Criminal: Cancer patient sentenced to 48 months’ imprisonment

Where the district court committed no clear error when it found that the Bureau of Prisons could provide the necessary care for the defendant’s cancer, its 48-month sentence was affirmed.

Background

Christopher Kirk Gray appeals the 48-month sentence imposed upon revocation of his supervised release.

Cancer

In asserting that his revocation sentence is procedurally unreasonable, Gray argues that the district court erroneously found that the Bureau of Prisons, or BOP, could adequately care for his unique form of cancer. While Gray acknowledges that the government presented evidence that the BOP could provide him with the drugs he was currently prescribed, Gray asserts that the evidence failed to establish that the BOP could closely monitor his condition.

The district court committed no clear error when it found that the BOP could provide the necessary care for Gray’s cancer. First, the testifying BOP physician explained that she reviewed Gray’s medical records and had no reservations about treating his cancer, and she indicated that she consulted with a BOP oncologist, who also had no concerns and confirmed that the BOP would be able to continue with the treatment plan formulated by Gray’s private physician. The BOP physician also testified that the BOP could send Gray to outside specialists and oncologists, when necessary, and to outside hospitals and facilities for required procedures.

And although defense counsel suggested that Gray’s care may be interrupted if he was incarcerated, the BOP physician assured the court that the BOP would not interrupt Gray’s treatment. Given the testimony and evidence before it, the district court could reasonably find that the BOP had the resources and capabilities necessary to care for Gray, including any necessary monitoring that was part of his treatment plan. Accordingly, the district court did not clearly err in determining that the BOP could adequately care for Gray’s cancer during his incarceration.

Priority

Gray also argues that his sentence is substantively unreasonable because the court erroneously prioritized the need to incarcerate him over his need for required medical care. The court disagrees.

Because the imposed 48-month sentence here is below Gray’s advisory policy statement range of 51 to 60 months in prison, it is presumptively reasonable. Moreover, 18 U.S.C. § 3583(e) directs district courts to consider many of the same § 3553(a) sentencing factors that are relevant to substantive criminal sentencings, such as the defendant’s history and characteristics; the nature of the offense; the need for deterrence and protecting the public and the need to provide medical care “in the most effective manner.”

Here, the district court expressly balanced the allowed § 3553 factors it deemed relevant, including Gray’s serious medical needs and his repeated breaches of trust by distributing large quantities of methamphetamine while on supervised release. Indeed, it is undisputed that the district court was well aware of Gray’s medical condition and struggled with incarcerating a defendant with serious medical needs. But, exercising its considerable discretion, the district court ultimately determined that prison time was necessary, specifically highlighting Gray’s recidivism and egregious breaches of trust, as well as its finding that the BOP could adequately care for Gray’s cancer.

And while Gray suggests that the court should have given more weight to his need for medical care, his “disagreement with the district court’s weighing of the sentencing factors” is insufficient to render the sentence unreasonable. Under the totality of the circumstances, Gray’s revocation sentence is substantively reasonable.

Affirmed.

United States v. Gray, Case No. 24-4420, July 8, 2025. 4th Cir. (per curiam), from WDVA at Danville (Jones). Mary E. Maguire and Erin Trodden for Appellant. Zachary T. Lee and Jonathan Jones for Appellee. VLW 025-2-256. 6 pp.