It was a Friday afternoon and Debbie Dillinger was hoping for a pain-free weekend. Car accidents had left the 47-year-old mother of three with chronic neck pain and headaches, and to deal with it she was visiting Dolson Avenue Medical, a clinic in Middletown, New York.
Around 5 p.m., Dillinger swung through the glass front door of the office. She checked in at a curved reception desk in the clinic’s large, open treatment area, where patients lay on massage tables and exercised on a variety of equipment. Behind the desk, a floor-to-ceiling mural of a waterfall, trees and a soaring eagle set a serene tone.
The clinic was run by two brothers, James “Jay” and Jeffrey “Jeff” Spina. For more than 30 years, they had worked in Middletown as chiropractors — medical providers who treat musculoskeletal disorders, commonly through manipulation of a patient’s spine.
On this day in March 2017, Dillinger’s treatment included something else. She was directed into one of the private rooms, where Charles Bagley, an M.D. and neurologist, would give her a facet injection. A facet joint, one of the locations where adjacent vertebrae meet in the spine, can become inflamed due to trauma like Dillinger’s. Injecting lidocaine into a joint can relieve the pain. But inserting a needle into the spine involves risk, and many experts say the injections should be used only as a last resort — and even then, sparingly, no more than eight times a year.
This was Dillinger’s third facet injection that month.
She climbed onto the examination table, rolled over on her stomach and pressed her face into a doughnut-shaped pillow. Bagley pushed a long needle into a facet joint in her neck and injected the medication. Dillinger’s body went limp. Bagley felt for a pulse. Nothing.
If you went to a chiropractor’s office with a sore neck, the last thing you’d expect is Dillinger’s fate: Taken away in an ambulance, she was dead within a week.
A criminal scheme revealed
Dolson Avenue Medical had a good reputation among its many longtime clients. How could something so egregious happen under the watch of the Spina brothers, whose outside activities hinted that they had their community’s best interests at heart? Jay regularly made presentations to schoolchildren about the importance of avoiding drugs. Jeff distributed food to the homeless, coached youth soccer and basketball, and volunteered with the Salvation Army.
Five months after Dillinger’s death, however, the FBI showed up at Dolson Avenue Medical. Federal agents combed through the clinic’s files, cramming a white van with stacks of cardboard boxes containing confiscated medical records, handwritten notes and other material. Continue Article