Nicholas J. Capos Jr. was a 1977 graduate of the Northwestern School of Medicine and a successful cardiologist with offices in Grass Valley and Yuba City.
But he had a side business: prescribing thousands of narcotic pain pills to patients.
In one case, Capos prescribed 2,640 hydrocodone pills to a patient over 28 days, meaning the patient would have taken 94 pills a day. In another, he prescribed 2,100 oxycodone pills to a patient over a 50-day period, which would have meant the patient was taking 42 pills a day.
In all, prosecutors say Capos, a Granite Bay resident, prescribed thousands of pills to patients who didn't need them and whom he had not properly examined, ordering up methadone and other drugs in exchange for what he called a $100 "DEA Fee."
Never miss a local story.
On Thursday, the final blow came as Capos, 67, was sentenced to 52 months in federal prison for what U.S. District Judge Morrison C. England Jr. called an "amazing" contribution to the nation's opioid crisis.
"All of a sudden we're in the middle of this opioid crisis that has been going on for years, and this defendant was in the middle of it," England said. "We're talking hundreds of thousands of pills over time."
Capos, who surrendered his license to practice in 2016 after agreeing to a plea deal, could have faced 20 years in prison if he had gone to trial following his 2014 indictment on charges of conspiracy to distribute and possess the drugs.
Instead, England agreed to the lesser sentence after Assistant U.S. Attorney Paul Hemesath noted that Capos had been cooperating with prosecutors.
"It's probably giving you a break more than you deserve at this time," England said, "but I'm going to do it."
Capos presented himself in court Thursday as a broken man, apologizing to the judge for his actions.
"I just want to accept responsibility for what I did and I apologize for the damage I've caused," Capos said.
In a hand-written letter to the judge before sentencing, Capos told England his actions were "excessive, irresponsible."
"I have lost my medical license, family, home and practice," he wrote. "Previously, my professional status was radiant; now, I am invisible."
Capos' attorney, Tom Johnson, said after court that he was satisfied with the sentence.
"Dr. Capos made a series of bad decisions when he was practicing medicine, and those decisions he regrets," Johnson said. "He's lost everything because of it, his home, his medical license, and now he's going to be going to prison, so it's a difficult day" Johnson said.
Capos' indictment followed an investigation that included the use of an undercover agent and alleged the doctor prescribed 1,590 pills illegally just in summer 2012.
The plea agreement Capos signed says he agrees that he prescribed opioid drugs to the undercover agent "without clinical indication," then later prescribed stronger pills at the patient's request.
"On July 17, 2012, Capos prescribed oxycodone without valid clinical indication," according to documents filed with the plea agreement. "He went on to warn the patient about staying under the 'radar.'"
In the plea agreement documents, Capos admitted that "he did not properly examine the patients, he willfully ignored obvious indications that the patients were abusing or selling the controlled substances, he prescribed quantities to those patients far in excess of human tolerance and he accepted payments on a per-prescription basis, which are all practices contrary to accepted medical practice."