Pubdate: Sun, 30 Jun 2002
Source: Palm Beach Post, The (FL)
Copyright: 2002 The Palm Beach Post
Contact:  http://www.gopbi.com/partners/pbpost/
Details: http://www.mapinc.org/media/333
Author: Kathleen Chapman

ADDICTS SPREAD WORD ABOUT DOCTOR

Before her arrest in March, patients and an employee of Dr. Asuncion Luyao 
had begun to complain about her new clientele -- prescription pain pill 
addicts who were nodding off, passing out and, in a few cases, dealing 
drugs by cell phone in her waiting room.

Some said the lobby had become a "madhouse," packed with more and more 
people whose only affliction seemed to be the fact that they had not bathed 
in days.

The descriptions of three-hour waits and crowds spilling out the door to 
the doctor's office are included in some of about 100 depositions taken so 
far by prosecutors as they build their case against the 60-year-old Port 
St. Lucie doctor.

Hoping to send Luyao to prison on charges of manslaughter, racketeering and 
drug trafficking, prosecutors have interviewed patients who said the 
doctor's prescription practices were so famously loose and unscrupulous 
that she attracted addicts from all over Florida.

They have uncovered a statement from Luyao, denying responsibility in the 
overdose death of a blackjack dealer she first met during one of her 
monthly cruises on a gambling boat.

And they are trying to corroborate the story of a dancer who claims that 
Luyao was paying a Broward County man cash to bring in new pain patients.

In more than 6,000 pages of documents released last week, witnesses for the 
state tell the story of a physician whose business increased with the 
popularity of the powerful drug OxyContin and how she became one of a 
handful of doctors nationwide to face homicide charges as a result.

Some have charged in sworn statements that she got legitimate chronic 
patients hooked on large, inappropriate doses of powerful narcotics and fed 
the addictions of obvious drug abusers for an $80 office fee, until they died.

"Everybody knew Dr. Luyao, I mean, that's the truth, everybody knew you 
don't have to be sick.... Go in there and tell her you had a headache, and 
I guarantee you'd come out with anything you wanted and more," one former 
patient, Angela Haag, said in a sworn interview with prosecutors.

Luyao said in a deposition that it is true she had accepted patients whom 
other doctors had refused.

But even drug addicts deserve prescriptions for their pain, she told 
attorneys on March 20, six days before her arrest.

"There are a lot of people who take to the streets because nobody believes 
that they have pain and they have abused their medication and they are 
finding an alternative, which is cheaper, affordable and can make them live 
again," Luyao said. "And those are people that I take care of that, quote, 
are drug addicts, that come in here, so that they can control their pains, 
can live again."

Luyao said her prescriptions had allowed patients to rise from their 
wheelchairs, walk without canes.

"I am very happy for what I do for this town," she said.

Luyao recounted talking about her medical practice at a blackjack table 
aboard a casino boat one night when she met Bradley Towse, who was dealing 
cards at her table. Luyao said she later took on the Palm Beach Gardens man 
as a patient and prescribed him methadone and other painkillers. She wrote 
those prescriptions after examinations in her office, she said, never on 
her monthly cruises.

"I don't do business in the boat," she said.

Luyao said Towse needed the narcotics for shoulder and neck pain from 
dealing blackjack and painful withdrawal symptoms after he stopped taking 
the painkiller Lorcet.

"Like I said, he was in a job where it called for him to stand up eight 
hours a day, OK, deal his things and pick them up this way and that caused 
- -- that can cause a lot of pain. And that's credible enough for us people 
who will recognize that a lot of people have pain without some 
explanation," she told lawyers for his family.

Towse was 23 years old when he died in June 2000 of an accidental drug 
overdose.

Luyao has not been charged in his death.

Clientele changed in mid-'90s Certified in internal medicine, Luyao moved 
from New York and set up practice in Port St. Lucie in 1977. For two 
decades, the physician saw patients with a wide range of problems -- high 
blood pressure, diabetes -- George Buchko Jr., who has worked in Luyao's 
office as a medical assistant since 1987, told prosecutors in May.

Luyao said in her deposition that about five or six years ago she began to 
notice an increase in the number of people complaining of chronic pain, so 
she went to seminars to learn how to treat them.

Buchko told prosecutors he thinks it was 1995 when representatives from the 
pharmaceutical company Purdue Pharma first met with Luyao to tout their new 
drug, OxyContin. The Federal Drug Administration first approved the potent 
painkiller that same year.

The drug caught on gradually, Buchko said in the deposition, as Luyao's 
patient load steadily began to increase. Many loyal patients followed her 
when she moved into a new office in a U.S. 1 shopping plaza in Port St. 
Lucie in 1997. But the majority of newcomers were pain patients referred by 
lawyers for workers compensation claims and injuries from car crashes, 
Buchko told prosecutors.

In early 2001, OxyContin, which is chemically similar to heroin, morphine 
and methadone, started gaining a local and national reputation for being 
widely abused. Some snorted or crushed the drug to get high, and users 
found that they could not quit.

"I just can't do it, I tried, I can't do it, this drug just takes your 
soul," one of Luyao's patients, Louis Perrotta, said in a deposition.

In June of last year, Jupiter doctor Denis Deonarine was arrested on a 
variety of drug trafficking charges. Assistant State Attorney Tom Bakkedahl 
said he has found "quite a few" people who merely switched from Deonarine 
to Luyao.

Business was thriving -- up to 50 or 60 patients a day for the single 
doctor, according to Buchko's deposition. Though the bulk of her clients 
came from the Treasure Coast, the patient list includes addresses in West 
Palm Beach, Cape Canaveral, Deerfield Beach, Miami, Davie and Tampa.

Some were not pleased with the new clientele.

"The older patients were saying, 'George, this looks like skid row in 
here,' " Buchko told prosecutors.

Some patients complained of three-, four- and even five-hour waits 
alongside people they described as "buzzed," "sedated" and "nodding out."

Former patient Paul Bayne told prosecutors that many appeared to be in 
their 20s -- "mostly young and I think they're just for the drugs, myself."

One time he waited from 1 to 6 p.m. to see the doctor.

"Once the word of mouth got out and all the kids started coming... that's 
what the pain in the butt was, we'd have to wait."

Some of the newer patients appeared not to have bathed for days and openly 
disobeyed a sign prohibiting food or drink inside, according to Buchko's 
deposition.

They were "bringing these big 134-ounce mugs and I don't know what -- what 
was in it," Buchko said.

When asked what Luyao thought of the change in her patients, Buchko said he 
couldn't recall, exactly.

"She might have mentioned... 'button your shirt up' or something like that, 
you know.'"

In a few instances, patients said they overheard others using cell phones 
to arrange sales of their prescriptions from the waiting room. The doctor 
asked those people to leave, Buchko said. He also said Luyao refused to 
prescribe drugs for some patients, who would storm out of the office irate, 
refusing to pay for the office visit.

Detox patients referred others Several patients said in sworn depositions 
that by 2000 and 2001 the word was out that Luyao would prescribe drugs 
based on patients' reports of pain -- with few questions asked.

One man said he got the idea to visit Luyao at a Narcotics Anonymous 
meeting, and another said he heard her name from fellow patients in drug detox.

Thomas Sikes, 36, of Fort Pierce told prosecutors he began seeing Luyao 
while in rehab at Savannas Hospital and Treatment Center in Port St. Lucie.

"I told her that I had back pain and, um, I asked her for Percocet and I... 
I believe I asked her for Clonidine and then I asked her for, uh, some 
antidepressants," he said.

Once every month or two, he went back for more, also sampling Xanax, Viagra 
and OxyContin. Another man, Michael Brown, told investigators he would 
drive up from Coral Springs to see Luyao and get drugs after a cursory 
explanation. He was able to get refills for his wife, Rayanne, even when 
she didn't accompany him to the appointment, he told investigators.

Two patients have claimed Luyao was not just exploited by addicts but a 
willing participant.

In a sworn statement, a dancer named Barbara Henderson accused Luyao of 
paying off a man named Dominick to bring in more customers for OxyContin. 
He already had about five recruits, Henderson said.

"That is absolutely a lie, totally untrue," said Luyao's attorney, Joel 
Hirschhorn of Miami.

Another woman told St. Lucie County detectives last fall that on two 
occasions she saw Luyao show up in a bar in the Treasure Coast dressed in a 
white coat and go into a back room.

The woman said in a sworn statement she believes the doctor would sell the 
prescriptions to the bar owner, who would in turn sell to patrons.

The allegations are "beyond laughable," Hirschhorn said. "Give me a break."

The problem with the state's case, he said, is that a significant portion 
of its evidence rests on the statements of prescription drug abusers. They 
lie to protect themselves from prosecution, he said, and their memories are 
unreliable.

By mid-to late 2001, family members of patients who had overdosed or grown 
addicted to Luyao's prescriptions began to confront the doctor and contact 
authorities in greater numbers.

'Someone's going to find out' Furious when she discovered that Luyao was 
still prescribing OxyContin for her husband George after a year and a half 
of treatment, Yvette Mercado brushed past Luyao's staff and barged into her 
office. Interrupting Luyao's appointment with a patient, Mercado demanded 
information on her husband's treatment. When Luyao told her she couldn't 
discuss his case because of confidentiality rules, Mercado screamed at her.

"I told her... that someone is going to find her out," Mercado said in an 
interview with prosecutors.

Some pharmacists had already stopped taking Luyao's prescriptions, 
witnesses said.

None of the Kmarts in the area would fill Luyao's requests, as she noted on 
a sign in her office, Buchko said, and some pharmacists at Walgreens and 
Eckerd also were declining them.

In December 2001, state and local investigators searched Luyao's office, 
removing dozens of patient files.

A Florida Department of Health investigation found that, in some cases, 
Luyao had prescribed drugs after inadequate, superficial exams and with 
little explanation. On March 22, state investigators suspended her license. 
She was arrested four days later. Luyao is out of jail on bond and living 
at her Port St. Lucie home as she waits for trial.

In their interview with Buchko this May, prosecutors told the medical 
assistant that of 50 or 60 patient files they had seized and reviewed, the 
vast majority contained no medical records at all.

"I want to know where they are," a prosecutor told him.

Buchko couldn't say.

"You'd have to ask the doctor," Buchko replied.
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