Free Sentencing Memo (Supporting Documents) - District Court of Arizona - Arizona

l Nancy I-Iineheliffe
State Bar No. 004052
2 11 West Jefferson, Suite 2
Phoenix, Arizona 85003-2302
3 (602) 252-3200
Attorney for Defendant
-4
5 UNITED STATES DISTRICT COURT
6 DISTRICT OF ARIZONA
7
8 United States of America,
9 Plaintiff No. CR 03-1060-PHX-PGR
ll 0 v. DEFENDANT MITZEL’S
SUPPLEMENTAL ATTACHMENT
1 1 Derek Ralph Mitzel,
1 2 Defendant.
13
14 Defendant Derek Ralph Mitzel by his attorney, Nancy I-Iinehcliffe, submits, as an
ll 5 attachment to Defendant Mitzel’s Sentencing Memorandum re Medical Condition, Request
16 for a Mitigated Sentence or, in the Alternative, Motion for Dewnward Departure, the report
17 of M. A Verso, MD., regarding the detendant’s medical condition.
18 Dated this gf day of August, 2005.
19 1.‘.1 .. .... _ .
anc ‘ me c 1‘ ef
20 Attorney for Defendant
21 Coply of this supplemental attachment
1‘na1 ed and e-1na1led this ‘i'“*“ day of
22 August, 2005, to:
23 Frederick Battista
Nanc%“|:l£5h¢|i"° Assistant U.S. Attorney
— 24 Two Renaissance Square
11Wm;¤;*¤¤¤¤ 40 North Central Avenue, Ste. :1200
Ph0enix,AZB5DDB 25 PIIOBIIIX, Arizona
‘ ‘‘‘‘‘‘‘‘ ‘ ‘i11‘ “ ‘‘‘‘‘1‘‘ ‘—‘ [email protected]
Pnsna: (502}252·3200 Q6
Fax; (E23)321-79813
27 By: MW
28
ase 2:03-cr-O1060—PGR Document 76 Filed O8/O9/2005 Page 1 of 3

a1.ns—s——&ea5 @:41 Fam: Turasslram P.2
Diplerneles ef the American Beard ef lntemal Medicine and the Subspeclally Beard el Endecrinelegy and Metahelism
PHOENIX ENDOCRINDLOGY CIJNIC. LTD-
PHll..lP LEVY, MD. Edwards Melee: Plas
M. A. VERSD. M.¤.. F.A.<:.l=·. 1300 N. 12lh sims, suse 600
Diabetes .McIIitud · Phoenix. Arlztma 85006
Esdsmdnelsgu & Metabolism {sez} 252—a699
Fax; {scm 253-0461
August 00, 2005
Review ef the file et Derek Mittel, birth date rliilarch, 1903.
This gentleman developed Type I diabetes at age 11. By the time
ef incarceratien in 2002, he had already develeped diabetic retinepathy
retlulrieg laser therapy bllaterally. in additien, he already had diabetic
renal disease with an amcunt ef mierealbuminurla ccnsistent with
nephrltlc syndrerne as well as an elevatlen et serum ereatlnlne. He ls
being treated fer high chelesterel with minimally acceptable results.
in addltlen, his bleed pressure was abeve the level censldered
desirable fer semeene with dlebetes. Despite having labile bleed
sugars, diabetic eentrel was judged te he geed since his Ate (an
average ef bleed sugars fer the past three menths} tended te be
satisfactery. Altheugh the patient is stated te werk eat, he has been
gaining weight gradually in the past few years se that his current
weight is 50 lbs heavier than three years age. l wish te be emphatic
that the weight gain has been gradual with HD partlcular shert time In
which he put en this weight.
lt is my epinierl that his care in pI’a$tL|l'I has been geed. Altheugh
his diabetes weuld be better served by feur lnjectlens ef lnsuilnlday, he
has been fellewed by the nursing staff with multiple Accwchek
i readings as well as eccaslerqai standard bleed tests. He has received
tluatlnellt fer his wumplalnts and has been sent te .speclall5i‘5 fer
further therapy. _
Fregnesis fer this gentleman is net geed. Althcugh the semni
creatinine level has net increased in the past three years, (ln fact, the
level is lewer new than In 2002), the marked rnicrealbumlnurla
indicates his being ln a high risk greup fer renal failure. Hewever, he is
Case 2:03-cr-01060-PGR Document 76 Filed O8/O9/2005 Page 2 of 3

»=v.1G—E=~&·1ao$ wv:-41 FROM: T¤¤a5:;=·.1mo F-.;
not as far down ln kldnoy function as would havo boon oxpootod glvoh
tho longth of time ho hoo had this nroblom. Not only has his serum
oroatinino lovol romainod stablo but ho still has a good blood count,
which indlcatos ho still has a lot of hmotionol kldnoy tloouo lott. l
assumo ho has boon stahilizosl by Liainopril, an AGE inhihitor.
· ltowovor, ll ho roturno to smoking, this will nogato oorno of thlo
laudatorlr olroot. lt will also lncnoaso his rloln tor coronary ortory and
porlolioral artory dlsoaso. Elosldos tho lncroasod risk of dlahotos
olono, hlo olovatod cholostorol also incroaooo his riolr ol' a cardiac
ovont. I aoaurno tboro lo somo docroaoo in lncldonoo olnco ho lo on
. anti-cholostoml modlcatlon. 1'hc Hol: wlll Incroooo if hlo blood
prossuro is not rnoro tlghtly oontrollod.
Although ho has a numbor of uotontial problomo and could tooo
dialysis within 5 yoara aa woll ao coronary artory disoooo ond otroko ln
10-Ill yoars, ho is not in omlnonl: dangor of dooth within tho noxt tow
yoaro. Ho hoo boon oonlplnlnlng ol ohouldor pain, which ls thought. to
roprooont at norvo prohlom ln hls nook or may bo tho otort of dlollotlo
nouropathy. This has tho ootontlal to bocomo a wor! Pdlnful condition
although it is not llfo throatonlng.
It ohould bo atatod that tho oationt soomo otalalo now but has
lnultlplo risk factors: thot may rosult ln oarly domino. ln particular, ho
ls lllroly to rogulro dialysis in a row yoars. (Although ho would bo a
oandidato lor ronal transplant, unloos ho has o kldnoy donor, ho would
bo plaood on tho bottom of tho Iiot IIQGBIIBE of tho oyo dlsoaso ho has
had In tho past, which indicates a hlghor llltollhood of poor proghoals.)
Ho Io in tho hlghoot risk group for hourt attack andlor stroko within tho
nont ton yoars.
l havo not oddrossod tho fact that ho has had oplsodoo or low
augoro wlthout having symptoms, tho ao··callod hypoglycomla
onawaronosc. This gonoraily indicatoo a problorn with tho norvos to
tho abdomcn and hoart. lf this oontlnuoo, ho booomoo furlhor at rlolt of
auddon doath. In all, I would put hls llfo oxpootanoy at 20 your! at tho
maximum.
Blnooroly yours,
Wa *g",,:.··•»=»o QW?
lll. A. vomo, M.¤., F.A.o.l¤., l=.A.¤.E.
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