Illinois Official Reports 

Appellate Court

In re Christopher C., 2018 IL App (5th) 150301

Appellate Court 

Caption

In re CHRISTOPHER C., Alleged to Be a Person Subject to 

Involuntary Administration of Psychotropic Medication (The People 

of the State of Illinois, Petitioner-Appellee, v. Christopher C., 

Respondent-Appellant).

District & No. Fifth District

Docket No. 5-15-0301

Rule 23 order filed

Motion to publish

granted

Opinion filed

October 18, 2018

November 16, 2018

November 16, 2018

Decision Under 

Review

Appeal from the Circuit Court of Randolph County, No. 15-MH-74; 

the Hon. Richard A. Brown, Judge, presiding.

Judgment Reversed.

Counsel on

Appeal

Veronique Baker and Barbara A. Goeben, of Guardianship and 

Advocacy Commission, of Alton, for appellant.

Jeremy R. Walker, State’s Attorney, of Chester (Patrick Delfino, 

David J. Robinson, and Chelsea E. Kasten, of State’s Attorneys 

Appellate Prosecutor’s Office, of counsel), for the People.
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Panel PRESIDING JUSTICE BARBERIS delivered the judgment of the 

court, with opinion.

Justice Moore concurred in the judgment and opinion.

Justice Cates dissented, with opinion.

 OPINION 

¶ 1 The respondent, Christopher C., appeals from the order of the circuit court of Randolph 

County authorizing the involuntary administration of psychotropic medication and testing, 

pursuant to section 2-107.1(a-5) of the Mental Health and Developmental Disabilities Code 

(Code) (405 ILCS 5/2-107.1(a-5) (West 2014)). The respondent argues that the court’s order 

failed to comply with the Code (id. § 2-107.1(a-5)(4)(G), (a-5)(6)) because (1) the State failed 

to prove by clear and convincing evidence that the testing and procedures requested in the 

petition were essential for the safe and effective administration of the medication and (2) the 

court’s designation of specific persons authorized to administer treatment was not supported 

by the evidence. In addition, the respondent argues that he was denied effective assistance of 

counsel. For the reasons that follow, we reverse. 

¶ 2 I. Background 

¶ 3 The respondent was admitted to the Chester Mental Health Center (CMHC) on May 21, 

2015, after he was found unfit to stand trial on a charge for aggravated assault. On July 23, 

2015, the respondent’s treating psychiatrist at CMHC, Dr. Nageswararao Vallabhaneni, filed a 

petition seeking an order authorizing the involuntary administration of psychotropic 

medications and testing, alleging the tests were necessary for the safe and effective 

administration of the medications. The petition detailed the primary and alternative 

medications, tests, and procedures in three separate tables that Dr. Vallabhaneni recommended 

for the respondent. The first table listed two primary medications, specifically, olanzapine and 

lorazepam. The second table listed two alternative medications, specifically, risperidone and 

clonazepam. The third table indicated that periodic blood draws and tests would be necessary 

to monitor the respondent’s medication, electrolyte, and enzyme levels. 

¶ 4 On July 29, 2015, the circuit court held a hearing on the petition. Dr. Vallabhaneni testified 

to the following. Dr. Vallabhaneni evaluated and then diagnosed the respondent with psychotic 

disorder, not otherwise specified. Because the respondent had a long history of recurrent 

symptoms (i.e., threatening and disruptive behavior), Dr. Vallabhaneni opined that the 

respondent’s mental illness had resulted in a deterioration of his ability to function. 

¶ 5 Dr. Vallabhaneni described specific occasions where the respondent had displayed 

threatening and disruptive behavior. While in jail for the most recent aggravated battery 

charge, the respondent refused medication and was placed in isolation after he threatened to 

physically harm inmates and staff members. After the respondent was ordered to undergo a 

fitness evaluation, he was found unfit to stand trial and remanded to CMHC for treatment. 

While at CMHC, the respondent had to be physically restrained in an isolated, quiet room on 

several occasions, and during one incident, he was forced to take emergency medication to 

control his disruptive behavior. While the respondent denied suffering from a mental illness, 

he had voluntarily taken the maximum recommended dose of Seroquel because he believed the 
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medication treated anxiety. Despite taking the maximum dose of Seroquel, the respondent 

continued to display psychotic and paranoid behaviors. Although Dr. Vallabhaneni advised the 

respondent that Seroquel had been ineffective and recommended the administration of 

different medications, the respondent refused to consent to the administration of different 

medications. 

¶ 6 Dr. Vallabhaneni testified that the respondent lacked the capacity to make a reasoned 

decision about his treatment and condition. Dr. Vallabhaneni explained that his opinions and 

conclusions were based on the respondent’s denial of his mental illness, limited insight, and 

refusal to take medication and participate in a treatment intervention. Dr. Vallabhaneni stated 

that the respondent was provided with written documents that listed the alternatives to 

medication and provided detailed information about the benefits and potential side effects of 

each medication. When asked if, in his medical opinion, the benefits of the listed treatments 

and medications far outweighed any harm that could arise from the medications, Dr. 

Vallabhaneni responded, “Yes, they do.” After Dr. Vallabhaneni discussed the purpose and 

potential side effects of each medication, the State asked Dr. Vallabhaneni whether he sought 

the “ability to test so [the psychotropic medications] may be safely administered. Since [the 

respondent is] not on the medications yet, you are going to establish a blood level?” Dr. 

Vallabhaneni responded, “Yes.” The State then inquired whether Dr. Vallabhaneni had 

established a blood level, since the respondent had been taking Seroquel, and Dr. Vallabhaneni 

replied, “That is correct.” 

¶ 7 The State admitted the petition into evidence without objection. The written information 

that was provided to the respondent was also attached to the petition. The written information 

indicated that blood tests “may be needed to check for unwanted effects” from olanzapine and 

that “lab tests” would be conducted at regular visits to check the effects of each medication. 

¶ 8 The respondent testified to the following details. He was on permanent physical disability 

because he had suffered a leg injury in April 2014. The respondent’s leg injury had been 

treated by a medical doctor, as well as several surgeons. The respondent explained that his 

medical doctors and surgeons had advised him against taking the medications. 

¶ 9 After considering the testimony and exhibits introduced at the hearing, the circuit court 

entered an order for the administration of authorized involuntary treatment, finding the 

respondent had a serious mental illness, had exhibited deterioration in his ability to function, 

and had exhibited threatening behavior. The court’s order listed olanzapine and lorazepam as 

the respondent’s primary medications and risperidone and clonazepam as the respondent’s 

alternative medications. Additionally, the court authorized periodic blood draws and tests to 

monitor medication, electrolyte, and enzyme levels, finding the tests and procedures essential 

for the safe and effective administration of treatment. The order specified that the treatment 

would be administered by “N. Vallabhaneni, M.D., Psychiatrist at Chester Mental Health 

Center.” The order also stated that the respondent’s alternative psychiatrists would be “the 

psychiatric staff at Chester Mental Health Center including: T. Casey; R. Gupta; P. Tiongson; 

M. Reddy; M. Galioto; and R. Maitra.” This appeal followed.

¶ 10 II. Analysis 

¶ 11 On appeal, the respondent raises three issues in support of his contention that the circuit 

court’s order authorizing the administration of involuntary treatment and testing should be 

reversed. First, the respondent argues that the State failed to prove by clear and convincing 
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evidence that the tests and other procedures ordered by the court were essential for the safe and 

effective administration of treatment. Second, the respondent argues that the court’s order 

designating specific persons to administer the medication was unsupported by the evidence. 

Third, the respondent argues he was denied effective assistance of counsel. 

¶ 12 Before addressing the merits of the respondent’s arguments, we must first address the issue 

of mootness. “An appeal is considered moot where it presents no actual controversy or where 

the issues involved in the trial court no longer exist because intervening events have rendered it 

impossible for the reviewing court to grant effectual relief to the complaining party.” In re J.T., 

221 Ill. 2d 338, 349-50 (2006). The present appeal is technically moot because the 90-day 

period for the administration of the psychotropic medications authorized by the circuit court’s 

order, which was entered on July 29, 2015, has expired. See In re Donald L., 2014 IL App (2d) 

130044, ¶ 17. 

¶ 13 Reviewing courts generally do not decide moot questions, render advisory opinions, or 

consider issues where the result will not be affected regardless of how those issues are decided. 

In re Barbara H., 183 Ill. 2d 482, 491 (1998). A reviewing court will review a technically moot 

question, however, when the question falls within one of the three recognized exceptions to the 

mootness doctrine: (1) the public-interest exception, (2) the capable-of-repetition exception, 

and (3) the collateral-consequences exception. Donald L., 2014 IL App (2d) 130044, ¶ 19. 

Although no “general exception” to the mootness doctrine exists for mental health cases, most 

appeals will usually fall within one of the three established exceptions. In re Alfred H.H., 233 

Ill. 2d 345, 355 (2009). The determination whether a case falls within a particular exception 

must be made on a case-by-case basis. Id. 

¶ 14 While the respondent contends that all three of the exceptions to the mootness doctrine 

apply, we need not address his arguments regarding the public-interest and collateralconsequences exceptions because we agree that the capable-of-repetition exception applies. 

That exception applies when the respondent shows that (1) the challenged action is of such 

short duration that it cannot be fully litigated prior to its cessation and (2) there is a reasonable 

expectation that the same complaining party would be subjected to the same action again. Id. at 

358. Although the challenged action need not be identical under the second prong of the 

exception, the action “must have a substantial enough relation that the resolution of the issue in 

the present case would be likely to affect a future case involving [the] respondent.” Id. at 359. 

We conclude that the capable-of-repetition exception applies, here, due to the short duration of 

involuntary treatment orders and the respondent’s ongoing mental health issues and 

unwillingness to take medication. See In re Joseph M., 405 Ill. App. 3d 1167, 1175 (2010). In 

so concluding, we note that the respondent raises sufficiency-of-the-evidence claims that may 

have no bearing on future proceedings. We will, however, reach the merits of the respondent’s 

appeal because his claims also involve issues of statutory compliance that could affect the 

outcome of a future case. 

¶ 15 Turning to the merits, the respondent first argues that the circuit court’s order violated both 

his due process rights and the requirements set forth in the Code because its finding that he was 

subject to involuntary administration of psychotropic medication was against the manifest 

weight of the evidence. Specifically, he asserts that the State failed to prove, by clear and 

convincing evidence, that the tests and other procedures that the court ordered were essential 

for the safe and effective administration of the medication. 
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¶ 16 Because the involuntary administration of psychotropic medications to individuals alleged 

to suffer from mental illness implicates constitutionally protected liberty interests (In re C.E., 

161 Ill. 2d 200, 213 (1994); In re Bobby F., 2012 IL App (5th) 110214, ¶ 14), the Code sets 

forth certain procedural safeguards to protect these substantial liberty interests. In re John R., 

339 Ill. App. 3d 778, 785 (2003). Strict compliance with the procedural safeguards is required 

due to the liberty interests involved. Id. at 783-84. When a mental health patient exercises his 

or her right to refuse medication or lacks the capacity to make a reasoned decision about the 

treatment, the treatment may be administered only pursuant to section 2-107 or 2-107.1 of the 

Code. 405 ILCS 5/2-102(a-5) (West 2014). Pursuant to section 2-107.1(a-5), a person may 

petition the circuit court for an order authorizing the involuntary administration of 

psychotropic medication to a mental health patient. A petitioner seeking authorization for 

testing and other procedures must prove, by clear and convincing evidence, “that such testing 

and procedures are essential for the safe and effective administration of the treatment.” Id.

§ 2-107.1(a-5)(4)(G). 

¶ 17 While this standard may be satisfied through the presentation of expert testimony, expert 

opinions alone are insufficient and must be supported with specific facts establishing the bases 

for those opinions. In re David S., 386 Ill. App. 3d 878, 883 (2008). The State is required to 

present “specific testimony about the requested testing and procedures.” In re Steven T., 2014 

IL App (5th) 130328, ¶ 16 (citing David S., 386 Ill. App. 3d at 883). The testifying 

psychiatrist’s affirmation that the testing was requested to ensure the safe and effective 

administration of the medication does not satisfy the Code’s requirement of clear and 

convincing evidence. In re Larry B., 394 Ill. App. 3d 470, 478 (2009). 

¶ 18 Whether there was substantial compliance with a statutory provision is a question of law, 

which we review de novo. In re Tiffany W., 2012 IL App (1st) 102492-B, ¶ 10. A reviewing 

court will not reverse an order authorizing the involuntary administration of psychotropic 

medication unless the circuit court’s order is contrary to the manifest weight of the evidence. 

John R., 339 Ill. App. 3d at 781. A ruling is against the manifest weight of the evidence only 

when an opposite conclusion is clearly apparent or when the findings appear to be 

unreasonable, arbitrary, or not based on the evidence. In re Louis S., 361 Ill. App. 3d 774, 779 

(2005). 

¶ 19 Here, the State’s presentation of Dr. Vallabhaneni’s testimony at the hearing was 

insufficient to meet the clear and convincing standard set forth in the Code. Dr. Vallabhaneni 

did not testify that blood tests were essential for the respondent’s treatment. Although Dr. 

Vallabhaneni discussed the potential negative side effects associated with each medication, he 

failed to relate the potential side effects to the testing requested in the petition. In addition, Dr. 

Vallabhaneni offered no specific testimony regarding the procedure or frequency of the 

requested blood draws and tests. Instead, he merely provided an affirmative response when 

asked whether he sought the “ability to test so [the psychotropic medications] may be safely 

administered. Since [the respondent is] not on the medications yet, you are going to establish a 

blood level?” As such, Dr. Vallabhaneni’s affirmation did not constitute clear and convincing 

evidence that the testing and procedures were essential for the safe and effective administration 

of the respondent’s treatment.

¶ 20 While conceding that Dr. Vallabhaneni’s testimony alone was insufficient, the State points 

out that the petition and group exhibit were also admitted into evidence at the hearing. The 

petition specifically sought authorization for periodic blood draws and tests to monitor the 
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medication, electrolyte, and enzyme levels. While the petition stated that the requested tests 

and procedures were essential for the safe and effective administration of the respondent’s 

treatment, the State failed to present any evidence in support of this conclusion. In fact, the 

State’s group exhibit, which included the written information that was provided to the 

respondent detailing each medication listed in the petition, indicated only that blood tests “may

be needed to check for unwanted effects” of olanzapine. (Emphasis added.) The written 

information pertaining to the other medications indicated only that “lab tests” would be 

conducted at regular visits to check the effects of each of the medications. Without more than a 

mere conclusion that the requested testing and procedures were essential, the State failed to 

provide the clear and convincing evidence required by the Code to administer the requested 

tests without the respondent’s consent. See Steven T., 2014 IL App (5th) 130328, ¶ 17. Thus, 

the circuit court’s finding that the periodic blood draws and tests were essential for the safe and 

effective administration of treatment was against the manifest weight of the evidence. 

Although reversal of the court’s order is warranted on this basis alone, we will address the 

merits of the respondent’s second argument because it is likely that our resolution of the issue 

may affect a future case involving the respondent. 

¶ 21 In his second argument, the respondent contends that the circuit court’s order failed to 

comply with the Code because its designation of specific persons authorized to administer 

treatment was not supported by the evidence presented by the State at the hearing. Section 

2-107.1(a-5)(6) of the Code sets forth certain requirements pertaining to court orders 

authorizing the involuntary administration of psychotropic medications. 405 ILCS 

5/2-107.1(a-5)(6) (West 2014). Specifically, section 2-107.1(a-5)(6) states that the order “shall 

designate the persons authorized to administer the treatment under the standards and 

procedures” set forth in subsection (a-5). Id. A court’s failure to name specific individuals who 

are authorized to administer the medication in the order warrants reversal. In re Cynthia S., 326 

Ill. App. 3d 65, 69 (2001). Whether there was substantial compliance with a statutory provision 

is a question of law, which we review de novo. Steven T., 2014 IL App (5th) 130328, ¶ 13 

(citing Tiffany W., 2012 IL App (1st) 102492-B, ¶ 10). When reviewing the sufficiency-of-theevidence claim, we will reverse the court’s order only if it is against the manifest weight of the 

evidence. In re Cathy M., 326 Ill. App. 3d 335, 341 (2001). 

¶ 22 Here, it is undisputed that the circuit court’s order named specific persons authorized to 

administer psychotropic medications to the respondent. In particular, the order stated that the 

treatment would be administered by “N. Vallabhaneni, M.D., Psychiatrist at Chester Mental 

Health Center.” The court’s order also provided that the respondent’s alternative psychiatrists 

would be the “psychiatric staff at Chester Mental Health Center,” including the following: T. 

Casey, M.D.; R. Gupta, M.D.; P. Tiongson, M.D.; M. Reddy, M.D.; M. Galioto; and R. Maitra, 

M.D. The parties’ dispute, instead, centers on what evidence the State is required to present at 

the hearing to support the court’s order authorizing these persons to administer the 

respondent’s treatment. 

¶ 23 While this court is aware of no case precedent specifically addressing this issue, we note 

that our colleagues in the Fourth District addressed a similar issue in In re A.W., 381 Ill. App. 

3d 950 (2008). In considering the requirement that the circuit court’s order “specify the 

medications and the anticipated range of dosages that have been authorized” (405 ILCS 

5/2-107.1(a-5)(6) (West 2006)), the Fourth District acknowledged that the Code does not 

explicitly require the State to establish by clear and convincing evidence the proposed 
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medications and the anticipated range of dosages. A.W., 381 Ill. App. 3d at 958. The Fourth 

District noted, however, that the type of medication is a necessary component of section 

2-107.1(a-5)(4)(D) and that courts have usually required some evidence of the medications 

sought to be administered. Id. at 958-59. Thus, the Fourth District held that the circuit court’s 

order must be supported by evidence presented by the State “as to the anticipated range of 

dosages of the proposed psychotropic medication.” Id. at 959. In so holding, the Fourth District 

rejected the State’s argument that the list of anticipated dosages contained in the petition was 

sufficient where the circuit court did not take judicial notice of the anticipated dosages listed in 

the petition, the petition was not admitted into evidence for the purpose of establishing the 

anticipated dosages, and there was no testimony that the proposed psychotropic medications 

were requested in the dosages listed in the petition. Id. 

¶ 24 Similarly, here, although the Code does not explicitly require the State to present clear and 

convincing evidence as to the individuals authorized to administer the treatment, we conclude 

that the State is required to present evidence as to each person who will administer the 

involuntary treatment. In so concluding, we note that the Code requires that recipients of 

mental health services “be provided with adequate and humane care and services in the least 

restrictive environment, pursuant to an individual services plan” (405 ILCS 5/2-102(a) (West 

2014)) and provides that “[a] qualified professional shall be responsible for overseeing the 

implementation of such plan” (id. § 2-102(a-5)). In addition, section 2-107.1(f) requires 

“annual trainings for physicians and registered nurses working in State-operated mental health 

facilities on the appropriate use of psychotropic medication” and the standards for using such 

medications. Id. § 2-107.1(f). Thus, in our view, the circuit court’s order must be supported by 

evidence presented by the State to “ensure that only a limited number of designated—and 

presumably well-trained—individuals will be able to administer these powerful drugs, 

pursuant to a court order, to an unwilling recipient.” In re Miller, 301 Ill. App. 3d 1060, 1072 

(1998). 

¶ 25 Based on our review of the evidence, we conclude that the circuit court’s order, authorizing 

Dr. Vallabhaneni to administer treatment to the respondent, was supported by Dr. 

Vallabhaneni’s testimony. In particular, Dr. Vallabhaneni testified that he was the 

respondent’s treating physician and that he sought to administer the medications and dosages 

listed in the petition. The State, however, failed to present sufficient evidence to support the 

court’s order authorizing the alternative psychiatrists to administer treatment. As in A.W., the 

State, here, argues that the court’s order was supported by the petition, which provided a 

detailed list of the respondent’s alternative psychiatrists. While the alternative psychiatrists 

were individually named in the petition, the court neither took judicial notice of the individuals 

named in the petition nor admitted the petition into evidence for the purpose of establishing 

that those individuals would be authorized to administer the respondent’s treatment. In 

addition, Dr. Vallabhaneni offered no testimony regarding the alternative psychiatrists listed in 

the petition. Accordingly, the court should not have authorized those persons to administer the 

respondent’s treatment without supporting evidence.

¶ 26 The respondent also argues he was denied effective assistance of counsel. Because of our 

resolution of the preceding issues and our determination that the order granting the petition 

must be reversed, we need not consider the respondent’s allegations regarding his counsel’s 

representation. See Larry B., 394 Ill. App. 3d at 479. 
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¶ 27 III. Conclusion 

¶ 28 For the foregoing reasons, the order of the circuit court of Randolph County authorizing the 

involuntary administration of psychotropic medications and testing is hereby reversed. 

¶ 29 Reversed. 

¶ 30 JUSTICE CATES, dissenting: 

¶ 31 Based upon the circumstances reflected herein, I believe this case is moot, and this appeal 

should be dismissed. Inasmuch as my colleagues disagreed and decided the merits of the 

appeal, I dissent. In my view, there was sufficient evidence to support the circuit court’s order 

authorizing the involuntary administration of psychotropic medication, as allowed by the 

Mental Health and Developmental Disabilities Code (405 ILCS 5/2-107.1(a-5) (West 2014)).