UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 12-6316
UNITED STATES OF AMERICA,
Petitioner - Appellee,
v.
CORNELL M. TAYLOR,
Respondent - Appellant.
Appeal from the United States District Court for the Eastern
District of North Carolina, at Raleigh. W. Earl Britt, Senior
District Judge. (5:06-hc-02196-BR)
Argued: January 29, 2013 Decided: March 5, 2013
Before WILKINSON, MOTZ, and THACKER, Circuit Judges.
Affirmed by unpublished per curiam opinion.
ARGUED: Diana Helene Pereira, OFFICE OF THE FEDERAL PUBLIC
DEFENDER, Raleigh, North Carolina, for Appellant. Jennifer Dee
Dannels, OFFICE OF THE UNITED STATES ATTORNEY, Raleigh, North
Carolina, for Appellee. ON BRIEF: Thomas P. McNamara, Federal
Public Defender, Joseph B. Gilbert, Assistant Federal Public
Defender, OFFICE OF THE FEDERAL PUBLIC DEFENDER, Raleigh, North
Carolina, for Appellant. Thomas G. Walker, United States
Attorney, Jennifer P. May-Parker, Assistant United States
Attorney, David T. Huband, Special Assistant United States
Attorney, OFFICE OF THE UNITED STATES ATTORNEY, Raleigh, North
Carolina, for Appellee.
Unpublished opinions are not binding precedent in this circuit.
2
PER CURIAM:
Cornell M. Taylor (“Appellant”) appeals the district
court’s order continuing his civil commitment pursuant to 18
U.S.C. § 4246. Appellant argues that the district court erred
in concluding he continues to suffer from a mental disease or
defect such that his release would create a substantial risk of
bodily injury to another person or serious damage to the
property of another. In so doing, Appellant asserts that his
recent good behavior justifies his release, offering only his
own testimony in support. The evidence presented below,
including an expert report from Appellant’s treating physician
and a psychologist, testimony from the treating physician, and
an additional expert report authored by a court-appointed
independent physician, convincingly demonstrates that
Appellant’s continued commitment is warranted. For these
reasons and as set forth below, we affirm.
I.
On February 1, 2006, the District Court for the
Central District of Illinois found Appellant incompetent to
stand trial for the charge of threatening a federal official.
Thereafter, on July 10, 2006, the Illinois district court
ordered Appellant evaluated for civil commitment pursuant to 18
3
U.S.C. § 4246. 1 On November 3, 2006, the Government then filed a
certificate of mental disease or defect and dangerousness in the
District Court for the Eastern District of North Carolina. 2 On
January 9, 2007, the district court held a § 4246 hearing. Upon
finding by clear and convincing evidence that Appellant suffered
from a mental disease or defect, as a result of which his
release would create a substantial risk of bodily injury to
another person or serious damage to property of another, the
district court committed him under § 4246(d) in an order dated
January 10, 2007.
1
“Section 4246 applies to individuals who are due for
release from federal custody either because they have been found
not competent to stand trial, because the charges against them
have been dropped solely because of mental illness, or because
they have completely served their sentences of imprisonment.”
United States v. Baker, 45 F.3d 837, 840 n.1 (4th Cir. 1995).
2
Pursuant to 18 U.S.C. § 4246(a), the director of the
facility in which a person found incompetent to stand trial is
hospitalized may certify that the person
is presently suffering from a mental disease or defect
as a result of which his release would create a
substantial risk of bodily injury to another person or
serious damage to property of another, and that
suitable arrangements for State custody and care of
the person are not available, [and the director] shall
transmit the certificate to the clerk of the court for
the district in which the person is confined.
18 U.S.C. § 4246(a). Because Appellant was then-hospitalized at
the Mental Health Division at the Federal Medical Center in
Butler, North Carolina, the warden filed the certificate in the
District Court for the Eastern District of North Carolina.
4
On September 27, 2007, the district court ordered
Appellant’s conditional release to reside at a community home
for adults in Springfield, Illinois. 3 The district court
ultimately revoked his release on April 7, 2008. 4 Appellant was
then returned to the Federal Medical Center in Butner, North
Carolina (“Butner”).
On March 28, 2011, mental health staff at Butner filed
an annual report with the district court in accordance with 18
U.S.C. § 4247(e)(1)(B) concerning the mental condition of
Appellant and the need for his continued commitment. The annual
report, authored by Dr. Robert G. Lucking, M.D., and Dr. Angela
Walden Weaver, Ph.D., indicated Appellant had been prescribed a
combination of drugs, including Haloperidol Decanoate (an anti-
psychotic medication), for treatment of his schizoaffective
disorder. Against the advice of his primary clinician,
Appellant refused to take the Haloperidol Decanoate. Due to
Appellant’s refusal to take the prescribed medication necessary
to control his mental illness, the mental health staff concluded
3
Neither the briefs nor the record indicate the precise
grounds for Appellant’s conditional release.
4
The probation officer was informed that Appellant violated
the conditions of his release by returning to the community home
facility under the influence of alcohol and in possession of a
bottle of alcohol. In addition, the probation officer reported
experiencing problems supervising Appellant in the placement
facility.
5
that Appellant was not suitable for conditional release and
recommended continued commitment.
On November 9, 2011, Appellant moved the district
court for a hearing to determine whether he still met criteria
for commitment under § 4246. The next day, the district court
set a hearing for February 6, 2012, to determine whether
Appellant continued to meet the criteria for commitment. In
connection with the hearing, the district court appointed an
independent mental health examiner to evaluate Appellant. 5 The
independent examiner, Dr. Katayoun Tabrizi, M.D., completed a
forensic psychiatry report, which contained Appellant’s relevant
medical, psychiatric, and social background; a mental health
diagnosis; and a risk assessment pursuant to § 4246.
Dr. Tabrizi examined Appellant on January 12, 2012,
and diagnosed him as suffering from schizoaffective disorder,
bipolar type; alcohol abuse, in a controlled environment; and
adult antisocial behavior (provisional). She reported that
Appellant was then presently prescribed anti-psychotic
medication for his mental illness but was refusing to take it.
She stated that Appellant showed limited insight into his mental
illness and need for treatment. Appellant’s symptoms, which
5
Appellant requested the appointment of an independent
psychiatrist in his November 9, 2011 motion.
6
were active at the time of his evaluation, included irritable
affect, argumentativeness, and paranoia. Dr. Tabrizi further
reported that treatment with anti-psychotic medication, which
Appellant was refusing, is the only effective treatment for his
psychotic symptoms.
Dr. Tabrizi also concluded that Appellant exhibited
several risk factors shown to be associated with an increased
risk of violent/aggressive behavior, including a psychotic
mental illness with persecutory delusions, poor insight into his
mental illness, refusal of anti-psychotic medications, history
of alcohol abuse while subject to release conditions, history of
aggression and threats due to his psychiatric symptoms, history
of gun possession, inadequate social support, and an extensive
juvenile and criminal history. Based on these factors, Dr.
Tabrizi opined that as a result of Appellant’s mental disease or
defect, his release would create substantial risk for bodily
injury and damage to the property of another. She concluded,
“[f]or as long as [Appellant] is refusing to accept
antipsychotic medications, he is not a suitable candidate for
conditional release to a community-based program.” J.A. 44. 6
6
Citations to the “J.A.” refer to the Joint Appendix filed
by the parties in this appeal.
7
On February 6, 2012, the district court convened the
hearing to determine whether Appellant continued to meet the
criteria for commitment under § 4246. Appellant’s treating
psychiatrist, Dr. Lucking, testified that he had been treating
Appellant since his admission to Butner in 2006. Dr. Lucking
further stated that Appellant suffered from schizoaffective
disorder and was then demonstrating
significant re-emergence of psychotic symptoms with
evidence of paranoid delusional symptoms involving
Judge Britt, myself, his attorney Ms. Pereira,
thinking we’re conspiring to keep him locked up in
this facility. He has some significant anger and
hostility and aggression, which I don't think you can
attribute specifically to either or [sic] the
affective or psychotic symptoms. It’s probably a
combination of both of them. So he’s angry, hostile,
uncooperative.
J.A. 17. He also opined that Appellant’s refusal to take his
prescribed medication had attributed to the reemergence of his
psychotic symptoms and “a progressive decline into psychosis.”
Id. 18. Dr. Lucking further stated that Appellant had, in 2006,
threatened to kill himself and staff and engaged in aggressive
behavior by throwing and breaking food trays. Dr. Lucking
concluded that, without medication, he expected Appellant to
decline into further psychosis and to engage in the behaviors he
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exhibited in 2006. 7 Appellant’s sole offer of support of his
motion was his own testimony.
The district court concluded that Appellant continued
to meet criteria for care and treatment under § 4246 and ordered
Appellant’s continued commitment.
Appellant now appeals that order, arguing the district
court’s determination supporting his continued commitment
constitutes reversible error.
II.
We review the district court’s factual findings for
clear error and its legal conclusions de novo. See United
States v. Cox, 964 F.2d 1431, 1433 (4th Cir. 1992) (“The trial
court’s ruling denying [the committed person’s] unconditional
release . . . is a factual determination that will be overturned
by this court only if clearly erroneous.”); United States v.
Hall, 664 F.3d 456, 462 (4th Cir. 2012) (“On appeal, we review
7
Dr. Tabrizi did not testify at the hearing, though Dr.
Lucking confirmed that she held the same view. See J.A. 19
(“[Dr. Tabrizi’s] opinion was similar. She believed that
[Appellant] met the criteria for commitment and should not be
released unless he was placed on treatment with an anti-
psychotic.”). Likewise, staff psychologist Angela Walden Waver,
Ph.D., did not testify but joined in the annual report with Dr.
Lucking.
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the district court’s factual findings for clear error and its
legal conclusions de novo.”).
III.
A.
A person committed under § 4246 may, through his
counsel or legal guardian, file a motion for a hearing to
determine whether he should be released. See 18 U.S.C.
§ 4247(h). The court that ordered the commitment may discharge
the person if it finds, by a preponderance of the evidence, that
the person has recovered from his mental disease or defect to
such an extent that his unconditional release would no longer
create “a substantial risk of bodily injury to another person or
serious damage to property of another.” Id. § 4246(e). The
committed person seeking discharge bears the burden of proving
that he has so recovered. See United States v. Evanoff, 10 F.3d
559, 563 (8th Cir. 1993); Sealed Appellee v. Sealed Appellant,
665 F.3d 620, 623 n.4 (5th Cir. 2011). 8
8
See also United States v. Anderson, No. 97–6372, 1998 WL
372382, at *2 (4th Cir. May 19, 1998) (On a motion to discharge,
“the Government no longer bears the burden of proving
dangerousness. Rather, [the committed person] must present a
preponderance of evidence proving his release ‘no longer
create[s] a substantial risk of bodily injury.’” (quoting 18
U.S.C. § 4246(e))).
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B.
In this case, we conclude that the district court’s
findings justifying Appellant’s continued commitment were not
clearly erroneous. First, the expert witnesses, through their
testimony and reports, offered concurring opinions establishing
that Appellant suffers from a severe mental illness, namely,
schizoaffective disorder. They reported that Appellant
continued to manifest active symptoms of his illness, and
nothing in the record contradicts the expert opinions that
Appellant continued to suffer from a severe mental disease or
defect. He offered no testimony other than his own to suggest
he had recovered from his illness. Accordingly, the district
court did not clearly err when it found that Appellant continued
to suffer from a mental disease or defect.
Second, the totality of the evidence before the
district court established that, in light of Appellant’s mental
illness, his release would create a substantial risk of bodily
injury to another person or serious damage to property of
another. In support of her opinion, the independent
psychiatrist, Dr. Tabrizi, reported that Appellant exhibited
several risk factors shown to be associated with an increased
risk of violent/aggressive behavior, including a psychotic
mental illness with persecutory delusions, poor insight into his
mental illness, refusal of anti-psychotic medications, history
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of alcohol abuse while subject to release conditions, history of
aggression and threats due to his psychiatric symptoms, history
of gun possession, inadequate social support, and an extensive
juvenile and criminal history.
Dr. Lucking testified that Appellant’s refusal to take
his prescribed medication during his current hospitalization has
attributed to the reemergence of his psychotic symptoms, which
Dr. Lucking expects will cause Appellant to engage in
threatening and aggressive behavior against persons and
property. Dr. Lucking testified concerning Appellant’s
condition before he was medicated:
[Appellant] threatened to kill himself and other staff
members. He engaged in specific aggressive behavior
against property by breaking and throwing food trays.
I think it’s only a limited period of time before we
see the emergence of this behavior again.
J.A. 18-19.
The factors presented by the experts are among those
typically considered by mental health professionals when
conducting risk assessments. See, e.g., United States v. Cox,
964 F.2d 1431, 1433 (4th Cir. 1992); United States v. Ecker, 30
F.3d 966, 970 (8th Cir. 1994). Thus, when considered in its
entirety, the evidence before the district court established
that Appellant’s release would create a substantial risk of
bodily injury to another person or serious damage to property of
another.
12
Appellant responds that the opinions offered by Dr.
Lucking and the opinions contained in the March 2011 Butner
annual report regarding Appellant’s risk of dangerousness are
speculative in nature, and, thus, not enough to support a
finding of “substantial risk” under § 4246. He emphasizes that,
“since the annual report entered in October 2011, [he] has not
engaged in any physically aggressive behavior directed against
others or property.” Appellant’s Br. 11. The dangerousness
evaluation and determination, however, require the evaluators
and the district court to consider Appellant’s “entire
behavioral and psychological profile.” United States v.
Williams, 299 F.3d 673, 677 (8th Cir. 2002); see also Cox, 964
F.2d at 1433. Thus, the experts properly considered a broad
range of historical and clinical data, rather than a selected
event or narrowly defined characteristic or time period. As
such, the length of time since Appellant’s last aggressive
behavior is merely one piece of data among the array of
information that is properly considered.
As detailed above, the experts involved in
Appellant’s review considered a host of relevant factors that
convinced them Appellant was still suffering from a mental
disease or defect to the extent that his release would create a
substantial risk of bodily injury to another person or serious
damage to property of another. As such, the evidence cleared
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the statutory hurdle that Appellant’s release presents a
“substantial risk.” 18 U.S.C. § 4246(d). Accordingly,
Appellant did not meet his burden to show that he had recovered,
and the district court did not clearly err when it relied upon
the uncontroverted expert testimony to find that Appellant
continues to satisfy the criteria for civil commitment under
§ 4246.
IV.
For the foregoing reasons, the district court’s order
is
AFFIRMED.
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