United States v. Chia Lee
966 F.3d 310
5th Cir.2020Background
- Theodore "Tad" Taylor (physician) and Chia Jean Lee (office manager/nurse) ran Taylor Texas Medicine in Richardson, TX; indicted for conspiring to distribute controlled substances (2010–early 2012).
- Seven-day jury trial produced convictions for conspiracy to distribute five controlled substances; Taylor sentenced to statutory maximum 20 years, Lee to ~15 years (Guidelines bottom).
- Prosecution presented evidence of a "pill mill": rapid shift to pain patients, high volume (40–50 patients/day), brief exams, pre-signed prescriptions, cash-based payments, steep revenue rise, and pricing tied to drug-test results.
- Undercover visits, pharmacist complaints, patient/family complaints, and numerous patient files showed prescribing despite negative/illegal drug tests and knowledge of patients receiving other prescriptions.
- Defendants raised sufficiency, venue, multiple trial-error claims (premature deliberation, expert reliability, deliberate ignorance instruction), and sentencing challenges (drug-quantity calculation, Guidelines offense level, firearm enhancement).
Issues
| Issue | Gov't Argument | Taylor/Lee Argument | Held |
|---|---|---|---|
| Sufficiency of evidence to convict of conspiracy to distribute outside professional practice | Evidence (undercover visits, patient files, pharmacist, drug tests, financial records) shows illegal prescribing and agreement | Practices were legitimate pain management; acted in good faith; isolated mistakes | Affirmed — a rational jury could find guilt based on the record |
| Venue (trial in Eastern Dist. though clinic in Northern Dist.) | Overt acts (bookkeeping at home, bank checks from Eastern Dist.) occurred in Eastern District, so venue proper | Primary criminal acts occurred in Northern District; Eastern venue improper | Affirmed — venue proper because overt acts in Eastern District supported by evidence |
| Premature jury deliberation / juror misconduct | Jury clarification note was not deliberation; jurors denied discussing merits; court investigated and excused Juror 10 | Note and security officer comment show jurors began deliberating prematurely; merits affected | Affirmed — district court did not abuse discretion; presumption jurors followed admonition upheld |
| Reliability/admission of government experts (small, nonrandom samples) | Experts opined on reviewed files; testimony admissible and cumulative to other strong evidence | Samples unrepresentative; testimony unreliable under Rule 702 and Daubert | Affirmed (harmless error if any) — expert testimony was largely limited, contested at trial, and cumulative |
| Deliberate-ignorance (willful blindness) jury instruction | Instruction appropriate because defendants claimed lack of knowledge and evidence permitted inference | Instruction rarely proper; defendants did not purposefully avoid knowledge; instruction prejudicial | Instruction should be given rarely; here unnecessary but any error was harmless given substantial evidence of actual knowledge |
| Sentencing: drug-quantity estimation and Guidelines offense level | DEA task-force estimation (prescriptions minus 25%) reliable; 2011 Guidelines applied and produced base level 36 | Calculations wrong; misapplied Guidelines versions and Schedule caps | Affirmed — district court's drug-quantity findings not clearly erroneous; offense level 36 correct under either Guidelines manual |
| Sentencing: firearm enhancement | Gun found in clinic office near transaction area; presence supports §2D1.1(b)(1) enhancement | Gun in separate office; no nexus to drug activity where prescriptions occurred | Affirmed — temporal/spatial nexus supported; enhancement not clearly improbable |
Key Cases Cited
- United States v. Oti, 872 F.3d 678 (5th Cir. 2017) (elements and indicators in doctor pill-mill prosecutions)
- United States v. Moore, 423 U.S. 122 (1975) (evidence of prescribing without regulating dosage as indicia of unlawful distribution)
- United States v. Romans, 823 F.3d 299 (5th Cir. 2016) (venue in conspiracy cases; overt-act venue rule)
- United States v. Kiekow, 872 F.3d 236 (5th Cir. 2017) (overt-act definition and jury-venue review)
- United States v. Ricard, 922 F.3d 639 (5th Cir. 2019) (standards for deliberate-ignorance instruction)
- Daubert v. Merrell Dow Pharm., Inc., 509 U.S. 579 (1993) (expert admissibility framework)
- United States v. York, 600 F.3d 347 (5th Cir. 2010) (presumption jurors follow court instructions; review of premature deliberation claims)
- United States v. Evans, 892 F.3d 692 (5th Cir. 2018) (admissibility and harmlessness of lay/expert testimony in pill-mill context)