In United States v. Heaton, No. 20-12568 (Feb. 14, 2023) (Wilson, Jill Pryor, Hull), the Court affirmed Dr. Heaton’s convictions.

Dr. Heaton was charged with one count of conspiracy to unlawfully distribute and dispense controlled substances, in violation of 21 U.S.C. §§ 841(b)(1)(C), 843, & 846; 102 counts of unlawful dispensing of controlled substances to patients, in violation of 21 U.S.C. §§ 841(a)(1), (b)(1)(C); and 27 counts of aiding and abetting a patient’s acquisition of controlled substances by deception, in violation of 21 U.S.C. § 843(a)(3) and 18 U.S.C. § 2.  He proceeded to trial and was found not guilty on the conspiracy and guilty on all substantive counts.

On appeal, he challenged the district court’s jury instructions.  He first challenged the court’s use of “or” instead of “and” in its § 841(a) offense instruction.  He argued that § 841(a) requires the government to prove that he prescribed medication both “outside the course of professional practice” and “for no legitimate medical purpose.”  The Court disagreed, citing to prior caselaw and 21 C.F.R. § 1306.04(a).

Dr. Heaton next argued that the court’s instructions as to mens rea for § 841(a) ran afoul of the Supreme Court’s recent decision in Ruan.  More specifically, he argued that the district court erred in instructing the jury to apply an objective standard to the “outside the usual course of professional practice” requirement.  The Court agreed that because the instruction allowed the jury to convict Dr. Heaton without considering whether he knowingly or intentionally issued prescriptions outside the usual course of professional practice, the jury instruction was erroneous under Ruan.  The Court, however, found any instructional error to be harmless because the evidence extensively proved beyond a reasonable doubt that Dr. Heaton knew his prescriptions were issued outside the usual course of professional practice.  In so holding, the Court distinguished this case from that of Ruan on remand, wherein the Court found the instructional error not to be harmless.

Finally, the Court rejected Dr. Heaton’s argument that § 841 is unconstitutionally vague as applied to him.