Peo in Interest of Bates

• Court: Colorado Court of Appeals
• Decided: July 24, 2025
• Docket: 25CA0871
• Status: Unpublished

Opinion

25CA0871 Peo in Interest of Bates 07-24-2025

COLORADO COURT OF APPEALS

Court of Appeals No. 25CA0871 Pueblo County District Court No. 24MH30112 Honorable Kelle Thomas, Magistrate

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of William Bates,

Respondent-Appellant.

ORDER AFFIRMED

Division VI Opinion by JUDGE YUN Tow and Sullivan, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced July 24, 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 William Bates appeals a district court magistrate’s order

authorizing staff at the Colorado Mental Health Hospital in Pueblo

(the hospital) to involuntarily medicate him. We affirm.

I. Background

¶2 Bates suffers from schizoaffective disorder. He was admitted

to the hospital after being found incompetent to proceed in a

criminal case. A district court authorized involuntary treatment,

and a division of this court affirmed the court’s order, which expired

in early May 2025.

¶3 In late April 2025, Dr. Paul Mattox, the hospital psychiatrist

responsible for Bates’s care and treatment, met with Bates.

Dr. Mattox noted that, as a result of the initial course of involuntary

medications, Bates had not been physically aggressive, his

psychotic symptoms had decreased, and he had progressed to a

less restrictive unit. Although Bates knew that he was taking

valproic acid (Depakote), he was unaware that he was taking

olanzapine (Zyprexa). Dr. Mattox sought an order authorizing the

continued involuntary administration of these two medications

based on his belief that it was unlikely Bates would voluntarily

consent to the medications given his history of medication refusal.

1 ¶4 The People filed a petition seeking authorization to continue to

involuntarily medicate Bates with Depakote and Zyprexa.

Consistent with People v. Medina, 705 P.2d 961 (Colo. 1985), the

petition asserted that (1) Bates is incapable of effectively

participating in decisions affecting his health and treatment; (2) the

requested treatment is necessary to prevent a significant and likely

long-term deterioration in his mental health condition or to prevent

the likelihood of him causing serious harm to himself or others;

(3) a less intrusive treatment alternative is not available; and

(4) Bates’s need for treatment is sufficient to override any bona fide

and legitimate interest he has in refusing treatment.

¶5 After a hearing, at which both Dr. Mattox and Bates testified, a

district court magistrate granted the petition, finding that the

People had proved all four Medina elements by clear and convincing

evidence.

II. Standard of Review

¶6 When, as here, a patient challenges the sufficiency of the

evidence supporting an involuntary medication order, we review the

district court’s legal conclusions de novo but defer to its factual

findings if they have record support. People v. Marquardt, 2016 CO

2 4, ¶ 8. We view the evidence as a whole and in the light most

favorable to the petitioning party, leaving the resolution of

testimonial conflicts and the determination of witness credibility

solely to the fact finder. People in Interest of Uwayezuk, 2023 COA

69, ¶ 57; People in Interest of R.C., 2019 COA 99M, ¶ 7. As the fact

finder, the district court determines the sufficiency, probative effect,

and weight of the evidence, along with the inferences and

conclusions to be drawn therefrom. R.C., ¶ 7.

III. Discussion

¶7 A court may order the involuntary administration of

medication to a patient only if the People prove, by clear and

convincing evidence, each of the four elements outlined in Medina.

Medina, 705 P.2d at 973. Bates does not contest the second, third,

or fourth Medina elements. He contends only that the evidence

presented at the hearing was insufficient to prove the first element.

We are not persuaded.

¶8 The first Medina element requires a court to determine

whether the patient is incompetent to effectively participate in the

relevant treatment decision. Id. A court may not order the forced

medication of an involuntarily committed patient unless it is

3 satisfied that the patient’s mental illness has so impaired his

judgment as to render him incapable of participating in decisions

affecting his health. Id.

¶9 Dr. Mattox offered his expert opinion that, although Bates has

“some” insight into his mental illness, his lack of insight into his

need for medication treatment makes him incapable of effectively

participating in decisions about his health, including whether

psychiatric medications are needed. Dr. Mattox noted that, when

he met with Bates, Bates acknowledged being diagnosed with

schizoaffective disorder but stated that he believes he does not need

the requested medications to maintain stability. To the contrary,

Dr. Mattox testified, Bates indeed needs these medications, and

without them, he will suffer a significant and likely long-term

deterioration of his mental condition — namely, he will become

psychotic and manic.

¶ 10 The magistrate credited Dr. Mattox’s testimony and adopted

the doctor’s opinions. See People v. Pflugbeil, 834 P.2d 843, 846-47

(Colo. App. 1992) (physician’s testimony alone may constitute clear

and convincing evidence). Nonetheless, Bates asserts that

Dr. Mattox’s testimony was insufficient because “the first Medina

4 element cannot hinge on whether the patient agrees that he needs

medication.” But, as the magistrate noted, Bates’s own testimony

reflected a lack of understanding that he needs the requested

medications to control the symptoms of his mental illness. During

the hearing, Bates initially denied that his mental illness required

any medication, instead stating that he preferred to be treated with

therapy. He then said he wished to be treated with twenty-five

milligrams of Thorazine.

¶ 11 Yet Dr. Mattox testified that this dosage of Thorazine was “an

extraordinarily low dose” and would not have any antipsychotic or

persisting mood stabilizing effect. If Bates ceased taking Depakote

and Zyprexa in favor of such a regimen, Dr. Mattox opined, he

would become psychotic and manic.

¶ 12 Given Bates’s lack of insight into his need for the requested

medications and the severity of his illness, in combination with the

weight the magistrate placed on Dr. Mattox’s credibility, we cannot

conclude that the evidence was insufficient to support the

determination that Bates is incompetent to effectively participate in

the relevant treatment decision.

5 IV. Disposition

¶ 13 The order is affirmed.

JUDGE TOW and JUDGE SULLIVAN concur.