Title: Michigan v. Hartwick (Opinion - Leave Granted)
Citation: N/A
Docket Number: 148444, 148971
State: Michigan
Issuer: Michigan Supreme Court
Date: July 27, 2015

PEOPLE v HARTWICK 
PEOPLE v TUTTLE 
 
Docket Nos. 148444 and 148971.  Argued January 15, 2015 (Calendar Nos. 5 and 6).  Decided 
July 27, 2015. 
 
 
Richard Lee Hartwick was charged in the Oakland Circuit Court with manufacturing 
marijuana and possessing it with the intent to deliver it.  Hartwick was a registered qualifying 
patient under the Michigan Medical Marihuana Act (MMMA).  He served as his own primary 
caregiver and the primary caregiver for five other registered qualifying patients to whom he was 
properly connected under the MMMA.  The police, acting on a tip, confronted Hartwick and 
later conducted a consent search of his home where the police discovered a disputed number of 
marijuana plants and approximately 3.69 ounces of marijuana.  Hartwick moved to dismiss the 
charges, claiming immunity under § 4 of the MMMA, MCL 333.26424, and the affirmative 
defense under § 8 of the MMMA, MCL 333.26428.  In the alternative, Hartwick sought 
permission to present a § 8 defense at trial.  The trial court, Colleen A. O’Brien, J., denied the 
motions.  The Court of Appeals denied Hartwick’s delayed application for leave to appeal.  The 
Supreme Court, in lieu of granting leave to appeal, remanded the case to the Court of Appeals for 
consideration as on leave granted.  493 Mich 950 (2013).  The Court of Appeals, SAAD, P.J., and 
SAWYER, J. (JANSEN, J., concurring), affirmed the trial court.  303 Mich App 247 (2013).  The 
Supreme Court granted leave to appeal in Docket No. 148444.  496 Mich 851 (2014).   
 
 
Robert Tuttle was charged in the Oakland Circuit Court with three counts of delivering 
marijuana, one count of manufacturing marijuana, one count of possessing marijuana with the 
intent to deliver it, and two counts of possession of a firearm during the commission of a felony.  
Tuttle was a registered qualifying patient under the MMMA who served as his own primary 
caregiver.  It was unclear whether he was properly connected as the primary caregiver to one or 
two other registered qualifying patients.  Tuttle was arrested for selling marijuana on three 
occasions to an individual with whom Tuttle was not properly connected under the MMMA.  
Tuttle claimed immunity under § 4 and the affirmative defense under § 8 of the MMMA.  The 
trial court, Michael D. Warren, Jr., J., rejected both claims and denied Tuttle’s request to present 
a § 8 defense at trial.  According to the court, immunity was not appropriate because Tuttle’s 
illegal conduct—selling marijuana to an individual outside the protection of the MMMA—
tainted Tuttle’s conduct with regard to the other charges.  The trial court denied Tuttle use of the 
affirmative defense in § 8 because Tuttle failed to present prima facie evidence of each element 
of the defense.  The Court of Appeals denied Tuttle’s application for leave to appeal.  In lieu of 
 
Michigan Supreme Court 
Lansing, Michigan 
Syllabus 
 
Chief Justice: 
Robert P. Young, Jr. 
 
Justices: 
Stephen J. Markman 
Mary Beth Kelly 
Brian K. Zahra 
Bridget M. McCormack 
David F. Viviano 
Richard H. Bernstein 
This syllabus constitutes no part of the opinion of the Court but has been  
prepared by the Reporter of Decisions for the convenience of the reader. 
Reporter of Decisions: 
Corbin R. Davis 
granting Tuttle’s application for leave to appeal, the Supreme Court remanded the case to the 
Court of Appeals for consideration as on leave granted.  493 Mich 950 (2013).  The Court of 
Appeals, SAAD, P.J., and SAWYER, J. (JANSEN, J., concurring), affirmed the trial court.  304 Mich 
App 72 (2014).  The Supreme Court granted leave to appeal in Docket No. 148971.  496 Mich 
851. 
 
 
In a unanimous opinion by Justice ZAHRA, the Supreme Court held: 
 
 
The availability of immunity under § 4 of the MMMA is a question of law to be decided 
before trial, and a defendant has the burden of proving by a preponderance of the evidence his or 
her entitlement to immunity.  Immunity must be claimed for each charged offense, and the 
burden of proving immunity is separate and distinct for each offense.  Conduct that is 
noncompliant with the MMMA with respect to one charged offense does not automatically rebut 
the presumption of medical use with respect to conduct relating to any other charged offenses.  
Rather, noncompliant conduct involved in one charged offense can negate otherwise compliant 
conduct involved in a separate charged offense if there is a nexus between the noncompliant and 
the otherwise compliant conduct.  Raising an affirmative defense under § 8 of the MMMA 
requires a caregiver to present prima facie evidence of each element of the defense for him- or 
herself and for each registered qualifying patient to which the caregiver is connected.  Having 
established a prima facie case, the defendant has the burden of proving each element by a 
preponderance of the evidence.  A valid registry identification card does not create any 
presumption for purposes of § 8. 
 
1.  The lower courts erred by denying Hartwick § 4 immunity without properly making 
the factual determinations required by § 4.  The Court of Appeals failed to recognize that the trial 
court did not make proper factual determinations on the elements of § 4, specifically, the number 
of plants Hartwick possessed.  In addition, the trial court and the Court of Appeals erred by 
concluding that Hartwick should have known his registered qualifying patients’ debilitating 
conditions, the amount of marijuana they needed, and the identities of their physicians.  Section 4 
does not require that knowledge.  To establish immunity under § 4 of the MMMA, the defendant 
must prove four elements by a preponderance of the evidence: (1) the defendant possessed a 
valid registry identification card; (2) the defendant complied with the requisite volume 
limitations in § 4(a) and § 4(b); (3) the defendant kept any marijuana plants in an enclosed, 
locked facility; and (4) the defendant was engaged in the medical use of marijuana.  Under the 
MMMA, a defendant is presumed to be engaged in the medical use of marijuana if the defendant 
possesses a valid registry identification card and is not in violation of the volume limitations.  
The presumption is rebuttable by evidence that a defendant’s conduct was not for the purpose of 
alleviating a qualifying patient’s debilitating medical condition or its symptoms.  If a 
presumption of medical use has been rebutted, the defendant may still prove by a preponderance 
of the evidence that the defendant’s conduct was in furtherance of the administration of 
marijuana to treat or alleviate a registered qualifying patient’s debilitating medical condition or 
symptoms associated with the debilitating medical condition under MCL 333.26423(f).  The 
written certification necessary to obtain a registry identification card is not similar to a 
pharmaceutical prescription and satisfies none of the elements of a § 8 defense.  People v 
Hartwick had to be remanded to the trial court for an evidentiary hearing to determine the 
number of plants in Hartwick’s possession and whether Hartwick was entitled to § 4 immunity.  
 
2.  The Court of Appeals properly held that Hartwick was not entitled to raise the 
affirmative defense under § 8 because he failed to present prima facie evidence of each element 
of the defense.  A primary caregiver must provide prima facie evidence of all § 8(a) elements for 
him- or herself and for the registered qualifying patients to which he or she is connected under 
the MMMA.  Specifically, Hartwick failed to provide evidence of a bona fide physician-patient 
relationship for himself, as a patient, and his connected patients, he failed to provide evidence 
that a physician conducted a full assessment of his and his patients’ medical histories and current 
medical conditions, and he failed to show that a physician determined that he and his patients 
had debilitating medical conditions that would likely benefit from the medical use of marijuana.  
Hartwick further failed to present prima facie evidence that the amount of marijuana he 
possessed was not more than was reasonably necessary to ensure its uninterrupted availability for 
the treatment of his and his patients’ debilitating medical conditions.  Finally, Hartwick failed to 
present prima facie evidence that he and his patients were engaged in the use of marijuana for a 
medical purpose. 
 
3.  The Court of Appeals erred by concluding that Tuttle’s unprotected conduct with the 
unconnected individual tainted what might otherwise be protected conduct on which additional 
separate charges were based.  A defendant must raise the claim of § 4 immunity to each charged 
offense, the trial court must decide as a matter of law before trial whether to grant the 
defendant’s motion for immunity, and the defendant must prove immunity by a preponderance of 
the evidence each time immunity is raised.  The defendant’s burden of proving entitlement to 
immunity is separate and distinct for each charged offense.  MMMA-compliant conduct is not 
automatically tainted by the defendant’s improper conduct related to a different charged offense 
unless there is a nexus between the improper conduct and the otherwise proper conduct.  People 
v Tuttle had to be remanded to the trial court for an evidentiary hearing to determine whether 
there was a nexus between the charges based on Tuttle’s improper conduct and the charges based 
on Tuttle’s otherwise proper conduct, in addition to other factual findings. 
 
4.  The Court of Appeals properly held that Tuttle could not claim the affirmative defense 
under § 8 because he failed to establish prima facie evidence of at least one of the elements of 
the defense for each of his possibly connected patients.  Specifically, Tuttle failed to provide 
evidence of the actual amount of marijuana needed to treat his patients; the evidence showed 
only the actual amount of marijuana each patient obtained from Tuttle.  In addition, Tuttle failed 
to show that one patient had undergone a full medical assessment in the course of a bona fide 
physician-patient relationship. 
 
Hartwick affirmed in part, reversed in part, and remanded to the trial court for an 
evidentiary hearing to determine Hartwick’s entitlement to § 4 immunity. 
 
Tuttle affirmed in part, reversed in part, and remanded to the trial court for an evidentiary 
hearing to determine Tuttle’s entitlement to § 4 immunity. 
 
 
©2015 State of Michigan 
 
 
 
 
FILED  July 27, 2015 
 
S T A T E  O F  M I C H I G A N 
 
SUPREME COURT 
 
 
PEOPLE OF THE STATE OF MICHIGAN, 
 
 
Plaintiff-Appellee, 
 
 
v 
No. 148444 
 
RICHARD LEE HARTWICK, 
 
 
 
Defendant-Appellant. 
 
 
 
PEOPLE OF THE STATE OF MICHIGAN, 
 
 
Plaintiff-Appellee, 
 
 
v 
No. 148971 
 
ROBERT TUTTLE, 
 
 
 
Defendant-Appellant. 
 
 
 
BEFORE THE ENTIRE BENCH  
 
 
 
 
 
 
Michigan Supreme Court 
Lansing, Michigan 
OPINION 
 
Chief Justice: 
Robert P. Young, Jr. 
 
 
Justices: 
Stephen J. Markman 
Mary Beth Kelly 
Brian K. Zahra 
Bridget M. McCormack 
David F. Viviano 
Richard H. Bernstein 
 
 
 
 
 
2 
ZAHRA, J.  
In 2008, the voters of Michigan passed into law a ballot initiative1 now codified as 
the Michigan Medical Marihuana2 Act (MMMA), MCL 333.26421 et seq.  Unlike the 
procedures for the editing and drafting of bills proposed through the Legislature, the 
electorate—those who enacted this law at the ballot box—need not review the proposed 
law for content, meaning, readability, or consistency.3  
                                              
1 Under Article 2, § 9 of the 1963 Michigan Constitution, “[t]he people reserve to 
themselves the power to propose laws and to enact and reject laws, called the 
initiative . . . .” A voter initiative may be invoked by a relatively small number of 
registered voters.  “To invoke the initiative . . . , petitions signed by a number of 
registered electors, not less than eight percent . . . of the total vote cast for all candidates 
for governor at the last preceding general election at which a governor was elected shall 
be required.”  Const 1963, art 2, § 9. 
2 The MMMA uses the variant “marihuana.”  Throughout this opinion, we use the 
vernacular “marijuana” unless quoting from the statute.  
3 Members of the Legislature generally request that the Legislative Council, a bipartisan, 
bicameral body of legislators established in Article 4, § 15 of the 1963 Constitution of 
Michigan, see that bills to be proposed in their respective chambers are drafted. See 
Const 1963, art 4, § 15; MCL 4.1103; MCL 4.1105.  The council oversees the Legislative 
Service Bureau.  MCL 4.1105.  The bureau has a director and staff, and maintains a 
legislative reference library containing material which may be of use in connection with 
drafting and editing proposed legislation.  MCL 4.1106; MCL 4.1107.  At the request of 
the members of the Legislature, the bureau drafts “bills and resolutions or amendments 
to, or substitutes for, bills and resolutions; draft[s] conference committee reports; and 
examine[s], check[s], and compare[s] pending bills with other pending bills and existing 
laws to avoid so far as possible contrary or conflicting provisions.”  MCL 4.1108(a).  In 
sum, the Legislature has a staff of experienced attorneys who work with the various 
legislators to develop and revise any manner of laws.  After a bill is drafted and 
supported, the chambers of the Legislature may refer it to conference committees for 
additional review by legislators and the public.  The Governor also has an opportunity to 
review bills before signing them into law.  This extensive drafting process works to 
clarify language, limit confusion and mistakes, and in a general sense, ensure that enacted 
laws have a modicum of readability and consistency. 
 
 
 
3 
This lack of scrutiny in the lawmaking process is significant because initiatives 
such as the MMMA cannot be modified “except by a[nother] vote of the electors” or by a 
three-fourths vote of each chamber of the Legislature.4  This constraint on Legislative 
power suggests that there can be matters of public policy so important to the people that 
they cannot be left in the hands of the elected legislators.  But this constitutionally 
protected reservation of power by the people comes with a cost.  The lack of procedural 
scrutiny in the initiative process leaves the process susceptible to the creation of 
inconsistent or unclear laws that may be difficult to interpret and harmonize.  The 
MMMA is such a law.  While the MMMA has been the law in Michigan for just under 
seven years, this Court has been called on to give meaning to the MMMA in nine 
different cases.5  The many inconsistencies in the law have caused confusion for medical 
marijuana caregivers and patients, law enforcement, attorneys, and judges, and have 
consumed valuable public and private resources to interpret and apply it.  This confusion 
mainly stems from the immunity, MCL 333.26424 (§ 4), and the affirmative defense, 
MCL 333.26428 (§ 8), provisions of the MMMA.  We granted leave in People v 
                                              
4 See Const 1963, art 2, § 9. 
5 The Court previously interpreted the MMMA in the following cases: People v Mazur, 
497 Mich ___; 854 NW2d 719 (2015); Ter Beek v City of Wyoming, 495 Mich 1; 846 
NW2d 531 (2014); People v Green, 494 Mich 865 (2013); People v Koon, 494 Mich 1; 
832 NW2d 724 (2013); State v McQueen, 493 Mich 135; 828 NW2d 644 (2013); People 
v Bylsma, 493 Mich 17; 825 NW2d 543 (2012); People v Kolanek, 491 Mich 382; 817 
NW2d 528 (2012).  This term, the Court granted leave in People v Hartwick, 496 Mich 
851 (2014), and People v Tuttle, 496 Mich 851 (2014). 
 
 
 
4 
Hartwick6 and People v Tuttle7 to once again consider the meaning and application of 
these two very important sections of the MMMA.8 
 
                                              
6 In Hartwick, we directed the parties to address the following questions: 
(1) whether a defendant’s entitlement to immunity under § 4 of the 
Michigan Medical Marihuana Act (MMMA), MCL 333.26421 et seq., is a 
question of law for the trial court to decide; (2) whether factual disputes 
regarding § 4 immunity are to be resolved by the trial court; (3) if so, 
whether the trial court’s finding of fact becomes an established fact that 
cannot be appealed; (4) whether a defendant’s possession of a valid registry 
identification card establishes any presumption for purposes of § 4 or § 8; 
(5) if not, what is a defendant’s evidentiary burden to establish immunity 
under § 4 or an affirmative defense under § 8; (6) what role, if any, do the 
verification and confidentiality provisions in § 6 of the act play in 
establishing entitlement to immunity under § 4 or an affirmative defense 
under § 8; and (7) whether the Court of Appeals erred in characterizing a 
qualifying patient’s physician as issuing a prescription for, or prescribing, 
marijuana. [Hartwick, 496 Mich at 851.] 
7 In Tuttle, we directed the parties to address the following questions: 
(1) whether a registered qualifying patient under the Michigan 
Medical Marihuana Act (MMMA), MCL 333.26421 et seq., who makes 
unlawful sales of marijuana to another patient to whom he is not connected 
through the registration process, taints all aspects of his marijuana-related 
conduct, even that which is otherwise permitted under the act; (2) whether a 
defendant’s possession of a valid registry identification card establishes any 
presumption for purposes of § 4 or § 8; (3) if not, what is a defendant’s 
evidentiary burden to establish immunity under § 4 or an affirmative 
defense under § 8; and (4) what role, if any, do the verification and 
confidentiality provisions in § 6 of the act play in establishing entitlement 
to immunity under § 4 or an affirmative defense under § 8.  [Tuttle, 496 
Mich at 851-852.] 
8 The same panel of the Court of Appeals presided over People v Hartwick and People v 
Tuttle. 
 
 
 
5 
For the reasons fully explained in this opinion regarding § 4, we hold:  
(1) entitlement to § 4 immunity is a question of law to be decided by 
the trial court before trial;  
(2) the trial court must resolve factual disputes relating to § 4 
immunity, and such factual findings are reviewed on appeal for clear error;  
(3) the trial court’s legal determinations under the MMMA are 
reviewed de novo on appeal; 
(4) a defendant may claim immunity under § 4 for each charged 
offense if the defendant shows by a preponderance of the evidence that, at 
the time of the charged offense, the defendant 
(i) possessed a valid registry identification card,  
(ii) complied with the requisite volume limitations of § 4(a) 
and § 4(b),  
(iii) stored any marijuana plants in an enclosed, locked 
facility, and  
(iv) was engaged in the medical use of marijuana; 
(5) the burden of proving § 4 immunity is separate and distinct for 
each charged offense; 
(6) a marijuana transaction by a registered qualifying patient or a 
registered primary caregiver that is not in conformity with the MMMA 
does not per se taint all aspects of the registered qualifying patient’s or 
registered primary caregiver’s marijuana-related conduct;  
(7) a defendant is entitled to a presumption under § 4(d) that he or 
she was engaged in the medical use of marijuana if the defendant has 
shown by a preponderance of the evidence that, at the time of the charged 
offense, the defendant 
(i) possessed a valid registry identification card, and  
 
 
 
6 
(ii) complied with the requisite volume limitations of § 4(a) 
and § 4(b);9  
(8) the prosecution may rebut the § 4(d) presumption that the 
defendant was engaged in the medical use of marijuana by presenting 
evidence that the defendant’s conduct was not for the purpose of alleviating 
the registered qualifying patient’s debilitating medical condition; 
(9) non-MMMA-compliant 
conduct 
may 
rebut 
the 
§ 4(d) 
presumption of medical use for otherwise MMMA-compliant conduct if a 
nexus exists between the non-MMMA-compliant conduct and the otherwise 
MMMA-compliant conduct;  
(10) if the prosecution rebuts the § 4(d) presumption of the medical 
use of marijuana, the defendant may still establish, on a charge-by-charge 
basis, that the conduct underlying a particular charge was for the medical 
use of marijuana; and 
(11) the trial court must ultimately weigh the evidence to determine 
if the defendant has met the requisite burden of proof as to all elements of 
§ 4 immunity. 
Regarding § 8, we hold:  
(1) a defendant must present prima facie evidence of each element of 
§ 8(a) in order to be entitled to present a § 8 affirmative defense to a fact-
finder;  
(2) if the defendant meets this burden, then the defendant must prove 
each element of § 8(a) by a preponderance of the evidence; and  
(3) a valid registry identification card does not establish any 
presumption under § 8.10  
                                              
9 A valid registry identification card is a prerequisite to establish immunity under § 4.  
But possession of a valid registry identification card, alone, does not establish any 
presumption for the purpose of § 4.  Further, the verification and confidentiality 
provisions in § 6(c) and § 6(h) do not establish that a defendant has engaged in the 
medical use of marijuana, or complied with the requisite volume and storage limitations 
of § 4.  
10 A valid registry identification card is prima facie evidence that a physician has 
determined the registered qualifying patient has a debilitating medical condition and will 
 
 
 
 
7 
For the reasons stated in this opinion, and in accordance with the conclusions of 
law described above, we affirm in part, and reverse in part, the November 19, 2013 
judgment of the Court of Appeals in People v Hartwick.11  We further remand Hartwick 
to the trial court for an evidentiary hearing regarding Hartwick’s entitlement to immunity 
under § 4.  In People v Tuttle, we affirm in part, and reverse in part, the January 30, 2014 
judgment of the Court of Appeals.12  We also remand Tuttle to the trial court for an 
evidentiary hearing regarding Tuttle’s entitlement to immunity under § 4. 
I.  STATEMENT OF FACTS 
A.  PEOPLE V HARTWICK 
In late 2011, police officers in Oakland County received a tip regarding a 
marijuana growing operation at Hartwick’s home.  Law enforcement officers confronted 
Hartwick, who admitted growing marijuana, but stated he was in compliance with the 
MMMA.  After consenting to a search of his home, Hartwick led the police officers to a 
                                              
likely benefit from the medical use of marijuana to treat the debilitating medical 
condition.  In addition, a valid registry identification card issued after April 1, 2013, the 
effective date of 2012 PA 512, is also prima facie evidence that a physician has 
conducted a full, in-person assessment of the registered qualifying patient.  We reach this 
conclusion because § 6(c) requires the state to verify all the information contained in an 
application for a registry identification card; therefore, a valid registry identification card 
is prima facie evidence of anything contained in the application. This prima facie 
evidence satisfies two elements of § 8(a)(1), but does not satisfy the last element 
requiring prima facie evidence of a bona fide physician-patient relationship. 
11 People v Hartwick, 303 Mich App 247; 842 NW2d 545 (2013). 
12 People v Tuttle, 304 Mich App 72; 850 NW2d 484 (2014). 
 
 
 
8 
bedroom containing dozens of marijuana plants in varying sizes.13  The police officers 
also found a total of 104.6 grams—approximately 3.69 ounces—of usable marijuana in 
the home. 
The Oakland County Prosecutor charged Hartwick with manufacturing 20 to 200 
marijuana plants and possession with intent to deliver marijuana.  Hartwick moved to 
dismiss those charges based on both the immunity (§ 4) and the affirmative defense (§ 8) 
provided in the MMMA.  The trial court held an evidentiary hearing at which Hartwick 
was the only witness.  Hartwick testified that he was a medical marijuana patient and his 
own caregiver,14 and a connected15 primary caregiver to five registered qualifying 
patients.  He submitted into evidence the registry identification cards for himself and the 
                                              
13 Hartwick alleges 71 plants were found, while the police allege he possessed 77 plants.  
Hartwick, 303 Mich App at 253-254, 259-260.  Additionally, while this issue was not 
appealed, we note that Hartwick testified the door to the bedroom was locked before he 
unlocked it for the police, while the police allege it was unlocked when they arrived.   
14 We do not use the terms “patient” and “caregiver” in the traditional sense associated 
with a patient/medical provider relationship.  Rather, we use these terms because they are 
used in the MMMA.  Under the MMMA, a medical marijuana user, or “patient,” may 
elect to either manufacture marijuana for personal medical use or have someone else 
manufacture and supply marijuana to him or her.  Such a supplier is known under the 
MMMA as a “primary caregiver.” We refer to the qualifying patient as being his or her 
“own caregiver” when the patient has not designated a primary caregiver.  We use the 
terms “patient” and “caregiver” throughout this opinion simply to track the language of 
the MMMA and not to suggest that someone asserting a defense or immunity under the 
MMMA is a “patient” or “caregiver” as those terms are generally understood.  Whether 
one is a “patient” or “caregiver” under the MMMA, as opposed to a supplier or user of 
illegal marijuana, is a question to be resolved on a case-by-case basis. 
15 When a qualifying patient elects a primary caregiver, a registry identification card is 
also issued to the primary caregiver.  When a qualifying patient has properly designated a 
primary caregiver under the MMMA, the primary caregiver is said to be “connected” to 
that particular qualifying patient. 
 
 
 
9 
five connected qualifying patients.  Hartwick could not identify the debilitating 
conditions suffered by two of the qualifying patients statutorily connected to him.  
Further, Hartwick could not identify the certifying physician for any of the five connected 
qualifying patients. 
The trial court concluded that Hartwick was not entitled to § 4 immunity.  The 
court reasoned that Hartwick did not comply with the requirements of the MMMA 
because he did not know if the patients connected to him even had debilitating medical 
conditions.16 
The trial court similarly denied Hartwick’s motion to dismiss under § 8 and his 
motion in the alternative to present a § 8 affirmative defense to the jury.  The court 
determined that Hartwick failed to present “testimony regarding a ‘bona fide physician-
patient relationship or a likelihood of receiving therapeutic or palliative benefit from the 
medical use of marijuana,’ or any testimony on whether defendant possessed no more 
marijuana than reasonably necessary for medical use.”17  Thus, Hartwick failed to 
establish his entitlement to a § 8 affirmative defense. 
The Court of Appeals affirmed the trial court, rejecting Hartwick’s contention 
“that his possession of a registry identification card automatically immunizes him from 
prosecution under § 4 and grants him a complete defense under § 8.”18  The Court of 
                                              
16 An individual claiming § 4 immunity must comply with the requirement that marijuana 
be only for a medical use. 
17 Hartwick, 303 Mich App at 255. 
18 Id. at 251. 
 
 
 
10 
Appeals focused on the “primary purpose” of the MMMA, “which is to ensure that any 
marijuana production and use permitted by the statute is medical in nature and only for 
treating a patient’s debilitating medical condition.”19   
B.  PEOPLE V TUTTLE 
Tuttle was a registered qualifying patient and his own caregiver.  He was also 
connected as a registered primary caregiver to at least one other registered qualifying 
patient.20  On three separate occasions in early 2012, Tuttle sold marijuana to William 
Lalonde even though Tuttle was not formally connected to Lalonde under the MMMA.  
In addition to arresting Tuttle for providing marijuana to Lalonde, the Oakland County 
Sheriff’s Office searched Tuttle’s home where they found 33 marijuana plants, 38 grams 
of marijuana (approximately 1.34 ounces), and several weapons locked in a gun safe.  
Tuttle was subsequently charged with multiple counts related to the possession, delivery, 
and manufacture of marijuana, as well as possession of a firearm during the commission 
of a felony.21 
                                              
19 Id. 
20 At all relevant times, Tuttle was connected as a registered primary caregiver for 
Michael Batke.  Additionally, Tuttle was at some point connected as a primary caregiver 
to Frank Colon.  It is unclear whether Colon remained connected to Tuttle at the time of 
Tuttle’s offenses in this case.  Colon may have renewed his MMMA card and listed 
himself as his own caregiver.  Notwithstanding this possible inconsistency, Colon 
testified in the lower court that Tuttle supplied him with marijuana for his personal 
medical use.  See pages 11and 12 of this opinion. 
21 Counts I-III relate to Tuttle’s provision of marijuana to Lalonde.  Counts IV-VII relate 
to the marijuana found in Tuttle’s home. 
 
 
 
11 
Tuttle attempted to invoke the immunity provided under § 4 for counts IV-VII 
relating to possession of the marijuana in his home.  Tuttle argued that he possessed a 
valid registry identification card and complied with the volume and storage limitations of 
§ 4(a) and § 4(b).  The prosecution argued that Tuttle did not comply with the 
requirements of § 4 because Tuttle provided marijuana to Lalonde outside the parameters 
of the MMMA.  According to the prosecution, these transactions (for which Tuttle was 
charged in counts I-III) tainted all of Tuttle’s marijuana-related activity.  The trial court 
agreed and denied Tuttle’s motion under § 4 for immunity and dismissal of the charges. 
Tuttle then raised the § 8 affirmative defense to counts I-III.  At an evidentiary 
hearing, Tuttle presented his registry identification card and the registry identification 
cards belonging to two allegedly connected qualifying patients: Michael Batke and Frank 
Colon.  Lalonde, Batke, and Colon testified at the hearing.   
Lalonde testified that he was a registered qualifying patient who met Tuttle 
through an internet site that purported to match medical marijuana patients with 
caregivers.  Lalonde also testified that he told Tuttle he used marijuana to treat chronic 
pain.  Batke testified that he was a registered qualifying patient and that Tuttle was 
properly connected to him under the MMMA as a registered primary caregiver.  Batke 
also testified that he would call Tuttle every time he needed marijuana, and Tuttle 
provided Batke with approximately two ounces of marijuana a month.  Lastly, Colon 
testified that he was a medical marijuana patient, that he had a debilitating medical 
 
 
 
12 
condition,22 and that he utilized Tuttle as a primary caregiver.  Colon stated he requested 
between one and two ounces of marijuana a week from Tuttle.  
After the evidentiary hearing, the trial court determined that Tuttle did not present 
prima facie evidence for each element of § 8(a).  Specifically, the trial court determined 
that Tuttle failed to present any evidence that the medical marijuana users to whom Tuttle 
was connected had physicians who “completed a full assessment of each patient’s 
medical history and current medical condition” as required by § 8(a)(1).23  The court also 
concluded that Tuttle failed to establish a question of fact regarding whether the quantity 
of marijuana he possessed was reasonable under § 8(a)(2).24  The Court of Appeals 
affirmed the trial court and additionally concluded that Tuttle had not presented prima 
facie evidence as to Tuttle’s own medical use of marijuana under § 8(a)(3).   
Regarding § 4 immunity, the Court of Appeals concluded that providing marijuana 
to Lalonde tainted all of Tuttle’s marijuana-related conduct thereby negating Tuttle’s 
ability to invoke § 4 immunity for any charge.  Regarding the affirmative defense 
available under § 8, the Court of Appeals concluded that Tuttle’s registry identification 
card did not establish prima facie evidence of the required elements of § 8.  The court 
                                              
22 The physician’s statement indicates that Colon’s debilitating medical condition was 
shoulder and lower back pain.   
23 Tuttle, 304 Mich App at 79. 
24 The trial court did find the testimony of Lalonde, Batke, and Colon credible as to their 
need for the medical use of marijuana to treat a debilitating medical condition under 
§ 8(a)(3).   
 
 
 
13 
also concluded that the testimony of Tuttle’s patients was equally deficient in presenting 
prima facie evidence of those elements. 
II.  ANALYSIS 
The possession, manufacture, and delivery of marijuana are punishable criminal 
offenses under Michigan law.25  Under the MMMA, though, “[t]he medical use of 
marihuana is allowed under state law to the extent that it is carried out in accordance with 
the provisions of th[e] act.”26  The MMMA grants to persons in compliance with its 
provisions either immunity from, or an affirmative defense to, those marijuana-related 
violations of state law.  In the cases before us, we must resolve questions surrounding the 
§ 4 grant of immunity and the § 8 affirmative defense. 
A.  STANDARD OF REVIEW 
We review questions of statutory interpretation de novo.27  The MMMA was 
passed into law by initiative.  We must therefore determine the intent of the electorate in 
approving the MMMA, rather than the intent of the Legislature.28  Our interpretation is 
ultimately drawn from the plain language of the statute, which provides “the most reliable 
evidence” of the electors’ intent.29  But as with other initiatives, we place “special 
                                              
25 See Kolanek, 491 Mich at 394 n 24. 
26 MCL 333.26427(a). 
27 Kolanek, 491 Mich at 393. 
28 McQueen, 493 Mich at 147 (“ ‘[T]he intent of the electors governs’ the interpretation 
of voter-initiated statutes, just as the intent of the Legislature governs the interpretation of 
legislatively enacted statutes.”) (citation omitted). 
29 Id.  
 
 
 
14 
emphasis on the duty of judicial restraint.”30  Particularly, we make no judgment as to the 
wisdom of the medical use of marijuana in Michigan.  This state’s electors have made 
that determination for us.  To that end, we do not attempt to limit or extend the statute’s 
words.  We merely bring them meaning derived from the plain language of the statute. 
B.  SECTION 4 IMMUNITY 
Section 4 grants broad immunity from criminal prosecution and civil penalties to 
“qualifying patient[s]”31 and “primary caregiver[s].”32  Subsection (a) specifically grants 
immunity to qualifying patients and states in relevant part: 
(a) A qualifying patient who has been issued and possesses a registry 
identification card[33] shall not be subject to arrest, prosecution, or penalty 
in any manner . . . for the medical use[34] of marihuana in accordance with 
                                              
30 Schmidt v Dep’t of Ed, 441 Mich 236, 241-242; 490 NW2d 584 (1992). 
31 The MMMA defines “qualifying patient” or “patient” as “a person who has been 
diagnosed by a physician as having a debilitating medical condition.”  MCL 
333.26423(i). 
32 The MMMA defines “primary caregiver” or “caregiver” as “a person who is at least 21 
years old and who has agreed to assist with a patient’s medical use of marihuana and who 
has not been convicted of any felony within the past 10 years and has never been 
convicted of a felony involving illegal drugs or a felony that is an assaultive crime . . . .”  
MCL 333.26423(h). 
33 The MMMA defines “registry identification card” as “a document issued by the 
department that identifies a person as a registered qualifying patient or registered primary 
caregiver.”  MCL 333.26423(j).  The “department” is the “department of licensing and 
regulatory affairs.”  MCL 333.26423(c). 
34 “Medical use” is defined as “the acquisition, possession, cultivation, manufacture, use, 
internal possession, delivery, transfer, or transportation of marihuana or paraphernalia 
relating to the administration of marihuana to treat or alleviate a registered qualifying 
patient’s debilitating medical condition or symptoms associated with the debilitating 
medical condition.”  MCL 333.26423(f). 
 
 
 
15 
this act, provided that the qualifying patient possesses an amount of 
marihuana that does not exceed 2.5 ounces of usable marihuana, and, if the 
qualifying patient has not specified . . . a primary caregiver . . . , 12 
marihuana plants kept in an enclosed, locked facility.[35] 
A registered qualifying patient, therefore, may possess up to 2.5 ounces of usable 
marijuana.36  Additionally, a registered qualifying patient may possess up to 12 marijuana 
plants, kept in an enclosed, locked facility, unless that patient specified a primary 
caregiver during the state registration process.37  Section 4 immunity also requires that 
the registered qualifying patient was engaged in the medical use of marijuana. 
Similarly, § 4(b) provides immunity to registered primary caregivers.  It states, in 
relevant part: 
(b) A primary caregiver who has been issued and possesses a 
registry identification card shall not be subject to arrest, prosecution, or 
penalty in any manner . . . for assisting a qualifying patient to whom he or 
she is connected through the department’s registration process with the 
medical use of marihuana in accordance with this act. . . .  This subsection 
applies only if the primary caregiver possesses an amount of marihuana that 
does not exceed: 
(1) 2.5 ounces of usable marihuana for each qualifying patient to 
whom he or she is connected through the department’s registration process; 
and 
                                              
35 MCL 333.26424(a). 
36 “Usable marihuana” is defined as “the dried leaves and flowers of the marihuana plant, 
and any mixture or preparation thereof, but does not include the seeds, stalks, and roots of 
the plant.”  MCL 333.26423(k). 
37 When a patient does not specify a primary caregiver through the state registration 
process, the patient is typically considered his or her own caregiver. When no primary 
caregiver is properly identified under the law, the patient has legal authority to possess up 
to 12 marijuana plants. 
 
 
 
16 
(2) for each registered qualifying patient who has specified that the 
primary caregiver will be allowed under state law to cultivate marihuana for 
the qualifying patient, 12 marihuana plants kept in an enclosed, locked 
facility; and 
(3) any incidental amount of seeds, stalks, and unusable roots. 
A primary caregiver, therefore, may only possess up to 2.5 ounces of usable marijuana 
and 12 marijuana plants in an enclosed, locked facility for each registered qualifying 
patient who has specified the primary caregiver during the state registration process.  
Similar to § 4(a), this section only applies if the primary caregiver is assisting a 
qualifying patient with the medical use of marijuana. 
1.  PROCEDURAL ASPECTS OF § 4 
We begin our analysis of the procedural aspects of § 4 with the rather 
unremarkable proposition that entitlement to immunity under § 4 is a question of law.  
Immunity is a unique creature in the law and is distinguishable from other traditional 
criminal defenses.  A successful claim of immunity excuses an alleged offender for 
engaging in otherwise illegal conduct, regardless of the sufficiency of proofs in the 
underlying case.  This is consistent with the way claims of immunity are handled in other 
areas of law.38  Moreover, the parties agree that § 4 immunity should be determined as a 
matter of law.  There is no indication that the voters who enacted the MMMA intended to 
treat § 4 immunity differently than other claims of immunity.   
                                              
38 Morden v Grand Traverse Co, 275 Mich App 325, 340; 738 NW2d 278 (2007) 
(“Whether a defendant is entitled to qualified immunity is a question of law . . . .”); 
Snead v John Carlo, Inc, 294 Mich App 343, 354; 813 NW2d 294 (2011) (“[T]he 
determination regarding the applicability of governmental immunity and a statutory 
exception to governmental immunity is a question of law . . . .”).   
 
 
 
17 
Our decision in Kolanek supports this conclusion.  There we explained that § 4 
“ ‘grants qualifying patient[s]’ who hold ‘registry identification card[s]’ broad immunity 
from criminal prosecution, civil penalties, and disciplinary actions.”39  A registered 
qualifying patient, however, “who do[es] not qualify for immunity under § 4, as well as 
unregistered persons, are entitled to assert in a criminal prosecution the affirmative 
defense . . . under § 8 . . . .”40  By contrasting the broad grant of immunity in § 4 “from 
prosecution” with the affirmative defense in § 8 “in a criminal prosecution,” we implied 
that the decision regarding entitlement to immunity must be made before trial.  By its 
very nature, immunity must be decided by the trial court as a matter of law, and in 
pretrial proceedings, in order to establish immunity from prosecution.   
Deciding these questions of law necessarily involves resolving factual disputes.  
To determine whether a defendant is entitled to the § 4 grant of immunity, the trial court 
must make factual determinations, including whether the defendant has a valid registry 
identification card and whether he or she complied with the volume, storage, and medical 
use limitations.  The expediency of having the trial court resolve factual questions 
surrounding § 4 underscores the purpose of granting immunity from prosecution.   
Other matters routinely conducted in pretrial contexts, such as entrapment 
hearings, call for the trial court to act as both the finder of fact and arbiter of law.41  Like 
                                              
39 Kolanek, 491 Mich at 394-395 (emphasis added). 
40 Id. at 415 (emphasis added). 
41 See People v Julliet, 439 Mich 34, 61; 475 NW2d 786 (1991) (opinion by BRICKLEY, 
J.) (entrapment determined by trial court); People v Jones, 301 Mich App 566, 575-576; 
837 NW2d 7 (2013) (discussing similarities between § 4 immunity hearings and 
entrapment hearings). 
 
 
 
18 
entrapment, § 4 immunity “is not a defense that negates an essential element of the 
charged crime.  Instead, it presents facts that are collateral to the crime that justify barring 
the defendant’s prosecution.”42  We therefore conclude that the trial court must resolve 
factual disputes for the purpose of determining § 4 immunity. 
Of course, the trial court’s determinations are not without review.  Questions of 
law are reviewed de novo by appellate courts.43  A trial court’s factual findings are 
subject to appellate review under the clearly erroneous standard: 
Findings of fact by the trial court may not be set aside unless clearly 
erroneous.  In the application of this principle, regard shall be given to the 
special opportunity of the trial court to judge the credibility of the witnesses 
who appeared before it.[44] 
We find no reason, nor have the parties offered any reason, to deviate from this 
model of appellate review.  Therefore, we conclude that specific factual findings made by 
the trial court in a § 4 immunity hearing are reviewed under the clearly erroneous 
standard, and questions of law surrounding the grant or denial of § 4 immunity are 
reviewed de novo.  Further, the trial court’s ultimate grant or denial of immunity is fact-
dependent and is reviewed for clear error.45 
 
 
                                              
42 Julliet, 439 Mich at 52 (opinion by BRICKLEY, J.). 
43 See People v Keller, 479 Mich 467, 473-474; 739 NW2d 505 (2007). 
44 MCR 2.613(C). 
45 See People v Johnson, 466 Mich 491, 497; 647 NW2d 480 (2002), citing People v 
Jamieson, 436 Mich 61, 80; 461 NW2d 884 (1990) (opinion by BRICKLEY, J.). 
 
 
 
19 
2.  SUBSTANTIVE ASPECTS OF § 4 
Section 4 provides a broad grant of immunity from criminal prosecution and civil 
penalties to registered qualifying patients and connected primary caregivers.  As we have 
stated, the statute leaves much to be desired regarding the proper implementation of this 
grant of immunity.  When addressing this question, we must consider (a) the evidentiary 
burden required to establish immunity and the presumption of medical use under § 4, (b) 
the elements required to establish immunity and the presumption of medical use, and (c) 
what evidence may properly rebut a presumption of medical use. 
a.  BURDEN OF PROOF 
The MMMA is silent regarding the burden of proof necessary for a defendant to 
be entitled to immunity under § 4.  When statutes are silent as to the burden of proof, “we 
are free to assign it as we see fit, as long as we do not transgress the constitutional 
requirement that we not place on the defendant the burden of persuasion to negate an 
element of the crime.”46 
Assigning the burden of proof involves two distinct legal concepts.  The first, the 
burden of production, requires a party to produce some evidence of that party’s 
propositions of fact.47  The second, the burden of persuasion, requires a party to convince 
the trier of fact that those propositions of fact are true.48  The prosecution has the burden 
                                              
46 People v Mezy, 453 Mich 269, 283; 551 NW2d 389 (1996), citing Patterson v New 
York, 432 US 197; 97 S Ct 2319; 53 L Ed 2d 281 (1977). 
47 See McCormick, Evidence (7th ed), § 336, pp 644-645. 
48 Id.  Some courts have conflated the burden of proof with the burden of persuasion or 
the burden of production.  See Director, Office of Workers’ Comp Programs v Greenwich 
Collieries, 512 US 267, 272-276; 114 S Ct 2251; 129 L Ed 2d 221 (1994) (referring to 
 
 
 
 
20 
of proving every element of a charged crime beyond a reasonable doubt.49  This rule of 
law exists in part to ensure that “there is a presumption of innocence in favor of the 
accused . . . and its enforcement lies at the foundation of the administration of our 
criminal law.”50  To place the burden on a criminal defendant to negate a specific element 
of a crime would clearly run afoul of this axiomatic, elementary, and undoubted principle 
of law.51 
A defendant invoking § 4 immunity, however, does so without regard to any 
presumption of innocence.  The defendant does not dispute any element of the underlying 
charge when claiming immunity.  Indeed, the defendant may even admit to otherwise 
unlawful conduct and yet still be entitled to § 4 immunity.  When claiming § 4 immunity, 
the defendant places himself in an offensive position, affirmatively arguing entitlement to 
§ 4 immunity without regard to his or her underlying guilt or innocence of the crime 
charged.  In People v D’Angelo, we determined that the accusatorial nature of a 
defendant’s request for a defense of entrapment, without regard to his or her guilt or 
innocence of the underlying criminal charge, required the burden of proof by a 
                                              
the “burden of proof” as the “burden of persuasion”).  But these are different concepts.  
The burden of proof, which may also be generally referred to as a party’s evidentiary 
burden, refers both to a party’s burden to provide actual evidence of alleged facts and a 
party’s burden to persuade the trier of fact as to the veracity of those facts. 
49 See People v Crawford, 458 Mich 376, 389; 582 NW2d 785 (1998) (“[T]he 
prosecution must carry the burden of proving every element beyond a reasonable 
doubt . . . .”). 
50 Coffin v United States, 156 US 432, 453; 15 S Ct 394; 39 L Ed 481 (1895). 
51 Id. 
 
 
 
21 
preponderance of the evidence to be allocated to the defendant.52  The accusatorial nature 
of an entrapment defense and the offensive nature of immunity are similar because in 
both the defendant posits an affirmative argument, rather than defending a particular 
charge.  We now follow this well-established rule of criminal procedure and assign to the 
defendant the burden of proving § 4 immunity by a preponderance of the evidence.  
b.  ELEMENTS REQUIRED TO ESTABLISH IMMUNITY 
A defendant may claim entitlement to immunity for any or all charged offenses.  
Once a claim of immunity is made, the trial court must conduct an evidentiary hearing to 
factually determine whether, for each claim of immunity, the defendant has proved each 
element required for immunity.  These elements consist of whether, at the time of the 
charged offense, the defendant: 
 
(1) was issued and possessed a valid registry identification card, 
(2) complied with the requisite volume limitations of § 4(a) and § 4(b), 
(3) stored any marijuana plants in an enclosed, locked facility, and 
(4) was engaged in the medical use of marijuana.53 
The court must examine the first element of immunity—possession of a valid 
registry identification card—on a charge-by-charge basis.  In most cases, satisfying the 
first element will be an all-or-nothing proposition.  A qualifying patient or primary 
caregiver who does not have a valid registry identification card is not entitled to 
immunity because the first element required for immunity cannot be satisfied.  
                                              
52 People v D’Angelo, 401 Mich 167, 180, 183; 257 NW2d 655 (1977). 
53 MCL 333.26424(a)-(b). 
 
 
 
22 
Conversely, a qualifying patient or primary caregiver satisfies the first element of 
immunity if he or she possessed a valid registry identification card at all times relevant to 
the charged offenses.  In some cases, there may be a gap between a qualifying patient’s or 
a primary caregiver’s earliest conduct underlying the charged offenses and his or her 
most recent conduct.  A court must pay special attention to whether the effective date or 
expiration date of a registry identification card occurred within this gap and determine 
whether the conduct occurred when the patient or caregiver possessed a valid registry 
identification card.  A qualifying patient or primary caregiver can only satisfy the first 
element of immunity for any charge if all conduct underlying that charge occurred during 
a time when the qualifying patient or primary caregiver possessed a valid registry 
identification card. 
Generally, the second and third elements of immunity are also all-or-nothing 
propositions.  The second element—the volume limitations of § 4(a) and § 4(b)—requires 
that the qualifying patient or primary caregiver be in possession of no more than a 
specified amount of usable marijuana and a specified number of marijuana plants.  When 
a primary caregiver is connected with one or more qualifying patients, the amount of 
usable marijuana and the number of plants is calculated in the aggregate—2.5 ounces of 
usable marijuana and 12 marijuana plants for each qualifying patient, including the 
caregiver if he or she is also a registered qualifying patient acting as his or her own 
caregiver.54  When a qualifying patient cultivates his or her own marijuana for medical 
                                              
54 For example, a registered qualifying patient who is his or her own caregiver and the 
caregiver to five other qualifying patients is allowed to possess up to 72 marijuana plants 
and up to 15 ounces of usable marijuana.  If that individual actually possessed 73 
 
 
 
 
23 
use and is not connected with a caregiver, the patient is limited to 2.5 ounces of usable 
marijuana and 12 marijuana plants.  A qualifying patient or primary caregiver in 
possession of more marijuana than allowed under § 4(a) and § 4(b) at the time of the 
charged offense cannot satisfy the second element of immunity.   
The third element of § 4 immunity requires all marijuana plants possessed by a 
qualifying patient or primary caregiver to be kept in an enclosed, locked facility.  Thus, a 
qualifying patient or primary caregiver whose marijuana plants are not kept in an 
enclosed, locked facility at the time of the charged offense cannot satisfy the third 
element and cannot receive immunity for the charged offense. 
The fourth element conditions immunity on the “medical use” of marijuana, as 
defined in § 3(f).  Unlike elements two and three, the fourth element does not depend on 
the defendant’s aggregate conduct.  Instead, this element depends on whether the conduct 
forming the basis of each particular criminal charge involved “the acquisition, 
possession, cultivation, manufacture, use, internal possession, delivery, transfer, or 
transportation of marihuana or paraphernalia relating to the administration of marihuana 
to treat or alleviate a registered qualifying patient’s debilitating medical condition or 
symptoms associated with the debilitating medical condition.”55  Whether a qualifying 
patient or primary caregiver was engaged in the medical use of marijuana must be 
determined on a charge-by-charge basis. 
                                              
marijuana plants or 16 ounces of usable marijuana and was charged with multiple 
marijuana-related offenses, the individual could not satisfy the second element of 
immunity under § 4 for any of the charged offenses because the individual possessed 
marijuana in excess of the volume limitations in § 4(a) and § 4(b). 
55 MCL 333.26423(f). 
 
 
 
24 
While the qualifying patient or primary caregiver retains the burden of proving 
this fourth and last element of immunity, § 4(d) of the MMMA creates a rebuttable 
presumption of medical use when the qualifying patient or primary caregiver satisfies 
certain requirements. 
(d) There shall be a presumption that a qualifying patient or primary 
caregiver is engaged in the medical use of marihuana in accordance with 
this act if the qualifying patient or primary caregiver: 
(1) is in possession of a registry identification card; and 
(2) is in possession of an amount of marihuana that does not exceed 
the amount allowed under this act. The presumption [that one is engaged in 
the medical use of marihuana] may be rebutted by evidence that conduct 
related to marihuana was not for the purpose of alleviating the qualifying 
patient’s debilitating medical condition or symptoms associated with the 
debilitating medical condition, in accordance with this act.[56] 
The requirements necessary to establish the presumption of medical use mirror the first 
two elements required to establish immunity.  Therefore, a qualifying patient or primary 
caregiver is entitled to the presumption of medical use in § 4(d) simply by establishing 
the first two elements of § 4 immunity.57   
In sum, a qualifying patient seeking to assert the protections of § 4 must prove 
four elements by a preponderance of the evidence.  A qualifying patient must prove that, 
at the time of the charged offense, he or she (1) possessed a valid registry identification 
card; (2) possessed no more marijuana than allowed under § 4(a); (3) stored any 
                                              
56 MCL 333.26424(d). 
57 These elements are (1) possessing a valid registry identification card, and (2) 
complying with the volume limitations of § 4(a) and § 4(b). 
 
 
 
25 
marijuana plants in an enclosed, locked facility; and (4) was engaged in the medical use 
of marijuana.  If the qualifying patient establishes the first and second elements, then a 
presumption exists that the qualifying patient was engaged in the medical use of 
marijuana, thereby establishing the fourth element. 
Similarly, a primary caregiver seeking to assert the protections of § 4 must prove 
four elements by a preponderance of the evidence.  A primary caregiver must prove that, 
at the time of the charged offense, he or she (1) possessed a valid registry identification 
card; (2) possessed no more marijuana than allowed under § 4(b); (3) stored any 
marijuana plants in an enclosed, locked facility; and (4) was assisting connected 
qualifying patients with the medical use of marijuana.  If the primary caregiver 
establishes the first and second elements, then a presumption exists that the primary 
caregiver was engaged in the medical use of marijuana, thereby establishing the fourth 
element. 
c.  REBUTTING THE PRESUMPTION 
The presumption of the medical use of marijuana is a powerful tool for a 
defendant in asserting § 4 immunity.  But this presumption is rebuttable: 
The presumption [that one is engaged in the medical use of 
marihuana] may be rebutted by evidence that conduct related to marihuana 
was not for the purpose of alleviating the qualifying patient’s debilitating 
medical condition or symptoms associated with the debilitating medical 
condition, in accordance with this act.[58] 
                                              
58 MCL 333.26424(d)(2). 
 
 
 
26 
According to § 4(d)(2), the presumption of the medical use of marijuana may be rebutted 
by examining “conduct related to marihuana . . . .”  While the statute does not specifically 
state whose marijuana-related conduct may be used, when read in context it is clear that it 
refers to the defendant’s conduct.  Stated differently, in § 4(d), only the defendant’s 
conduct may be considered to rebut the presumption of the medical use of marijuana.  
This interpretation is consistent with the purpose of § 4, which is to provide immunity 
from prosecution to a defendant who abides by certain restrictions.   
For this reason, we hold that the prosecution may not rebut a primary caregiver’s 
presumption of medical use by introducing evidence of conduct unrelated to the primary 
caregiver,59 such as evidence that a connected qualifying patient does not actually have a 
debilitating medical condition or evidence that a connected qualifying patient used 
marijuana for nonmedical purposes.  Similarly, the prosecution may not rebut a 
qualifying patient’s presumption of medical use by introducing evidence that the 
connected primary caregiver used the qualifying patient’s marijuana for nonmedical 
purposes.60 
                                              
59 We recognize that “conduct” may be misfeasance as well as nonfeasance.  Nothing in 
our holding should be interpreted to shield a primary caregiver who has actual knowledge 
that the marijuana provided to a qualifying patient is being used in a manner not 
permitted under the MMMA. 
60 The MMMA requires the state to verify all information contained in an application for 
a registry identification card and to keep confidential the list of registry identification 
cards issued, except to verify the validity of such cards to law enforcement.  Hartwick 
and Tuttle both argue that because of the verification and confidentiality requirements, 
the issuance of a registry identification card establishes either immunity under § 4 or, at 
least, a presumption of the medical use of marijuana under § 4(d).  As we have already 
concluded, a registry identification card is only one requirement for establishing 
immunity under § 4.  The verification and confidentiality provisions do not establish that 
 
 
 
 
27 
We must also determine whether one or more transactions that are outside the 
scope of the MMMA may rebut the presumption of medical use for otherwise-compliant 
MMMA conduct.  As noted § 4(d)(2) provides the prosecution with the ability to rebut 
this presumption.61 
In Tuttle, the Court of Appeals held that a noncompliant marijuana transaction 
negates a defendant’s ability to claim § 4 immunity as to the defendant’s entire 
marijuana-related conduct.  The court determined that “§ 4 does not allow [a] defendant 
to decouple . . . illicit actions involving marijuana from . . . other[wise MMMA-
compliant] marijuana-related activities . . . .”62  The court concluded that illicit 
marijuana-related conduct rebuts the § 4(d) presumption of medical use for otherwise 
MMMA-compliant conduct.63   
The prosecution agrees with the Court of Appeals, arguing that if a primary 
caregiver has provided marijuana to an unconnected individual, the presumption of 
medical use has been rebutted for all of the primary caregiver’s marijuana-related 
conduct, including conduct that otherwise complies with § 4.  Therefore, according to the 
prosecution, any unprotected marijuana-related conduct rebuts a defendant’s presumption 
                                              
a defendant has engaged in the medical use of marijuana or abided by the requisite 
volume and storage limitations of § 4(a) and § (4)(b).  Simply put, a registry 
identification card, alone, does not establish § 4 immunity or a presumption of the 
medical use of marijuana under § 4(d). 
61 MCL 333.26424(d)(2). 
62 Tuttle, 304 Mich App at 84. 
63 Id. 
 
 
 
28 
of medical use for all of the defendant’s marijuana-related conduct, regardless of its 
relevance to the charged offense. 
Tuttle argues that unprotected marijuana-related conduct may only rebut the 
presumption as to otherwise protected conduct if a nexus exists between the unprotected 
conduct and the protected conduct.  In Tuttle, counts I-III relate to unprotected transfers 
of marijuana from Tuttle to an unconnected patient.  Tuttle agrees that this conduct is not 
protected and that there is no § 4 immunity with regard to that conduct.  Counts IV-VII, 
however, relate to the marijuana being manufactured in Tuttle’s home.  Tuttle argues that 
the conduct in counts I-III does not necessarily affect the conduct underlying counts IV-
VII.   
Tuttle specifically stresses that § 4(d)(2) provides that the presumption of medical 
use “may” be rebutted.  Tuttle relies on the word “may” for the proposition that the trial 
court in its fact-finding capacity may either reject or accept evidence presented by the 
prosecution.  Therefore, Tuttle claims, the trial court is not obligated to accept evidence 
of an unrelated and unprotected transaction to rebut the presumption of medical use for 
an otherwise protected transaction. 
It is clear, as Tuttle concedes, that conduct violating the MMMA directly rebuts 
the presumption of medical use when a defendant’s charges are based on that specific 
conduct (such as the illicit conduct on which counts I-III against Tuttle are based).  It is 
not clear, however, that conduct violating the MMMA would also rebut the presumption 
of medical use related to other charges against the defendant when the illicit conduct does 
not form the basis of charges (such as the otherwise MMMA-compliant conduct on 
which counts IV-VII against Tuttle are based).  While the statutory language is neither 
 
 
 
29 
compelling nor expressly direct, we nonetheless conclude that the statutory text lends 
support for Tuttle’s proposition. 
Use of the permissive “may,” in conjunction with the trial court’s general 
gatekeeping responsibility to admit only relevant evidence,64 leads us to conclude that to 
rebut the presumption of medical use the prosecution’s rebuttal evidence must be 
relevant, such that the illicit conduct would allow the fact-finder to conclude that the 
otherwise MMMA-compliant conduct was not for the medical use of marijuana.  In other 
words, the illicit conduct and the otherwise MMMA-compliant conduct must have a 
nexus to one another in order to rebut the § 4(d) presumption.  This is consistent with the 
conclusions that the fourth element of immunity—medical use—is dependent only on the 
conduct forming the basis for each particular criminal charge and that immunity is 
claimed and generally proved on a charge-by-charge basis.   
Further, Tuttle’s view not only has statutory support, but also comports with how 
generally a presumption should be rebutted.  Only relevant evidence that allows the fact-
finder to conclude that the underlying conduct was not for “medical use” may rebut the 
§ 4(d) presumption.  A wholly unrelated transaction—i.e., a transaction with no nexus, 
and therefore no relevance, to the conduct resulting in the charged offense—does not 
assist the fact-finder in determining whether the defendant actually was engaged in the 
medical use of marijuana during the charged offense.  Conduct unrelated to the charged 
offense is irrelevant and does not rebut the presumption of medical use. 
                                              
64 See MRE 401 and MRE 402. 
 
 
 
30 
Therefore, under § 4(d)(2), the prosecution may rebut the presumption of medical 
use for each claim of immunity.  Improper conduct related to one charged offense may 
not be imputed to another charged offense unless the prosecution can establish a nexus 
between the improper conduct and the otherwise MMMA-compliant conduct.  The trial 
court must ultimately determine whether a defendant has established by a preponderance 
of the evidence that he or she was engaged in the medical use of marijuana.  The 
defendant may do so by establishing this powerful presumption of medical use.  If the 
presumption of medical use has been rebutted, however, the defendant may still prove 
through other evidence that, with regard to the underlying conduct that resulted in the 
charged offense and for which the defendant claims immunity, the defendant was 
engaged in the medical use of marijuana, as defined in § 3(f). 
C.  SECTION 8 DEFENSE 
Section 8(a) of the MMMA provides any patient or primary caregiver—regardless 
of registration with the state—with the ability to assert an affirmative defense to a 
marijuana-related offense.  The affirmative defense “shall be presumed valid where the 
evidence shows”: 
(1) A physician has stated that, in the physician’s professional 
opinion, after having completed a full assessment of the patient’s medical 
history and current medical condition made in the course of a bona fide 
physician-patient relationship, the patient is likely to receive therapeutic or 
palliative benefit from the medical use of marihuana to treat or alleviate the 
patient’s serious or debilitating medical condition or symptoms of the 
patient’s serious or debilitating medical condition; 
(2) The patient and the patient’s primary caregiver, if any, were 
collectively in possession of a quantity of marihuana that was not more than 
was reasonably necessary to ensure the uninterrupted availability of 
marihuana for the purpose of treating or alleviating the patient’s serious or 
 
 
 
31 
debilitating medical condition or symptoms of the patient’s serious or 
debilitating medical condition; and 
(3) The patient and the patient’s primary caregiver, if any, were 
engaged in the acquisition, possession, cultivation, manufacture, use, 
delivery, transfer, or transportation of marihuana or paraphernalia relating 
to the use of marihuana to treat or alleviate the patient’s serious or 
debilitating medical condition or symptoms of the patient’s serious or 
debilitating medical condition.[65] 
In Kolanek, we determined that if a defendant establishes these elements and no 
question of fact exists regarding these elements, then the defendant is entitled to dismissal 
of the criminal charges.66  We also clarified that if questions of fact exist, then “dismissal 
of the charges is not appropriate and the defense must be submitted to the jury.”67  
Additionally, if a defendant has not presented prima facie evidence of each element of § 8 
by “present[ing] evidence from which a reasonable jury could conclude that the 
defendant satisfied the elements of the § 8 affirmative defense, . . . then the circuit court 
must deny the motion to dismiss the charges,” and “the defendant is not permitted to 
present the § 8 defense to the jury.”68   
A defendant seeking to assert the MMMA’s statutory affirmative defense must 
present prima facie evidence for each element of § 8(a).69 Overcoming this initial hurdle 
                                              
65 MCL 333.26428(a)(1)-(3). 
66 Kolanek, 491 Mich at 416. 
67 Id. 
68 Id.  
69 Id. at 415-416.  In Kolanek, we did not determine the standard by which a defendant 
must establish a § 8 defense.  We now clarify that well-established rules of criminal 
procedure require a defendant to prove the affirmative defense by a preponderance of 
evidence.  See, e.g., D’Angelo, 401 Mich at 183 (holding that the defendant has the 
 
 
 
 
32 
of presenting prima facie evidence of each element is not an easy task.  The elements of 
§ 8 are clearly more onerous than the elements of § 4.  The statutory scheme of the 
MMMA is designed to benefit those who properly register and are meticulous in their 
adherence to the law.  Presumably, a properly registered defendant facing criminal 
charges would invoke immunity under § 4.  However, a § 8 defense may be pursued by 
any defendant, regardless of registration status.  With this background, we consider each 
element of the § 8 affirmative defense.   
1.  SECTION 8(A)(1):  THE IMPRIMATUR OF THE  
PHYSICIAN-PATIENT RELATIONSHIP 
Section 8(a)(1) requires a physician to determine the patient’s suitability for the 
medical use of marijuana.  It provides: 
(1) A physician has stated that, in the physician’s professional 
opinion, after having completed a full assessment of the patient’s medical 
history and current medical condition made in the course of a bona fide 
physician-patient relationship, the patient is likely to receive therapeutic or 
palliative benefit from the medical use of marihuana to treat or alleviate the 
patient’s serious or debilitating medical condition or symptoms of the 
patient’s serious or debilitating medical condition[.][70] 
This provision may be reduced to three elements: 
(1) The existence of a bona fide physician-patient relationship, 
(2) in which the physician completes a full assessment of the patient’s 
medical history and current medical condition, and 
                                              
burden of proving entrapment by a preponderance of the evidence).  Thus, when the § 8 
affirmative defense is submitted to a fact-finder, the defendant’s burden of proof is to 
establish the elements of § 8(a) by a preponderance of the evidence. 
70 MCL 333.26428(a)(1). 
 
 
 
33 
(3) from which results the physician’s professional opinion that the patient 
has a debilitating medical condition and will likely benefit from the medical 
use of marijuana to treat the debilitating medical condition. 
Each of these elements must be proved in order to establish the imprimatur of the 
physician-patient relationship required under § 8(a)(1) of the MMMA.  Hartwick and 
Tuttle argue that the registry identification card establishes these three elements.  We do 
not find merit in this position. 
As part of the process for obtaining a registry identification card, an applicant 
must submit, among other materials, a “written certification.”71  At the time of the 
offenses at issue,72 the MMMA defined a written certification as:  
[A] document signed by a physician, stating the patient’s debilitating 
medical condition and stating that, in the physician’s professional opinion, 
the patient is likely to receive therapeutic or palliative benefit from the 
medical use of marihuana to treat or alleviate the patient’s debilitating 
medical condition or symptoms associated with the debilitating medical 
condition.[73] 
Thus, at the time of the offenses at issue, a written certification was a document prepared 
by a physician that contained at least two representations: (1) the patient has a debilitating 
medical condition, and (2) the patient will likely benefit from the medical use of 
marijuana.  Further, MCL 333.26426(c) provides that the department “shall verify the 
                                              
71 MCL 333.26426(a)(1).   
72 In 2012, the Legislature garnered sufficient votes to satisfy the three-fourths super 
majority required to amend a voter-enacted initiative and amended the MMMA to include 
the additional requirement that the physician conducted a full, in-person assessment of 
the patient.  See 2012 PA 512, effective April 1, 2013. 
73 Former MCL 333.26423(l).  “Written certification” has since been amended and 
renumbered as § 3(m).  See 2012 PA 512, effective April 1, 2013. 
 
 
 
34 
information contained in an application” and that the department “may deny an 
application . . . only if the applicant did not provide the information required pursuant to 
this section, or if the department determines that the information provided was falsified.”   
Comparing the definition of “written certification” with the elements of § 8(a)(1), 
a registry identification card satisfies the third element (the patient has a debilitating 
medical condition and would likely benefit from the medical use of marijuana).  A 
registry identification card, however, does not establish the second element (a physician 
has completed a full assessment of the patient’s medical history and current medical 
condition).74  The second element must be established through medical records or other 
evidence submitted to show that the physician actually completed a full assessment of the 
patient’s medical history and current medical condition before concluding that the patient 
is likely to benefit from the medical use of marijuana and before the patient engages in 
the medical use of marijuana.  Additionally, the physician certification leaves unsatisfied 
the first element of § 8(a)(1) (the existence of a bona fide physician-patient relationship).   
At the time of the offenses at issue, the MMMA did not define “bona fide 
physician-patient relationship.”75  In Kolanek, we stated that “this term envisions ‘a pre-
                                              
74 We note that registry identification cards issued on or after April 1, 2013, the effective 
date of 2012 PA 512, establish the second element.  See note 72 of this opinion. 
75 The MMMA has since been amended by 2012 PA 512, effective April 1, 2013, to 
define a “bona fide physician-patient relationship.”  
“Bona fide physician-patient relationship” means a treatment or 
counseling relationship between a physician and patient in which all of the 
following are present: 
(1) The physician has reviewed the patient’s relevant medical 
records and completed a full assessment of the patient’s medical history 
 
 
 
 
35 
existing and ongoing relationship with the patient as a treating physician.’ ”76 Thus, to 
satisfy the first element—the existence of a bona fide physician-patient relationship—
there must be proof of an actual and ongoing physician-patient relationship at the time the 
written certification was issued.77 
                                              
and current medical condition, including a relevant, in-person, medical 
evaluation of the patient. 
(2) The physician has created and maintained records of the patient’s 
condition in accord with medically accepted standards. 
(3) The physician has a reasonable expectation that he or she will 
provide follow-up care to the patient to monitor the efficacy of the use of 
medical marihuana as a treatment of the patient’s debilitating medical 
condition. 
(4)  If the patient has given permission, the physician has notified the 
patient’s primary care physician of the patient’s debilitating medical 
condition and certification for the use of medical marihuana to treat that 
condition.  [MCL 333.26423(a).] 
76 Kolanek, 491 Mich at 396 n 30 (quoting a joint statement by the Michigan Board of 
Medicine and the Michigan Board of Osteopathic Medicine and Surgery). 
77 We acknowledge that the actual text of the physician’s statement submitted as part of 
the registration process might suffice.  Although hearsay, the physician’s written 
certification is a “report of . . . occurrences, events, conditions, opinions, or diagnoses, 
made at or near the time by . . . a person with knowledge [that is] kept in the course of a 
regularly conducted business activity [and is a] regular practice of that business activity 
to make . . . .”  MRE 803(6).  That physicians are required by statute to prepare a 
certificate to recommend the medical use of marijuana tends to establish that the 
certificate is prepared in regular practice.  Moreover, nothing prevents a physician from 
including a statement in the written certificate indicating that it was prepared in the 
course of a bona fide physician-patient relationship or indicating the physician’s 
recommendation as to the particular amount of marijuana.  Likewise, nothing prevents 
the department from revising the physician certification to attest to these elements.  Nor 
does anything prevent another individual from creating his or her own written 
certification acceptable to the department.  Accordingly, the written certification could 
itself provide prima facie evidence of the elements of § 8(a).  Further, a defendant may 
 
 
 
 
36 
A primary caregiver has the burden of establishing the elements of § 8(a)(1) for 
each patient to whom the primary caregiver is alleged to have unlawfully provided 
marijuana.  In this context, a primary caregiver who provides marijuana to a putative 
patient plainly assumes the risk that the patient does not actually meet the elements of 
§ 8(a)(1) or that the patient may not cooperate in a subsequent prosecution of the primary 
caregiver, regardless what that person may have otherwise told the primary caregiver.78 
2.  SECTION 8(a)(2): THE QUANTITY OF MARIJUANA 
Section 8(a)(2) requires a patient or primary caregiver to show: 
The patient and the patient’s primary caregiver, if any, were 
collectively in possession of a quantity of marihuana that was not more than 
was reasonably necessary to ensure the uninterrupted availability of 
marihuana for the purpose of treating or alleviating the patient’s serious or 
debilitating medical condition or symptoms of the patient’s serious or 
debilitating medical condition[.][79] 
                                              
present patient testimony or other evidence to satisfy his or her burden of presenting 
prima facie evidence of the elements of § 8(a).  A defendant who submits proper 
evidence would not likely need his or her physician to testify to establish prima facie 
evidence of any element of § 8(a). 
78 Because “[p]ossession, manufacture, and delivery of marijuana remain punishable 
offenses under Michigan law,” Kolanek, 491 Mich at 394, a caregiver-defendant’s patient 
might be unwilling to testify to the patient’s marijuana-related activities due to fear of 
criminal prosecution.  This would present a significant barrier to the caregiver’s ability to 
establish a defense under § 8.  And because a witness cannot be compelled to give 
testimony that the witness reasonably believes could be used against him or her in a 
criminal prosecution, a patient’s justified refusal to cooperate might prove fatal to the 
primary caregiver’s § 8 defense.  See Hoffman v United States, 341 US 479, 486; 71 S Ct 
814; 95 L Ed 1118 (1951) (“It is for the court to say whether [the witness’s] silence is 
justified.”).  While this may seem a harsh consequence, this Court has no power to alter 
the statutory language. 
79 MCL 333.26428(a)(2). 
 
 
 
37 
The critical phrase from the above quoted passage is “reasonably necessary to 
ensure uninterrupted availability of marihuana [for treatment] . . . .”  Hartwick and Tuttle 
maintain that a registry identification card establishes a presumption that any amount of 
marijuana possessed by a defendant is a reasonable amount of marijuana under the 
MMMA.  In the alternative, they argue that a valid registry identification card, coupled 
with compliance with the volume limitations in § 4, establishes a presumption that the 
amount of marijuana possessed is reasonable.  Again, we do not find support for the 
defendants’ position in the text of the MMMA. 
The issuance of a registry identification card or compliance with the volume 
limitations in § 4 does not show that an individual possesses only a “reasonably 
necessary” amount of marijuana “to ensure uninterrupted availability” for the purposes of 
§ 8(a)(2).  A registry identification card simply qualifies a patient for the medical use of 
marijuana.  It does not guarantee that an individual will always possess only the amount 
of marijuana allowed under the MMMA.   
Further, nothing in the MMMA supports the notion that the quantity limits found 
in the immunity provision of § 4 should be judicially imposed on the affirmative defense 
provision of § 8.  Sections 4 and 8 feature contrasting statutory language intended to 
serve two very different purposes.80  Section 4 creates a specific volume limitation 
applicable to those seeking immunity.  In contrast, § 8 leaves open the volume limitation 
to that which is “reasonably necessary.”  The MMMA could have specified a specific 
                                              
80 Section 4 grants broad immunity from arrest or prosecution, while § 8 provides for an 
affirmative defense during a prosecution. 
 
 
 
38 
volume limitation in § 8, but it did not.  In the absence of such an express limitation, we 
will not judicially assign to § 8 the volume limitation in § 4 to create a presumption of 
compliance with § 8(a)(2).  Indeed, the only instance in which a primary caregiver must 
control a patient’s dosage is when he or she is the parent of a minor patient.81  That the 
statute requires these particular caregivers to control a patient’s dosage, but does not 
require it of others, indicates that all other caregivers need not be particularly aware of 
their patients’ medical needs.  Instead, a primary caregiver may reasonably rely on the 
amount his or her patient states is needed to treat the patient’s debilitating medical 
condition. 
A patient seeking to assert a § 8 affirmative defense may have to testify about 
whether a specific amount of marijuana alleviated the debilitating medical condition and 
if not, what adjustments were made to the consumption rate and the amount of marijuana 
consumed to determine an appropriate quantity.  Once the patient establishes the amount 
of usable marijuana needed to treat the patient’s debilitating medical condition, 
determining whether the patient possessed “a quantity of marihuana that was not more 
than was reasonably necessary to ensure [its] uninterrupted availability” also depends on 
how the patient obtains marijuana and the reliability of this source.  This would 
necessitate some examination of the patient/caregiver relationship.   
The same analysis applies to primary caregivers seeking to present a defense under 
§ 8.  Primary caregivers must establish the amount of usable marijuana needed to treat 
their patients’ debilitating medical conditions and then how many marijuana plants the 
                                              
81 MCL 333.26426(b)(3)(C). 
 
 
 
39 
primary caregiver needs to grow in order ensure “uninterrupted availability” for the 
caregiver’s patients.  This likely would include testimony regarding how much usable 
marijuana each patient required and how many marijuana plants and how much usable 
marijuana the primary caregiver needed in order to ensure each patient the “uninterrupted 
availability” of marijuana. 
3.  SECTION 8(a)(3): THE USE OF MARIJUANA FOR A MEDICAL PURPOSE 
Section 8(a)(3) requires a patient or primary caregiver to show: 
The patient and the patient’s primary caregiver, if any, were engaged 
in the acquisition, possession, cultivation, manufacture, use, delivery, 
transfer, or transportation of marihuana or paraphernalia relating to the use 
of marihuana to treat or alleviate the patient’s serious or debilitating 
medical condition or symptoms of the patient’s serious or debilitating 
medical condition. [82] 
Although there is a purposeful distinction made between the amount of marijuana 
permitted under § 4 and the “reasonably necessary” restraint on quantity found in 
§ 8(a)(2), § 8(a)(3) requires a patient and primary caregiver to show that any marijuana 
use complied with a very similar “medical use” requirement found in § 4, and defined in 
§ 3: 
“Medical use” means the acquisition, possession, cultivation, 
manufacture, use, internal possession, delivery, transfer, or transportation 
of marihuana or paraphernalia relating to the administration of marihuana 
to treat or alleviate a registered qualifying patient’s debilitating medical 
condition or symptoms associated with the debilitating medical 
condition.[83] 
                                              
82 MCL 333.26428(a)(3). 
83 MCL 333.26423(f). 
 
 
 
40 
The slight variance between the definition of “medical use” in § 4 and medical use 
as it appears in § 8 can be attributed to the fact that only registered qualifying patients 
and registered primary caregivers may engage in the “medical use” of marijuana, as 
indicated by use of the term in § 4.84  Those patients and primary caregivers who are not 
registered may still be entitled to § 8 protections if they can show that their use of 
marijuana was for a medical purpose—to treat or alleviate a serious or debilitating 
medical condition or its symptoms.  Hartwick and Tuttle again argue that a registry 
identification card alone, or a registry identification card coupled with compliance with 
either the volume limitations of § 4(a) and (4)(b) or § 8(a)(2), satisfies § 8(a)(3).  Once 
again, defendants seek to attribute greater significance to the registry identification card 
than that which is expressly provided in the MMMA.  We simply do not find support for 
the defendants’ arguments in the text of the MMMA. 
A registry identification card merely qualifies a patient for the medical use of 
marijuana.  It does not establish that at the time of the charged offense, the defendant was 
actually engaged in the protected use of marijuana.  Section 8(a)(3) requires that both the 
patient’s and the primary caregiver’s use of marijuana be for a medical purpose, and that 
their conduct be described by the language in § 8(a)(3).  Thus, patients must present 
prima facie evidence regarding their use of marijuana for a medical purpose regardless 
whether they possess a registry identification card.  Primary caregivers would also have 
                                              
84 The definition in § 4 includes “internal possession” and specifies that the patient is a 
registered qualifying patient.  The permitted uses in § 8 do not include “internal 
possession,” and the requirements apply to “patients” who are not necessarily registered. 
 
 
 
41 
to present prima facie evidence of their own use of marijuana for a medical purpose and 
any patients’ use of marijuana for a medical purpose.  
III.  APPLICATION TO HARTWICK AND TUTTLE 
A.  PEOPLE V HARTWICK 
1.  SECTION 4 IMMUNITY 
Hartwick is a registered qualifying patient, his own caregiver, and at all times 
pertinent to this dispute, a primary caregiver to five registered qualifying patients.  The 
prosecuting attorney charged Hartwick with manufacturing marijuana and possession of 
marijuana with the intent to deliver.  Hartwick sought to invoke § 4 immunity.  In order 
to qualify for § 4 immunity, Hartwick must prove by a preponderance of the evidence 
that for each charged offense he  
(1) possessed a valid registry identification card for himself as a 
qualifying patient and for each of the five other connected registered 
qualifying patients,  
(2) possessed no more than 72 marijuana plants and 15 ounces of 
usable marijuana,85  
(3) kept the marijuana plants in an enclosed, locked facility, and  
(4) was engaged in the medical use of marijuana.   
Hartwick is entitled to a presumption of the medical use of marijuana if he shows 
by a preponderance of the evidence that he possessed:  
                                              
85 As a registered qualifying patient, Hartwick may possess up to 12 marijuana plants and 
2.5 ounces of usable marijuana.  As a primary caregiver, Hartwick may possess up to 12 
marijuana plants and 2.5 ounces of usable marijuana for each connected registered 
qualifying patient. 
 
 
 
42 
(1) a valid registry identification card for himself as a patient and for 
each of the five other registered qualifying patients to whom he is 
connected under the MMMA, and  
(2) no more than 72 marijuana plants and 15 ounces of usable 
marijuana. 
The prosecution may then rebut this presumption in accordance with § 4(d)(2). 
The lower courts erred with respect to Hartwick’s entitlement to immunity under 
§ 4.  There is no statutory requirement under § 4 that Hartwick know the debilitating 
conditions of, the amount of marijuana needed for, the length of time treatment should 
continue for, or the identities of the physicians of, the registered qualifying patients to 
whom Hartwick is connected under the MMMA.  This lack of information cannot be 
used to rebut Hartwick’s presumption of the medical use of marijuana under § 4(d).  For 
purposes of § 4, the lower courts should have instead focused on Hartwick’s conduct. 
The Court of Appeals also should not have determined that the number of 
marijuana plants Hartwick possessed was “moot.”86  The trial court never made a factual 
determination of the number of marijuana plants in Hartwick’s possession or the other 
elements of § 4.  Even if such facts had been established, the Court of Appeals reviews 
the trial court’s factual findings for clear error.  Thus, a new § 4 evidentiary hearing 
conforming to the holdings expressed in this opinion is necessary to determine 
Hartwick’s entitlement to § 4 immunity. 
 
 
                                              
86 Hartwick, 303 Mich App at 259. 
 
 
 
43 
2.  SECTION 8 DEFENSE 
In contrast to Hartwick’s claim of immunity under § 4, the lower courts correctly 
concluded that Hartwick was not entitled to the § 8 affirmative defense.  Even though 
Hartwick provided testimony of his own medical condition and evidence of registry 
identification cards for himself and five patients, he did not present prima facie evidence 
for each element of § 8(a).  Specifically, Hartwick failed to provide any evidence of 
§ 8(a)(1) (bona fide physician-patient relationship), § 8(a)(2) (amount of marijuana the 
patients needed), or § 8(a)(3) (whether the patients engaged in the use of marijuana for a 
medical purpose). 
Further, to the extent the Court of Appeals determined that a written certification 
was comparable to a pharmaceutical prescription, this determination was erroneous.  A 
written certification is not similar to that of a pharmaceutical prescription.  Marijuana is a 
Schedule 1 controlled substance.87  Therefore, a doctor is not legally able to prescribe 
marijuana to an individual for any reason.  A written certification is a statutorily 
mandated document that must meet specific statutory requirements so that an individual 
may successfully apply for a registry identification card.  While the MMMA states that 
“[m]odern medical research . . . has discovered beneficial uses for marihuana in 
treating . . . debilitating medical conditions,”88 the terminology employed in the MMMA 
and the actual function of primary caregivers and patients is not comparable to how a 
                                              
87 See MCL 333.7212(c). 
88 MCL 333.26422(a). 
 
 
 
44 
medical doctor’s treatment of an actual patient.  Primary caregivers carry out a statutorily 
created task that is completely unrelated to how a doctor would treat a patient. 
B.  PEOPLE V TUTTLE 
1.  SECTION 4 IMMUNITY 
Tuttle is a registered qualifying patient, his own caregiver, and a primary caregiver 
to at least one registered qualifying patient.  The prosecuting attorney charged Tuttle with 
multiple counts of manufacturing, possessing, and delivering marijuana.  Tuttle sought to 
have counts IV-VII, which relate to the manufacture and possession of marijuana in 
Tuttle’s home, dismissed under the immunity provisions of § 4.   
In order to qualify for immunity under § 4, Tuttle must prove by a preponderance 
of the evidence that for each charged offense he: 
(1) possessed a valid registry identification card for himself as a 
qualifying patient and for each connected registered qualifying patient,  
(2) possessed no more than the volume of marijuana permitted by 
§ 4(a) and § 4(b),89  
(3) kept the marijuana plants in an enclosed, locked facility, and  
(4) was engaged in the medical use of marijuana.   
                                              
89 It is unclear in the record exactly how many qualifying patients Tuttle was connected 
to under the MMMA.  Without that information, we are unable to determine how many 
marijuana plants and how much usable marijuana Tuttle was allowed to possess under 
§ 4(a) and § 4(b).  If Tuttle was his own caregiver and the primary caregiver to two other 
qualifying patients, then Tuttle would be permitted to possess no more than a total of 36 
marijuana plants.  Under those facts Tuttle would not be entitled to § 4 immunity for any 
charged offense if he possessed more than 36 marijuana plants. 
 
 
 
45 
Tuttle is entitled to a presumption that he was engaged in the medical use of marijuana if 
he shows by a preponderance of the evidence that he possessed:  
(1) a valid registry identification card for himself as a patient and for 
each connected registered qualifying patient, and  
(2) no more than the volume of marijuana allowed by § 4(a) and 
§ 4(b).   
The prosecution may then rebut this presumption in accordance with § 4(d)(2).   
The lower courts erred when they concluded that Tuttle’s provision of marijuana 
to Lalonde necessarily tainted all of Tuttle’s marijuana-related activity thereby negating 
his ability to claim § 4 immunity for each charged offense.  Providing marijuana to 
Lalonde did not per se taint all of Tuttle’s marijuana-related conduct.  Tuttle was not 
connected to Lalonde under the MMMA.  Therefore, Tuttle was clearly outside the 
parameters of § 4 when he provided marijuana to Lalonde (counts I-III).   
Tuttle, however, may still be entitled to immunity for the remaining charges in 
counts IV-VII.  With regard to the charges of possessing and manufacturing marijuana in 
his home, the trial court must make factual determinations regarding the number of 
patients connected to Tuttle under the MMMA, the number of marijuana plants Tuttle 
had in his home and the amount of usable marijuana Tuttle possessed,90 whether the 
marijuana plants were stored in an enclosed, locked facility, and whether Tuttle was 
engaged in the medical use of marijuana. 
                                              
90 Subject to the exclusion of “any incidental amount of seeds, stalks, [or] unusable 
roots . . . .”  MCL 333.26424(4)(a) and (4)(b)(3). 
 
 
 
46 
Tuttle must prove entitlement to immunity for each charged offense. And the 
prosecution may only use evidence of conduct relating to one charged offense to rebut the 
presumption of medical use for another charged offense if a nexus exists between the 
charged offenses.  Put simply, improper conduct related to Lalonde in counts I-III may 
only affect counts IV-VII if the prosecution can establish a nexus between the improper 
conduct in counts I-III and the otherwise MMMA-compliant conduct in counts IV-VII.  
Only if this nexus exists can the trial court determine that the illicit conduct in counts I-III 
rebuts the presumption that Tuttle was engaged in the medical use of marijuana for the 
conduct underlying counts IV-VII. 
The trial court must ultimately weigh the evidence to determine if the prosecution 
successfully rebutted Tuttle’s presumption of medical use for counts IV-VII by evidence 
of the conduct relating to marijuana in counts I-III and, if so, whether Tuttle has 
otherwise shown that the charged conduct for which he claims immunity was consistent 
with the medical use of marijuana.  The flexibility allowing the trial court to make this 
decision in § 4(d) permits the trial court to hear evidence to determine if Tuttle truly was 
a primary caregiver simply trying to assist patients, or if Tuttle acted outside the 
protection of the MMMA.91 
                                              
91 Under § 4, losing the § 4(d) presumption is not fatal.  Even if the prosecution 
successfully rebuts the § 4(d) presumption in counts IV-VII related to Tuttle’s 
manufacturing of marijuana for himself and any patients, Tuttle may still prove by a 
preponderance of the evidence that he satisfied the last element of § 4(a) and § (4)(b), 
which requires that he was engaged in the medical use of marijuana during the conduct 
resulting in the specific charged offense(s). 
 
 
 
47 
To that end, factual findings are needed to determine Tuttle’s entitlement to 
immunity under § 4 for counts IV-VII.  As a result, a new § 4 evidentiary hearing 
conforming to the holdings expressed in this opinion is necessary to determine Tuttle’s 
entitlement to § 4 immunity. 
2.  SECTION 8 DEFENSE 
The lower courts properly concluded that Tuttle was not entitled to the § 8 
affirmative defense.  During an evidentiary hearing, Tuttle presented his registry 
identification card and the registry identification cards belonging to Michael Batke and 
Frank Colon.  Lalonde, Batke, and Colon also testified at the hearing.   
Lalonde testified that he first came into contact with Tuttle through an unofficial 
internet site intended to match medical marijuana patients and caregivers.  He also 
testified that he was a registered qualifying patient and that he told Tuttle he was using 
marijuana to alleviate pain.  Lalonde’s testimony, however, did not meet the first and 
third element of § 8(a), requiring his condition to be diagnosed in the course of a bona 
fide physician-patient relationship through which the physician found the condition 
suitable for the medical use of marijuana.  Lalonde did not testify about how much 
marijuana he needed to treat his debilitating condition under § 8(a)(2) or if he engaged in 
the use of marijuana under § 8(a)(3) to treat his debilitating condition. 
Batke testified that he was a registered qualifying patient and that Tuttle was 
connected to him as a registered caregiver.  Batke also testified that he would call Tuttle 
every time he needed marijuana.  As a result, Tuttle provided Batke with approximately 
two ounces of marijuana a month.  This does not speak to the amount of marijuana Batke 
 
 
 
48 
reasonably needed in order to treat his debilitating condition, only to the amount of 
marijuana actually provided.  Nor did Batke establish that he had a bona fide relationship 
with a physician.  Lastly, Colon testified that he was a registered qualifying patient, that 
he had a medical condition, and that he utilized Tuttle as a caregiver.  Colon stated he 
would request between one and two ounces of marijuana each week from Tuttle.  Colon 
did not testify that he received a full medical assessment in the course of a bona fide 
physician-patient relationship. 
Lalonde’s, Batke’s, and Colon’s testimony was deficient in establishing at least 
one element of § 8(a).  Additionally, the patients’ testimony combined with their registry 
identification cards did not establish prima facie evidence under § 8(a).  Therefore, Tuttle 
failed to present prima facie evidence of each element of § 8(a).  The Court of Appeals 
correctly affirmed the trial court’s denial of Tuttle’s motion to dismiss under § 8 and 
correctly denied his request to present a § 8 defense at trial. 
IV.  CONCLUSION 
In People v Hartwick, Docket No. 148444, we conclude that (1) the trial court 
must hold a new evidentiary hearing to determine Hartwick’s entitlement to immunity 
under § 4, and (2) Hartwick is not entitled to an affirmative defense under § 8.  
Accordingly, we affirm the judgment of the Court of Appeals in part, reverse in part, and 
remand to the trial court for proceedings not inconsistent with this opinion. 
In People v Tuttle, Docket No. 148971, we conclude that (1) the trial court must 
hold a new evidentiary hearing to determine Tuttle’s entitlement to immunity under § 4, 
 
 
 
 
49 
and (2) Tuttle is not entitled to an affirmative defense under § 8.  Accordingly, we affirm 
the judgment of the Court of Appeals in part, reverse in part, and remand to the trial court 
for proceedings not inconsistent with this opinion. 
 
 
Brian K. Zahra 
 
Robert P. Young, Jr. 
 
Stephen J. Markman 
 
Mary Beth Kelly 
 
Bridget M. McCormack 
 
David F. Viviano 
 
Richard H. Bernstein