United States v. Chatmon, No. 12-4725 (4th Cir. 2013)
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Defendant, indicted for conspiracy to distribute crack cocaine and heroin, was diagnosed with paranoid schizophrenia and deemed incompetent to stand trial. The district court, applying Sell v. United States, granted the government's motion to involuntarily medicate defendant for trial competency purposes. The district court did not mention or analyze any of the less intrusive alternatives suggested by the Supreme Court in Sell or by defendant himself. Therefore, the court vacated the district court's order and remanded for further proceedings because careful findings concerning the availability of less intrusive means were necessary to vindicate the Supreme Court's admonition that forcible medication motions should be carefully scrutinized due to their impact on personal liberty.
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PUBLISHED UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT No. 12-4725 UNITED STATES OF AMERICA, Plaintiff - Appellee, v. FRANK CHATMON, Defendant - Appellant. Appeal from the United States District Court for the Eastern District of Virginia, at Alexandria. Claude M. Hilton, Senior District Judge. (1:10-cr-00477-CMH-7) Argued: May 15, 2013 Decided: June 10, 2013 Before WILKINSON, MOTZ, and SHEDD, Circuit Judges. Vacated and remanded by published opinion. Judge Wilkinson wrote the opinion, in which Judge Motz and Judge Shedd joined. ARGUED: Charles Burnham, BURNHAM & GOROKHOV PLLC, Washington, D.C., for Appellant. Lisa Owings, OFFICE OF THE UNITED STATES ATTORNEY, Alexandria, Virginia, for Appellee. ON BRIEF: Eugene V. Gorokhov, Ziran Zhang, BURNHAM & GOROKHOV PLLC, Washington, D.C., for Appellant. Neil H. MacBride, United States Attorney, Sean P. Tonolli, Assistant United States Attorney, Scott B. Nussbum, Special Assistant United States Attorney, OFFICE OF THE UNITED STATES ATTORNEY, Alexandria, Virginia, for Appellee. WILKINSON, Circuit Judge: After his indictment for conspiracy to distribute crack cocaine and heroin, appellant Frank Chatmon was diagnosed with paranoid schizophrenia and deemed incompetent to stand trial. The government then filed a motion seeking permission to forcibly medicate Chatmon in order to restore him to competency, which the district court granted. In doing so, the district court purported to apply the standard mandated in Sell v. United States, 539 U.S. 166, 181 (2003). That standard permits involuntary medication for trial competency purposes if, inter alia, less intrusive treatments are unlikely to achieve substantially the same results. The district court found this criterion satisfied, Id. summarily stating that involuntary drugging [is] necessary because there is no less intrusive means shown to be available. In reaching that conclusion, however, the court did not mention or analyze any of the less intrusive alternatives suggested by the Supreme Court in Sell or by Chatmon himself. concerning necessary the to availability vindicate the of Because careful findings less Supreme intrusive Court s means admonition are that forcible medication motions should be carefully scrutinized due to their vacate impact the on district personal court s liberty, order proceedings. 2 see and id. at remand 180-81, for we further I. A. In December 2010, Chatmon was arrested and charged with conspiracy to distribute 280 grams or more of crack cocaine and 100 grams or §§ 841(a)(1) charges, more and of 846. Chatmon s heroin, Before in attorney he violation could expressed be of tried concern 21 U.S.C. on about these his psychological condition, declaring to the district court that Chatmon s mental state has deteriorated to the point where I feel he doesn t understand what s going on anymore. attorney thus filed a motion seeking a formal Chatmon s competency evaluation under 18 U.S.C. § 4241(a). The district court granted the motion and ordered that Chatmon be evaluated at the Butner Federal Medical Center in North Carolina. to Butner Pursuant to that order, Chatmon was transferred from his jail cell in Alexandria, Virginia evaluation by a staff psychologist in May and June 2011. psychologist s report diagnosed Chatmon with for The Schizophrenia, Paranoid Type and described several of his symptoms, including the fact that he heard voices in his head and his beliefs that a satellite was attached to his brain and that his thoughts were being manipulated via remote control. the opinion that Chatmon suffers 3 The report concluded with from a mental disease that renders him unable to understand the nature and consequences of the proceedings against him or assist counsel in his defense. Based on these unchallenged findings, the district court deemed Chatmon incompetent to stand trial and ordered that he be returned to Butner for hospitalization and treatment to determine whether he might be restored to competency such that the criminal proceedings could go forward. 4241(d). See 18 U.S.C. § Chatmon was accordingly transferred back to Butner for a competency restoration evaluation in September 2011. Upon his return to Butner, Chatmon was placed in the facility s Restrictive Movement Unit ( RMU ), a unit in which individuals are held in solitary confinement in cells for all but one hour of the day. Chatmon was housed in the RMU during the entire period in which his competency restoration evaluation was performed. employees: Chatmon s That evaluation was conducted by three Butner Samantha primary DiMisa, a evaluator; psychology Dr. Angela intern who Weaver, a was staff psychologist who supervised DiMisa; and Dr. Robert Lucking, a staff psychiatrist who interviewed antipsychotic medication. on December 9, 2011. Chatmon once to discuss Together, the three produced a report The report confirmed Chatmon s initial diagnosis of paranoid schizophrenia and identified symptoms such as paranoid beliefs, ideation, hostility, and auditory hallucinations, tangential conversation. 4 delusional The report also observed that Chatmon denied having a mental illness and would not consent to treatment with psychotropic medication. Finally, the report expressed the evaluators shared opinion that although Chatmon remained incompetent for trial, there is a substantial probability that Mr. Chatmon s competency can be restored with a period of treatment with haloperidol decanoate, a type of antipsychotic medication. On December 20, 2011 (eleven days after Chatmon s competency restoration report had been completed but before it had been submitted to the parties or the district court), Chatmon was transferred from the RMU to an open population unit within Butner where he was able to move freely in and out of his cell and interact with other inmates. Chatmon had previously made multiple requests to be transferred into such a unit, but each had been rejected. allowing the transfer According to DiMisa, the reasons for were that Chatmon had begun to show greater engagement with Butner staff members and that he had completed paperwork that he had previously refused to sign. Chatmon demonstrated while in the open unit. notable improvement in his behavior DiMisa testified that when she met with him two weeks after his transfer, on January 5, 2012, Chatmon was more visited responsive the library to her and redirection exercised during regularly, conversation, had a good relationship with his roommate, and expressed the desire to take 5 a GED class and work in the kitchen. Chatmon had adjusted population. well when In DiMisa s opinion, transferred to the open DiMisa also noted, however, that just because someone becomes better able to manage their behavior does not necessarily indicate that [they are] competent to stand trial. Still, notwithstanding Chatmon s progress, Butner staff did not conduct any additional evaluation of his competency and instead submitted the December 9, 2011 report to the parties and the district court on January 10, 2012. B. Based on the findings in the December report, the government filed a motion for permission to forcibly medicate Chatmon in February 2012. The district court held a hearing on the motion on August 29. During the hearing, the district court began its analysis by identifying the four-part standard provided by Sell v. United States, 539 U.S. 166 (2003), for determining whether the government may involuntarily medicate a defendant in order to restore him to competency for trial. 1 1 As relevant to the two The government has made no contention that Chatmon is dangerous to others, which would remove this case from the Sell framework discussed herein. See 539 U.S. at 181-82 (discussing Washington v. Harper, 494 U.S. 210, 225-26 (1990), which recognized the government s important interest in medicating prisoners who pose a danger to themselves or to others). 6 elements at issue in this appeal, the court found first that the government had shown an important interest in medicating Chatmon because he had been charged with one of the most serious offenses that can be committed, a drug offense punishable by a term of up to life in prison. court stated that See id. at 180. involuntary drugging Second, the would be necessary because there is no less intrusive means shown to be available. See id. at 181. In reaching that conclusion, however, the district court did not address a particular alternative required by Sell: a court order to the defendant backed by the contempt power. Id. treatments Chatmon Nor did the court discuss two less intrusive proposed by remain in to confinement. 2 the government Chatmon: an open group therapy unit rather and than permitting solitary The court nonetheless issued an order permitting to medicate Chatmon against his will, which Chatmon now appeals. II. The question of when the government may involuntarily administer psychotropic drugs to a defendant for the purpose of 2 According to Chatmon s counsel, after Chatmon s competency restoration evaluation was completed (and after he had made progress while being housed in Butner s open unit), Chatmon was returned to jail in Alexandria and placed in solitary confinement, where his mental health again deteriorated. 7 rendering balance him between altering accused competent the medication to trial. to stand trial defendant s and interest society s The Supreme entails in interest Court a difficult refusing in mind- bringing recognized the the weighty concerns on both sides of this balance in Sell, noting that while individual defendants possess a significant constitutionally protected liberty interest in avoiding the unwanted administration of antipsychotic drugs, so too does the government possess an important interest in protect[ing] through application of the criminal law the basic human need for security. 539 U.S. at 178, 180 (quoting Washington v. Harper, 494 U.S. 210, 221 (1990)). Our own cases have conveyed the same point. States v. White, forced medication for as example, a drastic we characterized resort that, if In United recourse to allowed to become routine, could threaten an elementary imperative of individual liberty. 620 F.3d 401, 422 (4th Cir. 2010). We also acknowledged, however, that when an individual is alleged to have committed a serious crime, the individual may in some cases forfeit[] her liberty interest . . . to the extent necessary for the government to bring her to trial. Id. at 409. The crux of the matter, then, is how to reconcile these competing individual and societal interests so as to know which cases warrant the serious intervention of forced medication and 8 which do not. Courts are guided in this process by the four- part test announced in Sell, which we have described as follows: First, the government must show that important governmental interests are at stake and that special circumstances do not sufficiently mitigate those interests. Sell, 539 U.S. at 180. Second, involuntary medication must significantly further the government's interests by making it substantially likely to render the defendant competent to stand trial and substantially unlikely to have side effects that will interfere significantly with the defendant s ability to assist counsel at trial. Id. at 181. Third, the involuntary medication must be necessary to further the government s interests, and less intrusive means must be unlikely to achieve substantially the same results. Id. And last, the court must conclude that the administration of drugs is medically appropriate and in the patient s best medical interests in light of her medical condition. Id. White, 620 F.3d at 410. The government must establish each element of this test by clear and convincing evidence. United States v. Bush, 585 F.3d 806, 814 (4th Cir. 2009). In applying the Sell test, we note that circuit courts have upheld involuntary medication orders on prior occasions. See, e.g., United States v. Green, 532 F.3d 538 (6th Cir. 2008); United States v. Bradley, 417 F.3d 1107 (10th Cir. 2005). But we have never departed from the recognition that such orders are a tool that must not be casually deployed, for forced medication is a serious intrusion upon the integrity of the individual and the effects of such medication upon body and mind are often difficult to foresee. concurring). See White, 620 F.3d at 422 (Keenan, J., While involuntary medication orders may sometimes 9 be necessary, they carry an unsavory pedigree. U.S. at 229-30 antipsychotic (describing medication how can have forced See Harper, 494 administration serious, even fatal of side effects, such as cardiac dysfunction and tardive dyskinesia, a neurological disorder in 10% to 25% of patients characterized by uncontrollable understanding movements of the of legal various muscles ). framework, we With turn now this to the application of the Sell test to Chatmon s case. III. A. Chatmon argues first that the district court incorrectly deemed his drug trafficking charge a serious crime, a ruling that (if interest. correct) gives rise to an important government See Sell, 539 U.S. at 180 ( The Government s interest in bringing to trial an individual accused of a serious crime is important. ). consideration Unfortunately for determining whether when Chatmon, a the particular central crime is serious enough to satisfy this factor is the maximum penalty authorized by statute. 237 (4th Cir. 2005). United States v. Evans, 404 F.3d 227, For example, we held in White that certain offenses were serious because they exposed a defendant to a maximum prison term of over ten years. 620 F.3d at 410-11. That Chatmon has been accused of a serious crime is thus clear 10 because the offense with which he is charged carries the highest possible maximum § 841(b)(1)(A). also prison term: life imprisonment. 21 U.S.C. The seriousness of Chatmon s charged offense is reinforced by the fact that § 841(b)(1)(A) imposes a mandatory minimum of ten years, which rises to twenty years if the defendant has a prior felony drug conviction, as the government contends is true of Chatmon. Chatmon responds that the maximum statutory prison term for his drug trafficking charge is of no consequence because Sell commands that in order to constitute a serious crime, offense must be against persons or property. Br. 22. But that is not the law. the Appellant s Indeed, we expressly rejected this argument in Evans, where we held that Sell s mention of serious crimes against the person or . . . against property does not impose[] the additional requirement that the crime also be against either [a] person or property in order to be a serious one. 404 F.3d at 237 n.6. Other circuits agree. See, e.g., United States v. Green, 532 F.3d 538, 550 (6th Cir. 2008). Instead, mentioned as crimes we explained against in persons Evans, and the property Sell Court for the unexceptional purpose of highlighting that those were the type of charges that Sell himself faced. Finally, would Chatmon mitigate the points to government s 11 404 F.3d at 237 n.6. no special interest in circumstance bringing that him to trial. Sell, 539 U.S. at 180. Chatmon s case, for example, is unlike White because the defendant in that case faced a likely prison sentence of approximately 42-51 months if convicted -and would have already served more than that amount by the time of trial. 620 F.3d at 418. Here, by contrast, Chatmon faces a potential mandatory minimum of twenty years if convicted, and has been confined to date for but a fraction of that time -roughly two and a half years. notes, this is likely not Furthermore, as the government a case where its interest in prosecuting Chatmon could be assuaged through a civil commitment order because Chatmon has not been found to pose the risk of injury to others necessary to warrant such commitment under 18 U.S.C. § 4246(d). We therefore reject Chatmon s contention that the government has no important interest at stake in his case. B. We turn now to Chatmon s challenge relating to the third Sell factor, the existence of means for restoring a defendant to competency less intrusive than involuntary medication. at 181. Appellate courts have reviewed findings on this factor for clear error. a district 539 U.S. court s See, e.g., United States v. Fazio, 599 F.3d 835, 839-40 (8th Cir. 2010). As relevant here, a district court commits clear error if it takes an erroneous view of the controlling legal standard or makes factual findings without properly 12 taking into account substantial evidence to the contrary. Miller v. Mercy Hosp., Inc., 720 F.2d 356, 361 (4th Cir. 1983). To start, standard. In the district Sell, the court Supreme misapprehended Court the explained legal that the overarching inquiry with respect to the third factor is whether involuntary medication is necessary because alternative, less intrusive treatments are unlikely to achieve substantially the same results. 539 U.S. at 181. But Sell also contained a specific command that must be met before a district court may answer this inquiry in the affirmative: the court must consider less intrusive means for administering the drugs, e.g., a court order to the defendant backed by the contempt power. Id.; see also, e.g., United States v. Bradley, 417 F.3d 1107, 1115-16 (10th Cir. 2005) (finding third Sell factor satisfied where court entered order requiring defendant to take medication on threat of civil contempt). Of course, this is not tantamount to a requirement that a defendant must be first held in contempt in each and every case. This option would, however, allow the defendant to decline at least for a period of time forcible medication, albeit at the cost of confinement or some other civil sanction. The district court failed to heed this legal requirement. The court s discussion of less intrusive means at Chatmon s hearing was limited to the summary conclusion that involuntary 13 drugging would be necessary because there is no less intrusive means shown to be available. The district court entered a written order confirming this ruling a week later, but it was just as brief, declaring simply that involuntary medication of the defendant is necessary to further the government s interests and any alternative, less intrusive treatments are unlikely to achieve substantially the same result. court acknowledge Sell s requirement At no point did the that it must consider less intrusive means for administering Chatmon medication such as a court order backed by contempt sanctions. We think such consideration requires that the court explain upon remand why less intrusive means would prove ineffectual. The court also needs to account for evidence of other less intrusive means presented by Chatmon. before the alternative district means for court, During the oral hearing Chatmon s restoring counsel Chatmon to discussed competency: two group therapy and allowing Chatmon to reside in an open population unit rather than solitary confinement. In proposing those alternatives, counsel repeatedly referenced supportive evidence in the record, referring in particular to Ms. DiMisa s deposition testimony regarding Chatmon s improvements upon being admitted into nevertheless Butner s found no open less unit. intrusive The means district to be court available without recognizing this contrary evidence or explaining why it 14 might be insufficient. Of course, a district court need not credit a defendant s evidence or accept his arguments, but its findings should offer some reason why it did not. oral argument, district the court government offered no candidly reasons why Here, during conceded Chatmon s that the alternatives might be unavailing and essentially provided no rationale in support of its ruling. See United States v. Francis, 686 F.3d 265, 273 (4th Cir. 2012) ( A court commits clear error when it makes findings without properly taking into account substantial evidence to the contrary. (quoting Miller, 720 F.2d at 361)). It is findings the context significant. of this case that makes supported The need for such findings serves typically not as a broad red light upon a judicial disposition but as a blinking yellow. In a matter as sensitive as an involuntary medication order, which trenches upon the elemental individual liberty administration of interest in mind-altering refusing medication, the the need invasive to slow down and consider less intrusive alternatives is important. Put simply, such consideration is necessary to provide this court with assurance that forcible medication orders, while sometimes warranted, will not become a device routinely or casually employed. Because the district court erred in its analysis of the third Sell factor, we vacate the involuntary medication order 15 and remand for further findings. We remand because the district court remains far better situated than we are to evaluate in the first instance availability and the conflicting effectiveness evidence of less concerning intrusive means the for restoring Chatmon to competency. Upon consider, ordering remand, as we Sell Chatmon to note that suggests, take his the the district less prescribed backing of civil contempt sanctions. court intrusive medication should option of with the The district court should also consider and evaluate less restrictive means that Chatmon plausibly suggests for restoring him to competency. For the foregoing reasons, we vacate and remand for further proceedings consistent with this decision. VACATED AND REMANDED 16
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