Opinion ID: 717496
Heading Depth: 4
Heading Rank: 2

Heading: The fraud convictions

Text: 52 Dumlao also appeals her conviction on thirteen counts of knowingly or intentionally acquiring or obtaining a controlled substance by misrepresentation, fraud, deception, or subterfuge in violation of the Controlled Substances Act, 42 U.S.C. § 843(a)(3). First, like her defense to the conspiracy charge, Dumlao argues that she was not aware that she was unlawfully issuing prescriptions, and thus did not have the requisite intent and knowledge to perpetrate a fraud upon pharmacies. In sum, Dumlao claims she was not the source of the fraud, but its victim--merely the conduit for the misrepresentations. This is a variation of the argument addressed above in the conspiracy context, and goes no further here. The jury found otherwise, and had a rational basis for doing so. 53 Dumlao next argues that the evidence offered to prove some of these counts was insufficient. Seven of the thirteen counts were based on prescriptions for six patients, none of whom testified at trial. Citing the Fourth Circuit's decision in United States v. Tran Trong Cuong, 18 F.3d 1132 (4th Cir.1994), Dumlao claims that the lack of testimony from these patients is impermissible because it invites the jury to find guilt by association or pattern, rather than consider each count independently. 54 In Tran Trong Cuong, the government attempted to prosecute a physician for over 130 counts of distribution of a controlled substance. The evidence for eighty of these counts, however, consisted merely of copies of the prescriptions and an expert's testimony and exhibit summarizing a fraction of the patients' files. 18 F.3d at 1141. None of the twenty patients who received the prescriptions testified. Id. Finding this to be a classic example of 'overkill' by the prosecution, the Fourth Circuit reversed Tran's convictions on the eighty counts for insufficiency of the evidence. Id. at 1142. 55 In a more recent case, however, the Fourth Circuit emphasized that the presence or absence of witness testimony is not the only criterion of sufficiency. In United States v. Singh, 54 F.3d 1182 (4th Cir.1995), the court stated that [i]n Tran Trong Cuong, we reversed the convictions, not because the victims did not testify, but rather because their lack of testimony was not replaced by any substantive evidence. Singh, 54 F.3d at 1188. Indeed, while witness testimony is important, it is difficult to see why it should be the touchstone in such determinations, especially given the fact that many patients in this case had terminal illnesses or suffered from a variety of other misfortunes which might have precluded availability. 56 In any event, unlike Tran Trong Cuong, there was plenty of substantive evidence regarding these counts without witness testimony. Much of this information was individual and particularized. In addition to the copies of the specific prescriptions, the government produced Dumlao's medical files on the patients in question. Furthermore, the government's expert reviewed all of these files and concluded that none contained adequate justification for a Dilaudid prescription--indeed, he noted some files contained information making such a prescription improper. Moreover, as a general factor, the jury was aware that all of these nontestifying patients were associated with Sanchez and her scheme to obtain Dilaudid. With these additional items of information, the jury was not asked to infer guilt on these counts merely from the other improper prescriptions. Accordingly, we find the evidence sufficient to support the convictions rendered.