25CA0495 Peo in Interest of Patricio-Saguilan 06-12-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0495 Pueblo County District Court No. 24MH30081 Honorable J. Steven Patrick, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Brandon Jonathan Patricio-Saguilan,
Respondent-Appellant.
ORDER AFFIRMED
Division V Opinion by JUDGE JOHNSON Welling and Grove, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced June 12, 2025
Cynthia Mitchell, County Attorney, Kate H. Shafer, Special Assistant County Attorney, Pueblo, Colorado, for Petitioner-Appellee
Tezak Law P.C., Mary Tezak, Florence, Colorado, for Respondent-Appellant ¶1 Brandon Jonathan Patricio-Saguilan (Patricio-Saguilan)
appeals the district court’s order authorizing staff at the Colorado
Mental Health Hospital in Pueblo (the hospital) to medicate him
without his consent. We affirm.
I. Background
¶2 Patricio-Saguilan was admitted to the hospital in August 2024
after being found incompetent to proceed in a criminal case. His
symptoms included paranoia, delusional beliefs that his food was
being poisoned, auditory hallucinations, agitation, and ideas of
reference (believing that he was being sent messages specific to him
by television shows and music). Later the same month, Patricio-
Saguilan punched another patient in the head without provocation,
and hospital staff started him on emergency medications to
decrease his aggression.
¶3 In early September 2024, the district court issued an order
authorizing the involuntary administration of olanzapine (Zyprexa)
and haloperidol (Haldol). That order was set to expire in early
March 2025.
1 ¶4 In late February 2025, the State filed another petition seeking
authorization to medicate Patricio-Saguilan involuntarily. This
time, the State requested to medicate him only with olanzapine.
¶5 At the hearing on the petition, Patricio-Saguilan’s hospital
psychiatrist testified as an expert that Patricio-Saguilan’s diagnosis
is “unspecified schizophrenia and other psychotic disorder,” which
constitutes a substantial disorder that grossly impairs his judgment
or capacity to recognize reality or to control his behavior. The
psychiatrist also testified that, despite Patricio-Saguilan’s
“significant psychiatric psychotic symptoms,” Patricio-Saguilan “is
not sure if he has a mental illness,” and thus has “[m]inimal”
insight into his mental illness.
¶6 The psychiatrist also (1) opined that Patricio-Saguilan needs
medication treatment with olanzapine, an antipsychotic medication;
and (2) reported that the medication had primarily resolved Patricio-
Saguilan’s psychotic symptoms, his mood had stabilized, and he
hadn’t been aggressive. Despite these improvements, the
psychiatrist reported that Patricio-Saguilan “doesn’t believe that he
needs medication treatment.” The psychiatrist opined that, without
the medication, (1) there will be a significant and likely long-term
2 deterioration of Patricio-Saguilan’s mental condition, and (2) he will
pose a serious risk of harm to others at the hospital.
¶7 When Patricio-Saguilan was asked at the hearing whether he
has a mental illness, he responded, “I don’t think so.” When he was
asked whether he needs any medications, he again responded, “I
don’t think so.” He also testified that he does not want to take any
medications and he “doesn’t know” whether he would take the
medication without a court order. He asked the court to deny the
petition.
¶8 The district court granted the petition, and in an oral and
written order concluded that the State had met its burden of
proving all four elements from People v. Medina, 705 P.2d 961, 973
3 (Colo. 1985). Patricio-Saguilan did not contest below nor on appeal
that the Medina elements apply.1
II. Standard of Review and Applicable Law
¶9 Application of the Medina test involves mixed questions of fact
and law. People v. Marquardt, 2016 CO 4, ¶ 8. We defer to the
district court’s factual findings if they have record support, while we
review the court’s legal conclusions de novo. Id. Resolving conflicts
in testimony and determining the credibility of the witnesses are
matters solely within the province of the district court. People in
Interest of Ramsey, 2023 COA 95, ¶ 23.
¶ 10 We must affirm the district court’s ruling if the evidence,
viewed as a whole and in the light most favorable to the prevailing
1 A different test applies to petitions to administer medication
involuntarily for the purpose of restoring competency for a criminal proceeding. See People in Interest of R.F., 2019 COA 110, ¶¶ 10-15, n.1 (discussing the test from Sell v. United States, 539 U.S. 166, 180 (2003)). Although Patricio-Saguilan was admitted to the hospital for that purpose, the parties agree that the test from People v. Medina, 705 P.2d 961 (Colo. 1985), applies here. Indeed, the petition’s stated purposes, and the district court’s bases for granting the petition, were (1) to prevent a significant and long-term deterioration in Patricio-Saguilan’s mental condition and (2) to prevent the likelihood of him causing serious harm to himself or others at the hospital, both of which are part of the second element of the Medina test. See R.F., ¶ 11 n.1.
4 party, is sufficient to support the court’s order. People in Interest of
R.K.L., 2016 COA 84, ¶ 13. The testimony of the physician seeking
to administer treatment may be sufficient, without more, to satisfy
the Medina test. Id. at ¶ 30.
¶ 11 Under that test, a district court may authorize the involuntary
administration of medication if the State demonstrates by clear and
convincing evidence that (1) the person is incompetent to effectively
participate in the treatment decision; (2) the treatment is necessary
to prevent a significant and likely long-term deterioration in the
person’s mental health condition or to prevent the likelihood of the
patient causing serious harm to himself or others at the institution;
(3) a less intrusive treatment alternative is not available; and (4) the
person’s need for treatment is sufficiently compelling to override
any bona fide and legitimate interest of the person in refusing
treatment. Medina, 705 P.2d at 973.
III. Analysis
¶ 12 Patricio-Saguilan concedes that the State met its burden of
proving the second, third, and fourth Medina elements. He
challenges the sufficiency of the evidence supporting solely the first
5 Medina element — that he is incompetent to effectively participate
in the treatment decision.
¶ 13 The district court found in its written order that Patricio-
Saguilan is incompetent to effectively participate in decisions
regarding his mental illness. That finding is supported by the
psychiatrist’s testimony that, despite Patricio-Saguilan’s significant
psychotic symptoms, Patricio-Saguilan isn’t sure if he has a mental
illness and therefore has “[m]inimal” insight into his mental illness.
It is also supported by Patricio-Saguilan’s testimony during which
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25CA0495 Peo in Interest of Patricio-Saguilan 06-12-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0495 Pueblo County District Court No. 24MH30081 Honorable J. Steven Patrick, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Brandon Jonathan Patricio-Saguilan,
Respondent-Appellant.
ORDER AFFIRMED
Division V Opinion by JUDGE JOHNSON Welling and Grove, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced June 12, 2025
Cynthia Mitchell, County Attorney, Kate H. Shafer, Special Assistant County Attorney, Pueblo, Colorado, for Petitioner-Appellee
Tezak Law P.C., Mary Tezak, Florence, Colorado, for Respondent-Appellant ¶1 Brandon Jonathan Patricio-Saguilan (Patricio-Saguilan)
appeals the district court’s order authorizing staff at the Colorado
Mental Health Hospital in Pueblo (the hospital) to medicate him
without his consent. We affirm.
I. Background
¶2 Patricio-Saguilan was admitted to the hospital in August 2024
after being found incompetent to proceed in a criminal case. His
symptoms included paranoia, delusional beliefs that his food was
being poisoned, auditory hallucinations, agitation, and ideas of
reference (believing that he was being sent messages specific to him
by television shows and music). Later the same month, Patricio-
Saguilan punched another patient in the head without provocation,
and hospital staff started him on emergency medications to
decrease his aggression.
¶3 In early September 2024, the district court issued an order
authorizing the involuntary administration of olanzapine (Zyprexa)
and haloperidol (Haldol). That order was set to expire in early
March 2025.
1 ¶4 In late February 2025, the State filed another petition seeking
authorization to medicate Patricio-Saguilan involuntarily. This
time, the State requested to medicate him only with olanzapine.
¶5 At the hearing on the petition, Patricio-Saguilan’s hospital
psychiatrist testified as an expert that Patricio-Saguilan’s diagnosis
is “unspecified schizophrenia and other psychotic disorder,” which
constitutes a substantial disorder that grossly impairs his judgment
or capacity to recognize reality or to control his behavior. The
psychiatrist also testified that, despite Patricio-Saguilan’s
“significant psychiatric psychotic symptoms,” Patricio-Saguilan “is
not sure if he has a mental illness,” and thus has “[m]inimal”
insight into his mental illness.
¶6 The psychiatrist also (1) opined that Patricio-Saguilan needs
medication treatment with olanzapine, an antipsychotic medication;
and (2) reported that the medication had primarily resolved Patricio-
Saguilan’s psychotic symptoms, his mood had stabilized, and he
hadn’t been aggressive. Despite these improvements, the
psychiatrist reported that Patricio-Saguilan “doesn’t believe that he
needs medication treatment.” The psychiatrist opined that, without
the medication, (1) there will be a significant and likely long-term
2 deterioration of Patricio-Saguilan’s mental condition, and (2) he will
pose a serious risk of harm to others at the hospital.
¶7 When Patricio-Saguilan was asked at the hearing whether he
has a mental illness, he responded, “I don’t think so.” When he was
asked whether he needs any medications, he again responded, “I
don’t think so.” He also testified that he does not want to take any
medications and he “doesn’t know” whether he would take the
medication without a court order. He asked the court to deny the
petition.
¶8 The district court granted the petition, and in an oral and
written order concluded that the State had met its burden of
proving all four elements from People v. Medina, 705 P.2d 961, 973
3 (Colo. 1985). Patricio-Saguilan did not contest below nor on appeal
that the Medina elements apply.1
II. Standard of Review and Applicable Law
¶9 Application of the Medina test involves mixed questions of fact
and law. People v. Marquardt, 2016 CO 4, ¶ 8. We defer to the
district court’s factual findings if they have record support, while we
review the court’s legal conclusions de novo. Id. Resolving conflicts
in testimony and determining the credibility of the witnesses are
matters solely within the province of the district court. People in
Interest of Ramsey, 2023 COA 95, ¶ 23.
¶ 10 We must affirm the district court’s ruling if the evidence,
viewed as a whole and in the light most favorable to the prevailing
1 A different test applies to petitions to administer medication
involuntarily for the purpose of restoring competency for a criminal proceeding. See People in Interest of R.F., 2019 COA 110, ¶¶ 10-15, n.1 (discussing the test from Sell v. United States, 539 U.S. 166, 180 (2003)). Although Patricio-Saguilan was admitted to the hospital for that purpose, the parties agree that the test from People v. Medina, 705 P.2d 961 (Colo. 1985), applies here. Indeed, the petition’s stated purposes, and the district court’s bases for granting the petition, were (1) to prevent a significant and long-term deterioration in Patricio-Saguilan’s mental condition and (2) to prevent the likelihood of him causing serious harm to himself or others at the hospital, both of which are part of the second element of the Medina test. See R.F., ¶ 11 n.1.
4 party, is sufficient to support the court’s order. People in Interest of
R.K.L., 2016 COA 84, ¶ 13. The testimony of the physician seeking
to administer treatment may be sufficient, without more, to satisfy
the Medina test. Id. at ¶ 30.
¶ 11 Under that test, a district court may authorize the involuntary
administration of medication if the State demonstrates by clear and
convincing evidence that (1) the person is incompetent to effectively
participate in the treatment decision; (2) the treatment is necessary
to prevent a significant and likely long-term deterioration in the
person’s mental health condition or to prevent the likelihood of the
patient causing serious harm to himself or others at the institution;
(3) a less intrusive treatment alternative is not available; and (4) the
person’s need for treatment is sufficiently compelling to override
any bona fide and legitimate interest of the person in refusing
treatment. Medina, 705 P.2d at 973.
III. Analysis
¶ 12 Patricio-Saguilan concedes that the State met its burden of
proving the second, third, and fourth Medina elements. He
challenges the sufficiency of the evidence supporting solely the first
5 Medina element — that he is incompetent to effectively participate
in the treatment decision.
¶ 13 The district court found in its written order that Patricio-
Saguilan is incompetent to effectively participate in decisions
regarding his mental illness. That finding is supported by the
psychiatrist’s testimony that, despite Patricio-Saguilan’s significant
psychotic symptoms, Patricio-Saguilan isn’t sure if he has a mental
illness and therefore has “[m]inimal” insight into his mental illness.
It is also supported by Patricio-Saguilan’s testimony during which
notwithstanding admitting that he has impulses or urges that he
cannot control, he also testified that he doesn’t think he has a
mental illness. This testimony supports the court’s finding that he
is not competent to effectively participate in decisions regarding his
mental illness due to a lack of insight into the existence or severity
of his mental illness. See R.K.L., ¶¶ 6-7, 33 (affirming the district
court’s finding that the first Medina element was met where the
patient’s psychiatrist testified that the patient had schizophrenia
with possible bipolar disorder, but the patient testified that he did
not think he had a mental illness).
6 ¶ 14 The district court’s finding that Patricio-Saguilan is
incompetent to effectively participate in decisions regarding his
mental illness is also supported by the psychiatrist’s testimony that
despite Patricio-Saguilan thinking he does not need the medication,
his condition improved on olanzapine. And although Patricio-
Saguilan’s psychotic symptoms had primarily resolved by the time
of the hearing, the psychiatrist opined that, without continued
administration of the medication, (1) there will be a significant and
likely long-term deterioration of Patricio-Saguilan’s mental
condition, and (2) he will pose a serious risk of harm to others at
the hospital. On this record, we perceive no error in the court’s
findings on the first Medina element.
IV. Conclusion
¶ 15 The order is affirmed.
JUDGE WELLING and JUDGE GROVE concur.