By JEN McCAFFERY
THE ROANOKE TIMES

Archives Reprint

   Tiffany Durham was the bad cop to Roanoke pain specialist Cecil Byron Knox's good cop before his medical practice was shut down in February 2002.

    In a strong day for the prosecution, Durham testified in federal court Tuesday that Knox wanted her to question some of his patients about what they were doing with their painkillers when they ran short of their medications.

    Knox, in turn, wanted to be the good cop, so patients would trust him enough to feel comfortable telling them if they were abusing the narcotics he prescribed for them, Durham testified.

    Durham's recounting of what went on at Knox's practice, Southwest Physical Medicine and Rehabilitation at 1130 Second St. in Roanoke marked the only testimony of a person associated with the practice who has pleaded guilty to crimes in connection with the practice.

    "That's why I am here, to admit that I am responsible " for playing a part in the criminal activity Durham said was going on at the practice.

    Durham, 29, maintained her innocence until August, when she pleaded guilty to two counts of knowledge that a felony was going on at the practice and not reporting it to authorities. She testified Tuesday that she came to realize that activity at the practice was criminal after her attorney - Jeff Dorsey of Salem - told her about evidence that was going to be presented at trial.

    Defense attorneys did not challenge the allegations Durham made during her testimony. But Durham did concede on cross-examination that her cooperation with federal prosecutors Rusty Fitzgerald and Pat Hogeboom meant she, the mother of three children - ages 9, 2 and 1 - no longer faced the prospect of life imprisonment.

    Durham, who lives in Blue Ridge, also said that when she testified before the federal grand jury in 2001, it was as a witness, not as the target of the investigation. But she was later charged along with Knox, office manager Beverly Gale Boone, Willard Newbill James and Kathleen O'Gee.

    Durham faced some of the most serious counts in the indictment, including that she took part in the prescription of medication outside the scope of medical practice that led to the death or serious injury of nine people. She had worked for Knox since she was a teenager and eventually became his medical assistant, despite no formal training in the field.

    According to Durham's testimony:

    Boone and Durham would only "allow" Knox one prescription pad at a time because he would leave a prescription pad unguarded on the desk in his office. Some of Knox's patients would bypass the waiting room and come directly to the side door for their prescriptions.

    Boone decided the practice should stop seeing new patients from Pulaski after several of Knox's patients got arrested in connection with the diversion of OxyContin and other drugs. Boone later changed her mind and decided the practice should start accepting patients again for more revenue.

    Knox made statements dismissing reports from pharmacists and police about drug diversion, saying they couldn't always be trusted.

    Before Knox left town on vacation, he would sign blank prescriptions and leave them with Boone in case emergency refills were necessary.

    After Knox learned that the practice was under investigation, he began taping some of his meetings with patients, unbeknownst to them.

    Boone oversaw financial matters at the practice and encouraged physical therapists to use hot packs for Medicaid and Medicare patients, which would generate a higher cost reimbursement.

   The prosecution is expected to wrap up its case today.

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