Dr. James Graves

Dr. Graves, who was Florida's top prescriber of the powerful painkiller, faces up to 30 years in prison.

Graves, 55, is the nation's first doctor to stand trial on manslaughter or murder charges in the OxyContin death of a patient.

Prosecutor Russell Edgar estimated that Graves, who testified he had up to 1,000 patients at his pain management offices in Pace and Brewton, Ala., brought in $500,000 a year.

"The defendant in effect put people in a chemical straitjacket," Edgar said Tuesday. "It was to his financial benefit to do so and ... also it served his ego."

Graves had testified that he did not know his patients were abusing drugs and said no one would have died if OxyContin had been taken as prescribed.


Jury begins deliberating doctor's fate

Monica Scandlen

A Santa Rosa County jury of four men and two women at 11 a.m. Tuesday began deliberating the fate of Dr. James Graves.

Their job is to determine if Graves' actions led to the deaths of four patients who fatally overdosed on medications he prescribed. In addition to four counts of manslaughter, the Pace doctor is charged with one count of racketeering and five counts of unlawful delivery of a controlled substance.

To convict Graves of manslaughter by culpable negligence, jurors must find that Graves should have reasonably known that his prescriptions were "likely to cause death or great bodily injury."

To be guilty of unlawful delivery of a controlled substance, the jury must decide that Graves "acted outside the usual course of professional practice" and for "no legitimate medical purpose." Under Florida law, doctors can prescribe controlled substances like OxyContin or Xanax, if they are acting in good faith and within the course of professional practice.

The racketeering charge requires jurors to agree that at least twice, Graves either illegally prescribed controlled substances or is guilty of the manslaughter of two people.

Assistant State Attorney Russ Edgar argued Graves prescribed virtually the same potential deadly combination of drugs to dozens of patients who didn't need them. Many patients became dependent or addicted to the drugs.

"The defendant, in effect, put people in a chemical straightjacket," Edgar said. "It was to his financial benefit to do so and ... also it served his ego."

Edgar estimated Graves brought in $500,000 a year during from his pain-management office on U.S. 90 in Milton. The office opened in September 1998 and closed in July 2000 after Graves' arrest.

Graves' narcotics of choice were OxyContin in two strengths, Lortab, Soma and Xanax, dubbed the "Graves cocktail" by pharmacists.

Two dozen pharmacists testified they were so concerned about the drugs they warned some patients they could die from the combination. By the end of 1999, all the chain pharmacies in Escambia and Santa Rosa counties and some independent pharmacies had stopped filling Graves' prescriptions.

Graves, 55, testified for three days. He insisted he did nothing wrong in treating the chronic pain patients and believed them when they described their symptoms.

He said even when four patients overdosed within seven months, he didn't question his practice of medicine. He admitted his records lacked patient notes.

PUBLISHED MONDAY, FEBRUARY 18, 2002, 4:00 p.m.

Prosecutor: Graves like 'a vending machine'

Comparing Dr. James Graves' medical practice to a vending machine, Assistant State Attorney Russ Edgar asked jurors to find the Pace doctor guilty of all charges against him.

Edgar spoke for three hours during closing arguments today. The defense is scheduled to argue this afternoon and the jury is expected to begin deliberations tomorrow.

"The defendant had an anyone, anytime, anywhere philosophy of practicing medicine," Edgar said.

In outlining the case against Graves, Edgar made the vending machine analogy. He said it was as if patients paid $50 or $60, punched the buttons that corresponded with their symptoms, then pulled the lever for the medication.

"It was as if (Graves) was a vending machine," Edgar said.

Graves generally prescribed a potent combination of OxyContin, Lortab, Xanax and Soma to patients without virtually any examination.

About 35 people were in the Santa Rosa County courtroom, including Graves' wife Alicia, son Jimmy and daughter Jordan, all of whom testified for the defense.

Graves is charged with manslaughter, racketeering and unlawful delivery of a controlled substance. If convicted he faces 15 to 30 years in prison. The trial is in Circuit Judge Kenneth Bell's courtroom at the Santa Rosa County Courthouse.


Testimony ending in Graves trial; juror dismissed

As the trial of Dr. James Graves approaches the end, Circuit Judge Kenneth Bell today dismissed an alternate juror.

This leaves six jurors and two alternates to hear the last day of testimony today and closing arguments Monday. The panel is expected to begin deliberating Tuesday.

Friday, the prosecution presented more witnesses to rebut some of the statements Graves' made during his three days on the witness stand.

The Pace doctor said he always gave patients complete exams before prescribing medicine.

But Wesley S. Odom, who was Graves' financial consultant at Smith & Barney and went to see the doctor one time, said the doctor performed no blood tests or other diagnostic tests before prescribing a cholesterol-lowering medicine and Vioxx.

"He said it would make me feel good," Odom said.


Patient: Graves likely saved my life

Several former patients of Dr. James Graves testified Thursday they were satisfied with the care the Pace doctor provided.

One patient, Bill Willis, even said Graves likely saved his life because he referred him to another doctor who diagnosed Willis' colon cancer.

Defense attorney Mike Gibson asked Willis whether Graves saved his life.

"Had the cancer spread, it could be a very good possibility," Willis answered.

The prosecution is trying to prove Graves so recklessly prescribed narcotics that he is responsible for the overdose deaths of four patients.

The defense says Graves was just doing his job as a doctor and many patients were addicts who lied to get the drugs they craved.

The trial in Circuit Judge Kenneth Bell's court is on track to be one of the longest in Santa Rosa County. It enters its sixth week next week.

Graves, 55, of Pace is charged with manslaughter, racketeering and unlawful delivery of a controlled substance. If convicted he faces 15 to 30 years in prison. The manslaughter charges stem from the deaths of four patients who overdosed and died on medication Graves prescribed.

Graves often prescribed a mixture of powerful drugs, including the narcotic painkiller OxyContin, to patients. Some local pharmacists dubbed the combination of OxyContin, Soma, Xanax and Lortab "the Graves cocktail."


Tape reveals inconsistencies in treatment

Defense attorneys played three audiotapes Wednesday morning _ all secretly taped _ which revealed many inconsistencies in the way Dr. James Graves treated patients.

Two were of visits by patient Martha Blackmon and one was a conversation between Graves, Florida Department of Law Enforcement Agent Dennis Haley and Assistant State Attorney Russ Edgar.

In one visit by Blackmon on March 9, 2000, Graves examines her fresh needlemarks, tells her to go get drug treatment and stop injecting drugs, then says she can come back for her prescriptions until she can get into a rehabilitation program. Addicts crush the tablets, mix it with water, heat it and inject it.

"If you'll stop it right now, I'll give you enough medication to keep you comfortable," Graves said.

The trial moved briefly Wednesday afternoon to the U.S. District Courthouse in Pensacola so jurors could hear the video testimony of a defense witness.


Expert: Graves' prescriptions legitimate

A defense expert testified today that Dr. James Graves prescribed medicines for legitimate medical purposes.

Dr. Daniel Handel, a pain medicine and palliative-care specialist at the National Institutes of Health, reviewed some of Graves' records and said he found nothing unusual about the Pace doctor's prescriptions for OxyContin, Lortab, Xanax, and a sleeping medicine like Ambien or Soma.

Handel, who is part of the speakers bureau for Purdue Pharma, the company which makes OxyContin, also said there wasn't anything odd about Graves' writing prescriptions at home the night before.

"It's a time-saving measure," Handel said.

Graves is accused in the deaths of four patients who overdosed on the died on the medications he prescribed. He maintains he is not responsible for how his patients took their drugs once they left his office.


Graves: 'I prescribed properly'

Dr. James Graves still insists he did nothing wrong in the almost two years he operated his Milton pain management practice.

In Circuit Judge Kenneth Bell's courtroom Tuesday, Graves said he didn't see any reason to change his prescription patterns, even after several patients overdosed and died on the medications he prescribed, many pharmacies stopped filling his orders, and he knew some of his patients were addicts.

"I prescribed properly," said Graves, 55. "(The medication) wasn't taken properly or used in the manner it was prescribed."

This is third day the Pace doctor has been on the stand. The trial is in its fifth week.

Local pharmacists dubbed Graves' prescriptions the "Graves cocktail," which usually included OxyContin in two strengths, Lortab, Xanax and Soma. The way Graves prescribed, patients were to take a total of 12 pills a day.

Prosecutors contend Graves recklessly prescribed the mixture of drugs despite signs some of his patients were abusing them. The defense maintains Graves was deceived by people addicted to the medications who lied about their symptoms to get their fix.


Graves spars with prosecutor

Dr. James Graves continued to defend his practice Friday, at times sparring with Assistant State Attorney Russ Edgar. The Pace doctor called several of Edgar's questions "ridiculous."

Graves said again on the stand that he only provided legitimate medical care to patients and some of those patients were drug addicts. That, though, didn't exclude them from his care. He said he saw intravenous drug users as human beings.

"I think, as a human being, they deserve care," Graves said.

Several times during morning testimony, Circuit Judge Kenneth Bell instructed Graves to answer Edgar's specific questions, rather than give rambling explanations.

More than once, Bell also had to Graves to let him finish talking.

"I talk, you shut up," Bell said. "I talk, counsel shuts up. That's the rule."

Much of morning testimony revolved around Graves' care of two married patients, Martha and Danny Blackmon, who Graves said he eventually referred to treatment for their addictions.

When Edgar asked if Graves had ever waved a walkie-talkie around a patient to see if she was wearing a microphone to secretly record her visit, Graves responded:

"Isn't that a ridiculous statement you just made, Mr. Edgar?"

Even before Friday, Graves was outspoken in his defense, writing to the newspaper and national Web sites.


Graves takes the stand

Dr. James Graves took the stand Thursday and told jurors he didn't do anything wrong in prescribing medicines to four patients who overdosed and died.

Even before Thursday, Graves was outspoken in his defense, writing to the newspaper and national websites.

When asked by defense attorney Mike Gibson asked if he ever prescribed medicines for anything other than medical purposes, Graves answered: "Never."

Did he prescribe drugs patients did not need, Gibson asked.

"Never," Graves answered.

Prosecutors contend Graves routinely prescribed a potent mix of pain medications, including the narcotic OxyContin, to patients, some of whom became addicted to the drugs.

He said he did not know the four people who overdosed were addicted to the drugs. He also did not notice needle marks on some of his patients.

Generally, he said, some pain patients have the potential to abuse their medicine, but they still deserve treatment.

"If they have a real medical problem that is causing them pain, they deserve treatment for their pain," Graves said.

Cross-examination of Graves will take place Friday.


Graves defense continues to present its case

Wednesday, calling more family members and former patients in support of the Pace doctor.

Among them was Graves daughter, Jordan, a senior at Pace High School. The 18-year-old worked briefly at her father's office in 1999 doing odd jobs.

She told jurors in Circuit Judge Kenneth Bell's court she saw nothing unusual about her father's practice. She said he did take files home at night.

"He was always working on his charts," she said.

Defense attorneys say he did his job, treating patients for their symptoms, and many were addicts who lied to get drugs for their fix.

Prosecutors asked Bell to dismiss two jurors because they aren't paying attention. Bell said he will decide Thursday on the jurors fates.


Graves not a lawbreaker, wife testifies

Dr. James Graves may have been a sloppy bookkeeper but he did not break any laws in treating his patients, four of whom died, his wife testified Tuesday.

Alicia Graves, who has been married to the doctor for 32 years, was the first witness to testify in her husband's defense. She did paperwork at the office on U.S. 90 in Milton when it opened in September 1998 until July 2000, when it closed after Graves' arrest.

"He loves medicine and he knew that he was good at medicine and that's something he could do," she said.

She now teaches first grade at Hallmark Elementary School in Escambia County.

Her husband is accused of illegally prescribing narcotics _ including the powerful painkiller OxyContin _ to dozens of patients in order to make money. The prosecution says Graves prescribed the drugs so recklessly that he is responsible for the deaths of four patients who overdosed.

The defense counters he was doing his job by treating patients for their symptoms and many patients were addicts who lied to get the narcotics.


Addiction expert says Graves 'reckless'

From staff reports

A medical expert in addiction said Monday a Pace doctor was "reckless" in the pattern of prescription he routinely issued for patients.

Dr. Theodore Parran of Cleveland teaches at Case Western Reserve University School of Medicine. Parran is board certified in internal medicine and addiction medicine. His review of patient files - including four people who overdosed - found Dr. James Graves, 55, prescription pattern "unconscionable."

Dozens of former patients have testified they were addicted to a powerful cocktail of narcotics - including Oxycontin - Graves routinely prescribed.

Parran said Graves should have known patients were addicts, even if they lied to him because there were physical signs of drug abuse, including track marks.

Parran said it would be difficult to take even a blood pressure reading and not notice such marks.

"It doesn't even come close to the usual standards of care," Parran said. "It isn't even in the ballpark."


Graves kept records of pharmacists'complaints

Monica Scandlen

The trial of Dr. James Graves on Friday turned from personal accounts of his patients to hard evidence.

That evidence includes items seized from Graves' Milton office on April 13, 2000, a day after a patient, Howard Rice, died from a drug overdose.

A note with Rice's name and the words "dead" and "needle tracks over his arm" was found in a trash can, testified Cpl. Chris Watson, a Santa Rosa County narcotics officer. Investigators also found a spiral notebook that included the names of patients who overdosed and messages from pharamacists and family members concerned about how Graves treated his patients.

Judge Kenneth Bell allowed the items to be entered into evidence.

The prosecution is expected to wrap up its case Monday. Defense attorneys expect to take at least a week to refute charges.


Pharmacist: Graves' prescriptions 'excessive'

The senior pharmacist with the Agency for Health Care Administration testified Thursday she began collecting records from area pharmacies in February 1999 that dealt with prescriptions issued by Dr. James Graves.

Sara Helen Lowe said she mainly looked at OxyContin and other "Schedule II" narcotics Graves prescribed for his patients. Her investigation was prompted by a call from the Drug Enforcement Administration.

After reviewing the records she found an "over, excessive prescription" by Graves.

Lowe testified Thursday morning as the trial of Graves continued for a third week. The trial was suspended Wednesday so other court cases could be heard.

Earlier Thursday, officials from West Florida Hospital testified Graves was allowed the lowest level of privileges at the hospital. Graves had no privileges at other hospitals in Escambia and Santa Rosa counties.


Testimony suspended

Testimony was suspended in the trial of Dr. James Graves to allow other criminal cases to be heard. The trial resumes Thursday.


Graves' patients had deadly levels of drugs

Monica Scandlen

A toxicologist testified Tuesday that four of Dr. James Graves patients had potentially deadly levels of drugs in their systems.

Bruce Goldberger, director of toxicology at the University of Florida, oversaw the laboratory tests of blood and other body fluids taken from the bodies of the four patients.

The levels of different drugs ranged from twice the toxic level of hydrocodone in one case to almost four times the deadly level of oxycodone in another case.

"The toxicology is fairly evident these levels are high and would be consistent with a drug death," Goldberger said.

Graves is suspected of prescribing a combination of OxyContin, Lortab, Xanax and Soma, dubbed the "Graves cocktail" to dozens of patients. Four of them overdosed and died.

Oxycodone is the main ingredient in OxyContin and hydrocodone is the main ingredient in Lortab.

The defense says many of those patients were drug addicts who lied to Graves to get the drugs.


Doctor who shared patient with Graves thought medications too risky

A doctor who treated one of Dr. James Graves' patients testified she would not have prescribed the same medications Graves prescribed to Howard Rice.

Rice, 41, died April 12, 2000, of a drug overdose.

The prosecution is trying to prove Graves is responsible for Rice's death and the deaths of three other people who overdosed. The Pace doctor is also accused of illegally prescribing narcotics - including OxyContin - to dozens of other patients who didn't need them.

Dr. Barbara Wade, who is board certified in internal medicine and infectious diseases, testified she treated Rice between July 1999 and November 1999. Rice was HIV positive, but was not terminal.

Rice was seeing both doctors at the same time, but neither knew that, according to court testimony Monday.

She once prescribed Rice methadone for pain, along with other medications for his HIV. After Wade found out Rice had overdosed twice, she stopped prescribing narcotics.

"I thought the repeated overdose history was too risky," Wade said.

When questioned about Graves' prescriptions of OxyContin, Lortab, Soma and Xanax, Wade called it a "tremendous amount of drugs."

"I just think that's an unsafe combination of medications to give at one time."


Woman visited Graves two days before she died

Relatives of 34-year-old Anne Carroll said it was no secret she was addicted to drugs, especially in the days before she died March 14, 1999.

Carroll's son, Shane Carroll, who was 15 when his mother overdosed, testified she went to Dr. James Graves' office March 12, 1999, with three to five track marks on each arm.

He said he ocassionally accompanied her to the doctor's office and on "most ocassions" she was "staggering, obviously intoxicated."

Anne Carroll generally was prescribed OxyContin, MSContin, Lortab, Somas and Xanax. Shane Carroll said his mother injected the OxyContin and MSContin and swallowed the Lortab, Soma and Xanax.

She would typically go into the bathroom to crush the drugs, mix them with water and heat them in a spoon, then inject them into her arm, Shane Carroll said.

After a hit, Shane Carroll said, his mother had "no equilibrium, no sense of judgment.

"Same as any other narcotic, I'd imagine," he testified.


Graves gave patient hundreds of pills

A former patient of Dr. James Graves said he sold OxyContin, Lortab and other medication the Pace doctor prescribed for him.

Thomas Wilson, 63, said he mainly sold the drugs Graves gave him. Wilson testified he visited Graves but lied when he told the doctor he suffered pain after falling from a house when he was 12 or 13.

Wilson, also known as Buddy Wilson, testified during the eighth day of testimony in a trial that is expected to last two more weeks.

Wilson was arrested in July 1999 for drug trafficking. When police searched his house he had between 3,000 and 4,000 pills.

"Most of them came from Doctor Graves," Wilson told Assistant State Attorney Russ Edgar.

Wilson would sell some pills - a 40-milligram dose of OxyContin fetched $25; twice that much for 80 milligrams - and barter them for goods. He traded Soma for Lortab with other patients of Graves. He was sentenced to 18 months in prison for intent to distribute oxycodone/hydrocodone.

On cross examination, Wilson admitted Graves treated him for other ailments. Graves prescribed antibiotics and medicine to treat his cholesterol. Graves also gave him samples of Viagra.

"I didn't tell him I needed no Viagra," he said.


Patient admits selling pills for profit

Derek Pivnick

Former patients, their parents and medical professionals highlighted testimony Wednesday in the trial of Dr. James Graves.

One of those patients, Norman Perrow, said he could make $1,000 to $2,000 in just a few days selling painkillers given to him by Graves. He was a roommate of Jeffrey Daniels, a Graves patient who died. Daniels' death is one of four that prosecutors say Graves caused by prescribing painkillers.

Perrow said he was taking methadone for pain he suffered following a 1980 motorcycle accident. Perrow broke his neck in the crash.

He said the methadone didn't dull his pain so he tried OxyContin and visited Graves to get the prescription. Though he says he never got high off the prescription, it did reduce his pain. He then admitted selling some of the OxyContin for profit.

On cross-examination, he told Graves' attorneys he had a drug problem before he visited Graves and that he lied to Graves to get the prescriptions. Several patients last week and this week also admitted lying to Graves to get pills.


Former patient reported Graves to DEA

Monica Scandlen

A former patient of Dr. James Graves testified Tuesday she reported the Pace doctor to the federal Drug Enforcement Agency after two friends fatally overdosed from his prescriptions.

Angela Cabaniss, a patient of Graves from July through November 1999, said Graves gave her a prescription of Oxycontin, Lortab, Soma and Xanax, and she sold them. She said she was addicted to methadone at the time.

"I'm an addict and whenever we hear there's a doctor who would write something, we basically know what to say," Cabaniss said.

She knew 30 or 40 people who were patients of Graves.

"People were shooting dope; they were selling it," she testified. "It was out of hand."

On cross examination, when Graves' lawyers asked her why she continue selling drugs if she was distressed about the overdoses, she said: "I wouldn't have been able to sell them if he wasn't giving them to me."

She also admitted she complained to the DEA a few months after Graves stopped filling prescriptions.


Patient sold pills prescribed by Graves

Testimony continued Monday in the trial of a Pace doctor accused of manslaughter in the deaths of four patients.

Monday Joanna Barnes testified in Circuit Judge Kenneth Bell's court she started going to Graves just to get pills she could sell for profit. Later, she became a user, injecting the mix of Lortab, Oxycontin, Soma and Xanax local pharmacists dubbed the "Graves cocktail."

Barnes said she made between $1,500 and $2,000 a month selling pills Graves prescribed for her for migraine headaches, neck and back pain from a car accident years ago.

She saw Graves from October 1998 to December 1999. She is in the Santa Rosa County Jail on a probation violation.

In that time, Barnes was arrested on a warrant while leaving The Prescription Shop in Milton. She had with her owe sheets, a list of people she had fronted drugs who still owed her money.

Police questioned her about the owe sheets, a conversation she later relayed to Graves.

"He said he had the right to write prescriptions and I'm the one who needed to be careful," she testified.

On cross examination, Barnes said she did get prescriptions for Oxycontin from another doctor, but that "was my family doctor. Dr. Graves was my drug doctor."


Graves wrote prescriptions for addicted patient

At least one former patient said Friday that Dr. James Graves knew she was addicted to her pain medication, yet he continued to write her prescriptions for the drugs.

Dana Black was among several former patients who testified on the third day of the Pace doctor's trial.

She said Graves still wrote her prescriptions for a mix of Oxycontin, Lortab, Soma, Xanax and Valium even after her stint in rehab at Lakeview Center.

Black said she went to the psychiatric facility to try to kick her addiction, but relapsed. She went back to seeing Graves and told him about her stay at Lakeview.

"I still left with my prescriptions," Black testified.

Black said she first began seeing Graves at his Pensacola office for back pain following a car accident. But when she went to his office on U.S. 90 in Pace, she was going just to get the prescriptions for the cocktail of powerful pain mediations.

"We never really talked about anything medical wise," Black said.

Under questioning by defense attorneys, Black said Graves once did refuse to write her a prescription when she told him the original was stolen.

Graves' trial continues in Santa Rosa County Circuit Court on Monday, even though it is the Martin Luther King Jr. holiday.


Patient: Graves saw 30-40 patients per day

A patient of Dr. James Graves testified Thursday the Pace doctor handed out prescriptions from his front porch, threatened to withhold prescriptions from her, and asked her to subscribe to a long-distance telephone plan.

Susan Amerson also worked in Graves' offices in Milton and in his Pace home. She was the first patient to testify in the trial of Graves, who is charged with manslaughter, racketeering and unlawful delivery of a controlled substance.

Amerson estimated Graves saw 30-40 patients per day from his office on U.S. 90 in Milton and wrote virtually the same prescription for each.

"The same thing was written over and over and over," Amerson said. "Same dosage. Same amounts."


Pharmacists questioned Graves' prescriptions

Pharmacists from Escambia and Santa Rosa counties testified Wednesday they became increasingly suspicious of Dr. James Graves' prescriptions for strong painkillers, including OxyContin, and eventually stopped filling them.

The pharmacists were the first witnesses in the trial of Graves, 55, of Pace, who is charged with manslaughter, racketeering and unlawful delivery of a controlled substance.

Thomas Weekley of Weekley's Pharmacy in Milton said he stopped filling Graves' prescriptions when he noticed several new customers all with an identical prescription. Graves' patients came from as far away as Panama City and lower Alabama, he said.

"Everybody can't have the same problem," Weekley said.


Graves' jury hears opening statements

A Santa Rosa County jury will have to decide whether Dr. James Graves was a doctor who ran a "prescription mill" or merely a physician who treated his patients' symptoms.

Graves' attorneys and prosecutors made opening statements Tuesday afternoon in the trial of Graves, 55, who is charged with manslaughter, racketeering and unlawful delivery of a controlled substance.

Assistant State Attorney Russ Edgar said Graves prescribed thousands of pills to people he knew were drug addicts just to make money. He told the 11 jurors Graves practice was a "prescription mill" and the Pace doctor bragged to people that it was a gold mine for him to get rich.

Graves' lawyers argued Graves treated the symptoms he saw in patients and that patients lied to get the drugs they craved.

Those in attendance Tuesday included family members of those who overdosed on Graves' prescriptions.

How Alike Are OxyContin Cases?


OxyContin Doctor Seeks Retrial



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