United States v. Lancaster

36 M.J. 1115, 1993 WL 114738
U S Air Force Court of Military Review·Decided March 29, 1993·No. ACM 29461·Published·Cited by 4 cases

Opinion

OPINION OF THE COURT

JOHNSON, Judge:

This started out as a case about a nurse charged with stealing controlled drugs from her duty section in a hospital ward and using them. The instructions of the military judge and the findings of the members changed it into a case about whether it is conduct punishable under Article 112a, UCMJ, 10 U.S.C. § 912a, for a military member to use a controlled prescription drug for an ailment other than the one for which the drug was prescribed. We hold that such use is not punishable under the UCMJ, and we set aside the findings of guilty.

Captain Lancaster was charged with stealing and using Demerol and wrongfully using oxycodone.1 The members found her not guilty of stealing or using Demerol but guilty of wrongfully using oxycodone.

In September 1990 Captain Lancaster was assigned to the cardio-thoracic ward at Wilford Hall USAF Medical Center. Her duties involved primarily the care of patients who had undergone heart surgery or were recovering from heart attacks. She often administered Demerol, oxycodone, and other medications to patients. On the morning of 27 September 1990, it was discovered that several packages of drugs, including Demerol, in the ward’s medication supplies had been tampered with. Four days earlier similar tampering with a drug package was discovered. In the late afternoon of 27 September 1990, Captain Lancaster appeared to be under the influence of some drug, as a result of which her commander authorized a seizure of a urine sample for analysis. Her sample tested positive for oxycodone and Demerol.

Captain Lancaster denied stealing or knowingly using Demerol and suggested someone must have put it in a cup of soda she kept on top of her medications cart. She admitted she had used Tylox, a brand name form of oxycodone, on the morning she provided the urine sample. She also testified, however, that she did not believe her use of Tylox was wrongful because it was prescribed to her. Dental records showed that Tylox was prescribed to her in 1988 for pain caused by the removal of a wisdom tooth. She testified she took the Tylox remaining from her 1988 prescription to relieve pain caused by an injured and infected hip.2

Several registered nurses who appeared as defense witnesses testified it was common practice for persons to whom prescription drugs were prescribed to keep remaining unused amounts of drugs and to use them later for other ailments. The prosecution presented no rebuttal to this evidence, and it did not ask the military judge to take judicial notice of any directive specifying that such use was prohibited.

[1117] The prosecution attacked the credibility of the testimony concerning Captain Lancaster’s use of Tylox. There was evidence that two capsules of Percocet (another drug containing oxycodone) might have been missing from the ward on the day in question. As a result, there was evidence before the members of several different theories concerning the possible source of the oxycodone in Captain Lancaster’s urine sample.

In his instructions on findings, the military judge properly told the members they could not find Captain Lancaster guilty of wrongful use of Demerol or oxycodone unless they found beyond a reasonable doubt that such use was wrongful. He defined wrongful use as follows:

Use of a controlled substance is wrongful if it is knowing and without legal justification or authorization. By way of example, use of a controlled substance would not be wrongful if it was 1) done pursuant to legitimate law enforcement activity, or 2) done pursuant to legitimate medical practice, or 3) done unknowingly by a person who ingests something not knowing that it contains an illicit drug or controlled substance____ To be wrongful, use of those substances must be not only without legal justification or excuse, it must also be knowing and voluntary. Use of a controlled substance may be inferred to be wrongful in the absence of evidence to the contrary, but the drawing of this inference is not required (emphasis added).

The military judge provided no definition of the term “legitimate medical practice” in his instructions. Captain Lancaster argues the military judge’s instructions were insufficient guidance for the members as to the elements of the offense of wrongful use of oxycodone. In the specific circumstances of this case, we agree.

The military judge has an obligation to inform the members of each element of every charged or lesser included offense. See Article 51(c), UCMJ, 10 U.S.C. § 851(c); R.C.M. 920(e)(1). Depending on the circumstances of each case, it may be necessary, in order to provide a complete instruction, to give a detailed definition of the terms used in one or more of the elements. United States v. Mance, 26 M.J. 244 (C.M.A. 1988), cert. denied, 488 U.S. 942, 109 S.Ct. 367, 102 L.Ed.2d 356 (1988) (“knowledge” must be further defined in wrongful drug use cases); United States v. Johnson, 24 M.J. 101 (C.M.A.1987) (error not to define “national defense material” in a sabotage case); United States v. Brauchler, 15 M.J. 755 (A.F.C.M.R.1983), pet. denied, 18 M.J. 21 (C.M.A.1984) (error not to define “indecent liberties” in a specification alleging conduct unbecoming an officer).

The instruction on “wrongfulness” quoted above told the members Captain Lancaster’s use of oxycodone would not be wrongful if she took it pursuant to legitimate medical practice. It then gave them no guidance as to what legitimate medical practice is concerning a patient taking leftover prescription drugs for another ailment. During the discussion among the military judge and counsel on proposed instructions, the defense counsel raised the issue of further defining legitimate medical practice, but the military judge stated, “[A]s we well know, if it wasn’t prescribed for that injury, then it was not pursuant to medical practice.” His solution was to give the members an instruction on the defense of mistake of fact, as follows:

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United States v. Lancaster, 36 M.J. 1115, 1993 WL 114738 (usafctmilrev 1993).

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