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United States v. Beck

United States District Court, M.D. North Carolina

June 28, 2019



          Catherine C. Eagles, District Judge.

         Angela M. Beck is a federal prisoner serving a sentence for drug and firearms offenses. She has cancer in her left breast and the Bureau of Prisons has not provided appropriate medical care for her disease, with repeated delays that have prevented her from timely obtaining urgent tests and treatment. In the meantime, her cancer spread to her lymph nodes and possibly to her right breast. Ms. Beck has filed a motion under the First Step Act of 2018 seeking immediate compassionate release. Because Ms. Beck's invasive cancer and BoP's history of indifference to her treatment constitute extraordinary and compelling reasons, and because the § 3553(a) factors support a sentence reduction to time served, the motion for compassionate release will be granted.

         I. Facts and Procedural History

         The Court has considered the record evidence in this criminal case, where Ms. Beck submitted her motion for compassionate release. The Court has also considered the documentary evidence submitted in Ms. Beck's civil case against BoP officials for inadequate medical care in violation of her constitutional rights. See Beck v. Hurwitz, No. 1:19-cv-00488 (M.D. N.C. May 10, 2019). Unless otherwise specified, docket citations are to the criminal case.[1]

         Beginning sometime in 2012, Angela Beck and her husband began operating a methamphetamine lab in their home in Surry County, North Carolina. See Doc. 192 at 12-13. They participated in a conspiracy to distribute methamphetamine that included many other participants, see Doc. 73 (identifying 20 defendants), and other labs. See Doc. 192 at 1-20. During a search of the Beck home on January 4, 2013, law enforcement located items consistent with the manufacture of methamphetamine, 12 firearms, and drug paraphernalia. Id. at 12-13. Several persons on the premises possessed methamphetamine, including Ms. Beck. Id. at 13. In the preceding months, Ms. Beck had purchased over 42 grams of pseudoephedrine, one of the precursor chemicals that can be used to manufacture methamphetamine. Id. at 14.

         After Ms. Beck was arrested on state charges and released on bond, see Doc. 429-1 at 1, she and her husband continued to manufacture and sell meth out of their home. Doc. 192 at 16. During a search on February 18, 2013, law enforcement located items consistent with the manufacture of methamphetamine, a revolver and ammunition, drug paraphernalia, and numerous cell phones. Id.

         Several months after her second arrest, Ms. Beck pleaded guilty in this Court to conspiracy to distribute 500 grams or more of methamphetamine (Count 1, object 1) and possession of a firearm in furtherance of a drug trafficking crime (Count 12). Doc. 201 at ¶¶ 1-2; Minute Entry 09/06/2013. The Court granted the Government's motion under U.S.S.G. § 5K1.1 to depart from the guidelines, Doc. 249; Minute Entry 12/12/2013, and sentenced her to 129 months of imprisonment as to Count 1 and, as required by law, to a consecutive term of 60 months as to Count 12, for a total sentence of 189 months. Doc. 277 at 2. The Fourth Circuit dismissed her appeal. Doc. 363. The Court later reduced her sentence on Count 1 to 105 months based on a retroactive sentencing guideline amendment, making her total sentence 165 months. Doc. 442.

         Ms. Beck is in the custody of the United States Bureau of Prisons and is assigned to the Federal Correctional Institute in Aliceville, Alabama. Civil Doc. 3-3 at ¶ 1; Civil Doc. 12 at ¶ 3. She has served approximately 76 months of her 165-month sentence. See Doc. 429-1 at 1. There is nothing in the record to indicate that she has incurred any disciplinary violations or infractions while in BoP's custody.

         Ms. Beck is 47-years old, Doc. 429-1 at 3, and has a family history of breast cancer. Civil Doc. 3-3 at ¶ 3. In the fall of 2017, she discovered lumps in her left breast and promptly sought medical attention. Id. at ¶¶ 2, 4-5. When she first saw the prison doctor to report the masses, see Id. at ¶ 6, he recommended imaging and consultation with a surgeon, 10/16/2017--Griffin [BoP 22], but almost two months passed before BoP took Ms. Beck to see a surgeon. Civil Doc. 3-1 at ¶ 19.[2] Imaging results obtained two weeks later were “highly suggestive” of cancer, id. at ¶ 19; 12/22/2017--DeVenny [BoP 36], and in the ensuing days, weeks, and months, Ms. Beck's doctors repeatedly said she needed a biopsy to test for cancer. See, e.g., 12/22/2017--DeVenny [BoP 36]; 12/29/2017--Griffin [BoP 39]; 01/08/2018--Griffin [BoP 65]; 05/11/2018--Griffin [BoP 96]; 08/07/2018--Bilton [BoP 110]. A biopsy should be performed no more than two months after the detection of an abnormality, Civil Doc. 3-1 at ¶ 11, but BoP waited eight months after imaging before taking her for a biopsy. Id. at ¶ 20.

         When the biopsy was finally performed, the surgeon observed “extensive breast disease that extended laterally.” 08/28/2018--Bilton [BoP 115]. The biopsy confirmed invasive cancer in her left breast and the surgeon recommended additional surgery, but another two months passed before BoP took her for surgery. Civil Doc. 3-1 at ¶¶ 20-21. In November 2018, over a year after Ms. Beck first noticed the lumps, the surgeon removed her entire left breast and part of her pectoral muscle and confirmed a diagnosis of metastatic breast cancer. 11/01/2018--Bilton [BoP 252]; 11/02/2018--Bilton [Page 18, Doc. #10] (“Post op diagnosis: Left breast cancer.”); see also Civil Doc. 3-1 at ¶ 21 (declaration of Dr. Winkfield, reviewing records and noting a “diagnosis of stage IIB (T2N1) breast cancer”). During surgery, doctors discovered the cancer had spread to Ms. Beck's lymph nodes, 11/06/18--Bilton [Page 34, Doc. #12] (noting “metastatic carcinoma” in two nodes), and removed several nodes. Civil Doc. 3-1 at ¶ 21.

         Despite the fact that she had a drain and despite her surgeon's direction that she needed to see him about a week or less after surgery, 11/03/2018--Bilton [Page 10, Doc. #6], BoP did not return her for a post-operative visit until six weeks had passed. Civil Doc. 3-1 at ¶ 22. When she finally saw the surgeon again, he told her that she needed an oncology appointment for potential chemotherapy, id., but five months elapsed after her surgery and over three months passed after her surgeon advised her to see an oncologist before BoP took Ms. Beck to a medical oncologist to determine appropriate treatment and therapy. Id. at ¶¶ 22-23.

         In total, some seventeen months passed between the time medical care providers at the prison learned about the lumps in Ms. Beck's left breast, see Id. at ¶ 18; Civil Doc. 3-3 at ¶¶ 5-6, and the time BoP allowed her to consult with a medical oncologist. Civil Doc. 3-1 at ¶ 23; see also Id. at ¶ 15 (noting chemotherapy is sometimes implemented before surgery to help shrink “invasive” and “extensive” tumors). When BoP finally took her to see a medical oncologist on April 3, 2019, the oncologist determined that it was too late to begin chemotherapy, which must be instituted soon after surgery to be effective. See 04/03/2019--Evans [BoP 311]; see also Civil Doc. 3-1 at ¶ 23. When BoP took her to a radiation oncologist in May 2019, he similarly determined that it was too late to begin radiation therapy. 05/03/2019--Crew [BoP 318].

         Dr. Karen Winkfield, an experienced oncologist at Wake Forest Baptist Comprehensive Cancer Center who reviewed Ms. Beck's medical records, has testified that “with respect to timing of systemic therapy following definitive surgery, delays beyond 12 weeks (3 months) compromise both recurrence free survival and overall survival.” Civil Doc. 3-1 at ¶ 26. BoP waited well over three months before taking Ms. Beck to see physicians who could order such treatment. Id. at ¶ 23.

         In January 2019, Ms. Beck reported new lumps in her right breast to prison medical officials, who confirmed the lumps. Civil Doc. 3-3 at ¶ 15; 01/30/2019--Nikki [BoP 259] (noting “firm nodule approximately golf ball size[d]” in her right breast); 02/12/2019--Hunter-Buskey [BoP 276] (noting “multiple lumps [in her] right breast; . . . the first is walnut size[d] and the second is a small peach size”). Nearly six weeks later, BoP took Ms. Beck for a PET scan, which suggested the new lumps may be benign. 03/11/2019--Guarisco [BoP 287]. About two weeks after that, BoP took her to see a surgeon, who noted a “solid mass” and cyst in her right breast, observed that the new masses “appear benign, ” and ordered a puncture aspiration and ultrasound guidance. 03/27/2019--Bilton [USA Bilton 3-4]. BoP did not schedule a further consultation with the surgeon until mid-June, nearly three months after the initial surgical evaluation.[3]Civil Doc. 29 at ¶ 8; Civil Doc. 44 at ¶ 9. It appears Ms. Beck has received the tests and procedures the surgeon ordered in March, Civil Doc. 45 at 4; Civil Doc. 44 at ¶ 9, but there are still “multiple nodularities” in her right breast and the surgeon has ordered another ultrasound, noting the potential need for a biopsy. Civil Doc. 45 at 5. Pursuant to a court order to schedule recommended treatments, see infra, BoP has scheduled the ultrasound and other appointments. Civil Doc. 47 at ¶¶ 1-4.

         As noted supra, Dr. Winkfield, an experienced oncologist, reviewed Ms. Beck's medical records. While she was unable to determine from BoP's records “whether the above delays in care . . . have resulted in progression of [Ms. Beck's] cancer, ” Civil Doc. 3-1 at ¶ 27, Dr. Winkfield testified without dispute that “[p]rompt evaluation is particularly important in patients who have a family history of breast cancer” and that the “delays in time to surgery and subsequent delays in adjuvant therapy clearly raise a significant risk of relapse and irreparable harm to Ms. Beck.” Id. at ¶¶ 11, 27.

         In early December 2018, Ms. Beck through counsel asked the Warden of FCI Aliceville to file a compassionate release motion to reduce her sentence based on her medical condition and the poor medical care she was receiving. Doc. 522-1 at 6. On December 17, the Warden acknowledged receipt of the request and explained BoP's general criteria for evaluating such requests. Id. at 5. After over a month of no action on the request, Ms. Beck submitted a second request to BoP to file a compassionate release motion on her behalf. Doc. 521-1 at ¶ 3. A week later, with no BoP action on either request, Ms. Beck filed her motion for compassionate release with this Court on January 24, 2019. Doc. 494.

         Nearly two months later, on the day the Government's response was due, see Text Order 02/27/19, the Government sought a stay so that BoP could finish its administrative review of Ms. Beck's request. Doc. 510. Ms. Beck did not object, id, and the Court granted the stay. Doc. 511. Another six weeks passed with no action by BoP on the request, and on May 10, 2019, Ms. Beck initiated a civil suit against several BoP officials and a private contractor, alleging violations of her Eighth Amendment rights against cruel and unusual punishment. Civil Doc. 1. She sought a temporary restraining order and preliminary injunction. Civil Doc. 3. BoP denied her request for a compassionate release motion almost immediately thereafter. Doc. 521-1 at 8. The same day, the Court lifted the stay and directed the Government to file a response to her compassionate release motion. See Text Order 05/13/2019; Doc. 521 (Government's response in opposition).

         The Court held a hearing on Ms. Beck's motion for a TRO in her civil case on May 17, 2019. Civil Minute Entry 05/17/2019. On May 20, the Court entered a TRO compelling three BoP officials in their official capacities to take specific steps to provide urgent medical treatment to Ms. Beck for her cancer. Civil Doc. 15; see also Civil Doc. 16 (Amended TRO). The Court found that Ms. Beck had shown a likelihood of success on the merits of her claim that BoP officials' indifference to her life-threatening medical condition and treatment violated her Eighth Amendment rights. Civil Doc. 16. After another hearing, see Minute Entry 06/05/2019, the Court extended the Amended TRO while considering this motion and a motion for preliminary injunction. Civil Doc. 40.

         The Court will address additional facts as needed in the context of the issues presented.

         II. Compassionate Release

         Federal law has long authorized courts to reduce the sentences of federal prisoners facing extraordinary health conditions and other serious hardships, but only under very limited circumstances. Before passage of the First Step Act of 2018, district courts could grant compassionate release sentence reductions only upon a motion by the BoP Director.[4] See Pub. L. No. 98-473, ch. II(D) § 3582(c)(1)(A), 98 Stat. 1837 (1984); see also Green v. Apker, No. 5:13-HC-2159-FL, 2014 WL 3487247, at *2 (E.D. N.C. July 11, 2014) (collecting cases and noting that “BOP's decision regarding whether or not to file a motion for compassionate release is judicially unreviewable”). Then as now, a defendant must satisfy one of two statutory conditions before a court can grant a BoP compassionate release motion: (i) the defendant has to be at least 70 years old, have served at least 30 years in prison, and the BoP Director must have determined the defendant was not a danger to the public; or (ii) “extraordinary and compelling reasons” warrant the reduction. 18 U.S.C. § 3582(c)(1)(A). When BoP files such motions, reviewing courts also must consider the sentencing factors set forth in 18 U.S.C. § 3553(a) and can only grant reductions to defendants who met the statutory requirements if the reduction was “consistent with applicable policy statements issued by the Sentencing Commission.” 18 U.S.C. § 3582(c)(1).

         To assist courts, the Sentencing Commission adopted U.S.S.G. § 1B1.13 as the applicable policy statement for motions filed by the BoP Director under § 3582(c)(1)(A). The guideline essentially repeats the statutory prerequisites and adds only a requirement that the defendant must not be “a danger to the safety of any other person or to the community.” U.S.S.G. § 1B1.13(2).

         The application notes to § 1B1.13 are more specific. The notes list three specific categories and examples of “extraordinary and compelling reasons, ” along with a fourth catch-all provision.

         Specifically, the notes discuss when a defendant's medical condition (subdivision A), health and age together (subdivision B), or family circumstances (subdivision C) will qualify. U.S.S.G. § 1B1.13, application note 1. Subdivision A provides that a “medical condition of the defendant” may qualify as an “extraordinary and compelling reason” justifying a sentence reduction in several different circumstances, such as when, inter alia, the defendant has a “terminal illness.” Id. at note 1(A)(i). Subdivision D acknowledges that there may be other situations which constitute extraordinary and compelling reasons and provides a non-specific blanket authorization for early release, labeled “Other Reasons.” Id. at note 1(D). That provision allows compassionate release if, “[a]s determined by the Director of the Bureau of Prisons, there exists in the defendant's case an extraordinary and compelling reason other than, or in combination with, the reasons described in subdivisions (A) through (C).” Id.

         In 2018, Congress passed the First Step Act. Pub. L. 115-391, 132 Stat. 5194. Among other things, it amended § 3582(c)(1)(A) to add a provision allowing courts to consider motions by defendants for compassionate release without a motion by the BoP Director so long as the defendant has asked the Director to bring such a motion and the Director fails or refuses.[5] The First Step Act applies the same statutory requirements to a defendant's motion for compassionate release as previously applied, and still apply, to motions by the Director: “extraordinary and compelling reasons” must warrant the reduction, [6] the court must consider the ยง 3553(a) ...

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