United States of America v. Janalee Wilson

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RECOMMENDED FOR FULL-TEXT PUBLICATION
Pursuant to Sixth Circuit Rule 206
ELECTRONIC CITATION: 2003 FED App. 0356P (6th Cir.)
File Name: 03a0356p.06
UNITED STATES COURT OF APPEALS
FOR THE SIXTH CIRCUIT
_________________
UNITED STATES OF AMERICA,
Plaintiff-Appellee,
v.
JANALEE WILSON,
Defendant-Appellant.
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No. 02-5290
Appeal from the United States District Court
for the Western District of Tennessee at Jackson.
No. 00-10065—James D. Todd, Chief District Judge.
Argued: September 11, 2003
Decided and Filed: October 6, 2003
Before: MERRITT, MOORE, and GILMAN, Circuit
Judges.
_________________
COUNSEL
ARGUED: Stephen B. Shankman, OFFICE OF THE
FEDERAL PUBLIC DEFENDER FOR THE WESTERN
DISTRICT OF TENNESSEE, Memphis, Tennessee, for
Appellant. R. Leigh Grinalds, ASSISTANT UNITED
STATES ATTORNEY, Jackson, Tennessee, for Appellee.
ON BRIEF: Stephen B. Shankman, M. Dianne Smothers,
2 United States v. Wilson No. 02-5290
OFFICE OF THE FEDERAL PUBLIC DEFENDER FOR
THE WESTERN DISTRICT OF TENNESSEE, Memphis,
Tennessee, for Appellant. R. Leigh Grinalds, ASSISTANT
UNITED STATES ATTORNEY, Jackson, Tennessee, for
Appellee.
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OPINION
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MERRITT, Circuit Judge. Appellant Janalee Wilson, a
former emergency room nurse, injected her husband with
insulin on three separate occasions in an effort to cause his
death so that she could collect the proceeds from several life
insurance policies. On July 29, 1996, her husband died as a
result of severe hypoglycemia brought on by an injection of
insulin. Soon thereafter, she submitted claims to various
insurers and succeeded in collecting nearly $300,000.00 in
life insurance proceeds.
On September 19, 2001, a federal jury convicted Janalee
Wilson of three counts of mail fraud in violation of 18 U.S.C.
§ 1341, eight counts of wire fraud in violation of 18 U.S.C.
§ 1343, seven counts of money laundering in violation of 18
U.S.C. § 1957, and returned a special verdict of liability on
one count of criminal forfeiture pursuant to 18 U.S.C. § 982.
At sentencing, the district court granted the government’s
motion for an upward departure based on the fact that a death
resulted from her fraudulent scheme, increasing her base
offense level from 23 to 33, the level corresponding to second
degree murder under the Guidelines. The sentencing judge
then added a two-level enhancement because Wilson used her
special skill as a nurse to perpetrate the fraud. Using a
combination of concurrent and consecutive sentences on the
eighteen counts of conviction, the district court sentenced
Wilson to 210 months in prison, the maximum term allowed
for offense level 35 and a criminal history category of I.

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No. 02-5290 United States v. Wilson 3
Wilson appeals, arguing in her brief that (1) the evidence
was insufficient as a matter of law to establish beyond a
reasonable doubt that she caused her husband’s death as part
of a scheme to defraud; (2) the district court erred by
enhancing her sentence based on her “special skill” as a nurse
under § 3B1.3 of the Guidelines; and (3) the district court
erred in granting an upward departure of ten levels based on
the evidence and the jury’s finding that she caused her
husband’s death as part of her scheme to defraud. Since the
briefs were filed in this case, a panel of this Court issued its
decision in United States v. Mayle, 334 F.3d 552 (6th Cir.
2003), upholding a district court’s granting of a 23-level
upward departure under U.S.S.G. § 5K1.2 based on the
district judge’s finding by a preponderance of the evidence
that the defendant murdered his victim in order to facilitate a
mail fraud offense. At oral argument in this case, Federal
Public Defender Stephen B. Shankman advised that, in light
of our decision in Mayle, Wilson chose to discuss only the
point regarding the special skill enhancement under § 3B1.3.
We find no error in the findings of the court below on any of
the issues raised, and we address here only the point discussed
at oral argument.
Section 3B1.3 provides that the district court may increase
the offense level by two if “the defendant . . . used a special
skill, in a manner that significantly facilitated the commission
or concealment of the offense.” U.S.S.G. § 3B1.3. A
“special skill” is defined as “a skill not possessed by members
of the general public and usually requiring substantial
education, training, or licensing.” Id. § 3B1.3 cmt. 2. Janalee
Wilson was a licensed practical nurse working in an
emergency room. In order for the enhancement to apply, her
skills as a licensed practical nurse must have made it
“significantly ‘easier’ for [her] to commit . . . the crime.”
United States v. Lewis, 156 F.3d 656, 659 (6th Cir. 1998)
(internal quotation marks omitted). We review a district
court’s factual finding regarding the application of § 3B1.3
for clear error. Id. at 658.
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On June 12, 1996, Mr. Wilson was admitted to Methodist
Hospital with extremely low blood sugar. Records indicate
that Janalee Wilson told a nurse and other emergency workers
that she had given her husband a shot of Toradal (a
prescription pain medication) at home because family
members were sick with nausea and vomiting. He recovered
from the incident. Medical tests later revealed that the high
level of insulin in Mr. Wilson’s body came from an injectable
source. Janalee Wilson was a Type II diabetic, requiring
insulin to control her blood sugar, and had access to insulin
and needles at the hospital.
On July 10, 1996, Mr.Wilson was again admitted to the
emergency room with low blood sugar. The defendant told
hospital workers that she had given her husband a shot of
Phenergan (a prescription nausea medication) the night
before. Tests once again indicated a high insulin level. Mr.
Wilson was referred to an endocrinologist, who concluded
that Mr. Wilson’s glandular system functioned normally.
On July 28, 1996, Janalee Wilson was at work and called a
neighbor at around 9 P.M. and asked him to check on her
husband. She told the neighbor that when she left for work
earlier that evening, her husband was sick and she was
worried about him. She later told others that she had checked
his blood sugar before she left for work. The neighbor found
Mr. Wilson unconscious in a chair. On the direction of
Janalee Wilson, paramedics took Mr. Wilson to a different
hospital from the one he had been taken to for the previous
episode. Once again, he suffered from dangerously low blood
sugar. He stayed only a few hours, and the doctor released
him to the care of Janalee Wilson based on his understanding
of her training and expertise. (J.A. at 152-53.)
The next morning, Mr. Wilson was taken by paramedics to
the emergency room with low blood sugar. Mr. Wilson later
died as a result of a prolonged episode of hypoglycemia
caused by an injection of insulin. At trial, the district judge
specifically instructed the jury that, in order to convict Janalee

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No. 02-5290 United States v. Wilson 5
Wilson of mail fraud, it must first find that she caused her
husband’s death by injecting him with insulin.
At sentencing, the district court ruled that “the defendant
did use a special skill, that of being a nurse. She injected the
defendant with Toradol and Phenergan, and she said she did,
and she told that to the doctors in an effort to cover up the fact
that she had, in fact, injected him with insulin. She was using
a special skill.” (J.A. at 356.)
Title 18, § 3742(e) provides for the standard of appellate
review in guidelines cases, stating in relevant part:
The court of appeals shall give due regard to the
opportunity of the district court to judge the credibility of
the witnesses, and shall accept the findings of fact of the
district court unless they are clearly erroneous and . . .
shall give due deference to the district court’s application
of the guidelines to the facts.
18 U.S.C. § 3742(e) (2003). We cannot say the district
court’s factual findings were erroneous, or the “application of
the guidelines to the facts” unreasonable. The evidence in the
record fully supports the finding that Wilson’s training and
licensing as an emergency room nurse enabled her to obtain
medications and administer them in an injectable form in
order to set the stage for her crime and to divert suspicion
from herself. Although a member of the general public
might be able to buy insulin and hypodermic needles at a drug
store, such a lay person would not have been able to rely on
her skills as a nurse to obtain pain medication in injectable
form and to administer it to her family member at home in
order to provide logical explanations for the injections as a
way to conceal her crime. Without known nursing expertise
and experience, the layperson’s claim to have medicated her
husband at home with injectable forms of prescription
medications would no doubt have prompted further
investigation. Indeed, Mr. Wilson’s treating physician, Dr.
David M. Larsen, testified that typically he provides
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injectable pain medications only to terminal cancer patients,
but that he “certainly could have” made an exception with
Janalee Wilson because she was a nurse. (See J.A. at 55.) As
noted above, another physician witness testified that he felt
comfortable releasing Mr. Wilson to the care of Janalee
Wilson on the night of July 28, 2003 because of her special
training as a nurse and expertise. In short, her special skill as
a nurse made it significantly ‘easier’ for [her] to commit . . .
the crime.” United States v. Lewis, 156 F.3d at 659
(affirming the two level enhancement for use of a special skill
where the defendant was convicted of fraud for overbilling
Medicaid by exaggerating the nature of medical procedures
performed).
The sentence is AFFIRMED.

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