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Jury clears two local pill mill doctors of eight overdose deaths, convicts them of money laundering

By Jane Musgrave - Palm Beach Post Staff Writer

In a stunning defeat for federal prosecutors, a jury on Tuesday cleared two doctors of causing the overdose deaths of eight patients — charges that could have sent them to prison for life.

After deliberating for roughly 20 hours over three days, the 12-person jury found the only crime Drs. Cynthia Cadet and Joseph Castronuovo committed was money laundering.

Calling the verdict inconsistent, their attorneys predicted even that charge would fall given that the jurors agreed the doctors did nothing wrong when they worked at so-called pain clinics run by now imprisoned Wellington man Christopher George.

“It’s a huge victory,” said attorney Michael Weinstein, who represented Cadet during the nearly two-month-long trial. “The jury spoke loudly and clearly that she was not guilty of possession of oxycodone, not guilty of conspiracy and not guilty of causing any deaths.”

If Cadet didn’t do anything wrong, he asked, what money did she have to launder?

Attorney Thomas Sclafani, who represented the 74-year-old Castronuovo, agreed. “If he’s not a drug dealer then how could he be money-laundering?” he asked.

Their questions about the verdict — as well as ones that arose as the jury of nine men and three women struggled to reach a verdict — will have to wait.

They and prosecutors will return to court today to present evidence to help the jury decide how much, if anything, the doctors should have to forfeit for their criminal acts.

Sclafani said Castronuovo shouldn’t be forced to forfeit any of the estimated $164,000 he earned during the months he worked part time at Executive Pain in West Palm Beach. Since the jury cleared Castronuovo of conspiring to distribute controlled substances and of causing the deaths of two patients, he apparently made his money by properly treating patients, he said.

Further, Sclafani said, because Castronuovo made comparatively little working at the pain clinic, it is unlikely the doctor, who for years was chief of nuclear medicine at a Long Island hospital, would be sentenced to any more than three years in prison.

Weinstein also said he will argue that Cadet, who was accused of causing the deaths of seven patients before one charge was dropped, doesn’t owe the government a dime. She made roughly $1.3 million during the 15 months she worked American Pain, which operated in Broward County and Boca Raton before moving to a former bank in Lake Worth.

“Which patient that she saw did she violate the standard of care? The jury said none,” Weinstein said. “Our argument about what she should forfeit? Zero.”

Further, he said, with no criminal record, the 43-year-old Ivy League educated emergency room physician, who retired from the Air Force as a major, is unlikely to receive a 10-year sentence, the maximum punishment for money-laundering.

Weinstein said it is likely jurors convicted the two physicians of conspiracy to commit money laundering because that’s the charge nine other doctors who worked at the clinics pleaded guilty to as part of plea deals.

“It was a compromise verdict to put her in line with the other doctors,” Weinstein said. However, he said, she wasn’t like the others, six of whom testified in prison blues with their arms and legs shackled. The others admitted they quickly recognized their work for now 33-year-old Wellington twins Chris and Jeff George for what it was: illegal.

Cadet and Castronuovo, in contrast, sincerely believed that when they doled out monthly prescriptions for 240 pills of 30 milligram oxycodone, 60 pills of 15 milligram oxycodone and 30 tablets of Xanax they were helping patients deal with excruciating pain, their attorneys said.

Prosecutors, who are expected to ask that both doctors be forced to part with sizable chunks of their earnings, don’t comment on jury verdicts. During the trial they painted the clinics that raked in an estimated $40 million over two years as lawless operations that lured addicts and dealers from Ohio, Tennessee, Kentucky and West Virginia.

The clinics accepted only cash and the greenbacks piled up so quickly they overflowed garbage cans. A video showed security guards screaming at patients not to shoot up in the waiting room of American Pain. A taped phone conversation between Chris George and his mother, now also in prison, captured them laughing about a drug overdose linked to the clinics.

Throughout the day Tuesday, it was clear jurors were struggling to reach a consensus. At 2 p.m., they announced, a verdict had been reached.

However, U.S. District Judge Kenneth Marra grimaced when he reviewed it. The jury hadn’t decided nine of the 13 charges the two doctors faced. It cleared Cadet of causing three deaths and Castronuovo of one.

“Each count has to be voted on either guilty or not guilty,” Marra told jurors. “You can’t leave it blank. If you’ve left it blank, that’s not a decision.”

The jury returned three hours later to again say it had reached a verdict. But again, Marra said, it was flawed. He asked the foreman to specify whether the jury had found Castronuovo guilty of money laundering. That last-minute change raised Sclafani’s eyebrows and, he said, yet another reason for appeal.

The verdicts cap a lengthy investigation by the FBI, U.S. Drug Enforcement Administration, IRS and numerous local law enforcement agencies. It ensnared 33 people. Cadet and Castronuovo are the only ones to ask a jury to determine their fates. All the others took plea deals in federal court except two doctors who died. One doctor is awaiting trial in state court.

During closing arguments, Weinstein insisted that the government had already won. It successfully prosecuted the others for their involvement in one of the biggest illicit prescription drug operations in the nation. Convicting Cadet and Castronuovo would have a chilling effect on a doctor’s ability to prescribe medicine patients need, he said.

Sclafani said the argument undoubtedly persuaded jurors. “They understood that for the government to get in a physician’s chair and tell them how to do his job is not their business,” he said.

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