Detention Of E.c.

Court of Appeals of Washington·Decided August 3, 2021·No. 54608-6·Unpublished

Opinion

Filed

Washington State

Court of Appeals

Division Two

August 3, 2021

IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON

DIVISION II

In the Matter of the Detention of: No. 54608-6-II E.C.,

STATE OF WASHINGTON, Respondent,

v.

UNPUBLISHED OPINION

E.C.,

Appellant.

SUTTON, J. — EC appeals from an order for involuntary administration of an antipsychotic medication, olanzapine, under RCW 71.05.217(1)(j)(i).1 EC argues that substantial evidence does not support the findings that (1) there was a compelling interest in allowing him to be involuntarily medicated because he was likely to be detained substantially longer, at increased public expense, without such treatment, (2) treatment with olanzapine was necessary and effective, and (3) alternative treatments were less effective. He further argues that with respect to the finding that the treatment was necessary and effective, the superior court failed to make specific findings as required under RCW 71.05.217(1)(j)(ii). And he asks that we “clarify the level of evidence that is

1 The legislature amended this statute in 2020. Laws of 2020, ch. 302 § 31. Because this amendment was not substantive, we cite to the current version of the statute.

required to support an order for involuntary treatment with [antipsychotic] medication.” Br. of Appellant at 1, 13. These arguments fail. Accordingly, we affirm.2 FACTS

I. PETITION FOR INVOLUNTARY TREATMENT On July 11, 2019, the criminal court signed an order dismissing several criminal charges against EC after finding he was incompetent to stand trial. The criminal court then committed EC to Western State Hospital for an evaluation and possible civil commitment.

In late July, EC’s treatment providers petitioned for 180 days of involuntary treatment based on EC being gravely disabled and the fact that there was a substantial likelihood that he would repeat his criminal acts. In the declaration supporting the petition, 3 EC’s treatment providers stated that EC had one prior admission to Western State Hospital from August 2011 to August 2012, four additional hospitalizations in the community between 2010 and 2011, “three outpatient crisis contacts” with a mental health facility in May 2019, and “several” emergency room visits for “‘mental health crises[es]’” in January 2019. Clerk’s Papers (CP) at 7. EC’s treatment providers noted that EC was “unable to participate meaningfully in treatment due to his severe and persistent symptomology and intense focus on delusional themes.” CP at 13. In early October, following a jury trial, the superior court granted the petition and entered an order

2 Although the order at issue has expired, this issue is not moot because it could have collateral consequences in future proceedings. In re Detention of B.M., 7 Wn. App. 2d 70, 76-77, 432 P.3d 459, review denied, 193 Wn.2d 1017 (2019). 3 This declaration was signed under penalty of perjury.

detaining EC at Western State Hospital for up to 180 days pending arrangements to place him in a less restrictive alternative placement.

Just over a month later, but almost four months after the criminal court referred EC for evaluation, Dr. Xiaping Xie filed a petition for involuntary treatment with antipsychotic medication, specifically “Olanzapine or Fluphenazine/Fluphenazine Decanoate, or Risperidone/Risperadal Consta.” CP at 19-20. In the petition, which Dr. Xie signed under penalty of perjury, Dr. Xie alleged that EC did “not believe he needs psychiatric medication.” CP at 20. Dr. Xie further stated that EC had “recently threatened, attempted or caused serious harm to others”4 and that treatment with antipsychotic medication would “reduce the likelihood that [EC] will cause serious harm to others.” CP at 21.

Dr. Xie asserted that “[f]ailure to treat [EC] with antipsychotic medication may result in the likelihood of serious harm or substantial (further) deterioration” and that there were no “[p]ossible alternative treatments.” CP at 21-22. Dr. Xie noted that EC had refused to take any psychiatric medications since his admission in July and that he had “not shown any sign of self- remitting since then.” CP at 21. The doctor also asserted that EC would “likely be detained for a substantially longer period of time, at increased public expense, without such treatment.” CP at 21.

4 Specifically, Dr. Xie alleged that EC had “been repeatedly threatening staff by cursing them, waving fists or bobbing shoulder at them while approaching close to them” and that EC had “punched a staff member hard in the neck on [November 12, 2019] without warning.” CP at 21.

II. HEARING ON PETITION FOR INVOLUNTARY TREATMENT A superior court commissioner pro tem considered the petition. Dr. Xie and EC were the only witnesses. A. DR. XIE’S TESTIMONY EC’s psychiatrist, Dr. Xie, testified that he had reviewed EC’s records; had spoken with EC’s treatment team; and had attempted, unsuccessfully, to discuss the medication with EC. Dr. Xie stated that EC had been diagnosed with schizoaffective disorder, bipolar type. The doctor further testified that EC was psychotic, “frequently” made “grandiose [and] persecutory” “delusional statements,” and exhibited “mood instability,” and that EC’s prognosis was “poor” if he was not treated with antipsychotic medication. Verbatim Report of Proceedings (VRP) (Dec. 2, 2019) at 15, 21.

When Petitioner’s counsel asked Dr. Xie if “there [was] a likelihood of serious harm to himself or others [i]f anti-psychotic medication is not administered,” Dr. Xie responded, “Yes. He is dangerous to others.” VRP (Dec. 2, 2019) at 21. Dr. Xie then stated that on November 12, EC had “hit the ward secretary” in the face and the secretary had been on sick leave since then. VRP (Dec. 2, 2019) at 21-22. EC’s counsel objected to this testimony based on hearsay; the commissioner admitted this testimony under ER 703.5

5 ER 703 provides:

The facts or data in the particular case upon which an expert bases an opinion or inference may be those perceived by or made known to the expert at or before the hearing. If of a type reasonably relied upon by experts in the particular field in forming opinions or inferences upon the subject, the facts or data need not be admissible in evidence.

Based on EC’s history, Dr. Xie opined that the administration of antipsychotic medications would be effective. Dr. Xie stated that EC’s records showed that during a prior hospitalization between 2011 and 2012, EC had received the antipsychotic medication haloperidol and that he responded to this medication. EC’s counsel objected based on hearsay to Dr. Xie’s testimony about EC’s prior admission in 2011 and his prior treatment. The court admitted the testimony under ER 703.

Dr. Xie then testified that he was seeking to involuntarily administer olanzapine, “a second generation anti-psychotic” that EC had not taken before. VRP (Dec. 2, 2019) at 19, 30. The doctor noted that EC had been prescribed olanzapine upon his admission, but he had refused to take it. Dr. Xie further testified that with “strong encouragement,” EC had previously been treated successfully with another antipsychotic drug, haloperidol. 6 VRP (Dec. 2, 2019) at 19. The testimony about the haloperidol was admitted under ER 703.

Dr. Xie described the main potential adverse side effects of antipsychotics, including olanzapine, as “[extrapyramidal (EPS)] symptoms, like shaking hands and unsteady gait;” dizziness; drowsiness; and “metabolic syndrome.” VRP (Dec. 2, 2019) at 18, 26. Metabolic syndrome could include such issues as increased “[b]lood sugar levels and lipid profile,” and weight gain. VRP (Dec. 2, 2019) at 26. Dr. Xie stated that the rarer side effects included fever, delirium, and death.

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