Dr Xiulu Ruan2Xiulu Ruan, MD, of Physician’s Pain Specialists of Alabama in Mobile and co-owner of C&R Pharmacy, is the co-defendant to Dr. John Patrick Couch. Most of the discussion of the articles written about Dr. Couch on my post about him also apply to Dr. Ruan.  He has also been caught up in the bad reporting/government agenda.

Dr. Ruan was charged with what’s been called “excessive and dangerous” painkiller prescribing practices per the sensationalist media, WKRG, the local CBS affiliate.

In actuality there is no such charge. The accurate phraseology of the code for what he has been charged with is (1) conspiracy to distribute controlled substances outside the usual course of professional practice and not for a legitimate medical purpose, and (2) conspiracy to commit healthcare fraud.

He is also accused of killing two patients through prescriptions he wrote, one in 2012 for a prescription for MS-Contin and one in 2014 for a prescription for Opana. The patients are only identified by their initials, J.B and D.W respectively. Dennis Knizley, Dr. Ruan’s attorney, said evidence will show Ruan followed medical criteria in evaluating patients and prescribing medications.

Neither of these medications would be typical in an overdose due to inaccurate prescribing. Therefore, it could only be assumed that the people who died were drug abusers and manipulated the medication to abuse. No doctor should be held responsible for the behavior of a patient who does not follow his instructions. If that is the direction our Justice department is going, then any profession should be held liable for a client not following instructions, not just doctors. Are we, as a society, going to allow this? Well, it is being done all over the country. There are doctors sitting in prison cells that did nothing wrong to cause the death of people they are being punished for. This has to be changed. Media such as WKRG needs to stop painting doctors as criminals for people abusing their medications, and juries need to stop convicting doctors on such charges. I would appreciate if the families of the patients D.W. and J.B. would come forward and share with me the truth behind the probable abuse of their medications.

WKRG continued their sensational tactics by writing that the first indictment filed against the doctors showed that investigators gathered evidence of 66,892 prescriptions written by Couch and Ruan combined in 2014, deliberately “over-prescribing controlled substances to increase revenue.”

These numbers do not reflect over-prescribing considering it was a pain management practice and involved 2 doctors. It probably reflects the average numbers of prescriptions written by any pain management practice in the country which uses opioids appropriately. The Indictment alleged Dr. Ruan engaged in a conspiracy to commit healthcare fraud to increase the health insurance reimbursements by routinely ordering expensive urine drug tests. The Indictment alleges these tests were ordered primarily because of the extremely high rate of reimbursement paid by insurance providers.  The Indictment also alleged he engaged a conspiracy to fraudulently bill a physician extender’s services under the physician’s national provider identifier number.

Now considering the scrutiny that pain management practices are under today, and I’m sure Dr. Ruan and Dr. Couch were aware of this, I doubt they would bill inappropriately. It is perfectly okay to bill a physician extender’s visit under a doctor’s number if the doctor is available for consult. They don’t even have to be in the office. And I’m sure one or the other of the doctors were available for consult every day, as theirs was probably a busy practice since it was described as being “lucrative”. Also, it is completely appropriate to order urine drug screens on patients being prescribed opiates. It would depend entirely on the labs available what they would order. It is my opinion they ordered the test that would best protect themselves if they were ever attacked for their pain management. Imagine their surprise when they are charged with criminal activity for the exact action they used for protection of such. It’s amazing!!

Individually, Ruan is facing separate charges of money laundering.

Several co-defendants in the case have reached plea agreements with prosecutors, including former employees Thomas Justin Palmer and Bridgette Williams Parker, and Christofer Manfuso, the owner of Comprehensive RX Management, who acknowledged paying $864,770 to Couch and $1.7 million to Ruan over a three-year period.

Now from personal experience, I can attest to the fact that witnesses like these can’t be believed. They have probably been threatened with prosecution themselves and are testifying for self-preservation. They will lie and state on the witness stand whatever the prosecution tells them to say. The extent of prosecutorial misconduct in this country has become rampant, probably due to the actual immunity we have awarded government employees. Because they have taken advantage of this trust, we need to take this immunity away. If it has been found that the prosecution has used illegal means to convict a doctor, the doctor should immediately be acquitted of all charges.

As a result of these charges, the government achieves its goals of attacking doctors for money. They are looking at seizing the forfeiture of “numerous bank accounts, exotic vehicles, and real property.” But in addition to a forfeiture of their assets and the revocation of their medical licenses, the charges carry penalties of 60 to 105 years in prison if the defendants are convicted as indicted. The trial was originally scheduled to begin in June, but in light of the new charges, there is currently a joint motion before the court to push it back to October.

I hope I can be there, or at least enough people are there to support these doctors at their trial. If I can be of any help with their defense, I hope their lawyers will contact me. If you know of either of these doctors—Dr. Ruan or Dr. Couch, please pass this on to them. Please refer also to the post on Dr. John Couch for further comments on this outrageous government conduct.