Sriramloo Kesari, MD, 78, a general practitioner in Charleston, West Virginia, faces up to two decades behind bars after being convicted by a federal jury for illegally distributing Suboxone (buprenorphine) “outside the scope of medical practice,” according to a U.S. Department of Justice (DOJ).  Investigators said at his trial that Kesari operated a cash-only business.  He would sign for prescriptions that were distributed by an employee in exchange for cash.  Kesari, himself, was often out of state, in California, when the prescriptions were issued to patients, and did not provide any actual addiction treatment.Prosecutors indicted Kesari in September 2019 as part of an “opioid strike force takedown” across the state and in Ohio and Virginia, which ultimately resulted in charges against 13 individuals, including 11 physicians.  Overall, the strike force indicted sixty individuals, and authorities announced overprescribing of controlled substances charges, including Suboxone, against all those indicted.

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The other two West Virginia physicians the DOJ cracked down on were Ricky Houdershelt, a doctor of osteopathic medicine who was “accused of illegal drug distribution in Putnam County” and charged with “six counts of illegal drug distribution,” and Michael Shramowiat, MD, “accused of nine counts of illegal drug distribution in Wood County.”  Kesari’ indictment explains, “Defendant SRIRAMLOO KESARI, M.D., had an active Drug Enforcement Administration (DEA) registration number that allowed him to prescribe controlled substances, including Schedule III controlled substances, for legitimate medical purposes in the usual course of his professional medical practice and within the bounds of medical practice.”  The practice he ran, however, was outside the scope of his registration.The doctor received his West Virginia medical license in 1979 and in 1987, the Board of Medicine placed Kesari on a three-year probation because of his failure to keep records for patients to whom he prescribed controlled substances, including Suboxone.  The West Virginia Board ultimately suspended Kesari’s license in February 2020, stating that he is not “mentally and/or physically fit to practice medicine and surgery with reasonable skill and safety.”  The decision was made after his attorneys filed motions periodically throughout his trial showing that psychiatric and neurological examinations indicated that the physician was cognitively impaired.  However, a few months later, the Board allowed Kesari to write prescriptions for schedule II and III substances in the Boone Hospital emergency room.The Board also lists settlements of four malpractice cases against Kesari and the dismissal of a fifth case between 1986 and 2001.  Kesari was evidently known to keep sparse patient records.  He is scheduled to be sentenced on August 25 of this year.The Appalachia region of the U.S. has been hit especially hard by the opioid crisis, which led to the Justice Department’s strike force.  The epidemic, in general, has devastated many areas nationwide and the problem has increased due to the Covid-19 pandemic and social isolation.“To the doctors, pharmacists, and other medical professionals engaged in this egregious criminal behavior across Appalachia and across our country: the data in our possession allows us to see you and see you clearly, no matter where you are,” Assistant Attorney General Brian Benczkowski said. “And if you behave like a drug dealer, we will find you and ensure that the American justice system treats you like a drug dealer you are.”

Sources:

Physician Convicted in Buprenorphine Scheme Faces Up to 20 Years in PrisonFederal charges announced against 11 doctors in AppalachiaUNITED STATES DISTRICT COURT FOR THE SOUTIIIIERN DISTRICT OF WEST VRGINIA CHARLESTON GRAND JLRY 2019, SEPTEMBER 17,2019 SESSION