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Legal battle ends: doctor fails to overturn prison sentence for opioid prescribing fraud

Legal battle ends: doctor fails to overturn prison sentence for opioid prescribing fraud
Caryn Dolley
By Caryn Dolley
1 Dec 2024
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Afzal Beemath, a medical doctor from SA, has failed to set aside a jail sentence in the US, where he pleaded guilty to baselessly prescribing opioids worth millions of dollars to ‘patients’ who instead sold the drugs to others.

A six-year legal battle in the US has culminated in a doctor from South Africa failing to set aside a 10-year prison sentence for prescribing drugs to patients who did not need the medication and instead sold it to other people in the US.

Afzal Beemath previously pleaded guilty to several charges he was facing, but subsequently argued that his lawyers pressured him into doing so because he suspected they were not ready for a trial.

On 19 November 2024, though, it emerged that Beemath had not managed to set aside his prison term. A US court decision on the matter said it was anticipated that “Beemath likely will be deported to South Africa upon his release from prison”.

Palliative medicine


A 2013 article about him on the US news and information platform Patch said he was the first black palliative medicine director at the DMC Sinai-Grace Hospital in Detroit.

Beemath, a licensed medical doctor specialising in pain management, was involved in dealing with terminally ill patients.

The article said he was raised in South Africa and hoped to extend palliative medicine in this country by sending a voluntary team to assist with palliative care services or patients without access to such.

Two colleagues quoted in the article had praised Beemath’s work.

He was quoted as saying: “I always had a lifelong dream of being a physician. It also satisfies that personal craving for helping fellow man.”

Opioids worth millions


Beemath’s legal issues in the US started about six years ago, in October 2018, when an indictment against him was unsealed.

It alleged that he operated an outfit that marketed itself as a palliative care clinic in Lathrup Village in Michigan. Only cash was accepted as payment at the clinic.

The indictment claimed that between January 2013 and October 2018, Beemath conspired with others and prescribed opioids, which are used to treat pain but can be highly addictive, to patients who did not need the drugs.

At that stage he was accused of issuing more than a million dosage units of opioids worth in excess of $32-million.

The quantity, and therefore the value, of opioids that Beemath was accused of baselessly prescribing later became a point of contention.

Read more: Fatal fentanyl hits SA – Mexican cartels among drug trafficking gangs and money launderers ‘active’ in Mzansi

Opioids are a massive problem in terms of abuse and drug trafficking. Daily Maverick recently reported on how fentanyl, a synthetic opioid behind an overdose crisis in the US, has been picked up in South Africa and is among the drugs now being trafficked through the country.

In October 2018, when the indictment against Beemath was unsealed, the US Attorney’s Office for the Eastern District of Michigan issued a statement emphasising that handing out prescriptions with no medical necessity was illegal and a factor further fuelling the opioid epidemic.

Patients sold prescription meds


Details about the six years of legal proceedings Beemath has been through are contained in the November 2024 court decision about his imprisonment.

It was alleged that patients had paid to obtain appointments at Beemath’s clinic, and in exchange he had, without legitimate reasons, prescribed them oxycodone, oxymorphone and alprazolam.

“Patients then filled the prescriptions and sold the drugs,” the court document said. “Beemath worked with recruiters to find more patients; over five years, Beemath prescribed drugs with a total street value of some [$22-million].”

Read more: Waterford Doctor Charged With Prescription Drug Scheme

In October 2018, Beemath was charged with conspiracy to possess, and the unlawful distribution of, controlled substances.

A few months later, in April 2019, another 16 related counts were added to that.

Beemath’s South African citizenship became an issue as the case developed. It was found that because he was from this country and “has substantial family ties” here, “he posed a substantial flight risk”. He was therefore detained in custody in the US, pending a trial.

Guilty plea


But in about September 2019 he was granted bail with conditions because he had not been given adequate access to the materials he needed to prepare for the trial.

That month, Beemath pleaded guilty to 20 of the 30 counts he faced. According to the November court document, he pleaded guilty to conspiring with two others “to prescribe controlled substances without a legitimate medical purpose, and he acknowledged that his co-conspirators recruited patients to come to the clinic for the medications when they had no legitimate need for them”.

A runner, who was allegedly part of the scheme and delivered the medication, pleaded guilty in a separate case.

Read more: Opioid distributors win case alleging they fuelled drug abuse

During previous legal proceedings, the quantity of controlled substances that Beemath was to be held accountable for became a point of contention.

“After hearing argument, the court calculated a drug quantity of 20,067 kilograms, based solely on the prescriptions that the government’s physician expert had found to lack a legitimate medical basis from a review of patient records,” the November court document stated.

Beemath was sentenced to 10 years in prison. He appealed on grounds including that he could not adequately contest the US government’s drug quantity evidence because he had not had proper access to discovery materials, in other words, items of information.

His appeal was denied.

‘Lawyers pressured me’


Beemath pushed on and in January 2023 filed a motion to try to have the sentence against him set aside. This is what led to this November’s court decision.

It said that Beemath argued that his attorneys did not provide him with proper representation. He contended that “they did not learn about the nature of his medical practice, which led to their inability to answer the court’s questions at the sentencing hearing”.

Beemath added that his attorneys had failed “to submit documents that would have established the lawfulness of some of his prescriptions”.

He said they had also not submitted evidence relating to a 2o14 State of Michigan and Michigan Board of Medicine investigation against a co-conspirator which supposedly cleared him of wrongdoing.

“Beemath asserts that his lawyers pressured him into pleading guilty; he speculates that they were not ready for the upcoming trial.”

Read more: McKinsey agrees to pay $230m to settle more opioid lawsuits

But the November court decision said that the US’s case against him was strong.

“Although he maintains that his patient records establish the lawfulness of his prescribing practices, he has not tendered any evidence to support that argument,” it said.

“To the contrary, the evidence that the government presented at the sentencing hearing, bolstered by the opinion testimony of its physician expert, easily establishes that the government’s case against him was so strong that it would have been irrational for him to proceed to trial.” DM

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R35.

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