J-S15032-15

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37

IN THE INT. OF: C.L.A IN THE SUPERIOR COURT OF

PENNSYLVANIA

APPEAL OF: C.L.A.

No. 1745 MDA 2014

Appeal from the Order Entered October 8, 2014

In the Court of Common Pleas of Centre County

Civil Division at No(s): 2001-1717

BEFORE: LAZARUS, J., WECHT, J., and JENKINS, J.

MEMORANDUM BY JENKINS, J.: FILED MARCH 11, 2015

Appellant C.L.A. appeals from an order of the Centre County Court of 

Common Pleas ordering that Appellant be committed to inpatient treatment 

pursuant to the Mental Health Procedures Act, 50 P.S. §§ 7101, et seq., for 

a period not to exceed 90 days. We affirm.

On September 11, 2014, the Centre County Mental Health and 

Intellectual Disabilities office (“MH/ID”) filed an application for involuntary 

emergency examination and treatment of Appellant pursuant to 50 P.S. § 

7302.1 Appellant was committed to Mount Nittany Medical Center for a 

period of not more than five days.

____________________________________________

1

 50 P.S. § 7302 provides: 

(a) Application for Examination.--Emergency 

examination may be undertaken at a treatment facility 

(Footnote Continued Next Page)
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On September 15, 2004, MH/ID filed a petition for extended 

involuntary treatment of Appellant pursuant to 50 P.S. § 7303 (“section 

303”).2 On September 16, 2014, the mental health review officer held a 

section 303 hearing and recommended that the trial court find Appellant 

severely mentally disabled and in need of involuntary treatment and 

recommended that the trial court order that Appellant be committed to 

inpatient treatment for a total commitment period not to exceed 20 days. 

Report of Mental Health Review Officer, 9/16/2014, at 1, 3. On September 

18, 2014, the trial court ordered Appellant’s commitment to inpatient 

treatment at Mount Nittany Medical Center or other designated facility

(Footnote Continued) _______________________

upon the certification of a physician stating the need for 

such examination; or upon a warrant issued by the county 

administrator authorizing such examination; or without a 

warrant upon application by a physician or other 

authorized person who has personally observed conduct 

showing the need for such examination.

2 50 P.S. § 7303 provides:

(a) Persons Subject to Extended Involuntary 

Emergency Treatment.--Application for extended 

involuntary emergency treatment may be made for any 

person who is being treated pursuant to section 302 

whenever the facility determines that the need for 

emergency treatment is likely to extend beyond 120 hours. 

The application shall be filed forthwith in the court of 

common pleas, and shall state the grounds on which 

extended emergency treatment is believed to be 

necessary. The application shall state the name of any 

examining physician and the substance of his opinion 

regarding the mental condition of the person.
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approved by his team and Centre County MH/ID for a period not to exceed 

twenty (20) days.

On September 18, 2014, Appellant filed a petition for review of 

certification to involuntary inpatient mental health treatment, which the trial 

court denied on September 19, 2014. 

On October 3, 2014, MH/ID filed a petition for extended involuntary 

treatment of Appellant pursuant to 50 P.S. § 7304 (“section 304”). On 

October 6, 2014, a mental health review officer held a section 304 hearing. 

Lynette Turay, M.D., a board certified psychiatrist and Appellant’s 

treating psychiatrist, testified. N.T., 10/6/2014, at 6-7. Dr. Turay examined 

Appellant and diagnosed him with chronic paranoid schizophrenia and 

substance abuse disorder. Id. at 7-8. Dr. Turay also reviewed Appellant’s 

treatment records and relied on the information contained therein for her 

treatment and diagnosis of Appellant. Id. at 7, 11. 

Dr. Turay testified, to a reasonable degree of psychiatric certainty, 

that Appellant was currently unable to provide for his basic needs without 

care and assistance of others and that death or serious debilitation would be 

likely within 30 days if he was not treated. N.T., 10/6/2014, at 8. She also 

stated Appellant had a history of failing to take his medications and seeking 

other medications that were not appropriate for treatment of chronic 

paranoid schizophrenia. Id. at 8-9. Dr. Turay stated that Appellant did not 

believe he suffered from chronic paranoid schizophrenia, felt the 

recommended treatment was inappropriate for him, and had paranoia 
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regarding the hospital staff, who he felt were trying to cause him trouble or 

concern. Id.

Dr. Turay testified Appellant refused to talk with her and others about 

his medications, refused to participate in routine medical observation and 

care, and refused to sit down and reason through with the treating staff 

about his failure to participate in treatment. N.T., 10/6/2014, at 13-14. 

Over Appellant’s objection, Dr. Turay testified, based on hospital records, 

that Appellant had increasing delusions of chips being placed in him and 

being tortured and that he heard voices telling him that the workers at 

Strawberry Fields, where he resided, were in a conspiracy and attempting to 

kill him. Id. at 16. Further, over Appellant’s continued objections, Dr. Turay 

testified that Appellant told a medical student that he intended to seek out a 

professor in Israel to assist him in manufacturing and distributing a 

“chemical for a nicotine free base and methanol” and that Appellant 

acknowledged to medical staff that he had voices in his head that stopped at 

8:15 on October 2nd. Id. at 12, 18.

Dr. Turay opined that, if released, Appellant would return to his 

pattern of non-compliance and seek controlled substances that are not 

recommended. N.T., 10/6/2014, at 19-20. She further opined that 

inpatient treatment was the least restrictive form of treatment, and was 

required to prevent Appellant from harming himself. Id. at 19.

The Mental Health Review Officer, who presided over the section 304 

hearing, recommended that the trial court find Appellant severely disabled 
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and in need of treatment and recommended that the trial court order 

Appellant be committed to inpatient treatment at the Mount Nittany Medical 

Center with subsequent transfer to Danville State Hospital or other 

designated facility approved by his treatment team and Centre County 

MD/ID for a total commitment period not to exceed 90 days. Report of 

Mental Health Review Officer, 10/6/2014, at 1, 3. On October 8, 2014, the 

trial court ordered that Appellant be committed to inpatient treatment for a 

total commitment period not to exceed 90 days. Order, 10/8/2014.

On October 10, 2014, Appellant filed a petition for review of 

certification to involuntary inpatient mental health treatment. That same 

day, the trial court affirmed the decision and ordered that Appellant remain 

in involuntary inpatient psychiatric treatment for a period not to exceed 90 

days. 

On October 14, 2014, Appellant filed a timely notice of appeal. Both 

Appellant and the trial court complied with Pennsylvania Rule of Appellate 

Procedure 1925.3

____________________________________________

3 Although the period of commitment has expired, this appeal is not moot. 

In re Woodside, 699 A.2d 1293, 1296 (Pa.Super.1997). Involuntary 

commitment:

affects an important liberty interest, and . . . by their 

nature most involuntary commitment orders expire before 

appellate review is possible. [W]ere we to dismiss such 

appeals as moot, the challenged procedure could continue 

yet its propriety would evade our review.

(Footnote Continued Next Page)
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Appellant raises the following issues:

I. Whether the hearing examiner committed reversible 

error by overruling Appellant’s timely hearsay objections to 

the testimony of the state’s expert witness relating to 

overt acts supporting her opinion that Appellant was a 

danger to himself or others?

II. Whether the state failed to present competent and 

admissible evidence of the overt facts underlying its 

expert’s opinion that death or serious physical debilitation 

or bodily injury were likely imminent if Appellant were not 

forced to undergo involuntary psychiatric treatment?

Appellant’s Brief at 5.

Appellant first contends the trial court erred when it permitted the 

expert, Dr. Turay, to testify regarding statements made by Appellant to a 

medical student and to medical staff. Appellant’s Brief at 11-15. Appellent 

claims these statements constitute inadmissible hearsay. Id.

“The admissibility of evidence is a matter addressed solely to the 

discretion of the trial court and may be reversed only upon a showing that 

the court abused its discretion.” Klein v. Aronchick, 85 A.3d 487, 491 

(Pa.Super.2014) (quoting Commonwealth v. Marshall, 743 A.2d 489, 492 

(Pa.Super.1999)). We reverse an evidentiary ruling only if it is erroneous 

and “harmful or prejudicial to the complaining party.” Id. (quoting 

McManamon v. Washko, 906 A.2d 1259, 1268–1269 (Pa.Super.2006)).

(Footnote Continued) _______________________

Id. (internal citations and quotation marks omitted).
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Appellant relies on In re Hutchinson to support his inadmissible 

hearsay claim. In In re Hutchinson, the Supreme Court of Pennsylvania 

found counsel was ineffective at a section 304 hearing for not objecting to 

testimony of the examining psychiatrist, who relayed statements contained 

on the commitment forms and a statement the patient’s grandmother made 

during a telephone conversation claiming the patient assaulted the 

grandmother with a gun. 454 A.2d 1008, 1011 (Pa.1982). The Court found 

the statements were hearsay because they were the grandmother’s out-ofcourt statements and were offered to prove the appellee committed the 

assault. Id. The Court found counsel “had no reasonable basis for failing to 

object.” Id. 

Here, the trial court properly admitted the statements, which were the 

foundation for Dr. Turay’s expert testimony. Pennsylvania Rule of Evidence 

703 provides: “An expert may base an opinion on facts or data in the case 

that the expert has been made aware of or personally observed. If experts 

in the particular field would reasonably rely on those kinds of facts or data in 

forming an opinion on the subject, they need not be admissible for the 

opinion to be admitted.” This Court has stated:

It is well-established that an expert may express an 

opinion which is based on material not in evidence . . . 

where such material is of a type customarily relied on by 

experts in his or her profession. Such material may be 

disclosed at trial even though it might otherwise be 

hearsay . . . . Such hearsay is admissible because the 

expert’s reliance on the material provides its own 

indication of the material’s trustworthiness: “The fact that 

experts reasonably and regularly rely on this type of 
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information merely to practice their profession lends strong 

indicia of reliability to source material, when it is presented 

through a qualified expert’s eyes. 

In re D.Y., 34 A.3d 177, 182 (Pa.Super.2011) (quoting Boucher v. Pa. 

Hosp., 831 A.2d 623, 628 (Pa.Super.2003)) (internal citation omitted).

Unlike the expert in Hutchinson, Dr. Turay testified that she relied on 

information provided by other medical staff and that members of her 

profession rely on such information. N.T., 10/6/2014, at 10-12. 

Accordingly, the medical health examiner acted within her discretion in 

admitting the statements and the trial court acted within its discretion when 

relying on the statements. See, e.g., In re D.Y., 34 A.3d at 183 (expert 

permitted to testify as to name and fingerprints on ten print card even 

though the testimony was hearsay because fingerprint experts reasonably 

rely on ten print cards). 

Appellant next contends MH/ID presented insufficient evidence of overt 

acts underlying Dr. Turay’s opinion that death or serious physical debilitation 

or bodily injury were likely imminent if Appellant were not forced to undergo 

involuntary psychiatric treatment. Appellant’s Brief at 16-20. We disagree.

This Court reviews determinations pursuant to the Mental Health 

Procedures Act to “determine whether there is evidence in the record to 

justify the hearing court’s findings.” In re T.T., 875 A.2d 1123, 1126 

(Pa.Super.2005) (citing Com. ex rel. Gibson v. DiGiacinto, 439 A.2d 105, 

107 (Pa.1981)). Although “we must accept the trial court’s findings of fact 
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that have support in the record, we are not bound by its legal conclusions 

from those facts.” Id. (citing Gibson, 439 A.2d at 107).

Section 304(a) provides:

(a) Persons for Whom Application May be Made.--(1) 

A person who is severely mentally disabled and in need of 

treatment, as defined in section 301(a), may be made 

subject to court-ordered involuntary treatment upon a 

determination of clear and present danger under section 

301(b)(1) (serious bodily harm to others), or section 

301(b)(2)(i) (inability to care for himself, creating a 

danger of death or serious harm to himself), or 

301(b)(2)(ii) (attempted suicide), or 301(b)(2)(iii) (selfmutilation).

(2) Where a petition is filed for a person already subject to 

involuntary treatment, it shall be sufficient to represent, 

and upon hearing to reestablish, that the conduct originally 

required by section 301 in fact occurred, and that his 

condition continues to evidence a clear and present danger 

to himself or others. In such event, it shall not be 

necessary to show the reoccurrence of dangerous conduct, 

either harmful or debilitating, within the past 30 days.

50 P.S. § 7304(a). Section 301(a) provides:

Whenever a person is severely mentally disabled and in 

need of immediate treatment, he may be made subject to 

involuntary emergency examination and treatment. A 

person is severely mentally disabled when, as a result of 

mental illness, his capacity to exercise self-control, 

judgment and discretion in the conduct of his affairs and 

social relations or to care for his own personal needs is so 

lessened that he poses a clear and present danger of harm 

to others or to himself.

50 P.S. § 7301(a). Section 301(b) defines clear and present danger as 

follows:

(b) Determination of Clear and Present Danger.--(1) 

Clear and present danger to others shall be shown by 
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establishing that within the past 30 days the person has 

inflicted or attempted to inflict serious bodily harm on 

another and that there is a reasonable probability that 

such conduct will be repeated. . . . For the purpose of this 

section, a clear and present danger of harm to others may 

be demonstrated by proof that the person has made 

threats of harm and has committed acts in furtherance of 

the threat to commit harm.

(2) Clear and present danger to himself shall be shown by 

establishing that within the past 30 days:

(i) the person has acted in such manner as to evidence 

that he would be unable, without care, supervision and the 

continued assistance of others, to satisfy his need for 

nourishment, personal or medical care, shelter, or selfprotection and safety, and that there is a reasonable 

probability that death, serious bodily injury or serious 

physical debilitation would ensue within 30 days unless 

adequate treatment were afforded under this act; or

(ii) the person has attempted suicide and that there is the 

reasonable probability of suicide unless adequate 

treatment is afforded under this act. For the purposes of 

this subsection, a clear and present danger may be 

demonstrated by the proof that the person has made 

threats to commit suicide and has committed acts which 

are in furtherance of the threat to commit suicide; or

(iii) the person has substantially mutilated himself or 

attempted to mutilate himself substantially and that there 

is the reasonable probability of mutilation unless adequate 

treatment is afforded under this act. For the purposes of 

this subsection, a clear and present danger shall be 

established by proof that the person has made threats to 

commit mutilation and has committed acts which are in 

furtherance of the threat to commit mutilation.

50 P.S. § 7301(b).

In a section 304 hearing, the petitioner does not need to establish 

dangerous conduct recurred within the past 30 days. 50 P.S. § 7304(b); 

Commonwealth v. Romett, 538 A.2d 1339, 1341-42 (Pa.Super.1988). 
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Rather, the petitioner must establish that the patient’s condition continues to 

evidence a clear and present danger to himself or others. 50 P.S. § 

7304(a).

In Romett, this Court addressed the provision requiring that upon 

recommitment it “shall be sufficient to represent, and upon hearing to 

reestablish, that the conduct originally required, . . . in fact occurred.” 

Romett, 538 A.2d at 1342. The Court found the provision does not require 

that the grounds for original commitment be relitigated. It reasoned that 

section 304 “is satisfied as long as the patient’s commitment history shows 

that the requisite behavior occurred in the past, unless on recommitment the 

patient affirmatively challenges the original commitment. In that event, the 

burden is on the patient to show that the original commitment was 

improper.” Id. 

The trial court noted Dr. Turay, Appellant’s treating psychiatrist, 

testified that although Appellant was uncooperative, she treated him to the 

extent he allowed it. Trial Court Opinion, 11/26/2014, at 2. He was 

diagnosed with chronic paranoid schizophrenia and substance abuse disorder 

and he was paranoid, psychotic, and delusional. Id. Appellant had a history 

of failing to take his required medications upon discharge from the hospital 

and a history of seeking medications that were not appropriate. Id. Dr. 

Turay testified that Appellant was unable to provide for his basic needs, 

including health, safety, welfare, and nutrition, without the assistance of 

others and there was high risk of death, disability, or serious physical 
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debilitation. Id. She stated Appellant required inpatient treatment, which 

was the least restrictive means of treatment that would prevent him from 

harming himself or others. Id. 

The evidence presented, including Dr. Turay’s testimony, supports the 

trial court’s 90-day commitment order. Although on appeal Appellant 

maintains MH/ID failed to support his original commitment, he did not 

affirmatively challenge his original commitment at the hearing. Appellant’s 

Brief at 19; N.T., 10/6/2014. Further, his petition for review of the section 

304 determination merely asserts that the Commonwealth “presented no 

competent and admissible evidence of the overt facts underlying Dr. Turay’s 

expert opinion that death or serious physical debilitation or bodily injury 

were likely imminent if [Appellant] were not forced to undergo treatment.” 

Petition for Review of Certification to Involuntary Inpatient Mental Health 

Treatment at ¶ 14. Because Appellant did not contest his original 

commitment, MH/ID was not required at the 304 hearing to establish that 

the conduct underlying the original commitment occurred.4 See Romett, 

538 A.2d at 1342.

____________________________________________

4

Further, the record justifies Appellant’s original commitment. The original 

application asserted that Appellant had previously stated that he would like 

to end his life by taking cyanide and that he knew how to purchase it on the 

internet. Application for Involuntary Emergency Examination and 

Treatment, 9/11/2014. On September 11, 2014, the date the application 

was filed, Appellant had nitric acid in his room and had an unopened box 

from Apollo Scientific Limited Unit, which sold chemical-based products. Id. 

The original application includes letters Appellant wrote to the State College 

(Footnote Continued Next Page)
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Order affirmed.

Judgment Entered.

Joseph D. Seletyn, Esq.

Prothonotary

Date: 3/11/2015

(Footnote Continued) _______________________

Police Department, including a September 8, 2014 letter in which he wrote 

he had been “tortured day and night with voices, noise and lack of sleep,” he 

is a “wreck,” he “just can’t function anymore and . . . see[s] no hope for the 

future.” Letter Dated Sept. 8, 2014 from C.L.A. to State College Police 

Department, attached to Application for Involuntary Emergency Examination 

and Treatment, 9/11/2014. He wrote of hearing voices, being in pain, and 

having a “chip near each ear.” Id. The September 8, 2014 letter stated: 

“This has been going on for more than 10 years. I have lost my life to this 

and suffered greatly. I have suffered from constant death threats. I just 

can’t live like this.” Id. The letter also claimed the workers at Strawberry 

Fields, where Appellant resided, were in a conspiracy with the government. 

Id.