THE U.S. Attorney’s Office for the Districts of Guam and the NMI wants Dr. John Doyle to pay civil penalties in the total amount of $4,936,771 for allegedly dispensing opioids and controlled substances.
District Court for the NMI Magistrate Judge Heather Kennedy issued a summons for Doyle to respond to the lawsuit within 21 days after being served with the complaint.
Failing to respond may result in the issuance of judgment by default against Doyle, she added.
The summons was received, on behalf of Doyle, by the office of attorney Steven Pixley on March 8, 2021.
The U.S. Attorney’s Office is also asking the court to issue an injunctive relief to “address and restrain defendant’s violations of law; post-judgment interest, costs; and such other and further relief as the court deems just and proper.”
According to the complaint, under the Controlled Substance Act, 21 U.S.C. §§ 801-904, Doyle allegedly issued multiple prescriptions for high quantities of a dangerous combination of drugs commonly known as the “Holy Trinity” — opioids, benzodiazepines, and muscle relaxants — as well as other controlled substances to the spouse of a colleague, frequently without examining the patient.
He also allegedly issued other controlled substances to another patient, ignoring obvious signs of addiction and physical and mental deterioration.
Opioid abuse is a national public health emergency, the U.S. Attorney’s Office stated.
“The prescribing, dispensing, and distributing of controlled substances, including prescription opioid painkillers, without a legitimate medical purpose and outside the usual course of professional practice, exacerbates this health crisis and harms public health,” it added.
The factual allegations of the complaint stated that the Drug Enforcement Agency reviewed select patient files of Doyle from 2015 to 2020, and conducted an investigation of his controlled substances prescribing activities from October 2016 to January 2020.
The DEA also reviewed patient files from the Marianas Medical Center and the Commonwealth Health Center for two patients, J.F. and J.H., prescription logs at Pacific Health Inc. and Brabu Pharmacies, as well as patient J.F.’s medical and prescription records from San Diego, California where Patient J.F. traveled to and from frequently.
The DEA likewise conducted two interviews with the defendant on Jan. 7 and 9, 2020.
The complaint stated that at all times relevant the defendant “knew or should have known how to recognize signs of diversion, abuse, and misuse of controlled substances and the dangers of prescribing high doses of opioids and dangerous combinations of controlled substances, as well as the importance of conducting examinations and properly documenting such examinations.”
Prior to practicing in the CNMI, the complaint stated, Doyle was disciplined by the Kentucky Medical Board for similar practices, including “inadequate documentation and maintenance of patient treatment records…and grossly negligent and incompetent treatment and diagnosis of patients’ conditions….”
Specific to the dispensation of opioids to a particular patient, the complaint stated that the Kentucky Medical Board found that Doyle continued prescribing controlled substances “while knowing that the patient intended to use this medication for other than acceptable therapeutic services…in such amounts that Doyle had reasons to know were excessive under standards of practice…which, under the circumstances, constituted gross negligence and incompetence; and…which, under the circumstances, constituted a departure from, or failure to conform to, the standards of practice.”
This particular patient ultimately died of acute Methadone intoxication or overdose, the complaint added.
According to the complaint, patient J.F. was initially being treated and prescribed controlled substances by another physician at MMC from 2010 to 2018, as well as by patient J.F.’s husband, who worked with the defendant as a physician at CHC. In 2018, the defendant took over patient J.F.’s treatment.
The complaint stated that the controlled substance prescriptions issued by the defendant to J.F. were outside the usual course of legal professional medical practice; they were not medically legitimate; and each was an extreme departure from the standard of care.
Sometime between November 2018 and January 2019, after filling prescriptions from the defendant for the “Holy Trinity” and Dronabinol, patient J.F. traveled from Saipan back to California.
On Jan. 20, 2019, the complaint stated that patient J.F. was delivered to a hospital Emergency Room due to “overdose and altered mental status.”
The hospital’s admission stated that a bottle of Alprazolam prescribed the by defendant on Dec. 26, 2018, containing 150 tablets, was already empty.
Despite having no notes documenting patient visits, the defendant issued approximately 14 controlled substance prescriptions, with refills, to J.F. in 2019, the complaint stated.
It added that some of the prescriptions were issued after he signed the April 12, 2019 relinquishment letter to the doctor at Pain Care of San Diego.
The complaint stated that on Jan. 9, 2020, Doyle provided DEA with additional information.
He admitted that he prescribed the “Holy Trinity” to patient J.F. only because to prescribe it to others “would raise too many red flags,” the complaint stated.
He also admitted that he started prescribing Soma (the generic is called Carisoprodol) to J.F. because J.F.’s husband requested it, and that he described his prescriptions to J.F. as a favor to his friend and colleague, J.F.’s spouse, the complaint stated.
DEA is accusing Doyle of 28 dispensing violations.
As for the other patient, J.H., DEA’s investigation revealed red flags with the defendant’s prescription activity, the complaint stated.
For patient J.H., DEA is accusing Doyle of 45 dispensing violations.
‘Garbage on garbage’
Asked for comment, Dr. Doyle e-mailed the following statement:
“Last Friday I was shocked, as were many others, at the press release from the [U.S. Department of Justice] that was plastered all over the press, strategically timed to inflict the most damage and was nothing but slanderous propaganda and bloviation designed to incite fear and loathing among the citizens here in the CNMI.
“In their unethical quest to pile garbage on garbage they have no respect for any boundaries of decency. I would not be surprised if their next installment describes the cars these patients drive.
“Saipan is a small place. How many of you have already figured out who they are trying to shame? How many have narrowed it down to just a few?
“So please let me comment on the very lengthy article that I am supposed to comment on.
“I know that DOJ and DEA need headlines. They have made that clear from the start but how dare they do that in such a small tight knit community?
“How dare they imply that these patients had no legitimate medical issues?
“They make a huge deal that I was seeing a ‘colleague’s wife’ as a patient as if that is sinister and proof of my guilt. What doctor on the island can she see and not be a colleague’s wife?
“Do not disparage others in your quest to try your case on the front page of the paper. Do not penalize and shame people with significant medical problems for seeking help.
“Show some common decency. This belongs in the courtroom where you actually have to prove your case.
“I will not address your issues on the front page.
“I will not further risk the privacy and dignity of my patients to argue this on the front page. It belongs in a courtroom where your lies and slanderous accusations will have to be backed up.
“That is all I ask.
“Common decency.
“And for the record, since I never got to comment on the Friday night special please allow me this.
“I was sent a letter in November saying I did bad things and if I give them 4.9 million dollars and my DEA permit I could settle it as long as it made the front page.
“I politely declined and invited them over to prove it.
“Then they called back and offered me a bargain of $200K and my permit implying how damaging a trial would be. On the front page of course.
“I politely declined and repeated my invitation to come and prove it.
“Then they called back again and offered only to take away the top schedule but the fine could be negotiated way down as long as they could put it on the front page.
“Once again, I politely declined and repeated my invitation to come here to a jury of my neighbors, my community, my familia and try to tell them I would ever do something to harm them.
“At no time did I ever give medicines for non-legitimate purposes nor would I.
“They conveniently forget to point out that the patients came to me on these medicines and I promptly set about getting the patients off of them.
“These patients are not addicts. They are victims. Not of me. I was trying to undo the damage.
“So no, they are not the Cavalry coming to rescue you from a rogue doctor. They are unethical and willing to bend, twist, obfuscate, scare people with impunity. I have no recourse against their vile statements. I can’t sue. I can only take out my wallet and try to defend myself. That is what I will do.
“I hope I have done enough good in the community to speak for my integrity. I pray that I have been a help to my patients.
“I trust my community to hear me and judge me appropriately.
“I have no illusions about what is about to happen. I have no resources. I only have the truth.
“I can’t stand up for long and they will roll over me like a boulder. I will put the house on the market and sell whatever I can but I will not bow. Even when I win, and I will be vindicated, I lose. So you already won. I’m wiped out either way. You already won.
“Please show some decency and redact the patient info. They are not your target. I am. And Saipan is too small.
“I am here. I’m not going anywhere. Please leave my patients alone.”
