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U.S. v. SANCHEZ-HURTADO

November 17, 1999

UNITED STATES OF AMERICA, PLAINTIFF
v.
JESUS SANCHEZ-HURTADO, DEFENDANT.



ORDER RE GOVERNMENT'S MOTION TO CLARIFY ORDER COMMITTING
  DEFENDANT FOR TREATMENT

I.

Introduction

A motion hearing came on regularly before this Court on November 4, 1999. Phillip Halpern, Assistant United States Attorney, appeared for the Government, and Shaun Khojayan appeared on behalf of Defendant Jesus Sanchez-Hurtado ("Defendant"). The Government moved the Court for clarification of its order of July 2, 1999. Specifically, the Government sought a declaration from the Court that commitment of Defendant for diagnosis and treatment of his mental defect includes implicit authority to administer psychotropic medication, even against Defendant's will. Defendant opposed his further commitment and the involuntary medication.

II.

Factual Background

Defendant is a forty-four year old male who was born in Baja, California. On or about April 23, 1999, Defendant was arrested for (1) attempted illegal reentry into the United States in violation of 8 U.S.C. § 1326; and (2) falsely and willfully misrepresenting his national status to an Immigration and Naturalization Services ("INS") Inspector in violation of 18 U.S.C. § 911. On May 6, 1999, Defendant was arraigned before Magistrate Judge Louisa S. Porter. A preliminary examination was set for May 20, 1999.

On May 20, 1999, the date set for the preliminary examination, a hearing was held before Magistrate Judge Larry A. Burns in Judge Porter's absence. At that hearing, Mr. Khojayan requested that Defendant be examined in order to determine his competency to stand trial. Judge Burns found that there were "reasonable grounds to believe that Mr. Jesus Sanchez-Hurtado may be incompetent to understand the nature and consequences of the proceedings against him and/or assist properly in his defense." (Order Appointing Psychiatrist Pursuant to 18 U.S.C. § 4241(b) for Examination to Determine Present Mental Competency at 1.) In accordance with this finding, Judge Burns ordered that Defendant be examined by Dr. Mark Kalish to make a determination about Defendant's competency. (Id. at 1-2.)

Dr. Kalish conducted a psychiatric examination of Defendant on June 15, 1999. During that examination, Defendant shared with Dr. Kalish his "messianic delusion" that he was Jesus Christ. (Report from Mark A. Kalish to Judge Burns of 6/21/99, at 2.) Defendant also demonstrated auditory hallucinations. (Id.) Based upon his clinical evaluation, Dr. Kalish reported that Defendant suffered "from a significant mental illness." (Id. at 4.) Dr. Kalish concluded that Defendant was "presently incompetent to assist his attorney in the preparation of a defense to the charges pending against him." (Id. at 5.) Dr. Kalish expressed his belief that treatment with antipsychotic medications would quickly restore Defendant to competency. (Id.)

On July 1, 1999, a hearing was held before Judge Porter to determine Defendant's mental competency. During that hearing, the Court received in evidence Dr. Kalish's report. After considering the report and comments from counsel, the Court found that Defendant was "presently suffering from a mental disease or defect rendering him mentally incompetent to the extent that he is unable to understand the nature and consequences of the proceedings against him or to assist properly in his defense." (Order Finding Def. Not Competent to Stand Trial and Committing Def. for Treatment Pursuant to 18 U.S.C. § 4241(d) at 1.) In accordance with this finding, the Court ordered that Defendant be committed to the custody of the Attorney General for hospitalization and treatment to ensure Defendant's competency to stand trial, "and to also help clarify his diagnostic picture." (Id.) A further status conference was scheduled for November 4, 1999.

On or about August 10, 1999, Defendant was admitted to the Mental Health Division of the Federal Correctional Institution ("FCI") at Butner, North Carolina. (Forensic Evaluation from FCI Butner to Judge Porter of 10/29/99, at 1.) Upon his arrival at that facility, Defendant was seen individually by Moira Artiguez, M.D., Fellow in Forensic Psychiatry, with supervision by Bruce Berger, M.D., a staff psychiatrist at FCI Butner. (Id.) Defendant also received a psychological consultation with Angela Walden, Ph.D. (Id.)

Defendant underwent a physical examination and laboratory tests on August 10, 1999. (Id. at 5.) At the time of his initial mental status examination, Defendant reported "auditory hallucinations, `the voice of God' and a `whispering noise'" that indicated to him that his mind was being actively surveilled by the CIA. (Id.) He also stated that he was "the Holy Spirit." (Id.)

The forensic evaluation from FCI Butner indicates that Defendant "functioned adequately on the open compound, spending much of his time alone, seated in the dayroom watching the activity of staff and other inmates. He attended Catholic Mass. several times per week. He was pleasant and amenable to staff directions." (Id. at 6.) However, the evaluation also indicates that Defendant continued to exhibit delusional beliefs and auditory hallucinations, and persisted in his belief that "he is `The Son of God,' that he is an informant for the CIA, and that his daughter's organs had been taken from her." (Id.) The treatment team at FCI Butner felt that Defendant's beliefs "would interfere in a significant way with his ability to work with an attorney and prevented his rational comprehension of the nature of the charges against him." (Id.)

The treatment team offered a trial of antipsychotic medications to Defendant to deal with his delusional beliefs. Defendant "did not agree that his auditory hallucinations and expressed delusional thoughts represented psychosis." (Id.) Defendant refused the trial of medications, "stating he did not believe he had a mental illness." (Id.)

On September 7, 1999, an involuntary medication hearing was held. (Id.) The hearing officer agreed with the treatment staff that Defendant was psychotic and "that he was not competent to stand trial in his current mental state."*fn1 (Id.) Defendant disagreed with this finding and appealed that decision to the warden. (Id.) The warden denied Defendant's appeal on September 14, 1999. (Id.) Defendant has not received any treatment with antipsychotic medications pending resolution of the legal issues involved in the decision whether to involuntarily medicate him.

The forensic evaluation from FCI Butner indicates that Defendant is diagnosed with Schizophrenia, Paranoid Type. (Id. at 7.) The evaluation indicates that the usual treatment for this diagnosis is antipsychotic medications. (Id.) It is the belief of the treatment staff at FCI Butner that Defendant could be restored to competency with this treatment. (Id. at 8.)

III.

Commitment Under 18 U.S.C. § 4241(d)

18 U.S.C. § 4241 sets out the procedures that apply in determining whether a defendant is competent to stand trial. Section 4241(d) provides that if, after a hearing, a court finds that, a defendant is incompetent to stand trial,

  the court shall commit the defendant to the Attorney
  General. The Attorney General shall hospitalize the
  defendant for treatment in a suitable facility
  —
  (1) for such a reasonable period of time, not to
  exceed 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 trial to proceed; and
  (2) for an additional reasonable period of time until
  —
    (A) his mental condition is so improved that trial
    may proceed, if the court finds that there is a
    substantial probability that within such additional
    period of time he will attain the capacity to permit
    the trial to proceed; or
    (B) the pending charges against him are disposed of
    according to law;

whichever is earlier.

18 U.S.C. § 4241(d).

In this case, the Court held a hearing regarding Defendant's competency, and after finding him incompetent to stand trial, committed Defendant to the custody of the Attorney General for treatment in a suitable facility for a reasonable period of time. As stated in the statute, the purpose of this hospitalization is to determine whether there is a substantial probability that Defendant will, in the foreseeable future, attain the capacity for the trial to proceed. The medical staff at FCI Butner believe that the appropriate treatment for Defendant's incompetence is antipsychotic medications, and that with such treatment he could be restored to competency. However, Defendant has refused the antipsychotic medications, and no other treatment has been discussed. This Court, therefore, finds itself in the position of being unable to determine if there is a substantial probability that Defendant will be made competent without first deciding whether Defendant may be medicated against his will. If Defendant may be medicated against his will, then there is a substantial probability that he will, in the foreseeable future, attain competency. However, if Defendant may not be medicated against his will, and in the absence of some other form of treatment, there is little, if any, chance that Defendant will attain the capacity for the trial to proceed.

The Court notes that Defendant's hospitalization began on August 10, 1999, and that according to 18 U.S.C. ยง 4241(d)(1), his four-month time period will elapse on December 10, 1999. Defendant argues that a "substantial injustice" would result if he was hospitalized for an additional four months. However, the Court has not recommended any hospitalization of Defendant beyond the four-month time period as permitted by the statute, much less an additional four months. At this time, the Court finds that it is necessary to continue Defendant's hospitalization until December 10, 1999, ...


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