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Hawaii island physician Rudy Puana, who was convicted of running a prescription drug ring that his former prosecutor sister, Katherine Kealoha, tried to conceal, is headed to prison for 7 1/2 years, a federal judge ruled Monday.

The sentencing comes after a jury found Puana guilty in April of 38 counts for distributing oxycodone and fentanyl. A licensed pain doctor and anesthesiologist, Puana wrote prescriptions for thousands of oxycodone pills to friends who sold them or traded them for cocaine. 

Kealoha used her position in the Honolulu Prosecutor’s Office to control a criminal investigation into the drug ring and steer suspicion away from her brother. Kealoha pleaded guilty in 2019 for her role in the scheme, and she is currently serving a 13-year sentence for that and other crimes.

In addition to the prison time, U.S. District Judge J. Michael Seabright sentenced Puana to three years of supervised release, a fine of $50,000 and a special assessment of $3,900. The prison sentence was less than the sentencing guidelines, which recommended a prison term of at least 12 1/2 years.

At the time of his crimes, Puana was addicted to drugs. But since he learned he was under criminal investigation, Puana has turned his life around, according to his attorney Clint Borden, and character witnesses who testified on his behalf in court on Monday.

Seabright took Puana’s four years of sobriety into consideration in delivering his sentence, but he also took seriously the violation of Puana’s oath as a doctor. Puana falsified medical records in an attempt to justify prescriptions for people who didn’t need them, the judge noted.

“This is a very difficult case for me,” Seabright said. “There is this almost blind trust people have in doctors, in the medical community, that you’re going to do the right thing. … This was a gross abuse of a position of trust.”

The judge acknowledged that Puana was not in his right mind at the time of his crimes but said that doesn’t excuse his actions.

“I don’t think your addiction got you to the point where you have no free will,” Seabright said. “There is something called personal responsibility.”

During the sentencing hearing, several witnesses testified about Puana’s character since he got sober. They described a kind and generous person who is committed to sobriety.

“He has expressed remorse for his past actions to me many times,” said Kristopher Bjornson, Puana’s addiction psychiatrist.

Puana teared up as he listened to his friend, Scott Byron, describe how Puana encouraged him to go to the hospital for a health issue – a decision that Byron said likely saved his life.

“Please consider what use this man can be to his community … outside of the walls of prison,” Byron said.

But Assistant U.S. Attorney Michael Wheat said those character witnesses don’t capture the reality of Puana’s crimes, which he called a “complete breach of everything a doctor should do.”

“You have to look at the actual conduct he was engaged in and the poison he put onto the streets of these islands,” he said.

Puana didn’t speak during the hearing, but his attorney asked the judge to consider whether his client needed to be incarcerated for the public’s safety.

“I dare say the community does not need to be protected from Dr. Puana – the sober, redeemed, rehabilitated Dr. Puana,” he said.

Ultimately, Seabright agreed with that, noting that it is likely Puana will lose his medical license.

“My view is if you stay clean, you’re not an ongoing danger to the community,” Seabright said. “But you’ve shown how far off the reservation you go when you’re not.”

Puana’s license was still in good standing with the Hawaii Medical Board as of Monday, . But the Department of Commerce and Consumer Affairs has a pending complaint regarding his license, a spokesman said Monday afternoon.

“If there is an alleged violation of the laws or rules, the licensee must first be investigated and afforded proper due process before action may be taken against a license,” DCCA spokesman William Nhieu said. “In the case of Dr. Puana’s license, to date, the Board has not taken formal action against said license.”

Puana’s drug case is just one tentacle of a sprawling corruption investigation led by Wheat that’s been ongoing since 2015.

His efforts have resulted in the 2019 conviction and imprisonment of Katherine Kealoha, former Honolulu Police Chief Louis Kelaoha and HPD officers for framing Katherine Kealoha’s uncle for stealing the couple’s mailbox. Katherine and Louis Kealoha also pleaded guilty to financial crimes related to fraudulent bank loans and the theft of money from children for whom Katherine Kealoha served as a guardian. 

Wheat is now prosecuting three former city officials – Donna Leong, Max Sword and Roy Amemiya – for criminal conspiracy for their roles in securing Louis Kealoha’s $250,000 severance payment. All the defendants have pleaded not guilty. 

And most recently, Wheat’s team secured the indictments of former Honolulu Prosecutor Keith Kaneshiro, businessman Dennis Mitsunaga and several of Mitsunaga’s associates. Kaneshiro is accused of pursuing a bogus prosecution of one of Mitsunaga’s former employees in exchange for campaign donations. All of those defendants have also pleaded not guilty.