People v. Val Q.

919 N.E.2d 976, 396 Ill. App. 3d 155, 336 Ill. Dec. 51, 2009 Ill. App. LEXIS 1163
CourtAppellate Court of Illinois
DecidedNovember 20, 2009
Docket2-08-0132
StatusPublished
Cited by29 cases

This text of 919 N.E.2d 976 (People v. Val Q.) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
People v. Val Q., 919 N.E.2d 976, 396 Ill. App. 3d 155, 336 Ill. Dec. 51, 2009 Ill. App. LEXIS 1163 (Ill. Ct. App. 2009).

Opinion

JUSTICE BOWMAN

delivered the opinion of the court:

Respondent, Val Q., appeals from the trial court’s order authorizing the involuntary administration of psychotropic medication to respondent for up to 90 days pursuant to section 2 — 107.1 of the Mental Health and Developmental Disabilities Code (Code) (405 ILCS 5/2 — 107.1 (West 2006)). Respondent contends that the trial court erred in granting the petition where the State failed to prove by clear and convincing evidence that (1) she lacked the capacity to make a reasoned decision concerning her own treatment, (2) the benefits of treatment outweighed the harm, and (3) she was suffering because of her mental illness or exhibited a deterioration in her ability to function. We agree with her second contention and reverse accordingly.

On December 10, 2007, respondent was brought into the emergency room of Good Samaritan Hospital for bleeding from rectal cancer. Respondent was also diagnosed with hypertension. Respondent was refusing medical treatment for both her cancer and her hypertension because she did not believe the doctors’ diagnoses or their prognosis for respondent if the medical conditions were left untreated. It was also reported to hospital staff that respondent was sleeping in the hallways of her apartment building because she believed her apartment was being gassed. Because respondent was exhibiting disorganized thinking and behavior, she was assessed by psychiatrist Dr. Bhatt.

After observing respondent and administering neuropsychological testing, Bhatt diagnosed respondent as suffering from a mental illness, namely, a delusional disorder. Bhatt opined that respondent’s symptoms had been long standing. Bhatt recommended psychotropic medication for respondent but respondent simply refused. Respondent did not explain why she was refusing psychotropic medication and Bhatt opined that respondent’s refusal was a direct result of her delusional thinking.

Bhatt petitioned for authorization to administer Invega as the primary medication. As alternatives, Bhatt was seeking to administer Haldol Decanoate and Risperdal. According to Bhatt, these medications are antipsychotics that would improve respondent’s thinking. With improved and more organized thinking, respondent would be more compliant with receiving treatment for her cancer and hypertension. The most common side effect of all three medications was sedation. Haldol Decanoate also had a possible side effect of involuntary shaking of the hands. Bhatt testified to the specific dosages he was seeking to administer for each medication. He further testified that there was no contraindication between the medications he was recommending and respondent’s cancer or hypertension.

Bhatt opined that, based on respondent’s mental illness, she would need psychotropic medication long term. Without psychotropic medication, respondent would remain guarded and suspicious and would continue living in an unsafe environment, namely, sleeping in public hallways because of her delusions that her apartment was being gassed. Furthermore, without psychotropic treatment, respondent’s recovery from cancer was in question.

On cross-examination, Bhatt testified that, upon respondent’s admission to the hospital, an EKG showed an abnormal QT interval. Apparently, the QT interval measures the time it takes the heart to reset itself between beats. See Janssen Pharmaceutica, Inc. v. Bailey, 2002 — CA—00736—SCT (119) (Miss. 2004). According to Bhatt, an abnormal QT interval is “not that significant.” However, Bhatt also acknowledged that the medication he was seeking to administer had the potential to increase an already-irregular QT interval, which in turn could increase the risk of arrhythmia and heart attack. Bhatt testified that, if respondent had agreed to take psychotropic medication, Bhatt would have first consulted with respondent’s primary care physician before administering the medication. If the primary care physician expressed any concern with administering the medication, Bhatt would have followed the doctor’s recommendations, including a recommendation to consult a cardiologist. Bhatt had not consulted with respondent’s primary care physician, because respondent was not receiving any medication. Bhatt would begin involuntary treatment only after consulting with respondent’s primary care physician.

Bhatt testified that there was no increased risk in administering the petitioned-for psychotropic medications to elderly patients. These medications carried a “black-box warning” for patients at risk of stroke or heart attack, if the patients also had dementia. Bhatt performed tests that showed that respondent did not suffer from dementia. Thus, apparently, the “black-box warning” did not apply to respondent.

Next, respondent’s sister, Mildred Blacke, testified that she had been appointed respondent’s temporary guardian. According to Blacke, respondent had suffered from mental illness “for awhile” and was psychiatrically hospitalized several times in the past few years. Doctors had recommended psychotropic medication for respondent in the past, but respondent had always refused. Blacke opined that respondent was unable to make decisions concerning her health and safety because respondent would sometimes go “missing” for days.

Respondent testified that she was 78 years old. She acknowledged that she was not sleeping in her apartment because she felt that it was unsafe. Respondent testified to two prior “gas incidents” where gas vapors permeated her apartment building. According to respondent, the existence of the gas vapors was verified by her neighbors and the vapors were found to be coming from the boiler room of the apartment building.

Respondent did not want to take psychotropic medications, because of potential side effects. Respondent was first diagnosed with cancer at Loyola Medical Center but she refused treatment at Loyola because she was asked to sign forms without being allowed to read them. Respondent understood that cancer treatment was necessary. She agreed to receive the treatment, but not at Good Samaritan Hospital.

The trial court found that the State had sustained its burden of proof by clear and convincing evidence, and the court authorized the petitioned-for treatment in the dosages testified to by Bhatt. The court found that the evidence showed that the benefits of treatment outweighed the harm. The court, however, noted the possible risk of heart attack associated with the medications and found that this risk “will be considered by Dr. Bhatt” in consultation with a cardiologist, if necessary. Thus, the court authorized involuntary treatment with the “initial caveat,” “as has been recommended by Dr. Bhatt, that there be a consultation, if necessary, to determine the risk to [respondent’s] heart of taking these medications.” Lastly, the court commented: “I do not intend to substitute my judgment for that of the physician’s [sic], but only to recognize that that is one of the caveats that they have and would clear before giving these medications, in keeping with good and standard medical practice.” Respondent timely appeals, challenging the trial court’s order authorizing involuntary treatment.

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Cite This Page — Counsel Stack

Bluebook (online)
919 N.E.2d 976, 396 Ill. App. 3d 155, 336 Ill. Dec. 51, 2009 Ill. App. LEXIS 1163, Counsel Stack Legal Research, https://law.counselstack.com/opinion/people-v-val-q-illappct-2009.