United States v. Campbell

Judge EFFRON

delivered the opinion of the Court.

A special court-martial composed of officer and enlisted members convicted appellant, contrary to his pleas, of wrongful use of lysergic acid diethylamide (LSD), in violation of Article 112a, Uniform Code of Military Justice, 10 USC § 912a. The members sentenced appellant to a bad-conduct discharge, confinement for 75 days, forfeiture of $549.00 pay per month for 2 months, and reduction to the lowest enlisted grade. The convening authority approved these results, and the Court of Criminal Appeals affirmed.

On appellant’s petition, we granted review of the following issue:

WHETHER THE MILITARY JUDGE ERRED IN ADMITTING THE URINALYSIS TEST RESULTS AND THE GOVERNMENT’S EXPERT OPINION TESTIMONY REGARDING THE TEST ABSENT A SHOWING THAT THE NOVEL LSD TESTING METHODOLOGY WAS SUFFICIENTLY RELIABLE.

After oral argument in December 1997, the Court specified the following related issues:

I

WHETHER THE CONSTITUTION, THE MANUAL FOR COURTS-MARTIAL, REGULATIONS, OR OTHER APPLICABLE LAW REQUIRE A PARTICULAR CUT-OFF LEVEL IN ORDER FOR THE PROSECUTION TO ESTABLISH BEYOND A REASONABLE DOUBT APPELLANT’S KNOWING USE OF LSD.

II

WHETHER THE RECORD OF TRIAL CONTAINS SUFFICIENT SCIENTIFIC EVIDENCE REGARDING THE BASIS FOR THE CUT-OFF LEVEL FOR REPORTING POSITIVE GC/ MS/MS TEST RESULTS (200 PG/ML) SUCH THAT THE MEMBERS COULD DRAW AN INFERENCE OF WRONGFULNESS OF THE USE FROM THE CONCENTRATION OF LSD REPORTED IN APPELLANT’S SAMPLE (307 PG/ML). SEE UNITED STATES V. THOMPSON, 34 MJ 287 (CMA 1992); UNITED STATES V. HARPER, 22 MJ 157 (CMA 1986).

Ill

WHETHER THE EXPERT TESTIMONY REGARDING THE RESULTS OF THE CERTIFICATION AND BLIND AND OPEN QUALITY CONTROL TESTING WAS SUFFICIENT TO DEMONSTRATE THE RELIABILITY OF THE TESTING PROCEDURE UNDER DAUBERT TO REASONABLY EXCLUDE THE POSSIBILITY OF A FALSE POSITIVE RESULT.

A. WHAT EVIDENCE, IF ANY, INTRODUCED AT TRIAL DEMONSTRATES THAT GC/MS/MS WAS SUFFICIENTLY RELIABLE WITH REGARD TO REPORTING RESULTS AS POSITIVE OR NEGATIVE AND WITH REGARD TO PRECISELY IDENTIFYING THE EXACT CONCENTRATION OF LSD IN URINE.

B. WHAT WAS THE SIGNIFICANCE, IN TERMS OF ESTABLISHING THE RELIABILITY OF GC/ MS/MS, OF EACH OF THE FOLLOWING STATEMENTS ABOUT THE TEST RESULTS:

1. THAT THE ARMY CONCLUDED THE GC/MS/MS METHODOLOGY WAS “VERY ACCURATE” (R. 151);

2. THAT NORTHWEST TOXICOLOGY LABORATORY (NTL) HAS ALWAYS BEEN “WITHIN PLUS OR MINUS 20 PERCENT OR 2 STANDARD DEVIATIONS OF THE MEAN” WHEN ITS RESULTS ARE COMPARED TO THE TWO NAVY LABS CONDUCTING LSD CONFIRMATION TESTING (R. 188); AND

3. THAT NTL HAS NEVER INCORRECTLY REPORTED A BLIND QUALITY CONTROL RESULT, I.E., THAT NTL HAS NEVER INCORRECTLY REPORTED A RESULT AS POSITIVE OR NEGATIVE WHEN IT TESTS FOR THE PRESENCE OF LSD (AS OPPOSED TO QUANTIFYING THE CONCENTRATION OF THE DRUG) (R. 187).

For the reasons discussed below, we reverse the decision of the Court of Criminal Appeals.

FACTS

As noted by the court below, the sole evidence pertaining to the charge of wrongful use of LSD in this case consisted of the report of results of a urinalysis test. At trial, defense counsel moved to exclude evidence of the urinalysis and the supporting expert testimony on the ground that the scientific methodology used in the confirmatory test — gas chromatography tandem mass spectrometry (GC/MS/MS) — did not meet the standards of reliability required by Mil.R.Evid. 702, Manual for Courts-Martial, United States (1995 ed.), and relevant case law. See Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 113 S.Ct. 2786, 125 L.Ed.2d 469 (1993); United States v. Nimmer, 43 MJ 252 (1995). Consideration of the motion, which was contested, involved testimony from three expert witnesses.

The military judge denied the defense motion. Subsequently, he documented his decision in an appellate exhibit headed “Court Findings of Fact, Conclusions of Law, and Ruling on the Defense Motion In Limine.”

The evidence at issue was obtained during a routine unit inspection in which members of appellant’s unit were required to produce urine samples. This was not prompted by any concern about appellant’s duty performance or behavior.

Appellant’s sample was sent to the Army’s drug testing laboratory at Fort Meade, Maryland. It was tested twice over a 4-day period using radioimmunoassay analysis (RIA) for LSD. Both tests indicated that appellant’s urine contained LSD. The RIA procedure, however, does not quantify the amount of the drug in a sample and has not been certified by the Department of Defense as reliable for prosecution under the Uniform Code of Military Justice.

After the RIA test results were obtained, the sample was sent to Northwest Toxicology Laboratory (NTL) in Salt Lake City, Utah, for additional testing. At NTL, appellant’s sample was examined through a test using GC/MS/MS methodology. That test showed a level of 307 picograms (one-trillionth of a gram) of LSD per milliliter of urine. The Department of Defense has established a cutoff level of 200 picograms.

Dr. Rodger Foltz, the Laboratory Director of NTL, testified on behalf of the prosecution. He stated that the GC/MS/MS test is “based on scientific principles ... accepted by the scientific community” and represents the “state of the art” in testing for drugs. He stated that there are “a few” other toxicology laboratories that use that same test, but he added that its use is not widespread because the testing instrument costs about $350,000. He stated that this method of testing had been “presented at conferences on at least two occasions by two fellow toxicologists,” where it was subject to peer review. Dr. Foltz also testified that he had published an article in a peer-reviewed journal, Analytical Chemistry, in 1992 on the GC/MS/MS testing employed at NTL. He testified that there were no other articles on this method, because the “normal practice” is for scientists to publish an article only when there is a problem. He pointed out that this method had been published “in the open literature,” so “any other lab with that instrumentation is certainly free to use it.” He acknowledged, though, that he was “not aware, at this time, of any other labs actually using it.”

With respect to quality control, he testified that NTL received 20 “open quality-control samples” per month to ensure the accuracy of its testing. These samples were presented for analysis, and the laboratory did not know what drug, if any, was present or in what level of concentration. These samples had been received since January 1993, when the laboratory first entered into a contractual agreement with the Army.

Dr. Foltz testified that, prior to awarding them a contract, the Armed Forces Institute of Pathology (AFIP) had conducted an “extensive review” of the procedures used at NTL to make sure the methodology was reliable. After NTL had been given-a number of samples and had passed the quality control of AFIP, the Army had concluded that NTL’s methodology for detecting LSD was “very accurate.” Moreover, 15 blind quality-control samples were returned by NTL to AFIP over the period of several months between getting the Army contract and receiving appellant’s sample, all of which were tested correctly. Additionally, AFIP sent 10 “open quality controls” per month to NTL, and the past results of these tests fell within the standard deviation permitted for quality control. These open quality-control tests also were compared with two Navy laboratories that performed urine testing for LSD, but with a different methodology, and no significant statistical deviation was found between their results and NTL’s findings.

Dr. Arthur J. MeBay, a retired state forensic toxicologist, testified for the defense. He stated that, although GC/MS/MS had been accepted in the scientific community for uses such as hair analysis, it had not been accepted as a method of testing for drugs. Concerning the RIA test, Dr. MeBay indicated that it was “a reliable means to screen for LSD.”

Dr. MeBay testified that he was familiar with the publications Analytical Chemistry and the Journal of Analytical Chemistry and, as a scientific peer, had reviewed articles for the former, as well as for other journals. He testified that there was a distinction between acceptance of a paper for publication, on the one hand, and acceptance by the scientific community of the methodology described in such a paper, on the other. Asked whether “publication of a single article — like the one that [he was] asked about by the prosecution — constitutes peer review of a scientific methodology!,]” Dr. MeBay responded: “Well, it’s peer review of that particular presentation of that article — that’s all.” He added: “[N]ow, if you give me 100 papers that are accepted on that particular topic, that would be a different matter or a dozen or something else, but you’ve got one” on the GC/MS/MS methodology.

Dr. MeBay testified that true peer review would include the same methodology being employed by more than one laboratory. “But one is at a loss if, indeed, only one laboratory could do something and there’s no other laboratory that you could use to check the results with another sample, for instance.” He acknowledged that the GC/ MS/MS methodology used at NTL would tend to produce valid results if more than one laboratory within the Department of Defense conducted tests of urine for LSD using different methodologies but obtained results similar to NTL on open quality-control samples.

Dr. Robert K. Simon, owner of Toxicology International, also testified for the defense. Dr. Simon testified as to GC/MS/MS procedure, as follows:

[G]as chromatography tandem mass spectrometer procedure ... combine[s] a gas chromatograph with essentially two mass spectrometers so that instead of having one mass spectrometer to try to identify a particular drug substance, a rather unique system has been established to combine two mass spectrometers together to give us some additional data that can hopefully be used for drug identification.

He added:

The difficulty in analyzing for this particular substance in urine, blood or any other biological fluid or even in a piece of — a tab of LSD paper is that the amount is extremely small. The dose that one takes of LSD is somewhere between perhaps 70 and 100 micrograms, that is 70 to 100 one-millionth of a gram, so it is a very small quantity. That then, diluted into the body can then possibly emerge into urine over a period of hours after use in concentrations that are in pieograms and that really is a unit that is one thousand lower than the normal drug substances appear which is nanograms, so we’re at ten-to-the-minus-twelfth range of concentration of this drug per milliliter of urine.

Dr. Simon pointed out that the equipment used at Northwest Toxicology was the only such equipment in the country and that the methodology of that equipment had not been accepted in the scientific community. He explained that with essentially only one functional unit in the country — the one at NTL— “there would be no way to have a scientific peer evaluation of either the technique or this particular method at this time.” He stated: “This is a very novel technique, a novel piece of equipment and a very novel methodology.” He also testified that the reliability of NTL’s results from GC/MS/MS could be shown by the use of open control tests confirmed by two other laboratories employing different methodologies.

The judge then asked the following question for a member:

Q. Dr. Simon, I have this question for you. Based upon your experience gained from working drug testing for DoD, if GC/MS/MS is in experimental stages, why would DoD contract Northwest to conduct drug confirmation?

A. I think the answer to that question is, there is certainly a compelling interest in determining LSD in urine. Certainly the statistics in and outside of DoD tell us that LSD use has reemerged in the late ’80’s and early ’90’s as a drug of choice among individuals, so there is a great interest in being able to develop this method. And certainly, Dr. Foltz is well recognized in the field of forensic toxicology and scientific research as a person highly capable to do this work. So I certainly think the interest is there and I think the reason DoD would contract with him is, he’s a prime individual who has been involved in this type of research for many years. That’s why they would actually contract with him.

Later, Dr. Simon was recalled. He testified that, because of the unusual peaks on the test, he would “disqualify th[e] entire batch,” including the results pertaining to appellant. He explained in detail how the court members should examine these peaks and determine the reliability of the test for LSD.

Dr. Foltz also was recalled. He testified that the “commercial version” of the GC/ MS/MS instrument was introduced in 1979 and that there were more than 300 such “instruments in operation around the world,” most of them being “used in the pharmaceutical industry for analysis of various drugs undergoing development in biological specimens, including blood and urine.” He added that, to his knowledge, NTL was the only laboratory “currently using GC/MS/MS for confirmation of LSD in urine.” He also stated that any issue concerning the absence of testing in universities was probably a reflection of the high cost of the equipment. The defense expert, Dr. McBay, also stated that the equipment was not available in many laboratories because of its expense.

DISCUSSION

A

The armed forces have a compelling interest in addressing the corrosive impact of drug abuse on the readiness of the armed forces to engage in combat. The Supreme Court has emphasized that “it is the primary business of armies and navies to fight or be ready to fight wars should the occasion arise.” United States ex rel. Toth v. Quarles, 350 U.S. 11, 17, 76 S.Ct. 1, 100 L.Ed. 8 (1955). Congress, in Article 112a of the Uniform Code of Military Justice, has authorized court-martial proceedings against any servicemember who “wrongfully uses” controlled substances or commits a variety of other offenses involving illegal drugs.

To obtain a conviction under Article 112a, the prosecution must introduce sufficient evidence to convince a reasonable factfinder, beyond a reasonable doubt:

(a) That the accused used a controlled substance; and

(b) That the use by the accused was wrongful.

Para. 37b(2), Part IV, Manual, supra. Often, the prosecution may be able to prove wrongful drug use through an admission by the accused or observations by witnesses capable of identifying use of a controlled substance, particularly in terms of the effect on the behavior of the accused.

In some cases, however, the prosecution has no direct evidence of use and no circumstantial evidence in the form of any effect on the conduct of the accused. The only evidence in such cases may be the results of a drug test that identifies the presence of the drug or a metabolite in the accused’s body fluids.

In the Manual for Courts-Martial, the President has recognized our case law providing that proof of drug use requires proof of knowledge:

Knowledge of the presence of the controlled substance is a required component of use. Knowledge of the presence of the controlled substance may be inferred from the presence of the controlled substance in the accused’s body or from other circumstantial evidence. This permissive inference may be legally sufficient to satisfy the government’s burden of proof as to knowledge.

Para. 37c(10), Part IV.¹ To satisfy the second element of the offense — that the use was “wrongful”- — the President has made clear that the use must be “without legal justification or authorization.” The Manual provides that use “may be inferred to be wrongful in the absence of evidence to the contrary.” Para. 37c(5).

Our Court has considered these inferences in the context of our longstanding recognition that the serious threat to military readiness posed by drug abuse permits use of evidence-gathering techniques that would not necessarily pass muster in a civilian context. See, e.g., United States v. Jackson, 48 MJ 292 (1998); Murray v. Haldeman, 16 MJ 74, 78 (1983); United States v. Middleton, 10 MJ 123 (1981); United States v. Trottier, 9 MJ 337, 345-46 (1980). In United States v. Bickel, 30 MJ 277 (1990), a case upholding use of urinalysis test results in court-martial proceedings, we noted that such use is in contrast to the Supreme Court’s approach to civilian urinalysis programs. That approach reflects limited approval of compulsory urinalysis in circumstances where the Government has demonstrated that the duties of the employees warranted such testing and where the results were used for administrative, rather than prosecutorial, purposes. Id. at 281, citing Skinner v. Railway Labor Executives’ Association, 489 U.S. 602, 109 S.Ct. 1402, 103 L.Ed.2d 639 (1989), and National Treasury Employees Union v. Von Raab, 489 U.S. 656,109 S.Ct. 1384,103 L.Ed.2d 685 (1989); and n. 2.

Going well beyond the constitutional analysis that the Supreme Court has applied in civilian society, we have approved prosecuto-rial use of permissive inferences in criminal proceedings to sustain convictions based solely upon the results of a drug test. To sustain a prosecution in such cases, we have required only that the results be supported by expert testimony explaining the underlying scientific methodology and the significance of the test result, so as to “provid[e] a rational basis for inferring that the substance was knowingly used and that the use was wrongful.” United States v. Graham, 50 MJ 56, 58-59 (1999). We have permitted, but have not required, the factfinder to conclude on that basis that the Government has satisfied its burden to establish both elements of the offense — use of the controlled substance, as well' as the wrongfulness of the use. See, e.g., United States v. Thompson, 34 MJ 287 (CMA 1992); United States v. Ford, 23 MJ 331 (CMA 1987); United States v. Murphy, 23 MJ 310 (CMA 1987); United States v. Harper, 22 MJ 157 (CMA 1986).

Urinalysis testing has proved to be a powerful tool in the effort to combat drug use in the military, maintain good order and discipline, and ensure combat readiness. Drug testing, however, is designed and performed by humans and, as such, is fallible. The possibility of a positive result from an error in the test or from unknowing ingestion of a substance that does not trigger any reaction on the part of the servieemember is the worst nightmare of every good servicemem-ber and a cause of serious concern to the judicial system.

Reliance on urinalysis test results alone in courts-martial permits a criminal conviction to be adjudged solely on the basis of a test result when there is no other evidence of criminality, including no evidence of an observable reaction to the substance. Such a conviction may be adjudged in the case of a member of the armed forces who has given years of dedicated service to the country, who has an unblemished record, whose performance has been exemplary, who has served in combat, and who never has exhibited any impairment in function under the intensive daily scrutiny that military members receive from their superiors, peers, subordinates, friends, and family.

The result, in the case of conviction under Article 112a for use of LSD, may include a dishonorable discharge, confinement for 5 years, and total forfeitures. For a career servieemember, the discharge alone may result in the loss of hundreds of thousands of dollars in retired pay. For the member— and the member’s family — the consequences may be devastating. Because the consequences of drug abuse in the military may be all the more devastating to the nation, we have sustained use of urinalysis test results where they logically permit a rational factfin-der to conclude beyond a reasonable doubt that the results prove wrongful use. At the same time, we have not permitted use of test results where such logical proof of wrongful use has been lacking. See Art. 112a; United States v. Harper, supra.

Under applicable case law, the prosecution cannot rely solely on the presence in the body of the drug or its constituent elements. The cases which have permitted the inference of wrongfulness strictly require that the prosecution also establish the reliability of the testing methodology and explain the significance of the results of the test of the accused’s sample. The prosecution’s expert testimony must show: (1) that the “metabolite” is “not naturally produced by the body” or any substance other than the drug in question (see, e.g., Harper, supra at 161); (2) that the cutoff level and reported concentration are high enough to reasonably discount the possibility of unknowing ingestion and to indicate a reasonable likelihood that the user at some time would have “experienced the physical and psychological effects of the drug,” see id. at 163; Murphy, supra at 312; and (3) that the testing methodology reliably detected the presence and reliably quantified the concentration of the drug or metabolite in the sample. See Dau-bert, supra at 590, 113 S.Ct. 2786 (expert scientific testimony must “establish ] a standard of evidentiary reliability”). Once this showing is made, the prosecution is not required to disprove the possibility of unknowing ingestion in order to sustain the legal sufficiency of a conviction. See, e.g., Ford, 23 MJ at 336.

B

The case before us was litigated in light of this well-established case law. This case involves the novel use of the GC/MS/MS testing procedure for LSD, which, according to the record, was conducted by only one laboratory in the United States and was used in no other jurisdiction for purposes of criminal prosecution.

The issue is not whether members of the armed forces may be subjected to urinalysis testing or whether such a test may be used as the basis for a court-martial. The answer to both questions is squarely in the affirmative. Likewise, the question is not whether sufficient evidence might be presented to sustain use of the GC/MS/MS test for LSD.

Instead, the specific question we must resolve is whether the prosecution- — in this case — presented sufficient evidence on the record about the test that, under our case law, would permit a reasonable factfinder to conclude beyond a reasonable doubt that appellant used LSD and that the use was wrongful. See Jackson v. Virginia, 443 U.S. 307, 319, 99 S.Ct. 2781, 61 L.Ed.2d 560 (1979).

In United States v. Harper, supra, our Court recognized the inferences of drug use and wrongfulness that could be drawn from a positive drug-test result supported by expert testimony explaining the significance of the result. In finding the evidence sufficient to allow a “permissive inference of wrongfulness” to be drawn in that case, we noted in particular two aspects of the expert testimony presented by the prosecution about marijuana testing: (1) that the reported “readings ... ruled out the possibility of passive inhalation”; and (2) “that these particular results indicated that the user at sometime experienced the physical and psychological effects of the drug.” 22 MJ at 163. By contrast, the Government did not provide similar evidence of wrongfulness in this case.

Here, the prosecution introduced evidence that (1) LSD is not naturally produced by the body; (2) DoD has established a cutoff level of 200 pg/ml, above which all samples are reported as positive for LSD; (3) the GC/ MS/MS test of appellant’s urine sample reported a concentration level of 307 pg/ml; and (4) NTL’s quantitative results with respect to testing for LSD in urine have been validated against other tests. Those other tests, however, were tests that DoD declined to validate for forensic purposes. The latter point, therefore, proves only that the GC/ MS/MS test produced results consistent with a test that, itself, was not considered by the Department of Defense to be valid for purposes of criminal prosecution.

Of critical importance is that the Government did not prove the levels or frequency of error, which would indicate: (1) that the particular GC/MS/MS test reliably detected the presence of LSD metabolites in urine; (2) that GC/MS/MS reliably quantified the concentration of those metabolites; and (3) that the DoD cutoff level of 200 pg/ml was greater than the margin of error and sufficiently high to reasonably exclude the possibility of a false positive and establish the wrongfulness of any use. In particular, the Government introduced no evidence to show that it had taken into account what is necessary to eliminate the reasonable possibility of unknowing ingestion or a false positive.

The evidence left open the question whether the cutoff level established by DoD and the concentration level reported by NTL, in view of the margin of error, would reasonably exclude the possibility of a false positive and would indicate a reasonable likelihood that at some point a person would have experienced the physical and psychological effects of the drug. This is the type of evidence we required in Harper to ensure that any use was wrongful.² It is missing in this case.

C

The foregoing analysis leads us to the following disposition of the granted and specified issues: With respect to Specified Issue II, concerning the basis for the inference of wrongfulness, we conclude that there was no rational basis upon which the factfinders could draw a permissible inference of wrongfulness of use from the concentration of LSD reported in appellant’s urine sample. It may well be in a future ease that the Government could make the necessary showing with respect to the significance of the concentration levels and the reliability of this particular GC/MS/MS test or a follow-on version of the test. Because of the deficiencies in the prosecution’s presentation in this case, however, the evidence would not permit a reasonable factfinder to conclude that the GC/MS/MS test result in this case (1) reasonably excluded the possibility of a false positive and (2) indicated a reasonable likelihood that at some point a person would have experienced the physical and psychological effects of the drug.

With respect to Specified Issue I, concerning the cutoff level, we note that the law does not “require a particular cutoff level in order for the prosecution to establish beyond a reasonable doubt appellant’s knowing use of LSD.” (Emphasis added.) To the extent that the prosecution seeks to rely on the permissible inference of knowledge from the presence of the drug in the sample, however, the cutoff level must be such as to rationally permit factfinders to find beyond a reasonable doubt that an accused’s use was knowing.

In view of these considerations, we decline to address the Granted Issue and Specified Issue III in a manner that forecloses the Government from relying on the GC/MS/MS test or a follow-on version of the test in a subsequent case. It is appropriate to decide this case on a more limited basis. As noted earlier, our opinion leaves open the opportunity for the Government to make the necessary showing with respect to the significance of the concentration levels and the reliability of this particular GS/MS/MS test or a follow-on version of the test. Our discussion in Part B identifies the questions raised by the Government’s presentation at trial in this case regarding the reliability of the testing procedure and also notes the type of evidence that could sustain a conclusion of reliability. We leave for a future case, presented in accordance with Harper, the issues concerning the rulings of a military judge with respect to reliability of expert testimony under Daubert.

DECISION

The decision of the United States Army Court of Criminal Appeals is reversed. The findings and sentence are set aside. The Charge is dismissed.

1 . This provision is based on United States v. Harper, 22 MJ 157 (CMA 1986) (discussed at 160 and 161, infra), and United States v. Ford, 23 MJ 331 (CMA 1987) (discussed at 160-61, infra). See Drafters’ Analysis, Manual, supra at A23-11.

2 . Paragraph 37c(5), Part IV, Manual for Courts-Martial, United States (1995 ed.), quoted supra at 159, recognizes that, contrary to the suggestion in the dissent by Judge Sullivan, 163, this standard — which follows our precedent in Harper— does not establish new law. None of the post-Harper cases cited by the dissent involved the issue of whether the DoD cutoff level was consistent with the Harper standard.