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#Inside a top doctor’s pill ring that left many patients dead

#Inside a top doctor’s pill ring that left many patients dead

The night he died in 2010, Nicholas Rappold dashed out of his house in Flushing, blowing a kiss to his mom. He said he was going on a date.

The handsome 21-year-old restaurant worker picked up his girlfriend Kaci, and they joined two high school friends to hang out in his Jeep Cherokee, cruising on the Clearview Expressway, listening to music.

They talked. They smoked pot. They took pills.

Rappold, an avid athlete who struggled with painkiller addiction, got high that night on Roxicodone and Xanax.

Later, after the friends got dropped off and Rappold took Kaci to her home in the Murray Hill section of Queens, he parked around the corner and passed out.

Opening statements expected in manslaughter trial of NYC doctor Stan Xuhui Li accused of the overdose death of two patients. The shady anesthesiologist prescribed hundreds of Xanax and oxycodone pills to a 21-year-old man in the five weeks before he was found dead from an overdose of the narcotics in 2010. Li also wrote scripts for drug-addled killer David Laffer who slaughtered four people in 2011 when he held up a Long Island pharmacy for pain killers.
Dr. Stan Li at his trial. On a wall in his office was a plaque honoring him as one of New York’s best doctors of 2003.
Steven Hirsch

A cop ticketed his Jeep in the morning but didn’t notice that Rappold was inside, slumped over the center console.

He had died of an overdose, one more tragedy in the opioid crisis. But his death was remarkable because of how he got the drugs.

They were supplied by Dr. Stan Li, a respected anesthesiologist who on the weekends ran a pain-management clinic out of a basement office in Queens.

Li would later become known as a notoriously reckless supplier of lethal drugs — the first doctor in New York state to be convicted of killing his patients with pills.

For $150 in cash, which he would slip into his white coat pocket, Li freely wrote out prescriptions for potent narcotics to anybody willing to pay, virtually no questions asked.

“It’s very mechanical,” said one witness at his trial, according to “Bad Medicine: Catching New York’s Deadliest Pill Pusher,” by Charlotte Bismuth. “He’s doing it to feed an addiction network as part of his business model.”

And the results were devastating: 16 people died of overdoses, some within days of seeing Li, writes Bismuth — the prosecutor who put him away.

One baffling part of Li’s practice was that he was a highly educated physician who emigrated from China as an MD, did a fellowship at the University of Pittsburgh Hospital and worked for Robert Wood Johnson Hospital in New Jersey.

On a wall in his office was a plaque honoring him as one of New York’s best doctors of 2003.

Haven Drugs Pharmacy where David Laffer gunned down four people
Haven Drugs Pharmacy where David Laffer — a patient of Li’s — gunned down four people.
victorialcorn.com

During the week, his regular practice in Flushing, where he treated mostly Chinese patients for pain and offered anesthesiology services for surgical procedures, had no problems. His wife, Anna Guo, was also a doctor who managed his legitimate practice, and they lived in Hamilton, NJ, in a “blue, two-story poolside home,” Bismuth writes.
But on the weekends, addicts packed his basement waiting room in a different Flushing office.

Sometimes they would line up down the block hours before he opened.

Patients’ families would occasionally call and plead with Li to stop prescribing dangerous drugs to their loved ones, Bismuth writes.

But Li kept going, motivated by money. The doctor raked in hundreds of thousands of dollars from his sketchy side gig — most of it in cash.

He was also double-dipping by collecting payments from patients, then submitting for reimbursement from insurance companies.

Fentanyl pills
Fentanyl, Vicodin, Xanax, Percocet — you name it — Li would prescribe it, no questions asked.
AP

If patients called him on the fraud, Li would promise to pay them back once he got paid.
In October 2010, one of them, a former bodybuilder called Eddie Valora, stormed into the doctor’s office angry, blowing past the waiting room and pounding on the doctor’s door.

“I want my money back!” he hollered.

Valora also demanded a refill on his Xanax prescription.

Li refused.

Not only wasn’t he going to give him money, the doctor made it clear that Valora would have to pay him another $150 if he wanted a fresh supply, Bismuth writes.

The patient threatened to go to the cops and expose Li’s dealings.

Suddenly two big guys employed by Li “who looked like bouncers from a bar” lunged at Valora and he bolted, Bismuth writes.

“We’re gonna f–king kill you,” they growled.

Charlotte Bismuth, author of "Bad Medicine: Catching New York's Deadliest Pill Pusher"
Charlotte Bismuth — the prosecutor who put Dr. Li away.
Lindsay May

Valora made good on his threat. He went to the cops and told his story, kicking off an investigation by the city’s Office of the Special Narcotics Prosecutor.

During her four years on the case, Bismuth learned that Li was not the only game in town. Addicts knew to see different doctors, to get their pills at pharmacies across the city and elsewhere.

One of Li’s patients was David Laffer, who came to Li in 2009 asking for help with knee and jaw pain. He was prescribed extra-strength Vicodin, then Norco three months later. Soon Li found out that Laffer was also getting Norco from another doctor, giving the patient access to 540 pills over three months.

But that didn’t matter to Li. He kept giving Laffer more.

The last time the doctor saw him was June 11, 2011.

Eight days later, Laffer walked into Haven Drugs in Medford, Long Island, pulled out a gun and killed four people.

It was a robbery so he could get more pills.

Li typically didn’t request medical records or perform tests on those who came in. The doctor saw as many as 120 patients a day, barely enough time to hear why they wanted pills before he grabbed his pad, Bismuth writes. One simply had to tell him a tale and he’d start scribbling.

No ache or pain was too small to require the most powerful opioids, including morphine and the surgical anesthesia fentanyl.

‘I did not create this problem. The problem already existed.’

Dr. Li, blaming the addicts who died in his care

One 30-something patient, Joe Haeg, visited the doctor in January 2009, complaining of lower back pain. Li prescribed Roxicodone, six pills a day. Three weeks later, Haeg was back, asking for more. Over the next 11 months, Li prescribed hundreds of additional doses, adding Percocet, Xanax, naproxen, gabapentin and a fentanyl patch.

Haeg stopped eating, couldn’t sleep, became withered and withdrawn.

“He was very confused,” his sister Kristin recalls in the book. “He would call me, he would say he was with imaginary friends or that he was working at two o’clock in the morning. Very bizarre.”

On Dec. 29, 2010, cops found Haeg sprawled out on a bed at his apartment in the Suffolk County hamlet of Moriches, with several empty medication bottles nearby, all stamped with the name of Li.

Almost one year later, on Nov. 19, 2011, Li was arrested. It turned out he had two bank accounts that appeared to be just for his pill mill, containing a total of $584,000, and he had raked in a further $140,000 in dodgy insurance reimbursements. His wife quickly divorced him and moved back to China.

Book "Bad Medicine: Catching New York's Deadliest Pill Pusher" by Charlotte Bismuth

In July 2014, a jury convicted Li on 195 counts, including two counts of manslaughter for the deaths of Haeg and Rappold. He was also convicted for having sold prescriptions to Laffer without a medical purpose. He was later sentenced to 10 to 30 years in state prison, but never admitted any fault, consistently claiming that he was trying to help his patients after other doctors had turned them down.

“I did not create this problem,” he said at his sentencing. “The problem already existed.”

Li died in prison of COVID-19, aged 66, on April 26, 2020.

Before Li was sentenced, Nicholas Rappold’s mother, Margaret, told the judge that she forgave the doctor.

“But I will never, ever forget what he did to me and my family,” she said.

Nicholas “was a young man and I’m sure not an angel. He did not deserve to die. And no mother should have to go through what I’m going through. I miss him terribly.”

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