Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 1 of 34

UNI TED STATES DI STRI COURT CT SOUTHERN DI STRI OF FLORI CT DA

CASENO. I 8OI CRO- 49- MAO HOPKW SI I SIS) 21U. C.j846 S. 21U. C.j8 S. 4l 21U. C.j859() S. a FI LED by 1 U. C.j1 h) 8 S. 956(
UNI TED STATES OF AM ERI CA

D. C.

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STEVEN M.L MORE ARI cLERK U s. I T. T. Ds c s. o F> . FT.L D. f ' AUD.

CYNTHI CADET,M . . A D and J OSEPH CASTRONUOVO,M . . D,

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SECOND SUPERSEDI I CTM ENT NG NDI The Gr J yc r st t and ur ha ge ha : GENERAL ALLEGATI ONS Attm e ma e i lt t sSe ond Supe s di I cm e : i s t ra o hi c r e ng ndit nt
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Co- ons r t sope a e as isoft lm il' wher tonspr m e es rpton c pia or r t d ere l ls' pi epar oc dpr c i i

na c is a c r l s t nc under t g s of m e c nec st A t l m il'i a r otc nd ontoled ubsa es he uie dial es iy. t l l' s pi

physca sofk e c i c, he t c r f c lt t tr i l e gesi t pr tc ofpr c i ng i in' f , lni or alh a e a iiy ha outney nga n he aci e es rbi
a ordipe i c r l d s t nc sou sde t s ope oft pr valng sa r ofme ca nd/ s nsng ontole ubs a e t i he c he e ii t nda ds di l p a tcea wihouta lgii aem e c lpum os r c i nd t e tm t di a e.

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Suie 1 For La r l Fl i 1 t 00, t ude da e, orda; 001 W .Cypr s Cr e Road,Suie 206,For La r e, es ek t t ude dal
Fl rdaia 1 Norh Di eHi o i ; nd 200 t xi ghwa La W o t Fl i y, ke rh, orda.

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Int roduct on i

4.

The dici i ofpai m a e e wa a a c ed and r ogni e me c ls bs plne n nag m nt s n c ept ec z d di a u

s cilt pr tc d by phys canst oug tt Unie Stt s. Le tm a e a qualfe pa n pe a iy aci e i i hr hou he t d ae gii t nd iid i m a ge nte rshaves i i d kno e na me xpe t pecalze wl dge, duc ton,r ni a expe i nc a utlzea e a i tai ng, nd re e nd ii mulidicplna y a oa h. Pr s l t dicplne ofpa n m a ge e i r c z d by sa e t- s i i r ppr c e enty, he s i i i na m nt s e ogni e tt
r gult y boa ds a a s s i t o a shesol y,physc l m e c ne a r ha lt ton, e a or r s ub-pecaly f ne t i og ia dii nd e biiai ne ol y,a ps hity,whi a e r cog z d a prma y s c a tes i t Unie St es ur og nd yc a r ch r e nie s i r pe i li n he t d at .

Fe l hi tai ngpr a se s f t pur e off rhe e ai i t s s cilyofpan lows p r ni ogr m xit or he pos u t r duc ton n he ub-pe at i ma ge e , a ng gr duaese i bl f boa d ce tt a i i pan m a na m nt m ki a t lgi e or r rik ton n i nage e . m nt 5. The c c pia o sr n wha wer t l m il'whih i ve ose i y o f rng o- ons r t r a t e t l ls' c nvol d tnsbl f e i pi

i vi l i i m a ge e ' by doi ltl mor t n m ii pr crptonsf na c i a ndi duas d n na m nt' pa ng ite e ha tng es i i or r otcs nd
o he c r ld s t nce whi h t i vi l r quese Thepr s rptonswe eprma iyf t r ontole ubsa s c he ndi dua s e t d. e ci i r i rl or

lr qua ii ofoxyc age nttes odonei 1 and30milg a ( )dos geunis.Fr t rbusne s i n 5 lir m mg a t om hei i ses n
t Sout r Diti t of Fl i t c c pia o s pr de na co i s and ot r c tole he he n src orda, he o- ons r t r ovi d r tc he on r l d

s bsanc st dr a c sa dr gta t ke sfo Ke uc Te s ee, o, es Vigi aa u t e o ug ddi t nd u r fk r r m nt ky, nne s Ohi W t r ni nd es whe e le r .
6. Co- pia o s i udi de e ntphysc a Ca ta Casr cons r t r ,ncl ng f nda i i ns de nd tonuovo, te e at mpt d

t i ult t ms ve fom c i i la lt ir ht a o ns a e he el s r rm nali biiytloug he ppea anc ofl ii a emedi l aci , r e egtm t ca pr tce

i l ngt us ofcur or physca exn s pr prn e m e ca f r s mag tcr s nc i a ng ncudi he e s y i l m , e it d di l o m , nei e ona e m gi
2

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(t ' rpo t,a d u iay i. Th ds e sn a d d srb to ofc ntold s b tn e wa $ ) e rs n rn lss e ip n ig n itiu in o r le u sa c s s MRl
unde t nprma iy f apr k m otve. rake i rl or of i
Applcabl Feder Law i e al

The Contole Subsanc sAct Til 21 Unie St t Code Se i n 801 # s q. r ld t e , te , t d aes , cto ,.1 e

( ria tr eCS 'g v r e t dsrb to a dd s e i o v ro slse d u s icu i heen fe dh A' o en d he itiu in n ip nsng f ai u it d r g ,n ldng t )
na c ist ta epr s rbe by physca a ot rlc ns d he t c r pr de s r otc ha r e c i d i ins nd he ie e alh a e ovi r .
TheCSA a sgne l la hort f t r gulton ofcontoled s t nc st t s i d ega ut iy or he e a i r l ubs a e o he

U. Dr gEn o c me tAd nitain(e en fe lheDEA' .TheCSA c r e t eDEA wih S. u f r e n mi srto h ria tr s t ' ) hag s h t
t p eve i detc i andi tga i of hedi r i ofc r ld s t esfom l gii ae he r nton, e ton, nvesi ton t ve son ontole ubsanc r e tm t

chn l whie smulane l e urng t ta nnes l i t ousy ns i ha dequae s pples a e a lbl t me lgii ae t u i r vaia e o et e tm t dom e tcm e ca,s i ntf a i ti lnee . si di l c e ik, nd ndusra ds
9. TheDEA i s d r gitai numbe st quaiyi pe s who a e a horze t s ue e sr ton r o lf ng r ons r ut i d o

dipe e c tole s t nce . To is a pr c i i f r a co r ld s t nce l uly,a s ns on r ld ubsa s sue es rpton o ntole ubsa awf l physcin mus belc edt pr tc by a sae a hort mus havea DEA r gita i num b r ia t iens o aci e t t ut iy, t e sr ton e, a mus co pl wih alDEA r ultonsa a 1a iabl f der llws nd t m y t l eg a i nd l pplc e e a a .

1 0.

Undert CSA,het m a ii 'wasdefne i he t er f cttoner' pr i d,nperi nt r, a i a tne pa tas t cin phys

rg see ,o o h r s p r te b t e Untd S ae o t j rs ito i whc te e itr d r t e wie emi d y h ie tts r he u idcin n ih h t

p a ttone pr di s ...o diti e dipe e ... a i ser... contole s tncei t r cii r a ce t srbut , s ns or dm nit a r ld ubsa n he c s ofpr es i pr tc ... TheDEA r sr ton gr nt pr c ii sf de ala hort t oure of sonal aci e ' ' egita i a s a ttoner e r ut iy o

ha e c r ld s t nc . Howe r a DEA-e se e pr cttone m a onl e ndl ontole ubsa es ve , r gitr d a ii r y y ngagei t e n hos

a t iista aea to ie u d rsae1w f rtej rs ito i whc teprciei lc td. ci te h t r uh rz d n e tt a o h u id ci n n ih h a tc s o ae v

11 . Contole s t ce mayonl be diti t d ordipe ed l u l i t m n r r ld ubsan s y srbu e s ns awf ly n he nne

pr c i d by t mec nim c ea e by t CSA. The l ii t diti i of c tole es rbe he ha s r t d he eg tma e srbuton on r ld

3

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s tnc si ba e upon t conc ptofa os s t m . Suc ac os s t m e bl st DEA ubsa e s s d he e s ed yse ' cl ' h l ed yse na e he t m o t a ta kc tole s t nce f o t m a a t e ot endus r Thi r quiese h o nior nd r c on r ld ubsa s r m he nuf c ur rt he e . s e r ac

pe s ore iy i t diti i c n t ob an a r ita i numberfo t DEA,t ke p r on ntt n he srbuton hai o t i eg sr ton r m he o e r c ds a t m a r t ofalcontole s t nc tans tons Asac ton ofm ant ni e or , nd o ke epors l r l d ubsa e r aci . ondii i ai ng
s h ar gitaton, c r sr tmus t ke r a ona ese t e ur t tt r gita i i not uc e sr i ea h egitan t a e s bl tps o ns e ha he e sr ton s

bei utlz d asa s ceofdi son. ng ii e our veri

1 2. Pr sonsoft CSA ma t d t tt pe s orentt r git r d wih t DEA ovii he nda e ha he r on iy e se e t he

mus be a e t a ount f al c r l s t nc s whih ha be r ce ve ditiut d, t bl o cc or l ontoled ubsa e c ve en e i d, srb e dipe e ordipos d. Al r gita s, a a t e s diti or ,pha m a i s, pr c ii r s ns d s e 1 e sr nt m nuf c ur r , srbut s r c e and a ttone s s r r s nsbiiy f mai ani appr pra es f ua dsa i tdi son. ha e e po i lt or nt i ng o it a eg r ga ns ver i Cont ole Subsanc r ld t es 1 3. TheCSA a isi e nd t mplmentngr ultonss t orhwhi hdr gsa ot s t nce i eg a i e f t c u nd her ubsa s

a ede d by 1w ast ontole s t nc , a t ec r l s t esa et a sg t r fne a f r ld ubsa es' nd hos ontoled ubsanc r hen s i ned o c ' one of fve s dul ,Sc i che es hedul 1 I ,11 I ,or V,de ndi upon t i pot nta f a e, e , I 1, V pe ng her e i l or bus lke i i lhoodofphysc orps ial ychol ca de ogi l pende y,a ce e m e c lus a a ce e s f t f nc c ptd di a e, nd c pt d a e y or
us unde medials r ii e r c upe v son.

Thetr t c e ue1'me n t a 'th d u o oh rs bsa c h s g p tn il e m h d l 1 a s h tl l e r g r te u tn e a ahih oe ta s ' l

f ra us l thed u o o h rs bsa c h sac re ty a c p e me ia u ei te t n i t e o b e ,l r g r t e u tn e a u rn l c e t d dc l s n rame t n h Untd Sae o ac re t a c p e me ia u ewihs v r r srci s, n la u eo ted u i tts r u rn l c e t d dc l s t e ee etiton l a d b s f h r g e y
orot rs t nce ma l a t s ve eps hol c lorphysc de nde ' he ubsa s y e d o e r yc ogia ial pe nce. '

1 5. Thetr sc dul 11' a t tgl dr orot rs t ehasapoe ilfr em f he e 19me nsha the ug he ubsanc tnta o

a u els ta ted u so oh rs b tn e i s h d lsIa d1(th d u o oh r u sa c h s b s e s h n h r g r te u sa c s n c e ue n 1,l e r g r te s b tn e a

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 5 of 34

ac re t a c pe me ia u ei te t n i teUntdS ae ga d a u eo t ed u o oh r u rn l c e td dc l s n r ame tn h ie tts , n ) b s f h r g r te y

s bsanc sma ladt m ode a eor1 physc de ndenc orhi ps u t e ye o rt ow ial pe e gh ychol c lde nde e. ogia pe nc ' '

Th tr c e u eI ' a s h tsl ed u o o h r u sa eh s l wp tnil e em h d l v'me n t a ith r g r t e s b tnc a a o o e ta s g

fra u erltv t t d u so ohe s b tn e i s h d l 1I,l d u o oh rs b tn eha o b s eaie o he r g r t r u sa c s n c e u e Ig the r g r te u sa c s

ac re t a c pe me ia u ei te t n i t eUni dS ae la la us ofhed u o oh r u rnl c e td dc l s n rame t n h y t tts , nd b e t r g r te e
s tnc sm a l a t lmied physc depe nce orps hol i alde nde e r a i t t ubsa e y ed o i t ial nde yc og c pe nc eltve o he
dr orot rs t e i s he e11' ugs he ubsanc s n c dul 1. 5

1 7.

Oxyc nei cas ii d a a Sc dul 1 c r l s t e.l i s d ge rcal odo s l sfe s he e 1 ontoled ubsanc t s ol ne i ly

o unde ava it ofbr ndna e ,ncl ngRoxi odone Oxycontn,a Pe coc t W henl ly r r rey a m s i udi c , i nd r e . egal

pr c i d f ral ii ae medialpur e,hes dr a eus d t te tmoder t t s ve epan. es rbe o eg tm t c pos t e ugs r e o r a ae o e r i

1 8. Puruantt t CSA a isi e e i r gul tons al a a ,i cl sfe a s o he nd t mplm ntng e ai , pr zolm s as iid s

aSc dul I c r l s t nc a i s d ge rc ly o unde abr nd name s a Xa x. he e V ontoled ubsa e, nd s ol ne i a l r r a uch s na W he l alypr s rbedf al tm aem e c lpur e,ti us t te ta e ydior r pa c n eg l e c i or egii t dia pos i s ed o r a nxit s de , ni

dior er a a ey c e by de e son. s d , nd nxit aus d pr s i

1 . Ox c d n c nb c u h d a d s o td o dsole a d ij ce t r s l i a 9 y o o e a e r s e n n re , r is v d n n e td, o eut n n i dit h g Th sa u ec n la t o ed s a d s tme d ah. eij cin meh of mme ae ih. i b s a e d o v r o e n omei s e t Th ne to tod
a u e o o y o o e tn ote d u s g n r ly la e hihl vsbl s as a d uc r o a b s f x c d n a d h r r g ) e e al e v s g y ii e c r n le s n
i vi al ar s ndi du ' m . s

20 Ti e21 Co eof d r l g lto , cin 1 0 0 ( )sae ,np rie t r, . t , d Fe e a Re uains Se to 3 6.4 a ttd i e t n pat l n
t tavai pr c i i f aco r l d s t et t i s f al gii aemedial os ha ld es rpton or ntole ubsanc i mus be s ued or e tm t c pum e
by a i vi ua pr c ii n ndi d l a ttonerac i i t us lco s of hi pr es i tng n he ua ur e s of s onalpr c i .. An or r a tce. . de

pur tng t be a pr crpton is d noti t us l c s of pr es i lteam e or i pori o es i i s ue n he ua oure of sona r t nt n lgii t a au horz dr ea c i not pr s rptonwihi heme ni andi ent Se to 309 e tmae nd t i e es r h s a e c i i t nt a ng nt of ci n
5

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o (h CS ( U. C. 8 )a dtep ro k o n l fligs hap r re p e c ito a f t e A) 21 S. j 29 n h e s n n wigy iln uc upo td r srpin, s wel s h p ro is n i,hal es b e totep n le p o i e fr o ai n o t ep o iins la t e es n suig ts lb u j c t h e at s r v d d o vilto s fh r v so i
of1 w r ai t c r l s t nc . a eltng o ontoled ubsa es' '

Ti e21 Co eo F dea Re uain, e to 1 0 .6 a p o d d,np rie t at t , d f e rl g lto S cin 3 17 () r vie i e t n p r, l n

t tp i a r ita sts lno e oy a a age ore oye whoha a es t con r l ha hyscin eg sr nt thal t mpl s n nt mpl e s cc s o toled

s t e , any pe s who ha bee convit d of a f ony ofe e r l t t con r l ubsanc s r on s n ce l f ns e aed o toled
s bsa es.' u t nc --'
22.

Til 21 Co eo Fe e a Re uain, e to 1 04 1 () n 1 0 1 4)1 a d(i te , d f d rl g lto S cins 3 . 1a a d 3 4.1 3() n i )

pr de i pe tne pa q t ta i nt y i a c ovi d, n ri nt r ha n nve or s ( ompl t a ac a e r c d ofalc r ld ee nd cur t e or 1 ontole s bsa e on ha on t da e t i nt y i t ken' a de e mi by a Ge tc t'f r u tnc s nd he t he nve or s a ' s t r ned n xac oun ' o Sc dul Ia 1 c r l d s tnc a a esi aed c he e nd 1 ontole ubsa es nd n t tm t ountorm e ur oft c e t 'ofa as e he ont n s'

Sc dul 11 I orV c r l s tnc ( e st conti rhol mor t n 1000tbl s,n he e 1,V, ontoled ubsa e unls he ane ds e ha , a et i whihcaehe/hemus makea exa tc oft c e s . c s s t n c ount he ontnt)

2 3. Til 21 Co e o Fe ea g lto , S cins 1 0 1 9( ) p o ie t a t , d f d r lRe uain e t e o 3 4.44 1 r vd d h t

i nt i a r c dsofSc dul 1 co r ld s t nce t halbem ant i d s pa ael fo nve ores nd e or he e 1 ntole ubsa s t l s i a ne e r t y r m
a loft r c dsoft r gi t a . l he e or he e s r nt' '

2 4. Til 21 Co eof d rl g lto S cins1 0 1 ( ) r v d d,np rie t r, te , d Fe ea Re u ain, e to 3 4.1b p o i e i e t n pat n

t til ver peron rquied t ke p r or s ltke a i t y ofal soc ofc r ld ha tel y s e r o e ec ds hal a n nvenor 1 t ks ontole
s t nc onhandont da ehe s fr te ge i t .. srbuton, dipe i ofc r ld ubsa es he t / he is nga s n he .diti i or s nsng ontole
s t nc .. ubs a es .' '
25.

Til 21,CodeofFe r lReg a i Se ton 1 03pr ded t ta DEA Fo m te de a ulton, c i 305. ovi ha r

222o iselc r cequi l nti r r df ea hditi i ofaSc dul 1 contole s t ce r t e toni va e s equie or c srbuton he e 1 r l d ubsan , wih lmie e ptonsno a i bl t t i t ntc s t i t d xce i t pplca e o he nsa a e.

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 7 of 34

26.

Til 21, te CodeofFe r lRe aton, c i 1 05pr de t t a physcan de a gul i Se ton 305. ovi d ha ny ii

r itan ma a ho i one ormor i vi l , t rornott y a el t d a t r it r d eg sr t y ut rze e ndi dua s whehe he r oca e t he eg se e l a i t obti a e ut DEA For s 222 by gr ntng a powe ofa t n t e c s h oc ton, o a n nd xec e m a i r tor ey o a h uc i vi l ndi dua . Applcabl Fl i Law:a Regul i i e orda nd atons

The Fl rda Adm i sr i Code Rul 6488- 01 - St ndar f t Us of oi nitatve e 9. 3 a ds or he e

Contole Subsanc f t Tr at r ld t es or he e mentofPan -t whih a 1physcins lc ns d t pr tce i o c 1 i a ie e o aci m e ci i Fl i m us c di ne n orda t ompl sae i pe tne pa t asf l : y, t td, n ri nt r, olows

() 3

S a d r : eBo r F lrd Bo r o M e ii )ha a o tdte tn ads Th a d o i a ad f d cne s d pe h

() a Ev lain o t ePain . A c mpeeme ia h so ya d au to f h te t o lt dc l itr n

f l ng sa r f t us ofc r l s t esf pa n c r : olowi t nda ds or he e ontoled ubsanc or i ontol

physca e i l xami to mus be c nai n t onduc e a doc e ed i t m e ca r c d .. t d nd um nt n he di l e or .

( ) Tr ame tPln. Th wrtt te t n pln s o l sae b et n a e itn r ame t a h ud tt o jcie t a wilb u e t d tr n te t n s c e s s c a pan rle a d be tv s h t l e s d o ee mie rame t u c s , u h s i eif n
i ove physca a ps hos i lfmc i a s d i c t i any f t r mpr d i l nd yc oc a t ton, nd houl ndi a e f urhe di nosi e ua i orot te t nt a epl nne Afe team e be ns t ag tc val tons her r a me s r n d. tr r t nt gi , he

p y iins o da j t nl tea yt t eidvdu l dc l e ds f a hp te t h sca h ul dus d g h r p o h n ii a me ia n e o e c ain .

Ot rteam e m o lte orar ha lt tonpr a m a bene s a yde he r t nt daii s e biiai ogr m y ce s r pendi ng on t e i ogy oft pai a t e e t whih pai i a s a e wih physc he tol he n nd he xt nt o c n s s ocit d t ial a ps hos a i iment nd yc ocil mpar .

() c

I fr d Co s n a d Ag e me tf r Tr ame t . The no me n e t n re n o e t n . . .

paints lr c ve pr s rptons fom one physc a a one pha m a whe e te hal e ei e ci i r ii n nd r cy r pos i e... sbl . ( ) Pei i Re iw.Ba e on t i vi alcicum sancesof d rodc ve sd he ndi du r t t pai nt t physc a s d r vi t c s of te t e a a ne he te , he ii n houl e ew he our e r a m nt nd ny w i or ai ab tt e i ogyoft pan.Co i ton ormodiiaton oft r py nf m ton ou he tol he i ntnua i fc i he a s d de nd on t ph i a se uai oft pai ' pr es .I tea me houl pe he yscin' val ton he tents ogr s f r t nt

g asaen tb iga hiv d, e p t me iaina j sme t,h p sca s o l o l r o en c e e d s ie dc t du t ns te hy iin h u d o

r vaua et a opra e sofc i dte t e t Thephysc a s dm onior ee l t he ppr it nes ontnue r a m n . ii n houl t pa intc te ompla ei mediaton us geand r l e tea me pl . i nc n c i a eatd r t nt ans

() e

Co s lain. Thep y iin s o l b wil t rf rt e n utto h sca h u d e li o ee h ng

pa int a nec s r f r a to le ua i a te t t i or r t a hi ve te s es a y o ddii na val ton nd r a men n de o c e

te t n o j cie .S e i l te to s o l b gv n t t s p i p te t wh rame t be tv s p ca atn in h ud e ie o ho e an ain s o

a ea rs f mius ngt rme ca i a t ewhos lvi a r men spos r t ik or s i hei di tons nd hos e i ng range t e ars f me c i mius ordi r i ik or diaton s e ve son.

( 9

M e ia rc r s Th p y iini rq rdt k e a c rt d c l e o d . e h sca s e uie o e p c uae

i t o: a com pl t r or t i l bu notbe lm ied t nd e e ec ds o ncude, t

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 8 of 34

2. 3.

The m e c hit y and ph i al exa i ton, dial sor ysc m na i i l ng hit y of dr a e or de de e,a ncudi sor ug bus pen nc s a oprae; ppr i t Di nosi ,t a utc, nd lbor t y r uls ag tc her pe i a a aor es t ; Evauai andco ula i l tons ns ttons;
Dic son ofrs a be t ; s us i iks nd neks Tr m ent eat s;

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8. 9.

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l tu tonsa ag e ment;a nsr c i nd r e s nd Perodi r viws Rec dsm us r i c e e . or t emai c r nta n ure nd be mai a ne i a a c sbl m a r a r adiy nti d n n c es i e nne nd e l a ia ef r vi w. va lbl or e e

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Complan wih Conr ld Subsanc La a i ce t tole t es ws nd

Re a i . To pr crbe,dipe e,or admi se c r l s t ce , t gultons es i s ns nit r ontoled ubsan s he ph ii n mus belc edi t saeandcompl wih a ia ef der la sa e ysc a t iens n he t t y t pplc bl e a nd tt r gultons... e ai . De e f ndantPhysc ansCynt a Cade and Jos ii hi t eph Cas r t onuovo 28. Def nda physcanCa twasaphyscin lc e t pr ctcem e ci i t St e e nt ii de i a iens d o a i di ne n he at

ofFl i De e orda. f ndr t i r ca ob a ne physci det t i dDEA num be rBc8l1 2637whih al ddef nda c lowe e nt Cad t dipe ec r ld s t e .Def nt sci Ca twor d prm a iy a Ame ian et o s ns ontole ubsanc s enda phy i an de ke i rl t rc
Pai n.

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Fr i o a tDe embe 2008t onoraboutM ar 3, 0, f ndant om n r bou c r o ch 201 de e physcan ii

Ca tor r d a orr c ved fom va i pha mac utc whol s l s87 200 dos ge u t of de de e nd/ e ei r rous r e ial e aer 6, a nis
ox do yco ne.

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t Stt ofFl i De e ntphyscin Ca tonuovo obt ne DEA num be AC7880950 whih he a e orda. f nda i a sr ai d r c
al lowed def nda phys ci n Casr e nt ia tonuovo t di pens c r l d s t s D e e o s e ontole ubsance . f ndantphysci n ia

Ca tonuovo wor d a Exec i Pai sr ke t utve n.

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 9 of 34

Fr on or a om boutFe u r 26,2009 t on or a br a y o boutM a c 3,201 de e nt rh 0, f nda physcin Ca tonuovo o der d a / r c ve fom va i pha m a e i lwhol s l s38 600 i a sr r e nd or e ei d r rous r c utca e aer 8, dos geunisofoxyc a t odone.
Di t i i and D i pens ne St i tcs s r buton s i ats i

32.

Durng t ope a i of Sout Fl i Pan and Am e i a Pai t ph i a i he r ton h orda i rc n n, he yscins

e o d t eor r a l as 6, 55, dos e unisofoxyc mpl ye her de ed t e t 1 020 ag t odone.

33. Durng t ope ai ofExe tve Pan,t physc a empl i he r ton cu i i he ii ns oyed t eor r a her de ed t

l s 1438, dos ge unisofoxyc ea t , 200 a t odone. 34. Fr on ora om boutJ y 7,2008t ough on ora ul hr boutM a c 2,201 a oxi a ey rh 0, ppr m t l

66,71pr s rptonswe edipe e fom Amerca Pai Oft pr s rp i fled a Ame ia 8 ec i i r s ns d r i n n. he e c itons il t rc n Pa n, pr ma ey 96per e we efle f eihero i ap oxi t l c nt r ild or t xycodoneoral az n . pr olm
35. Thepr s rpto fle at e c i i ns il d Ame ia Pai r fe tt ta oxi t y80pe c ntwe e rc n n el c ha ppr ma el re r

f i vi l who lse addr s esou sdeofFl i . or ndi dua s itd es ti orda 3 6. Oft 66, pr s rptonsfle a Am e i a Pai a oxi el 43pe c we e he 871 e c i i ld t rc n n, ppr mat y r ent r

fle f i vi al who lsedana es i Ke u ild or ndi du s it ddr s n nt cky.I vi l fom Te s e a ount f ndi dua s r nne s e cc ed or
a oxi ael 1 4 pe c an t efom Ohi ac ount d f a oxi e y 115per e . ppr m t y 8. r ent d hos r o c e or ppr matl . c nt

37.

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mo trn p o r msC ni ig r ga TDM P' whihe a l p y iin , ama it, n lc lsaea dfd rl o ' c n b e h sca s ph r css a d o a, tt n e ea )
a m i sr i and lw e or me a hortes t i ntf and ta k d ug abus s who obti d nitatve a nf ce nt ut ii o de iy rc r er an muli epr crptonswihi at rp da pe i A PDM P i asa e a nit r daa c l c i tpl es i i t n hit y rod. s t t - dmi se ed t ole ton s t m us d t ga he pr crpton i or a i Suc daa s sa ss i pr ntng dnz a e s yse e o t r es i i nf m ton. h tba e s it n eve i g bus r fom ob ani pr c i i fom m uli ephysc a . ThePDM P' a e us d by saest a r s r t i ng es rptons r tpl ii ns S r e t t o dd es pr s rpton dr g a e,di r i a ad ci e ci i u bus ve son nd diton. The PDM P' f ciiae a e S a lt t nd ncourge t a he
9

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 10 of 34

ientfc to i e v i a team e ofpe s a c e t pr c i i d ii a in,ntr enton nd r t nt r ons ddit d o es rptondr , nde bl sae ugs a na e t ts t e t bls publchea t i tai est ough t i ii a i ofus an a ete .Durng t o sa ih i lh nii tv hr he dentfc ton e d bus r nds i he
tmepe i s tf rhi t i t Se i rod e o t n he nsant condSu redi I ct ntt rp fvesat hadope a i l pe s ng ndi me , hit i t es r tona
PDM PS.

38.

Durng t tm epe i s tf t i t Se i he i rod e orh n he cond Supe s ng I ct e , ordahad redi ndi m nt Fl i

no a tveope a i PDM P. ci r tonal

Rol a Re ponsbiii sofDe endantPhysc ansand es nd s i lte f ii Co Cons r orPhysc ans pi at ii 39. Def ntphysci Ca a Casr enda i ans det nd tonuovo,t ough t i empl hr her oymenta t t he

clni ,woul pr c i l r quan iisofc r l s t nc st i vi l , t algii t i cs d es rbe a ge tte ontoled ubs a e o ndi dua s wihout e tma e
me c pu pos a ou sdet c s ofac e e me c pr c ie.De enda phys ca Ca t dial r e nd t i he oure c pt d dial a tc f nt i ins de

a Ca tonuovo ha t ri ta e pl nd sr d hei nii l m oyme i e e wih c c pia o s Chrsophe Pa nt ntni ws t o- ons r t r i t r ul Ge ge a / Et n Ba or nd or ha umhof Neihe Chrsophe PaulGeo georEt Ba f t r it r r han umhof ha pro f d ir lgii ee re eowni mana nga s r sngm e c ofi es butwe ei f t i rl e tmat xpe inc ng, gi nd upe vii dial fc , r n ac prma iy i er t di t a nt ese n he mounta t peofc r ld s t e t physcinswer wilngt pr s rbe. nd y ontole ubsanc s he ia e li o e c i
Onc hie t e r d,hephy i i woul t ha s cans d t dow'ot rco r pt s ' he r u physci e o a t c i c i or r i ans mpl yed t he lni s n de t be o comef m ii rwih t e m i ton a pr c i ng pr c ies Thede enda p i insa a la t he xa na i nd es rbi a tc . f nt hysca nd

co- piaorphysca ( enafe rfre t a thephysca ' woul fi t i e nta cons rt iins heri tr eerd o s t t iins' ) d al o mplme
teamen pl n whih woul pa tc a ie a va y t te t ntg ve t i vi l ba e upon r t t a c d ri ulrz nd r he r a me i n o ndi dua s s d

t i co ton, f nctona iy a goa s a i ta woul pr c i a sa r S k ai' of her ndii u i lt nd l, nd nse d d es rbe t nda d t t l' coc con r ld s t e i vi aton ofac e e m e ca pr c iei o dert ge r t a m uc i tole ubsanc s n ol i c pt d di l a tc n r o ne ae s h ncome
aspos i e Thephyscinswoul pr tc me cneou sdet s opeoft i educ ton,tani sbl . ia d ac ie dii t i he c her a i r i ng, e renc a e rie. xpe i e nd xpe ts Thephyscansc pie wihot r cons r t st haveurnet t an i i ons r d t he co- piaor o i ess d

1 0

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 11 of 34

M Rl condu e prort e s ctd i o xami ton ofi vi si or oc e et a a anc t t hedoct s nai ndi dual n dert r at he ppe r e ha t or
wer e agi i l ii t m edial a tc i a a tmptt i ult t physcansfom s r i e ng ng n eg tma e c pr c ie,n n te o ns ae he i i r c utny

b lw e f re n a d ohe a e ce . Su h dig o tctss we e is fiin t j siy te y a n o c me t n t r g n is c a n si e t r n u fce t o u tf h

pr c i i oflr qua ii ofc r l d s t nce .Thephysc a woul ag e t bepa dpe es rpton a ge nttes ontole ubsa s ii ns d re o i r

i vi e m i di o de oma m iet i om pe ai Thephysc a woul a e t obt i ndi dual xa ne n r rt xi z herc ns ton. i i ns d gr e o an c r ld s t e fom m uli ephar a utc lwhol s e s byus oft i DEA numbe s i ontole ubsanc s r tpl m ce i a e alr , e he r r ,n
or rt mai ai a quaei nt re f dipe i fom t ci cs Thephys ca we eawa e de o nt n de t nve o is or s nsng r he lni . i ins r r

t tt i nt i sofc r l ds bsa e or r da m ant i unde herDEA n ha he nve ore ontole u t nc s de e nd i aned rt i umbe swe e r r
ia d ai o t m ne he ccla y ny m iha e b ci c e oye . The physcinswoul f lt deer i t a tr c ofa s ndld y lni mpl es i nt i a o i pe i oft rs y ofc r l s t nc s Thephyscinswe ea r nve ores nd/ r ns ctons hei uppl ontoled ubsa e . ia r wa e

t ts isofc r l s tnce we eta f redbe wee physcins i nt i wihoutt ha upple ontoled ubsa s r r nse r t n i a ' nve ores t he r q r d DEA f m s The physcins woul ag ee t be pad i c h, wihout s e uie or . ia d r o i n as t uppori tng do cume ai i r t n f mai ai ng i nt isofc r l s tnc a t c i cs The nt ton, n e ur or nt ni nve ore ontoled ubsa es t he lni . ph iinswo da r et m a ma e il se e e a i t pha ma utc whol alr r r ng ysca ul g e o ke t ra mir pr s nt tons o r ce ial es e s ega di t tue pe c nt of i vi s fom outi t St e o Fl i who ha be n pr s rbe he r r e age ndi dual r sde he at f orda d e ec i d
c r ld s t ce a t t eper e ageofpr c i i whi h we ef ontole s t nc , ontole ubsan s nd he nz c nt es rptons c r orc r ld ubsa es i o dert e ur t c i d s pm e by phar ce i a whol alr of lr qua ii of n r o ns e he ontnue hi nt ma utc l es e s a ge nttes

co r ld s t ce t t c i cs Thephysc a woul c ntole ubsan s o he lni . ii ns d onduc bre physc e t if ial xami tonsof na i
i vi al s e ng contoled s tnc i or t exa i as m an i vi s perda a ndi du s e ki r l ubsa es n der o m ne y ndi dual y s pos i e a t make i a a t tt y we e pr tcng l gii ae m e ci The physca sbl nd o t ppe r ha he r aci i e tm t di ne. i ins

e ly d a Ameia Pan a dEx c tv P i we ea r t tte mao iy o t idviu l mpo e t rc n i n e u ie an r wae ha h j rt f he n i d as

s e ng c r l d s t nce w e e not r s de s of Fl i and ha t a l d i e es of one e ki ontole ubs a s r e i nt or da d r ve e n xc s

t an m ie t o a n c tole s t nce . De e n physcin Ca tonuo a t c hous d l s o bt i on r l d ubsa s f nda t ia sr vo nd he o11

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 12 of 34

c piaorphysc a e oye a Exe utvePa nwe ea r t m a oft i vi l s eki ons r t ii ns mpl d t c i i r wa e hat ny he ndi dua s e ng co r l s t es pr vi l ha be n r f ed s r ce a dic ge fom Am e i n Pan ntoled ubsanc e ousy d e e us e vi nd s har d r rca i

be a et yex bie i r venoustac m a ksa d s r a ot r as , nd hadbe r ere c us he hi t d nta r k r n ca s nd her e ons a en ef r d

t Exe i Pai by c c piaor ,i udi c c piaorDe i N oln. o cutve n o- ons r t s ncl ng o- ons r t rk a

40.

Urne s mpl m ant i d f a l i we e ofe t nt d orf sfe t pr d i a es i ane or nayss r tn ai e alii d o ovi e

i c ur t r s t a we eanayz byclni pe s lwho wer notquai d t pe f m s h a na c a e e uls nd r l ed i c r onne e le o ror uc

f ton.Thephysc a woul a eet r fa nfo a tonals si a e urnaysst t whih unc i ii ns d gr o e r i r m ddii , ophitc t d i l i ess c

wo d mor a cur t y r fec prordr us e. The physcans woul utlz medialf ms ul e c ael e l t i ug ag ii d ii e c or pr de a c e t dbyc cons r t s i l ngc c pia or Chrsophe a J fr yGeor , ovi d nd r a e o- piaor ,ncudi o- ons r t s it r nd e fe ge
t make i a a t t y we e e ge i t l gii e pr c ie ofm e ci The physcins o t ppe r hat he r nga d n he e tmat a tc di ne. ia

woul r r i fom c d efan r onduc i i nt i soft c tole s t nc or r d a ma nti d a tng nve ore he on r l d ubsa es de e nd i a ne t t ci c unde t rDEA num be s.Thephyscanswoul r fan fom c he lni s r hei r ii d e r i r omm uni tngwih p i ca i t ror te tng ph i a a o s i it i or rt e rai yscins nd/ r pecals s n de o xpediet e t he xami tons nai .Thephysc a woul i i ns d notr r t pr ton ofprorte t tr cor ofi vi ss ki c r l d s t nc equie he oduc i i r a men e ds ndi dual ee ng ontole ubsa es pro t t is nc ofpr s i i f c r l s t nce . Thephysc a woul a r et us i r o he s ua e e crptons or ontoled ubsa s ii ns d ge o e asn t pr pa epr crptonsf c r l d s t nc . Thes sa pswoul ha pr - i ed t mp o e r es i i or ontole ubsa es e tm d ve e prnt qua ii a sr ng hsofc r l s bsa es Thephysc a woul r r i fom i vi ualz d nttes nd te t ontoled u t nc . ii ns d efan r ndi d i e a pariul rze te t ntpl nsi o dert e die e m i i a t ilgaldipe i of nd tc a i d r a me a n r o xpe t xa natons nd he le s nsng
c tole s t es Def nda physc a Ca tonuovo a t c c pia or physc a on r l d ubsanc . e nt i i n sr nd he o- ons r t ii ns

e oye a Exe utvePai woul oc sona l r duc t qua iyofoxycodonepil pr s rbed mpl d t c i n d ca i ly e e he ntt ls e c i
t i vi l i a a tm ptt a d lw e or men a ad i sr tve s r tn Thephysca o ndi dua s n n te o voi a nf ce t nd m nita i c u i y. i ins

wo dnot e r t pr tonoforgi l RI X-a CT s a fl sand/ ot rdi ul r quie he oduc i i na M , r y, c n im or he agnosi t s tc ool a i t a woul r l on M RI r ol it r t i o der t e nd nse d d ey adi og s epors n r o xpedie t e t he xami ton of na i
1 2

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 13 of 34

i vi uas. The physca wo d,a tm e ,r l on pr lm i r r ol s r pors i t r ndi d l i ins ul t i s ey e i na y adi ogit e t n hei pr s rbi oflr equa iisofc r ld s tnc .Thephyscinswoul t m i ma ,fa e c i ng a g ntte ontole ubsa es ia d ake ni l i ny,
se t de e mi i t compl i ofal edpai c r l t d wih t M R.r por.The p ii ns t ps o t r ne f he ant leg n ore a e t he Ie t hysc a

wo df i t unde tkem e ni ulaci t e ul a l o ra a ngf ton o xnmi , a eortea t underyi c us oft ne di gnos r t he l ng a e he

alg d p i.Th p y iins u d rto ta t e mao iy o id vd as s e i c n r le l e an e h sca n e so d h t h j rt f n i iu l e kng o told e

s b tn e wo dalg c mplit o n c o b c p i Th mao iy o s h idiiu l h d u sa c s ul l e o an s f e k r a k an. e j rt f uc n vd as a e

ta e i e es ofonet and mie fom Te r veld n xc s hous ls r nnes e Ke uc Ohi a es whe ea pad s e, nt ky, o nd le r nd i

lre s a g ums of ca h f exn i ton,M RI , a d t pur ha e of c r l d s t e . The s or m na i s n he c s ontole ubsanc s physc a woul r f an fom ca e u l r vi wi t a lge medialfl s pera ni t s h i i ns d er i r r f ly e e ng he le d c ie ti ng o uc i vi al i or t a c ran i onsse e i t i o ma i pr de b s hi vi l .The ndi du s n der o s e ti nc itncis n he nf r ton ovi d y uc ndi dua s p ii ns woul r r i f om pr c i ng at r tve te t nt m oda ii , i l ng a i hysc a d efan r es rbi le na i r a me ltes nc udi nti l mma or me ca i , nfa t y di tons TEN Sunis physc lt r y, cl r l xa s l dos sofc tole t, ia he ap mus e e a nt ,ow e on r ld

s t c a o i e e i pai r a me pr dm es Thei vi l obt i ng c r le ubs> es nd/ r nt N ntonal nm ge nt oce . ndi dua s ani onto ld s tnce s htt 30 m g oxyc ubsa s oug he odone pil be us s pil coul be di td,il ly s d ls ca e uch ls d vere legal ol a orunlwf l co um e Thephyscinswoul r fai fom a ec a yr i t qua iy nd/ a uly ns d. ia d e r n r ppr i bl educ ng he ntt a sr t ofo odonepil pr c i d t i vi s The ph i i woul a r et r r n nd tengh xyc ls es rbe o ndi dual . yscans d g e o efai
fom a tmptng t we n i vi sof ofhi dos ge ofc r l s t esa orr f s h r te i o a ndi dual f gh a s ontoled ubsanc nd/ e er uc

i vi st lce edde oxii a i f iiisa me a he lh a c i e t .Thephysc a ndi dual o i ns t fc ton aclte nd nt l at dditon xpers ii ns

wo dr fan fo sg iia tya j sigt ed u te a yt t i dvd l dia n e o te ul e ri rm in fc nl d u tn h r g h r p o he n iiua me c l e ds f h

i vi l The physcinswoul r quie i vi ual t be e m i d e r 28 da i or rt ndi duas. ia d e r ndi d s o xa ne ve y ys n de o
g ne at pr ee f t m s vesa t c i cs Durngt i ta oper tonofAm e i a Pa n,he e r t oc ds or he el nd he lni . i he nii l a i rc n i t physcins woul r r i fom r vi ng a i ta i pr s i i . The physcins woul ia d efan r e ewi nd niilng e crptons ia d pr s rbe c r l d s bsa st empl s oft de e e c i ontole u t nce o oyee he f ndantclni s wihoutt s owi ofa i c t he h ng 1 3

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 14 of 34

me c ne es iy. Suc empl eswe e wor ng on a dal bassi t de e ntclni an dial c st h oye r ki iy i n he f nda i cs d
e bii no sgnsofpai Thephysc a woul pr c i m i m a quan ii ofme c tonot r xhi tng i n. ii ns d es rbe ni l ttes di a i he t n c r l d s t nce ,s h a bl pr s e a a i otcs i or t ma i a ha ontole ubsa s uc s ood es ur nd ntbi i , n der o ke t ppea t t r ha t y we e e he r ngag d i a l ii ae pr c i e ofm e c ne a t e ur t c tnued s y of e n egtm t a tc dii nd o ns e he on i uppl

c r l d s t nc fom pha m a e ials ir Co- ons r t Chrsophe Pa Ge ge ontole ubsa es r r c utc upple s. c pia or it r ul or wo d r viw t team e r c ds i or r t monior t a ul e e he r t nt e or n de o t he mount of c r l d s t ce ontole ubsan s pr s rbe M a ge s a clni empl esofAm e i n Pai a Exe utve Pai we e finds e c i d. na r nd i c oye rca n nd c i n r re ,
f m iy me be s a o a s a e ofc co piat Chrsophe Pa Ge g who ha no pror a l m r nd/ r s ocit s o- ns r or it r ul or e d i ii d gr o r nse r d mong a nd e renc o r tng medialclni . The physcanswoul a eet be ta fr e a xpe i e pe a i c i cs bewe nt de e ntc i csbyc c pia orChrsophe Pa Geo g a ot rc cons r t s t e he f nda lni o- ons r t it r ul r e nd he o- piaor .

Co- ons r t s who dipe ed c r ld s t nc i t clni s woul be fi nds a or c piaor s ns ontole ubsa es n he i c d re nd/
as oca e of c c pia or Chrsophe Pa Geo g who di not have a m e c or s it s o- ons r t it r ul re d ny dial pha m a e ialr ni ore ince. physcanswe ea r t thei vi l pr pa i a r c utc tai ng xpere The ii r wa e ha t ndi dua s e rng nd

dipe i c r ld s tnc we e ofe comm itng ero si t pr pa a i ofpr c i i n s nsng ontole ubsa es r tn ti r r n he e r ton es rpto
botl s te . COUNT I TheGe a A leg tonss c i oft sSec Supe s ngI cm e i r - le d ner l l a i e ton hi ond r edi ndi t nt s e a lge

a expr s l i nd e sy ncom or t d he ei asi s tf t i f l a e r n f e orh n ul.

Fr m i orabout2007 t on ora o n o boutM a c 3,201 i t Sou he n Dititof rh 0, n he t r src Flrdaa elewher t defnda s o i nd s e,he e nt ,

CYNTHI CADEX M . a A D. nd
JOSEPH CASTRO NUOVO , . , M D.

14

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 15 of 34

asr ita t a horz d t dipe e c tole s tnce knowi y and wilu l c eg sr n s ut i e o s ns on r ld ubsa s, ngl lf ly ombi d, ne
c ns r c e r t a ag ee wihoneano he a wihot rpe s knowna unknown o pied, onf de a ed, nd r d, t t r nd t he r ons nd t t Gr nd J r t diti e,dipens a pos es wih i e t diti e a dipe e a o he a u y, o srbut s e, nd s s t nt nt o srbut nd s ns , qua iyofoxyc ntt odone, Sche e1 na c i c r l s t e, sdet s opeofpr es i l a dul 1 r otc ontoled ubsanc out i he c of sona pr c ie a notf a lgii a e medialpum os i vi a i ofTil 21,Unie St t s Code a tc nd or e tm t c e, n olton te td ae ,

S cin8 ()1. e to 41a( )

M anner a M eans oft C ons rac nd he pi y

l nora bout zoo7, o- ons r t swoul esa iht il l nm a ge e c i c, c c pia or d t bls he lega pai na m nt lni

So hFl i Pa n, s dupona cer c vedfom aco z tp iin.Thec cons r t swoul ut orda i ba e dvi e ei r m p hysca o- piaor d
t r afe sa ihAm e i nPanwhihwoul best t d a s r ll a i i Br r a Pam he e tre t bls rca i c d iuae t eve a oc tons n owa d nd l
Be c c tes a h oun i . 4.

Co- pia or woul s i tphyscinst ough t us ofa ts m e spl c d cons r t s d olci i a hr he e dverie nt a e

o Cr gsita i ne pa r . n ai ls nd n ws pe s
5.

I or a n bout Dec m be 2008,de enda physc a Ca t was e pl d by coe r f nt ii n de m oye

c pi a or a A m e i n Pa n. ons r t s t rca i

6.

I ora n bout2009, o- ons r or woul esa ihExe utvePai i anefor t r t n c c piat s d t bls c i nn f to eai

t ei vi ss e ngc r l d s t nce whowoul bedic r d fom Amerc Pan due hos ndi dual e ki ontole ubsa s d s ha ge r ian i t m a ksan ors r fom i r nousdr us e a ot rr a ons o r d/ ca s r ntave ug ag nd he e s . Onc i vi l woul be dic r e f o Am e i n Pai f i r nous d ug e ndi duas d s ha g d r m rca n or ntave r
us georot rr a ons c cons r t swoul diec t t Exe i Pan. a he e s , o- piaor d r t hem o cutve i 8. Exe utvePai woul beo c i n d wnedbyac c pia o , o- ons r t r who wa pr ousy c vit s evi l on ced

ofaf onyofe er a e t c r ld s tnc andt r or pr bied fom ha ng a c st el f ns elt d o ontole ubsa es he ef e ohi t r vi c es o

15

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 16 of 34

c r ld s t e a plce i t na ofaco- ons r t i o dert conc lhi o r hi ontole ubsanc s, nd a d n he me c pia or n r o ea s wne s p
i e es . nt r t

l ora n bout Febr r 2009, e ntphysca Casr ua y def nda i in tonuovowoul bee oy by d mpl ed c c piaor t wor a Exe utvePan. o- ons r t s o k t c i i

1 0.

l taly, f ntphyscin Casr uo woul bediec e by c c pia or t nii l de enda ia ton vo d r td o- ons r t s o

obs r de e nt ysca Ca t tAm e i npai nor rt be e ve f nda ph i in de a rca ni dt o comtf mii rwiht pr s rbi n la t he e c i ng pr c i soft c piac a tce he ons r y.
l1 . Co- ons r t swhoha no me c e aton,r i ng, e incewoul c eae c piaor d di al duc i ta ni or xpere d r t

medialf m st beus by t physc a i o de t gi t a a a ofl tm a emedial c or o ed he ii ns n r r o ve he ppe r nce egii t c

pr c i e. a tc

1 2.

Co- ons r or woul r us t a e i ur nc a apa ntm ehod a woul c piat s d ef e o cc pt ns a e s yme t nd d

ag e t a c ptonl c h or c e tc r aspa re o c e y as r di a ds ymen f e m i ton b t physc a a t t or xa na i y he ii ns nd he is nc ofpr crptons i or rt a d pot i l1 w e or e e and admi sr tve s r tny. s ua e es i i , n de o voi enta a nf c m nt nita i c u i
Co- ons r or wo d r quiei vi ss eki c r l s t nce t pr e c piat s ul e r ndi dual e ng ontoled ubsa s o es nt
M l lr pors l s t n t o ye r o1 i a a t m p t i ul t t c c pi a or a t m a t t e t e s ha w a s d n n te t o ns a e he o- ons r t s nd o ke he

c i c a physca a arlgii ae. lnis nd i ins ppe e tm t

Co- pia or e oye a t c i c woul pr de i vi swih e t rpr cons r t s mpl d t he lni s d ovi ndi dual t ihe esgne pr s rptonsf M Rl orc r dieci t i vi st a M RIf iiy wiho ha ng i d e c i i or s a ds r tng he ndi dual o n ac lt t ut vi
s h i vi l fr tc e wih t ph i ans uc ndi dua s is onf r t he ysci .

1 5.

Co- ons r t se oy da t ci cswoul i r of hei vi l whe he s h c pia or mpl e t he lni d nquie t ndi duas t r uc

i vi sr ndi dual eque t d prm arl nec orba k M r s s e i iy k c .

16

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 17 of 34

Co- ons r t se pl d a t clni s woul r f r i vi s t n c piaor m oye t he i c d e e ndi dual o, mong ot r he

f c lte , mobieM RIf c lt whi woul r m an ope afe mi ghti or rt ac m modae a iii s a l a iiy ch d e i n tr dni n de o co t i vi l s ki contole s t e . ndi duas ee ng r ld ubsanc s

Co- ons r or woul r r t ti vi spr deaurnes mpl i or rt t c piat s d equie ha ndi dual ovi i n e n de ha a u i l i be c rnayss onduc e prort e mi tonby aphysc a Theurna ysswoul beconduce t d i o xa nai ii n. i l i d td i o d t ma i a a t tt a tvii oft clni a t physcinswe epr pe a i a n r er o ke t ppe r ha he c i tes he i c nd he ia r o r nd n n
at tempt oma t pr c i i ofcontole s tnce a t ke he es rpton r l d ubsa s ppea t bel tma e.Theurnes m pl r o egii t i a e woul be p ovi d by i vi swihouts r i i ormoniorng. d r de ndi dual t upe v son t i

1 8.

Co- pia or woul ilgaly s i ti vi l fom outi t St eofFl i cons r t s d le l olci ndi duas r sde he at orda

t oughr c uier , hr e r t s who wo d r f rlr numbe sofi vi l fom Te s ee, nt ky, o, ul e e a ge r ndi dua s r nne s Ke uc Ohi W es Vig ni a es whe e t r i a, nd le r .

1 9.

Thephysc a woul r r i fom a e abl r duci t qua iya sr ngt of ii ns d efan r ppr ci y e ng he ntt nd te h

o odonepil pr c i d t i vi l . Thephyscanswoul ag eet r fai fom at mptng xyc ls es rbe o ndi dua s ii d r o er n r te i

t we i vi l of ofhi dos sofc r ld s t ce and/ r f rs h i vi al t o an ndi duas f gh age ontole ubsan s or e e uc ndi du s o lce eddeoxii tonf ciiisan mentlhe t a cto e rs Thephyscanswoul r r n i ns t fcai a lte d a alh ddi i n xpe t. ii d efai

fo sg i c nl a j si t ed u te a yt teidviu l d c l e d of h i dvd as r m inf a t d u tng h r g h rp o h n i d a me ia n e s t e n iiu l. i y

20. Thephyscinsdic s a a e edt tc c piaorChrsophe Paul or ia s us ed nd cc pt ha o- ons r t it r Ge ge

woul r vi t te t ntr c ds i or r t m onio t a d e ew he r a me e or n de o t r he mount of contole s t nce r ld ubsa s

pr c i ed. es rb
2l.

The physci woul r r i fom pr c i ng ale nai te t nt moda ii s i ans d efan r es rbi tr tve r a me lte ,

i l nga ii l m m a or m e ca i , nc udi nt-nta t y di tons TEN S unis phys c t r py, us l r l nt , o dos s t, i al he a m c e e axa s l w e

ofc r l s t es and/ i eventonalpai ma eme pr edur s. ontoled ubsanc , or ntl i n nag nt oc e

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 18 of 34

22.

Co- ons r t swoul a e t compe a et physca pe i vi e m i d c pia or d gr e o ns t he i ins r ndi dual xa ne

i or t i et physcinst i ppr i tl exa i asm a i vi sa pos i e. n der o nduc he i a o na opraey m ne ny ndi dual s sbl The physcanswoul peror am i ma a cur o yphysc e ii d f m ni l nd s r i al xami ton oft na i he

i vi l i a at m p t i ult t c c pia or a ma t rac i tesa ndi duas n n te t o ns a e he o- ons r t s nd ke hei tvii ppea lgii t . r e tma e Thephyscinswoul ag eet e m i e h i vi f t m i m a amountof ia d r o xa ne ac ndi dual or he ni l

tm e i or rt e i t lr es num be ofi vi l e c da a t ge r t t lr t i n de o xam ne he a g t r ndi duas a h y nd o ne a e he a ges

a mountofc i na pr ee f t rmi l oc ds or hems l a t ot rme be soft c pia y. eves nd he he m r he ons r c Thephyscans i or rt e mi t ma mum num be ofi vi uasonadaiy i i , n de o xa ne he xi r ndi d l l bass woul r r i fom communia i wih s ilss prorte i physcinsorat r tve i, d efan r c tng t peca it , i r atng ia le na i
m e c pr de s dial ovi r . 26. The physc a woul no r uie t pr ton oforgi lM RI X-a CT s an ii ns d t eq r he oduc i i na , r y, c

tl sa orot di im nd/ her agnosi t s a i tad wo d r y on M llr di ogitr porsi or rt tc ool, nd nse ul el t a ol s e t n de o e die t exa na i ofi vi l The ph i a woul a tmes r l on pr lmi y xpe t he mi ton ndi duas. yscins d, t i , e y ei nar r ol s r porsi t rpr s rbi ofl g qua ii sofco r ld s t es adi ogit e t n hei e c i ng ar e ntte ntole ubsanc .

27.

Co- ons r t swoul die ti vi l t t dipensng f c lte l t d wihi c pia or d r c ndi dua s o he s i a iii s ocae t n

t clni sort pha m a e owne a contole b co- ons r t s i or rt g r t c i i l he i c he r cis d nd r ld y c pia or ,n de o ene a e rm na
pr e a i a at m p t a d g r nts r tny. oc eds nd n n te t o voi ove nme c u i 28. The physcans woul us pr pa ed sn ps t c e t pr s rptons f c r ld ii d e e r tm o rae e ci i or ontole

s t nc .The esa woul ls t s m ea ountofco r l d s t nc f ea i vi l ubsa es s t mps d it he a m ntole ubsa es or ch ndi dua . 29. Co- ons rt swoul d srbut c r a ti sont sr e nda ho el fe c pia or d iti e a ds nd ler he te ta t t s r quen e td

by i vi uas fom outi t St t of Flrda i or r t a rie t clni s and t s ii ndi d l r sde he a e o i n de o dve ts he i c o olct i vi l fom out i t Stt ofFl i . ndi dua s r sde he a e orda

18

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 19 of 34

Co- ons r t swoul ma c h pa e sofa oxi t y $1000pe mont t c pia or d ke as ym nt ppr ma el , r ho

t physc a e pl d a Ame ia Pa n a Exe utve Pan i r ur f t r ma n a ni he ii ns m oye t rc n i nd c i i n et n or hei i t i ng

i nt isofc tole s tnc a t f iiy. nve ore on r ld ubsa es t he aclt

Thephysca woul e cut powe - - tom e f r salowi co- ons r t st i ins d xe e rofa t y o m l ng c piaor o

o de ndobt nc r l s t esfom pha mac utc whol aer bym e nsof hephysc a ' r ra ai ontoled ubsanc r r e ial es l s a t ii ns
DEA r gita i num be s e sr ton r. 32. De e nt f nda physcinsCa ta Casr ia de nd tonuovoa ot rc c pia or woul or e nd he o- ons r t s d dr

q n iisofnon- ontoled s tnc fom pha ma utc ls i r t bedipe e fom t ua tte c r l ubsa es r r ce i a upple s o s ns d r he

ci c BocaDr gs a Quikpham l ,na atmptoa dl e oreme s rtn a ma lnis, u , nd c r nc.i n te t voi aw nf c nt cuiy nd ke
s h e ii a uc nttes ppea t b l gii a e. r o e e tm t

33.

Co- ons r or we e a r t i vi ss e ng contoled s t e woul c piat s r wa e hat ndi dual e ki r l ubsanc s d

brng urne s m pl obt i fom ot peronsi c a ne sand/ c i i a es aned r her s n ont i r or ondomsi or t pr de n der o ovi s h urne f urnal i . Such a i t wa c uc i or i yss ctviy s ondu e t conc alt ilgaldr us of t ctd o e he le ug e he

i vi l s ki c r l s tnc and t pr de fa entr ulson t urnal i t ss ndi duas ee ng ontoled ubsa es o ovi r udul es t he i yss e t . 3 4. Co- ons r t swoul dic st de t ofi vi al whoha obt i co r l d c pia or d s us he a hs ndi du s d aned ntole

s bsa sfom t physcansatpai c i csowne a orc r ld by c c piat s u tnce r he ii n lni d nd/ ontole o- ons r or .

3 . Id vd as wh s u iay i r te td maiu n u e wo l b p r te t b 5 n i iu l o e rn l ss el ce r a a s ud e e mitd o e j

e xami d byac i cphysc a Theu i s ne lni ii n. rne nmpl tke at es a n Amerc Pai woul bem ant i di ian n d i ane n
ata on t too oft c i c. I vi l whos urnal i r s t r fe t dcocaneus gewoul r y he l r he lni ndi dua s e i yss e uls e l c e i a d b i tuce t l vet clni a r ur f te mentwihi onet t we ks e nsr td o ea he i c nd et n or r at t n o wo e . 36. Co- pia or who ha no tani ore re e i t dipe i ofc r ld cons r t s d r i ng xpe inc n he s nsng ontole

s tnce woul a ti t c pact of pha m a y tchni a a woul fe nty dipe es h ubsa s d c n he a iy r c e cins nd d r que l s ns uc
c r l d s t nc att clni . ontole ubs a es he i cs 1 9

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 20 of 34

Co- ons r t swho woul dipe ec r l s t nce a t clni swo dtke c piaor d s ns ontoled ubsa s t he i c ul a c r ld s t e fom one physcan' i ontole ubsanc s r ii s nvent y i or rt c r a s tge i a t r or n de o ove hora n no he physc a si nt y wihoute c i t doc e aton a r quied by DEA r ultonsa ii n' nve or t xe utng he um nt i s e r eg ai nd
f de a l w. e rl a

38.

Co- ons r t sa Am t i a Panclni woul a c pt s g a uii sfom i vi al c piaor t rc n i i c d c e ca h r t te r ndi du s

i or rt e n de o xpedie s h i vi uas me tng wih t physcans Thes co- ons r t swo d t uc ndi d l e i t he ii . e c pia or ul
obt n t a ofdola spe we k i il ga g a uiis ai hous nds l r r e n le l r t te .

39.

Va i e oye sof hec i c owne a or a e rous mpl e t lni s d nd/ oper t dbyt co- ons r t r woul he c pia o s d

be e m i d by t physci ns i udi de e ntphysca Ca ta Ca tonuovo,a be xn ne he i a , ncl ng f nda i ins de nd sr nd

pr s rbe lr n o sofc r l ds t nc wihoutt s e c i d a ge m unt ontole ubsa es t he howi ofamedi l es iy.Suc ng ca nec st h c c piaor woul il ly s la diti et c r ld s t es o- ons r t s d lega l el nd srbut he ontole ubsanc . 40. Physcins e pl d at t clni s i l di de e n physcins Ca t a i a m oye he i c , nc u ng f nda t ia de nd

Casr tonuovo,c ompetd f a c st d olo - viis'be a e s h e ms c d be c e or c es o t l w up st' c us uc xa f oul ompltd ee mor quikl t i ta viisa t r f em or i vi sc d be e m i ona dal ba i. e c y han niil st nd he e or e ndi dual oul xa ned iy ss
41. Physcans dtrngt i ta pe i of hec piac woul f i t i pe a i ta i i , li he niil rod t ons r y, d al o ns ct nd niil

t pr c i i is d t i vi ss e ng c r l s t e he es rptons sue o ndi dual e ki ontoled ubsanc s. 42. Physcins durng t i ta perod of t c piac woul f i t i pe t i a , i he nii l i he ons r y, d a l o ns c

pr c i ton botl prort t dipe i ofs h botl . es rp i tes i o he s nsng uc tes l vi l whopr s n e a Ame i a Pa nci cwihobvi m a ksa s a sfom ndi duas e e td t rc n i lni t ous r nd c r r
i r ve nta nousdr gus woul ber f redt Exe utvePan ci cbyac c pia o ,obepr c i d u e d eer o c i i lni o- ons r t r t es rbe c r lds t nc byt c c pia orphyscins i l ngdef nda physc a Casr ontole ubsa es he o- ons r t i a ,ncudi e nt ii n tonuovo.

20

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 21 of 34

44.

De e ntphy i a Ca tonuovo ag ee t sgn a r is pr crptons f r f nda scin sr r d o i nd e-s ue es i i o

c r ld s t ce whi ha be pr ousy is d by co- ons r or physcans durng ontole ubsan s ch d en evi l s ue c piat ii i defndan p i a Casr e t hyscin tonuovo' a e e fo Exec i Pan. s bs nc r m utve i

45.

Co- ons r or a Am e i n Pai wo d m ant i c h ge r t d t ough t c piat s t rca n ul i an as ne a e hr he

diti i n a dipe i ofco r l d s tnce i ta h ba i t ci cs Suc ta h ba srbuto nd s nsng ntole ubsa s n r s gs n he lni . h r s gs

fledwih c s woul t bede ie atva i fna i li tt i . il t ah d hen postd rous i nc a nsiutons

46. Co- pia or woul mai ai an i cons r t s d nt n nvent y of Fl i De rt e of He 1h or orda pa m nt at

c ompl nt fl ag ns de enda physcansCa ta Ca tonuovo a t ot rc c pia o ai s ied ai t f nt ii de nd sr nd he he o- ons r t r

ph i a .Co- pia or woul r t i anatom eyt r pr s n de e ntphyscanCa t ndc yscins cons r t s d e an t o e e e t f nda ii de a o-

c piaorphyscinsi a i sr tvepr ee ngsi or rt c i t il ga ope a i oft ons r t i a n dm nitai oc di n de o ontnue he le l r ton he

clni . i cs

47.

Co- ons r or woul dicus t pos i ll t t = a e ial es lrwoul c piat s d s s he sbii ha aphn c utc whol ae d

r c t n ount co r lds tnc pr de t t c c piaor i t tuenumbe out edu e he m of ntole ubsa es ovi d o he o- ons r t s f he r rof -

ofsa ei vi l who r ce ve c r l s t e wasdicl e t t whol a e . -tt ndi dua s e i d ontoled ubsanc s s os d o he es l r

48. Co- ons r or ,ncl ngc c piat c piat s i udi o- ons r orphyscans woul s sm a ngm ae il ii , ddicus ki tra

mir pr s nt i t apha m a eu i ls irr r ngt pe ce ageofm e c tonspr c i ed s e e e atons o r c tca upple ega di he r nt dia i es rb whih we e c r l s t ce a t per ent e ofi vi s beng pr de c r l d c r ontoled ubsan s nd he c ag ndi dual i ovi d ontole
s tnc swho r i d out i t St t ofFlrda. ubsa e esde sde he a e oi 49. Def nda physc a Ca t a Casr e nt ii ns de nd tonuovo woul sgn f r s s d i om ent t o

pha c utc s i swhi h c aned f le satm e sr ga di outofsa ei vi swho nna e ial uppler c ont i a s t e nt e r ng - -t t ndi dual
ha r e ved c r l d s t nc . d ec i ontole ubs a es

A1 i vi atonofTil 21 Unie St e Code,Se i 846. l n ol i te , td ats cton

21

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 22 of 34

COUNT Z The Ge r lAleg i s ton,a t M a r a M ea oft Co piac ne a l atons eci nd he nne nd ns he ns r y

s tonofCount1oft sSec Supe s di l cm e , r r - l dande e syi om or td eci hi ond r e ng ndi t nt a e e alege xpr s l nc ae
he en a i s tf t i f l r i s f e orh n ul. Fr i ora ut2009 t on ora om n bo o boutM a c 3,201 i t Sout r Diti tof rh 0 n he he n src

Fl i a es whe e, hede e nt orda nd le r t f nda ,

JO SEPH CASTRO NUOVO , . , M D.

a a r sr nta horz t dipens contole s tnc s k s egita ut ied o s e r ld ubsa e , nowi y a wiluly c ngl nd lf l ombi ned, c pie c ed a e a a e d wih ot rpe s known a unkno t t Gr J y f ons r d, onf er t d nd gr e t he r ons nd wn o he and ur or
a pe s a l s 18ye r ofa t diti e,dipe e,a pos e swih i e t diti t a ron t ea t a s ge o srbut s ns nd s s t nt nt o srbu e nd

dipe e, qua iyofoxyc ne a Sc dul 1 na c i c r l s t nce, sdet s opeof s ns a ntt odo , he e 1 r otc ontoled ubsa outi he c
pr e sona pr c ie a notf a lgii em e c lpur e,t pe s unde t nt of s i l a tc nd or e tmat di a pos o r ons r we pone y r ea s ofag e.

A1 i vo ai no Tie21 Uni d S ae Co e S cins8 , 41a( )a d8 9 a . 1 n ilto f t , t tts d , e to 46 8 ()1 n 5 () l e

COUNT J On ora boutDe e be 31 2008,i t Sout r DititofFl i t def nt cm r , n he he n src orda,he enda , CYNTHI CADET, . , A M D.

ar gita a horze t dipe econ r ld s t nc ,kno ngl a i e i ly diti e e sr nt ut i d o s ns tole ubsa es wi y nd ntntona l srbutd, dipe ed, ndpos es e wihi e t diti ea dipens aqua iyofoxyc s ns a s s d t nt nt o srbut nd s e, ntt odone aSc dul , he e
1 na c i c r ld s t e, nd aquantt ofal a olm , Sc dul I co r l s t nce 1 r otc ontole ubsanc a iy pr z a a he e V ntoled ubsa , outi t s pe ofpr e sona pr c ieandnotf al tma em e ca pum os whih r ule sde he co of s i l a tc or egii t di l e, c es t d i t de t ofSt c Edwa d M as fom t us oft toxyc n he a h ay r on r he e ha odonea al a a ,n vi a i of nd pr zolm i olton

Ti e2l Un td Sae Co e Se to s8 1a( )a d8 1b ( )C) t , ie tts d , cin 4 ()l n 4 ( )1( . l

22

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 23 of 34

COUNT 4

On o a r boutJ y 1 2009,i t Sout r DititofFl i ,t de e nt ul 6, n he he n src orda he f nda ,

CYNTH I CADET,M . , A D.

a r ita ta horz t di pe e c r ld s tnce ,knowi y a i e i ly diti e eg sr n ut ied o s ns ontole ubsa s ngl nd nt ntona l srbut d, dipe e a pos e s dwihi e t diti eanddipe e, qua iyofoxycodo aSc ul s ns d, nd s s e t nt nt o srbut s ns a ntt ne, hed e

1 na c i c r ld s t nce, nd aqua iy ofapr zolm ,aSc dul I contole s t e, 1 r otc ontole ubsa a ntt la n he e V r ld ubsanc
o sdet s opeofpr es i na pr c ieand no f al gii t m e ca pum os whih r s td ut i he c of s o l a tc t or e tma e di l e, c e ule
i t de t ofAlc M a i M oor fom t us oft toxyco n he ah ie re e r he e ha donea apr z a ,i vi ai of nd l a olm n olton

Tie21 UntdS ae Co e S cins8 ( )1 a d8 ( )1( . t , ie tts d , e t 41a () n 41b ( )C) l o

COUNT S On ora boutOc obe 28, t r 2009, nt Sout n DititofFl i t de e i he her src orda,he f ndant , CYNTHI CADET,M . , A D.

ar gita ta horz t dipens c r l s t e knowi y a i e i l diti t d, e sr n ut ied o s e ontoled ubsanc s, ngl nd nt ntonaly srbu e dipe e a pos es e wihi e t diti eanddipe e, qua iyofoxycodone, Sc dul s ns d, nd s s d t nt nt o srbut s ns a ntt a he e 1 na c i c r le s t nc ou sdet s opeofpr e sona pr c i a notf al ii ae 1 r otc onto ld ubsa e, t i he c of s i l a tce nd or egtm t me ca pur e, c r s t d i t de t ofParc aM a cusfom t us oft tox done, n di l pos whi h e ule n he a h tii r r he e ha yco i

voaino Tie21 Uni d S ae Co e Se to s8 ()1 a d 8 ( ( )C) ilto f t , t tts d , cin 41a ( ) n 41b)1( . l e
COUNT 6

On orabou De embe 4,2009,i t Sout r DititofFl i t def nt t c r n he he n src orda,he enda ,

CY NTH I C AD ET,M . . A D,

ar gita aut i e t dipe e c r ld s tnc ,knowi y a i entona l diti e e sr nt horz d o s ns ontole ubsa es ngl nd nt i ly srbut d, dipe e a pos es edwih i ent oditi t anddipe e, qua iyofoxy s ns d, nd s s t nt t srbu e s ns a ntt codone, Sc ul a hed e

1 n c i c r l d s t nc out i t s o ofpr e sona pr tc and notf al gii t 1 ar otc ontole ubsa e, sde he c pe of s i l ac ie or e tmae
23

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 24 of 34

m e c pur e,whi h r ule i t deah ofSt phen Andr w W oot n fom t us oft t dial pos c es t d n he t e e e r he e ha

o y o n ,nvo ai no Tie21 Uni d S ae Co e S cins8 ()1 a d 8 ( )1( . x c do e i ilto f t , t tts d , e to 41a( ) n 41b ( )C) l e
COUNT ; On ora boutDe ember7,2009,i t Sout m DititofFl i ,t de enda , c n he he src orda he f nt
CY NT H I C A DET,M . . A D,

ar gita a horz d t dipens c r ld s tnce ,kno ngl a i en i ly diti ed, e sr nt ut i e o s e ontole ubsa s wi y nd nt tonal srbut dipe ed, ndpos e s wihi e oditi ea dipe e, qua iy ofoxyc s ns a s s ed t ntntt srbut nd s ns a ntt odone, Sc dul a he e 1 na co i c r l s t nc o sdet s 1 r tc ontoled ubsa e, ut i he copeofpr es i pr c i a notf a lgii t of sonal a tce nd or e tma e m e c pum os whi r ule i t de t of Bobby Sha Rom i fom t us of t dial e, ch es td n he a h ne ne r he e hat

o y o o e i vilto o Til 21 Untd Sae Co e S cins8 ( )1 a d 8 1b ()C) x c d n ,n oain f te , ie tts d , e to 41a ( ) n 4 ( ) 1( .

CO UNT #

On ora utDe embe 28,2009,i t Sout r DititofFl i t def nt bo c r n he he n src orda,he enda ,
CYNTH I CADET, . . A M D ,

ar ita a horze t dipens co r l s t nce ,knowi y a i entona l diti e eg sr nt ut i d o s e ntoled ubsa s ngl nd nt i ly srbutd, dipe e a pos e s dwih i e t diti eanddipe e, qua iyofoxyc s ns d, nd s s e t ntnt o srbut s ns a ntt odone, Sche e a dul 1 nacotcco r l d s tnc out i t s ope ofpr es i pr ctc a no f al ii t 1 r i ntole ubsa e, sde he c of sonal a i e nd t or eg tmae m e ca pur e,whih r uled i t de t of Da d Keih Cofm a f o t us of t t di l pos c es t n he a h vi t f nn r m he e ha

o y o o e i voainof te21 Untd Sae Co e Se to s8 ( )1 a d 8 ( ()C) x c d n ,n ilto Til , ie tts d , cin 41a ( ) n 41b)1( .
COUNT 9

On ora boutJ anua y 1 201 i t Sou he n DititofFl i t de e nt r 5, 0,n he t r src orda, he f nda ,
C Y NTH I CA D ET,M . . A D,

a r gita a horz t dipens contole s t nc ,knowi y and i e i nal diti e e sr nt ut ied o s e r ld ubsa es ngl ntnto ly srbut d,

dipe e a pos es edwihi t ntt diti eanddipe e, qua iyofoxycodone, Sc dul s ns d, nd s s t n e o srbut s ns a ntt a he e
24

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 25 of 34

1 na c i co r l s t nc out i t s ope ofpr es i pr ctc a no f al ii a e 1 r otc ntoled ubsa e, sde he c of sonal a i e nd t or egtm t
m e ca pur e,whih r s t d i t de t of Sha M i elHa pe fom t us of t t di l pos c e ule n he a h wn cha r r r he e ha

o y o o e i vo ai o Til 21 Uni d S ae Co e Se to 8 ()1 a d 8 ( )1( . x c d n ,n ilt f te , t tts d , cins 41a( ) n 41b ( )C) on e
COUN T 1 0
On orabou M a c 30, t r h 2009,i t So he n Diti tofFl i ,t de enda , n he ut r src orda he f nt

JOSEPH CASTRO NUOVO,M . , D.

ar gitan au horze t dipe e c r ld s t nc ,knowi y a i e i ly diti t d, e sr t t i d o s ns ontole ubsa es ngl nd nt ntona l srbu e

dipens d, ndpos e s d wih i en t diti ea dipe e aqua iyofoxycodone, Sc dul s e a s s e t nt t o srbut nd s ns , ntt a he e
1 na co i c r ld s t e,outi t s peofpr es i pr tcea notf a lgii t 1 r tc ontole ubsanc sde he co of sonal ac i nd or e tma e me ca pur e whi h,r s t d i t de t of Tomm y W ay Ha rs fom t us of t t di l pos c e ule n he a h ne r i r he e ha

o y o o e i v oaino Til 21 UntdS ae Co e S ci n 8 ()1 a d 8 ( )1( . x c d n ,n i lto f te , i tts d , e to s 41a( ) n 41b ( )C) e
CO U N T 11

On orabou J 29,2009,i t Sout m Diti ofFl i t de e nt t une n he he srct orda, he f nda ,

JO SEPH CASTRO NUOVO , . , M D. ar gita a horze t dipe econtole s t nc s kn ngl and i entona l diti e e sr nt ut i d o s ns r ld ubs a e , owi y nt i ly srbutd,

dipens a pos e s dwih i e t diti eanddipe e aquantt ofoxyc s ed, nd s s e t ntnt o srbut s ns , iy odone, Sc a hedul e
1 na cotc c r ld s t e,outi t s ope ofpr e sonalpr c i a notf a lgii e 1 r i ontole ubsanc sde he c of s i a tce nd or e tmat

me c lpu os whi h r uled i t de h ofM i elGr ntfom t us oft toxyc ne i di a m e, c es t n he at cha a r he e ha odo , n

vo aino Ti e21 Untd Sae Co e Se to s8 ()1 a d 8 ( )1( . ilt f t , i tts d , cin 41a( ) n 41b ( )C) o l e
COUNT 12
Fr i o a om n r boutM ay 2009 t i o a o n r boutSe e be 2009,i t So he n D i ti t pt m r n he ut r s rc

ofFl i t defnda , orda, he e nt

C Y NTH I CA D ET,M . . A D,

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 26 of 34

a r sr nt a horz d t dipe e c r l s t nce ,knowi y a wiluly c egita ut i e o s ns ontoled ubsa s ngl nd lf l ombi d, ne c pie c e r ed a a e wih o he per onsknown a unknown t t Gr nd J y,t ons r d, onf de at nd gr ed, t t r s nd o he a ur o diti e dipe e a pos es wihi entoditi ea dipe e, srbut , s ns , nd s s t nt t srbut nd s ns aqua iyofa bolcse oi , ntt na i tr ds
i udi St noz ol Oxa ol Na ol Dec noa e, nd Tesoser Cy ona e, ncl ng a ol , ndr one, ndr one a t a t t one pi t Sche e dul l1c r ld s bsa es out i t s opeofpr e sona pr tcea notf a lgii t medial l ontole u t nc , sde he c of s i l aci nd or e tma e c

p r o e i volto o Tie21 Uni dS ae Co , e to s8 ()1 a d 8 () u p s ,n i ain f t , t tts de S cin 41a( ) n 29 e . l e

A pplcabl Fe ralLaw i e de

2 .

Ti e21 UntdS ae Co e Se to 8 9e ( )sae t c n r le s b tn et a t , ie tts d , cin 2 ()1 ttd,t o to ld u sa c h t l No

i a pr s rpton dr a de e ne unde t Fed a Food,Dr a Cos e i Ac may be s e ci i ug s t nni d r he er l ug nd m tc t de i r d,ditiut d,o dipe e by me oft I e netwihou avald pr s rpton. lve e srb e r s ns d ans he ntr t t i e ci i ' '

3 .

Til 21 Uni dSae Co e Se to 8 9 e sae ta ai ai p e c i in'me n te , t tts d , cin 2 () ttd h t l ld r srpto ' a s e v

a pr s rpton is by a pr c ii r f a l tma e me c pur e i t us lc s of e c i i s ued a ttone or egii t dial pos n he ua our e

pr es i l a tc b aphysc a afe heha c of sona pr c ie y ii n tr s onduc e a las onei pe s m e ca evauaton. td te t n- r on di l l i An Sn- r on me c leva uai ' s: me c evauaton t i c i pe s i dia l ton'i $ dial l i hat s onduc e wih t pa i i t a t d t he tent n he ph ialpr s e oft pr ttone ,wiho r r t wheher pori of t e l ton a e ysc e enc he acii r t ut ega d o t tons he vaua i r

c onduced b ot he t pr es i l . t y her alh of sona s' '

M anne and M eans oft C ons r y r he pi ac

4.

Co- ons r or woul fna e,e t ih,m a c piat s d i nc sabls nage and o r t an il ga i e ne , pe a e le l ntr t

a a oi seodditiu in b sn s , A He 1h& Reuv nai nI c, c ilg lyd srb td n b l tr i srb to u ie s L c at j e to n .whih le al iti ue
a bolc se oi t cusomer wihoutfrtc na i t r ds o t s t is onduc i an i pe s exn i to a r r b tng n r on m na i n s equied y
f de a l w . e rl a

A c c pia o woul r erd e ntphysc a Ca tt ot rc cons r t sf r o- ons r t r d ef ef nda ii n de o he o- piaor o e oy e ti t il lser d diti i busne s mpl m n n he lega t oi srbuton i s .
26

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 27 of 34

Co- ons r t s woul e oyde e ntphysc a Cade t il ga l e c i lr c piaor d mpl f nda ii n t o le lypr s rbe a ge

q a tte o a a o i se od t c so r o L A He lh& Reu e ai nl . to tc n u t u n i s f n b lc tr is o u tmes f i at j v n to nc wi u o d ci h ng

a i peron e n n- s xami i a r quied byf r llw. naton s e r ede a a

Def nt enda physca Ca t iin de woul t rz andis dau ho ie s uepr crptonsf lr equan ii s es i i or a g tte ofa bolcser dswihoute t bls ngalgii aephysca pa intr a i hi a wihoutfr t na i t oi t sa ihi e tm t i in/ te eltons p nd t is c uc i a tn- r on medi le l ton' oft cusome s a wihou a lgii ae medial ond tng n s pe s i ca va uai ' he t r , nd t t e tm t c
pu os a outi t c s ofpr es i pr ctc m e nd sde he our e of sonal a ie. 8. Co- pia or woul a e t pa d e ntphyscin Ca tonet a dola s cons r t s d gr e o y ef nda ia de hous nd lr

pe we k t is pr c i i f ra bolc se oi . r e o s ue es rptons o na i tr ds

Al i vi a i ofTil 21 Unied St t sCod Sec i 846. l n olton te , t ae e, ton

COUNT 13

TheGe r l l tonss c i a t M nnne ndM ea ofheCons r cys ci ne a Alegai e ton, nd he ra ns t pia e ton ofCount1oft sSe hi cond Su r e ng I c me ,a er - le d andexpr sy i pe s di ndit nt r e a lge es l ncomor td he ei ae r n
a i s tf t i 1 1. s f e orh n 1 Be nni i ora gi ng n bout2007andco i ngt i ora tAprl201 t e ctdaes ntnui o n bou i 0, he xa t beng lnknown, n t Sout r DititofFl i a e s i l i he he n src orda nd lewher t de enda s e, he f nt , CYNTHI CADET,M . a A D. nd JOSEPH CASTRO NUOVO,M . , D.

knowi y a wiluly c ngl nd lf l ombi d,c pied,c ede a e and a e d wih e ch ot ra wih ne ons r onf r t d, gr e t a he nd t
ot rpe s known a unknownt t Gr J y, ocomm i c ra nofe e a i tt Unie he r ons nd o he and ur t t e ti f ns s gans he t d St e ,i vi l ton ofTil 18,Unie St esCode,Seci 1 ats n o a i te t d at ton 957,t ti t knowi y e gea ha s o ngl nga nd
a t m pt t e age i m one a y tans ctons by, t ough, or t a fna a i tt i a f ctng te o ng n tr r a i hr o i nci l nsiuton, f e i

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 28 of 34

i e sa eandf ei commer e,nc i nal derve pr t ofaval g ea e t n$1 000 s h ntr tt or gn c i rmi ly i d opery ue r t r ha 0, , uc
pr ry ha ng be n de i ed fom a s ii d unl ulac i t ope t vi e rv r pecfe awf tviy.

I i f t al ge t tt s c fe unl ulac i t i t diti i dipe i and t s urher le d ha he pe ii d awf tviy s he srbuton, s nsng
pos es i wih i e t diti e and dipe e,oxyc s son t ntnt o srbut s ns odone,a Sche e 1 na cotc co r l d dul 1 r i ntole s t nce out i t s ope ofpr es i pr tc a notf a l tm ae m e c lpum os ,i ubsa , sde he c of sonal aci e nd or egii t di a e n

voaino Til 21 Un td S ae Co e Se to 8 ()1. ilto f te , ie tts d , cin 41a( )

A1 i vi ai ofTil 1 UniedStt Code,Secin 1 h) 1 n olton te 8, t aes to 956( .

28

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 29 of 34

DRUG CO NSPI ACY FO RFEI R TURE ALLEGATI ONS

Th aleg tonsc ai di Cou 1oft sSe ndSu r e ngI cme ar r by e l a i ont ne n nt hi co pe s di ndi t nt ehe e

r - lge a i r ae byr f r nc f t pur eofal gi f f t r pur ua t Til 21 e ale d nd nco por td e e e e or he pos le ng oreiu es s nt o te ,
Unied St e Code,Seci 853. t ats ton Upo co c i ofCount1of t sSec Supe se ng I ct e ,hedef nda s n nviton hi ond r di ndi m nt t e nt,

CYNTHI CADET, . and A M D. JO SEPH CA STR O N UO V O ,M . . D,

s l f f i t t Unie St t a pr ryconsiutng, de i d fom ,a pr ee obt n ha l oret o he td aes ny ope t tt i or rve r ny oc ds aied,

die tyori r ty, t r ul ofs h ofe e a a pr pe t us d, i e r cl ndiecl as he es t uc f ns , nd ny o ry e or nt nded t beus i o ed, n

a ma rorpa t t comm i, t f iiat t commi son of t ofe e. Thepr ry t be ny nne r, o t or o aclt e he si , he f ns ope t o

f retdicu e , u i n t i tdt ,h s m o $13milo ,e r snt amo e u g n f r o fi n ld s b t s o lmie o t e u f . lin r p e e i e ng n yj d me t o

t a ountofpr e t def nda sob aned fom t vi aton alege i Count1 he m oc eds he e nt t i r he ol i l d n .

l tep o e t d srb da o ea b igs b e t ofret r, sar s l o a ya t r f h r p ry e c ie b v s en u j c t o fiu e a e ut f n c o

o sino ted fn a ts, miso f h ee d n g)
() 1 ( 2) () 3 () 4 () 5 c nnotbel tdu t execieofduediienc a ocae pon he r s lg e; ha be ta fre o s dt orde iedwih at r pes s en rnserd r ol o, post t hid ron; h sb e plc db y n tej rs ito o t eCo r; a e n a e e o d h u idcin f h u t h sb e s b tn il dmiih di v le; r a e n u sa tal i n s e n au o y ha be nc s e ommi e wihot r opet c c ngld t he pr rywhih annot s vi dwihout be ubdi de t
dit uly; fk t
t e Unied St e s lbe e ild t f f iur ofs tt e pr pe t pur ua t Til 21 Unie h t ats hal ntte o oret e ubsiut o ry s nt o te , t d

Stt Code Se ton85 p) aes , ci 3( .

Th a o en me d fn a t, n e c o te a e o nl a ds v r l la l fr h e b v -a d e e d ns a d a h fh m, r j i ty n e eal ibe o t e y
f fiuroret emoneyj me algedabove. udg nt le

Alp ru n t Ti e21 UntdSttsCo e Se to 8 3 a ( )a d()2) 1 u s a t o t , ie ae d , cin 5 ( )1 n a ( . l

29

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 30 of 34

M ONEY LAUNDERI CONSPI ACY FO RFEI NG R TURE ALLEG ATI ONS The ale tonsc aned i Count 1 oft s Se ond Super e ng I ct nta e l ga i ont i n 3 hi c s di ndi me r he e r - lge a i om o atd by r f r e f rt pur e o al gi f f t e pu s ntt r by e ale d nd nc r e e e enc o he pos f le ng oreiur s r ua o

Til 1 , i dS ae Co e Se to 9 2 a () te 8 Unt tts d , cin 8 ( )1. e

2. Upon c ci ofCount1 oft sSec Supe s di I cm e ,hedef nt, onvi ton 4 hi ond r e ng ndi t nt t enda s CYNTHI CADET,M . and A D. JO SEPH C A ST RO NU O V O ,M . , D.

s l f f tt t Unie St e ofAm e i a pr ry,r alorpe s ,i ol i orta a e ha l orei o he t d ats rca ny ope t e r onal nv ved n r ce bl

t t ofe e Thepr ry t bef f ie i l , i notlm ie t t s of$13 m ilon, o he f ns . ope t o ore td ncudes but s i td o, he um . li

rp e e tn amo e u g nt o t ea u t f o e d d fn n sd rv d fo t ec n pia y e r sn ig n yj d me f r h mo n o pr c e s ee da t eie r m h o s rc

s tf r h i Count 1 e ot n 4.

I a oft pr pe t de c i ed a f ny he o ry s rb bove a a r s tofany ac or omi son oft , s e ul t si he

dee nts: fnda l)

a.

b.
C.

ca nnotbel t upon t exe c s ofd dii nc ocaed he r ie ue lge e; hasbee tansere ors d t ordepost d wih,at r pa t n r f r d ol o, ie t hid ry;

h sb e p a e b y n t ej rs ito o tec u t a e n lc d e o d h u id cin f h o r;

ha be n s tnta l di i s d i vaue;or s e ubsa ily m nihe n l ha bee comm i e wih o he pr ry whi h c nno bedi de wihout s n ngld t t r ope t c a t vi d t difc t fi uly,

d.
e.

t Unie Stt ofAm e i s l e ildt f f iur ofs tt epr pe t purua t Til 21 he t d a es rca halbe ntte o oret e ubsiut o ry s nt o te ,

Unie Stts Code Se ton 853( ,a i r atd by Til 1 Unie Stt Code Se to td ae , ci p) s ncopor e te 8, td aes , cin 98 b)1. 2( ( )
4.

Th a v - a dd fnd n s a de c o t m, r on l a ds veal la l frt e e bo en me e e a t, n a h f he aej ity n e r ly ibe o h

fret r- n yj d me talg da o e o fiu emo e u g n le e b v .

30

Case 9:10-cr-80149-KAM Document 870 Entered on FLSD Docket 07/19/2012 Page 31 of 34

A1pu s a tt Til 1 , tdSae Co e S ci n 9 2() 1, n t ep o e u e o Til l ru n o te 8 Uni tts d , e to s 8 a () a d h r c d rs f te e

21 Unie Stt Code,Se ton 85349,asi o ort by Til 1 Unied Stt Code,Se ton , td aes ci . 1 nc m aed te 8, t aes ci

9 2b ( ) 8 () 1.
A TRUE BI LL

pfk r F *u * < .: r?
-

? .
,T .
.

WI FREDO A . FERRER U NI TED STA TES A TTORN EY

*

PAU L F.SCH W A RTZ ASSI STANT UNI TED STA TES ATTORN EY

LAW CE D . ECCHI L O ASSI STANT UNI TED STATES ATTORNEY