Stabroek News

New York-based Guyanese doctor Kevin Lowe, 55, was on Monday jailed for 12 years in what the Manhattan US Attorney’s office said was one of the largest oxycodone diversion schemes ever dismantled.

Lowe was arrested in 2014 after the massive pain-killer scam was busted at various Bronx clinics run under the name Astramed. He was convicted in May last year and the sentence was handed down on Monday.

Yesterday’s New York Daily News said that in delivering the sentence Judge Lorna G. Schofield said “Yours is not an easy case for a judge”. She said that she had to weigh his accomplishments with his misdeeds. “I don’t believe you are an evil person … but you have broken the law,” she said.

Lowe, who had faced up to 20 years in jail, will appeal his conviction, his lawyer said. The Daily News said that Lowe was convicted for operating a chain of Astramed clinics that, for three years, drew up around 35,000 fraudulent prescriptions for some 5.5 million tablets of oxycodone — worth up to US$165 million on the street, the Manhattan U.S. Attorney’s office has said.

The doctor, who studied in Hungary before moving to the United States, was accused by the US Attorney’s office of relentlessly proceeding with the sale of the prescription pain killer to addicts and drug dealers from his clinic.

In his sentencing memorandum to the court which was seen by Stabroek News, US Attorney Preet Bharara said that the government offered evidence at the trial to show that from January 2011 to early February 2014 Lowe was “the leader of a massive drug distribution scheme centered primarily at the defendant’s Southern Boulevard location i.e., the Clinic. There, crews of purported `patients’ received medically-unnecessary prescriptions for oxycodone from doctors employed by the defendant, doctors who prescribed high quantities of oxycodone to patients without performing any physical examination or medical testing”.

During the period in question, Bharara said that Lowe took in approximately US$7m from the medically unnecessary prescriptions at the Clinic alone and at the time of his arrest had US$2.5m in his various accounts.

At trial, Bharara said that the government established that in 2009, Lowe hired a doctor with no training or experience in pain management treatment who would write prescriptions for the pain killer. Of the over two dozen persons arrested in this case, Lowe was the only person who went to trial as the others pleaded guilty and some testified against Lowe.

Bharara noted that at trial the government called a state investigator who met with Lowe in 2011 to discuss concerns about the high number of oxycodone prescriptions being generated by Astramed and the prescribing habits of the doctor who had been hired by Lowe. A representative of an insurance company also testified of raising similar concerns with Lowe.

Lowe’s response to this, Bharara said, was to move the pain management practice from insurance to cash only, thereby closing off the ability of state regulators to monitor and pick up the illicit nature of the operation.

The key clinic where the scam was run, Bharara said, catered exclusively to pain management patients. According to Bharara’s sentencing memorandum “The Clinic had no useable medical equipment – the primary “patient” room had no examination table, no gowns, not even a scale, a computer, or any other method by which a doctor could review an MRI or x-ray. Indeed, according to the defendant’s own testimony, the defendant converted the only actual examination room in the Clinic into a “printing room” i.e. a room devoted exclusively to printing medically unnecessary oxycodone prescriptions….”

To write the prescriptions, Bharara said that Lowe hired a retirement-age physician who had no prior experience with pain management, had been unemployed for over six years, suffered from mild dementia and had been deemed unfit to practice by medical evaluators in Colorado just shortly before he began to work in the clinic. Despite this, the US government said that Lowe installed the doctor as the sole physician.

“The Clinic quickly came to resemble an open-air drug den under the guise of a medical facility. On a daily basis, massive crowds gathered outside the clinic, clamoring to pay cash to see (the doctor) for their guaranteed prescription for high doses of oxycodone”, Bharara said in his memorandum.

He argued that Lowe continued to direct and oversee the clinic’s unlawful activities closely monitoring the doctor with a focus on increasing the number of prescriptions written to the exclusion of any concern about medical care. Importantly, the US government said that Lowe installed an extensive network of surveillance cameras that captured virtually every movement within the clinic. `Crew Chiefs’ or thugs became a daily part of the clinic and Bharara said this was a constant reminder of the illegitimate nature of the operation which was plainly evident to the defendant on the surveillance video.

“In sum, the defendant’s deep involvement in the Clinic’s illegal operations was soundly established at trial. The evidence showed that, not only had he designed the Clinic to operate in this fashion and not only could he observe substantially every movement within the Clinic from his complex network of surveillance cameras, but the defendant was frequently told unequivocally by employees on the ground about the chaos and illegal activity unfolding all around them”, Bharara told the court.

In one text message displayed at the trial an employee wrote to Lowe that the Clinic “is run by drug dealers” and that they were the ones bringing in patients. The US government further argued that Lowe’s primary motive for turning the Astramed locations into pill mills was for the direct financial benefit.

“Indeed, in 2013, the last full year before the defendant’s arrest, the defendant took in nearly US$6.3 million from cash and money order “pain management” patients, as compared to just US$1.3 million at the defendant’s eight other Astramed locations combined”, Bharara said. More troubling in some respects, the US said, was the manner in which Lowe carefully selected ill-equipped, desperate doctors in need of work and pushed them to prescribe high doses of oxycodone.

In mitigation Lowe’s lawyer Florian Miedel said that the defendant’s life reflected the hardship, struggle and success of an immigrant who worked hard to realise the American dream. There were various testimonials from family members.