Lester and Nancy Sadler, a husband and wife, ran a series of pain management clinics in Ohio.
As the Sixth Circuit explained, “these were not conventional plain clinics.” For example, at one clinic
patients would arrive well before it opened, filling the clinic’s parking lot and the lots of nearby businesses. While waiting for the clinic to open, the patients used drugs and traded prescription forms for cash in the parking lots. The patients often traveled long distances (and in large groups) to come to the Sadlers’ shops, sometimes as much as 316 miles in a roundtrip, even though most of the patients lived much closer to other clinics.