ORDER AND JUDGMENT
CARLOS F. LUCERO, Circuit Judge.
Miranda Rentz pled guilty to one count of involuntary manslaughter and one count of assault resulting in serious bodily injury. The district court imposed an above-Guidelines sentence, which Rentz now appeals as substantively unreasonable. Exercising jurisdiction under 18 U.S.C. § 3742(a) and 28 U.S.C. § 1291, we affirm.
On January 17, 2015, Rentz caused a two-car, head-on collision that resulted in the death of John Doe and life-threatening injuries to Jane Doe. Rentz admitted that she had been drinking the day of the accident and that she was taking medication she knew should not be mixed with alcohol. Her blood alcohol content registered as.19 approximately two hours after the crash.
Rentz's husband reported to a criminal investigator that he had received a call from Rentz shortly before the accident in which she was distraught and said something to the effect of, "I'm taking off my seatbelt. Whatever happens, happens." The couple's son, who also heard the phone call, provided a similar account. A witness to the accident stated that Rentz was speeding and crossed into the oncoming lane of traffic in front of the Does' vehicle. And a data recording device recovered from Rentz's vehicle indicates she was traveling at 75 miles per hour, her accelerator was 96% depressed at the time of the crash, and Rentz did not attempt to break. According to emergency personnel who responded to the accident, Rentz asked responders to "let [her] die." Rentz later denied being suicidal on the day of the accident but admitted being upset with her husband and stated that but for his mistreatment, the crash never would have happened.
Rentz was indicted on one count of involuntary manslaughter, in violation of 18 U.S.C. § 1112, and one count of assault resulting in serious bodily injury, in violation of 18 U.S.C. § 113(a)(6). She pled guilty to both charges without a plea agreement. A Presentence Investigation Report ("PSR") calculated Rentz's total offense level at 21 with a criminal history category of I, for an advisory Guidelines range of 37-46 months' imprisonment. Prior to sentencing, the government moved for an upward departure or variance, arguing Rentz acted with extreme recklessness by deliberately crashing her car. It requested that Rentz be sentenced to 96 months. In response to the government's request, the Probation Office filed an addendum to the PSR stating that Rentz's conduct involved "aggravating factors exceeding the typical degree of recklessness present in the heartland of involuntary manslaughter cases" and recommended a two-level upward departure, which would result in a Guidelines range of 46-57 months. Rentz opposed the government's request for an above-Guidelines sentence, arguing that she was not suicidal and did not intentionally cause the accident. She requested a downward departure or variance and a sentence of 24 months.
At sentencing, the government presented evidence regarding Rentz's intent to crash her vehicle. After hearing argument and testimony, the district court announced it would impose a non-Guidelines sentence. It found that "the facts of this case support beyond a reasonable doubt that the defendant was suicidal the day of the incident and she intended to harm herself in a vehicular collision, giving no regard to the other innocent lives who would forever be impacted by such decision." It concluded a variance was warranted in light of the 18 U.S.C. § 3553(a) factors, emphasizing the extreme injuries suffered by both victims and the terrible impact the accident had on the victims' children. In evaluating Rentz's conduct, the court acknowledged that "she didn't take a gun out and shoot anybody," but concluded that "she took a car out, and in wanting to kill herself, then took on to kill someone else and injure someone very, very badly." The district court stated that it would upwardly depart by six levels, for a Guidelines range of 70-87 months. It imposed a sentence of 84 months' imprisonment. Rentz timely appealed.
The sole issue presented on appeal is whether Rentz's sentence is substantively reasonable.
Rentz asserts that the district court erred by increasing her sentence based on an improper factor, i.e., her mental and emotional health issues. We reject this framing of the district court's decision. Although the district court discussed Rentz's suicidal state, it did so only in the context of finding she acted with extreme recklessness in purposefully crashing her car.
We have previously held that a district court may impose an upward variance on this basis:
Rentz argues that the district court failed to appreciate that her mental health impairments and suicidal state reduced her ability to recognize the impact of her behavior.
Finally, Rentz argues that the district court did not explain why it rejected the PSR's recommendation of a two-level increase and did not provide a written reason for its variance. This argument blurs the line between substantive and procedural reasonableness. A district court's failure "to adequately explain the chosen sentence—including an explanation for any deviation from the Guidelines range"—is considered a procedural, not substantive, error.
Because Rentz has not shown that her sentence was outside the "range of possible outcomes the facts and law at issue can fairly support,"