When Dr. Gautam Arora, a pain management specialist from Amherst, returned home last Friday, the FBI was waiting for him.
Under investigation for fraud and doling out illegal prescriptions, Arora closed his medical practice in December and fled to his native India, according to investigators.
He returned late last week, they said, after sending his wife several texts threatening a cooperating witness in his case. He is also accused of posting photos of himself with a gun and knife on social media.
"I will cut (his) jugular and take his head back to India where I burnt my father," one of the texts says of the witness.
Arora is charged with making a threatening communication and is currently being held without bail.
An FBI agent who confronted Arora when he arrived from India last week said he denied making the threats but eventually admitted sending the texts. The agent said he also acknowledged his reasons for leaving the country late last year.
"He told FBI agents that he fled to India because of the investigation and that he had no intention of returning," said Assistant U.S. Attorney Joel L. Violanti.
Violanti, during a detention hearing last week, made it clear Arora's billing and prescription drug practices are at the root of the probe and that charges could be imminent.
"There are investigations pending," he told U.S. Magistrate Judge Michael J. Roemer.
In court papers, the prosecutor said the allegations involve "unlawful medical practices and billing."
At this point, Arora is not charged in the prescription drug investigation but, if he is, he would not be the first local doctor linked to illegal prescriptions. Over the past five years, more than a half-dozen doctors have been charged or convicted of illegally dispensing painkillers.
One of them, Dr. Eugene Gosy, is still fighting allegations that his illegal prescriptions resulted in six deaths. At the the time of his arrest, Gosy was one of the busiest pain specialists in the state.
Arora's arrest also came amid the opioid epidemic and hundreds of fatal overdoses in recent years.
Before he left for India, Arora owned and operated Hens Pain Center on Lawrence Bell Drive in Amherst, not far from Erie Community College's North Campus. He closed the practice in December.
In court last week, Arora's lawyer said his decision to shut down the business and move to India was rooted in his desire for a fresh start, not to escape an FBI investigation.
The doctor, he said, was coming off an inpatient treatment program for alcohol abuse and wanted to flee the stress in his life, not federal investigators.
"He agreed to surrender his license and went into treatment," Brian Comerford, an assistant federal public defender, told the court last week.
Comerford, in an effort to gain Arora's release, questioned the timing and seriousness of the texts, and suggested there is no imminent threat to the witness in the case.
He also claims his client's decision to return to the United States last week indicates he did not fear arrest. It also supports his version of why he left in the first place — to escape the stresses of his life here, he said.
"He had no issue coming back here," Comerford said last week.
Roemer disagreed and ordered Arora detained. Roemer cited the alleged threats against the witness and the possibility that Arora might flee.
In court papers, an FBI agent said the cooperating witness was contacted and confirmed his fears about Arora.
The agent met Arora upon his arrival at Buffalo Niagara International Airport and interviewed him. The agent said Arora initially denied sending the texts but later admitted making the threats.
Arora indicated the texts were sent out of anger, the agent said, and he never intended to act upon them. The texts and photos are part of the criminal complaint filed by the FBI's Health Care Fraud Unit.
Even though Arora is a doctor, he qualified for representation by the federal public defender. In court papers, he indicated his assets were frozen by the government.
Arora is also facing allegations of domestic abuse, which his lawyer denied, and reports that he may be a danger to himself and others.
He remains in federal custody.