Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca9-12-10294/USCOURTS-ca9-12-10294-0/pdf.json

Parties Involved:
Albert Garza
Appellant
United States of America
Appellee

Document Text:

FOR PUBLICATION

UNITED STATES COURT OF APPEALS

FOR THE NINTH CIRCUIT

UNITED STATES OF AMERICA,

Plaintiff-Appellee,

v.

ALBERT GARZA,

Defendant-Appellant.

No. 12-10294

D.C. No.

1:10-cr-00165-AWI-1

OPINION

Appeal from the United States District Court

for the Eastern District of California

Anthony W. Ishii, Senior District Judge, Presiding

Argued and Submitted

January 14, 2014—San Francisco, California

Filed May 20, 2014

Before: Richard C. Tallman and Sandra S. Ikuta, Circuit

Judges, and Beverly Reid O’Connell, District Judge.*

Opinion by Judge Tallman

* The Honorable Beverly Reid O’Connell, United States District Judge

for the Central District of California, sitting by designation.

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2 UNITED STATES V. GARZA

SUMMARY**

Criminal Law

Affirming a criminal judgment, the panel held that the

district court did not plainly err by failing to sua sponte

convene a hearing on the defendant’s competency.

The panel held that there is no substantial evidence that a

reasonable judge would harbor a genuine doubt about the

defendant’s competency, where the defendant’s medical

history evidence isn’t strong and there is no clear connection

between the defendant’s putative dementia and any negative

impact on his ability to understand the proceedings or assist

in his defense.

The panel rejected the defendant’s attempt to reach plain

error in reliance on 18 U.S.C. § 4241(a), requiring

competency hearings on reasonable cause, and 18 U.S.C.

§ 4247(b), governing commitment for the purposes of an

examination.

** This summary constitutes no part of the opinion of the court. It has

been prepared by court staff for the convenience of the reader.

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UNITED STATES V. GARZA 3

COUNSEL

Carolyn Wiggin (argued), Assistant Federal Public Defender,

Sacramento, California, for Defendant-Appellant.

Brian W. Enos (argued), Assistant United States Attorney,

Eastern District of California, Office of the United States

Attorney, Fresno, California, for Plaintiff-Appellee.

OPINION

TALLMAN, Circuit Judge:

Albert Garza was sentenced to 20 years in prison after a

jury convicted him of one count of “receipt or distribution”

and one count of “possession” of child pornography. Garza

appeals his conviction and sentence on several grounds. In a 

memorandum disposition we address all but one of Garza’s

arguments. In this opinion we decide whether the district

court plainly erred by failing to sua sponte convene a hearing

on Garza’s competency. It did not, so we affirm.

I

A

By monitoring an online file-sharing network, federal

agents discovered that Garza was downloading child

pornography. Warrant in hand, the agents went to his home. 

While some searched, a pair of agents interviewed Garza at

length. During the interview, he confessed to everything. The

search turned up two computers and a compact disc

containing thousands of photographs and videos of child

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4 UNITED STATES V. GARZA

pornography. Garza was arrested and indicted for one count

of “receipt or distribution” under 18 U.S.C. § 2252(a)(2) and

one count of “possession” under § 2252(a)(4)(B).

B

Shortly after Garza’s indictment, his first lawyer hired Dr.

Thomas Middleton, a clinical psychologist, to examine Garza

and prepare a written competency report. The report paints

Garza as mentally and emotionally crippled by various

disabilities and the impact of his arrest. Middleton diagnosed

Garza with anxiety and with dementia caused by uncontrolled

diabetes. He concluded, if obliquely,

1

that Garza was

incompetent to stand trial. Middleton based these

conclusions on a single interview and several aptitude tests. 

He reviewed no medical records.

Relying on Middleton’s report, the parties stipulated to,

and the district court entered, an order committing Garza to

the Attorney General’s custody for a competency evaluation. 

Garza was sent to a Bureau of Prisons facility in Los Angeles

for several weeks. There, he was observed at length, tested,

and interviewed by government doctors. A comprehensive

1 Middleton began his report by summarizing his task, which specifically

included assessing “competence.” But in his conclusion Middleton never

specifically says “incompetent.” He writes that “Mr. Garza does not

appear to be able to rationally address his legal circumstances at this

time.” Though this sentence is vague, the gist of the report makes its

import clear. We will give Garza the benefit of the doubt and treat this as

a specific diagnosis of incompetency.

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UNITED STATES V. GARZA 5

report was prepared.2 Dr. Lisa Hope, a forensic psychologist

and the report’s author, wrote that Garza suffered from an

anxiety disorder but not dementia. She concluded that he was

competent to stand trial.

Hope also concluded that Middleton’s dementia diagnosis

was speculative. She noted that a proper diagnosis requires

access to records that Middleton did not have and testing that

Middleton did not do. Hope also reported that Garza was

malingering—trying to appear incompetent—by deliberately

throwing some of his aptitude tests. Oddly, she also wrote

that Garza “appeared motivated for testing, and put forth

sufficient attention and concentration . . . he would say ‘Yes!’

out loud once he figured out [the answer.] Overall, he

seemed to enjoy the testing process . . . .” Her report never

reconciled this apparent contradiction.

Potential malingering aside, Hope’s observations were

consistent with her competency finding. She wrote that

Garza exhibited appropriate behavior in his interactions with

other prisoners and staff. She wrote about Garza’s

commendable work history—he was steadily employed as a

mechanic for decades until a heart attack left him unable to

work. Moreover, Hope made clear that Garza understood his

situation. He was able to describe the charges he faced and

the identities and roles of the various actors in the criminal

process. Garza told Hope that he liked and trusted his lawyer.

2 We unseal the sealed pages of the Hope report cited in this opinion

only to the extent that unsealing is necessary for purposes of this opinion.

The sealed materials, including the specific pages cited herein, otherwise

remain sealed.

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6 UNITED STATES V. GARZA

After Garza was released from medical custody and

Hope’s report was circulated, the competency issue was

dropped. Garza’s lawyer (a new one) never raised the issue

with the trial judge nor moved for a hearing. None was ever

held. Accordingly, the district court made no specific finding

as to Garza’s competency.

C

Ultimately, plea negotiations failed and Garza went to

trial. The investigating agents testified about how they

located Garza and found child pornography at his home. A

recording of Garza’s interview with the arresting agents was

played for the jury. The jurors heard him admit to the agents

that he had searched for and downloaded child pornography

for years.

Garza took the stand to testify in his own defense. On

direct, his testimony hinted at incompetence. He testified that

he’d seen numerous psychiatrists, that he was mentally

disabled, and that “diabetes . . . was eating [his] brain.” This

last statement, though it sounds over the top, is arguably

consistent with Middleton’s opinion that Garza’s unchecked

diabetes may have caused brain damage.

This came later:

Q: Have there been times during this case

when you haven’t really understood

everything that’s been going on?

A: All of it.

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UNITED STATES V. GARZA 7

Q: Sometimes when we talk, do you

understand everything I’m telling you?

A: (Witness shakes head.)

Garza’s lawyer elicited this testimony but did not move to

have his client declared incompetent. Nor did the district

court take any action on its own. Later, on crossexamination, Garza contradicted the arrest interview by

testifying that he had never before seen child pornography.

The jury convicted Garza on both counts.

D

At the sentencing hearing, the district court and both

partiesrepeatedlymentioned Garza’s mental health, but never

referred to his competency. Both Middleton’s and Hope’s

reports were discussed. The district court said that it took “at

face value” that Garza “does suffer from some mental defects

or deficiencies . . . .” The focus of all this discussion was

mitigation. The talk never strayed toward competency.

In aggravation, the government argued, and the district

court agreed, that Garza willfully perjured himself when he

testified contrary to what he had told the arresting agents. To

justify its finding that Garza’s statements were deliberate lies,

the court, reading from its own trial notes, offered its

impression that Garza was playing possum on the

stand—pretending to be confused on direct only to become

alert and engaged on cross. Both the judge and the prosecutor

noted that Garza even anticipated one of the prosecutor’s

questions. “I think Mr. Garza is malingering,” the court said.

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8 UNITED STATES V. GARZA

It then sentenced Garza to 240 months on the receipt or

distribution charge and 120 months on the possession charge,

both terms to run concurrently. Garza’s contribution to the

hearing, his allocution, was this: “Just that I apologize, sir, for

everything—I just want to get better. Sorry. I’m sorry.”

II

We have jurisdiction under 28 U.S.C. § 1291 and

18 U.S.C. § 3742(a).

III

A defendant that “lacks the capacity to understand the

nature and object of the proceedings against him, to consult

with counsel, and to assist in preparing his defense may not

be subjected to a trial.” See Drope v. Missouri, 420 U.S. 162,

171–72 (1975). And “the failure to observe procedures

adequate to protect a defendant’s right not to be tried or

convicted while incompetent to stand trial deprives him of his

due process right to a fair trial.” Id. at 172 (citing Pate v.

Robinson, 383 U.S. 375 (1966)). Sometimes “adequate”

means that the district court must sua sponte consider a

defendant’s competency. The question is whether this is one

of those times.

Garza says yes. He argues that the district court plainly

erred by failing to sua sponte hold a competency hearing.

3

3 The failure to sua sponte hold a competency hearing will always be

reviewed for plain error. United States v. Dreyer, 705 F.3d 951, 960 (9th

Cir. 2013) (“This is because a defense counsel who is attuned to his

client’s mental condition and recognizes that the defendant’s competency

is in question would not leave it up to the district court to order a

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UNITED STATES V. GARZA 9

Failing to sua sponte hold a competency hearing is plain error

only if “the evidence of incompetence was such that a

reasonable judge would be expected to experience a genuine

doubt respecting the defendant’s competence.” Dreyer,

705 F.3d at 961 (internal citations and quotations omitted). 

To raise a genuine doubt, there must be “substantial evidence

that, due to a mental disease or defect, the defendant is either

unable to understand the nature and consequences of the

proceedings against him or to assist properly in his defense.” 

Id. (internal citations and quotations omitted) (emphasis in

original). Relevant evidence falls into three broad categories: 

medical history, the defendant’s behavior in and out of court,

and defense counsel’s statements about the defendant’s

competency. See, e.g., United States v. Marks, 530 F.3d 799,

814 (9th Cir. 2008).

Our review is limited. We ask only whether substantial

evidence exists such that a reasonable judge would harbor a

genuine doubt.4See United States v. Mitchell, 502 F.3d 931,

986 (9th Cir. 2007). Whether the defendant is, in fact,

competent is a separate inquiry outside our ambit.

competency hearing sua sponte, rather, he would move for such a hearing

himself. If his motion was denied we would then evaluate the district

court’s denial of the motion rather than its failure to order a hearing sua

sponte.”).

4 Even though this is a direct appeal, we look to our cases reviewing

collateral challenges to the extent they also involve a “substantial

evidence” inquiry. See, e.g., Deere v. Woodford, 339 F.3d 1084, 1086

(9th Cir. 2003) (applying substantial evidence standard to pre-AEDPA

habeas proceeding); Davis v. Woodford, 384 F.3d 628, 644–45 (9th Cir.

2000) (applying substantial evidence standard to post-AEDPA habeas

proceedings).

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10 UNITED STATES V. GARZA

A

The substantial evidence standard is “not easily applied.” 

Basset v. McCarthy, 549 F.2d 616, 619 (9th Cir. 1977). 

“There are, of course, no fixed or immutable signs which

invariably indicate the need for further inquiry to determine

fitness to proceed; the question is often a difficult one in

which a wide range of manifestations and subtle nuances are

implicated. That they are difficult to evaluate is suggested by

the varying opinions trained psychiatrists can entertain on the

same facts.” Drope, 420 U.S. at 180. Accordingly, it is

understandable that our case law lacks specific rules about

when the standard is met.

Nonetheless, general guidelines have emerged. For

example, an appellant who has absolutely no medical history

evidence indicating incompetency will almost certainly fail

to upset his conviction. See, e.g., Mendez-Sanchez, 563 F.3d

935, 948 (9th Cir. 2009); Marks, 530 F.3d at 815. Of course,

a case may arise where the other indicators of incompetence

are so powerful that we are compelled to find plain error even

absent medical history evidence. It just hasn’t happened yet.

Often, even cases with detailed medical history evidence

fail to convince us that a reasonable judge would have a

genuine doubt. Basset, 549 F.2d at 617, provides an apt

example. There, the defendant, who had been deemed

schizophrenic since childhood, was declared “presently

insane” by two government psychiatrists just prior to trial. 

Id. at 617–20. He was then committed for treatment, and

later released after other government doctors certified his

competency. Nonetheless, the defendant later misbehaved

toward his counsel at trial. That misbehavior could have

arisen from schizophrenia or simple frustration. We decided

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UNITED STATES V. GARZA 11

the latter after noting that, prior to the crime, the defendant

was a socially capable, average college student and that, in

spite of the misbehavior, neither the court nor defense counsel

raised the competency issue. Id.

Darrow v. Gunn, 594 F.2d 767 (9th Cir. 1979), is similar. 

There, two government psychiatrists deemed the defendant

normal. Id. at 769–70. Another, hired by the defendant,

labeled him a “paranoid schizophrenic living in a delusional

world.” Id. at 769. In spite of that finding, the defense

psychiatrist claimed that the defendant was “aware of the

nature of the charges against him and could cooperate and

collaborate with the public defender’s office.” Id. We found

no substantial evidence. Id. at 770–71.

Basset and Darroware but two unextraordinary examples

of the many cases where we have found that some medical

evidence—even some medical evidence of an extraordinarily

debilitating condition—does not rise to the level of

substantial evidence. See, e.g., Davis, 384 F.3d at 644; Boag

v. Raines, 769 F.2d 1341, 1344 (9th Cir. 1985); Steinsvik v.

Vinzant, 640 F.2d 949, 954 (9th Cir. 1981); Sailer v. Gunn,

548 F.2d 271, 274 (9th Cir. 1977). The bar is plainly high.

B

But some cases do get over it. And that leaves the

question of how to distinguish between the cases with

medical evidence that do and the cases with medical evidence

that don’t. There appear to be two key factors: strong

evidence of a serious mental disease or defect, and a clear

connection between that disease or defect and some failure by

the defendant to understand the proceedings or assist in his

own defense.

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12 UNITED STATES V. GARZA

Turning to the first factor, the question is how strong have

we required the evidence of a serious mental disease or defect

to be. Historically, we have deemed it sufficient in either of

two situations. First, where it is undisputed that the defendant

has a serious mental disease or defect. See Torres v. Prunty,

223 F.3d 1103, 1109–10 (9th Cir. 2000); Miles v. Stainer,

108 F.3d 1109, 1112–13 (9th Cir. 1997); Moore v. United

States, 464 F.2d 663, 665–67 (9th Cir. 1972). And second,

where the existence of a mental disease or defect is disputed,

but the defendant engages in bizarre or erratic behavior,

especially in court. See Maxwell v. Roe, 606 F.3d 561,

574–76 (9th Cir. 2010); McMurtrey v. Ryan, 539 F.3d 1112,

1125–27 (9th Cir. 2008); Chavez v. United States, 656 F.2d

512, 519 (9th Cir. 1981); Tillery v. Eyman, 492 F.2d 1056,

1059 (9th Cir. 1974). But, where the defendant behaves and

the medical experts battle over whether he is mentally

disabled at all, we have not found substantial evidence. See

Amaya-Ruiz v. Stewart, 121 F.3d 486, 492–93 (9th Cir.

1997); de Kaplany v. Enomoto, 540 F.2d 975, 983–85 (9th

Cir. 1976) (en banc).

The second factor is a clear connection between the

defendant’s serious mental disease or defect—established via

the first factor—and some failure by the defendant to

understand the proceedings or assist in his own defense. 

Where the defendant’s mental problem—even if severe—has

no discernible impact on the proceedings, we have not found

substantial evidence. See Davis, 384 F.3d at 645–46; Boag,

769 F.2d at 1343–44; Steinsvik, 640 F.2d at 952–54; Bassett,

549 F.2d at 620–21. Even a mentally deranged defendant is

out of luck if there is no indication that he failed to

understand or assist in his criminal proceedings. See, e.g.,

Steinsvik, 640 F.2d at 951–54. And even if that same

defendant did fail to understand or assist in his proceedings,

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UNITED STATES V. GARZA 13

he would still be out of luck unless his mental impairment

caused the failure. See, e.g., Amaya-Ruiz, 121 F.3d at

492–93. We must see a connection. A defendant who

refuses to work with his lawyer out of spite alone is not

incompetent even if that defendant has a serious mental

disease or defect. See, e.g., Davis, 384 F.3d at 645–46.

Our cases finding substantial evidence have consistently

turned on these two key factors. Our most recent case and

one of our oldest are prime examples. In Dreyer, 705 F.3d at

958–59, all the medical experts diagnosed the defendant with

frontotemporal dementia. Id. And because the dementia was

the stated reason why the defendant chose not to allocute at

sentencing, we found substantial evidence that a reasonable

judge would harbor a genuine doubt about his competency. 

Id. Both factors were present. There was no dispute that

Dreyer suffered from a serious mental disease or defect and

it was that disease or defect that prevented him from assisting

in his defense by preventing him from allocuting.

Similarly, in Rhay v. White, 385 F.2d 883, 884 (9th Cir.

1967), it was undisputed that the defendant had a “history of

chronic mental disturbances, paranoid traits, violent

behavioral explosions and previous institutional diagnoses,

from the time he was a boy to his commission at age 22 of the

murders.” Equally clear was that his inability to control

himself hindered his defense, as defense counsel had to ask

for recesses throughout the trial to allow his client time to

cool down because he was “very close to a psychotic break.” 

Id. at 885.

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14 UNITED STATES V. GARZA

C

By attempting this rough categorization we do not mean

to imply more uniformity than exists or to create rules where

only rough guidelines are appropriate. Substantial evidence

is, inevitably, a case-by-case analysis. And we acknowledge

the presence of outliers. See, e.g., Deere, 339 F.3d at

1086–87 (finding substantial evidence based solely on

disputed medical evidence without extreme behavior). This

discussion of the substantial evidence standard is meant only

to provide general guidelines. Guidelines we now apply to

Albert Garza.

IV

There is no substantial evidence such that a reasonable

judge would harbor a genuine doubt about Garza’s

competency. Garza has medical history evidence but neither

of the two key factors is present. Garza’s medical history

evidence is not strong—it is disputed whether he has a serious

mental disease or defect at all, and his behavior, both in and

out of court, was far from erratic. Nor is there a clear

connection between any mental disease or defect and any

failure on Garza’s part to understand the proceedings or assist

in his own defense. Thus, Garza’s case falls among those

with some medical history evidence that nonetheless fail to

exhibit substantial evidence.

A

Garza has shown neither of the two hallmarks that

separate the cases with medical history evidence that reach

substantial evidence from those that do not. First, Garza’s

medical history evidence isn’t strong. Although dementia

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UNITED STATES V. GARZA 15

certainly qualifies as a serious mental disease or defect,

Middleton and Hope dispute whether Garza has it.5 Because

of the dispute, Garza needs strange behavior to satisfy the

first factor. But he exhibited none. According to Hope,

“Garza was housed in the general population . . . without

incident. [And he] was generally able to adapt to the demands

of incarceration.” “There were no signs of odd or bizarre

behavior” during his weeks in federal medical custody. The

trial was no different. Garza sat through the trial and testified

without incident, much less an incident like what we’ve

required in the past. See Maxwell, 606 F.3d at 570–71

(suicide attempts); Tillery, 492 F.2d at 1057 (laughing at the

jury, ripping off clothes, screaming).

Second, there is no clear connection between Garza’s

putative dementia and any negative impact on his ability to

understand the proceedings or assist in his defense. To the

contrary, we know Garza understood the nature of the

proceedings because he described them, accurately and in his

own words, to Hope. And Garza was, in fact, able to assist in

his defense. He testified. He allocuted. And his counsel had

no complaints. Garza’s own testimony that he didn’t know

what was going on is simply not credible in light of his

explanation to Hope and his sharp, if false and unsuccessful,

testimony on cross-examination. There is no substantial

evidence here.

5 We think that no reasonable judge would doubt that Hope got the better

of the debate. Middleton was tentative. He repeatedly noted that a review

of Garza’s medical records would have firmed-up his diagnosis, but he

never reviewed those records. Hope did. She also conducted more tests

and observed Garza for far longer than did Middleton.

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16 UNITED STATES V. GARZA

This conclusion draws further support from two obvious

places. First, Garza’s lawyer dropped the competency

challenge after Garza was evaluated in federal medical

custody. That he chose to yield the issue, rather than seek a

hearing, is telling. See Hernandez v. Ylst, 930 F.2d 714, 718

(9th Cir. 1991) (“[A] defendant’s counsel is in the best

position to evaluate a client’s comprehension of the

proceedings.”). That he never raised the issue at trial, even

after Garza’s testimony on the subject, is even more so. 

Second, the district court was well aware of Garza’s mental

health issues. He said so. And he reviewed the two doctors’

reports before the sentencing. Yet, instead of holding a

hearing, he found that Garza was malingering and that he

committed willful perjury on the stand. These findings, made

by an experienced trial judge with a far better vantage point

than ours, give us confidence in our conclusion.

B

Garza makes another argument, attempting to reach plain

error by statutory, as opposed to evidentiary, means. He

relies on the statutes providing for competency proceedings

in federal court, including 18 U.S.C. § 4241(a), which

obligates district courts to sua sponte hold competency

hearings on reasonable cause:

The court shall . . . order [a competency]

hearing on its own motion, if there is

reasonable cause to believe that the defendant

may presently be suffering from a mental

disease or defect rendering him mentally

incompetent to the extent that he is unable to

understand the nature and consequences of the

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UNITED STATES V. GARZA 17

proceedings against him or to assist properly

in his defense.

18 U.S.C. § 4241(a) (emphasis added). Subsection (b)

provides that “prior to the date of the hearing, the court may

order a psychiatric or psychological examination” and it

refers to 18 U.S.C. § 4247(b), which allows the court to,

“[f]or the purposes of an examination[,] . . . commit the

person to be examined . . . to the custody of the Attorney

General.”

Relying on these statutes, Garza makes two arguments. 

The first runs like this: Garza was committed under §§ 4241

and 4247, so the district court must have had reasonable

cause to believe he was incompetent. Since the district court

had reasonable cause, Garza argues that we must find

substantial evidence that a reasonable judge would harbor a

genuine doubt. This logic ignores our obligation to review all

the evidence before the district court, not just the evidence it

had when it committed Garza. All the judge had at that time

was Middleton’s report and the parties’ stipulation; Hope’s

contrary report and Garza’s courtroom performance came

much later. We have just explained why all the evidence,

taken together, fails to establish plain error. It is simply

irrelevant that some of the evidence would do the trick if

evaluated in isolation.

The second argument appears to be that any defendant

committed for examination under § 4247 is, by virtue of the

committment, entitled to a competency hearing. This

argument is not without textual support, as § 4241(b) does

imply that the “examination” will be ordered “prior to the

hearing.” But the more specific language trumps the general,

and that specific language requires a hearing on “reasonable

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18 UNITED STATES V. GARZA

cause.” It makes perfect sense that the examination ordered

under § 4247 might, as it apparently did here, dispel

reasonable cause. A § 4247 examination does not

automatically entitle a defendant to a hearing.

V

There was no plain error here because no reasonable

judge would harbor a genuine doubt about Garza’s

competency; no reasonable judge would harbor a genuine

doubt about Garza’s competency because there was not

substantial evidence; there was not substantial evidence

because Garza’s medical history, his behavior in and out of

trial, and his defense counsel’s statements do not reveal a

defendant incapable of either understanding the nature of the

proceedings against him or assisting in his defense.

AFFIRMED.

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