Jun.26, 2010

In a case that illustrates the hazards physicians face when fulfilling their duty to relieve patients' pain, a federal jury yesterday found Kansas pain management physician Dr. Stephen Schneider and his nurse wife Linda guilty of conspiring to profit from illegally prescribing pain relief medications to patients, dozens of whom died.

The couple had been charged in a 34-count indictment with illegally dispensing drugs, health care fraud, and money laundering. Jurors found them guilty of a conspiracy linked -- however tenuously -- to some 68 deaths. Prosecutors portrayed the couple as money-hungry pill pushers who not only wrote prescriptions for those in severe pain but also for drug abusers who faked their symptoms.

"The evidence in this case of patients suffering from overdose and death points to the fact that when prescription pain killers are unlawfully prescribed, they can be as dangerous as illegal drugs," US Attorney Lanny Welch said in a statement.

Attorneys for the Schneiders and pain relief advocates had a different take. "We are absolutely shocked," Dr. Schneider's attorney Lawrence Williamson said outside the courthouse. "These two people are totally innocent of these charges." Saying it was "a sad day for our justice system today," Williamson added that an appeal was planned. "Dr. Schneider was practicing medicine -- he wasn't being a drug dealer," Williamson said.

Both husband and wife were found guilty on five counts of illegally writing prescriptions and 11 counts of health care fraud. They also faced 17 money laundering counts. Stephen Schneider was found guilty of two of them and Linda Schneider was found guilty of 15 of them.

The couple was taken into custody after the verdicts were read. They face mandatory minimum sentences of 20 years on the most serious counts and could be sentenced to life in prison. The judge in the case has not yet decided whether to go ahead with seizing their assets.

Siobhan Reynolds, head of the patient and doctor advocacy group the Pain Relief Network, which had championed the Schneiders' cause, was also present for the verdict. "The crisis in pain treatment is going to deepen even further," Reynolds said outside the courtroom. "People are going to have trouble getting care because doctors are afraid this is going to happen to them."

Schneider had testified that he was only trying to help patients in pain and that he had been deceived by some of them. He also said he had never meant to hurt or defraud anyone.

Defense attorneys for the pair had argued that the government was meddling in doctor-patient relationships and that the government had overinflated the deaths attributable to Schneider's prescribing by including patients who committed suicide, patients who took illegal drugs, patients he had never seen or had treated months before their deaths, and patients who died while the couple was in jail.

Federal authorities have prosecuted hundreds of pain management physicians in the last decade, throwing what advocates say is a pall over pain management and deepening what they say is a crisis in chronic pain treatment. Now, the Schneiders and the patients they will not be able to help are the latest martyrs in the battle for chronic pain treatment.