Case II: Chapter 11: We Need A Strategy

Case II: Chapter 11: We Need a Strategy

It didn’t take much effort for Dudley to convince Isabella that he wanted to talk with her. To say that she was expecting an explanation after seeing him with Frank Garcia would be an understatement.

The next morning the three of them met in Isabella’s office. Dudley began by explaining what he observed in the physical therapy room and his suspicions regarding Ekaterina Bubolsky’s special drink concoctions. He briefly summarized the results of the lab tests that he requested through Lt. Garcia. He concluded by saying that it was important to not accuse someone of a serious crime when, in reality, it may be nothing more than a very clever approach to physical therapy.

“But if there is something going on with these prescription medications, we need to know about it as quickly as possible, said Isabella quite forcefully. I will not jeopardize the reputation and integrity of La Vida Aureo under any circumstances.”

“Then we need to figure out how to run this to ground as quickly as possible with the maximum amount of discretion”, offered Garcia. Doc, you may have probably already aroused some suspicion with Ekaterina and you need to back away from any direct involvement in future actions. Is also important to that we determine whether this is the activity of the single individual, namely Ms. Bubolsky, or whether or she is simply part of a larger operation. Although she appears to be very clever, my gut tells me that she is not acting alone. Do either of you know what her connection is to the orthopedic surgeon who recommended her?”

“I do know that she came highly recommended by Doctor Malinikov’s office, said Isabella, and he has also sent a number of his patients here for rehabilitation after knee or hip replacement surgery. All of those patients checked out through our initial screening process so they are legitimate patients. Suppose I contact a number of the other facilities in the Albuquerque area? I know a number of other Executive Directors personally and can speak to them on a confidential basis to inquire if they have seen anything similar to do what Doc has observed.”

“I think that makes sense, said Garcia, but I trust you will be very circumspect in your initial questioning. We don’t want to alarm people or alert to anyone that we are suspicious. I would also like to consider setting up some kind of undercover sting operation to gain a better understanding of exactly what’s going on and the extent of these activities.”

“I think I forgot to mention the interchange between Bubolsky and one of the patients in our facility, namely Horace Johnson, added Dudley. Last week they seemed to be having an argument and he accused her of trying to recruit someone, a new patient. I think there may be some significance to his use of the word recruit and I think it is important to understand what she was potentially recruiting him to do.”

“That makes sense, Doc. The patients are the ones who have legal access to these drugs and need to have some role in the overall process.”

“It’s also important to mention that Ekaterina had offered to pick up Mrs. Arthur’s pain medication prescription for her. And, as I mentioned, Mrs. Arthur complained that her pain medications weren’t working once she began working with Ekaterina. In that case, I don’t think she recruited Mrs. Arthur but she may be using her to gain access to her legitimate prescriptions.”

“The instances that you described would give Ekaterina access to the prescription medication drugs and if she is substituting over-the-counter analgesics, she would then have the prescription drugs to do with as she pleases.”

“Let me summarize, said Isabella. It sounds like we’ve identified a potential source of the drugs as well as a very clever way to obtain them from patients without their knowledge.   I suspect Mrs. Arthur is an unwilling participants but it is still not clear to me what role Mr. Johnson’s playing.”

“It is obvious, at least to me, that he is involved and is somehow being manipulated by Ekaterina’s wiles.”

“I think we have a good place to start, said Garcia. If it is 0K with everyone, let’s meet back here next Monday morning and review the situation and decide on how to proceed. I appreciate your raising the red flag, Doc, and I appreciate your full cooperation, Isabella.”

“As I said, I will not tolerate any kind of suspicious, much less illegal, activity in this facility.”

As they all got up to leave, Isabella asked Dudley to remain. “I am still a little upset that you didn’t tell me about this situation sooner. I assume you have your reasons. I understand you were hesitant to say anything and accuse people of a potentially very serious crime. Remember, you were the one who said we don’t need any more Millicent Branches at this facility!”

“I appreciate your understanding, Isabella. You are correct. I had to observe several instances before I decided to act and even then it was difficult for me.”

“Even though Garcia suggested that you stay in the background as this investigation proceeds, I still want you involved in all future discussions with him or any other authorities involved. I know you share my commitment to this facility and its residents and would do everything to protect its integrity.”

The following Monday morning, Lt. Garcia, Isabella Duncan and Matthew Dudley met in her office to review what they had learned. Isabella began by summarizing the conversations that she had with two other executive directors.   “Each of them has one physical therapist that came highly recommended through Dr. Malinikov’s office, one young man and one young woman. Both seem competent and well liked by the residents and neither of them is using this idea of a special shake drink to facilitate taking the pain medication. There was, however, some concern expressed by some residents that their rehabilitation wasn’t progressing very rapidly and that the level pain they were experiencing seemed to be intermittent. There was no evidence that they were not receiving pain medication, or at least what they were told was prescription painkillers.”

“I’ve been able to do some background checking on this Dr. Malinikov, said Garcia. He joined the Sierra Vista Orthopedics Group within the past year. There are no complaints filed with the State Medical Board and he seems to have steadily increased his practice. He also has begun delivering guest lectures at the local junior college to physical therapy and healthcare aide students.”

“I’ve also talked to my colleagues on the drug enforcement side and there seems to be an increasing amount of drug overdoses related to prescription pain medication in some of the more well-to-do parts of Albuquerque. I don’t know if these events or are connected but I thought it was worth mentioning this bit of information.”

“Have you given any more thought to some sort of undercover or sting operation?” asked Dudley.

“We have. We’ve arranged for two people to be placed in two separate rehabilitation facilities. One is an officer who had recently had major knee surgery and the other is an administrative person who suffers from chronic back pain. I decided that it would not be appropriate to have either of these people at this facility.”

“I had a meeting with my counterpart in drug enforcement to talk about possible ways that this entire operation might be set up and alternative ways for the prescription meds to flow from a legitimate source to the street market. He told me that it is typically necessary to provide some mechanism so that the legitimate owner of the prescription can be deceived. He described some cases where older people have simply not been given their medication and it was stolen by a friend or relative using the excuse of picking up the prescription for the older persons to have. He also described situations where some sort of sugar pill or substitute was provided in lieu of the prescription painkiller. His final comment was that the people who are participating in this area illegally had become increasingly creative as these opioids have become the “drug of choice” in certain parts of the city.”

“This entire area is new to me, said Doc. But I can certainly see how those techniques could be employed just based on what I’ve seen with the two instances of Horace Johnson and Martha Arthur.”

“I think we can learn from what we’ve seen in the past few days, said Garcia and I will be responsible for the next series of actions. While I realize this is primarily a police matter, I will report back to you as soon as we have further information and before we take any action that involves this facility.”

“Thank you very much, Lt. Garcia. Please let me know if there is anything that Doc or I can do to expedite this process. I know you must move cautiously but I remain concerned about the health and well being of our residents and other elderly citizens and facilities throughout the city.”


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