Opinion ID: 4513522
Heading Depth: 3
Heading Rank: 2

Heading: L.K.W.’s Cause of Death (Count 2)

Text: Hamm and Shields also argue that there is insufficient evidence that L.K.W.’s “death . . . result[ed] from” carfentanil use, so they cannot be liable for the sentencing enhancement on Count 2. 21 U.S.C. § 841(b)(1)(C). This argument also fails. To apply the enhancement, assuming that “use of the [carfentanil] [was] not an independently sufficient cause of [L.K.W.’s] death,” the jury needed to conclude that carfentanil use was a but-for cause of L.K.W.’s death. Burrage v. United States, 571 U.S. 204, 218–19 (2014). When he died, L.K.W. had carfentanil in his blood at a concentration of 114 picograms per milliliter. The medical examiner, Dr. William Ralston, testified that L.K.W. died “[b]ecause of the carfentanil,” and that had he not used carfentanil, “he would not have died at that time.” Similarly, Michael Ward, the government’s toxicology expert, opined that if L.K.W. “had not had Nos. 17-6383/18-5121 United States v. Hamm, et al. Page 9 that level of carfentanil, I believe that he could have survived.” Id. at 1133. A reasonable juror could have credited this testimony and concluded that carfentanil use was a but-for cause of L.K.W.’s death.3 It is true that L.K.W. also had methamphetamine in his blood, at a potentially fatal concentration of 213 nanograms per milliliter.4 However, “[b]ut-for causation exists where use of the controlled substance ‘combines with other factors to produce’ death, and death would not have occurred ‘without the incremental effect’ of the controlled substance.” United States v. Volkman, 797 F.3d 377, 392 (6th Cir. 2015) (quoting Burrage, 571 U.S. at 211). A reasonable juror could have concluded that carfentanil and methamphetamine combined to cause L.K.W.’s death and that L.K.W.’s death would not have occurred without the marginal effect of the carfentanil. The testimonies from Ward and Ralston support that conclusion. Hamm alone makes one other causation argument. He claims that he “was not the cause of death and injury to others as Tracey Myers was the one responsible for giving the toxic product to [L.K.W.] and others.” Appellant Br. at 36. He seems to be importing a tort concept of proximate cause, arguing that Myers’s intervening conduct breaks the chain of causation and cuts off his liability. But as we will discuss further below, a defendant may be convicted of distribution of controlled substances by virtue of being in a conspiracy with the perpetrator of the substantive distribution offense. To be liable for the § 841(b)(1)(C) enhancement after having been convicted on a conspiracy theory, the defendant need only have been part of the distribution chain of the drug at some point and need not have distributed the drug directly to the victim. 3Both Ralston and Ward also opined that L.K.W.’s carfentanil consumption was independently sufficient to cause his death. An independently sufficient cause is not quite the same thing as a but-for cause. See Antony Honoré and John Gardner, Causation in the Law, Stanford Encyclopedia of Philosophy (Winter 2010 ed.), https://plato.stanford.edu/archives/win2010/entries/causation-law/. In Burrage, the Supreme Court left open the question of whether the death-or-injury enhancement applies when drug use is an independently sufficient cause of death. 571 U.S. at 214–15. Because there is sufficient evidence that carfentanil use was a but-for cause of L.K.W.’s death, we need not address independently sufficient causation. 4Dr. Ralston testified that “[t]he methamphetamine is at a relatively low level, although, it too could potentially cause death.” Ward explained that the concentration of methamphetamine in L.K.W.’s blood was “[t]oxic, without question,” but whether it was “[l]ethal” depended on whether L.K.W. was “a first time user” and on “his health history.” Another witness, Dr. Feola, testified that L.K.W.’s methamphetamine concentration was “in the low range” of the “spectrum” in which methamphetamine could cause death. Nos. 17-6383/18-5121 United States v. Hamm, et al. Page 10