(September 12, 2011) Appeal from the United States District Court for the Northern District of Florida Panel: Hull, Black and Stapleton, Circuit Judges.
Per Curiam: Affirmed Defendant–Appellant David W. Webb, a Florida-licensed physician, was convicted of 130 counts of wire fraud, health care fraud, and unlawful dispensing of controlled substances, including three counts charging that a patient’s death resulted from the use of controlled substances dispensed by Webb, or from his health care fraud violation. In two related issues of first impression, the Eleventh Circuit held that no foreseeability or proximate cause requirement is contained in the enhanced penalty under § 841(b)(1)(C) which applies whenever “death or serious bodily injury results from the use of” the controlled substance. That is, the 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. Put yet another way, 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.
Next, the Court held that Congress did not insert a foreseeability or proximate cause requirement into § 1347(a)’s penalty enhancement, either. This enhanced penalty applies if “the [health care fraud] violation results in death.” The Court stated that there was no principled way to distinguish between the “results in” language in § 1347(a) and the “results from” language in § 841(b)(1)(c). The lack of foreseeability or proximate cause language in § 1347(a) was telling, the Court wrote, because Congress has included such language in numerous other criminal statutes, including statutes where the required connection is between the defendant’s offense conduct and death or bodily injury. Third Circuit Judge Stapleton, sitting by designation, concurred with the first result but dissented from the second, agreeing with the conclusion of the Sixth Circuit on this issue that proximate cause is the appropriate standard to apply in determining whether a health care fraud violation “results in death,” writing that Section 1347 . . . does not deal with a discrete problem arising from products involving an inherent risk of serious injury or death. Rather, it provides an enhanced penalty for health care fraud if the fraudulent scheme of the defendant resulted in death or serious bodily injury. Section 1347 thus applies to a wide variety of economically motivated health care activities and focuses on the relationship between the defendant’s conduct and the consequences thereof. The full text of the decision can be found here: http://www.ca11.uscourts.gov/opinions/ops/201010574.pdf
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