Feds Drop All Death Enhancements Against Mobile Pain Doctors

Dr. John Patrick Couch (left) and Dr. Xiulu Ruan (right).
Dr. John Patrick Couch (left) and Dr. Xiulu Ruan (right).

Jury selection is set to begin on Wednesday for a high profile case involving Mobile pain doctors, Xiulu Ruan and Patrick Couch. The doctors are accused of running a “pill mill” out of their Physicians Pain Specialists office according to the federal indictment and face multiple charges including health care fraud, racketeering, and conspiracy.

Federal prosecutors dropped all four of what’s known as death enhancements that were added to the original charges. The enhancements could have resulted in life behind bars if the doctors were found guilty of writing prescriptions that caused the deaths of four patients, but were removed before the trial was set to begin.

In court, Doctors Couch and Ruan will face at least four people who have already taken plea deals with prosecutors; former nurse Bridgette Parker, Physicians Assitant Thomas Palmer, former in-house pharmacist Christofer Manfuso, and pharmaceutical sales rep Natalie Perhacs.

Perchacs was reportedly hired by the pharmaceutical company Insys, based in Arizona, at the request of Dr. Xuilu Ruan. She told the court Ruan was romantically interested in her and it was his urging that led to her employment with the company.

Insys was at the height of a nationwide effort to boost sales of a spray version of the highly potent narcotic known as Fetanyl. The spray is called Subsys and was marketed to cancer patients, but according to court documents, Insys was encouraging sales reps to target general practitioners and other doctors to prescribe the off-label version to other patients.Perhacs admitted to being involved.

In early December, the government indicted six Insys executives, including former CEO Michael Babich.

Drs. Ruan and Couch have pleaded not guilty. Their defense attorneys argue that the prescriptions they wrote were legitimate. During a pre-trial meeting on Tuesday, a federal judge ruled that she would not allow testimony on patients that were not related to the incitement or that received prescriptions appropriately.

Defense attorney Dennis Knizely said there is an undercover video that shows Dr. Ruan refusing to illegally prescribe pain medicine to an undercover agent, but the judge ruled that it would not be brought up in court.

We’ll have more on what was revealed in pretrial tonight at 5,6, and 6:30.





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