United States v. Cleveland J. Enmon
686 F. App'x 769
| 11th Cir. | 2017Background
- Dr. Cleveland Enmon operated two Georgia pain clinics (Brunswick Wellness and Ocean Care) that investigators characterized as "pill mills;" he wrote large numbers of prescriptions in short periods and charged cash per visit.
- DEA raided both clinics; Enmon was indicted on 92 federal counts including conspiracy, unlawful dispensation of controlled substances (21 U.S.C. § 841), and money laundering, and was convicted on all counts.
- A magistrate ordered a competency evaluation; a forensic psychologist found Enmon competent though with antisocial/narcissistic traits; Enmon repeatedly chose to waive counsel and proceed pro se after multiple Faretta colloquies and standby counsel was appointed.
- At trial, the district court instructed the jury to apply an objective standard ("usual course of professional practice" judged by generally accepted standards) and told jurors that the defendant’s good-faith belief was irrelevant to that objective inquiry; subjective belief remained relevant only to the separate element of "legitimate medical purpose."
- The jury convicted on all counts; at sentencing the court varied well below the absurdly high guideline calculation and imposed 240 months’ imprisonment; Enmon appealed raising instructional error, Faretta waiver validity, insufficiency of evidence re: medical standards, and sentence reasonableness.
Issues
| Issue | Plaintiff's Argument (Enmon) | Defendant's Argument (Government) | Held |
|---|---|---|---|
| Jury instruction re: good-faith and "usual course of professional practice" | Instruction plainly erred by saying good-faith belief irrelevant to whether prescriptions were in the usual course of practice | Precedent requires an objective standard for "usual course"; subjective belief may only bear on "legitimate medical purpose" | No plain error; instruction consistent with Eleventh Circuit precedent (objective standard) and Tobin interpretation |
| General verdict form and unanimity | General verdict listing alternative mens rea routes prevented unanimous agreement and violated due process | General verdicts are permissible where jury is instructed to find all elements beyond a reasonable doubt; special verdict disfavored | No reversible error; jury was properly instructed and form did not affect substantial rights |
| Waiver of counsel (self-representation) | Waiver was invalid because Faretta colloquies were inadequate and standby counsel’s involvement undermined voluntariness | Multiple thorough Faretta colloquies occurred; Enmon repeatedly confirmed understanding and knowingly waived counsel; standby counsel was available | Waiver was valid; district court did not err in allowing Enmon to proceed pro se at trial and sentencing |
| Sufficiency of evidence (standard of care) | Government failed to prove violation because it did not present Georgia-specific medical standards as a benchmark | State standard not an element; ample lay and expert testimony showed prescribing outside professional practice and lack of legitimate medical purpose | Evidence sufficient; conviction not a miscarriage of justice |
| Substantive reasonableness of 240-month sentence | Guidelines skewed toward street dealers; sentence substantively unreasonable and disparate | District court varied massively downward from guideline, balanced §3553(a) factors, no valid comparator for disparity claim | Sentence reasonable and affirmed |
Key Cases Cited
- United States v. Tobin, 676 F.3d 1264 (11th Cir. 2012) (clarifies objective standard for "usual course of professional practice")
- United States v. Merrill, 513 F.3d 1293 (11th Cir. 2008) (requires objective inquiry into whether prescribing was within generally accepted medical practice)
- Schad v. Arizona, 501 U.S. 624 (1991) (plurality on permissibility of general-verdict instructions that list alternative means)
- Faretta v. California, 422 U.S. 806 (1975) (constitutional right to self-representation)
- Gall v. United States, 552 U.S. 38 (2007) (reasonableness review of sentencing; deferential abuse-of-discretion standard)
- United States v. Joseph, 709 F.3d 1082 (11th Cir. 2013) (jury may convict physicians based on lay witness evidence of prescribing circumstances)
- United States v. Moriarty, 429 F.3d 1012 (11th Cir. 2005) (plain-error review framework for unpreserved objections)
- United States v. Cash, 47 F.3d 1083 (11th Cir. 1995) (inadequate Faretta colloquy can render waiver invalid)
- United States v. Langston, 590 F.3d 1226 (11th Cir. 2009) (no unwarranted disparity where cooperating/pardoned co-defendant receives lesser sentence)