WFAA reveals questionable practices inside two pain clinics now under DEA scrutiny

WFAA is shooting video because our informant said drivers recruit people on these inner-city streets.

News 8 Investigates

A note to viewers: Last year, a man who lives in a homeless shelter asked WFAA to check out a clinic he said was picking up homeless people and paying them to get prescriptions for painkillers. To find out if his story was true, we hit the streets and recorded what we saw. We also asked our homeless source to wear a camera and record the next time he was offered a ride. In exchange, we agreed to protect his identity. This is what we found.

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DALLAS -- It's 4:30 a.m. in downtown Dallas near The Bridge homeless shelter.

This is the scene at night – a sea of humanity, blanketing the sidewalks, huddling on concrete to sleep and stay warm.

To many, these are the unfortunate souls society simply can't help. To others, they may be a gold mine.

WFAA is shooting video because our informant said drivers recruit people on these inner-city streets.

He said drivers target the homeless – because they are likely to have a Medicaid ID and a willingness to play along for cash.

On four different occasions, from July to October, WFAA recorded drivers spending nearly an hour recruiting homeless to deliver them to two clinics in Mesquite.

Sometimes the drivers took them to the clinic off Highway 80 in east Mesquite called DFW Bridge Care.

At 5:40 a.m. one morning, we found it already open for business.

We watched as more than a dozen people filed in to see the doctor.

A short time later, just a few miles away, at another DFW Bridge Care clinic on East Kearney Street, another lobby filled with patients.

Outside in the parking lot, three rows of cars, filled with people, lined up and waiting. In one of these cars, our informant is wearing our hidden camera and captures what's about to happen.

Our hidden camera captures what appears to be a clinic staffer, wearing scrubs, walking from car to car gathering names. Minutes later, WFAA cameras record video of passengers. Their names are called – and they file inside the clinic, four or five at a time.

There at the reception desk, that same “staffer” in scrubs, calls the patients in to see the doctor.

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The doctor is Philip Kelton, a retired cosmetic surgeon.

Watch now as the patient wearing our undercover camera is called. He told us he was coached by the driver on what to say.

“Wait right there. How many pills you taking?” the doctor asks.

“Per day? A whole bunch ‘cause I was in a car accident. Just as many as I can get”

“Just three.”

“I was in a car accident on the 16th, I've been to the emergency (room) three times with this back.”

“Ok, we'll have your medicine ready.

“Ok, thank you so much doctor."

The encounter lasts 22 seconds and began with the doctor saying, “Wait right there” at the door.

After his office visit, our undercover patient said he never actually receives a written prescription or pills.

Instead, our undercover video shows his driver gives him $50 cash.

WFAA was unable to determine where the pills end up.

Our Investigates team later arrived at the two clinics to inquire about what we documented.

At one location, the clinic staffer can be seen hustling away from the clinic.

Staff at the other clinic on East Kearney Street allows WFAA inside, and we see dozens of patients waiting. Several are unable or unwilling to identify the doctor. We are taken to the doctor’s office.

Minutes later, Dr. Kelton appears.

It’s the same doctor seen by our undercover informant. He allows producer Mark Smith to ask him questions raised by WFAA’s investigation.

Dr. Kelton said he sees about 30 patients a day with chronic pain in each of the two clinics – the same clinics where WFAA recorded SUVs delivering patients. He said he’s been working at both clinics for about 10 months.

“We give them a certain number of pills,” Dr. Kelton said. “Three per day is standard … 90 per month.”

“What do you prescribe to them?” our producer asked.

“It’s narco, a 10-milligram hydrocodone pill,” Dr. Kelton said.

Dr. Kelton tells WFAA several times he’s unaware of any possible cash exchanged for prescriptions.

"No, I’m not aware that someone is paying somebody $50 to come in and get pills,” Dr. Kelton said.

Our producer asked Dr. Kelton about the amount of time he spends with his patients.

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“It will vary but, it will be a short time,” Dr. Kelton said.

“Very short?”

“Pretty short,” Dr. Kelton said. “A minute and a half.”

“A minute and a half and you can make an assessment on an opioid prescription on that?”

“Sure,” Dr. Kelton said.

“Really? Without doing any kind of check up on them at all?”

“Sure,” Dr. Kelton said.

“Do you think that’s standard medical procedure?”

“I think it is for this particular practice, yes, this sort of circumstance, I do,” Dr. Kelton said.

Our producer asked Dr. Kelton about prescribing opioids this way.

“When you’re prescribing opioids isn’t that a big deal, nowadays?”

“What a big deal?” Dr. Kelton asked.

“There are pill mills out there, doctor. Isn’t that a concern that you may be operating a pill mill?”

“Sure,” Dr. Kelton said. “That’s the reason that I ask each patient, if I can, to bring me your evaluations so I can see what happened to your back, see if we can in some way, get that treated such that you can go back to work.”

We asked about where he gets his patients.

“Not sure,” Dr. Kelton said. “Don’t know, don’t ask.”

“You don’t know your patients?”

“I know basically what’s wrong with them,” Dr. Kelton said. “But I don’t know where they live or what their family circumstance is.”

We also inquire about the lack of medical equipment in the clinic.

“It’s pretty much of a history-based circumstance,” Dr. Kelton said. “Patient comes in. We’re not evaluating them. We feel like if we can get them … back to work, which is the concept of the clinic in the first place.”

The office manager also explains.

“We’re doing chronic pain, so I do have some instruments to check the level of pain,” she said. “I’ll show you.”

She brings out two instruments.

“We have the reflex hammer and we have this,” holding a tuning fork.

The office manager, who identified herself as Bianca Karawa, also denied knowledge of homeless patients being paid to come see the doctor at the clinic.

We showed our video and images to a former prosecutor.

“What we don't see in these particular videos is any type of real doctor/patient relationship,” said Matt Orwig, the former U.S. Attorney for the Eastern District of Texas who has experience prosecuting medical fraud cases.

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He said he’s concerned the standard of care spelled out in strict new federal and state pain management regulations may not have been followed.“As far as I can tell, there's no discussion of symptoms, there's not discussion of a need, no discussion of medical symptoms,” Orwig said.

“There's no medical discussion whatsoever.”

Orwig says the concerns about a flood of opioids are not unfounded.

In an unrelated case, filed in federal court, a Dallas-area former clinic owner was sentenced late last year to prison for operating so-called opioid “pill mills” in Dallas and Arlington.

According to court documents, Stanley James Jr. pleaded guilty to operating “illegitimate clinics, commonly referred to as ‘pill mills’" that may recruit homeless or indigent individuals to pose as patients.

In that case, people were “paid a fee, such as $30, to pose as patients to go to clinics.”

Drivers were paid and “coached the recruit on what to say inside the clinic to obtain the prescription,” according to James’s plea papers.

Orwig pointed to the federal definition of a pill mill as "a facility that appears to be a medical clinic but in reality distributes large quantities of controlled substances...without regard for medical necessity."

Also, according to the state, "a pain management clinic may not operate without obtaining a certificate from the Texas Medical Board.”

Officials at the TMB found no certification for DFW Bridge Care, or Dr. Kelton.

Again, our investigation was unable to determine where the pills end up.

Since our visit to these clinics, the TMB and the federal Drug Enforcement Administration have begun to investigate.This month, after discovering both clinics closed, we contacted Dr. Kelton’s attorney, Dan

Garrigan. He said his client has done nothing wrong.

He said Dr. Kelton had no ownership of the clinics and was instead a contract employee.

“I understand that there were issues at the clinic, but Dr. Kelton was not the underlying cause of those issues,” Garrigan said by phone. “We anticipate that, ultimately, that’s what the findings are going to be.”

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Bianca Karawa, who is listed as an officer of the clinics in public corporate filings, later told WFAA she is a “staffer” and declined further comment.

Dr. Kelton is still licensed to practice medicine.