PHYSICIAN PROLIFIC AT WRITING PRESCRIPTIONS

'Pill Mill' Operator Indicted in Deaths; State Was Slow To Act

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."

'Pill Mill'

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.

Second-Guessing

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."

Personal Losses

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."