25CA0050 Peo in Interest of Hall 03-27-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0050 Pueblo County District Court No. 24MH30125 Honorable Timothy O’Shea, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Tyler Jordan Hall,
Respondent-Appellant.
ORDER AFFIRMED
Division III Opinion by JUDGE TOW Dunn and Martinez*, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced March 27, 2025
Cynthia Mitchell, County Attorney, Kate H. Shafer, Special Assistant County Attorney, Pueblo, Colorado, for Petitioner-Appellee
Tezak Law, P.C., Mary E. 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 Tyler Jordan Hall appeals the district court’s order authorizing
staff at the Colorado Mental Health Hospital in Pueblo (the hospital)
to medicate him involuntarily. We affirm.
I. Background
¶2 The record indicates that before Hall’s admission to the
hospital in November 2024, he was a patient at the Colorado Mental
Health Hospital in Fort Logan from November 2023 to March 2024.
There, his symptoms included agitation, hostility, and grandiose
delusions; and he assaulted his treating physician and repeatedly
hit himself on the head. He was eventually stabilized on a
combination of the antipsychotic medication olanzapine (Zyprexa)
and the mood-stabilizing medication valproic acid (Depakote).
¶3 Eight months after Hall’s discharge from the hospital in Fort
Logan, he was admitted to the hospital in Pueblo after being found
incompetent to proceed in a criminal case. Upon his admission, he
presented with impulsive behaviors, delusions, paranoia, and
aggression. Due to his escalating behaviors — which included
saying that he was going to “start murdering nurses” — he was
placed on emergency medications.
1 ¶4 The People petitioned the district court to authorize the
involuntary administration of Zyprexa, Depakote, and
chlorpromazine (Thorazine). However, at the hearing on the
petition, the People, through the testimony of Hall’s psychiatrist at
the hospital, effectively amended their request by dropping the
Thorazine and adding the antipsychotic medication ziprasidone
(Geodon), which Hall had taken in the past.
¶5 At the hearing, Hall’s psychiatrist, an expert in clinical
psychiatry, testified that Hall’s diagnosis was an unspecified mood
disorder. In discussing the medication change mentioned above,
which was based on Hall’s complaint that Zyprexa was causing a
rash on his back, the psychiatrist testified that he was seeking to
treat Hall with Geodon and Depakote as scheduled medications and
Zyprexa as needed for episodes of acute agitation. The psychiatrist
explained that Geodon and Zyprexa can improve psychotic
symptoms such as delusions and paranoia, and Depakote can
improve symptoms of mania and prevent depressive episodes.
¶6 The psychiatrist testified that Hall had been successfully
treated in the past with Geodon, Zyprexa, and Depakote, and,
during this hospital stay, Hall had “significantly improved” on the
2 medications and was “on his way to returning to his baseline.” The
psychiatrist opined that, off the medications, Hall would be a
danger to both himself and others at the hospital and would suffer
a significant and likely long-term deterioration of his mental
condition. But, according to the psychiatrist, Hall did not have any
insight into his mental illness and did not want to take any
medications.
¶7 During Hall’s testimony, when asked whether he had a mental
illness, he responded, “I don’t.” He also repeatedly testified that he
did not need the medications and would not take them without a
court order. In terms of medication side effects, Hall testified that
when he previously took Zyprexa, he gained a lot of weight, had a
fatty liver, and had bumps all over his back. He then added, “I
think I got my liver back — I got my weight back. I worked out
really hard, and I cut down food.” He also testified that he did not
like Depakote because it makes him tired and hungry all day long.
¶8 Following the testimony, the district court found that the
psychiatrist had testified credibly and persuasively, and it expressly
adopted the psychiatrist’s opinions. The court then examined each
of the four elements of the test from People v. Medina, 705 P.2d
3 961, 973 (Colo. 1985), concluded that all four elements were met,
and granted the petition.
II. Applicable Law and Standard of Review
¶9 Under the Medina test, a district court may authorize the
involuntary administration of medication if the People demonstrate
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 in 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. Id.
¶ 10 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
4 solely within the province of the district court. People in Interest of
Ramsey, 2023 COA 95, ¶ 23.
¶ 11 We must affirm the district court’s ruling if 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. The testimony of the physician seeking
to administer treatment may be sufficient, without more, to satisfy
the Medina test. Id. at ¶ 30.
III. Analysis
¶ 12 Hall concedes that the first, second, and third elements of the
Medina test were met. However, he challenges the sufficiency of the
evidence supporting the fourth Medina element — that his need for
treatment was sufficiently compelling to override any bona fide and
legitimate interest he had in refusing treatment.
¶ 13 Hall first argues that his interest in avoiding side effects from
the medications was bona fide and legitimate. He then argues that,
because the district court did not sufficiently acknowledge that
interest, it could not properly balance it against the State’s interest
in medicating him.
5 ¶ 14 The district court noted that, though Hall vaguely identified a
religious basis for resisting medications, these views were
undeveloped and unsupported by the evidence. Noting Hall’s
repeated assertion that he does not need the medications, the court
concluded that “he just has a general preference to not take
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25CA0050 Peo in Interest of Hall 03-27-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA0050 Pueblo County District Court No. 24MH30125 Honorable Timothy O’Shea, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Tyler Jordan Hall,
Respondent-Appellant.
ORDER AFFIRMED
Division III Opinion by JUDGE TOW Dunn and Martinez*, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced March 27, 2025
Cynthia Mitchell, County Attorney, Kate H. Shafer, Special Assistant County Attorney, Pueblo, Colorado, for Petitioner-Appellee
Tezak Law, P.C., Mary E. 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 Tyler Jordan Hall appeals the district court’s order authorizing
staff at the Colorado Mental Health Hospital in Pueblo (the hospital)
to medicate him involuntarily. We affirm.
I. Background
¶2 The record indicates that before Hall’s admission to the
hospital in November 2024, he was a patient at the Colorado Mental
Health Hospital in Fort Logan from November 2023 to March 2024.
There, his symptoms included agitation, hostility, and grandiose
delusions; and he assaulted his treating physician and repeatedly
hit himself on the head. He was eventually stabilized on a
combination of the antipsychotic medication olanzapine (Zyprexa)
and the mood-stabilizing medication valproic acid (Depakote).
¶3 Eight months after Hall’s discharge from the hospital in Fort
Logan, he was admitted to the hospital in Pueblo after being found
incompetent to proceed in a criminal case. Upon his admission, he
presented with impulsive behaviors, delusions, paranoia, and
aggression. Due to his escalating behaviors — which included
saying that he was going to “start murdering nurses” — he was
placed on emergency medications.
1 ¶4 The People petitioned the district court to authorize the
involuntary administration of Zyprexa, Depakote, and
chlorpromazine (Thorazine). However, at the hearing on the
petition, the People, through the testimony of Hall’s psychiatrist at
the hospital, effectively amended their request by dropping the
Thorazine and adding the antipsychotic medication ziprasidone
(Geodon), which Hall had taken in the past.
¶5 At the hearing, Hall’s psychiatrist, an expert in clinical
psychiatry, testified that Hall’s diagnosis was an unspecified mood
disorder. In discussing the medication change mentioned above,
which was based on Hall’s complaint that Zyprexa was causing a
rash on his back, the psychiatrist testified that he was seeking to
treat Hall with Geodon and Depakote as scheduled medications and
Zyprexa as needed for episodes of acute agitation. The psychiatrist
explained that Geodon and Zyprexa can improve psychotic
symptoms such as delusions and paranoia, and Depakote can
improve symptoms of mania and prevent depressive episodes.
¶6 The psychiatrist testified that Hall had been successfully
treated in the past with Geodon, Zyprexa, and Depakote, and,
during this hospital stay, Hall had “significantly improved” on the
2 medications and was “on his way to returning to his baseline.” The
psychiatrist opined that, off the medications, Hall would be a
danger to both himself and others at the hospital and would suffer
a significant and likely long-term deterioration of his mental
condition. But, according to the psychiatrist, Hall did not have any
insight into his mental illness and did not want to take any
medications.
¶7 During Hall’s testimony, when asked whether he had a mental
illness, he responded, “I don’t.” He also repeatedly testified that he
did not need the medications and would not take them without a
court order. In terms of medication side effects, Hall testified that
when he previously took Zyprexa, he gained a lot of weight, had a
fatty liver, and had bumps all over his back. He then added, “I
think I got my liver back — I got my weight back. I worked out
really hard, and I cut down food.” He also testified that he did not
like Depakote because it makes him tired and hungry all day long.
¶8 Following the testimony, the district court found that the
psychiatrist had testified credibly and persuasively, and it expressly
adopted the psychiatrist’s opinions. The court then examined each
of the four elements of the test from People v. Medina, 705 P.2d
3 961, 973 (Colo. 1985), concluded that all four elements were met,
and granted the petition.
II. Applicable Law and Standard of Review
¶9 Under the Medina test, a district court may authorize the
involuntary administration of medication if the People demonstrate
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 in 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. Id.
¶ 10 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
4 solely within the province of the district court. People in Interest of
Ramsey, 2023 COA 95, ¶ 23.
¶ 11 We must affirm the district court’s ruling if 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. The testimony of the physician seeking
to administer treatment may be sufficient, without more, to satisfy
the Medina test. Id. at ¶ 30.
III. Analysis
¶ 12 Hall concedes that the first, second, and third elements of the
Medina test were met. However, he challenges the sufficiency of the
evidence supporting the fourth Medina element — that his need for
treatment was sufficiently compelling to override any bona fide and
legitimate interest he had in refusing treatment.
¶ 13 Hall first argues that his interest in avoiding side effects from
the medications was bona fide and legitimate. He then argues that,
because the district court did not sufficiently acknowledge that
interest, it could not properly balance it against the State’s interest
in medicating him.
5 ¶ 14 The district court noted that, though Hall vaguely identified a
religious basis for resisting medications, these views were
undeveloped and unsupported by the evidence. Noting Hall’s
repeated assertion that he does not need the medications, the court
concluded that “he just has a general preference to not take
medications.” However, the court never actually considered
whether Hall’s stated concerns about side effects were bona fide
and legitimate. This was error — but not reversible error.
¶ 15 This is because the court went on to balance Hall’s interest in
not taking the medications and the State’s interest in administering
them. The court found that, even if Hall’s interest in not taking the
medications was bona fide and legitimate, his need for the
medications was sufficiently compelling to override that interest. In
other words, though the court erred when it did not assess the
sincerity of Hall’s claim that he wished to avoid the side effects of
the medications, it abrogated the effect of that error when it treated
Hall’s concerns as legitimate during the next step of the analysis.
¶ 16 We agree with the district court’s determination. Even if Hall
had legitimate concerns that the medications had certain side
effects, the psychiatrist’s and Hall’s testimony called into question
6 the significance of those side effects. In terms of Hall’s concern
regarding developing a fatty liver, the psychiatrist testified that
Hall’s liver functioning was being monitored through lab work; and
if Hall were to develop any liver issues, his medications would be
adjusted accordingly. In terms of Hall’s weight, when he was asked
at the hearing whether he had gained any weight since this
admission to the hospital, he responded only, “I’ve been walking
around a lot.” Further, the psychiatrist testified that the bumps on
Hall’s back were “more consistent [with] acne,” and that he has not
seen any specific cases where these medications caused acne in a
patient. And finally, in terms of Hall’s sedation, the psychiatrist
confirmed that Hall “may be more sedated than if he were not
taking the medications,” but it was not a severe side effect that
affects his daily functioning. The psychiatrist also testified that the
sedation might improve the longer that Hall is on the medications.
¶ 17 More importantly, though, the psychiatrist’s testimony
regarding the severity of Hall’s symptoms, behavior, and prognosis
without the medications, which the district court credited, provides
ample support for the court’s determination that Hall’s desire to
refrain from taking these medications “must yield to the legitimate
7 interest the State has in preserving his life and health and
protecting the safety of those in the institution.” We thus discern
no basis for reversal. See Marquardt, ¶ 8; Ramsey, ¶ 23; R.K.L.,
¶¶ 13, 30.
IV. Disposition
¶ 18 The order is affirmed.
JUDGE DUNN and JUSTICE MARTINEZ concur.