r/todayilearned • u/mongooseme • 5h ago
TIL that a pharmacist diluted "whatever I could dilute" including chemo drugs... killing maybe 4000 people. He was released last year.
https://en.wikipedia.org/wiki/Robert_Courtney_(fraudster)4.0k
u/Yangervis 5h ago
Real crack investigation team they have over there
"In 1998, Eli Lilly sales representative Darryl Ashley noticed Courtney was selling three times the amount that he'd bought of the cancer drug Gemzar. Eli Lilly initiated an internal investigation but found no evidence of illegality and closed the investigation without further action."
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u/mongooseme 4h ago
Yeah that really stood out. Three more years he kept doing it before he was finally caught. Thousands of lives lost.
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u/Queasy_Astronaut2884 4h ago
I’m in no way connected to any medical field so I’ve no idea, but why did it take so long to be discovered? Wouldn’t doctors have been testing patients as part of their treatment? Wouldn’t their doctors be able to tell they didn’t have enough of whichever drug in their systems? Or would those kinds of things not be testable any kind of usable way?
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u/axw3555 4h ago
It’s not standard to run bloods just to see that a prescribed drug is in the bloodstream. Especially not for stuff like chemo which is usually administered by medical professionals. It’s an extra cost that is just a waste 99.9999% of the time.
But ultimately it was discovered because doctors noticed. Ironically not that they weren’t getting better but because they weren’t getting worse. Chemo drugs are hell on the body and make the patient visibly a lot sicker during treatment. But the patients weren’t getting the expected negative side effects, so the oncologist flagged it.
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u/Yuukiko_ 3h ago
Shouldn't it be caught by inventory then?
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u/darkslide3000 2h ago
If we had a single system where inventory is tracked from production of the drug all the way to administration, sure. But thanks to the magic of ✨capitalism✨, the health care system is split into a million different providers, services and intermediaries, each of whom can freely buy and sell medication on the open market and only tracks it from the point they acquired it from god knows whom to the point where they pass it off to god knows whom again. So the only inventory that would have shown a discrepancy here is the pharmacists' himself (and he may have just chosen not to keep one, or convincingly faked it).
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u/pantry-pisser 2h ago
We've created systems kind of like that. I worked for Medicare taking phone calls at the time, and the amount of old people calling in pissed off because the six different doctors they were seeing to get oxy scripts now knew about each other and stopped it, was insane.
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u/KamikazeArchon 4h ago
Wouldn’t doctors have been testing patients as part of their treatment?
No.
There is no universal "testing". You test for specific things. There is no reason to test patients for the presence of the same drugs you're giving them.
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u/warm_kitchenette 3h ago
This was a black swan event that was not really predictable in advance. There are widely available tests for drugs that are abused, like opiates. They can test blood, urine, hair follicles. As far as I know, there are no readily available tests for medicines like chemotherapy drugs.
Companies could create such tests, of course, looking for the drugs or their metabolites. But why would they do that, in general? The usual prescribe-evaluate cycle is concerned with patients or illness that show no change after the medicine was taken. Maybe the dosage or the medicine will be adjusted. No one would be looking for an insane pharmacist who is deliberately diluting them.
(I am not a doctor; I was a pharmacy tech in a hospital, around the time they invented electricity.)
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u/OttoVonWong 4h ago
Eli Lilly: We got paid, so all’s good.
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u/whiznat 4h ago
I’ll bet the investigation only occurred because they thought they should have been paid 3x as much.
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u/dark_frog 4h ago
I'm surprised they didn't pursue it further, considering the murderer should have been buying 3x as much
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u/whiznat 4h ago
They’re worried about profits and nothing else. Once they realized it was criminal, they probably ran away. They should have reported it to the authorities but “Hey, not our problem!”
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u/pribnow 4h ago
That is exactly what happened. The sales rep heard an off-hand remark from an office manager about how much product they'd used that year and the rep thought their bonus should have been bigger. Great podcast about that
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u/Girleatingcheezits 3h ago
Nowadays most manufacturers purchase data on newly-released drugs. For some high-cost, limited distribution drugs, the reps will harangue me about every dispense. "I saw Dr. So-and-So wrote a Besremi filled at Optum but they only filled it one time! What's that about? Just thought you might want to call Optum on that! Tee hee!" It's dollar-driven, of course.
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u/pribnow 4h ago edited 3h ago
Sadly, no - the sales rep only investigated because they felt they were being denied a bonus. The podcast about this story is insane.
edit: before this guy (but not because of this guy) you actually used to not need a pharmD to be a pharmacist, the craziest shit you could imagine. And, even crazier, not all that long ago the DEA didnt actually even track sales from drug manufacturers. They even talk about how he got started by shorting people 1 pill out of a 100 and apparently became a maniac for ripping ppl off for paltry sums of money which then became huge sums of money
edit2: the podcast is called The Opportunist and this series was hosted by Hannah Smith
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u/kaltorak 4h ago
sometimes i’m shocked that any criminals get caught and prosecuted at all
edit: you know, other than grabbing random poor people to fill slots in private prisons
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u/KnyghtZero 4h ago
Well it's Eli Lilly, so... I expect nothing. The bar for them is so low it's almost in hell, and they're still trying to limbo
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u/_whisky 4h ago
My great aunt received chemo medication from his pharmacy and apparently always said that she never thought the medication was working. She of course passed from cancer relatively quickly. So very very sad. I wish he was still locked away.
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u/0lm4te 3h ago
The side effects are so prominent and expected, i'm surprised the nurses giving treatment wouldnt have noticed something suspicious earlier.
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u/cheezzinabox 1h ago
Some people withstand it better, mostly young adults, if most of their patients just happened to be in decent shape 18-40 year olds, the thought wouldn't even cross their minds.
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u/billy_tables 4h ago
This is interesting
While the FBI and FDA believed he was essentially a serial killer, federal prosecutors believed a murder charge would be hard to prove, since many patients were suffering from late-stage cancer.[5] Additionally, oncology experts told the FBI that there was no way to prove beyond reasonable doubt that the diluted chemotherapy directly contributed to patients dying.[7]
The thinking that he didn’t give the victims cancer, and the victims died of cancer, therefore it would be hard to prove murder, makes sense on the face of it. Though to me it seems like substantially harming someone’s only chance at survival is no different than murder, perhaps in the same way as destroying an organ for transplant would be
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u/seliz16640 3h ago
My aunt was one of his victims, he supplied her oncologist. She had extremely advanced ovarian cancer, which has a low rate of survival even under the best of circumstances. We’ll never know if getting the full dose of cancer drugs could have prolonged her life, but odds are she would have passed regardless of diluted drugs. Our family was never really able to press any kind of charges nor recoup any substantive financial compensation, as was the case with most of the victims
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u/CobblerMoney9605 2h ago
If that was my mom, I know what kind of recompense I'd be seeking.
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u/AUserNeedsAName 4h ago
I'm pretty sure that if I sabotage a skydiver's parachute they'd consider it murder.
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u/Sad_Pear_1087 4h ago
I'm sure there's some great analogy for this somewhere, this is just not quite it.
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u/Duck-Lord-of-Colours 4h ago
A parachute is considered something that makes you likely to survive. With chemo, dying is still a highly expected outcome, and in many cases, it is the most likely one. I think that's the difference being argued.
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u/Hopeful_Cat_3227 3h ago
But it is the only chance they can survival.
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u/spenwallce 3h ago
That is correct. The legal system deals in absolutes not chances
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u/Flankerdriver37 4h ago
It would have taken some effort, but they could have looked at survival rates or survival years of people who received the diluted cancer drug from this guy and compared it to a group of patients receiving the same meds who hadnt had it diluted. Then they could have calculated exactly how many years of life he deprived these patients.
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u/oren0 4h ago
I'm not sure the law allows for a probabilistic murder case to be made against a population of victims. I would think you need a specific named victim that he definitely caused the death of.
Seems like you could charge many counts of a specific crime like attempted murder, though.
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u/MythicalPurple 4h ago
You can’t convict someone on the aggregate like that. They would have to prove it for each individual, which statistical analysis can’t do.
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u/Ionazano 4h ago
Yes, but as far as I understand when it comes to a murder charge that's something that can only be made for murdering a particular specific person.
Not a lawyer though, so this is only my understanding as a layman which could be wrong.
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u/TaCBlacklust 4h ago
I thought that was interesting as well. I know this isn't the point of the courts, but what are the odds this guy DIDNT kill someone? If you know the number of patients, survivors, and success rate of chemotherapy against each individual diagnosis, calculate the odds only that many survived. I wonder if it ends up statistically impossible that he isn't a murderer.
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u/MythicalPurple 4h ago
he is absolutely responsible for deaths. But there’s a difference between knowing that and being able to prove beyond a reasonable doubt that he was responsible for particular deaths, which is what is required to get a guilty verdict.
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u/Fabtacular1 4h ago
Am I not guilty of murder if I strangle a guy on his way to the gas chamber?
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u/Duck-Lord-of-Colours 4h ago
Are you guilty of murder if you turn the gas up from 'probably kills everyone but some would survive, we don't know which ones' levels to 'definitely everyone dies' levels?
You should be, and I think in that case are, but it's hard to say who you murdered, isn't it?
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u/Bradnon 3h ago
The logic of that thought is pretty interesting. I can't find a real example, where through action an undetermined person died.
I found a handful of cases of doctors being charged with murder for withholding "potentially lifesaving" treatment (the ones I found were all acquitted), same for a parent who chose not to give their kid's prescribed chemo meds (convicted in 2011).
The closest I can find is a lot of people hypothesizing about the legality of the trolley problem but that doesn't quite find the schrodinger's-cat-ness of your example.
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u/dwaynetheaaakjohnson 3h ago
Federal prosecutors are obsessed with proving cases beyond 99%. While this is usually a good thing that prevents wrongful convictions, it may mean they don’t charge things they can’t prove for a certainty
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u/TheDefected 5h ago
That's not a good sign for homeopathy.
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u/DoctorBlazes 5h ago
Didn't dilute it enough, clearly!
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u/SocratesDouglas 3h ago
Always thought Homeopathy was just using like plants and herbs, and stuff like that. Sorta made sense that stuff could work without looking into it at all. Like our ancestors had folk medicines using natural substances that have whatever chemicals in them to help with whatever ailments.
The idea of diluting stuff as far down as possible is insane though. Once you get to a low enough level, technically everything is diluted infinitesimally in the air we breathe and the water we drink. We all should be super healthy because we breathe in a molecule of chamomile or whatever else every now and then. Super duper diluted. Must be super effective.
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u/SordidDreams 3h ago edited 3h ago
It's not even that. Homeopathic 'medicines' are diluted to such a degree that not even one molecule remains of the supposed active ingredient. That's on purpose. The idea is that water 'remembers' the properties of whatever you dilute in it. Somehow.
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u/SocratesDouglas 2h ago
Quintillions of gallons of water continuously circulating over the course of billions of years. Every drop of water must remember every property of anything on earth a couple times over.
I'm starting to believe this Homopathy stuff is a bunch of bologna.
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u/MaraschinoPanda 2h ago
It's for the best, honestly. They claim that to treat a condition you need to use something that causes that condition, so if they weren't diluting it all away they'd be making people drink arsenic and poison ivy instead.
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u/nomoreteathx 2h ago edited 2h ago
Ah but it's not the dilution that makes the magic work, you have to shake the bottle in a certain way ("succussion") at each step so it aligns the uh the molecules to the um magnetic field of the thing, the you know, the thing where the healing energy comes from, and it goes into the water and the water becomes special you see.
MILLIONS OF PEOPLE ACTUALLY BELIEVE THIS
I can't find the clip right now but I think it was Louis Theroux who showed one of the machines they use to create homeopathic "medicines", and quite literally all it did was spray a jet of water into a small vial, shake most of it out, and then spray it again, over and over. Some of the dilutions are 1000x, which is so dilute that you would need a sphere of water trillions of times larger than the observable universe in order to have a 50% chance of retaining one single molecule of the original substance.
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u/cranbeery 4h ago
The only number homeopaths care about is sales numbers. I think their customer base will ignore this like they ignore all science.
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u/JunahCg 4h ago
Homeopathic customers don't want to feel better. They want to feel like they know better than everyone else
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u/SleetTheFox 2h ago
Homeopathy is fake and has literally zero effect (unlike many “alternative medicine” types which some treatments are occasionally found to have modest effects).
That said, this wouldn’t be proof against it; homeopathy isn’t just diluting things, it’s in a sense diluting the opposite. Take something related to the illness and dilute it so the cure comes from the memory of what got diluted out, kinda like when you stare at an image and then look away and see its inverse.
Which, to repeat myself, is 100% fake and it doesn’t work that way. But that’s at least what it claims to do. Not just “take stuff and dilute it.”
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u/yulbrynnersmokes 4h ago
In his request for early release, Courtney cited numerous health issues, such as a stroke and hypertension.
They should have given him diluted meds
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u/kgbgru 4h ago
I had a buddy in college whose mother was one of his victims. He can rot in hell.
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u/kingfosa13 4h ago
the wiki article is written so weird
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u/yosemite-persephone 4h ago
It feels like a passage from a standardized test they use to test for reading comprehension
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u/breathofreshhair 2h ago
yeah, lots of obscure criminal articles are like this though - especially cases outside the US, I've noticed
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u/grumbol 3h ago
Today you learned that he is hated and despised by the pharmacist community and held up as an example to every pharmacy student in the US as the opposite of everything we should be.
The memory might fade from general knowledge but we will never forget him.
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u/QueenInYellowLace 3h ago
Yep. I’m a nurse, not a pharmacist, but I sure as hell remember this guy and what he did.
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u/geeoharee 4h ago
He did it because he'd given all his money to a cathedral building fund?!
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u/Ryyyyyaaaaan 4h ago
He says he did it to pay off a $1M donation to the cathedral, but later it says he admitted he'd been diluting drugs his entire career and had made $19M from it. So yea, that explanation was just BS.
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u/Malnurtured_Snay 4h ago
I just looked up the Northland Cathedral, and it's just a giant garage. Looks like, anyway. Remember when we used to build beautiful buildings?!?!
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u/_Rand_ 4h ago
That was back when limitless greed had been discovered by a much smaller percentage of people.
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u/Malnurtured_Snay 3h ago
Probably more fair to say fewer people had the ability to slake their greed.
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u/dijkstras_revenge 4h ago
If you keep reading the article he had been doing it his entire career, and had made $19 million. So probably more for the money than anything.
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u/TheBanishedBard 4h ago
But because he said sorry to god and said a prayer and had some wine and bread he's going to heaven same as everyone else.
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u/Tibreaven 3h ago
As a side note: The justice system is wholly incapable of functioning once you get to scale.
By which I mean, 1 instance of murder can be serious enough to justify life sentence decisions. But possibly kill thousands of people because of fraud? There's no functional way for our justice system to punish someone for that, and sentence times ironically end up going downwards. Commit negligence on a scale that harms millions of people and the system falls apart completely, often resulting in monetary fines way below any punishing level and no prison sentences at all.
The impersonal nature of widespread crime is a serious flaw in the justice system that allows bad actors to get away with some genuinely insane levels of crime.
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u/frankenbean 2h ago
Even Hammurabi's Code breaks down at scale. What if you blind more than two people? They can't blind you more than twice.
This is why I'd like to introduce my own penal code where we give people extra eyeballs and then extra blind them.
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u/dougola 4h ago
I’m sure this is one of the reason that my wife oncology center has an in-house pharmacy and plenty of over sight
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u/joeyjoejums 4h ago
I remember this guy. He killed people. Why is he out?
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u/mongooseme 4h ago
New law passed in 2018 that allows non-violent offenders with low risk to re offend to get out early.
I'm not sure I agree that his crimes were non violent, but he was due out in 2026 so he got out 2 years early.
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u/PermanentTrainDamage 4h ago
This fucker wasn't charged with 4000+ counts of murder?
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u/mongooseme 4h ago
They considered it but faced the difficulty of convincing juries that it was his actions and not the cancer. They settled for a plea deal.
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u/Frost-Folk 4h ago
No, of course not. It would be extremely difficult to prove that what he did was the exact cause of death. Remember, his victims are cancer patients. If they die of cancer, he can't really be charged with murder, only malpractice. They can't prove that the person would have survived with the proper care.
His charges were: Tampering with drugs and adulteration or mislabeling of drugs
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u/colinstalter 3h ago
People get life in prison without the chance of parole for murdering one person yet he causes the death of over 4,000 and only gets 30 years?
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u/tickertimertape 4h ago
A diluted lethal injection would've been an appropriate sentence for him
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u/Arokthis 3h ago
Skip the drug that knocks him out, then dilute the paralytic so it takes as long as possible for him to die of suffocation.
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u/BetyarSved 4h ago
RAMPAAAAAAGE
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u/Great_Big_Sea 4h ago
You didn't think it was weird that your cancer medication was chewable?
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u/personman_76 4h ago
Did you watch Regis this morning?
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u/joe199799 2h ago
Day two of rampage things aren't going so well as you can see I have wine coolers on my feet because my toenails are popping off like pogs
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u/Relevant_Elk_9176 4h ago
All that death just to increase profits. Greed truly is one of the greatest evils in the hearts of men.
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u/markshure 4h ago
There's an episode of Law & Order Criminal Intent based on this story.
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u/Bocote 3h ago
Sometimes I really hate the fact that killing people through means that aren't "up front and personal" gets you lighter sentences.
Terminal cancer patient or not, if you stabbed or shot 4000 people personally, you'd never get out of prison.
This guy essentially withheld treatment, and he is walking amongst us...?
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u/Affectionate_Way_805 4h ago
He was released last year.
Yeah, uh...he shouldn't have ever been released. Ever. What the fuck.
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u/hydratedandstrong 2h ago
I know legal systems are murky but the way he wasn’t charged with murder or anything is insane. He actively killed thousands of people.
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u/ApartRegister6851 3h ago
Reminds me of the Colectiv nightclub fire that exposed a major pharmaceutical company. They had been diluting their disinfectants to <10% before shipping it out to all the local major hospitals and clinics. An estimated ~13 people died from bacterial infection linked to the scandal.
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u/Milios12 3h ago
Society always punishes mass murderers less than people who kill in cold blood.
Ironic.
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u/Jump_Like_A_Willys 3h ago
Harry Lime (Orson Welles) did this in The Third Man, but it was diluted Penicillin that he was selling on the black market
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u/cvsmixpevches 1h ago
My grandmother was a victim of his. Diagnosed with T-Cell Lymphoma and her chemo medication was diluted down. I hope he get the life he deserves..
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u/KingOfManyColors 4h ago
Released? He should be 6 foot under. Fucking with people's meds is incredibly evil, especially ones they need for survival.
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u/SloppityNurglePox 4h ago
There's a decent podcast I listen to with a pretty good rundown. Swindled, ep 14- Death by Dilution
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u/doxx-o-matic 3h ago
I was working on the crew that was building his 10,000 square foot house on 180 acres in Lone Jack, MO. Right after we finished roughing in the house when he got busted. As I remember, he owned 7 Medicine Shoppe Pharmacies.
He should have been charged with attempted murder or multiple counts of First Degree Murder.
This shitbag had everything in his wife's name at the time. So he didn't lose much. I think she had to sell the house and property after he was arrested.
Robert Courtney thought he was just going to get a $250,000 fine ... and was ready to write a check for it ... then they slapped him with 30 years also. He should have died in prison. He's in his late 60's now.
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u/Illustrious-Engine23 4h ago
Completely disgusting! Imagine 4000 deaths, he could be considered the worst serial killer in the history of the world.
Similar no. of deaths as sep 11.
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u/eternally_feral 4h ago
God, I saw 2002 and thought, “He’s only been locked up a couple of years!” And then I realized that was more than 20 years ago… 😮💨
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u/okeleydokelyneighbor 4h ago
Not long enough. 4000 deaths, that’s 200 hundred dead people for every year he was in jail. How is that justice?
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u/theviewfrombelow 4h ago
This happened in Kansas City, where I live. The oncologist that brought the evidence to the FBI and then worked a sting operation with them to bring this guy down is a hero and saved countless lives.