United States v. Juan Lopez
689 F. App'x 732
| 4th Cir. | 2017Background
- Defendant Juan Lopez, a VAMC nurse, was convicted by a jury of aggravated sexual abuse (18 U.S.C. § 2241(b)(2)) and making a false statement (18 U.S.C. § 1001(a)(2)); district court sentenced him to 204 months.
- Victim presented to the VAMC with severe pain and nausea; Lopez, on duty, administered morphine after the victim twice refused.
- While alone in an exam room, Lopez placed a bedpan, pulled down the victim’s pants/underwear, repeatedly inserted fingers into her vagina, and later forced a cloth into her vagina causing pain; victim found blood in her underwear.
- Lopez later admitted in a sworn statement that he inserted one or two fingers into the victim’s vagina; he initially denied this to federal agents but recanted about a month later.
- On appeal Lopez challenged sufficiency of evidence for both convictions; the Fourth Circuit reviewed de novo and affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Sufficiency of evidence that Lopez administered morphine without consent | Government: victim’s testimony shows Lopez administered morphine despite explicit refusals | Lopez: visiting VAMC implied consent to treatment; no nonconsensual administration | Court: Evidence sufficient — competent patients can refuse treatment; victim’s repeated refusals support nonconsensual administration |
| Sufficiency of evidence that Lopez committed a “sexual act” under §2246(2)(C) | Government: repeated digital/vaginal penetration and forced insertion of cloth show sexual act intended to abuse/humiliate | Lopez: actions were medically intended to assist, not to arouse or abuse | Court: Evidence sufficient — penetration had no medical purpose, jury reasonably inferred intent to abuse/humiliate; victim’s pain and bleeding corroborate intent |
| Sufficiency of evidence for false-statement conviction under §1001(a)(2) | Government: Lopez knowingly lied to federal agents that he did not penetrate victim; lie was capable of influencing investigation | Lopez: initial denial immaterial and later corrected; not capable of influencing agents | Court: Evidence sufficient — false denial was material (could have ended investigation); recantation does not negate §1001 liability |
| Standard of review for sufficiency challenge | Government: defer to jury credibility findings; substantial-evidence standard | Lopez: challenges application of standard to facts | Court: Applies de novo review but upholds verdict if substantial evidence exists; defers to jury credibility determinations |
Key Cases Cited
- United States v. Engle, 676 F.3d 405 (4th Cir. 2012) (standard for sufficiency review and inferring intent from circumstantial evidence)
- United States v. Perry, 757 F.3d 166 (4th Cir. 2014) (definition of substantial evidence supporting a conviction)
- United States v. Louthian, 756 F.3d 295 (4th Cir. 2014) (deference to jury credibility and conflict resolution)
- United States v. Wilson, 115 F.3d 1185 (4th Cir. 1997) (uncorroborated witness testimony can support conviction)
- Cruzan v. Dir., Mo. Dep’t of Health, 497 U.S. 261 (1990) (competent patient’s right to refuse medical treatment)
- King v. Rubenstein, 825 F.3d 206 (4th Cir. 2016) (recognition of patient autonomy in medical decisions)
- United States v. Hamilton, 699 F.3d 356 (4th Cir. 2012) (elements of a §1001 false-statement offense)
- United States v. Garcia-Ochoa, 607 F.3d 371 (4th Cir. 2010) (test for materiality under §1001)
- United States v. Sarihifard, 155 F.3d 301 (4th Cir. 1998) (false statements capable of influencing an investigation are material)
- United States v. Stewart, 433 F.3d 273 (2d Cir. 2006) (no safe harbor for recantation under §1001)
- United States v. Beaver, 515 F.3d 730 (7th Cir. 2008) (recantation does not negate §1001 liability)