Pubdate: Wed, 15 Oct 2003
Source: Roanoke Times (VA)
Copyright: 2003 Roanoke Times
Contact:  http://www.roanoke.com/roatimes/
Details: http://www.mapinc.org/media/368
Author: Jen McCaffery

WITNESS TESTIFIES KNOX WORKED WITHIN LIMITS

The Defense Witness, Who Was Paid Hundreds Of Dollars An Hour, Said Cecil 
Byron Knox Stayed Within Legitimate Medical Practice.

An expert witness for the defense team of Roanoke pain specialist Cecil 
Byron Knox testified Tuesday that Knox's prescription of painkillers such 
as OxyContin and methadone fell within the scope of legitimate medical 
practice.

Dr. Richard Bonfiglio testified that Knox "ended up at the bottom of the 
funnel" of doctors for the "difficult" patients who comprised much of his 
practice. Many had medical histories that included workplace accidents, 
multiple surgeries and histories of substance abuse or psychiatric 
problems, Bonfiglio testified.

Based on the 31 patient charts he reviewed, Bonfiglio said Knox did not 
stray outside the scope of legitimate medical practice with the dosages of 
painkillers he prescribed and that it was appropriate for Knox to prescribe 
more than one painkiller at a time.

On cross-examination by Assistant U.S. Attorney Rusty Fitzgerald, 
Bonfiglio, who practices pain management in Pittsburgh, admitted that he 
had testified in about 80 cases over the past 20 years. He also testified 
that he was being paid $450 per hour for his review of the medical charts 
in the case, $750 for his first hour at trial and $600 per hour for the 
rest of the time he testified.

Bonfiglio also agreed with Fitzgerald that it would be outside the scope of 
medical practice for a doctor to let a nurse write prescriptions with his 
signature already on them when he was out of the country. He also testified 
that it would be inappropriate for a doctor to smoke marijuana with his 
patients outside the office.

After objections by defense attorneys, Chief U.S. District Judge Samuel 
Wilson reminded Fitzgerald that the charges against Knox concerned the 
prescription of medication outside the scope of legitimate medical 
practice, not necessarily inappropriate activities.

Fitzgerald also asked Bonfiglio if he prescribed as high a dosage for his 
patients as Knox did.

Bonfiglio replied that he doesn't, not because there isn't a medical 
justification for it, but because he did not want to find himself the 
subject of a federal prosecution.
- ---
MAP posted-by: Beth Wehrman