Case Explained: 26a0171p.06

Court: United States Court of Appeals for the Sixth Circuit Filed: 2026-06-16 The Sixth Circuit affirmed the convictions and sentences of Evann Herrell, Mark Grenkoski, and Keri McFarlane for conspiracy to distribute controlled substances, healthcare fraud, and money laundering arising from their operation of a “pill mill” clinic. The court held that the evidence was sufficient to support the verdicts under the standard that any rational trier of fact could find the essential elements of the crimes beyond a reasonable doubt when viewing the evidence in the light most favorable to the prosecution. Specifically, applying the subjective mens rea standard established in *United States v. Ruan*, the court found ample evidence that the defendants subjectively knew their prescriptions were not issued for a legitimate medical purpose or in the usual course of professional practice, evidenced by their prescribing habits, failure to screen patients, and knowledge of drug diversion. Regarding evidentiary rulings, the court applied an abuse of discretion standard, finding no error in the exclusion of evidence regarding the elimination of the “X-waiver” rule due to its low probative value given the timeline mismatch, nor in the admission of hearsay statements offered to show their effect on the listener or why a witness acted as they did. The court also determined that any isolated evidentiary errors, such as the admission of text messages and a passing reference to patient deaths without a limiting instruction, were harmless because they did not materially affect the verdict in light of the extensive evidence presented over a 30-day trial. The court further rejected McFarlane’s motion to sever, concluding she failed to demonstrate compelling, specific, and actual prejudice from the joint trial, and upheld the jury instructions on mens rea and deliberate ignorance as legally accurate under *Ruan*. Finally, the court affirmed the denial of Grenkoski’s Rule 35 motion to correct or reduce his sentence because the district court correctly determined it lacked jurisdiction after the statutory 14-day deadline had passed. As a practical consequence, the defendants’ convictions and prison terms remain in effect: Herrell is sentenced to 120 months, Grenkoski to 108 months, and McFarlane to 52 months imprisonment. The judgment of the District Court for the Eastern District of Kentucky is affirmed, and the case is closed with no further relief granted. Do It For The Case Law is a news reporting service. Nothing in this episode constitutes legal advice.