Peo in Int of Chavira

• Court: Colorado Court of Appeals
• Decided: December 11, 2025
• Docket: 25CA1788
• Status: Unpublished

Opinion

25CA1788 Peo in Interest of Chavira 12-11-2025

COLORADO COURT OF APPEALS

Court of Appeals No. 25CA1788 Prowers County District Court No. 25MH7 Honorable Tarryn L. Johnson, Judge

People of the State of Colorado,

Petitioner,

In the Interest of Miriam Chavira,

Respondent-Appellant.

ORDER AFFIRMED

Division I Opinion by JUDGE GROVE J. Jones and Schutz, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced December 11, 2025

No Appearance for Petitioner

Tezak Law, P.C., Mary Tezak, Florence, Colorado, for Respondent-Appellant ¶1 Respondent, Miriam Chavira, appeals the district court’s order

authorizing staff at Porter Adventist Hospital (Porter) to treat her

with electroconvulsive therapy (ECT) without her consent. We

affirm.

I. Background

¶2 In August 2025, Chavira was certified for short-term treatment

based on a physician’s diagnosis of schizophrenia and catatonia

that caused her to be gravely disabled. See § 27-65-109, C.R.S.

2025.

¶3 The Prowers County Attorney also filed a petition requesting

that Porter be allowed to treat Chavira with ECT without her

consent. According to the petition, Chavira’s treating psychiatrist,

Dr. Karina Drake, reported that Chavira had been admitted to the

hospital with recurring catatonic symptoms resulting in weight loss

and functional difficulties. Dr. Drake also reported that Chavira

remained at high risk of unintentional self-harm as a result of poor

oral intake, dehydration, and hypotension.

¶4 At the September 2, 2025, hearing on the petition, Dr. Drake

testified that she had diagnosed Chavira with catatonia and that

she had a historical diagnosis of schizophrenia. Dr. Drake testified

1 that when Chavira was admitted Porter she was “essentially mute

and nonconversant,” “refused to take any medication,” and was “not

eating or drinking.” And Chavira would stand on a towel in the

middle of her hospital room, moving very minimally, for ten to

fifteen hours a day.

¶5 Dr. Drake explained that she started Chavira on involuntary

medication in the form of Ativan on an emergency basis. Chavira

later consented to the medication. Dr. Drake testified that since

receiving Ativan, Chavira had improved and was now having “at

least some oral intake,” but was not progressing.

¶6 Dr. Drake described ECT treatment, including that it requires

the patient to be under general anesthesia, and opined that it is the

“gold standard” to treat catatonia. She also explained its side

effects, most commonly including memory loss. Dr. Drake opined

that without ECT, Chavira will likely need to be moved to a full-time

care facility, and it is very likely she will again be hospitalized

because of her inability to eat or drink while experiencing catatonic

symptoms.

¶7 Chavira also testified, explaining why she opposes the petition

for involuntary treatment.

2 ¶8 The district court granted the petition authorizing Porter to

involuntarily administer six ECT treatments.

II. Discussion

¶9 The district court found that the People had proven by clear

and convincing evidence all four elements required under People v.

Medina, 705 P.2d 961, 973 (Colo. 1985), to authorize the

involuntary administration of medical treatment.

¶ 10 On appeal, Chavira challenges the sufficiency of the evidence

supporting only the fourth Medina element, namely, whether the

patient’s need for the treatment is sufficiently compelling to override

any bona fide and legitimate interest of the patient in refusing the

treatment. Id.; see also People in Interest of M.K.M., 765 P.2d 1075,

1076 (Colo. App. 1988) (approving of the use of the Medina criteria

to analyze an order for involuntary ECT treatment).

¶ 11 We conclude that the evidence is sufficient to support the

court’s finding on the fourth Medina element.

A. Standard of Review

¶ 12 The district court’s order presents a mixed question of fact and

law. People in Interest of Strodtman, 293 P.3d 123, 131 (Colo. App.

2011). We defer to the court’s factual findings if there is evidence

3 supporting them, but we review the court’s legal conclusions de

novo. Id. We must determine whether the evidence, viewed as a

whole and in the light most favorable to the prevailing party, is

sufficient to support the court’s order. People in Interest of R.K.L.,

2016 COA 84, ¶ 13. Testimony by a physician supporting a petition

for involuntary treatment may be sufficient. See id. at ¶ 30 (citing

People v. Pflugbeil, 834 P.2d 843, 847 (Colo. App. 1992)).

B. Analysis

¶ 13 Chavira contends that the People failed to prove the fourth

Medina element by clear and convincing evidence because of the

“many serious side effects” of ECT, “some of which can be fatal.”

She asserts that the procedure itself is “intended to induce a

seizure” and that when she underwent the procedure previously,

she felt “powerless” and “docile.” She also asserts that she suffered

memory loss and struggled to find employment for a year.

¶ 14 At the hearing, the district court acknowledged Chavira’s

objections to ECT, finding them bona fide and legitimate and noting

that it takes personal autonomy “very seriously.” Nevertheless, the

court noted that Chavira had responded to ECT favorably in the

past and that the deterioration she would experience if ECT is not

4 administered now is not speculative. The court found that Chavira

was receiving the maximum amount of Ativan and had improved to

some extent, but still has life threatening symptoms, and that,

according to Dr. Drake, there is no additional or alternative

medication available to resolve the catatonia.

¶ 15 We acknowledge the evidence in the record that ECT has

serious side effects including impaired memory that can last for

months. And Dr. Drake testified that the procedure can result in

death in about one in every ten thousand patients, which she

opined were the same risks as any individual undergoing general

anesthesia. Nonetheless, Dr. Drake testified that the risks do not

outweigh the benefits associated with ECT and that “the potential

decline of [Chavira’s] current psychiatric symptoms [is] far more

likely to cause significant issues and medical side effects than

ECT.” Dr. Drake also testified that Chavira had been hospitalized

in the past and received ECT treatment for catatonic symptoms

with good results.

¶ 16 Chavira also contends that there is a less drastic treatment

because she consented to receiving Ativan and since taking the

medication voluntarily, she had been eating and drinking. She

5 argues that even if Ativan is “technically less effective than ECT,” it

has been shown to generate improvement in her condition.

¶ 17 But Dr. Drake testified that Chavira still had “very prominent

catatonic symptoms” even after taking medication and was already

on the maximum allowable dosage of Ativan. She testified that

Chavira was still standing immobile for ten to fifteen hours a day

without moving, and “despite consistently taking the medications,”

Chavira’s catatonic symptoms continue to “impair[] her ability to

function.” Dr. Drake explained that “there are no other medication

options . . . to further resolve [the] catatonic symptoms” and that

ECT is the only remaining treatment available.

¶ 18 In summary, the record sufficiently supports the district

court’s order for involuntary administration of ECT. Accordingly,

we affirm the district court’s order authorizing the involuntary

administration of up to six ECT treatments, and required related

medical testing and procedures, during the period of the short-term

certification.

III. Disposition

¶ 19 The order is affirmed.

JUDGE J. JONES and JUDGE SCHUTZ concur.