PAIN DOCTOR'S TRIAL SET TO BEGIN

Charge: Illegally Distributing Drugs

ROANOKE - Was the clinic run by Dr. Cecil Byron Knox a haven for patients no
one else would treat or an illegal drug-distribution operation?

Jurors are expected to spend much of the next few weeks hearing evidence to
help them answer that question. The Roanoke pain specialist and three of his
former colleagues at Southwest Virginia Physical Medicine and Rehabilitation
will go on trial beginning today in federal court.

Knox, 54, is accused of illegally distributing drugs, some of which resulted in
death or serious injury to some of his patients. The defendants also face
charges that include conspiracy, mail fraud, health-care fraud and obstruction
of justice.

Federal prosecutors Rusty Fitzgerald and C. Patrick Hogeboom III have
characterized Knox's practice as a criminal enterprise, a place where fraud was
prevalent and prescriptions for OxyContin and other drugs were doled out
freely, even through a side door.

But defense attorneys are expected to present evidence from experts who will
testify that Knox's prescriptions did not violate medical standards. Most of
his patients suffered from "serious, life-altering, often debilitating pain,"
according to the opinion of one of the defense expert witnesses, Dr. Richard
Bonfiglio of Pittsburgh. He also found that Knox had established procedures to
monitor his patients' prescriptions. Bonfiglio suggested there was a limit to
Knox's responsibility for his patients' actions.

"Despite any doctor's best efforts, there is nothing that will absolutely
prevent or detect a patient's lying, attempting forgery, or misdirecting
medications," Bonfiglio said in court documents.

Michael Troyer, president of the National Chronic Pain Outreach Association, an
advocacy group in Millboro for people who suffer chronic pain, said he has been
watching the case closely.

"The last thing we need to be doing is persecuting physicians who are willing
to take these risks for those that the entire rest of the medical community has
shunned," Troyer said.

He estimated that up to 5 million Americans suffer from "intractable pain," and
added that the medical community has only in recent years tried to start
addressing chronic-pain management.

Since his indictment in February 2002, Knox has been prohibited from practicing
medicine.

The other defendants are Beverly Gale Boone, a registered nurse and Knox's
office manager; and Willard Newbill James Jr. and Kathleen G. O'Gee, who worked
with Knox at Southwest Virginia Physical Medicine and Rehabilitation.