Fourth Circuit Delivers Major Post-Ruan Decision Reversing All Counts of Conviction Against Dr. Joel Smithers

On Friday, February 2, 2024, in U.S. v. Joel Smithers, the Fourth Circuit reversed all counts of conviction against Martinsville, Virginia osteopath and pain-killer provider, Joel Smithers. The Government marshalled a mountain of evidence against Smithers, showing that he operated a classic pill-mill operation. But the case went to trial before the Supreme Court's landmark 2022 decision in Ruan v. United States. Ruan held that, in unlawful distribution cases against doctors, "[a]fter a defendant produces evidence that he or she was authorized to dispense controlled substances, the Government must prove beyond a reasonable doubt that the defendant knew that he or she was acting in an unauthorized manner, or intended to do so." Acting in an unauthorized manner means acting without a legitimate medical purpose outside the scope of professional practice. Prior to Ruan, most circuits allowed the Government to prevail if it proved either that a physician acted without a legitimate medical purpose or that he/she acted outside the scope of professional practice. And, importantly, the prosecution was allowed to prove that a doctor acted outside the scope of professional practice under an objective standard, without regard to the defendant's subjective intent or knowledge.  Ruan changed all that. Dr. Smithers was convicted under an instruction that allowed the jury to convict him without regard to his state of mind. That is why he gets a new trial. The unanimous panel opinion, written by Judge Roger Gregory, rejected various waiver and harmless error arguments advanced by the Government. Congratulations to Beau Brindley and his colleagues for the victory. Here is the opinion:

U.S. v. Joel Smithers (4th Cir. 2024).

(wisenberg)