Dr. Ray D. Howell, 57, was booked into the Putnam County Jail on 15 Class D felony counts, 12 involving "recklessly, knowingly or intentionally" distributing or dispensing a controlled substance.
At least three of those counts allege that the excessive amounts of controlled substances Howell prescribed were ostensibly written "to facilitate sexual encounters."
Nine patients, all female, were interviewed by investigators, and six reported unwanted sexual advances or actual sexual acts allegedly occurring with Dr. Howell as a result of their visits to his office.
Feeling effects of the allegedly excessive doses of medication, patients routinely told investigators they felt "like a walking zombie," the drugs were "becoming addictive" or they realized they were "not coherent for a while."
Putnam County Prosecutor Tim Bookwalter, whose office has been involved in the case the past 18 months, said he personally witnessed interviews with some of the patients in Connersville and Greensburg and was amazed at how they all told virtually the same story yet obviously did not know each other nor did they know about the others' cases.
Although no specific charges have been filed involving the deaths of any patients treated by Dr. Howell, four occasions in which patients died soon after receiving controlled substances from the doctor were detailed in the probable cause affidavit. Three of those involved Fayette County patients, while the fourth was a Franklin County patient who died of an overdose of hydrocodone.
The investigation began in 2009 after pharmacists from Connersville, Danville and Crawfordsville expressed concern that Dr. Howell was writing prescriptions for "unusually large quantities of controlled substances," the probable cause affidavit filed in Putnam Circuit Court notes.
Those pharmacists also noted that Dr. Howell had a number of patients traveling great distances to obtain prescriptions -- some from as far away as Richmond, Hagerstown and Connersville, all more than 100 miles from Roachdale.
Some pharmacies even decided to no longer fill controlled substance prescriptions written by Dr. Howell, who has been the owner and sole practitioner of Tri-County Family Medical Clinic in Roachdale for more than 20 years.
Among the 12 felony counts, the drugs he allegedly over-prescribed or unnecessarily prescribed included eight instances of Oxycodone, three instances of Methodone, two instances of Adipex and separate prescriptions for Clonazepam, Lortab, Vicodin, Alprazolam, Xanax, Percocet and Hydrocodone.
According to the probable cause affidavit, Drug Enforcement Administration (DEA) investigators sent an undercover Indiana State Police officer to Tri-County Medical Clinic in April and May 2009 to see if Dr. Howell would write her prescriptions for controlled substances "for no legitimate medical reason."
Even though she had no weight issues, the undercover officer asked for diet pills, telling the doctor she was tired all the time and needed them for energy.
On both visits to Dr. Howell's office he wrote her a prescription for 30 Adipex (37.5 mg tablets), a stimulant normally used in the treatment of obesity.
Investigators also reported that the Indiana Scheduled Prescription Electronic Collection and Tracking (INSPECT) Program showed that controlled substance prescriptions filled for Dr. Howell's patients increased dramatically over the period 2006-2009.
In 2006, he had 3,783 such prescriptions filled, followed by 4,833 in 2007, then 7,763 in 2008 and jumping to 11,187 in 2009.
The INSPECT report also found that "several prescriptions written by Dr. Howell to be for significant amounts of schedule II narcotics (up to 50 dosage units of narcotics per day)."
One patient told investigators that Dr. Howell prescribed her up to 24 Methadone 10mg tablets per day. Another said he was given in excess of 40 oxycodone 30 mg tablets per day, while a third patient said she was prescribed a "cocktail" of Methadone (10 mg), Oxycodone (30 mg), Xanax (2 mg) and Klonopin (1 mg).
Still another patient ended up in the Hendricks Regional Hospital emergency room due to respiratory failure after unexplained weight loss was apparently brought on by her medications. The emergency room physician reportedly told the woman "she needed to get away from Dr. Howell or she would end up dying," the probable cause affidavit states.
After multiple patient files were seized from Howell's Tri-County Clinic by investigators in April 2010, they were forwarded to a medical expert for his professional evaluation.
The subsequent report the evaluator drafted included the following summary: "Unequivocally Dr. Howell negligently prescribed excessive, egregious and inappropriate doses of narcotics that resulted in the deaths of several of his patients and the addiction of several others. Additionally, based on the number of prescriptions he has written, there is no question that these drugs were being diverted by a multitude of his patients based on the numbers of the prescriptions, the dosing strengths of the prescriptions, and the pattern of prescriptive behavior. This deviates from all accepted, normal and clinically germane prescriptive patterns."
Three additional felony counts allege that Dr. Howell furnished false or fraudulent information involving his controlled substance inventory, receipts and dispensing records.
Investigators also discovered that Dr. Howell could not account for more than 2,100 tablets of various controlled substance samples between March 2008 and April 2010, as required by federal law.
Subsequently, due to recordkeeping violations, Dr. Howell signed a civil settlement agreement and paid a $65,000 civil penalty in May 2011.