An internist with offices in Grass Valley and Yuba City was indicted Thursday by a federal grand jury for running an illegal prescription practice.
Nicholas J. Capos Jr., 63, of Granite Bay, was charged with one count of conspiracy to distribute, dispense and possess with intent to distribute oxycodone and five counts of illegal distribution and dispensation of oxycodone.
Capos participated in a conspiracy to distribute the drug oxycodone, said Lauren Horwood, with the U.S. Attorney’s Office. He is also charged with the distribution and dispensation of oxycodone outside the usual course of professional medical practice and without legitimate medical purposes.
The indictment alleges that he illegally dispensed 1,590 30-milligram oxycodone pills in the summer of 2012.
“The misuse of oxycodone and other prescription painkillers is responsible for thousands of deaths every year,” said U.S. Attorney Benjamin B. Wagner in a prepared statement.
“In this case, the government alleges that a licensed physician dispensed these powerful and deadly painkillers without a legitimate medical purpose. The law provides a consequence for persons who prescribe narcotics outside the scope of legitimate medicine.”
The federal grand jury indictment was not available as of press time. However, the indictment stemmed from a fully investigated complaint against Capos by the Medical Board of California, which was referred to the Attorney general’s Office for prosecution in August 2013.
That accusation alleged that Capos was guilty of multiple causes for discipline in cases involving 11 patients — one of whom actually was an undercover operative. In nine of the cases, Capos was reportedly guilty of gross negligence, prescribing without an appropriate prior exam, excessive prescribing and keeping inaccurate medical records.
In two of the cases, he reportedly was guilty of repeated negligence. Most of the cases deal with office visits in 2012.
In a typical instance, Capos reportedly saw a patient who had been prescribed heavily for pain medication, conducting normal physical exams but refilling and increasing pain prescriptions.
One patient’s prescription in 2012 peaked to 10 times the dose the patient had been receiving three years previously — 4,600 tablets a month of hydrocodone, oxycodone, oxymorphone and methadone, the accusation alleged.
One patient with a history of drug abuse and noncompliance reportedly was prescribed excessive narcotics, even though there were notes in her chart indicating that local and regional pharmacies were refusing to fill her prescriptions due to concerns about her diagnosis and the amounts of narcotics prescribed.
Capos reportedly would make minimal notes for visits and fail to perform appropriate diagnostic exams.
In one case, Capos reportedly failed to properly evaluate the cardiac care of an 85-year-old man with atrial fibrillation; in another case, Capos reportedly was negligent in the care of a patient who eventually died of sickle-cell anemia.
According to the accusation by the state medical board, an undercover operative visited Capos for a cardiovascular exam, telling him she had been referred due to an abnormal cardiac test at an urgent care center.
Capos reportedly performed a full physical exam, which was reported to be totally normal. The undercover operative then requested pain pills, even though she told Capos she could not remember where the pain was. He subsequently prescribed Vicodin.
On her follow-up visit, the undercover operative told Capos that Vicodin made her nauseous and she wanted something nicer and stronger.
Capos reportedly prescribed for her Ambien, Percocet, oxycodone and a cough syrup with codeine.
The federal case against Capos is the product of an investigation by the Drug Enforcement Administration, the California Medical Board and the California Attorney General’s Bureau of Medi-Cal Fraud and Elder Abuse. Assistant U.S. Attorney Paul Hemesath is prosecuting the case.
“Physicians who prescribe powerful prescription drugs without a legitimate medical purpose and outside the usual course of professional practice are not acting as doctors, nor are they acting in the best interest of the public,” said DEA Special Agent in Charge Jay Fitzpatrick.
“The DEA will aggressively pursue those who put the health and safety of the public at risk and contribute to the epidemic of prescription drug abuse.”
If convicted, Capos faces a maximum statutory penalty of 20 years in prison and a $1 million fine.
To contact City Editor Liz Kellar, email firstname.lastname@example.org or call 530-477-4229.
“The misuse of oxycodone and other prescription painkillers is responsible for thousands of deaths every year.”
U.S. Attorney Benjamin B. Wagner