PROVIDENCE, R.I. --Short and stout, with gray ringlets of hair framing a round, bespectacled face, Ana Maria Santi looks the part of a doting grandmother.
Instead, the 68-year-old disgraced doctor from Queens, N.Y., has become the most unlikely face of a national steroid ring that reportedly involved Orioles outfielder Jay Gibbons, among others.
Yesterday, in federal court here, Santi received a two-year jail sentence, plus one year of house confinement and two additional years of supervised probation for issuing thousands of prescriptions for human growth hormone and other illegal steroids to clients she never examined. She also has to forfeit $24,340 she made from a New Jersey company as part of the scam and repay $19,205 to Blue Cross and Blue Shield of Rhode Island, which had reimbursed customers who received the illegal drugs.
"She may have a grandmotherly face, but her actions certainly were not grandmotherly," said Adi Goldstein, the assistant U.S. attorney prosecuting the case. "She committed the serious crimes of writing prescriptions for steroids and hGH. She had customers, not patients."
Santi, dressed in a blue prison jumpsuit, sat quietly in the courtroom but occasionally turned to her two adult sons, waved and smiled. When asked by U.S. District Court Judge William E. Smith whether she wanted to make a comment for the record, she said: "No, your honor. Thank you very much, and I am sorry for what I did."
According to a federal investigation in Rhode Island of Internet drug operations - which is separate but similar to the ongoing state investigation in Albany, N.Y. - Santi admitted using the name and prescription number of a dying former co-worker for at least five years. She did so despite having her medical license revoked in 1999 and "without ever meeting, diagnosing, speaking to or observing" her clients, Goldstein told the court yesterday.
From 2005 to 2006, Goldstein said Santi earned $125,000 for the forged signatures.
"She committed this offense with a stroke of a pen and a push of a fax button from her home," Goldstein said.
Furthermore, she said Santi recruited fellow New York City doctor Victor Mariani, a former medical school classmate of Santi's in Argentina, to participate in the scam. Mariani, 73, was sentenced yesterday to one year of home confinement, two additional years of supervised probation, a $6,000 fine and forfeiture of $34,485 in earnings. Unlike Santi, who had a history of previous insurance fraud, Mariani was a first-time offender and was considered "not as culpable" as Santi, Goldstein said.
Mariani said at the sentencing hearing that he believed someone was examining and diagnosing patients - presumably Santi - but admitted to never seeing them himself.
He and Santi signed the majority of their prescriptions for American Pharmaceutical Group, which was run by co-defendant Daniel McGlone out of his kitchen and home office in North New Brunswick, N.J.
McGlone, according to court documents, found prospective clients through various methods, including magazine advertisements that targeted bodybuilders. He paid doctors $25 for each steroid/hGH prescription, then had the prescriptions filled by compound pharmacies, such as the federally raided Signature Pharmacy in Orlando, Fla. According to court documents, McGlone made approximately $860,000 in profit from individual clients and pharmacies. He is awaiting sentencing in Rhode Island federal court in February.
Santi and the principal ownership of Signature are among those charged by the Albany County District Attorney's office, which made headlines earlier this year with a series of steroids raids in Florida. Santi has pleaded guilty in Albany and is awaiting sentencing, while the Signature group is awaiting trial there.
Santi and Mariani were facing harsher penalties under federal sentencing guidelines yesterday, but Judge Smith took into consideration the defendants' age and health. Yet Smith said it was important to "send a message to the medical community that ... this is a very serious offense, and the court values it as such."
Goldstein, the federal prosecutor, said it's important to expose the steroid rings as much wider in scope than athletes looking for an edge. In Rhode Island, she said, the investigation uncovered at least 20 individuals who had ordered a total of 4,000 units of hGH.
"This extends beyond professional athletes and goes beyond the doors of gyms as well," she said. "People are using this for anti-aging, for weight loss. Not just as performance enhancers."
Because doctors such as Santi and Mariani did not know the previous medical or psychological histories of those receiving the drugs, some recipients possessed significant risk factors, including a man who later was charged with the brutal beating of a Rhode Island state trooper, she said.
As for athletes, Goldstein would not confirm whether any NFL or Major League Baseball players received drugs prescribed by yesterday's defendants.
"That's not something I am willing to comment about," she said. "And I probably wouldn't know it if they were."
However, SI.com previously reported that Gibbons received shipments of hGH and anabolic steroids from South Beach Rejuvenation Center in Miami Beach - and filled by Signature Pharmacy - from 2003 to 2005. According to SI.com, one of the prescribing physicians in the Gibbons case was "A. Almarashi," the alias used by Santi.
"A. Almarashi," the name of a now-deceased former co-worker of Santi's, also was the signature on prescriptions for Genotropin allegedly sent to Jerry Hairston Jr., a Texas Rangers infielder-outfielder, by an Alabama-based compound pharmacy in 2004, according to SI.com.
Hairston and Gibbons were Orioles teammates from 2001 to 2004. Hairston has denied that he received or used illegal performance enhancers. Gibbons has refused comment on the story since it was reported in September, except to say that he has cooperated with MLB in its investigation of the matter.
Santi, an anesthesiologist, first had her medical license suspended in 1994 after problems with alcohol. She had it revoked in 1999, the same year she was involved with a liposuction case that resulted in the death of the patient.
She also had at least one prior conviction for insurance fraud, said Edward C. Roy, her attorney in Rhode Island.
"What has befallen her is alcohol," Roy said. "When she is not drinking, she is a great person."
As a child, Roy said his client was "smuggled out of Poland" to England during World War II, and her family later relocated to Argentina. There, he said, she went to medical school and became a doctor, a difficult task for a woman of her era.
Eventually she was forced out of her profession and turned to the prescription scam to survive financially.
"She is remorseful, I'll tell you that," Roy said. "The fact is she is such a brilliant person and achieved a lot in her life and then lost all of those achievements because of alcoholism."