Mobile Pain Doctors Found Guilty of Running Pill Mill

MOBILE, AL (WKRG) — The once-popular pain doctors charged with running one of the most high-volume pill mills in the country have been found guilty in federal court.

Dr. John Patrick Couch and Dr. Xiulu Ruan were found guilty on 19 of 20 counts in a Mobile courtroom on Thursday.  The verdict is the culmination of a month-long trial into Couch and Ruan, who were accused of “excessive and dangerous” painkiller prescribing practices at their clinic, Physician’s Pain Specialists of Alabama (PPSA).

Couch and Ruan
Old billboard for PPSA, the clinic run by Dr. Couch and Dr. Ruan.

The doctors were found guilty on charges that include distribution of a controlled substance, drug conspiracy, healthcare fraud conspiracy, money laundering and more.

Couch faces a maximum sentence of 225 years in federal prison.  Ruan faces 255 years in federal prison under the maximum sentence.

In May 2015, authorities executed a raid of PPSA and C&R Pharmacy, both operated by Couch and Ruan. It was part of “Operation Pillution,” a massively-coordinated DEA raid of prescription painkiller clinics across four southern states. Dr. Couch and Dr. Ruan were both arrested for distributing controlled substances outside of legitimate medical purposes and healthcare fraud.

Physician’s Pain Specialists of Alabama
Physician’s Pain Specialists of Alabama

For weeks after the raid, dozens of Couch and Ruan’s former patients held small, unorganized protests outside PPSA.  They called the investigation into the clinic a “witch hunt,” and defended Couch and Ruan’s character and intentions.

However, the rallies quickly ended once investigators released a plethora of evidence against the doctors and their methods.  On, News 5 published the 153-page affidavit used to obtain the search warrants that culminated in the federal raids.

WKRG ARCHIVES: Shocking Evidence Against Pain Doctors’ Pill-Prescribing Practices (June 2015)

In the first indictment filed against the doctors, investigators gathered evidence that Couch and Ruan wrote 66,892 prescriptions combined in 2014, deliberately “over-prescribing controlled substances to increase revenue.”  It amounted to writing a prescription once every four minutes.

One informant who previously worked for Couch and Ruan said the two doctors would regularly compete to see who could hand out the most prescriptions to patients.

Couch and Ruan were originally accused of prescribing the painkillers that led to the deaths of four patients, but those charges were dropped by prosecutors.

PDF2nd Superseding Indctment Couch Ruan

Dr. Ruan
Dr. Ruan

Evidence collected by federal investigators suggested a significant portion of the clinic’s patients had no legitimate need for pain medication. They were described as “pill seekers” who obtained the drugs to use for themselves or give to others. Patients from at least 18 different states were said to have received prescription painkillers from Dr. Couch or Dr. Ruan.

Federal investigators were thorough and methodical in their pursuit of Couch and Ruan.  The affidavit also included a lengthy section about Dr. Ruan’s collection of exotic cars, which he kept hidden in a warehouse in Mobile.

A sentencing date is expected to be announced shortly.  It is likely the defense will file an appeal, though that is yet to be confirmed.


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