Opinion ID: 8410701
Heading Depth: 2
Heading Rank: 2

Heading: Conduct Involving Conscious or Reckless Risk of Death or Serious Bodily Injury

Text: We turn next to Redman's challenge to the application of the enhancement for placing patients at risk of death or serious injury. Section 2B1.1(b)(15)(A) calls for a two-level upward adjustment if the offense involved the conscious or reckless risk of death or serious bodily injury. Serious bodily injury is a phrase of general applicability used frequently throughout the Guidelines and means injury involving extreme physical pain or the  protracted impairment of a function of a bodily member, organ, or mental faculty; or requiring medical intervention such as surgery, hospitalization, or physical rehabilitation. U.S.S.G. § 1B1.1, Cmt. 1(L). Actual injury need not occur for the enhancement to apply. Vivit , 214 F.3d at 921 . In applying this enhancement, the district court emphasized that Redman's patients, who had serious psychiatric problems, relied on him to diagnose and treat their illnesses. Redman had absolutely no training to equip him to do that. His conduct, both in what he did to treat patients and what he might have missed because of his lack of training, put his patients at risk. Similarly, the government argues on appeal that the risk of addiction and even death from misprescribed medications, along with the risk that a misdiagnosis of a patient with a serious mental illness could lead to serious harm to the patient or others, falls squarely within the standard for serious bodily injury. U.S.S.G. § 1B1.1, Cmt. 1(L). The real Dr. Julian Lopez Garcia penned a letter that was read at sentencing, stating that [e]very time a prescription is written, the physician has to weigh the benefits, risks, adverse reaction profile and potential benefit for the patient. Also, the doctor has to prescribe a precise dose and evaluate possible interactions with other medications. It is a complex process but if done incorrectly can have serious implications in the health of a patient and can even cause their demise. ... Mr. Redman put every patient's life at stake when he recklessly decided to treat and write prescriptions under my name. (Docket #105 at 9). Redman argues that, despite his lack of medical training or credentials, he was capable of acting as a psychiatrist and prescribing controlled substances in a way that did not cause a risk of serious injury. He made a similar argument at his sentencing hearing, noting that 150 years ago, there were no formal licensing requirements for medical treatment providers and those providers were nonetheless competent to do their jobs. This argument strains credulity. Of course, Redman not only lacks the requisite credentials, he lacks any training or knowledge about the practice of medicine. And, as the district court aptly noted, Redman's crimes did not occur 150 years ago. Redman committed his crimes at a time when educational and licensing requirements were in place to protect patients from potential harm from unqualified people like Redman. Indeed, Redman's conduct was more egregious than that of other defendants whose conduct we have found warranted this enhancement. See, e.g., United States v. Jimenez , 41 Fed.Appx. 1 , 4 (7th Cir. 2002) (defendant podiatrist prescribed painkillers and anxiety medications to patients who did not need them); Vivit , 214 F.3d at 920 (defendant physician failed to perform physical examinations on patients who visited him following automobile accidents and failed to perform certain basic diagnostic tests, such as taking blood pressure, on other patients who later proved to be at risk). Unlike Vivit and Jimenez, Redman is not a trained and licensed medical professional who performed his duties with criminal negligence. He is a high-school dropout fraudster. Finally, Redman argues that the district court erred by re-lying on speculation in determining whether Redman's conduct involved the conscious or reckless risk of death or serious bodily injury. He points to the judge's observation at sentencing that no one knows the long-term harm caused by [Redman's] actions. (Docket #105 at 17). But Redman's argument  misses the mark, because the enhancement applies in cases involving a risk of serious injury, not proof of actual injury. Although it is true that sentencing determinations must be based on reliable evidence, not speculation or unfounded allegations, United States v. Bradley , 628 F.3d 394 , 400 (7th Cir. 2010), the district court in this case relied on ample evidence that Redman exposed his patients and others to the risk of tragic harm. The district court did not clearly err by concluding that Redman recklessly created a serious risk of bodily injury.