Week 3 - Stephen Schneider Trial

"Half-remembered names and faces But to whom do they belong?
When you knew that it was over
In the autumn of goodbyes" Lyrics from Windmills (or Pill Mills) of your Mind

Former doctor Stephen Schneider & his wife Linda, who worled as a nurse in his clinic.

(WICHITA, Kansas) - In Week 3 of the Stephen and Linda Schneider trial in Wichita, Kansas, the jury heard Ted Parran, a physician from Cleveland, Ohio refer to the Schneider Medical Clinic as a "pill mill." Dr. Parran is considered a nationally recognized addiction specialist.

Marianne Skolek

Parran, who teaches at the medical school at Case Western Reserve University, testified that in his studies he had developed approximately 10 characteristics of a "pill mill" or a "script clinic." His description was they are clinics that "dispense prescription drugs and strong narcotics beyond what is normally considered good medical practice." "They're offices and doctors, but I wouldn't call it a medical practice," Parran testified. Characteristics common to these clinics are frequently prescribing drugs on the first office visit, little attention to prior medical histories, sloppy record-keeping and lack of diagnostic testing for ailments. "I rarely find all of them present," Parran said. "Were they all present at the Schneider clinic?" prosecutor Tanya Treadway asked. "Yes," Parran answered. Parran testified there was little regard for the patient in the prescribing practices of Schneider's pain clinic. "Even the clinic's own records showed potential dangers" Parran testified. One patient had been involved in 15 car accidents related to drugs. Schneider's records indicated he saw the woman in his clinic for 75 visits and continued to prescribe strong narcotics -- even after receiving reports she had a heart attack and respiratory failure. "She eventually died of a drug overdose" Parran testified. A 16-year-old teenager was treated at the clinic for migraine headaches and was prescribed Actiq, a lollipop of fentanyl (a narcotic many times stronger than morphine). Parran said the teenage boy's dose was 4 times what was typically given to a "dying cancer patient". "This was not a duped physician's office, or a dated physician's office," Parran testified. "This was a dishonest office ... a pill mill."

Records showed "a lack of medical history", Parran testified, and blank spaces on drug assessment and pain management forms. "It was very common the patients were prescribed what they asked for," said Parran. "In that case, who is the doctor?" prosecutor Tanya Treadway asked. "The patient is," Parran said. The defense is expected to point out that Parran was the target of a federal investigation for billing fraud last year. The Cleveland Plain Dealer reported that the investigation ended with no criminal charges being filed. Parran, meanwhile, has testified as a government expert in other federal cases involving medical practitioners, such as the Schneiders, charged with illegally prescribing pain killers. The records from the Schneider clinic, Parran said, showed what he called "a dishonest practice." In a brief filed Tuesday morning, federal prosecutors criticized Dr. Stephen and Linda Schneider's defense strategy, calling it "purposely and seriously misleading."

Read the Entire Brief

"This is not a case in which rogue employees were acting on their own, without the defendants' direct instructions and/or knowledge," write U.S. Attorneys Lanny Welch and Tanya Treadway. In the brief, prosecutors encourage Judge Monti Belot to instruct jurors about the laws of conspiracy and liability of criminal conduct when testimony in the trial ends. They say the Schneiders only want to be held accountable for their direct actions, but the defendants owned and operated the clinic. Therefore, prosecutors say the Schneiders should be held responsible for all deaths. The trial is in its third week of evidence, and defense attorneys have created a pattern of pointing out many patients who died weren't directly treated by Dr. Schneider. Many patients were treated by Physician's Assistants or other doctors working at the clinic. In the brief, prosecutors say many Physician's Assistants were instructed to prescribe pain medications as Dr. Schneider had previously prescribed. They also write that the Schneiders "reversed the Physician's Assistants' attempts to change the controlled substances prescriptions or terminate abusing patients." Dr. Graves Owen, a pain management specialist, was also a prosecution witness this week. Owen told jurors he met for an hour with Schneider and his staff in December 2004. He testified the doctor did not take his advice on how to change his clinic practices. Owen also said he never acted as a mentor to the clinic, as Schneider had claimed in a letter to a government insurance program. "Half-remembered names and faces, but to whom do they belong? When you knew that it was over in the autumn of goodbyes"

This article written as a voice for Jessie D age 21 died July 11, 2003.

The trial resumes Monday morning.

The Series:

Jun-16-2010: Schneiders Fate in the Hands of the Jury - Marianne Skolek Salem-News.com

Jun-11-2010: Schneider Trial Week 7 - Marianne Skolek Salem-News.com