By MARK SHERMAN – Associated Press
Judge Stephen Breyer wrote for the court that prosecutors must prove doctors knew they were illegally prescribing strong painkillers in violation of federal controlled substances law.
The decision came as the United States saw a record number of drug overdose deaths, many from the highly lethal opioid fentanyl.
Assessing the sentences of two doctors who each face more than two decades in prison, the judges ruled on a matter on which advocates for patients and doctors had urged the court to distinguish between criminal behavior and medical errors made in good faith.
He did it in the decision. Prosecutors, Breyer wrote, “must prove beyond a reasonable doubt that the defendant knowingly or intentionally acted in an unauthorized manner.” The judges ruled unanimously in favor of the doctors, although only six approved Breyer’s sentencing standard.
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Fear of aggressive lawsuits has previously led doctors to avoid prescribing opioids “against their best medical judgment,” the National Pain Advocacy Center told the court in a written filing.
But justice did not overturn the convictions of two doctors whose appeal was heard in February. Instead, he ordered federal appeals courts to reconsider their cases.
The court ruled on appeals from Xiulu Ruan of Mobile, Alabama, and Shakeel Kahn, who practiced medicine in Ft. Mohave, Arizona and Casper, Wyoming.
Ruan is serving a 21-year federal prison sentence. Kahn is in prison for up to 25 years. They will have another chance to argue that their convictions should be overturned.
Ruan and a partner, James Couch, were convicted of overprescribing drugs at their Alabama pain medicine clinic and at a pharmacy.
The two doctors “made their fortunes through a long-running agenda of illegally issuing prescriptions for addictive and potent controlled substances in response to their own financial incentives rather than the legitimate medical needs of their patients,” the company said. Solicitor General Elizabeth Prelogar, the top official in the Biden administration. Supreme Court attorney, told the court in a written filing.
They grossed $20 million between 2012 and a raid in 2015, prosecutors said. In 2014, they wrote 66,892 prescriptions, according to prosecutors.
Kahn was convicted of conspiracy to illegally distribute and distribute controlled substances causing death, including oxycodone, an opioid painkiller, and fentanyl, a synthetic opioid.
Kahn “routinely performed only cursory examination — or no examination at all — before prescribing controlled substances to a patient,” the Justice Department said in a Supreme Court brief.
Jessica Burch, of Lake Havasu City, Arizona, was a Kahn patient who died of an overdose in 2015.
Kahn wrote nearly 15,000 prescriptions for controlled substances over six years, totaling nearly 2.2 million pills, prosecutors said. Almost half were oxycodone, they said.
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