Peo in Interest of Wolfe
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Opinion
25CA1501 Peo in Interest of Wolfe 11-13-2025
COLORADO COURT OF APPEALS
Court of Appeals No. 25CA1501 Pueblo County District Court No. 25MH30072 Honorable Amiel Markenson, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Elliot Robert Wolfe,
Respondent-Appellant.
ORDER AFFIRMED
Division II Opinion by JUDGE MEIRINK Fox and Brown, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced November 13, 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, Elliot Robert Wolfe, appeals the district court
order authorizing staff at the Colorado Mental Health Hospital in
Pueblo (CMHHIP) to medicate him involuntarily. We affirm.
I. Background
¶2 Wolfe was admitted to CMHHIP after being found incompetent
to proceed to trial on criminal charges. According to the affidavit of
Dr. Hareesh Pillai, Wolfe’s treating physician, Wolfe has a history of
mental illness and prior psychiatric hospitalizations. He is
diagnosed with unspecified mood disorder.
¶3 CMHHIP began administering psychiatric medications to Wolfe
on an emergency basis after his screaming, threats, and posturing
required intervention from security staff. The People then
petitioned for a six-month order authorizing the continued
involuntary administration of three medications: Zyprexa,
Depakote, and Thorazine.
¶4 At the evidentiary hearing, Dr. Pillai testified that an
involuntary medication order was warranted under Medina because
(1) Wolfe is incompetent to effectively participate in his treatment
decisions; (2) the requested medications are necessary to prevent a
significant and likely long-term deterioration in his mental health
1 condition and to prevent the likelihood that he would pose a serious
risk of harm to others; (3) a less intrusive treatment alternative is
not available; and (4) Wolfe’s need for treatment with psychiatric
medications outweighs any bona fide interest in refusing
treatment.1 See People v. Medina, 705 P.2d 961, 973 (Colo. 1985).
The district court found that Dr. Pillai’s testimony was credible and
persuasive and adopted his opinions.
¶5 Wolfe testified that he objected to taking psychiatric
medication and to the corresponding blood draws because he
suffers from various side effects and is a Jehovah’s Witness. The
district court found Wolfe’s testimony to be credible as to a few of
his alleged side effects — specifically, jitteriness, tremors, and
blurry vision — and as to his religious beliefs. Though the court
found that Wolfe had expressed bona fide and legitimate reasons to
1 When the state seeks to administer antipsychotic drugs to a
mentally ill criminal defendant involuntarily so that she can stand trial, a reviewing court applies the Supreme Court’s test in Sell v. United States, 539 U.S. 166, 178 (2003). However, reviewing courts apply state law tests if the state, as here, seeks to administer antipsychotics involuntarily for “a different purpose,” including a purpose “related to the individual’s dangerousness, or . . . the individual’s own interests where refusal to take drugs puts his health gravely at risk.” Id. at 181-82.
2 refuse medication, it also found that his prognosis without
treatment was so unfavorable that his personal preference must
yield to the interests of the State.
¶6 The court ultimately concluded that the People provided clear
and convincing evidence for each Medina element. It issued an
order authorizing CMHHIP staff to administer all of the requested
medications.
II. Discussion
¶7 On appeal, Wolfe challenges the sufficiency of the evidence for
only the fourth Medina element — whether his need for treatment is
sufficiently compelling to override his bona fide and legitimate
interest in refusing treatment. See id. He argues that because the
district court found that the People had not presented clear and
convincing evidence that treatment was necessary to prevent harm
to others (under the second Medina element), it afforded too much
weight to the State’s interests versus his interests in refusing
medication. We conclude that the record provides ample support
for the district court’s findings and legal conclusion on this element.
3 A. Standard of Review and Legal Authority
¶8 When a patient challenges the sufficiency of the evidence
supporting the district court’s findings on any of the Medina
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 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. A physician’s testimony alone may
constitute clear and convincing evidence. See People v. Pflugbeil,
834 P.2d 843, 846-47 (Colo. App. 1992).
¶9 In assessing the sufficiency of evidence for the fourth Medina
element, a court must determine (1) “whether the patient’s refusal
is bona fide and legitimate” and, if so, (2) “whether the prognosis
without treatment is so unfavorable that the patient’s personal
preference must yield to the legitimate interests of the state in
4 preserving the life and health of the patient placed in its charge and
in protecting the safety of those in the institution.” Medina, 705
P.2d at 974.
B. Sufficient Evidence of Fourth Medina Element
¶ 10 Wolfe challenges the district court’s finding that his prognosis
without treatment is so unfavorable that his interest in refusing
medication must yield to the State’s interests in preserving his
health and in protecting the safety of those in CMHHIP. Dr. Pillai’s
testimony supports this finding.
¶ 11 Dr. Pillai testified that without treatment, Wolfe was likely to
suffer a significant and long-term deterioration of his mental
condition, exhibiting symptoms including disorganized thinking,
mania, irritability, impulsivity, aggression, pressured speech, and
poor sleep. Specifically, without the requested medications, “Wolfe
is unable to safely control his behaviors, and becomes extremely
agitated.” Despite two weeks on emergency medications, Wolfe
showed several of the symptoms listed by Dr. Pillai and
demonstrated his lack of self-control when he interrupted the
evidentiary hearing multiple times.
5 ¶ 12 Dr. Pillai also opined that Wolfe posed a risk of harm to others
at CMHHIP, based on his screaming, posturing, and threats
(although he had not actually struck anyone at CMHHIP). He
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