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United States v. Sadler

United States Court of Appeals for the Sixth Circuit

March 13, 2014, Argued; April 24, 2014, Decided; April 24, 2014, Filed

File Name: 14a0087p.06

Nos. 12-4450/4458


 [*588]  [***2]   SUTTON, Circuit Judge. A jury convicted Lester and Nancy Sadler, husband and wife, of various crimes associated with the operation of several pain-management clinics in central and southern Ohio. They each appeal their convictions, and Nancy challenges her sentence as well. We affirm on all grounds save one: Nancy's conviction for wire fraud.

In 2001, Nancy and Lester opened a pain-management clinic, "First Care," in Garrison, Kentucky. Nancy was the owner,  [**2] but employees at the clinic considered both Nancy and Lester to be "in charge." R. 205 at 8-9. The clinic closed after the Drug Enforcement Agency investigated it and confiscated the license of the clinic's doctor for overprescribing narcotics.

In 2002, they moved the clinic to Waverly, Ohio. In 2004, the Sadlers renamed the clinic "Ohio Medical and Pain Management." Sometime after February 2008, Ohio Medical opened a second office in Columbus, Ohio. Unlike at the previous clinics, Lester (not Nancy) was Ohio Medical's owner and statutory agent.

The evidence introduced at trial showed that these were not conventional pain clinics. At the Waverly clinic, patients would arrive well before it opened, filling the clinic's parking lot and the lots of nearby businesses. While waiting for the clinic to open, the patients used drugs and traded prescription forms for cash in the parking lots. The patients often traveled long distances (and in large groups) to come to the Sadlers' shops, sometimes as much as 316 miles in a roundtrip, even though most of the patients lived much closer to other clinics.

Matters did not improve once the patients entered the Sadlers' clinics. After paying their $150  [**3] appointment fee (cash only), they met an "assessor" who would review the patients' health-facts "day sheet" and hand the patients an already completed prescription form. Clinic staff  [*589]  sometimes filled out these day sheets and prescription forms weeks in advance, pulling the content from the patients' last day sheet and prescription and altering them slightly to make sure they didn't look the same. Patients then stepped into an office, where they met the doctor for a  [***3]  minute or two. After that, they left the clinic (some "almost skipping," reported one witness, R. 325 at 81) with a signed prescription for a fresh supply of hydrocodone, oxycodone or other pain medications in hand. As many as 100 people per day completed this "five minute[]" process of assessment and prescription, R. 317 at 69, a tall order, the evidence showed, for a clinic committed to practicing medicine responsibly.

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750 F.3d 585 *; 2014 U.S. App. LEXIS 7661 **; 2014 FED App. 0087P (6th Cir.) ***; 2014 WL 1622194

UNITED STATES OF AMERICA, Plaintiff-Appellee, v. LESTER SADLER (12-4450) and NANCY SADLER (12-4458), Defendants-Appellants.

Subsequent History: Decision reached on appeal by United States v. Sadler, 2016 U.S. App. LEXIS 10493 (6th Cir.), 2016 FED App. 307N (6th Cir.) (6th Cir. Ohio, 2016)

Prior History:  [**1] Appeal from the United States District Court for the Southern District of Ohio at Cincinnati. No. 1:10-cr-00098-1—Sandra S. Beckwith, District Judge.

United States v. Sadler, 2012 U.S. Dist. LEXIS 114988 (S.D. Ohio, Aug. 15, 2012)


clinic, patients, pills, prescriptions, distributors, drugs, sentence, deprive, pain, conspiracy, distributing, controlled substance, prescribed, district court, wire fraud, convictions, enhancement, hydrocodone, employees, addicts, probation, quotation, charges, license, phantom, opened, marks, accurate information, intangible right, premises

Criminal Law & Procedure, Standards of Review, Substantial Evidence, Sufficiency of Evidence, Fraud, Wire Fraud, Elements, Criminal Offenses, General Overview, Governments, Legislation, Interpretation, Rule of Lenity, Controlled Substances, Delivery, Distribution & Sale, Conspiracy, Evidence, Types of Evidence, Circumstantial Evidence, Acts & Mental States, Mens Rea, Knowledge, Inferences & Presumptions, Inferences, Sentencing Guidelines, Adjustments & Enhancements, Burdens of Proof, Preponderance of Evidence, Sentencing, Aggravating Role, Criminal History, Appeals, Proportionality & Reasonableness Review, Presumptions, Creation