Case Title: Commonwealth v. Accime

Citation: 

Docket Number: SJC-12081

State: massachusetts

Court: Massachusetts Supreme Court

Date: 2017-02-13T00:00:00Z

Document:
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SJC-12081 
 
COMMONWEALTH  vs.  RICHIE ACCIME. 
 
 
 
Suffolk.     November 9, 2016. - February 13, 2017. 
 
Present:  Gants, C.J., Botsford, Lenk, Hines, Gaziano, Lowy, & 
Budd, JJ. 
 
 
Idle and Disorderly Person.  Self-Defense.  Practice, Criminal, 
Instructions to jury. 
 
 
 
 
Complaint received and sworn to in the Central Division of 
the Boston Municipal Court Department on July 19, 2011. 
 
 
The case was tried before Annette Forde, J. 
 
 
The Supreme Judicial Court granted an application for 
direct appellate review. 
 
 
 
Jeffrey A. Garland, Committee for Public Counsel Services, 
for the defendant. 
 
Donna Jalbert Patalano, Assistant District Attorney (Neil 
J. Flynn, Jr., Assistant District Attorney, also present) for 
the Commonwealth. 
 
Bettina Toner, Robert D. Fleischner, Jennifer Honig, Chetan 
Tiwari, & Phillip Kassel, for Center for Public Representation & 
another, amici curiae, submitted a brief. 
 
 
 
BOTSFORD, J.  The defendant, Richie Accime, appeals from 
his disorderly conduct conviction under G. L. c. 272, § 53, 
2 
 
 
 
claiming there was insufficient evidence to support it.  The 
charge was brought against him in relation to his conduct as a 
patient in the psychiatric area of the emergency department at a 
hospital in Boston.  Accime argues that in the circumstances of 
this case, the Commonwealth failed to prove he consciously 
disregarded a "substantial and unjustifiable risk of public 
inconvenience, annoyance, or alarm."  Emphasizing the setting-
specific inquiry required by our case law, we agree with the 
defendant and reverse the judgment of conviction.1 
 
1.  Background.  a.  Facts.  Viewing the facts in the light 
most favorable to the Commonwealth, the jury could have found 
the following.  In the afternoon of June 5, 2011, the defendant 
was brought by ambulance and against his will to the emergency 
department of a hospital.  There he was involuntarily detained 
in a small room in the psychiatric area of the hospital's 
emergency department.  Although this detention was purportedly 
pursuant to G. L. c. 123, § 12 (a), which allows the temporary 
restraint and hospitalization of persons posing a serious risk 
of harm by reason of mental illness, according to the defendant, 
who testified at trial, he was shown no evidence of compliance 
with the procedures required by § 12 (a), nor was any such 
evidence produced at trial. 
                     
 
1 We acknowledge the amicus brief of The Center for Public 
Representation and The Mental Health Legal Advisors Committee. 
3 
 
 
 
 
When told he would likely be held in the hospital for two 
or three days, the defendant began to shout.  Medical staff 
requested assistance from hospital security officers and, on 
their arrival, instructed the officers not to allow the 
defendant to leave.  At approximately 8 P.M., a security officer 
called for additional assistance; at least four other security 
responded.  At least one officer was armed with a baton and 
handcuffs in addition to the pepper spray that was carried by at 
least three officers. 
 
The officers attempted to persuade the defendant to take 
medication that he told them he did not want.  Having heard the 
defendant repeatedly say, "I don't want to take the medication.  
I want to get out of here," the officers told him that if he 
refused to take the medication, he would be restrained, and 
later, that if he did not comply with orders he would be pepper 
sprayed. 
 
In response to the officers' orders, the defendant stated, 
"I'm not taking any medications.  You can't hold me here against 
my will"; "I don't want to fuck anybody up, but I guarantee I'm 
leaving one way or the other"; "if anybody puts their hands on 
me, I'm going to fuck them up"; and "if anybody pepper sprays me 
I'm going to beat the fuck out of them."  Furthermore, when the 
officers first entered the room, the defendant had said, "The 
first person in, I'm going to break their arm.  And then the 
4 
 
 
 
next person in, I'm going to break theirs, and then the next, 
and then the next."  Other patients were "looking on"; as a 
precautionary measure, officers directed anyone in the hallway 
to an alternate route "just in case something happened if [the 
confrontation] spilled out" of the room.2  The officers asked the 
defendant to calm down, and repeated their request that he 
accept medication. 
 
The defendant took his shirt off,3 and began pacing with 
clenched fists, hitting the open palm of one hand with the 
clenched fist of the other.  He repeated his desire to leave, 
insisted no one was going to stop him, and refused to sit on a 
stretcher to be restrained.  He then adopted a "fighting" 
stance.4 
 
After officers threatened the use of pepper spray and 
approached the defendant, the defendant "put his hands out like 
                     
 
2 There was no evidence introduced to suggest that any 
aspect of the disturbance the defendant was claimed to have 
caused in the room ever extended beyond the confines of the 
room. 
 
 
3 The defendant was described at trial as having a muscular 
build, weighing about 270 pounds, and standing about six feet, 
four inches in height. 
 
 
4 There was conflicting testimony as to whether this stance 
preceded or followed a supervising officer's statement to the 
defendant that he would be pepper sprayed if he refused to 
comply:  of three testifying officers, one testified that the 
stance came before the threat of pepper spray, one testified 
that the threat came first, and the third offered conflicting 
testimony on this point. 
5 
 
 
 
he wanted to fight."  At least three, and as many as six, 
officers then directed pepper spray at the defendant's head and 
face.5  The defendant retreated into a corner of the room and 
subsequently agreed to sit on the stretcher, where he was 
handcuffed before the spray was rinsed off him. 
 
b.  Procedural history.  On July 19, 2011, a criminal 
complaint issued from the Boston Municipal Court Department 
charging the defendant with threatening to commit a crime in 
violation of G. L. c. 275, § 2; disorderly conduct in violation 
of G. L. c. 272, § 53; and assault in violation of G. L. c. 265, 
§ 13A.  The defendant was tried before a jury in June, 2014.  He 
moved for a required finding of not guilty at the close of the 
Commonwealth's case and again at the close of his case; the 
trial judge denied each motion.  The judge also refused the 
defendant's requested instructions as to his right to use self-
                     
 
5 Two separate audio recordings of officers, describing the 
incident shortly after it had occurred, were admitted as trial 
exhibits and played several times before the jury.  In one 
recording, one officer said that "six of us sprayed the guy," 
and described the defendant as "built like a frigging refridge 
. . . too big, too jacked . . . like six four and 280 pounds of 
pure, just, ripped nastiness."  Stating in the recording that 
"we" "doused" and "covered" the defendant with pepper spray, 
this officer said that he had emptied his spray canister and 
that he and a third officer would need new ones.  This force 
notwithstanding, the other officer who was recorded conceded 
that officers "sprayed the big dude because he didn't want to 
comply.  But he didn't really fight back that much."  When asked 
whether the defendant would be locked up, the unnamed officer 
responded, "No.  He didn't fight.  He didn't really fight 
anyone.  He complied after, you know.  Everybody, like, five 
people sprayed him." 
6 
 
 
 
defense against excessive force, unlawful detention, and 
forcible medication.  The jury acquitted the defendant of 
assault, but convicted him of disorderly conduct, and failed to 
agree on a verdict on the charge of threatening to commit a 
crime.  Consistent with § 53, the judge imposed a fine on the 
disorderly conduct conviction.  The defendant filed a timely 
notice of appeal, and this court allowed his application for 
direct appellate review. 
 
2.  Discussion.  a.  Sufficiency of the evidence.  The 
defendant argues that there was insufficient evidence to support 
his conviction of disorderly conduct under G. L. c. 272, § 53.  
Specifically, he argues the Commonwealth failed to prove either 
(1) his recklessness in creating a risk of "public 
inconvenience, annoyance, or alarm," or (2) the "public" 
character of any such risk.  In reviewing this claim, we 
consider the evidence introduced at trial in the light most 
favorable to the Commonwealth, and determine whether a rational 
trier of fact could have found the essential elements of the 
crime beyond a reasonable doubt.  Commonwealth v. Latimore, 378 
Mass. 671, 676-677 (1979). 
 
General Laws c. 272, § 53, provides that being a 
"[d]isorderly person[] and disturber[] of the peace" is a 
7 
 
 
 
criminal offense punishable by a fine for the first offense.6  In 
order to interpret the term and ensure its constitutionality, 
this court has "engrafted the Model Penal Code definition of 
'disorderly' onto the separate § 53 offense" of being a 
disorderly person.  Commonwealth v. Chou, 433 Mass. 229, 231-232 
(2001).  As so construed, the disorderly conduct provision in 
§ 53 requires proof that a person, "with purpose to cause public 
inconvenience, annoyance or alarm, or recklessly creating a risk 
thereof," engage in "fighting or threatening, or in violent or 
tumultuous behavior" or create "a hazardous or physically 
offensive condition by any act which serves no legitimate 
purpose of the actor."  Commonwealth v. Sholley, 432 Mass. 721, 
727 n.7 (2000), cert. denied, 532 U.S. 980 (2001), quoting Model 
Penal Code § 250.2 (Official Draft and Revised Comments, 1980).7  
The comments to the Model Penal Code emphasize that "[n]othing 
                     
 
6 General Laws c. 272, § 53, provides, in relevant part: 
 
 
"(b) Disorderly persons and disturbers of the peace, 
for the first offense, shall be punished by a fine of not 
more than $150.  On a second or subsequent offense, such 
person shall be punished by imprisonment in a jail or house 
of correction for not more than [six] months, or by a fine 
of not more than $200, or by both such fine and 
imprisonment." (Emphasis added.) 
 
 
7 In Commonwealth v. A Juvenile, 368 Mass. 580, 585-586, 
587, 592 (1975), this court, construing the disorderly person 
provision, limited the adopted portion of the Model Penal Code 
definition to § 250.2(1)(a) and (c), because § 250.2(1)(b), in 
the court's view, was unconstitutionally overbroad, reaching 
protected speech. 
8 
 
 
 
less than conscious disregard of a substantial and unjustifiable 
risk of public nuisance will suffice for liability."  Model 
Penal Code § 250.2 comment 2, at 328–329 (1980).  See 
Commonwealth v. Feigenbaum, 404 Mass. 471, 475 (1989), quoting 
Model Penal Code § 250.2(2)(c) (Official Draft and Revised 
Comments, 1985) (disorderly conduct conviction requires proof 
that defendant "consciously disregard[ed] a substantial and 
unjustifiable risk that the material element exists or will 
result from his conduct").8  "Conviction cannot be had merely on 
proof that an actor should have foreseen the risk of public 
annoyance or alarm."  Model Penal Code § 250.2 comment 2, at 329 
(1980). 
 
Against this backdrop, the defendant argues there was 
insufficient evidence that he recklessly created a risk of 
public inconvenience, annoyance, or alarm.  We agree.  The 
Commonwealth argues the evidence shows that the defendant's 
"violent and tumultuous behavior" was motivated by his desire to 
leave the room despite the officers' contrary warnings and 
regardless of the consequences, causing public inconvenience, 
                     
 
8 See Instruction 7.160, Supplemental Instruction 3, of the 
Criminal Model Jury Instructions for Use in the District Court 
(2009) ("A person acts recklessly when he consciously ignores, 
or is indifferent to, the probable outcome of his actions.  The 
defendant was reckless if he [she] knew, or must have known, 
that such actions would create a substantial and unjustifiable 
risk of public inconvenience, annoyance or alarm, but he [she] 
chose, nevertheless, to run the risk and go ahead"). 
9 
 
 
 
annoyance, and alarm and requiring that traffic be rerouted 
around his hospital room.  The totality of this causal 
relationship is doubtful, given that the rerouting of hospital 
traffic was initiated by the security officers as a prophylactic 
step and there was no evidence that it was actually needed.  But 
even assuming the validity of the Commonwealth's 
characterization of the scene, the fact that the defendant's 
behavior caused officers to reroute and inconvenience people 
does not mean that the defendant was aware that his behavior had 
this effect, and acted in conscious disregard of its occurrence.  
No evidence was presented that the defendant ever went out of 
the room he was in; that he knew of the hospital pedestrian 
rerouting officers decided to institute; or that he saw any 
patients "looking on" through the window into the room.  Quoting 
Justice Holmes, the Commonwealth claims that recklessness "in a 
moral sense" signifies "a certain state of consciousness with 
reference to the consequences of one's acts," Commonwealth v. 
Pierce, 138 Mass. 165, 175 (1884), and that a failure to predict 
the consequences is immaterial if, "under the circumstances 
known to [the defendant], the . . . jury . . . thought them 
obvious."  Id. at 178.  This elegantly phrased observation seems 
contrary to the Model Penal Code's statement of the standard as 
set out in comment 2 to § 250.2, but even if Justice Holmes's 
statement did represent an appropriate articulation of the 
10 
 
 
 
standard, by its terms, it depends on "the circumstances known 
to [the defendant]" (emphasis added).  Id.  It bears emphasis 
that at the time of this incident, according to the 
Commonwealth, the defendant had been brought to and was detained 
in the hospital's emergency department because he was thought to 
be dangerous to himself or to others by reason of mental 
illness.  See G. L. c. 123, § 12.  We do not decide that a 
person detained in such circumstances can never satisfy the 
intent element of the crime of disorderly conduct, but in the 
circumstances presented here, without any evidence showing or 
even suggesting that the defendant was at all aware that his 
conduct had any impact on anyone in the hospital outside his 
room, the Commonwealth has failed to prove that the defendant 
acted with the requisite conscious disregard of an 
"unjustifiable risk" of public annoyance or alarm created by his 
conduct. 
 
Moreover, quite apart from the element of intent, in the 
context in which they took place, the defendant's actions do not 
amount to the sort of "public inconvenience, annoyance, or 
alarm" that G. L. c. 272, § 53, targets.  See Instructing 7.160 
of the Criminal Model Jury Instructions for Use in the District 
Court (2009).  Disorderly conduct embraces those activities 
which "intentionally tend to disturb the public tranquility, or 
alarm or provoke others" (citation omitted).  Commonwealth v. A 
11 
 
 
 
Juvenile, 368 Mass. 580, 595-596 (1975).  See Commonwealth v. 
Mulvey, 57 Mass. App. Ct. 579, 584 (2003) (characterizing 
"tendency of the actor's conduct to provoke violence in others" 
as foundational to theory behind criminalizing disorderly 
conduct).  The comments to the Model Penal Code note that "[o]ne 
of the chief uses of a disorderly conduct statute is to prohibit 
public brawling."  Model Penal Code § 250.2 comment 3, at 330 
(1980).  Disorderly conduct includes a subset of "tumultuous 
behavior," that is, conduct "involving riotous commotion and 
excessively unreasonable noise so as to constitute a public 
nuisance" (citation omitted). A Juvenile, supra at 597.  See 
Sholley, 432 Mass. at 730, and cases cited. 
 
For purposes of G. L. c. 272, § 53, "public" is defined as 
"affecting or likely to affect persons in a place to which the 
public or a substantial group has access."  Alegata v. 
Commonwealth, 353 Mass. 287, 304 (1967), quoting Model Penal 
Code § 250.2 (Proposed Official Draft, 1962).9  We have 
                     
 
9 See, e.g., Commonwealth v. Richards, 369 Mass. 443, 446-
448 (1976) (defendants in shopping mall refusing to cease public 
drinking, shouting obscenities, resisting arrest, and attracting 
crowd of about 200 people hostile and abusive to police 
warranted disorderly conduct convictions); Commonwealth v. 
Sinai, 47 Mass. App. Ct. 544, 548 (1999) (disorderly conduct 
conviction upheld where defendant in parking lot of public town 
beach was screaming and yelling at parking attendant and then 
two police officers, pounding on steering wheel of his 
automobile with both hands, attempting to strike two police 
officers and forcibly resisting arrest by three police officers, 
which attracted crowd of twenty onlookers and caused traffic to 
12 
 
 
 
recognized, however, that conduct disruptive in one setting may 
be tolerable in another.  See Sholley, 432 Mass. at 730 n.11 
("conduct proscribed [under § 53] varies with the setting and 
the surrounding circumstances").  See also Commonwealth v. 
Orlando, 371 Mass. 732, 735 (1977), and cases cited (hurling 
objects in deserted location would not disturb peace while 
hurling objects in populated area would be violation). 
 
In the Sholley case, we concluded that the threshold for 
acceptable disruption was lower in a court house than it would 
be elsewhere, reasoning that 
"the fact that Sholley's threats, yelling and screaming 
occurred in a court house, while several court rooms were 
in session, makes the conduct far more damaging to public 
order than would the same noise level -- or even words 
suggestive of threats -- at, for example, a sporting event.  
At a court house, the level and duration of 'commotion' 
that can be tolerated by the public is relatively low, and 
the point at which noise becomes 'excessively unreasonable' 
is also relatively low." 
 
Sholley, 432 Mass. at 730–731.  In concluding that the 
defendant's outburst "went far beyond the level of noise and 
                                                                  
be rerouted); Commonwealth v. Mulero, 38 Mass. App. Ct. 963, 
964-965 (1995) (during roadside stop, defendant's actions of 
removing his hands from police cruiser, flailing them in 
agitated and belligerent manner while berating police officer 
with loud profanities and shoving his hands into pockets of his 
shorts while crowd of thirty people gathered was sufficient to 
constitute probable cause to arrest defendant on charge of 
disorderly conduct); Commonwealth v. Carson, 10 Mass. App. Ct. 
920, 921-922 (1980) (intoxicated defendant who became 
belligerent when approached by police outside college dormitory 
and resisted arrest while crowd of about fifty people gathered 
was guilty of disorderly conduct). 
13 
 
 
 
commotion ordinarily encountered in court house hallways," the 
court considered relevant both the spectators who gathered10 and 
"the number of persons who abandoned their ordinary duties to 
respond to that noise and commotion."  Id. at 729.  These 
included a court officer leaving a sitting judge to follow the 
defendant through the building; an assistant district attorney 
interrupting a meeting to check on the safety of the attorneys 
she supervised; and three police officers abandoning their posts 
to investigate the disturbance.  Id.  Together, these actions 
"gave rise to a sense of emergency on the part of those who 
heard it, an emergency that went way beyond the ordinary 'hurly-
burly' to which they were accustomed."  Id. 
 
The same cannot be said of the defendant's conduct in this 
case.  His behavior in the emergency department did not attract 
the crowd of onlookers that typifies public disturbance under 
our law.  See note 10, supra.  All the evidence shows is that 
the behavior was witnessed and experienced by the hospital's 
treating staff attending the defendant and the security officers 
called in by the staff.  The evidence would permit a finding 
that unquantified "other" patients may have observed the 
defendant's loud and aggressive behavior in his room; "other" 
                     
 
10 These included people "peering out of doors on the second 
floor to see what was happening," and people who "came out of 
the first session and the probation department on the first 
floor."  Id. at 730. 
14 
 
 
 
patients looking in on a patient arguably out of control in a 
small hospital room does not qualify as the kind of public 
disturbance that § 53 is intended to address. 
 
Indeed, far from going "way beyond" a hospital's day-to-day 
"hurly-burly," a patient's resistance to detention and 
medication would seem to be the kind of disruption a psychiatric 
area in the hospital's emergency department is designed to 
absorb.11  The responding officers, moreover, were not leaving 
their posts, but carrying out an assignment that fit squarely 
within their job to provide security to the hospital community.12  
Where the inquiry is setting-specific, Sholley, 432 Mass. at 730 
n.11, criminal charges of disorderly conduct in the context of 
mental health treatment in the emergency department of a large 
urban hospital, although not per se unavailable, should be rare.  
To decide otherwise risks criminalizing mental illness in the 
very treatment centers where help must be available. 
We do not minimize the challenges faced by staff in the 
psychiatric ward of a large hospital like the one here, 
                     
 
11 Cf. Zun, Care of Psychiatric Patients:  The Challenge to 
Emergency Physicians, 17 W.J. Emerg. Med. 173, 173 (2016). 
 
 
12 One officer testified that his duties as a special police 
officer at the hospital ranged from "radio calls for service to 
patrol," and he expressed familiarity with the psychiatric area; 
another officer identified as his primary responsibility "to 
make sure that we proactively protect and serve the community at 
[the hospital]," including patrol; and a third officer was 
"posted in the emergency department at the hospital." 
15 
 
 
 
including the hospital's security officers.  This would be a 
very different case if the defendant had actually struck a 
member of the hospital staff or had intentionally or recklessly 
caused a substantial disruption to other patients or hospital 
operations.  Here, however, the jury found the defendant not 
guilty of assault and reached no verdict on the charge of 
threatening to commit a crime.  The defendant's belligerent 
actions, given their context and location, do not rise to the 
level of disorderly conduct. 
In sum, considering all the evidence in this case in the 
light most favorable to the Commonwealth, we conclude that it 
was not sufficient to permit a reasonable jury to find beyond a 
reasonable doubt that the defendant consciously disregarded a 
"substantial and unjustifiable risk of public inconvenience, 
annoyance, or alarm."  The defendant's conviction of disorderly 
conduct must be reversed.13 
 
b.  Additional considerations.  The defendant argues in 
this case that his detention in the hospital and the forced 
administration of medication without his consent were unlawful, 
and that as a consequence, he was entitled to a jury instruction 
on self-defense in relation to all three of the criminal charges 
                     
 
13 The defendant may be entitled to a refund of any fine he 
may have paid.  Cf. Commonwealth v. Martin, 476 Mass. 72, 77-78 
(2016) (because distinguishable from punitive fines, probation 
fees for voidable convictions need not be returned). 
16 
 
 
 
against him.  We need not reach this issue in light of the fact 
that the defendant was found guilty only of disorderly conduct, 
and we have concluded that there was insufficient evidence to 
support that conviction. 
 
The defendant is correct, however, that as a general 
matter, the involuntary hospitalization and forcible medication 
of an individual on account of mental illness is not permitted 
unless there is compliance with the specific statutory 
requirements of G. L. c. 123, §§ 12 and 21.  It has long been 
the law that medical treatment of a competent patient without 
his consent is a battery, and is permitted only for incompetent 
patients where procedural protections are followed.  See, e.g., 
Matter of Spring, 380 Mass. 629, 638 (1980), and cases cited.  
See also Rogers v. Commissioner of the Dep't of Mental Health, 
390 Mass. 489, 499-500 (1983). 
At trial, the judge instructed the jury that "if there is a 
need to give medications, a hospital follows certain procedures, 
which we're not getting into here because it has no relevance to 
this case," and that the "procedures being followed . . . [are] 
not a part of this case."  But the defendant makes the point 
that the Commonwealth presented no evidence at trial of 
compliance with either the requirements of G. L. c. 123, § 12, 
as to the defendant's hospitalization or with those of G. L. 
c. 123, § 21, as to the defendant's forced medication.  Because 
17 
 
 
 
adherence to these statutory protections generally is a 
condition precedent to involuntary hospitalization and 
medication, we disagree with the judge that evidence on this 
point has no relevance.  To the contrary, failure to adhere to 
the protections of G. L. c. 123, § 12 or 21, may well be 
relevant to consideration of the defendant's requisite intent -- 
i.e., that a person act intentionally or recklessly to cause or 
create public inconvenience, annoyance, or alarm.14 
 
Conclusion.  The defendant's conviction of disorderly 
conduct is reversed, the judgment is vacated, and the case 
remanded to the Boston Municipal Court for entry of a judgment 
of dismissal. 
 
 
 
 
 
 
 
So ordered. 
                     
14 As previously stated, we do not reach the defendant's 
arguments about a self-defense instruction in this case.  
However, in connection with criminal charges involving the use 
of force, evidence of failure to comply with G. L. c. 123, § 12 
or 21, may be a relevant consideration in weighing whether a 
defendant may be entitled to an instruction on self-defense in 
some circumstances.  Cf. Instruction 9.260, Supplemental 
Instruction 12, of the Criminal Model Jury Instructions for Use 
in the District Court (2009) (police privilege; resisting 
arrest).