TAMPA — In 2004, Dr. Rosetta Cannata pleaded guilty to three felonies and permanently relinquished her Florida medical license after she was caught prescribing addictive painkillers to an undercover cop for cash.
Cannata's physician assistant, James H. Coker, lost his state license, too. He was prescribing painkillers at a Tampa strip club using prescription slips presigned by Cannata.
Yet professional disgrace didn't stop either Cannata or Coker. Both have gone on to own pain management clinics, hers in Tampa, his in Brandon and Jacksonville.
It's a striking example of the nearly nonexistent regulation that has enabled scores of "pill mills'' to pop up throughout the Tampa Bay area and the rest of Florida. But that may come to an end when a tough new state law takes effect in October.
"One of the purposes of the bill was to ensure that people like this will be put out of business,'' says Sen. Mike Fasano, R-New Port Richey, a sponsor of the law. It bans private pain clinics owned by doctors like Cannata who have lost their licenses, as well as clinics owned by non-physicians like Coker.
A Hillsborough County ordinance effective June 15 has similar provisions and could lead to an even quicker shutdown of clinics that authorities say are fueling an epidemic of prescription-drug abuse. (Pinellas County recently passed a much less restrictive ordinance.)
Neither Cannata nor Coker returned calls for comment. Though Cannata has not been allowed to practice medicine in Florida for six years, a receptionist who answered the phone at her clinic at 4700 N Habana Ave. last week said "she's with a patient'' and couldn't take the call.
The office manager, who refused to identify himself, denied that Cannata owned the clinic though she is listed as the sole officer and director in corporate records. Asked who the owner is, he said: "None of your damn business.''
Now 53, Cannata got her medical degree from the American University of the Caribbean and did a residency in anesthesiology at a hospital connected with the New York state university system. In 1986, she was licensed to practice in Florida, where she opened offices in Cape Coral, Englewood and Tampa.
The Tampa office catered to "persons who were working in the adult entertainment business,'' according to state Board of Medicine records. Cannata even rented space in clubs like the Pink Pony to use as examination rooms.
In July 2001, Cannata was hit with a $111,139 judgment for breaching a lease in a Sarasota shopping center. Soon afterward, the Hillsborough County Sheriff's Office learned from an informant that her physician assistant — Coker — was selling prescriptions for addictive drugs at the Diamond's Men's Club and Cannata's Tampa office.
Between July 14, 2001, and Feb. 12, 2002, undercover detectives — including one who posed as a call girl — bought the antianxiety drug Xanax and the painkillers Lortab, Vicodin and Roxicet — all containing substances controlled by law.
"All of the prescriptions were presigned by (Cannata),'' the Board of Medicine found. "(She) was not present during the appointments and did not evaluate the undercover detectives at any time prior'' to Coker filling out the prescription slips.
State law prohibits physician assistants from prescribing controlled substances.
In November 2001, the investigation widened to Sarasota County, where an undercover detective posing as a patient who had been in a car wreck met with Cannata herself.
The doctor checked his blood pressure but "neither X-rays, MRIs or blood tests were performed or scheduled,'' the detective said in a probable cause affidavit.
After the detective handed over $100 in cash, Cannata gave him prescriptions for Lortab and methadone, used as a painkiller and to treat heroin addiction. Cannata suggested he get the prescriptions filled at different pharmacies and "stay away from large chain pharmacies that might be linked.''
The detective met with Cannata twice more, both times receiving prescriptions in exchange for $100 cash. On a visit in 2002, she asked no questions about his health and instead spent the time chatting about places around New York City that both were familiar with.
Cannata "has demonstrated a willingness to excessively and inappropriately prescribe addictive controlled substances to a patient who was not medically examined,'' the affidavit said.
In 2004, Cannata pleaded guilty to three counts of writing prescriptions for controlled substances for monetary gain. Though the maximum penalty was 15 years in prison, she got 18 months' probation and agreed to relinquish her medical license.
Her assistant, Coker, was acquitted in 2003 of federal charges of selling controlled substances. His state license was revoked a year later for violating state laws in prescribing drugs.
Both continued in the pain field.
In 2006, records show, Cannata's office on Dr. Martin Luther King Jr. Boulevard became Gulfshore Pain Management. Later renamed Gulfshore Pain and Wellness Center — "When life is not a day at the beach, go to the SHORE'' — it moved to Habana Avenue so recently that the sign outside the fourth-floor office is a sheet of paper stuck up with masking tape.
One day last week, a woman in a wheelchair and several men were in the waiting room. A receptionist said that the initial consultation is $300 and that new patients are required to provide an MRI and a three-month prescription drug history.
To one expert, that sounds like a classic example of how pain mills operate. "What they do is find some sort of documentation that there's something wrong and proceed to use that as an excuse to not evaluate patients,'' says Dr. Eduardo Fraifeld, president of the American Academy of Pain Medicine. "That's just inadequate.''
Instead, he says, "good practitioners'' get complete medical histories and "look at the patient as a whole'' in determining how best to relieve pain.
"Adequate pain management is not usually a single thing. There's therapy, medication, psychiatry, surgeries."
The only doctor listed on the clinic's business card is T. J. McNichol, a 2005 graduate of the same Caribbean medical school that Cannata attended. State records show that he is licensed to prescribe drugs and has had no disciplinary action.
Under the new state law and Hillsborough ordinance, however, the clinic could not continue to operate if it is owned by Cannata, an unlicensed physician.
The regulations could also put Coker, 51, out of business. In 2007 he incorporated Omega Pain Care, a Jacksonville clinic, and last year opened the Brandon Pain Center.
The doctor in Brandon is an osteopath, Roderick Beaman. In 2007, the Florida Board of Osteopathic Medicine fined him $7,500 after he prescribed methadone "without medical justification, in quantities which endangered the patient's health.''
Beaman could not be reached for comment.
As for Cannata, her problems aren't just regulatory ones. In January, Citibank foreclosed on her $1.5 million Sarasota County home.
Times researcher Carolyn Edds contributed to this report. Susan Taylor Martin can be contacted at firstname.lastname@example.org.