In United States v. Ruan, No. 17-12653 (Jan. 5, 2023) (Wilson, Newsom, Coogler) (per curiam), the Court affirmed in part and vacated in part the defendants' convictions.
This case was on remand from the Supreme Court, which clarified the mens rea standard for a doctor’s liability under the federal drug statute, 21 U.S.C. 841. The Supreme Court explained that the defendant must have knowingly or intentionally dispensed a controlled substance, and knowingly or intentionally did so in an unauthorized manner. What matters in that regard is the defendant’s subjective mens rea. Applying that new standard to the facts of this case, the Eleventh Circuit held that the district court’s “good faith” instruction was insufficient because it did not make clear that the defendant’s subjective intent was what mattered. As to the defendants’ substantive drug convictions, the Eleventh Circuit held that this erroneous instruction was not harmless because the jury may have convicted based on an objective reasonable-doctor standard and may not have convicted had it been properly instructed on a subjective standard. However, the Court found that the erroneous instruction was harmless as to the remaining convictions for conspiracy to violate the Controlled Substances Act, conspiracy to commit health care fraud, conspiracy to violate the Anti-Kickback statute, conspiracy to commit mail or wire fraud, conspiracy to violate RICO, and money laundering.