US v. Okechukwu Dimkpa

Circuit 4Mar 3, 2026

Split Score

SplitScore: 47/100

Case Summary

Disposition

Affirmed

The Fourth Circuit affirmed the denial of Dr. Okechukwu Dimkpa’s § 2255 motion challenging his oxycodone-distribution convictions. The court held that Dimkpa procedurally defaulted his claim that, under Ruan v. United States, the government had to prove he subjectively knew his prescriptions were unauthorized because that legal argument was reasonably available at the time of his 2019 guilty plea.

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Circuit Split Identified

Legal Issue

Whether, in prosecutions of physicians under 21 U.S.C. § 841(a)(1), the government must prove that the doctor subjectively knew or intended that the prescriptions were unauthorized (subjective scienter) or whether it is sufficient to show the prescriptions were objectively outside the course of professional practice (objective standard).

Circuit Positions

Circuit 4(this circuit)

Objective standard – government need not prove the physician knew prescriptions were unauthorized.

Circuit 7Circuit 9

Subjective scienter required – government must prove the physician knowingly or intentionally acted without authorization.

Conflict Summary

Before the Supreme Court’s 2022 decision in Ruan, most circuits — including the Fourth — applied an objective ‘outside the course of professional practice’ test that did not require proof of the doctor’s knowledge or intent. The Seventh and Ninth Circuits, however, required the government to show the physician subjectively intended to act without authorization.

Parties & Counsel

Parties

Appellant:Okechukwu Dimkpa
Appellee:United States of America

Legal Counsel

Appellant:Blair T. Westover & Beau B. Brindley, The Law Offices of Beau B. Brindley, Chicago, IL
Appellee:Julie C. Niemeier, Assistant U.S. Attorney; on brief Randall S. Galyon, Acting U.S. Attorney, Office of the U.S. Attorney, Greensboro, NC