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First Do No Harm

John Brownlee, U.S. Attorney General; The Roanoke Times; 2006-01-30. Posted: 2006-02-01.  

Related resources:
Knox / Boone collection  ;  War on Doctors/Pain Crisis Journalism and Advocacy archives 
See also:
U.S. Attorney, Heal Thyself – LTE in response to “First Do No Harm” -
DeLuca; 2006

[Full Text of this Article in Adobe PDF format]

John Brownlee is the United States attorney for the Western District of Virginia who prosecuted Dr. Cecil Knox and Beverly Boone.

She was a young mother and thrilled to be pregnant again. She and her husband had two beautiful children, and now they were expecting another baby girl. Unfortunately, this young mother had fallen on the ice and injured her lower back -- causing her pain and discomfort. Her obstetrician/gynecologist had prescribed a mild pain medication, but the expectant mother found no relief. She was then referred to Dr. Cecil Knox, a self-described "pain specialist."

According to evidence presented at his trial, Knox prescribed to this young mother, who was now four months pregnant, 120 40 milligram tablets of the powerful painkiller OxyContin at her initial consultation. Two weeks later, Knox prescribed an additional 115 pills, and an additional 220 pills over the next three weeks.

Within days, the powerful opiate had taken control of her and her unborn baby. As both mother and child craved the OxyContin, Knox was ready and willing to keep the drug flowing -- while billing the insurance company for each visit.

Although Knox promised her other doctors that he would "taper" her OxyContin, Knox continued to increase this young woman's OxyContin dosage. The week before her baby was born, Knox prescribed 450 20mg OxyContin pills and ordered her to take 12 pills a day -- nearly a 100 percent increase from her initial prescription.

As one can imagine, the baby was born addicted to OxyContin. Dr. Robert W. Allen, the neonatologist who took care of the baby, told investigators that hers was "the worst drug withdrawal syndrome [he had] experienced in over 30 years" of practicing medicine. Fortunately, the child has fully recovered and is now a beautiful and healthy 6-year-old girl. But, as her mother testified, the family will always bear the physical and psychological scars caused by Knox.

On Jan. 20, Knox was sentenced for racketeering, illegal distribution of prescription drugs, health care fraud and distribution of marijuana to a patient. Knox admitted to illegally sharing prescription and street drugs with patients and attempting to defraud those who were paying for his services.

The Honorable James P. Jones stripped Knox of his medical license and prohibited him from prescribing medications -- including OxyContin. Knox was sentenced to five years probation and fined $5,000. The court has assured that Knox will never again harm another patient.

Although some of the local media coverage focused on the impact of this prosecution on the lives and fortunes of Knox, an objective and complete summary of the case must include the voices of those patients and family members who spoke about the years they suffered because of excessive medication or combinations of medications prescribed by Knox.

During the investigation, patient after patient, and family members for those who had died, described the dehumanizing effects of drug use at the levels and in the combinations Knox prescribed.

Finally, many of Knox's patients went on to other doctors and other treatments after Knox was arrested, and most of those patients testified that their quality of life dramatically improved.

One woman testified that being tapered off the very high levels of narcotics Knox prescribed was like "waking from a dream" and allowed her to realize and remember that she had small children who were growing up without her. Post-Knox, she managed her discomfort with over-the-counter medications while remaining active in her family's life. That good news is an important part of this story.

[Full Text of this Article in Adobe PDF format]



Dr. DeLuca's Addiction, Pain, and Public Health Website

Alexander DeLuca, M.D.

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Originally posted: 2006-02-04

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