In revealing $2.4 million seizure, feds call Trolley Square clinic a 'pill mill'

Federal authorities seized nearly $2.4 million from a brokerage account belonging to a deceased Wilmington doctor, labeling past operations at his Trolley Square pain clinic a "pill mill."

The revelations follow months of mystery surrounding a September police raid on the clinic that is tucked away within a shopping center between a laundromat and massage parlor.

Neighbors' descriptions of the raid provided most of the details known to the public. Last fall, they said they saw federal agents for hours hauling boxes away from the Delaware Chronic Pain Management and Detox Center.

Just two weeks before, clinic owner Dr. George Dutkewych had died.

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His obituary, which called the death sudden, told the story of a man born in the former Soviet Union who later became a U.S. Army Green Beret and then a private surgeon. He had practiced medicine in Bolivia, Florida, New York and Wilmington. 

Several former patients commented in the online obituary, sharing warm memories of the doctor. One said he had saved her life.  

The U.S. Drug Enforcement Administration declined to comment last fall, but had briefly disclosed in government documents that agents had seized from the late doctor two cars – an Acura and a Lexus – as well as bundles of cash from his clinic and bank account assets totaling more than $300,000. 

They cited laws prohibiting the illicit sale of controlled substances as the reason for the seizure.

Last month, federal prosecutors filed court documents disclosing that the government's ultimate haul from the Trolley Square doctor – with the addition of the multimillion-dollar brokerage account – was closer to $3 million. 

While questions remain about the nature of the clinic's business, the court filings added details to its story. Still, it is one punctuated by sharp divides between patients who said Dutkewych did good by supplying critical medicines and federal authorities who say his clinic illicitly supplied opioids through mostly cash transactions. 

In court documents, prosecutors said Dutkewych, whom they referred to by the initials G.D., owned 70% of the clinic at the time of his death. "His relatives" own the remainder, they said. 

Prosecutors noted the existence of two other prescribers at his clinic.

Together, they operated the pain clinic as a "pill mill, at which drug dealers and addicts could buy prescriptions for frequently abused controlled substances ... without any medical necessity."

For seven years before Dutkewych's death, employees at the clinic, which operated under the legal name DE CPM and Detox Center LLC, deposited $13.7 million into a WSFS Bank account. The money flowed to the clinic because of its prescriptions of oxycodone, morphine, oxymorphone and methadone, prosecutors said.

While court documents claim the clinic supplied dealers, they did not go into detail about the structure of the flow of drugs.  

It can be difficult to separate users from dealers, said Sam Quinones, author of Dreamland, a 2015 book that changed, in part, the national conversation about opioids.

"In the world of opiate addiction, it doesn't take much for a user to become a dealer," he said. "You're dealing to support your addiction ... and those lines get blurred quickly."

Direct 'questions toward the DEA'

The September raid was not the first time Dutkewych's operations attracted scrutiny from authorities.

A Delaware drug regulator told Delaware Online/The News Journal in 2011 that Dutkewych's medical practice – which was among the top half-percent of opioid prescribers in the country in past years – was suspicious because it charged patients $200 in cash for visits and, at the time, wrote 500 to 750 prescriptions a week for narcotics and anti-anxiety medications. 

Yet, despite its past and prosecutors' recent claims, there are no criminal cases associated with their seizures. A spokesperson for the U.S. attorney for the District of Delaware declined to comment. 

A call to the still-operating Delaware Chronic Pain Management and Detox Center was not immediately returned. Last fall, a clinic employee also declined to comment.

On Thursday, Dutkewych's widow referred questions to her attorney, Adam Balick. In an email, Balick declined to comment until after he files a response to the government's civil claim against the late doctor's assets. 

On Tuesday morning, the parking lot adjacent to the Trolley Square clinic was half-filled with cars bearing Delaware and Maryland plates. Inside some were people wearing masks and gloves waiting to be called into the office amid the coronavirus pandemic. 

One who declined to comment for the story proceeded to walk into the facility. An employee then exited the clinic and asked that reporters direct "questions toward the DEA."

Another patient, who was waiting to be seen, said he believes the DEA is wrong about the clinic. The sentiment echoed those expressed last fall from patients quick to defend Dutkewych.

Most said they suffered from pain that would prevent them from holding a job without medications. One longtime construction worker said he wouldn't "get out of bed" in the morning if not for the prescription painkillers. 

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Yet, such prescription drugs have long been blamed as a root cause of the opioid crisis. As patients took what many thought were innocuous pain pills after surgeries or injuries, some became hooked. 

Prescription opioid overdose deaths have fallen recently in the United States, while fatalities from the stronger, cheaper drug fentanyl have surged.

The Centers for Disease Control and Prevention reported 12,757 overdose deaths from prescription painkillers in 2018, down from 14,926 deaths in 2017. A study published in 2016 by the American Public Health Association attributed reductions in overdoses, in part, to police enforcement actions at pain clinics. 

More than 300,000 people have died from opioid overdoses during the last two decades, according to the Centers for Disease Control and Prevention.

In October, the DEA's independent watchdog painted a damning picture of its oversight of opioids during the past two decades, claiming the agency was slow to respond to an exploding epidemic, allowed bad actors to keep manufacturing and distributing opioids, and failed to prevent controlled substances from entering the illegal drug trade.

In response, the DEA said it improved how it detects and deters bad actors and has imposed millions of dollars in civil penalties against drug companies.

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Bad backs and rheumatoid arthritis

Before forming the Delaware Chronic Pain Management and Detox Center in 2007, Dutkewych practiced medicine in Florida and New York. Before his death, he had been living in West Chester, Pennsylvania, and also owned a townhome within a beach development, 90 miles north of Miami.

Public records show numerous Florida addresses associated with Dutkewych over the past two decades, but their exact relationship to him is unclear.

In 2011, Dutkewych told The News Journal he was prescribing pain medicine responsibly. To ensure patients were not abusing their medications, he regularly would count patients' pills and conduct urine tests, he said then.

He also scoffed at the notion that he was breaking any law. His patients had bad backs, rheumatoid arthritis and pelvic injuries, he said then. 

"Thirty-seven years of being a physician, all of a sudden I'm turning into some felon," Dutkewych said in 2011.

Reporter Xerxes Wilson contributed to this story.

Contact Karl Baker at kbaker@delawareonline.com or (302) 324-2329. Follow him on Twitter @kbaker6. Contact Nick Perez at (302) 324-2856, nperez@gannett.com or Twitter @nickdnperez. Reporter Meredith Newman contributed to this story.