PINELLAS PARK — Investigators spent two years building the case against Dr. Jacinta Gillis.
It consumed more than 700 hours of Pinellas County sheriff's detective work and cost the department $30,000. Deputies went on numerous undercover stings at her two clinics in Pinellas Park and Lee County. They even hired two pain management experts to review patient files, a first for sheriff's investigators.
The result was the most comprehensive pill mill investigation in the Sheriff's Office history.
"We had to basically outline everything this woman had done to show a probable cause for her arrest," said Capt. Robert Alfonso, who heads the sheriff's prescription drug task force. "We wanted to make this stick."
But as the Sheriff's Office has learned from past cases, prosecuting doctors is not like prosecuting drug traffickers. Even after a painstaking investigation, drug enforcement experts say murky legal questions about pain management make any conviction an uphill battle.
Gillis, they say, could very well walk free.
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How did Jacinta Gillis go from being a 1997 graduate of Meharry Medical College in Nashville, Tenn., to the focus of local and state investigations 12 years later?
By 2003, she finished residencies in surgery and internal medicine in Ohio and Tennessee. Four years later, she was a licensed physician in Florida.
It didn't take long for her to draw the attention of Pinellas sheriff's investigators.
They first began investigating her in 2008 while she was working at U.R. Medical Clinic in Pinellas Park. Tipsters said Gillis, who did not return calls to the St. Petersburg Times, was prescribing without medical need.
Investigators interviewed her about her practices, but she was never arrested.
She told them she was leaving, starting her own pain management clinics and making a list of "good patients" that she would take with her, according to the arrest warrant affidavit.
After she opened clinics in Pinellas Park and Lee County, the tips poured in again.
Investigators at both locations began building a case, saying Gillis was seeing as many as 60 patients a day, often by web-cam, records show.
All of the patients interviewed by investigators said they received prescription drugs — mostly oxycodone — every time they visited. They paid cash. Many traveled hours to see her, skipping over many closer clinics.
Detectives interviewed patients and staffers and tracked their criminal records. They hunted down Gillis' bank accounts, where they said $1.3 million was deposited in cash. They said Gillis cultivated loyalty by buying patients breakfast and lunch, according to search warrants.
On 11 undercover visits, deputies posing as patients scored more than 1,600 oxycodone pills, 1,200 methadone pills and 90 Valium tabs, they said.
On each visit, they got oxycodone, a frequently abused prescription painkiller.
The clinics were absent electronic equipment, except for the computers in the reception area. Investigators said patient rooms lacked tongue depressors, swabs, hand sanitizer or other standard medical equipment. Investigators said they were never touched.
On Oct. 5, deputies raided her two clinics. She surrendered her Drug Enforcement Administration license but wasn't arrested and didn't lose her medical license.
In an interview after the raid, Gillis maintained her innocence.
"I've been a victim, basically," she said. "I feel like I've been a victim. And unfortunately, I know that the war on crime — the war on drugs — is difficult and it's hard to decipher good from bad a lot of times. And so, I feel like I have been a victim."
She was arrested on drug trafficking charges in April during a traffic stop in Lee County.
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Putting a doctor behind bars, even with what seems like a slam-dunk case, is far more complicated than the typical arrest.
Pinellas investigators learned this the hard way.
In 2006, deputies arrested Dr. Alex Petro, a chiropractor who could not prescribe painkillers, and Dr. Ty Anderson on drug trafficking charges.
Detectives said Petro's Clinic, Doctors Urgent Care Walk-In Clinic in St. Petersburg, saw about 60 people a day. Anderson rarely visited the clinic and supplied Petro with signed, blank prescriptions, they said.
Undercover agents with no injuries or medical records went to the clinic and got prescriptions without physical exams. Consultations lasted less than 10 minutes.
At least three patients died of prescription drug overdoses.
Anderson's license was suspended, but he was eventually allowed to continue practicing. Petro pleaded guilty to reduced charges and served 10 years of probation. Three members of Petro's medical staff also got probation.
No one at the clinic, now closed, spent a day in prison.
"We learned a lot of lessons from that," Alfonso said. "There were some missteps and a lot of files we couldn't use because of HIPPA (health privacy act) laws."
Investigators have had success in cases where criminal activity was more blatant.
In 2007, detectives arrested Dr. Craig Bammer on drug-trafficking charges after he sold undercover deputies prescription drugs out of his Gulfport clinic — a vacant flower shop with no power.
Bammer, who was addicted to OxyContin, was broke, divorced, living in a shack behind his illegal clinic.
Posing as a patient, one detective infiltrated the office. He told Bammer he would help get the power restored in exchange for a prescription. He got 370 pills.
He was arrested a month later and charged with drug trafficking. He spent three days in jail and posted bail.
Two months later, he wrote another undercover agent painkillers. He was arrested again.
He pleaded guilty to drug trafficking in 2009 and was sentenced to 17 years in prison.
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Law enforcement officials long for the day when it is easier to investigate and charge doctors suspected of abusing the system. In the grand scheme of criminal behavior, pill mills are still relatively new.
"Law enforcement has never had to deal with medical practice in this manner before," Alfonso said.
The biggest legal question: Did the doctor believe his or her patients were in legitimate pain and needed drugs? What is the standard that doctors must follow when it comes to treating pain?
Drug task force agencies around the state are hoping the Florida Legislature eventually will pass a law making it easier to prove when doctors — especially pain management doctors — are not providing an acceptable standard of care.
For now, they must rely on expensive expert testimony, months of careful undercover work and the hope that with each investigation the crackdown on suspected pill mills gets a little easier.
"We're just so over all this doctor stuff," said Alfonso. "It's so time consuming. But it has to be done."
Emily Nipps can be reached at firstname.lastname@example.org or (727) 893-8452.