Opinion ID: 3033156
Heading Depth: 2
Heading Rank: 3

Heading: Substantial Likelihood of

Text: Medication to Restore Competency Grape also argues that the District Court erred in finding for the Government on factor two of the Sell test, which we review for clear error. The Sell Court describes factor two as follows: Second, the court must conclude that involuntary medication will significantly further those concomitant state interests. It must find that administration of the drugs is substantially likely to render the defendant competent to stand trial. 10 We also recognize, however, that Grape’s forced medication pursuant to Harper before our decision in the instant appeal altered the facts of his case. Therefore, we decline to reach whether Grape’s potential for indefinite civil confinement on the facts prior to his Harper medication would have sufficed under the first Sell factor to overcome the Government’s stated interests. We limit our holding here to the facts of Grape’s individual case, as presented to us at the time of our decision. 27 At the same time, it must find that administration of the drugs is substantially unlikely to have side effects that will interfere significantly with the defendant’s ability to assist counsel in conducting a trial defense, thereby rendering the trial unfair. Sell, 539 U.S. at 181. The clear error standard of review is important to our analysis of this issue. This Court has defined clear error review as follows: We accept the district court’s findings of fact unless they are clearly erroneous. A finding of fact is clearly erroneous when, after reviewing the evidence, the court of appeals is “left with a definite and firm conviction that a mistake has been committed.” Thus, even if we might have come to different factual conclusions based on this record, we defer to the findings of the district court unless we are convinced that the record cannot support those findings. Oberti v. Bd. of Educ., 995 F.2d 1204, 1220 (3d Cir. 1993) (citations omitted) (quoting Anderson v. Bessemer City, 470 U.S. 564, 573 (1985)). The Government bears the burden of establishing the second Sell factor by clear and convincing evidence. See Gomes, 387 F.3d at 159. The District Court declared this part of its analysis the “central question in this case[, i.e.,] whether medication is substantially likely to restore Mr. Grape’s competency.” 28 Grape challenges the District Court’s holding on this factor in two ways. First, he challenges the sufficiency of the evidence before the District Court to find that he was in fact “substantially likely” to return to competence if administered such antipsychotic drugs. The parties debated over the testifying doctors’ evidence that the Government showed such a substantial likelihood through Dr. Pietz’s testimony that “the Bureau [of Prisons] has approximately a 70 percent success rate in restoring involuntarily medicated defendants to competency.” Yet, Dr. Sarrazin later acknowledged that the Bureau’s “success in restoring competency is a little bit lower for people that have to be forcibly medicated than for people who do not,” such as Grape, because they are “uncooperative with [their] treatment[,] . . . have absolutely no insight into their illness[,] do not believe they are mentally ill[, and] are oftentimes sicker individuals.” Second, Grape argues that the District Court “fail[ed] to appreciate that the government had the burden of proof on this issue, and therefore any lack of evidence to support a finding that forcible medication was substantially likely to render Mr. Grape competent to stand trial had to be resolved against the government, not [for] the government.” Grape has not shown that the District Court clearly erred in accepting the doctors’ testimony that antipsychotic medication would be substantially likely to render him competent to stand trial. However, we can dispose of Grape’s hypothetical arguments as to Sell factor two by referring to the facts of what actually happened after the Government forcibly medicated him 29 pursuant to Harper. 11 Both the District Court and the Springfield staff found that the medications restored Grape to competency. Regardless of whether the District Court “abdicat[ed] its fact-finding role,” or failed to hold the Government to its burden of proof, this tangible evidence shows that “involuntary medication will significantly further those concomitant state interests” by being “substantially likely to render [Grape] competent to stand trial,” yet also being “substantially unlikely” to have detrimental side effects affecting Grape’s trial preparation. Sell, 539 U.S. at 181. 11 The District Court’s analysis, of course, did not consider the actual results of Grape’s forcible medication with antipsychotic drugs. However, “it would be pointless to remand the case simply to have the District Judge take notice of that which we may notice ourselves.” United States v. Remoi, 404 F.3d 789, 793 n.1 (3d Cir. 2005); see also Werner v. Werner, 267 F.3d 288, 295 (3d Cir. 2001) (“A court may take judicial notice of an adjudicative fact if that fact is not subject to reasonable dispute . . . [and such a] fact must either be generally known within the jurisdiction of the trial court, or be capable of accurate and ready determination by resort to sources whose accuracy cannot reasonably be questioned.” (citing Fed. R. Evid. 201)); In re Indian Palms Assoc., Ltd., 61 F.3d 197, 205-06 (3d Cir. 1995) (“Judicial notice may be taken at any stage of the proceeding, including on appeal, as long as it is not unfair to a party to do so and does not undermine the trial court’s factfinding authority.” (citations omitted)). 30 Thus we need not consider the research and scientific and empirical evidence the parties debated regarding the likelihood that antipsychotic medications would restore Grape to competency.12 We now know that Grape most probably suffers from paranoid schizophrenia, and definitely is responsive to medicinal treatment for such a diagnosis. Further, although we find that Grape did suffer side effects while taking antipsychotic medications, we have limited information on the exact side effects and their severity. Based on the parties’ representations and the subsequent District Court finding of Grape’s competency to stand trial, we assume that although Grape suffered some side effects, they were not sufficient to “interfere significantly with [his] ability to assist counsel in conducting a trial defense.” Sell, 539 U.S. at 181. Therefore, the Government has met its burden by clear and convincing evidence that, if medicated involuntarily, Grape is substantially likely to have his competence restored. For the above reasons, the District Court did not clearly err in coming to the conclusion it did. 12 The debate between the parties in their briefs hinges around the 70% restoration of competence statistic, whether that alone reaches a sufficient likelihood of restoration, and how far under that threshold Grape falls. We find this inconsequential because the tangible evidence garnered from Grape’s actual forcible medication resolves the issue over which the parties disputed – whether the medication plan outlined by Dr. Sarrazin would be substantially likely to restore Grape to competence with limited side effects. The plan did in fact restore Grape to competence with limited side effects. 31