Roanoke, Virginia, pain management specialist Dr. Cecil Knox has been re-re-indicted by a federal grand jury in Charlottesville in a vivid example of prosecutorial manipulation of the grand jury system. Knox, who operated the Southwest Virginia Physical Medicine and Rehabilitation clinic, was originally charged and tried on a 69-count indictment alleging he and his office staff caused the death of patients by improperly prescribing opioid pain relievers and that they defrauded Medicaid by writing the improper prescriptions. But a federal jury last fall found Knox innocent on 30 counts and could not reach a verdict on the remaining counts, prompting the trial judge to declare a mistrial.
Having been defeated initially in their effort to send Dr. Knox away for decades, the federal prosecutors went back to the federal grand jury and sought a new indictment in January. Even though the judge in the initial trial had not yet decided whether to dismiss the remaining counts, the prosecutors couldn't wait. As is always the case with prosecutors and grand juries, the prosecutors got what they wanted. This time Knox was to be charged with 95 counts, including 14 counts of illegally prescribing medication that caused death or bodily harm, and running a continuing criminal enterprise, or racketeering. The federal crime of racketeering was originally designed to target organized crime, but has since been used by innovative prosecutors to charge people who don't have anything to do with what is commonly considered organized crime. Like a doctor's office.
Last week, the feds were back before the grand jury to massage a slightly different indictment from it, one that makes it easier for them to prove their racketeering case. Under federal law, a jury must convict a defendant of at least two of the acts listed in the racketeering charge. To un-level the playing field, prosecutors got the grand jury to indict as three crimes what it had indicted as one crime in January.
In January, the grand jury charged that Knox improperly prescribed the stimulant Fastin to a patient as one of the seven acts listed in the racketeering indictment. Now, again at the prompting of federal prosecutors, the grand jury as split the Fastin-prescribing incident into three separate acts, making it that much easier for the feds to achieve the magic number of two acts needed to get the racketeering conviction.
US Assistant Attorneys Tom Bondurant and Patrick Hogeboom were not returning media calls with questions about the re-re-indictment. Knox and his office manager, Beverly Gale Boone, are set for re-trial on November 1.
See our earlier coverage of the Knox case at: