IN THE SUPREME COURT OF IOWA

No. 16–0955

Filed April 27, 2018

STATE OF IOWA,

Appellee,

vs.

WONETAH EINFELDT,

Appellant.

Appeal from the Iowa District Court for Dallas County, 

Randy Hefner, Judge. 

A defendant argues that the district court erred in failing to order a 

competency hearing during trial and in excluding certain evidence. 

REVERSED AND REMANDED. 

Mark C. Smith, State Appellate Defender, and Vidhya K. Reddy, 

Assistant Appellate Defender, Des Moines, for appellant. 

Thomas J. Miller, Attorney General, Louis S. Sloven, Assistant 

Attorney General, Wayne Reisetter, County Attorney, and Stacy L. Ritchie 

and Ronald Forsell, Assistant County Attorneys, for appellee. 
2

APPEL, Justice.

This appeal involves an important intersection involving mental 

illness and the criminal justice system. In this case, a criminal 

defendant’s lawyer moved midtrial for a competency examination of his 

client who, due to the stresses of trial was “incapable of aiding [him] in 

her defense.” The record reveals that the client, among other things, 

testified she suffered from paranoid schizophrenia but had stopped 

taking prescribed medications due to lack of funds, stated that she 

wanted to stab her lawyer in the neck and wanted to kill him, declared 

that she did not know why her lawyer was sitting next to her, told the 

court that she had called the FBI and was told she did nothing wrong, 

and further declared that she would not write notes to her lawyer during 

trial for fear the lawyer would pass the notes to the prosecution. The 

district court denied the motion and the case proceeded to verdict. On 

appeal, the defendant claims the district court erred in not ordering a 

competency examination and in excluding evidence. For the reasons 

expressed below, we reverse the judgment of the district court and 

remand the case for further proceedings.

I. Factual Background.

Wonetah Einfeldt and her two daughters were charged with willful 

injury causing bodily injury over a physical altercation between the three 

women and a fourth woman named Mulika Vinson on July 14, 2015. 

The case went to trial and the defendants were tried jointly.

Prior to trial, the State sought to exclude all character evidence 

about the victim, Vinson. This included evidence related to Vinson’s 

prior threatening behavior and her convictions for two assaults and an 

escape in Nebraska in 2001. She was fifteen or sixteen years old at the 

time of the first assault and nineteen years old at the time of the second 
3

assault. At the time of trial, Vinson was thirty-one years old. Further, 

the State sought to exclude evidence of a shooting that occurred at 

Einfeldt’s apartment complex the evening of the altercation between

Einfeldt, Einfeldt’s daughters, and Vinson. The State asserted that the 

police found no evidence of Vinson’s involvement in the shooting or that 

the shooting was directed at Einfeldt. Finally, the State sought to 

specifically exclude testimony by Lacey Chicoine about Vinson’s 

reputation for violence.

Einfeldt resisted this part of the motion in limine. She argued that 

this character evidence was admissible due to her self-defense 

justification defense rendering Vinson’s character relevant and probative. 

With respect to the shots fired the evening of the altercation, Einfeldt 

argued that the evidence was relevant because it supported Einfeldt’s 

belief that Vinson was a danger to her and others.

At a pretrial hearing, the district court judge reserved ruling on the 

admissibility of Vinson’s prior felonies. The court sustained the part of 

the State’s motion in limine with respect to the shots fired at Einfeldt’s 

apartment complex, but emphasized that this was a preliminary ruling 

and stated that Einfeldt could make an offer of proof at trial at which 

point the court might reconsider its ruling. With respect to Chicoine’s 

testimony about Vinson’s reputation, the court stressed that proper 

foundation would have to be laid to show that Chicoine was aware of 

Vinson’s reputation.

After jury selection, but before the presentation of evidence, 

Einfeldt again raised the issue of Vinson’s prior felony convictions. The 

district court found that the probative value of the evidence was 

outweighed by its danger of unfair prejudice, given how long ago the 

convictions happened and Vinson’s age at the time.
4

Later during trial, an attorney for one of Einfeldt’s daughters made 

an offer of proof concerning Chicoine’s testimony about Vinson outside 

the presence of the jury. Chicoine related that at one point she and 

Vinson were dating the same man, and Vinson threatened to “kick 

[Chicoine’s] ass” or “beat [her] up” if Chicoine didn’t stay away from the 

man. These threats were verbally made to Chicoine over the course of 

six months. Vinson never assaulted Chicoine, however. Chicoine was 

not aware of Vinson ever assaulting anyone.

The district court found that Chicoine’s testimony about threats 

was only marginally relevant to the issue of Vinson’s character trait of 

being prone to physical aggression. The court noted that Vinson only 

made threats and never assaulted Chicoine. The court thus excluded the 

evidence as more prejudicial than probative.

When Einfeldt made an offer of proof about the shots-fired incident 

at her apartment complex, the court ruled that evidence about the 

incident was inadmissible. The court found that the victim’s character 

could not be proven by a specific instance of conduct in this case or,

alternatively, that there was not clear proof that Vinson was involved in 

the shooting, and so the probative value of the evidence was outweighed 

by the danger of unfair prejudice.

At the beginning of the third day of trial, Einfeldt’s attorney 

advised the court that his client did not remember the events of the 

previous day. He called his client to the stand to further make a record

for the purpose of seeking a competency evaluation under Iowa Code 

chapter 812 (2015). When asked if she remembered the events of 

yesterday, Einfeldt responded, “No, I guess not. I don’t know.” She 

testified that she did not remember calling the prosecutor a liar or that 
5

she slammed her hand down and was animated with her lawyer. 

Further, Einfeldt volunteered, “I just want to kill you [her lawyer].”

Einfeldt testified that she thought her lawyer was taking her 

written notes and giving them to the State and to other parties.1 She

admitted that she told her lawyer that she wanted to stab him “with my 

pen in your neck.” When asked if she could pay attention to the trial, be 

helpful to her lawyer, and assist the court when asked to do things, she 

responded, “Yeah. Yeah, I don’t know, I don’t hear any noises. It’s not 

buzzing. I just really—I’m in control.” Einfeldt volunteered that someone 

was “poisoning the water.” In light of this testimony, her lawyer told the 

court that Einfeldt has suffered from mental health issues in the past 

and that “the stress of the trial has caused her to be incapable of aiding 

[him] in her defense.”

When the district court asked her if she could assist her counsel, 

Einfeldt said, “I just, I believe that I don’t—I kind of don’t, really. I do, 

but I don’t know who he is sometimes. Right now I don’t know why he’s 

sitting by me. I don’t understand this.” Einfeldt recognized, however, 

that the person sitting next to her was her attorney. When the district 

court asked whether she understood the charges, she stated, “I don’t,

 1A few months after trial, Einfeldt filed a pro se motion for a new trial and in 

arrest of judgment. In the motion, she continued to express her belief that her lawyer 

was revealing confidential communication to the prosecution. She accused the 

prosecutor of engaging in prosecutorial misconduct by obtaining privileged 

communication between Einfeldt and her attorney and using this information to cause 

the State’s witnesses to change their testimony. She additionally argued that she 

received ineffective assistance of counsel because her attorney disclosed confidential 

information to the prosecution. In a section apparently detailing her evidence showing 

that her counsel disclosed confidential communications to the prosecution, she 

described statements her attorney made such as telling her of his plans to go to a 

Subway after the outcome of the trial and order a Diet Coke, telling her that he finds 

dance recitals boring and would rather meet with clients, and stating to her that some 

evidence obtained from discovery was not admissible.
6

honestly. I called the F.B.I., and they said they don’t think I did 

anything wrong.”

When asked by the district court if she understood that she was 

being tried for the assault of Vinson, she responded, “I guess I don’t 

know what assault means, because I think that I have a right to defend 

myself.” When asked if she thought she had a defense to the charge, 

Einfeldt responded, “Yeah. I don’t know.”

Einfeldt told the district court that she had been diagnosed with 

paranoid schizophrenia, bipolar disorder, posttraumatic stress disorder, 

and attention deficit disorder. She stated she had prescriptions for these 

disorders but had not been taking her medication for a couple of months 

because she did not have the money.

The district court denied the request to suspend the proceedings 

and order a chapter 812 examination. The district court concluded that 

based on its observations, Einfeldt was capable of assisting counsel in 

providing a defense and understood the nature of the charges against 

her.

The district court revisited the question prior to sentencing. At 

this juncture, the district court had the opportunity to review Einfeldt’s 

medical records as well as a presentence investigation (PSI) report 

prepared by the department of correctional services.

The medical records from 2013 showed a provisional diagnosis at 

Broadlawns Medical Center (Broadlawns) of paranoid schizophrenia. The 

records stated that Einfeldt reported leaving Minnesota because people 

wanted to kill her. She further stated that the television talked to her. 

Her thought processes were characterized in the records as delusional. A 

regime of drug therapy was prescribed.
7

The PSI report, among other things, noted that Einfeldt had been 

diagnosed with “Schizo-Affective Disorder and Bipolar Depression” at 

Broadlawns. She had episodes of paranoia in the past and had received 

treatment for mental health issues. Based on Einfeldt’s self-report, and 

corroborated in the interview, the PSI report stated that Einfeldt was 

reporting “psychotic characteristics.” The PSI report recommended an 

assessment by a licensed professional “to more thoroughly examine the 

validity and severity of these observed features.”

The district court again declined to order a chapter 812 hearing. 

The district court stressed that up until the trial, the issue of her 

competency had not been presented by counsel. The district court stated 

that while there had been disruptive behavior, there was no behavior 

that indicated she did not understand the charge or was unable to assist

counsel with her own defense.

The district court then moved on to sentencing, and Einfeldt was 

called to the stand by her attorney. In response to her attorney’s 

questions, Einfeldt gave rambling, off-topic, and incoherent answers. For 

example, when her attorney asked her to confirm that they were asking 

the court to sentence her to probation, Einfeldt denied wanting to ask for 

probation and denied that she and her attorney were trying to seek 

probation. She announced that she did not care, and then she launched 

into a narrative in which she said that she could not think of three 

positive things about herself for the PSI report, that she was hurt by the 

PSI report author thinking she would reoffend, and that she would have 

lower recidivism because “[m]y prison number is 80655. You never 

forget that crap.” She then explained that the first crime she committed 

was theft in second grade, that her mother made her stand in the cellar 

for a week as punishment, that she was made to feel ashamed in school, 
8

that she is “a fighter” and no one messes with her, and that she never 

wanted a jury trial but instead wanted a bench trial. She concluded by 

denying that she cares about herself and stating, “I live my life every day 

for death. I don’t want to be here.”

After this allocution, the district court sentenced Einfeldt to a term 

of up to five years’ incarceration. Einfeldt appealed.

II. Standard of Review.

We review whether a trial court should have ordered a competency 

hearing de novo. State v. Mann, 512 N.W.2d 528, 531 (Iowa 1994); Jones 

v. State, 479 N.W.2d 265, 270 (Iowa 1991).

“Evidentiary rulings are generally reviewed for abuse of discretion.” 

State v. Tipton, 897 N.W.2d 653, 690 (Iowa 2017); see also State v. 

Buenaventura, 660 N.W.2d 38, 50 (Iowa 2003). If a trial court exercises 

its discretion “on grounds or for reasons clearly untenable or to an extent 

clearly unreasonable,” an abuse of discretion has occurred. 

Buenaventura, 660 N.W.2d at 50 (quoting State v. Rodriquez, 636 N.W.2d 

234, 239 (Iowa 2001)); see also Tipton, 897 N.W.2d at 690.

III. Overview of Requirement of Evaluation of Competency to 

Stand Trial.

A. Due Process. Under the United States Constitution, the 

United States Supreme Court has declared that the conviction of an 

incompetent defendant violates due process. Pate v. Robinson, 383 U.S. 

375, 378, 86 S. Ct. 836, 838 (1966). In Dusky v. United States, a onepage opinion, the Supreme Court declared that the test for competence to 

stand trial is whether the defendant has “sufficient present ability to 

consult with his lawyer with a reasonable degree of rational 

understanding . . . and . . . a rational as well as factual understanding of 
9

the proceedings against him.” 362 U.S. 402, 402, 80 S. Ct. 788, 789 

(1960) (per curium).

The Supreme Court has also declared that in order to comport with 

due process, there must be a procedural mechanism to determine 

whether a competency evaluation should be conducted. Ford v. 

Wainwright, 477 U.S. 399, 417, 106 S. Ct. 2595, 2605 (1986); Pate, 383 

U.S. at 387, 86 S. Ct. at 843. The Supreme Court has said that due 

process requires a threshold hearing to be held to determine if there is 

sufficient doubt regarding the defendant’s mental capacity to show a 

need for further evaluation. Drope v. Missouri, 420 U.S. 162, 172, 95 

S. Ct. 896, 904 (1975). Further, the Supreme Court has made it clear 

that a defendant cannot waive the due process right to competency. 

Pate, 383 U.S. at 384, 86 S. Ct. at 841.

The constitutional commands of due process have been captured 

in the ABA’s Criminal Justice Standards on Mental Health. Criminal 

Justice Standards on Mental Health (Am. Bar Ass’n 2016), 

https://www.americanbar.org/content/dam/aba/publications/criminal_

justice_standards/mental_health_standards_2016.authcheckdam.pdf

[hereinafter Mental Health Standards]. The ABA standards generally 

incorporate Dusky, noting that the test for determining a defendant’s 

competency when represented by counsel should be “whether the 

defendant has sufficient present ability to consult with defendant’s 

lawyer with a reasonable degree of rational understanding” and whether 

the defendant “has a rational as well as factual understanding of the 

proceedings.” Id. standard 7-5.2, at 43. The standards emphasize that 

the question of competence may be raised “at any stage of the 

proceedings.” Id. standard 7-4.4, at 32. Defense counsel may move for a 

competency evaluation even if the motion is over the defendant’s 
10

objection. Id. standard 7-4.3(c), at 31. If a motion for a competency 

evaluation is made by a represented defendant after probable cause has 

been found that a criminal violation has occurred, the court should enter 

an order for an evaluation if there is “a good faith doubt” as to the 

competency of the defendant. Id. standard 7-4.4(a), at 32.

B. Statutory Provisions. Iowa, like many states, has adopted a 

statutory procedure to implement the federal due process requirements 

as enunciated by the Supreme Court. Iowa Code section 812.3(1)

provides that “at any stage of a criminal proceeding” a competency 

hearing is required when the district court finds probable cause that 

there exist “specific facts showing that the defendant is suffering from a 

mental disorder which prevents the defendant from appreciating the 

charge, understanding the proceedings, or assisting effectively in the 

defense.” The court may make a finding of probable cause either after 

application by the defendant or the defendant’s attorney, or after holding 

a probable cause hearing on its own motion. Id. Probable cause exists 

for a competency hearing when a reasonable person would believe that 

there is a substantial question of the defendant’s competency. State v. 

Kempf, 282 N.W.2d 704, 706 (Iowa 1979); see also Moore v. United 

States, 464 F.2d 663, 666 (9th Cir. 1972) (noting that due process 

requires that when evidence raises a reasonable doubt about the 

defendant’s competency to stand trial, it is “substantial evidence” 

requiring that a competency hearing be held under the rule of Pate). 

When the district court orders an evaluation of competency, Iowa Code 

section 812.4 establishes a timetable for the subsequent competency 

hearing and the structure of the hearing.

We have emphasized that whether to hold a competency evaluation 

presents a legal question. State v. Edwards, 507 N.W.2d 393, 395 (Iowa 
11

1993). As a result, “[t]he trial court’s discretion does not play a 

role . . . .” Id. When a constitutional question is raised, our review of a 

district court decision regarding whether to order a competency 

evaluation is de novo. Id.

In connection with application of section 812.3, we have favorably 

cited Griffin v. Lockhart, 935 F.2d 926, 930 (8th Cir. 1991), for the 

proposition that a hearing should be held when a reasonable trial judge 

would experience doubt on whether the defendant was competent to 

stand trial. Mann, 512 N.W.2d at 531. Griffin also stands for the 

proposition that “an express doubt by the attorney for the accused is a 

legitimate factor to consider.” 935 F.2d at 930.

IV. Application of Due Process and Statutory Requirements.

Einfeldt claims that her constitutional right to due process2 as well 

as her statutory rights under Iowa Code chapter 812 were violated by the 

refusal of the district court to order a competency hearing in this case.

Upon review of the entire record, we conclude the district court 

was presented with sufficient reason to order a competency evaluation

under Iowa Code section 812.3, which is a statutory expression of state 

 2Einfeldt generically refers to “due process” and does not explicitly cite the Iowa 

or the United States Constitution. Under our caselaw, when a generic reference is 

made to a constitutional guaranty present in both the Iowa and United States 

Constitutions, the party does not offer a distinctive interpretation of the Iowa 

Constitution, and the party relies primarily on cases under the Federal Constitution, we 

apply the federal substantive standards, but reserve the right to apply those standards 

under the Iowa Constitution in a fashion different from prevailing federal authority. 

State v. Gaskins, 866 N.W.2d 1, 6 (Iowa 2015); King v. State, 797 N.W.2d 565, 571 (Iowa 

2011). For independent state constitutional interpretations of the due process clause, 

see State v. Cox, 781 N.W.2d 757, 768 (2010) (“[T]he Iowa Constitution prohibits 

admission of prior bad acts evidence based solely on general propensity.”); War Eagle 

Village Apartments v. Plummer, 775 N.W.2d 714, 721 (Iowa 2009) (holding notice by 

certified mail for forcible entry and detainer violates due process under Iowa 

Constitution); and Callender v. Skiles, 591 N.W.2d 182, 192 (Iowa 1999) (“We find a 

putative father of a child born into a marriage may have a right to standing to challenge 

paternity under the Due Process Clause of the Iowa Constitution.”).
12

and federal due process requirements. The professional statement of 

Einfeldt’s attorney regarding the difficulty of representation plays an 

important role. See United States v. Sandoval, 365 F. Supp. 2d 319, 

321–22, 325–26 (E.D.N.Y. 2005) (relying heavily on the opinions of 

defense counsel regarding competence); Jones v. State, 362 So. 2d 1334, 

1336 (Fla. 1978) (per curiam) (noting role of representations of counsel in

determining competency issues); Richard J. Bonnie, The Competence of 

Criminal Defendants: Beyond Dusky and Drope, 47 U. Miami L. Rev. 539, 

563 (1993) [hereinafter Bonnie] (“[T]he attorney is best situated to know 

whether the defendant’s impairments compromise the defense of the 

case.”). Her professed statements about wanting to kill her lawyer and

stab her lawyer in the neck with a pen, her statement that she did not 

know why the lawyer was seated beside her, and her stated belief that 

her lawyer would turn over her notes to the State gives one pause. 

Einfeldt’s lack of memory about what occurred during the prior day at 

trial is also troublesome.

Before the district court, Einfeldt’s lawyer made a credible initial 

showing that Einfeldt could not have the kind of relationship with her 

lawyer to assist in the development of her legal defense due to her mental 

state. See Dusky, 362 U.S. at 402, 80 S. Ct. at 789. Competency 

evaluations include a “careful assessment of the accused’s ability to 

interact with counsel.” See John T. Philipsborn, Searching for Uniformity 

in Adjudications of the Accused’s Competence to Assist and Consult in 

Capital Cases, 10 Psychol. Pub. Pol’y & L. 417, 422 (2004). Certainly 

competence to assist counsel includes a capacity to recognize and relate 

pertinent information to counsel concerning the facts of the case. 

Bonnie, 47 U. Miami L. Rev. at 561. The ABA standards stress the need 

for “present ability” to consult with counsel. Mental Health Standards, 
13

standards 7-4.2, -5.2, -8.7, at 30, 43, 62. The ABA standards also note

that a finding of incompetence to proceed may arise from any mental 

disorder or condition “as long as it results in a defendant’s inability to 

consult with defense counsel . . . .” Id. standard 7-4.1, at 30.

Further, the “rational understanding” required under Dusky means 

more than being “oriented to time and place” but includes accurate 

perception of reality and proper response to the world around the 

defendant, not disruptive behavior and a paranoid relationship with 

counsel. Lafferty v. Cook, 949 F.2d 1546, 1550 (10th Cir. 1991) (quoting 

Dusky, 362 U.S. at 402, 80 S. Ct. at 789). Here, we have evidence of a 

previous diagnosis of paranoid schizophrenia, along with 

contemporaneous testimony about bizarre thoughts and behavior, 

including claims of collusion between defendant’s counsel and the 

prosecution. See United States v. Ghane, 490 F.3d 1036, 1040–41 (8th

Cir. 2007) (finding defendant who suffered from intermittent periods of 

delusional paranoia and whose behavior indicated distrust of his own 

lawyers incompetent); United States v. Friedman, 366 F.3d 975, 980–81 

(9th Cir 2004) (finding defendant incompetent because paranoid 

schizophrenia directly prevented rational assistance in defense); United 

States v. Hemsi, 901 F.2d 293, 296 (2d Cir. 1990) (finding defendant 

incompetent when record revealed inability to cooperate rationally in own 

defense because of paranoia); Nagi v. People, 389 P.3d 875, 879 (Colo. 

2017) (noting “wild accusations of collusion between his counsel and the 

prosecution” a factor indicating need for competency evaluation).

When the record shows that the defendant wants to stab her 

lawyer in the neck and kill him, believes her lawyer is turning written 

notes over to the prosecution, recently has heard buzzing noises, claims 

to have been told by the FBI she did nothing wrong, states she is worried 
14

about someone poisoning the water, and has advised the court that she 

has had a history of mental health issues including a diagnosis of

paranoid schizophrenia, yet was noncompliant with prescribed drug 

therapy, a reasonable trial court should at least have some doubts as to 

the defendant’s competency to effectively assist in the defense as 

required by Iowa Code section 812.3(1). See Maxwell v. Roe, 606 F.3d 

561, 569–70 (9th Cir. 2010) (holding reasonable doubt of defendant’s 

competence was created by defendant’s history of mental illness, refusal 

to take prescribed antipsychotic medication, inability to control himself

in the courtroom, and exhibition of paranoia impairing attorney–client 

relationship). Consistent with ABA Standard 7-4.1(d) related to inability

to consult with defense counsel, the Supreme Court has stated that any 

one factor alone may sufficiently raise a reasonable doubt in the mind of 

a reasonable trial judge. Dusky, 362 U.S. at 402, 80 S. Ct. at 789; 

Mental Health Standards, standard 7-4.1(d), at 30.

There is, perhaps, the question of malingering. The Supreme 

Court addressed malingering in the context of competency evaluations in 

Cooper v. Oklahoma, 517 U.S. 348, 116 S. Ct. 1373 (1996). In Cooper, 

the question was whether a state could impose a heightened “clear and 

convincing” standard of proof on a defendant seeking to show 

incompetence. Id. at 362, 116 S. Ct. at 1380. In rejecting a higher 

standard of proof, the Supreme Court looked at the consequences of 

error. Id. at 362–63, 116 S. Ct. at 1381. According to the Cooper Court, 

“For the defendant, the consequences of an erroneous determination of 

competence are dire. Because he lacks the ability to communicate 

effectively with counsel, he may be unable to exercise other ‘rights 

deemed essential to a fair trial.’ ” Id. at 364, 116 S. Ct. at 1381 (quoting 

Riggins v. Nevada, 504 U.S. 127, 139, 112 S. Ct. 1810, 1817 (1992) 
15

(Kennedy, J., concurring)). On the other hand, “[b]y comparison to the 

defendant’s interest, the injury to the State of the opposite error—a 

conclusion that the defendant is incompetent when he is in fact 

malingering—is modest.” Id. at 365, 116 S. Ct. at 1382. The teaching of

Cooper regarding comparative interests of the state and the defendant is 

particularly compelling in the context of a preliminary proceeding to 

simply order a mental health evaluation.

And, it is true that Einfeldt expressed the view that trial should 

continue. So did the defendant in Kempf, who declared he desired to 

plead guilty and get started on prison time to “get it over with.” 282 

N.W.2d at 707. Such statements did not defeat the assertion of 

incompetence advanced by Kempf’s counsel. Id. at 707, 710; see also 

Sandoval, 365 F. Supp. 2d at 324, 328 (finding defendant incompetent 

despite defendant denying incompetence). They should not do so here.

It is important that our district court judges not put the proverbial 

cart before the horse in the competency setting. The district court was 

not called upon in this case to make a definitive determination of 

competency. See Moore, 464 F.2d at 666; Commonwealth v. Kostka, 350 

N.E.2d 444, 449 (Mass. 1976). The only question was whether the 

relatively low threshold had been met to require further evaluation and a 

subsequent hearing on the question of competency after a professional 

evaluation. Cf. Blakeney v. United States, 77 A.3d 328, 348 (D.C. 2013) 

(characterizing reasonable doubt threshold of local law on competency as 

not difficult to reach by design); Bonnie, 47 U. Miami L. Rev. at 563 

(characterizing the threshold for referral for further inquiry as “very low 

in order to cleanse all cases of doubts about competence”). The trial 

court must take care to ensure that the preliminary hearing to determine 

whether there is a bona fide doubt as to the defendant’s competency does 
16

not turn into a substitute for the determination of competency itself. 

State v. Bishop, 667 P.2d 1331, 1334 (Ariz. Ct. App. 1983).

Here, it was not the district court but the PSI report which came to 

no specific conclusion regarding Einfeldt’s mental health but, noting a 

diagnosis of schizo-affective disorder, “episodes of paranoia” in the past,

and evidence of “multiple, and fairly significant, mood and/or anxiety 

disorder indicators,” urged a thorough mental evaluation after 

sentencing. That was a good recommendation, but under the 

incompetency caselaw, this recommendation for a mental evaluation 

occurred at the wrong place and at the wrong time.

The district court relied in part upon its observations at trial. 

Such observations are, of course, relevant considerations. Yet, as the 

Supreme Court has emphasized,

[a]lthough a defendant’s demeanor during trial may be such 

as to obviate “the need for extensive reliance on psychiatric 

prediction concerning his capabilities,” . . . “this reasoning 

offers no justification for ignoring the uncontradicted

testimony of . . . (a) history of pronounced irrational 

behavior.”

Drope, 420 U.S. at 179, 95 S. Ct. at 907 (first quoting Note, Incompetency 

to Stand Trial, 81 Harv. L. Rev. 454, 469 (1967); then quoting Pate, 383 

U.S. at 385–86, 86 S. Ct. at 842). Here, in addition to the bizarre 

statements and conduct, there was evidence of a history of paranoid 

schizophrenia.3

 3Of course, a past history of mental illness, without more, is insufficient to 

trigger a competency hearing under Iowa Code section 812.3 or due process. Jones, 

479 N.W.2d at 270; Hickey v. Dist. Ct., 174 N.W.2d 406, 410 (Iowa 1970). The question 

is one of present competency, not past malady. Further, even the presence of mental 

illness at trial, in and of itself, is not necessarily sufficient to trigger the requirement of 

a competency hearing under Iowa Code section 812.3 and due process. See State v. 

Myers, 460 N.W.2d 458, 460 (Iowa 1990); State v. Lucas, 323 N.W.2d 228, 233 (Iowa 

1982). The present mental illness must be sufficient to give rise to a serious question 

as to whether the defendant meaningfully understands the charges and is capable of 

meaningfully assisting in the defense. Iowa Code § 812.3; Myers, 460 N.W.2d at 460.
17

The district court also relied on pretrial behavior of Einfeldt. But 

as the Supreme Court has noted, “[e]ven when a defendant is competent 

at the commencement of his trial, a trial court must always be alert to 

circumstances suggesting a change that would render the accused 

unable to meet the standards of competence to stand trial.” Drope, 420 

U.S. at 181, 95 S. Ct. at 908.

There is a question of remedy. At this late date, the possibility of 

making a meaningful determination of competency at the time of trial 

given the passage of time is simply not possible. See State v. Myers, 460

N.W.2d 458, 460 (Iowa 1990) (holding failure to hold a competency 

hearing not capable of cure by an ex post facto determination sometime 

after trial). As a result, we reverse the judgment of the district court and 

remand the case for a new trial. In any subsequent trial, the district 

court should monitor the proceedings and ensure that the defendant’s 

due process and statutory rights related to competency are properly 

protected throughout the proceedings.

V. Evidentiary Rulings.

Einfeldt argues that the district court erred by disallowing evidence 

of Vinson’s prior assault convictions, threats against Chicoine, and 

involvement in the shots-fired incident at Einfeldt’s apartment complex. 

Because these issues may reoccur on retrial, we address them.

A. Evidence of Violent Character of Victim. Under Iowa Rule of 

Evidence 5.404(a)(1), “[e]vidence of a person’s character or character trait 

is not admissible to prove that on a particular occasion the person acted 

in accordance with the character or trait.” An exception to this rule is 

when a defendant seeks to offer “evidence of the victim’s pertinent trait.” 

Id. r. 5.404(a)(2)(A)(ii). While ordinarily evidence of a victim’s prior violent 

or turbulent character is immaterial and not admissible at trial, if the 
18

accused asserts he or she acted in self-defense, specific instances of the 

victim’s conduct may be used to demonstrate his or her violent or 

turbulent character. State v. Webster, 865 N.W.2d 223, 243 (Iowa 2015); 

State v. Jacoby, 260 N.W.2d 828, 837 (Iowa 1977).

Yet, if such evidence’s probative value is substantially outweighed 

by danger of “unfair prejudice, confusing the issues, misleading the jury, 

undue delay, wasting time, or needlessly presenting cumulative 

evidence,” a court may exclude the evidence. Iowa R. Evid. 5.403. We 

use a two-part test to determine whether evidence should be excluded 

under rule 5.403. Webster, 865 N.W.2d at 242; State v. Huston, 825 

N.W.2d 531, 537 (Iowa 2013). “First, we consider the probative value of 

the evidence. Second, we balance the probative value against the danger 

of its prejudicial or wrongful effect upon the triers of fact.” Webster, 865 

N.W.2d at 242 (quoting Huston, 825 N.W.2d at 537). In weighing the 

probative value against the danger of unfair prejudice, we consider,

(1) the need for the proffered evidence “in view of the issues 

and other available evidence,” (2) whether there is clear proof 

it occurred, (3) the “strength or weakness of the prior-acts 

evidence in supporting the issue sought to be prove[d],” and 

(4) the degree to which the evidence would improperly 

influence the jury.

State v. Martin, 704 N.W.2d 665, 672 (Iowa 2005) (quoting State v. 

Henderson, 696 N.W.2d 5, 11 (Iowa 2005)). “Weighing probative value 

against prejudicial effect ‘is not an exact science,’ so ‘we give a great deal 

of leeway to the trial judge who must make this judgment call.’ ” State v. 

Putman, 848 N.W.2d 1, 10 (Iowa 2014) (quoting State v. Newell, 710 

N.W.2d 6, 20–21 (Iowa 2006)).

We believe that the district court acted within its discretion when it 

found that both the evidence of Vinson’s prior felonies and Chicoine’s 

testimony about threats were inadmissible under Iowa Rule of Evidence 
19

5.403. With respect to the prior felonies, these assaults occurred over 

ten years ago, when Vinson was fifteen or sixteen and nineteen 

respectively. As our juvenile sentencing caselaw emphasizes, an 

adolescent’s character is frequently not formed, and such adolescents

often develop into adults with completely different characters. See State 

v. Sweet, 879 N.W.2d 811, 833 (Iowa 2016). Without any more recent 

evidence of convictions for assaults, evidence of assault convictions 

occurring during adolescence says very little about Vinson’s adult 

character. The district court properly excluded this evidence as being 

substantially more prejudicial than probative.

Further, we find that the district court acted within its discretion 

when it excluded Chicoine’s testimony about receiving threats from 

Vinson. As the district court noted, Vinson never assaulted Chicoine. 

Verbal threats are not very probative on the issue of a person’s tendency 

toward physical confrontations and violence.

B. Evidence of Shots Fired. We affirm the district court’s ruling 

excluding evidence of the shots-fired incident at Einfeldt’s apartment 

complex. There was simply not enough evidence linking Vinson with the 

shooting or that Einfeldt or her daughters were the targets of the 

shooting. See Iowa R. Evid. 5.403; id. r. 5.404(a)(2)(A)(ii); Martin, 704 

N.W.2d at 672. The district court was within its discretion in finding 

that this evidence was not relevant to Vinson’s character.

VI. Conclusion.

For the above reasons, the judgment of the district court is 

reversed and the case remanded to the district court for further 

proceedings.

REVERSED AND REMANDED.

All justices concur except Mansfield, Waterman, and Zager, JJ., 

who concur in part and dissent in part.
20

#16–0955, State v. Einfeldt

MANSFIELD, Justice (concurring in part and dissenting in part).

I respectfully dissent in part. The majority’s reading of the record 

is selective. Based on my review of the entire record, the district court 

should not be reversed. Rather, its handling of the trial should be 

applauded as a model of how to deal with a difficult defendant.

Wonetah Einfeldt made some bizarre statements during the trial. 

But they were always out of the presence of the jury. When the jury was 

present, Einfeldt’s behavior changed. She made occasional, targeted 

interjections, generally to express her disagreement with unfavorable 

testimony. In today’s impolite world, this hardly sets her apart.

Viewing the trial as a whole, Einfeldt showed a sophisticated 

understanding of the proceedings. She ultimately worked well with her 

defense counsel, heeding his undoubtedly sound advice that she not take 

the stand and instead allow the defense case to be presented through the 

testimony of her codefendants.

The majority opinion sets the bar too low for when a defendant can 

hold up a trial by being disruptive or making bizarre remarks. I fear 

today’s decision will make trial management more difficult for our trial 

judges.

Like the majority, I take the issue of mental illness seriously. But I 

think their opinion is naive. According to the Iowa Department of 

Corrections, over half of Iowa prisoners have either a serious mental 

illness or a chronic mental health diagnosis. See Iowa Dep’t of Corr., 

Mental Health Information Sharing Program 1 (Jan. 2017), 

http://idph.iowa.gov/Portals/1/Meetings/MeetingFiles/OtherFiles/95/8

d8a73aa-da57-475e-b44f-77c91800cbd0.pdf. Mental illness and 

criminal conduct to some extent go together. Except in exceptional cases 
21

when the criteria of Iowa Code section 812.3 have been met, mental 

illness is not a reason to halt a criminal trial, thereby necessitating a 

later do-over.

I. The Facts Revisited.

The majority characterizes this case as a “physical altercation 

between [Einfeldt and her two daughters] and a fourth woman named 

Mulika Vinson on July 14, 2015.” This sanitized description of the case 

does not do justice to its facts. The evidence of Einfeldt’s guilt was quite 

strong.

The trial evidence showed that this was a deliberate, planned 

beating of the victim (Vinson). Two bystanders saw what happened and 

testified at trial. Most importantly, one of those bystanders managed to 

record part of the beating on his cell phone. The video was replayed at 

trial. As we know from current events, video evidence can be very 

powerful. It was powerful here.

A. The Events of July 14, 2015. On July 14, 2015, Einfeldt, 

accompanied by her daughters Danielle and Beatrice Abang-Ntuen, 

walked up to the front door of Vinson’s home in Perry. Vinson was at

home with her five-year-old daughter and her four-year-old son. The 

impetus for the visit was apparently an ongoing feud between Danielle 

and Vinson over a male coworker.

Meanwhile, two individuals were putting up siding on a nearby 

house. They heard the commotion and witnessed much of the 

altercation. One of them later testified that Einfeldt, Danielle, and 

Beatrice were coming down the street, “angry and looking for a fight.” 

According to this worker, Einfeldt and her daughters yelled at Vinson to 

come out of her house, which she did. This same worker testified that 

Danielle initiated the altercation and Einfeldt and Danielle then grabbed 
22

Vinson together and threw her to the ground. He recalled that Einfeldt 

and Danielle did most of the damage to Vinson, but Beatrice also 

delivered a few blows.

The other worker likewise testified that he saw the three women 

walking up to Vinson’s house, yelling for Vinson to come out. He saw 

Vinson standing inside the door, reluctant to come outside, although she 

eventually did. According to this worker, Vinson kept telling the 

defendants her children were watching. This worker then saw Einfeldt, 

Danielle, and Beatrice dragging Vinson by the arms and beating her. He 

recorded a portion of the altercation on his cell phone before he 

intervened to stop it. The cell phone video, although only a few seconds 

long, shows both Einfeldt and Danielle dragging and striking Vinson as 

she lies helpless on the ground. Beatrice is standing and watching, just 

a few feet away.

Once the second worker intervened, Einfeldt and her two 

daughters started to walk away down the street. The worker followed 

them on foot as he spoke on his cell phone with the Perry police 

department. Vinson remained on the ground injured.

The police arrived soon afterward. Einfeldt and Danielle were 

taken into custody. Einfeldt told the police, “I beat her mother____ ass, 

now book me up.” When Einfeldt was advised that paramedics were with 

Vinson, she said something to the effect that “she’s going to need them.” 

Vinson was admitted to a hospital later that evening and treated for her 

injuries.

B. Trial Begins. On August 5, Einfeldt and both daughters were 

charged with willful injury causing bodily injury. See Iowa Code 

§ 708.4(2) (2015). The defendants were tried jointly beginning on April 

18, 2016.
23

Einfeldt and Danielle raised justification as a defense, while 

Beatrice denied participating in the assault. All of them asserted that 

Vinson had brandished a handgun in a threatening manner when she 

answered the door. They admitted they didn’t see the gun after that.

Vinson denied she had a gun. No one found a gun. The 

construction workers never saw a gun or heard anyone say anything 

about a gun. It defies common sense that Vinson would have 

brandished a gun when answering the door, then walked outside without 

the gun to subject herself to the mercy of the three angry defendants.

As the trial went on, Einfeldt was disruptive at times. During the 

prosecutor’s opening statement, she made interjections out loud three 

times. The third time, the court took a recess. Out of the presence of 

the jury, the court had a colloquy with Einfeldt. During this colloquy, 

Einfeldt took the opportunity to correct a factual statement the 

prosecutor had made relating to the admissibility of Vinson’s prior 

convictions. Still, she agreed to keep quiet in the future. She also 

explained that she has anxiety and if she starts having a panic attack, it 

usually starts with coughing and she would need to leave. The court 

advised her to let her attorney know “or raise your hand, and we’ll take a 

recess. . . . We do want to accommodate those health issues.”

Vinson was the State’s first witness to testify. Einfeldt kept silent 

throughout her testimony. One of the bystander workers testified next. 

During his cross-examination, Einfeldt said “objection” one time after he 

gave a harmful answer.

C. The Probable Cause Hearing. The next morning, before the 

jury was summoned, Einfeldt’s counsel advised the court that Einfeldt 

had told him “she did not remember the events of yesterday” and had 

discussed “her current mental state” with him. He asked permission to 
24

make a record as to Einfeldt’s mental condition. The district court 

agreed.

When questioned by her counsel, Einfeldt said she remembered 

“some” of the evidence from the previous day and “want[ed] to go 

forward.” But when counsel asked Einfeldt if she thought she would be 

able to pass notes to him when needed, Einfeldt answered, “No, because 

I don’t want you reading my notes. I don’t know if I trust—I mean, I do. 

I think you’re a good person. But I just want to kill you. I don’t know 

you.” She acknowledged that the previous day she had been upset 

because she thought her counsel was passing her notes to other parties. 

She said she had wanted to stab her counsel with a pen in the neck, 

although she didn’t. Yet she said she thought she would be able to pay 

attention to the trial and was “in control.” She concluded,

I don’t want to go [to] the hospital. I don’t want to go back. I 

don’t want to go to Oakdale. I just want to finish this, and 

whatever happens just happens. And I want my kids to be 

all right, and I just don’t know what to do. I don’t want to 

answer any more questions.

Einfeldt interjected one further comment: “I think she’s poisoning the 

water.”

At this point, Einfeldt’s counsel represented to the court, “I don’t 

believe nor have ever felt threatened by her.” Nonetheless, he moved to 

suspend the proceedings under Iowa Code chapter 812, relating to 

competency to stand trial.

The State opposed the motion. It urged there had been no showing 

that Einfeldt did not understand the nature of the charges and their 

consequences or that she was unable to assist in her defense.

The district court questioned Einfeldt further. Einfeldt claimed she 

had “a diagnosis of paranoid schizophrenia with manic bipolar, PTSD 
25

and ADD, or something like that.” She said she had prescriptions but 

had not taken them for a couple of months for financial reasons.

The district court denied the motion to suspend the trial. It 

explained,

Based upon my observations, not only during the first two 

days of this trial, but during previous hearings, it appears to 

me as if Ms. Einfeldt is capable of assisting Mr. Macro in 

providing a defense.

I do believe she understands the nature of the charges. 

Just the explanation of the defenses that she believes she 

has, suggest to me that conversely she understands the 

underlying charges.

The court added that the previous day had gone relatively smoothly and 

reassured Einfeldt that if she needed to take a break, she could do so.

D. The Trial Continues. During the course of that morning’s 

testimony, Einfeldt said, “Liar,” once during the testimony of a police 

officer. She later blurted, “I never said that,” when another police officer 

referred to a statement Einfeldt supposedly made. Later, she said, “Ha 

ha ha,” and slapped the table when that officer claimed the only injury 

he saw on a photograph of Danielle’s face was a mosquito bite.

After the jury had been excused for the morning, defense counsel 

for Danielle and Beatrice complained that Einfeldt had been putting her 

head down and pulling out tissues loudly and stuffing them back in the 

box, “all disruptive behavior.” The district court denied their motion for 

mistrial, although it agreed these events had occurred.

In the afternoon, Einfeldt made three brief audible comments 

during the testimony of the worker who had taken a video of the 

altercation. Thereafter, the State rested and the jury was excused again. 

At this point, Einfeldt became a more active participant.
26

All three defense counsel argued motions for judgment of acquittal. 

When they were denied, Einfeldt inquired of the district court, “Can I ask 

one question off the record? Do you ever grant dismissal? I just want to 

ask.” After the prosecutor later argued for the exclusion of a defense 

witness, Einfeldt asked, “Why are you guys trying to hide the truth? I 

can’t understand that.” When there was a discussion about whether the

defendants would testify, Einfeldt stated, “I’m telling everybody [Vinson] 

drove by my house and tried to shoot us”—a reference to an incident that 

had been excluded based on a motion in limine ruling. She added, “I 

[will] tell everything that you guys are trying to hide, all the lies that 

you’re making people tell.” Her counsel requested a break, and the jury 

then returned and two defense witnesses testified without incident.

The day concluded with an offer of proof out of the jury’s presence. 

As her attorney concluded his offer-of-proof examination of one witness, 

Einfeldt added a suggestion that he ask the witness about having 

received a controlled substance from Vinson. Later, while the prosecutor 

was cross-examining this same witness during the offer of proof, Einfeldt 

inquired, “Why are we redeposing her? What is going on?”

When Einfeldt’s counsel requested permission to speak privately 

with Einfeldt, Einfeldt said she wanted “everything on the record,” and 

“she can’t take this.” She asked generally, “Why [are] you hiding the 

truth?” She added that she wanted an African-American lawyer. The 

district court explained the purpose of the offer of proof to her. Einfeldt 

countered,

I want to know how come everything that’s in front of the 

jury has to be screened by you, but everything that she [(the 

prosecutor)] put in, all the lies that she told, was not 

screened by you. I don’t get it. We’re supposed to have more 

rights than her.
27

The court responded that it had explained the offer of proof as best as it 

could and asked Einfeldt to agree to remain quiet during the remainder 

of the offer.

The next day was uneventful until the time came to make a record 

on Einfeldt’s decision whether to testify or not. She indicated she wanted 

to testify and continued to argue about the shooting incident that the 

district court had excluded. The district court emphasized that Einfeldt 

would be able to answer the questions asked and nothing more. Einfeldt 

further commented that “[t]he judge is a good guy” and later added that 

she wanted a trial before the judge rather than the jury.

The jury returned, and Einfeldt generally behaved well as defense 

witnesses, including Danielle and Beatrice, testified. Meanwhile, Einfeldt 

had changed her mind and decided not to testify on the advice of her 

counsel. A record was made with the court out of the jury’s presence.

Closing arguments took place the next day, the final day of trial. 

Einfeldt said nothing during the prosecutor’s initial argument or the 

arguments of the other defense counsel. She corrected her counsel when 

he said “Beatrice” instead of “Danielle” during closing argument and 

clapped at the end of that closing. Otherwise, she was quiet. However, 

during the prosecutor’s rebuttal argument, Einfeldt made three brief 

interjections. Following the third, the district court advised her that if 

she did that again, she would have to be removed from the courtroom. 

At that point, Einfeldt voluntarily got up and left.

The jury returned guilty verdicts against Einfeldt and Danielle. It 

found Beatrice guilty of the lesser-included offense of assault.

E. Sentencing. A presentence investigation report (PSI) was 

prepared on Einfeldt. Attached to it were two records from Broadlawns 

Medical Center relating to Einfeldt. In June 2013, Einfeldt appeared at 
28

Broadlawns for a psychiatric evaluation complaining of “feeling stressed 

out.” Einfeldt stated that she had been hospitalized at age seventeen4

and had had recurring paranoia and “exacerbations of her paranoid 

symptoms” since then but no other hospitalizations. According to the 

report, she believed she was “married to the devil” and was “vague about 

hearing voices.” However, she “did not want to discuss past diagnoses.”

The Broadlawns report gave her a “provisional” diagnosis of 

paranoid schizophrenia and noted “hallucinations (questionable).” 

Einfeldt was prescribed one new medication and told to follow up in a 

month, but she did not return.

Einfeldt next went for another psychiatric evaluation at 

Broadlawns in October 2015, after she had been charged in this case. 

She said she had not returned after the first visit “because upon her 

leaving she saw a body bag.” She complained again of paranoia. Once 

again, the same medication was prescribed, and Einfeldt was told to

follow up in one month which, again, she did not do.

The PSI recommended incarceration of Einfeldt. It further 

recommended that while incarcerated, she obtain a mental health 

evaluation and be screened for an assaultive behavior class or anger 

management.5

The PSI also included Einfeldt’s version of the offense. There, 

Einfeldt did not mention any mental health concerns. Instead, she 

provided—in her own words and handwriting—a statement that deftly 

accepted a degree of responsibility. She wrote, “I am not justifying my 

 4Einfeldt was forty-one years old at the time of this evaluation.

5According to the PSI, Einfeldt admitted attempting suicide as a teenager, over 

twenty years before. Einfeldt denied this at the sentencing hearing and denied any 

suicidal ideations or attempts.
29

behavior. I take full responsibility for the fight . . . .” Yet she then 

repeated her claims that Vinson had a gun and that she (Einfeldt) was 

acting in self-defense. Still, she concluded, “Self-defense doesn’t 

constitute beating the holy crap out of someone even if they have a gun.”

The district court began the sentencing hearing by considering 

Einfeldt’s motion for new trial. That motion had, among other things, 

reraised the question of competency. Concerning Einfeldt’s competency, 

the court explained it had now considered the PSI and attached medical 

records in addition to the trial and pretrial proceedings. It stated as 

follows,

Here’s what I note regarding that issue: The trial 

information in this case was filed on August 5, 2015. There 

was no application for an 812 exam from that date until trial 

started on April 20[, 2016]. So I infer from that, and I believe 

it’s a reasonable inference, that up until the time Mr. Macro 

brought this issue to my attention, there was not a concern 

about Ms. Einfeldt’s legal competency.

During the trial it did appear to me as if Ms. Einfeldt 

was participating in her defense. She also responded 

appropriately during the colloquy regarding her decision to 

not testify.

Without question, Ms. Einfeldt did engage in 

disruptive behavior during the trial, but that may have been 

simple disrespect. Or I think in Ms. Einfeldt’s case it was 

probably spontaneous emotional outbursts. But that is 

different from being legally incompetent.

I did not observe behavior that suggested Ms. Einfeldt 

did not understand the charge or the proceedings or that she 

was unable to assist with her own defense.

After denying the motion for new trial, the court proceeded to 

sentencing. Einfeldt testified she had been diagnosed with different 

mental diagnoses but did not agree with those diagnoses. She elaborated 

that she was not seeing a doctor or therapist or taking any medications. 

She addressed the judge and said, “I do respect you.” She added, “I do 
30

respect the whole system. I believe in the law.” She went through much 

of her prior life history, including past brushes with the law. She 

acknowledged that “there’s a[n] appeal going to be filed in this case,” and 

said she understood “what reversible error is.” She stated, “I do honestly 

believe the Judge was fair,” but “[t]he rules are slanted, and they’re in 

favor of [the] State.” She testified that if she were put on probation, she 

would have a job and a place to live and she would comply with the 

terms of probation. She made no references to any delusions or 

impulses or paranoia.

The district court sentenced Einfeldt to an indeterminate term of 

five years’ incarceration. See Iowa Code § 902.9(1)(e).

II. The District Court Properly Denied Einfeldt’s Motion to 

Terminate the Trial for Purposes of a Competency Hearing.

The fighting issue is whether the district court erred in denying 

Einfeldt’s request to suspend proceedings for a competency hearing 

during the second day of trial. Had the court done so, this would of 

course have necessitated a new trial at a later date.

A. The Controlling Law. Iowa Code section 812.3 governs this 

issue and provides,

If at any stage of a criminal proceeding the defendant or the 

defendant’s attorney . . . alleges specific facts showing that 

the defendant is suffering from a mental disorder which 

prevents the defendant from appreciating the charge, 

understanding the proceedings, or assisting effectively in the 

defense, the court shall suspend further proceedings and 

determine if probable cause exists to sustain the allegations.

Iowa Code § 812.3(1) (2016). Additionally, if the court finds probable 

cause to sustain the allegations,

[T]he court shall suspend further criminal proceedings and 

order the defendant to undergo a psychiatric evaluation to 

determine whether the defendant is suffering a mental 

disorder which prevents the defendant from appreciating the 
31

charge, understanding the proceedings, or assisting 

effectively in the defense.

Id. § 812.3(2). The psychiatric evaluation is then followed by a 

competency hearing. Id. §§ 812.4–.5.

Although Iowa has long had provisions relating to mental 

incompetency of the accused, this two-step process of a probable cause 

hearing followed by an evaluation and a competency hearing if necessary

dates only to 2004. See 2004 Iowa Acts ch. 1084, § 5 (codified at Iowa 

Code § 812.3 (2005)). Here, the district court followed the correct 

procedure. It suspended the proceedings briefly and temporarily so that 

Einfeldt’s counsel and the court could examine her, and so the parties 

could provide argument and additional information to the court. Hence, 

the court conducted the clearly required probable cause hearing. But it 

denied Einfeldt’s request to terminate the trial so she could undergo a 

psychiatric evaluation and a full-blown competency hearing.

Under our precedent, a competency hearing should be granted 

when the “record contains information from which a reasonable person 

would believe a substantial question of the defendant’s competency 

exists.” Jones v. State, 479 N.W.2d 265, 270 (Iowa 1991) (quoting State 

v. Kempf, 282 N.W.2d 704, 706 (Iowa 1979)). We consider three factors: 

“(1) the defendant’s irrational behavior, (2) any demeanor at the trial that 

suggests a competency problem, and (3) any prior medical opinion on the 

defendant’s competency to stand trial.” State v. Edwards, 507 N.W.2d 

393, 395 (Iowa 1993).

These factors illuminate for us the ultimate question of 

competency facing the judge: whether the defendant is prevented from 

“appreciating the charge, understanding the proceedings, or assisting 

effectively in the defense.” Iowa Code § 812.3(1) (2016); see also State v. 
32

Johnson, 784 N.W.2d 192, 194 (Iowa 2010). Mental illness alone is not 

sufficient to establish incompetency. See State v. Rieflin, 558 N.W.2d 

149, 152–53 (Iowa 1996), overruled on other grounds by State v. Lyman, 

776 N.W.2d 865, 873 (Iowa 2010). Furthermore, we presume that the 

defendant is competent to stand trial. Lyman, 776 N.W.2d at 874 

overruled on other grounds by Alcala v. Marriott Int’l, Inc., 880 N.W.2d 

699, 708 & n.3 (Iowa 2016).

B. Applying the Law Here. Applying each of these tests and 

standards, I agree with the district court that probable cause did not 

exist to stop the trial and order Einfeldt to undergo a psychiatric 

evaluation and a competency hearing. There is no question that Einfeldt 

understood she had been charged with assaulting and injuring Vinson 

on July 14, 2015. She recognized she had been offered before trial the 

opportunity to plead to two aggravated misdemeanors but without the 

chance to argue for a deferred judgment. She declined this offer. She 

also understood justification was her primary defense. She was able to 

explain this defense to the district court during the probable cause 

hearing.

Einfeldt’s comprehension of the proceedings is vividly illustrated by 

her own statements, both in and out of the presence of the jury. 

Typically, Einfeldt’s interjections in front of the jury were brief comments 

disputing testimony or statements that she recognized were harmful to 

that defense. For example: “Lie,” “No they didn’t,” “Liar,” “Ha ha ha,” “I 

never said that,” “Ha.” Sadly, these kinds of courtroom disruptions are 

not all that uncommon and aren’t limited to litigants suffering from 

mental illness. See United States v. Clements, 522 F.3d 790, 796 (7th 

Cir. 2008) (“Clements’s behavior at trial does not suggest incompetence; 
33

it was merely Clements’s attempts to interject his own view of the issues 

and generally frustrate the progress of the trial.”).6

Outside the jury’s presence, Einfeldt took the opportunity to 

debate legal points with the court. She questioned why her evidence had 

to undergo an offer-of-proof screening process, when the State’s did not. 

She threatened to circumvent the court’s ruling excluding certain 

evidence by taking the stand. When the State decided to cross-examine 

a witness during the defendants’ offer of proof, she asked, “Why are we 

redeposing her?” At one point she told the court, “We’re supposed to 

have more rights than [the prosecutor].” These comments demonstrate 

Einfeldt’s savvy, not an inability to understand the proceedings. See id.

(“While Clements was at times disruptive, his objections, questions, and 

suggestions were generally pertinent to the issues being addressed, 

indicating that Clements was fully attentive to the proceedings and 

readily offered suggestions and opinions about the evidence and his 

defense.”).

The record also indicates that Einfeldt was able to assist effectively 

in her defense. Despite the distrust she claimed to have for her attorney 

at the beginning of the second day of trial, she communicated effectively 

with him about her case through the rest of the proceedings. She did not 

hesitate to direct him toward facts she believed were helpful to her. She 

generally consulted off the record with him when he asked. Despite her 

ebullience she ultimately accepted his recommendation not to testify. 

She applauded when he completed his closing argument on her behalf.

 6Other interjections just showed that she was paying careful attention. When 

counsel for one of the codefendants started cross-examining a witness who had the 

same last name as this counsel, Einfeldt piped up, “No relation.” Also, as noted earlier, 

Einfeldt corrected her defense counsel when he inadvertently referred to the wrong 

daughter in closing argument.
34

Einfeldt apparently suffers from certain mental health conditions, 

and she testified that she had some disturbing impulses. But apart from 

making audible editorial comments, and a few theatrical gestures, she 

generally controlled those impulses in front of the jury until she walked 

out just a few minutes before the prosecutor finished her rebuttal closing 

argument. It is true she made some bizarre statements, but never in the 

presence of the jury. And Einfeldt’s counsel made clear that he never felt 

threatened by her.

Here we have the benefit of the trial court’s observations of 

Einfeldt’s demeanor. See Johnson, 784 N.W.2d at 195. It concluded that 

Einfeldt was actively engaged with her counsel in the defense of her case. 

Nothing in the record contradicts that.

This does not mean that Einfeldt’s outbursts helped her cause. 

Defendants are often their own worst enemy. Yet disruptive statements 

by a defendant need to be distinguished from those matters that 

ultimately tip the scales under Iowa Code section 812.3. Those matters 

are whether the defendant understands the charges and the proceedings 

and can effectively assist her counsel. A defendant who engages in rude 

or even offensive behavior in front of the jury may still be able to 

effectively assist counsel. Many cases have so found. See United States 

v. Perkins, 787 F.3d 1329, 1339–40 (11th Cir. 2015) (holding that the 

district court did not abuse its discretion in not ordering a competency 

hearing before trial because the defendant chose to “act like a . . . 

lunatic” during the trial but appeared lucid in other interactions 

(alteration omitted)); Paul v. United States, 534 F.3d 832, 845 (8th Cir. 

2008) (finding the defendant had not shown the district court would have 

found him incompetent, despite the fact that his obstreperous behavior 

during trial was “unwise and detrimental to him and his cause”); 
35

Clements, 522 F.3d at 796 (finding the district court did not err in not 

sua sponte ordering a competency hearing, despite the defendant’s 

disruptive interjections throughout trial, because “his objections, 

questions, and suggestions were generally pertinent to the issues being 

addressed, indicating that [the defendant] was fully attentive to the 

proceedings and readily offered suggestions and opinions about the 

evidence and his defense”); United States v. Rivers, No. 95–1364, 1996 

WL 167748, at *1 (2d Cir. Apr. 10, 1996) (holding that the district court 

did not err in not ordering a hearing into the defendant’s competency to 

stand trial, even though the defendant’s behavior at trial was “at times 

unruly,” because his interjected “remarks were generally directly 

responsive to what was being discussed”); Foster v. Wainwright, 686 F.2d 

1382, 1383–86 (11th Cir. 1982) (per curiam) (“reject[ing] as meritless” the 

defendant’s claim that the trial court erred in not ordering a hearing on 

his competency to stand trial, even though the defendant frequently 

interrupted the proceedings, to the point that the judge justifiably 

removed him from the courtroom); State v. Woods, 348 P.3d 583, 592–93 

(Kan. 2015) (holding that district court did not abuse its discretion in not 

ordering a reevaluation of competency because the defendant exhibited 

disruptive behavior that was unrelated to what was occurring in trial but 

was “isolated and could easily be attributed to an attempt to derail the 

judicial process”); State v. McCoy, 218 So. 3d 535, 617–20 (La. 2016) 

(finding a second sanity commission was not justified, even when the 

defendant was disruptive during trial, in part because he “exercised selfcontrol when he wanted to”); Commonwealth v. Holland, 73 N.E.3d 276, 

286 (Mass. 2017) (affirming a determination of competency when at the 

competency hearing the doctor noted that the defendant’s “outbursts 

[and] bouts of uncooperativeness with attorneys . . . make him a 
36

problematic defendant, but not an incompetent one” (alteration omitted)); 

Hutto v. State, 227 So. 3d 963, 976 (Miss. 2017) (finding that after a 

pretrial hearing had determined competency, a subsequent midtrial 

outburst did not change the determination because the defendant was 

not “incoherent and deluded during trial; rather, . . . [the defendant] 

actively participated in the proceedings and engaged in discussions with 

his counsel”); State v. Ramirez, No. S–1–SC–34576, 2016 WL 7029226, at 

*4–5 (N.M. Dec. 1, 2016) (finding there was no basis for a reevaluation of 

competency, even though defendant “was labile, crying, interrupting, and 

making statements contrary to his interests during trial”).

The additional information made available at the time of 

sentencing did not alter the district court’s view of the matter, and does 

not alter mine. According to a medical record attached to the PSI, 

Einfeldt received a “provisional” diagnosis of paranoid schizophrenia and 

“hallucinations (questionable)” in 2013. Yet she did not return for 

another consultation until she had been criminally charged, more than 

two years later. Then she didn’t return again.

Einfeldt’s conduct during sentencing does not suggest 

incompetence. Rather, Einfeldt testified and allocuted at some length on 

her own behalf. Einfeldt’s statements—and the letter she wrote to the 

judge beforehand—amounted to a detailed recital of extenuating 

circumstances and a plea for clemency. She artfully complimented the 

trial judge on his fairness. In her only reference to mental health 

conditions, she minimized them. She made no odd statements 

whatsoever.

I accept as unresolved the actual status of Einfeldt’s mental 

illness. The PSI appropriately recommended a formal diagnostic 

assessment of the “validity and severity” of Einfeldt’s mental health 
37

issues if she were sentenced to prison. However, for present purposes, 

the question is whether the record establishes probable cause to believe 

that Einfeldt was prevented from appreciating the charge, understanding 

the proceedings, or assisting in her defense. See Iowa Code § 812.3(1), 

(2). The record did not show any of these things.

Cases finding incompetency or probable cause for incompetency 

correctly focus on the effects of mental illness, rather than the mere 

presence of mental illness. See, e.g., Maxwell v. Roe, 606 F.3d 561, 569–

70, 576 (9th Cir. 2010) (noting the defendant requested his attorney turn 

over evidence that would be helpful to the prosecution, refused to attend 

or even listen to the trial proceedings, and tried to kill himself during 

trial); United States v. Ghane, 490 F.3d 1036, 1040–41 (8th Cir. 2007) 

(affirming a finding of incompetency to stand trial on a “clear error” 

standard of review given the defendant’s belief that the charges against 

him were part of a “wide ranging government conspiracy related to events 

that occurred in the early 1990s” and the defendant’s insistence on 

calling irrelevant witnesses); United States v. Friedman, 366 F.3d 975, 

981 (9th Cir. 2004) (affirming a finding of incompetency to stand trial 

because the defendant’s “paranoid schizophrenia [was] preventing him 

from working with his attorney”); Lafferty v. Cook, 949 F.2d 1546, 1549, 

1555 (10th Cir. 1991) (noting the defendant refused to let his attorney 

present evidence and “suffered from paranoid delusions which drove his 

decision in these proceedings”); United States v. Hemsi, 901 F.2d 293, 

294, 296 (2d Cir. 1990) (affirming a finding of incompetency to stand trial 

where expert testimony indicated that defendant could maintain his 

composure “only on rare, non-threatening occasions” and his own 

attorney, even while opposing a finding of incompetence, “disclaimed any 

view that [the defendant] could make any rational decisions regarding the 
38

defense”); Nagi v. People, 389 P.3d 875, 877, 879 (Colo. 2017) (affirming 

the trial judge had a “good faith basis” to hold a competency hearing in 

light of defendant’s questionable decision to represent himself in a case 

involving potential life sentence plus “wild accusations” and other 

“aberrant behavior”).

I am convinced the district court gave the competency question the 

serious attention it deserved and made an appropriate ruling that 

applied the correct law to the facts. Given my agreement with the 

majority’s resolution of the evidentiary issues, I would affirm Einfeldt’s 

conviction and sentence.

Waterman and Zager, JJ., join this concurrence in part and 

dissent in part.