PORTLAND — A nurse practitioner who helped run an illegal “pill mill” in Portland will become Oregon’s first medical professional to face federal sentencing Tuesday for unlawfully prescribing opioids, according to the U.S. attorney’s office.
Julie Ann DeMille subsidized her job working for a Clackamas County public health clinic by running the Fusion Wellness Center, first on Southeast 122nd Avenue in Portland and then later at a larger site in Northeast Portland, according to Assistant U.S. Attorney Donna Maddux.
An expert’s review of patient files found DeMille regularly wrote prescriptions for opioids without a documented medical purpose and outside the usual course of professional practice, at times ignoring or disregarding medical histories that indicated a patient’s propensity for addiction, the prosecutor wrote in a sentencing memo.
A co-defendant DeWayne Taylor told investigators that in 2015, word was out that the Fusion Wellness Center was just “a candy store,” according to court records.
In December, DeMille, now 60, pleaded guilty to two counts of illegal opioid distribution, and one count each of filing a false tax return and lying to a federal agent from the Drug Enforcement Administration.
DeMille falsely told an undercover DEA agent posing as a DEA clerk that she was only practicing at a public clinic operated by Clackamas County, where she was then employed, concealing her work at Fusion Wellness, apparently to avoid a modest registration fee charged by federal narcotics enforcement agency.
“Although Ms. DeMille remains at a loss as to why she did so, Ms. DeMille freely admits that she in fact lied to the DEA about working only for Clackamas County,” her defense lawyer Philip Lewis wrote in his sentencing memo.
Under a negotiated plea deal, DeMille is expected to receive a four-year prison sentence, followed by three years of supervised release, and ordered to DeMille pay $43,126 in restitution to the Internal Revenue Service.
DeMille lost her nurse practitioner’s license, and in 2016, voluntarily surrendered her DEA registration as a narcotics provider.
Based on a review of Fusion Wellness patient records seized in July of 2016, every one of the approximately 580 patients received a prescription for opioids written by DeMille at nearly every visit, according to the government.
DeMille’s defense lawyer Philip Lewis argues that the business manager of the Fusion Wellness Clinic, co-defendant Osasuyi Kenneth Idumwonyi, was the mastermind of the illegal scheme. He pleaded guilty earlier in the case and was a cooperating witness for the government, but then after he provided untruthful information, the government decided to revoke some or all of the benefits initially offered under a plea deal, according to Lewis. Idumwonyi will be sentenced in June and is expected to face a longer sentence.
One customer of the Fusion Wellness Clinic told investigators that Idumwonyi and his girlfriend, Brandi Elwood, also a co-defendant, would go to Narcotics Anonymous meetings to recruit patients, according to court documents.
Oregon has one of the highest rates of prescription opioid misuse in the country, with an average of three deaths in Oregon every week from prescription opioid overdose, Maddux wrote in her sentencing memo, quoting figures from the Oregon Health Authority.
In 2015 , DeMille wrote at least 1,940 prescriptions for controlled substances, according to the investigation. Charging her patients $200 a visit, the prescriptions generated at least $388,000 in revenue for the clinic in 2015, and DeMille split the proceeds with her business partner, according to prosecutors.
When DeMille filed her federal income tax return for 2015, she only reported her income from her job at the Clackamas County clinic. She didn’t report any of her income from the Fusion clinic, and failed to pay taxes on the income she received in 2015 or 2016 from the clinic, according to court records.
Initially, 21 people were indicted after the Drug Enforcement Administration’s 14-month investigation, but two federal prosecutors who took over the case from the initial assistant U.S. attorney Pat Ehlers ended up dismissing charges against 10 defendants, after finding the evidence and the law didn’t support the allegations.
Federal authorities say DeMille conspired to illegally write prescriptions for opioids from the clinic from January 2015 until her arrest in July 2016. DeMille moved to Oregon in 2014 after working as a nurse practitioner in Texas, at one time working for Idumwonyi at a Houston clinic.
Oregon was an attractive place to work because nurse practitioners here can write prescriptions without the oversight and approval of a physician, Maddux said. She was hired to work at a Clackamas County public health clinic in July 2014 but formed the Fusion Wellness Center by November of that year.
She opened the Fusion Wellness Clinic in January 2015 at 1320 Southeast 122nd Ave., across the street from the Multnomah County parole and probation office.
“Word quickly spread of the small, cash-only clinic where opioid prescriptions came easy,” Maddux wrote in a sentencing memo.
By April 2015, DeMille and her business partner and office manager moved the clinic to 2442 NE 101st Ave., Suite 205, after the Southeast Portland location became too cramped, with patients waiting in their parked cars for their appointments on Friday and Saturday mornings.
Their prescription practices immediately triggered red flags, and prompted an inquiry by the Oregon Board of Nursing just three weeks after the Fusion clinic opened in 2015.
In early January 2015, three of the Fusion clinic patients received identical prescriptions on the same day for 60 tablets of 30mg doses of oxycodone. The three then went together to a pharmacy to fill their prescriptions. A pharmacist turned them away and alerted Gresham police. A Gresham police officer caught up with the patients on their way to a second, nearby pharmacy. The officer contacted DeMille, who insisted that the prescriptions were legitimate, and so the officer forwarded his report to the state.
The Oregon Board of Nursing requested DeMille provide files from eight specific patients.
According to the prosecutors, the clinic’s patient files in early 2015 included very few records, contained no medical histories, no prior medical records, few examination notes and no risk assessments for the use or abuse of opioids. But once contacted by the state board, DeMille forged patient signatures on newly-created forms, backdated and filled out forms that were not completed during a patient visit, and inserted falsified documents into patient files, Maddux said.
DeMille’s lawyer acknowledged that DeMille was “in way over her head,” but countered that his client never signed another person’s name, and never completed any forms for patients, but the same was not true for Idumwonyi, who often altered forms without DeMille’s knowledge.
The Board of Nursing eventually found DeMille’s charting and protocols for prescribing to be adequate. The Board of Nursing issued DeMille a letter of concern, but did not pursue disciplinary action until the close of the federal criminal investigation.
