When you fill a prescription, you trust the medicine inside is exactly what the doctor said you need.
That's not what happened to four tons of prescription pills that were processed in a Nashville warehouse.
The president of the company is going to prison for 15 years.
The video of the illegal drug operation at work helped send him to prison.
Pills were bought off the streets of New York and Miami and then resold to unsuspecting pharmacies for a huge profit.
"Every day they were operating they were generating a ridiculous amount of risk for the general public," said Henry Leventis, Assistant U.S. Attorney for the Middle District of Tennessee.
Cumberland Distribution Inc. was, on paper, a licensed drug wholesaler. In reality, the drugs came from patients who sold their prescriptions.
"Most often they were purchased on the streets from Medicaid patients who had received the drugs for free," said Leventis.
The pills ended up at a Nashville warehouse where workers dumped out the boxes. Workers sorted and checked the bottles. Any patient labels were wiped off.
"Then they clean each bottle, often using lighter fluid," said Leventis.
The bottles were then resold to mom and pop drug stores across the country. That is until pharmacies called the Food and Drug Administration, and they raided the warehouse finding pill bottles with broken seals, foreign objects inside, one bottle of what was supposed to be Viagra was something else.
Psychiatric drugs, HIV drugs? Some contained the wrong dosages, the wrong meds entirely.
One bottle contained Tic Tacs. Prosecutors figure the patient who sold his prescription made the switch.
Cumberland Distribution got away with it for a while.
The U.S. Attorney's office said they faked paperwork and set up shell companies in empty offices.
"This was a deliberate attempt to bypass the safety net that we depend on when we buy drugs," said Donald Q. Cochran, U.S. Attorney, Middle District of Tennessee.
After the FDA raid, the business relocated.
"They got new warehouses, they used burner phones, they set up secret email accounts," said Leventis. "They even commissioned a private pilot to start flying drugs in from their shell companies."
Three key players plead guilty and a fourth was convicted after a trial. A key piece of evidence was the company's own internal surveillance video.
When asked what he thought after seeing the video, Leventis said, "I'm going to win this case."
"We trust the system and the system in this country works incredibly well when it's followed," said Cochran.
What happened to those patients who may have gotten the wrong drugs? Did they get sicker? Did they die?
Federal investigators weren't able to track that.