People in the Interest of D.N.W.
2024 COA 129. No. 24CA1584. Involuntary Administration of Medication—Backup Medication—Sufficiency of Evidence.
December 26, 2024
D.N.W. was diagnosed with schizoaffective disorder, bipolar type. D.N.W. has a long history of psychiatric hospitalizations and short- and long-term care certifications, and she was certified for long-term care and treatment because she was gravely disabled. The People filed a notice of extension of long-term care and treatment and a motion for an order authorizing the involuntary administration of Haldol, lithium, Ativan, and Cogentin. The court granted the extension of treatment and ordered that the requested medications be administered to D.N.W. against her will.
On appeal, D.N.W. challenged only the court’s order to involuntarily administer lithium. A court may authorize the involuntary administration of medications to a patient where the petitioner establishes by clear and convincing evidence the four elements in People v. Medina, 705 P.2d 961, 973 (Colo. 1985). D.N.W.’s challenge concerned only the third Medina element, that a less intrusive alternative is not available, maintaining that there was insufficient evidence to support the court’s findings on this element. D.N.W. contended that a less drastic alternative to lithium would be the continued administration of Haldol. However, the record supports the court’s findings on this element. And considering the state’s legitimate interests and the patient’s right to “bodily integrity,” the court of appeals held that, under the facts of this case, the court did not err by authorizing the involuntary administration of a backup medication. But because no Colorado published opinion has addressed whether and under what circumstances a court may order the involuntary administration of a backup medication, the court analyzed this issue. The court concluded that a trial court has authority to authorize administration of a backup medication “only when the petitioner presents clear and convincing evidence, and the court finds a specific articulable concern, that the involuntary administration of the primary medication will be ineffective, if the patient experiences a recurrence of a condition or symptoms that previously required administration of the backup medication.” Here, Dr. Koransky testified that he sought authorization to administer D.N.W. lithium based on a known and potentially recurring situation particular to D.N.W. based on her mental health history, and the court found the testimony was “uncontroverted and credible.” Accordingly, the People met their burden as to D.N.W.
The order was affirmed.