Eleventh Circuit: Autopsy Reports Are Testimonial Evidence, Subject to Confrontation Clause

In United States v. Ignasiak, the Eleventh Circuit reversed the defendant’s convictions for health care fraud and unlawful dispensing of controlled substances, holding that the district court violated the Confrontation Clause by admitting autopsy reports into evidence without requiring in-court testimony by the medical examiners who performed the autopsies.

In this case, a jury convicted Dr. Robert Ignasiak of health care fraud and dispensing controlled substances in violation of 18 U.S.C. § 1347 and 21 U.S.C. § 841(a)(1)-(2), respectively. As evidence of fraud and improperly prescribing medications, the Government called two medical examiners to testify about autopsies they had performed, allegedly as a result of Dr. Ignasiak’s practices. During this testimony, the Government admitted (over the defendant’s objections) charts and autopsy reports of other patients whom the testifying doctors did not examine and questioned the doctors about those reports.

On appeal, the defendant argued that the admission of these reports/charts into evidence with no indication as to the availability of the doctors who actually performed the autopsies and authored the reports violated the Confrontation Clause and the rules of evidence. The Eleventh Circuit agreed.

The court of appeals, citing Crawford v. Washington, held that autopsy reports are testimonial evidence and, therefore, subject to the Confrontation Clause. The court also noted that there was no evidence that the individuals who performed the exams and authored the reports were unavailable or that the defendant had an opportunity to cross examine them. The defendant’s convictions were reversed and the case was remanded.