Blind trust: Don’t assume you’re seeing a doctor — even at the Mayo Clinic

What Hughes left out was that his on-the-job-training started as an inmate at a prison in Sugar Land, Texas, as he would later confess to Judge Anna Baca.

Asked under oath whether he'd ever been arrested or served time, Hughes initially forgot to mention his years in prison. He answered, "Yes, speeding and changing lanes without a proper signal, and just everyday things that . . . I seemed to be in a hurry everywhere I went, so I accumulated a few traffic tickets."

Attorney: "Have you ever been to jail or in jail?"

Hughes: "Yeah. I went to jail because I didn't pay the fines."

Attorney: "How may times?"

Hughes: "One."

Attorney: "How long did you stay?"

Hughes: "One day. Actually, not a full day."

Attorney: "Anything else?"

Hughes: "No."

During the trial, it was revealed that Hughes hadn't told the whole truth. He had actually been to jail multiple times and prison once, and had been convicted of two crimes: forgery and possession of cocaine. The forgery conviction landed him a six-year prison sentence. Turns out that's when Hughes first learned about the human eye.

In the prison infirmary, Hughes met an ophthalmologist. He says he worked under him as a volunteer inmate for almost two years. When Hughes walked out of prison, he had one asset he didn't have before — a two-year prison education about the eye.

He applied for a job at Lee Optical in nearby Amarillo. "That's where I began my optical profession, in a store with something like five doctors and 60 people," Hughes said in his first deposition. Hughes was in charge of making and distributing the glasses that doctors prescribed.

Hughes then learned how to craft prosthetic eyes. He worked the Texas area as a "traveling eye salesman," selling (not installing) prosthetic eye implants to Vietnam vets who'd lost eyes in combat.

Hughes regularly solicited his prosthetic wares to eye doctors. During a cold-call sales pitch in Houston, he met an ophthalmologist by the name of Dr. John Creasman. The two became close friends.

Around 20 years later, the same Dr. Creasman got a call from an old medical school friend. Did he want to start an ophthalmology clinic in Scottsdale? Creasman agreed to assemble a staff at a for-profit business — the Mayo Clinic. The year was 1987.

The next year, Creasman hired Hughes to work as a technician at the brand-new Mayo Clinic's ophthalmology department in Scottsdale. Hughes apparently didn't even interview for the position.

"He just hired me and put me in charge," Hughes said in his deposition. For Hughes, it was a dream job. The Scottsdale region and the Mayo Clinic both enjoyed a decade of rapid growth. By 2001, Hughes was seeing between six and 13 patients per day, without any direct supervision from doctors, according to Mayo receptionist Cheri Chandler's deposition.

Attorney: "When you schedule [patients] with Hughes, are those patients seeing Dr. Creasman after?"

Chandler: "They are usually just scheduled with Paul."

That testimony aligned with Hughes' own words about his role as a near-doctor at Mayo. "The procedure is that the patient calls into the ophthalmology department, and they're triaged over the phone, best they can. And then they're scheduled with me . . . they're just scheduled on the schedule for either a doctor or myself."

Department head Dr. John Creasman also testified that Hughes was the only technician to see patients without a doctor present. He said none of Mayo's other six technicians saw patients alone, but Hughes did. According to Creasman, Hughes actually had a patient schedule.

It's that appointment schedule that Paul Phillips somehow landed on — even though his wife specifically requested an appointment with Dr. Thomas McPhee, an ophthalmologist.

On the night of March 11, 2001, Paul and LuWanna Phillips were watching TV. Phillips had never met Paul Hughes, but the two shared more than a common first name. They were both born in the late 1930s. And like Hughes, Phillips also grew up in a farming family.

Phillips spent most of his life picking oranges and building a wholesale produce business. He eventually sold his Phoenix-based Wholesale Produce and invested the profits into commercial property — mostly west Phoenix storage facilities built in the early '80s.

In 1979, Phillips had a 3,600-square-foot home built on the border of Glendale and Phoenix. When the Mayo Clinic opened in 1987, Phillips was one of their first customers. He and LuWanna knew the clinic's prestigious reputation. So they took their most serious concerns to Mayo — battles with cancer, other maladies, and, eventually, Paul's eyesight.

Phillips was first treated at Mayo's ophthalmology department in 1999. There he met Dr. Thomas McPhee, a reputable ophthalmologist who became his eye doctor. In 2000, Dr. McPhee left Mayo to practice on his own. Phillips says he would have followed McPhee to his private practice but didn't know McPhee had left.

As it turned out, Phillips' vision problems began a few months after McPhee left Mayo. Phillips recognized the symptoms as a possible detaching retina, only because his son once suffered the same serious problem. Phillips also knew his diabetes made him particularly susceptible.

LuWanna called the number for Dr. McPhee's office at the Mayo Clinic and booked the earliest available appointment, two days later. As LuWanna and Paul drove the 50 minutes from their home to Mayo, they both thought they'd be seeing Dr. McPhee.