Dr. Costino Fights Charges on Website

NORTH WILDWOOD — After reading several reports in the Herald and other local newspapers regarding the insurance fraud and prescription drug case against him, Dr. John Costino reached out to give his side of the story.
The Herald met with Costino several times at his closed office where he showed this reporter stacks of evidence supporting his claims of innocence.
“I’m mad as hell,” Costino told the Herald. “This whole thing has been a disgrace from the beginning. All of these stories are based on distorted facts, bad information and questionable practices by attorneys and officers in our so-called justice-system.”
Costino, who had practiced medicine in Cape May County since May 1976, was arrested in September 2007 after an investigation by the county Prosecutor’s Office, which was looking into the alleged over-prescription of pain medication.
He was indicted in February 2008 on multiple counts of distributing oxycodone (Percocet) and filing false health insurance claims. He is accused of prescribing painkillers to undercover officers who had questionable complaints and without completing examinations.
Costino practiced general medicine, workers compensation, sports medicine, pain management and geriatric medicine. In 2003, he began the treatment of heroin addiction. He was certified by the Drug Enforcement Agency (DEA) to prescribe Suboxone, a treatment for heroin addicts.
He directed this newspaper to review a 22-page letter to his patients posted on the website, www.urnotabovethelaw.us.
“The actions of certain officers and attorneys in the Prosecutor’s Office and Board of Medical Examiners have been unconscionable,” Costino claimed. “The facts I outline in that letter refute all of the charges against me.”
County Prosecutor Robert Taylor told the Herald that he was aware of the website, but declined comment for this story, stating that the case stands on its own.
“I have no comment about Dr. Costino or the case,” Taylor said. “The grand jury proceedings and indictment are a matter of record.”
Costino argues, however, that the indictment was based on inaccurate, incomplete and false information.
For instance, Costino said he was originally brought to the attention of the Prosecutor’s Office in 2005 through a computer-generated report from the DEA that indicated he had prescribed “excessive amounts of addictive pain medications.”
“What the Prosecutor’s Office didn’t tell the grand jury is that prior to that report, I had prescription pads stolen from my office by three former employees and one patient, that would account for the large amount of illegal prescriptions identified,” Costino said. “Other pads were stolen by another employee from a locked cabinet in March 2007, which added to the problem.”
Costino also claimed that detectives from the Prosecutor’s Office relied on bogus stories from the same people who stole prescription pads from his office to build the case against him. He cited Catherine Mills, who was mentioned in the most recent appellate decision in his case.
“Catherine Mills is a jailbird who made up stories against me to get out of prison. She flat out lied,” Costino said. “By way of example, Mills claimed to be employed in my office for seven months as the ‘office manager,’ when in fact she was employed for a mere five days before she was found to be calling in prescriptions for herself and friends.”
“Why would they take the word of a criminal?” he asked. The jail records division in the Cape May County Correctional Facility confirmed that Mills had been incarcerated in April 2005 on a contempt of court charge.
Following the investigation when law enforcement officers were ready to raid his office, Costino said they kept exculpatory evidence out of their search warrant application.
In December 2005, the first undercover officer from the Prosecutor’s Office was sent to his office posing as a heroin addict looking for painkillers, the doctor said. Costino refused narcotics to the supposed addict, but instead wrote a prescription for Suboxone.
“I told him no way would I prescribe narcotics to kick a heroin addiction,” Costino recalled. “I said that illegal drug use would kill him and offered to help fight his addiction.”
Costino claimed that a certain detective had a responsibility to provide that exculpatory evidence to the warrant judge, but did not. “They also kept this information from the grand jury and my attorneys for over 2½ years,” Costino said.
The next two undercover operatives sent into his office were Egg Harbor Township Class II Officer Tonya Anderson, who posed as an exotic dancer, Tonya Smith, and DEA Agent Margarita Abbattiscianni, who posed as Smith’s friend Maggie Ortiz, also an exotic dancer.
According to the record, Anderson stated she was taking Percocet, which she obtained illegally from a girlfriend.
Anderson was sent to Costino and was instructed not to use the word “pain” and to be certain to say that she was already on Percocet, Costino said.
Costino said he did the following examination:
“I observed her mannerisms, her arm and leg movements, her eye movements, her gait and disposition. Her pupils were equal, the extraoccular muscles were intact bilaterally, her extremities demonstrated normal movement, both arms and legs, and her ambulatory gait was normal,” Costino stated in his letter.
“She was able to move her neck without discomfort and able to bend at the waist without restriction. The heart sounds demonstrated a regular rate and rhythm without murmurs, rubs, or gallops. Lung sounds were relatively clear except for a few rhonchi, as she was a smoker. Additionally her blood pressure and pulse rate were normal.”
Costino noted that he saw no indication of addiction, habituation or drug-seeking behavior. He did not order any blood work because she told him that she had just had it done a few months before in connection with breast enhancement surgery.
“I ask a million questions and observe everything and by the end, I know everything about the patient,” he said.
“During this initial office visit with ‘Tonya Smith,’ my opinion was that she was an honest person who stated in the record that she wanted to establish herself with a pain management physician, in order to obtain a legal prescription in a reasonable manner for a legitimate problem,” Costino said. Anderson signed Costino’s pain management agreement.
“Why would she sign a pain management agreement if she didn’t have pain?” Costino asked.
His presumptive diagnosis was acute and chronic strain and sprain of the thoracolumbar spine. “This diagnosis fits well with a person who is an exotic dancer, who slides up and down a pole and dances around a stage for eight hours a night.”
He saw Anderson seven times and Abbattiscianni two times over a five-month period. Both diagnoses were similar.
“Had these two impostors been actual dancers responding to the same questions immediately following a hard night of work, their answers would in all likelihood have included complaints of pain,” Costino said. “It is ridiculous for the State or anyone else to suggest anything different.”
Costino discovered that Anderson was actually in pain during her office visits and lied under oath to authorities, stating: “I hereby certify that from the time period of April 12, 2006 through and including Aug. 23, 2007 I did not have any medical problems related to the cervical spine, thoracic spine, or lumbar spine.”
She, in fact, had both medical problems and treatment to her cervical, thoracic and lumbar spine under the care of Dr. O’Rourke of the Seaport Chiropractic Center in Egg Harbor Township in July of 2007, during her tenure with Costino, he said.
She complained to O’Rourke of pain and discomfort in her upper back, neck, her right shoulder and lumbar region with sleep disturbance for the past four years. O’Rourke’s diagnosis included: neck and spine pain as well as back muscle spasms.
“If my treatment of Anderson was so deficient as to warrant suspension of my license, why does Dr. O’Rourke’s diagnosis mimic my diagnosis?” Costino asked. “Anderson’s medical records and Dr. O’Rourke’s diagnosis exonerate me.”
Next, Costino pointed to the “case of the misspelled name” and the indictment.
Detectives removed a number of charts from Costino’s office. According to an appendix in the search warrant application, the two undercover officers were named Tonya Smith and Maggie Artiz, instead of Maggie Ortiz.
Costino states that authorities did that on purpose.
This name switcheroo was very damaging for his case at the grand jury presentation.
“By misspelling Ortiz’s name to Artiz on the list of charts to be seized, the detective was able to tell the Grand Jury that I had no medical records for Ortiz,” he said. “This clever deception prompted one of the grand jurors to ask: ‘Do you mean that Dr. Costino is charging money for an office visit, but not producing a medical chart?’ The detective answered yes.”
In addition to Costino’s claims against the Prosecutor’s Office, he said the Board of Medical Examiners was equally at fault for accepting those charges against him without a full investigation.
“The Board of Medical Examiners consists of about a dozen politically appointed physicians,” he said. “These physicians are supposed to be independent individuals who examine all of the relevant information before making a decision.”
Instead of the physicians running the board, Costino claims it is controlled by deputy attorneys general, who are “career state lawyers” that wield undue influence over the physicians of the board, he said.
“The physicians do not read the briefs or transcripts offered by the defense, but simply rely upon the state attorneys to make the determinations and tell them how to vote on the matter,” Costino stated.
At his administrative law hearing, Costino said his attorney presented a strong defense and his expert witnesses testified that his medical records were “above average” and his billing practices were “very good.” Despite this, the board still ruled against him, he said.
“The physicians of the Board of Medical Examiners have failed in their duty and responsibility to insure that I received due process before suspending or revoking my license to practice medicine,” Costino said.
Despite his uphill battle, Costino said he remains confident that justice will prevail in the end and his good name will be restored.
“My name was my father’s name and is my son’s name and my grandson’s name,” he said. “I’m going to fight these charges against me to the end and I will be the last man standing.”
To read Costino’s full letter, visit www.urnotabovethelaw.us.