Dr. Eugene M. Gosy, the Williamsville pain specialist who came to symbolize the opioid crisis, stood before a federal judge Tuesday and admitted that he unlawfully prescribed painkillers to his patients over a 10-year period.
Gosy, who at one time operated one of the largest pain management practices in the state, acknowledged prescribing fentanyl, oxycodone and other drugs without a legitimate medical purpose.
As part of a plea deal with prosecutors, the 59-year old doctor did not admit any connection to the six overdose deaths detailed in the indictment against him.
Gosy will face a recommended sentence of 6½ years in prison when he is sentenced on May 21 by Chief U.S. District Judge Frank P. Geraci Jr.
For now, Gosy will keep his medical license but it is likely the state will review his license in the wake of his conviction. As part of the plea, Gosy has surrendered his DEA license to prescribe controlled substances, prosecutors said.
The plea agreement also calls for Gosy to pay $344,562 in restitution and forfeit $345,064, the latter of which represents the value of drugs and medical services not provided or drugs that were not medically required.
In the end, with his federal court trial ready to begin, he pleaded guilty to two of the more than 70 felony charges against him — conspiracy to unlawfully distribute controlled substances and health care fraud.
U.S. Attorney James P. Kennedy Jr. called the plea agreement "the high watermark of success in our enforcement efforts," adding that aggressive prosecutions "helped to turn the tide on the opioid epidemic here in Erie County."
In a statement Tuesday, Gosy's lawyers said their client, "apologizes for any shortcomings."
"Dr. Gosy's professional career was dedicated to help suffering patients," his lawyers said. "He never wanted to turn anyone away."
During Gosy's court appearance, Geraci repeatedly questioned him about his admissions that he unlawfully prescribed painkillers over a 10-year period.
"The organization has produced actions, broadly speaking, that have been evaluated as against normal medical practice," Gosy said of his practice.
At one point, Geraci asked him if he prescribed drugs for patients who were abusing them, and Gosy answered, "Yes, your honor."
Prosecutors claim Gosy's wrongdoing included a practice of signing unused prescription forms and then allowing his staff to fill them.
"The prescriptions were prepared by individuals without proper medical training," said Assistant U.S. Attorney Brendan Cullinane.
Kennedy said Gosy prescribed drugs "outside the course of reasonable practice" by issuing prescriptions without appropriate medical examinations or — in some cases — any examination at all. The doctor also kept prescribing drugs despite indications patients were misusing them and failing to provide appropriate follow-up or monitoring, as well as failing to keep appropriate patient files.
Gosy's guilty plea marks the culmination of a criminal case that began in 2016 when he was accused of writing more than 300,000 illegal prescriptions over four years.
Gosy was initially charged in a 166-count indictment, but prosecutors dropped dozens of felony counts as they pared down their case. The charges that remained included felony counts related to the deaths of Gosy's patients and the allegation that, over a 10-year period, he prescribed fentanyl, oxycodone, morphine and other pain medications to patients who were abusing those drugs.
Prosecutors said earlier that the six patients who died were from Western New York.
Kennedy acknowledged the plea agreement offered a "measure of mercy" to Gosy, who was not required to plead guilty to the charges tied to patient deaths.
The agreement recognizes "the fact that Dr. Gosy, frankly, is not a cold-blooded murderer," Kennedy said, "but a physician who likely started treating patients for pain with the best intentions and who, to some patients at least, was a godsend."
“I think that he probably started off with good intentions as a physician and that at some point he made a conscious decision where he had to cut corners in his practice in order to be able to maintain the number of patients and the income flow that he wanted," Kennedy said. "So it is, in some ways, a tragic case, too. That may be where the moral flaw lies here. Not that he wanted to hurt anybody, but that he experienced greed, as we see in so many criminal cases.”
On Tuesday, the same day jury selection in Gosy's trial was set to begin, lawyers on both sides were instead hammering out the final details of a plea agreement that will send him to prison.
The trial had been expected to last at least four months. If convicted of all the charges against him, Gosy could have faced a maximum of life in prison.
In their statement Tuesday, Gosy's lawyers — Joel L. Daniels, Herbert L. Greenman and Eric Soehnlein — noted that Gosy pleaded guilty to just two of the charges against him. They also referred to the inherent risks of treating pain management patients.
"Using his experience and judgment, he prescribed opiate medications to most patients because no available medication was as successful relieving their pain," they said. "Of course, these medications can present risks such as dependence, even addiction."
Investigated by the FBI and the Drug Enforcement Administration, Gosy's case began as a health care fraud investigation and is rooted in his reputation as one of the highest prescribers of opiates in the state.
He was charged with defrauding the state workers' compensation system and other health insurance funds by submitting patient claims for office visits when he was actually outside the Buffalo area.
The prosecution was handled by Cullinane, Charles J. Volkert and Jonathan P. Cantil.
Prosecuting Gosy has had an effect on behavior on the streets of local communities, as well as on prescribing practices in the region, according to Kennedy.
He cited figures he said showed a significant decrease in the amount of oxycodone prescriptions in Erie County from 2015 to 2018. He also cited the decrease in fatal drug overdoses in the county — 301 in 2016 compared with 108 last year.
During a news conference after the court hearing, Kennedy told reporters that shortly after he became U.S. attorney for the Western District of New York, some in the medical community visited his office and brought a message — that the office bringing the criminal case against Gosy "was having a chilling effect on the practice of medicine in Western New York."
He said his response then was the same as what it would be now.
"If that means that we're getting doctors to think twice before they prescribe these opioids, good."