25CA0526 Peo in Interest of Campbell 06-12-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0526 Pueblo County District Court No. 25MH30024 Honorable Amiel Markenson, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Martin Ray Campbell,
Respondent-Appellant.
ORDER AFFIRMED
Division A Opinion by JUDGE TAUBMAN* Román, C.J., and Martinez*, J., 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
*Sitting by assignment of the Chief Justice under provisions of Colo. Const. art. VI, § 5(3), and § 24-51-1105, C.R.S. 2024. ¶1 Martin Ray Campbell appeals the district court’s order
authorizing the involuntary administration of antipsychotic and
mood stabilizing medications for the purpose of restoring him to
competency to stand trial in a criminal case. We affirm.
I. Background
¶2 In September 2023, Campbell was found incompetent to
proceed in a felony trial, and in August 2024, he was admitted to
the Colorado Mental Health Hospital in Pueblo (CMHHIP) for
competency restoration. CMHHIP staff prescribed an antipsychotic
medication for Campbell when he was admitted, but he refused to
take it. When Campbell was re-evaluated in January 2025, the
evaluator opined that Campbell had not progressed toward
psychiatric stabilization and was unlikely to be restored to
competency without psychotropic medication; thus, he remained
incompetent to proceed. Dr. Hareesh Pillai subsequently met with
Campbell, reviewed his records, diagnosed him with unspecified
schizophrenia spectrum disorder and other psychotic disorder, and
recommended treatment with antipsychotics and a mood stabilizer.
¶3 The People filed this case under section 16-8.5-112(1), C.R.S.
2024, seeking authorization for CMHHIP to involuntarily administer
1 psychotropic medications to Campbell. The physician’s affidavit
accompanying the petition sought permission to administer two
antipsychotic medications, risperidone and haloperidol; and one
mood stabilizer, lithium. Consistent with Sell v. United States, 539
U.S. 166, 180-181 (2003), Dr. Pillai’s affidavit asserted that treating
Campbell with the requested medications (1) would assist the
important governmental interest of prosecuting a serious crime
while assuring a fair trial; (2) would be substantially likely to render
Campbell competent and unlikely to cause side effects that would
interfere with his ability to assist counsel in his criminal defense;
(3) was necessary to achieve competency as other treatments had
failed; and (4) was medically appropriate and in Campbell’s “best
medical interest considering his psychiatric condition.”
¶4 The district court held an evidentiary hearing at which Dr.
Pillai and Campbell testified. Following the hearing, the court
found that Dr. Pillai had testified credibly and persuasively and
adopted his opinions. Based on Dr. Pillai’s testimony, the court
found that all four Sell factors had been proved by clear and
convincing evidence. It specifically found, as relevant here, that the
involuntary administration of medication was medically appropriate
2 and in Campbell’s best interest in light of his medical conditions.
However, because Dr. Pillai had requested authorization to
administer haloperidol only as a backup in the event oral
risperidone or lithium were refused, and Campbell had testified that
he would take court-ordered oral medications, the court authorized
the involuntary administration of only the oral versions of
risperidone and lithium.
II. Discussion
¶5 On appeal, Campbell contends that insufficient evidence
supported the district court’s finding as to the fourth Sell factor.
Specifically, he asserts that the ordered medications were not
medically appropriate or in his best medical interest because Dr.
Pillai was not aware of Campbell’s medical conditions, which
allegedly included two heart attacks and a family history of
diabetes. We conclude that the People provided sufficient evidence
to support the court’s finding.
A. Applicable Law and Standard of Review
¶6 When, as in this case, the involuntary administration of
medication is sought for the sole purpose of rendering a defendant
competent to stand trial, the People must satisfy the four-part test
3 articulated by Sell. People in Interest of R.F., 2019 COA 110, ¶ 21,
451 P.3d 1238, 1243. First, they must demonstrate that important
governmental interests — such as bringing to trial an individual
accused of a serious crime — are at stake. Sell, 539 U.S. at 180.
Second, involuntary medication must significantly further those
interests. Id. at 181. Third, the medication must be necessary to
further those interests. Id. Fourth, the medication must be
“medically appropriate, i.e., in the patient’s best medical interest in
light of his medical condition.” Id. The People must prove each
factor by clear and convincing evidence. R.F., ¶ 16, 451 P.3d at
1242. A physician’s testimony alone may constitute clear and
convincing evidence. See People v. Pflugbeil, 834 P.2d 843, 846-47
(Colo. App. 1992).
¶7 When a respondent challenges the sufficiency of the evidence
supporting the district court’s findings on a Sell factor, we review
the record as a whole and, viewing it in the light most favorable to
the People, determine whether the evidence is sufficient to support
the court’s order. See People in Interest of Ramsey, 2023 COA 95, ¶
23, 541 P.3d 1198, 1204 (addressing the involuntary
administration of medication under People v. Medina, 705 P.2d 961,
4 973 (Colo. 1985)). We also defer to the district court’s resolution of
evidentiary conflicts and its determinations of witness credibility,
the weight of the evidence, and the inferences to be drawn from it.
See People in Interest of R.C., 2019 COA 99M, ¶ 7, 451 P.3d 1229,
1231.
¶8 Only the first Sell factor presents a legal question subject to de
novo review. R.F., ¶ 21, 451 P.3d at 1243. The district court’s
findings with respect to the other Sell factors are factual in nature,
and we defer to findings of fact if supported by evidence in the
record. Id.; see People v. Marquardt, 2016 CO 4, ¶ 8, 360 P.3d 499,
502.
B. Application
¶9 As relevant to the fourth Sell factor and Campbell’s challenge
on appeal, Dr. Pillai directly testified that the administration of the
requested medications was medically appropriate and in Campbell’s
best interest given his medical conditions. Dr. Pillai expounded as
follows:
• Even taking competency restoration out of the equation,
he would recommend risperidone, haloperidol, and
lithium to treat Campbell’s psychiatric symptoms
5 (paranoia, delusional ideation, grandiosity, hyper
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25CA0526 Peo in Interest of Campbell 06-12-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0526 Pueblo County District Court No. 25MH30024 Honorable Amiel Markenson, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Martin Ray Campbell,
Respondent-Appellant.
ORDER AFFIRMED
Division A Opinion by JUDGE TAUBMAN* Román, C.J., and Martinez*, J., 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
*Sitting by assignment of the Chief Justice under provisions of Colo. Const. art. VI, § 5(3), and § 24-51-1105, C.R.S. 2024. ¶1 Martin Ray Campbell appeals the district court’s order
authorizing the involuntary administration of antipsychotic and
mood stabilizing medications for the purpose of restoring him to
competency to stand trial in a criminal case. We affirm.
I. Background
¶2 In September 2023, Campbell was found incompetent to
proceed in a felony trial, and in August 2024, he was admitted to
the Colorado Mental Health Hospital in Pueblo (CMHHIP) for
competency restoration. CMHHIP staff prescribed an antipsychotic
medication for Campbell when he was admitted, but he refused to
take it. When Campbell was re-evaluated in January 2025, the
evaluator opined that Campbell had not progressed toward
psychiatric stabilization and was unlikely to be restored to
competency without psychotropic medication; thus, he remained
incompetent to proceed. Dr. Hareesh Pillai subsequently met with
Campbell, reviewed his records, diagnosed him with unspecified
schizophrenia spectrum disorder and other psychotic disorder, and
recommended treatment with antipsychotics and a mood stabilizer.
¶3 The People filed this case under section 16-8.5-112(1), C.R.S.
2024, seeking authorization for CMHHIP to involuntarily administer
1 psychotropic medications to Campbell. The physician’s affidavit
accompanying the petition sought permission to administer two
antipsychotic medications, risperidone and haloperidol; and one
mood stabilizer, lithium. Consistent with Sell v. United States, 539
U.S. 166, 180-181 (2003), Dr. Pillai’s affidavit asserted that treating
Campbell with the requested medications (1) would assist the
important governmental interest of prosecuting a serious crime
while assuring a fair trial; (2) would be substantially likely to render
Campbell competent and unlikely to cause side effects that would
interfere with his ability to assist counsel in his criminal defense;
(3) was necessary to achieve competency as other treatments had
failed; and (4) was medically appropriate and in Campbell’s “best
medical interest considering his psychiatric condition.”
¶4 The district court held an evidentiary hearing at which Dr.
Pillai and Campbell testified. Following the hearing, the court
found that Dr. Pillai had testified credibly and persuasively and
adopted his opinions. Based on Dr. Pillai’s testimony, the court
found that all four Sell factors had been proved by clear and
convincing evidence. It specifically found, as relevant here, that the
involuntary administration of medication was medically appropriate
2 and in Campbell’s best interest in light of his medical conditions.
However, because Dr. Pillai had requested authorization to
administer haloperidol only as a backup in the event oral
risperidone or lithium were refused, and Campbell had testified that
he would take court-ordered oral medications, the court authorized
the involuntary administration of only the oral versions of
risperidone and lithium.
II. Discussion
¶5 On appeal, Campbell contends that insufficient evidence
supported the district court’s finding as to the fourth Sell factor.
Specifically, he asserts that the ordered medications were not
medically appropriate or in his best medical interest because Dr.
Pillai was not aware of Campbell’s medical conditions, which
allegedly included two heart attacks and a family history of
diabetes. We conclude that the People provided sufficient evidence
to support the court’s finding.
A. Applicable Law and Standard of Review
¶6 When, as in this case, the involuntary administration of
medication is sought for the sole purpose of rendering a defendant
competent to stand trial, the People must satisfy the four-part test
3 articulated by Sell. People in Interest of R.F., 2019 COA 110, ¶ 21,
451 P.3d 1238, 1243. First, they must demonstrate that important
governmental interests — such as bringing to trial an individual
accused of a serious crime — are at stake. Sell, 539 U.S. at 180.
Second, involuntary medication must significantly further those
interests. Id. at 181. Third, the medication must be necessary to
further those interests. Id. Fourth, the medication must be
“medically appropriate, i.e., in the patient’s best medical interest in
light of his medical condition.” Id. The People must prove each
factor by clear and convincing evidence. R.F., ¶ 16, 451 P.3d at
1242. A physician’s testimony alone may constitute clear and
convincing evidence. See People v. Pflugbeil, 834 P.2d 843, 846-47
(Colo. App. 1992).
¶7 When a respondent challenges the sufficiency of the evidence
supporting the district court’s findings on a Sell factor, we review
the record as a whole and, viewing it in the light most favorable to
the People, determine whether the evidence is sufficient to support
the court’s order. See People in Interest of Ramsey, 2023 COA 95, ¶
23, 541 P.3d 1198, 1204 (addressing the involuntary
administration of medication under People v. Medina, 705 P.2d 961,
4 973 (Colo. 1985)). We also defer to the district court’s resolution of
evidentiary conflicts and its determinations of witness credibility,
the weight of the evidence, and the inferences to be drawn from it.
See People in Interest of R.C., 2019 COA 99M, ¶ 7, 451 P.3d 1229,
1231.
¶8 Only the first Sell factor presents a legal question subject to de
novo review. R.F., ¶ 21, 451 P.3d at 1243. The district court’s
findings with respect to the other Sell factors are factual in nature,
and we defer to findings of fact if supported by evidence in the
record. Id.; see People v. Marquardt, 2016 CO 4, ¶ 8, 360 P.3d 499,
502.
B. Application
¶9 As relevant to the fourth Sell factor and Campbell’s challenge
on appeal, Dr. Pillai directly testified that the administration of the
requested medications was medically appropriate and in Campbell’s
best interest given his medical conditions. Dr. Pillai expounded as
follows:
• Even taking competency restoration out of the equation,
he would recommend risperidone, haloperidol, and
lithium to treat Campbell’s psychiatric symptoms
5 (paranoia, delusional ideation, grandiosity, hyper
religious beliefs, and thought disorganization).
• Treating Campbell’s symptoms “is a large benefit to him”;
he would recommend the same treatment for any patient
presenting with Campbell’s symptoms — to improve the
symptoms that affect thinking and influence behavior.
• Even if Campbell had had heart attacks and a family
history of diabetes, his opinion would not change — the
recommended medications were less likely than others in
their classes to cause side effects that would exacerbate
those alleged medical conditions.
¶ 10 The district court credited Dr. Pillai’s testimony and declined
to make credibility findings about Campbell’s alleged medical
history, finding that risperidone and lithium were medically
appropriate for Campbell whether or not the reported history was
accurate. Deferring to the court’s witness credibility
determinations, as we must, and viewing the record in the light
most favorable to the People, we conclude that Dr. Pillai’s testimony
supports the finding that the fourth Sell factor was satisfied by clear
and convincing evidence. See Marquardt, ¶8, 364 P.3d at 502; R.C.,
6 ¶ 7, 451 P.3d at 1231; Ramsey, ¶ 23, 541 P.3d at 1204; Pflugbeil,
834 P.2d at 846-47.
III. Disposition
¶ 11 The order is affirmed.
CHIEF JUDGE ROMÁN and JUSTICE MARTINEZ concur.