United States v. Julio Diaz
876 F.3d 1194
| 9th Cir. | 2017Background
- Dr. Julio Diaz ran a Santa Barbara clinic (1995–2011) that treated geriatric patients and later provided pain management; between 2008–2011 he wrote >50,000 prescriptions for >5 million opiate pills.
- In 2012 Diaz was indicted on 88 counts under 21 U.S.C. § 841(a)(1); the government tried 79 counts referencing prescriptions for nine patients.
- To convict under § 841(a)(1) the government must prove distribution of controlled substances, that distribution was outside the usual course of professional practice and without a legitimate medical purpose, and that the practitioner acted with requisite intent.
- At trial the government’s expert, Dr. Rick Chavez, testified (without objection) that the challenged prescriptions were "outside the usual course of medical practice" and "without a legitimate medical purpose."
- The jury convicted Diaz on all 79 counts; district court imposed a Guidelines sentence of 327 months. On appeal Diaz argued Dr. Chavez impermissibly gave a legal conclusion in violation of FRE 702 and 704. The Ninth Circuit affirmed the conviction but vacated and remanded the sentence for resentencing.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Admissibility of expert testimony that prescriptions were "outside the usual course of medical practice" and "without a legitimate medical purpose" | Dr. Chavez’s testimony impermissibly stated a legal conclusion and supplanted the jury’s role | Government: expert may testify on medical standards; Rule 704 permits opinions on ultimate issues so long as expert does not state a legal conclusion | Court: Admission not plain error—terms used lacked a specialized legal meaning distinct from ordinary medical usage, and the expert provided helpful medical opinion rather than instructing the jury on law |
Key Cases Cited
- United States v. Feingold, 454 F.3d 1001 (9th Cir.) (elements required to convict a practitioner under § 841(a)(1))
- United States v. Davis, 564 F.2d 840 (9th Cir.) (post-Rule 704 permissibility of physician testimony about prescribing outside usual practice)
- Hangarter v. Provident Life & Accident Ins. Co., 373 F.3d 998 (9th Cir.) (expert may not give an opinion that states a legal conclusion)
- United States v. Moran, 493 F.3d 1002 (9th Cir.) (expert’s label of a transaction as a "sham" admissible where jury still must make legal findings)
- United States v. McIver, 470 F.3d 550 (4th Cir.) (expert testimony that treatment was outside usual practice is not plain error where terms have ordinary meaning)
- United States v. Volkman, 797 F.3d 377 (6th Cir.) (experts may say prescriptions were not for a legitimate medical purpose when phrase lacks specialized legal meaning)
- United States v. Katz, 445 F.3d 1023 (8th Cir.) (addressing limits on expert testimony on ultimate issues)
- United States v. Chube II, 538 F.3d 693 (7th Cir.) (recognizing necessity of experts to use language overlapping legal standards in medical-prescribing cases)