Opinion ID: 77178
Heading Depth: 3
Heading Rank: 4

Heading: Suzanne Burgos

Text: Suzanne Burgos argues that the evidence was not sufficient to support her conviction; that the district court erred by admitting certain extrinsic evidence and by treating an inspector’s audit as intrinsic rather than extrinsic evidence; and that the district court should not have instructed the jury on deliberate ignorance. Burgos also argues that in determining her guideline range for sentencing, the district court incorrectly calculated the loss attributable to her. After careful review of the record, we find that the evidence was sufficient to support the jury’s conclusion that Suzanne Burgos knowingly participated in the 11 conspiracy. Documentary evidence established that Suzanne was a corporate officer of both La Moderna Pharmacy and South Beach Pharmacy, and several witnesses testified that Suzanne was involved in hiring personnel for those pharmacies, including personnel whose work involved filling the fraudulent aerosol prescriptions. Mary Ghabrial, who worked as a managing pharmacist at La Moderna and was not charged with any wrongdoing, testified that Suzanne Burgos was manager of the pharmacists at these pharmacies and “always made it a point to know what was going on in each pharmacy. . . . She called at the end of the day to get the sales and how many [prescriptions] . . . .” In her daily reports to Suzanne, Ghabrial was required to report aerosol sales separately. Ghabrial further testified that although she was hired to supervise only the prescription area at La Moderna, which did not include the aerosol compounding section, she became aware that significant quantities of aerosol medication were nonetheless being dispensed with La Moderna labels, often with Ghabrial’s initials as dispensing pharmacist, without her supervision. Ghabrial testified that she informed Suzanne Burgos about this. Additionally, according to Ghabrial’s testimony, Areta Ruiz, a pharmacy technician, was dispensing aerosol medication from Peripheral DME, a DME company located next door to and affiliated with La Moderna, with no apparent pharmacist supervision, as is required by law. On cross 12 examination, Ghabrial testified that Ruiz reported to either Marco or Suzanne Burgos. Additionally, Ghabrial testified that Janeide Reguiero, a pharmacy technician at South Beach Pharmacy, told Ghabrial that Suzanne Burgos knew that Reguiero was filling aerosol prescription vials with incorrect volumes of medication. In light of the evidence establishing the substantial fraudulent aerosol business ongoing at both La Moderna and South Beach Pharmacies,11 the jury was entitled to infer that Suzanne Burgos, a licensed pharmacist whom evidence established was active in managing both the personnel and day-to-day activities of both pharmacies, was a knowing participant in the fraudulent conspiracy.12 Similarly, the district court did not err by instructing the jury on deliberate ignorance, as there was evidence to support an inference that Suzanne Burgos, 11 Pharmacy technician Odalys Regil, who pled guilty and cooperated with the prosecution, testified that La Moderna Pharmacy would borrow aerosol medication from South Beach Pharmacy to fill the prescriptions and that she knew the medications she was helping dispense were not for actual use by patients because “the DME owners would brag about [the fraud].” Ghabrial's testimony underscored the cooperation between the Burgos’ two pharmacies in filling the aerosol prescriptions for the DME companies, testifying that after La Moderna moved to a new location, the aerosol medications were no longer compounded or filled at La Moderna. Rather, the DME companies faxed prescriptions directly to South Beach, where medication was compounded, filled in boxes, and delivered to La Moderna for dispensal. 12 Additionally, Carlos Gomez, a La Moderna pharmacy technician, testified that Burgos was active in supervising the compounding, even directing him to modify the formula. Regil testified to the sloppy compounding and dispensal methods at La Moderna, as discussed below, Section II.E. Although Regil testified that Michael Iheagwara was her primary managing pharmacist at La Moderna, Suzanne Burgos would occasionally substitute as managing pharmacist and, like Iheagwara, failed to supervise Regil's work supplying prescriptions for the DME companies. Finally, Suzanne Burgos’ initials appear in La Moderna logs on numerous occasions as the dispensing pharmacist for aerosol medications. 13 through her role at South Beach and La Moderna Pharmacies, was aware of facts that should have put her on notice of the fraudulent activity, but deliberately insulated herself from positive knowledge. The district court did not abuse its discretion by admitting extrinsic evidence or by allowing Agent Cesar Arias to testify about his audit of La Moderna and South Beach Pharmacies, as the audit represented intrinsic evidence that the pharmacies had purported to sell more product during the time period of the conspiracy than the volume of supplies they purchased would have allowed. As to Suzanne Burgos’ sentence, the district court did not err in calculating the amount of loss attributable to Suzanne Burgos – in a jointly undertaken criminal activity, each defendant is responsible for “all reasonably foreseeable acts and omissions of others in furtherance of the jointly undertaken criminal activity.” U.S.S.G. § 1B1.3(a)(1)(B).