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Motion: More Overdose Charges Loom in Pill-Mill Case

A grandmother accused of heading up a $17.5 million pill-mill operation in East Tennessee has received two bits of bad news in the past week - her lawyer is bailing, and federal authorities are preparing to try to hold her legally accountable for even more overdose deaths than previously alleged.

In a motion filed earlier this week in U.S. District Court, a Florida attorney who has been representing accused pill-mill maven Sylvia Hofstetter says he needs to bow out of her case because she's stopped paying him for the work he's already done, she can no longer afford his services and she may soon be facing additional charges involving the overdose deaths of patients tied to her pain clinics.

Hofstetter is accused, along with unindicted Florida benefactors, of setting up a network of primary care and pain management clinics in Lenoir City and Knoxville that put 12 million prescription painkillers in the hands of addicts and netted $17.5 million in profit in six years and specifically targeting East Tennessee because of its epidemic levels of opiate addiction. It was the largest such operation ever unmasked in East Tennessee.

The 52-year-old grandmother was initially charged in 2015 with basic drug conspiracy and money laundering charges. But earlier this year, federal prosecutors Tracy Stone and Anne-Marie Svolto slapped her with a new indictment that included both a new set of defendants - five medical professionals - and a slew of new charges. Among those new allegations is a claim that Hofstetter, Dr. Richard Larson of Dandridge and nursing assistant Cynthia Clemons are directly responsible for the overdose death of a patient in February 2014. The new indictment carries a potential penalty of life in prison.

Defense attorney Richard Escobar has been mounting a vigorous defense of Hofstetter since her initial indictment, including seeking to have her trial moved outside East Tennessee. Escobar has a firm in Tampa, Fla. Hofstetter hails from Florida.

But in a motion, Escobar says he quoted a price for legal services to Hofstetter, who has been jailed since 2015, and her family based on the initial charges. That fee is wholly inadequate in the face of both the new allegations already filed and more charges Escobar said he expects to be filed in the case. He wrote that his firm hasn't been paid in a while now.

"Defendant and members of her family have stated that they are unable to pay the agreed-upon trial fee for the original indictment," Escobar wrote. "They have also stated they are unable to retain undersigned counsels for representation on the charges contained in the superseding Indictment. Likewise, payments on accumulated costs have also stopped. There are now no available funds to retain experts, cover travel and lodging expenses for trips to Knoxville, or even pay printing expenses."

Stone, he wrote, has "indicated to attorney Escobar that there is a probability and likelihood that a second superseding indictment will be sought alleging additional deaths and additional defendants."

It is technically up to a judge on whether an attorney can bow out of a case, but Hofstetter has signed an affidavit in which she agrees Escobar should be allowed to drop her case and signals the need for a court-appointed lawyer.

The FBI and other agencies in March 2015 raided three pain management clinics - one in Lenoir City and two in Knoxville - and at least two primary care clinics prosecutors contend were all linked. Stone and Svolto have alleged in court three men considered the kings of the South Florida pill-mill trade sent Hofstetter to East Tennessee to employ their playbook of creating cash-for-pills clinics that relied upon patients funneled from more legitimate primary care clinics and addicts whose trips were funded by so-called "sponsors" who took half their pills to sell on the streets. The three men, identified in court records as Luca Sartini, Luiga Palma and Benjamin Rodriguez and labeled on wire tape recordings as "the Italians," have not been charged. But more than 100 people have been, ranging from sponsors to patients to street dealers and users.

The new indictment represents the first time in this case that medical professionals who allegedly were paid to write prescriptions without examining patients have been drawn into the investigation and the second time medical professionals involved with East Tennessee pain clinics have been indicted as garden-variety drug dealers.

Now charged with Hofstetter in the new indictment is Larson, who was supposed to oversee other medical workers, New Jersey physician's assistants Alan Pecorella and Theodore McCrary and nursing assistants Clemons and Courtney Newman.

Prosecutors have said in court they suspect at least nine patients in the Hofstetter case died from overdoses. A trial in the case is not set until September 2017.

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