The US Supreme Court agreed to hear arguments in Ruan v. United States and Kahn v. United States. Both cases concern appeals from doctors who were convicted of illegally distributing prescription drugs. The cases center around the question of whether doctors can defend themselves against these claims by arguing that they acted in good faith.
In Ruan, physician Xuilu Ruan of Mobile, Alabama was convicted along with his partner, James Crouch, for overprescribing medications at their pain specialist clinic. Together, the two wrote more than 66,000 prescriptions in the year of 2014 alone. They amassed nearly $20 million in revenue between 2012 and 2015. Ruan argued that he used a case-by-case determination for each patient and always acted in good faith when prescribing medication.
The appeals court denied rehearing of the case on November 4, 2020, affirming and remanding in part for re-sentencing. Relying on language from the Controlled Substances Act and decisions in the Eleventh Circuit, Ruan contends that the district court erred by depriving him of a meaningful good faith defense to these charges. Ruan says there is no clear standard for criminal liability in the context of doctors prescribing controlled narcotics in the United States.
In Kahn, Shakeel Kahn, a physician who practiced in both Ft. Mohave, Arizona, and Casper, Wyoming, was convicted of unlawfully distributing controlled substances resulting in death. Kahn prescribed the opioid pain reliever oxycodone along with fentanyl, another controlled substance. Of the nearly 15,0000 prescriptions written by Kahn between 2011 and 2016, almost 1.1 million pills prescribed were oxycodone. In 2015, one of Kahn’s patients died of an overdose.
The court of appeals denied rehearing of the case on February 25, 2021, affirming the District Court of Wyoming’s decision and finding the evidence of guilt overwhelming. Khan argued that he had no idea that his patients were abusing the medication he prescribed. Khan’s defense aims to require the government to prove both that a practitioner intentionally issued a prescription not for a legitimate medical purpose and that its issuance was outside of the usual course of medical practice.
Both cases alleged that their respective juries should have been instructed that it had to be shown that the defendants intended to act outside the bounds of their normal professional practice to be found guilty. The Supreme Court will now have to decide whether prescribing prescription medication in good faith absolves doctors from criminal liability in the future.
