Opinion ID: 3048275
Heading Depth: 4
Heading Rank: 1

Heading: of this section shall be sentenced as follows:

Text: ... such person . . . if death or serious bodily injury results from the use of such substance shall be sentenced to a term of imprisonment of not less than twenty years or more than life . . . . 21 U.S.C. § 841(b)(1)(C) (emphasis added). The dispute in this case centers on whether § 841(b)(1)(C)’s enhanced penalty requires the jury to find (1) merely that the patient’s use of the controlled substance (unlawfully prescribed by Webb) was the actual cause of death; or (2) 7 The indictment does not specify whose death resulted from the use of which drugs; it does not even mention the names of the victims. Evidence adduced at trial indicates that Morris died from the use of fentanyl and Ross died from the use of oxycodone. 23 that Webb’s conduct proximately caused the death or at least that the death was reasonably foreseeable to Webb. As to the § 841offenses (Counts 38 and 107), the district court instructed there was no foreseeability or proximate cause requirement, and that instead the government must prove that “but for” (had it not been for) the victim’s ingesting of the drugs charged in the indictment, the victim would not have died. The district court’s instruction stated: Similarly, as it concerns Counts 38 and 107, the law provides that whenever death or serious injury is a result of the victim’s use of a controlled substance that has been distributed or dispensed by the Defendant, a more serious offense is committed, regardless of whether the defendant knew or should have known that death would result. There is no requirement that the death resulting from the use of the controlled substance dispensed was a reasonably foreseeable event, or that the controlled substance was the proximate cause of the death. This standard is satisfied upon a finding by you that, but for the victims ingesting the controlled substances charged in the indictment, the victims would not have died. Therefore, you are to determine as follows: ... Whether in Count 38 the death of Trebble Morris resulted from the use of fentanyl and whether the death of Victoria Ross resulted from the use of oxycodone that Defendant had caused to be dispensed, between in or about December, 2002 and on or about September 13, 2007. 24 Whether in Count 107 the death of Victoria Ross resulted from the use of oxycodone that the Defendant caused to be distributed or dispensed, between on or about August 15, 2004 and on or about August 16, 2004. On appeal, Webb contends that the district court (1) erred in refusing his requested instruction and (2) should have instructed that, to find Webb responsible for the deaths, it had to find “proof of actual cause and effect” between Webb’s own conduct and his patients’ deaths.8 Webb submits that “[l]egal causation (proximate cause and foreseeability) is a fundamental principle of jurisprudence and it should have been part of the government’s burden of proof for all three deaths—Congress has not stated otherwise.” We disagree. Rather we join several of our sister circuits and hold that § 841(b)(1)(C)’s enhanced penalty requires only proof that the death resulted from the victim’s use of a controlled substance dispensed by the defendant. See United States v. De La Cruz, 514 F.3d 121 (1st Cir. 2008); United States v. Houston, 406 8 Webb challenges both the failure to give his instruction and the instruction the district court gave instead. We review a district court’s rejection of a proposed jury instruction for abuse of discretion. Merrill, 513 F.3d at 1305. “The district court has broad discretion in formulating jury instructions as long as those instructions are a correct statement of the law.” Id. (quotation marks omitted). We will reverse the district court’s refusal to incorporate a requested jury instruction “only if the proffered instruction was substantially correct, the requested instruction was not addressed in the charges actually given, and failure to give the instruction seriously impaired the defendant’s ability to present an effective defense.” Id. (quotation marks omitted). We review the legal correctness of the jury instruction actually given de novo. United States v. Prather, 205 F.3d 1265, 1270 (11th Cir. 2000). Jury instructions are subject to harmless error review. See Davis v. Kemp, 752 F.2d 1515, 1520-21 (11th Cir. 1985) (en banc). 25 F.3d 1121 (9th Cir. 2005); United States v. McIntosh, 236 F.3d 968 (8th Cir. 2001); United States v. Robinson, 167 F.3d 824 (3d Cir. 1999); United States v. Patterson, 38 F.3d 139 (4th Cir. 1994). We discuss these decisions in depth, as some focus on foreseeability and others on proximate cause.9 1. United States v. Patterson, 38 F.3d 139 (4th Cir. 1994) In Patterson, the Fourth Circuit held that reasonable foreseeability is not an element of the death “results from” sentence enhancement in § 841(b)(1)(C). Patterson, 38 F.3d at 145. The two defendants in Patterson pled guilty to unlawful distribution of controlled substances, but reserved the right to contest at sentencing whether victim Carroll’s death resulted from their distribution of controlled substances. Id. at 141.10 The sentencing court found that Carroll’s death resulted from the drugs brought by defendant Patterson to the party. Id. at 141-42. On appeal, the defendants argued that the district court erred in not requiring the government to prove that Carroll’s death was a foreseeable result of 9 While Webb has not directed us to any definition of the two terms, foreseeability is widely defined as an element of proximate cause. See Black’s Law Dictionary 721 (9th ed. 2009) (“Foreseeability, along with actual causation, is an element of proximate cause in tort law.”). 10 Carroll attended a party at Defendant Laythe’s residence. Patterson, 38 F.3d at 142. Defendant Patterson brought controlled substances to the party, “including Demerol, Mepergan, morphine sulfate, and Valium, all in tablet or capsule form.” Id. Carroll later took some of the pills Patterson gave to Laythe, and injected some heroin that Patterson melted down. Id. Everyone involved went to sleep, and when Patterson and Laythe awoke, they found Carroll dead. Id. 26 the defendants’ distribution of controlled substances before applying the enhanced penalty in § 841(b)(1)(C). Id. at 142-43. The defendants argued that “(1) the statute imposes a ‘reasonable foreseeability of death’ requirement, and (2) the Government failed to provide sufficient evidence to prove that the death of Carroll was, in fact, a reasonably foreseeable consequence of their actions.” Id. at 145. Rejecting this claim, the Fourth Circuit concluded that “because we find that § 841(b)(1)(C) imposes no reasonable foreseeability requirement, we need not address the question whether Carroll’s death was reasonably foreseeable” to the defendants. Id. The Fourth Circuit explained that “the plain language of § 841(b)(1)(C) does not require, nor does it indicate, that prior to applying the enhanced sentence, the district court must find that death resulting from the use of a drug distributed by a defendant was a reasonably foreseeable event.” Id. Instead, “[t]he statute puts drug dealers and users on clear notice that their sentences will be enhanced if people die from using the drugs they distribute.” Id. The Fourth Circuit concluded that: “Where serious bodily injury or death results from the distribution of certain drugs, Congress has elected to enhance a defendant’s sentence regardless of whether the defendant knew or should have known that death would result.” Id. The Fourth Circuit refused to “second-guess [Congress’s] unequivocal choice.” Id. 27 2. United States v. Robinson, 167 F.3d 824 (3d Cir. 1999) The Third Circuit concluded that § 841(b)(1)(C) does not require proof that a defendant’s actions are the proximate cause of a victim’s death. Robinson, 167 F.3d at 826. Defendant Robinson delivered heroin to Bungar, who delivered it to Allison, who died of a heroin overdose. Id. at 826-27. The jury convicted Robinson of conspiring to distribute heroin. The sentencing court “concluded that Robinson distributed heroin that resulted in Allison’s . . . death,” and imposed the mandatory minimum 20-year sentence in § 841(b)(1)(C). Id. at 827. On appeal, defendant Robinson contended that § 841(b)(1)(C) “requires a 20-year mandatory minimum only if a court finds that the distribution of the substance was in the common law sense the proximate cause of death or serious bodily injury.” Id. at 826. In other words, “even though Robinson acknowledges that a user of the heroin he supplied died from its use, he challenges the sentence because the district court did not make a finding that his conduct was a proximate cause of the user’s death.” Id. Looking to Patterson for guidance, the Third Circuit stated “the [Fourth Circuit] explained that the ‘statute puts drug dealers and users on clear notice that their sentences will be enhanced if people die from using the drugs they distribute.’” Id. at 830 (quoting Patterson, 38 F.3d at 145). After quoting the 28 Fourth Circuit’s explanation that “it would ‘not second-guess [Congress’s] unequivocal choice,’” id. (quoting Patterson, 38 F.3d at 145), the Third Circuit said that “[w]e will not either.” Id. Instead, “[w]here, as here, Congress’ language is ‘plain and unambiguous,’ we simply apply the language of the statute as written.” Id. at 830-31. The Third Circuit added that “[i]n the circumstances, it would be sophistry to say that Allison’s death did not result from the use of the heroin delivered pursuant to the conspiracy.” Id. at 831. The Third Circuit emphasized that “we are applying a statute dealing with a discrete problem, the distribution of controlled substances, products which Congress recognized will in some cases cause death or serious bodily injury.” Id. “Congress recognized that the risk is inherent in the product and thus it provided that persons who distribute it do so at their peril.” Id. In sum, “[i]t is obvious Congress intended in such a case that the 20-year mandatory minimum would apply if death or serious bodily injury resulted from the use of the substance without regard for common law proximate cause concepts.” Id. Although acknowledging that there might be some limiting principles on application of the enhancement, the Third Circuit stated that “[i]f section 841(b)(1)(C) is not to be applied as presently written, Congress and not 29 this court should narrow its application.” Id. at 832. 3. United States v. McIntosh, 236 F.3d 968 (8th Cir. 2001) In McIntosh, the Eighth Circuit similarly concluded that the enhanced penalty in § 841(b)(1)(A) did not have a foreseeability or a proximate cause requirement.11 McIntosh, 236 F.3d at 972. Defendants McIntosh and McMillan conspired to produce methamphetamine. Id. at 970. McIntosh shared his methamphetamine with Jean Creswell, who lived with him, and with her niece Amy Creswell. Id. Some of this methamphetamine eventually reached Jessica Smith, Jean’s fourteen-year-old daughter, even though McIntosh had specifically instructed his friends not to give Jessica methamphetamine. Id. Jessica died after using the methamphetamine. Id.12 The district court determined that: “1) Jessica’s death resulted from the use of methamphetamine; 2) the methamphetamine used by Jessica . . . came from 11 The relevant wording of § 841(b)(1)(A), which applies to different controlled substances, is the same as the enhanced penalty in § 841(b)(1)(C): (1)(A) In the case of a violation of subsection (a) . . . ... such person shall be sentenced to a term of imprisonment which . . . if death or serious bodily injury results from the use of such substance shall be not less than 20 years or more than life . . . . 21 U.S.C. § 841(b)(1)(A) (emphasis added). 12 McIntosh pled guilty to conspiracy to manufacture methamphetamine. McIntosh, 236 F.3d at 970. His plea agreement “left open for the district court’s determination at sentencing whether McIntosh was subject to an enhanced sentence because of Jessica’s death.” Id. at 97071. 30 either Amy Cresswell, Jean Creswell, or McMillan;[] and 3) regardless of which of the three supplied the methamphetamine, it ‘originally came’ from McIntosh.” Id. at 971. The district court also found that the “government failed to prove that McIntosh directly furnished Jessica with methamphetamine nor [sic] that he had any knowledge she was being supplied with the drug by the others.” Id. Despite the latter two findings, “the district court concluded McIntosh was subject to the enhancement because he played a part in manufacturing the drug [Jessica] did use,” and sentenced him to twenty years’ imprisonment. Id. On appeal, McIntosh contended that § 841(b)(1)(A) permits a sentence enhancement only if death “was a reasonably foreseeable result of, or was proximately caused by, a defendant’s conduct,” and that he did not proximately cause Jessica’s death and could not reasonably have foreseen it. Id. The Eighth Circuit explained that “[t]he starting point for ascertaining the intended meaning of any statute is the language of the statute itself.” Id. The statute’s “language is unambiguous and . . . giving effect to its plain meaning prohibits us from superimposing upon the statute a foreseeability or proximate cause requirement.” Id. at 972. The Eighth Circuit “decline[d] to hinder Congress’s will, apparent from the face of the statute, through a judicial pronouncement that the statute requires more than it says.” 31 Id. The Eighth Circuit agreed with the Third and Fourth Circuits’ conclusions “that Congress intended § 841(b)(1)(A)’s enhancement to apply without regard to the principles of proximate cause or the foreseeability of death or serious bodily injury.” Id. at 972-73. The Eighth Circuit acknowledged that “[o]ur conclusion that the statute imposes strict liability upon McIntosh for Jessica’s death vitiates [McIntosh’s] argument” that the enhanced sentence only applies if the defendant intends to cause death or knowingly risks death. Id. at 974.13 4. United States v. De La Cruz, 514 F.3d 121 (1st Cir. 2008) In De La Cruz, the First Circuit also concluded that § 841(b)(1)(A)’s enhanced penalty does not require the government to prove foreseeability. De La Cruz, 514 F.3d at 138. A jury convicted defendant De La Cruz of conspiracy to distribute heroin and possession with intent to distribute heroin, in violation of 21 U.S.C. §§ 841(a)(1), 846. Id. at 125. De La Cruz sold heroin to Tracy, who sold 13 Other circuits have also opined that § 841(b)(1)(C) (or provisions with similar language) creates a strict liability regime. See United States v. Carbajal, 290 F.3d 277, 283 (5th Cir. 2002) (interpreting sentencing guideline with similar “death . . . resulted from” language to § 841(b)(1)(C) and determining that it “is a strict liability provision that applies without regard for common law principles of proximate cause or reasonable foreseeability”); United States v. Rebmann, 226 F.3d 521, 522, 525 (6th Cir. 2000) (indicating in dicta that § 841(b)(1)(C) “[o]n its face, . . . is, in effect, a strict liability statute with respect to the injury or death of another arising out of the distribution of drugs”), overruled on other grounds by United States v. Leachman, 309 F.3d 377, 385 n.9 (6th Cir. 2002). 32 some of that heroin to Flynn, who sold some to Wallace. Wallace later died in his home of heroin use. Id. at 126. At trial, the district court instructed the jury that it: [M]ust find, beyond a reasonable doubt, that Wallace ingested heroin, that this heroin was a “but for” cause of Wallace’s death, and that this heroin was distributed as part of the conspiracy charged in Count One and passed through Defendant’s hands as part of the distribution charged in Count Two. Id. at 137. On appeal, De La Cruz argued that the jury should have been instructed that, before finding him eligible for the enhanced penalty, it had to find that Wallace’s death was foreseeable to him. Id. at 136. Rejecting De La Cruz’s claim, the First Circuit noted that “[n]othing in the language of the statute suggests that a death must be foreseeable before the enhanced penalty provision applies.” Id. at 137. Instead, “[w]hat is required under the death-enhancing statute is that the government prove cause-in-fact, that is, that the decedent’s death was caused in fact by his or her use of drugs that were distributed either by the defendant himself or by others in a conspiracy of which the defendant was a part.” Id. at 138. In De La Cruz’s case, “the district court properly instructed the jury about the required proof of cause-in-fact, and-following the court’s instructions-the jury specifically found that Wallace died as a result of ingesting heroin that was 33 distributed during the course of the charged offenses by Defendant [De La Cruz] to Wallace through Tracy and Flynn.” Id.; see United States v. Hatfield, 591 F.3d 945, 947-48 (7th Cir. 2010) (discussing different types of causation and noting the “parties agree that the statutory term ‘results from’ required the government to prove that ingestion of the defendants’ drugs was a ‘but for’ cause of the deaths and the bodily injury” and “[t]he death or injury need not have been foreseeable”).14 5. United States v. Houston, 406 F.3d 1121 (9th Cir. 2005) In Houston, the Ninth Circuit concluded that proximate cause is not a required element of § 841(b)(1)(C)’s enhanced penalty. Houston, 406 F.3d at 1122-23. The jury convicted defendant Houston of distributing methadone to Bradford, who died. Id. at 1121. The district court instructed the jury that “the Government was required to prove beyond a reasonable doubt that ‘the 14 The error alleged in Hatfield was not that the district court charged the statutory language that the government must prove the victim died “as a result of ingesting a controlled substance . . . distributed by the defendants.” 591 F.3d at 947. The error was the added part of the charge which stated the controlled substances had to have been “a factor that resulted in death” and “although they need not be the primary cause of death . . . they must at least have played a part in the death.” Id. (quotation marks omitted). The Seventh Circuit concluded that: The defendants’ objection to the instruction was well taken. All that would have been needed to satisfy it was to eliminate the addition to the statutory language, which was a good deal clearer than the addition and probably clear enough. Elaborating on a term often makes it less rather than more clear . . . . Id. at 949. 34 defendant’s act was a proximate cause of . . . Bradford’s death.’” Id. at 1123. The Ninth Circuit determined that “[t]o the extent that this instruction suggested that Bradford’s death had to have been a foreseeable result of [defendant] Houston’s act, the instruction required the Government to prove more than the statute requires, and was therefore in error.” Id. (footnote omitted). The Ninth Circuit reasoned that “[t]he addition of proximate cause as an element necessary for invoking the twenty-year minimum sentence described in § 841(b)(1)(C) is inconsistent with the statutory language, our circuit’s related precedent, and the conclusions of every other federal court of appeals to consider the issue.” Id. The Ninth Circuit cited Patterson, McIntosh, and Robinson to support its conclusion that neither foreseeability nor proximate cause is required to support the enhanced penalty in § 841(b)(1)(C). See Houston, 406 F.3d at 1124. The Ninth Circuit added that, (1) “[a]ll that is necessary under the statutory language is that ‘death ... results’ from the offense described in § 841(a)(1),” and (2) “[c]ause-in-fact is required by the ‘results’ language, but proximate cause, at least insofar as it requires that the death have been foreseeable, is not a required element.” Id. at 1125. The Ninth Circuit determined that the district court erroneously instructed the jury that proximate cause was a required element of § 841(b)(1)(C), but found the error harmless and upheld defendant Houston’s 35 conviction and sentence. Id. at 1125-26. With this background, we turn to the jury instructions at Webb’s trial. 6. Jury Instruction at Webb’s Trial “The starting point for all statutory interpretation is the language of the statute itself . . . .” Med. Transp. Mgmt. Corp. v. Comm’r, 506 F.3d 1364, 1367 (11th Cir. 2007) (quotation marks omitted); Harris v. Garner, 216 F.3d 970, 972 (11th Cir. 2000) (en banc) (“[C]ourts should always begin the process of legislative interpretation . . . with the words of the statutory provision.”). “[O]ur task is to determine whether the language at issue has a plain and unambiguous meaning with regard to the dispute in the case. Our inquiry must cease if the statutory language is unambiguous and the statutory scheme is coherent and consistent.” Med. Transp. Mgmt. Corp., 506 F.3d at 1368 (quotation marks and citation omitted). Here, § 841(b)(1)(C) imposes an enhanced penalty whenever “death or serious bodily injury results from the use of” the controlled substance. 21 U.S.C. § 841(b)(1)(C). We agree with our sister circuits that the plain and unambiguous language of § 841(b)(1)(C) contains no foreseeability or proximate cause requirement. De La Cruz, 514 F.3d at 138; Houston, 406 F.3d at 1122; McIntosh, 236 F.3d at 972; Robinson, 167 F.3d at 826; Patterson, 38 F.3d at 145. The 36 government is not required to prove a defendant’s conduct proximately caused the victim’s death or that the death was reasonably foreseeable to the defendant. Rather, under § 841(b)(1)(C), the government must prove only that the death “results from” the victim’s use of a controlled substance charged in the indictment. We apply the language of the statute as written. The statute requires a cause-in-fact connection between the victim’s ingestion of the drugs and death. It does not require that the defendant’s conduct proximately cause the death. Accordingly, in Webb’s case, we find no error in the district court’s jury instruction regarding § 841(b)(1)(C), nor any error in the district court’s refusal of Webb’s requested instruction. The district court properly instructed that the § 841(b)(1)(C) standard was satisfied upon a finding that, but for the victims ingesting the controlled substances charged in the indictment, the victims would not have died. This “but for” charge told the jury it had to find “but for” (had it not been for) the victim’s ingestion, no death would have occurred. The statutory term “results from” is a cause-in-fact requirement that was met by the “but for” charge. Thus, as to § 841(b)(1)(C), the district court’s jury instructions were correct, and Webb’s requested instructions were not.