Either way, he'll 
change.

"I have realized the bottom line is my family needs me," he said 
"Greenbacks aren't enough."

Staff writers Clay Lambert, John Pacenti and staff researchers Monica 
Martinez, Madeline Miller and Sammy Alzofon contributed to this story.
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