## Facts

- Dr. William Eliot Hurwitz operated a pain-management practice and prescribed high dosages and large quantities of opioids to chronic-pain patients.
- Some patients were arrested for selling or attempting to sell controlled substances, including opioids obtained by prescription, and identified Hurwitz as the prescribing source.
- Federal investigators obtained and executed a warrant to search Hurwitz’s medical office for records and items connected to suspected drug offenses.
- The government prosecuted Hurwitz on drug-trafficking-related charges, including conspiracy, a continuing criminal enterprise charge, and multiple counts of unlawful distribution of controlled substances under 21 U.S.C. § 841, along with healthcare-fraud counts.
- At trial, the government argued Hurwitz’s prescribing fell outside legitimate medical practice; Hurwitz argued his prescribing reflected medical judgment in treating severe pain, supported by expert and patient testimony.
- The district court denied suppression of the office-search evidence and declined to instruct the jury that good faith could negate liability on the § 841 counts, limiting “good faith” to the healthcare-fraud charges.
- A jury convicted Hurwitz on numerous drug-related counts, and he appealed.

## Issues

1. Whether the warrant for the search of Hurwitz’s medical office lacked Fourth Amendment particularity such that seized evidence should have been suppressed.
2. Whether the jury instructions on physician liability under 21 U.S.C. § 841 erroneously prevented the jury from considering Hurwitz’s good faith in prescribing controlled substances.

## Decision

- The Fourth Circuit affirmed the denial of the suppression motion, holding the warrant met the particularity requirement when read with its incorporated attachment.
- The Fourth Circuit vacated Hurwitz’s convictions and remanded for a new trial because the jury was improperly instructed on the role of good faith in a physician prosecution under § 841.
- The court held the instructional error was prejudicial because it risked conviction without permitting the jury to assess whether Hurwitz subjectively believed he was prescribing for legitimate medical purposes within professional practice.

## Legal Principles

- A search warrant may satisfy the Fourth Amendment’s particularity requirement when it limits the search by incorporating an attachment that specifically describes items to be seized.
- Under the Controlled Substances Act, physicians are authorized to prescribe controlled substances only when acting for a legitimate medical purpose and within the usual course of professional practice.
- In § 841 prosecutions of physicians, the physician’s good faith is relevant to whether the government has proved that prescriptions were issued outside professional practice and with the required mens rea.
- Jury instructions that remove good faith from the jury’s consideration on § 841 counts misstate the governing standard for physician prescribing and can require a new trial when prejudicial.

## Conclusion

The Fourth Circuit upheld the office search but set aside Hurwitz’s drug convictions because the jury was not properly instructed that a physician’s good faith belief in the medical legitimacy of prescribing is relevant to whether prescriptions were issued outside the usual course of professional practice under § 841.


United States v. Hurwitz, 459 F.3d 463 (4th Cir. 2006)