Police say patients lined up at doctor's office, prescriptions in hand
CHARLESTON, W.Va. - The Logan building had no running water or examining tables, and the Texas doctor running it did not have any medical equipment on hand, but he did have a prescription pad, authorities said.
Dr. Fernando Gonzalez-Ramos, 47, of El Paso was arrested Sunday morning at his makeshift office on Old Logan Road after federal, state and local authorities showed up with a search warrant.
Gonzalez-Ramos was charged with conspiracy to distribute controlled substances, according to federal court documents. He is a practicing physician at the VA Hospital in El Paso but is licensed in West Virginia and Puerto Rico.
Officers began conducting drive-by surveillance of the office in December, noting the steady flow of people coming and going. Surveillance revealed one person spent five to 10 minutes inside, according to a search warrant.
A State Police trooper watching the office on Dec. 1, a Saturday, noted about 50 vehicles stopping in a two-hour period.
The FBI obtained a search warrant for the office Friday and was still conducting surveillance Saturday. Officers noted a number of people going into the building, including a patient who was secretly working with authorities.
The patient went inside and paid $450 in cash for a prescription of hydrocodone. She was in and out of the building in about three minutes, according to a criminal complaint filed late Monday and made public Tuesday.
Officers were back at the building about 8 a.m. Sunday. They found people waiting in a line outside.
When officers executed the search warrant about two hours later, they found the inside of the building "full of people waiting to get their prescriptions," the complaint said.
"It was clear that the prescriptions were being written outside the bounds of professional medical practice and were not for legitimate medical purposes," the complaint said.
"First, the building was not set up or furnished like a doctor's office. There were no examination tables, Gonzales (sic) did not have any medical equipment (no stethoscope, blood pressure machines, scales), and the building did not even have running water."
The employees described at the office were an armed security guard, a bodyguard carrying brass knuckles and a nurse/receptionist. Investigators said the nurse collected $450 cash from each customer getting a Schedule III drug and $500 from those getting a Schedule II narcotic.
The prescriptions were all prewritten and stored in patients' files, the complaint said.
The nurse, whose name has not yet been released, told investigators she made appointments with patients for the times Gonzalez-Ramos told her he would be in town. He traveled back and forth between Logan and Texas.
She said she wrote "progress reports" for the patients and prescriptions but did not sign them. The nurse then would mail the patient files to Gonzalez-Ramos in Texas. He would bring the signed notes and prescriptions back with him when he returned every few months.
"The investigation has revealed that Dr. Gonzales' practice of coming to Logan, West Virginia every three to four months is a sham and is solely for the purpose of writing a large number of narcotic prescriptions for cash," the agent wrote in the search warrant. "Dr. Gonzales travels to West Virginia for one day and then leaves the state.
"The Office is simply a building with a parking lot capable of allowing a lot of customers to arrive, pay for and obtain a prescription, and leave."
The agent said there also was no place in the office to store patients' records. He wrote that the only records seen at the office were in a box brought in by the nurse, and were only for those patients that would be seen that day.
Sgt. Michael Baylous, State Police spokesman, said authorities find out about questionable operations most often from members of the community.
"One of our best resources are the people in the community," Baylous said. "They know where people are lining up to get their pills, and they know when people are just a problem."
He said investigators receive tips online and by phone and sometimes just from talking to people while patrolling.
Baylous said cases involving doctors abusing their authority could be very complex.
The doctor was believed to have had 3,090 patients between July 2011 and February 2013. Investigators believe Gonzalez-Ramos made more than $1.1 million from those patients.
Gonzalez-Ramos is being held at South Central Regional Jail without bond. He appeared before U.S. Magistrate Mary Stanley Monday and will appear for a preliminary hearing this afternoon.
The matter remains under investigation.
Contact writer Ashley B. Craig at firstname.lastname@example.org or 304-348-4850.