ARLINGTON, Va. (WRIC) — An elderly Virginia doctor has been indicted on 21 counts of illegally distributing oxycodone as part of a massive conspiracy with her office manager that lasted a decade.

Dr. Kirsten Van Steenberg Ball, 68, of Arlington, faces up to 20 years in prison on each count if convicted. In an extensive indictment, prosecutors laid out allegations that Ball was the source of massive amounts of opioids that flooded Northern Virginia, conspiring with her office manager, Candie Calix, to distribute them to addicts.

Calix, 40, was herself sentenced to 7 years in prison in September 2022 for her role in the scheme. From 2012 to 2022, Calix alone, as a patient of Ball, was prescribed 40,000 30-mg oxycodone pills.

“Calix did not, however, function as a typical office manager,” prosecutors wrote. “Instead, CALIX recruited individuals — including Calix’s mother, Kendall Sovereign, and several other members of Calix’s family — to become ‘patients’ of Ball.”

According to the indictment, Calix even paid for Dr. Ball’s malpractice insurance.

Prosecutors claim Ball frequently prescribed large amounts of oxycodone without even seeing patients for an in-person visit. She also prescribed high doses of oxycodone alongside diazepam — despite knowing the dangers of that combination.

One patient, identified only as T.H. in the indictment, was prescribed 320 30-mg oxycodone pills in June of 2015. Later that month, Ball sent T.H. a letter supposedly expelling them from her practice for violating her policies — but Ball still prescribed T.H. another 180 oxycodone pills the following month.

In August 2015, T.H. died of an overdose.

Ball was investigated by the Virginia Board of Medicine from 2014-2015 for her reckless prescription of opioids, including eight cases in which she either performed no physical examination, requested no medical history, ignored positive drug results for illicit drugs and, in at least one case, prescribed opioids to a patient who was receiving them from three other doctors.

In light of these findings, the board required Ball to complete a 20-hour class on controlled substances — and then, according to documents obtained by 8News, promptly restored her medical license in full. It would not be revoked again until 2022, when federal investigators closed in on Calix.