# U ni te d S ta te s Co ur t of A pp ea ls

For the Eig hth Circu it

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No. 1 5- 39 54

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Uni te d S ta te s o f Am eri ca

ll ll ll ll ll ll ll ll ll ll l Pla in ti

ff - App el le e

v.

Larry Ri ck Mi ka wa

ll ll ll ll ll ll ll ll ll ll l Defe nd

an t - Ap pe ll an t

__ __ __ __ __ __

App eal fro m

Uni te d S ta te s Di st ric t Co ur t
fo r th e Weste rn Dis tri ct of M is so ur i - Kan sa s C it y

__ __ __ __ __ __

Su bm it te d: Nov em

be r 15 , 20 16

Fil ed : Fe br

ua ry 22 , 20 17 [Pu bl is he d]

__ __ __ __ __ __

Befo re RI LEY, Chi ef J ud ge , W OLLMAN and KELLY , Cir cu it Ju dg es

.

__ __ __ __ __ __

KELLY, Cir cu it Ju dg e.

Afte r be in g fo un d n o t g u i l t y by reas on of in sa ni ty of fal se pe rs on at io n of a

fed eral of fic er in Nov em

be r 20 12

, Larry Mi ka wa was ci vi ll y co m m it te d pu rs ua nt to

18 U.S.C. § 42 43

. Two y ears la te r, th e m en ta l he al th f a c i l i ty tre at in g Mi ka wa

de te rm in ed he ha d reco ve red fro m hi s m en ta l il ln es s su ffi ci en tl y to be el ig i b l e f o r

di sc ha rg e fro m th e ps y ch ia tri c ho sp it al

. The go ve rn m en t op po se d rel eas e, a n d th edi st ric t co ur t he ld an ev id en ti ary h e a r i n g

. In it s or de r, th e di st ric t co ur t de ni ed 1

rel eas e, fin di ng th at Mi ka wa po se d a su bs ta nt ia l ris k of da ng er to ot h e r p e r s on s or

pr op ert y . Mik awa ap pe al ed , and we no w affi rm fin di ng no cle ar er ro r.

I. Ba ck gr ou nd

On Apr il 6, 20 10

, Larry Mi ka wa was in di ct ed fo r fal se pe rs on at io n of a fed eral

of fic er in vi ol at io n of 18 U.S.C. § 91 2. Bas ed on a st ip ul at ed ps y ch ia tri c rep or t, th e

di st ric t co ur t fo un d M ik awa i nc om pe te nt to pr oc eed an d or de red hi m co m m it te d to

de te rm in e if

co m pe te nc y co ul d b e res to red

. Mi ka wa was tra ns ferr ed to th e Fed eral

Med ic al Cen te r (FM C) in Bu tn er, Nor th Caro li na fo r tr eat m en t. On Sep te m be r 11

, 2 0 12

, th e di st ric t co ur t fo un d Mi ka wa co m pe te nt to pr oc eed ba se d on an u p d a t e d

ps y ch ia tri c ev al ua ti on

. Mi ka wa was tra ns ferr ed to th e U.S. Pen i t e n t i a ry in

Leav en wor th

, Kan sa s fo r fu rth er pr oc eed in gs in hi s cri m in a l cas e. W hi le th ere,

Mi ka wa st op pe d ta ki ng hi s ps y ch ia tri c m ed ic at io ns , an d hi s ps y ch ot ic sym pt om s

ret ur ne d.

Sh or tl y th erea fte r, th e pa rti es fil ed a st ip ul at io n of fact s in su pp or t of an

in sa ni ty p le a b a s e d on a do ct or ’s c on cl us io n th at Mi ka wa was un ab le to ap pr eci at e

th e na tu re an d qu al it y or wro ng fu ln es s of hi s act s a t t h e t i m e of th e of fen se

. On

Nov em be r 27

, 20 12

, th e di st ric t co ur t fo un d Mi ka wa no t gu il ty by reas on of in sa ni ty

an d, per th e st ip ul at io n, co m m it te d hi m pu rs ua nt to 18 U.S.C. § 42 43

. Mi ka wa was

su bs eq ue nt ly tran sf

erre d t o t he FMC i n R oc he st er, Mi nn es ot a in Marc h 2 01 3.

On Ja nu ary 7, 20 15

, t h e w a rd en of FMC Ro ch es te r fil ed a “ Cert ifi cat e of

Rec ov ery an d Req ue st to Dis ch arg e fro m Ps y ch ia tri c Hos pi t a l

, ” w h ic h st at ed th at

cl in ic ia ns be li ev e t h a t Mi ka wa “ ha s reco ve red fro m hi s m en ta l di se as e or de fect to

The Hon or ab le Dean W hi pp le

, Uni te d St at es Dis tri ct Co ur t fo r th e We s t ern 1

Dis tri ct of M is so ur i.

-2

-su ch an ex te nt th at hi s rel eas e wou ld no lo ng er crea te a su bs ta nt ia l ris k of bo di ly

in jury to an ot he r pe rs o n o r s e r i ou s da m ag e to th e pr op ert y of an ot he r.” Att ach ed

were th e rep or ts of two Ri sk Ass es s men t P a ne ls (RAP)— co m po se d of at le as t two

no n- tre at in g ps y ch ia tri c pr of es si on al s an d ch ai red b y t h e faci li ty’ s ch ie f of

ps y ch ol og y

—d at ed Apr il 8, 20 14

, an d Nov em be r 12

, 20 14

. Bo th pa ne ls co nc lu de d

th at Mi ka wa ha d su ffer ed fro m a se ve re m en ta l il ln es s, di ag no se d as “ sc hi zo affe ct iv e

d is or de r, bi po la r type,” fo r at le as t th ree de cad es

. Afte r rev ie win g m ul t i p l e

ps y ch ia tri c ev al ua tio ns an d tr ea tm en t no te s an d co nd uc ti ng in te rv ie ws of Mi ka wa an d

hi s ex -wif

e, th e Apr il 20 14 pa ne l reco m m en de d un co nd it io na l rel eas e be cau se th ere

was no reco rd of Mi ka wa cau si ng in juri es or se rio u s p r o p e r ty da m ag e, an d hi s ag e

an d l ack of s ub st an ce ab us e su gg es te d fu tu re vi ol en ce was un li ke ly. The p an el di d

ack no wled ge th at it was un li ke ly Mi ka wa—w h o d i d no t be li ev e he ha d a m en ta l

ill ne ss or ne ed ed m ed ic at io ns —wo ul d in de pe nd en tl y co nt in ue tre at m en t, an d th us hi s

m en ta l st at us wou ld li ke ly de te rio rat e up on rel eas e. Bec a u s e M i k awa’s tre at in g

ps y ch ol og is t was on ex te nd ed m ed ic al le av e in Apr il 20 14

, an ot he r RAP was

co nv en ed in Nov em

be r 20 14

. The se co nd RAP fo un d no reas on to al te r it s pr io r

recom m en da ti on of un co nd it io na l rel eas e. The se co nd pa ne l fo un d li tt le ris k of in jury

or pr op ert y da m ag e as Mi ka wa ha d no in te nt or hi st or y of cau si ng ha rm , al th ou gh it

pr ed ic te d he “ li ke ly” wou ld en ga ge in “ nu is an ce o r bi zarr e be ha vi or th at m ay br in g

hi m to th e at te nt io n o f la w enf or cem en t.”

On Ja nu ary 13

, 20 15

, th e go ve rn m en t ob jecte d to th e rel eas e reco m m en da ti on

an d req ue st ed a di sc ha rg e he ari ng

. In su pp or t of it s req ue st

, th e go ve rn m en t at ta ch ed

a de cl arat io n fro m Mi ka wa’s tre at in g ps y ch ia tri st

, Dr. Dio nn e Hart

, who op in ed th at

Mi ka wa sh ou ld no t be un co nd it io na ll y rel eas ed

. The go ve rn m en t al so ha d Mik awa

ev al ua te d b y

Dr. Dawn Pe us ch ol d, wh o c on cl ud ed th at he sh ou ld no t b e rel eas ed

.

Bec au se th e g o ve rn m en t op po se d un co nd it io na l rel eas e, an ot he r RAP

co nv en ed on Mar ch 17

, 20 15

, to of fer an op in io n on a pr op os ed co nd it io na l rele as e pl an

. The con di ti on al rel eas e pl an pl aced Mi ka wa, who was pr im ari ly a res id en t of

-3

-Alas ka pr io r to hi s arre st

, at M a r e n a h’s Ass is te d Liv in g Hom e in Anc ho rag e. The

ho m e ha d su rv ei ll an ce c am eras an d an on si te care wor ke r who as si st ed wit h

ad m in is te rin g m ed ic at io ns , hygi en e, an d pr og ram m in g. Mi ka wa wou ld be req ui red

to rece iv e m en ta l he al th tre at m en t pr ov id ed by Anc ho rag e Co m m uni ty Men ta l Heal th

an d to ta ke al l pr es cri be d m ed ic at io ns

. Fu rth er, Mi ka wa wou ld be su pe rv is ed by Tim

Ast le o f t h e U.S. Pro ba ti on Offi ce in Anc ho rag e, who wou ld ha ve acce ss to al l of

Mi ka wa’s tre at m en t reco rd s a n d to th e ho m e. Mi ka wa al so wou ld be req ui red to

su bm it to dr ug te s t i n g

. H i s fai lu re to co m pl y wit h th e co nd it io ns of rel eas e co ul d

res ul t in hi s ret ur n to cu st od y

. The Mar ch 20 15 pa ne l u na ni m ou sl y ag reed th at th e

pr opos ed co ndi tio na l rel eas e wou ld “ ad eq ua te ly co nt ro l an d m in im iz e an y ris k re la te d

to Mr. Mi ka wa’s rel eas e fro m cu st od y .”

The di st ric t co ur t he ld a di sc ha rg e he ari ng on Octo be r 5 an d 6, 20 15

, an d he ard

te st im o n y fr om te n wit ne ss es

. Thre e of th e wit ne ss es , d oc to rs Ja so n Gab el , Da ni el

Carl so n, an d And rew Si m co x, pa rti ci pa te d as m em be rs of on e or m or e of Mi ka wa’s

th ree RAPs

. Each of th em op in ed th at ei th er co nd it io na l or un co nd it i o n a l r el eas e

wou ld be ap pr op ria te as Mi ka wa was on e of th e “ le as t da ng ero us ” co m m it te d pa ti en ts

th ey ha d se en , an d he ha d no hi st or y of su bs ta nc e ab us e, we a po n own ers hi p, or

in fli ct io n of se rio us in jury on ot he rs

. Two of Mi ka wa’s m en ta l he al th

pr of es si on al s— hi s ps y ch ol og is t at FMC Ro ch es te r, Dr. Em il y Wa k e m an , an d th e

m en ta l he al th co or di na to r at Leav en wor th , J eff Co wan —t es ti fie d th at Mi ka wa was

no t a “ th reat to an y on e” an d ha d no t ha d an y ph y si cal al te rcat io ns whi le co m m it te d.

Ast le an d Eli zab et h Meyer, a so c i a l w o r k er at FMC Ro ch es te r, te st ifi ed ab ou t th e

pr op os ed co nd it io na l rel eas e pl an an d Ast le ’s in sp ect io n of th e faci li ti es an d se rv ic es

Mi ka wa wou ld rel y

on in Anch or ag e if

co nd it io na ll y

rel eas ed

.

Dr. Dio nn e Hart

, Mi ka wa’s tre at in g ps y ch ia tri st at FMC Ro ch es te r, di sa gr eed

wi th he r fel lo w cl in ic ia ns , op in in g th at Mi ka wa sh ou ld no t be rel eas ed

. In he r

de cl arat io n, sh e ci te d th ree ob se rv at io n s th at le d he r to co nc lu de th at Mi ka wa “ ha s

no t reac he d th e m ax im

um be ne fit fro m ho sp it al iz at io n: ” fir st

, he rep eat ed ly in si st s he

-4

-do es no t ha ve a m en ta l il ln es s an d wil l no t ta ke hi s m ed ic at io ns ; se co nd

, he co nt in ue s

to ha ve de lu si on s ab ou t Sa rah Pal in , th e o ffi cers who arre st ed hi m , an d bei ng a la w

en fo rcem en t of

fic er; an d th ird

, he ha s a pr eo ccu pa ti on wit h hi s ex -wif e, who do es no t

wan t to ha ve an y co nt act wit h hi m

. At th e he ari ng , Dr. Hart ex pr es se d con cern th at

Mi ka wa wou ld co nt act hi s ex-wi fe, ci ti ng two le tt ers an d a pa ck ag e he ha d recen tl y

ad dr es se d to ho m es on th e st reet whe r e s h e li ve d. Dr. Hart reco m m en de d th at

Mi ka wa rem ai n at FMC Ro ch es te r fo r fu rth er tr e a t men t

, a s sh e di d no t be li ev e he

wou ld be ab le to co m

pl y wit h t he co nd it io ns of r el eas e.

Dr. Dawn Peu sc ho ld

, th e go ve rn m en t’s in de pe nd en t ps y ch ol og is t, te st ifi ed

co ns is te nt ly wit h he r rep or t th at Mi ka wa ha d no t reco ve red to su ch an ex te nt th at hi s

un co nd it io na l or co nd it io na l rel e a s e w o u ld no lo ng er crea te a su bs ta nt ia l ris k of

b o di ly in jury to an ot he r pe rs on or se rio us da m ag e to th e pr op ert y of an ot he r. Her

co nc lu si on s were ba se d on a rev ie w of Mi ka wa’s reco rd s as well as a fo ur -h ou r an d

fo rty-m in ut e in te rv ie w wit h hi m

. Dr. Peu sc ho ld ag reed th at Mi ka wa su f f e r s fro m

sc hi zo affe ct iv e d is or de r, bi po la r type an d th at he ex pe rie nc es sym pt om s, wh ic h a re

so m et im es se ve re, bo th du rin g an d ab se nt tre at m en t. Mi ka wa’s sym pt om s cau se hi m

to m is pe rcei ve ex te rn al real it y , gi vi ng hi m th e m is ta ke n be li ef th at he do es no t ha ve

a m en ta l il ln es s an d do es no t ne ed tre at m en t. Dr. Peu sc ho ld fo un d th at Mi ka wa’s

m en ta l il ln es s cau se s h i m t o “dis pl ay [] a m ul ti di m en si on al pa tt ern of di st ur bi ng ,
ag gr es si ve , or in ti m id at in g be ha vi or s,” whi ch he in te nd s to co nt in ue an d of te n la ck s

th e ab il it y to co nt ro l. Sh e fo un d hi s be ha vi or s “ co nc ern in g” an d s u b je c t iv el y

“ th reat en in g.” In ad di ti on , Dr. Peu sc ho ld te st ifi ed th at sh e do es no t be li ev e Mi ka wa

wil l co nt in ue to ta ke m ed ic at io ns ou ts id e of a ho sp it al se tt in g an d “ is no t s t a b l e

en ou gh ” to co m

pl y wit h t he ot he r co nd it io ns of r el eas e.

The f i na l wit ne ss was Mi ka wa’s se co nd ex -wif e, Cy nt hi a Mi ka wa. Sh e was

m arri ed to Mi ka wa fro m 19 99 to 20 08 an d th e co up le ha s on e ch il d, who was th irt een

at th e ti m e of Ms

. Mi ka wa’s te st im on y

. Dur in g th ei r m arri ag e, Mi ka wa was pr im ari ly

m ed ic at io n co m

pl ia nt an d he ld a s t e a d y jo b in Alas ka

, bu t in 20 07 he ab ru pt ly

-5

-di sa pp eare d, st op p e d ta ki ng m ed ic at io n, an d tra ve le d to Mi ss ou ri. Afte r hi s

di sa pp eara nc e, Mi ka wa cal le d an d wro te em ai ls th at Ms

. Mi ka wa fo un d th reat en in g:

cal li ng he r a “ de m on ,” st at in g sh e ne ed ed “ to be ki ll ed ” an d was go in g to “ go to he ll ,”

an d th reat en in g to ta ke th ei r da ug ht er to th e wil de rn es s. S h e o b t ai ne d a pr ot ect iv e

or de r ag ai ns t Mi ka w a i n 20 08

, whi ch he was fo un d gu il ty of vi ol at in g whe n he

sh owe d up at he r ho us e la te at ni gh t y el li ng

. Acco rd in g to Ms

. Mi ka wa, aft er he r ex

hu sb an d’s arre st in 20 10 an d as rece nt ly as Aug us t 20 15

, he wro te le tt ers to he r an d

he r da ug ht er fro m pr is on , m os t of whi ch sh e ret ur ne d to se nd er. On th e ou ts id e of th e

en ve lo pe s, Mi ka wa wro te no te s sa y in g, am on g ot he r th in gs , th at he was go in g to

arra n g e f o r M s

. Mi ka wa to be ki ll ed

. At th e he ari ng , Ms

. Mi ka wa te st ifi ed th at

Mi ka wa’s rel eas e m ak es he r afra id fo r he r an d he r da ug ht er’s sa fet y be cau se he wil l

no t s ta y on hi s m ed ic at io ns or b e ab le to ab id e b y th e co nd it io ns of r el eas e.

I n an or de r da te d Decem be r 1, 20 15

, th e di st ric t co ur t de ni ed Mi k a w a

di sc ha rg e fro m co m

m itm en t, ad opt ing the co nc lus io ns of th e go ve rn m en t’s ex pe rt an d

fin di ng th at Mi ka wa f

a i l e d t o c a rry hi s bu rd en to pr ov e th at hi s rel eas e wou ld no t

crea te a su bs ta nt ia l ris k of bo di ly in jury to an ot he r pe rs on or se rio us da m ag e t o

pr op ert y of a no th er. Mi ka wa ap pe al s t hi s o rd er.

II . Dis cus si on

A pe rs on fo un d no t gu il ty by reas on of in sa ni ty of an of fen se th at di d no t

in vo lv e a su bs ta nt ia l ris k of bo di ly in jury or pr op ert y da m ag e is el ig ib le fo r rel eas e, 2

or co nd it io na l rel eas e, if he can pro ve by a pr ep on de ran ce of th e ev id en ce th at “ hi s

rel eas e wou ld no t crea te a su bs ta nt ia l ris k of bo di ly in jury to an ot h e r p e r s o n or

se rio us da m ag e of pr op ert y of an ot he r du e to a pr es en t m en ta l di se as e or de fect .” 18

The pa rti es ag ree th at Mi ka wa’s of fen se , fal se pe rs on at io n of a fed eral of fic er 2

in vi ol at io n of 18 U.S.C. § 91 2, di d no t in vo lv e a su bs ta nt ia l ris k of bo di ly in jury or

pr op ert y da m ag e.

-6

-U.S.C. § 42 43 (d ). If th e st an da rd is m et

, th e di st ric t co ur t sh al l or de r th e co m m it m en t

be co m pl et el y di sc ha rg ed

, or or de r “ th at he be co nd it io na ll y di sc ha rg ed un de r a

pr es cri be d reg im en of m ed ic al

, ps y ch ia tri c, or ps y ch ol og ic al care or tre at men t th at

ha s b een pre pa red for hi m , th at ha s b een cert ifi ed to th e co ur t as ap pr op ria te by t he

di rect or of th e faci li ty in whi ch he is co m m it te d, an d th at ha s be en fo un d by th e co ur t

to be ap pr op ria te .” 18 U.S.C. § 4 2 4 3 ( f )(2 )(A). W e rev ie w an ap pe al of a di st ric t

co ur t’s or de r co nt in ui ng co m m it m en t un de r 18 U.S.C. § 42 43 an d it s da ng ero us ne ss

fin di ng fo r cl ear erro r. See Uni te d St at es v. Bi lyk, 94 9 F.2 d 25 9, 26 1 (8 th Ci r. 19 91 )
(ci ti ng Uni te d St at es v

. St ei l, 91 6 F.2 d 48 5, 48 8 (8 th Ci r. 19 90 ) (h ol di ng th at th e

“ cl earl y erro ne ou s st an da rd go ve rn s ou r rev ie w of a di st ric t co ur t’s

. . . fin di ng of

da ng ero us ne ss ” u nd er 1 8 U.S.C. § 42 46 )). 3

Alt ho ug h th e ward en reco m m en de d bo th Mi ka wa’s un co nd it io na l an d th en

co nd it io na l rel eas e, on ap pe al Mi ka wa ch al le ng es on ly th e di st ric t co ur t’s refu sa l to

or de r co nd it io na l rel eas e. Mi ka wa al s o do es no t ch al le ng e th e fin di ng th at he

pr es en tl y su ffer s fro m a se ve re m en t al di se as e, na m el y sc hi zo affe ct iv e di so rd er,

bi po la r type, whi ch cau se s h i m t o e x pe rie nc e de lu si on s, ha ll uc in at io ns , pe rio ds of

di so r g a n iz at io n, an d m oo d sym pt om s. Thu s, th e cen tra l qu es ti on in th is ap pe al is

whe th er th e di s tri ct co ur t cl earl y erre d in co nc lu di ng th at be cau se of hi s m en ta l

il ln es s, Mi ka wa’s co nd it io na l rel eas e wou ld crea te a su bs ta nt ia l ris k of bo di ly in jury

to an ot he r pe rs on or s eri ou s d am ag e to th e p ro pe rty of an ot he r.

The di st ric t co ur t fo un d th e go ve rn m en t’s ex pe rt, Dr. Peu sc ho ld

, to be cred ib le

an d fo un d he r co nc lu si on s “ pe rs ua si ve an d co ns is te nt wit h t h e reco rd as a who le .”

W he reas 18 U.S.C. § 42 43 co nc ern s th e co mm i t ment of a pe rs on fo un d no t 3

gu il ty by re a s o n o f in sa ni ty, 18 U.S.C. § 42 46 ad dr es se s th e co m m it m en t of a ho sp it al iz ed pe rs on fo ll owi ng ex p i r a ti on of hi s or he r se nt en ce. The st an da rd us ed

to di sc ha rg e co m

m it m en t un de r §§ 42 43 an d 42 46 is th e sa m e; ho wev er, de pe nd in g

on th e pr oc ed ur al po st ur e, th e bu rd en s of p r o of m ay di ffer

. Co m pa re 18 U.S.C. §§

42 43 (d ), (f) wi th 18 U.S.C. §§ 42 46 (d ), (e).

-7

-Mi ka wa arg ue s th at Dr. Peu sc ho ld ’s co nc lu si on s sh ou ld no t be cred it ed be cau se sh e

do cu m en ts on ly on e in st an ce of ph y si cal inj ur y to anot he r pe rs on —M ik awa pu nc hi ng

hi s fir st wife twen ty-fiv e y ears ag o— an d fai ls to co nn ect Mi ka wa’s ru de

, an no y in g,

an d di st ur bi ng be ha vi or s to an y su bs ta nt ia l ris k of bo di ly in jury or pr op ert y da m ag e.

In st ead , Mik awa arg ue s t he pr ep on de ran ce o f th e ev id en ce s up po rts th e co nc lu si on

of th e th ree RAPs th at th e ab se nc e of vi ol en ce, sub st an ce abu se , an d weapo n us e in

Mi ka wa’s hi st or y

m ak es it un li ke ly tha t h e p os es a ph y si cal da ng er t o o th ers

.

The di st ric t co ur t reject ed Mi ka wa’s arg um en t an d r e f u s e d to cred it th e

op in io ns of th e do ct or s who se rv ed on th e RAPs , f i n d i n g th ey were “ no t su pp or te d
by th e reco rd .” Alt ho ug h th e di st ric t co ur t h i g h l i gh te d se ve ral fact s to su pp or t it s

da ng ero us ne ss fin di ng , th e RAP do c t o r s ’ co nc lu si on s de se rv e du e co ns id erat io n gi ve n th ei r cu m

ul at iv e ex pe rie nc e se rv in g on th ou sa nd s of ris k pa ne ls fo r co m m it te d

pa ti en ts an d th ei r co ns id erat io n of a pl et ho ra of Mi ka wa’s fo ren si c, he al th

, an d le ga l

reco rd s an d a mu l t i -y ear co ur se of ob se rv at io n, in te rv ie ws, an d te st in g of Mi ka wa.

Nev ert he le ss , th e di st ric t co ur t su bs ta nt ia te d it s da ng er o u s n e s s fin di ng , ci ti ng to

fo ur te en act s by Mi ka wa whi ch “ were vi ol en t or po se a ris k of bo di ly i n ju ry to

an ot he r pe rs on or se rio us da m ag e to pr op ert y of an ot he r,” in cl ud in g th at he : (1 ) us ed

a Sam ur ai swo rd to d e s t r o y pr op ert y at hi s ap art m en t in 19 88 ; (2 ) hi t hi s fir st wife

se ve ral ti m es du rin g a si ng le in ci de nt in th e la te 19 80 s; (3 ) ha d pr ot ect iv e o r d e rs

is su ed ag ai ns t hi m

by his sec on d e x- wife , a ga y rig ht s o rg an iz at io n, an d wor ke rs at

a sp o r t s aren a in Anc ho rag e, Alas ka ; (4 ) le ft th reat en in g le tt ers at a Kan sa s Ci ty,

Mi ss ou ri fed eral co ur th ou se in 20 10 ; (5) was pla ced in le g iro ns an d tran sp or te d by

st ret ch er at FMC Bu tn er in Aug us t 2 01 1 a fte r ve rb al ly ass au lt in g a nd pu ll in g away

fro m an es co rti ng of

fic er; (6 ) se nt le tt ers to hi s se co nd ex -wif e fr o m F M C Bu tn er

in di cat in g th at sh e ne ed ed to be ki ll ed ; (7 ) th rew wate r on an el ect ric fan ou ts id e hi s

cel l in an effo rt to sh oc k hi s cel lm at e; (8 ) th rew a m il k cart on wit h fece s an d ur in e at

a co rrec ti on al of

fic er in Ju ly 20 11 ; (9 ) sp it at em pl oyees whi le te m

po rari ly ho us ed at

th e Fed eral Co rrec ti on al In st i t ut io n in Oxf or d, W is co ns in in 20 13 ; (1 0) cal le d hi s

tre at in g ps y ch ia tri st

, Dr. Hart

, a “ ch em ic al te rro ris t” ; (1 1) pr e t e n d e d to “ sh oo t” at

-8

-co rrec ti on al o f f i c e r s b y po in ti ng hi s fin ge rs at th em in th e sh ap e of a gu n; (1 2)

po un de d an d ki ck ed hi s cel l do or at FMC Ro ch es te r; (1 3) m ad e ne ar-d ai ly rep or ts to

FMC Ro ch es te r do ct or s an d e m pl oyees ab ou t ot he r pa ti en ts ’ be ha vi or , c on si de rin g

hi m se lf a la w en fo rcem en t of fic er; an d (1 4) se nt le tt ers to hi s da ug ht er (d ire ct ly an d

th ro ug h a fri en d of he rs ) in Aug us t 20 15 wit h a no ta ti on to no t sh ow th e le tt er to he r

m ot he r. Giv en th es e de ta il ed fin di ng s an d ou r de fere nc e to th em , we can no t co nc lu de

it was cl ear erro r fo r th e di st ric t co ur t to reject th e op in io ns of so m e ex pe rts an d ad op t

th e op in io n o f a n o t h e r

. See Bi lyk, 94 9 F.2 d at 26 1 (“ Giv en ‘the tri al jud ge ’s

awes om e res po ns ib il it y to th e pu bl ic to en su re th at a cl in ic al pa ti en t’s rel eas e is sa fe,’

th e di st ric t co ur t m ay reject ex pe rts ’ co nc lu si on s w h en th ei r reas on in g su pp or ts

di ffer en t res ul ts .” (q uo ti ng Uni te d St at es v. Cl ark

, 89 3 F.2 d 12 77

, 12 82 (1 1t h Ci r.

19 90 ))).

W e reco gn iz e th at pe rh ap s as co m pa red to ot he r co m

m it te d pa ti en ts

, Mi ka wa

ha s few doc um en te d in ci de nt s of ph y si cal in jury to an ot he r pe rs on

. The ab se nc e of

pr io r vi ol en t act s cert ai nl y can be a ke y fact or in an al y zi ng whe th er di sc ha rg e of

co m m it m en t is ap pr op ria te

, bu t “ ov ert act s of v i o l e n ce are no t req ui red to pr ov e

da ng ero us ne ss .” Uni te d St at es v. LeC l a i r, 33 8 F.3 d 88 2, 88 5 (8 th Ci r. 20 03 )
(d an ge ro us ne ss pr ov en by cl ear an d co nv in ci ng ev id en ce whe re de fen da nt ha d on ly

on e ag gr es si ve act , an a ss au lt , and ha d n ot sh own an y ag gr es si ve be ha vi or

whi le in

tre at m en t); Uni te d St at es v. W ill iam s, 29 9 F.3 d 67 3, 67 7 (8 th Ci r. 20 02 ) (co m m it m en t

ap pr op ria te ev en th ou gh de fen da nt ha d “ m in im al hi st or y of act ua l vi ol en ce” an d a

“ rel at iv el y pr ob le m -fre e in carc erat io n” ); St ei l, 91 6 F.2d at 487– 88 (t hr ea te nin g le tters

a n d be li ef th at de lu si on s are real en ou gh to pr ov e da ng ero us ne ss ev en th ou g h

de fen da nt ha d no hi st or y of vi ol en t be ha vi or ). Here, th e di st ric t co ur t po in te d to on e

act of ov ert vi ol en ce— Mi ka wa’s ad m it te d at ta ck of hi s fir st wife —as well as se ve ral

th reat s of vi ol en ce, ha ras si ng an d as sa ul ti ve be ha vi or s, an d ag gr es si ve an d m en aci ng

act s. It was no t clea r erro r to rel y on th es e al arm in g beh av io rs in fin di ng Mi ka wa’s

rel eas e crea te d a su bs ta nt ia l ris k of ha rm

. See W il li am s, 29 9 F.3 d at 67 7 (co ns id eri ng

“ si gn ifi can t ep is od es of bi zarr e, de fia nt

, an d ex pl os iv e be ha vi o r ” d u r in g

-9

-in car c e r a t i o n )

. It is tru e th at Mi ka wa’s as sa ul t of hi s fir st wife is en ti tl ed to le ss

weig h t b e c a u s e it oc cu rred ov er twen ty-fiv e y ears ag o, bu t it ne ed no t be en ti rel y

di sc ou nt ed

. See Uni te d Stat es v. Evan of f, 10 F.3 d 55 9, 56 3 (8t h Cir. 19 93 ) (“ [T]he

rece nc y or rem ot en es s of an y pa rti cu la r act iv it y si m pl y aff e c ts th e weig ht th e co ur t

wil l gi ve to th at pa rti cu la r ev id en ce.”)

. W hi le no ne of th e act io ns ci te d by th e di st ric t

co ur t in de pe nd en tl y m ay ha ve be e n e n o u g h to su pp or t a fin di ng of da ng ero us ne ss ,
to ge th er th ey pr ov id ed su ffi ci en t ev id en ce fro m whi ch th e di st ric t co ur t c o ul d

co nc lu de th at Mi ka wa po se d a su bs ta nt ia l ri sk of b od il y in jury to ano th er pers on or

se rio us da m ag e to th e pr op ert y of an ot he r. See Uni te d St at es v. Dix on , 96 3 F.2 d 37 7,

at *3 (8 th Ci r. 19 92 ) (u np ub li sh ed ta bl e de ci si on ) (p er cu ria m) ( h o l d i n g th ere was

cl ear an d co nv in ci ng ev id en ce of a s u b st an ti al ris k of fu tu re ha rm to an ot he r un de r § 42 46 whe re de fen da nt “ ve rb al ly t h r e a t e ne d hi s fo rm er wife wit h bo di ly ha rm ,

ex hi bi te d a nt is oc ia l b eh av io r, an d c ou ld no t co nt ro l h is tem pe r an d e m ot io ns ”).

Mi ka wa al so ch al le ng es th e di s t r i c t co ur t’s co nc lu si on th at th e co nd it io na l

rel eas e pl an de ve lo pe d for hi m was in su ffi ci en t t o a m el io rat e th e su bs ta nt ia l ris k of

in jury he po se d to ot he rs

. Am on g ot he r th in gs , th e di st ric t co ur t was co nc ern ed th at

if co nd it io na ll y rel eas ed

, Mi ka wa co ul d fai l to ta ke hi s m ed ic at io n an d de co m pe ns at e

ps y ch ia tri cal l y, ex hi bi t di st ur bi ng , ag gr es si ve , or in ti m id at in g be ha vi or s in th e

co m m un it y , walk away fro m th e gr ou p ho m e, ha rm hi s ex -wif e or da ug ht er, or st al k

Sara h Pal in

. Mi ka wa arg ue s th at by req ui rin g th at he co n t i n u e to ta ke ps y ch ia tri c

m ed ic at io ns , co ns en t to dr ug te st in g, an d ris k reco m m it m en t fo r no nc om

pl ia nc e, th e

co nd it io na l rel eas e pl an ad eq ua te ly ad dr es se d an y ris k of in jury fro m th e po ss ib il it y

th at he wou ld st op tak in g h is m ed ic at io ns

.

The co nd it io na l rel eas e p la n i nc lu de d te rm s an d co nd it io ns th at wou ld res ul t

in cl os e m on it or in g of Mi ka wa’s co m pl ia nc e wit h tre at m en t fo r hi s m en ta l il ln es s,

whi ch in so m e c i r c u ms t a nc es wou ld be su ffi ci en t to al le vi at e th e di st ric t co ur t’s

co nc ern s. Giv en Mi ka wa’s lo ng -te rm an d freq ue nt in si st en ce th at he do es no t su ffer

fro m a m en ta l il ln es s an d do e s n o t w a n t to be on an d ha s a rep eat ed hi st or y of

-1 0-refu si ng ps y ch ia tri c m ed ic at io ns , ho wev er, th e di s t r i c t co ur t di d no t cl earl y err in

co nc lu di ng th at th e p ro po se d c on di ti on s d id no t s uf fic ie nt ly add res s t he su bs ta nt ia l

ris k th at Mi ka wa wou ld st op ta ki ng hi s m ed ic at io ns , de co m pe ns at e, an d cau se bo di ly

ha rm or pr op ert y da m ag e

. S e e LeCl ai r, 33 8 F.3 d at 88 5 (u ph ol di ng co nt in ue d

co m m it m en t whe re pa ti en t ha d “ li tt le in si gh t in to h i s men ta l il ln es s an d ne ed fo r

tre at m en t ” a n d th ere was “ no as su ran ce of co m pl ia nc e wit h tre at m en t ou ts id e a

st ru ct ur ed se tt in g” ); see al so Uni te d Stat es v. Jack so n, 19 F.3 d 10 03

, 10 08 (5 th Ci r.

19 94 ) (“ Sect io n 42 43 do es no t req ui re th at Ja ck so n be [co nd it io na ll y ] rel eas ed si m pl y

be cau se th ere a r e mecha ni sm s whe reb y he co ul d be cl os el y m on it or ed on an

ou tp a ti en t ba si s.”)

. Alt ho ug h th e di st ric t co ur t co ul d ha ve im po se d ad di ti on al

co nd it io ns to al la y it s co nc ern s, se e Uni te d St at es v. Fran kl in

, 43 5 F.3 d 88 5, 88 9 (8 th

Ci r. 20 06 ), we can no t fau lt th e di st r i c t co ur t fo r fai li ng to co ns id er hypo th et ic al

co nd it io ns no t pr es en te d to it

. In th is cas e, it was no t rev ers ib le erro r fo r th e di st ric t

co ur t to de ny co nd it io na l di sc ha rg e ba se d on th e pl an pr es en te d in th e rep or ts an d at

th e he ari ng

. See Uni te d St at es v. Ph el ps , 28 3 F.3 d 1 1 7 6

, 11 84 (9 th Ci r. 20 02 ) (“ If

ad eq ua te co nd it io ns can no t be or are no t de ve lo pe d to th e sa ti sf act io n of th e co ur t to

en su re p ub li c sa fet y , th en th e co ur t h as th e res po ns ib il it y to de ny the rel eas e.”).

W hi le we do no t fin d th at th e co ur t cl earl y erre d in de nyin g th e di sc ha rg e of

Mi ka wa’s co m

m it m en t on th e reco rd pr es en te d he re, we are m in df ul th at th e st at ut or y

m ax im um se nt en ce fo r Mi ka wa’s of fen se is th ree y ears im

pr is on m en t. See 18 U.S.C.

§ 91 2. Mi ka wa ha s be en in fed eral cu st od y fo r ne arl y se ve n y ears , an d hi s bu rd en is

to pr ov e hi s el ig ib il it y fo r rel eas e on ly by a pr ep on de ran ce of th e ev id en ce. 18 U.S.C.

§ 42 43 (d ). “ ‘It ha s to be reca ll ed th at th e go ve rn m en t’s ro le he re is no t th a t of

pu ni ti ve cu st od ia n of a fu ll y co m pe te nt in m at e, bu t b en ig n c us to di an of o ne leg al ly

co m m it te d to it fo r m ed ic al care an d t r e a tm en t— sp eci fic al ly fo r ps y ch ia tri c

tre at m en t.” St ei l, 91 6 F.2 d at 48 8 (q uo ti ng Uni te d St at es v. Ch art ers , 86 3 F.2 d 30 2,

31 2 (4 th Ci r. 19 88 )). A p e r so n co m m it te d pu rs ua nt to 18 U.S.C. § 42 43 is en ti tl ed

to an an nu al ev al ua ti on of hi s men t a l c on di ti on an d th e ne ed fo r co nt in ue d

co m m it m en t. 18 U.S.C. § 42 47 (e)( 1) (B). At or al arg um en t, it was di sc lo se d th at

-1 1-Mi ka wa ha s no t rece iv ed su ch an ev al ua ti on si nc e hi s pr io r RAP in Mar ch 20 15

. “ In

it s cu st od ia l ro le

, th e go ve rn m en t of co ur se m us t fu lfi ll it s st at ut or y du ti es ,” St ei l, 91 6

F. 2 d a t 48 8, an d we are co nf id en t th at th e go ve rn m en t wil l en su re Mi ka wa is

reev al ua te d in du e co ur se to de te rm in e whe th er th ere is a ne ed f o r hi s co nt in ue d

ho sp it al iz at io n. See al so 18 U.S.C. § 42 47 (h ) (s ta ti ng th at Mi ka wa’s co un se l m ay fil e

a m ot io n fo r a he ari ng to de te rm in e Mi ka wa’s el ig ib il it y fo r di sc ha rg e “ at an y ti m e”).

II I. Co ncl us io n

Fo r th e fo reg oi ng reas on s, we af fir m th e o rd er o f th e d is tri ct co ur t.

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __

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