Big Island Pain Doctor Convicted by Federal Jury to Various Drug Crimes

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A federal jury found a former Waimea pain doctor connected to the Kealoha scandal on Oʻahu guilty of all 38 counts of an indictment charging him with conspiracy to distribute oxycodone and fentanyl and distribution of oxycodone and fentanyl outside the course of professional practice and without a legitimate medical purpose.

Immediately following the jury’s verdict on Wednesday, April 20, Chief District Judge J. Michael Seabright ordered Rudolph B. Puana to be remanded into custody. Puana’s sentencing is scheduled on Sept. 12.

“Today’s guilty verdict is a testament that no doctor should use his license to unlawfully distribute controlled substances and falsify medical records to conceal his crimes,” said FBI Special Agent in Charge Steven Merrill. “The FBI will continue to work with our partners to hold those who abuse their positions of trust accountable, and to protect the public.”

Following a three-week trial, the jury deliberated for less than one day and convicted Puana of distributing substantial quantities of oxycodone to his close friends to sell to pay for tuition at one of the most expensive private schools in the State of Hawaiʻi and to purchase cocaine, according to a press release from the U.S. Department of Justice. The jury also found that Puana provided another friend with oxycodone and fentanyl to pay for cocaine they used to party together on Oʻahu.


Prior to the jury trial, Puana pleaded guilty to being an addict in possession of approximately seven firearms. At the guilty plea hearing on March 28, 2022, Puana admitted that between 2014 and 2018 he was addicted to hydrocodone while possessing seven firearms, which included handguns rifles, and a shotgun.

During the trial, the United States proved that Puana used cocaine with his friends and introduced his best friend to Puana’s “trinity”—cocaine, opioids, and alcohol—which combined to prolong and even out the “high.” Puana also popped hydrocodone pills—which he referred to as his “skittles”—in front of one of his friends. Puana said he obtained his “skittles” from the “doctor’s candy store.” Puana also left his script pad with his best friend and falsified medical records to legitimize a medical purpose for the substantial amount of oxycodone he provided to his friends. While addicted and abusing drugs, Puana distributed more than 7,810 oxycodone 30mg pills to his friends so that they could sell them to pay for tuition and cocaine. The street value of the oxycodone he supplied to his friends exceeded $117,000.

To conceal his crimes, Puana fabricated handwritten medical records for his closest friends, which included false drug tests. During their testimony, Puana’s friends admitted that Puana was not their pain doctor and that they had never gone to his clinic (previously the Puana Pain Clinic) for any medical visits, even though Puana falsely documented that they were examined there. In addition to falsifying the clinic’s files, Puana also kept a secret notebook hidden in the clinic’s drug closet. The notebook was handwritten by Puana to cover up his multi-year addiction to hydrocodone.


“The unlawful diversion of prescription drugs is one of the most serious problems plaguing our communities, and it is fueling the opioid epidemic that is ravaging families across the country,” said U.S. Attorney Randy S. Grossman. “The conviction of a pain doctor abusing his power and position to distribute highly addictive and dangerous oxycodone and fentanyl sends a strong message to any medical professional acting outside the regular course of practice and prescribing opioids without a legitimate medical need.”

Prosecutors said Puana, who is Katherine Kealoha’s brother, prescribed pain medication to his friends and family members to sell or trade for cocaine. Kealoha was among those wrapped up in the scheme.

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