Opinion ID: 3161987
Heading Depth: 2
Heading Rank: 2

Heading: 2013 Competency Evaluation Report

Text: On May 3, 2013, the district court received a forensic evaluation of Steinger under seal. Psychiatrist Ralph Newman, M.D., and psychologist Adeirdre Stribling Riley, Ph.D., authored the report describing Steinger’s mental and physical condition. They stated that Steinger was 63 years old and suffered from spinal stenosis, myeloradiculopathy, chronic obstructive pulmonary disease, which required oxygen, benign prostatic hypertrophy, gastro-esophageal reflux disease, polyps on the gallbladder, sleep apnea, insomnia, obesity, and incontinence, and had masses on his parotid glands and needed a catheter to urinate. Between 1994 and 2009, Steinger had three surgeries for his spinal stenosis. While awaiting trial, Steinger was housed at Larkin Community Hospital (“Larkin”), where physicians recommended that he be evaluated for further surgical intervention. Steinger, however, refused to have any operation at Larkin, and requested instead that he be transferred to the University of Miami Hospital (“UMH”) for the recommended evaluation. 1 Steinger raised competency concerns in his 2012 case. The parties ultimately agreed that the results of the competency hearing in the 2008 case would be binding on both cases. Consequently, all of the proceedings relevant to Steinger’s competency and the appeals before us occurred in the 2008 case. 3 Case: 14-14081 Date Filed: 12/11/2015 Page: 4 of 16 Steinger relied on a battery of drugs to control his pain. He used a fentanyl patch and took venlafaxine, ozcarbazepine, ibuprofen, acetaminophen, methadone, and morphine. He also took Ativan for anxiety, in addition to other miscellaneous medications for his gastrointestinal and prostate ailments. Steinger rated his pain as ten out of ten. As to Steinger’s mental health, Dr. Newman and Dr. Stribling Riley concluded: [A]lert and oriented to person, place, time, and situation. His memory is intact for immediate, recent, and remote recall to include details of the alleged offense . . . . Thought processes are well-organized without a thought disorder. He denies delusions or hallucinations. He is somatically preoccupied with his pain and discomfort, which appears to be genuine, although pain is subjective. They noted that Steinger was “more depressed than the average person” but “less depressed than the average pain patient.” His anxiety was average when compared to the general community but “considerably below average for pain patients.” Overall, the doctor examiners determined that Steigner was competent to stand trial. They opined that Steigner did not suffer from a severe mental disease or defect, and that he understood the charges against him and the possible penalties and benefits associated with pleading guilty. Steinger could assist counsel in his defense, and his medication regimen did not impede his ability to do so or to understand the proceedings. Finally, the doctors documented some malingering, 4 Case: 14-14081 Date Filed: 12/11/2015 Page: 5 of 16 noting that Steigner sought to “portray himself with a severe physical disability which would limit his ability to participate in . . . legal activities.”