Opinion ID: 559981
Heading Depth: 2
Heading Rank: 3

Heading: sufficiency of the evidence

Text: 20 Sufficiency of the evidence is a question of law which this Court reviews de novo. United States v. Kelly, 888 F.2d 732, 739 (11th Cir.1989). This Court examines the evidence, including all reasonable inferences and credibility choices, in the light most favorable to the government. Id. at 740. The inquiry is whether a factfinder could find that the evidence establishes guilt beyond a reasonable doubt. Id. The Court need not exclude every reasonable hypothesis of innocence or find guilt to be the only reasonable conclusion. Id. 21 Dr. Hooshmand argues that the evidence supporting the convictions for false EMG billing was insufficient. He argues that the government failed to rule out the possibility that surface electrodes instead of needles were used to perform the EMG tests and that the patient witnesses were not credible. 22 An EMG requires a needle to be inserted into the muscle. The insertion of the needle generally causes considerable pain. Patients generally remember the pain unless they have severe nerve problems. Occasionally, surface electrodes instead of needles are used where detection of gross movement is sufficient for diagnosis, e.g., Parkinson's disease. However, a needle exam is most common. 23 Each of the patient-witnesses testified about the tests performed on them by Dr. Hooshmand and his technicians. Their accounts of procedures utilized contradicted the customary EMG procedures described above. None of the patients had nerve damage so severe as to render them incapable of feeling or recalling the pain associated with an EMG test. Therefore, the jury could reasonably infer that the tests were never conducted. Although one witness apparently suffered from occasional hallucinations, the question of the capacity and credibility of these witnesses to recall the procedures is properly a question for the jury. United States v. McRary, 616 F.2d 181, 183 n. 1 (5th Cir.1980), cert. denied, 456 U.S. 1011, 102 S.Ct. 2306, 73 L.Ed.2d 1307 (1982). 7 24 There was also testimony that Dr. Hooshmand ordered his staff to schedule tests on patients and mark EMGs on charge sheets before he had even examined the patients. Finally, neither of the technicians who assisted Dr. Hooshmand in giving the EMGs testified about ever performing the EMG or observing one performed with surface electrodes. This evidence was sufficient to sustain Dr. Hooshmand's convictions on the EMG claims. 8