United States v. Quinones, 635 F.3d 590

Antonio Quinones entered the Internet pharmacy business in 2002 by purchasing Prescriptions & Travel and RX Networks, with doctors reviewing orders via a doctors module and no patient-doctor interaction.
Antonio controlled the operation through a back-end system, hired doctors who reviewed questionnaires for per-questionnaire pay, and ran pharmacies that filled about 1,000 orders daily.
He used corporate entities (My Rainbow Marketing and Thundergames) to buy medicine, route payments, and operate a call center; Herman Quinones assisted and ran 888meds.com connected to the back-end.
Following Chhabra’s 2003 arrest, Antonio moved filling from Florida to Queens to avoid state law constraints and operated across roughly a dozen different pharmacies as enforcement actions occurred.
In December 2007, Antonio and Herman were indicted on conspiracy to distribute, distribution, and money laundering conspiracy; evidence showed unlawful distribution and reliance on doctors/pharmacists despite knowledge of bad faith.
The district court gave a conscious avoidance jury instruction; the jury convicted Antonio on all counts and Herman on distribution; sentencing followed with 97 months for Antonio and 18 months for Herman.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the conscious avoidance instruction was prejudicial	Quinones: instruction improperly defined knowledge and should have included actual belief as a qualifier	Quinones: instruction was flawed and not harmless; Kaiser requires new trial	Not prejudicial; overwhelming evidence of knowledge supports upholding
Santos interpretation of proceeds for money laundering	Quinones: Santos limits 'proceeds' to profits, challenging the conspiracy	Quinones: Santos permits proceeds to include gross receipts for contraband; supports conviction	Santos allows profits or broader receipts depending on context; the conviction affirmed

United States v. Kaiser, 609 F.3d 556 (2d Cir. 2010) (plain-error review for conscious-avoidance instruction; actual-belief proviso required)
United States v. Santos, 553 U.S. 507 (Supreme Court 2008) (proceeds definition in money laundering; profits vs receipts debate)
United States v. Ferrarini, 219 F.3d 145 (2d Cir. 2000) (conscious-avoidance framework and requirement to inform actual belief)
United States v. Vamos, 797 F.2d 1146 (2d Cir. 1986) (conscious-avoidance standard for knowledge via completing knowledge alternatives)
Marks v. United States, 430 U.S. 188 (1977) (determine controlling rationale where multiple opinions concur for judgment)
United States v. Sicignano, 78 F.3d 69 (2d Cir. 1996) (concerns that lack of actual belief defeats conscious-avoidance)