Eleventh Circuit Vacates Doctors Conviction for Dispensing Controlled Substances – U.S. v. Ignasiak

February 1, 2012 by David S. Seltzer

As a south Florida drug crimes defense lawyer, I was interested to see a recent conviction of a doctor accused of over-prescribing the kinds of controlled substances widely abused in our state’s “pill mills.” In United States v. Ignasiak, Robert L. Ignasiak, Jr., appealed his convictions for health care fraud and violations of the Controlled Substances Act. Ignasiak was a medical doctor until the charges, which alleged that he prescribed pills with no legitimate medical purpose or in excessive amounts. The prescriptions at issue were for a total of 20 patients, two of whom later died. He was sentenced to more than 24 years in prison and appealed on several grounds, including that he was deprived of his constitutional right to confront witnesses when autopsy reports and medical notes were admitted without testimony from their authors. The Eleventh U.S. Circuit Court of Appeals reversed in that ground.

Ignasak operated his own busy clinic in the Florida Panhandle. He came under scrutiny because the federal government felt he was billing higher amounts than normal for a family-practice doctor. However, a review of the records raised the auditor’s concerns that Ignasak was prescribing significant amounts of narcotic painkillers for most of his adult patients, along with drugs less likely to lead to abuse. Ignasak retired later that year and sold his clinic. The new doctor also became alarmed at the number of narcotics prescriptions in the practice, especially after discovering that patients would be visibly angry when he declined to write new prescriptions. The government eventually seized all the patient files and prosecuted Ignasak on 54 total counts. At trial, over Ignasak’s objection, the court allowed introduction of autopsy records in patient deaths (including seven not charged but admitted into evidence) and handwritten medical notes despite no testimony from their authors. After his conviction, he appealed.

While the Eleventh Circuit upheld the trial court’s decision as to the sufficiency of the evidence, it agreed with Ignasak that the authors of the documents should have testified. It first found that the autopsy records were testimonial evidence subject to the constitution’s Confrontation Clause because they are forensic records, on which the Supreme Court has called for more scrutiny because of their scientific nature. Thus, the testimony of the area’s chief medical examiner is not a constitutionally adequate substitute for the testimony of the autopsy reports’ actual authors (where they were different people). Under the Confrontation Clause, Ignasak should have had the right to confront and cross-examine his accusers. Furthermore, the Eleventh found that the error was not harmless — that is, it wasn’t confident that the “powerful” evidence of the extra autopsy reports did not contribute to the verdicts. In light of the fact that the government’s case was not overwhelming otherwise, the court vacated the conviction and ordered a new trial.

As a Miami criminal defense attorney, I’m pleased to see that this case will get a new trial. The constitutional right to confront one’s accuser is so fundamental that denying it denies the defendant a fair trial in the first place. Consider the possibility that some records admitted as testimony could have been produced by someone who was not reliable — for example, because of simple negligence, substance abuse or conflicts of interests. When this is the case, a jury seeking to make the best possible decision needs to know about the problem so it can fairly judge whether the evidence shows the defendant’s guilt. The precedent established here by the Eleventh Circuit will benefit all the clients I take on as a Fort Lauderdale drug crimes defense lawyer, as well as any other criminal defendant in Florida.

Seltzer Law, P.A., represents clients across the state of Florida who are facing criminal charges. We know police officers don’t stop making arrests just because business hours have ended, so we make sure we’re available at all times — 24 hours a day and seven days a week. If you’re charged or believe you will be and you’d like to talk about your rights and your options, call us today for a free consultation at 1-888-THE-DEFENSE (1-888-843-3333) or send us a message online.

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