FILED U.S. COURT OF AP P EALS E LEVEN T HC IRC UIT JULY 8, 2008 THOMAS K. KAH

N CLERK [ DO NO T P UB L I S H]

I N THE UN I TE D STATE S C OU RT OF APPE ALS F O R T H E E L E V E N T H C IR C U IT

________________________ N o. 08- 10406 N on -A rgum entC al endar

________________________ D . C . D o ck etN o . 0 7 -6 0 2 4 5 -C R -W JZ U N I T E D S T A T E S O F A M E R I C A , P la in tif f - A p p e lle e , v ersu s D A V I D M . B A R O N , D e f e n d a n t- A p p e lla n t.

________________________ N o. 08- 10460 N on -A rgum entC al endar

________________________ D . C . D o ck etN o . 0 7 -6 0 0 2 7 -C R -W JZ U N I T E D S T A T E S O F A M E R I C A , P la in tif f - A p p e lle e , v ersu s M .D . D A V I D B A R O N , D e f e n d a n t- A p p e lla n t.2 _______________________ A pp ea l s f

rom the U ni t ed S t at es D i stri ctC ou rt f orthe S outhe rn D i s tr i c tof F l or i da

_________________________ ( Ju l y 8, 2008) B efo re A N D E R S O N , B IR C H an d H U L L , C i rcu i tJu d g es. P E R C U R I A M: I n th is c o n s o lid a te d ap p e a l, D a v id B a r o n , M .D ., ap p e a ls h is 2 5 - m o n th s e n te n c e f

o rc o n s p ir a c y to d is tr ib u te p h a rm a c e u tic a l c o n tr o lle d s u b s ta n c e s , in v io la tio n o f

2 1 U .S .C . § 8 4 6 . B a r o n a r g u e s th a t: ( 1 ) th e d is tr ic t c o u rt e rr e d in d e n y in g h is r e q u e s t f

o ram in o r - r o le r e d u c tio n b e c au s e it f a ile dto c o m p a r e h is cond uctw i th thatof hi s m ore c ul pabl e c od ef endant s; and (2) hi s w i thi n-G ui del i nes s e nt e nc e w a s unr e a s onabl e . W e f i nd tha tB a r on pl a y e d as i gni f i c a ntr ol e i n the c o n s p ir a c y a s ap h y s ic ia n ille g a llyap p r o v in g o n lin e p h a rm a c e u tic a l r e q u e s ts . Mo r e o v e r , h i s wi th i n - Gu i d e l i n e s s e n t e n c e wa s r e a s o n ab l e . Ac c o r d i n g l y , we A F F I R M. I . B AC KG RO UN D A c c o r d in g to th e p r e s e n te n c e in v e s tig a tio n r e p o rt ( “P S I ” ) , B a r o n p le d g u ilty t o C ountO ne of

a12- c ounti ndi c tm e nt , a nd as i ngl e - c ounti nf orm a t i on or i gi na t i ngThe c ase w as transf erred to the Southern District of F lorida. R1-1. 1 3 in th e U .S . D is tr ic t C o u rt f o rth e E a s te rn D is tr ic t o f P e n n s y lv a n ia , b o th c o u n ts 1 al l egi ng conspi ra cyt o d i stri bu t e S chedul e I II and IV ph arm ac eut i ca l control l ed s ubs t a nc e s , i n vi ol a t i on of 21 U . S . C . § 846. P S I ¶¶ 1-2. B oth c ount s a r os e outof an on -l i ne sc hem e i nv ol vi ng the i l l egal di stri bu t i on of S chedul e I II and IV ph arm ac eut i ca l subst ance s, i n w hi ch B ar on and tw o o ther physi ci ans r evi ew ed c us t om e rque s t i onna i r e s a nd appr ove d orde ni e d the i ron- l i ne or de r s f or p r e s c r ip tio n d ie t a n d s le e p in g p ills . I d . ¶¶ 9 - 1 3 . B a r o n au th o r iz e d ap p r o x im a te ly 300 S c he dul e I I I pr e s c r i pt i ons a nd 33, 990 S c he dul e I V pr e s c r i pt i ons , f orw hi c h he re ce i ved $ 31 4, 01 5. Id. ¶¶ 31 -32. T he P S I not ed thatB ar on had accrued

“ si gn i fi cantchi l d sup po rtarre ar ages , ” i ncl ud i ng a bal ance of $2 97 , 40 2. 28 , and w as r e l i a nton hi s 82- y e a r - ol d m othe rf orf ul l f i na nc i a l s upport . I d. ¶¶ 100, 104. T he P S I a s s i gne d aba s e of f e ns e l e ve l of

20, w hi c h i tr e duc e d by2 l e ve l s , f or m ee t i ng the “ sa fe ty val ve” r equi re m ent s. Id. ¶¶ 54 -55. Itthen app l i ed a tw o-l evel i ncre as e f

or B ar on ’ s use of a s peci al ski l l i n a m anner thatsi gn i fi cant l y f ac i l i t at ed the c om m i s s i on of

the of f e ns e , a nd athr e e - l e ve l r e duc t i on f ora c c e pt a nc e of resp o n si b i l i ty. Id . ¶¶ 5 7 , 6 1 -6 2 . A cco rd i n g l y, th e P S I assi g n ed a t o t al o ffen se l e ve l of 17 a nd ac r i m i na l hi s t ory c a t e goryof I , y i e l di ng agui de l i ne r a nge of 24- 30 m onths ’ i m pr i s onm e nt . I d. ¶¶ 63, 66, 106. B a r on obj e c t e d t o, i nt e ra l i a , the l a c k of4

a m i no r- rol e r educt i on and request ed a dow nw ar d v ar i ance , yi el di ng a probat i on ary se nt ence , base d o n con si dera t i on of the nature of the offens es , hi s per sonal c ha r a c t e r i s t i c s , a nd the ne e d f orthe s e nt e nc e i m pos e d t o r e f l e c tthe s e r i ous ne s s of the offens es , prom ot e r es pectfor the l aw , af ford adequat e det erre nce, and p rot ec t the publ i c . P S I A dde ndum ; R 1- 9 a t1- 8. B a r on s ubm i tt e d va r i ous l e tt e r s f r om fam i l y m em b ers an d a co w o rk er, att est i n g t o h i s g o o d ch aract er an d w o rkas a ne ur os ur ge on, a nd ane w s pape ra rt i c l e f e a tur i ng hi s w ork a s as ur ge on. S e e R 1- 9, E x h s . A - F . A t s e n te n c in g , B a r o n r e n e w e d h is o b je c tio n to th e la c ko f

am in o r - r o le r e duc t i on, a r gui ng tha thi s r ol e — r e vi e w e rof onl i ne r e que s t s f

orpr e s c r i pt i on d ru g s— w as l ess th an th e ro l es p l ayed b y th e sch em e’ s o w n ers an d o p erat o rs, p h a rm a c ie s , a n d p h a rm a c y m a n a g e r s b e c au s e h e d id n o t p a rtic ip a te in th e o v e r a ll pl a nni ng, de c i s i on- m a ki ng, s upe rvi s i on, orr e c rui t i ng, a nd he di d nots uppl yor d is tr ib u te a n y d ru g s . R 3 a t 4 - 6 . T h e g o v e rn m e n t a r g u e d th a t th e o f f e n s e s c o u ld notha ve oc c urr e d butf

orhi s s t a tus a s al i c e ns e d phy s i c i a n w i th aD rug E nf or c e m e ntA dm i ni s tr a t i on ( “ D E A ” ) r e gi s tr a t i on, a nd am i nor - r ol e r e duc t i on w o u ld ig n o r e th e f

a c a d e o f le g itim a c yth a t h e g a v e th e ille g a l s c h e m e . I d . a t 6 - 7 . B a r on a s s e rt e d tha tthe gove rnm e nt ’ s “ butf or ” a na l y s i s ha d be e n r e j e c t e d bythe court s. Id. at8-9. T he di stri ctcourtov errul ed B ar on ’ s obj ec t i on , fi nd i ng that5

B aro n o ccu p i ed m o re th an a m i n o r ro l e i n th e o v eral l sch em e. Id . at9 -1 0 . In so do i ng , the courtst at ed thati tw as adop t i ng the st at em ent s of the prosecut or. Id. at 10. B a r o n n e x t a r g u e d th a t h e tru th f u llya d m itte d h is c o n d u c t to D E A a g e n ts in 2 0 0 4 a n d p r o v id e d s p e c if ic in f o rm a tio n ab o u t th e s c h e m e , w h ic h d e m o n s tr a te d h is d esi re “ t o m ak e am en d s. ” Id . at1 2 . R eg ard i n g h i s h i st o ry an d ch aract eri st i cs, B ar on st at ed thathe w as 61 ye ar s ol d, had n everbeen conv i ct ed of a cr i m e, w as di vor c e d w i th 3 l i vi ng c hi l dr e n a nd 1 de c e a s e d c hi l d, a nd w a s c a r i ng, de di c a t e d, h a r d w o rk in g , a n d tru s tw o rth y , a s d e m o n s tr a te d b yth e le tte r s th a t h e s u b m itte d . Id. at13 . H e s t at ed thathe w as l i vi ng w i th h i s 82-ye ar -ol d m other, w ho depend ed up on hi m on a dai l y bas i s. Id. at13 -14. B ar on st at ed thathe foun d h i m se l f bef ore th e c o u rt b e c au s e h e w a s “f in a n c ia llyd e s p e r a te ” a f te rlo s in g h is m e d ic a l lic e n s e in F l or i daa nd c l os i ng hi s pr a c t i c e . I d. a t15- 16. H e s t a t e d tha the w a s de pr e s s e d, unabl e t o s e c ur e f

ul l - t i m e e m pl oy m e nt , a nd de pe nde ntupon hi s e l de r l ym othe r . I d. a t 1 6 . B a r o n r e q u e s te d as e n te n c e o f p r o b a tio n . I d . a t 1 7 . T he di stri ctcourtst at ed thati thad con si dere d the part i es ’ st at em ent s, the P S I, the a dvi s ory gui de l i ne c om put a t i on a nd r a nge , a nd “ a l l of the s t a tut oryf

a c t or s . ” I d. a t23. I tf

ound tha tB a r on m e tthe s a f e ty - va l ve c r i t e r i a , a nd, thus , i m pos e d a s e nt e nc e “ i n a c c or da nc e w i th the a dvi s orygui de l i ne r a nge w i thoutr e ga r d t o a ny6

s t a tut ory m i ni m um s e nt e nc e . ” I d. a t24. T he c ourtthe n s e nt e nc e d B a r on t o 25 m onths ’ i m pr i s onm e nta nd 3 y e a r s ’ s upe rvi s e d r e l e a s e a s t o e a c h c ount , t o be se rved concurrent l y. Id. Itst at ed thatB ar on ’ s obj ec t i on t o the m i no r- rol e i ss ue w as re new ed and i t s pre vi ou s rul i ng re m ai ned the sam e. Id. at26 . W hen asked w hether he ha d a ny obj e c t i ons t o the c ourt ’ s f i ndi ngs of

f a c t s orc onc l us i ons of

l a w , B a r on re pl i ed thathe di d n ot , other than the re new ed m i no r- rol e i ss ue. Id. W hen asked w hether he had any obje ct i on t o the m anner or procedure i n w hi ch the se nt ence w as i m pos e d, he s t a t e d tha the di d not . I d. a t27. I I . DI S CUS S I ON O n appe a l , B a r on a r gue s tha tthe di s tr i c tc ourt ’ s c ur s orya dopt i on of the g o v e rn m e n t’s a r g u m e n ts r e g a r d in g th e m in o r - r o le is s u e w a s in s u f f ic ie n t b e c au s e it f a i l e d t o c o m p a r e h i s c o n d u c twi th th a to f h i s m o r e c u l p ab l e c o d e f e n d a n t s . He a s s e rt s tha the : ( 1) ha d no e qui ty i nt e r e s ti n the ove r a l l s c he m e ; ( 2) ha d no de c i s i onm a k in g au th o r ity ; ( 3 ) d id n o t p u r c h a s e a n d m a il th e d ru g s ; a n d ( 3 ) d id n o t r e c ru it a n y p a rtic ip a n ts . A c ourt ’ s f

i ndi ng r e ga r di ng ade f

e nda nt ’ s r ol e i n the of

f e ns e i s r e vi e w e d f

or cl ear e rr or. U ni t ed S t at es v. D e V ar on , 17 5 F . 3d 93 0, 93 7 (11 th C i r. 19 99 ) ( en ba nc ) . T he pr opone ntof the r e duc t i on a l w a y s be a r s the bur de n of pr ovi ng a m itig a tin g r o le in th e o f f e n s e b y ap r e p o n d e r a n c e o f th e e v id e n c e . I d . a t 9 3 9 .7

P u r s u a n t to U .S .S .G . § 3 B 1 .2 ( b ) , ad e f e n d a n t m a yr e c e iv e atw o - le v e l r e d u c tio n in h i s b a s e o f

f e n s e l e v e l wh e r e h i s r o l e i n th e o f f e n s e wa s m i n o r . S e e U. S . S . G. § 3 B 1 .2 ( b ) . T h e d is tr ic t c o u rt’s u ltim a te d e te rm in a tio n o f th e d e f e n d a n t’s r o le in the offens e s ho ul d b e i nform ed by: (1) the defendant ’ s r ol e i n the re l evantcond uct for w hi ch he has been hel d acc ou nt abl e a tse nt enci ng ; and (2) hi s r ol e a s c om pare d to th a t o f o th e rp a rtic ip a n ts in h is r e le v a n t c o n d u c t. D e V a r o n , 1 7 5 F .3 d a t 9 4 0 .

“ [W ] here the re l evantcond uctattri bu t ed t o a defendanti s i dent i ca l t o h erac tual c onduc t , s he c a nnotpr ove tha ts he i s e nt i t l e d t o am i norr ol e a dj us tm e nts i m pl yby poi nt i ng t o s om e br oa de rc r i m i na l s c he m e i n w hi c h s he w a s am i norpa rt i c i pa ntbut f o rw h ic h s h e w a s n o t h e ld a c c o u n tab le .” I d . a t 9 4 1 . “I n m a k in g th e u ltim a te de t e rm i na t i on of

the de f e ndant ' s r ol e i n the of

f e ns e , the s e nt e nc i ng j udge ha s no du ty t o m ake any spec i fi c s ub si di ary f ac tual fi nd i ng s. . . [and , s] o l on g as the di stri ct c ourt ' s de c i s i on i s s upport e d by the r e c or d a nd the c ourtc l e a r l yr e s ol ve s a ny d is p u te d f

a c tu a l is s u e s , as im p le s ta te m e n t o f th e d is tr ic t c o u rt's c o n c lu s io n is s uf f i c i e nt . ” I d. a t939. T h e d is tr ic t c o u rt w a s n o t r e q u ir e d to a rtic u la te s p e c if ic f a c tu a l f in d in g s ; its s im p le s ta te m e n t o f

its c o n c lu s io n th a t B a r o n w a s n o t e lig ib le f o ram in o r - r o le r e duc t i on w a s s uf

f i c i e nt . S e e D e V a r on, 175 F . 3d a t939. T he r e c or d s upport s the d is tr ic t c o u rt’s c o n c lu s io n , a s th e r e le v a n t c o n d u c t f o rw h ic h h e w a s h e ld8

ac coun t abl e w as on l y the drug s thathe i l l egal l y pre sc ri bed— no tthe broader c r i m i na l s c he m e , a nd he a nd the othe rphy s i c i a ns pl a y e d ai ndi s pe ns abl e a nd s i gni f i c a ntr ol e i n the c ons pi r a c y by pr ovi di ng the i l l e ga l s c he m e w i th af a c a de of le g itim a c y th a t an o n - d o c to rc o u ld n o t p r o v id e . S e e id . a t 9 4 0 - 4 1 ; P S I ¶¶ 2 8 - 3 1 , 4 5 . T hus , w e f

i nd no e rr ori n the di s tr i c tc ourt ’ s de t e rm i na t i on. W hi l e c onc e di ng tha tthe di s tr i c tc ourtne e d note xpl i c i t l ydi s c us s e a c h of the § 3553( a ) f

a c t or s , B a r on a s s e rt s tha tthe di s tr i c tc ourtga ve no s pe c i f i c r e a s ons f

or i m pos i ng aw i thi n- G ui de l i ne s s e nt e nc e a nd f a i l e d t o a ddr e s s a nyof

the “ uni que fa ct s” of hi s c as e, despi t e hi s argum entthatthe gu i del i ne se nt ence w as grea t erthan ne c e s s a ry t o a c hi e ve the purpos e s of s e nt e nc i ng a nd hi s di s c us s i on of the f a c t s of hi s c as e. B ar on ar gu es thata s ent ence w i thi n the gu i del i ne rang e w as un re as on abl e, c ons i de r i ng hi s pe r s ona l c ha r a c t e r i s t i c s a nd the na tur e of hi s c r i m e . S pe c i f

i c a l l y , he s t a t e s tha the : ( 1) ha d no c r i m i na l hi s t ory ; ( 2) w a s ar e s pe c t e d ne ur os ur ge on f or m a ny y e a r s w ho tr e a t e d pa t i e nt s w i thoutr e ga r d f orthe i rabi l i tyt o pa y ; ( 3) c a r e s f or hi s e l de r l y m othe r ; a nd ( 4) s uf f e r s f r om s e ve r a l m e di c a l c ondi t i ons . R e ga r di ng the nature of the offens e, he st at es that“ he w as no tpedd l i ng m ore s er i ou s drugs, ” s uch as coca i ne or heroi n. A pp el l ant ’ s B ri ef at16 . B ar on cont ends thathe show ed re m orse , i s unl i kel y t o com m i tfurther c ri m es , and coo pera t ed ful l y w i th l aw e n f o r c e m e n t.9

A s an i ni t i al m att er , w e nee d n otre sol ve w hether B ar on ’ s f ai l ure t o rai se a r e a s onabl e ne s s obj e c t i on a f t e rhi s s e nt e nc e w a s i m pos e d m a nda t e s pl a i n e rr or r e vi e w be c aus e , a s di s c us s e d be l ow , B a r on c a nnotde m ons tr a t e a nye rr orbythe di stri ctcourt , or thathi s s ent ence w as un re as on abl e. A ft erU ni t ed S t at es v. B oo ker, 5 4 3 U .S . 2 2 0 , 1 2 5 S .C t. 7 3 8 , 1 6 0 L .E d .2 d 6 2 1 ( 2 0 0 5 ) , ad is tr ic t c o u rt, in de t e rm i ni ng ar e a s onabl e s e nt e nc e , m us tc orr e c t l yc a l c ul a t e the s e nt e nc i ng r a nge un der the G ui del i nes and then con si der the fa ct ors s etforth i n § 35 53 (a ). S ee U n ite d S ta te s v . T a lle y , 4 3 1 F .3 d 7 8 4 , 7 8 6 ( 1 1 th C ir . 2 0 0 5 ) . T h e C o u rt h a s h e ld thatappel l at e c ou rt s m ustre vi ew al l se nt ence s und era def er ent i al abuse- ofd i s c r e t i o n s t a n d a r d . Ga l l v . Un i t e d St a t e s , __U. S. __ , 1 2 8 S. Ct . 5 8 6 , 5 9 1 , 1 6 9 L. E d. 2d 44 5 (20 07 ). A l tho ug h the di stri ctcourtm ustbe gu i ded b y the § 3 55 3(a) fa ct ors, w e have hel d that“ no thi ng i n B oo ker or e l se w here re qu i re s the di stri ct courtt o st at e on the re cord thati thas e xp l i ci t l y c on si dere d eac h o f the § 3 55 3(a) f a c t or s ort o di s c us s e a c h of the § 3553( a ) f

a c t or s . ” U ni t e d S t a t e s v. S c ott , 426 F . 3d 13 24 , 13 29 (11th C i r. 20 05 ). “ [A ] n ackno w l edgm entby the di stri ctcourtthat it h a s c o n s id e r e d th e d e f e n d a n t’s a r g u m e n ts a n d th e f a c to r s in s e c tio n 3 5 5 3 ( a ) is s u f f ic ie n t u n d e rB o o k e r .” T a lle y , 4 3 1 F .3 d a t 7 8 6 . T he di s tr i c tc ourt , i n s e nt e nc i ng B a r on, s t a t e d tha ti tha d c ons i de r e d the p a rtie s ’ s ta te m e n ts , th e P S I , th e a d v is o ryg u id e lin e c o m p u ta tio n a n d r a n g e , a n d “a ll10

of the s t a tut ory f

a c t or s . ” S e e R 3 a t23. T he s e a c know l e dgm e nt s w e r e s uf f i c i e nt unde rB ooke r . S e e T a l l e y , 431 F . 3d a t786. R e ga r di ng B a r on’ s di s c us s i on of spec i fi c f ac t ors, the gu i del i ne rang e t oo k i nt o acc ou ntthathe had n o cri m i nal hi s t ory a nd tha thi s of

f e ns e i nvol ve d “ l e s s e r ” drugs , a s the r a nge w a s c om put e d by a s s i gni ng ac r i m i na l hi s t ory c a t e goryof I a nd ba s i ng the of

f e ns e l e ve l on the type a n d a m o u n t o f

d ru g s in v o lv e d . S e e U .S .S .G . § 2 D 1 .1 ( a ) ( 3 ) , ( c ) ; P S I ¶¶ 5 4 , 6 6 . M o r e o v e r , h is p e r s o n a l c h a r a c te r is tic s , c o n s is tin g o f h is s ta tu s a s af

o rm e r ly r e s p e c te d n e u r o s u r g e o n w h o c u rr e n tlys u f f e r s m e d ic a l c o n d itio n s a n d c a r e s f o rh is e l de r l y m othe r , a r e nots o w e i ghty orof ac ha r a c t e rtha tthe di s tr i c tc ourt ’ s de c i s i on nott o va ry be l ow the G ui de l i ne r a nge a f t e rc ons i de r i ng the m c oul d c ons t i tut e e rr or or abuse of di sc re t i on . A cc ordi ng l y, B ar on ’ s s ent ence w as re as on abl e. I I I . CONCL US I ON T he di s tr i c tc ourt ’ s s e nt e nc e i n thi s c a s e i s due t o be a f f i rm e d ba s e d upon a th o r o u g h r e v i e w o f

th e r e c o r d . Bar o n , al i c e n s e d p h y s i c i a n h o l d i n g aDEA r e gi s tr a t i on, pl a y e d as i gni f i c a ntr ol e i n the c ons pi r a c yt o di s tr i but e onl i ne p h a rm a c e u tic a l r e q u e s ts ille g a lly . A ls o , h is s e n te n c e w a s w ith in th e ap p lic ab le G ui del i nes r ange. A cc ordi ng l y, w e A F F I R M.