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Press Release

Federal Jury Convicts Big Island Pain Doctor Rudolph B. Puana of Conspiracy and Distribution of Oxycodone and Fentanyl

For Immediate Release
U.S. Attorney's Office, Southern District of California

Special Attorneys Michael Wheat (619) 546-8437, Joseph Orabona (619) 546-7951, Janaki Chopra (619) 546-8817, Colin McDonald (619) 546-9144, and Andrew Chiang (619) 546-8756


HONOLULU, Hawaii – A federal jury has found former Big Island pain doctor Rudolph B. Puana guilty of all 38 counts of an indictment charging him with conspiracy to distribute oxycodone and fentanyl and distribution of oxycodone and fentanyl outside the course of professional practice and without a legitimate medical purpose.  Immediately following the jury’s verdict, Chief District Judge J. Michael Seabright ordered Puana to be remanded into custody. 

Following a three-week trial, the jury deliberated for less than one day and convicted Puana of distributing substantial quantities of oxycodone, a Schedule II controlled substance, to his close friends to sell to pay for tuition at one of the most expensive private schools in the State of Hawaii and to purchase cocaine. The jury also found that Puana provided another friend with oxycodone and fentanyl to pay for cocaine they used to party together on Oahu.  Prior to the jury trial, Puana pleaded guilty to being an addict in possession of approximately seven firearms.  At the guilty plea hearing on March 28, 2022, Puana admitted that between 2014 and 2018 he was addicted to hydrocodone, a Schedule II controlled substance, while possessing the seven firearms, which included handguns, rifles, and a shotgun. 

During the trial, the United States proved that Puana used cocaine with his friends and introduced his best friend to Puana’s “trinity”—cocaine, opioids, and alcohol—which combined to prolong and even out the “high.” Puana also popped hydrocodone pills—which he referred to as his “skittles”—in front of one of his friends.  Puana said he obtained his “skittles” from the “doctor’s candy store.”  Puana also left his script pad with his best friend and falsified medical records to legitimize a medical purpose for the substantial amount of oxycodone he provided to his friends.  While addicted and abusing drugs, Puana distributed more than 7,810 oxycodone 30mg pills to his friends so that they could sell them to pay for tuition and cocaine. The street value of the oxycodone he supplied to his friends exceeded $117,000.

To conceal his crimes, Puana fabricated handwritten medical records for his closest friends, which included false drug tests.  During their testimony, Puana’s friends admitted that Puana was not their pain doctor and that they had never gone to his clinic (previously the Puana Pain Clinic) for any medical visits, even though Puana falsely documented that they were examined there. In addition to falsifying the clinic’s files, Puana also kept a secret notebook hidden in the clinic’s drug closet. The notebook was handwritten by Puana to cover up his multi-year addiction to hydrocodone. 

“The unlawful diversion of prescription drugs is one of the most serious problems plaguing our communities, and it is fueling the opioid epidemic that is ravaging families across the country,” said U.S. Attorney Randy S. Grossman. “The conviction of a pain doctor abusing his power and position to distribute highly addictive and dangerous oxycodone and fentanyl sends a strong message to any medical professional acting outside the regular course of practice and prescribing opioids without a legitimate medical need.”

“Today’s guilty verdict is a testament that no doctor should use his license to unlawfully distribute controlled substances and falsify medical records to conceal his crimes,” said FBI Special Agent in Charge Steven Merrill.  “The FBI will continue to work with our partners to hold those who abuse their positions of trust accountable, and to protect the public.”

During trial, the prosecution relied on a multitude of documentary evidence, including Puana’s false clinic files, Puana’s handwritten notebook, pharmacy records, text messages, and other business records, as well as the testimony of Puana’s closest friends, federal agents, a forensic accountant, a medical expert, and police officers, among others, to prove Puana intentionally distributed oxycodone and fentanyl outside the usual course of professional practice and without a legitimate medical purpose.

Chief District Judge Seabright of the District of Hawaii, who presided over the trial, set sentencing for Rudolph B. Puana on September 12, 2022, at 1:30 p.m.

U.S. Attorney Grossman praised prosecutors Michael Wheat, Joseph Orabona, Colin McDonald, Janaki Chopra, and Andrew Chiang, and FBI agents in Honolulu for their excellent work on this case.

DEFENDANTS                                 Case Number: CR 19-00015 JMS-WRP                            

Rudolph B. Puana                               Age: 50                       Waimea, Hawaii


Count 1 – Conspiracy to Distribute or Dispense Oxycodone and Fentanyl – Title 21, U.S.C., Sections 841(a)(1) and 846

Maximum Penalty: Twenty years in prison, $250,000 fine.

Counts 3-38 – Distributing or Dispensing Oxycodone – Title 21, U.S.C., Section 841(a)(1)

Maximum Penalty: Twenty years in prison per count, $250,000 fine per count.

Count 39 – Distributing or Dispensing Fentanyl – Title 21 U.S.C., Section 841(a)(1)

Maximum Penalty: Twenty years in prison, $250,000 fine

Count 54 – Unlawful Possession of Firearm While Addicted to Controlled Substance – Title 18, U.S.C. Section 922(g)(3)

Maximum Penalty: Ten years in prison, $250,000 fine


Federal Bureau of Investigation

Honolulu Division

Updated April 20, 2022

Drug Trafficking
Prescription Drugs
Press Release Number: CAS22-0420-Puana