Opinion ID: 4394859
Heading Depth: 2
Heading Rank: 2

Heading: Sierra

Text: Sierra submitted a restitution request for $10,000. In support of her request, Sierra submitted a medical letter from Dr. Sharon W. Cooper, a forensic pediatrician, based on her December 2015 evaluation of Sierra. Dr. Cooper explained that victims of child pornography can experience physical, emotional, and spiritual issues as a result of their online exploitation, including immunological 6 Case: 17-12349 Date Filed: 05/08/2019 Page: 7 of 67 problems, posttraumatic stress disorder (“PTSD”), anxiety, depression, suicidal ideation, and feelings of hopelessness. Dr. Cooper noted that “[w]hen images are known to be in distribution, the pre-existing dysfunction caused by the initial abuse is typically worsened, since children remain at risk for further victimization by the ongoing downloading, trading and possession of their images.” With respect to Sierra specifically, Dr. Cooper stated that Sierra’s medical evaluation showed she suffered from worsening insomnia, attention deficit hyperactivity disorder (“ADHD”), depression, suicidal ideation, PTSD, and mood lability. Dr. Cooper noted that, despite being on five different medications, Sierra’s condition remained unstable and she recently required emergency treatment for suicidality. Dr. Cooper opined that “[t]he ongoing presence of trafficking in images [of Sierra] on the Internet constitutes a significant aspect of psychological maltreatment that will add on to the initial adversities” caused by the original abuse. Based on Sierra’s past medical history, the documented adversities faced by victims of child sexual abuse and child pornography offenses, and Sierra’s present medical symptoms, Dr. Cooper estimated a total cost of $661,453.00 for Sierra’s future medical care. Sierra’s counsel also submitted a declaration of attorney’s fees, indicating Sierra had incurred nearly $5,000 in attorney’s fees in connection with this case. 7 Case: 17-12349 Date Filed: 05/08/2019 Page: 8 of 67 The government supported Sierra’s $10,000 restitution request. The government observed that four other defendants had been ordered to pay restitution to victims in the same series of images as Sierra. Those awards were for $4,000, $1,000, $9,000, and $2,000. Rothenberg opposed Sierra’s restitution request. Rothenberg noted that he possessed only one image of Sierra1 and that the requested restitution amount was more than double the average of Sierra’s prior awards ($4,000). Rothenberg argued that Sierra’s restitution materials made no attempt at disaggregation and that the government provided no information to demonstrate the relative amount of Sierra’s harm caused by his conduct.