The trial of a doctor and his wife accused of contributing to the fatal overdoses of 68 patients by overprescribing pain medication went to jurors on Tuesday.
Stephen Schneider and his wife Linda were portrayed by the prosecution in closing arguments as running a "Burger King for pain pill addicts" while the defense argued that the state's case was overblown.
It case has drawn attention in part because of a debate over the medical treatment of pain in the United States, but also the high number of deaths attributed to the defendants.
"This is a sordid tale of how money and not medicine controlled the defendants' actions," Assistant U.S. Attorney Tanya Treadway told jurors in closing arguments.
"The defendants were running a pill mill, not a legitimate medical practice," she added.
But defense attorneys said the case was pushed by insurance companies who didn't want to pay for expensive medication that Dr. Schneider prescribed to poor people.
"This is a reimbursement case for insurance, at most," Kevin Byers, the attorney for Linda Schneider, told jurors. He said the Schneiders' practice had been "doctored up to look like a huge, rolling death machine."
At least one patients' advocacy group has voiced its support for Schneider, who is no longer practicing medicine.
The Schneiders are charged in federal court with illegally prescribing narcotics, health-care fraud and money laundering. They face up to life in prison if convicted.
The indictment against the couple alleges their actions contributed to the deaths of 68 patients.
Treadway recounted testimony about many of them Tuesday, detailing how they had failed drug screening tests, required increased dosages of medication, and suffered non-fatal overdoses before finally dying.
One patient was a stripper for whom Schneider prescribed drugs to relieve performance anxiety, Treadway said.
Many died within days of their last visit to Schneider's clinic, she said. Schneider often saw more than 50 patients in a day at the clinic, which was located in Haysville, a small town south of Wichita in south-central Kansas.
The Schneiders did not receive money for the drugs their patients took, but they fraudulently billed insurance companies and the government for patient services, using the money to buy a Hummer and a home in Mexico overlooking the Pacific Ocean, Treadway said.
Byers conceded that the volume of patients seen by the Schneiders made for a "chaotic" practice. "I'm sure there were mistakes made," he said. "That doesn't make it criminal or an illegal enterprise."