Emotions High as Pharmacist Pleads Guilty to Diluting Drugs

ST. LOUIS —  They had known in advance what he would say. But the cancer patients packed into a Kansas City, Mo., courtroom on Tuesday still recoiled in fear and in fury when pharmacist Robert Courtney pleaded guilty to diluting their chemotherapy drugs with salt water.

Courtney, shackled and struggling against tears, admitted to diluting 158 infusions of the drugs Taxol and Gemzar for 34 patients.

He also agreed to tell federal authorities about any other prescriptions he may have tampered with. Investigators believe there could be quite a list.

Lab tests show that six other cancer-fighting drugs from his pharmacy in Kansas City were diluted before patients received them, FBI spokesman Jeff Lanza said. A fertility drug from a second pharmacy that Courtney owned in Kansas also turned out to be diluted, Lanza said. And many other prescriptions Courtney filled still are being tested.

Under his plea agreement, Courtney, 49, will not face any additional charges as long as he fully discloses his criminal activities. He faces 17 1/2 to 30 years in federal prison for the counts he pleaded guilty to Tuesday. In addition, a federal judge has frozen his assets--now worth up to $12 million--and will draw up a plan to distribute the bulk of the funds to his victims.

Choking over his words as many in the courtroom around him sobbed, Courtney apologized to those victims, saying he could not explain why he had cheated them of the drugs they were counting on to save their lives. In the past, he had told investigators that the scheme netted him profits he needed to pay $600,000 in back taxes and make good on a $1-million pledge to his church.

But on Tuesday, Courtney said there was no “rational explanation” for his actions.

“I am guilty,” he said.

And later: “I am extremely sorry.”

Watching him, cancer patient Delia Chelston was surprised to find herself in tears. She was crying in frustration for the months or years she might have lost; battling advanced ovarian cancer, she believes that three of the six chemotherapy treatments she received from Courtney were worthless. She tries not to think of those wasted infusions, but her mind loops back insistently: How many moments in her garden might she have lost? How many hugs from her grandchildren? Those questions were in her tears Tuesday.

But she also was crying--unexpectedly--for the pharmacist. She had built him up in her mind as a monster. “He must not have a conscience, really,” she had thought. In court, in his orange prison jumpsuit, he was so human that she buckled.

“In my estimation, if they had told him, ‘An electric chair is right behind you and there’s someone here ready to throw the switch,’ he would have gone to sit in it,” Chelston said. Hearing his contrition “made me feel a little bit better.”

Ken Atwood also took some comfort in the proceedings. His wife, Adelia, died of ovarian cancer a year ago. She had received $84,000 worth of chemotherapy from Courtney’s pharmacy. Atwood is convinced that Courtney cheated his wife--if not of a cure, at least of time, of strength, of a fighting chance. “She was shorted of her life,” he said.

He had looked forward, he added, to watching Courtney’s trial, which was due to start in less than two weeks. “I wanted to sit there and look mean at him, maybe growl a bit.” He did not get that chance Tuesday; with every seat in the courtroom taken, he had to crowd with dozens of other victims and family members into a side room to watch the hearing on closed-circuit TV. Still, Atwood said, he was fairly content with the plea agreement--especially the proviso that Courtney come clean about any other patients who may have received diluted drugs.

Prosecutors, FBI agents and Food and Drug Administration investigators plan to begin grilling the former pharmacist on that subject early next month. They would not comment Tuesday on how many drugs they suspect he diluted or how many patients might have been affected

Courtney’s attorney, Jean Paul Bradshaw, also said that “it would be inappropriate” to discuss such numbers now. His client, he added, “is relieved to be able to come in and accept responsibility for what he has done.”

Jailed since he surrendered to the FBI on Aug. 15, Courtney has been stripped of his license and has sold his two pharmacies. His wife and four children have been able to tap some of his money for living expenses, Bradshaw said, but the bulk of his fortune will be doled out as restitution to the 34 victims named in the criminal case and to some of the 300 others who have filed civil lawsuits against him.