After the prosecution rested Thursday, the defense began to build its case that Dr. Hamada Makarita's longtime office manager has a history of impropriety and has falsely accused the Oakton dentist of illegally distributing narcotics.
Makarita, 51, is facing charges of Makarita, who owns a practice on Chain Bridge Road in Oakton, pleaded not guilty to the charges in June.
Assistant U.S. Attorney Gene Rossi, Special Assistant United States Attorney Mazen Basrawi and Special Assistant United States Attorney Danya Atiyeh are representing the prosecution.
U.S. District Court Judge Leonie M. Brinkema is presiding over the case.
Before the defense began its argument — much of which revolves around discrediting his former office manager, Karen Derder, who earlier testified to having first-hand knowledge of Makarita committing health care fraud and dispensing controlled substances — the prosecution called the last of its witnesses.
The prosecution ended its case Thursday with final testimony from its expert witness, Dr. Lawrence Singer, who reiterated his stance that Makarita overprescribed the patients to whom he is accused of dispensing controlled substances.
Special Agent Joseph Parker, with the FBI, also testified Thursday, outlining how the case unfolded over the course of about two years. Serving on the FBI's health care squad, Parker came across the case after Makarita filed a complaint accusing his longtime office manager, Karen Derder, of embezzling funds from the practice's 401k and stealing a prescription pad. In an interview with Parker, Derder accused Makarita of illegally providing narcotics to his and his staff's friends and family.
Parker said he pulled Makarita's report from the Virginia Prescription Monitoring Program (PMP) and noticed a few patients who had multiple prescriptions and high pill counts in a relatively short period of time. When he showed Makarita the report, he said the dentist took a few seconds to confirm each of the patients were his — "suspicious" behavior considering Makarita had suggested the FBI pull the PMP, Parker said.
Because of the inconsistencies between the PMP and patient files, Parker submitted the case to the Department of Health Professions for review.
He also testified Makarita admitted to having vicodin in his system upon his March 15 arrest before taking a urine analysis, the results of which were not presented to the court, and told the FBI he had received the pills from Reem Hamoud — one of four patients to whom Makarita is accused of illegally dispensing drugs.
Also testifying for the government, Janet Brumbaugh outlined her relationship with Makarita, which went from patient-doctor to romantic in 2007. She claimed Makarita provided her with narcotics several times throughout their relationship without a medical reason, one time calling in a prescription while driving her to the pharmacy to pick it up.
"I feel like it was the beginning of my addiction," said Brumbaugh, who has been in recovery since 2009.
Brumbaugh, a former model, also testified Makarita took compromising pictures of her after she had taken drugs he provided her. She said he emailed her the pictures and told him she felt "disgusted" he would take the photos.
The prosecution ended its case with testimony from Dr. Sameh Kassem, who is related by marriage through Makarita's ex-wife and worked with Makarita for a few months soon after receiving his dentistry degree in the mid-'90s.
The FBI found several claim checks from Aetna addressed to Kassem but deposited with Makarita's signature for dental work done on Makarita's parents. Kassem testified to never receiving nor cashing the checks, noting he once received an explanation of benefits for a claim check in his name then called Makarita's office, spoke with Derder about the mistake and assumed the problem had been resolved.
Defense Begins to Build Case
The defense, as represented by James Tate, Douglas Bywater and Allan Robertson of the Vienna firm Tate, Bywater and Fuller, began its case Thursday with testimony from Reem Hamoud.
Makarita is accused of distributing illegal narcotics to Hamoud and other patients. Hamoud, who admits to having an extramarital affair with Makarita while also being treated by him, said Makarita has prescribed narcotics on several occasions but only for dental purposes. She said she has had extensive dental work — extractions, bridges, gum surgery, full mouth reconstruction and temporomendibular joint disorder (TMD) — and a low tolerance for pain.
"The pain was excruciating ... It was unbearable," said Hamoud, who added each of Makarita's prescriptions coincided with that pain.
The defense then called a string of witnesses to testify to Makarita's character: Barbara Lunsford, his longtime dental assistant who said the second assistant once complained he asked her to pick up a prescription in her name but otherwise knew of no wrongdoing on Makarita's part; Danielle Larson, Makarita's dential hygienist; Laila Mazeas, a childhood friend.
And then came a string of witnesses whose testimony attempts to discredit Derder: a friend of Derder's who admitted to receiving prescriptions from her; a patient who claimed she exposed herself to him; Derder's daughter's former teacher who said Derder secured her a prescription of diazepam (valium); a patient who dealt with Derder after being billed multiple times for the same dental procedure; a patient who said Derder would tell her to call anytime if she needed more of her prescription; a former lawyer for Makarita who said a lawyer connected to Derder called to say she would stop accusing Makarita if he dropped the case against her complaining of embezzlement; and Makarita's parents, who testified to the extensive dental work they knew of no rule from Aetna and the World Bank — where Makarita's father was employed — excluding one's qualification for claims if dental procedures were performed by a family member.
William Beatty, a close friend and patient of Makarita's, testified to the dentist's character. He said any narcotics he received coincided with dental pain and had never seen Makarita drink or take drugs throughout their friendship.
He talked of Makarita's tendency to forgive charges when patients could not fully afford a procedure, which Beatty experienced firsthand when money became tight during his divorce.
Friday's proceedings ended with the testimony of Dr. Vincent Clark, an expert witness for the defense who says he believes Makarita has a tendency to underprescribe, not overprescribe.
"I think it's almost unethical to call a patient a liar when it comes to pain," Clark said. "People come to us for relief."
He explained the TMD's symptoms in particular are continual — it does not necessarily coincide with a particular dental procedure. Nor can one read a patient's chart and assume that a prescription given is for the same procedure they had that day, Clark said, as patients will often describe other problems they are experiencing during the examination.
Clark's testimony will continue when the trial begins again 9:30 a.m. today at the U.S. District Court in Alexandria.
- Dentist Trial: Experts Begin Testimony for Prosecution
- Dentist Trial: Both Sides Argue Abuse of Power
- Oakton Dentist Pleads Not Guilty
- Grand Jury Indicts Oakton Dentist on 15 Charges
- Accused Dentist Says Witness Is Fired Employee
- Oakton Dentist Arrested for Distributing Narcotics