Anti-ageing doctor Julie Epstein found guilty of misconduct: HGH and Steroids for Anti-Aging and Body Building

DRUG ENFORCEMENT AGENCY News Release
FOR IMMEDIATE RELEASE
September 02, 2011
Contact: David Melenkevitz, PIO
Number: 954-660-4602

Palm Beach, Broward and Martin County Pill Mills and Pharmacies are
Shut Down
Thirteen, including doctors and a pharmacist, charged with Illegal Distribution of Anabolic Steroids, Human Growth Hormones and Oxycodone

SEP 02 -- MIAMI – Mark R. Trouville, Special Agent in Charge, Drug Enforcement Administration (DEA), Miami Field Division, Wifredo A. Ferrer, United States Attorney for the Southern District of Florida and Tony West, Assistant Attorney General for the Civil Division at the Department of Justice, announced the unsealing of a federal indictment charging thirteen defendants, including five doctors, one pharmacist and one chiropractor, for their participation in, among other things, the illegal distribution of pain killers, steroids and human growth hormones through pill mills operating in Broward, Palm Beach and Martin Counties and through the internet, respectively. The charges involve a wide-ranging scheme to illegally distribute these drugs nationwide.

Researchers from the Centers for Disease Control and Prevention report that Schedule II prescription painkillers, like oxycodone, today cause more drug overdose deaths than cocaine and heroin combined. Oxycodone and other Schedule II drugs have a high potential for abuse and can be crushed and snorted, or dissolved and injected, to get an immediate high. This abuse can lead to addiction, overdose, and sometimes death.

DEA Special Agent in Charge Mark R. Trouville stated, “Today’s announcement reflects the Drug Enforcement Administration’s continued efforts to take the profit out of the illegal diversion of pharmaceutical drugs. Furthermore, we are sending the message once again to those that are still profiting and those who are considering entering this business, that we remain vigilant and aggressively pursue those conducting business outside the course of accepted medical practice.”

U.S. Attorney Wifredo A. Ferrer stated, “Operation Pill Nation, Operation Snake Oil, Operation Oxy Alley, and now Operation Juice Doctor 2. In a span of just six months, we have attacked from every angle what can only be described as a homegrown prescription drug epidemic. In Operation Juice Doctor 2, we have charged corrupt pharmacy and clinic owners, complicit doctors and employees, all of whom made a handsome living dealing in prescription drugs, while hiding behind a medical license. Working with our federal and local partners, we are shutting down these dangerous pill mills and internet pharmacy operations.”

“According to the indictment unsealed today, these defendants were involved in a scheme to push dangerous drugs -- steroids, human growth hormone, and oxycodone -- into the hands of buyers who lacked legitimate prescriptions,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. “Sadly, the defendants include physicians who, we allege, were doctors doing harm: ignoring their oaths and obligation to put the health and safety of patients first.”

The 42-count indictment, filed August 31, 2011 and unsealed today, charges the defendants with numerous crimes, including conspiracy to distribute anabolic steroids (Count 1), distribution of anabolic steroids (Counts 2 through 21), conspiracy to distribute oxycodone (Count 22), distribution of oxycodone (Counts 23 through 25), conspiracy to distribute human growth hormone (Count 26), distribution of human growth hormone (Counts 27 through 41), and attempted importation of anabolic steroids (Count 42). Charged in the indictment are Peter DelToro, Pharm.D. , 38, of Palm City, Richard DelToro , 60, of Port St. Lucie, Jaclyn Rubino , 31, of Stuart, Pedro Carrillo, M.D., 52, of Escondido, California, Jeffrey Perelman, M.D. , 54, of Fort Lauderdale (The Longevity and Aesthetics Institute and Palm Beach Life Rx), Paul Joyce , 49, of Palm Beach Gardens, Charles Cooke , 50, of Palm Beach Gardens, Donald Montano , 74, of Jupiter, Kevin Johnson , 41, of Jupiter, Craig Beaver, D.C. , 47, of Lake Worth, Alan Lefkin, M.D. , 53, of Parkland, Steven Pearlstein, M.D. , 56, of Coral Springs, and Timothy Sigman, M.D. , 40, of Sebastian.

According to the indictment, Peter DelToro, Richard DelToro, and Jaclyn Rubino operated Treasure Coast Specialty Pharmacy, in Jensen Beach, and distributed steroids, human growth hormone, and oxycodone to individuals and clinics across the nation and abroad. Other defendants named in the indictment allegedly operated various clinics, including “anti-aging,” “hormone replacement therapy,” and “pain management” clinics. The indictment alleges that the clinics employed physicians who signed prescriptions that were written by clinic operators and salespeople. The indictment further alleges that the prescriptions were issued without a physical examination of the patient, outside the usual course of professional medical practice, and not for a legitimate medical need. The prescriptions were for controlled substances and human growth hormone for unapproved uses.

The indictment also alleges that clinics forwarded the prescriptions to Treasure Coast Specialty Pharmacy in Jensen Beach, Florida, for filing and shipment directly to customers and, at times, to the clinics. According to the indictment, the pharmacy owner illegally attempted to import steroids, of the same type used to fill the clinics’ prescriptions, from China.

If convicted, the defendants face a statutory maximum penalty of 10 years in prison on Counts 1, 7 through 8, 10 through14, 17 through 21 and 42, 5 years on Counts 2 through 6, 9, 15 through16, and 26 through 41, and 20 years on Count 22 through 25.

Today’s case, dubbed Operation Juice Doctor 2, is the result of the ongoing efforts between federal, state and local law enforcement agencies. Mr. Trouville thanked the Food and Drug Administration’s Office of Criminal Investigations and the Boca Raton Police Department for their invaluable assistance in this investigation.

An indictment is only an accusation and the defendants are presumed innocent until proven guilty.

N.J. taxpayers get bill for millions in steroid, growth hormone prescriptions for cops, firefighters

Published: Monday, December 13, 2010, 7:30 AM     Updated: Monday, December 13, 2010, 10:15 AM

Reena Rose Sibayan/The Jersey JournalJersey City police officer Victor Vargas, shown during a court appearance in 2008, was named in a lawsuit alleging a case of "roid rage." Vargas received anabolic steroids and growth hormone from Jersey City physician Joseph Colao, records show. The case went to binding arbitration in October.

On Jan. 31, 2007, Jersey City police officer Victor Vargas filled a prescription for Norditropin, a brand of human growth hormone. He was billed $8, the co-pay set by his government health plan.

Taxpayers picked up the remaining $1,076.

Through August of that year, Vargas, then 30, filled at least five more prescriptions for growth hormone, along with prescriptions for testosterone, an anabolic steroid, and HCG, a drug that boosts production of testosterone in the body, according to legal documents related to an ongoing brutality lawsuit against Vargas and other officers.

In all, the officer paid $96 for the three substances in those eight months. The cost to the public: $7,013.

Vargas’ purchases provide a window into the enormous financial burden borne by taxpayers under a wink-and-nod arrangement between a Jersey City doctor, Joseph Colao, and his loyal patients in law enforcement agencies and fire departments across New Jersey.

A Star-Ledger investigation has found that at least 248 officers and firefighters obtained steroids, growth hormone and other testosterone-boosting drugs from Colao before his death in August 2007. In addition, the newspaper found Colao often falsely diagnosed his patients with hormone deficiencies to justify his prescriptions, a violation of the law and medical ethics.

For the officers and firefighters in the physician’s practice, the drugs came cheap.

Like Vargas, they used their government benefits to pay for the substances in most, if not all, cases. A Star-Ledger analysis suggests the total cost to taxpayers runs into the millions of dollars, driven primarily by Colao’s willingness to so widely prescribe human growth hormone, one of the most tightly regulated drugs in the nation.

Strong at Any Cost

A three-part Star-Ledger series on the secret world of steroid use by law enforcement officers and firefighters.
• About this series
• List of law enforcement agencies, fire departments
• Glossary of terms

Part 1: Sunday
• N.J. doctor supplied steroids to hundreds of law enforcement officers, firefighters
• Five deaths in 19 months linked to steroids, Lowen's pharmacy
• Legal cases linked to N.J. police who received steroids through Dr. Colao
• Ex-Jets quarterback Ray Lucas was prescribed steroids, HGH by Dr. Colao

Part 2: Today
• N.J. taxpayers get bill for millions in steroid, growth hormone prescriptions for cops, firefighters
• Ex-Harrison firefighter on disability works full-time for N.C. fire department

Part 3: Coming Tuesday
• Booming anti-aging business relies on risky mix of steroids, growth hormone

For members of the Jersey City Police Department alone, Colao wrote 235 growth hormone prescriptions in a 13-month period, according to legal filings related to the brutality suit.
The public cost of just those prescriptions, based on an average price of $1,100 per month, runs to nearly $260,000.

Pharmacy records obtained by The Star-Ledger show hundreds of other prescriptions went to law enforcement officers and firefighters from 53 agencies, including the state Department of Corrections, the State Police, the NJ Transit Police Department, county sheriff’s offices and municipal departments large and small.

As expansive as Colao’s practice became, the abuse of taxpayer funds for steroids and other hormones didn’t begin or end with one Jersey City doctor.

The Star-Ledger found Colao to be an example of a wider problem, one fueled by a lack of oversight within police and fire agencies, a reluctance by prosecutors to bring criminal charges for insurance fraud and a failure by health plan administrators to flag outlandish claims.

In the years before Colao’s death, for example, New Jersey’s residents were billed $300,000 for steroids and growth hormone a group of Trenton police officers bought over the internet from a Florida dentist, state officials confirmed.

The dentist pleaded guilty to federal drug charges. The officers were investigated but not prosecuted. Three were later promoted.

Since then, insurance companies that administer public health plans have stepped up controls, particularly over growth hormone, but there are signs little else has changed.

The Star-Ledger found hundreds of officers and firefighters, some of them Colao’s former patients, continue to receive treatment from doctors who specialize in prescribing testosterone and other hormones.

Several of those doctors said that while they don’t accept insurance for growth hormone because of its strict regulation, they generally do recommend patients use their insurance coverage for testosterone.

Briefed on The Star-Ledger’s findings, Attorney General Paula Dow, the state’s top law enforcement official, said officers and firefighters who use their government benefits to pay for such drugs when they aren’t medically necessary appear to be engaging in fraud.

And at a time when New Jersey faces “crippling” expenses and the lingering effects of the longest recession in decades, Dow said, the state can ill afford to subsidize the recreational use of steroids and other substances among public workers.

“The increased cost of benefits is a major concern for this administration, and if we can show costs are shooting up in the prescription area because of an abuse in the system, that’s just wrong,” Dow said. “It’s borderline illegal, and that alone demands we take a look at this issue.”

A Mounting Tab

Joe Ramundo didn’t think twice about using his government insurance for the trio of drugs Joseph Colao prescribed him early in 2007.

Ramundo, then 42, was a sergeant in the Passaic County Sheriff’s Department. Now retired, he said Colao reviewed his blood tests and told him he needed testosterone, HCG and human growth hormone, all of which were delivered to Ramundo’s Wanaque home from Lowen’s Pharmacy in Bay Ridge, Brooklyn.

Tyson Trish/The Record Joe and Paula Ramundo of Wanaque were photographed earlier this year for a story in The Record about their appearance on the TV show "The Marriage Ref." In a subsequent interview with The Star-Ledger for this story, Ramundo, a retired Passaic County Sheriff's Department sergeant, said he got prescriptions from Joseph Colao for testosterone, HCG and HGH with co-pays of just $5.

“I don’t think he did anything wrong,” Ramundo said. “I felt more alive.”

It is illegal to prescribe growth hormone for all but a handful of conditions in adults. One of them, adult growth hormone deficiency, legitimately affects just one of every 100,000 people annually, according to the American Association of Clinical Endocrinologists.

Told that of that estimate, Ramundo responded, “I know I needed it.”

Apparently, many of Ramundo’s former colleagues feel the same way. He said law enforcement officers from “all over” Passaic County use steroids and growth hormone, mainly obtained from doctors and wellness clinics.

Ramundo said his own regimen lasted about six months, ending with Colao’s death.

During that time, he said, his only bills were $5 co-pays.

Based on the average monthly prices for the drugs Ramundo was taking, the balance likely ran to about $8,000.

“If you need it, you need it,” Ramundo said, questioning why cost was an issue and complaining that insurance companies pocket millions of dollars each year.

“They’re all about the money,” Ramundo said. “They’re full of (expletive).”

But it wasn’t an insurance company that bore the cost of Ramundo’s treatment. Like many counties and municipalities, Passaic County pays medical claims out of a self-insurance fund, meaning tax dollars satisfied the bills.

Ramundo retired from the sheriff’s office in July 2007 with an annual pension of $76,740, records show. In March of this year, he was featured on a reality television show, “The Marriage Ref,” in which his wife told a national audience he spent too much time tanning, grooming and primping.

Ramundo was one of at least 18 Passaic County sheriff’s officers or corrections officers in Colao’s practice, The Star-Ledger found. Collectively, those officers filled scores of prescriptions for testosterone, growth hormone, HCG and stanozolol, a powerful steroid favored by athletes and bodybuilders, records show.

Photos courtesy of Bayonne Medical Center/Leon ColaoJersey City physician Joseph Colao. The picture at left is from 1997. The photo at right was taken in 2005. A survivor of triple-bypass surgery, Colao underwent a transformation. His new body: tanned, toned and muscled. In 2007, Colao died of hardening of the arteries at age 45.

Other cities and towns that took a financial hit include Newark, Paterson, Union City, Edison and Franklin Township in Somerset County. In each of those communities, at least six officers or firefighters filled prescriptions through Colao. In Bayonne and Hoboken, it was a dozen or more.

Across New Jersey, however, no municipality absorbed a bigger financial blow from Colao’s prescribing habits than his own hometown.

Colao, who was 45 when he died of heart failure [Perls: ? from steroid and GH use? He looks like he was into body building], grew up in Jersey City. And when he decided to leave a group practice in Newark, it was to Jersey City he returned, opening an office on John F. Kennedy Boulevard, not far from Lincoln Park.

The struggling pain-management practice took off in 2005 and 2006, former employees said, when Colao recast himself as an anti-aging physician specializing in hormone replacement therapy. By some estimates, he had more than 5,000 patients at the time of his death.

They included at least 40 Jersey City police officers and 27 city firefighters, all of whom received steroids or growth hormone — and in most cases both — through Lowen’s Pharmacy.

Putting a Price on It

To more precisely gauge the cost to the public, the newspaper filed a request under the Open Public Records Act seeking the city’s total payments for growth hormone and anabolic steroids among members of the police and fire departments, or nearly 1,400 people in all. Jersey City’s legal department denied the request.

But a sense of the toll on taxpayers can be found in public documents and in court records filed in connection with a Jersey City resident’s lawsuit against Victor Vargas.

The resident, Mathias Bolton, claims Vargas and another of Colao’s steroid patients, officer Michael Stise, were in the throes of “roid rage” when they mistook him for a burglar and beat him on Aug. 20, 2007. Vargas and Stise are among several officers named in the suit. The officers deny any wrongdoing.

Records subpoenaed by Bolton’s lawyer show Jersey City, which provides medical coverage for its 2,900 employees through a self-insurance fund, spent more than $255,000 on various forms of growth hormone in 2006.

By 2007, when Colao’s practice was at its height, the spending on growth hormone more than doubled, to $677,000.

Seen another way, the city spent more that year to treat growth hormone deficiency, an extremely rare disorder, than on any other medical condition, including high cholesterol, high blood pressure or diabetes, the records show.

Bolton’s steroids expert, Gary Wadler, said in court papers the spending clearly indicates abuse, noting the cost to treat growth hormone deficiency ranked 43rd among other government clients of Express Scripts, the city’s pharmacy benefits manager at the time.

City spending on various anabolic steroids also soared year over year, more than tripling to $160,000 in 2007 from $52,000 the previous year.

Express Scripts apparently rubber-stamped the flood of prescriptions, part of a broader industry failure to monitor the use of medications at the time. In September 2007, a subsidiary of the company, Specialty Distribution Services, paid a $10.5 million fine after federal prosecutors in Boston charged the firm with illegally providing HGH to athletes and entertainers.

Jersey City Mayor Jerramiah Healy declined repeated requests for an interview about the use of steroids by city employees or the costs to the public.

His spokeswoman, Jennifer Morrill, instead released a statement saying Healy would be “troubled” if it was determined any police officer or firefighter was abusing steroids, “much less steroids paid for by the taxpayers.”

“Should the investigations of any law enforcement agencies determine that to be true, the city will demand restitution or civil action to recover those costs,” Morrill said. “However, the mayor cannot presume that the mere existence of a prescription for steroids that was written by a medical doctor and filled by a licensed pharmacy for a city employee is not medically necessary or otherwise a fraud.”

Enlarge Star-Ledger Staff Sgt. Anthony Manzo, 50, was one of a dozen current or former Trenton police officers who bought steroids or human growth hormone over the internet, paying for the drugs with their government health plans, authorities said. The total cost to taxpayers: $300,000. The state Attorney General's Office investigated the officers but did not charge them. Manzo remains on the force. (Tim Larsen/The Times of Trenton) Steroid bills for N.J. law enforcement, firefighters come at taxpayer cost gallery (5 photos)

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No Charges to Answer

Fred Beaver calls it one of the great frustrations of his career in government service.

On a spring day in 2006, Beaver learned a dozen active and former Trenton police officers had been ordering vast amounts of anabolic steroids and human growth hormone over the internet for two years, beginning in 2002.

And with each purchase, the officers had used their government health benefits. State prosecutors would later peg the cost at $300,000.

As director of the Division of Pensions and Benefits at the time, Beaver oversaw the State Health Benefits Program, a self-insurance fund that covers state workers and employees for more than half of New Jersey’s school districts and municipalities.

Because Trenton participated in the plan, all of the state’s taxpayers were on the hook for the steroid and HGH purchases of a dozen cops.

“I couldn’t believe it,” said Beaver, who retired in April after eight years in the post. “Some of these guys were getting three prescriptions a week for 30-day supplies. It was the most ridiculous arrangement I ever saw.”

Horizon Blue Cross Blue Shield of New Jersey, the insurer that administers the state program, eventually brought the purchases to Beaver’s attention, but he wondered why it had taken the company years to discover them.

“How did they let this go on?” he asked. “Where were the controls?”

The source of the steroids and growth hormone wasn’t even a medical doctor. Jeffrey Weiser, now 50, had been a dentist in Burlington County before giving up his practice and beginning a new life as a personal fitness consultant in Florida.

Part of that business involved peddling steroids and growth hormone for as much as $1,700 a prescription on bodybuilding websites.

Weiser later pleaded guilty to federal charges of unlawfully distributing the substances. In November 2007, he was sentenced to six months’ home confinement and four years’ probation.

Beaver expected the same sort of treatment for the police officers.

“To me, this was a clear-cut case of insurance fraud,” he said.

Beaver said Horizon forwarded the allegations to the Mercer County Prosecutor’s Office, which spent months on the case but ultimately declined to bring charges. Incensed, the former pensions director wrote a letter to the state Attorney General’s Office requesting another probe.

That investigation lasted more than a year, ending quietly in late 2008 without an indictment.

“That points to the problem in this state,” said Beaver, who now works in the private sector. “This is taxpayer money. If you’re not willing to take this on, if you’re willing to absorb hundreds of thousands of dollars in costs, I think it’s ludicrous.”

The case was equally frustrating to Joseph Santiago, then Trenton police director.
Santiago, who now serves as police director in Irvington, cast the issue in moral terms, saying officers charged with upholding the law, and who sometimes testify under oath in narcotics cases, appeared to be buying drugs illegally.

At the same time, he said, he worried officers on steroids could be susceptible to episodes of increased aggression. Santiago said he reviewed the officers’ records, finding a “significant amount” of excessive force complaints.

“When you looked at these records, you start to see where there might be a correlation,” he said. “Is it absolutely clear? No. Would a complaint have been there regardless of steroids? Those are issues that need to be addressed.”

One of the officers, Jason Woodhead, was named in a civil suit alleging he and another officer severely beat a 53-year-old man in 2004 for disobeying an order to remain in his home while the pair conducted an investigation outside.

The resident, Charles Hendrix, suffered a broken nose, broken ribs, a broken hand and spinal injuries, according to the suit. In April of this year, the city settled with Hendrix for $500,000, court records show. Taxpayers picked up that tab, too.

Woodhead, now 32, was one of six officers implicated in the internet purchases to remain on the Trenton force through the state and county investigations.

Marc Bellagamba/The Times of TrentonTrenton detectives John Zappley, right, and Anthony Manzo, left, escort a suspect out of Superior Court in Trenton in this 2001 photo. Zappley and Manzo are now sergeants. The two are among a dozen officers who bought human growth hormone or steroids over the internet, paying for the drugs with their government health plans, authorities said.

The others are Sgt. John Zappley, 43; officer Matthew Przemieniecki, 32; Detective Randall Hanson, 41; Detective Anthony Manzo, 50; and Lt. Joseph Valdora, 50, the president of the department’s Superior Officers Association.

In September 2008, as the investigation dragged on, Santiago stripped the officers of their weapons and put them on desk duty. Within a week, all but Hanson were in a Trenton courtroom, asking a Superior Court judge to compel Santiago to return their weapons, according to a published account. The judge declined.

It turned out to be moot.

Santiago left the department later that month, forced out because he did not comply with the city’s residency requirement. The officers were soon reinstated.

Woodhead and Manzo are now sergeants in Trenton. Valdora, promoted to captain in April 2009, retired in October. None of the officers responded to requests for comment.

A seventh officer, Detective Robert Smith Jr., took a job with the Mercer County Sheriff’s Office. Today, he is chief instructor at the county police academy. Smith did not respond to requests for comment.

The other five officers retired either before or directly after the internet purchases were discovered. Four of them could not be identified. The remaining retiree, Sgt. Richard Merlino, left the department in December 2004 at age 41.

Merlino, who now lives in South Carolina, called the allegations “90 percent baseless.”

“There’s a lot of untruths to the story,” he said.

In response to the complaints by Beaver and Santiago, a spokesman for the Attorney General’s Office said prosecutors, after a careful analysis, determined they couldn’t prove the officers intended to break the law.

Several factors played a role in the decision, said the spokesman, Peter Aseltine, noting that Horizon signed off on the officers’ reimbursements and that a pharmacy filled the prescriptions.

In addition, Aseltine said, the dentist misled his customers by identifying himself as a medical doctor, a fact cited by the officers in claiming they didn’t realize they were engaging in wrongdoing.

“I’m not commenting on the validity of the officers’ claims, but I am commenting on the difficulty we would have had in proving the requisite mental state,” Aseltine said. “The mental element can be the hardest part of a case to prove.”

Casey DeBlasio, a spokeswoman for the Mercer County Prosecutor’s Office, declined to comment.

Tightening the Reins

If one positive development has emerged from the misuse of taxpayer funds for muscle-building drugs, it’s that the insurance industry is paying better attention.

Prescriptions and reimbursement claims for human growth hormone are no longer routinely waved through without a second look, industry officials say, and doctors who prescribe large amounts of steroids are more likely to face inquiries from investigators.

“We’ve got some good controls in place across many of our products now,” said Thomas Rubino, a spokesman for Horizon, the state’s largest insurer. “We challenge and seek additional information from the provider making a request for the prescription of a human growth hormone or a steroid. Awhile ago, that would have just gone through the system.”

The changes grew out of hard lessons.

Beyond the Trenton case, Rubino said, the company took note of spikes in steroid and HGH prescriptions in 2006 and 2007. By looking deeper, investigators found millions of dollars had been lost to fraud.

“The cases we investigated have been significant-dollar cases,” Rubino said.
Other industry officials say investigators are now better trained to look for patterns that could indicate fraud.

A patient taking an anabolic steroid in conjunction with an estrogen-blocker, for example, might signal an effort to avoid the development of excess breast tissue, a side effect of steroid abuse. A large number of young men receiving testosterone from a single doctor also would raise a red flag.

“All these drugs have legitimate and important medical uses, but you have to look at the context of how they’re being prescribed,” said Steve Russek, chief clinical officer of Accredo Specialty Pharmacy, a division of Medco Health Solutions.

Medco administers prescription benefits for some 65 million people across the country. When former Passaic County sheriff’s officer Joe Ramundo put through his claims for growth hormone and testosterone, it was Medco that signed off on them.

The increased scrutiny may have cut the costs to taxpayers, but it hasn’t entirely eliminated them.

Testosterone — which can run up to $300 per month, depending on the dose and the form in which it’s delivered — is a staple drug of the growing anti-aging industry. And in doctors’ offices and clinics where anti-aging medicine is practiced, law enforcement officers and firefighters can often be found.

Santiago, the former Trenton police director, contends the use of steroids in the ranks — and the related burden on taxpayers — will remain a problem unless departments and prosecutors get tougher on the issue.

“You need to signal to everybody that it’s not okay to do this,” he said. “Cops are like everyone else. They pay attention.”

Report: Late NJ doc improperly supplied steroids {and growth hormone}

Originally published: December 12, 2010 7:05 PM
Updated: December 12, 2010 7:22 PM
By The Associated Press  

NEWARK, N.J. - (AP) — Hundreds of law enforcement officers, firefighters and corrections officers in New Jersey improperly obtained anabolic steroids and human growth hormone from a Jersey City physician before his death, according to a published report.

A seven-month investigation by The Star-Ledger of Newark found Joseph Colao frequently broke the law and his own oath by faking medical diagnoses to justify his prescriptions for the drugs.

The newspaper found at least 248 officers and firefighters from 53 agencies obtained muscle-building drugs from Colao, including some that have been linked to increased aggression, confusion and reckless behavior.

Six of those patients were named in lawsuits alleging excessive force or civil rights violations around the time they received drugs from him or shortly afterward.

The newspaper's seven-month investigation involved drew on prescription records, court documents and detailed interviews with the physician's employees. It found many of the officers and firefighters willingly took part in the ruse, while others were persuaded by Colao's sales pitch, one that glossed over the risks and legal realities.

In most cases, if not all, those obtaining the drugs used their government health plans to pay for the substances. Evidence gathered by the newspaper suggests the total cost to taxpayers reaches into the millions of dollars.

Colao's younger brother, Leon Colao, disputed the claims made against his brother. He said that in the several years he worked as his brother's office manager, he never saw him push a drug that wasn't medically necessary. Leon Colao left the practice in 2005, returning to work there shortly before his brother's death.

"My brother worked a very long time to get his medical license," Leon Colao told the newspaper. "He wouldn't jeopardize that for anything in the world."

According to the report, Colao — who was 45 when he died of hardening of the arteries in 2007 — steered his clients to a Brooklyn pharmacy that sent him boxes of HGH as a kickback.

He apparently began prescribing the drugs in earnest in 2005, and his practice quickly grew, drawing law enforcement officers and firefighters from across the state who — according to the report — learned about Colao through word of mouth.

State Attorney General Paula Dow called the newspaper's findings "disturbing" on a number of levels. She said the issue should be collectively examined by state officials, prosecutors and police chiefs.

"If it's shown that these law enforcement officers are getting steroids and human growth hormone through illegal manners, and specifically through false prescriptions, that's a violation of the law," Dow said. "It's a fraud on the system, and it's something that should be stopped."

At the time of his death, Joseph Colao was under investigation by the state Board of Medical Examiners, which licenses and disciplines doctors. The board opened an investigation into Colao in March 2007, though it did not contact him in the five months before his death, spokesman Jeff Lamm said.

Colao also was dealing with other problems in his final months.

Medicare officials had conducted a fraud investigation of his practice in 2006, and Horizon Blue Cross/Blue Shield was demanding to see records. The insurer would later file a $900,000 notice of claim against Colao's estate, alleging he falsified diagnoses to prescribe growth hormone, a Horizon spokesman said.

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Information from: The Star-Ledger, http://www.nj.com/starledger

Doctor who helped prescribe growth hormone charged with tax violations

[ONE OF THE FATHERS OF "ANTIAGING": LEON CASS TERRY]

Ex-Medical College official has agreed to cooperate in a federal investigation linked to another state.

By John Fauber of the Journal Sentinel

News Release [print friendly page]
FOR IMMEDIATE RELEASE
January 29, 2009
Contact: Chuvalo J. Truesdell
PIO/AFD
Number: 404-893-7124

Doctor Pleads Guilty to All 175 Charges of Illegal Prescriptions
Dr. Philip Astin III Admits Prescribing Drugs Improperly Over 5-Year Period

JAN 29 -- Atlanta, Georgia - Dr. PHILIP C. ASTIN, III, 52, of Carrollton, Georgia, has entered a guilty plea to all 175 counts of a superseding indictment charging him with illegally dispensing prescription drugs from 2002 until his arrest in 2007. 

Rodney G. Benson, Special Agent in Charge (SAC) of the DEA Atlanta Field Division (AFD) stated, “DEA continues to actively investigate medical doctors, pharmacists and other clinicians who indulge in illegal prescribing practices.  Although Dr. Astin admitted guilt in this case, the scarred lives of the addicted patients may never heal and he cannot bring back the patient who died of an overdose from drugs prescribed by him. His fate now rests in the hands of the United States’ judicial system where he will be held accountable for his deplorable actions.  Today’s guilty plea illustrates how DEA and our local, state and federal law enforcement counterparts are committed to eradicating this problem.”

David E. Nahmias, United States Attorney for the Northern District of Georgia, said, “Communities in Carroll County and throughout North Georgia were harmed by the hundreds of illegal prescriptions written by Dr. Astin and the terrible addictions caused or fed by these drugs.  This case demonstrates the irreparable damage that can be done when a doctor violates his oath to help others and instead chooses the path of illegal drug dealing.  Dr. Astin has now admitted his criminal conduct, and we will continue to work hard to ensure that he receives an appropriate sentence that ensures he is never able to harm anyone again.”

ASTIN pleaded guilty to offenses relating to 19 patients who received hundreds of illegal prescriptions for methadone, Percocet, Oxycontin, M.S. Contin, Demerol, Lorcet, Ritalin, Vicodin, Klonopin, Vicoprofen, Xanax, Adderall, and Soma.  Through the plea agreement, ASTIN further admitted that the prescriptions he issued resulted in the death of one patient when she overdosed on the drugs.  ASTIN also admitted that he wrote and filled 16 prescriptions for Lortab, Xanax, Dexedrine, Adderall, and Ritalin in the names of two patients without their knowledge. 

According to United States Attorney Nahmias and the information presented in court:  From approximately May 2002 until the date of his arrest in July 2007, ASTIN intentionally wrote prescriptions for controlled substances that were not for a legitimate medical purpose and were not in the usual course of a physician’s professional practice.  ASTIN dispensed these prescriptions without conducting the appropriate physical examinations and diagnoses to justify the prescriptions and, as a result, many of the patients who received these illegitimate prescriptions became addicts or had existing addictions which were fed by the illegitimate prescriptions.

ASTIN admitted that he dispensed the painkillers and other drugs that the patients requested without an adequate medical history, physical exam, x-ray, MRI, or referral to a orthopedist or pain management specialist.  ASTIN also wrote prescriptions in quantities and in contexts that bore no relationship to a legitimate medical problem or legitimate pharmacological benefit–for example, combinations of several painkillers dispensed together along with muscle relaxers, sleep aids, amphetamines, and other drugs, that are commonly abused together and referred to as “cocktails” by drug abusers.

 ASTIN also admitted to writing multiple prescriptions for the same drug on the same date, sometimes as many as four simultaneous Percocet prescriptions to the same patient for the same 30-day period, and wrote undated prescriptions as well.  Federal law requires medical practitioners to sign and date each prescription for controlled substances on the date that it is issued.  Finally, ASTIN dispensed methadone as a maintenance therapy without the proper license to dispense drugs in this fashion and in quantities and durations that readily perpetuated the addiction of these patients.

The evidence presented at the plea hearing included descriptions of several of the patients to whom ASTIN wrote illegal drugs.  For example, two married patients were abusing Lorcet, Xanax, and Soma they received from another doctor and heard from an acquaintance that Dr. ASTIN would give them the prescriptions without conducting a thorough examination. The female patient began receiving the same drugs from ASTIN in 2002 and developed an addiction to the drugs, which continued until her death in 2007.  Her husband told investigators that ASTIN never performed any kind of medical examinations or tests to justify the prescriptions that he and his wife received.  On June 20, 2007, the patient overdosed on Lortab, Xanax, and Soma that was prescribed by ASTIN and died from acute toxicity of the drugs.

Another patient, who was a professional wrestler, said that it was widely known in the professional wrestling community that ASTIN would dispense prescriptions without performing a medical examination.  This patient received prescription drugs, including Lorcet, Percocet, Xanax, and Soma, from ASTIN from December 2004 until November 2005, and said that he did not receive a legitimate medical examination or testing from ASTIN during that time.  The wrestler developed an addiction to the drugs, and ASTIN never questioned his addiction and instead simply wrote prescriptions for larger quantities of pills.  The patient said that a number of professional wrestlers obtained prescription drugs from ASTIN for the purpose of abusing the drugs, adding that some of these wrestlers also were addicted to the drugs.

ASTIN was charged in a superseding indictment on May 29, 2008, with 174 counts of illegally distributing prescription drugs and one count of conspiring to distribute prescription drugs.  ASTIN pleaded guilty to all 175 counts of the superseding indictment.  He could receive a maximum sentence of 20 years in prison and a fine of up to $1,000,000 on each count.  In determining the actual sentence, the Court will consider the United States Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for most offenders. 

Sentencing is scheduled for May, 12, 2009, at 10 a.m., before United States District Judge Jack T. Camp.

ASTIN surrendered his medical license at the time he was arraigned on these charges. This case is being investigated by Diversion Investigators of the Drug Enforcement Administration (DEA) and the Fayette County Sheriff Department’s Drug Suppression Task Force, with the assistance of the West Georgia Drug Task Force, and the Carroll County Sheriff’s Department.

This case is being prosecuted by Assistant United States Attorneys John Horn and Jeffrey Davis.

SAC Benson of the DEA AFD encourages parents, along with their children, to educate themselves about the dangers of legal and illegal drugs by visiting DEA’s interactive websites at www.justhinktwice.com and www.dea.gov. DEA.gov takes you directly to the Diversion Control and Prescription Drugs link.

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A California doctor who was accused in the Mitchell Report of prescribing steroids and human growth hormone to Major League Players was sentenced six months home detention.

Ramon Scruggs was also sentenced to two years of probation during a hearing in U.S. District Court in San Jose on Monday.

An indictment handed down in March 2008 said that agents for Major League Baseball players referred their clients to Scruggs to obtain performance-enhancing drugs. Scruggs' patients included former Mets pitcher Scott Schoeneweis and Cardinals third baseman Troy Glaus.

The illicit prescriptions written by Scruggs were forwarded to pharmacies in California and to Signature Pharmacy in Orlando. Signature Pharmacy was at the center of the Albany County District Attorney's office investigation into illegal Internet drug distribution.

At times, according to the indictment, the drugs dispensed were preloaded with anabolic steroids and sent directly from New Hope to Scruggs' clients.

Scruggs preached that steroids and HGH could improve quality of life for his patients, some of whom he never saw personally.

Scruggs was charged with conspiracy to distribute anabolic steroids, including the hard-core steroids nandrolone, testosterone and stanolozol, HGH and other prescription drugs to baseball players and law-enforcement personnel for "non-legitimate purposes, including performance enhancement, aesthetic body improvement and other non-medical reasons."

Scruggs pleaded guilty to one count of conspiracy to distribute anabolic steroids and HGH and one count of money laundering in June.

MLB drug supplier Ramon Scruggs pleads guilty on federal charges

By Nathaniel Vinton
DAILY NEWS SPORTS WRITER

Updated Monday, June 1st 2009, 7:28 PM

California-based medical guru Ramon Scruggs, who was accused in the Mitchell Report of having prescribed steroids and human growth hormone to several Major League players, pleaded guilty to two federal criminal charges Monday.

Scruggs appeared in a U.S. District Court in San Jose to plead guilty to one count of conspiracy to distribute anabolic steroids and HGH and one count of money laundering. His sentencing is set for Sept. 14.

Once the flamboyant owner of a profitable clinic called the New Hope Health Center in Costa Mesa, Calif., Scruggs preached that steroids and HGH could improve quality of life for his patients, some of whom he never saw personally. Among Scruggs' patients were former Mets pitcher Scott Schoeneweis and Cardinals third baseman Troy Glaus.

The indictment a grand jury issued against Scruggs and his co-defendants in March 2008 said sports agents referred pros to Scruggs for drugs that were "unavailable to the players through lawful medical channels absent the illegal prescriptions provided by Scruggs."

Two of Scruggs' former employees, Allen Danto and Heidi McPherson, were also indicted in the case. Danto pleaded guilty earlier this month to conspiracy to distribute anabolic steroids and HGH. McPherson pleaded not guilty and is set for a trial beginning Sept. 21.

Documents filed by the state medical board in June 2004 and updated in June 2006 said Scruggs had “prescribed approximately 6,073 prescriptions of dangerous drugs or controlled substances over the Internet without a good faith examination of the patients” in and out of California since 2000. Scruggs settled the matter and accepted a $4,800 fine and 35 months of probation.

Inside a Tempting World of Easy Steroids

United States Department of Justice

United States Attorney Joseph P. Russoniello
Northern District of California

In a consolidated proceeding (Practitioner’s and Exporter’s Registrations), on November 7, 2001, DEA issued an Order to Show Cause and Notice of Immediate Suspension to Respondent on the ground that continued registration threatened the public health and safety. DEA issued another Order to Show Cause on May 24, 2002, which proposed to deny Respondent’s application for an exporter’s registration on the ground that registration would be inconsistent with the public interest. Respondent requested a hearing, conducted in three stages between January 28 and December 11, 2003. On July 28, 2005, the Administrative Law Judge recommended that DEA revoke Respondent’s practitioner’s registration and deny his application for an exporter’s registration.

The 2001 Order alleged that Respondent purchased controlled substances from illegitimate sources and re-distributed them without a legitimate medical purpose. Undercover operations revealed that Respondent prescribed human growth hormones and testosterone to patients before obtaining the results of necessary blood tests. Execution of a search warrant discovered that Respondent was in possession of numerous controlled substances without the appropriate purchase, use, and inventory records.

On June 29, 1998, the Medical Board of California initiated proceedings against Respondent that resulted in revocation of his state medical license. Once the Board revoked his license, Respondent sold the clinic to his sister, who held a valid registration. Despite the transfer in ownership, Respondent, without a state license, continued to run the clinic and direct employees in the handling and shipping of controlled substances. Respondent’s history of distributing controlled substances in violation of the Controlled Substances Act and inadequate recordkeeping constituted conduct that threatened public health and safety. Consequently, DEA revoked Respondent’s registration because continued registration was inconsistent with the public interest. 21 U.S.C. §§ 823(f) and 824(a)(4).

The 2002 Order proposed to deny Respondent’s application for an exporter’s license because he had already engaged in exporting behavior illegally. On May 7, 2001, Respondent submitted an application for an exporter’s registration. The "application was not accepted for filing" and the filing fee was refunded. Respondent submitted a second application, which triggered an administrative inspection and investigation.

Respondent’s records indicated that he exported over 300 controlled substances to at least eleven countries without an exporter’s registration. Furthermore, some of the foreign shipments of controlled substances Respondent made violated international treaties. Respondent continued to export controlled substances after DEA notified him that it was illegal and even after receiving the Notice of Immediate Suspension. Respondent also imported two controlled substances from a Mexico pharmacy without an importer’s registration, in violation of 21 U.S.C. 957(a).

Respondent’s history of exporting controlled substances without the appropriate registration and his participation in the diversion of controlled substances constituted conduct that threatened public health and safety. Consequently, DEA denied Respondent’s application for an exporter’s registration as inconsistent with the public interest. 21 U.S.C. § 958(d).

Respondent claimed the DEA proceeding should be dismissed because the Office of Chief Counsel engaged in misconduct during the proceeding that required replacement with private counsel. Respondent alleged that a DEA employee committed perjury by certifying that she was the Acting Unit Chief of the Registration Unit although she no longer held that position on the day she signed the affidavit regarding the failure to process Respondent’s application. The position of the employee on the date of the declaration is immaterial because she conducted the investigation leading to the non-acceptance of the application and did not have the intent to deceive.

Respondent further alleged that the employee committed perjury by asserting that the first application was not accepted "for an unexplained reason." The first application was refunded because the office mistakenly believed he already had a DEA registration number. There is no mandatory duty to register an applicant and Respondent’s violations of federal law, revealed during investigation for the second application, support a finding that his first application would have been denied. Furthermore, Respondent did not demonstrate that he relied on any act or statement by DEA that would establish the materiality of the allegedly perjurious assertion. Both of Respondent’s challenges were without merit.

Greeley doctors implicated in illegal steroid ring

Sharon Dunn, (Bio) sdunn@greeleytribune.com
January 26, 2008

Three Greeley doctors have been implicated in a nationwide steroid ring, and one pleaded guilty this week in an Alabama court.

Dr. Scott Corliss, a physician with the Greeley Medical Clinic, pleaded guilty Thursday in U.S. District Court in the Southern District of Alabama to dispensing illegal steroids. As a part of his plea agreement, he agreed to turn over $12,000 he had received in proceeds from 2005-06. He faces up to three years in prison and a fine of up to $250,000.

His plea agreement implicates Family Physicians Dr. Kenneth Olds and Dr. Kelly Tucker, who also faces a charge of sexual assault against a patient in a separate case. That charge was made in Weld District Court.

Olds refused to comment.

Officials at Greeley Medical Clinic would not comment about the case, but Dr. Dan Zenk, the center's president, e-mailed a prepared statement:

"The Greeley Medical Clinic learned today that Dr. Scott Corliss, a physician affiliated with our clinic, accepted a plea bargain concerning certain unlawful activities. The Greeley Medical Clinic emphasizes to the community that any illegal activity that involved Dr. Corliss occurred without the Greeley Medical Clinic's knowledge or approval, and was completely unauthorized in nature. Any type of illegal conduct is contrary to the Greeley Medical Clinic's values, mission and professional obligations to the health and well-being or our patients. We are investigating this matter further."

According to court documents, the doctors worked with Brett Branch, owner of Infinite Health in Eaton, and a sales representative for Applied Pharmacy Services Inc., a compounding pharmacy in Mobile, Ala., which court records state manufactured and sold anabolic steroids, HGH, and other drugs. A compounding pharmacy can custom-make prescriptions for individual patients.

Applied Pharmacy Services also was one of the pharmacies named in the recent Mitchell Report, in which former Sen. George Mitchell investigated rampant steroid use in Major League Baseball.

Contacted Friday, Branch said based on his attorney's advice, he could not comment about if he'd been charged or about his involvement in the case.

Tucker vehemently rejected his inclusion in the record of Corliss' guilty plea in Alabama. "That's false," he said.

"If Scott Corliss did something, that's not me," he said. When asked if he knew Branch, he paused, then he hung up the phone.

Court documents stated Branch "recruited customers at various gyms and sports clubs," and he received a percentage payment from Applied Pharmacy for each of the drugs dispensed to his customers. Branch approached the doctors in March or April 2005, court documents state, and he paid for Corliss and Tucker to attend the American Academy of Anti-Aging Medicine conference in May 2005 in Las Vegas.

Court documents stated Branch, who is not a doctor, would fax pre-printed prescription orders to Drs. Olds, Tucker and Corliss, along with his customers' blood test results. The customers would then see the doctors, who would then sign the prescription orders, court documents state. The prescriptions were for steroids such as Trenbolone, a bovine/equine steroid not approved for human use, and Human Growth Hormone. Court documents stated Branch would pay the doctors $100 for each prescription.

In September 2005, Branch asked Corliss and Tucker to become part owners of Infinite Health, an offer that only Tucker accepted, court documents state. A month later, court documents state, Corliss read an article that stated the growth hormone he and the others had been prescribing was illegal and brought it to Branch's and Tucker's attention. Court documents state that Tucker and Branch replied, "Because the physicians saw the patients and reviewed their blood work, the practice was legal."

Corliss' participation decreased then, but court documents state when Tucker became sick in February 2006, Branch asked Corliss to see patients normally referred to Tucker. Corliss agreed, court records state, detailing 11 incidents in which Corliss prescribed illegal steroids from February 2006 to May 9, 2006.

In September 2006, Corliss spoke with Drug Enforcement Agents. Court documents stated, "although the initial customers sent to him by Branch requested the anabolic steroids and HGH for 'anti-aging' treatment, Corliss began to doubt the legitimacy of the anti-aging justification."

Soon thereafter, Corliss sent a letter to Branch, ending his association with Infinite Health, court records state, then notified his partners and his employer of his conduct. Court records state he also turned himself in to the Colorado Board of Medical Examiners, which then admonished him.

According to the admonishment issued by the Board on May 18, 2007, Corliss saw 32 patients referred from Branch, and he prescribed steroids to at least 18 patients complaining about excess body fat. Corliss' license is still active, according to state records, but the Board threatened to suspend it if there were more complaints about him prescribing the drugs.

Corliss completed a three-day course on "Prescribing Controlled Drugs: Critical Issues and Common Pitfalls of Mis-Prescribing," the court records state.

Corliss joined the Greeley Medical Clinic in 1996 after serving for five years as associate director of the North Colorado Family Medicine residency in Greeley, and he has "special interests" in weight management and anti-aging concerns, according to the Greeley Medical Clinic's Web site.

It is not known at this time if Tucker, Olds or Branch also have been charged with wrongdoing. Officials with the U.S. District Attorney's office in the Southern District of Alabama did not return calls Friday.

-- Donovan Henderson contributed to this report.

More online

To read a PDF of Dr. Scott Corliss' plea agreement, visit www.greeleytribune.com

Doctor founded clinic with ex-wrestler

By Hal Habib

Palm Beach Post Staff Writer

Sunday, April 08, 2007

BRANDON — While law enforcement silently pursued him in Palm Beach County, a heart doctor now charged with peddling steroids and growth hormones on the Internet tried to pump up business in this Tampa suburb by teaming with a former professional wrestler called Cyborg.

Dr. Robert G. Carlson and partner Kevin Donofrio of Brandon formed Florida Rejuvenation Institute in September, state corporation records show. Six months later, Carlson was arrested for his role at Palm Beach Rejuvenation Center, an alleged prescription mill in Jupiter that prosecutors say made millions prescribing steroids, testosterone and other potentially dangerous hormones through its Internet site without face-to-face examinations of patients.

Alleged steroid doctor  Dr. Robert Carlson pitches his rejuvenation clinics

Donofrio said Florida Rejuvenation Institute was founded in hopes of repeating the Jupiter company's success. He said he had no idea Carlson was being investigated. But six or eight weeks after the company was formed, Donofrio said he backed away from their enterprise.

"I realized he didn't really want to see patients face to face," Donofrio said. "They were into this Internet medicine business."

Carlson was arrested in February after a three-year national investigation of prescription drug sales on the Internet. Fourteen Floridians have been charged, plus seven more in Texas and New York.

Carlson, a 50-year-old former Eagle Scout, has pleaded not guilty to seven counts of selling controlled substances. He has refused comment. His attorney, Thomas J. O'Hern of Albany, N.Y., would not answer written questions faxed to his Albany office. Carlson's former attorney has said more prescriptions were written with Carlson's name that the doctor had signed.

A professional wrestler for seven years, 44-year-old Donofrio now operates Partners in Wellness, a string of health clubs and clinics providing primary care, physical rehabilitation and pain management. He touts himself as a five-time All-American in Greco-Roman and freestyle wrestling and a Coastal USA Body Building Champion. He also has coached high school wrestlers.

It was through wrestling that Donofrio met Carlson's brother-in-law, Joseph Raich, a longtime booster of amateur wrestling, as well as the wrestling team at Jupiter Christian School, and vice president of Palm Beach Rejuvenation. When investigators raided the company's headquarters in February, Chris Ruh, son of the high school's wrestling coach, was working there, court records show.

Ruh has not been charged, nor have authorities publicly stated that he is under investigation. Raich has not been charged, but prosecutors call him an unindicted co-conspirator. He has hired a criminal defense lawyer.

Their connections to the company and the wrestling team prompted the Florida High School Athletic Association to open an inquiry into the wrestling program. A year ago, Jupiter Christian became the smallest school ever to win a state wrestling title in Florida.

"My main reason was I heard they were the number one company in the world," Donofrio said of his interest in Palm Beach Rejuvenation. "I'd always known success leaves clues. I figured if they're the No. 1 company in the world, in terms of producing volume, they must do it right, you would think. Like the number one football team, they must have the best players, right?"

Because Donofrio already had medical facilities in Brandon, he said he started the company with about $20,000, some of it spent on advertising. They launched Florida Rejuvenation with a couple of public seminars featuring Carlson, a trim-and-fit heart surgeon who hails the benefits of hormones in combating the common effects of aging: weight gain and the loss of sexual libido and energy.

The two seminars drew 230 prospects, Donofrio said, with 40 later meeting face to face with Carlson. But after that, Donofrio said, Carlson told him he didn't want to see patients. He said the doctor, whose practice and home are an hour's drive away in Sarasota, wanted patients' laboratory test results faxed or e-mailed to him rather than having him personally examine patients seeking prescriptions. Carlson insisted it was legal, Donofrio claims.

"That was kind of when a red light went off and I said, 'Nah, I'm not doing that. I'm not getting into that kind of business,'''' Donofrio said.

The law in New York, where Carlson was charged, prohibits doctors from writing prescriptions without face-to-face visits. Florida law has a similar prohibition, with a few exceptions for emergencies and other circumstances.

Doctors at Donofrio's other medical clinics, he said, spend 11/2 hours with each patient, followed by a nutritionist spending an hour with the patient. Only then, he said, are prescriptions written.

"Carlson is a brilliant doctor," Donofrio said. "He's no dummy. The guy is well-educated, but I can't feel good about having my customers, whom I've worked 20 years for, faxing their labs to Sarasota or to Palm Beach for review and not having face-to-face contact with the physician."

A lack of face-to-face contact is central to the charges brought in New York against Carlson and Palm Beach Rejuvenation employees Glenn and George Stephanos, brothers who also have pleaded not guilty to drug charges.

"It's sad," Donofio said. "These guys, they're out there making millions, but I don't know what'll happen to them. But I can sleep at night."

While awaiting trial, Carlson continues his cardiac practice from a third-floor suite in Sarasota. Tacked on the door along with his name is a sign for Palm Beach Rejuvenation of Sarasota, a business he formed six weeks before opening Florida Rejuvenation Institute with Donofrio. Carlson's pitch on his Sarasota company's Web site: "You need hormone replacement for a better quality of life."Donofrio said that, to his knowledge, Carlson never wrote prescriptions for Florida Rejuvenation Institute patients without a face-to-face examination. He said the company was dissolved in late 2006, right after his falling out with Carlson. Told that state records show the company remained in active status, Donofrio produced the copy of a check to the state as well as a state form he signed to dissolve the company. The check was dated March 29, the same day he was interviewed about the company by The Palm Beach Post.

"It was an oversight," he said, when asked why the form and fee weren't filed earlier.

Sitting in his second-floor office at The Athletic Club, his newly renovated health club in Brandon, Donofrio was surrounded by reminders of his days as Cyborg: dozens of photos, from Hulk Hogan to an autographed picture of Dwayne "The Rock" Johnson, a former University of Miami football player who became a wrestler and now stars in action films.

There's also a picture of Eddie Guerrero, a wrestling star who died young. The death certificate for Guerrero, who was 38 when he died in 2005, listed an enlarged heart caused by steroid use as a contributing factor.

The picture is a reminder of why Donofrio says he won't help anyone seeking steroids or human growth hormone to boost athletic performance. Donofrio recalled the parents of an athlete who had shoulder surgery asking for human growth hormone to speed up the healing.

"I said, 'Absolutely not. The guy's 16 years old. He's got plenty of hormones,'''' Donofrio said. "I make it very clear to people: We're not in business for athletic performance. We're in business to give people therapy that need it."

Donofrio has remained involved in youth athletics by volunteering as an assistant coach and fund-raiser for the Brandon High School wrestling team, whose winning dynasty is among the greatest in the nation. The Eagles have a 34-year winning streak of 439 dual matches and have won 18 state championships, including the past seven. Because of its size, the school doesn't compete in the same classification as Jupiter Christian.

"I needed somebody to work with my heavyweights, and so I took him on," Brandon coach Russ Cozart said of Donofrio. "He worked with my heavyweights for three years and did a great job. He was always there for the kids."

Demands of his businesses caused him to miss this past season at Brandon High, but Donofrio said he hopes to return soon.Donofrio added to his business interests in November, forming Infinite Vitality of Brandon, part of a chain of hormone replacement clinics with offices in Tampa and Beverly Hills, Calif. Carlson is not involved, he said.

"We have been led to believe that the changes that occur to our bodies with age are inevitable," Infinite Vitality says on its Web site. "In fact, many of these changes can be minimized or prevented by recent advances in the field of Age Management Medicine."

Infinite Vitality is a "very reputable" hormone-replacement firm, Donofrio said, that requires face-to-face examinations with its physicians. "We're not going to get rich, but we're going to help people and I'm going to continue to help people in the health and fitness industry," Donofrio said. "That's what I got in it for."

Staff researcher Sammy Alzofon contributed to this story.

Skin doctor’s license placed on probation

By Felice J. Freyer

Shamed doctor gets two years in steroid case

'Grandmotherly' Santi wrote thousands of prescriptions

By Dan Connolly | Sun reporter

November 3, 2007

PROVIDENCE, R.I. - Short and stout, with gray ringlets of hair framing a round, bespectacled face, Ana Maria Santi looks the part of a doting grandmother.

Instead, the 68-year-old disgraced doctor from Queens, N.Y., has become the most unlikely face of a national steroid ring that reportedly involved Orioles outfielder Jay Gibbons, among others.

Yesterday, in federal court here, Santi received a two-year jail sentence, plus one year of house confinement and two additional years of supervised probation for issuing thousands of prescriptions for human growth hormone and other illegal steroids to clients she never examined. She also has to forfeit $24,340 she made from a New Jersey company as part of the scam and repay $19,205 to Blue Cross and Blue Shield of Rhode Island, which had reimbursed customers who received the illegal drugs.

"She may have a grandmotherly face, but her actions certainly were not grandmotherly," said Adi Goldstein, the assistant U.S. attorney prosecuting the case. "She committed the serious crimes of writing prescriptions for steroids and hGH. She had customers, not patients."

Santi, dressed in a blue prison jumpsuit, sat quietly in the courtroom but occasionally turned to her two adult sons, waved and smiled. When asked by U.S. District Court Judge William E. Smith whether she wanted to make a comment for the record, she said: "No, your honor. Thank you very much, and I am sorry for what I did."

According to a federal investigation in Rhode Island of Internet drug operations - which is separate but similar to the ongoing state investigation in Albany, N.Y. - Santi admitted using the name and prescription number of a dying former co-worker for at least five years. She did so despite having her medical license revoked in 1999 and "without ever meeting, diagnosing, speaking to or observing" her clients, Goldstein told the court yesterday.

From 2005 to 2006, Goldstein said Santi earned $125,000 for the forged signatures.

"She committed this offense with a stroke of a pen and a push of a fax button from her home," Goldstein said.

Furthermore, she said Santi recruited fellow New York City doctor Victor Mariani, a former medical school classmate of Santi's in Argentina, to participate in the scam. Mariani, 73, was sentenced yesterday to one year of home confinement, two additional years of supervised probation, a $6,000 fine and forfeiture of $34,485 in earnings. Unlike Santi, who had a history of previous insurance fraud, Mariani was a first-time offender and was considered "not as culpable" as Santi, Goldstein said.

Mariani said at the sentencing hearing that he believed someone was examining and diagnosing patients - presumably Santi - but admitted to never seeing them himself.

He and Santi signed the majority of their prescriptions for American Pharmaceutical Group, which was run by co-defendant Daniel McGlone out of his kitchen and home office in North New Brunswick, N.J.

McGlone, according to court documents, found prospective clients through various methods, including magazine advertisements that targeted bodybuilders. He paid doctors $25 for each steroid/hGH prescription, then had the prescriptions filled by compound pharmacies, such as the federally raided Signature Pharmacy in Orlando, Fla. According to court documents, McGlone made approximately $860,000 in profit from individual clients and pharmacies. He is awaiting sentencing in Rhode Island federal court in February.

Santi and the principal ownership of Signature are among those charged by the Albany County District Attorney's office, which made headlines earlier this year with a series of steroids raids in Florida. Santi has pleaded guilty in Albany and is awaiting sentencing, while the Signature group is awaiting trial there.

Santi and Mariani were facing harsher penalties under federal sentencing guidelines yesterday, but Judge Smith took into consideration the defendants' age and health. Yet Smith said it was important to "send a message to the medical community that ... this is a very serious offense, and the court values it as such."

Goldstein, the federal prosecutor, said it's important to expose the steroid rings as much wider in scope than athletes looking for an edge. In Rhode Island, she said, the investigation uncovered at least 20 individuals who had ordered a total of 4,000 units of hGH.

"This extends beyond professional athletes and goes beyond the doors of gyms as well," she said. "People are using this for anti-aging, for weight loss. Not just as performance enhancers."

Because doctors such as Santi and Mariani did not know the previous medical or psychological histories of those receiving the drugs, some recipients possessed significant risk factors, including a man who later was charged with the brutal beating of a Rhode Island state trooper, she said.

As for athletes, Goldstein would not confirm whether any NFL or Major League Baseball players received drugs prescribed by yesterday's defendants.

"That's not something I am willing to comment about," she said. "And I probably wouldn't know it if they were."

However, SI.com previously reported that Gibbons received shipments of hGH and anabolic steroids from South Beach Rejuvenation Center in Miami Beach - and filled by Signature Pharmacy - from 2003 to 2005. According to SI.com, one of the prescribing physicians in the Gibbons case was "A. Almarashi," the alias used by Santi.

"A. Almarashi," the name of a now-deceased former co-worker of Santi's, also was the signature on prescriptions for Genotropin allegedly sent to Jerry Hairston Jr., a Texas Rangers infielder-outfielder, by an Alabama-based compound pharmacy in 2004, according to SI.com.

Hairston and Gibbons were Orioles teammates from 2001 to 2004. Hairston has denied that he received or used illegal performance enhancers. Gibbons has refused comment on the story since it was reported in September, except to say that he has cooperated with MLB in its investigation of the matter.

Santi, an anesthesiologist, first had her medical license suspended in 1994 after problems with alcohol. She had it revoked in 1999, the same year she was involved with a liposuction case that resulted in the death of the patient.

She also had at least one prior conviction for insurance fraud, said Edward C. Roy, her attorney in Rhode Island.

"What has befallen her is alcohol," Roy said. "When she is not drinking, she is a great person."

As a child, Roy said his client was "smuggled out of Poland" to England during World War II, and her family later relocated to Argentina. There, he said, she went to medical school and became a doctor, a difficult task for a woman of her era.

Eventually she was forced out of her profession and turned to the prescription scam to survive financially.

"She is remorseful, I'll tell you that," Roy said. "The fact is she is such a brilliant person and achieved a lot in her life and then lost all of those achievements because of alcoholism."

dan.connolly@baltsun.com

By MELISSA KLEIN

 October 14, 2007 -- An Upper East Side doctor caught writing steroid and growth-hormone prescriptions for patients of a Florida clinic linked to a baseball slugger has had her license suspended.

Dr. Barbara Nichols apparently never met the 11 patients for whom she prescribed human growth hormone, testosterone and other drugs in 2002. They were patients of an Internet business called Modern Therapy based in Miami Beach, according to state documents.

Modern Therapy, also known as South Beach Rejuvenation Center, allegedly hooked up Baltimore Orioles outfielder Jay Gibbons with human growth hormone and steroids, according to recent published reports.

Pat Courtney, a spokesman for Major League Baseball, told The Post that MLB has an ongoing investigation into Gibbons and his association with Modern Therapy.

HGH and testosterone are considered performance-enhancing drugs and are banned in baseball and other sports.

Nichols, 57, reviewed records provided by Modern Therapy and prescribed the drugs. She failed to adequately evaluate and treat the patients and prescribed the drugs without medical need, according to the charges against her by the state Board for Professional Medical Conduct.

The board accused Nichols of 68 acts of misconduct.

She signed a consent agreement with the board, which requires her to pay a $10,000 fine and to stop practicing medicine for three months. She can no longer prescribe controlled substances and hormones.

Nichols did not return calls seeking comment.

Nichols worked for the city Sanitation Department for the last 10 years, earning $105 an hour to do pre-employment and other exams for the department, but did not treat workers or write prescriptions, said Kathy Dawkins, a department spokeswoman. She gave notice in mid-September that she would be quitting, Dawkins said.

Nichols, who lives on East 90th Street, has been in trouble before. She pleaded guilty in 1993 in federal court to willful failure to file income-tax returns. She also filed for bankruptcy protection twice in the 1990s.

Improperly taking HGH - which is legitimately prescribed to help short children grow - can cause the organs to enlarge, and its use is linked to diabetes and high blood pressure.

melissa.klein@nypost.com

AG Obtains Default Judgment Against Milwaukie Doctor

November 22, 2004

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