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Sounding the alarm
A Philadelphia pharmacist was alarmed by what he says was a flood of prescriptions for "obscene" amounts of drugs. His concern sparked a massive state investigation, which ended with the arrest of a Bensalem doctor.
The first guy was big. That's all Ron Hyman remembers about him. That and the prescriptions the guy slid across the counter and wanted filled, pronto.
The scripts were for two drugs, Oxycontin and Xanax. The first is a powerful painkiller. The second an anti-depressant.
Both have become hot commodities on the street. In fact, three teens in the Philadelphia neighborhood where Hyman runs his small drugstore have died from Oxycontin overdoses since last summer - including one of Hyman's employees.
The dosages prescribed for that first big guy were "obscene," recalled Hyman, who owns Esterson's Good Neighbor Pharmacy at the corner of Norris and Memphis streets in the Fishtown section.
Only twice before in his 16 years as a pharmacist had he seen Xanax prescribed at two milligrams twice a day - both times by psychiatrists who were treating terribly ill patients.
An hour later, another customer presented Hyman with a prescription for the same drugs in the same dosages.
Hyman phoned the doctor who had written the scripts, Richard Paolino, at his Bensalem practice.
Hyman didn't know it at the time, but he was about to spark a massive state investigation that snared Paolino for allegedly writing prescriptions "for anyone who wanted them," including teen-agers, according to a court affidavit.
On March 2, Paolino, 57, was arrested on charges of forging prescriptions and practicing medicine without a license after his license was suspended for failing to pay his malpractice insurance. He is in Bucks County prison on $8 million cash bail. On the day he was charged and arraigned, Paolino told reporters he is innocent.
There is no indication what will happen to two other doctors whom officials said had pre-signed prescription pads for Paolino. Kevin Harley, a spokesman for the state attorney general, said the investigation is continuing.
A court affidavit states that investigators believe Paolino was writing prescriptions to patients who didn't need the medication, and that the pills were being resold on the streets of Philadelphia for up to $40 a pill.
When the big guy walked into Hyman's store last summer, Hyman filled his prescription - uneasily, he said. Within an hour, a young girl carrying a baby was standing at his counter. She also handed him a prescription from Paolino's office.
"She didn't seem to be in any pain," said Hyman, who called Paolino about it.
"[Paolino] didn't seem concerned about it. He said the patient needs it, and if I didn't fill the prescription he would tell her where to get it filled," Hyman said.
Within three or four hours, 10 more people came into his store with nearly identical prescriptions for Oxycontin and Xanax, all from Paolino - a doctor Hyman said he had never heard of and who was 25 miles away from his store. He refused to fill them.
Within a month, Hyman estimated that 40 to 45 more people came to his store, again with the same prescription for the same drugs from the same doctor. Again, he wouldn't fill them.
"If I had filled every prescription, that would have been nearly 5,000 pills hitting the streets," Hyman said.
The summer onslaught of prescriptions alarmed Hyman.
He called the U.S. Drug Enforcement Agency, which referred him to the Pennsylvania attorney general's office. He spoke with an agent, but the agent went out on sick leave shortly after, and it seemed to Hyman that there was little interest in pursuing the case.
So, he said, he called the Philadelphia newspapers and TV stations. Only one responded - a TV station, which he said told him a news crew would be out shortly. Hyman then called the attorney general's office and told them he had gone to the media. They asked him not to speak to the media, and he agreed.
"Within a few minutes, agents were here looking through my files," Hyman said.
Hyman's tip launched an extensive investigation into Paolino's practice. Surveillance teams sat in the parking lot outside his office on Hulmeville Road, chronicling dozens of people who came and went.
Confidential informants were sent into the doctor's office. Once, informants said Paolino's waiting room was crowded with people who appeared "gaunt, their eyes were dilated and their faces were sunken, like they were on drugs and irritable as if they were going through withdrawal," according to the probable cause affidavit.
Agents questioned a former employee of Paolino's. She said she had quit her job because Paolino was writing prescriptions for Oxycontin and Xanax "for anyone that wanted them, including children as young as 15 years old," the affidavit states.
Investigators found that Paolino was running a cash-only business, charging $66 for the first visit and $59 for each subsequent visit. Physical exams seemed cursory, consisting of blood pressure checks and urine samples, before Paolino wrote the prescriptions, the affidavit said.
After Paolino was arrested at his office, he told reporters that he ran a "pain management" practice, and that he never endorsed abuse of prescriptions that he wrote. He denied prescribing drugs to kids.
The arrest shocked neighbors of his Upper Makefield neighborhood, where he recently put his tract mansion up for sale.
A former patient, Josephine Baehr, said she was stunned. Paolino had been her family physician for 34 years when she lived in Levittown until she moved to Virginia two years ago.
She recalled him being a "wonderful man" who would treat her children for free when money was short for her and her husband.
"These charges are trumped up. They have to be. He's an angel," she said. "He's so caring. He has dedicated his life to helping people."
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