CINCINNATI — Several nurses and medical assistants testified on Wednesday that when Dr. Saad Sakkal began working at Lindenwald Medical Center in early 2015, the family medical practice soon became overcrowded with patients aggressively seeking pain medication.
“Some of them cried just to get pain prescriptions,” medical assistant Alicia Hayes said. “They were not easy to deal with unless they left with the prescriptions they came there for."
Hayes testified during the third day of trial in U.S. District Court for the Hamilton doctor, who stands accused of overprescribing pain pills and deadly drug combinations that directly led to at least two patients’ deaths.
Patients at the understaffed medical center tried to manipulate and bully Sakkal into writing prescriptions for pain pills, she added. She described them as difficult, demanding and overwhelmingly poor, with “one hundred percent of them on Medicaid.”
A grand jury charged the 71-year-old doctor with illegally prescribing pain medication that led to the overdose deaths of two patients: Ashley Adkins, 31, of Middletown, and 51-year-old Lisa Anne Hawkey, of Hamilton. Each charge carries a mandatory minimum penalty of 20 years to life in prison.
Family members of both women are expected to testify on Thursday.
Sakkal's indictment also mentions six other patients who died in 2016 from drug use complications. He is not charged in those deaths.
RELATED: Defense: Hamilton doctor was 'sloppy,' 'careless,' even 'stupid' — but patients killed themselves
On Wednesday, jurors heard from nurses and medical staff who worked with Sakkal during his tenure at Lindenwald from early 2015 until late 2016.
The traditional family practice changed significantly when Sakkal arrived, Hayes testified, with 80 percent of patients then seeking medication for pain, psychiatric or mental health issues.
She testified that many pharmacists called concerned about the prescriptions the doctor was writing.
“A lot of the calls were, 'This medication isn’t right,' or, 'This medication doesn’t exist,'” testified medical assistant Kimberly Jackson.
Jackson also fielded calls from patients.
“A lot of patients that were calling in were looking for narcotics,” Jackson testified. “A lot of walk-ins asked if your doctor prescribes pain pills.”
Sakkal didn’t use the Ohio Automated Rx Reporting System (OARRS), Jackson testified. This is what doctors use to monitor patients’ controlled substance prescription history and identify suspected abuse.
He also dictated the results of patient exams to his son, Mohammed Sakkal, who worked at Lindenwald inputting information into computer records, Hayes testified.
“I don’t think Dr. Sakkal was very tech savvy,” Hayes testified.
Several former employees described the now-closed Lindenwald as chaotic, understaffed and overwhelmed with patients.
Often the waiting room was completely filled so patients would wait on the front porch, Jackson testified.
Nurse practitioner Lisa Goins testified that when she first began working at Lindenwald, she shadowed Sakkal on patient exams for two days. She testified that he did not use a stethoscope on patients, did not listen to what they said and often spoke over them.
“They were upset because they had waited hours to see a doctor and the only got a few minutes with him,” she testified.
Goins testified that she did not dispense opiates – only Sakkal did at the office. That often angered her patients.
“A few patients got angry and walked out on me … because I would not fill a prescription for them,” Goins testified.
Sakkal also faces 30 counts of illegal distribution of controlled substances and seven counts of using a nurse practitioner’s prescription pad to write prescriptions for his patients. His attorney described those actions as honest mistakes.
“He was doing the best he could in a bad situation,” Richard Goldberg said, who admitted his client ran a sloppy practice. “He was not trained to deal with addicts in pain.”
The trial is expected to last into next week.
