Opinion ID: 6330205
Heading Depth: 4
Heading Rank: 2

Heading: Hofstetter’s Conspiracy Convictions

Text: Hofstetter also argues that insufficient evidence supported her three conspiracy convictions: a conspiracy to distribute controlled substances at Gallaher View and Lenoir City, a conspiracy to distribute controlled substances at Lovell Road, and a RICO conspiracy. To prove that Hofstetter participated in the first two drug conspiracies, the government was required to show that she, along with at least one other individual, “agreed to violate a drug law (such as § 841(a)(1)’s ban on distributing drugs) and that [she] knowingly and voluntarily entered into this agreement.” United States v. Wheat, 988 F.3d 299, 306 (6th Cir. 2021). Because conspiracy is an inchoate offense, the essence of a conspiracy “is an agreement to commit an unlawful act.” Id. (quoting Iannelli v. United States, 420 U.S. 770, 777 (1975)). The government did need not to prove that Hofstetter “completed [her] agreed-upon drug crime” or even that she “took an overt act to implement the crime.” Id. Furthermore, “[a]n agreement can be tacit, not formal, and the ‘government may meet its burden of proof through circumstantial evidence.’” United States v. Williams, 998 F.3d 716, 728 (6th Cir. 2021) (quoting United States v. Layne, 192 F.3d 556, 567 (6th Cir. 1999), cert. denied, 529 U.S. 1029 (2000)). Benjamin Rodriguez, one of the Florida partners, testified that the partners discussed that they did not intend Gallaher View and Lenoir City to be legitimate clinics, and that Hofstetter was involved in those discussions and aware of their intent. Rodriguez described that Hofstetter “would always call us the three amigos and that we were here to open up a pill mill.” (Trial. Tr., R. 936, PageID 74948.) Witnesses also testified that Hofstetter approached Tipton about opening Lovell Road, without the Florida partners, and that she found patients for this new clinic Nos. 20-6245/6426/6427/6428 United States v. Hofstetter, et al. Page 21 by soliciting patients that had previously been discharged from other clinics for exhibiting signs of drug abuse. Rodriguez and Tipton also described how the Florida partners fired Hofstetter from the Hollywood clinic for suspected embezzlement, but then later re-hired her to run the Tennessee clinics and retained her even though they believed her to be embezzling again. The government argued that this evidence further demonstrates that the Florida partners and Hofstetter intended to operate the clinics unlawfully. See infra part II.D.i.a. Viewing all the evidence in the light most favorable to the government, we find that there was sufficient support for the jury’s conclusion that Hofstetter knowingly agreed to violate a drug law at the clinics. Hofstetter’s arguments about conflicting testimony and weight of the evidence are not for us to consider. See LaVictor, 848 F.3d at 456. To prove that Hofstetter participated in a RICO conspiracy, the government was required to show that she “intended to further an endeavor which, if completed, would satisfy all the elements of a substantive RICO criminal offense[.]” United States v. Fowler, 535 F.3d 408, 420 (6th Cir. 2008) (quotation marks and brackets omitted) (quoting United States v. Saadey, 393 F.3d 669, 676 (6th Cir. 2005)). A substantive RICO offense requires the government to prove: (1) the existence of an enterprise that affects interstate commerce; (2) Hofstetter’s association with the enterprise; (3) Hofstetter’s participation in the conduct of the enterprise’s affairs; and (4) that the participation occurred through a pattern of racketeering activity. Id. at 418. Hofstetter appears to challenge the evidentiary support for the first element: she suggests that the clinics were not “RICO organization[s]” because there is not substantial evidence that they “unlawfully distribute[d] pain medication outside the usual course of professional practice and for no legitimate medical purpose.” (Hofstetter Br. 42–43.) She highlights specific testimony in support. But as already discussed throughout this section, the government submitted sufficient evidence for the jury to find otherwise. Hofstetter offers no other argument as to this charge. We therefore affirm the verdict. Nos. 20-6245/6426/6427/6428 United States v. Hofstetter, et al. Page 22