In January, Dr. Antoine Francis Cawog used credit cards to buy nearly 36,000 tablets of medicines, triggering concern among drug enforcement agents.
In a 61-page search warrant application and affidavit unsealed this week, investigators said Cawog purchased 21,900 tablets of hydrocodone, a pain medication, and 14,000 other pills, such as mood-changing drugs and appetite suppressants, from a pharmaceutical distributor in Valparaiso, Ind.
That same month, the Indiana Drug Enforcement Administration recorded Cawog buying 7,500 other pills, including 5,000 more hydrocodone.
The application asserts that "the amount of controlled substances purchased by Cawog is atypically high for physicians in the Western District of Pennsylvania.
"Excessive purchases of controlled substances by a physician is indicative of illegal drug activity," it said.
Cawog, 63, of 102 Foxwood Drive, Unity, is charged with 24 counts of violating the state drug act and 10 counts of attempting to commit Medicaid fraud. A preliminary hearing will be held July 17 before Greensburg District Judge James Albert.
The state Attorney General's Office alleges that Cawog sold prescriptions for pain medicine to patients, a confidential informant and others, at times driving his Cadillac Escalade to rendezvous spots. Other times, he allegedly exchanged prescriptions for work to be done at his home.
Authorities charged the doctor, who was born in Syria and became a naturalized U.S. citizen in 1980, with giving prescriptions to an undercover investigator without doing proper medical evaluations during 10 visits to Cawog's Irwin office.
Cawog, who is in federal custody, was indicted last month in federal court in Pittsburgh on two counts of money laundering. Prosecutors accused Cawog of sending $275,000 in 2004 to a bank in Lebanon with the intent of "concealment of assets in connection with a bankruptcy case."
Prosecutors allege Cawog wired nearly $1.7 million to Lebanon while he owed about $2.6 million in federal income taxes since 1986.
The affidavit was filed by Mark Armstrong II of the Drug Enforcement Administration and Stephen E. Wagner of the Internal Revenue Service in connection with a search of Cawog's home. Among the items sought by investigators were computers and computer storage equipment, medical records, bank statements and other financial documents, correspondences, drugs and prescriptions for controlled substances.
The affidavit said the owner of an Irwin business near Cawog's 422 Main St. practice expressed concerns about some of the people going there.
"According to the business owner, Cawog was issuing controlled-substance prescriptions to individuals who appeared to be drug-dependent," the affidavit said. "The business owner reported that many of these individuals, after acquiring their controlled-substance prescriptions, utilized their cellular telephones to arrange illegal sales of their prescribed medication."
In November 2002, the Clairton Police Department contacted federal investigators after a woman reported she had mistakenly received Vicodin tablets from Cawog in the mail. The intended recipient said Cawog had been sending pain medication through the mail for a while, investigators allege.
A confidential informant used to make undercover buys from Cawog said the doctor was writing the prescriptions in exchange for "cash, coins, 'girls' and services," the affidavit said.
The informant said Cawog wanted money to build a home in the Middle East, where he planned to go within three years, investigators said. That departure was moved up, prompting his arrest in late April, investigators said.
The informant said "Cawog prefers 'patients' to pay in cash, in order to avoid detection by the government," the affidavit said.
The same informant indicated that a man did computer repairs at Cawog's home "in exchange for pills."
The affidavit details how Cawog purportedly made wire transfers to banks in Lebanon, allegedly with the help of his 25-year-old daughter, Stephanie, who has not been charged.
Cawog traveled overseas nine times in 2007, at least once after a wire transfer was made to a Lebanon bank, according to the court papers.
Cawog and his wife, Aurora, filed for bankruptcy three times. All were dismissed by the court. While their second case was pending in 2004, Cawog's medical office in Youngwood was destroyed by fire.
Cawog then collected $217,745 in insurance payments, but allegedly reported only $47,500 to bankruptcy court.
The affidavit alleges Cawog secreted funds into his daughter's bank account to buy three of his properties up for sale at a 2006 IRS auction -- his Unity home and the properties in Youngwood and Irwin. Cawog, a former general practitioner at Excela Health Westmoreland hospital in Greensburg, has five daughters, three of whom were attending American University in Lebanon this spring.
