Prescription for Evil

By James K. Davis

On May 27, 2001, a nurse in Kansas City oncologist Dr. Hunter-Hicks' office placed a five c.c. vial of Taxol chemotherapy medicine in a package and sent it to the National Medical Services laboratory. On June 12, 2001, the lab results arrived back. The Taxol sample from the lab was a bombshell. It had approximately one-third of the amount of Tax

• Language: English
• Publisher: Genius Book Publishing
• Release date: Mar 15, 2024
• ISBN: 9781958727256

Book preview

Praise for

Prescription for Evil

Jim Davis has written a captivating account of how one individual, a pharmacist, became the center of worldwide condemnation due to his heinous crimes against people who depended on him for their life-saving medications. Robert Courtney, who espoused to be a family man and a man of religious convictions, created a world of misery for patients, caregivers and their families. Jim Davis takes you through the case by describing, in detail, the scope of the FBI investigation and the effect on patients and their families, as well as the unique situation that this case resulted in for both state and federal oversight agencies. The narrative describes a case no one could believe would ever happen. A case that baffled law enforcement and caregivers as to the enormity of one person’s greed and complete disregard for the welfare of individuals that entrusted their care to Robert Courtney. The book chronicles not only the criminal behavior of one pharmacist but also covers other individuals who were complicit in the diversion of pharmaceuticals from legitimate providers into the black market of prescription drugs. Thorough research by the author provides for a detailed and compelling account of what happened.

—Kevin Kinkade R.Ph.,

Retired Executive Director

Missouri Board of Pharmacy

At the time, it was the most significant criminal investigation in the FBI. Director Robert Mueller had just committed an unprecedented deployment of FBI resources to the Kansas City Division. Then it all changed in a matter of seconds as an aide whispered into the Director’s ear, and the meeting came to an abrupt end shortly after 9am on the morning of 09/11/2001 as those pledged resources were diverted to address the most horrific terrorist attack ever on U.S. soil. Jim Davis takes the reader on a gripping journey that chronicles the team effort of Agents and Prosecutors who worked to expose the dark world of pharmacist Robert Courtney before another patient fell victim to his diabolical scheme. Courtney’s actions were so twisted—purposely diluting life-saving chemotherapy prescriptions to help fund a $1 million donation to his church—that he correctly told the court there was no rational explanation for his behavior. Davis tirelessly chronicles the mesmerizing story into a concise primer—full of jaw-dropping moments and gut-wrenching accounts from family members who lost loved ones. This is a must-read for those interested in the investigative and prosecutive process, but it also serves as a historical accounting of the perverted actions of a man who was once a member of one of the most trusted profession in America.

—Robert Herndon

FBI Case Agent

The Black-Market Drug Division Case

Jim Davis does an incredible review and examination of the most significant and impactful crime that the Kansas City area has experienced. A crime so horrific that initially the FBI Special Agents and the Federal prosecutors involved could not believe that the initial allegations were true and that there must be a misunderstanding. The allegations brought forth by an oncologist dedicated to helping people fight cancer involved a local pharmacist supposedly diluting the chemotherapy treatments for those undergoing treatment and fighting for their very lives. Unfortunately, the allegations —no matter how hard to believe—were proven to be true. While Federal agents and prosecutors were used to investigating and prosecuting individuals involved in various crimes from organized crime to drugs to public corruption, they had not seen a person who was truly evil until this crime which affected thousands of individuals for over a decade before being brought to justice.

—David Parker

FBI Case Agent

Robert Courtney Investigation

This book details one of the most difficult and horrifying cases in recent American criminal history about a crime so terrible that it defies understanding. Jim Davis takes a matter of fact, almost clinical—and therefore even more chilling—approach to telling the story, from its horrific beginning to its sad and unsatisfying end. It is a satisfying ready from beginning to end by an author who is very experienced in writing about real-life criminal law cases. You will want to divert your eyes, but the story is so compelling that you must keep on. The book is hard to put down; you will never feel the same about your fellow human beings again.

—Don Dagenais

Attorney

Kansas City Missouri

PRESCRIPTION FOR EVIL

Major Case #183

The Most Horrific Murder for Profit Case in FBI History

James Kirkpatrick Davis

Prescription for Evil

Originally published in 2020 as Operation: Diluted Trust

Copyright © 2020, 2023 James Kirkpatrick Davis

All Rights Reserved. No part of this book may be reproduced by any means without the written permission of the publisher, except for short passages used in critical reviews.

Published by:

Genius Book Publishing

PO Box 250380

Milwaukee, Wisconsin 53225 USA

GeniusBookPublishing.com

Library of Congress Control Number: 2020935099

221210

Contents

ACKNOWLEDGMENTS

Operation: Diluted Trust

Introduction

1. First Warning of the Most Hideous Crime Imaginable

2. Verda Hunter-Hicks, MD

3. The Search Warrant

4. The FBI Nightmare

5. In the United States District Court for the Western District of Missouri, August 15, 2001

6. In the United States District Court for the Western District of Missouri, August 20, 2001

7. The Federal Grand Jury August 23, 2001

8. The Black-Market Drug Diversion Case

9. Resources for the Investigation and Prosecution of Healthcare Fraud Crimes

10. The Plea Agreement

11. Interrogation March 1, March 11, April 11 & May 21, 2002

12. Government Sentencing Memoranda

13. In the United States District Court for the Western District of Missouri, Victims’ Testimony, December 5, 2002

14. In the United States District Court for the Western District of Missouri, December 5, 2002

15. The Civil Case. Jackson County Circuit Court

16. Mediation

17. The Georgia Hayes Civil Trial

18. Northland Cathedral

19. Disbarment

20. Laura Courtney

21. Prison

22. The U.S. Supreme Court has Refused to Consider Courtney’s Sentence

23. Compensation for the Victims

Bibliography

The man who lies to the world, is the world’s slave from then on…There are no white lies, there is only the blackest of destruction, and a white lie is the blackest of all.

—Ayn Rand, Atlas Shrugged

For

Winifred Lee Kirkpatrick Davis

&

John Plantz Davis II

&

Michael Carter Davis

ACKNOWLEDGMENTS

I am indebted to several persons who provided valuable assistance during the lengthy process of preparing this book. First and foremost, special thanks to my remarkable wife, Neva J. Patterson Davis.

Whitney Kirkpatrick Davis provided her usual excellent proofing services as Copy Editor while Anne Marie Butler carefully monitored the text as Fact Editor. Don Dagenais, as Manuscript Editor, reviewed the text and provided excellent suggestions many times for most chapters.

Gene Porter, Assistant United States Attorney, Western Missouri, directed the investigation from the United States Attorney’s office. For the past several years, I have benefited from my previous association with the late former Director of the FBI and Kansas City Chief of Police Clarence M. Kelley. Retired FBI officials in this investigation included Kansas City FBI Field Office Supervisory Special Agent Judy Lewis-Arnold; David Parker, FBI Case Agent, The Robert Courtney Investigation; Bob Herndon, FBI Case Agent, The Black-Market Drug Diversion Case; FBI Special Agent Mary Carter; and FBI Special Agent Frank Carey. These officials, including retired Office of Criminal Investigations FDA Special Agent Steve Holt, made themselves available for extended interviews and proofing—each provided unique observations on the nearly unbelievable events of the Robert Ray Courtney investigation. Kevin E. Kinkade, retired Executive Director of the Missouri Board, was available for interviews and careful proofing from his technical perspective. David L. Dotlo, Director of the Society of Former FBI Agents, greatly assisted in locating key personnel. David M. Hardy, Section Chief, FBI Records Management Division; Lauren M Guinn, Public Liaison/G/15 FBI Records; and Francis M. Seiner, OCI/FOIA Officer Food & Drug provided essential documents regarding the Courtney investigation. Ron Faust, Records Clerk, United District Court, provided critical court documents. Valery Hartman, Public Information Officer, and Kathy Foley, Court Reporter, Division 19, both with the Sixteenth Judicial District, were able to make testimony transcripts available. I benefited from recommendations provided by Tom Burns, Research and Liaison Librarian at the University of Missouri Library. Thanks to Dr. John A Horner, I was able to use the resources of the Missouri Valley Special Collections, Kansas City Public Library. Finally, I benefited from the unique services provided by Mike Ruth which aided in completing the text.

Prescription for Evil

On May 27, 2001, a nurse in Kansas City oncologist Dr. Hunter-Hicks’s office placed a five c.c. vial of Taxol chemotherapy medicine in a package and sent it to the National Medical Services laboratory. On June 12, 2001, the lab results arrived back. The Taxol sample from the lab was a bombshell. It had approximately one-third of the amount of Taxol the doctor had ordered. The doctor knew the precise chemotherapy requirements for each patient. Many were at crucial stages of their illnesses. Diluted medication could result in serious, possibly fatal results.

Introduction

One of the things that served as a driving force for all of us was the fact that this whole thing never got out of our consciousness, it was a public health issue.

Gene Porter

Assistant United States Attorney

District of Western Missouri

IN 2001, THE DIRECTOR OF THE FEDERAL Bureau of Investigation was Robert S. Muller, III. It was under the authority of his office that Major Case #183: Diluted Trust became the Bureau’s single highest priority case in the nation. In its 96-year history, the Federal Bureau of Investigation had never before focused on this type of crime. This investigation, beginning on August 7, 2001, targeted the horrifying criminal behavior of Robert Ray Courtney of Kansas City, a licensed clinical pharmacist.

At Director Muller’s request for a Courtney investigation briefing, Kansas City FBI Field Office Supervisory Special Agent Judy Lewis-Arnold and Special Agent Melissa Osborne arrived at FBI Headquarters the Monday morning of September 11, 2001.

They had assembled a comprehensive presentation outlining details of Major Case 183 for Director Muller. We went to the director’s private conference room, Lewis-Arnold recalls, ready to meet with the director. A person came in and said the director was a few minutes delayed. Next, another person came in and told us the director was detained because a plane had crashed into the World Trade Center in New York. At that point, we thought it was an accident. We soon learned that it was not an accident. Disaster had struck in New York and Washington. At that moment, the Courtney investigation became The Bureau’s second highest priority case in the nation.

***

In 2001, about 224,000 licensed pharmacists were employed in the United States. Working pharmacists received median incomes of about $87,000, and experienced a generally high level of public trust, just below that of nurses. In some studies, pharmacists’ general level of public trust rated them even higher than members of the clergy. Pharmaceutical services in the U.S. are almost always provided at very high levels of expertise. Professional services include the preparation and dispensing of prescription medicines, ointments, and tablets. Pharmacists also advise patients on how prescriptions should be administered for maximum medicinal benefit while also providing physicians and other healthcare professionals with updates on the proper usage of new and existing prescription and over-the-counter medicines, including the appropriate dosages, potential drug interactions, and side effects. Pharmacists are not considered to be mere order takers. Pharmacists are usually welcomed as significant contributors directly involved in patient care. They often act as professional intermediaries among physicians and patients—the majority work as community pharmacists in retail locations. Many serve as the first point of contact for patients with health inquiries.

Training and educational requirements for aspiring pharmacists have always been rigorous. In 1991, for example, pre-pharmacy students were required to complete at least two years of college to become eligible for pharmacy school, and most would complete 3-4 years of a bachelor’s degree program. Although students were not required to pursue specific majors, they were encouraged to complete undergraduate work in chemistry, physics, biology, and calculus to prepare for advanced pharmacy classes. Areas of qualification and specialization for some pharmacists have expanded to include such disciplines as pharmacology, chemistry, organic chemistry, biochemistry, pharmaceutical care, microbiology, pharmacy practice, pharmaceutics, pharmacy law, physiology, nephrology, hematology, drug delivery and sterile compounding of medicines.

Pharmacists take their work very seriously. Pharmacist Duane Stevens recently wrote, … the entire goal of the industry is to improve, prolong or even save lives…. Some physicians in private practice, primarily oncologists, may attempt to reduce overall operating costs by working with the smaller office staff. In one such effort, instead of having on-site nurses or on-site pharmacists mix sterile drug compounds for cancer patients, some physicians employ outside independent pharmacists to prepare these critical, often life-saving medicines. Thus, physicians and office personnel are saved from the trouble and anxiety of dealing with these toxic drugs. Some hospitals also assign the mixing and preparation of chemotherapies to outside pharmacists. In filling this specialized need, a small number of independent pharmacists choose to undertake the critical responsibility of mixing chemotherapy medicines for cancer patients.

In the entire United States in 1991, just a few thousand independent pharmacists mixed and compounded chemotherapy drugs. At that time, the Home Infusion Association membership included pharmacists, nurses, and other health care professionals providing infusion therapy services, including chemotherapy in home and outpatient clinic settings.

Considerable efforts are made to provide a basic professional level of pharmaceutical practice in the country. Each practicing pharmacist in the United States is subject to stringent licensing requirements while also being subject to unannounced inspections by state authorities. The system is not perfect—it remains nearly impossible to provide the necessary oversight to detect every instance in which criminal activity might take place

During the years 1987 through 2001, while physicians and other healthcare providers were focusing on providing the highest levels of patient care, it is doubtful any medical professional in Kansas City or anywhere in the United States considered that prescriptions for their patients could be or would be intentionally diluted, adulterated or misbranded.

For the first and only time in American medical history, one pharmacist in one major American city was able to corrupt the dispensation of chemotherapy medications targeting prescribing physicians and desperately ill cancer patients for a far more extended period than anyone thought possible.

The evolution of pharmacy practices nationwide… Kevin Kinkade, R.Ph., retired Executive Director of the Missouri Board of Pharmacy, reports, we now see more and more retail pharmacies being involved in sterile product compounding primarily because… changes in Medicare have resulted in hospitals sending patients home much sooner than in the past.

Following the Courtney scandal, Kinkade added, pharmacy boards generally have asked for additional funding to hire more investigators to expand unannounced random sterile product testing in pharmacies.

***

Robert Ray Courtney was, in early 1987, an independent pharmacist working in the Kansas City area. In achieving a level of financial success attained by few practicing pharmacists, he became a self-made multimillionaire in less than 13 years.

His life and that of his sisters began in minuscule Hayes Kansas, on September 28, 1952. Courtney was the only son of an Assembly of God itinerant country preacher. His father, Reverend Robert Lee Courtney, was ordained in September 1951 and based in Scott City, Kansas. For nearly a generation, Reverend Courtney’s traveling evangelical ministry was comprised of his wife, Nellie, son Robert Ray Courtney, and two daughters. They lived in a 33-foot trailer home pulled by a 1953 Dodge sedan. The group initially went from Hayes to a first ministry in Palco, Kansas. One year later, the family moved to Wynne, Arkansas. Then they moved northwest to Kimball, Nebraska, a town near the Wyoming border with a population of about 2,500. Finances were always critical. Utilizing whatever resources they could muster, the group arrived in Kimball. They lived in the Elm Court Trailer Park for six months. A large tent was placed nearby to establish the area’s first Assembly of God Church in Kimball, leading to worship and a Sunday school meeting, drawing 23 persons. The Courtney family then moved to a small three-bedroom house next to the church. A year later, the family moved to Reform, Alabama then to Beaver City, Nebraska, then back to Kimball, followed by a move to the Texas Panhandle and later to a low-income neighborhood in Wichita, Kansas where Reverend Courtney became pastor of the Trinity Assembly of God church in 1970.

Juleen Turnage, public relations director with the Assembly of God church headquarters in Springfield, Missouri, said there was apparently a great deal of shuffling around in Reverend Courtney’s ministry. She noted Reverend Courtney’s ambitious nomadic ministerial career represented the work of a minister who travels around holding revivalist meetings in various churches for their pastors.

The Courtneys were poor during these early years. Traveling evangelical ministers frequently took a second job to survive. Reverend Courtney worked part-time in area oil fields when work was available. In each new town, Nellie Courtney organized and managed the congregation’s business office, including payables, fundraising, and membership. Schools for the Courtney children changed continuously over the years with enrollments at a new school following their arrival in each new town.

Few, if any, now remember the small, shy preacher’s son who wore horn-rim glasses and nearly every day lugged his trombone to attend Wichita South High School. On a campus of 1,500 students, Courtney made little impression. One person vaguely remembered him as a shy, geeky, minister’s kid. Another person at Wichita High, Bob Simison, editor of the school newspaper, said, I sort of remember him. Kind of a geek wasn’t particularly stylish in how he dressed. I remember he wasn’t a very good trombone player. Simison added, The way that high school worked, all of the social groupings revolved around where you went to junior high. When you are coming in as a sophomore, you are not going to be a part of any crowd. Nonetheless, Courtney did serve as vice president of the Wichita South High School Band Council during his senior year. He also performed in the Symphonic Band and the school orchestra.

Courtney graduated with his twin sister from Wichita South in 1970. After beginning college at Wichita State University in the fall of that same year, Courtney transferred to the University of Missouri-Kansas City. At UMKC, he was mostly in the background. He did not earn academic honors, and he did not associate with a fraternity or participate in on-campus social organizations. Courtney graduated from the UMKC School of Pharmacy with a Bachelor of Science degree in 1975.

Ashok Gumbhir, professor of pharmacy at UMKC, said Courtney as a student was quiet but not shy. He would respond to you very respectfully, but he was not the first to raise his hand. At some point, Gumbhir became impressed with Courtney, who appeared to be a student with an open mind. The professor spoke to him about filling an existing void in local pharmaceutical marketing—mixing cancer drugs for doctors. I had used him as an example of how pharmacists can do more than count pills. Courtney benefited from his professor’s advice by capitalizing on the outpatient trend by compounding chemotherapy drugs in an office building shared by oncologists and other medical specialists including the oncology practice of Verda J. Hunter-Hicks, MD. Gumbhir later sent students to study Courtney’s operation.

Courtney became one of the first pharmacists in the Kansas City area to dispense cancer-fighting chemotherapy medications, prepared off-site in pre-mixed ready-to-use bags for delivery to physicians.

A lot of pharmacists didn’t want to do that, they didn’t want the responsibility, said Jim Frederich, a retired pharmacist who employed Courtney for a decade and then sold him his pharmacy. He was always looking for some other avenue to provide a service, Frederich recalls, always thinking outside the box. It was a nice successful pharmacy when I sold it to him—he seemed to be a reliable person in every respect.

One morning in early 1987, Courtney was routinely drawing up a medication and noticed there was more of an ordered drug in the sealed capsule—the capsule, apparently to allow for spillage, contained a 10% overfill.

That was the beginning, Courtney later told FBI and FDA investigators, pointing out that he quickly deduced that other drug ampules must have contained similar overfills. It was at this moment while observing this simple procedure by a drug manufacturer that Courtney took the first fateful steps in creating the first and most extensive chemotherapy drug tampering, misbranding, and dilution conspiracy operation in the history of American medicine.

At some point, Courtney apparently reasoned, as attorney and author A.L. DeWitt observed, if cancer patients didn’t notice missing pills when there was supposed to be a specific number of pills in a plastic bottle surely they would never catch on to the fact that he was giving them less chemotherapy in a premixed IV bag than they expected. The Courtney criminal enterprise that quickly developed from this point, which generated huge, nearly unbelievable profits, was appallingly simple.

It is the insidiousness of the deed, as Kansas City journalist Jack Cashill later wrote, "and its ineffable sense of betrayal, more than the results themselves that have provoked so huge of a public outcry… it is the high levels of trust that people bestow on the pharmacist