Nolan Denny Crisp, 76, of Halfway, Mo., was sentenced by U.S. District Judge Brian C. Wimes on Monday, Oct. 28, 2013, to two years in federal prison without parole. The court also ordered Crisp to pay a $10,000 fine.
Crisp pleaded guilty on April 8, 2013. Under the terms of his plea agreement, Crisp was required to surrender his license to practice medicine; he can never again seek licensing to practice medicine in the United States.
â€śA doctor handing out prescriptions in the parking lot is no better than a drug dealer on the street corner,â€ť Dickinson said. â€śAs a professional who certainly knew the health risks and the threat to public safety, he betrayed his oath and the trust of the community in order to profit from the dangerous abuse of prescription drugs.â€ť
Special Agent in Charge of the FBI Michael Kaste stated, â€śThere is no tolerance for the reckless dispensing of controlled substances. Dr. Crispâ€™s actions were a betrayal of his oath and the publicâ€™s trust resulting in significant harm. Law enforcement remains committed to investigating medical professionals who abuse their positions of trust, escalating the growing and serious problem of non-medical use of prescription pain relievers.â€ť
Crisp was employed at Pomme de Terre Wellness Center (also known as the Bolivar Family Wellness Clinic and Northwoods Psychiatric Services, Inc.) in Bolivar from June 2009 through Nov. 10, 2010 to provide pain management and other services to patients.
Crisp admitted that he wrote prescriptions for OxyContin, Oxycodone Hydrochloride, and Oxycodone-Aspirin for a purported patient with whom he was involved in a sexual relationship. The prescriptions were illegal because they were not in the usual course of professional practice and for a person who had no legitimate medical need for the prescriptions.
Current and former clinic employees expressed concerns about Crispâ€™s prescription-writing practices. For example, clinic staff noticed Crisp meeting people in the parking lot and giving them prescriptions, even though they were not being seen in the clinic. The clinic was getting so many patients claiming that their prescriptions were lost or stolen that they began requiring a police report. A nurse practitioner said word got out that Crisp was generous with narcotics prescriptions, and she would see patients parked across the street in a church parking lot waiting for him so they could get prescriptions. She also said that sometimes the clinic nurses would run a drug screen that revealed the patient was not taking the drugs being prescribed; they informed Crisp, but he continued writing prescriptions for the patient.
The federal investigation included reviewing overdose reports from Citizens Memorial Hospital, Crispâ€™s appointment schedule for the clinic, Crispâ€™s Medicaid billing records while he was at the clinic, information regarding prescriptions written by Crisp and filled at six major pharmacies in Bolivar, and information from the Polk County Coroner. During the period that Crisp worked at the clinic, there were 96 overdose incidents at the hospital, 29 of whom were connected to his care. During that same period, six of the patients who died from overdoses were connected to his care.
The government retained an internal medicine physician specializing in pain management to review patient files. The physician was provided with charts for certain patients who were known to be drug abusers or who had overdosed. In the physicianâ€™s report, he provided background regarding the standard of care for the use of controlled substances in the treatment of pain. He also provided a detailed analysis of Crispâ€™s treatment of 20 patients. For the 20 patients, his opinion was that Crispâ€™s treatment was reckless, dangerous, life-threatening, and inconsistent with sound medical practice.
This case was prosecuted by Assistant U.S. Attorney Cindi Woolery. It was investigated by the FBI, the Drug Enforcement Administration, the Bolivar, Mo., Police Department and the Missouri Medicaid Fraud Control Unit.