Case study: Drs. John P. Couch and Xiulu Ruan - KCBD NewsChannel 11 Lubbock

Case study: Drs. John P. Couch and Xiulu Ruan

Drs. John P. Couch, right, and Xiulu Ruan ran a pain clinic in Mobile, AL, and amassed a fortune. Federal agents say that 240 patients died under their care. Drs. John P. Couch, right, and Xiulu Ruan ran a pain clinic in Mobile, AL, and amassed a fortune. Federal agents say that 240 patients died under their care.
  • Drs. John P. Couch and Xiulu Ruan
  • Practice: Physicians Pain Specialists of Alabama
  • Specialty: Interventional pain management
  • Opioid prescriptions paid by Medicare 2013-2015: 75,190
  • Costs to Medicare: $15.9 million 
  • Discipline: federal convictions and medical-license revocations
  • Sentence: 20 and 21 years in prison, respectively

(RNN) - Pushing opioids to patients made Drs. John P.  Couch and Xiulu Ruan very rich men, and costs hundreds of patients their lives, Drug Enforcement Agency investigator said.

Their greed was so excessive that the agent in charge of the investigation, Steven Azzam, told Raycom Media that the doctors are “pieces of garbage.”

The doctors’ office in Mobile, AL attracted patients from as many as 18 different states, according to federal court records. Federal agents estimated that as many as two-thirds of them were “pill seekers.”

By 2013, the doctors were top prescribers of opioids – and the pharmacy they owned filled more prescriptions than any other. Federal and state law enforcement officials took notice and launched an investigation.

Agents determined the doctors prescribing rates were so high they were writing a prescription every four minutes or so. 

In 2014, Ruan began to worry that they would be caught because Alabama had become No. 1 in the nation for the volume of opioid prescriptions written – a troubling distinction for the state with only 4.8 million residents.

Ruan encouraged his partner to back away from prescribing so much Roxicodone and Oxycotin because they were the “biggest red flag [sic] . . . especially (because) we are trying to convince AL board of medical examiners that we have a great system,” Ruan wrote in an email contained in the federal court records.

Their operation was lucrative, with each doctor collecting millions of dollars from private and taxpayer-funded insurance companies. They were also receiving kickbacks from opioid distributors and speaking fees from drug makers.

When the operation was shuttered with the doctors’ indictments in 2015, the FBI seized at least two dozen bank and investment accounts, including their children’s college funds, three houses and two beach houses.

The government also took their cars. Couch had four: Cadillac Escalade, Land Rover, Maserati and a Porsche.

Ruan owned 13 luxury cars including two Ferraris, two Lamborghinis and a Spyker Laviolette that sells for around $200,000. One bore the license plate, “Pain MD.”

They were convicted in 2017. Each will spend at least two decades in a federal prison and owe more than $32 million in restitution to the U.S. government.

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