Pubdate: Wed, 08 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, The Roanoke Times
Bookmark: http://www.mapinc.org/people/Cecil+Knox
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

Testimony Highlights Strong Day for Prosecution

FORMER RECEPTIONIST TESTIFIES IN KNOX CASE

Tiffany Durham, Dr. Cecil Byron Knox's receptionist, testified against him 
Tuesday after she came to realize that activity at the practice was 
criminal, she said.

Tiffany Durham was the bad cop to Roanoke pain specialist Cecil Byron 
Knox's good cop before his medical practice was shut down in February 2002.

In a strong day for the prosecution, Durham testified in federal court 
Tuesday that Knox wanted her to question some of his patients about what 
they were doing with their painkillers when they ran short of their 
medications.

Knox, in turn, wanted to be the good cop, so patients would trust him 
enough to feel comfortable telling them if they were abusing the narcotics 
he prescribed for them, Durham testified.

Durham's recounting of what went on at Knox's practice, Southwest Physical 
Medicine and Rehabilitation at 1130 Second St. in Roanoke marked the only 
testimony of a person associated with the practice who has pleaded guilty 
to crimes in connection with the practice.

"That's why I am here, to admit that I am responsible " for playing a part 
in the criminal activity Durham said was going on at the practice.

Durham, 29, maintained her innocence until August, when she pleaded guilty 
to two counts of knowledge that a felony was going on at the practice and 
not reporting it to authorities. She testified Tuesday that she came to 
realize that activity at the practice was criminal after her attorney - 
Jeff Dorsey of Salem - told her about evidence that was going to be 
presented at trial.

Defense attorneys did not challenge the allegations Durham made during her 
testimony. But Durham did concede on cross-examination that her cooperation 
with federal prosecutors Rusty Fitzgerald and Pat Hogeboom meant she, the 
mother of three children - ages 9, 2 and 1 - no longer faced the prospect 
of life imprisonment.

Durham, who lives in Blue Ridge, also said that when she testified before 
the federal grand jury in 2001, it was as a witness, not as the target of 
the investigation. But she was later charged along with Knox, office 
manager Beverly Gale Boone, Willard Newbill James and Kathleen O'Gee.

Durham faced some of the most serious counts in the indictment, including 
that she took part in the prescription of medication outside the scope of 
medical practice that led to the death or serious injury of nine people. 
She had worked for Knox since she was a teenager and eventually became his 
medical assistant, despite no formal training in the field.

According to Durham's testimony:

Boone and Durham would only "allow" Knox one prescription pad at a time 
because he would leave a prescription pad unguarded on the desk in his 
office. Some of Knox's patients would bypass the waiting room and come 
directly to the side door for their prescriptions.

Boone decided the practice should stop seeing new patients from Pulaski 
after several of Knox's patients got arrested in connection with the 
diversion of OxyContin and other drugs. Boone later changed her mind and 
decided the practice should start accepting patients again for more revenue.

Knox made statements dismissing reports from pharmacists and police about 
drug diversion, saying they couldn't always be trusted.

Before Knox left town on vacation, he would sign blank prescriptions and 
leave them with Boone in case emergency refills were necessary.

After Knox learned that the practice was under investigation, he began 
taping some of his meetings with patients, unbeknownst to them.

Boone oversaw financial matters at the practice and encouraged physical 
therapists to use hot packs for Medicaid and Medicare patients, which would 
generate a higher cost reimbursement.

The prosecution is expected to wrap up its case today. 
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MAP posted-by: Richard Lake