‘He would never hurt a fly’
Two opposing portraits are emerging of a Canadian doctor facing 17 years in a U.S. prison for health care fraud
When James Hill left Shreveport, Louisiana, for a trip to his native Canada last year, the family physician’s office remained packed. Though the doctor was far away, it appears that his patients got what they wanted.
Police say Dr. Hill had left behind pads of prescriptions for Oxycontin, methadone and other powerful opiates, signed in advance by the physician and ready to be doled out to the patients in his absence — for $100 each.
At a time when prescriptiondrug abuse is rampant across America, it all seemed to add up, and a criminal indictment was soon issued against the 59-yearold Canadian.
Last week, a Louisiana judge dubbed Dr. Hill a “drug dealer with a medical licence” and slapped him with a steep, 17-year prison sentence for inappropriate prescribing and health care fraud. Under the U.S. federal court system, the physician from Newmarket has no chance of parole.
“He was hammered,” said an official on the prosecution’s side of the case.
But as Dr. Hill appeals the sentence, two opposing portraits of him are emerging.
The judge and federal prosecutors depicted the Canadian as almost indiscriminately handing out prescriptions for highly addictive pharmaceuticals, leading to at least one death, and touted the 200-month term as a deterrent. “Even medical doctors can become common criminals,” Donald Washington, U.S. attorney for western Louisiana, said in a statement.
But one of Dr. Hill’s attorneys decried the sentence yesterday as a product of the Bush administration’s zealous anti-drug agenda and an unofficial crackdown on family physicians who treat pain patients with opiates. He said the University of Toronto graduate was only trying to help people who could find no other relief for their chronic pain.
Many of Dr. Hill’s patients had no health insurance and could not get in to see overburdened pain specialists, said Randal Fish, one of his defence lawyers.
He also stressed that far from living the high life, getting rich by peddling Oxycontin scripts, the physician was in dire financial trouble.
Dr. Hill’s own son and girlfriend, the office bookkeeper and manager respectively, had agreed to testify against him in exchange for prosecution.
The doctor eventually pleaded guilty in a deal with the U.S. attorney, but is “stunned” at his punishment, his lawyer said.
“I’ve specialized in criminal defence law for close to 27 years now and this has to be, bar none, the most horrible, egregious miscarriage of justice I’ve seen in my
from life,” Mr. Fish said.
“And I’m from the southern United States so, believe me, I’ve seen some egregious miscarriages of justice.”
The judge calculated the sentence by applying a mandatory formula that translates the quantity of narcotics involved in a drug offence into length of time behind bars — then almost doubled that minimum amount, said the lawyer.
Dr. Hill graduated from the University of Toronto medical school in 1979, after winning academic awards two separate years, and then trained as a pediatrician in Canada and the United States. In 1989, he decided to settle in Shreveport, La., said his sister, Jeanette Florence, who lives in Guelph.
She called her brother a “brilliant” man with a big heart who likely got into trouble because he could never refuse to help a patient, even if they were unable to pay him.
“He is the last person in the world who should be in jail,” Ms. Florence said. “He is so trusting, he would never hurt a fly.”
Dr. Hill had pleaded guilty last December to one count of health care fraud and one of illegal distribution of controlled substances. His sister said that since his arrest in January, 2006, he had been held in a rural Louisiana jail alongside child murderers and other hardened criminals and eventually authorities “broke him.”
As part of the plea bargain deal, prosecutors withdrew more than 30 other counts of fraud and almost 80 drug-distribution charges, but he had to take his chances with the sentence.
The U.S. Justice Department alleges that Dr. Hill often handed out prescriptions for narcotics with little or no examination of the patient, charging $100 for the visit. One count related to a male patient for whom he prescribed some Oxycontin in the man’s name, and more in the name of his wife, stoking an addiction that was accompanied by heavy drinking.
In another case, he allegedly provided a fake prescription for methadone to a patient who had to undergo a job-related drug test and expected the test would reveal traces of methadone he had taken illicitly.
The man died about a year later and an autopsy pinned the cause of death on an overdose of methadone and Xanax, an antianxiety medication, the Justice Department said.
In a civil suit filed in Shreveport in 2005, William and Melanie Huck charged that Dr. Hill repeatedly prescribed Oxycontin to both of them, after the husband complained of back pain and the wife of migraine headaches. Both became addicted, Mr. Huck to the point where he had to “perform illegal acts” to support his habit.
“At no time during his treatment did Dr. Hill ever actually perform a physical examination of [the Hucks] or lay his hands on either in any way, except to shake hands,” charged the suit. The allegations were never proven in court, though the case was settled out of court.
But Mr. Fish said his client, who was also his family doctor for several years, filled an important role in treating pain patients at a time when there is a shortage of pain specialists in the United States.
Dr. Hill may well have made some mistakes in how he handled prescriptions, his lawyer said, but he wanted to make sure that his patients had at least a temporary supply of drugs while he was away in Canada.
James Hill, shown above at a 2003 wedding in Guelph, is facing a 17-year prison sentence in Louisiana for inappropriately prescribing drugs and health care fraud.