Doctor Billions | 4. Egomaniac Airlines

When Robert Pereira met the owner of a medical hardware company called Spinal Solutions, he thought his dream of becoming a professional pilot had come true. Instead, he soon realizes there’s a new dimension to this billion dollar scam. Want the full story? Binge every episode of Doctor Billions ad-free now by subscribing to The Binge+. You’ll unlock over 60 true crime series instantly, get early access to drops on the first of every month, and hear exclusive bonus episodes. Search for the channel on Apple Podcasts or head to GetTheBinge.com. For behind-the-scenes details, join our free newsletter at Patreon.com/TheBinge. Doctor Billions is a production of Sony Music Entertainment and Western Sound. Follow @sonypodcasts and discover more at sonymusic.com/podcasts. Learn more about your ad choices at podcastchoices.com/adchoices. The Binge — feed your true crime obsession. Learn more about your ad choices. Visit podcastchoices.com/adchoices

• 0:00Speaker 00

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• 0:31Speaker 01

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• 1:07Speaker 02

  A once-prominent, later disgraced neurosurgeon now finds himself accused of taking kickbacks to implant fake parts in patients.

• 1:16Speaker 01

  One evening in 2015, a woman named Tammy Gore was sitting at home with her husband, Bob, watching the news when a name caught her ear.

• 1:24Speaker 02

  Colly White is one of more than a dozen doctors across the country accused of using parts made in a tool shop on their patients.

• 1:33Speaker 01

  The name Colly White was an important one for her and Bob.

• 1:39Speaker 01

  When Bob and Tammy met, they were both seniors. They'd both lost their spouses, and neither one was looking for love necessarily.

• 1:47Speaker 03

  Oh, he was actually looking for somebody to go out to dinner with.

• 1:50Speaker 01

  They met online on one of those dating sites.

• 1:53Speaker 03

  He looked like Santa Claus, and he used a cane. And I thought, oh, he took care of his wife for 20-some years. And I just thought, if anybody's like that, he must be a really good person. And he really was. Bob was probably the kindest guy you ever could meet.

• 2:10Speaker 01

  Like I said, they weren't necessarily looking for love, but they also weren't not looking for it. They met in May, and by July, he proposed.

• 2:20Speaker 03

  And we were married in December.

• 2:23Speaker 03

  And it was wonderful.

• 2:27Speaker 03

  He didn't wait.

• 2:30Speaker 01

  Bob and Tammy had both been through a lot, and Bob had severe mobility issues due to a terrible back injury on the job. The pain was awful.

• 2:41Speaker 03

  And from that point on, then he had to have surgery.

• 2:46Speaker 01

  But the surgery didn't help. It just seemed to make everything worse. Bob's pain never went away. He was on disability for the rest of his life. Sometimes it was so bad, he couldn't even lie down at night.

• 2:59Speaker 03

  Well, he would sleep in the chair at night. And so, we never hardly even slept together, except like in the mornings, he would somehow be able to go and sleep.

• 3:13Speaker 01

  They wanted to travel and have new experiences, but Bob's pain was too much.

• 3:19Speaker 03

  We could never travel on a plane because it would have never been enjoyable for him as a trip or anything, so.

• 3:27Speaker 01

  But they made the best of it.

• 3:28Speaker 03

  He loved to get in the car, and we lived close to Michigan, about 40 minutes. So, we'd ride the ridge up along Lake Superior and stuff all the time. And then on the way home, we'd stop at a supper club or whatever. That was his favorite. Or fishing. We did take lawn chairs and just sit on the side of a lake and just sit and fish. It was hard for him even to get on a pontoon boat. I had to go without him. He missed out on a lot.

• 3:55Speaker 01

  Tammy adored Bob.

• 3:57Speaker 03

  And we loved being together. We were together like 24/7. And people thought, oh, that's crazy. But we really enjoyed each other's company and missed him terribly.

• 4:09Speaker 01

  And on one of those typical days, sitting together on the couch watching TV.

• 4:13Speaker 03

  We were watching Channel 12.

• 4:15Speaker 01

  They saw that news report.

• 4:17Speaker 02

  12 News obtained court records that claim Spinal Solutions would pay defendant Colly White unlawful kickbacks to surgically implant the counterfeit spinal hardware.

• 4:27Speaker 03

  I said to Bob, what's the name of your doctor? And he said, Colly White.

• 4:32Speaker 02

  The lawsuit claims each hospital turned a blind eye and permitted counterfeit, non-FDA-approved hardware into its surgical facilities, which was then implanted into unwitting patients.

• 4:43Speaker 01

  Tammy says Bob turned white as a sheet. His doctor was now under investigation.

• 4:53Speaker 01

  I'm Benadere. From Sony Music Entertainment and Western Sound, you're listening to Dr. Billions.

• 5:15Speaker 01

  This is episode four, Egomaniac Airlines.

• 5:25Speaker 01

  When Michael Drobot, owner of Pacific Hospital, was setting up his billion-dollar fraud machine, he became aware of a particular California law that must have made him raise his eyebrows. It was called the Spinal Pass Through Law. We talked about how new spinal tech came online in the late 90s, and suddenly, back surgeries were helping many more people than before. But the hardware used in these surgeries, the rods, screws, and bone cages, that's what they're called, bone cages, it was expensive. Just a handful of manufacturers could make this high-precision, surgical-grade spinal hardware that was honestly like a miracle for some people.

• 6:05Speaker 01

  So, in 2001, a California assemblyman named Tom Calderon wrote a bill that allowed hospitals to get reimbursed for the full cost of that hardware, plus a small premium, on top of everything else they were already billing. Hmm. So, what's a forward-thinking entrepreneur with big dreams gonna do? If you're Michael Drobot, you start a new company called International Implants. Drobot then paid doctors an extra kickback if they used International Implants hardware. And since Drobot knew the person at International Implants who was writing the invoices, and he knew the person at Pacific Hospital approving the invoices, International Implants could

• 6:48Speaker 01

  charge whatever it wanted for the gear. Because whatever was on the invoices got reimbursed by law.

• 7:00Speaker 01

  Michael Drobot was not the only person to figure this out.

• 7:05Speaker 04

  Hello, my name is Robert Pereira, and I used to be a representative for Spinal Solutions, and I'm very happy to be here today.

• 7:13Speaker 01

  Back in 2009, Robert Pereira had two jobs. During the week, he was a product rep for a pharmaceutical company, selling meds to doctors' offices and urgent cares. He says this first company he worked for, they were one of the good guys.

• 7:27Speaker 04

  It was just a great company, very ethical, very well-run, and we were growing.

• 7:33Speaker 01

  He had no idea he was about to join a company that was so very, very different. Robert's side hustle and true passion was flying. He was a licensed helicopter pilot, and he was working towards his airplane license. So, on the weekends, he worked at a small, local airport, mostly as a fuel guy. That's what he called it, a fuel guy.

• 7:56Speaker 04

  I was doing pharmacy Monday through Friday, and then on the weekends, I was working there as a fuel guy.

• 8:02Speaker 01

  The airport is called French Valley Airport. It's out in Murrieta, California, which is in the desert southeast of Palm Springs. Just a single runway and a bunch of private hangars. On a very hot Thursday, I met him there.

• 8:14Speaker 04

  Yeah, we're at French Valley Airport, also known as Foxtrot 70. It's not towered, so it's a small airport. It's in Class G and E airspace. Just means there's no tower and it's not real busy.

• 8:25Speaker 01

  So, every weekend, Robert's out here, meeting the people flying in and the people who call this airport their home base. When most people think about private planes, they're thinking, you know, opulent wealth. They're thinking like 100 millionaires, billionaires. Is that true, or are there other types of people who have planes too?

• 8:43Speaker 04

  Yeah, there are those guys here, but most of these guys are small business owners that have just worked their butts off, maybe learned to fly when they were young, and then they see their aircraft as a tool. I mean, you already know how horrible traffic is in Southern California. So, if you want to get somewhere fast, and you know how to fly, and you have an aircraft, well, here to almost anywhere in Southern California is less than an hour. So, you jump in your plane, you're ahead of your competition because the tools you have.

• 9:13Speaker 01

  Hmm, okay. In addition to the hangars and the very small terminal building, there are several office buildings on the airport grounds. And about 15 years ago, located on the bottom floor of one of those buildings was a medical hardware distributor called Spinal Solutions. Spinal Solutions didn't just do spine. They had at least one subsidiary that sold knee and hip hardware too. To Robert, they appeared to be very successful. Just around the corner from the office, the company had a big hangar. And inside that hangar was not one, not two, three different airplanes.

• 9:50Speaker 04

  I think the most they ever put in there was two aircraft, but when I was there, they owned three aircraft. They owned a Desalt Falcon 10, they had a Conquest 441, and then they had a Cirrus SR22.

• 10:03Speaker 01

  Robert would see the airplanes coming and going. Sometimes he'd fuel them up. And eventually, he met the owner, a guy named Roger Williams.

• 10:12Speaker 01

  For the record, Roger Williams was never charged with or found guilty of any crimes. We reached out to him multiple times, but never heard back. Everything you can hear about him and his business has been reported from multiple sources, including interviews, depositions, court testimony, and investigative reports. So Robert and Roger strike up a conversation. Roger told him he wanted to add to his fleet.

• 10:37Speaker 04

  He had mentioned, hey, I want to buy a helicopter, and I'm looking for a pilot. And I said, I'm your guy. And he said, well, let's go to dinner. And I said, tell me when.

• 10:47Speaker 01

  Turns out, Roger Williams was a huge Los Angeles Lakers fan, the basketball team.

• 10:52Speaker 04

  His interests were to fly from La Cresta, where they lived. La Cresta is about halfway in between LA and San Diego. And he wanted to fly from La Cresta to the Ritz-Carlton.

• 11:03Speaker 01

  That's the downtown LA Ritz-Carlton Hotel, a 54-story high-rise.

• 11:09Speaker 04

  He wanted to land on top of the Ritz-Carlton, take the elevator down, and then walk straight across the street to go to the Staples Center to watch basketball games. And I'm like, great, no problem.

• 11:21Speaker 01

  Williams basically gave Robert a job right then and there. Find him a helicopter, and then fly him to the games. So Robert does his research, and then presents his new boss with some quotes.

• 11:32Speaker 04

  So I was doing the due diligence for him and giving him the options and showing him, hey, if that's what you want to do, you're going to need this type of aircraft, and it's this much money. And yeah, he got real upset. And I was like, that should have been the first red flag. I was dealing with a maniac.

• 11:47Speaker 01

  When you say he got real upset, what did that look like?

• 11:50Speaker 04

  He just throws temper tantrums. I'm like, Roger, I don't set the prices. This is the aircraft. You need to do what you want to do, and this is how much they cost.

• 12:00Speaker 01

  Williams nixed the helicopter. But he was still into Robert. He liked his connections in the medical field.

• 12:06Speaker 04

  He says, well, I still am interested in your pharmacy contacts. We'll still bring you on board. He knew my medical knowledge, my anatomy, pharmacology. He knew I could do the job. So I'm like, great, you know, it's extra money.

• 12:19Speaker 01

  I mean, not the gig he was hoping for, but, you know, this guy and his company was successful with a capital success. Three planes. So probably more opportunities will just pop up from being in his orbit.

• 12:33Speaker 04

  Yeah, I had two, two boys and a beautiful blonde, so things are expensive, and, and I'm just always looking to do more. Plus, I, I just had a calling. If there was an opportunity that I could entertain to, to better my family, I was going to take it.

• 12:47Speaker 01

  Robert started dialing back his work for the other company and moved more and more of his work over to Spinal Solutions. He became a product rep, taking the surgical implants to the doctors and hospitals who'd use them. So he started studying all the procedures and what happens in the operating rooms. He wanted to be as helpful as he could.

• 13:06Speaker 04

  I get all the instruments set out in a sequential manner. I help them be efficient and help the case go along in a timely manner. So when they're reaching for something, it's, it's right there every time they grab it.

• 13:19Speaker 01

  The doctors are getting paid by the surgery, obviously. Robert is too.

• 13:23Speaker 04

  In the beginning, it was wonderful. It was, it was great. I was making extra money. I was probably making an extra 600, 700 bucks a week, getting out of debt, you know, family's happy. And I wasn't working too many crazy hours, but, you know, that would come later.

• 13:38Speaker 01

  It also felt good. He was helping people. You could see a difference.

• 13:42Speaker 04

  You saw people with crippling knee and hip pain. You know, they were doing great, and they, they had a whole new lease on life, if you will.

• 13:53Speaker 01

  But you knew there was a but coming. The more he got to know the surgeries, the more he realized, as many in this series have, the real money was in spines.

• 14:03Speaker 04

  Yeah, yeah, I started transitioning in spine. I would stay either behind after hours at the office, and I would just familiarize myself with the techniques and the instrumentation, as well as the implants. I remember looking at some of the screws and just feeling the difference between, you know, different manufacturers, different product lines, and also different techniques, different approaches, you know, trying to be a well-rounded rep.

• 14:31Speaker 01

  And the money was jaw-dropping.

• 14:33Speaker 04

  I know, because I saw the invoices. They were paying $150 to buy these screws, and they were charging $6,000 once the screw was in the patient.

• 14:45Speaker 01

  That's quite a markup.

• 14:46Speaker 04

  That's an amazing markup, and that was very common. I would see the invoice, this is what they're paying, this is what they're getting.

• 14:54Speaker 01

  Which started explaining a few things Robert had noticed around the office, like three airplanes, gassed and ready to go at a moment's notice, and the doctors, Spinal Solutions' clients, getting rides all over the country, sometimes out of the country.

• 15:10Speaker 04

  He was running a mini-airline.

• 15:12Speaker 01

  And the crazy things he says he saw happening on those airplanes.

• 15:16Speaker 04

  A lot of those doctors had girls everywhere. It was horrible. And Roger would just shuttle them to these girls. So yeah, he was running a mini-airline with prostitutes. I don't, I don't want to go into libel slander, but crazy amounts of hookers, crazy amounts of sick shit that these guys were doing on the plane.

• 15:34Speaker 01

  And that was just the start of it.

• 15:41Speaker 00

  Whenever fall comes back around, it always feels like a fresh start. This year, I've been layering in some styles from the new Lululemon Fall Drop, because the weather is shifting, and I find I have to be ready for the entire day and not just one part of it. Lululemon's fall line has some really versatile transitional pieces, so I can just wake up, throw on a matching set, add a jacket or a fleece, and head out, knowing that I'll feel comfortable enough to go wherever the day takes me. Check out the new fall arrivals in store and online now at lululemon.com.

• 16:10Speaker 05

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• 16:43Speaker 01

  Roger Williams, Robert Pereira's boss at Spinal Solutions, is an elusive guy, even more elusive than Michael Drobot. There's hardly anything about him online. Robert Pereira, who worked for him for years, could share only limited things about his personality. He had a lot of money, and he had a bad temper. Here's Robert.

• 17:03Speaker 04

  Like it was absolute bipolar Jekyll and Hyde. Call you and fire you over something stupid or small, but then text you right away and say, can you work tomorrow? You're fired, fuck you. And then a couple hours later, you get a text, hey, can you please cover this case tomorrow? That was, that was common. That was actually common. Fired on Friday, please come to work on Monday. Was very common at this place.

• 17:27Speaker 01

  And Roger Williams, like we said, loved the Lakers.

• 17:31Speaker 04

  That's all everyone ever talked about, is Roger's courtside at the Laker game. Big deal, who cares? But for him, that was important.

• 17:40Speaker 01

  Williams never responded to our emails, so here's a thought. You know how people say, if you really want to know a city's secrets, talk to the taxi drivers? I figure if we really want to understand Roger Williams and Spinal Solutions, we should talk to his pilots.

• 17:55Speaker 06

  My name's Chris Warner, and I'm a pilot. I'm a corporate pilot.

• 18:00Speaker 01

  Pilot number one.

• 18:01Speaker 06

  During this time period, I was exclusively a contract pilot, where people would call and have me come out and fly their planes.

• 18:09Speaker 01

  One day, late summer 2007, Chris was minding his business in Texas, when he got a call from a guy in California who'd just bought what Chris thinks is a very special airplane, a Falcon 10.

• 18:21Speaker 06

  It was a very, very good performer, very solid-built, strong airplane. I mean, it, like a fighter jet. It's built by the French and uses a lot of the same parts as their fighter jets use.

• 18:35Speaker 01

  Oh, wow.

• 18:36Speaker 06

  And it's very fast, and you could put an airshow on with this aircraft. It was, it was unbelievable.

• 18:42Speaker 01

  Falcon 10 is relatively inexpensive to buy, but very expensive to operate.

• 18:48Speaker 06

  It burned about the same amount of gas as, as planes twice the size. Parts were expensive, so that's why you could buy them real cheap.

• 18:57Speaker 01

  Cheap is maybe a relative word? In 2007, they would go for about a half million bucks, roundabouts. When they first approached you for the job, what did you think you were getting into? What did you think the job was? What did you think the company was?

• 19:11Speaker 06

  Yeah, I mean, they did the surgeries, and they were expanding, and they were going to get all these, try to go nationwide. They were just there in California, and they were going to get doctors.

• 19:21Speaker 01

  So maybe like, take doctors to conferences, maybe fly them to nice dinners, you know, entice them to work with the company.

• 19:28Speaker 06

  I've flown with business people. That makes sense, you know? Go and market your product and entertain your clients, you know, so they'll use your product. That sounds like a normal thing.

• 19:39Speaker 01

  But almost right away, something seemed different about this job.

• 19:44Speaker 06

  So we fly out the next day, and I meet Roger, and he's super nice. He's excited. He's seeing his plane for the first time. And he gets on, and we fly him back to Cabo, and he's just pleasant as can be.

• 20:01Speaker 01

  The first big trip. Roger, plus a bunch of folks from Wisconsin that Chris had picked up, he's pretty sure they're all doctors, fly him down to Cabo San Lucas for a fishing weekend.

• 20:11Speaker 06

  We go to this house up on the hill, and it's this beautiful house, white house overlooking the town. And it kind of, as I was describing to my wife, I'm like, it's like I'm in Greece, you know? This house up over it, white, and this big house.

• 20:27Speaker 01

  But they didn't go fishing. After a big dinner, they all started going club to club.

• 20:33Speaker 06

  And, and there's some adult clubs there, and...

• 20:36Speaker 01

  Chris was all, hey, man, I'm just the pilot.

• 20:39Speaker 06

  Yeah, well, I'm just standing in the background. I, I don't do that kind of stuff.

• 20:42Speaker 01

  But it's back at the house that things got really weird. Chris had gone to bed, but then woke up later, because there were doctors, there were sex workers, there were...

• 20:53Speaker 06

  I didn't even, I, there were some things I'd never heard of, like some, some pretty grotesque, perverted stuff.

• 21:02Speaker 01

  It's like he woke up in the middle of a porno.

• 21:05Speaker 06

  You know, and I'm about kind of gagging, like, oh my gosh, that's, oh.

• 21:10Speaker 01

  Eventually, everyone went off into separate bedrooms.

• 21:13Speaker 06

  And I'm like, oh my gosh, what have I gotten into? And I don't remember, that was the end of that night, you know? And I'm like, I go to sleep. And so then the next day, they kind of do it again.

• 21:29Speaker 01

  The morning of the last day, everyone did climb onto a fishing boat, just long enough to take some pictures. Then they flew out.

• 21:38Speaker 06

  This, so to describe this trip was like a bunch of 20-year-old fraternity boys going on spring break. Yeah, I did. I lost a little bit of respect for those guys.

• 21:50Speaker 01

  That was the first trip of many.

• 21:53Speaker 06

  So this is my first experience in my life dealing with people from California. Okay. So I'm like, wow, this is quite an experience.

• 22:02Speaker 01

  These trips are not just guys having what they think is a good time. For doctors, these trips are gifts with a quid pro quo attached. As soon as it's a quid pro quo, as soon as it's this for that and patients are involved, it becomes a kickback. Chris was not Spinal Solutions' main pilot. He only flew the Falcon. The main pilot was another guy. Everybody called him Pilot Bob.

• 22:29Speaker 04

  Pilot Bob, great guy, great pilot as well.

• 22:32Speaker 01

  Here's Robert Pereira again, who gets a real gleam in his eye when he's talking about Pilot Bob.

• 22:37Speaker 04

  You won't find a better pilot and a funnier guy. I mean, he plays an amazing fiddle. He's got hundreds and hundreds of poems memorized. He's got this brain, you just, this incredible brain. He's just so brilliant.

• 22:52Speaker 01

  We reached out to Pilot Bob in multiple ways, but we never heard back. Pilot Bob was a certified flight instructor, so he kind of took Robert under his wing, so to speak. Robert took a ton of flights with him while working towards his own pilot license.

• 23:07Speaker 04

  I know Pilot Bob very well. I consider him a friend and, and yeah, I know all these stories and I know that they're true because he's an honest guy.

• 23:15Speaker 01

  The stories are bananas.

• 23:18Speaker 04

  Yeah, I, I'm a family guy and I got two kids. I, I knew to stay away. I didn't go on any of those flights. I just knew, never go down to Mexico. I knew not to go.

• 23:28Speaker 01

  Outside of being a little quirky, Pilot Bob was very meticulous. We obtained his pilot records where he recorded the flights he took, who was on them, which plane, where they went, et cetera. From 2006 to 2011, Pilot Bob flew around 5,000 hours, which is a lot for a contract pilot. He flew about a dozen doctors, many of them spinal surgeons, to places like Las Vegas, Palm Springs, and Mexico. One name stood out. Shout out to the last podcast I made for the binge, Doctors Orders, came out summer 2025. In the summer of '07, two trips list Dr. Munir Uweda. One's a simple commute from the Santa Monica Airport to Corona, California.

• 24:11Speaker 01

  The other's an overnighter to Tokyo, out and straight back. Not sure what I make of that.

• 24:16Speaker 04

  Bob would tell me stuff and I'm like, that's not fucking cool, Bob. That's not cool at all.

• 24:21Speaker 01

  Robert says Roger Williams just treated Pilot Bob like garbage, yelling at him, screaming, making him fly in unsafe conditions.

• 24:29Speaker 04

  There's rules. You don't fly into bad weather. But there's times where Roger would be having Bob fly him around the country. Bob would say, hey, weather's coming in, we're kind of stuck here. You know, it's not safe to fly home. And Roger would freak out. I need to get home. If you don't get me home, I'll find a pilot that will. I remember Bob telling me multiple stories where they would just fly into really bad, dangerous weather because Roger had get-homeitis and Bob didn't want to lose his job.

• 25:01Speaker 01

  But it's the doctors, Robert says, who were the absolute worst. If you have kids around, I would maybe skip ahead a minute. Okay, ready? We're gonna bleep it anyway, just because it's too much.

• 25:14Speaker 04

  I was a copilot, so [BLEEP] in the back, just [BLEEP] prostitute and just [BLEEP] all over the airplane. And he's just [BLEEP] left and right. Anytime he flies, he's bringing a girl and they're in the back in the mile high club. And he's just [BLEEP]. And she's [BLEEP]. And they're just [BLEEP]. And then when we land, I'm thinking, I ain't cleaning it. Fucking Bob's got to clean it up. And he's just, they just humiliated the guy after humiliating the guy.

• 25:45Speaker 01

  Looking at Pilot Bob's flight records and seeing all those doctors' names is pretty shocking. But as we dug in and really started scrutinizing the logs, there was another set of flights that stood out even more. Not because of who they had on them, but because of what.

• 26:07Speaker 00

  Whenever fall comes back around, it always feels like a fresh start. This year, I've been layering in some styles from the new Lululemon fall drop because the weather is shifting and I find I have to be ready for the entire day and not just one part of it. Lululemon's fall line has some really versatile transitional pieces, so I can just wake up, throw on a matching set, add a jacket or a fleece, and head out, knowing that I'll feel comfortable enough to go wherever the day takes me. Check out the new fall arrivals in store and online now at lululemon.com.

• 26:36Speaker 05

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• 27:09Speaker 01

  According to Pilot Bob's flight logs, on April 17, 2007, Bob made two trips. First, he flew from Long Beach, California to Torrance, California. The two airports are literally just a 30-minute drive from one another. Then he flew from Torrance to Las Vegas. There were no passengers onboard. The log lists, quote, "surgical implants." A week later, another trip with no passengers, just hip stem implants delivered to Modesto, California. Entire flights, just for a box of hardware.

• 27:42Speaker 06

  I'm like, you know, it costs a bunch to fly this airplane.

• 27:46Speaker 01

  This is Chris Warner again, pilot number one.

• 27:48Speaker 06

  We had to fly from Urieta and we went to like Riverside, then we went up to North California and all we were doing was flying this box. It was the tools used for surgery.

• 27:59Speaker 01

  Chris says sometimes it was him and the Falcon, but mostly it was Pilot Bob.

• 28:04Speaker 06

  He would literally go from like one airport in Southern California and they would run the tools out and he would fly them to another part of the town. Someone would be there, get the tools and they would go. So these tools must have been expensive because they were just going around on an airplane a lot, yeah.

• 28:23Speaker 01

  When it wasn't a box, sometimes it was just a fat envelope.

• 28:30Speaker 01

  On November 10, 2007, Pilot Bob flew from Stafford Regional Airport in Virginia to Palm Springs, California. The log says, quote, "dollar sign delivery," unquote. On December 4, 2007, a flight from Redig, South Dakota to Santa Monica, California. Delivery, and then in parentheses, "wine and dollar sign."

• 28:53Speaker 06

  We were, I guess, in Dallas and we had to go to San Antonio and Bob was going to be at the airport. So we fly in to go to the private terminal there in San Antonio and call him Bob. He doesn't answer or anything like that.

• 29:11Speaker 01

  Chris says Bob had fallen asleep in the terminal.

• 29:14Speaker 06

  But Bob shows up and he looked, you know, unshaven, disheveled. He goes, yeah, I've got to give this to the doctor that we're picking up. And it was this envelope and he opens it up and it's got $50,000 cash in it.

• 29:28Speaker 01

  Whoa.

• 29:28Speaker 06

  And he starts laughing. He's like, oh my gosh, can you imagine if one of those janitors cleaning around me just picked it up? And that money would have been gone.

• 29:39Speaker 04

  Big fat envelopes full of cash. Robert Pereira. Big fat FedEx. You unzip it and there's 200 grand in cash in there? You bring that home to mama? Oh, and the next month, here's 200 grand. Here's 200 grand. Every 30 days? These dudes were stoked on a top of their already million-plus-a-year doctor salary.

• 30:01Speaker 01

  Spinal Solutions spared no expense and the orders for the hardware kept coming in.

• 30:07Speaker 04

  They just had so many physicians wanting access to those kickbacks, access to those aircraft, access to all the things that they provided these guys, that they, they got everyone's business.

• 30:19Speaker 01

  Were there other competitors to Spinal Solutions?

• 30:22Speaker 04

  Yeah, there's some big ones, but they're ethical. They don't give kickbacks. They don't give you 200 grand a month or use of the jet or Laker tickets or prostitutes or all the cash, you know, envelopes and cougarans and gold coins and whatnot.

• 30:39Speaker 01

  Even before Robert was doing spine, when he was still doing knees and hips, he realized there were more things he could do for doctors than just sell them the hardware and set it up. Doctors would ask him to modify their tools.

• 30:52Speaker 04

  That was very common.

• 30:53Speaker 01

  It was a kind of industry expectation. Your hardware guy was your hardware guy, whether he's selling you screws or fixing your surgical tools. Spinal Solutions used a nearby machine shop to get the doctors what they wanted.

• 31:06Speaker 04

  And I was told by the company, oh, take that to Crowder and tell Crowder what the doctor told you and have that patella clamp modified or whatever the doctor wants.

• 31:14Speaker 01

  Crowder Machine Shop was in Temecula, about 15 minutes from the office in the airport. It's gone out of business and the owner, William Crowder, has passed away.

• 31:24Speaker 04

  It was in a light industrial complex. They did, you know, precision machining of different types for different industries, aviation, medical, aerospace. You know, he was an engineer and a machinist.

• 31:38Speaker 01

  Robert said it was cluttered and dirty, very different from the hospitals where these tools would be used.

• 31:44Speaker 04

  I've been in machining shops before, professional machining shops, where, you know, you could eat off the floor. And Crowder had a different way of doing business. There was, it was pretty cluttered and pretty filthy, but, you know, that's his business.

• 31:56Speaker 01

  When Robert started working with spine doctors, he started learning all about the different spinal tools, how the doctors liked those to be modified.

• 32:04Speaker 04

  Would just familiarize myself with the techniques and the instrumentation as well as the implants. I remember looking at some of the screws and just feeling the difference between, you know, different manufacturers and different product lines and also different techniques, different approaches, you know, trying to be a well-rounded rep.

• 32:26Speaker 01

  And he started noticing big differences in how the spinal hardware looked, how it felt in his hand.

• 32:32Speaker 04

  I remember picking up screws and going, man, you know, some of these screws are really high quality. And then some of these screws are just, you can just feel that they were just cheap. They were, they were garbage. They just, they were crude and they weren't well-made. Maybe it missed a step in the quality control. But then after a while, I started finding these same screws that were supposedly made by the same manufacturer. And I found that hard to believe.

• 33:00Speaker 01

  The screws, both the good ones and the ones that looked off, were packed together from the same manufacturer. And they were being sold at the same incredibly inflated price point. One day, Robert was dropping off some instruments at Crowder to be modified.

• 33:15Speaker 04

  And I saw on the lathe, screws being made. And I thought, wow. Hmm, that's very interesting.

• 33:25Speaker 01

  He says the screws looked a lot, like the screws he was delivering to the hospitals.

• 33:30Speaker 04

  But I didn't jump to any conclusions at first. I mean, they could have been prototypes. I didn't necessarily know they were even for us, but they sure did look like the screws that we used.

• 33:39Speaker 01

  Later, he started noticing a real decline in quality in the screws he was delivering to surgeons.

• 33:45Speaker 04

  I had spoke to one of the other reps at the company. I said, hey, you know, have you noticed that the quality's just gone to shit? You know, what's, what's up with these? They appear to be the same size, the same dimensions, but man, it seems like they skipped a step in the manufacturing or the quality's just gone straight to hell.

• 34:07Speaker 01

  The other rep looked at him and laughed.

• 34:11Speaker 04

  Took a while to pry it out of him. And he's like, no, those, those screws are being made by Crowder.

• 34:18Speaker 01

  Both screws, the heavier, more precision screws and the lighter, sloppier screws, had the same brand name etched onto them. But on one, it was smaller and italic. On the other, it was slightly bigger and straight up and down. It was like a Gucci shirt you might buy on the street. It's spelled G-U-C-C-I, but it does not look like the real thing. Only, these were going into people's bodies.

• 34:46Speaker 04

  No matter how much I was being paid, I just couldn't stand by going, these guys are going to have surgery tomorrow morning and these implants are going in their spine and they're bullshit. And the company's going to make $60,000 per surgery. There's five, six surgeries on the board and these people are fucked. These screws were going around the country. It wasn't just in Southern California. They were going all over the country to doctors, all the way to the East Coast, down to Texas, Nevada. They were going all over the place.

• 35:19Speaker 01

  Robert Pereira held those screws in his hand and he made himself a promise.

• 35:24Speaker 04

  This is very, very intense surgery. And I would look at the board and I'd be like, this is bullshit. Something's got to be done. I don't care about the money. These people are fucked.

• 35:42Speaker 01

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• 36:31Speaker 01

  Dr. Billions is produced by Western Sound for Sony Music Entertainment's The Binge. I'm your host, Ben Adair. I'm also the executive producer for Western Sound. From Sony Music Entertainment, the executive producers are Jonathan Hirsch and Catherine St. Louis. Dr. Billions was reported and produced by Dana Balut. It was written by Dana Balut and Ben Adair. Najib Amini is our fact checker. Michael Rayfield is the mix engineer. Music courtesy of North Figaroa Studios. Legal by Sam Borenzweig at Claris Law, P L L C.

• 37:20Speaker 00

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