Pubdate: Thu, 23 Oct 2003 Source: Richmond Times-Dispatch (VA) Copyright: 2003 Richmond Newspapers Inc. Contact: http://www.timesdispatch.com/ Details: http://www.mapinc.org/media/365 Author: Rex Bowman Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) DOCTOR'S FATE NOW IS UP TO THE JURY Prosecutors Contend That His Prescription Practices Were Fatal To Some Patients ROANOKE - A federal jury in Roanoke is set to begin asking itself this question today: Was Roanoke physician Cecil Byron Knox what prosecutors portrayed him as - a sort of "Dr. Feelgood" who liberally dispensed potent drugs to addicts for no legitimate medical reason but with fatal results - or was he the man portrayed by defense attorneys - an old-fashioned, friendly practitioner from Norman Rockwell's America? Settling the question could take days. In seven weeks of testimony in a federal courtroom, prosecutors alleged that Knox - who, with his long hair, jeans and sandals, looked more hippie than physician in his clinic - ran a "pill mill" from his cluttered office on Roanoke's Second Street, handing prescriptions to known addicts and others who came to see him with stories of severe pain. Knox's tendency to prescribe potent drugs contributed to the deaths of seven patients, prosecutors alleged. Prosecutors and defense attorneys finished their closing arguments in U.S. District Court at 3 p.m. yesterday. Chief U.S. District Judge Samuel Wilson then sent jurors home for the night, to return this morning to begin deliberations. In one year, Knox wrote prescriptions for $1.6 million worth of OxyContin, according to testimony, becoming the nation's 19th leading prescriber of the drug. Defense attorneys, however, portrayed Knox as a throwback to an earlier kind of doctoring, saying he spent lots of time with patients, many of whom were in such severe pain that they couldn't get relief from other doctors who barely had the time to examine them. Knox, they said, was a sympathetic doctor who took on the kind of patients other doc-tors wouldn't. Many of Knox's patients sat in the courtroom during the entire trial to offer support. "He was a spend-time-with-you doctor," attorney John Lichtenstein, who represents Knox's medical office, told jurors yesterday. "He was not a six-minute doctor." Knox faces 50 charges related to allegations that he prescribed medicines, especially methadone and OxyContin, for no legitimate medical reason. He and his office manager, Beverly Gale Boone, also face 19 fraud, conspiracy and racketeering charges related to their billing methods. A third defendant, licensed counselor Willard Newbill James Jr., faces five charges. Authorities allege Newbill paid Knox's office kickbacks in return for patient referrals. The bulk of the federal prosecutors' case, however, revolved around Knox's free-handed philosophy of prescribing drugs. Assistant U.S. Attorney Rusty Fitzgerald introduced evidence suggesting that seven of Knox's patients died of overdoses or drug-related causes, while an additional three people suffered serious physical harm. Fitzgerald said Knox's liberal dispensing of painkillers was nearly unprecedented. "This doctor is the World Series of OxyContin," Fitzgerald said. Lichtenstein, though, likened Knox to the friendly doctors painted by Norman Rockwell. He reminded jurors of testimony that many of Knox's patients knew they had to lie about their pain to get prescriptions from him, suggesting that Knox was an honest healer who was duped by those he tried to help. Lichtenstein said some of the patients given painkillers were also taking illegal drugs like cocaine, a circumstance that should exonerate Knox from responsibility for their deaths. Because the jurors have to sift through seven weeks of testimony and evidence and several boxes of documents, attorneys said a verdict could be days away. - --- MAP posted-by: Larry Seguin