New book details how prosecutors stopped 'New York's deadliest pill pusher' Dr. Stan Li, who wrote over 21,000 prescriptions for cash and was found guilty of manslaughter in two of his patients' overdose deaths

 The pill mill opened at 8.30am, but everyone knew to come earlier to get in line.

Like a bakery, the pain management clinic was first come, first served. A receptionist handed them a card and they waited for the well-credentialed doctor to call their number – not their name.

Dr. Stan Xuhui Li was ready to write several prescriptions for powerful drugs like oxycodone and Xanax for the right amount of cash.


It was a lucrative weekend practice for the anesthesiologist who worked at a New Jersey hospital during the week. From 2008 to 2011, Li wrote more than 21,000 prescriptions for controlled substances and raked in almost half a million dollars.

He saw patients 'long enough to write out the prescriptions and pocket the cash,' Charlotte Bismuth, a former assistant district attorney who worked with a team to prosecute Li, told DailyMail.com.

The price of his greed was high: Sixteen patients who died of overdoses are tied to the doctor. One of his patients, David Laffer, murdered four people at a Long Island pharmacy while stealing prescription pills on Father's Day in 2011.

Ultimately, Li was found guilty of manslaughter in two of his patients' overdose deaths and 196 other counts that included reckless endangerment, criminal sale of prescriptions, and falsifying business records in 2014. Li was sentenced to more than 10 years in prison and in April last year, he died of COVID-19 while serving his time. He had been at Fishkill Correctional Facility since 2015, according to PIX11.

It was a groundbreaking case in New York state: the first time 'a doctor faced homicide charges related to the overdose deaths of his patients,' Bismuth wrote in her new book, Bad Medicine: Catching New York's Deadliest Pill Pusher.

'When Dr. Li sold prescriptions for oxycodone and Xanax out of his weekend basement clinic in Flushing, Queens, he risked the lives of his patients. This story of recklessness, indifference, tragedy, and greed is so cruel as to be nearly unbelievable. It is the opioid epidemic in a microcosm.'

Dr. Stan Xuhui Li 'had excellent credentials: medical school in China, a fellowship at the University of Pittsburgh Medical Center, a residency at the Rutgers New Jersey Medical School, board certification in Anesthesiology and Pain Management, a license to practice medicine in New York and a job as an anesthesiologist at a teaching hospital in New Jersey,'  Charlotte Bismuth  wrote in her new book, Bad Medicine: Catching New York's Deadliest Pill Pusher.                 , a former assistant district attorney who worked with a team to prosecute Li

Dr. Stan Li, above, on the day of his arrest at his pain management clinic in Flushing, Queens in November 2011. After receiving a tip, Charlotte Bismuth, a former assistant district attorney, started looking into the doctor. He 'had excellent credentials: medical school in China, a fellowship at the University of Pittsburgh Medical Center, a residency at the Rutgers New Jersey Medical School, board certification in Anesthesiology and Pain Management, a license to practice medicine in New York and a job as an anesthesiologist at a teaching hospital in New Jersey,' she wrote in her new book, Bad Medicine: Catching New York's Deadliest Pill Pusher

The doctor likely earned $240,000 a year for his anesthesiology practice during the week and also ran a basement clinic in Flushing on the weekends, according to the book. From 2008 to 2011, Li wrote over 21,000 prescriptions for controlled substances like oxycodone and Xanax and raked in almost half a million dollars. He saw patients 'long enough to write out the prescriptions and pocket the cash,' Bismuth told DailyMail.com. Above, the door to his clinic

The doctor likely earned $240,000 a year for his anesthesiology practice during the week and also ran a basement clinic in Flushing on the weekends, according to the book. From 2008 to 2011, Li wrote over 21,000 prescriptions for controlled substances like oxycodone and Xanax and raked in almost half a million dollars. He saw patients 'long enough to write out the prescriptions and pocket the cash,' Bismuth told DailyMail.com. Above, the door to his clinic     

At Li's trial, the doctor's receptionist testified that a line was usually formed before the clinic opened at 8.30am. On a typical day Li saw 70 patients. However, there were times he saw over 100 patients, Bismuth told DailyMail.com. One of his patients was Nicholas Rappold, seen above on his prom night in 2007. In September 2010, Rappold, 21, died of an overdose in his car. 'Three days after he'd filled his last prescription from Dr. Li,' Bismuth wrote in Bad Medicine. Li was found guilty of manslaughter in Rappold's death

At Li's trial, the doctor's receptionist testified that a line was usually formed before the clinic opened at 8.30am. On a typical day Li saw 70 patients. However, there were times he saw over 100 patients, Bismuth told DailyMail.com. One of his patients was Nicholas Rappold, seen above on his prom night in 2007. In September 2010, Rappold, 21, died of an overdose in his car. 'Three days after he'd filled his last prescription from Dr. Li,' Bismuth wrote in Bad Medicine. Li was found guilty of manslaughter in Rappold's death

On Father's Day morning in 2011, David Laffer, above, went into a Long Island pharmacy and shot and killed employees Raymond Ferguson, 45, and Jennifer Mejia, 17. He then killed two customers who walked into the store, Byron Sheffield, 71, and Jaime Taccetta, 33. He stole oxycodone and fled. After he was caught and arrested, he pleaded guilty and was sentenced to life in prison, according to news reports. Laffer was one of Li's patients

On Father's Day morning in 2011, David Laffer, above, went into a Long Island pharmacy and shot and killed employees Raymond Ferguson, 45, and Jennifer Mejia, 17. He then killed two customers who walked into the store, Byron Sheffield, 71, and Jaime Taccetta, 33. He stole oxycodone and fled. After he was caught and arrested, he pleaded guilty and was sentenced to life in prison, according to news reports. Laffer was one of Li's patients 

It all started with a tip.

In December 2010, Bismuth was an assistant district attorney who was fairly new to the Office of the Special Narcotics Prosecutor. In 1971, New York City founded the agency, which is tasked with investigations and prosecutions, 'in response to a sweeping heroin epidemic,' she wrote. 

Over time, the office's focus expanded from illegal drugs to include legal prescription opioids and benzodiazepines. In the late 1990s, big pharmaceutical companies like Purdue pushed potent painkillers like oxycodone while they 'reassured the medical community that patients would not become addicted,' according to the US Department of Health and Human Services' website

Opioids were increasingly prescribed, which led to misuse, abuse, addiction, overdoses and deaths. The pills also fueled a black market.

The investigation into Li started with a note her boss handed her one night that December. In early 2011, she would meet a man she called Eddie Valora in the book. (It is not his real name.) 

Valora had been on disability since a young age, Bismuth told DailyMail.com. 

When he received a letter from Medicare outlining the payments made to Li, Valora realized he had been scammed. Li was making him pay cash when he visited the clinic with the doctor promising he would 'pay Valora back when Medicare paid,' Bismuth explained in her book.

When Valora confronted Li, 'two big guys who looked like bouncers from a bar' came in and 'went nuts' when he mentioned involving the police.

'We're gonna f***ing kill you,' they told Valora, according to Bad Medicine.

It was after this incident that he reported Li. 'Valora's life hadn't been perfect or easy - but if there was one thing he couldn't stand, it was to let someone get away with wrongdoing,' she wrote. 

In her new book, Bad Medicine: Catching New York's Deadliest Pill Pusher, Bismuth, above with her children when they visited her office in 2012, is candid about her personal struggles during the four-year period in which her team investigated and tried Li. She went through a divorce but later on met her current husband and had a third child

In her new book, Bad Medicine: Catching New York's Deadliest Pill Pusher, Bismuth, above with her children when they visited her office in 2012, is candid about her personal struggles during the four-year period in which her team investigated and tried Li. She went through a divorce but later on met her current husband and had a third child 

Bismuth practiced her opening statement for the trial several times. She wrote: 'I wanted the jury to understand the case as we had come to understand it: a human tragedy brought about by one man¿s greed.' Above, a photo of Nicholas Rappold, who died of a drug overdose, in the binder with her opening statement. 'We will prove that the defendant recklessly endangered the lives of four patients, recklessly caused the death of two patients, and put three additional patients at risk of death'

Bismuth practiced her opening statement for the trial several times. She wrote: 'I wanted the jury to understand the case as we had come to understand it: a human tragedy brought about by one man's greed.' Above, a photo of Nicholas Rappold, who died of a drug overdose, in the binder with her opening statement. 'We will prove that the defendant recklessly endangered the lives of four patients, recklessly caused the death of two patients, and put three additional patients at risk of death'

Through an 'overdose alert system' that Bismuth and the others working on this case set up, they were learned about Michael Cornetta, seen above, who died from the 'combined effects of fentanyl, cocaine, and benzodiazepines' on November 18, 2010 - 'a few months after his last visit to Dr. Li in August 2010,' according to the book

Through an 'overdose alert system' that Bismuth and the others working on this case set up, they were learned about Michael Cornetta, seen above, who died from the 'combined effects of fentanyl, cocaine, and benzodiazepines' on November 18, 2010 - 'a few months after his last visit to Dr. Li in August 2010,' according to the book

When Bismuth started looking into Li, she wrote that he was a doctor with 'excellent credentials: medical school in China, a fellowship at the University of Pittsburgh Medical Center, a residency at the Rutgers New Jersey Medical School, (and) board certification in Anesthesiology and Pain Management.'

At first, it was unclear why Li, who was working at teaching hospital in New Jersey during the week, would have a weekend pain management clinic in Flushing, Queens.

Later, the motive was clear: money. Bismuth, her fellow prosecutor Peter Kougasian, who then had been an assistant district attorney since 1979, and investigators spent years building their case against Li.

To keep the payments flowing from patients, Medicare and insurance companies, Li ignored signs of addiction, reports from medical professionals and his patients of overdoses and suicide attempts, and pleas from families who begged him by phone, letter and in person to stop prescribing the pills.

In the early stages of the investigation, Bismuth explains in the book that they set up an 'overdose alert system' that included sending requests to the medical examiners in New York City and nearby Nassau and Suffolk counties.

Through that system, they were learned about Michael Cornetta, who died from the 'combined effects of fentanyl, cocaine, and benzodiazepines' on November 18, 2010 - 'a few months after his last visit to Dr. Li in August 2010,' according to the book.

The team was eventually able to get a search warrant for his clinic in November 2011 and arrest Li. The Queens practice, which he ran from 2004 to 2011, was shut down for good. A grand jury then indicted Li on numerous counts. By the time it went to trial in 2014, Li faced 211 counts that included manslaughter in the case of two overdose deaths: Joe Haeg and Nicholas Rappold. 

'Even after all these years that sign is jarring,' Bismuth told DailyMail.com about the above fee schedule. She explained it outlined a pay-for-pills scheme. According to the book, it was 'posted on the reception window... It was no shocker to the clinic's regulars, because the sign simply formalized practices that had been in place for years in that weekend basement clinic: cash for prescriptions, with a penalty for drug abuse or wanting to kill yourself'

'Even after all these years that sign is jarring,' Bismuth told DailyMail.com about the above fee schedule. She explained it outlined a pay-for-pills scheme. According to the book, it was 'posted on the reception window... It was no shocker to the clinic's regulars, because the sign simply formalized practices that had been in place for years in that weekend basement clinic: cash for prescriptions, with a penalty for drug abuse or wanting to kill yourself'

'Doctors - especially those licensed to prescribe controlled substances - operated in a special territory, and if we were to pursue a criminal case against Dr. Li, we needed to be able to prove that he had stepped outside the boundaries of legitimate medical care and even further beyond, into illegality,' Bismuth wrote in Bad Medicine. Li's trial was the first time 'a doctor faced homicide charges related to the overdose deaths of his patients,' in New York state, according to the book. Above, Li leaves court during his trial in April 2014

'Doctors - especially those licensed to prescribe controlled substances - operated in a special territory, and if we were to pursue a criminal case against Dr. Li, we needed to be able to prove that he had stepped outside the boundaries of legitimate medical care and even further beyond, into illegality,' Bismuth wrote in Bad Medicine. Li's trial was the first time 'a doctor faced homicide charges related to the overdose deaths of his patients,' in New York state, according to the book. Above, Li leaves court during his trial in April 2014

Li's trial took 18 weeks and the jury found him guilty of manslaughter in the overdose deaths of Joe Haeg and Nicholas Rappold. 'This case treated overdose victims as crime victims. We believed that accountability mattered,' Bismuth said in the book's press release. 'This defendant was a doctor who knew better, and his victims deserved justice.' Above, pre-written prescriptions that authorities seized during a search of his clinic in November 2011

Li's trial took 18 weeks and the jury found him guilty of manslaughter in the overdose deaths of Joe Haeg and Nicholas Rappold. 'This case treated overdose victims as crime victims. We believed that accountability mattered,' Bismuth said in the book's press release. 'This defendant was a doctor who knew better, and his victims deserved justice.' Above, pre-written prescriptions that authorities seized during a search of his clinic in November 2011

Rappold was 21-years-old when he died of an overdose. He was found early one morning in his car in September 2010. A city traffic agent had issued a ticket for the car, according to the New York Daily News.

'The agent hadn't realized that the car's driver was still inside—or that he was dead. We peered at the fuzzy photo together: the driver was a young man with a smile, a backwards baseball hat, and a black hoodie. Cause of death? Suspected overdose. Three days after he'd filled his last prescription from Dr. Li,' Bismuth wrote.

During Li's trial, Rappold's mother, Margaret, testified that her son had admitted his addiction over the summer and was trying to get clean. He went through withdrawal but that August, she said that he seemed better. 

Rappold went to see Li on September 11 and the doctor prescribed Roxicodone and Xanax. After a night out with friends while taking the pills, he died in his car.

Li's trial took 18 weeks in 2014 and the jury found him guilty of 198 counts.

At Li's sentencing, Margaret Rappold spoke about the impact her son's death had on her, according to the book.

'I just feel that my heart was broken. It was just that he put his hand right through my chest and ripped my heart out…

I feel it was because of greed. But I forgive him. But I will never, ever forget what he did to me and to my family and to everyone who was associated with my son. He was a young man and I'm sure not an angel. He did not deserve to die.'         

Above, Peter Kougasian, left, a longtime assistant district attorney and Bismuth's trial partner, and Jon Courtney, right, an investigative analyst and paralegal with the Office of the Special Narcotics Prosecutor as the jury began deliberations in July 2014. Joseph Hall, a senior investigator with the office, also worked on Li's case

Above, Peter Kougasian, left, a longtime assistant district attorney and Bismuth's trial partner, and Jon Courtney, right, an investigative analyst and paralegal with the Office of the Special Narcotics Prosecutor as the jury began deliberations in July 2014. Joseph Hall, a senior investigator with the office, also worked on Li's case

'This book does not purport to be a journalistic overview of the opioid epidemic; it is a memoir from the trenches. It is a look back at a time when we hoped to be seeing the worst of it - before it got even worse. It is an expression of gratitude for the team, the work, and the resources that so many people devoted to stopping this killer in a white coat,' Bismuth wrote in Bad Medicine: Catching New York's Deadliest Pill Pusher, the cover is seen above. She told DailyMail.com that part of the book's proceeds will go to the nonprofit FED UP! Coalition

'This book does not purport to be a journalistic overview of the opioid epidemic; it is a memoir from the trenches. It is a look back at a time when we hoped to be seeing the worst of it - before it got even worse. It is an expression of gratitude for the team, the work, and the resources that so many people devoted to stopping this killer in a white coat,' Bismuth wrote in Bad Medicine: Catching New York's Deadliest Pill Pusher, the cover is seen above. She told DailyMail.com that part of the book's proceeds will go to the nonprofit FED UP! Coalition

New book details how prosecutors stopped 'New York's deadliest pill pusher' Dr. Stan Li, who wrote over 21,000 prescriptions for cash and was found guilty of manslaughter in two of his patients' overdose deaths New book details how prosecutors stopped 'New York's deadliest pill pusher' Dr. Stan Li, who wrote over 21,000 prescriptions for cash and was found guilty of manslaughter in two of his patients' overdose deaths Reviewed by CUZZ BLUE on March 09, 2021 Rating: 5

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