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United States v. Garnos

United States District Court, D. South Dakota, Central Division

February 10, 2017

UNITED STATES OF AMERICA, Plaintiff,
v.
GRAHAM GARNOS, Defendant.

          OPINION AND ORDER ON THE INVOLUNTARY ADMINISTRATION OF ANTIPSYCHOTIC MEDICATIONS

          ROBERTO A. LANGE UNITED STATES DISTRICT JUDGE.

         The United States charged Graham Garnos with violating 18 U.S.C. § 875(c), Interstate Communications with Threat to Injure, on March 4, 2015. Doc. 1. On April 20, 2015, this Court granted the United States' motion to transport Garnos to a federal medical center to determine his mental competency to stand trial and aid in his own defense, pursuant to 18 U.S.C. § 4241. Doc. 17. Following several competency hearings and reports on Garnos' mental status and evaluations, Docs. 38, 45, 49, this Court determined that Garnos was not competent to stand trial and aid in his defense within the confines of § 4241, and ordered him to be hospitalized in an appropriate treatment facility for four months, "as is necessary to determine whether there is a substantial probability that in the foreseeable future he will attain the capacity to permit the proceedings to go forward." Doc. 50.

         In the forensic report completed in those four months, Garnos' psychologist at the Federal Medical Center in Butner, North Carolina, Dr. Robert E. Cochrane, explained that Garnos was diagnosed with delusional disorder (persecutory type), and with amphetamine-type substance, cocaine, and opioid use disorders; and that "Garnos' extensive history of substance abuse further clouds any concise explanation for his psychiatric symptoms." Doc. 69 at 11. Dr. Cochrane reported that Garnos was refusing all mental health treatment and determined that "it is unlikely that Mr. Garnos will be competent to stand trial in the foreseeable future without involuntary treatment." Doc. 69 at 14. The medical staff submitted a follow up addendum to the forensic report several months later after the Court requested additional analysis to include recently released medical records, a proposed treatment plan, and the factors needing medical analysis for the completion of a Sell hearing. Gov't Ex. 2.

         After Garnos' continued refusal to participate in treatment or take psychiatric drugs of any sort, [1] Docs. 69, 76, the United States filed a motion on December 27, 2016 to determine whether involuntary administration of anti-psychotic drugs was appropriate to restore competency, Doc. 77. This hearing, consistent with the requirements established by the Supreme Court in Sell v. United States, 539 U.S. 166 (2003), was held on January 31, 2017. At the hearing, Dr. Cochrane testified regarding Garnos' competency and the substance of the two forensic health examinations submitted to the Court. Based on the evidence presented at the hearing, and this Court's review of the record, the United States' request for the involuntary administration of anti-psychotic drugs is granted, provided that Garnos first be given a fourteen-calendar day opportunity to voluntarily comply with this Court's order through the use of prescribed oral antipsychotic medications.

         I. Sell Factors

         In Sell, the Supreme Court considered "whether the Constitution permits the Government to administer antipsychotic drugs involuntarily to a mentally ill criminal defendant-in order to render that defendant competent to stand trial for serious, but nonviolent, crimes." 539 U.S. at 169. The Supreme Court created four criteria for a court to consider before ordering the involuntary administration of antipsychotic drugs to avoid any unconstitutional deprivation of a defendant's "'liberty' to reject medical treatment." 539 U.S. at 178 (quoting U.S. Const, amend. V); see also Riggins v. Nevada, 504 U.S. 127 (1992); Washington v. Harper, 494 U.S. 210 (1990). "[T]he Constitution permits the Government involuntarily to administer antipsychotic drugs to a mentally ill defendant facing serious criminal charges in order to render that defendant competent to stand trial, but only if the treatment is medically appropriate, is substantially unlikely to have side effects that may undermine the fairness of the trial, and, taking account of less intrusive alternatives, is necessary significantly to further important governmental trial-related interests." Sell, 539 U.S. at 179. The Supreme Court admonished that these situations will be "rare." Id., at 180. It is a question of law for this Court to determine whether there are important governmental trial-related interests at stake, but the United States retains the burden of proving, by clear and convincing evidence, the remaining three Sell requirements. See United States v. Nicklas, 623 F.3d 1175, 1178 (8th Cir. 2010). The Eighth Circuit has summarized the Sell requirements:

First, "a court must find that important governmental interests are at stake, " though "[s]pecial circumstances may lessen the importance of that interest." Second, "the court must conclude that involuntary medication will significantly further those concomitant state interests." This includes finding that "administration of the drugs is substantially likely to render the defendant competent to stand trial, " and "[a]t the same time . . . 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." Third, "the court must conclude that involuntary medication is necessary to further those interests" and that "any alternative, less intrusive treatments are unlikely to achieve substantially the same results." Fourth, and finally, "the court must conclude that administration of the drugs is medically appropriate, i.e., in the patient's best medical interest in light of his medical condition." The Court then emphasized that the goal of this test is "to determine whether involuntary administration of drugs is necessary significantly to further a particular governmental interest, namely, the interest in rendering the defendant competent to stand trial."

United States v. Fazio, 599 F.3d 835, 839 (8th Cir. 2010) (quoting Sell, 539 U.S. at 180-81) (internal citations removed).

         II. Discussion

         A. Presence of an Important Governmental Interest

         First, this Court must determine whether the indictment filed against Garnos represents an important government interest in "bringing to trial an individual accused of a serious crime." Sell 539 U.S. at 180. The defendant faces a statutory maximum penalty of five years' imprisonment for violation of 18 U.S.C. § 875(c), which involves an interstate communication with a threat to injure. Doc. 1. In involuntary medication cases, the Eighth Circuit has previously found that the United States had an important governmental interest in the prosecution of the same charged offense with an identical maximum sentence. Nicklas, 623 F.3d at 1178 (finding an important interest in prosecuting a defendant who had threatened to kill one FBI agent per day); United States v. Levitas. No. CR 09-10025, 2010 WL 3909925, at *3 (D.S.D. Sept. 30, 2010) (finding an important governmental interest in prosecuting a defendant for making repeated threatening statements to a federal judge and assaulting federal officers while being taken into custody); see also United States v. Palmer. 507 F.3d 300, 304-05 (5th Cir. 2007) (affirming a finding that there was an important governmental interest in prosecuting a defendant who had previously been diagnosed with delusional disorder for threatening to murder a federal official where he was indicted for possessing a firearm after being adjudicated mentally defective, in violation of 18 U.S.C. § 922(a)(6)). Garnos is charged with the crime of threatening the murder of an individual through interstate communications. Doc. 1. While Garnos' alleged actions did not involve violence, they included the threat of severe violence.[2] This bolsters the United States' interest in prosecution to further "the basic human need for security, " even though the maximum sentence for his crime is only five years. Sell, 539 U.S. at 180 (citing Riggins, 504 U.S. at 135-36). Garnos is alleged to have left a five minute voicemail on the victim's cell phone threatening to shoot her in the head, and including the names of the victim's husband and employer in the call. Doc. 78 at 5. In the voicemail, the caller makes the specific threat numerous times in various iterations: "if I ever see your face . . . ever, anywhere, you are going to die from a bullet to the head;" "the very first time I see you, I will kill you in self-defense;" and "if I ever see you again you will die from a bullet in your fucking head." Doc. 78 at 5.

         This Court needs to consider whether there are any special circumstances that may lessen the important governmental interests at stake. Sell, 539 U.S. at 180. As was the case in Nicklas, Garnos has been in federal "custody for less than half the time for which he could be imprisoned if convicted of the charge of the Indictment." 623 F.3d at 1179; Doc. 1. Therefore, the United States retains an interest in preventing Garnos from committing any future crimes before he has completed any imposed sentence should he be convicted. See Sell, 539 U.S. at 180 ("The possibility that the defendant has already been confined for a significant amount of time ... for which he would receive credit towards any sentence ultimately imposed . . . affects, but does not totally undermine, the strength of the need for prosecution."). Garnos has participated in mental health treatment and been a productive member of society through education and employment in the past, and has not been a danger to himself or others while at the Federal Medical Center in Butner, suggesting the possibility that a "lengthy confinement in an institution for the mentally ill.. . that would diminish the risks that ordinarily attach to freeing without punishment one who has committed a serious crime" is not present in this case. Sell, 539 U.S. at 180; Doc. 69 at 4-7; Gov't Ex. 2 at 3-5; see also United States v. Gomes. 387 F.3d 157, 161 (2d Cir. 2004) (finding that the prospect of civil commitment was insufficient to undermine the United States' interest where the record was devoid of evidence that the defendant would qualify for civil commitment because his doctors had testified that he was not a danger to himself or others in the prison system). Therefore, this Court finds that the United States has an important interest in prosecuting Garnos for his alleged crime, and that there are no special circumstances in this case to lessen the importance of that interest.

         B. Involuntary Medication Will Significantly Further the Government's Interest

         Under the second Sell factor, this Court must determine that the involuntary administration of antipsychotic medications will further the important governmental interest identified above. This requires the Court to find that the "administration of the drugs is substantially likely to render the defendant competent to stand trial, " and that the "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 second forensic report prepared by Dr. Cochrane, and his testimony at the hearing, contained information on both the likelihood that antipsychotic drugs would restore ...


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