Nurse Practitioner Called a Drug-Dealer at Sentencing

Nurse Practitioners in Alabama are required to have physician collaboration. However, at Lillian Akwuba, skirted this law and others when she prescribed controlled substances to patients who didn't need it and forged the signatures of physicians. She's been sentenced to 10 years in prison and called a "drug dealer." Find out more about this story.

Nurse Practitioner Called a Drug-Dealer at Sentencing

On May 29th, a Montgomery, Alabama judge sentenced former Nurse Practitioner, Lillian Akwuba to 10 years in federal prison. Akwuba was found guilty on 23 counts of healthcare fraud and drug distribution. However, she wasn’t alone in her acts that caused Judge Sharon Blackburn to tell Akwuba that she was a “ highly educated drug dealer” who wrecked the lives of patients and families to make money.

The Story

Dr. Gilberto Sanchez, who owned Family Practice in Montgomery, was arrested in 2017 for allegedly running a pill mill. He was indicted along with other staff members from his office, including Akwuba. They were charged with prescribing unnecessary controlled substances, such as hydrocodone, oxycodone, fentanyl, and methadone. Not only did they give these dangerous drugs for no reason, but they also had patients return to their office every month to get their prescriptions. These visits were considered unnecessary and a form of healthcare fraud.

According to AL.com Akwuba left Sanchez’ practice in 2016 and opened her own practice, Mercy Family Health Care in Montgomery. She continued to overprescribe the same controlled substances. However, since she was legally required to collaborate with a physician, she broke the law in new ways. Prosecutors reported that she began forging signatures of physicians and faking the collaboration required under Alabama state law.

A WSFA News 12 article , reported that Akwuba pleaded for mercy at her trial and stated that her family depends on her for support. She said that she was remorseful. However, the judge pointed out that at no point during her hearing did Akwuba ever comment about the people that she prescribed dangerous drugs to and probably turned into addicts. Blackburn even replied that she didn’t feel that the former nurse practitioner understood the extent of her conduct and just how criminal her actions were.

An Assistant United States Attorney, Jonathan Ross was also present for the trial. He told WSFA that Akwuba showed “complete and utter disrespect to her patients and the court by lying under oath during the trial, and disrespect to the doctors who tried to work with her and curb her prescribing habits.” Ross also called Akwuba a “drug dealer.”

Ross feels that Akwuba is at higher levels of blame compared to Sanchez, who pleaded guilty to five counts and was sentenced to serve more than 12 years in prison. Akwuba remains detained until her family produces her passport, at which time she could be released on bond before heading to serve her sentence.

The Dilemma

There are so many issues in this story. Did Akwuba understand her prescribing actions? How was she able to go for such a long time forging the names of physicians? The state of Alabama only gives nurse practitioners limited authority to prescribe, which means they must have physician collaboration. Did pharmacists in the area not recognize the forgery?

Stories such as these can be used as ammunition to support the notion that nurse practitioners should not be given autonomy to prescribe without physician oversight and work independently. However, these stories are few and probably shouldn’t be used to set precedence for future laws. But, we all know what one bad apple can do to an entire bag, right?

What do you think should happen to Akwuba, and where did this situation go wrong? Share your thoughts below.

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Melissa Mills

About Melissa Mills, BSN

Workforce Development Columnist

Melissa is a professor, medical writer, and business owner. She has been a nurse for over 20 years and enjoys combining her nursing knowledge and passion for the written word. She is available for writing, editing, and coaching services. You can see more of her work at www.melissamills.net.

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Sanchez was running a "pill mill", was over Akwuba, and basically taught her how to scam the system but she's more to blame and more dangerous, and labeled the drug dealer. Why? Her blackness wouldn't be a factor now would it? (sarcasm)

Both are dead wrong and both were highly educated drug dealers but the judge only deems one more to blame. Alabama will never get it together. SMH

Anywho, glad they're both paying for their crimes.

To answer your question: Akwuba should be charged and sentenced for her role. She knew what she was doing was wrong and willingly did it. It went wrong, on her part, when she didn't leave sooner and report Dr. Sanchez. Instead, she chose to leave and continue his misdeeds. Should she be sentenced, yes. 10 years, no. I have seen drunk drivers, drug dealers, etc get far less time. They're holding her accountable because of her status. However, from recent news, only medical professionals seem to suffer from the courts feeling "you should have known better" when sentencing. Can these rules be applied to bankers, truckers, politicians, etc.?

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Here in New York State, controlled substances are electronically sent to the pharmacy, usually the patient isn't even handed a traditional script. This NP showed us a weak spot in the system that electronic scripts would solve. Many providers were annoyed when it rolled out, because none of us like change, but it works beautifully now. We also are able to see every script that was filled from every pharmacy state wide to curb doctor shopping. The saddest part of this entire story however, is people with addiction are still out there dying. I wish we did more continuing education and utilized recovery coaches so when a patient is identified as being in active addiction, we can actually help them instead of cutting them off and sending them out to get them off of the streets.

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On 6/3/2019 at 3:31 PM, bsmalls said:

Here in New York State, controlled substances are electronically sent to the pharmacy, usually the patient isn't even handed a traditional script. This NP showed us a weak spot in the system that electronic scripts would solve. Many providers were annoyed when it rolled out, because none of us like change, but it works beautifully now. We also are able to see every script that was filled from every pharmacy state wide to curb doctor shopping. The saddest part of this entire story however, is people with addiction are still out there dying. I wish we did more continuing education and utilized recovery coaches so when a patient is identified as being in active addiction, we can actually help them instead of cutting them off and sending them out to get them off of the streets.

Most states are like that. However, backwards AL does things off brand and gawd forbid you try to tell them any different. Regular prescriptions get electronically sent to pharmacies but narcs are by paper script. Completely backwards. SMH

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What a big shocker, she lied about her physician supervision.

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If she had cared about being the sole support of her family she would have practiced within the law. No sympathy for her.

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I get it, many foreign nurses must send money home to help their families but it is real messed up that she was more concerned about that versus the people here that she was supporting being addicts. I don't feel bad for her one bit.

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Specializes in SICU, trauma, neuro.

How did her forgery go so long? Lots of criminals get away with their actions for a long time without being caught.... it’s unfortunate but true. That’s why serial killers are even a thing.

Why didn’t the pharmacists recognize the forgeries? As nurses who have the frequent and ridiculous expectations of doing others’ jobs (housekeeping doesn’t want to clean poop off the floor? Lab is short staffed? Kitchen sent the wrong food? No problem..... the nurse can fix it!)....... Why would we expect a pharmacist to be a forensic handwriting analyst? ?

She was black in AL? (Referring to a comment, not the OP) Or she could be deemed more to blame than dr SANCHEZ because she 1) didn’t have the legally mandated oversight and 2) committed forgery...... in addition to the pill-mill prescribing practices. Now my Scandinavian self has admittedly never been black in AL... but it seems kind of prejudicial to assume that the white population of the Deep South must all be bigots, no?

Did she “understand her prescribing actions?” Really? REALLY?? This question is just plain insulting to her profession.

I’m getting sick to death of trying to find other people, other circumstances to blame for CRIMINAL BEHAVIOR.

This woman’s CRIMINAL BEHAVIOR contributed to disease — just as an oncologist recommending H2O2 infusions.... she was putting pts’ lives at risk, she contributed to the “epidemic” aspect of opioid use which I believe is causing legit pain to be under treated............ She probably contributed to the See-NPs-can’t-be-unsupervised side of the oversight dialogue......

AND she broke her state’s practice law and committed forgery.

I don’t feel sorry for her.

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7 hours ago, Here.I.Stand said:

How did her forgery go so long? Lots of criminals get away with their actions for a long time without being caught.... it’s unfortunate but true. That’s why serial killers are even a thing.

Why didn’t the pharmacists recognize the forgeries? As nurses who have the frequent and ridiculous expectations of doing others’ jobs (housekeeping doesn’t want to clean poop off the floor? Lab is short staffed? Kitchen sent the wrong food? No problem..... the nurse can fix it!)....... Why would we expect a pharmacist to be a forensic handwriting analyst? ?

She was black in AL? (Referring to a comment, not the OP) Or she could be deemed more to blame than dr SANCHEZ because she 1) didn’t have the legally mandated oversight and 2) committed forgery...... in addition to the pill-mill prescribing practices. Now my Scandinavian self has admittedly never been black in AL... but it seems kind of prejudicial to assume that the white population of the Deep South must all be bigots, no?

Did she “understand her prescribing actions?” Really? REALLY?? This question is just plain insulting to her profession.

I’m getting sick to death of trying to find other people, other circumstances to blame for CRIMINAL BEHAVIOR.

This woman’s CRIMINAL BEHAVIOR contributed to disease — just as an oncologist recommending H2O2 infusions.... she was putting pts’ lives at risk, she contributed to the “epidemic” aspect of opioid use which I believe is causing legit pain to be under treated............ She probably contributed to the See-NPs-can’t-be-unsupervised side of the oversight dialogue......

AND she broke her state’s practice law and committed forgery.

I don’t feel sorry for her.

I said all white people are bigots where? Secondly, you're not black in AL and yes it can be hard so you can/should stop there. Thirdly, did you not see "sarcasm" or you wanted to go on a rant about race and ignore a whole thesis statement after the one you're fake outraged about? What you said isn't far off from what I said but you chose that one sentence and went on a whole rant about it. Who really has a thing with race here?

FYI I live in AL, am black in AL, and know far more about this than you. It's not up for debate.

Also having said that, yes she's at fault, no one in this thread said she wasn't but she learned from Sanchez who's also a doctor, and they're both in the wrong. All the extra fluff against her was just that, fluff.

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Specializes in Critical Care.
On ‎6‎/‎3‎/‎2019 at 7:08 AM, NurseBlaq said:

Sanchez was running a "pill mill", was over Akwuba, and basically taught her how to scam the system but she's more to blame and more dangerous, and labeled the drug dealer. Why? Her blackness wouldn't be a factor now would it? (sarcasm)

Both are dead wrong and both were highly educated drug dealers but the judge only deems one more to blame. Alabama will never get it together. SMH

Anywho, glad they're both paying for their crimes.

To answer your question: Akwuba should be charged and sentenced for her role. She knew what she was doing was wrong and willingly did it. It went wrong, on her part, when she didn't leave sooner and report Dr. Sanchez. Instead, she chose to leave and continue his misdeeds. Should she be sentenced, yes. 10 years, no. I have seen drunk drivers, drug dealers, etc get far less time. They're holding her accountable because of her status. However, from recent news, only medical professionals seem to suffer from the courts feeling "you should have known better" when sentencing. Can these rules be applied to bankers, truckers, politicians, etc.?

I don't know what your suggestion that Akwuba was more harshly punished than Sanchez is based on. Sanchez was sentenced to 12 years and Awkuba 10, and neither of these sentences are excessive, I'm disappointed that either will ever get out of jail.

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5 hours ago, MunoRN said:

I don't know what your suggestion that Akwuba was more harshly punished than Sanchez is based on. Sanchez was sentenced to 12 years and Awkuba 10, and neither of these sentences are excessive, I'm disappointed that either will ever get out of jail.

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Ross feels that Akwuba is at higher levels of blame compared to Sanchez

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Judge Sharon Blackburn to tell Akwuba that she was a “ highly educated drug dealer” who wrecked the lives of patients and families to make money

A. I didn't say she was more harshly "punished" I said "more to blame and more dangerous", see quotes above. My post wasn't pointing out the sentence, it was pointing out the rhetoric used when speaking on Akwuba when both she and Sanchez share the same blame and done the exact same thing. . Yes, both should have been "punished" which I also pointed out.

Now what else don't you understand about what I said?

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Specializes in ER.

She'll probably get out sooner than 10 years. These pill pushers deserve jail time. A 10 year sentence assures she'll definitely get a few. I have more respect for a street dealer than someone who uses the cloak of the medical establishment to get people hooked.

As for her race, it's obnoxious to bring out the race card for every time a black person is involved, especially having not seen the trial. The judge made one comment you didn't like, don't let it push your buttons. I'll bet some black folk were victimized by that woman!

I didn't read that she was foreign born, only that they wanted her passport before she got bail, standard operating procedure for everyone. If she is, shame on her for coming to this country and breaking the law. People like that give immigrants a bad name.

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