Doctor Allegedly Prescribed Opioids for Dead and Incarcerated People in “Pill Mill” Operation; Doctor and Seven Others Arrested and Charged

Assistant U. S. Attorney Larry Casper (619) 546-6734    

NEWS RELEASE SUMMARY – March 12, 2018

SAN DIEGO – Egisto Salerno, a medical doctor, who owns and operates a medical office on El Cajon Boulevard in San Diego, and seven others have been arrested on federal charges stemming from their alleged roles in a conspiracy to possess with the intent to distribute hydrocodone as part of a ‘pill mill’ operation. 

Special agents with the Drug Enforcement Administration arrested Dr. Egisto Salerno, 73, of San Diego; Stephen Toney, 57, of San Diego; April Cervantes, 27, of San Diego; David Apple, 25, of Chula Vista; Amber Horne, 28, of El Cajon; Lonnell Ligon, 55, of San Diego; Shalina Latson, 47, of San Diego; and LaJuan Smith, 38, of San Diego.  Each is charged with one count of conspiracy to possess with the intent to distribute a controlled substance.

The complaint alleges that, beginning not later than November 2014, defendant Stephen Toney and others recruited individuals, often homeless or of limited means, to pose as “patients” at the office of Salerno to obtain hydrocodone prescriptions.  Salerno, who received an office visit fee for each “patient,” performed a cursory or no physical examination and prescribed the hydrocodone despite the lack of any legitimate medical purpose and outside the usual course of professional practice.  The “patients” were paid for turning over their hydrocodone tablets to defendants. The defendant recruiters arranged transportation of these “patients” to Salerno’s office, to a pharmacy to pick up the hydrocodone, and then returned them to or near homeless shelters or their residences.  Toney and other co-conspirators intended to further distribute these hydrocodone tablets.

Salerno is alleged to have prescribed hydrocodone for, among others, dead “patients” and “patients” who were in jail and who could not, therefore, have been in Salerno’s office when they were allegedly examined by Salerno and hydrocodone was prescribed in their names.  For example, one patient died in October 2015 and Salerno allegedly saw that patient and prescribed hydrocodone in that patient’s name five times after death, including two prescriptions written more than a year after the death. 

According to the charging documents, Salerno and two of his medical assistants allegedly falsified chart notes and medical records to justify these hydrocodone prescriptions and further the conspiracy.  In one instance, the medical chart for an undercover agent who visited the clinic was seized by agents during execution of a search warrant. That chart included a set of medical examination notes in Salerno’s handwriting and signed by him purporting to document a visit that never occurred.  The charging documents allege that hydrocodone was prescribed on that date in the name of the undercover agent and the tablets were picked up from the pharmacy by defendant Stephen Toney.

Hydrocodone is the generic name for a narcotic analgesic that is sold under a variety of brand names such as Vicodin, Norco and Lortab. When legally supplied by a licensed practitioner for a legitimate medical purpose in the usual course of professional practice, hydrocodone is used to combat moderate pain.  It is a Schedule II controlled substance (narcotic) that is widely abused and it is frequently diverted from legitimate medical channels and distributed illicitly on the street for profit and abuse.

“The opioid crisis is ravaging families in San Diego and Imperial Counties and is part of a national epidemic,” said U.S. Attorney Adam Braverman.  “We are and will continue to zealously prosecute and bring to justice those doctors, pharmacies, medical providers and others who are furthering this epidemic to line their own pockets.”

“Patients trust their doctors to give them the best care possible,” said DEA San Diego Acting Special Agent in Charge Steve Woodland.  “It’s DEA’s responsibility to ensure that DEA registrants are worthy of that trust.  DEA will keep conducting these investigations to ensure that registrants are following all the rules when prescribing these potentially deadly drugs.”

Anyone with information about opioid abuse/diversion or other drug diversion should report that to the Drug Enforcement Administration at https://apps.deadiversion.usdoj.gov or contact the DEA hotline at 1-877-RX-Abuse (1-877-792-2873).   

DEFENDANTS                                            Case Number 18mj1080                                          

Egisto Salerno                                                 Age: 73                                   San Diego, CA

Stephen Toney                                                Age: 57                                   San Diego, CA           

April Cervantes                                               Age: 27                                   San Diego, CA

David Apple                                                    Age: 25                                   Chula Vista, CA

Amber Horne                                                  Age: 28                                   El Cajon, CA

Lonnell Ligon                                                 Age: 55                                   San Diego, CA

Shalina Latson                                                Age: 47                                   San Diego, CA

LaJuan Smith                                                  Age: 38                                   San Diego, CA

SUMMARY OF CHARGES

Conspiracy to Unlawfully Distribute and Dispense a Controlled Substance, 21 U.S.C. 846

Maximum penalty: 20 years’ imprisonment; $1,000,000 fine or twice the pecuniary gain or loss, whichever is greater, and five years’ supervised release.

INVESTIGATING AGENCIES

Drug Enforcement Administration

Internal Revenue Service

Health and Human Services-Office of Inspector General

California Department of Health Care Services

San Diego County Sheriff’s Department

California Department of Justice

San Diego Police Department

*The charges and allegations contained in a Complaint are merely accusations, and the defendants are considered innocent unless and until proven guilty.