RICHMOND – A federal appeals court heard arguments Oct. 28 over whether federal drug regulation prevents North Carolina from imposing additional restrictions on the prescribing and dispensing of mifepristone, the medication at the center of a long-running state lawsuit.
The Fourth Circuit’s official audio archive identifies the case as Amy Bryant v. Timothy Moore, No. 24-1576. It lists Judges Robert King, Julius Richardson and Henry Floyd on the panel and Erin Hawley, Paul Mezzina and Nicholas Brod as the lawyers presenting arguments.
Reuters reported that judges questioned the federal-preemption argument. Lawyers for Bryant and the state defended the FDA’s regulatory choices, while counsel for Republican legislative intervenors defended North Carolina’s additional restrictions. Those exchanges do not establish how the panel will rule.
The appeal follows a split April 30, 2024, decision by U.S. District Judge Catherine Eagles. Her opinion held that federal law displaced several state requirements: physician-only prescribing; in-person prescribing, dispensing and administration; scheduling an in-person follow-up appointment; and reporting nonfatal adverse events to the FDA.
Eagles did not invalidate every requirement challenged in the case. She left in place provisions concerning an advance in-person consultation, ultrasound, examination, blood testing and reporting to state health authorities.
The distinction in that ruling was between restrictions the FDA had considered and removed and requirements addressing informed consent or medical practice that the agency had not expressly rejected. Eagles concluded that the first group interfered with Congress’ regulatory framework, while the second did not.
Bryant is a physician who prescribes mifepristone. Her challenge asks when a state may impose conditions beyond the federal rules for distributing an approved drug. The legislative intervenors have defended the restrictions as serving state interests.
The Oct. 28 development is an appellate hearing, not a new order reinstating or striking down the disputed provisions. The case concerns the scope of government regulatory authority, with potential consequences for how the drug can be provided in North Carolina.
Sources
- Fourth Circuit: official oral-argument record
- Reuters: October 28 hearing coverage
- District court: April 30, 2024 opinion and order
Photo Credit: File photograph of the Lewis F. Powell Jr. U.S. Courthouse in Richmond, Virginia, April 1, 2015, by Smash the Iron Cage, via Wikimedia Commons; CC BY-SA 4.0. Cropped and resized; photographic adaptation licensed CC BY-SA 4.0. Context image, not the October 2026 hearing.
Editor’s Note: This article was drafted with the assistance of artificial intelligence and was reviewed and fact-checked by a member of the NC Political News editorial team before publication.