United States v. Goldberg ( 2008 )


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  •                                                                                                                            Opinions of the United
    2008 Decisions                                                                                                             States Court of Appeals
    for the Third Circuit
    8-8-2008
    USA v. Goldberg
    Precedential or Non-Precedential: Precedential
    Docket No. 07-1048
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    http://digitalcommons.law.villanova.edu/thirdcircuit_2008/592
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    PRECEDENTIAL
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    No. 07-1048
    UNITED STATES OF AMERICA
    v.
    MARVIN GOLDBERG,
    Appellant
    Appeal from the United States District Court
    for the Eastern District of Pennsylvania
    (D.C. Criminal Action No. 05-cr-00157)
    District Judge: Honorable J. Curtis Joyner
    Argued June 10, 2008
    Before: AMBRO, CHAGARES and
    GREENBERG, Circuit Judges
    (Opinion filed: August 8, 2008)
    Maureen Kearney Rowley
    Chief Federal Defender
    Brett G. Sweitzer (Argued)
    Assistant Federal Defender
    David L. McColgin
    Assistant Federal Defender
    Defender Association of Philadelphia
    Federal Court Division
    601 Walnut Street
    The Curtis Center, Suite 540
    Philadelphia, PA 19106-0000
    Counsel for Appellant
    Patrick L. Meehan
    United States Attorney
    Robert A. Zauzmer
    Assistant United States Attorney
    Chief of Appeals
    Anita D. Eve
    Assistant United States Attorney
    Catherine Votaw (Argued)
    Assistant United States Attorney
    Office of the United State Attorney
    615 Chestnut Street, Suite 1250
    Philadelphia, PA 19106-0000
    OPINION OF THE COURT
    2
    AMBRO, Circuit Judge
    Marvin Goldberg ran an outfit called Equihealth Products
    that sold veterinary grade prescription drugs to horse owners so
    long as they affirmed that they were using the drugs to treat their
    own horses and that under their state’s law owners treating their
    own horses were considered veterinarians. Because his clientele
    made these affirmations, Goldberg argued that Equihealth could
    legally dispense these drugs without proof of prescription, a
    proposition he supported by citation to Food, Drug, and
    Cosmetic Act (F.D.C.A.) provisions permitting veterinarians to
    transfer prescription drugs to other veterinarians without a
    prescription.     Specifically, Goldberg argued that since
    Equihealth, which had a veterinarian on staff, was selling to
    owners who were recognized as veterinarians under their states’
    laws, Equihealth’s activities involved a legal vet-to-vet transfer,
    and thus were exempt from the F.D.C.A.’s prescription
    requirement.
    The Food and Drug Administration (F.D.A.) and its state
    counterparts took a dim view of Goldberg’s argument,
    repeatedly notifying him that this explanation was nothing more
    than an excuse for dispensing prescription drugs illegally.
    Because Equihealth continued to rely on this vet-to-vet transfer
    rationale even after hearing from these agencies, and thus
    continued to dispense drugs without the required prescription,
    the Federal Bureau of Investigation (F.B.I.) launched an
    investigation that eventually led to Goldberg’s indictment for
    3
    crimes related to Equihealth’s operations, as well as for crimes
    related to his role in supplying his brother, a race horse trainer,
    with anabolic steroids for use in the brother’s training operation.
    At trial, the jury rejected Goldberg’s theory as to the legality of
    Equihealth’s actions– finding instead that he was in the business
    of illegally dispensing prescription drugs – and further found
    him guilty on all the steroid-related counts.1
    On appeal, Goldberg accepts that Equihealth’s activities
    were illegal, but argues that his conviction was nonetheless
    flawed and that the District Court erred in calculating his
    sentence. For the reasons stated below, we affirm in part,
    reverse in part, and vacate Goldberg’s sentence.
    I. Factual and Procedural Background
    This case stems from the formation of Equihealth
    Products,2 which was an operation dedicated to circumventing
    1
    As a result, this opinion recounts the relevant facts in the
    light most favorable to the verdict. United States v. Cartwright,
    
    359 F.3d 281
    , 285-86 (3d Cir. 2004).
    2
    Although this entity was initially called “Equirace Health
    & Speed Products,” both parties refer to it exclusively as
    Equihealth or Equihealth Products and we follow suit. That
    said, references to Equihealth may include activities taken under
    its former name.
    4
    the F.D.C.A.’s general ban on dispensing certain drugs without
    a prescription and to circumventing the agreements Equihealth
    had with some of its suppliers not to distribute commercially the
    drugs that it received.
    Although he never explained why it was permissible to
    mislead his suppliers, at trial Goldberg contended that
    Equihealth’s activities were legal under the F.D.C.A. because “it
    is perfectly permissible for veterinarians to transfer drugs
    amongst themselves without prescriptions [and] the definition
    of ‘veterinarian’ is governed by state law, which generally
    permits animal owners to practice veterinarian medicine on their
    own animals, without the need for an educational degree or
    license,” propositions that he took to mean that “transfers of
    drugs from Equihealth to animal owners, for use exclusively on
    their own animals, are veterinarian-to-veterinarian transactions
    that need not be accompanied by a prescription.” Goldberg Op.
    Br. 7-8.
    Relying on this view of the law, Goldberg repeatedly sold
    prescription veterinary drugs to any visitor to his website who
    affirmed that, where he or she lived, owners treating their own
    horses were considered veterinarians and that these drugs were
    to be used accordingly. From the outset, the F.D.A. was aware
    of Equihealth’s operations and its purported justification –
    indeed, Goldberg actually called the F.D.A. to get its approval
    for the vet-to-vet transfer theory on which Equihealth was
    relying. But despite these overtures, the F.D.A. never approved
    5
    the operations of Equihealth or its view of the law; to the
    contrary, it told Goldberg on multiple occasions that
    Equihealth’s activities were illegal. Indeed, the F.D.A. twice
    warned Equihealth that it was violating the F.D.C.A. because, as
    Goldberg charitably puts it, the agency “disagreed with the
    notion that animal owners are veterinarians with respect to their
    own animals, and viewed Equihealth as dispensing drugs
    without the requisite prescription from a veterinarian.” 
    Id. at 8.
    Various state boards of veterinary medicine also wrote
    Equihealth to tell it the same thing: this was not a permissible
    way to dispense prescription drugs. Unwilling to cede to the
    federal and state agencies’ views, Goldberg and/or his counsel
    “responded in writing to each of these []administrative
    warnings,” restating the argument that Equihealth’s activities
    were legal under the vet-to-vet transfer exception, and thus that
    it would continue to sell drugs without proof of prescription. 
    Id. at 8-9.
    While he was battling with the F.D.A. and its state
    counterparts, Goldberg used his position at Equihealth to obtain
    anabolic steroids for his brother, a race horse trainer who used
    them in his training operation. One such transaction involved
    the purchase of Stanozolol, an anabolic steroid marketed as
    Winstrol.     According to Goldberg’s version of events,
    Equihealth resident veterinarian Dr. Jack Wilkes ordered the
    drugs, had them sent to Equihealth’s main office (Goldberg’s
    home), and then, once they arrived, Goldberg sent them on to his
    brother. However, on a call recorded by F.B.I. Agent Greg
    Tremaglio, with whom Dr. Wilkes was cooperating, the
    veterinarian offered a very different version of events, accusing
    6
    Goldberg of stealing his (Wilkes’) Drug Enforcement
    Administration (D.E.A.) number and placing the order without
    his knowledge.
    A jury convicted Goldberg of: (1) wire and mail fraud
    based on his transactions with Luitpold Pharmaceuticals, an
    Equihealth supplier with whom Goldberg had an agreement not
    to resell commercially the drugs that he received (Counts 1-28);
    (2) possession with intent to distribute Stanozolol, an anabolic
    steroid (Counts 29-36); (3) two counts of introducing
    misbranded drugs into interstate commerce (Counts 37 and 39);
    and (4) misbranding (Counts 38 and 40). He now appeals.3
    II. Merits
    A. The Response to the Jury’s Question
    3
    Our Court has jurisdiction pursuant 28 U.S.C. § 1291 and 18
    U.S.C. § 3742(a). On appeal, the jury’s findings will not be
    disturbed unless no “rational trier of fact could have found the
    essential elements of the crime beyond a reasonable doubt,” and
    the District Court’s factual findings will be credited unless they
    appear to be clearly erroneous. United States v. Lloyd, 
    469 F.3d 319
    , 321 (3d Cir. 2006); United States v. Cartwright, 
    359 F.3d 281
    , 285-86 (3d Cir. 2004). The District Court’s legal
    conclusions are reviewed without deference. United States v.
    Myers, 
    308 F.3d 251
    , 255 (3d Cir. 2002).
    7
    We turn first to Goldberg’s claim that the District Court
    erred in responding to a question posed by the jury concerning
    the possession with intent to distribute charges. During
    deliberations, the jury asked if they had to find that the events
    recounted in the indictment’s second paragraph – namely that
    “Defendant Marvin Goldberg used Dr. [Wilkes’] Drug
    Enforcement Administration (‘DEA’) number to order and
    receive controlled substances from Pet Health Pharmacy in
    Youngstown, Arizona . . . . without the knowledge and consent
    of Dr. [Wilkes]” – in order to convict, asking:
    For counts 29 through 36 [the counts related to
    the Stanozolol possession], does Paragraph 2 of
    the indictment . . . count as an element of the
    charges, or do we need to only consider elements
    pertaining to distribution and possession? In other
    words, do we need to find guilty on all four
    elements for an overall guilty verdict on Counts
    29 through 36.
    Goldberg wanted the District Court to respond by instructing the
    jury that “it must find that [he] illegally possessed the
    Stanozolol” because “implied in the term possession is illegal
    possession.” The District Court refused, concluding that by
    giving Goldberg’s proposed instruction it would erroneously add
    another element to the crime, illegal possession, when under the
    law either legal or illegal possession would suffice. After so
    ruling, the District Court made the following statement to the
    8
    jury about the elements needed to convict:
    One, that the defendant, Marvin Goldberg,
    possessed Stanozolol, the controlled substance
    described in the indictment.
    Two, that the defendant knew that the substance
    charged in the indictment was a controlled
    substance.
    And, three, that the defendant intended to
    distribute the controlled substance alleged in the
    indictment.
    Those are the three essential elements for each of
    these offenses.
    Paragraph 2 of the indictment is, as I indicated
    from the outset, the indictment is not evidence.
    It’s what the government is alleging that took
    place. It’s not an element of the offense charged.
    So you have to determine whether or not the
    government has proven these three elements on
    each of these three counts. These are the most
    crucial factors.
    On appeal, Goldberg argues that the District Court’s failure to
    9
    give his proposed instruction led the jury to convict even though
    a critical element, illegal possession, was absent.4
    Although we are not certain that Goldberg’s proposed
    instruction was appropriate given its attenuated relationship with
    the question, we put this aside to focus on the larger issue:
    whether “possession,” as it is used in “possession with intent to
    distribute,” is limited to instances of illegal possession.
    Goldberg cites no law in support of his argument that it is, and
    our own survey has not found any either. That said, we have
    found an abundance of precedent to the contrary, generally
    involving pharmacists facing charges of possession with intent
    to distribute after being caught moonlighting as drug dealers. In
    this context, the earliest case where we found an argument
    equivalent to Goldberg’s was United States v. Goldfine, where
    one such pharmacist argued that because his possession was
    legal, he could not be convicted of possession with the intent to
    distribute. 
    538 F.2d 815
    , 819-20 (9th Cir. 1976). The Court of
    4
    In his reply brief, Goldberg for the first time advances an
    alternative argument: that he was seeking a defense instruction
    to the effect that his possession would have been permissible
    had the prescription been valid. Such an instruction would have
    been inappropriate because Goldberg had not produced any
    evidence that his possession was permissible under 21 U.S.C.
    § 822, which covers the limited circumstances where one can
    legally possess controlled substances. Accordingly, we do not
    deal with this argument.
    10
    Appeals for the Ninth Circuit flatly rejected this argument,
    explaining that possession, when used in this context,
    encompasses both its legal and illegal variants, a proposition
    that every other Court of Appeals confronting this issue over the
    past 30-plus years has either explicitly or implicitly agreed with.
    See, e.g., United States v. Gurgiolo, 
    894 F.2d 56
    , 58 (3d Cir.
    1990) (reviewing the case of a pharmacist convicted of
    possession with intent to distribute after he admitted selling to
    individuals who lacked valid prescriptions); United States v.
    Lartey, 
    716 F.2d 955
    , 967 (2d Cir. 1983).
    As a result, we believe that possession – not “illegal”
    possession – is all that is required to sustain a charge of
    possession with intent to distribute. Therefore, we conclude that
    the District Court’s refusal to give Goldberg’s proposed
    response was entirely proper.
    B. Whether Hearsay Testimony Introduced at Trial Violated the
    Constitution’s Confrontation Clause
    The irrelevance of the illegal/legal possession distinction
    ties directly into the next issue we consider: whether the
    admission of Dr. Wilkes’ hearsay testimony suggesting that
    Goldberg’s possession of the steroids was illegal violated the
    Confrontation Clause of the Constitution.
    During the course of its investigation of Equihealth, the
    Government reached out to Dr. Wilkes, Equihealth’s then in-
    11
    house veterinarian who was weakened by illness and unable to
    care for himself at the time that the F.B.I. spoke with him. As
    a result of his circumstances, we surmise that Wilkes was more
    than willing to cooperate with the F.B.I.’s investigation in order
    to avoid arrest and/or incarceration for his role in Equihealth’s
    operations, and accordingly view his statements made under the
    circumstances with a degree of suspicion.
    During the course of his interview, Wilkes told the agent
    what he did for Equihealth on a day-to-day basis, and then
    disclosed an incident where Goldberg obtained Stanozolol for
    his brother to use on racehorses in his care. In order to prove
    that his story was true, Wilkes agreed to place a call to Goldberg
    that would be surreptitiously recorded.               During that
    conversation, Goldberg freely admitted that he had obtained
    steroids for his brother after a three-way call involving Wilkes,
    Goldberg, and Goldberg’s brother. In response, Wilkes told
    Goldberg that he did not remember that call, implying instead
    that Goldberg had actually obtained the prescription by forging
    his signature and D.E.A. number on the order form submitted to
    the wholesaler. Wilkes stated, “I don’t understand . . . how you
    got . . . my DEA number.” In response, Goldberg recounted to
    Wilkes the following chain of events: “You called Pet Health
    and gave it to them . . . . I called you and told you that I wanted
    to use it for, uh, my brother’s horses, and you said okay[;] you
    called [P]et [H]ealth, and you gave them the number, you never
    gave the number to me.”
    12
    Later in the same conversation, Wilkes accused Goldberg
    of lying about his qualifications, saying, “you told me you had
    a license to practice in Pennsylvania[,] [t]o sell drugs in
    Pennsylvania.” Again, Goldberg responded with his version of
    events: “Naw, I didn’t, I am not a Vet, Doc,” and further
    explained that he had no license to dispense drugs at the behest
    of a veterinarian, saying, “I never told you I am a pharmacist, I
    don’t have a pharmacy.” Wilkes retorted, “Well that’s . . . what
    I was led to believe, that’s all.”
    Although Wilkes died before trial, the Government
    sought to introduce the tape (and succeeded in doing so), which
    it relied on during its closing argument to prove that Wilkes “did
    not know that Marvin Goldberg had his DEA number,” that he
    “didn’t know that Marvin Goldberg was repeatedly using that
    number in order to obtain Stanozolol from Pet Health
    Pharmacy,” and that Goldberg had lied to Wilkes about being
    licensed. Put another way, the Government offered Wilkes’
    self-interested, out-of-court statement to prove the matters
    asserted. The parties (and we) agree that this amounted to a
    violation of Goldberg’s rights guaranteed by the Confrontation
    Clause. As a result, we are only concerned with the harm visited
    by this event, and will reverse unless the Government proves
    this misstep was harmless beyond a reasonable doubt. E.g.,
    United States v. Toliver, 
    330 F.3d 607
    , 612 (3d Cir. 2003).
    The steroids transaction that we are concerned with here
    is the same one that is discussed above, the Stanozolol
    13
    transaction that led to the possession with intent to distribute
    charges. Relevant to our analysis, we note that the elements of
    the offense are: (1) “knowing or intentional” (2) “possession”
    (3) “with intent to distribute” of (4) “a controlled substance.”
    United States v. Lacy, 
    446 F.3d 448
    , 454 (3d Cir. 2006). For the
    same reasons that we disagreed with Goldberg’s claim that the
    jury had to be told that “possession” really meant “illegal
    possession,” we disagree with his claim that “the salient issue”
    was “whether Dr. Wilkes prescribed the Stanozolol in the
    amounts ordered, and whether he used his DEA number to
    obtain it.” Goldberg Op. Br. 38. Instead, we view the key issue
    to be whether Goldberg possessed (legally or illegally) a
    controlled substance with the intent to distribute it.
    The conflict between Wilkes’ statement and Goldberg’s
    version of events centers solely on the legality of his possession,
    which, as we explained above, has no bearing since a conviction
    for possession with intent to distribute can stand whether it is
    predicated on legal or illegal possession. Because Wilkes’
    statements are irrelevant to whether he had committed this
    crime, its admission into the mix of information the jury was
    considering in relation to this charge was harmless. Government
    of Virgin Islands v. Joseph, 
    964 F.2d 1380
    , 1390 (3d Cir. 1992).
    That said, we do consider the effect that Wilkes’
    statements, which undoubtedly impugned Goldberg’s credibility,
    could have had on the trial as a whole. To that end, we note that
    Goldberg’s credibility is simply not at issue in this case – the
    14
    balance of the charges can be grouped into two categories, those
    based on false certifications that the drugs would not be resold
    and those based on dispensing prescription drugs without a
    veterinarian’s order. At trial, the evidence supporting the jury’s
    finding that Goldberg lied about his intention not to resell the
    drugs was overwhelming, so these twenty-eight convictions still
    stand. Further, the remaining charges stem from dispensing
    drugs without a prescription, which is something that Goldberg
    readily acknowledges that he did, meaning that there were no
    credibility determinations that needed to be made as to these
    counts. In this context, the Government’s error was harmless.
    See 
    Joseph, 964 F.2d at 1390
    .
    C. The Felony Misbranding Convictions
    Counts 37-40 deal with Goldberg’s misbranding
    activities, and specifically Equihealth’s filling of two orders
    submitted by F.B.I. Agent Tremaglio. While Goldberg admits
    selling these drugs to Tremaglio, he argues that he cannot be
    convicted of misbranding because the drugs were not
    misbranded, and in any event not misbranded before they were
    sold. Further, he argues that even if what he did was
    misbranding, it was misdemeanor misbranding because there
    was no evidence that he acted with any intent to defraud or
    mislead. Accordingly, his appeal raises two issues: (1) was
    there sufficient evidence for a reasonable juror to conclude that
    Goldberg misbranded these drugs and/or held them for sale
    while they were misbranded; and if so, (2) was there sufficient
    15
    evidence for a reasonable juror to conclude that he acted with an
    intent to defraud or mislead (so as to make the convictions
    felonies)? We consider each issue in turn.
    1. Misbranding
    Misbranding is governed by 21 U.S.C. § 331(k), which
    in pertinent part prohibits “the doing of any . . . act with respect
    to . . . a food, drug, device, or cosmetic, if such act is done while
    such article is held for sale (whether or not the first sale) after
    shipment in interstate commerce and results in such article being
    adulterated or misbranded.”
    Although Goldberg admits selling these drugs without a
    valid prescription, he argues that he did not misbrand them,
    since (as a technical matter) he never “misbranded or adulterated
    the drugs in question.” Goldberg Op. Br. 21. In other words,
    Goldberg argues that misbranding prohibits “alter[ing] the
    product in some way – not merely dispensing to an end-user
    without a prescription.” 
    Id. at 45
    (emphasis deleted). However,
    Goldberg is a bit loose in his argument, because two paragraphs
    later he admits that “dispensing a drug without a prescription is
    ‘misbranding.’” 
    Id. at 46.
    And his second instinct is the correct
    one: misbranding does encompass dispensing these drugs
    without a prescription. 21 U.S.C. § 353(b)(1); see, e.g., United
    States v. Arlen, 
    947 F.2d 139
    , 141 n.2 (5th Cir. 1991) (“Any
    prescription drug that is dispensed without a prescription is
    deemed ‘misbranded’ as a matter of law.”); United States v.
    16
    Bradshaw, 
    840 F.2d 871
    , 872 n.2 (11th Cir. 1988).5
    However, Goldberg stands by his argument that “there is
    a temporal problem” because a drug cannot be “dispensed
    ‘while’ it is held for sale, because it cannot be ‘delivered’ and
    ‘held for sale’ at the same time.’” Goldberg Op. Br. 46. This
    argument gets him nowhere because the statute clearly states
    that “[t]he act of dispensing a drug contrary to the provisions
    [requiring a prescription] shall be deemed to be an act which
    results in the drug being misbranded while held for sale.” 21
    U.S.C. §353(f)(1)(C). As a result, whatever temporal confusion
    comes with the misbranding provision, it is resolved by the
    relatively straightforward declaration that dispensing drugs
    without a prescription means that those drugs were misbranded
    while they were held for sale. 
    Id. We also
    reject Goldberg’s argument that he cannot be
    properly convicted under § 331(k) because this provision “was
    enacted to regulate the drug distribution chain, not dispensing to
    the end user.” Goldberg Op. Br. 47. To the contrary, the
    Supreme Court’s ruling in United States v. Sullivan notes that
    5
    Apparently, Goldberg too arrived at this conclusion,
    admitting that he was “properly convicted” of misbranding
    based on these activities. Goldberg Reply Br. 18. That said, his
    opening brief takes the opposite tack. We deal with this issue
    because we cannot find any precedent from our Court on point.
    17
    the purpose of § 331(k)’s misbranding prohibition was to
    “extend the Act’s coverage to every article that had gone
    through interstate commerce until it finally reached the ultimate
    consumer.” 
    332 U.S. 689
    , 696-97 (1948) (discussing H.Rep.
    2139, 75th Cong., 3d Sess., 3.). Accordingly, there is no reason
    grounded in legislative intent not to apply § 331(k) to
    Goldberg’s sales to end users.
    Based on the analysis above, we affirm Goldberg’s
    misbranding convictions.
    2. Requisite Intent
    Because we conclude that Goldberg was properly
    convicted of misbranding, we turn to whether the evidence
    shows that he acted with an intent to defraud or mislead as he
    conducted these misbranding activities. The presence or absence
    of intent is important since willful misbranding is only a
    misdemeanor unless there is “the intent to defraud or mislead.”
    21 U.S.C. § 333(a). Then it is a felony.
    Although the jury found such an intent, Goldberg claims
    that this finding has to be wrong. There was, he contends,
    undisputed evidence showing that “[f]ull disclosure was given
    to Equihealth’s customers about the drugs sold, the nature of the
    transaction, and Equihealth’s status as a non-prescribing party,”
    and he “was open and transparent with the FDA and the various
    state agencies that inquired about Equihealth.” Goldberg Op.
    18
    Br. 42-43.
    The Government offers three reasons to affirm on this
    issue. First, it claims that the “Product and Use Disclaimer,”
    which customers signed and supplied to Goldberg, was
    misleading as to, among other things, the rights of the customer
    to treat his or her own animal under the various state law
    provisions governing the practice of veterinary medicine. In
    making this argument, the Government overlooks that the
    Disclaimer is not an affirmative representation by Goldberg, but
    rather by the customer, meaning that any misrepresentation
    occasioned by the statements was caused by the customer lying
    about the applicable law in his or her home state, not the
    misbrander (Goldberg) that merely received the statement. As
    a result, it cannot be said that Goldberg misled anyone via the
    statements his customers made.
    Next, the Government points to “[s]ales literature
    assert[ing] that the company veterinarian actually would
    prescribe the drugs.” Government Br. 55. This is easily dealt
    with, as the literature in question has no tie to the four counts of
    misbranding that Goldberg was charged with. Agent Tremaglio
    was repeatedly told that the drugs he was ordering would not be
    provided pursuant to a prescription, were not prescribed by a
    veterinarian, and that he would not be able to consult directly
    with one either before or after he placed his order. As a result,
    the only way that we could deem Goldberg’s conduct misleading
    would be to hold that when a vendor permits outdated sales
    19
    literature to continue to exist in some form, even though it told
    customers not to rely on the representations therein, the vendor
    has misrepresented its activities. We are not prepared to do this,
    and therefore we deem that this argument does not justify
    Goldberg’s felony convictions.
    Finally, the Government argues that by “having [his
    suppliers] believe that they were sending him drugs pursuant to
    valid prescriptions, and that he would not resell the drugs,”
    Goldberg acted with deception or an intent to mislead in his
    misbranding activities. 
    Id. at 52.
    Whatever the merits of this
    argument, there is no factual basis for it. Nothing in the record
    shows that Goldberg made those statements (or implied them)
    in relation to the drugs he sold to Tremaglio. As a result, this
    argument, unsupported by any evidence we found, cannot justify
    Goldberg’s felony misbranding convictions.
    This leaves the Government without any persuasive
    argument in favor of sustaining Goldberg’s felony conviction
    for misbranding. Beyond that, our own independent review of
    the record has not yielded any trace of an intent on Goldberg’s
    part to avoid detection or misrepresent what he was up to.
    Instead, the evidence demonstrates that Goldberg conducted his
    admittedly illegal ventures in the open, and (at least as far as the
    drugs that led to the misbranding counts with which he was
    charged) in accordance with all the agreements he made. As a
    result, we vacate his felony misbranding convictions, making
    these convictions instead misdemeanors.
    20
    D. The Sentencing Challenges6
    Goldberg raises two challenges to his sentence, arguing
    that the District Court erred (1) in the way it calculated the
    losses associated with Equihealth’s conduct, and (2) in imposing
    an enhancement based on his disregard of numerous agency
    letters that informed him of the illegal nature of Equihealth’s
    activities. We address each in turn.
    1. Loss Calculation
    The District Court enhanced Goldberg’s sentence by
    sixteen levels pursuant to U.S.S.G. § 2B1.1(b)(1), providing for
    such an enhancement when the losses associated with the
    conduct in question are between $1 and $2.5 million. While
    Goldberg does not contest the general applicability of
    § 2B1.1(b)(1) to his situation, he argues that the District Court
    erred when it used Equihealth’s $1.1 million in total gross
    profits as a proxy for the losses suffered, and thus erred in
    relying on those profits to calibrate the § 2B1.1(b)(1)
    enhancement.
    6
    While we acknowledge that Goldberg will have to be
    resentenced based on our decision to overturn his felony
    convictions on the misbranding counts, we have no doubt that
    these same issues will arise again on remand, and thus we will
    address them now.
    21
    To this end, Goldberg correctly argues that § 2B1.1(b)(1)
    calls for a calculation based on the actual loss occasioned by his
    conduct, unless “there is a loss but it reasonably cannot be
    determined.” 
    Id. cmt. 3(B).
    Further, he is correct insofar as he
    argues that the record produces scant, if any, evidence of actual
    harm, and further provides little reason to suspect that the losses
    occasioned by his fraudulent conduct “bear[] a logical
    relationship to Equihealth’s gross profits.” Goldberg Op. Br.
    53.
    That said, he fails to appreciate that these provisions are
    not designed for offenders like him. Instead, the way to account
    for his conduct is established by § 2B1.1 cmt. 3(F)(v), which
    reads:
    (v) Certain Other Unlawful Misrepresentation
    Schemes.--In a case involving a scheme in which
    . . . . (III) goods for which regulatory approval by
    a government agency was required but not
    obtained . . . [,] loss shall include the amount paid
    for the property, services or goods transferred,
    rendered, or misrepresented, with no credit
    provided for the value of those items or services.
    As admitted by Goldberg and established by the numerous
    agency letters, F.D.A. approval was required for these drugs to
    be sold – they were prescription drugs after all. There was no
    such approval because the drugs were misbranded. This means
    22
    Goldberg was selling goods for which regulatory approval was
    required but not obtained. Therefore, under cmt. 3(F)(v), the
    District Court’s gross profits methodology was proper.
    2. Administrative Order Enhancement
    Turning to Goldberg’s alternative sentencing objection,
    we agree that the two-level enhancement pursuant to U.S.S.G.
    § 2B1.1(b)(8) – violating a “prior, specific judicial or
    administrative order, injunction, decree, or process not
    addressed elsewhere in the guidelines” – was unwarranted.
    As a general rule, federal courts of appeals considering
    the issue have been willing to impose the enhancement after a
    meaningful negotiation or interaction led the agency to issue a
    directive that the defendant subsequently violated. For example,
    the Second Circuit held that a defendant who failed to abide by
    a negotiated consent decree was subject to the enhancement, a
    proposition that the Seventh Circuit also agreed with. See
    United States v. Mantas, 
    274 F.3d 1127
    , 1132-33 (7th Cir.
    2001); United States v. Spencer, 
    129 F.3d 246
    , 252 (2d Cir.
    1997). Going even further, the Seventh Circuit in United States
    v. Mantas held that the enhancement was merited after the
    Illinois Department of Agriculture (the U.S.D.A.’s state
    counterpart) inspected a meat packing plant, discussed the
    situation with the owner face to face, proposed a possible
    remedy, and then officially seized the meat products at issue (the
    owner then sold the meat in question nonetheless).
    23
    That said, no court of appeals has held that a mere
    warning letter, without more, can justify the enhancement. To
    the contrary, the Seventh Circuit, in United States v. Wallace, a
    post-Mantas decision, held that the enhancement should not be
    applied “to every situation where a defendant knew or was told
    by someone in authority that what she was doing was illegal.”
    
    355 F.3d 1095
    , 1097-1098 (7th Cir. 2004). The Ninth Circuit
    also adopted this view in United States v. Linville, saying,
    “[T]he Guideline speaks of ‘violations.’ That is a perfectly
    intelligible usage as it applies to an ‘order, injunction [or]
    decree’ . . . . . It is considerably less intelligible if process is
    taken to mean a mere letter or . . . warning.” 
    10 F.3d 630
    , 633
    (9th Cir. 1993).
    We agree with the analysis of our sister circuit courts to
    the extent that they deem administrative orders, injunctions,
    decrees, and processes as flexible concepts. Cf. Morrissey v.
    Brewer, 
    408 U.S. 471
    , 481 (1972) (“[D]ue process is flexible
    and calls for such procedural protections as the particular
    situation demands.”). We also agree that even this flexible
    approach cannot permit a district court to impose the
    enhancement for no other reason than that the defendant
    continued to engage in certain conduct after the agency
    questioned its legality. As a result, we hold that imposing the
    two-level enhancement requires an interaction between the
    agency and defendant that allowed the defendant to participate
    in some meaningful way (if he elected to do so), and that led to
    a definite result, like a consent decree or a seizure. See Wallace,
    
    24 355 F.3d at 1097-1098
    ; United States v. Thayer, 
    201 F.3d 214
    ,
    227-28 (3d Cir. 1999).
    The question then is whether this happened here. The
    Government argues that the F.D.A.’s repeated dealings with
    Goldberg were sufficient because it notified Goldberg (by a so-
    called “Section 305 Notice”) that he had engaged in prohibited
    conduct, that he had the opportunity to attend a meeting with
    agency officials where he could “present [his] views on this
    matter,” and that the next step was to refer the matter to the
    Department of Justice for possible criminal prosecution. This,
    the Government contends, represented “the final agency action,
    a precursor to criminal proceedings.” Government Br. 89. In
    doing so, it equates § 2B1.1(b)(8)’s “prior, specific . . .
    administrative order, injunction, decree, or process” language
    with any “final agency action,” citing 21 U.S.C. § 335,
    governing the F.D.C.A., which provides that “[b]efore any
    violation of this chapter is [referred] for institution of a criminal
    proceeding, the person against whom such proceeding is
    contemplated shall be given appropriate notice and an
    opportunity to present his views, either orally or in writing, with
    regard to such contemplated proceeding.”
    We disagree. Just because the agency believes it has
    enough information to act – and thus believes itself finished
    with this part of the process – it has not a fortiori issued a
    “specific . . . administrative order, injunction, decree, or
    process” sufficient to trigger § 2B1.1(b)(8).          Instead,
    25
    § 2B1.1(b)(8) requires some specific directive that the defendant
    can defy. In other words, like the defendant in Mantas whose
    meat products were seized (and thus who had the option of
    either respecting the seizure or defying it), or the defendant in
    the Second Circuit’s Spencer case who entered into a consent
    decree, in order to subject Goldberg to this enhancement, he had
    to be ordered to stop. To that end, there is no dispute that the
    F.D.A. never issued any definitive order telling Goldberg that he
    had to stop. This makes the F.D.A.’s notice insufficient for
    these purposes.7
    In the alternative, the Government argues that the
    enhancement is proper in light of the letter Goldberg received
    from the Kentucky Board of Veterinary Examiners stating that
    he should “CEASE AND DESIST from engaging in the practice
    of veterinary medicine (emphasis in original).” 8 While this
    7
    We acknowledge that this is a highly formalistic
    interpretation. As the District Court observed, the F.D.A.’s
    notice said “you are dispensing illegal drugs. Does a person
    have to say the word ‘desist’ on that same line to tell him to
    stop?” Our answer is yes: if we are going to enhance a sentence
    based on a failure to comply with a directive, we do not think
    that it is too much to ask the directive be definitive in nature.
    8
    While the Government argues that a similar letter was sent
    by California authorities, the record does not show that
    Goldberg did any further business in California after receiving
    it. As a result, there is no evidence that Goldberg violated the
    26
    contains the explicit directive that we are looking for, it fails
    because the other required element is missing – Goldberg was
    not offered the chance to participate in the process in any
    meaningful way. The Kentucky letter starts out by stating that
    the Board has already “referred the . . . matter to the Office of
    the Attorney General” for possible enforcement proceedings
    (e.g., injunctive relief and/or criminal sanctions), and threatens
    to “pursue all available legal remedies” unless Goldberg
    “CEASE[S] AND DESIST[S] from engaging in the practice of
    veterinary medicine or consulting with unlicensed animal
    owners in the Commonwealth.” There is no invitation for
    Goldberg to state his case, or to come to a resolution with the
    Board. Instead, he has two choices, stop or be subject to further
    proceedings. This is the quintessential warning letter saying
    nothing more than stop or else. As a result, it cannot provide the
    basis for the two-level enhancement pursuant to § 2B1.1(b)(8).
    terms of the California letter, whatever its characterization may
    be. See App. at 327-29. Therefore, it cannot serve as the basis
    of the enhancement. By the same token, we set aside the more
    general warnings issued by remaining states because none of
    them contains sufficiently explicit language (e.g., cease and
    desist) to merit consideration of the enhancement. See, e.g.,
    App. at 285 (letter from the Pennsylvania Department of
    Health); 289-90 (letter from the Maryland State Board of
    Veterinary Medical Examiners); 315-16 (letter from the Texas
    Board of Veterinary Medical Examiners); 317-18 (letter from
    the Texas State Board of Pharmacy).
    27
    Therefore, we find nothing in the record justifying the
    two-level enhancement.
    VI.
    For the reasons stated above, we affirm Goldberg’s
    convictions in all respects except that we reverse his convictions
    for felony misbranding, as set forth in counts 37-40, and vacate
    his sentence. As a result, we remand to the District Court with
    instructions to enter a judgment of conviction for the
    misdemeanors corresponding to each of the felony misbranding
    convictions in counts 37-40 and for resentencing consistent with
    this opinion.
    28