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FOR PUBLICATION
In the
United States Court of Appeals
For the Eleventh Circuit
No. 25-11171
UNITED STATES OF AMERICA,
Plaintiff-Appellee,
versus
SCOTT ANDREW HOLLINGTON,
Defendant-Appellant.
Appeal from the United States District Court
for the Middle District of Florida
D.C. Docket No. 3:22-cr-00141-TJC-PDB-1
Before WILLIAM PRYOR, Chief Judge, and JILL PRYOR and BRASHER,
Circuit Judges.
WILLIAM PRYOR, Chief Judge:
This appeal requires us to decide whether sufficient evidence supports a physician’s convictions for unlawfully prescribing
controlled substances and for obstruction of justice and whether
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his sentence is reasonable. Scott Hollington ran an addiction clinic.
A jury convicted him of unlawfully prescribing controlled substances to five undercover officers and four real patients. It also
convicted him of obstruction of justice because he altered patient
records after his indictment. The district court sentenced him to
144 months of imprisonment, an upward variance from the guideline range of 30 to 37 months to account for sexual misconduct
Hollington committed against his patients. We affirm.
I. BACKGROUND
On March 23, 2023, a grand jury returned a superseding indictment charging Scott Hollington with 14 counts of unlawfully
distributing and dispensing controlled substances, one count of
conspiracy to commit that offense, and five counts of obstruction
of justice. The indictment alleged that Hollington prescribed controlled substances “not for a legitimate medical purpose in the
usual course of professional practice” to five undercover officers
and four patients. It also alleged that Hollington altered the undercover officers’ medical records after his indictment. Hollington
pleaded not guilty.
At trial, the four patients testified. The first patient, A.N.B.,
testified that she visited Hollington’s clinic to obtain treatment for
her heroin addiction. After a cursory evaluation, he prescribed her
buprenorphine. When it came time to refill the prescription,
A.N.B. told Hollington she could not afford to pay for an office visit
or the prescription. Hollington told her “not to worry” and directed
her to sit next to him on a couch. He then told her “how pretty
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[she] was,” “started rubbing his hand through [her] hair and down
[her] back,” and said that she “would be able to pay for [her] prescriptions . . . if [she] just let him taste [her].” A.N.B. allowed Hollington to perform oral sex on her in exchange for the prescriptions
and $300.
Another patient, E.L.M., testified that she visited Hollington
to continue her Suboxone prescription. After noting that E.L.M.’s
medical records showed that she had previously been prescribed
Xanax, Hollington remarked, “we don’t really do Xanax here in this
office, but maybe we can work out a deal.” He then asked her if he
could perform oral sex on her, and when she declined, he forcibly
removed her pants and sexually assaulted her. After E.L.M. left,
Hollington wrote her several prescriptions.
Patient D.A. testified that she visited Hollington for pain
management. Hollington prescribed her Subutex and benzodiazepine for about a year. D.A. was later incarcerated, and upon release,
she returned to Hollington to renew her prescriptions. She told
him she could not afford her prescriptions, and Hollington told her
not “to worry about payment,” commented on her appearance,
and proposed meeting outside the office. Soon after, he paid for a
hotel room for D.A. and performed oral sex on her there.
Finally, patient K.W. testified that she began visiting Hollington to obtain an Adderall prescription. At her appointment, he
asked her questions about her previous heroin addiction, including
how she “support[ed] [her] habit” and whether she “had a sugar
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daddy.” Hollington then wrote a script for Adderall without reviewing the medical records K.W. had brought to the appointment, conducting a physical examination, or taking her vitals. K.W.
also told him she could not sleep without ZzzQuil and that she had
been diagnosed with insomnia but not treated for it. Hollington
prescribed her Ambien. For the next two years, K.W. saw a nurse
practitioner at the clinic. But one time, she encountered Hollington. He “asked if he could see [her] bathing suit under [her] sundress” and “told [her] about him losing his virginity.” She declined
his overtures, and Hollington never engaged in any sexual contact
with her.
The five undercover officers testified to obtaining prescriptions from Hollington or his staff after minimal or no medical evaluation. The prosecution introduced undercover video footage corroborating the officers’ testimony.
The prosecution also introduced evidence that Hollington
added entries to the officers’ medical charts following his initial indictment. On November 4, 2022—a week after his initial indictment—Hollington called the officer who posed as “Kevin Lee” and
asked a series of medical questions he did not previously ask before
issuing Lee’s prescriptions. Hollington told Lee to answer truthfully, and he recorded Lee’s answers in his chart that same day.
On November 16, 2022, Hollington added entries to the
other four undercover officers’ medical charts. These entries stated
that the officers had “falsely” told Hollington they had various
symptoms and medical conditions. But the officers testified that
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they never told Hollington they had any of the conditions he recorded in their charts.
Hollington moved for a judgment of acquittal. See FED. R.
CRIM. P. 29. The district court granted the motion only as to the
conspiracy count. The jury convicted Hollington on the remaining
19 counts.
A probation officer prepared a presentence investigation report, which calculated a guideline imprisonment range of 30 to 37
months. It applied a total offense level of 18, which included twopoint adjustments for abuse of a position of trust and obstruction
of justice. See United States Sentencing Guidelines Manual
§§ 3B1.3, 3C1.1 (Nov. 2024). And it applied a criminal history category of II, based on a state sexual battery conviction Hollington
received during the pendency of his federal case. Hollington contested the enhancement for abuse of his position because his
charges for unlawfully prescribing controlled substances presupposed his status as a doctor.
At the sentencing hearing, the district court overruled Hollington’s objections and adopted the guideline range of 30 to 37
months. The government requested a 37-month sentence to run
consecutively to Hollington’s three-year state sentence. It submitted written victim impact statements from D.A. and E.L.M. and
statements from two more victims who did not testify at trial. One
of the non-testifying victims wrote that Hollington sexually assaulted her during an appointment. The other wrote that Hollington had “molest[ed]” her.
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Hollington requested a below-guideline sentence. His exwife testified that his incarceration would negatively impact their
disabled son. Hollington read an allocution statement in which he
denied trading “money for drugs, drugs for money, money for sex,
sex for money, drugs for sex, or sex for drugs.” He maintained his
innocence and stated he had “been failed by the system.” But he
said that “[h]aving been convicted, I accept that I have done
wrong.” Hollington’s counsel acknowledged that “[t]he allegations
of sex are . . . reprehensible,” but he argued that they were “separate from” his charges of unlawfully prescribing controlled substances.
The district court remarked that it “didn’t hear a word of
remorse” during Hollington’s allocution. It explained that it was
“surprised the guidelines were as low as they were” and noted that
“the drug counts don’t really take into account the terrible conduct
of Mr. Hollington towards these women patients.” It stated that it
was not “apparent” that a 37-month sentence would be sufficient
under the sentencing factors. See 18 U.S.C. § 3553(a). The district
court gave Hollington notice that it was considering an upward
variance. It then adjourned the sentencing hearing and scheduled a
second sentencing hearing. At the second sentencing hearing, Hollington gave a statement expressing remorse. Nevertheless, the district court sentenced Hollington to 144 months of imprisonment,
to run consecutively to his three-year state sentence. It explained
that the guideline range was inadequate because it was “driv[en by]
the . . . quantity of the drugs” and “ha[d] very little to do with” Hollington’s sexual misconduct.
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II. STANDARDS OF REVIEW
“We review the sufficiency of evidence to support a conviction de novo, viewing the evidence in the light most favorable to the
government and drawing all reasonable inferences and credibility
choices in favor of the jury’s verdict.” United States v. Taylor, 480
F.3d 1025, 1026 (11th Cir. 2007). We review the reasonableness of
a sentence for abuse of discretion. Gall v. United States, 552 U.S. 38,
56 (2007).
III. DISCUSSION
We divide this discussion into three parts. First, we explain
that sufficient evidence supports Hollington’s convictions for unlawfully prescribing controlled substances. Second, we explain that
sufficient evidence supports his convictions for obstruction of justice. Finally, we explain that Hollington’s sentence is reasonable.
A. Sufficient Evidence Supports Hollington’s Convictions for Unlawfully
Prescribing Controlled Substances.
Hollington challenges the sufficiency of the evidence for his
convictions of unlawfully prescribing controlled substances to
A.N.B., D.A., and K.W. He does not challenge his convictions as to
E.L.M. or the undercover officers. We must sustain the jury’s verdict “if any reasonable construction of the evidence would have allowed the jury to find the defendant guilty beyond a reasonable
doubt.” United States v. Grzybowicz, 747 F.3d 1296, 1304 (11th Cir.
2014) (citation modified).
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It is “unlawful for any person knowingly or intentionally . . .
to . . . distribute[] or dispense[] . . . a controlled substance” unless
“authorized by” a statutory exception. 21 U.S.C. § 841(a)(1). One
exception allows “practitioner[s]” to issue “prescription[s]” for controlled substances, id. § 829(a)–(b), “for a legitimate medical purpose . . . in the usual course of . . . professional practice.” 21 C.F.R.
§ 1306.04(a). A doctor violates section 841 if he knowingly or intentionally “prescribes controlled substances either (1) for no legitimate medical purpose or (2) outside the usual course of professional practice.” United States v. Heaton, 59 F.4th 1226, 1239 (11th
Cir. 2023); see also Ruan v. United States, 142 S. Ct. 2370, 2375 (2022).
The prosecution provided sufficient evidence that Hollington unlawfully prescribed A.N.B. buprenorphine. Hollington concedes that A.N.B. “engaged in consensual, albeit coerced, sexual activity with [him] in exchange for prescriptions and money.” We
held in Heaton that a physician’s prescribing of controlled substances to a patient with whom he had a sexual relationship “fell
outside the usual course of professional practice.” 59 F.4th at 1243.
Hollington contends that Heaton is distinguishable because a state
medical board previously warned the convicted physician that he
was “prohibit[ed] . . . from having sexual relationships with . . . patients.” Id. at 1232. By contrast, Hollington argues, the prosecution
did not prove he knew his conduct fell outside the usual course of
professional practice. But “[j]urors are entitled—indeed, expected—to make inferences based on common sense.” United States
v. Caldwell, 81 F.4th 1160, 1176 (11th Cir. 2023). And it is common USCA11 Case: 25-11171 Document: 44-1 Date Filed: 08/11/2026 Page: 9 of 15
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sense that “exchang[ing] [sex] for prescriptions” is not professional
behavior.
Sufficient evidence also supports Hollington’s conviction as
to D.A. Hollington contends that there was insufficient evidence
he traded prescriptions for sex because he wrote the scripts “several
days before h[is] sexual encounter” with D.A. But a reasonable jury
could infer that Hollington wrote the prescriptions in anticipation
of obtaining sex in return.
Finally, sufficient evidence supports Hollington’s conviction
as to K.W. The jury found that Hollington unlawfully prescribed
K.W. both amphetamine and zolpidem-tartrate, either of which
can independently support the conviction. See 21 U.S.C. § 841(a)(1).
But Hollington challenged only the finding that he unlawfully prescribed zolpidem-tartrate, so he forfeited any challenge to the jury’s
amphetamine finding. See United States v. Morel, 63 F.4th 913, 919
(11th Cir. 2023). And any error as to the zolpidem-tartrate finding
was harmless because the district court sentenced Hollington only
for distributing amphetamine, which carries a longer sentence than
unlawful distribution of zolpidem-tartrate. See 21 C.F.R.
§§ 1308.12(d)(1), 1308.14(c)(58) (classifying amphetamine as schedule II and zolpidem-tartrate as schedule IV controlled substances);
21 U.S.C. §§ 841(b)(1)(C), (b)(2) (providing, absent aggravating factors, a 20-year maximum sentence for schedule II violations and a
5-year maximum for schedule IV).
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Forfeiture aside, the prosecution proved that Hollington unlawfully prescribed amphetamine to K.W. She testified that Hollington prescribed her amphetamine without reviewing the medical records she provided and without checking her vital signs or
performing any physical assessment. She also testified that other
doctors refused to prescribe Adderall to her because of the other
medications that she took. The prosecution offered expert testimony that a doctor should perform a drug screen, check a patient’s
blood pressure and pulse, and review a patient’s medical records
before prescribing that drug. Because Hollington prescribed K.W.
amphetamine without taking those steps when other doctors
would not prescribe it at all, a reasonable jury could find that he
did so outside the usual course of professional practice.
B. Sufficient Evidence Supports Hollington’s Obstruction Convictions.
Hollington also challenges his convictions for obstruction of
justice. A person commits obstruction of justice if he “corruptly . . .
endeavors to influence, obstruct, or impede, the due administration of justice.” 18 U.S.C. § 1503(a). To prove obstruction, “the
government must [establish] that the defendant knowingly and intentionally undertook an action from which an obstruction of justice was a reasonably foreseeable result.” United States v. Thomas,
916 F.2d 647, 651 (11th Cir. 1990).
Sufficient evidence supports Hollington’s obstruction convictions. Hollington made the entries in the undercover officers’
medical charts soon after his indictment, and he could have reasonably foreseen that these records would be evidence at his trial. See USCA11 Case: 25-11171 Document: 44-1 Date Filed: 08/11/2026 Page: 11 of 15
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United States v. Aguilar, 515 U.S. 593, 599 (1995) (requiring that the
defendant have “knowledge that his actions are likely to affect [a]
judicial proceeding”). In four charts, Hollington added false entries
that the officers previously reported various conditions they never
reported having. In the fifth, he accurately recounted the information Lee told him over the phone after the indictment. But the
entry did not say when Lee provided that information and could
imply that Hollington’s screening preceded his prescription when
it did not. The jury could infer Hollington modified the medical
charts to serve as evidence that he conducted more thorough evaluations of those patients than he performed in person.
C. The District Court Imposed a Reasonable Sentence.
We employ a two-step framework to review the reasonableness of a sentence. First, we consider “whether the district court
committed any significant procedural error, such as miscalculating
the advisory guideline[] range, treating the guidelines as mandatory, failing to consider the [section] 3553(a) factors, selecting a sentence based on clearly erroneous facts, or failing to adequately explain the chosen sentence.” United States v. Cubero, 754 F.3d 888, 892
(11th Cir. 2014). Second, we consider “whether the sentence is substantively unreasonable under the totality of the circumstances and
in [the] light of the [section] 3553(a) factors.” Id. “[W]e are to vacate
the sentence if, but only if, we are left with the definite and firm
conviction that the district court committed a clear error of judgment in weighing the [section] 3553(a) factors by arriving at a sentence that lies outside the range of reasonable sentences dictated USCA11 Case: 25-11171 Document: 44-1 Date Filed: 08/11/2026 Page: 12 of 15
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by the facts of the case.” United States v. Irey, 612 F.3d 1160, 1190
(11th Cir. 2010) (en banc) (citation modified). Hollington has not
established either procedural or substantive error.
1. The District Court Did Not Procedurally Err.
Hollington argues that his sentence “rest[s] . . . on factually
unsupported findings.” See Cubero, 754 F.3d at 892 (explaining that
a district court procedurally errs by “selecting a sentence based on
clearly erroneous facts”). He contends the district court misunderstood the basis for his conviction when it remarked that Hollington’s unlawful conduct was “the prescribing of [drugs] not for a legitimate medical purpose.” Yet several of Hollington’s convictions
were indeed for prescribing drugs not for a legitimate medical purpose. And even if the district court misspoke, it made clear that
Hollington’s sexual misconduct drove his above-guideline sentence, not the theory of how he unlawfully prescribed controlled
substances.
Hollington also contends that the district court erroneously
said that he sexually assaulted “victims”—plural—when only one
victim, E.L.M., testified at trial that Hollington sexually assaulted
her. But the district court was entitled to credit the statements of
the two non-testifying victims whom Hollington sexually assaulted. See 18 U.S.C. § 3661 (“No limitation shall be placed on the
information concerning the . . . conduct of a person convicted of
an offense which a court . . . may receive and consider for the purpose of imposing an appropriate sentence.”); United States v. Overstreet, 713 F.3d 627, 636–38 (11th Cir. 2013) (affirming consideration USCA11 Case: 25-11171 Document: 44-1 Date Filed: 08/11/2026 Page: 13 of 15
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of uncharged criminal conduct as part of the section 3553(a) analysis).
Hollington also contends that “the vast increase” in his sentence beyond the advisory range “is not supported by sufficient justification.” See 18 U.S.C. § 3553(c) (requiring district court to state
“the reasons for its imposition of the particular sentence”); see also
Cubero, 754 F.3d at 892 (explaining that a district court procedurally
errs by “failing to adequately explain the chosen sentence”). Yet the
district court explained that an upward variance was necessary because the advisory range was driven by the quantity of drugs Hollington prescribed and did not account for his sexual misconduct.
That explanation was sufficient. See United States v. Steiger, 99 F.4th
1316, 1322 (11th Cir. 2024) (en banc) (explaining that “it isn’t onerous to comply with [s]ection 3553(c)”); United States v. Nilsen, 967
F.2d 539, 545–46 (11th Cir. 1992) (holding that district court provided sufficient explanation for above-guideline sentence by stating
that the guideline range “did not adequately reflect the seriousness
of [the defendant’s] criminal history”).
2. Hollington’s Sentence Is Substantively Reasonable.
The district court did not abuse its discretion in sentencing
Hollington to 144 months of imprisonment. It explained that Hollington’s conduct was severe because he abused his status as a doctor to harm vulnerable patients. See 18 U.S.C. § 3553(a)(2)(A). Although the guidelines provided an enhancement for that abuse,
U.S.S.G. § 3B1.3, the district court reasonably concluded that the
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that a severe sentence was necessary to protect the public because
it could not “rule out” that Hollington was a “predator[]” who
might assault other people.
Hollington contends that his sentence is unreasonable because two other physicians who unlawfully prescribed controlled
substances to patients with whom they had sexual relationships received lesser sentences. See Heaton, 59 F.4th at 1238 (72-month sentence); United States v. Shaker, 827 F. App’x 204, 206 (3d Cir. Sep. 24,
2020) (41-month sentence). Under section 3553(a), district courts
shall consider the “need to avoid unwarranted sentence disparities
among defendants with similar records who have been found
guilty of similar conduct.” 18 U.S.C. § 3553(a)(6). But “there can be
no ‘unwarranted’ sentencing disparities among []defendants who
are not similarly situated.” United States v. Azmat, 805 F.3d 1018,
1048 (11th Cir. 2015). Hollington is not similarly situated to the defendants in Heaton and Shaker because neither defendant committed sexual assault.
Hollington also contends that his sentence is excessive in the
light of his three-year state sentence for sexual battery. But precedent forecloses that argument. Section 3553(a)(6) aims to avoid
“unwarranted sentence disparities among federal defendants who
are similarly situated instead of disparate federal and state sentences.” United States v. Docampo, 573 F.3d 1091, 1102 (11th Cir.
2009).
Finally, Hollington argues that his sentence is unreasonable
because the government did not request an upward variance. But
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it “is well settled” that “the sentencing court is not bound by the
parties’ . . . recommendations.” United States v. Johnson, 132 F.3d
628, 630 (11th Cir. 1998). The district court did not err by “exercising [its] own legal decisionmaking authority” to fashion an appropriate sentence. Rita v. United States, 551 U.S. 338, 356 (2007).
To be sure, Hollington’s 144-month sentence represents a
substantial upward variance from his guideline range of 30 to 37
months. But we routinely affirm significant upward variances. See,
e.g., United States v. Turner, 474 F.3d 1265, 1274, 1281 (11th Cir.
2007) (affirming 240-month sentence where guideline range was 51
to 63 months); United States v. Osorio-Moreno, 814 F.3d 1282, 1284
(11th Cir. 2016) (affirming 120-month sentence where guideline
range was 51 to 63 months). And Hollington’s sentence falls well
below the statutory maximum term of 20 years. See 21 U.S.C.
§ 841(b)(1)(C); United States v. Stanley, 739 F.3d 633, 656 (11th Cir.
2014) (“A sentence imposed well below the statutory maximum
penalty is an indicator of a reasonable sentence.”). We cannot say
we are left with a “definite and firm conviction that the district
court committed a clear error of judgment.” Irey, 612 F.3d at 1190
(citation modified).
IV. CONCLUSION
We AFFIRM Hollington’s convictions and sentence.