United States v. Nguyen ( 2009 )


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  •                  FOR PUBLICATION
    UNITED STATES COURT OF APPEALS
    FOR THE NINTH CIRCUIT
    UNITED STATES OF AMERICA,                 No. 07-30197
    Plaintiff-Appellee,          D.C. No.
    v.                        CR-05-00270-05-
    TUYET THI-BACH NGUYEN,                         RSL
    Defendant-Appellant.
          OPINION
    Appeal from the United States District Court
    for the Western District of Washington
    Robert S. Lasnik, District Judge, Presiding
    Argued and Submitted
    December 8, 2008—Seattle, Washington
    Filed May 15, 2009
    Before: Robert R. Beezer, Ronald M. Gould, and
    Consuelo M. Callahan, Circuit Judges.
    Opinion by Judge Gould;
    Partial Concurrence and Partial Dissent by Judge Callahan
    5867
    UNITED STATES v. NGUYEN             5869
    COUNSEL
    Sheryl Gordon McCloud, Law Offices of Sheryl Gordon
    McCloud, Seattle, Washington, for appellant Tuyet Thi-Bach
    Nguyen.
    5870                 UNITED STATES v. NGUYEN
    Jeffrey C. Sullivan and Susan Loitz, U.S. Attorney’s Office,
    Seattle, Washington, for appellee United States of America.
    OPINION
    GOULD, Circuit Judge:
    Tuyet Nguyen (“Nguyen”) appeals her jury conviction and
    sentence for conspiracy to transport stolen property in inter-
    state commerce in violation of 
    18 U.S.C. § 2314
    , for two
    counts of the transportation of stolen property in interstate
    commerce in violation of 
    18 U.S.C. § 2314
    , for three counts
    of the introduction of misbranded medical devices into inter-
    state commerce in violation of 
    18 U.S.C. § 352
    (a), and for
    conspiracy to commit money laundering in violation of 
    18 U.S.C. § 1956
    . We have jurisdiction under 
    28 U.S.C. § 1291
    .
    We affirm in part and reverse in part, and we remand for
    retrial and resentencing.
    I
    On July 13, 2005, a grand jury returned an indictment
    against Nguyen, her husband Phu Nguyen, their company
    Columbia Medical Systems, Inc. (“CMS”), and Sess Merke
    (“Merke”). The indictment alleged that Tuyet and Phu
    Nguyen conspired with Merke, Robert Davies (“Davies”), and
    others to steal and transport medical equipment from their for-
    mer employer, ATL Philips Medical Systems (“Philips”). The
    indictment alleged that Nguyen had conspired to sell stolen
    ultrasound probes.1 The indictment alleged that the Nguyens
    resold these stolen probes through their company, CMS, after
    the probes were given new fake serial numbers. Merke and
    Davies withdrew from the conspiracy in 2000, but the govern-
    ment alleged that the conspiracy continued until 2003.
    1
    An ultrasound probe is the part of the ultrasound machine that comes
    in contact with the patient’s body.
    UNITED STATES v. NGUYEN                 5871
    Davies, an unindicted co-conspirator, testified under a grant
    of immunity that Phu Nguyen, Appellant’s husband, asked
    him to steal probes and sell them to CMS. With the help of
    Davies, the conspiracy worked its fraud as follows: Davies
    would tell Philips that a customer had a broken probe that
    needed replacement, even though the probe was working.
    Philips would send the new probe to the customer, expecting
    that the customer would ship the broken probe back. Davies
    would give Phu Nguyen the customer’s old but still function-
    ing probe, and Phu would transfer the functioning probe’s
    serial numbers onto one of the defective probes in the CMS
    stockroom. Then, Davies would send the defective probe to
    Philips. So, at Philips’s expense, Phu Nguyen and his com-
    pany, CMS, would end up with functioning probes that were
    in effect stolen by fraud, and CMS would have given up only
    defective probes.
    The fraudulent conspiracy was also furthered by the decep-
    tion of others. Co-conspirator Merke stole Philips’s inventory
    from its stockrooms. At trial, Evalyn Thomas (“Thomas”), a
    Philips data entry clerk who worked for Merke, testified that
    Merke removed finished probes from the “Finished Goods”
    inventory without adequate explanation several times.
    Thomas explained that usually when an employee took mate-
    rial from the Finished Goods stockroom, they would fill out
    a Material Transfer Form. That form tracked where the mate-
    rial went. Thomas testified that it was unusual for someone in
    Merke’s position to be dealing directly with customers, and it
    was also odd that Merke personally pulled the stock and com-
    pleted the entire form himself. According to Thomas, when
    the Material Transfer Form stated the employee was crediting
    the taken material to their “wash account,” the new material
    was being taken to replace some old, defective material.
    Therefore, a Material Transfer Form that took six parts from
    Finished Goods out of the stockroom and credited the “wash
    account” should also show the same number of parts going
    into the “Defective Material” stockroom. Thomas testified
    that this full accounting of material did not occur on several
    5872               UNITED STATES v. NGUYEN
    of Merke’s Material Transfer Forms. Instead, many parts “dis-
    appeared,” including forty-six ultrasound probes.
    Another Philips employee, Dave Westrich (“Westrich”),
    testified that Nguyen asked him to load some of Philips’s pro-
    prietary software onto a hard drive for her. Westrich refused
    and told Nguyen not to call him again. The government con-
    tended that Nguyen must have obtained the software another
    way because Don Davis, a CMS customer, testified that in
    June 2001, Nguyen approached him with the suggestion that
    she would give him access to Philip’s software if he agreed
    to guarantee a certain level of business with CMS.
    The prosecution introduced CMS business records to show
    that CMS sold more probes than it purchased for 1999
    through 2003. FDA Agent Borden also explained that many
    Philips probes tied to CMS had false serial numbers. The
    police seized several probes with false serial numbers when
    executing a search warrant in December 2003. The testimony
    tied other probes with false serial numbers to CMS based on
    its invoices.
    The prosecution also presented witnesses who said that
    having accurate serial numbers on ultrasound probes is impor-
    tant for FDA compliance, as well as for Philips’s inventory
    management. In a contract with CMS, one company included
    clauses emphasizing that CMS would only sell the company
    ultrasound components with original serial numbers. Also, a
    customer testified that he would return a product and refuse
    to pay for it if he discovered that it did not bear the original
    serial number.
    The government alleged that the Nguyens paid for these
    stolen probes with cash to hide their origin. FDA Agent
    Mahoney testified that the Nguyens had made out several
    checks to cash with the notation “purchase probes Merke” and
    “purchase probes.” These checks were drawn from CMS
    accounts, and Nguyen signed and negotiated several checks.
    UNITED STATES v. NGUYEN                5873
    The jury heard evidence of Nguyen’s statement in which
    she claimed that she and her husband did not buy any items
    from Merke, and that Merke had never delivered probes to
    her. Agent Borden also testified about statements that Merke
    had made during Merke’s interrogation. The government elic-
    ited information about that statement on direct examination,
    and Merke’s counsel elicited still more on cross-examination.
    Agent Borden testified that Merke had stated that he had sold
    stolen medical equipment to the Nguyens, and that he had
    received money from the Nguyens, though he refused to esti-
    mate how much money.
    During closing arguments, Nguyen argued that the evi-
    dence did not establish whether she knew the probes were
    stolen or that the serial numbers had been changed.
    On April 5, 2006, the jury found Nguyen guilty of conspir-
    acy to transport stolen property in interstate commerce. The
    jury convicted her of transportation of stolen property for the
    shipment of probes on July 25, 2000, and August 15, 2000,
    but acquitted her of those charges for the shipments occurring
    on August 10, 2000, and April 3, 2002. The jury found her
    guilty of introducing misbranded medical devices into inter-
    state commerce for the shipments of probes occurring on July
    25, 2000, August 10, 2000, and August 15, 2000, but acquit-
    ted her of those charges pertaining to shipments on June 18,
    2001, April 3, 2002, and December 3, 2002. The jury acquit-
    ted Nguyen of all five counts of holding for sale misbranded
    medical devices. Finally, the jury convicted her of conspiracy
    to commit money laundering.
    The district court sentenced Nguyen to 48 months incarcer-
    ation.
    II
    A.
    We review claims of a violation of the Confrontation
    Clause de novo. United States v. Nielsen, 
    371 F.3d 574
    , 581
    (9th Cir. 2004).
    5874                  UNITED STATES v. NGUYEN
    The parties dispute whether Nguyen preserved this claim of
    error. Before trial, Nguyen made several motions in limine
    and objected to the use of a statement Merke made to Agent
    Borden, alleging that its admission would violate the Con-
    frontation Clause. Nguyen objected to the admission of any
    portion of Merke’s statement that alluded to her both in the
    motion in limine and again at trial. The government argues
    that Nguyen should have objected to Merke’s use of his own
    statement when Merke’s counsel sent notice to all parties that
    Merke would admit his statements. Nguyen argues that she
    did not object because she understood Merke’s alert to mean
    that Merke would testify, curing any Confrontation Clause
    problem. Instead, Merke’s counsel elicited the statements for
    which Nguyen had a continuing objection. After opening
    statements at trial, the district court clarified that Nguyen did
    not need to make further objection on this issue and that the
    issue was preserved.2
    We have held that “ ‘where the substance of an objection
    has been thoroughly explored and the trial court’s ruling was
    explicit and definitive, the issue is preserved for appeal.’ ”
    United States v. Varela-Rivera, 
    279 F.3d 1174
    , 1177 (9th Cir.
    2002) (quoting United States v. Palmer, 
    3 F.3d 300
    , 304 (9th
    Cir. 1993). As we have explained, Nguyen brought the Con-
    frontation Clause issue to the district court’s attention twice,
    and the district court made a definitive ruling and then said
    she did not need to object further to preserve the issue.
    Accordingly, if there is Confrontation Clause error, we must
    apply harmless error review. Nielsen, 
    371 F.3d at 581
    .
    2
    The district court stated that Nguyen “[did not] have to object to pre-
    serve [the issue].”
    The government also argues that we should apply plain error because
    Nguyen did not move to sever Merke’s trial from her own. The key ques-
    tion, however, is whether the issue was “brought to the court’s attention.”
    Fed. R. Crim. Pro. 52(b) (plain error standard). Nguyen objected before
    and during trial, bringing her Confrontation Clause claim to the attention
    of both the district court and the government. A motion to sever was not
    necessary to avoid the plain error standard.
    UNITED STATES v. NGUYEN                 5875
    B
    We turn to the issue of whether the Confrontation Clause
    was offended by introduction of the statement made by Merke
    as related by Agent Borden in her testimony. Agent Borden
    testified that while at first Merke had said that he received
    nothing more than lunch money, “he said a lot more things”
    including that he actually had received other money from the
    Nguyens, including money “that he had taken as a result of
    selling equipment to them,” but he would not specify the
    amount. She also testified that “equipment” included probes.
    The government had previously offered to redact the portion
    of Merke’s statement where he referenced accepting money
    from the Nguyens for stolen equipment to avoid any Confron-
    tation Clause related errors, but Merke’s counsel elicited the
    testimony anyway.
    [1] Our Confrontation Clause analysis does not change
    because a co-defendant, as opposed to the prosecutor, elicited
    the hearsay statement. The Confrontation Clause gives the
    accused the right “to be confronted with witnesses against
    him.” U.S. Const. amend. VI; Crawford v. Washington, 
    541 U.S. 36
    , 43 (2004). The fact that Nguyen’s co-counsel elicited
    the hearsay has no bearing on her right to confront her accus-
    ers. See also United States v. Mayfield, 
    189 F.3d 895
    , 901 (9th
    Cir. 1999) (finding reversible error where a co-defendant’s
    counsel elicited hearsay statements in violation of the Con-
    frontation Clause).
    [2] Only hearsay statements that are testimonial implicate
    the Confrontation Clause. Crawford, 
    541 U.S. at 68
    . While
    the Court in Crawford did not comprehensively define testi-
    monial statements, it stated that statements to a police officer
    during interrogations qualified. 
    Id. at 52
    . Merke made his
    statement during Agent Borden’s interrogation, and we con-
    clude that it was testimonial.
    [3] This testimonial statement was hearsay. The govern-
    ment argues that Merke’s statement that he had sold the
    5876               UNITED STATES v. NGUYEN
    Nguyens scrap metal was admitted to show consciousness of
    guilt. The testimony, however, was broader and Agent Borden
    testified that Merke had sold the Nguyens medical equipment.
    This statement does not show Merke’s consciousness of guilt,
    nor is the statement “obviously false.” See, e.g., United States
    v. Trala, 
    386 F.3d 536
    , 544-45 (3rd Cir. 2004) (holding in a
    case where the government sought to prove bank robbery,
    conflicting hearsay statements by a co-defendant regarding
    the origin of the money were admitted to show consciousness
    of guilt and were “obviously false”). Merke’s statement in
    which he said that he had received some money from the
    Nguyens but denied receiving half a million dollars was also
    not “obviously false.” See 
    id.
     The government even acknowl-
    edged that this statement raised potential Confrontation
    Clause problems and offered to redact it.
    The government argues that Merke’s statement was not
    inculpatory. But this is not controlling on the existence of
    error. Crawford does not require that a statement inculpate a
    defendant to trigger error under the Confrontation Clause.
    Simply, Confrontation Clause error occurs at admission of a
    testimonial statement without an opportunity to cross-
    examine. Crawford, 
    541 U.S. at 68-69
    . If the statement is not
    inculpatory, that might be probative of the harmlessness of an
    error, but not of the existence of a Confrontation Clause error.
    [4] Because Merke’s statement was testimonial and admit-
    ted for its truth, we hold its admission at Nguyen’s trial was
    error.
    C
    [5] The prosecution bears the burden of proving the error
    was harmless beyond a reasonable doubt. United States v. Gil-
    lam, 
    167 F.3d 1273
    , 1277 (9th Cir. 1999) (“Once we find a
    [Confrontation Clause] error, the prosecution has the burden
    of showing that the error was harmless beyond a reasonable
    doubt.”); see also Chapman v. California, 
    386 U.S. 18
    , 24
    UNITED STATES v. NGUYEN                          5877
    (1967). “An assessment of harmlessness cannot include con-
    sideration of whether the witness’ testimony would have been
    unchanged, or the jury’s assessment unaltered, had there been
    confrontation; such an inquiry would obviously involve pure
    speculation, and harmlessness must therefore be determined
    on the basis of the remaining evidence.” Coy v. Iowa, 
    487 U.S. 1012
    , 1021-22 (1988). “Whether an error is harmless
    depends on a variety of factors, including whether the testi-
    mony was cumulative, the presence or absence of corroborat-
    ing or contradicting the testimony on material points, the
    extent of cross-examination, and of course, the overall
    strength of the prosecution’s case.” Mayfield, 
    189 F.3d at 906
    (citation and internal quotations omitted).
    The government argues that the error in admitting the hear-
    say statement was harmless.3 It contends that the evidence
    established that Merke had stolen probes from Philips, that
    both Nguyens had signed checks to Merke, some of which
    had “purchase probes Merke” on the memo line, that CMS
    had sold more probes than it had bought, that Phu Nguyen had
    solicited Davies to steal probes for CMS, that Tuyet Nguyen
    had solicited Westrich to steal Philips software for CMS, and
    that Tuyet Nguyen falsely denied doing any business with
    Merke. The statement that Merke received money from the
    Nguyens in exchange for medical equipment was the most
    persuasive evidence that tied Tuyet Nguyen to the stolen
    probes, and the only testimony that showed her knowledge
    that the probes were stolen.
    3
    The government also argues that the limiting instruction that these
    statements could only be used against Merke cured any error. In Bruton,
    the Court held that a case of the admission of a confession that implicates
    a co-defendant and where the co-defendant cannot cross examine the con-
    fessor was a situation “in which the risk that the jury will not, or cannot,
    follow instructions is so great . . . that the practical and human limitations
    of the jury system cannot be ignored.” Bruton v. United States, 
    391 U.S. 123
    , 135 (1968). Therefore, we do not rely on the limiting instruction to
    cure the error.
    5878                  UNITED STATES v. NGUYEN
    [6] We cannot say that the government carried its burden
    of establishing this error was harmless beyond a reasonable
    doubt. Specifically, the hearsay testimony supported the gov-
    ernment’s case that Nguyen knew that the probes were stolen.
    Her knowledge was an element of her convictions for the
    transportation of stolen property and, therefore, necessary to
    her conspiracy convictions. Nguyen’s closing argument to the
    jury centered on her contention that she did not know the
    probes were stolen. While the jury could have concluded that
    she knew the probes were stolen absent the hearsay testimony,
    the government has not proven that the jury would have so
    concluded beyond a reasonable doubt. We reverse and
    remand Nguyen’s convictions for conspiracy to transport
    stolen property, conspiracy to commit money laundering, and
    the transportation of stolen property because Nguyen was not
    able to cross-examine Merke about his statement. This Con-
    frontation Clause error does not affect her convictions for
    introducing a misbranded medical device into interstate com-
    merce.4
    III
    A.
    We next address the conviction for felony misbranding of
    medical devices. The problem before us here is that the jury
    instruction that defined felony misbranding of medical
    devices did not include a materiality element. Nguyen did not
    4
    Merke’s statements do not affect the jury’s verdict that Nguyen intro-
    duced misbranded medical devices into interstate commerce. For the jury
    to find that Nguyen committed this crime, it must find: that Nguyen (1)
    introduced (2) a medical device that is (3) materially adulterated or mis-
    branded, and (4) that she acted with intent to defraud or mislead. 
    21 U.S.C. § 331
    (a); see also United States v. Watkins, 
    278 F.3d 961
    , 964 (9th
    Cir. 2002). Nguyen did not need to know the probes had been stolen to
    commit this crime, only that their serial numbers had been altered. The
    hearsay statements do not discuss the probes’ serial numbers.
    UNITED STATES v. NGUYEN                 5879
    object to the instruction and argues that we should apply plain
    error review.
    The government to the contrary argues waiver and relies
    upon the invited error doctrine, which in an appropriate case
    allows us to decline to review instructions where a defendant
    invited the error and relinquished a known right. See United
    States v. Perez, 
    116 F.3d 840
    , 845 (9th Cir. 1997). As the
    court in Perez stated, “[f]orfeited rights are reviewable for
    plain error, while waived rights are not.” 
    Id.
     (citation omit-
    ted). Waiver occurs where a defendant “considered the con-
    trolling law, or omitted element, and, in spite of being aware
    of the applicable law, proposed or accepted a flawed instruc-
    tion.” 
    Id.
    Nguyen proposed another instruction, Instruction 30, and
    the government contends that this instruction shows that she
    knew that materiality was an element of felony misbranding.
    Instruction 30, however, only states that any omission must be
    material, it does not say that an affirmative statement need be
    material. Therefore, it is not clear that Nguyen considered the
    controlling law and accepted the flawed instruction. We con-
    clude that the waiver argument should be rejected and instead
    we accept Nguyen’s argument that we should review the jury
    instruction on felony misbranding of medical devices for plain
    error.
    B
    To prevail on plain error review, Nguyen must show (1)
    that the proceedings below involved error, (2) that the error
    is plain, and (3) that the error affected the substantial rights
    of the aggrieved party. See United States v. Olano, 
    507 U.S. 725
    , 732-35 (1993). In addition, a defendant must also show
    that the error “ ‘seriously affect[s] the fairness, integrity or
    public reputation of judicial proceedings’ before we will exer-
    cise our discretion pursuant to Rule 52(b) to correct the plain
    error.” United States v. Alferahin, 
    433 F.3d 1148
    , 1154 (9th
    5880               UNITED STATES v. NGUYEN
    Cir. 2006) (en banc) (citing Olano, 
    507 U.S. at 736
    ); see also
    United States v. Hai Waknine, 
    543 F.3d 546
    , 551 (2008).
    [7] Materiality indisputably is an element of felony mis-
    branding of medical devices. United States v. Watkins, 
    278 F.3d 961
    , 969 (9th Cir. 2002). It is thus somewhat surprising
    that the government’s proposed instructions did not include
    this element. The government concedes that Instruction 22 did
    not include that element but argues that this omission was
    cured by Instruction 30. That instruction stated:
    If any article is alleged to be misbranded because the
    labeling or advertising is misleading, then in deter-
    mining whether the labeling or advertising is mis-
    leading there shall be taken into account (among
    other things) not only representations made or sug-
    gested by statement, word, design, device, or any
    combination thereof, but also the extent to which the
    labeling or advertising fails to reveal facts material
    in the light of such representations or material with
    respect to consequences which may result from the
    use of the article to which the labeling or advertising
    relates under the conditions of use prescribed in the
    labeling or advertising thereof or under such condi-
    tions of use as are customary or usual.
    This instruction does not cure the lack of materiality element.
    It states that the article could be misbranded because of a mis-
    statement or a failure to state something that is material.
    Therefore, we hold the government’s argument is unavailing
    and that there was error. The instructions did not include the
    materiality element, this was an error and it is as simple as
    that.
    C
    It remains to be determined whether this error requires
    relief under the plain error standard. We believe that the first
    UNITED STATES v. NGUYEN                       5881
    element of that standard is met. An error is plain when it is
    “clear” or “obvious” under the law. Olano, 
    507 U.S. at 734
    .
    We have held that “a district court’s error is plain when its
    jury instructions fail to incorporate an element that has been
    clearly established by Ninth Circuit precedent.” Alferahin,
    
    433 F.3d at 1157
     (citation omitted). We hold that disregard of
    the materiality element for felony misbranding of medical
    devices is a plain error.
    [8] We turn next to the third element of the plain error stan-
    dard, whether substantial rights are affected, and it is here that
    Nguyen’s appeal falters. “[T]he omission of an element from
    jury instructions does not always ‘affect’ a defendant’s sub-
    stantial rights.” 
    Id.
     (citing United States v. Neder, 
    527 U.S. 1
    ,
    15 (1999)). Nguyen’s closing statement to the jury did not
    argue that the changed serial numbers were immaterial—it
    focused on the point that the numbers may have been changed
    by someone else and that Nguyen may have not known about
    it. Moreover, the government presented plenty of evidence to
    support a finding of materiality. Two customers testified that
    they would not buy ultrasound probes without original serial
    numbers. One of CMS’s customers included a clause in its
    contract stating that all probes would have original serial
    numbers. The testimony also demonstrated that the probes’
    original serial numbers were critical for FDA compliance and
    in the event of a recall. Thus, there was overwhelming evi-
    dence of the materiality of the altered serial numbers and very
    little evidence that these changes were unimportant.5
    5
    Nguyen argues that there was conflicting and slim evidence regarding
    serial numbers’ materiality. She states that there has never been a recall
    of ultrasound probes and that some evidence demonstrated that serial num-
    bers were not unique to individual probes. She argues that serial numbers
    were for inventory control above anything else. But it is a sufficient
    answer that a recall could have occurred, and the serial numbers, whether
    unique or not, would have aided customers in identifying whether their
    probes were recalled.
    5882                  UNITED STATES v. NGUYEN
    [9] Because of the strong evidence on materiality and
    because Nguyen did not contest materiality of altered serial
    numbers in her presentations to the jury, we hold that this
    error did not affect Nguyen’s substantial rights.
    IV
    [10] For the forgoing reasons, we conclude that Nguyen’s
    Confrontation Clause rights were violated and we REVERSE
    her convictions for conspiracy to transport stolen property, the
    transportation of stolen property, and conspiracy to commit
    money laundering. Her remaining convictions for felony mis-
    branding of medical devices are AFFIRMED. We REMAND
    for retrial, if the government wishes to pursue the charges that
    we reverse, and for resentencing.
    REVERSED IN PART, AFFIRMED IN PART, and
    REMANDED.
    CALLAHAN, Circuit Judge, concurring in part and dissent-
    ing in part:
    I agree with the majority that Tuyet Nguyen (“Nguyen”)
    adequately preserved in the district court her claim that the
    admission of the statement by Sess Merke to Agent Borden
    violated the Confrontation Clause. I also agree that the admis-
    sion of Merke’s statement offended the Confrontation Clause.
    I disagree, however, with the majority’s conclusion that this
    error was not harmless beyond a reasonable doubt. For this
    reason, I dissent in part from the majority’s opinion and
    would affirm Nguyen’s convictions for conspiracy to trans-
    port stolen property, conspiracy to commit money laundering,
    and transportation of stolen property.1
    1
    I agree with the majority’s conclusion that Nguyen’s conviction for fel-
    ony misbranding of medical devices should not be disturbed. Maj. Op.
    5878-82.
    UNITED STATES v. NGUYEN                       5883
    I.
    Confrontation Clause errors are subject to harmless error
    review. United States v. Schoneberg, 
    396 F.3d 1036
    , 1044
    (9th Cir. 2005). “[A]n otherwise valid conviction should not
    be set aside if the reviewing court may confidently say, on the
    whole record, that the constitutional error was harmless
    beyond a reasonable doubt.” Delaware v. Van Arsdall, 
    475 U.S. 673
    , 681 (1986). To assess the harmlessness of an error,
    we inquire “whether, assuming that the damaging potential of
    the cross-examination were fully realized,” we “might none-
    theless say that the error was harmless beyond a reasonable
    doubt.” 
    Id. at 684
    . Harmlessness is determined on the basis of
    the remaining evidence, Coy v. Iowa, 
    487 U.S. 1012
    , 1022
    (1988), and we consider a number of factors including “the
    importance of the witness’ testimony in the prosecution’s
    case, whether the testimony was cumulative, the presence or
    absence of evidence corroborating or contradicting the testi-
    mony of the witness on material points, the extent of cross-
    examination otherwise permitted, and, of course, the overall
    strength of the prosecution’s case.” Van Arsdall, 
    475 U.S. at 684
    .
    The majority initially asserts that “the most persuasive evi-
    dence that tied Tuyet Nguyen to the stolen probes, and the
    only testimony that showed her knowledge that the probes
    were stolen” was Merke’s statement, as related by Agent Bor-
    den, that Merke received money from the Nguyens in
    exchange for medical equipment.2 Maj. Op. at 5877. The
    2
    The panel majority and I have a difference of opinion regarding the
    persuasiveness of the evidence in the record. Although the majority finds
    Merke’s hearsay statement to be the most persuasive evidence in the
    record, other evidence in the record, including significant circumstantial
    evidence, establishes the harmlessness of the Confrontation Clause error.
    The government is not required to prove knowledge by direct evidence,
    and may rely on circumstantial evidence. See United States v. Santos, 
    128 S. Ct. 2020
    , 2029 (2008) (plurality) (stating that knowledge “must almost
    5884                  UNITED STATES v. NGUYEN
    majority’s subsequent discussion is more nuanced and deter-
    mines that, absent the hearsay testimony, the government has
    not proven that the jury would have concluded beyond a rea-
    sonable doubt that Nguyen knew the probes were stolen.3 Id.
    at 5878.
    I respectfully disagree. Based on all of the remaining evi-
    dence in the record, I conclude that any reasonable jury would
    have connected Nguyen to the stolen probes and determined
    that Nguyen knew the probes were stolen, even without
    Merke’s hearsay statement. The record demonstrates that
    Merke stole the probes, sold and transferred them to Nguyen
    and her company, Columbia Medical Systems, Inc. (“CMS”),
    and that Nguyen then sold the probes in interstate commerce.
    Evidence in the record indicates that Merke stole functional
    probes from Philips and sold them to CMS and Nguyen. Doc-
    umentary evidence and the testimony of Evalyn Thomas, a
    Philips data entry clerk, establish that equipment, including
    forty-six ultrasound probes, “disappeared” and could not be
    accounted for while Merke was in charge of Philips’s Defec-
    tive Materials storeroom and Finished Goods storeroom. See
    Maj. Op. at 5871-72. Also, documentary evidence in the form
    always” be proven by circumstantial evidence); Desert Palace, Inc. v.
    Costa, 
    539 U.S. 90
    , 100 (2003) (“[W]e have never questioned the suffi-
    ciency of circumstantial evidence in support of a criminal conviction, even
    though proof beyond a reasonable doubt is required.”); United States v.
    Wright, 
    215 F.3d 1020
    , 1028 (9th Cir. 2000) (stating that the government
    need not prove defendant’s knowledge of the objective of a conspiracy
    with direct evidence, and that inferences based on circumstantial evidence
    would sustain the conspiracy conviction); cf. United States v. Santos, 
    527 F.3d 1003
    , 1009 (9th Cir. 2008) (“The government is not required to pro-
    duce direct evidence of the defendant’s intent; rather, it may provide cir-
    cumstantial evidence from which the district court can draw reasonable
    inferences.”).
    3
    An element of the crime of interstate transportation of stolen goods
    under 
    18 U.S.C. § 2314
     is knowledge of the stolen nature of the trans-
    ported goods.
    UNITED STATES v. NGUYEN                      5885
    of shipping-related documents indicates that Merke repeatedly
    shipped packages to CMS and/or Tuyet Nguyen. The record
    contains numerous shipping invoices, logs, and waybills that
    connect Merke to Nguyen and CMS.
    Furthermore, the government presented evidence of CMS’s
    practice of using checks made payable to “Cash” to purchase
    probes and other ultrasound equipment, and testimony that
    this was an unusual practice in the industry given that it sig-
    naled potential illegal conduct. Of these checks payable to
    “Cash” on CMS’s account, 112 of them, totaling roughly
    $512,000, include a notation “Purchase probes (Merke)” or
    some similar descriptor. Tuyet Nguyen signed forty-nine of
    these 112 checks.4 This evidence overwhelmingly links
    Nguyen to the probes, and to Merke. The evidence of the
    checks payable to “Cash” and referencing both probes and
    Merke also directly contradicts Nguyen’s statement during a
    police interview that she had never purchased or taken deliv-
    ery of any items, including probes, from Merke.
    The government also produced evidence that CMS sold
    many more ultrasound probes than it recorded as purchased.
    For example, a comparison of CMS’s purchase and sales
    reports for specific, relevant equipment models indicates that
    for the year 1999, CMS purchased nine items and sold sixty
    items. For the year 2000, there were seven purchases and
    eighty-three sales. In 2001, there were four purchases and
    forty sales. In 2002, CMS purchased thirty-three items and
    sold fifty-four items. In 2003, there were no purchases, yet
    fifty-eight sales.5
    4
    Altogether, the record contains evidence of over one million dollars
    worth of checks payable to “Cash” and cashier’s checks, all of which were
    drawn on CMS’s accounts and bore some notation related to the purchase
    of equipment.
    5
    The illegality of the operation is supported by the testimony of FDA
    Agent Borden that, based on a comparison of physical evidence obtained
    during the execution of a search warrant and documentary evidence from
    CMS, many Philips probes tied to CMS had false serial numbers.
    5886                  UNITED STATES v. NGUYEN
    In addition, the government produced evidence of the
    Nguyens’ other attempts to facilitate their criminal scheme.
    First, as the majority notes, Phu Nguyen, Tuyet Nguyen’s
    husband and business partner in CMS, solicited Robert
    Davies, a Philips employee, to steal ultrasound probes for
    CMS. See Maj. Op. at 5870-71. Second, Tuyet Nguyen solic-
    ited Dave Westrich, her former colleague from Philips, to
    steal Philips’s proprietary software for her or CMS’s use.
    Based on the entire record, I conclude that the Confronta-
    tion Clause error was harmless beyond a reasonable doubt. As
    the Supreme Court recognized in Santos, knowledge “must
    almost always” be proven by circumstantial evidence. 
    128 S. Ct. at 2029
    . It is unlikely that the government would have
    ever been able to get Nguyen to confess outright that she
    knew the probes were stolen. But such a confession was not
    required to convict Nguyen. The jury could, and I believe
    would, draw inferences from the evidence presented to estab-
    lish the connection between Nguyen and the probes, and to
    establish Nguyen’s knowledge of the stolen nature of the
    probes that CMS had acquired and sold. Accordingly, I would
    find that the Confrontation Clause error here was harmless
    beyond a reasonable doubt.
    II.
    Because I would affirm the jury’s verdict in its entirety, I
    proceed to address Nguyen’s remaining substantive chal-
    lenges on appeal.6 These challenges to her money laundering
    conspiracy conviction, which she did not raise in the district
    court, are subject to plain error review. “Under plain-error
    review, reversal is permitted only when there is (1) error that
    6
    The majority opinion does not address these remaining issues, which
    relate to Nguyen’s conviction for conspiracy to launder money, because
    its reversal on the Confrontation Clause issue obviates the need to do so.
    Nonetheless, as the issues have been briefed and argued, an evaluation of
    their merits may assist the district court should the matter be retried.
    UNITED STATES v. NGUYEN                   5887
    is (2) plain, (3) affects substantial rights, and (4) seriously
    affects the fairness, integrity, or public reputation of judicial
    proceedings.” United States v. Cruz, 
    554 F.3d 840
    , 845 (9th
    Cir. 2009) (citations and internal quotations omitted). “An
    error is plain if it is ‘contrary to the law at the time of appeal
    . . . .’ ” United States v. Mejia, 
    559 F.3d 1113
    , 1115 (9th Cir.
    2009) (quoting Johnson v. United States, 
    520 U.S. 461
    , 468
    (1997)). To be plain, the error must be “clear-cut” or “obvi-
    ous.” See United States v. Zalapa, 
    509 F.3d 1060
    , 1064 (9th
    Cir. 2007).)
    A.
    On appeal, Nguyen contends that the district court improp-
    erly instructed the jury with respect to the charge of conspir-
    acy to launder money in violation of 
    18 U.S.C. §§ 1956
    (a)(1)(A), 1956(a)(1)(B), and 1956(h). She argues that
    although the district court’s instruction containing the ele-
    ments of the money laundering conspiracy offense, Instruc-
    tion 20, correctly stated that it is a specific intent crime, the
    district court committed reversible error by providing a subse-
    quent instruction regarding knowledge, Instruction 25.
    Instruction 25 allegedly “eviscerated” the specific intent ele-
    ment stated in Instruction 20. Instruction 20 states, in relevant
    part, that the government must prove that:
    (2) the defendant knew that the property repre-
    sented the proceeds of interstate transportation of
    stolen property; and
    (3) the defendant knew the transaction was
    designed in whole or in part to conceal or disguise
    the nature, source, ownership, or control of the pro-
    ceeds of interstate transportation of stolen medical
    devices, or the defendant acted with the intent to pro-
    mote the carrying on of interstate transportation of
    stolen medical devices . . . .
    5888               UNITED STATES v. NGUYEN
    Instruction 25, however, states: “An act is done knowingly if
    the defendant is aware of the act and does not act through
    ignorance, mistake, or accident. You may consider evidence
    of the defendant’s words, acts, or omissions, along with all
    the other evidence, in deciding whether the defendant acted
    knowingly.” Thus, Nguyen asserts that Instruction 25 negated
    the specific intent requirement by allowing the jury to deter-
    mine that she acted “knowingly” through “ignorance, mistake
    or accident.”
    Nguyen’s claim of error is based on our decision in United
    States v. Stein, where we held that a jury instruction on gen-
    eral knowledge that followed a correct money laundering
    instruction rendered the instructions, as a whole, erroneous
    because they effectively omitted an element of the offense.
    See 
    37 F.3d 1407
    , 1410 (9th. Cir. 1994). However, unlike
    Instruction 25 in this case, the general knowledge instruction
    in Stein contained a second sentence, which rendered the Stein
    instructions problematic. There, the general knowledge
    instruction stated that “an act is done knowingly if the defen-
    dant is aware of the act and doesn’t act through ignorance,
    mistake or accident. The Government is not required to prove
    that the defendant knew his act or omissions were unlawful.”
    
    Id. at 1410
     (emphasis added). The second sentence was the
    basis of the Stein court’s conclusion that the jury could have
    convicted Stein without finding he knew the predicate acts
    were unlawful. 
    Id.
     Because Instruction 25 does not contain
    the language that provided the taint in Stein, there was no
    error. Moreover, even if there was some error, it was not plain
    error; any possible error was not “so clear-cut, so obvious, a
    competent district judge should be able to avoid it without
    benefit of objection.” Zalapa, 
    509 F.3d at 1064
     (citation and
    quotation marks omitted). Accordingly, I would find no
    instructional error.
    UNITED STATES v. NGUYEN                        5889
    B.
    Nguyen belatedly challenges the sufficiency of evidence
    supporting her conviction for conspiracy to launder money,
    relying on the United States Supreme Court’s recent decision
    in United States v. Santos, 
    128 S. Ct. 2020
     (2008) (plurality).7
    Although the panel majority does not reach this issue, I con-
    clude that the error alleged by Nguyen was not plain error.
    In Santos, the Court considered “whether the term ‘pro-
    ceeds’ used in the federal money-laundering statute, 
    18 U.S.C. § 1956
    (a)(1), means ‘receipts’ or ‘profits.’ ” 
    128 S. Ct. at 2022
    . Santos involved the operation of a criminal lottery,
    and Santos was convicted of money laundering based on his
    payments of money to lottery winners and employees. See 
    id. at 2022-23
    . Four Justices found that the term “proceeds” was
    ambiguous and, applying the rule of lenity, concluded that the
    term “proceeds” in 
    18 U.S.C. § 1956
    (a)(1) universally means
    “profits,” and not “gross receipts.” See 
    id. at 2023-25
    . Under
    the plurality’s view, “to establish the proceeds element under
    the ‘profits’ interpretation, the prosecution needs to show . . .
    that a single instance of specified unlawful activity was profit-
    able and gave rise to the money involved in a charged transac-
    tion.” 
    Id. at 2029
    .
    However, Justice Stevens, whose separate concurrence pro-
    vided the fifth vote in Santos, took the narrower view that
    Congress could have intended the term “proceeds” to have
    different meanings in different contexts and, as a result, “pro-
    ceeds” might mean “profits” in the illegal lottery context, but
    might not have that meaning in the context of another predi-
    7
    Nguyen waited until November 24, 2008, just prior to oral argument,
    to raise this argument. Although the Supreme Court decided Santos on
    June 2, 2008, Nguyen did not raise the Santos issue in her reply brief,
    which was filed on August 5, 2008. Nonetheless, no authority appears to
    preclude consideration of this issue in light of the intervening decision by
    the Supreme Court.
    5890                UNITED STATES v. NGUYEN
    cate crime. 
    Id. at 2031-32
     (Stevens, J., concurring) (“[T]his
    Court need not pick a single definition of ‘proceeds’ applica-
    ble to every unlawful activity, no matter how incongruous
    some applications may be.”). Thus, Justice Stevens, agreeing
    with the analysis of four dissenting Justices, stated that “the
    legislative history of § 1956 makes it clear that Congress
    intended the term ‘proceeds’ to include gross revenues from
    the sale of contraband and the operation of organized crime
    syndicates involving such sales.” Id. at 2032; see also id. at
    2035 & n.1 (Alito, J., dissenting). Although Justice Stevens
    and the plurality contest the stare decisis effect of his opinion,
    the plurality recognizes that Justice Stevens’s narrower con-
    currence limits the Court’s holding. Compare id. at 2031, with
    id. at 2034 n.7.
    Based on the plurality’s opinion in Santos, Nguyen argues
    that the record does not support her conviction for conspiracy
    to launder money because it does not contain evidence dem-
    onstrating that she used profits to further or conceal the con-
    spiracy.
    Two aspects of the Santos decision indicate that any
    alleged error in this case is not so clear-cut or obvious as to
    render it “plain error.” First, the multiple opinions in Santos
    do not conclusively define “proceeds.” Justice Stevens’s con-
    curring opinion suggests that “proceeds” does not mean “prof-
    its” in the context of the sale of contraband and the operation
    of a criminal organization, which is at issue here. Moreover,
    his view is consistent with the views of four dissenting Jus-
    tices. Thus, the district court’s definition of “proceeds,” if
    error, cannot be considered plain error. See United States v.
    Fernandez, 
    559 F.3d 303
    , 316 (5th Cir. 2009) (“While Justice
    Stevens and the plurality disagreed over the precise preceden-
    tial effect of his statement, the uncertainty renders any error
    here not ‘plain.’ ”); accord United States v. Brown, 
    553 F.3d 768
    , 785 (5th Cir. 2008); see also Ninth Circuit Model Jury
    Instruction 8.120 Financial Transaction to Promote Unlawful
    Activity, Comment (Mar. 2009) (“Whether the instruction
    UNITED STATES v. NGUYEN                  5891
    must now be modified in all or some other cases to define
    ‘proceeds’ to mean ‘profits’ pursuant to Santos is unclear.”).
    Second, neither the Santos plurality or Justice Stevens’s
    concurring opinion addressed the quantum of evidence
    required to support a conviction for the charge of conspiracy
    to launder money, which is at issue here, as opposed to a con-
    viction for money laundering. See Santos, 
    128 S. Ct. at
    2023
    n.1. The plurality specifically stated that it was not addressing
    the possibility that the convictions for conspiracy to launder
    money at issue there would stand in light of its holding
    regarding the meaning of “proceeds.” 
    Id.
    Accordingly, despite the Supreme Court’s opinion in San-
    tos, the definition of proceeds under which Nguyen was con-
    victed, if erroneous, was not plain error.
    ***
    Based on the foregoing, I respectfully dissent in part. I
    would find that the violation of the Confrontation Clause was
    harmless error, and that Nguyen’s conviction for conspiracy
    to launder money did not involve plain error. Nguyen’s con-
    victions should be affirmed in their entirety.