Issue before the Court: Whether evidence of second-degree manslaughters (reckless) was legally sufficient in trial of doctor whose patients overdosed on proscribed opioids?

 

Factual Background: Dr. XuHui Li, a board-certified physician, ran a pain management clinic that essentially acted as a “pill mill.” He routinely proscribed opioids, Xanax, and other medications upon request, with little to no physical examinations or follow-up. He was made aware that at least some of his patients were addicts at risk of overdosing, because he received calls to that effect from several patients’ concerned family members and medical practitioners.

Two of Dr. XuHui Li’s patients ultimately died of overdoses after filling prescriptions he’d written for them. Neither was a patient whom Dr. XuHui Li had been advised had an addiction or overdose history. 

Dr. XuHui Li was charged in an 198 count indictment with various offenses related to his prescription-writing practices, including 2 counts of second-degree manslaughter for the overdose deaths of the two deceased patients.  

 

Held: In a 6-1 decision (Wilson, J., dissenting), the Court held that the evidence of manslaughter was legally sufficient. According to the majority, even absent evidence that Dr. XuHui Li was directly advised that the two deceased patients were abusing their prescriptions and at risk of overdosing, the jury could nevertheless infer from surrounding circumstances that he was aware of and consciously disregarded a substantial and unjustifiable risk of that result. 

 

CAL Observes: As Judge Wilson cautions in dissent, the ramifications of this decision have the potential to be sweeping, not only for medical practitioners but also for individual dealers in the midst of the current opioid crisis. Employing the majority’s reasoning, it seems that any dealer would be guilty of second-degree manslaughter if one of his customers died after overdosing on drugs he supplied.  

While the logic employed by the majority here applies equally to medical practitioners, they are not likely to bear the brunt of this decision. As Judge Wilson notes in his dissent, the prosecution of doctors for homicide is exceedingly rare. This is that rare case in which the doctor’s conduct was so “grotesquely reckless” that punishing him for the deaths of these two patients seemed a moral imperative, even if not a legally sound one.