United States v. Maurice W. Rosenberg, M.D.United States v. Maurice W. Rosenberg, M.D.
Lead Opinion
OPINION
Dr. Mаurice W. Rosenberg appeals from a judgment of conviction entered on April 15, 1974, in the Central District of California, following a jury trial at which he was found guilty of 27 counts of distributing a controlled substance in violation of
Rosenberg was a seventy-five year old doctor who had been practicing medicine in California for approximately 50 years. During 1973 the doctor was visited by five undercover agents working for the California Bureau of Narcotics, Department of Justice, and Department of Consumer Affairs.
Of course, we review the evidence in the light most favorable to the government. Glasser v. United States,
At no time did Dr. Rosenberg give any of the agents a physical examination. The agents never voluntarily indicated that they had any medical problem for which they needed medication. For example, when the doctor asked agent Van Diest what was wrong with her, she said that she did not have any problems, that she had been buying pills on the street and wanted a safer source, and that she had heard that she could get them from him. She told Dr. Rosenberg that she wanted some “reds.”
On the basis of the above described evidence, Dr. Rosenberg was charged with violating the federal Controlled Substance Act which provides that
[ejxcept as authorized by this subchap-ter, it shall be unlawful for any person knowingly or intentionally — (1) to manufacture, distribute, or dispense, or possess with intent to manufacture,distribute, or dispense, a controlled substance.
a physician, dentist, veterinarian, scientific investigator, pharmacy, hospital, or other person licensed, registered, or otherwise permitted, by the United States or the jurisdiction in which he practices or does research, to distribute, dispense, conduct research with respect to, administer, or use in teaching or chemical analysis, a controlled substance in the course of professional practice or research.
A prescription for a controlled substance to be effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice.
Our dissenting brother describes the language of
Our examination of the legislative history convinces us that Congress intended
There is no suggestion in the legislative history that the registration provisions were intended to be a substitute for the Act’s general criminal penalties. The legislative history expressly states that the Act “provides severe criminal penalties for persons engaged in illicit . sale of controlled drugs primarily for the profits to be derived therefrom.” Since this is what Dr. Rosenberg did, the severe criminal penalties contained in
One of the findings of the Congress in enаcting the Controlled Substances Act was that “(6) Federal control of the intrastate incidents of the traffic in controlled substances is essential to the effective control of the interstate incidents of such traffic.”
Moreover, we note that the dissent’s interpretation of the Act would make superfluous one of its main reform provisions. Title I of the Act deals with rehabilitation of addicts. Section 4 of that title provides that the Secretary of Health, Education, and Welfare, in consultation with the Attorney General, “shall determine the appropriate method of professional practice in the medical treatment of narcotic addiction.” This section was adopted in light of Congress’ awareness that there had been “criminal
The above considerations, taken altogether with the fact that there is no statement in the legislative history that indicates that doctors are not to be subject to
In dissent Judge Ely relies principally on a decision by the District of Columbia Circuit, United States v. Moore,
First, it noted that section 822(b) provides that “[pjersons registered by the Attorney General under this subchapter to manufacture, distribute or dispense controlled substances are authorized to . distribute or dispense such substances ... to the extent authorized by their registrations and' in conformity with the other provisions of this subchapter.” It concluded that this passage was a blanket authorization to dispense drugs that exempted registered doctors from
The second factor stressed by the Moore majority is that while certain of the penalty provisions found in
We see no reason to construe the statute’s clear language in those eleven sections to mean “person other than a registrant.” Section 843(a)(3), for example, applies to any person who “acquire[s] or obtain[s] possession of a controlled substance by misrepresentation, fraud, forgery, deception, or subterfuge” — a crime obviously committable by any person— registered doctor or otherwise. Yet the reasoning of the D.C. Circuit would seem to compel a holding that registrants were not subject to the provision because the word “registrant” is not included therein. We see no basis for such a result. Congress understood that persons included registrants (see, e. g.,
Finally, the court in Moore refused to interpret the 1970 Act in light of the Harrison Act,
Thus, we conclude that the Controlled Substances Act, including
We turn now to the arguments raised by Dr. Rosenberg in his various briefs filed in this court.
The two phrases in the indictment have essentially the same meaning. At no time did Judge Gray instruct the jury (or even suggest to the jury) that there were two separate ways in which the statute could be violated. In his instructions to the jury on what he called the “principal issue” Judge Gray charged that
(t)he law makes it unlawful for any person to distribute a controlled substances except a practitioner who causes the controlled substаnce to be distributed in the course of professional practice. If this doctor was causing the controlled substance to be prescribed while acting as a doctor in the course of his professional practice, then there’s no violation. However, if he was not acting in good faith as a doctor, but simply pushing pills, as counsel has said, then he does not come within the exception, and the law is violated.
The trial judge stressed that the jury had to look into Dr. Rosenberg’s mind to determine whether he prescribed the pills for what he thought was a medical purpose or whether he was passing out the pills to anyone who asked for them. He in no way indicated that the jury could find Dr. Rosenberg guilty if it found that he either acted not in the course of his professional practice or not for legitimate medical reasons. In fact, as the extract from the judge’s charge demonstrates, he laid out the issue as whether the doctor had acted not in the course of professional practice, which is the statutory language. While the trial judge later used the phrase “good faith for legitimate medical treatment in the usual course of his professional prаctice,” it seems clear that the trial judge was simply elaborating on the statutory language, as he did in other ways on different occasions.
Dr. Rosenberg next argues that the phrase “in the course of professional practice” is so vague that it violates the due process clause of the Fifth Amendment. The Supreme Court has recently held that “(t)o avoid the constitutional vice of vagueness, it is necessary, at a minimum, that a statute give fair notice that certain conduct is proscribed.” Rabe v. Washington,
The Supreme Court had several occasions to interpret this language when it was used in the Harrison Narcotics Law § 2, 38 Stat. 785. For example, in Jin Fuey Moy v. United States,
The ease and consistency with which courts have interpreted this language convinces us that it is not vague. See also United States v. Collier,
Third, Dr. Rosenberg attacks the constitutionality of the federal drug laws. He urges that they violate the Tenth Amendment.
As the doctor admits in his brief, the Tenth Amendment is generally viewed as stating a truism. “From the beginning and for many years the amendment has been construed as not dеpriving the national government of authority to resort to all means for the exercise of a granted power which are appropriate and plainly adapted to the permitted end.” United States v. Darby,
Fourth, Dr. Rosenberg argues /that the federal drug control statute violates due process because it establishes a
[i]t shall not be necessary for the United States to negative any exemption or exception set forth in this subchap-ter ... in any trial, hearing, or other proceeding under this subchap-ter, and the burden of going forward with the evidence with respect to any such exemption or exception shall be on the person claiming its benefit.
Wе find nothing wrong with this provision. It is a common provision in criminal statutes that contain many exemptions or exceptions. Without such a provision the government would be required to waste valuable court time disproving arguments that a defendant did not and" could not conceivably make. v
The important fact is that the quoted provision does not shift the .burden of proof. Once a defindant presents a claim that he falls within the exemption, the government must prove beyond a reasonable doubt that the accused does not fall within it. In this case a reading of the trial judge’s instructions to the jury leaves no doubt that the government was required to prove beyond a reasonable doubt that Dr. Rosenberg was not a physician acting in the course of his professional conduct.
Fifth, the doctor argues that there was insufficient evidence to sustain a guilty verdict. In addition to the testimony outlined above, there was additional evidence to support the conviction of the defendant. For example, the agents testified, among other things, that when they paid their money, but did nоt receive prescriptions, the money was refunded; that they indicated to the doctor that they were giving some of the prescribed pills to other people, and that they were also obtaining pills from other doctors. In addition, the government offered the testimony of a medical expert, who stated that proper professional practice required that a doctor give a physical examination before prescribing the drugs involved here for a patient he had never seen before. The expert also indicated that dexedrine has only limited uses and in the area of weight control is primarily used to help grossly obese people lose weight. In rebuttal, Dr. Rosenberg offered only his own testimony.
We think that the testimony of the expert and the facts outlined by the agents are sufficient to sustain the defendant’s conviction. Indeed, the jury could decide for itself, on the basis of the facts shown and without any expert testimony, that Dr. Rosenberg was not acting in the course of his professional practice. United States v. Larson,
Sixth, Dr. Rosenberg argues that his conviction should be overturned because his medical files were used against him in violation of his Fifth Amendment right against self incrimination.
A California statute requires that records of prescriptions for the drugs involved in this case be kept for two years. Cal.Health & Safety Code § 11191. While the statute does not expressly pro
In Grosso v. United States,
Finally, Dr. Rosenberg argues that he was improperly indicted for unlawfully “distributing” a controlled substance. He contends that he should have been charged with unlawfully “dispensing” a controlled substance. We find no merit in this argument. United States v. Black,
We have considered the other arguments made by Dr. Rosenberg and find them to be without merit.
Affirmed.
. Twelve of the counts charged the doctor with unlawfully distributing dextroamphetamine,
. Dr. Rosenberg argues that he was somehow denied due process because the state investigators turned their information over to the United States Attorney. Such a division of labor is highly desirable so long as it does not deprive a defendant of some constitutional right. There is no suggestion that the California investigators violated Dr. Rosenberg’s rights. The doctor was indicted by a grand jury and enjoyed all of the rights and procedural safeguards normally afforded a federal defendant.
. A street name for seconal.
. A street name for dexedrine, a drug that can be used for weight reduction purposes.
. The House Report refers to the violations in
. We do not understand the dissent’s suggestion that veterinarians would somehow be restricted by the Act. They are practitioners,
. The Supreme Court has written that
[t]he canon in favor of strict construction [of criminal statutes] is not an inexorable command to override common sense and evident statutory purpose. . . . [n]or does it demand that a statute be given the “narrowest meaning”; it is satisfied if the words are given their fair meaning in accord with the manifest intent of the lawmakers.
United States v. Brown,
In this regard it is interesting to note that the Senate report on the Narcotic Addict Treatment Act of 1974, Pub.L.No.93-281, 88 Stat. 124, discussed Dr. Moore’s conviction with approval. (Dr. Moore was the doctor involved in United States v. Moore,
.
. Apparently only Dr. Moore has thought that
. The Attorney General dоes have the power to “promulgate and enforce any rules, regulations, and procedures which he may deem necessary and appropriate for the efficient execution of his functions under this subchapter.”
. This interpretation is supported by language in the Supreme Court cases discussed infra.
. The Tenth Amendment states, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”
. Doremus was discussed and cited with approval in Linder, the case relied upon by defendant. Linder v. United States, supra,
. - The doctor argues that the cases upholding the constitutionality of drug laws are distinguishable because the defendants in those cases had prescribed excessive amounts of drugs and were clearly not acting in the course of professional conduct. He claims that since his prescriptions were within the legal quantity limits for such prescriptions and since it was not clear that he was acting other than in the course of his professional conduct, the Constitution somehow requirеs that the state of California must first find his acts were unauthorized before federal prosecution is permissible. We do not agree. If the Constitution allows the federal government to regulate the dispensation of drugs, it allows it to do so in every case, and not just where more than a certain quantity of drugs are involved. It would be impractical and unheard of first to determine whether a physician’s conduct was or was not sufficiently egregious in order to decide whether federal or state-federal prosecution was appropriate. The question of whether federal criminal laws have been violated is a federal issue to be determined in federal courts.
. On September 24, 1973, Dr. Rosenberg was served with a grand jury subpoena for his patient records as they related to the dispensation of narcotic substances to several named persons. He supplied the records for all but one of the patients covered by the subpoena. On a motion to suppress the records as evidence Dr. Rosenberg claimed that he was tricked intо surrendering them. The district court, however, found that he was not tricked.
. The statute at one time expressly provided that the records were to be open to such inspection.
. Since the defendant raised this argument only as an afterthought in a brief filed after the argument, he can scarcely claim that he was not fully apprised of the charges against him. See The Schooner Hoppet v. United States,
Dissenting Opinion
(dissenting):
I respectfully dissent.
In my view, the clear holding of United States v. Moore,
I. Statutory Analysis
In the 1970 Act, Congress undoubtedly intended to strike a hard blow at drug traffickers. Nevertheless, Congress had before it a competing consideration, which is listed first among its findings and declarations:
Many of the drugs included within this [Act] have a useful and legitimate medical purpose and are necessary to maintain the health and general welfare of the American people.
Within Part C, section 822(a) requires thаt physicians and the other professionals within the scope of the “closed system” register annually with the Attorney General. As to physicians, the Attorney General must grant such registration pro forma. He has absolutely no discretion to refuse to register a physician who is already licensed to dispense controlled substances by the state in which the physician practices.
Congress included within Part C a system of administrative controls over physicians and the other members of the “closed system.” There are, for example, extensive record-keeping requirements, and
In contrast,
There is no language whatsoever in either
As to both provisions, Judge MacKin-non overlooks the explanation that registered physicians have no authority to deal in Schedule I controlled substances. Consequently, a physician may illegally “dispense” Schedule I controlled substances and may be prosecuted under the felony provisions of
After studying the Act in its entirety, I am impelled to the conclusion that
II. Vagueness
Rejecting the careful statutory analysis of Moore, my Brothers choose instead to take our Court further dоwn the tortured and mistaken path first chosen by the Fifth Circuit in United States v. Collier,
In a nutshell, the majority’s reasoning is as follows: The “[ejxcept as authorized by this subchapter” proviso in
As the majority plainly recognizes, the validity of their view concerning the applicability of
The term “practitioner” means a .physician . . . licensed by . the jurisdiction in which he practices . to dispense a controlled substance in the course of professional practice . . ”
One’s first logical reaction after reading the phrase “ . . .in the course of professional practice . . .,” in the context in which it is used, must be that Congress included it within the definition in order to specify the type of license that qualifies a physician for the “practitioner” designation. Once a physician has received such a license from his state, it seems obvious, under the definition, that he is, and remains so long as he retains his license, a “practitioner.” At the time of Dr. Rosenberg’s alleged offenses, he was duly and regularly licensed by the State of California “ . . . to . . dispense a controlled substance in the course of professional practice . . .;” therefore, Dr. Rosenberg was a “practitioner.”
Assuming, arguendo, however, that Congress did intend to give the phrase the meaning the majority attributes to it, Congress has, without doubt, used language that is “ . . . so vague that men of common intelligence must necessarily guess as to its meaning and differ as to its application.” Connally v. General Construction Co.,
The majority apparently concedes that the phrase, “ . . .in the course of professional practice . . .,” is, on its face, too imprecise to support a criminal conviction. But the majority concludes that the phrase’s meaning has been clarified by several old decisions of the Supreme Court that construe what the majority asserts to be similar language in the now-repealed Harrison Anti-Narcotic-Act, ch. 1, 38 Stat. 785, enacted in 1914. I submit that the majority’s reliance on the Harrison Act cases is obviously misplaced.
The legislative history of the 1970 Act reveals that Congress intended the new Act to be a complete revision of the criminal provisions of the federal narcotics laws. See United States v. Moore, supra
But there is an additional reason for not doing what the majority has done with the Harrison Act decisions. In those cases the Supreme Court construed a proviso that appeared directly in the penal section of the Harrison Act and which read:
Nothing contained in this section shall apply—
(a) To the dispensing of any of the aforesaid drugs to a patient by a physician . . . registered under this Act in the course of his professional practice only.
Ch. 1, § 2, 38 Stat. 786. (Emphasis added.) Yet the majority seeks to employ the Supreme Court’s opinions to clarify the following phrase from the 1970 Act: “ . . . licensed ... to dispense ... a controlled substance in the course of professional practice . . ..”
Actually, the Harrison Act cases support my interpretation of the 1970 Act, rather than the wholly unwarranted interpretation of the majority. My Brothers assert that Congress intended in the 1970 Act to continue the same criminal liability for registered physicians that so clearly existed under the Harrison Act. If this is true, the majority might have undertaken an explanation of why Congress chose in the new Act, in the face of consistently favorable Supreme Court interpretations of the Harrison Act proviso, to alter drastically the language of the proviso by deleting “to a patient” and “only,” to cast the proviso in terms of “licensing” instead of “dispensing,” and to move the proviso from the penal provision to the general definitions section of the Act.
Finally, in further support of its interpretation of the phrase, “ . . . in the course of professional practice .,” the majority relies on an administrative regulation,
The majority, however, and correctly in my view, does not contend that violation of such a regulation, alone, could subject a physician to prosecution under the general penal provisions of
In conclusion, I firmly hold that Dr. Rosenberg’s convictions simply cannot be sustained on the basis of the majority’s reasoning. My Brothers, I think, have subconsciously responded to a realistic concern that the severe sanctions, of
men are not subjected to criminal punishment because their conduct offends our . . . emotions or thwarts a general purpose sought to be effected by specific commands which they have not disobeyed. Nor are they to be held guilty of offenses which the statutes have omitted ... to define and condemn. For the courts are without authority to repress evil save as the law has proscribed it and then only according to law.
Viereck v. United States, supra,
I would reverse.
. All sections of the Act are numbered as they aрpear in Title 21, United States Code.
. Dr. Rosenberg was licensed as a physician by the State of California. The statute defining the scope of a licensed physician’s practice in California, Cal.Bus. & Prof.Code § 2137 (West 1974), reads as follows:
The physician’s and surgeon’s certificate authorizes the holder to use drugs or what are known as medical preparations in or upon human beings and to sever or penetrate the tissues of human beings and to use any and all other methods in the treatment of diseases, injuries, deformities, or other physicial or mental conditions.
. The 1970 Act was derived principally from the House bill. As to
. The charges against Dr. Rosenberg were based on prescriptions he had written for controlled substances listed in Schedules II, III, and IV.
. The criminal penalties provided for registrants in
. The majority’s argument that Title I, section 4 of the Act,
. I was a member of the panel of this court that decided Larson, wherein we unanimously affirmed the
. See the relevant California statute, quoted supra n. 2.
. In Behrman, the Supreme Court reversed a District Court’s dismissal of an indictment that charged a physician with prescribing large quantities of heroin and morphine to a person known by the physician to be an addict for the allegedly illegal purpose of maintaining the addict’s habit. The Supreme Court held that the indictment stated an offense against the physician under the Harrison Act. Despite the language of the Harrison Act proviso pertaining
It seems to me impossible to construe the statute as tacitly making such acts, however foolish, crimes, by saying that what is in form a prescription and is given honestly in the course of a doctor’s practice, and therefore, so far as the words of the statute go, is allowed in terms, is not within the words, is not a prescription and is not given in the course of practice, if the Court deems the doctor’s faith in his patient manifestly unwarranted. It seems to me wrong to construe the statute as creating a crime in this way without a word of warning.
. The majority does note that