25CA2316 Peo in Interest of Lockley 02-19-2026
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA2316 Pueblo County District Court No. 25MH30116 Honorable Amiel Markenson, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Nefretarie Lockley,
Respondent-Appellant.
ORDER AFFIRMED
Division V Opinion by JUSTICE MARTINEZ* Tow and Lipinsky, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced February 19, 2026
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. 2025. ¶1 Respondent, Nefretarie Lockley, appeals the district court’s
order authorizing the involuntary administration of antipsychotic
medication for the purpose of restoring her to competency to stand
trial in two criminal cases. We affirm.
I. Background
¶2 Lockley was charged with multiple felonies and found
incompetent to stand trial in two cases. She was ordered to
undergo competency restoration and has been receiving inpatient
treatment at the Colorado Mental Health Hospital in Pueblo (the
hospital) since her admission in October 2025.
¶3 At the hospital, Lockley was diagnosed with schizoaffective
disorder, bipolar type, which causes her to exhibit disorganized
speech, delusions, depressed episodes, mania, and flight of ideas.
While Lockley initially agreed to take Latuda, an antipsychotic
medication, she subsequently refused all other antipsychotic
medications.
¶4 In November, the People petitioned the district court to
authorize the involuntary administration of antipsychotic
medication to restore Lockley to competency. After a hearing, the
court held that the People had satisfied all four elements required
1 by Sell v. United States, 539 U.S. 166 (2003), for the involuntary
administration of medication to restore a person’s competency.
Therefore, the court granted the petition and authorized the
involuntary administration of Invega and Zyprexa, both of which are
antipsychotic medications; however, the court declined to authorize
treatment with Latuda. (Zyprexa is also a mood stabilizer.)
II. Sufficiency of the Evidence
¶5 Lockley argues that the evidence presented at the hearing was
insufficient to support the involuntary medication order. While she
concedes that sufficient evidence supports the first, third, and
fourth elements set forth in Sell, she says the evidence did not
support the second element. We disagree.
A. Standard of Review
¶6 Divisions of our court have divided about the appropriate
standard of review for application of the Sell elements. Compare
People in Interest of Hardesty, 2014 COA 138, ¶¶ 15-17 (identifying
eight Sell elements and applying a mixed question review to the first
element, de novo review to the second element, and clear error
review to the remaining six elements), with People in Interest of R.F.,
2019 COA 110, ¶ 21 (identifying four Sell elements and applying de
2 novo review to the first element and clear error review for the
remaining three elements); see also People in Interest of Joergensen,
2022 COA 126, ¶¶ 11-12 (noting that there are “four [Sell]
elements” and stating that “[t]he resolution of a Sell motion
presents a mixed question of fact and law”).
¶7 We agree with the division’s reasoning in R.F. and review the
district court’s factual findings concerning the second Sell element
for clear error. Clear error review means we will not disturb a
court’s factual findings if there is any evidence in the record to
support them. Woodbridge Condo. Ass’n, Inc. v. Lo Viento Blanco,
LLC, 2020 COA 34, ¶ 24.
B. Applicable Law
¶8 As noted, the United States Supreme Court has established a
four-part test for determining when a state may involuntarily
administer antipsychotic medication to restore a defendant’s
competency in a criminal proceeding. See Sell, 539 U.S. at 180-81;
see also R.F., ¶ 21. The People bear the burden of proving each
part of the test by clear and convincing evidence. R.F., ¶ 16.
First, there must be important governmental interests at stake.
Sell, 539 U.S. at 180; R.F., ¶ 12. Bringing to trial a person accused
3 of a serious crime is an important governmental interest. Sell, 539
U.S. at 180; R.F., ¶ 12.
¶9 Second, administering involuntary medication must
significantly further those interests. Sell, 539 U.S. at 181; R.F.,
¶ 13. The state satisfies this element by showing that
(1) administering the medication is substantially likely to restore
the defendant’s competency and (2) the medication is substantially
unlikely to have side effects that will interfere with the defendant’s
ability to assist in her defense. Sell, 539 U.S. at 181; R.F., ¶ 13.
¶ 10 Third, the medication must be necessary to further the
government’s interests. Sell, 539 U.S. at 181; R.F., ¶ 14. The state
satisfies this element by showing that (1) any less intrusive
treatment alternatives are unlikely to achieve substantially the
same results and (2) less intrusive means for administering the
medication were considered. Sell, 539 U.S. at 181; R.F., ¶ 14.
¶ 11 Fourth, administering the medication must be medically
appropriate. Sell, 539 U.S. at 181; R.F., ¶ 15.
C. Analysis
¶ 12 Lockley asserts that there was insufficient evidence to
establish the second Sell element — that is, that the involuntary
4 administration of the requested medication would significantly
further the state’s interest in prosecuting her. In particular, she
contests the district court’s finding that the proposed treatment
plan is substantially unlikely to have side effects that would
interfere with her ability to assist in her defense.
¶ 13 First, Lockley alleges that the side effects she previously
experienced from Latuda — including “nausea, bodily tremors,
feelings of loss of control, difficulty remaining calm, discomfort
outside her normal mental state, and restlessness in her limbs” —
“risk impairing her ability to think clearly and communicate
effectively with counsel.” But the district court declined to order the
involuntary administration of Latuda based on Dr. Graham
Hoffman’s testimony that (1) Latuda would only be provided if
Lockley requested it and (2) there was “[n]ot a huge risk” in
returning to court to add another medication if it was needed. See
People in Interest of Ferguson, 2025 COA 82, ¶ 1 (a treating
physician’s demonstrated need for flexibility in treatment options is
a relevant consideration for the authorization of more than one
medication option). Accordingly, we do not address this contention.
5 ¶ 14 Next, Lockley alleges that the side effects she experienced
when she took Invega (seizures) and the possible side effects of
Zyprexa (sedation) risk impairing her ability to assist in her defense.
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25CA2316 Peo in Interest of Lockley 02-19-2026
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA2316 Pueblo County District Court No. 25MH30116 Honorable Amiel Markenson, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Nefretarie Lockley,
Respondent-Appellant.
ORDER AFFIRMED
Division V Opinion by JUSTICE MARTINEZ* Tow and Lipinsky, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced February 19, 2026
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. 2025. ¶1 Respondent, Nefretarie Lockley, appeals the district court’s
order authorizing the involuntary administration of antipsychotic
medication for the purpose of restoring her to competency to stand
trial in two criminal cases. We affirm.
I. Background
¶2 Lockley was charged with multiple felonies and found
incompetent to stand trial in two cases. She was ordered to
undergo competency restoration and has been receiving inpatient
treatment at the Colorado Mental Health Hospital in Pueblo (the
hospital) since her admission in October 2025.
¶3 At the hospital, Lockley was diagnosed with schizoaffective
disorder, bipolar type, which causes her to exhibit disorganized
speech, delusions, depressed episodes, mania, and flight of ideas.
While Lockley initially agreed to take Latuda, an antipsychotic
medication, she subsequently refused all other antipsychotic
medications.
¶4 In November, the People petitioned the district court to
authorize the involuntary administration of antipsychotic
medication to restore Lockley to competency. After a hearing, the
court held that the People had satisfied all four elements required
1 by Sell v. United States, 539 U.S. 166 (2003), for the involuntary
administration of medication to restore a person’s competency.
Therefore, the court granted the petition and authorized the
involuntary administration of Invega and Zyprexa, both of which are
antipsychotic medications; however, the court declined to authorize
treatment with Latuda. (Zyprexa is also a mood stabilizer.)
II. Sufficiency of the Evidence
¶5 Lockley argues that the evidence presented at the hearing was
insufficient to support the involuntary medication order. While she
concedes that sufficient evidence supports the first, third, and
fourth elements set forth in Sell, she says the evidence did not
support the second element. We disagree.
A. Standard of Review
¶6 Divisions of our court have divided about the appropriate
standard of review for application of the Sell elements. Compare
People in Interest of Hardesty, 2014 COA 138, ¶¶ 15-17 (identifying
eight Sell elements and applying a mixed question review to the first
element, de novo review to the second element, and clear error
review to the remaining six elements), with People in Interest of R.F.,
2019 COA 110, ¶ 21 (identifying four Sell elements and applying de
2 novo review to the first element and clear error review for the
remaining three elements); see also People in Interest of Joergensen,
2022 COA 126, ¶¶ 11-12 (noting that there are “four [Sell]
elements” and stating that “[t]he resolution of a Sell motion
presents a mixed question of fact and law”).
¶7 We agree with the division’s reasoning in R.F. and review the
district court’s factual findings concerning the second Sell element
for clear error. Clear error review means we will not disturb a
court’s factual findings if there is any evidence in the record to
support them. Woodbridge Condo. Ass’n, Inc. v. Lo Viento Blanco,
LLC, 2020 COA 34, ¶ 24.
B. Applicable Law
¶8 As noted, the United States Supreme Court has established a
four-part test for determining when a state may involuntarily
administer antipsychotic medication to restore a defendant’s
competency in a criminal proceeding. See Sell, 539 U.S. at 180-81;
see also R.F., ¶ 21. The People bear the burden of proving each
part of the test by clear and convincing evidence. R.F., ¶ 16.
First, there must be important governmental interests at stake.
Sell, 539 U.S. at 180; R.F., ¶ 12. Bringing to trial a person accused
3 of a serious crime is an important governmental interest. Sell, 539
U.S. at 180; R.F., ¶ 12.
¶9 Second, administering involuntary medication must
significantly further those interests. Sell, 539 U.S. at 181; R.F.,
¶ 13. The state satisfies this element by showing that
(1) administering the medication is substantially likely to restore
the defendant’s competency and (2) the medication is substantially
unlikely to have side effects that will interfere with the defendant’s
ability to assist in her defense. Sell, 539 U.S. at 181; R.F., ¶ 13.
¶ 10 Third, the medication must be necessary to further the
government’s interests. Sell, 539 U.S. at 181; R.F., ¶ 14. The state
satisfies this element by showing that (1) any less intrusive
treatment alternatives are unlikely to achieve substantially the
same results and (2) less intrusive means for administering the
medication were considered. Sell, 539 U.S. at 181; R.F., ¶ 14.
¶ 11 Fourth, administering the medication must be medically
appropriate. Sell, 539 U.S. at 181; R.F., ¶ 15.
C. Analysis
¶ 12 Lockley asserts that there was insufficient evidence to
establish the second Sell element — that is, that the involuntary
4 administration of the requested medication would significantly
further the state’s interest in prosecuting her. In particular, she
contests the district court’s finding that the proposed treatment
plan is substantially unlikely to have side effects that would
interfere with her ability to assist in her defense.
¶ 13 First, Lockley alleges that the side effects she previously
experienced from Latuda — including “nausea, bodily tremors,
feelings of loss of control, difficulty remaining calm, discomfort
outside her normal mental state, and restlessness in her limbs” —
“risk impairing her ability to think clearly and communicate
effectively with counsel.” But the district court declined to order the
involuntary administration of Latuda based on Dr. Graham
Hoffman’s testimony that (1) Latuda would only be provided if
Lockley requested it and (2) there was “[n]ot a huge risk” in
returning to court to add another medication if it was needed. See
People in Interest of Ferguson, 2025 COA 82, ¶ 1 (a treating
physician’s demonstrated need for flexibility in treatment options is
a relevant consideration for the authorization of more than one
medication option). Accordingly, we do not address this contention.
5 ¶ 14 Next, Lockley alleges that the side effects she experienced
when she took Invega (seizures) and the possible side effects of
Zyprexa (sedation) risk impairing her ability to assist in her defense.
But Dr. Hoffman testified that the chance of Invega causing a
seizure was “extremely unlikely” — less than 0.001 percent. He
also explained that the sedation that sometimes occurs with
Zyprexa “seems to disappear” after “a few months.” Dr. Hoffman
assured the court that the hospital personnel would monitor
Lockley for side effects and that additional medications were
available to neutralize some of those side effects, should they occur.
He also testified that treatment with the requested medications
would not interfere with Lockley’s ability to understand and
participate in her criminal proceedings; rather, “she’ll be even more
ready to participate in her defense when she’s thinking more
clearly, and the meds are designed to do that.” Further, Dr.
Hoffman testified that the failure to medicate Lockley would be
more harmful than the risks posed from the requested medications
because, without treatment, Lockley’s condition could become
permanent such that she will never be restored to competency.
6 ¶ 15 Based on this testimony, the district court found that
administering Invega and Zyprexa would significantly further the
important governmental interests at stake. The court further found
that the administration of the requested medication was
substantially likely to render Lockley competent to stand trial and
was substantially unlikely to have side effects that would interfere
significantly with her ability to assist her counsel in conducting a
trial defense, thereby rendering the trial unfair. In so finding, the
court specifically found that Dr. Hoffman testified “credibly and
persuasively,” while Lockley’s testimony was generally not credible,
and specifically not credible regarding her report that Invega and
Zyprexa caused her side effects.
¶ 16 Because there is factual support for the district court’s
findings, they are not clearly erroneous. Accordingly, we must
uphold the court’s finding that the People met their burden to
establish the second Sell factor by clear and convincing evidence.
III. Disposition
¶ 17 The order is affirmed.
JUDGE TOW and JUDGE LIPINSKY concur.