UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 14-4025
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: December 9, 2014 Decided: January 16, 2015
Before WILKINSON, SHEDD, and THACKER, Circuit Judges.
Affirmed by unpublished per curiam opinion.
ARGUED: Charles Burnham, BURNHAM & GOROKHOV, PLLC, Washington,
D.C., for Appellant. Richard Daniel Cooke, OFFICE OF THE UNITED
STATES ATTORNEY, Richmond, Virginia, for Appellee. ON BRIEF:
Eugene V. Gorokhov, Ziran Zhang, BURNHAM & GOROKHOV, PLLC,
Washington, D.C., for Appellant. Dana J. Boente, United States
Attorney, Lisa L. Owings, Assistant United States Attorney,
OFFICE OF THE UNITED STATES ATTORNEY, Alexandria, Virginia, for
Appellee.
Unpublished opinions are not binding precedent in this circuit.
PER CURIAM:
Frank Chatmon claims that the district court clearly erred
when it found the government had proved by clear and convincing
evidence that there were no less intrusive alternatives to
forcible medication to restore Chatmon to competency for trial.
We disagree, and hereby affirm the district court’s judgment.
I.
A.
The procedural history here is lengthy, but it makes sense
to begin discussion with the prior appeal and our remand. 1 In
2013, Chatmon appealed a district court order that he be
involuntarily medicated to restore his competency for trial. See
United States v. Chatmon, 718 F.3d 369 (4th Cir. 2013). Chatmon,
who was charged with conspiracy to distribute heroin and cocaine
in violation of 21 U.S.C. §§ 841(a)(1) and 846, suffers from
paranoid schizophrenia. A competency evaluation by psychologists
at Federal Medical Center, Butner (“Butner”), found that his
mental illness rendered him incompetent to stand trial. The
district court ordered hospitalization and treatment to
determine whether Chatmon could be restored to competency. The
1
The defendant attempts to raise due process and Speedy
Trial claims in this appeal. However, the case law is clear that
there is no irreparable injury here because these claims can be
reviewed adequately after final judgment. See United States v.
MacDonald,435 U.S. 850, 860-61 (1978); United States v.
Buchanan, 946 F.2d 325, 327 (4th Cir. 1991).
2
resulting report found a “‘substantial probability that Mr.
Chatmon’s competency can be restored with a period of treatment
with haloperidol decanoate,’ a type of antipsychotic
medication.” Chatmon, 718 F.3d at 372. The government moved to
involuntarily medicate Chatmon. The district court, after a
hearing, granted that motion, and Chatmon appealed.
On appeal, Chatmon challenged the district court’s analysis
under the four-part Sell standard for involuntary medication.
See United States v. Sell, 539 U.S. 166, 180-81 (2003). The Sell
test is designed to ensure that forcible medication orders are
properly evaluated and infrequently employed, in recognition of
the serious intrusion such orders impose on personal liberty and
the risk that the medications pose to a defendant’s physical and
mental health. See Chatmon, 718 F.3d at 373-74. Sell thus
requires (1) that the case involve an “important governmental
interest[]” that is not lessened by special circumstances; (2)
that there is a substantial likelihood of rendering the
defendant competent to stand trial through the treatment,
without a substantial likelihood of side effects that would
independently defeat competency; (3) that involuntary medication
is “necessary to further the government’s interests, and less
intrusive means [are] unlikely to achieve substantially the same
results”; and (4) that the treatment is “medically appropriate
and in the patient’s best medical interests.” United States v.
3
White, 620 F.3d 401, 410 (4th Cir. 2010) (emphasis omitted)
(citing Sell, 539 U.S. at 180-81).
Upon examination, we found the district court’s application
of the first, second, and fourth Sell factors sufficient.
However, the third factor of less intrusive means, which the
district court addressed only summarily, required additional
attention. Specifically, Chatmon had suggested that group
therapy or continued residence in an open population might be
sufficient to restore his competency for trial. See Chatmon, 718
F.3d at 376. We vacated and remanded so that the district court
might “consider and evaluate less restrictive means that Chatmon
plausibly suggests for restoring him to competency.” Id. at 376-
77.
B.
On remand, the district court ordered the defendant to take
his medication or be held in civil contempt consistent with this
court’s suggestion. See id. at 375-76. The penalty for contempt
was set at thirty days’ imprisonment at Butner, during which
time Chatmon was to be offered the medication daily. Agreeing to
take the medication during the thirty day period would lift the
penalty for contempt. Thus for thirty days, the medication was
offered, but the defendant declined it. The district court thus
ruled out civil contempt as a viable alternative to forced
medication.
4
Having eliminated civil contempt, the district court
reviewed additional deposition testimony taken by the government
on October 9, 2013, from two doctors on Chatmon’s treatment
team: Dr. Angela Walden Weaver, a psychologist, and Dr. Robert
Lucking, a psychiatrist. These experts had personal interactions
with Chatmon during his time at Butner. The doctors acknowledged
the improvements in Chatmon’s behavior once he was moved to the
open population, which permitted him to exercise regularly and
even take on a job in the facility’s vocational workshop.
However, both doctors emphasized that such changes in behavior
were not the same as improved competency or mental health.
Neither recommended any alterations in Chatmon’s diagnosis or
treatment plan as a result of his behavioral improvements.
Both experts were likewise insistent that although other
treatment options, such as group therapy and exercise, could be
beneficial as supplemental treatments to alleviate symptoms,
they were not -- by themselves -- effective treatment options
for psychosis. To support this conclusion, they pointed out that
Chatmon’s ability to engage in any of these treatment options
varied with his mental and physical health. Chatmon had turned
down opportunities to participate in group therapy options, had
long refused to sign the waiver that would permit him to exit
the Restricted Movement Unit into the open population, and had
injured his leg at one point such that he was unable to exercise
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for a time. The only effective means of restoring competency,
the doctors agreed, was medicating Chatmon with haloperidol, a
low-dosage long-acting antipsychotic drug. Tellingly, although
the defense protested the conclusions in the doctors’ testimony,
it presented no rebuttal expert of its own.
The district court reviewed this testimony and concluded
that the government had presented clear and convincing evidence
that no less intrusive means were available to restore Chatmon
to competency. It specifically noted that the doctors’
testimony, which it found persuasive, had acknowledged Chatmon’s
behavioral improvements since entering the open population and
yet still concluded -- as the December 2011 report had -- that
only medication could restore Chatmon to competency. While
alternatives such as group therapy and placement in the open
prison population might be used to improve Chatmon’s behavior,
the court accepted the doctors’ expert testimony that
“behavioral improvements cannot be conflated with improvements
in competency.” J.A. 467 (district court order). Having found
that the government had presented clear and convincing evidence
that the suggested treatment alternatives had not yet made
Chatmon competent and would not be sufficient to restore him to
competency in the future without medication, the court then
ordered that Chatmon be forcibly medicated. The defendant
appealed.
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II.
We can find no error in the proceeding below. The trial
court did not misapprehend the burden of proof, which belonged
with the government; or the standard of proof, which is clear
and convincing evidence; or the purpose of the hearing, which
was to determine whether there was any less intrusive
alternative to medication for restoring Chatmon to competency.
Moreover, the district court held a hearing, took testimony, and
made careful findings. It examined less intrusive means,
including placing Chatmon in open confinement. He has been
housed in open confinement for over two years thus far, without
improving sufficiently to stand trial. Contrary to the
defendant’s contentions, the district court and expert witnesses
did not confuse mental illness and competency. It was clear
throughout that the question was competency to stand trial. The
defendant did not even attempt to rebut the government’s expert
testimony, despite being given ample opportunity to do so.
The parties skirmish over how proceedings may unfold from
this point forward. But any remaining issues are in the first
instance within the province of the trial court. In this case,
we find that our mandate was observed and that the district
court did not clearly err in finding the government had
satisfied the third element of the Sell test.
AFFIRMED
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