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Detroit — More than a dozen doctors and medical professionals charged with federal crimes locally have fled the country in recent years amid a federal crackdown on illegal opioid use and health care fraud.

Prosecutors used the fugitive status of 16 medical professionals who have fled since 2011 to keep Dr. Rajendra Bothra jailed Wednesday while he awaits trial in a nearly $500 million conspiracy, one of the largest health care fraud cases in U.S. history.

U.S. Magistrate Judge Mona Majzoub cited the Bloomfield Hills doctor's lies, ties to India and riches, including overseas bank accounts filled with $3 million, before refusing to release Bothra on bond.

"I believe there is clear evidence that this defendant poses a risk of flight," Majzoub said, triggering loud sobs from Bothra's daughter, who was adopted from Mother Teresa's orphanage in India.

The medical professionals who have fled for overseas destinations including Jordan, Pakistan and Egypt in recent years have two things in common: foreign ties and big bank accounts that have financed flights from justice. In Bothra’s case, he has eight siblings in India and amassed a $35 million fortune and vast-real estate holdings, including a $1.99 million island estate.

An island estate owned by Dr. Rajendra Bothra in Waterford Township is for sale for $1.99 million. (Video: YouTube)

Federal court records shed light on some of the fugitives who used fake names, overseas bank accounts and illegal border crossings during daring escapes that left behind prosecutors, frustrated judges and severed GPS tethers.

“If history shows us anything, defendants similar to Dr. Bothra don’t stick around to have a court determine their fate,” Assistant U.S. Attorney Brandy McMillion told the judge. “This is, in large part, because of the charges they face and the significant penalties that come with those charges if convicted.”

The federal court system in southeast Michigan historically has had among the highest rates in the nation for the number of federal criminal defendants released on bond. But the court system ranks below the national average for the number of defendants who fail to appear in court.

Last year, 15 people, or 1.2 percent of the more than 1,200 defendants on bond in the Eastern District of Michigan, failed to appear, according to court statistics.

When defendants flee, the U.S. Marshals Service launches investigations that can become complicated when people hide in countries that lack diplomatic ties with the U.S.

"We just don’t forget about them," Deputy U.S. Marshal Robert Watson said. "We continue to monitor them and have mechanisms in place if they come back into the U.S. or move to extraditable countries."

Bothra is facing health care fraud and drug charges that could send him to federal prison for more than 20 years — a potential death sentence for the 77-year-old, who owns Pain Center USA in Warren and Eastpointe, and Interventional Pain Center in Warren.

Bothra and five other doctors are accused of cheating Medicare, Medicaid and Blue Cross/Blue Shield of Michigan by billing $464 million during what prosecutors say was a scheme that ran from 2013 until last month.

During that time, the doctors forced patients to undergo painful medical procedures in exchange for illegally receiving more than 13 million doses of prescription pain medication, including OxyContin, Vicodin, hydrocodone and Percocet, the government alleges.

"The volume of patients and severity of damage ... to these patients is beyond comprehension," Majzoub, the magistrate judge, said Wednesday.

Yet, Bothra almost was released on bond.

His hearing spanned two days and was delayed as lawyers studied whether the doctor could be released on a surety bond that would be forfeited to the government if Bothra bolted from the U.S.

Majzoub scrapped the idea Wednesday after learning a surety bond was not possible without a conviction.

Most of Bothra’s bank accounts and money have been frozen, his lawyer Thomas Cranmer argued late Wednesday.

But not all.

He has access to one retirement account — court records indicate it is worth $7.6 million — his lawyer said.

Bothra’s defense mounted another bid for bond late Wednesday, offering to ensure the retirement fund is used for “solely legitimate purposes.”

Doctors and medical professionals with clean criminal records and deep ties to the region are more likely to be good candidates for bond, but a review of cases shows prosecutors also focus on a defendant’s overseas ties and ability to finance an escape.

“If I had no money and go, ‘here’s an idea, why don’t I flee to someplace that doesn’t extradite, like in the Middle East or, maybe, Pakistan?’ That isn’t much of a plan,” said Wayne Pratt, chief of the health care fraud unit at the U.S. Attorney’s Office in Detroit. “But if you’re from that country and have substantial assets in that country or someplace else that you can transfer there, it makes it much more of a plan and an option.”

The list of fugitive doctors includes Mamoun Dabbagh, a Southfield psychiatrist known as the "Stripper Doc," who witnesses said visited topless bars while wearing a fanny pack that contained his prescription pad. Investigators say Dabbagh bought a rare 19th century harp with cash generated from a lucrative drug ring that traded prescription pills for sex with adult entertainers.  

Circumstances surrounding his fugitive status were not publicly available. He was charged with illegally distributing prescription drugs in April 2016 and set to plead guilty the next month.

Some flee while charges are pending, according to court records and interviews. Some flee after pleading guilty. And some flee while free on bond and awaiting the start of a prison sentence.

Dearborn Heights Dr. Basil Qandil, 36, disappeared four years ago after being convicted of 34 counts of illegal drug distribution, health care fraud and money laundering.

Evidence presented during his two-week trial showed Qandil prescribed more than 3.7 million doses of drugs, including Oxycodone and Vicodin. The drugs later were sold on the street or used by addicted patients.

During the fraud, Qandil transferred more than $1.5 million to a bank account in Amman, Jordan.

After being charged in January 2013, Qandil was released on $100,000 unsecured bond. 

Prosecutors appealed. U.S. District Judge Denise Page Hood allowed Qandil to remain free on bond but ordered him to wear a GPS tether and surrender his U.S. and Jordanian passports, among other conditions.

But in May 2013, Qandil's lawyer convinced U.S. District Judge Arthur Tarnow to remove the tether after arguing Qandil was a model, nonviolent defendant and not a flight risk.

"Judge, he's driving an old van. That's his only method of getting around. He can't afford airline tickets or to do anything to get out of the country," defense lawyer Loren Dickstein said during a court hearing. "Quite frankly, he's not interested in leaving the country."

Cutting off a tether "would require about 10 seconds, and give him a 15-minute to a couple-hour head start," Tarnow said. "A tether is not necessary."

Fifteen months later, after being convicted and while awaiting a possible 20-year prison sentence, Qandil failed to appear for a meeting with a court official in August 2014.

A federal agent visited Qandil's home. It was empty.

A neighbor reported earlier seeing Qandil load property into the same old van, an Oldsmobile Silhouette, and leaving with relatives.

The next month, investigators learned Qandil had crossed into Mexico and flown from Juarez to Madrid, Spain, with his wife, father and four children.

Investigators learned he used a Jordanian passport with a phony name, according to DEA Special Agent Joseph Robertson.

Another defendant defied bond conditions before disappearing.

The Justice Department hailed Muhammad Zafar's arrest in June 2015 as part of the nation's largest crackdown on Medicare fraud.

Zafar, 43, of Brownstown Township owned home health care agencies and was accused of participating in a $7.9 million conspiracy. He was brought into court to face multiple charges, including three 20-year felonies, ordered to surrender his passport and released on $10,000 unsecured bond.

Zafar, however, never surrendered the passport before fleeing to Pakistan, according to court records.

GPS tethers, which help court officials track the whereabouts of defendants, are not foolproof.

Southfield psychologist Sanyani Edwards, 39, was a "major player" in a $6 million medical scheme, prosecutors said. He was convicted of health care fraud and drug conspiracy charges in July 2013 but allowed to remain free on bond.

On the day Edwards was supposed to be sentenced to prison, he fled.

"In fact, he cut the tether off of his leg...," Assistant U.S. Attorney John Neal told Tarnow. 

"Isn't that a felony?" the judge asked.

"It is, your honor," Neal said.

Edwards spent two years hiding in Georgia with a fake name before being caught and brought back to Detroit to face the judge.

"I hope he enjoyed it because ... you are not going to get your wish getting probation or time served, Mr. Edwards," the judge said during the fugitive's sentencing.

Edwards was sentenced to more than five years in prison.

Before being locked up, Edwards asked to be incarcerated at the federal prison in Milan, unless the judge could suggest a better place.

"There is a hotel across the street," the judge joked.

"Sold," Edwards said.

Edwards didn't get his wish. He is incarcerated at a medium-security prison in Pennsylvania and is scheduled to be released in January 2020.

rsnell@detroitnews.com 

(313) 222-2486

Twitter: @robertsnellnews

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