UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF FLORIDA

CASE NO. 22-14073-CR-CANNON/MAYNARD

UNITED STATES OF AMERICA,

vs. 

CATHERINE SHANNON DUNTON,

 Defendant.

_________________________________/ 

GOVERNMENT’S SENTENCING MEMORANDUM AND RESPONSE TO THE 

DEFENDANT’S MOTION FOR DOWNWARD VARIANCE

The United States of America, by and through the undersigned Assistant United States 

Attorney, hereby files this sentencing memorandum recommending that this Court sentence the 

defendant, Catherine Shannon Dunton, to a sentence within the guideline range as calculated in 

the Presentence Investigation Report (DE 25). In support thereof, the United States submits as 

follows: 

Procedural History

On December 8, 2022, a federal grand jury in the Southern District of Florida returned a 

single count Indictment charging the defendant with tampering with a consumer product, in 

violation of Title 18, United States Code, Section 1365(a)(4). (DE 1). The defendant entered a 

guilty plea to the Indictment on April 11, 2023. (DE 19). The defendant’s sentencing hearing is

scheduled for June 27, 2023. 

According to the Presentence Investigation Report (“PSI”), the defendant has a total 

offense level of 26 and a criminal history category of I, which yields an advisory guideline range 

of 63 to 78 months’ imprisonment. (PSI at ¶¶ 28, 31, 102). The defendant’s Base Offense Level

pursuant to § 2N1.1(a) was 25. (PSI at ¶ 19). 

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 1 of 12
2

The defendant qualified for a 2-level increase pursuant to § 3A1.1(b)(1) for putting

vulnerable patients at risk by diluting or substituting the very medication administered to alleviate 

and control pain during the patient’s surgical procedure. (PSI at ¶ 21). The defendant also 

received an additional 2-level increase pursuant to § 3B1.3 for abusing a position of trust since as 

a licensed nurse she was supposed to provide safe and competent care to her patients. Instead, 

she stole the very medication required during surgical procedures for her own use. (PSI at ¶ 22). 

This increased the defendant’s offense level to 29 which after acceptance resulted in a Total Base 

Level of 26. (PSI at ¶¶ 24-28). Based upon a total offense lever of 26 and criminal history 1, the 

guideline imprisonment range is 63 to 78 months. (PSI at ¶ 102). Neither party filed objections to 

the PSI.

On June 21, 2023, the defendant filed a sentencing memorandum in support of a downward 

variance to a sentence of home confinement. Specifically, the defendant asks this Court to consider 

her lack of a history of violence, her stable residence, her compliance with the conditions of her 

pre-trial release, her ongoing cooperation with the U.S. Government and her need for treatment

for her opioid addiction (DE 29). 

ANALYSIS

The overarching goal of a sentencing court is to fashion a sentence that is sufficient, but 

not greater than necessary, to accomplish the goals of sentencing. Kimbrough v. United States, 

552 U.S. 85, 101 (2007). The sentencing court should begin the process by correctly calculating 

the applicable guideline range and must “remain cognizant of them throughout the sentencing 

process.” Gall v. United States, 552 U.S. 38, 50 n.6 (2007). Section 1B1.1 of the Sentencing 

Guidelines outlines, in express language, the order which district courts are to proceed. First, the 

district court calculates the applicable guideline range. U.S.S.G. § 1B1.1(a). Second, the district 

court applies any applicable departures under Sections H and K of Chapter 5. U.S.S.G. § 1B1.1(b). 

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 2 of 12
3

After the first two steps are complete, “the Court shall then consider the applicable factors in 18 

U.S.C. § 3553(a) taken as a whole.” U.S.S.G. § 1B1.1(c).

The Section 3553(a) factors are:

(1) the nature and circumstances of the offense and the history and characteristics 

of the defendant;

(2) the need for the sentence imposed—

(A) to reflect the seriousness of the offense, to promote respect for the law, 

and to provide just punishment for the offense; 

(B) to afford adequate deterrence to criminal conduct; 

(C) to protect the public from further crimes of the defendant; and 

(D) to provide the defendant with needed educational or vocations training, 

medical care, or other correctional treatment in the most effective manner;

(3) the kinds of sentences available;

(4) the kinds of sentence and the sentencing range established in the Guidelines;

(5) any pertinent policy statement by the Sentencing Commission;

(6) the need to avoid unwarranted disparities among defendants with similar records

who have been found guilty of similar conduct; and

(7) the need to provide restitution to any victims.

18 U.S.C. § 3553(a)(1)-(7).

Nature and Circumstances of the Offense

The essence of this case is that the defendant, a nurse, stole vials of fentanyl for personal 

use and refilled them with saline solution knowing that the adulterated substances would be 

administered to surgical patients. She began working at the clinic on September 20, 2021, as a 

circulating nurse. Her primary duties included interviewing patients, preparing patients for 

surgery, bringing patients to the procedure room, providing supplies and sterile instruments as 

needed during surgery, assisting other team members in monitoring the status of the patient and 

bringing the patient to the recovery room. Her duties also included retrieving controlled substances 

such as fentanyl from the RX room to be administered during surgical procedures as instructed by 

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 3 of 12
4

the treating physician. She also delivered controlled substances to other staff members or 

administered controlled substances directly to the patient while under the doctor’s supervision. 

The Clinic required staff to document the removal and use of any controlled substance on the 

controlled substance inventory log kept in the RX room which was monitored by a surveillance 

camera.

The defendant’s tampering came to light on April 18, 2022, when during a routine 

morning-controlled substance inventory, Clinic staff discovered that one full box (25 vials) of 

Fentanyl Citrate was missing. A search for the missing fentanyl box ensued. During the search, 

staff reviewed the Clinic’s external and internal surveillance footage, including the RX room 

where the key to the overstock cabinet wasstored. During this timeframe, the keys to the overstock

cabinet were secured by Clinic management. The overstock room was not fitted with a 

surveillance camera. At approximately 1:38 p.m., the missing fentanyl box (25 vials) was 

discovered by Clinic staff on the side of the locked overstock cabinet in the overstock room.

During the internal investigation, Clinic staff identified numerous boxes of fentanyl which 

appeared sealed, but upon closer inspection, had been opened from the rear. The plastic on the 

back of these boxes had been cut and appeared to have been accessed to remove the vials. A 

number of the vials bore dents on the crimps, the metal ring sealing the vials. During a review of 

some of the surveillance footage, Clinic staff observed the defendant opening the RX room’s 

controlled substance cabinet removing and replacing vials of fentanyl without documenting the 

controlled substance log. Clinic staff then contacted the Food and Drug Administration’s Office 

of Criminal Investigations (FDA) and reported their findings. 

During the course of this investigation, the defendant’s fingerprints were recovered from 

multiple tampered vials and boxes. An analysis of the sample tampered vials’ clear liquid revealed 

that amounts of active pharmaceutical ingredients were miniscule and that the liquid was actually 

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 4 of 12
5

a non-controlled liquid. In addition, the defendant’s hair sample submitted to the FDA lab tested 

positive for fentanyl.

The Clinic’s surveillance footage from February 27, 2022 through April 20, 2022 captured 

the defendant pocketing and removing approximately 450 fentanyl vials in the RX room. 

Sometimes she would take products from the drawers where biostatic water and lidocaine products 

were stored. Both of these products are clear liquids that resemble fentanyl. On some of the 

surveillance footage, the defendant appeared to open the plastic at the rear of the fentanyl boxes. 

Once opened, she accessed the vials from the back of the box, returning the boxes to the controlled 

substance cabinet by placing the sliced openings to the back of the cabinet to avoid detection. 

Besides the April 15, 2022 fentanyl vial box, the defendant tampered and/or stole 6 other boxes of 

fentanyl on six separate occasions in March of 2022.

According to FDA Dr. Arthur Simone, an anesthesiologist, fentanyl injections are used to 

provide pain relief (analgesia) during and after surgery. Fentanyl is often used in conjunction with 

other medicines before or during an operation as part of the overall anesthesia plan. Without 

adequate anesthesia, and in particular analgesia, there is an increased risk of patient movement 

during the surgical procedure that could lead to injury such as unintended cutting of skin, muscle, 

nerves, or blood vessels. Inadequate pain control can also lead to an elevated risk of clinically 

significant increases in the patient’s heart rate and blood pressure that can result in heart attack or 

stroke in vulnerable patients. The vial tampering alone presented a risk of contamination of the 

fentanyl. Any patient exposed to this contamination would be at risk of infection during or after 

the surgical procedure. In addition, and post-operatively, the patient’s complaints of pain and their 

need for additional pain medication may have been minimized and inadequately treated by the 

recovery room staff based on the amount of fentanyl that the staff believed was administered prior 

to or during the procedure. 

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 5 of 12
6

During her interview on May 11, 2022, the defendant admitted taking vials of fentanyl 

from the controlled substance cabinet. She described how she would take a vial’s cap off, remove 

the entire dose of fentanyl, and replace the contents with saline. She then self-administered the 

fentanyl by injecting it around her wrist area. After removing the vial’s cap, the defendant used a 

tool to recap the top of the vial. The tampered vial would be returned to the controlled substance 

cabinet in exchange for a new vial, repeating this process. She admitted to using saline and needles 

from the Clinic as part of the tampering process and self-administering the fentanyl. She selfadministered fentanyl while at work and at home. 

The defendant described the process of examining the vials to ensure removal of a new vial 

for personal use, instead of an already tampered vial. She recognized the tampered vials by the

pry marks left on the vial’s metal band. The defendant advised that these marks were left by the 

crimping tool when she recapped the vials. During the interview, the defendant led the agents to 

her bedroom where the crimping tool, syringes and saline solution were recovered. 

As to the April 15-18, 2022 timeframe, the defendant admitted taking an entire box of 

fentanyl (containing 25 vials) from the overstock cabinet. She removed the box from the Clinic

and over the course of the weekend self-administered all 25 vials replacing the contents as was her 

normal practice. When she returned to work on Monday April 18, 2022, she intended to return the 

tampered vials. After finding that the overstock cabinet keys were missing, she returned the box 

to the area of the cabinet surrounding the locked box. Dunton assumed the Clinic had noticed that 

fentanyl box was missing because the keys had been removed. 

The defendant acknowledged that she worked as a circulating nurse, working in the

operating rooms during surgeries. The surgeries included orthopedic, ophthalmology, ENT, and 

pain management. The defendant advised that she was aware that her actions caused patients to 

not receive their prescribed dose of fentanyl due to replacing the contents of the vials. The 

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 6 of 12
7

defendant denied hearing any negative reporting or patients reporting higher levels of pain then 

expected at the facility.

History and Characteristics of the Defendant

The defendant requests the Court grant a downward variance so that she can continue

battling her addiction and remain gainfully employed. The government does not dispute that these

are factors that the Court may consider. However, it is the defendant’s very addiction that put 

patients at risk. If and when she resumes her nursing career, will additional patients be put at risk. 

Though this Court may consider the defendant’s addiction and possible rehabilitation, the 

government submits that the defendant’s documented history of addiction and treatment supports 

a sentence within the guideline range.

Florida’s Board of Nursing’s (hereinafter “the Board”) public records confirm that on 

October 5, 2012, the Board issued a final order suspending the defendant’s Nursing License until 

she underwent an evaluation by the Intervention Project for Nurses (IPN) and complied with any 

and all terms and conditions imposed by the IPN as a result of the evaluation. Attached to the 

order was the settlement agreement and the Administrative Complaint. The Complaint alleged 

that, while working as a Nurse at Lawnwood, the defendant tested positive for fentanyl pursuant 

to an employer requested drug test administered on March 4, 2012. 

On August 23, 2022, Florida’s State Surgeon General ordered an emergency restriction of 

the defendant’s nursing license based on the evaluation and findings made by Dr. Lawrence 

Wilson, a physician specializing in addiction and psychiatry, during her IPN-facilitated evaluation 

conducted on May 24, 2022.1 (Attachment 1: Florida State Surgeon General’s August 23, 2022 

1

Dr. Wilson is Board Certified in Addiction Medicine and a Fellow of the American Society of Addiction 

Medicine. He is the Medical Director and CEO of 7 Summit Pathways Treatment and Recovery Center in 

Tampa. According to 7 Summit Pathways website, he is also a Physician Consultant to the Florida 

Department of Health. 

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 7 of 12
8

Order). Based on Dr. Wilson’s detailed findings in this publicly issued order, the defendant

admitted that in 2008 while employed as a nurse at Lawnwood, she diverted Demerol, morphine, 

fentanyl, and Percocet for personal use. She also reported that in 2009 she had entered into a 

substance abuse IPN monitoring contract based on her imbibing one bottle of wine or 4-5 vodka 

drinks a day for 3-years of her contract with Lawnwood.

Dunton also admitted that in 2011, she had entered into another IPN substance contract 

while still employed at Lawnwood for diverting and consuming by injection, 50-1000 mcg of 

fentanyl as least three days a week as discussed above. According to the defendant, she completed 

her IPN Monitoring Contract in 2017.

According to Dr. Wilson, the defendant admitted to being an active alcoholic by advising 

that when she did not consume alcohol, she experienced withdrawal symptoms which included 

headaches and diarrhea. She also reported that between February and April of 2022, she began 

diverting fentanyl and morphine from the Clinic by removing the metal cap, removing the contents, 

and replacing the contents with saline. She admitted diverting fentanyl and morphine two-to-three 

times a week and experienced withdrawals on weekends. The defendant also admitted that she 

knew there were occasions where the patients would only receive the saline.

As detailed in the Order, the defendant, in conjunction with the evaluation, underwent 

toxicology testing. The defendant’s PEth blood test was positive for prolonged or heavy “binge” 

alcohol consumption and her hair toxicology test was positive for fentanyl at 149 pg/mg with a 

cutoff of 25pg/mg. Based on his evaluation, Dr. Wilson diagnosed the defendant with severe 

opioid use disorder and severe alcohol use disorder. Based on his findings, Dr. Wilson found that 

the defendant was incapable of practicing nursing with reasonable skill and safety to patients. He 

recommended that the defendant undergo partial hospitalization or residential treatment with an 

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 8 of 12
9

IPN-approved treatment provider. Since the defendant failed to comply with Dr. Wilson’s 

recommendations as of August 23, 2022, the defendant’s license was immediately suspended. 

On May 10, 2023, the Board issued a final order finding that the defendant had been unable 

to practice nursing with reasonable skill and safety to patients by reason of illness or use of alcohol, 

drugs, narcotics, or chemicals or any other type of material or as a result of any mental or physical 

condition. (Attachment 2: Board’s May 10, 2023 Final Order). The defendant’s Nursing License 

was suspended until she undergoes an evaluation by the IPN and complies with any and all terms 

and conditions imposed by the IPN as a result of the evaluation. As in 2012, the defendant’s 

license was suspended, but not revoked. 

Need to Protect the Public, Reflect the Seriousness of the Crime, Promote 

Respect for the Law, and to Provide Just Punishment

The government submits that the aggravating aspects of the defendant’s offense and her 

history of addiction and failed rehabilitation warrants a guideline sentence. In United States v. 

Beumel, 522 Fed.App’x 623, 630 (11th Cir. 2013), Beumel “essentially stole fentanyl from patients 

on multiple occasions to feed his drug addiction, forcing those patients to endure extremely painful 

procedures without pain medication. Furthermore, after injecting himself with the stolen fentanyl, 

Beumel purposefully diverted the used syringes back to the patients. Although Beumel did not 

know he was infected with HCV at the time, he, as a health professional, must have known that 

reusing syringes in this way subjected the patients to a risk of potentially serious infection. Indeed, 

as a result of Beumel’s conduct, five patients of the Mayo Clinic were infected with HCV, which 

caused these patients to endure prolonged physical and mental suffering. . .” The Eleventh Circuit 

affirmed Beumel’s guideline sentence of 360 months’ imprisonment finding that the district court 

properly determined that Beumel’s actions reflected the seriousness of the offense, promoted 

respect for the law, provided just punishment, and deterred similar criminal conduct.

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 9 of 12
10

Beumel is instructive as the conduct, though much more sever, is similar in many respects 

as to those of the defendant. The defendant also stole fentanyl from patients on multiple occasions 

to feed her drug addiction, she exposed patients to painful procedures without pain medication and 

exposed them to serious risk of infection by tampering with the sterile vials. As a health 

professional and by her own admission, she knew she was subjecting some patients to such risk. 

In addition, her actions could have seriously damaged the Clinic’s reputation and might serve to 

erode public trust in medical institutions. 

The defendant has been diagnosed with severe opioid use disorder and severe alcohol use 

disorder. In 2009, she began abusing alcohol because of stress and then began to use drugs after 

undergoing two surgical procedures. Once her employer discovered that she was stealing pain 

medication, she reported herself to the IPN and entered into her first IPN contract which imposed 

a five-year monitoring period. The defendant chose not to self-report her alcohol addiction which 

allowed her to consume alcohol while she was being monitored. (PSI at ¶ 54, 55). She never 

completed the 2009 contract.

In 2012, she tested positive for fentanyl in an employer-requested drug screen prompting 

her to self-report. She again completed a six-week program followed by a six-month intense 

outpatient treatment with monitoring until 2017. After the second violation, the defendant was 

fired from Lawnwood.

According to the defendant, in 2021, she was in an accident which caused her to relapse. 

As a recovering addict, she could have reached out to the IPN when she realized that she was 

relapsing but chose not to. Instead, she devised a scheme of stealing vials while on camera and 

off camera while working at the Clinic. She injected herself with fentanyl and replaced the vials 

with saline solution. She did this for a period of months. Not only was she injecting herself with 

fentanyl, but was also abusing alcohol. For the third time, she was exposing her patients to 

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 10 of 12
11

undergoing surgery without the proper anesthesia and to possible infection. Only after she was 

caught, did she self-report. All of these factors show a far-reaching pattern of abuse of public and 

private trust.

Based on these factors, the government submits that this Court should impose a sentence 

with the guideline range to reflect the seriousness of the offense, to promote respect for the law, to 

provide just punishment for the offense. Though the defendant’s pattern of addiction has caused 

her to be fired, has led to the suspension of her license, she continued to tamper with vials of

fentanyl for personal use. Only when caught, did she report and it appears that she will seek to 

reinstate her license. 

The government submits that at this juncture a guideline sentence is needed to afford 

adequate deterrence to the defendant and to protect the public from further crimes of the defendant.

A guideline sentence would also provide a safeguard to other providers who may also face difficult 

personal circumstances from making the same choice as the defendant. Other licensed providers 

facing similar personal challenges should know that if they use their specialized access to deprive 

patients of needed narcotics, they will go to prison for a substantial period of time. Such a message 

would serve to deter other medical professionals as well as protect their patients. 

(INTENTIONALLY LEFT BLANK)

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 11 of 12
12

CONCLUSION

Therefore, the United States respectfully requests that the Court sentence the defendant to 

a sentence within the advisory guideline range as properly calculated by U.S. Probation. 

Respectfully submitted,

 MARKENZY LAPOINTE

 UNITED STATES ATTORNEY

 By: s/Diana M. Acosta

 DIANA M. ACOSTA 

Assistant United States Attorney

 Florida Bar No. 775185 

 101 South US Highway 1, Suite 3100 

 Fort Pierce, Florida 34950 

 Telephone: 772-293-0981 

 Email: Diana.Acosta@usdoj.gov

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that on June 23, 2023, I electronically filed the foregoing document 

with the Clerk of the Court using CM/ECF. I also certify that the foregoing document is being 

served this day on all counsel of record on the attached Service List in the manner specified. 

s/Diana M. Acosta 

 DIANA M. ACOSTA 

 Assistant United States Attorney

SERVICE LIST 

Diana M. Acosta, AUSA

EMAIL: diana.acosta@usdoj.gov 

101 S. U.S. Highway 1, Ste. 3100 

Ft. Pierce, FL 34950 

TEL: 772-293-0981 

Attorney for Plaintiff U.S.A.

Method of Service: CM/ECF

Michael R. Ohle, Esquire

EMAIL: ohlelaw@aol.com 

423 Delaware Avenue 

Fort Pierce, Florida 34950 

TEL:772-460-9801 

Attorney for Defendant 

Method of Service: CM/ECF

Frances Weisberg, USPO

EMAIL: Frances_Weisberg@flsp.uscourts.gov 

Flagler Center Building 

501 South Flagler Drive, Suite 400 

West Palm Beach, FL 33401

TEL: 561-804-6883 

Method of Service: CM/ECF

Case 2:22-cr-14073-AMC Document 30 Entered on FLSD Docket 06/23/2023 Page 12 of 12