A jury is deliberating the fate of Hawaii island doctor and brother of jailed former Deputy Prosecutor Katherine Kealoha, accused of writing opioid prescriptions for pills that were sold or traded for cocaine.
The U.S. Department of Justice and defense attorneys representing Rudolph B. Puana made their closing arguments to jurors Tuesday, the ninth day of his trial before U.S. District Chief Judge J. Michael Seabright.
Puana, an anesthesiologist and pain doctor, was accused by federal prosecutors in 2019 in a 53-count indictment of health care fraud and conspiracy to distribute oxycodone and fentanyl. Puana pleaded guilty March 29 to a single count of being a drug addict in possession of a firearm.
Following jury instructions delivered by Seabright, the federal government closed by arguing that Puana falsified medical records and treatment narratives to conceal illegal prescriptions for oxycodone that his friends sold for cash or traded for cocaine.
“The defendant was not their doctor. Doctors do not use cocaine with their patients. Doctors do not introduce their patients to drug dealers to sell oxycodone. Doctors do not introduce their patients to the trinity: alcohol, cocaine and oxycodone,” said Assistant U.S. Attorney Joseph Orabona, during the government’s closing argument. “He’s not their doctor. He’s their drug dealer.”
Puana wrote 31 prescriptions for Elena Rodriguez over a two-year period starting in 2013 for 4,620 oxycodone pills at a strength of 30 milligrams each. Her husband, Joshua Derego, allegedly sold individual pills from those prescriptions for $15 to $20 each to a drug dealer Puana allegedly introduced him to for about $70,000, according to the Justice Department.
That money was used to help cover the $16,000-a- year tuition for the couple’s two children, who at the time attended Hawaii Preparatory Academy with Puana’s kids.
“It was his (Puana’s) idea to do this to help them. The fiction he wrote in the files … 33 pages for 4,000 oxycodone pills? It doesn’t make sense. The file is his fiction, it’s false. All of the records in that file are in the defendant’s handwriting,” said Orabona.
Puana allegedly falsified medical records to show that he was treating Rodriguez for chronic knee pain and Derego’s family members for an array of maladies that did not exist, according to Orabona. Rodriguez was granted immunity from prosecution by the federal government in exchange for her testimony.
Puana allegedly had a similar arrangement with Christopher McKinney, a fiction author and English professor at Honolulu Community College, who was one of Puana’s best friends, Orabona said. McKinney received 24 prescriptions between April 2015 and October 2017 for 3,190 oxycodone pills, a total of $47,850 worth of illegal drugs, according to the Justice Department.
McKinney allegedly traded or sold the pills to pay for cocaine use by Puana and McKinney when Puana would travel to Oahu to party or work on a book the pair published in 2014.
“Tuition is not a medical purpose, and the defendant knows it. It was his plan to help his family, his friends, his brotherhood, so they could keep their kids at one of the most expensive schools,” said Orabona. “You saw how hard it was for Mr. McKinney to testify. He still loves the defendant. It was hard for him to do that.”
Puana’s attorney, F. Clinton Broden, countered by highlighting the immunity agreements given to Rodriguez and McKinney and attacking their credibility. He told the jury that they both sold the Justice Department a false narrative to save themselves. Puana was an admitted drug addict who was legally treating his friends, said Broden.
Rodriguez and Derego received two-thirds of their oxycodone prescriptions before they learned that a series of $5,000 scholarships from Puana and his ex-wife Lynn would end because the Puanas’ marriage was failing. Rodriguez and Derego needed the money for HPA tuition and to care for the health of one of their children, Broden said.
Derego knew the drug dealer he sold the pills to, not Puana, who did not know Rodriguez and Derego would sell the prescriptions for money, Broden said.
“Her story is a lie. Of course, it corresponds with her husband’s story. That’s what liars do,” said Broden. “They are grifters, and there was always a plan on how to do this long before they met Rudy Puana.”
McKinney and Puana did drugs and engaged in party talk via text messages, but Puana did not know McKinney was allegedly getting the cocaine they used by selling Puana’s prescriptions.
“They engaged in that gutter locker room talk. … They laid it all out there on the field,” said Broden. “But there is not one text message … that has anything to do with Christopher McKinney selling the oxycodone that was prescribed. Think about how important that is.”
Broden pointed out that McKinney receives medical cannabis for chronic back pain and is a professional storyteller who lied to get himself out of trouble.
“Christopher McKinney … a man who tells stories for a living … a man who teaches other people to tell stories and teaches fiction for a living,” said Broden. “The government threw him a lifeline. They offer him this immunity agreement. Christopher McKinney knows he is guilty of something. … He tells the government what they want to hear. He looked the iPad (used in the witness stand and by jurors to supplement testimony) right in the eye and lied to you.”
Broden reminded the jury that Puana is not his sister, who pleaded guilty in 2019 to using her position as a deputy prosecutor to shield her brother, who she claimed prescribed her pills that she would trade for cocaine.
The Justice Department special prosecutor leading the investigation, Assistant U.S. Attorney Michael Wheat, is the same attorney who handled the Kealoha case.
Wheat leads a team of federal prosecutors from California, including Orabona, investigating illegal intersections between politics, business and government in Hawaii.
“Rudy Puana is not Katherine Kealoha. I think you all know why I feel a need to say that. I’m just going to leave that right there,” said Broden during his closing argument.
Katherine Kealoha is serving 13 years in federal prison for conspiring to frame her uncle to conceal fraud and crimes committed by her and her estranged husband, former Honolulu Police Chief Louis Kealoha, who was sentenced to seven years in prison for his part in the conspiracy.
