Sep 3, 2005 By: Rex Bowman The Times Dispatch (VA)

A Roanoke doctor accused of running a “pill mill” from which he illegally prescribed vast numbers of potent painkillers pleaded guilty yesterday to four charges as federal prosecutors agreed to abandon efforts to link him to patients’ deaths.

Dr. Cecil Knox had faced 95 counts.

The guilty pleas came as part of a plea agreement that says Knox, 56, will serve no prison time and will avoid prosecution on 14 charges accusing him of being responsible for the harm or death of patients. The government also agreed to release his family’s assets, according to his attorneys.

The guilty pleas in U.S. District Court in Abingdon appeared to be an anticlimactic conclusion for federal prosecutors, who had described Knox as a major distributor of illicit painkillers in the Roanoke area. They had been unable to convince jurors: In 2003, a federal jury refused to convict the doctor of any of 69 counts against him, exonerating him on most of the charges and deadlocking on the others.

The resulting mistrial led to a 95-count indictment against Knox in January 2004. As part of yesterday’s plea agreement, Knox pleaded guilty to one of the 95 counts, racketeering, and the other 94 were dismissed. He also pleaded guilty to three new charges: illegal distribution of prescription drugs, illegal distribution of marijuana to a patient, and health-care fraud.

Defense attorneys John Lichtenstein and Tony Anderson said they were satisfied with the plea agreement, which they said Knox accepted only because the federal government met his terms.

“Not only did Dr. Knox never harm a patient, he was in fact the knot at the end of the rope for literally thousands of patients in severe pain and without hope,” according to a statement the attorneys released. “Dr. Knox gave them relief and hope.”

Prosecutors had contended that in one year alone Knox wrote prescriptions for $1.6 million worth of OxyContin from his small Roanoke clinic, becoming the nation’s 19th-largest prescriber of the powerful drug. Knox’s freewheeling way of prescribing drugs, prosecutors had alleged, had allowed addicts to stay supplied with their drugs of choice and led to patients’ deaths. Defense attorneys had described Knox as a doctor who treated patients in such severe pain that no other doctor would see them.

As part of the plea agreement, Knox will surrender his medical license to the state Board of Medicine. He is to be sentenced Nov. 21 and faces a maximum punishment of 12 months of house arrest, Anderson said. The defense attorneys said the home confinement will allow Knox to continue treatment he is undergoing for cancer.

In a written statement, U.S. Attorney John Brownlee hailed the plea agreement as a victory for Knox’s former patients “and the entire medical community.”

“With today’s guilty plea,” Brownlee said in the statement, “we have held Dr. Knox accountable for his crimes and put him out of business.”