Dr. Costino Awaits Court, Chides Jurors

NORTH WILDWOOD — Dr. John Costino, 66, is living in a netherworld few can imagine. A physician whose license was revoked by the state Board of Medical Examiners, he remains passionate about medicine and his patients.
A great part of his hurt was watching at least 15 of those devoted patients die, he said, because they refused to go, over his pleadings, to any other physician for treatment.
The Camden-born physician opened his practice here in 1976. Costino and his second wife, Barbara Haas, a registered nurse, believe the County Prosecutor’s Office is targeting them.
The couple was heartened recently when Superior Court Judge Raymond A. Batten dismissed an indictment for fraud in connection with health care claims after defense Attorney John Tumelty showed the court that what the prosecutor provided to the grand jury was not correct.
Cape May County Prosecutor Robert Taylor told the Herald, while the couple may be heartened by the seemingly bright spot, “The indictment was dismissed because of the mistaken use of the words T.E.N.S. (Transcutaneous Electrical Nerve Stimulation). Judge (Raymond) Batten, I believe, indicated it (mistaken term) was done in good faith. This is a highly technical indictment with technical terms.
“We intend to present this matter to the grand jury again,” Taylor added.
While he intends that to happen, Taylor said, “We are not in a hurry to do that.
“We want to first vigorously prosecute the dispense and distribution of drug charges,” he added.
“These rulings by the judge have nothing to do with the guilt or innocence of Dr. Costino, but we intend to vigorously prosecute Dr. Costino’s alleged criminal offenses of illegally dispensing or distributing drugs first,” Taylor said.
Costino and his wife were indicted in July 2009 for a 124-count indictment of health care fraud that focused on 62 patients.
Batten also tossed that indictment in December of that year after he found lack of “specificity.”
Undaunted in pressing the case, the Prosecutor’s Office went forward in August 2010 with a three-count indictment for health care fraud that named three of Costino’s patients.
As Costino talked with the Herald about the case, he hoped for two things:
• His day in court to convince a jury of his and his spouse’s innocence to all charges. He claims the ability to produce factual evidence to discount any allegation brought against him.
• That persons serving on the Cape May County Grand Jury would take their involuntary part-time job in the justice system very seriously.
To hear Costino expound his case is to puzzle about the judicial system.
A physician since 1971, Costino said he “had no malpractice suits, and never had an insurance company” question him.
“I never had Medicare or Medicaid or any insurance group audit me or say I had done anything fraudulent,” Costino said.
“This creature (Cape May County Prosecutor Robert Taylor) all of a sudden decides he is going to indict my wife, a registered nurse, who has been a registered nurse since 1975,” he continued.
Recounting his wife’s indictment, Costino said their attorneys “got that indictment dismissed. They were wrong. It is malicious prosecution.”
“They were so wrong, Judge Batten realized they were wrong, they were entirely incorrect,” said Costino.
He termed the indictment “malicious garbage,” and added, “They (detectives) have no idea what I do in my office.”
Part of what he did in that office was pain medicine, treating those who suffered, and who needed medication for their hurts and aches, many caused by accidents, either job related or crash inflicted.
In his early years, Costino practiced at Cooper University Hospital in Camden (1972-76). While there, he practiced emergency medicine, overseeing the wide range of trauma and illnesses common to inner city patients.
He then became a medical examiner for the New Jersey Department of Labor and Industry. In that capacity, Costino worked in various locations, from Trenton to Bridgeton and Atlantic City. He was the one who would examine those who were seeking claims for workers’ compensation for disabilities.
“I would hand the report to the judge and the case was over,” he said.
He wanted a simpler life and came to this resort; he opened his practice in 1976. From then until 2007, life was good for Costino and his patients, many of them elderly who relied on his house calls to relieve their aches and pains, cure their illnesses, and, in many cases most importantly, he was there to simply listen and be a friend.
Costino’s practice was largely that of a general practitioner with some internal medicine and geriatric cases.
“When you do this work, there is a lot of pain management. People have problems and discomfort, they have issues of the back and neck,” he said.
Costino looked around the county and saw an underserved area of the medical arts: pain management.
In those days, Costino said, “there was no pain management, and I had patients from other doctors, referrals, because those physicians were afraid to do pain management, to write prescriptions for pain management because of the (state) Board of Medical Examiners.”
His face grew red with anger as he uttered the title of that board of physicians, empowered by the state Attorney General to revoke licenses of physicians.
“They are a bunch of radical misfits, a disgraceful group of people who have no conception whatsoever of pain management,” said Costino.
“I was so upset with them…,” he said, stopping in mid sentence, and attempting to regain his composure.
In 2004, Costino said, “I took the course (in pain management) and took the exam for the DEA (Drug Enforcement Agency) to become certified in addiction treatment.”
In that year, Costino won certification from the DEA to offer addiction treatment as part of his practice.
Part of Costino’s woes stem from prescriptions that, he said, were nefariously written by persons who stole four prescription pads from his office. They were ordinarily kept in a secure place, but still were stolen, he said.
One pad was taken by a patient, he said, who was being seen by a “covering” physician in his absence. Costino alleged that the patient swiped the prescription pad in April 2005.
That theft, said Costino, was immediately reported to the North Wildwood Police Department. While police caught up with the patient, they never found the stolen pad of prescriptions.
Costino theorized that patient “wrote prescriptions and sold them.”
Costino said that pad contained from 50-80 sheets, which, when completed and signed, could be illegally sold to those seeking popular controlled pain medications such as Percocet, used to relieve moderate to severe pain, and oxycodone which is used to treat moderate to severe pain.
After that breech of prescription security, Costino hired a staff member who “worked for me for about four and a quarter days, who was referred to me by her aunt who was a patient of mine.”
“After four and a quarter days, we found her calling in prescriptions for narcotics,” said Costino.
He terminated the employee who later, while in county jail, became a state witness telling a detective her story.
Prescription pads, Costino said, were retained in a locked cabinet, but were accessible to office staff.
Two or three other staff members, he said, also stole prescription pads, forged his signature, and were able to get pain medications via the Internet.
In October 2010, the Appellate Division of state Superior Court upheld the state Board of Medical Examiners revocation of Costino’s license for fraudulently prescribing pain killers and “his falsification of medical records,” according to a state Attorney General’s release.
On Oct. 12, 2010, the court rejected Costino’s assertion that the term of license revocation and $70,733 were “excessive,” according to the release.
Costino’s license revocation hinged, in part, on an undercover investigation that, to this day, Costino believes was started to target him.
The release said that investigation of Costino, “found that (he) created diagnoses of acute sprain and strain to the thoracic and lumbar spine without examining these areas when undercover investigators came to him posing as patients.”
Costino countered there was a first undercover investigation in which a detective posed as a heroin addict in an attempt to have medication prescribed without a proper examination.
Costino related that, at that time, he brought his fist down hard on the desk and told that investigator, “You’ll do what I say or get the hell out my office.” The investigator left, said Costino, and that detective accurately filed a report stating Costino’s action.
That document, he said, was not immediately found as proceedings against him advanced, but was uncovered later in the process, too late to be of any value to him, he said. He retains a copy of that official report, he said.
Of earlier prescriptions given to two alleged female dancers from Atlantic City, who were undercover agents, Costino said they were for 30 Percocet tablets, one to be taken nightly for pain. Such a dosage of that prescription, he maintained, is well within established medical practice.
Costino believes that the state Board of Medical Examiners’ actions were taken because that body is under the auspices of the state Attorney General, at the time, Paula T. Dow.
Costino, who has every document that exists that pertains to his ongoing legal contention with the state, also shakes his head in disbelief over the way law enforcement swooped in on his office, filled with patients, and proceeded to take out files and not allow his staff to assist in acquiring any files.
One such file, that he was later accused of lacking, and for taking cash without making a chart, was a case of a name misspelled, he said. That patient’s name was Ortiz, and on the search warrant document was Artiz. No such file existed, but one did exist for the correctly- spelled patient.
He said the detective told the grand jury no office staff offered to help locate the file, while he possesses an affidavit that states the opposite, he said.
Two patients of the 80 charts sought, said Costino, were those of undercover agents, for whom he prescribed Percocet.
Costino believes the legal action against his wife is an indirect way the state is attempting to get him to “take a plea.”
That will not happen, said Costino, since “I know I am innocent and can prove it.”
“The case is not over,” he vowed.
“This is nothing but malicious prosecution of Dr. Costino and my wife, Barbara,” he said. Costino said entering a plea – admitting something he did not do –n is contrary to him.
“It is not in my character to plead to something that I did not do,” he said.
Taylor reminded a reporter that Costino had his cases heard by two judges, the Appellate Division and the state Board of Medical Examiners, “and they did not believe him.”
Taylor said Costino had attempted to get the case heard before the state Supreme Court, but the court refused to hear the case.
“People on the grand jury should be aware of their responsibility and also be aware that these detectives and prosecutors don’t tell the truth. They should question detectives and prosecutors, carefully question them in every aspect of the charge,” Costino said.
Extra care should be taken, he added, “Especially for a high-profile person like myself.
“All they did was lie throughout,” he added.
Contact Campbell at (609) 886-8600 Ext 28 or at: al.c@cmcherald.com