Opinion ID: 4524141
Heading Depth: 2
Heading Rank: 2

Heading: The Present Appeals

Text: Mr. Taylor, who has been diagnosed with schizophrenia, was arrested in June 2016 and charged with assaulting three people with a knife. After finding him incompetent to stand trial, the court committed him to Saint Elizabeths Hospital for 252, 262-63 (4th Cir. 1999) (holding that an institution’s decision in accordance with Harper to forcibly medicate a pretrial detainee is “subject only to judicial review for arbitrariness”). We also note that this court has not previously addressed whether an administrative involuntary medication decision must by law meet the requirements of a contested case, in which case judicial review would be in this court. 33 Compare § 7-1231.08(c) with Harper, 494 U.S. at 215-16. 16 competency restoration treatment. 34 Following his admission, Mr. Taylor continued to experience delusions, agitation, and paranoia, and to engage in a pattern of threatening and violent behavior toward other patients and Hospital personnel. Several of his altercations led to his involuntary emergency medication. On December 30, 2016, his prescribing psychiatrist applied for permission to initiate non-emergency involuntary psychotropic medication to treat Mr. Taylor and alleviate his dangerousness. The psychiatrist stated that he did not propose involuntary medication for the purpose of restoring Mr. Taylor to competence. A Medication Review Officer approved the request, and the Medication Review Panel, to which Mr. Taylor appealed, unanimously upheld the decision.35 34 See D.C. Code § 24-531.05 (2012 Repl.). 35 In its written report, the Panel concluded as follows: It is the opinion of the panel that Mr. Taylor suffers from a mental illness which interferes with his ability to make informed decisions about his mental health treatment. As a result of his mental illness, he is gravely disabled (in danger of serious physical harm due to his inability to provide for any of his basic needs for nourishment, or essential medical care, or shelter, or safety) or poses a likelihood of serious harm or dangerousness to self, others, or property without the medication. After considering less restrictive interventions, the panel opines that psychotropic medication is appropriate. Mr. Taylor has refused to take psychotropic medication, but given his symptoms as described above, it is the treatment of choice as recommended by the treatment team. He currently 17 After the Panel’s decision, Mr. Taylor moved in his pending criminal case to enjoin Saint Elizabeths from medicating him without his consent. He argued that because he was detained only for purposes of competency restoration, District law and due process required his involuntary medication to be authorized by court order. In addition, Mr. Taylor argued that he did not meet the substantive legal requirements for medicating him against his will. DBH, which defended the medication order, agreed to refrain from administering medication to Mr. Taylor while his motion was pending. The court denied the motion. It held that Saint Elizabeths lawfully could administer involuntary medication to Mr. Taylor without a court order because it had followed the constitutionally adequate procedures set forth in D.C. Code § 7- 1231.08; it was not the sole purpose of the medication to restore Mr. Taylor to competency; and DBH had shown a compelling need to medicate Mr. Taylor for his safety and that of Hospital staff and patients. lacks the capacity to give informed consent and without medication, he is at risk for continued serious mental illness and a reduced quality of life. The benefits of medication outweigh the risk of medication-associated side effects. Therefore, the panel is in unanimous agreement that Mr. Taylor should be medicated involuntarily. 18 Although the court stayed its order to allow Mr. Taylor time to request this court for a stay pending appeal, the Superior Court stay expired before this court received a motion for a stay. As a result, Saint Elizabeths commenced Mr. Taylor’s involuntary medication. On March 22, 2017, the Superior Court found that Mr. Taylor was competent. A week later he entered into a plea agreement and pleaded guilty. He was sentenced on June 9, 2017, and we are informed that he is now in the custody of the United States Bureau of Prisons.
Brandon Byrd was charged in August 2016 with the first-degree murder of his father. The Superior Court found him incompetent to stand trial and committed him to Saint Elizabeths Hospital for competency restoration treatment. While he was there, the United States moved the Superior Court to order his involuntary medication for the purpose of rendering him competent. In March 2018, the Superior Court granted the motion, but the medication order was stayed pending appeal and thereafter, at the behest of the United States, this court vacated the order and remanded the matter for further factual development of the record. In the meantime, efforts were under way at Saint Elizabeths to provide for Mr. Byrd’s medication for safety reasons. Mr. Byrd was diagnosed with paranoid 19 schizophrenia. Over time, his agitation, auditory hallucinations, and other psychiatric symptoms worsened, and he became seriously aggressive and threatening to others at the Hospital. He was medicated on an emergency basis after he threatened to jump into the nursing station and assault the staff. By February 2018, Mr. Byrd’s severe aggressive outbursts and angry, psychotic behavior led his treating psychiatrist to propose his involuntary medication for the purposes of reducing the danger he posed to himself and others. A Medication Review Officer approved the request, as did a unanimous Medication Review Panel, which found Mr. Byrd to be “gravely disabled” and, without medications, “a safety risk to self [and] others especially given his ongoing psychosis and recent escalation of his agitation [and] aggressive behaviors.” Mr. Byrd moved in his Superior Court criminal case for reversal of the Panel’s decision. He argued that the Hospital’s administrative determination violated his due process rights because it did not satisfy the heightened procedural and substantive requirements that Sell held applicable when involuntary medication is for the purpose of rendering a pretrial detainee competent to stand trial. Those requirements, Mr. Byrd contended, governed any non-emergency involuntary medication of pretrial criminal defendants held for competency restoration at Saint Elizabeths, regardless of the purpose. Mr. Byrd also argued that the involuntary 20 medication procedures of D.C. Code § 7-1231.08 could not be used in his case because he had not been committed to Saint Elizabeths under the District of Columbia Hospitalization of the Mentally Ill Act. 36 The Superior Court denied Mr. Byrd’s motion but temporarily stayed his involuntary medication to allow him to seek a stay in this court pending his appeal. This court granted that stay. Our stay order instructed Mr. Byrd to update this court regarding the stillpending proceedings on remand over his involuntary medication for the purpose of rendering him competent to stand trial. On November 15, 2019, the Superior Court ruled that the government had met its burden under Sell and could medicate Mr. Byrd without his consent to restore him to competence. Mr. Byrd’s counsel promptly informed us of this ruling and of Mr. Byrd’s decision not to take an immediate appeal from it. 37 36 Mr. Byrd presented additional arguments that he has not pursued on appeal. 37 Counsel represented that Mr. Byrd intended to preserve his objections to the Sell ruling for a potential future appeal. 21