Peo in Interest of CCG

• Court: Colorado Court of Appeals
• Decided: October 23, 2025
• Docket: 25CA1213
• Status: Unpublished

Opinion

25CA1213 Peo in Interest of CCG 10-23-2025

COLORADO COURT OF APPEALS

Court of Appeals No. 25CA1213 Pueblo County District Court No. 24MH30043 Honorable Amiel Markenson, Judge

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of C.C.G.,

Respondent-Appellant.

ORDER AFFIRMED

Division I Opinion by JUDGE MOULTRIE J. Jones and Kuhn, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced October 23, 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 Respondent, C.C.G., appeals the district court’s order

authorizing the involuntary administration of three antipsychotic

medications — quetiapine (Seroquel), paliperidone (Invega), and

chlorpromazine (Thorazine). We affirm the order.

I. Background

¶2 C.C.G. was admitted to the Colorado Mental Health Hospital in

Pueblo (CMHHIP) after being found incompetent to proceed to trial

in several pending criminal cases. According to the affidavit of his

treating physician, Dr. Paul Mattox, C.C.G. has a diagnosis of

schizoaffective disorder, is on his third admission to CMHHIP, and

has a history of refusing to voluntarily take medication. C.C.G.’s

symptoms during the current hospitalization include auditory

hallucinations, delusional beliefs, hypersexual behavior, assaultive

behavior, depression, suicidal ideation, and suicide attempts —

including attempting to hang himself on the day of his most recent

admission.

¶3 Leading up to the order at issue here, C.C.G. has been subject

to orders authorizing the involuntary administration of medications

(including Seroquel and Thorazine) since June 2024. C.C.G.

voluntarily took Invega for some portion of that time, but he refused

1 to take Invega beginning in May 2025. In June 2025, the People

petitioned for another six-month order authorizing the involuntary

administration of Seroquel, Invega, and Thorazine.

¶4 The district court conducted an evidentiary hearing, where Dr.

Mattox’s affidavit was admitted and Dr. Mattox and C.C.G. testified.

Dr. Mattox requested authorization to administer Seroquel and

Invega to C.C.G. on a regular basis, and to administer Thorazine

only as needed for agitation. The court granted the People’s petition

as to all requested medications. On appeal, C.C.G. challenges the

sufficiency of the evidence supporting the court’s order.

II. Legal Authority and Standard of Review

¶5 A court may authorize the involuntary administration of

medication to a patient only if the People establish each of the

following elements by clear and convincing evidence: (1) the patient

is incompetent to participate effectively in the treatment decision;

(2) treatment by medication is necessary to prevent a significant

and likely long-term deterioration in the patient’s mental condition

or to prevent the likelihood of the patient causing serious harm to

themself or others in the institution; (3) a less intrusive treatment

alternative isn’t available; and (4) the patient’s need for treatment

2 with medication is sufficiently compelling to override their bona fide

and legitimate interest in refusing medication. People v. Medina,

705 P.2d 961, 973 (Colo. 1985); accord People in Interest of

Strodtman, 293 P.3d 123, 131 (Colo. App. 2011).

¶6 When a patient challenges the sufficiency of the evidence

supporting the court’s findings on any of these elements, 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 decision. People in Interest of Ramsey, 2023 COA 95,

¶ 23. We review the court’s conclusions of law de novo and defer to

its findings of fact if supported by evidence in the record. People v.

Marquardt, 2016 CO 4, ¶ 8. We also defer to the court’s resolution

of evidentiary conflicts and its determinations of witness credibility,

the weight of the evidence, and the inferences to be drawn from the

evidence. See People in Interest of R.C., 2019 COA 99M, ¶ 7. A

physician’s testimony alone may constitute clear and convincing

evidence. See People v. Pflugbeil, 834 P.2d 843, 846-47 (Colo. App.

1992).

3 III. The First Medina Element

¶7 C.C.G. challenges the sufficiency of the evidence only for the

first Medina element. He argues that the People failed to establish

that he is incompetent to effectively participate in his treatment

decisions because his own testimony demonstrated some insight

into his illness. We conclude that Dr. Mattox’s affidavit and

testimony — which the district court explicitly found to be credible

and persuasive — provide ample support for the court’s legal

conclusion on this element.

¶8 A patient is incompetent to participate effectively in treatment

decisions when his “mental illness has so impaired his judgment as

to render him ‘incapable of participating in decisions affecting his

health.’” Medina, 705 P.2d at 973 (citation omitted). When a

patient’s failure to recognize that he has a mental illness interferes

with his ability to effectively participate in treatment decisions, the

first Medina element is “easily” satisfied. People in Interest of C.J.R.,

2016 COA 133, ¶ 32.

¶9 Dr. Mattox directly opined that C.C.G.’s mental illness renders

him incompetent to effectively participate in decisions regarding his

health and that C.C.G. lacks insight into his mental illness. By way

4 of example, Dr. Mattox testified that although Invega had previously

reduced (but not eliminated) C.C.G.’s hallucinations and delusional

behavior, C.C.G.’s condition was deteriorating because he began

refusing to take the medication voluntarily. And despite C.C.G.

acknowledging that he experienced some psychiatric symptoms

including hearing voices and engaging in suicidal and aggressive

behavior, he also said that he didn’t know whether he had a mental

illness or whether he needed to take antipsychotic medications.

¶ 10 To the extent that C.C.G.’s testimony conflicts with that of Dr.

Mattox or other record evidence, we defer to the district court’s

resolution of conflicting evidence. See R.C., ¶ 7. And because the

evidence supports the district court’s decision that C.C.G.’s mental

illness renders him incompetent to effectively participate in

decisions regarding his health, we conclude that the first Medina

element was satisfied. See C.J.R., ¶ 32.

IV. Disposition

¶ 11 The order is affirmed.

JUDGE J. JONES and JUDGE KUHN concur.