Section 242 “Results From” Requires Both But-For and Proximate Cause—and a Jury Must Be Told So

Case: United States of America v. Shronda Covington (No. 25-4282) & United States of America v. Tonya Farley (No. 25-4283)
Court: U.S. Court of Appeals for the Fourth Circuit
Date: July 2, 2026 (published)
Disposition: § 1001 convictions affirmed; Covington’s § 242 conviction vacated for instructional error; both sentences vacated; Farley resentencing required due to Guidelines error.

I. Introduction

This consolidated Fourth Circuit decision arises from the death of an incarcerated person (“W.W.”) after a prolonged medical crisis in Bureau of Prisons custody. Following an Office of the Inspector General (“OIG”) investigation, two BOP employees—correctional supervisor Shronda Covington and nurse Tonya Farley—were prosecuted.

The core legal issues on appeal were:

  • Section 242 causation: whether the felony enhancement in 18 U.S.C. § 242 (“bodily injury … results from”) requires proximate cause in addition to but-for cause, and whether the jury had to be instructed accordingly.
  • False statements: whether evidence was sufficient to sustain convictions under 18 U.S.C. § 1001, particularly the materiality element.
  • Sentencing (Guidelines): whether Farley’s January 9, 2021 conduct could be used to enhance the Guidelines calculation for her sole conviction (false statements in April 2023), in light of the definition of “relevant conduct” in U.S.S.G. § 1B1.3 and the new acquitted-conduct limitation in § 1B1.3(c).

II. Summary of the Opinion

The Fourth Circuit held that, for the § 242 enhancement, “bodily injury … results from” requires both but-for causation and proximate causation. Although the evidence was sufficient to convict Covington under that standard, the district court erred by instructing the jury only on but-for causation. The panel vacated Covington’s § 242 conviction because the government did not show the instructional error was harmless.

The court affirmed both defendants’ § 1001 convictions, rejecting challenges to materiality, due-process discovery theories, evidentiary/severance arguments, and various new-trial claims. Finally, the court vacated Farley’s sentence because the district court’s “relevant conduct” analysis under U.S.S.G. § 1B1.3(a)(1) was missing or legally flawed—particularly as to whether conduct more than two years earlier occurred “during,” “in preparation for,” or “in the course of attempting to avoid detection or responsibility for” the false-statement offense.

III. Analysis

A. New Rule / Clarified Doctrine: Proximate Cause Is an Element of the § 242 “Results From” Enhancement

The opinion’s principal precedential contribution is its statutory interpretation of § 242’s enhancement language. The court treats “results from” as importing the criminal-law “hybrid” of:

  • Actual cause (but-for): the result would not have happened absent the conduct; and
  • Legal cause (proximate cause): a foreseeability/scope-of-risk limitation preventing liability where the outcome is too attenuated or “mere fortuity.”

On that basis, the court holds: “bodily injury” only “results from” a § 242 violation if the defendant’s conduct was both the but-for and proximate cause of the injury.

B. Precedents Cited (and How They Shape the Holding)

1. Causation Framework and Presumptions

  • Burrage v. United States: supplied the foundational statement that crimes requiring a specified result generally require both actual and proximate causation. The court leaned on Burrage’s general rule even while distinguishing Burrage’s drug-statute context.
  • Paroline v. United States: reinforced that proximate cause may be required even absent express statutory language and described proximate cause as a “scope of the risk” limitation.
  • Hewitt v. United States: used to justify that Congress legislates against background presumptions, including causation principles.
  • LaFave and Model Penal Code § 2.03: cited as persuasive criminal-law authorities supporting a proximate-cause default rule in “result” crimes.

2. Civil Rights Statutes’ Parallel Text and History

  • United States v. Harris: pivotal Fourth Circuit authority construing identical “if death results” language in 18 U.S.C. § 241 to mean “proximate result.” Harris anchored the Fourth Circuit’s insistence that §§ 241 and 242 “travel together.”
  • United States v. Hayes and United States v. Guillette: out-of-circuit authorities supporting proximate cause in the cognate civil rights context; Hayes was also the case Harris quoted.
  • United States v. Williams: cited for the shared Reconstruction-era lineage of §§ 241 and 242 and for the interpretive force of their parallel development.

3. Rejecting the Government’s Attempted Analogy to Drug “Results From” Enhancements

  • United States v. Patterson and United States v. Alvarado: Fourth Circuit cases holding no proximate-cause requirement in 21 U.S.C. § 841(b). The court treated these as context-specific and refused to transplant their strict-liability flavor into § 242.
  • United States v. Pineda-Doval and United States v. Webb: cited to show circuit disagreement about extending the no-proximate-cause rule beyond drug sentencing factors.
  • United States v. United States Gypsum Co.: invoked to stress that strict liability is “generally disfavored,” reinforcing the court’s reluctance to construe § 242 as a strict-liability enhancement.

4. Statutory Interpretation Canons (Used Carefully)

  • Russello v. United States: acknowledged the expressio unius inference (inclusion in one section, omission in another), but the court limited that logic when comparing different statutes enacted at different times and for different purposes.
  • Yates v. United States and Bruesewitz v. Wyeth LLC: supported skepticism of cross-statute comparisons and post-enactment legislative developments as evidence of earlier congressional intent.

5. Instructional Error and Harmless-Error Framework

  • United States v. Raza: provided the reversible-error test for refusing a requested instruction (correctness; not substantially covered; important to defense).
  • Neder v. United States and United States v. Brown: supplied two harmless-error pathways: (i) the jury necessarily found the omitted element; or (ii) the omitted element was uncontested and supported by overwhelming evidence such that the verdict would be the same.
  • United States v. McFadden and United States v. Garcia-Lagunas: guided the court’s analysis and allocation of the harmless-error burden to the government.

6. Substantive Eighth Amendment Deliberate Indifference (as the § 242 Right at Issue)

  • Hixson v. Moran: supplied the objective/subjective test for deliberate indifference to serious medical needs.
  • Screws v. United States and United States v. Cowden: addressed § 242’s willfulness mens rea—no need for malice or “thinking in constitutional terms”; reckless disregard suffices under Fourth Circuit articulation.
  • United States v. Perkins: used to define “bodily injury” broadly for the enhancement.

7. Section 1001 Materiality and Related Issues

  • United States v. Gaudin: supplied the governing materiality definition (“capable of influencing”).
  • United States v. Smith: central to rejecting the “they already knew” defense—materiality does not evaporate because investigators knew the truth.
  • Kyles v. Whitley and United States v. Robinson: set the Due Process “team” standard for disclosure obligations; the court found no plain error because defendants failed to show BOP employees were part of OIG’s investigative team.
  • United States v. Taylor: reinforced that different government components can constitute different investigative teams.

8. Sentencing “Relevant Conduct” and Guidelines Calculation Discipline

  • Gall v. United States and United States v. Diaz-Ibarra: emphasized that Guidelines miscalculation is procedural error infecting the sentencing process.
  • Witte v. United States: used to frame that Guidelines ranges can incorporate relevant conduct beyond the offense of conviction—subject to the Guidelines’ definitions.
  • United States v. Agyekum: important comparator: relevant conduct must be linked under § 1B1.3(a)(1); Agyekum’s “temporally and qualitatively linked” logic undermined the government’s reliance on Farley’s two-years-earlier conduct.
  • United States v. Watts: distinguished the court’s obligation to calculate Guidelines correctly from the broader discretion to consider information at ultimate sentencing under 18 U.S.C. § 3661.
  • United States v. Shafa: cited (in a cautionary footnote) to ensure the new acquitted-conduct amendment is not read into meaninglessness if reached on remand.

C. Legal Reasoning

1. Why Proximate Cause Is Read into § 242’s “Results From” Language

The majority’s reasoning is structurally cumulative:

  • Textual parity: “results from” is classic result-language that usually carries proximate cause.
  • Intra-family coherence: § 241 and § 242 share ancestry and were amended together; Harris already reads proximate cause into § 241’s “if death results.” Divergent readings would be “passing strange.”
  • Background presumptions: criminal law generally requires proximate cause for result elements unless Congress clearly displaces it.
  • Rejecting the drug-statute analogy: § 841(b)’s strict-liability-style enhancement is treated as exceptional, not a general interpretive template.

2. Sufficiency vs. Instructional Error: The Critical Distinction

Even after holding proximate cause is required, the court:

  • Rejected acquittal: under sufficiency review, any rational juror could find proximate causation based on evidence Covington knew W.W. was repeatedly falling and did nothing.
  • Granted vacatur: under Neder, harmlessness fails if the record could rationally support a contrary proximate-cause finding—especially given the intervening ten-hour suicide-watch sequence and other actors’ failures after Covington left.

3. The Dissent’s Harmless-Error Theory and the Majority’s Implicit Rejection

Judge Rushing agreed proximate cause is required but would affirm under a “jury necessarily found it anyway” theory. The dissent relied on:

  • United States v. Whitfield and United States v. Brown: harmlessness where an “equivalent or identical” finding was made via other instructions.

The dissent argued the deliberate-indifference instructions—requiring actual knowledge of a “risk of harm”—necessarily entailed foreseeability of bodily injury, and thus proximate cause. The majority, however, focused on the factual “attenuation” possibility (other employees’ later conduct) and treated proximate cause as not compelled by the verdict. Practically, the split signals that, in § 242 omission cases, courts may differ on whether “risk of harm” findings substitute for proximate causation, especially where later intervening events complicate foreseeability.

4. Farley’s Sentencing: “Relevant Conduct” Cannot Be Reduced to “Context”

The court’s remand on sentencing is a methodological holding: the district court must apply the Guidelines’ defined term, not an evidentiary notion of relevance. Under U.S.S.G. § 1B1.3(a)(1), the question is whether January 9, 2021 acts/omissions occurred:

  • “during the commission of” the April 2023 § 1001 offense,
  • “in preparation for” it, or
  • “in the course of attempting to avoid detection or responsibility for” it.

Because the district court’s explanation (“there would be no false statements without” the earlier conduct; it “established the basis”) did not map onto those temporal/functional criteria, the Fourth Circuit vacated and remanded without definitively deciding the factual application in the first instance.

D. Impact

1. Section 242 Prosecutions in the Fourth Circuit

  • Charging and proof: prosecutors seeking felony penalties for bodily injury (or death) under § 242 should anticipate litigating proximate cause explicitly—especially in multi-actor institutional settings where intervening omissions are common.
  • Jury instructions: district courts should give a proximate-cause instruction when “results from” is at issue; otherwise, convictions risk vacatur even when evidence is sufficient.
  • Trial strategy: defendants gain a doctrinally validated defense theme: even if but-for causation is arguable, foreseeability/attenuation may break proximate cause.

2. Section 1001 Cases

  • Materiality remains broad: following United States v. Smith, lies can be material even if investigators already know the truth; the question is capability to influence the investigation’s course.

3. Sentencing After the 2024 Amendment (U.S.S.G. § 1B1.3(c))

  • Step discipline: courts must first satisfy § 1B1.3(a) before even reaching acquitted-conduct limits in § 1B1.3(c).
  • Temporal limits matter: a long gap between prior conduct and the offense of conviction makes § 1B1.3(a)(1) relevance harder to establish without a clear “preparation” or “avoid detection” nexus.
  • Foreshadowed disputes: the opinion’s footnote caution (citing United States v. Shafa) signals that, if reached, “establishes” in § 1B1.3(c) must be interpreted narrowly enough to preserve the amendment’s intended effect.

IV. Complex Concepts Simplified

1. “But-For” vs. “Proximate” Cause

  • But-for cause: “Would the injury have happened anyway?” If yes, no but-for causation.
  • Proximate cause: “Is the injury a natural, foreseeable result of the defendant’s conduct (within the risk the conduct created)?” If the chain becomes too unusual or depends on extraordinary intervening events, proximate cause can fail.

2. “Deliberate Indifference” (Eighth Amendment Medical Care)

  • Objective prong: the medical need is serious (obvious to a layperson or diagnosed as requiring treatment).
  • Subjective prong: the official actually knew of the risk and disregarded it—more than negligence, less than purposeful harm.

3. “Materiality” Under § 1001

A false statement is material if it is capable of influencing the agency’s decisions—even if the agency suspects or knows it is false.

4. “Relevant Conduct” Under the Guidelines

“Relevant conduct” is not “anything related.” Under § 1B1.3(a)(1), it must occur during, in preparation for, or in avoiding detection/responsibility for the offense of conviction (unless another guideline rule “otherwise specifies”).

V. Conclusion

This decision sets an important Fourth Circuit rule for civil-rights prosecutions: the § 242 felony enhancement for “bodily injury results” demands proof of both but-for and proximate causation, and juries must be instructed on proximate cause when the enhancement is in play. The court’s willingness to vacate despite sufficient evidence underscores that causation is not merely a sentencing formality but an element requiring a properly guided jury.

Separately, the opinion strengthens procedural rigor in Guidelines calculation—especially for defendants convicted of process crimes like § 1001—by insisting that “relevant conduct” cannot be justified as mere “context” and must satisfy § 1B1.3(a)(1)’s temporal/functional constraints, with the new acquitted-conduct amendment waiting in the wings for future cases.