What Happened
Andrew Catalone, 72, of Youngsville, Pennsylvania, a former nurse practitioner who owned medical practices in Auburn and Fulton, New York, pleaded guilty on April 9, 2026 to unlawfully possessing controlled substances with the intent to distribute them.
According to prosecutors, Catalone collected unused controlled substances that patients he had prescribed returned to him, then distributed the loose pills to other patients without prescriptions. Instead of disposing of returned medications through a lawful channel, he built an off-the-books supply that moved outside any prescription or dispensing record.
Under the plea agreement, the government and defense jointly recommend a 52-month term of imprisonment followed by three years of supervised release — a signal of how seriously the government treats the redistribution of returned medications. Sentencing was scheduled for August 18, 2026.
What Went Wrong
The public record does not describe the practices' internal procedures, so the analysis below is hypothesis based on the conduct admitted. This case illustrates what happens when patient-returned controlled substances have no lawful, documented pathway:
- No documented procedure for receiving, logging, securing and disposing of patient-returned controlled substances — returns were simply accumulated.
- Returned medications were treated as reusable inventory rather than being routed to reverse distribution or destruction.
- No reconciliation between prescriptions written and medications returned, so the size of the returned stockpile was never quantified or questioned.
- Dispensing occurred entirely outside prescription records, defeating the corresponding responsibility review that should accompany every controlled substance transfer.
- Staff and patients were not educated on lawful disposal options, leaving returned pills with no defined destination.
- No staff training on the legal handling of patient-returned medications, so the practice had no defined, lawful procedure to follow.
None of this required sophisticated concealment. The failure was structural: returned drugs had no lawful destination, so they accumulated as an off-book supply that could be moved without any record — the exact condition that makes redistribution possible.
How It Could Have Been Prevented
- Adopt a written policy stating that patient-returned controlled substances are never reissued, and route every return to a documented reverse distribution or destruction process.
- Log every returned controlled substance with patient, drug, quantity, date and a witnessing signature, and reconcile the log monthly.
- Secure returned medications in a segregated, locked area separate from dispensing stock.
- Reconcile DEA Form 222 order records against prescription dispensing to confirm that all distributed product traces to a legitimate order.
- Train staff and educate patients on lawful disposal channels, and document the training.
- Apply red-flag monitoring to the practice's own operations, including any pattern of loose-pill transfers without prescriptions.
Related Guidance
- 15 Red Flags of Drug Diversion — Behavioral and recordkeeping indicators of diversion by prescribers.
- Hospital Self-Assessment Checklist — Hospital self-assessment, 8 sections and 63 weighted items.
- Corresponding Responsibility Guide — The prescriber and pharmacist duty to ensure every controlled substance order serves a legitimate medical purpose.
- DEA Form 222 Ordering Guide — Ordering and recordkeeping requirements for Schedule II purchases.
Sources
- https://www.justice.gov/usao-ndny/pr/former-nurse-practitioner-pleads-guilty-possessing-controlled-substances-intent
- https://oig.hhs.gov/fraud/enforcement/former-nurse-practitioner-pleads-guilty-to-possessing-controlled-substances-with-the-intent-to-unlawfully-distribute-them
- https://www.syracuse.com/crime/2026/04/central-ny-nurse-practitioner-admits-giving-opioid-pills-to-patients-with-no-prescription.html