Background
Scott Hollington operated an addiction clinic and was charged with unlawfully prescribing controlled substances to five undercover officers and four patients. Trial evidence showed that some prescriptions followed minimal or nonexistent medical evaluations. Three patients testified about sexual conduct or propositions connected to Hollington’s treatment of them, including prescriptions exchanged for sexual activity. A fourth testified that Hollington prescribed Adderall without reviewing her records, examining her, or taking her vital signs.
After Hollington’s initial indictment, he added information to the undercover officers’ medical charts. Four additions falsely stated that the officers had reported conditions they denied reporting. In a fifth chart, Hollington recorded answers obtained during a post-indictment telephone call without indicating when the information had been supplied. A jury convicted him on 14 controlled-substance counts and five obstruction counts after the district court acquitted him on a conspiracy count.
The advisory sentencing range was 30 to 37 months. Concluding that the range did not adequately reflect Hollington’s sexual misconduct toward vulnerable patients, the district court imposed 144 months in prison, consecutive to his three-year state sentence for sexual battery.
The Court’s Holding
The Eleventh Circuit affirmed the controlled-substance convictions Hollington challenged. A reasonable jury could find that his prescriptions to A.N.B. and D.A. were tied to sexual activity and therefore issued outside the usual course of professional practice. As to K.W., Hollington forfeited a challenge to the amphetamine basis for the conviction, and the evidence independently showed that he prescribed amphetamine without medical-record review, vital-sign checks, a physical assessment, or other steps identified by the government’s expert.
The court also held that sufficient evidence supported the obstruction convictions. Because Hollington modified the medical charts shortly after his indictment, the jury could infer that he intended the entries to make it appear that he had performed more thorough evaluations before prescribing controlled substances. Even the accurate post-indictment entry could misleadingly imply that the screening occurred before the prescription.
Finally, the court held that the 144-month sentence was procedurally and substantively reasonable. The district court adequately explained that the drug-quantity-driven guideline range failed to account for Hollington’s sexual misconduct, permissibly considered statements from non-testifying victims, and reasonably emphasized his abuse of vulnerable patients and the need to protect the public. The substantial variance did not establish an abuse of discretion, particularly because the sentence remained below the applicable 20-year statutory maximum.
Key Takeaways
- Evidence that a physician exchanged or anticipated exchanging prescriptions for sexual activity can support a finding that the prescriptions fell outside the usual course of professional practice.
- Post-indictment alterations to medical records may constitute obstruction when they falsely or misleadingly suggest that proper evaluations occurred before prescriptions were issued.
- A sentencing court may impose a substantial upward variance based on sexual misconduct and other conduct inadequately captured by the guidelines, even when the government does not request the variance.
Why It Matters
The decision reinforces that controlled-substance liability for physicians extends beyond prescriptions lacking any medical purpose: prescriptions knowingly issued outside ordinary professional practice also violate federal law. The circumstances surrounding the physician-patient relationship, including sexual exploitation and failures to perform basic examinations, can establish that element.
The opinion also illustrates the breadth of federal sentencing discretion. A court may consider uncharged conduct and victim statements when applying the statutory sentencing factors, and a large variance can survive appellate review when the court explains why the advisory range understates the seriousness of the defendant’s conduct.