|Friday, September 26, 2003
|Experts: Drugs may have caused 8 deaths
Forensic experts testify in Knox case
|Defense attorneys have argued that Knox cannot be held responsible for patients who did not take medications as directed.
By JEN McCAFFERY
THE ROANOKE TIMES
Forensic experts testified Thursday in federal court that eight former patients of Roanoke pain specialist Cecil Byron Knox died because of large concentrations of drugs in their systems.
Roanoke Assistant Chief Medical Examiner William Massello said at the trial of Knox and three of his associates that former community activist Lin Edlich, former welder Edgar O'Brien, and former Wythe County resident Eben Earhart died as a result of the drugs they had taken.
Federal prosecutors Rusty Fitzgerald and Pat Hogeboom have argued that Knox and his office manager, Beverly Gale Boone, are responsible for the death of eight of Knox's patients. Meanwhile, defense attorneys have argued that Knox cannot be held responsible for patients who did not take medications as prescribed.
Massello addressed only three of the cases in court Thursday. Forensic pathologist James Kuhlman addressed some of the other cases.
Massello testified that Edlich, who had been severely wounded in an attack about six months before her death, died from the mixture of drugs in her system. Edlich, 54, died July 15, 2001, at her Smith Mountain Lake home in Bedford County. Edlich was co-founder of VA CARES, a program to help people adjust to life after prison.
"Several drugs, all of which in combination, brought about this woman's death," Massello said. He also testified that Edlich had a history of drug abuse.
Edlich's autopsy showed she had the painkillers hydrocodone and OxyContin as well as the antidepressant medication Zoloft in her system.
But in the case of Earhart, who was 48 when he died Jan. 10, 2002, a high dosage of OxyContin was the cause of death, Massello said.
"He died from the respiratory paralysis that this drug can cause," Massello said.
Former Roanoke resident Edgar O'Brien was 40 when he died May 25, 2002. Massello said O'Brien was a long-term abuser of intravenous drugs. His autopsy showed that O'Brien had morphine, the painkillers OxyContin, hydrocodone and methadone, along with the tranquilizer Valium in his system.
O'Brien also had cocaine in his system, Massello said. He also had injection marks on his arms that were fresh enough to suggest that the morphine in O'Brien's system could have resulted from the decomposition of heroin he injected.
The drug amounts were such that each one alone could have caused O'Brien's death, Massello testified. Altogether, they overwhelmed him, Massello said.
But on cross-examination by Roanoke attorney John Lichtenstein, who is representing Knox's practice, Southwest Virginia Physical Medicine and Rehabilitation, Massello agreed that people develop tolerances to medications.
In some cases, a concentration of methadone that might cause the overdose of a person who ingested the opiate for the first time, would not prove fatal to a longtime user , Massello agreed.
And Massello also did not dispute that any level of cocaine can kill a person, and that it could have been that factor alone that led to O'Brien's death.
Earlier in the day, Kuhlman testified that five other Knox patients - Michael Debusk, Monte Kidd, Michael March, John Tisdale and Donald Boyer - each also died with an amount of drugs in their systems that could be considered fatal.
Debusk, Boyer and Tisdale had large concentrations of methadone in their systems, while March and Kidd had large concentrations of morphine in their systems.
The trial continues today and is expected to last about four more weeks.