It didn’t matter that the septuagenarian hadn’t been stealing from his granddaughter before OxyContin came along, or cashing out his relatives’ life-insurance policies, or borrowing guns for protection from his new pill-peddling associates. It didn’t matter that he’d been treated with lower-strength opioids after losing two fingers to a 1980 coal-mining accident but did not develop a $300-a-day drug habit until 1999, shortly after his first bottle of OxyContin.
Nor did it matter that people like Van Zee had urged Dr. Norton not to fall for the Purdue reps’ spiel about “the great epidemic of untreated severe pain.” Van Zee had seen Norton’s clinic in nearby Duffield, with its parking lot full of out-of-state cars, and confronted him about it at a hospital meeting. (“I said, ‘You know, Rich, people are injecting this.’ And he was astounded,” Van Zee recalled.)
In 2000, Norton was sentenced to five years in federal prison, not for overprescribing OxyContin but for his role in an unrelated hospital corruption scheme. According to sales-rep notes subpoenaed in the McCauley case, federal prosecutors were also investigating Norton for operating a pill mill but opted to front-burner the wider and more urgent corruption case.
Stallard, the Big Stone Gap drug detective, remembered an informant unpacking the life of a Norton patient: “He told us, ‘Dr. Norton wrote prescriptions for Lortab, forty-milligram OxyContins, and eighty-milligram Oxys all in the same visit.’” When Stallard subpoenaed the physician’s records, he saw Norton had prescribed thousands of OxyContin pills in just thirty days.
Stallard turned the information over to Brownlee’s assistant prosecutors, who said physician cases were difficult to prove, since there was always another paid physician expert willing to testify that such prescription dosages were necessary. Nonetheless, the prosecutors brought in DEA agents to help target the most egregious prescribers, and local detectives started feeding them information, Stallard said.
“We sent all kinds of information in to the feds but we never got anything back out of them. They told us nothing,” he added, of Brownlee and his assistant prosecutors. “We started calling them the Shadow Company.”
The federal investigation actually began when the Shadow Company realized Norton was simply following his Purdue rep’s guidelines to a T, Stallard said.
But none of that counted in the civil cases against Purdue, wherein plaintiffs had to prove that a specific injury was directly tied to company wrongdoing with such specificity that a reasonable jury could assign the wrongdoing a dollar amount. Federal judge James P. Jones dismissed the McCauley case on the grounds that a jury would not have been able to divine whether OxyContin alone had caused the coal miner’s suffering.
Though other judges across the country simply dismissed the OxyContin lawsuits, Jones took the unusual step of inserting a personal opinion into his ruling: “Does the relief afforded by high-dosage opioids to those with severe, life-altering pain outweigh the risks of harm from addiction?” he wrote. McCauley’s case did not answer that question, he said.
*
A God-fearing Baptist, Fayne McCauley had loved country music and the Atlanta Braves. Everyone in the town of Jonesville knew him because he had refereed home basketball games at Lee High School for many years. His family had sent him to rehab seven times, before and after the case. “Every time he’d come back and lie to us and say he’s not taking the pills anymore when we knew he was,” his daughter, Lisa Green, told me. McCauley ended up selling family heirlooms at a flea market. He stole credit cards to buy a four-wheeler that he sold for money to buy drugs. “He would say my mom was trying to kill him when my mom doesn’t have a mean bone in her body,” Green added. “That drug took over his brain.”
Two years before her father’s death, Green would drive to her parents’ home to rescue her mom, bringing her back to Texas to live with her. Together they waited, cringing every time the phone rang late at night. Around dawn on October 22, 2009, it finally did.
When McCauley, seventy-five, died four years after his case was tried, police found him in his lime-hauling truck at 4 a.m. in the middle of a pasture—he’d crashed through a fence. Several near-empty bottles of pills, prescribed just two days earlier, were strewn on the seat next to him. A state trooper told McCauley’s daughter and wife that he died of a heart attack, but his daughter believes he was murdered over a bad drug deal.
His head was blown apart, she said, as if from a gun.
*
The boxes of juicy sales-rep call notes and depositions that represented Fayne McCauley’s case files did not molder in Yeary’s law office attic. They were folded into Wood and Brownlee’s trove of ammo for their case against Purdue. By the time Yeary lost the case, Brownlee’s office was in the process of secretly logging millions of records on spreadsheets. The Wood Reports were coming out at a rate of four or five a week, and one employee was assigned to do nothing but catalog documents for the investigation—all of them buttressing Brownlee’s belief that Purdue had knowingly concealed the drug’s addictiveness.
When a New York Post reporter broke the news in 2005 that a federal grand jury was investigating Purdue, Van Rooyan told Bisch and the other RAPP parents, “They think they’re going to run roughshod over a bunch of hillbilly lawyers.” She recalled how Udell had gloated over the scores of legal wins against people like McCauley, and his pledge that the company would never settle such “absurd lawsuits.”
But the company and its executives underestimated the U.S. attorney from Roanoke, who brought in prosecutors from neighboring jurisdictions and deputized them as special assistants to pick up the non-Purdue-case slack. To lead the Purdue investigation, he appointed assistant U.S. attorneys Randy Ramseyer and Rick Mountcastle, career government lawyers who were not given to drama and worked three hours west of Brownlee in the district’s satellite office in Abingdon, closer to the coalfields.
It would never occur to either of them to tote around a podium—or to voluntarily talk to the press. When I interviewed Ramseyer almost a decade later, he deflected questions with a combination of press paranoia and aw-shucks humility: “Sometimes people get intimidated by big companies and high-dollar lawyers. You just have to avoid that.” And: “It’s not rocket science; it’s just hard work.”
But Ramseyer and Mountcastle had watched their caseloads shift dramatically since OxyContin’s introduction. And they were well aware that the few federal prosecutors who’d earlier tried to bring Purdue to account for rising Oxy-related crime had fallen short, with only a handful of exceptions. Jay McCloskey, the U.S. attorney in Maine, had challenged the company’s promotional techniques early on, with some success. He had pushed the company to drop the doctor junkets and the 160-milligram version of its pill, only to leave his post in 2001 to work as a consultant for—wait for it—Purdue Pharma.
But the Abingdon prosecutors were content doing government work. Ramseyer and Mountcastle had sent a host of pill-mill doctors to jail over the years—one of whom had been doling out prescriptions from the back seat of his car. Since OxyContin’s introduction, the tiny Abingdon office had successfully prosecuted ten doctors, pharmacists, and dentists for overprescribing the drugs, including to nine-year-old kids. By the time their investigation was over, nine state and federal agencies would spend five years helping the stone-faced prosecutors build the case. Unlike the civil lawsuits that preceded them, Brownlee’s team had to prove only that the company had “misbranded” the drug, a broad and somewhat technical charge that makes it a crime to mislabel a drug or fraudulently promote it, or market it for an unapproved use. The federal prosecutors didn’t have to prove the misbranding was actually responsible for the overdoses and the addiction and misuse, just that Purdue Pharma had criminally misbranded the drug, according to Hammack, the Roanoke Times courts reporter. “So it was a very murky legal line, but Randy and Rick figured it out. But there was definitely this feeling by Purdue that this was a little bit of a backwoods, small-town outfit. I think they underestimated them to some degree,” Hammack said.