T hi s or derand j udgm enti s notbi ndi ng pr ece dentexce ptundert he * d o c tr in e s o f

la w o f th e c a s e , re s ju d ica ta and col l at er al es t oppel . I tm aybe ci t ed, h o w e v e r, fo r its p e rsu a siv e v a lu e c o n sis ten t w ith F e d . R . A p p . P . 3 2 .1 a n d 1 0 th C i r . R . 32. 1. 

## F I LED United States C ourt of Appeals Tenth Circuit 

### Ju ly24,2007 Elisab eth A. Shumaker C l erk of C ourt UNI TED S TATES CO URT O F AP PEALS

T E N T H C IR C U IT UNI T E D S T AT E S OF AM E RI CA , Pl ai nt i ff- A ppel l ee, v. M A N U E L T R U J I L L O , a / k / a M a n n y, D e fe n d a n t-A p p e llan t. N o. 06- 1501 ( D . C t . N o. 05- cr - 00374- E W N - 21)

(D . C o lo .)

ORDE R AND J UDGM EN T * B efo re T AC HA , C hi ef Ci r cui tJ udge, and BARRETT and BROR BY , Seni or C i rcui tJudg es.

A ft erexami ni ng t he br i efs and appe l l at e r ecor d, t hi s panel has det erm i ned unani m ous l yt hator al ar gum entw oul d notm at er i al l yas s i s tt he det erm i nat i on of th is a p p e a l. See F e d . R . A p p . P . 3 4 (a )(2 ); 1 0 th C ir. R . 3 4 .1 .9 (G ). T h e c a se is th e re fo re o rd e re d su b m itt e d w ith o u t o ra l ar g u m e n t.

A pp el l ant M anu el T ruj i l l o p l ed g uil tyt o o ne co un tof co nspir acyt o p ossessT h is a p p e a l is re la te d to a n o th e r a p p e a l b e fo re th is c o u rt , Uni t ed Stat es v. 1 L ucero , N o. 06- 1414, i n w hi ch A dam L ucer o w as al s o i ndi ct ed r egar di ng the sam e d rug tr affick ing inv esti g ati o n . H o w ev er, ou r disp o sit ion s in e ac h ca se a re w ri tt en sep ara tel yg iven the fac ts an d sen tenc ing issue s inv o lved are c o m p a ra tiv e ly d is tin c t. T he indi ct m ent br ou gh tfortydrug tr afficki ng and rel at ed ch arges agai nst 2 tw e n ty-th re e d e fe n d a n ts ; c o u n t o n e im p lic a te d M r. T rujillo . -2- w ith in ten t to d istrib u te a n d to d istrib u te 5 0 0 g ra m s o r m o re o f c o c a in e in v io latio n o f 2 1 U .S .C . § § 8 4 1 (a )(1 ) a n d (b )(1 )(B )(ii) a n d 8 4 6 . H e n o w a p p e a ls 1 h i s s i x t y - mo n th s e n t e n c e o n g r o u n d s h i s s e n t e n c e i s u n r e a s o n a b l e u n d e r1 8 U. S . C. § 3 5 5 3 (a ) b e c a u se , in g ra n tin g h is re q u e st fo r a d o w n w a rd d e p a rtu re b a se d o n h is t erm i nal i l l nes s , t he di s t r i ctcour ts ent ence d hi m t o a s i xty - m onth s ent ence r ather t han a t erm of h om e detent i on or a l essert erm of im pri sonm ent. W e exerci se juri sd ict ion p u rsua n t t o 1 8 U . S . C . § 3 7 4 2 (a) an d 2 8 U . S . C . § 1 2 9 1 an d affirm M r. T rujillo ’s s e n te n c e . I . Factual B ackgr ound A s s t i pul at ed byM r . T ruj i l l o, an i nves t i gat i on began i n J ul y2003 i nvol vi ng s ever al i ndi vi dual s i nvol ved i n drug tr aff i cki ng, i ncl udi ng m ember s of a ga ng know n as t he “G al l antK ni ght s I ns ane. ” B etw een J une 15 and J ul y2, 2005, as 2 par tof the ongoi ng i nves t i gat i on, author i t i es i nt er cept ed s ever al cal l s betw een V i ct orV al dez a nd M r . T ruj i l l o w hi ch es t abl i s hed M r . T ruj i l l o began pur chas i ng m u lti- o u n c e q u a n titie s o f c o c a in e f

ro m M r. V a ld e z .-3- I I . Pr ocedur al B ackgr ound T he fi nal s uper cedi ng i ndi ctm entchar ged M r . T ruj i l l o w i th di s tr i but i on of fi ve ki l ogr ams orm or e of pow dercoca i ne and f i ftygr ams orm or e of c r ack co ca ine in v iolati o n o f 2 1 U . S . C . § § 8 4 1 (a)(1), ( b )(1)(A )(i i) , an d (b)(1 )(A )(i ii ), and 846. A ft erhi s arr es t , M r . T ruj i l l o w as r el eas ed on bond s o he coul d r ece i ve m edi cal t r eatm entfora pr e- exi s t i ng l i vercondi t i on. H e then bega n as s oci at i ng w i t h hi s form ergang mem ber s and vi ol at ed the condi t i ons of hi s r el eas e by : 1) fa ili n g to a p p e a r fo r h is p re -tria l p ro c e e d in g s in th e in sta n t ca se ; 2 ) v io latin g h is par ol e i n a s t at e ca s e; and 3) fai l i ng t o m ai nt ai n cont actw i th hi s fede r al pr obat i on offi cerornot i fyherof new fel onychar ges pendi ng agai ns thi m w hen he w as arrested in the co m p an yo f o ther g an g m em b ers. Fo ll o w ing thes e v iolati o n s, M r. T ruj i l l o w as t aken i nt o fede r al cus t odyand then tr ans ferr ed t o the J effer s on C ount yD et ent i on C ent erw her e he r ece i ved medi cal att ent i on forhi s l i ver d is e a s e . U l t i m at el y , M r . T ruj i l l o ent er ed a gui l typl ea; i n hi s pl ea a gr eement , he agr eed t o pl ead gui l t yt o t he l es s eroffe ns e of di s tr i but i ng 500 gr ams orm or e of coca i ne i n vi ol at i on of 21 U . S. C . §§ 841( a) ( 1) and ( b) ( 1) ( B ) ( i i ) and 846. T he governm entand M r . T ruj i l l o al s o s t i pul at ed thathe s uffe r s fr om H epat i t i s C and c h ro n ic liv e r d ise a se a n d “ o b tain e d o p in io n s f ro m h is tre a tin g p h y sic ian s th a t h is m edical con dit i on i s t erm i nal” and “thata pre- sent ence e valuat i on of [ his ]T he pr obat i on offi ceral s o not ed M r . T ruj i l l o’ s bel i ef he w as r ece i vi ng 3 in a d e q u a te m e d ica l trea tm e n t w h ile in c a rc e ra ted a t th e Je ffe rso n C o u n ty D e ten tio n C e n ter . H o w e v e r, n o th in g in th e re c o rd su g g e sts M r. T rujil lo w o u ld re c e iv e in a d e q u a te tr e a tm e n t a t a fe d e ra l fa c ility a f te r h is s e n te n c in g . -4- m edi cal condi t i on i s appr opr i at e and ne ces s aryt o det erm i ne the ext entt o w hi ch a departur e maybe w arr ant ed under§ 5H 1. 4. ” R . , V ol . 1, D oc. 972 at4- 5.

Fol l ow i ng M r . T ruj i l l o’ s gui l typl ea, a pr obat i on offi cerpr epar ed a pr es ent ence r eportand arr i ved ata bas e offens e l evel of 30 and a tw o- l evel enhanc ementforobs t ruct i on of j us t i ce ba s ed on hi s fai l ur e t o appea rforthe pr et r i al pr ocee di ngs aft erbei ng r el eas ed on bond. H ow ever , the pr obat i on offi cer red u ce d h is offe n se lev el bythree leve ls fo r ac ce p tanc e o f re sp o n sibil ity , fo r a total offe n se lev el of

2 9 , w h ich, t o g ethe r w ith a c ri m inal h ist o ryca tego ryo f V I, r es ul t ed i n an advi s or yU ni t ed St at es Sent enci ng G ui del i nes ( “G ui del i nes ” or

“ U .S .S .G .” ) r a n g e o f

1 5 1 to 1 8 8 m o n th s im p ri s o n m e n t.

R el y i ng on a r evi ew of M r . T ruj i l l o’ s m edi cal r ecor ds and di s cus s i on w i t h a cou nsel or i n the Jeffers on C ou ntyD et enti on C enter , the p robat i on offi cer al so det ai l ed M r . T ruj i l l o’ s m edi cal condi t i on, confi r m i ng he s uffe r s fr om chr oni c, advanc ed l i verdi s eas e forw hi ch he ha s r ece i ved medi cal tr eatm entand not i ng a dow nw ar d departur e underU . S. S. G . § 5H 1. 4 forhi s phy s i cal condi t i on m i ghtbe a p p ro p ri a te . N e ith e r p a rt yo bje c te d to th e p re s e n te n c e re p o rt .

3T h e d o ctor a lso testi fied itw o u ld b e d ifficu ltfo r M r. T ruji ll o to w o rk 4 becau se of h i s i l l ness and t hat he m ustbe h ou sed byhim sel f bec ause t he d i sease i s cont agi ous and he ha s epi s odes of bl eedi ng and bout s of exc r et i ng bodyfl ui ds w h ic h m ig h t tr a n s m it th e d is e a s e to o th e r p e o p le . -5- P ri o r t o the s en tenc ing h ea ri n g M r. T ruji ll o fil ed a m o ti o n fo r do w n w ard departur e under§ 5H 1. 4, expl ai ni ng hi s t erm i nal l i verdi s eas e cons t i tut ed an extr aor di naryphy s i cal i m pai r m entw hi ch w arr ant ed s upervi s ed r el eas e forthe purpos e of r es i di ng w i t h hi s m ot her - i n- l aw , orforan uns peci fi ed “s hor tt erm of im p riso n m e n t.” A t th e se n ten c in g h e a rin g , a m e d ica l d o c to r tre a tin g M r. T rujil lo att he J effer s on C ount yD et ent i on C ent ert es t i fi ed M r . T ruj i l l o s uffe r ed fr om s ever e, advanc ed l i verdi s eas e r el at ed t o H epat i t i s C and had a l i fe e xpect ancyof a few y ear s t o under fi ve y ear s . B as ed on thi s t es t i m ony , M r . T ruj i l l o r enew ed 4 hi s r eques tfora dow nw ar d departur e under§ 5H 1. 4 fort he purpos e of a l l ow i ng h im to re s id e a t h o m e w ith h is m o th e r- in -l a w ra th e r t h a n s e rv e a p ri s o n s e n te n c e . I n r es pons e, t he di s t r i ctcourts t at ed: I ’ m m or e i nt er es t ed i n how . . . M r . T ruj i l l o deal s w i th the br eac h of fai t h w i t h t hi s cour tw hen he w as al l ow ed fort hi s veryr eas on t o be r el eas ed on pr etr i al det ent i on i n the fa ce of overw hel m i ng evi dence and i n t he fa ce of

s er i ous i nvol vementbyhi m , and he di s appea r ed. I thi nk he’ s m ani pul at ed the C our t . I don’ tdoubtt hatt he doct ors ay s he does n’ thave l ong t o l i ve. T hat ’ s s ad, butt hat ’ s no r eas on form e t o l ethi m l oos e, on hom e det ent i on oranyothernonc u sto d ya rra n g e m e n t. R . , V ol . 2 at14. T he governm ent , i n oppos i ng M r . T ruj i l l o’ s r eques tt o r emai n at-6-

hom e, poi nt ed outhe w as r el eas ed on bond bec aus e of hi s m edi cal condi t i on but abs conded w i t houtgovernm entappr oval and bega n as s oci at i ng w i th hi s form er g an g m em b ers. N ev erthe less, itd id n o t op p o se a red u cti o n in h is sen tenc e term bas ed on hi s m edi cal condi t i on. I tfur therr ecomm ended a departur e under U . S . S . G . § 5 K 1 . 1 fo r a n inety -on e- to n inety -five -m o n th se n tenc e b ase d o n M r. T ruj i l l o’ s as s i s t ance i n t he ca s e. T he governm ental s o expl ai ned medi cal t r eatm entata fe der al fac i l i t yl i ke the one i n R oches t er , M i nnes ot a, w hi ch has an aff i l i at i on w i t h t he M ay o C l i ni c, orother s as s oci at ed oraff i l i at ed w i th m edi cal fa cil it ies w o u ld b e a v ail ab le du ri n g h is i n ca rce rati o n , as w ell as h o sp ice c are t hr ough a compas s i onat e r el eas e pr ogr am. H ow ever , the governm entexpl ai ned t hatt o be el i gi bl e forcompass i onat e r el eas e hos pi ce c ar e M r . T ruj i l l o m us thave a m e d ica l d iag n o sis o f

a life e x p e c tan c yo f

six m o n th s o r le ss a t th e tim e o f h is r eques tand thathe coul d m ake s uch a r eques tata futur e dat e, w hi ch the g o v e rn m e n t w o u ld n o t o p p o s e . I n s ent enci ng M r . T ruj i l l o, the di s tr i ctcour tadopt ed the undi s put ed cal cul at i ons of the pr es ent ence r eport , cons i der ed the appl i cabl e G ui del i nes , and di s cus s ed the s ent enci ng fac t or s under18 U . S. C . § 3553( a) . I n s o doi ng, the d istric t co u rt p o in ted to M r. T rujil lo ’s c rim in a l h isto ryc a teg o ryo f V I, n o tin g it w as “mosts er i ous ” undert he G ui del i nes and thati tw oul d be di ffi cul tt o “i m agi ne ci r cumst ance s underw hi ch a man orw om an w i th thi s cr i m i nal hi s t oryw oul d not-7-

be i ncar cer at ed. ” R . , V ol . 2 at27- 28. I n di s cus s i ng the s ent enci ng fac t or s under 1 8 U . S . C . § 3 5 5 3 (a), the d istri ct co u rtfo u n d the m o st si g n ifi ca n t fac tors in M r. T rujil lo ’s c a se in c lu d e d th e n e e d fo r th e se n ten c e to re flec t th e se rio u sn e ss o f h is offense an d to prot ectt he p ub l i c from his futur e cri m es. In suppo rtof these fi ndi ngs , t he di s t r i ctcour tr ecount ed the fa ctM r . T ruj i l l o obt ai ned r el eas e on bond bas ed on hi s pl ea a bouthi s det er i or at i ng heal th butthen fa i l ed t o fol l ow t he condi t i ons of hi s pr e- t r i al r el eas e, i n par tbyi nvol vi ng hi m s el f i n fur thercr i m es b yb eing arrested in the co m p an yo f h is fo rm er g an g m em b ers. T h e d istri ct co u rt expl ai ned thatbas ed on thi s conducti thad “l es s s ym pathy ” fora depa r tur e bas ed o n h is te rm in a l illn e s s . A fter d iscu ssing M r. T ruji ll o ’s co n d u ct du ri n g h is r elea se, th e d istri ct co u rt a c k n o w led g e d M r. T rujil lo ’s s u b sta n tial a ss ista n c e to th e g o v e rn m e n t, ag re e in g it w a rr a n te d a re d u c tio n in h is s e n te n c e to n in e ty-o n e to n in e ty-fiv e m o n th s . T u r n i n g t o M r . T ruj i l l o ’ s r e q u e s tfo ra d o wn wa r d d e p a r tu r e u n d e rU. S . S . G. § 5 H 1 .4 , it fo u n d h e s u ffe re d f ro m H e p a titis C a n d a te rm in a l liv e r d is e a s e . R ecogni zi ng t he extr aor di naryci r cumst ance of M r . T ruj i l l o’ s t erm i nal i l l nes s and not i ng t he governm entdi d notoppos e s om e degr ee of addi t i onal departur e, the di s t r i ctcourtfound s uch an i l l nes s w arr ant ed a de partur e as an i m pai r m entunder U . S. S. G . § 5H 1. 4, butexpl ai ned i tdi d notj us t i fya s ent ence of pr obat i on or“a s ent ence ot hert han a s ent ence of i ncar cer at i on, w hen al l of the s t atut or ypurpos es-8-

o f se n ten c in g a re c o n sid e re d .” R ., V o l. 2 a t 3 2 . A f ter b a lan c in g a ll th e c riter ia di s cus s ed, t he di s t r i ctcour ti m pos ed a s ent ence of s i xtym onths i m pr i s onm entand not ed i t s “i nt ent i on” forM r . T ruj i l l o t o “s pend the r es tof hi s l i fe i n pr i s on fort he pr ot ect i on of s oci ety . ” Id.

I I I . D i s cus s i on O n a p p e a l, M r. T rujil lo a ss e rts th e d istric t co u rt “ im p o se d a n u n re a so n a b le se n ten c e b yse n ten c in g [ h im ] to six tym o n th s o f in c a rc e ra tio n a n d d e n y in g h is r eques tfora home det ent i on bas ed on hi s t erm i nal i l l nes s thatcons t i tut ed an e x tr a o rd in a ry p h y s ic a l im p a ir m e n t p u rs u a n t to [ U .S .S .G .] § 5 H 1 .4 .” A p t. B r. a t 1 . I n s uppor t , he poi nt s t o t he di s t r i ctcourt ’ s i nt ent i on forM r . T ruj i l l o t o s pend the rest of h is l ife in p ri so n ev en tho u g h itfo u n d h e q u ali fied fo r a d o w n w ard departur e under§ 5H 1. 4. Poi nt i ng outhe r ece i ved a f i ve- y ears ent ence even t hough hi s l i fe e xpect ancyi s underfi ve y ear s , M r . T ruj i l l o ar gues , “[t ] he U ni t ed S tate s C o d e d o e s n o t au th o riz e a life se n ten c e fo r th e c rim e [ h e ] p lea d g u iltyto and ther efor e the i nt ent i on of the courti n i m pos i ng w hatamount s t o and w as i nt ended t o be a l i fe s ent ence i s unr eas onabl e. ” Id . at11. W i thoutfur ther di s cus s i on he al s o s um m ar i l ycont ends , “[t ] he s ent ence w as al s o unr eas onabl e as i twa s g r e a t e rt h a n n e c e s s a r yt o c o mp l ywi th th e fa c t o r s s e tfo r th i n 1 8 U. S . C. § 3553( a) . ” Id.1 8 U . S . C . § 3 5 5 3 (a) p rov ides , in p art, the c o u rtsh all co n side r: 5 ( 1) t he natur e and c i r cumst ance s of the offens e and the hi s t or yand c h a ra c ter istics o f

th e d e fe n d a n t; (2) the n ee d fo r th e se n tenc e im p o sed -- ( A ) t o r efl ectt he s er i ous nes s of the offens e, t o pr om ot e r es pect fort he l aw , and t o pr ovi de j us tpuni s hm entfort he offens e; (B ) to a ffo rd a d e q u a te d e ter re n c e to c rim in a l co n d u c t; (C ) to p ro tec t th e p u b lic f ro m f u rth e r c rim e s o f

th e d e fe n d a n t; and ( D ) t o pr ovi de the defendantw i th neede d educa t i onal or vocat i onal tr ai ni ng, m edi cal car e, orothercorr ect i onal tr ea tm en t i n the m o st effec ti v e m an n er; (3 ) t h e k in d s o f

s e n te n c e s a v a ila b le ; ... ( 6) t he nee d t o avoi d unw arr ant ed s ent ence di s par i t i es among defe ndant s w i t h s i m i l arr ecor ds w ho have be en found gui l tyof s i m i l arconduct ; and (7 ) t h e n e e d to p ro v id e re s titu tio n to a n yv ic tim s o f th e o ffe n s e . -9- W e begi n ourdi s cus s i on bycl ar i fy i ng thata s ent ence above orbel ow the r ecomm ended G ui del i nes r ange ba s ed on an a ppl i cat i on of C hapt er s FourorFi ve of the G ui del i nes i s r efe r r ed t o as a “de partur e, ” w hi l e a s ent ence above orbel ow the re co m m en d ed G u idelines ran g e thro u g h ap p li ca ti o n o f th e se n tenc ing fa ctors i n 18 U . S. C . § 3553( a) i s cal l ed a “ var i ance . ” Un itedS ta tes v . A ten c io , 476 F. 3d 5 1099, 1101 n. 1 ( 10t h C i r . 2007) . I ti s evi dentM r . T ruj i l l o i s now al s o cl ai m i ng his sent ence is un reas on able und er the § 35 53 (a) fact ors based on t he sam e i l l ness h e p r e v i o u s l yr a i s e d t o s u p p o r th i s d o wn wa r d d e p a r tu r e r e q u e s tu n d e rU. S . S . G. § 5H 1. 4. W hi l e M r . T ruj i l l o m aynothave pr evi ous l yfr amed hi s obj ect i ons expr es s l yi n t he cont extof a va r i ance under§ 3553( a) , w e do notr equi r e a d e fe n d a n t to m a k e su c h a n o bjec tio n in o rd e r to p re se rv e a c laim h is s e n ten c e is-10-

u n re a s o n a b ly lo n g u n d e r t h o s e fa c to rs . See Uni t ed Stat es v. Torr es - D uenas , 461 F .3 d 1 1 7 8 , 1 1 8 3 (1 0 th C ir . 2 0 0 6 ), cer t . deni ed, ___ S. C t . ___, 2007 W L 1854536 ( U . S. J un. 29, 2007) ( N o. 06- 7990) . I ns t ead, w e r evi ew forr eas onabl enes s the s e n te n c e ’s le n g th , a s g u id e d b yth e fa c to rs in 1 8 U .S .C . § 3 5 5 3 (a ). See i d. T hese fac t or s “i ncl ude the natur e of the offens e and c har act er i s t i cs of the defendant , as w el l as t he nee d fort he s ent ence t o r efl ectthe s er i ous nes s of the cr i m e, t o pr ovi de a d e q u a te d e ter re n c e , to p ro tec t th e p u b lic, a n d to p ro v id e th e d e fe n d a n t w ith neede d t r ai ni ng ort r eatm ent. . . . ” Un itedS ta tes v . Kris tl , 437 F. 3d 1050, 1053 (1 0 th C ir . 2 0 0 6 ).

W e r equi r e r eas onabl enes s i n tw o r es pect s : “the l ength of the s ent ence , as w el l as t he met hod byw hi ch the s ent ence w as cal cul at ed. ” Id. a t 1 0 5 5 (e m p h a sis om i t t ed) . I n det erm i ni ng w hetherthe di s tr i ctcour tpr oper l yappl i ed the G ui del i nes , w e r evi ew i t s l egal concl us i ons de novo and i t s fac tual fi ndi ngs for c le a r e rr o r. Id. at1054. W e have al s o hel d “the s ent enci ng fac t or s s etfor th i n 18 U . S. C . § 3553( a) m us tbe cons i der ed bythe di s tr i ctcour ti t s el f w hen i m pos i ng a s ent ence . ” Uni t ed Stat es v. Sanchez - Juar ez , 4 4 6 F . 3 d 1 1 0 9 , 1 1 1 5 (10 th C ir . 2 0 0 6 ).[W ] her e a de fenda nthas r ai s ed a nonf r i vol ous ar gum entthatthe § 3553( a) fac t or s w arr anta bel ow - G ui del i nes s ent ence and has expr es s l yr eques t ed s uch a s ent ence , w e mustbe abl e t o di s cern fr om t he r ecor d t hatt he s ent enci ng j udge di d notr es ton the gui del i nes a lo n e , b u t co n sid e re d w h e th e r th e g u id e lin e s s e n ten c e a c tu a lly-11-

con form s, i n the ci rcum st ances, t o the st atutoryfact ors. Id. a t 1 1 1 7 (q u o ta tio n m a rk s , a lte ra tio n s a n d c ita tio n o m itte d ).

W i t h t hes e pr i nci pl es i n m i nd, w e tur n t o M r . T ruj i l l o’ s heal th, w hi ch i s but one of the fa ct or s t he di s t r i ctcourtw as r equi r ed t o cons i dert ogetherw i th the o ther § 3 5 5 3 (a) fa ctors. In this ca se, i t i s clea r th e d istri ct co u rtw eigh ed M r. T ruj i l l o’ s t erm i nal i l l nes s w i t h t he other§ 3553( a) fac t or s , s uch as the s er i ous n a tu re o f

h is o ffe n se a n d h is o th e r c h a ra c ter istics a n d h isto ry , inc lu d in g h is e x te n s iv e c ri m in a l h is to ry, p la c in g h im in th e h ig h e s t c ri m in a l h is to ry c a te g o ry. T h e d istric t co u rt a lso w e ig h e d M r. T rujil lo ’s h e a lth a g a in st th e n e e d fo r h is se n ten c e to p ro v id e a d e q u a te d e ter re n c e , to p ro tec t th e p u b lic, a n d to p ro v id e h im w i t h neede d t r eatm ent . I n t hatr egar d, the di s tr i ctcour tpart i ci pat ed i n a d isc u ss io n a b o u t M r. T rujil lo re c e iv in g m e d ica l an d h o sp ice c a re d u rin g h is in c a rc e ra tio n , rep e a ted lyh ig h lig h ted M r. T rujil lo ’s c o n tin u e d c rim in a l ac tiv ity aft erhi s r el eas e fort he purpos e of r ece i vi ng m edi cal car e, and i ndi cat ed the nee d t o pl ace M r . T ruj i l l o i n pr i s on for“the r es tof hi s l i fe” for“the pr ot ect i on of so ciety . ” T h u s, itis cl ea r th e d istri ct co u rtrea so n ab lyb eli ev ed M r. T ruji ll o ’s cr i m i nal conductdur i ng hi s r el eas e pendi ng tr i al demonstr at ed: 1) hi s s tr ong pr opens i t yt o cont i nue hi s cr i m i nal act i vi tydes pi t e hi s t erm i nal condi t i on and m edi cal car e nee ds ; and 2) t he nee d t o pr ot ectthe publ i c fr om hi s ongoi ng crim inal ac ti v ity . B ase d o n thes e fac tors, tog ethe r w ith the o ther fac tors-12-

cons i der ed, i ncl udi ng t he as s ur ance of m edi cal car e w hi l e i ncar cer at ed, w e ca nnot s ayt he di s t r i ctcour t ’ s r ej ect i on of M r . T ruj i l l o’ s r eques tfors upervi s ed r el eas e, p resu m ab lyu n d er the ca re o f h is m o ther-in-law , w as u n rea so n ab le. W h il e M r. T rujil lo su g g e sts h e e ss e n tiallyre c e iv e d a “ life se n ten c e ” fo r h is d ru g c rim e , h e in fa c t re c e iv e d a d o w n w a rd d e p a rtu re re late d to h is h e a lth w h ich re su lted in h is r e c e i v i n g a s e n t e n c e s i g n i fi c a n t l yl e s s th a n wh a th i s c o n d u c ti n th e i n s t a n tc r i me w a rra n ted w ith o u t su c h a d e p a rtu re . T h u s, M r. T rujil lo h a s n o t d e m o n stra ted h is ill n e ss , w h e n v iew e d in lig h t o f th e o th e r § 3 5 5 3 (a ) fa c to rs, is s u fficie n tly compel l i ng fort he purpos e of de t erm i ni ng thata s ent ence of s i xtym onths i m pr i s onm enti s unr eas onabl e underthe ci r cumst ance s pr es ent ed.

I V . C oncl us i on Fort he for egoi ng r eas ons , w e AF F I RM M r . T ruj i l l o’ s s ent ence . E n ter ed b y th e C o u rt: W ADE BRO RBY U ni t ed St at es C i r cui tJ udge