‘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

National Post (Latest Edition) - - News - BY TOM BLACK­WELL

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

im­mu­nity

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.

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