WICHITA -- Federal prosecutors asked a federal judge Friday to issue a gag order to silence a Haysville physician and his wife indicted for operating a "pill mill" linked to at least 56 overdose deaths.
In court papers, the U.S. attorney's office asked for a restraining order to keep physician Stephen Schneider and his wife, Linda, from talking to the media. Prosecutors also asked that the judge extend that order to include the Schneiders' family members and Siobhan Reynolds, president of the Pain Relief Network, a patient advocacy group.
Lawrence Williamson, the doctor's defense attorney, said he opposes the government motion.
"We strongly oppose a gag order because we believe in the public's access to the justice system," Williamson said. "We think the request is overbroad and not supported by law at all."
The government also asked the court to order Williamson to give prosecutors a recorded statement the doctor made at the jail that was subsequently turned over to The Associated Press.
Williamson said he didn't have a copy of that recording.
As an alternate to a gag order, the government sought a transfer of the trial, now scheduled for April 2009, to eliminate the possibility of the jury pool being prejudiced by publicity the case is getting in the Wichita media.
Government prosecutors announced in December that they had indicted the Schneiders, alleging that the doctor and his wife directly caused four deaths and contributed to the deaths of 11 other patients. In all, the indictment links the clinic to the accidental overdose deaths of 56 patients.
The Haysville physician and his wife were arrested on a 34-count indictment alleging conspiracy, unlawful distribution of a controlled substance resulting in death, health care fraud, illegal money transactions and money laundering.
Federal prosecutors asked the judge to admonish defense attorneys about professional rules of conduct regarding public statements.
Williamson said he was not trying to influence the jury pool.
"We are often contacted by media to respond to allegations that are made by the government and if the public has questions to the allegations we should be able to respond to those within the rule," Williamson said.
Hatcher said the government's motion threatened freedom of speech.
"They are trying to quiet down anything we would have to say in their defense so that people are only hearing one side of the story a=80" basically the prosecutor's side," she said.
The government is also seeking to keep Reynolds and Hatcher from contacting victims and witnesses in the case. Prosecutors claimed Reynolds had told a patient that if he or she was going to commit suicide because painkillers were no longer available, to do so publicly.
Reynolds called that claim "absolutely false."
"This is just a wild allegation," Reynolds said. "Basically it was put out there to try to smear me. Pain Relief Network works very hard to try to stop the suicides going on across the country because of untreated pain, the epidemic of untreated pain."
She said prosecutors should not be attacking constitutional rights: "I'm shocked that the government would try to get a gag order against a political activist. I find that stunning."
April 4, 2008 -- Topeka Capital-Journal (KS)
LTE: It's About The Pain Crisis
By Siobhan Reynolds, Pain Relief Network
On March 28th, this paper published an article (see below) in which the writer convicted Dr. Schneider and his wife prior to trial, condemned the Kansas Board of Healing Arts as negligent for failing to stop the Schneiders, and characterized myself and my organization, Pain Relief Network, as advocating public suicide by patients who have been victimized by the US Government's heavy-handed attack on the Schneider clinic.
This government action has deprived of medical care hundreds of Kansans, many of whom are critically ill, have complex medical problems, and are now left desperate and terrified.
The paper's failure to provide balanced reporting, or to check out the reliability of its sources, is stunning.
Never, in Pain Relief Network's six years working with the media around similar cases has our issue been treated so unfairly, nor have we ever seen a reporter allow himself to be so thoroughly exploited to its own ends by the US Attorneys office.
By declaring Dr. Schneider and his wife guilty, and then denigrating their perfectly constitutionally protected invocation of their 5th Amendment rights, this paper added another nail in the coffin for what used to be America's proud system of rule of law.
The article is the result of a rush to judgment and the publication of statements by Lilly Shipman, whose comments supposedly quoted me. The paper then "confirmed" her account with a "quote" from me that was taken entirely out of context.
The reporter asked me whether my organization supported or encouraged the public suicides of patients.
I made it perfectly clear that neither I, nor my organization, supported any such thing. In opposing the government's brutal attacks on medical practice of pain management, we are in fact the only organization taking direct action against the primary cause of the documented epidemic of untreated and under-treated pain in this country.
When people in unbearable pain are refused sufficient dosage of medication, they will quite understandably struggle with ending their torment. In our movement to reestablish rule of law and to normalize the doctor-patient relationship, we are constantly faced with desperate patients who ask us what do after they have been turned away from care dozens of times.
I explained to the reporter that these people were once prosperous, had full lives, and dreams and hope. But merely by suffering a crushing accident or a cancer diagnosis, they find themselves in chronic severe pain and in need of ongoing opioid therapy.
They then find themselves abused and reviled by the medical profession, which has adopted a culture of non-treatment. This is born of fear of being targeted by a drug war gone so very wrong.
So in addition to having to bear the burden of illness and pain, patients are forced to endure the insult and cruelty of being dismissed as "addicts," smugly kicked out of emergency rooms, and turned away from medical clinics and offices.
Chronic pain patients are sick and tired of suffering and dying in silence because our gvernment would rather catch "addicts" than allow physicians to relieve suffering and practice ethical medicine without police interference. It is hard to understand what it feels like to find oneself crushed by actions taken by one's own government against one's doctors.
I have seen this all first-hand. My husband suffered from an inherited condition, Ehlers-Danlos Syndrome. He died a year and a half ago because his medications were terminated by a doctor afraid to continue his care.
As a result, in front of our 14-year-old son, my husband died of a cerebral hemorrhage in a hotel room in Arkansas. We had been forced to drive there from our home in New Mexico, desperately seeking care, because there were no doctors closer by who dared to help my husband. Sean Greenwood did not choose suicide, but he considered it many times. Because I lived with him and fought for his life and for justice and dignity, I understand what Dr. Schneider's patients are now enduring.
That the United States government knows that their policies affect people in this way yet continues nevertheless to destroy clinics through public smear campaigns is appalling.
Those desperate patients who ask me about suicide are crying out for the salvaging of some modicum of dignity, for some comfort in knowing that their lives weren't utterly without value after all, and that we will as a society wake up from this gruesome nightmare that has ruined them and their families, and debased us all. I have listened to their stories, lived their stories, and told their stories, and I ask God to bless us all.
From the press I ask for simple fairness, and, with the exception of the Topeka Capital-Journal, the Kansas and national press have been mostly fair. Had this paper refrained from declaring the Schneiders guilty and mischaracterizing my statements and purposes, perhaps it could have found its way to reporting on what is actually a fascinating story right in front of it, but which it obviously cannot see, or want for some reason to obscure: the United States Department of Justice runs amok in Kansas, while the state medical board fumbles about in denial of a public health disaster-in-progress, and local politicians with nothing to offer but misinformed drug-war pandering, excitedly exclaim moral outrage, while good, innocent, people are quietly being destroyed.
Siobhan Reynolds, President
March 28, 2008 -- Topeka Capital-Journal (KS)
Physician Prolific At Writing Prescriptions
'Pill Mill' Operator Indicted in Deaths; State Was Slow To Act
By Tim Carpenter
HAYSVILLE -- Stephen Schneider knew the high volume of drug overdoses among his clinic patients was attracting the wrong kind of attention.
A piece of the proof emerged in 2006 while Schneider underwent questioning by attorney Larry Wall, who filed a malpractice lawsuit against the physician on behalf of a deceased patient. The interrogation was lengthy and, at times, heated. But the owner of the high-traffic, pain-management clinic was ready.
"Have patients died at the clinic?" Wall asked.
"Upon advice of counsel," Schneider replied, "I assert my Fifth Amendment rights."
"Have you experienced overdoses at the clinic where a patient would receive an injection of narcotic drugs and they would become comatose?"
"Upon advice of counsel, I assert my Fifth Amendment right."
In all, Schneider invoked his privilege to avoid self-incrimination 352 times in that deposition. Linda Schneider, his wife and business manager of the clinic south of Wichita, raised the same constitutional shield 281 times in a deposition with Wall.
The Kansas Board of Healing Arts, which regulates medical professionals, was also on the Schneiders' trail. The agency confirmed instances of negligence in 2004, 2005 and 2006 and filed a disciplinary case against Stephen Schneider in May 2006.
"Things were put on a very fast track," said Mark Stafford, the board's lead attorney.
Then, the board's case stalled.
Schneider Medical Clinic continued to run seven days a week. More civil lawsuits were filed against the Schneiders as overdose deaths among clinic patients climbed. Healing arts complaints linked to the Schneiders stacked up in Topeka while federal prosecutors pressed ahead in Wichita.
"What does it take?" asked Rep. Jeff Colyer, an Overland Park Republican and a physician.
Not until a federal grand jury issued a 34-count indictment Dec. 20 did the healing arts board act. Board attorneys sought "emergency" suspension of the doctor's medical license a=80" No. 05-22385 a=80" because he was suddenly an "imminent harm to the public health." By the time the board's suspension was official, the doctor had been behind bars for five weeks.
"It is tragic when it takes a 64-page indictment to get anyone's attention," Wall said. "I have been taking depositions and filing lawsuits for over two years, and the Board of Healing Arts has sat on its hands."
Stephen Schneider, 54, and nurse Linda Schneider, 50, began working in 2002 out of a new $1 million, 14-exam room clinic in Haysville.
The doctor, a graduate of the University of Health Sciences College of Osteopathic Medicine in Kansas City, Mo., focused on treating people who said they had debilitating pain. His freewheeling distribution of pharmaceuticals earned him the nicknames "candy man" and "Schneider the Writer."
Federal investigators raided the Broadway Street clinic Sept. 13, 2005, and March 28, 2006. Boxes of evidence were hauled away, but the clinic kept churning out prescriptions in this suburban town of 10,000.
The bottom didn't fall out until December, when a grand jury in Topeka returned felony indictments charging the Schneiders with operating a "pill mill." They are alleged to have issued narcotics that led directly to deaths of four patients and indirectly to deaths of 11 others. They were charged with conspiracy, five counts of unlawful distribution of controlled substances, 11 counts of health care fraud, 13 counts of illegal monetary transactions and four counts of money laundering.
The Schneiders pleaded not guilty to all charges. Attorneys associated with the Schneiders didn't comment on the case.
Stephen Schneider, held in cell No. 106 of the Butler County Jail, was the central target of a federal investigation examining 56 patient deaths from accidental prescription overdoses from 2002 to 2007. Prosecutors say dozens of Schneider patients had close calls. One Wichita hospital reported treating 94 clinic patients with accidental overdoses in the five-year period.
"He called patients who died from accidental overdoses 'bad grapes,' " said U.S. Attorney Eric Melgren.
One of them was Patricia Gaskill, who was among the four people prosecutors allege died as a direct result of careless doctoring. Gaskill, 49, began going to Schneider in 2003 for treatment of knee pain. She received progressively larger doses of medication. In 2005, Gaskill overdosed. A Wichita hospital notified the Schneider clinic the next day, but Gaskill walked out of the clinic soon after with new prescriptions for Lortab, an addictive narcotic pain reliever; Xanax, a sedative; and OxyContin, a morphine-like painkiller.
The coroner ruled her death two days later an accident.
The Board of Healing Arts has been criticized for not acting earlier to revoke the medical license issued to Stephen Schneider in 1988. The agency's current petition against Schneider contains a dozen allegations of professional misconduct, including a role in the death of five patients by drug overdose. But the agency didn't see fit to obtain legal authority to suspend the doctor's license to practice in Kansas until Jan. 29.
The 20-month time lag is significant. Between filing of the original action in May 2006 to the suspension, court records indicate, at least seven of Schneider's patients died of accidental drug overdoses.
"Could the state have done something to stop it?" asked Sen. Susan Wagle, a Wichita Republican and chairwoman of the Senate Health Care Strategies Committee.
Wall, the malpractice attorney representing former Schneider patients, said he provided depositions, exhibits and motions to federal prosecutors as they built a criminal case against the Schneiders. Wall made similar offers of assistance to the Board of Healing Arts, but he was rebuffed.
The board doesn't make a habit of investigating doctors based on allegations in malpractice suits, Stafford said. It isn't a good use of resources because only about one-fifth of malpractice cases result in financial settlements, he said.
Larry Buening, executive director of the healing arts board, said it was regrettable the board's legal staff didn't move ahead with disciplinary action against Stephen Schneider in 2006.
"Hindsight, in our particular case, would say we should have gone with what we had," Buening said. "This is going to sound crass, but 100 percent of patients of 100 percent of doctors die."
Betty McBride, president of the board, said federal prosecutors asked the board's staff in January 2007 to idle its civil action to avoid complicating development of a criminal case.
"That's exactly what was told to us," McBride said.
Assistant U.S. Attorney Tanya Treadway disputed that claim. She produced an Oct. 3, 2006, letter to Stafford that said coordination between the healing arts board and the U.S. Department of Justice would avoid duplication of effort and allow federal prosecutors "to stay out of KBHA's way in its administrative proceedings against Dr. Schneider."
Buening responded to Treadway's disclosure by sending a letter to Melgren demanding public acknowledgment of a federal request for the board to delay its disciplinary case. "Both the board's credibility and my personal and professional integrity are now being questioned," Buening wrote.
Melgren's reply, "We will not be willing to agree to misrepresentations regarding our conduct."
Nightmares born of decisions made at Schneider Medical Clinic are personal to Shadd Cox. He had hugged his mother, Haysville resident JoJo Rodgers, to say goodbye before heading off to work a night shift June 7, 2006.
"When we got home she was dead in her bed," Cox said. "It was a very bad situation."
Rodgers went to the Schneider clinic in early 2005 for treatment of back pain. An autopsy found a volatile mixture of anti-depressants, muscle relaxants and other medications in her bloodstream. The death of the 46-year-old woman was ruled an accidental overdose by the coroner. Federal prosecutors built part of their criminal case against Schneider by alleging he indirectly contributed to her demise.
"She seemed incoherent after her visits with Schneider," Cox said. "Whatever medicine he gave her didn't help."
El Dorado resident Donna Dodson, 48, was another Schneider patient to die of an accidental drug overdose after the healing arts board filed its complaint against Schneider and before his license was suspended.
"My mom was pretty much my best friend," said Katheryn Allen, a daughter who lives in Chanute. "It was a toxic mixture of three of her medications that killed her."
Dodson had fibromyalgia, a form of arthritis characterized by pain and fatigue. In 2005, one of Dodson's friends recommended Schneider.
"The first time she went, she was kind of in shock at how much pain medication he had prescribed on her first visit," Allen said. "She said it was the easiest doctor visit she ever had."
Schneider elevated the potency of her prescriptions, Allen said. Sometimes, she said, her 48-year-old mother refused to take all the pills given to her.
"She told the doctor that, but he still upped the prescriptions," Allen said.
Her mother's final appointment at the clinic was in July, less than a month before her death Aug. 16.
Investigators with the healing arts board have never contacted Rodgers or Allen about the deaths.
Feeling The Pain
The clinic had 1,000 clients when shut down. Patients, some of whom complained that area physicians refused to treat them because of negative publicity surrounding the criminal prosecution, rallied on behalf of the Schneiders in Haysville and Wichita. There were requests for cash contributions to the Schneiders' defense fund. Former patients lent support by attending court proceedings involving the Schneiders.
Lilly Shipman was in the middle of it all. The Wichita resident was a clinic patient from 2003 until the arrests and viewed Schneider as a "compassionate doctor." While the Schneiders languished behind bars, Shipman was imprisoned by savage withdrawal from morphine and Percocet.
Shipman began working with Siobhan Reynolds, president of the Pain Relief Network, a New Mexico-based patient-advocacy group brought to Wichita to generate public sympathy for the incarcerated doctor and his wife.
Reynolds orchestrated the filing of a lawsuit against the U.S. Department of Justice and the state of Kansas, including the Board of Healing Arts, in an effort keep the Schneider clinic open and medication flowing to patients.
"The government is saying Schneider is a killer. It's a complete human rights disaster," said Reynolds, who called for the couple's release on bond.
Recordings of jailhouse telephone conversations released by federal prosecutors, however, reveal Reynolds urged the Schneiders to remain behind bars to give Reynolds "leverage." On the tape, Reynolds called her involvement in the case the opportunity of a lifetime and talked of a book or movie on the couple.
Federal attorneys said in court papers that the recordings show Reynolds was "using the defendants' criminal case as a springboard for her own designs, which have nothing to do with effective criminal representation for the defendants."
Before the network's lawsuit derailed in a federal courtroom in Wichita, Shipman was called by a former patient claiming that she and her husband wanted to die rather than live without a steady supply of morphine from the clinic. Shipman called Reynolds to see if it was proper to send the addicts to a hospital emergency room.
According to an affidavit from Shipman, Reynolds replied, "If anyone is going to kill themselves, make sure they do it publicly." Reynolds recommended a Wichita hospital parking lot or the lobby of a local television station as ideal locations, Shipman said.
"I asked her," Shipman said, "I thought you came in here to save lives?"
The Pain Relief Network founder's rebuttal, according to Shipman, was, "Unfortunately, there will have to be deaths for this cause."
In a separate interview, Reynolds said her first inclination was to help suffering people obtain treatment. But, she said, that wasn't realistic in every instance. Reynolds said she told Shipman, "If you can't get help, make it count."
A public suicide by a drug-addicted Schneider patient would create momentum for a campaign to legitimize "opiate therapy" in the United States, Reynolds said. "People simply do not believe this unless they see it with their own eyes," she added.
Shipman severed ties to Reynolds and withdrew support for the Schneiders. She found a new doctor, but still wonders how a physician licensed by the Board of Healing Arts led her down a dark road.
"I believed in him," she said. "Now, I find he had me on five times the amount of medication I should have been on. This guy supposedly had my interests at heart."
Sen. Jim Barnett, an Emporia physician and former Republican nominee for governor, said the Schneider case illustrated the need for the state to establish stronger safeguards for patients.
"What bothers me most is that while this has gone on," he said, "the public has not been protected."
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