D.H. showed up at Dr. Naga Thota’s surgical center after hours on the doctor’s orders, she said. She woke with an IV in her arm and had no idea what had happened. It was 4 in the morning.

Dr. Thota’s critics called him a “Dr. Feelgood” for his reputation of playing fast and loose with prescriptions. From 2005 to 2012, at least 15 of the anesthesiologist’s patients died from the painkillers he allegedly handed out like candy. Others who cut ties with the doctor turned to street drugs like heroin in lieu of the powerful prescriptions he wrote.

But the nickname took on a grim new significance on Wednesday, when federal agents arrested 62-year-old Thota outside his San Diego practice. Thota didn’t just over-prescribe pills, a federal indictment claims—he allegedly traded pain meds for sex with his young female patients, upping their doses and sending them on spirals of addiction.

D.H., as investigators refer to her in a Wednesday indictment, was one of Thota’s patients at his pain-treatment practice. That didn’t stop Thota from sending her frequent personal text messages, sometimes asking for sex. He offered her $100, D.H. alleges in the indictment.

She’s one of at least three women to allege a sexual relationship with the doctor. Neither Thota’s lawyer nor his medical practice returned phone calls from The Daily Beast.

Beginning February 2013, Thota prescribed medication to a woman the indictment refers to as J.S. A recovering drug addict in her mid-20s, J.S. sought methadone or oxycodone for her withdrawal pain. But on their first meeting, Thota allegedly steered the conversation toward sex, acting “super friendly,” “flirty,” and “kinda unprofessional,” even asking about her nipple rings, J.S. told investigators.

He wrote her a prescription for the powerful painkiller hydrocodone, or Vicodin. Three days later, he called to ask her on a Valentine’s Day date.

As their doctor-patient and intimate relationships progressed, Thota kept J.S. heavily medicated. He switched her from hydrocodone to oxycodone, then allegedly doubled her dosage without informing her. Already working through one addiction, J.S. developed a new one. She loved oxycodone, she told investigators, and quickly became dependent on her increased dosage.

Dependency on oxycodone meant dependency on Thota. J.S. began to ask for early refills. When that wasn’t enough, she asked him to fill prescriptions in her brother’s and father’s names, under-the-table medications Thota would allegedly give her in the parking lot outside his practice, rather than in the office.

Thota’s text messages with J.S. suggest he knew he was over-prescribing. “The dose you are taking and the diagnosis doesn’t match my love,” he texted her when she tried obtaining her medication from another doctor. “I am not telling all this to your doc. It is only between you and me.”

Their relationship worsened as J.S. attempted to distance herself from Thota, who allegedly had control of her phone plan, before he canceled it without warning. Texting from her brother’s phone, J.S. threatened to reveal Thota’s history.

“I will show them how you pursued me and how you bribed me with drugs and how you let me get all these drugs under different people’s names. I will also share how much you pay to fuck me,” she wrote in text obtained by investigators.

But she never made good on the threats, and Thota went on practicing. Many of the patients he treated didn’t even choose him as a doctor; he was randomly assigned as their anesthesiologist in the hospital.

One such patient, a woman referred to as M.R. in the indictment, met Thota after an ambulance took her to a local hospital for withdrawal-related seizures. Thota prescribed her methadone, and called her after she was released from the hospital. M.R. began attending his practice for more methadone, but quickly ran through her prescriptions. Thota allegedly agreed to give her more medication if she’d meet him for lunch at Denny’s.

The meetings became a pattern, with M.R. meeting Thota in his car to trade handjobs for painkillers. M.R. felt as though if she did not agree to his demands, he’d stop filling her prescription, she told investigators.

But she couldn’t risk going to another doctor. Thota had allegedly upped her prescription over the course of their relationship. In the hospital, she’d been on a daily dose of 40 milligrams of methadone. Now she was on 60. When she finally ended all ties with the doctors, she lost her prescription and began using heroin.

M.R.’s was a classic case in Thota’s office. A notorious over-prescriber, Thota was in deep trouble with the Medical Board of California at the time of his arrest. After three formal sanctions, which accused him of everything from tax evasion to gross medical negligence, Thota was slapped with a seven-year suspension in March 2016.

He could still run his practice—but anyone who read the medical board’s 47-page smackdown would look for another doctor. The document accuses Thota of repeated negligence, prescribing pain medication and upping doses “without any rationale or documentation.”

Multiple clients developed deep addictions, including one man who entered the practice complaining of lower back pain and wound up unresponsive in the street, after consuming a morphine equivalent daily dose greater than 4,000 milligrams from 3½ years.

At least 15 others died on the medication, earning Thota a dubious reputation in California. (“We tell them every time when they come for follow-up: This medication can kill you,” he said during a 2013 NPR interview on overmedication. “You know that, right? But I will say it so many times: Be careful with them and use them carefully.”)

Even before the deaths, there were warning signs. An anonymous reviewer in January 2012 described a frightening encounter with a paranoid doctor who touched her inappropriately, then accused her of being a Drug Enforcement Administration agent.

“I have NEVER EVER been treated as poorly by a Doctor as I have Dr. Thota,” the reviewer wrote. “I went in to ask a simply question of Dr. Thota and was screamed at and called names I won’t repeat here. I am a stable, mature, great communicator and never lost my cool. This man has issues. He touched me inappropriately, went on and on about the DEA and how he thought I was a DEA person (WHAT)!?”

The reviewer claimed Thota has “severe issues,” and left prospective patients with a warning.

“RUN from his office…..no one should have to put up with his unprofessional manner. I wish I had a tape recorder with me with all the things he said to me, including…’you look just like someone I dated and I loved her so much’ I could go on. I have never filled out a form like this and hope I never have to again.”

Thota’s bail has been set at $100,000, but he still has his medical license. He’s barred from writing prescriptions for women without the approval of a medical partner. A bad reputation hasn’t stopped him from practicing in the past.

“Somebody has to take care of these people,” he said in a 2012 interview with the Los Angeles Times. “And I am the chosen one.”