Even though Gosnell is said to have operated more or less in the open -- making little attempt to dispose or conceal the remains of dead
children that he kept stored on site, in a medical facility that was reportedly known to reek of body fluids and cat urine, on a highly visible and heavily trafficked
corner on Drexel University's campus -- it wasn't until he started pushing pills that he was arrested.
For years, as laid out in the Gosnell murder trial's grand jury report, red flags were raised with various regulatory and oversight agencies like the Pennsylvania Department of State,
Department of Health, and the Board of Medicine about Gosnell. Little action was taken. On one occasion, a state
investigator had an off-site interview with Gosnell, who denied allegations of malpractice, that didn't lead to an inspection of his facility. His business went uninspected as newborn bodies allegedly stacked up for 17 years.
It was in the final years of Gosnell's practice that, if the allegations against him stand, he got heavily into the pill business. The move into drug selling would make strategic sense for a profit-driven person. During the earlier years of his practice, Philadelphia was a two drug town. Coke and heroin dominated the street drug scene throughout the '80s and '90s. There wasn't the kind of mass demand for unscrupulous doctors we see today.
But in Philly in the late 1990s and early 2000s, like much of the nation, new
prescriptions drugs like OxyContin were gaining traction in the black market among young, inexperienced, typically white, working class drug users who a
generation earlier probably would have gone straight to heroin. Additionally, in the hustler scene populated by young black and Latin
drug sellers, codeine cough syrup taken in combination with Xanax -- called "pancakes and syrup" on the streets -- skyrocketed in
popularity. Its praises were widely sung around Philly by the likes of rapper Beanie Sigel. Suddenly on the streets of Philadelphia there was a new drug landscape
where an array of pharmaceutical narcotics competed with old standbys for the top-selling spot. Dirty doctors around the nation were stepped in to fill
the black-market demand for meds, knowingly diverting pills out of the legitimate stream of prescription distribution and into the hands of dealers and
Prosecutors say Gosnell dove into this new market, taking cash tips in addition to appointment fees to write prescriptions for all of Philadelphia's new
favorite pharmaceutical narcotics: OxyContin, Percocet, Xanax, and codeine cough syrup.
His run as a pusher, as detailed by the prosecution, ended spectacularly. Gosnell was scribbling out as many as 200 narcotic prescriptions
a night. It's an irony of America's continued war against drugs that while Gosnell apparently could have been busted for murder years
before had various medical oversight agencies been more vigilant, he only got arrested when he messed with the DEA. The grand jury report in the murder trial, with its horrific descriptions of babies' feet preserved in jars in a
back room, has gotten more press. But the indictment handed down in his
drug case lays out all the gory details about his less-publicized alleged dope operation, which, unlike his illegal abortion business, was quickly and
efficiently shut down.