United States v. Castronuovo
| Decision Date | 17 May 2016 |
| Docket Number | No. 14-11765,14-11765 |
| Parties | UNITED STATES OF AMERICA, Plaintiff-Appellee, v. JOSPEH CASTRONUOVO, M.D., CYNTHIA CADET, M.D., Defendants-Appellants. |
| Court | U.S. Court of Appeals — Eleventh Circuit |
[DO NOT PUBLISH]
D.C. Docket No. 9:10-cr-80149-KAM-30
Appeals from the United States District Court for the Southern District of Florida
Before WILLIAM PRYOR and FAY, Circuit Judges, and ROBRENO,* District Judge.
Defendants Joseph Castronuovo and Cynthia Cadet ("Defendants") appeal their judgments of conviction under 18 U.S.C. § 1957 for conspiracy to engage in monetary transactions affecting interstate commerce in criminally derived property exceeding $10,000, also known as conspiracy to commit money laundering. After reviewing the record and hearing oral argument, we affirm the judgement of conviction for both Defendants.
Defendants were indicted by a federal grand jury in the Southern District of Florida and charged alongside thirty other individuals for their roles in an illegal "pill mill" operation involving two pain management clinics owned by Christopher George: American Pain and Executive Pain. The clinics' operations depended on doctors, like Defendants, who were licensed to prescribe and dispense narcotics. George paid the doctors a portion of their salary by check and the rest by cash. Before receiving their weekly paychecks, the doctors would sign forms that stated "I did not see anything illegal happen or do anything illegal at the office."
Defendant Cadet began working at American Pain, formerly called South Florida Pain, after responding to a Craigslist ad for employment. During her interview, George told Cadet that "we prescribe medication here for people that allege to be in pain, and that's all we do." He told her that she would earn $75 per patient and $1,000 per week for the use of her dispensing license.
Once employed, Cadet saw as many as 100 patients per day. On one particular day, surveillance videos and patient records indicated that Cadet spent an average of 4 minutes and 40 seconds with each patient, and prescribed a total of 15,860 Oxycodone pills at 30 mg each; 5,790 Oxycodone pills at 15 mg each; and 3,600 Xanax pills at 2 mg each. One patient testified at trial that Cadet prescribed pills to him after merely checking his blood pressure and reviewing his prescriptions from George's other clinic. Cadet also signed drug-supplier forms that falsely underestimated how many patients were seen daily, how many received prescriptions for controlled substances, and how many were from other states.
The Internal Revenue Service ("IRS") determined that Cadet received a total of $1,217,125 in compensation during her tenure. And Drug Enforcement Agency ("DEA") records showed that 878,600 Oxycodone pills were dispensed under Cadet's license between 2008 and 2010.
Defendant Castronuovo also responded to one of George's employment ads for a position at Executive Pain. During the interview, George stated that Castronuovo would be paid $75 per patient to prescribe pain medication and shared sample charts displaying patients' Oxycodone and Xanax prescriptions. George described the clinics' "business model" during the interview and testified that he "wouldn't have hired [Castronuovo]" if Castronuovo had not agreed to the clinics' prescription practices.
A statistical sample of Castronuovo's patient files showed that Castronuovo engaged in a "pattern" of prescribing Oxycodone, Xanax, and sometimes Soma. Like Cadet, Castronuovo signed documents falsely stating the number of patients from out of state and the number of patients receiving controlled substances. Because Castronuovo worked only part time, George paid him up to $200 per day for use of his dispensing license. But Castronuovo also received $75 for each patient he saw. Moreover, seized surveillance footage corroborated that he received $3,200 for seeing 40 patients on one particular day and $4,025 for seeing 51 patients on another day. The IRS determined that Castronuovo received a total of $164,025 during his tenure. And DEA records showed that 328,600 Oxycodone pills were dispensed under Castronuovo's license between 2008 and 2010.
On March 3, 2010, government agents executed search warrants at both clinics and recovered surveillance videos from American Pain's security cameras. Agents also seized all patient files and patient logs, which listed how many patients each doctor saw and dictated each doctor's pay.
On January 18, 2011, before he was charged with any crimes, Castronuovo and his attorney met with prosecutors and DEA agents to describe his prescription practices and compensation from the clinic. Castronuovo stated that he received $75 per patient, with a minimum daily total of $1,500. He explained that George paid him in cash during his first five months of employment and then by check.
The original indictment charged George, the clinics' owner, with unlawful possession of a firearm and ammunition, in violation of 18 U.S.C. §§ 922(g)(1) and 924(a)(2). Then, the first superseding indictment charged thirty-two clinic staff members and doctors, including Cadet and Castronuovo. Therein, Cadet was charged as part of a racketeering conspiracy, in violation of 18 U.S.C. § 1961(1) and (5); money laundering conspiracy, in violation of 18 U.S.C. § 1956(h); and an Oxycodone trafficking conspiracy, in violation of 21 U.S.C. § 841(a)(1). Both Cadet and Castronuovo were charged with mail/wire fraud, in violation of 18 U.S.C. §§ 1341 and 1343.
After a majority of the codefendants pled guilty, Cadet and Castronuovo were charged in a second superseding indictment with conspiracy to traffic in Oxycodone, in violation of 21 U.S.C. §§ 846, 841(a)(1), and 859(a), and conspiracy to engage in money laundering, in violation of 18 U.S.C. §§ 1956(h) and 1957. In addition, Cadet was charged individually with two counts of Oxycodone and Alprazolam distribution resulting in deaths, in violation of 21 U.S.C. § 841(a)(1) and (b)(1)(C); five counts of Oxycodone distribution resulting in deaths, in violation of 21 U.S.C. § 841(a)(1) and (b)(1)(C); and one count of conspiracy to distribute anabolic steroids, in violation of 21 U.S.C. §§ 841(a)(1) and 829(e). Castronuovo was charged individually with one count of Oxycodone distribution, in violation of 21 U.S.C. §§ 846, 841(a)(1) and 859(a), and two counts of Oxycodone distribution resulting in deaths, in violation of 21 U.S.C. § 841(a)(1) and (b)(1)(C).
Defendants pled not guilty and proceeded to trial. After the district court denied Castronuovo's motion to sever his trial from Cadet's, Defendants were tried together and agreed that objections made by one were joined by the other unless otherwise stated.
After a 31-day trial and four days of deliberations, the jury reported that they had reached a verdict and submitted the verdict forms. When the district court examined the returned verdict forms, it noted that "[t]he forms are not completely filled out" and instructed the jury to return to the deliberation room to "fill out either guilty or not guilty on all of the counts." The district court explained that "[y]ou can't leave it blank . . . We need to know what your decision is on each of those counts where you've left it blank." The court told the jury to send a note if they did not understand the instructions, and no party objected to these directions.
Shortly thereafter, the jury sent a note reporting that it was "deadlocked" on certain counts. After all parties agreed, the district court gave a modified Allen instruction based on the Eleventh Circuit Pattern Jury Instructions. Approximately 2 to 2 ½ hours later, the jury returned a guilty verdict against Defendants on the money laundering conspiracy count. Defendants were acquitted on all other charges.
The district court entered judgment against both Defendants after denying their post-trial motions. It sentenced Castronuovo to 18 months' imprisonment and two years' supervised release. It sentenced Cadet to 78 months' imprisonment and two years' supervised release. Defendants now appeal.
Numerous standards of review govern the issues on appeal. "We review the sufficiency of evidence to support a conviction de novo." United States v. Taylor, 480 F.3d 1025, 1026 (11th Cir. 2007). As to a cumulative error argument, we review de novo the cumulative impact of the alleged errors at trial. United States v. Dohan, 508 F.3d 989, 993 (11th Cir. 2007). We also review a claim of prosecutorial misconduct de novo "because it is a mixed question of law and fact." United States v. Duran, 596 F.3d 1283, 1299 (11th Cir. 2010).
"We review a district court's denial of a motion to dismiss an indictment for abuse of discretion but, in determining whether the court abused its discretion, we resolve issues of law de novo." United States v. Cavallo, 790 F.3d 1202, 1219 (11th Cir. 2015). We also review de novo the issue whether jury instructions constructively amended the indictment, United States v. Gutierrez, 745 F.3d 463, 473 (11th Cir. 2014), but when a defendant raises this argument for the first time on appeal, we review it for plain error, United States v. Madden, 733 F.3d 1314, 1322 (11th Cir. 2013).
United States v. Perkins, 348 F.3d 965, 969 (11th Cir. 2003) (citation omitted).
We review for abuse of discretion a district court's ruling on a severance motion, its limitation on the scope of cross-examination, its decision to give an Allen charge, and its refusal to give a requested jury instruction. See United States v. Maxwell, 579 F.3d 1282, 1295 (11th Cir. 2009) (limitation of cross-examination); United States v. Westry, 524 F.3d 1198, 1216 (11th Cir. 2008) ...
To continue reading
Request your trial