Doctor’s ‘Pill Mill’ Convictions Vacated Under Supreme Court Law

A doctor convicted of unlawfully dispensing opioids had his convictions vacated and his case remanded for a new trial in light of new US Supreme Court guidance requiring increased proof of mental state when prosecuting “pill mill” operations.

The US Court of Appeals for the Tenth Circuit on Friday vacated the convictions of Dr. Shakeel Kahn, explaining that the jury that weighed his case wasn’t properly instructed on the mental state required to secure a conviction. The jury was repeatedly told it could convict Khan if he acted outside the usual course of professional medical practice, but it should have been instructed that the government had to prove beyond a reasonable doubt that Khan knowingly or intentionally acted in an unauthorized manner, the appeals court said.

The jury instructions “were erroneous because they allowed the jury to convict Dr. Kahn after concluding either that Dr. Kahn subjectively knew a prescription was issued not for a legitimate medical purpose, or that he issued a prescription that was objectively not in the usual course of professional practice,” the court said. Both of these approaches “run counter” to the Supreme Court’s 2022 opinion in Ruan v. United States, the appeals court said.

In Ruan—which considered both Khan’s case and a related case against an Alabama doctor—the Supreme Court made it harder to convict doctors in connection with pill mill arrangements by requiring prosecutors to prove that doctors knew they were acting in an unauthorized manner, or intended to do so.

The Tenth Circuit’s ruling comes one month after the US Court of Appeals for the Eleventh Circuit vacated the Alabama doctor’s convictions in light of Ruan. But unlike the Eleventh Circuit—which allowed certain convictions on conspiracy charges to stand—the Tenth Circuit vacated all of Kahn’s convictions, saying they were all tainted by the erroneous jury instructions.

Judge Mary Beck Briscoe wrote the opinion. Judges Scott M. Matheson Jr. and Joel M. Carson joined.

Beau B. Brindley Law Office represents Kahn. Lawyers with the US Attorney’s Offices in Yellowstone, Wyo., and Casper, Wyo., prosecuted the case.

The case is United States v. Khan, 10th Cir., No. 19-8054, 2/3/23.