Peo in Interest of Wolfe

• Court: Colorado Court of Appeals
• Decided: May 21, 2026
• Docket: 26CA0267
• Status: Unpublished

Opinion

26CA0267 Peo in Interest of Wolfe 05-21-2026

COLORADO COURT OF APPEALS

Court of Appeals No. 26CA0267 Pueblo County District Court No. 25MH30072 Honorable Amiel Markenson, Judge

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of Elliot Wolfe,

Respondent-Appellant.

ORDER AFFIRMED

Division A Opinion by JUDGE TAUBMAN* C.J. Román, and Martinez*, J., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e) Announced May 21, 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 Elliot Wolfe appeals the district court’s order authorizing staff

at the Colorado Mental Health Hospital in Pueblo (the hospital) to

medicate him without his consent. We affirm.

I. Background

¶2 Wolfe was admitted to the hospital in July 2025 after being

found incompetent to proceed in two criminal cases. His symptoms

included pressured speech, agitation, moodiness, disorganized

thinking, and making delusional statements. Wolfe was started on

emergency medications after he began screaming and making

threatening statements to, and physically posturing at, staff

members. He was diagnosed with an unspecified mood disorder.

¶3 In August 2025, the district court granted the People’s petition

for authorization to involuntarily medicate Wolfe with Zyprexa

(olanzapine) and Thorazine (chlorpromazine), both antipsychotic

medications; as well as Depakote (valproic acid), a mood-stabilizing

medication. On appeal, a division of this court affirmed. See People

v. Wolfe, (Colo. App. No. 25CA1501, Nov. 13, 2025) (not published

pursuant to C.A.R. 35(e)).

1 ¶4 In January 2026, the People again petitioned the district court

for authorization to involuntarily medicate Wolfe, this time

requesting only Zyprexa and Depakote.

¶5 At the hearing on the petition, Wolfe’s psychiatrist at the

hospital, Dr. Paul Mattox, and Wolfe both testified. Dr. Mattox

testified that Wolfe’s unspecified mood disorder, which Dr. Mattox

described as “severe,” constituted a substantial disorder that

impaired Wolfe’s judgment or capacity to recognize reality or control

his behavior. While discussing Wolfe’s symptoms, Dr. Mattox

described two of Wolfe’s delusional beliefs: that his national birth

certificate was being destroyed and that his public defender was a

Jehovah’s Witness. Dr. Mattox described that Wolfe’s condition had

improved on the medications, and opined that, without the

medications, Wolfe would experience a significant, likely long-term

deterioration of his mental condition. He also testified that Wolfe

had been experiencing hand tremors, which could be caused by

Depakote, but that he could take propranolol to decrease the

tremors.

¶6 Wolfe testified that he did not believe that he had a mental

illness and did not need medication, explaining that “[t]heir

2 medications only screw things up.” But he also testified that he

was willing to take Zyprexa and Depakote voluntarily “if [he] feel[s]

it’s necessary,” explaining that he is “old enough and know[s]

enough to know when [he] need[s] to take medication and when [he

doesn’t].” He clarified that Zyprexa was not causing him any side

effects, but that he preferred a different medication than Depakote

because of his hand tremors.

¶7 Following the testimony, the district court found that Dr.

Mattox had testified credibly and persuasively, and it adopted Dr.

Mattox’s opinions. The court also specifically found that Wolfe’s

testimony that he would take the medications voluntarily if they

weren’t court-ordered was not credible. The court then examined

each of the four elements of the test from People v. Medina, 705

P.2d 961, 973 (Colo. 1985), concluded that the People had met their

burden of proving all four elements, and granted the petition.

II. Applicable Law and Standard of Review

¶8 The parties agree that the Medina test applies here. Under

that test, a district court may authorize the involuntary

administration of antipsychotic medication if the People

demonstrate by clear and convincing evidence that

3 (1) the patient is incompetent to effectively participate in the

treatment decision;

(2) the treatment with antipsychotic medication is necessary to

prevent a significant and likely long-term deterioration in the

patient’s mental health condition or to prevent the likelihood

of the patient causing serious harm to himself, herself, or

others in the institution;

(3) a less intrusive treatment alternative is not available; and

(4) the patient’s need for treatment with antipsychotic

medication is sufficiently compelling to override any bona fide

and legitimate interest the patient has in refusing treatment.1

¶9 Application of the Medina test involves mixed questions of fact

and law. People v. Marquardt, 2016 CO 4, ¶ 8, 364 P.3d 499, 502.

We defer to the district court’s factual findings if they have record

1 A different test applies to petitions to administer medication

involuntarily for the purpose of restoring a defendant’s competency in a criminal case. See People in Interest of R.F., 2019 COA 110, ¶¶ 10-15 & n.1 (discussing the test from Sell v. United States, 539 U.S. 166, 180 (2003)). Although Wolfe was initially admitted to the hospital for that purpose, the petition’s stated purpose, and the district court’s basis for granting the petition, was to prevent a significant and long-term deterioration in his mental condition. This consideration is relevant to the second Medina element. See id. at ¶ 11 n.1.

4 support, while we review the court’s legal conclusions de novo. Id.

Resolving conflicts in testimony and determining the credibility of

the witnesses are matters solely within the province of the district

court. People in Interest of Ramsey, 2023 COA 95, ¶ 23, 541 P.3d

1198, 1204.

III. Analysis

¶ 10 Wolfe does not contest the district court’s ruling that the

People met their burden of proving the first and third Medina

elements. However, he challenges the sufficiency of the evidence

supporting the court’s rulings that the People met their burden of

proving the second and fourth Medina elements.

¶ 11 On a sufficiency challenge, we must determine whether the

evidence, viewed as a whole and in the light most favorable to the

People, is sufficient to support the district court’s order. People in

Interest of R.K.L., 2016 COA 84, ¶ 13, 412 P.3d 827, 832. The

testimony of the physician seeking to administer treatment may be

sufficient, without more, to satisfy the Medina test. Id. at ¶ 30, 412

P.3d at 834.

5 A. The Second Medina Element

¶ 12 The district court found that the medications were necessary

to prevent a significant and likely long-term deterioration in Wolfe’s

mental condition (it did not find that they were necessary to protect

the safety of anyone at the hospital).

¶ 13 In determining whether medication is necessary to prevent a

significant and likely long-term deterioration in a patient’s mental

condition, a court “should focus on the nature and gravity of the

patient’s illness, the extent to which the medication is essential to

effective treatment, the prognosis without the medication, and

whether the failure to medicate will be more harmful to the patient

than any risks posed by the medication.” Medina, 705 P.2d at 973.

¶ 14 During its oral ruling, the district court specifically discussed

each of those factors. In terms of the nature and gravity of Wolfe’s

illness, the court credited Dr. Mattox’s testimony that Wolfe’s illness

was severe, and it specifically discussed the evidence that (1) in jail,

before being admitted to the hospital, Wolfe spat and cursed at

officers, threatened staff, and smeared feces in his cell; and

(2) upon Wolfe’s admission to the hospital, he spoke nonsensically

and made delusional statements. Regarding the extent to which the

6 medications were essential to effective treatment, the court focused

on the evidence of Wolfe’s improvement in no longer smearing feces

and being less intrusive toward others. In terms of Wolfe’s

prognosis without the medication, the court highlighted Dr.

Mattox’s testimony that if Wolfe were to stop taking the

medications, his condition would deteriorate back to his condition

in the jail and on his admission to the hospital. And finally, on the

issue of whether the failure to medicate would be more harmful to

the patient than any risks posed by the medication, the court

acknowledged that Wolfe was experiencing the side effect of hand

tremors and that Depakote could cause that, but emphasized that

Wolfe could take propranolol to help remedy that and the hospital

could continue to monitor that side effect. Dr. Mattox’s testimony,

which the district court credited, supports the court’s finding that

the medications were necessary to prevent a significant and likely

long-term deterioration in Wolfe’s mental condition. See Marquardt,

¶ 8; Ramsey, ¶ 23; R.K.L., ¶¶ 13, 30.

¶ 15 Wolfe argues that the district court erred regarding this

Medina element because the evidence showed two ways in which he

had not improved on the medications, and, thus, the medications

7 were not necessary. First, he emphasizes that he continued to

express delusional beliefs that his birth certificate had been

destroyed and that his public defender was a Jehovah’s Witness;

and second, he emphasizes that he continued to experience

agitation. However, the district court recognized that Wolfe had not

improved in terms of expressing those delusional beliefs. Instead,

the court based its finding that the medications were necessary on

Wolfe’s demonstrated improvement in not smearing feces and in not

behaving intrusively with others. Regarding agitation, Dr. Mattox

specifically testified, “[H]e remains agitated, but he has not been

making any threats or physically posturing” toward people at the

hospital. Here, too, the court relied not on Wolfe’s continued

agitation but on his improvement in not behaving intrusively toward

others.

B. The Fourth Medina Element

¶ 16 In analyzing the fourth Medina element, a court first

determines “whether the patient’s refusal [of treatment] is bona fide

and legitimate.” Medina, 705 P.2d at 974. If it is, the court then

determines “whether the prognosis without treatment is so

unfavorable that the patient’s personal preference must yield to the

8 legitimate interests of the state in preserving the life and health of

the patient placed in its charge and in protecting the safety of those

in the institution.” Id.

¶ 17 The district court found that Wolfe had two bona fide and

legitimate reasons for not taking the medications: avoiding hand

tremors, which can be caused by Depakote; and avoiding

hyponatremia, which was briefly mentioned in Dr. Mattox’s affidavit

as the reason Wolfe was on a fluid restriction. However, the court

reincorporated its findings on the second Medina element and

concluded that Wolfe’s prognosis without the medications was so

unfavorable that Wolfe’s aforementioned interests must yield to the

hospital’s interest in protecting his life and health by treating him

with the medications.

¶ 18 On appeal, Wolfe challenges the district court’s ruling on the

fourth Medina element by again emphasizing his hand tremors, as

well as one other interest — his prior hernia surgery — that he

suggests was a bona fide and legitimate reason to refuse the

medications. However, Dr. Mattox testified that Wolfe previously

had hernia surgery, but when Dr. Mattox was asked whether

Depakote could affect Wolfe’s stomach or his prior hernia, he

9 responded that “stomach irritation, upset, diarrhea, are certain

potential side effects” of the Depakote, but that he was “not aware

of any literature, reports or evidence that due to a prior hernia

repair that those side effect risks are increased.” The district court

did not make any clear finding whether Wolfe had a legitimate and

bona fide interest in not taking the medications because of his prior

hernia surgery.

¶ 19 Without any finding by the district court regarding the hernia

surgery, we simply note that Wolfe’s argument on appeal regarding

having a bona fide and legitimate interest related to his hernia

surgery is not persuasive and is not supported by the evidence.

Leaving then only the hand tremors that he advances on appeal as

to the fourth Medina element, we conclude that the district court’s

findings, and the evidence supporting them, on the second Medina

element, as discussed in Part III.A above, also lead us to conclude

that the court did not err in finding that the People had sufficiently

proven the fourth Medina element.

IV. Disposition

¶ 20 The order is affirmed.

CHIEF JUDGE ROMÁN and JUSTICE MARTINEZ concur.