Opinion ID: 1354921
Heading Depth: 2
Heading Rank: 5

Heading: Sufficiency of EvidenceCounts 2, 9 & 10

Text: The appellant next argues, as he did below in his motion to set aside the verdicts, that the evidence was not sufficient to support the convictions under counts 2, 9 and 10 of the indictment. We disagree. The familiar statement of the standard to be used in analyzing the sufficiency of the evidence in a criminal case is set forth in syllabus point one of State v. Starkey, 161 W.Va. 517, 244 S.E.2d 219 (1978): In a criminal case, a verdict of guilt will not be set aside on the ground that it is contrary to the evidence, where the state's evidence is sufficient to convince impartial minds of the guilt of the defendant beyond a reasonable doubt. The evidence is to be viewed in the light most favorable to the prosecution. To warrant interference with a verdict of guilt on the ground of insufficiency of evidence, the court must be convinced that the evidence was manifestly inadequate and that consequent injustice has been done. Accord, syl. pt. 1, State v. Ward, ___ W.Va. ___, 407 S.E.2d 365 (1991); syl. pt. 1, State v. Ferrell, ___ W.Va. ___, 399 S.E.2d 834 (1990), cert. denied, ___ U.S. ___, 111 S.Ct. 2801, 115 L.Ed.2d 974 (1991). We apply this Starkey test here to the evidence on the disputed elements of the offense charged in counts 2, 9 and 10, specifically, whether the prescriptions in question were issued for a legitimate dental purpose and, if not, did the appellant commit intentional malpractice. Our conclusion is that the evidence shows sufficiently that the prescriptions were issued intentionally for an illegitimate purpose, namely, only to satisfy the purported patients' desire for the Tylox. The court in United States v. Rosen, 582 F.2d 1032, 1036 (5th Cir.1978), gave a noninclusive list of factual scenarios indicating that purported prescriptions for controlled substances intentionally were not issued for a legitimate purpose. These recurring examples of behavior, extracted from the reported cases, include the following, one or more of which may be present in a given case: (1) no, or only a cursory, examination was given; (2) prescriptions were issued at intervals which were inconsistent with legitimate treatment of the underlying condition; (3) there was no logical relationship between prescribing only the controlled substance(s) and treatment of the underlying condition allegedly existing; (4) large numbers of prescriptions were issued; (5) a large quantity of the controlled substance(s) was prescribed; (6) the practitioner wrote more than one prescription on the same occasion to spread them out; (7) the practitioner warned the patient to fill prescriptions at different drugstores; (8) the practitioner used street slang rather than professional terminology for the controlled substance(s) prescribed; (9) the practitioner issued prescriptions to a patient known to be delivering the controlled substance(s) to others. The first four factual scenarios were present in this case as shown in subsection I(B) supra of this opinion. See also United States v. Chin, 795 F.2d 496, 500, 503 (5th Cir.1986) (only cursory examinations; patients gave exaggerated symptoms to defendant practitioner); Commonwealth v. Wood, 17 Mass.App.Ct. 304, 306-07, 457 N.E.2d 1131, 1132-33 (1983) (dentist prescribed narcotic analgesics repeatedly and frequently over several months; little or no examinations and little or no dental treatments; court rejected defendant's argument that evidence showed only negligence). The State's expert witness at trial, an emergency room physician trained and experienced in the area of narcotic prescribing practices was very critical of the appellant's narcotic prescribing practices. For example, in reviewing the appellant's charts on Gentry, the State's expert witness opined that those records suggested more than simply atrocious narcotic prescribing practice and atrocious record keeping; the records suggested the possibility of doing something illegal. While the State's expert witness admitted that he was conservative in prescribing the use of pain relievers, he also stated unequivocally that it clearly would not be sound medical judgment to prescribe Tylox for a problem that the patient simply does not seek other treatment for, if it's a treatable condition. [20] In any event there was sufficient evidence under the Starkey standard to show that the appellant's conduct in question bore virtually no more resemblance to professional dental practice than the conduct of any street-corner [drug] pusher. United States v. Larson, 507 F.2d 385, 388 (9th Cir.1974).