Opinion ID: 4123854
Heading Depth: 3
Heading Rank: 1

Heading: Medical-Condition Variance

Text: Pielsticker based his first motion for variance on his heart condition. He argues that the district court unreasonably denied the motion for variance by failing to consider the 18 U.S.C. § 3553(a) factors. In his motion and during sentencing, Pielsticker presented evidence that he relies on an implant to shock his heart when it fails or becomes arrhythmic; and that he needs to replace the implant. His treating cardiologist stressed that Pielsticker was at a “GREAT risk of death” and worried how prison might affect his medical condition. Appellant App. vol. 1 at 73-74. As a matter of procedural reasonableness, because Pielsticker’s sentence falls within the advisory Guidelines’ range, § 3553(c) requires that the district court state “the reasons for its imposition of the particular sentence.” 18 U.S.C. § 3553(c); United States v. McComb, 519 F.3d 1049, 1054 (10th Cir. 2007). The district court meets this threshold when it provides a “general discussion”12 of the § 3553(a) factors. Geiner, 498 F.3d at 1113. Despite Pielsticker’s contention that the district 12 Though we also noted that this “is not necessarily the best practice.” United States v. Geiner, 498 F.3d 1104, 1113 (10th Cir. 2007). 22 court failed to consider the § 3553(a) factors, the record shows that the district court provided more than a general discussion. Without explicitly listing the § 3553(a) factors, the district court considered the need “to provide the defendant with . . . medical care.” 18 U.S.C. § 3553(a)(2)(D). Based on a Bureau of Prisons’ (the “Bureau”) representation, the district court found that Pielsticker could have his implant replaced in a federal medical facility. It also found that Pielsticker’s “heart condition is not so extraordinary or unusual as to distinguish [his] case from typical cases covered by the guidelines.” Appellant App. vol. 3 at 585. Evidence from the record supported this finding, including (1) Pielsticker’s failure to have surgery within the eight months leading up to sentencing; (2) the Bureau’s representation that it had a federal medical facility capable of performing the replacement;13 and (3) Pielsticker’s ability to engage in normal life activities. Thus, the district court did not abuse its discretion in denying Pielsticker’s first motion for variance. 13 Pielsticker argues that the Bureau’s representation is “a double hearsay ex parte communication about a mission-critical fact.” Appellant Opening Br. at 43. But at sentencing, the district court can credit “relevant information without regard to its admissibility . . . provided that the information has sufficient indicia of reliability to support its probable accuracy.” USSG § 6A1.3(a); see United States v. Friedman, 499 F. App’x 807, 810-11 (10th Cir. 2012) (unpublished) (finding that the record suggested no prejudice from an assumed ex parte communication with the United States Marshals). 23