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Roanoke, Virginia,
pain management specialist Dr. Cecil Knox has been re-re-indicted by a
federal grand jury in Charlottesville in a vivid example of prosecutorial
manipulation of the grand jury system. Knox, who operated the Southwest
Virginia Physical Medicine and Rehabilitation clinic, was originally charged
and tried on a 69-count indictment alleging he and his office staff caused
the death of patients by improperly prescribing opioid pain relievers and
that they defrauded Medicaid by writing the improper prescriptions. But a
federal jury last fall found Knox innocent on 30 counts and could not reach
a verdict on the remaining counts, prompting the trial judge to declare a
mistrial.
Having been
defeated initially in their effort to send Dr. Knox away for decades, the
federal prosecutors went back to the federal grand jury and sought a new
indictment in January. Even though the judge in the initial trial had not
yet decided whether to dismiss the remaining counts, the prosecutors
couldn't wait. As is always the case with prosecutors and grand juries, the
prosecutors got what they wanted. This time Knox was to be charged with 95
counts, including 14 counts of illegally prescribing medication that caused
death or bodily harm, and running a continuing criminal enterprise, or
racketeering. The federal crime of racketeering was originally designed to
target organized crime, but has since been used by innovative prosecutors to
charge people who don't have anything to do with what is commonly considered
organized crime. Like a doctor's office.
Last week, the
feds were back before the grand jury to massage a slightly different
indictment from it, one that makes it easier for them to prove their
racketeering case. Under federal law, a jury must convict a defendant of at
least two of the acts listed in the racketeering charge. To un-level the
playing field, prosecutors got the grand jury to indict as three crimes what
it had indicted as one crime in January.
In January, the
grand jury charged that Knox improperly prescribed the stimulant Fastin to a
patient as one of the seven acts listed in the racketeering indictment. Now,
again at the prompting of federal prosecutors, the grand jury as split the
Fastin-prescribing incident into three separate acts, making it that much
easier for the feds to achieve the magic number of two acts needed to get
the racketeering conviction.
US Assistant
Attorneys Tom Bondurant and Patrick Hogeboom were not returning media calls
with questions about the re-re-indictment. Knox and his office manager,
Beverly Gale Boone, are set for re-trial on November 1.
See earlier Drug War
Chronicle coverage of the Knox case at:
http://stopthedrugwar.org/chronicle/307/knox.shtml
http://stopthedrugwar.org/chronicle/304/prn.shtml
http://stopthedrugwar.org/chronicle/239/rico.shtml
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Alexander DeLuca, M.D. 
