|Wednesday, October 22, 2003
|'What a long, strange trip it's been,' said one federal prosecutor in summarizing the trial
Closing arguments given in Knox case
|Defense attorney Tom Anderson said the trial has been a "complete character assassination" of the Roanoke doctor.
By JEN McCAFFERY
THE ROANOKE TIMES
Roanoke pain specialist Cecil Byron Knox showed "no remorse, no tears" for his dead patients.
Federal prosecutor Rusty Fitzgerald argued that point to a federal jury Tuesday in his closing argument. He likened the practice of medicine to a road bordered by a guardrail, one which Knox's medical treatment went outside, he said.
"He's driving past the guardrail into the deep weeds ... as a result of which, patients die," Fitzgerald argued.
But defense attorney Tony Anderson of Roanoke argued that some evidence presented against Knox at trial had nothing to do with the charges he faces.
"What you heard over the course of the last seven weeks has been complete character assassination of Dr. Knox," Anderson argued.
Knox and his office manager, Beverly Gale Boone, each face a mandatory minimum sentence of 20 years in connection with the 10 charges that the prescription of medication outside the scope of legitimate medical practice led to the death or serious injury of 10 people.
Roanoke attorney John Lichtenstein, who is representing Knox's practice, Southwest Virginia Physical Medicine and Rehabilitation, is expected to argue about alleged overdoses today. Defense attorneys for Knox's associates, Boone and counselor Willard Newbill James, are also expected to make their closing arguments today, and the case should go to the jury this afternoon.
As the trial wound down Tuesday, Fitzgerald invoked the Grateful Dead in the beginning of his closing argument, telling the jury, "what a long, strange trip it's been."
Though Fitzgerald presented much evidence to the contrary during the trial, he also argued that it wasn't Knox's ponytail and cowboy boots that meant he prescribed medicine outside the scope of legitimate medical practice. Rather, Fitzgerald argued, Knox had no scientific basis for the medical decisions he made.
"These patients were not fixing to die," Fitzgerald argued.
In a separate closing argument, federal prosecutor Pat Hogeboom argued that Knox's practice was a criminal operation.
"Beverly Boone was the person driving this ship financially," Hogeboom argued. He said the practice was struggling financially, and that the defendants in the case committed fraud to generate more money.
Hogeboom pointed out a performance review Boone submitted to Knox. In it, Boone wrote that she deserved a bonus for "quietly building the practice a small fortune" and managing it through several investigations and audits.
Hogeboom also showed e-mails between Boone and Knox's wife, Roanoke lawyer Donna Knox, that concerned the decision to tape record patients without their knowledge. He argued that the defendants tried to conceal their fraud.
Hogeboom also rejected the anticipated argument that practice members didn't know how to navigate the complex and ever-changing rules of health care billing.
"They knew the rules well enough to get payment," Hogeboom argued.
But Anderson argued that in May 2002, three months after Knox and his associates were arrested and his practice was shut down, the practice received a letter from the Center for Medicaid and Medicare Services.
The letter notified the practice that after a review of Knox's medical files, the federal health care program intended to place Knox in a pre-payment review plan. No mention was made of prosecuting anyone in the practice in connection with how the billing was done.
"It would appear from this exhibit that the right hand did not know what the left hand was doing," Anderson said.
He also argued that he had added up the total for the amount of alleged fraudulent billings the practice had submitted to health care programs and insurance companies. That total came to $5,032.85.
Anderson argued that federal prosecutors were using Knox's medical records both as evidence against him in his prescribing practices, and as evidence that he kept incriminating information out of the patient files.
After two raids on Knox's practice in 2001 and 2002 and one on his Roanoke County home, the defendants in the case knew they were under federal investigation, Anderson argued.