Drug Enforcement Administration

New Orleans

Brad L. Byerley, Special Agent in Charge

April 24, 2017

Contact: SA Debbie Webber

Phone Number: (571) 362-4803

Nurse-Practitioner Sentenced In High Profile Pill Mill Case

Justin Palmer Forged Physician’s Signatures on Prescriptions at Least 25,000 Times

MOBILE, Ala. - A former nurse practitioner, Thomas “Justin” Palmer, has been sentenced to 30 months in federal prison for his role in the operation of a massive pill mill run by Dr. Xiulu Ruan and Dr. John Patrick Couch, announced DEA Assistant Special Agent-in-Charge Bret Hamilton and Acting United States Attorney Steve Butler of the Southern District of Alabama. 

Following service in the United States Navy Palmer began working as a registered nurse at hospitals in southern Alabama. He then went back to school and earned a Master’s degree in nursing. Upon completion, Palmer was hired by Physicians Pain Specialists of Alabama which was co-owned and operated by Dr. Ruan and Dr. Couch. Palmer originally worked under both doctors, however, after about six months Palmer began to work for Dr. Couch exclusively. While working for Dr. Couch, Palmer knowingly and intentionally conspired to prescribe various controlled substances outside the usual course of professional practice and not for a legitimate medical purpose. This included the prescribing of Subsys and Abstral - both of which are brand name forms of instant release fentanyl, a Schedule II Controlled Substance.
During the recent trial of Dr. Ruan and Dr. Couch, Palmer testified that he regularly saw patients without any oversight from a doctor. He also admitted to forging Dr. Couch’s signature on prescriptions, and estimated he did this approximately 25,000 times over a four year period. Evidence at trial showed that both Dr. Couch and Dr. Ruan knew Palmer was forging Dr. Couch’s signature.  However, disciplinary action was never taken, and he was never reported to the nursing board. Palmer also testified that he was a habitual intravenous drug abuser, and that he was under the influence of very powerful opioids virtually every day while he was seeing and treating patients.

Based on his substantial assistance, including his testimony in the trial against Dr. Ruan and Dr. Couch, Palmer received a 50 percent sentence reduction recommendation from the United States.  The Court accepted this recommendation, and then sentenced Palmer to serve 30 months in federal prison for his criminal actions.

Bret Hamilton, DEA Assistant Special Agent-in-Charge for the State of Alabama, stated, “Justin Palmer had an honorable and promising career. His patients expected him to provide them with professional medical care. Instead of the welfare of his patients being the basis for his decision making process, his greed for financial gain and his illicit use of drugs guided him.”

Acting U.S. Attorney Steve Butler stated, “As Judge Granade observed at the sentencing hearing, Justin Palmer’s conduct was ‘beyond the pale.’ Forging a doctor’s name on a prescription is reprehensible, and even more so is the conduct of the doctors that let Palmer do this. That said, the United States recognizes that Palmer began cooperating even before the arrest of Dr. Couch and Dr. Ruan, and that his testimony was an important part of trial. Thus, the United States accepts the 30-month sentence handed down by the Court.”

In addition, Robert Laskey, Special Agent-in-Charge of the Federal Bureau of Investigation, Mobile Division, stated, “This type of behavior in the field of medicine cannot be tolerated by a doctor or an employee of the clinic. The FBI will continue to vigorously investigate these cases with a sense of urgency.”

This case was jointly investigated by DEA-Mobile and FBI-Mobile.    

Parents and children are encouraged to educate themselves about the dangers of drugs by visiting DEA’s interactive websites at www.JustThinkTwice.com, www.GetSmartAboutDrugs.com and www.dea.gov. 

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