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JON M. SANDS

Federal Public Defender

J. LEONARDO COSTALES

Assistant Federal Public Defender

Louisiana State Bar# 35721

407 W. Congress, Suite 501

Tucson, AZ 85701-1355

Telephone: (520)879-7500

Attorney for Defendant

Leo_Costales@fd.org

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

United States Of America,

 Plaintiff,

v.

Robert Francis Krebs,

 Defendant.

CR18-0263-TUC-JGZ (JR)

BRIEFING REGARDING 

COMPETENCY

Robert Francis Krebs, through undersigned counsel respectfully submits the 

following briefing regarding his competency to stand trial.

RESPECTFULLY SUBMITTED: June 7, 2019.

JON M. SANDS 

Federal Public Defender

/s/ J. Leonardo Costales 

J. LEONARDO COSTALES

Assistant Federal Public Defender

Case 4:18-cr-00263-JGZ-JR Document 64 Filed 06/07/19 Page 1 of 4
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BRIEF

Robert Francis Krebs is an 81-year-old man who has self-reported as suffering 

from symptoms of Alzheimer’s disease. The government’s Exhibits 7 and 8, which have 

Mr. Krebs recounting his Alzheimer’s diagnosis, corroborate this. Notably, this selfreporting occurred before the government ever filed a complaint or indictment against 

Mr. Krebs.

Alzheimer’s disease is degenerative. Transcript (Tr.) at 73-76. No imaging tool 

can diagnose Alzheimer’s disease. Tr. at 60. Apart from post-mortem examinations, a 

practitioner must rely on an individual patient’s self-reported symptoms in order to draw 

a diagnostic conclusion. See Tr. at 61. Family history is also relevant. Tr. at 32. An 

Alzheimer’s patient could potentially lack orientation to time and place. Tr. at 65. 

Unfortunately, there is no cure for Alzheimer’s. Tr. at 73-76. 

Mr. Krebs is an inmate and criminal defendant as well as a patient. His diagnostic 

criteria and credibility are different than that of an average individual. For example, 

whereas a non-Bureau of Prisons doctor might look for a motivation before considering a 

malingering diagnosis, Dr. Cochrane readily supplied avoidance of criminal prosecution 

as a motivation despite little evidence to support this theory. Tr. at 123. He assumed that 

Mr. Krebs, an 81-year-old man under a lengthy term of probation out of Florida, would 

seek to avoid prosecution by feigning feeble-mindedness. This is despite the fact that 

success in this context would have a strong likelihood of leading to either civil 

commitment or state incarceration for the duration of Mr. Krebs’ life. Tr. at 122-24. Dr. 

Cochrane did, however, rule out factitiousness as a differential diagnosis. Tr. at 111.

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If Mr. Krebs is believed at his word, he is not oriented to time or place and is 

suffering from a condition to which he has a family history. The condition in question 

does not necessarily have a constant presentation of symptoms, with variation in 

presentation of symptoms not uncommon. Tr. at 74. It is also a condition that could lead 

to a “step-down” decline and worsening of symptoms. Tr. at 93-94. Dr. Cochrane chose 

not to believe at Mr. Krebs at his word, and instead relied heavily on collateral 

information about Mr. Krebs’ criminal history. Tr. at 96-97. From this, he concluded that 

Mr. Krebs had Anti-Social Personality Disorder and was, in short, a liar. Dr. Cochrane 

did not appear to seriously entertain that Mr. Krebs might be suffering from early stage 

Alzheimer’s despite Mr. Krebs reporting worsening memory deficits and a family history 

of the disorder. Tr. at 32. However, Dr. Cochrane did admit at the hearing that he could 

not definitely rule out Alzheimer’s. Tr. at 94. 

Alzheimer’s is not the only medical issue Mr. Krebs suffers from. An MRI 

revealed ischemic changes in his brain, consistent with micro-traumas. Tr. at 59-60. He 

has a history of pulmonary embolisms and congestive heart failure, which could lead to 

neuro-cognitive decline. Tr. 63-64. He is also 81 years old, which itself could lead to 

dementia. 

In short, Mr. Krebs reports symptoms that, if accepted, lead to serious doubts 

about his competency to stand trial. Indeed, an Alzheimer’s diagnosis leads any patient to 

having their quality of life thenceforth intrinsically tied with the progression of the 

disease. 

/ / /

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On September 14, 2018, this court found reasonable cause to believe that Mr. 

Krebs may currently be suffering from a disease or defect rendering him incompetent to 

stand trial. The standard now requires the Court to find Mr. Krebs either competent or 

restorable within a certain set period of time (not to exceed 120 additional days). Making 

this finding, despite the inability of the treating practitioner to rule out a diagnosis of 

Alzheimer’s would lead to a serious risk that a person suffering from progressive 

dementia may be tried and convicted. Alzheimer’s does not get better, it gets worse. And 

if Mr. Krebs suffered from a mental disease or defect stemming from Alzheimer’s or 

another form of dementia on September 14, 2018, he likely still suffers from the disease 

or defect, possibly with worsened symptoms. 

Given these facts, there is insufficient evidence to show that Mr. Krebs is

competent to stand trial. Given the information suggesting he may suffer from 

Alzheimer’s disorder, there is reason to believe, based on the known progression of that 

disorder, which he may never get better and will likely get worse. For the above reasons,

the defense respectfully urges the Court to find that Mr. Krebs currently remains not 

competent to stand trial.

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