United States v. Abdur Tai, 750 F.3d 309

The Fen-Phen Settlement Trust paid claimants for valvular heart disease if a board-certified, Level 2 echocardiographer signed a physician report and Green Form and submitted an echocardiogram recording.
Dr. Abdur Razzak Tai, a board-certified Level 2 cardiologist, read echoes and signed Green Forms for claimant attorneys; he estimated ~12,000 reads and claimed >$2M in fees/bonuses.
Tai admitted to law enforcement that he sometimes signed reports despite knowing measurements were wrong and delegated many reads to a non-physician technologist and an office manager.
A government expert found many submitted measurements were clearly incorrect or anatomically impossible; audits approved only a small fraction of forms for one attorney’s submissions.
Tai was indicted on 13 counts of mail and wire fraud, convicted on all counts, and sentenced to 72 months imprisonment plus restitution and supervised release.
On appeal (plain-error review), Tai challenged the willful-blindness jury instruction and three Guidelines enhancements: abuse of position of trust, use of a special skill (§3B1.3), and aggravated role (§3B1.1(c)). The conviction was affirmed but the role enhancement remanded for factual findings.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the willful‑blindness jury instruction impermissibly shifted burden to defendant	Gov't: instruction properly describes how knowledge may be proved by willful blindness; burden remains on government	Tai: model instruction implied defendant must disprove knowledge, shifting burden	No plain error — instruction read in context preserved government’s burden beyond a reasonable doubt (affirmed)
Whether §3B1.3 two‑level enhancement (abuse of trust / special skill) was plain error	Gov't: Tai’s credentials and signings gave Trust reliance; his medical skill and credentials facilitated fraud	Tai: Trust audits and reliance do not create actionable position of trust; he sometimes didn’t exercise skill when he merely signed	No plain error — court found position of trust and use of special skill sufficiently established (affirmed)
Whether §3B1.1(c) two‑level aggravated‑role enhancement was warranted without finding supervised subordinate was criminally culpable	Gov't: enhancement appropriate because Tai employed and directed a technologist who read echoes	Tai: no finding that technologist had requisite mens rea; he withdrew objection at sentencing	Plain error — remand required because sentencing court made no finding that supervised participant was criminally responsible; resentencing for factual finding required (vacated and remanded on this issue)

Patterson v. New York, 432 U.S. 197 (1977) (Due process requires government to prove required mental state beyond a reasonable doubt)
United States v. Sherman, 160 F.3d 967 (3d Cir. 1998) (physician can occupy position of trust with insurer/claimant relying on professional integrity)
United States v. Badaracco, 954 F.2d 928 (3d Cir. 1992) (to apply role enhancement, government must prove supervised participants were criminally responsible)
United States v. Flores, 454 F.3d 149 (3d Cir. 2006) (willful‑blindness instructions acceptable when read with burden reminders)
United States v. Olano, 507 U.S. 725 (1993) (plain‑error review framework)
Johnson v. United States, 520 U.S. 461 (1997) (clarifies plain‑error requirements)
United States v. Pollen, 978 F.2d 78 (3d Cir. 1992) (role enhancement can affect substantial rights; remand may be required)