United States v. Cunningham
103 F.3d 553 (1996)
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Rule of Law:
Tampering with a consumer product in a way that reduces its efficacy and prevents it from alleviating pain constitutes placing a person in danger of bodily injury under 18 U.S.C. § 1365(a), as "bodily injury" includes physical pain.
Facts:
- Constance Cunningham was a registered nurse at an Indiana hospital with a history of Demerol addiction.
- Cunningham had previously stolen Demerol from another hospital, which resulted in the temporary suspension of her nursing license.
- As a condition of her license reinstatement, she was required to undergo periodic drug testing, and she falsified the results of some of these tests.
- At her current hospital, syringes containing the painkiller Demerol were found to have been tampered with; the drug had been replaced with a saline solution.
- Cunningham was one of five nurses who had access to the locked cabinet where the tampered syringes were stored.
- When interviewed by police, Cunningham denied tampering with the syringes but admitted her past addiction.
- She voluntarily submitted to blood and urine tests, and while the blood test was negative, the urine test was positive for Demerol, indicating recent use.
Procedural Posture:
- Constance Cunningham was charged in federal district court (the court of first instance) with tampering with a consumer product in violation of 18 U.S.C. § 1365(a).
- At trial, the district court admitted evidence of Cunningham's prior Demerol theft, license suspension, and falsification of drug test results over her objection.
- A jury found Cunningham guilty of the charge.
- The trial court sentenced Cunningham to 84 months in prison.
- Cunningham (as appellant) appealed her conviction to the U.S. Court of Appeals for the Seventh Circuit, arguing that the evidence was insufficient for conviction and that the trial court improperly admitted the evidence of her prior bad acts.
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Issue:
Does a nurse who tampers with syringes of a painkiller by replacing the drug with a saline solution, thereby withholding pain relief from a patient, place that person 'in danger of... bodily injury' within the meaning of 18 U.S.C. § 1365(a)?
Opinions:
Majority - Posner, Chief Judge
Yes. Tampering with a consumer product in a way that withholds pain relief places a person in danger of bodily injury. The court reasoned that the statute's definition of 'bodily injury' explicitly includes 'physical pain.' Therefore, conduct that perpetuates an injury by preventing the product from alleviating it is legally on the same footing as tampering that creates a new injury, such as adding poison. The court also held that evidence of Cunningham's prior Demerol addiction, license suspension, and falsified drug tests was admissible under the motive exception of Federal Rule of Evidence 404(b). This evidence was not used to show a general propensity for wrongdoing, but to establish a specific motive—feeding her addiction—that distinguished her from the four other nurses who also had access to the drugs.
Analysis:
This decision clarifies and broadens the scope of the federal product tampering statute, 18 U.S.C. § 1365(a), by establishing that rendering a medical product ineffective is as unlawful as making it actively harmful. It sets a precedent that interfering with a product's intended therapeutic effect, such as pain relief, constitutes causing 'bodily injury.' The opinion also provides a clear application of the motive exception in Fed. R. Evid. 404(b), affirming that evidence of addiction can be highly probative to show a unique motive for a crime, distinguishing it from inadmissible character or propensity evidence.
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