The Daily Times

KNOXVILLE — The owner of the former Maryville Pain Management and Detox clinic is standing trial this week in U.S. District Court on charges of operating a money-making “pill mill,” where its clients paid up front for prescriptions without having to prove legitimate medical needs.

Tamral (Tammy) Guzman, 42, along with four others, was arrested in December 2010 following a 13-month investigation into the clinic, as well as the Breakthrough Pain Therapy Center.

A federal grand jury in Knoxville returned multiple indictments against Guzman, who is not a licensed medical professional. However, she did not have to be licensed to own a pain management clinic, according to state law.

According to the indictment, Guzman used information from the licensed medical professionals she employed to buy controlled substances in bulk and give prescriptions. Guzman is also accused of illegally distributing drugs, including painkillers such as oxycodone and hydrocodone, among others, as well as money laundering and conspiring to avoid reporting transactions.

Through her attorney, Michael Menefee, Guzman claimed that her clinic, which opened in the fall of 2008 in Parliament Square at 118 Parliament Drive in Maryville, operated outside the boundaries of state law, and depended heavily on the medical professionals she employed. None of them were charged, but some have already testified against her.

The trial is reportedly the first one in Knoxville’s federal court system to involve the “pill mill” industry.

$28,000 a day

According to court records, Guzman was earning as much as $28,000 per day in cash payments from patients who paid up front to get prescriptions for painkillers.

Prosecuting U.S. Attorneys Jennifer Kolman and Frank Dale presented documents suggesting Guzman gave out prescriptions herself to patients using blank pads signed by a nurse practitioner, identified as Maimoune Wright, who was also charged and will have a separate trial.

Medical files for patients were rare, sometimes containing only a patient’s name on a diagnosis form. Patients received prescriptions for more than 100 pills at a time, according to records.

Several witnesses testified during Wednesday’s session, including former employees and clients of Guzman.

Jenalee Silva, who was an office manager at the clinic, testified that the office was disorganized and did not have much room. There were also issues with the medical professionals, such as Wright.

“I met with the drug task force and tried to go through the files to make sure we didn’t have any fraudulent records,” Silva said. “(Wright) was stubborn and hard to talk to when she had something in her head.”

When cross-examined by Menefee, Silva said she would run the office when Guzman was gone, and Guzman and Wright often argued.

‘Didn’t feel comfortable’

Dr. Margaret Troxell, an anti-aging medicine specialist who worked at the clinic, testified that she was paid $100 per hour by Guzman, but would not give patients drugs who did not have records.

“I had to make sure things were run properly. It was my license on the line,” Troxell said. “I didn’t feel comfortable. I took the job only for Christmas money, and it went against what my practice was.”

Dr. Kevin Gross, an oral surgeon for Foothills Oral and Maxillofacial Surgery, formerly located next to the Maryville Pain Management clinic, testified that his practice suffered because of lack of parking and increased traffic from the clinic’s patients.

“Cars would be lined up, and there would be food, trash and cigarette butts in the parking lot,” Gross continued. “I went over to speak with their doctors, and I was told they would handle the parking situation. I spoke with the Maryville Police to get any help I could. The only time there was parking in front of the building was when there was a police car there.”

Doctor ‘suspicious’

Dr. Shailendra Kapoor, who worked at the clinic for five months before sending a resignation letter to Guzman via fax, testified that he did not want his DEA (Drug Enforcement Administration) number, which allows a physician to prescribe medications, used to distribute drugs while he was employed there.

He said he was asked to pre-sign blocks of prescription forms.

“I was suspicious,” said Kapoor, who now practices in Richmond, Va. “I started to go through them, then I thought about it and said I didn’t feel comfortable.”

Bridgette Lindsey, who is currently serving in the Blount County Detention Facility on charges of violation of probation and theft, testified that she was a drug addict and met Guzman at a bar before she officially opened her clinic.

“She said they were going to open a pain clinic in Maryville after moving here from Florida,” Lindsey said. “She offered me a pain pill and I asked her about becoming a patient at the clinic. She had a conversation with Dr. Kapoor and he gave me drugs. I stopped going after my third time because of my incarceration.

“I wanted to testify because I wanted to help other addicts. I don’t want to be considered as a snitch,” Lindsey said.

The trial continues at 9 a.m. today with more witness testimony.