Commonwealth v. Brown

52 A.3d 320

2012 PA Super 150

COMMONWEALTH of Pennsylvania, Appellee

v.Richard A. BROWN, Appellant.

Superior Court of Pennsylvania.

Submitted April 2, 2012.

Filed July 25, 2012.

Scot R. Withers, West Chester, for appellant.

Christopher L. de Barrena–Sarobe, Assistant District Attorney, West Chester, for Commonwealth, appellee.

BEFORE: BOWES, DONOHUE, and COLVILLE,^* JJ.

OPINION BY BOWES, J.:

Richard A. Brown appeals from the judgment of sentence of eight to sixteen years imprisonment entered by the trial court after his convictions for violating 35 P.S. § 780–113(a)(14), relating to his prescription of drugs to six patients between June 1, 2002 and June 30, 2004 while he was a licensed practicing physician. Finding that the trial court erred in allowing the introduction of evidence of bad acts occurring in and before 1984 under the common law res gestae exception, we reverse and remand for a new trial.

Following a grand jury investigation, the Commonwealth charged Appellant and his wife with various tax and criminal conspiracy violations. In addition, Appellant was charged with 810 counts of violating the Controlled Substance, Drug, Device and Cosmetic Act (“Drug Act”). The trial court severed Appellant's drug charges from the remaining counts and ordered that he be tried separately for the Drug Act violations. At the same time, based on the pertinent statute of limitations, the court dismissed all charges related to Appellant's alleged procurement of his medical license through fraud. Accordingly, the Commonwealth filed an amended criminal information alleging 540 Drug Act violations and five counts each of tampering with public records and criminal conspiracy. The Commonwealth also sought to introduce evidence of prior bad acts, namely, Appellant's 2001 arrest and ultimate 2003 nolo contendere plea for committing the same offense for which he was convicted in this matter. Appellant responded by filing an omnibus pre-trial motion challenging the amended information, including a motion in limine seeking to prohibit the introduction of bad acts evidence.

The trial court awarded Appellant relief in the nature of dismissing 270 counts in the amended information and barring the introduction of evidence relating to Appellant's previous arrest and plea. The counts that remained pertained to Appellant's treatment of six patients between June 1, 2002 and June 30, 2004, and his prescription of certain medications to those patients.¹ The court also prohibited the Commonwealth from presenting evidence that Appellant fraudulently received his medical degree and medical license. However, the court indicated that it would be willing to reconsider the issue if the Commonwealth argued that the fraud evidence was part of the res gestae of the case.² Taking its cue from the court, the Commonwealth filed a motion to reconsider and argued that in the late 1970's and early 1980's, Appellant fraudulently obtained his medical degree and license. It asserted that this evidence was part of the history and chain of events of the case at bar, and was necessary to prove that Appellant either prescribed drugs in bad faith in the course of his professional practice or did not act in accordance with treatment principles accepted by a responsible segment of the medical profession. The court thereafter authorized the introduction of the evidence as to how Appellant obtained his medical degree and license.

The central theme of the prosecution's opening statement, significant portions of its case, and closing argument revolved around Appellant's alleged improper receipt of his medical degree in the late 1970's and early 1980's, as well as his submission of forged or altered documents to obtain his medical license.³ The Commonwealth also presented expert testimony concerning Appellant's treatment of six patients and the testimony of those patients. The expert testified that Appellant's treatment was not in accordance with treatment principles accepted by a responsible segment of the medical profession. According to the Commonwealth, Appellant was engaged in a scripts-for-cash scheme conducted from his home, which served as his office.

Appellant also presented his own medical expert who testified that Appellant's treatment was not improper, and pointed to treatment that these patients received after Appellant's care, which was similar in nature to what Appellant provided. The jury returned guilty verdicts on sixteen counts of unlawfully prescribing medicine under section 780–113(a)(14).⁴ The court subsequently sentenced Appellant to an aggregate sentence of eight to sixteen years incarceration. This appeal ensued. The trial court directed Appellant to file and serve a Pa.R.A.P. 1925(b) concise statement of errors complained of on appeal. Appellant complied, and the trial court authored its Pa.R.A.P. 1925(a) opinion. The matter is now ripe for our review.

Appellant presents the following questions for our consideration.

A. Whether the trial court erred as a matter of law and/or abused its discretion in its rulings on Appellant's pre-trial motions and the Commonwealth's motion for reconsideration, in which the trial court refused to preclude, and allowed the Commonwealth to present, over Appellant's objections at trial, evidence regarding allegations of fraud by Appellant in obtaining his license to practice medicine and evidence regarding Appellant's academic record, transcripts and credentials, resulting in prejudice to Appellant?

B. Whether the trial court erred as a matter of law and/or abused its discretion in overruling Appellant's objection to the evidence regarding his discharge from Chestnut Hill Hospital, and in permitting the testimony of a records custodian regarding Appellant[']s medical records when those records could not properly be authenticated, resulting in prejudice to Appellant?

C. Whether the jury's verdict was not supported by sufficient evidence where, as here, the Commonwealth failed to meet its burden of proving that Appellant violated the standard of care in the medical profession in caring for his patients?

Appellant's brief at 5.

We recently reiterated that a successful sufficiency-of-the-evidence challenge warrants discharge rather than a new trial, see Commonwealth v. Stokes, 38 A.3d 846 (Pa.Super.2011); therefore, we analyze Appellant's final issue at the onset. In reviewing a sufficiency claim, we find cynosure in the following well-settled precepts.

We must determine whether the evidence admitted at trial, and all reasonable inferences drawn therefrom, when viewed in a light most favorable to the Commonwealth as verdict winner, support the conviction beyond a reasonable doubt. Where there is sufficient evidence to enable the trier of fact to find every element of the crime has been established beyond a reasonable doubt, the sufficiency of the evidence claim must fail.

The evidence established at trial need not preclude every possibility of innocence and the fact-finder is free to believe all, part, or none of the evidence presented. It is not within the province of this Court to re-weigh the evidence and substitute our judgment for that of the fact-finder. The Commonwealth's burden may be met by wholly circumstantial evidence and any doubt about the defendant's guilt is to be resolved by the fact finder unless the evidence is so weak and inconclusive that, as a matter of law, no probability of fact can be drawn from the combined circumstances. Commonwealth v. Mobley, 14 A.3d 887, 889–890 (Pa.Super.2011). Additionally, “in applying the above test, the entire record must be evaluated and all evidence actually received must be considered.” Commonwealth v. Coleman, 19 A.3d 1111, 1117 (Pa.Super.2011).

Stokes, supra at 853–854.

The relevant language of the statute under which Appellant was convicted reads:

(a) The following acts and the causing thereof within the Commonwealth are hereby prohibited:

....

(14) The administration, dispensing, delivery, gift or prescription of any controlled substance by any practitioner or professional assistant under the practitioner's direction and supervision unless done (i) in good faith in the course of his professional practice; (ii) within the scope of the patient relationship; (iii) in accordance with treatment principles accepted by a responsible segment of the medical profession.

35 P.S. § 780–113(a)(14). The jury expressly found in its verdict that Appellant acted within the scope of the doctor-patient relationship. Thus, Appellant focuses his argument on the remaining aspects of the statute.

Appellant first argues that the prosecution did not prove that he prescribed the medications in bad faith. According to Appellant, the sole evidence introduced to show bad faith was that Appellant allegedly committed fraud in obtaining his medical degree and license before 1984. Appellant contends that, even assuming the evidence was admissible, it does not demonstrate any relationship to his actions in 2002 through 2004. Instead, he posits that the evidence establishes that he was a licensed doctor who treated six patients within the scope of the doctor-patient relationship.

Additionally, Appellant maintains that the Commonwealth failed to prove that no responsible segment of the medical profession would have approved of the treatment he provided. In this respect, Appellant highlights the testimony of his expert witness, Dr. Jason Brajer. Having reviewed the medical records for the six patients in question, Dr. Brajer testified to a reasonable degree of medical certainty that Appellant did not deviate from accepted standards of care. The Commonwealth for its part relies exclusively on the trial court's explanation as to why the evidence was sufficient. We conclude that, viewing the evidence in a light most favorable to the Commonwealth, the evidence was sufficient and note that the testimony of the Commonwealth's expert, Dr. William Vilensky, was itself sufficient to...