Saturday, July 22, 2006

No Verdict in Doctor's Fraud Trial (Portland Press Herald, July 20, 2006)

No Verdict in Doctor's Fraud Trial
Portland Press Herald, Thursday, July 20, 2006

Dr. Mark Shinderman

Marc Shinderman admits he signed another doctor's name.

A federal jury deliberated for nearly four hours Wednesday without reaching a verdict in the case of an addiction treatment specialist charged with prescription fraud.

Dr. Marc Shinderman, 64, is charged with using another doctor's name and federal registration number to write prescriptions for controlled drugs used by patients of his Westbrook methadone clinic during 2001 and 2002. His trial in U.S. Distinct Court in Portland ended Wednesday morning as lawyers for both sides made closing arguments in the case, the result of a five-year federal investigation.

Whether he is convicted may have less to do with what Shinderman did than why he did it, lawyers said.

In two days of testimony, Shinderman admitted that he signed the name and wrote the Drug Enforcement Administration number of Dr. Steven Keefe on prescription sheets, ordering anti-anxiety and other medications for patients of CAP Quality Care Inc., the for-profit methadone clinic owned by Shinderman's wife.

Prosecutors charge that Shinderman, a psychiatrist from Illinois, was able to lure patients to his clinic by prescribing drugs that would enhance the euphoric effect of the methadone they were receiving.

But Shinderman, who had the authority to write prescriptions in Illinois but not in Maine, claimed that he mistakenly thought he could use the prescription-writing authority of a colleague who saw the same patients. His lawyer said his actions were mistakes, not crimes.

The stakes for Shinderman are high. The government charged him with 67 separate crimes for forging prescriptions, aiding someone filling illegal prescriptions and falsifying medical records. If convicted, he faces up to five years in prison on each of the most serious counts and fines of up to $250,000.

The clinic is the defendant in a civil suit filed by the government, which is expected to go to trial next year.

The criminal trial began July 11 and featured testimony by current and former patients and staff of CAP Quality Care, as well as state and federal regulators. Shinderman took the witness stand for two days and freely admitted to doing everything the government alleged. Shinderman said he was more concerned with treating patients than making money.

On Wednesday, Assistant U.S. Attorney Donald Clark, who prosecuted the case, told the jury that the issue was simple: Shinderman intentionally wrote prescriptions in Maine even though he knew he was not authorized to do so.

Clark compared a doctor's DEA number to a driver's license and asked jurors to use their common sense.

"If you need a license, you get it," Clark said. "And if you don't have one and get caught, you don't say, 'My Mom has a licence and she let me use it,' or . . . 'I'm an excellent driver and I don't need a license.' "

For more than an hour Wednesday, Clark methodically showed the jury 26 prescription slips that were filled out by Shinderman using Keefe's name and number. Clark showed how 16 of the slips were connected by investigators to medical records kept at CAP in which Shinderman saw a patient and signed Keefe's name or initials. Clark said Shinderman was falsifying records to cover up what he knew was an illegal prescription writing practice.

"If he had written accurate records, the regulators would have seen what he was doing and would have stopped it." Clark said.

Shinderman's lawyer, Thimi Mina, told the jury that his client should not be convicted of a crime for making a mistake.

Shinderman believed that he could legally write prescriptions, and even if he was wrong, he was not doing anything but treating his patients' legitimate medical needs, Mina said.

"No criminal intent, no crime," Mina repeatedly told the jury.

Mina said Shinderman was not prosecuted for violating the law regarding prescription writing, but for his controversial views on methadone treatment for addicts.

"This case is all about methadone," Mina said. "If Dr. Shinderman were a pediatrician I submit we never would have been here."

In the first year of CAP's operation, greater Portland saw a rapid increase in the number of overdose deaths involving methadone. Shinderman came under special scrutiny because he published his opinion that some patients require much higher doses of methadone than normally prescribed at clinics. While the usual therapeutic dose of methadone is 80 to 100 milligrams a day, Shinderman had at least one CAP patient on 1,000 milligrams.

But Mina said Shinderman is committed to treating patients.

"The government has attacked a man who had devoted his life to treating people that that the rest of us step over," Mina said. "What the government asks for in this instance is not justice."

The closing arguments began at 10 a.m. before a packed courtroom, including friends and supporters of Shinderman, including state Sen. Ethan Strimling, D-Portland, and Gardiner Mayor and state Senate candidate Brian Rines. Other benches were filled with state and federal prosecutors and police officers curious about the outcome of the case.

Jurors are scheduled to return to the courthouse at 8 a.m. today to resume deliberations.

Staff Writer Gregory D. Kesich can be contacted at 791-6336 or at:

Staff photo by John Ewing

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