Evidence of Uncharged Patients In Doc Drug Case Inadmissible

US v. Brizuela: Brizuela was a doctor in West Virginia who was charged with 21 counts of distributing controlled substances outside the bounds of medical practice, conspiracy, and 16 counts of illegal remuneration under the anti-kickback statute. At trial he was convicted of 15 counts of distribution, but acquitted on all other counts (the Government dismissed the conspiracy count). The 21 distribution charges involved prescriptions written for five different patients, two of whom testified at trial. The Government also called four other patients to testify about what they received from Brizuela, over his objection. Brizuela was eventually sentenced to 48 months in prison.

On appeal, the Fourth Circuit reversed Brizuela’s convictions. Among the issues Brizuela raised was that the district court erred by allowing the Government to call patients to testify beyond those involved in the counts charged in the indictment. The court rejected the Government’s argument that such testimony was necessary under Rule 404(b) to “complete the story of the crime on trial.” The court noted that the “crime on trial” was distribution of drugs to particular patients and the testimony of other patients could not complete that story. The court also rejected the Government’s argument that the testimony was necessary to show Brizuela’s conduct was not a mistake or accident, but the court noted he never made that argument. The court also held that the error was not harmless because (1) the Government never argued that it was and (2) it was a “close” question and therefore was resolved in Brizuela’s favor.

This case is a really good, deep dive into the limits of the “complete the story” argument of which the Government is so fond and worth a close read.