UNPUBLISHED
UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT
No. 19-4805
UNITED STATES OF AMERICA,
Plaintiff - Appellee,
v.
CHRISTOPHER LEWIS TUCKER,
Defendant - Appellant.
Appeal from the United States District Court for the Middle District of North Carolina, at Greensboro. Thomas D. Schroeder, Chief District Judge. (1:17-cr-00221-TDS-1)
Submitted: September 13, 2021 Decided: September 24, 2021
Before KING, DIAZ, and FLOYD, Circuit Judges.
Remanded with instructions by unpublished per curiam opinion.
Christopher R. Clifton, Michael A. Grace, Greer B. Taylor, GRACE, TISDALE & CLIFTON, P.A., Winston-Salem, North Carolina, for Appellant. Matthew G.T. Martin, United States Attorney, Eric L. Iverson, Assistant United States Attorney, OFFICE OF THE UNITED STATES ATTORNEY, Greensboro, North Carolina, for Appellee.
Unpublished opinions are not binding precedent in this circuit. PER CURIAM:
A federal grand jury indicted Christopher Lewis Tucker for two counts of attempted
production of child pornography, in violation of 18 U.S.C. § 2251(a); transportation of
child pornography, in violation of 18 U.S.C. § 2252A(a)(1); receipt of child pornography,
in violation of 18 U.S.C. § 2252A(a)(2)(A); and possession of firearms and ammunition by
an unlawful user of—and a person addicted to—a controlled substance, in violation of
18 U.S.C. § 922(g)(3). After Tucker underwent extensive psychological examinations, the
district court concluded that he was incompetent to stand trial and ordered an additional
evaluation to determine whether there was a substantial probability that he could be
restored to competency in the foreseeable future. During this first restoration period and
the second, Tucker was intermittently compliant with his medication regimen. Tucker’s
failure to voluntarily take his medications on a consistent basis led the Government to move
for an order authorizing the involuntary administration of antipsychotic medication,
pursuant to Sell v. United States, 539 U.S. 166 (2003). The district court concluded that
the Government established each of the four Sell factors by clear and convincing evidence
and ordered the involuntary administration of antipsychotic medication to restore Tucker’s
competency. This Sell order included the specific dosages prescribed by Dr. Logan
Graddy, the Chief Psychiatrist at the Federal Medical Center in Butner, North Carolina
(“FMC-Butner”). The district court stayed the order pending this interlocutory appeal. 1
1 Tucker argues that we should first consider his pro se appeal of the district court’s order finding him incompetent to stand trial and ordering the first period of competency restoration. But the district court never docketed an appeal of that order. Indeed, Tucker’s
2 Proceedings continued in the district court during the pendency of this appeal. The
court committed Tucker for a third restoration period, during which he was compliant
with—and responded well to—his medications. Thereafter, the COVID-19 pandemic
broke out, and Tucker was transferred to a local jail. The medical records from the jail
indicated that Tucker had been compliant with his medications, though his compliance
could not be confirmed. Unfortunately, Tucker’s condition regressed during his stay in the
local jail. Dr. Tanya Cunic, FMC-Butner’s Chief of Psychology, surmised that Tucker’s
regression may have been precipitated by stress caused by the legal proceedings, a recent
altercation, or forced isolation due to the COVID-19 pandemic. Dr. Cunic recommended
an additional restoration period, explaining that defendants who are restored to competency
once are likely to be restored again. Dr. Cunic further suggested that Tucker’s medications
may need to be adjusted, considering that he regressed during a period in which he was
purportedly compliant with his medication regimen. Upon the Government’s motion, the
court ordered a fourth restoration period, but Tucker’s transfer from the local jail to FMC-
Butner was delayed. Tucker consistently refused to take his medications during this fourth
restoration period.
At this point, we asked the parties to submit supplemental briefs addressing whether
recent developments in Tucker’s case require a remand to the district court for
reconsideration of its Sell order. The Government has moved to remand the case so that
motion for an extension of time in which to appeal the order is still pending in the district court.
3 the district court may reconsider its Sell order based on the events that have occurred during
the pendency of this appeal. Tucker opposes the motion.
In Sell, the Supreme Court held that involuntary administration of antipsychotic
medication for the sole purpose of restoring a mentally ill defendant to competency is
appropriate only if the court finds that (1) “important governmental interests are at stake”;
(2) “involuntary medication will significantly further those concomitant state interests”;
(3) “involuntary medication is necessary to further those interests”; and (4) “administration
of the drugs is medically appropriate.” Sell, 539 U.S. at 180-81.
We have emphasized that “the forcible administration of antipsychotic medication
constitutes a deprivation of liberty in the most literal and fundamental sense.” United
States v. Watson, 793 F.3d 416, 419 (4th Cir. 2015) (internal quotation marks omitted).
Accordingly, we have cautioned that the forcible administration of antipsychotic
medication “for the sole purpose of rendering [a defendant] competent to stand trial . . . is
the exception, not the rule,” and that “courts must be vigilant to ensure that such orders,
which carry an unsavory pedigree, do not become routine.” Id. (internal quotation marks
omitted). To that end, “we have set a deliberately high standard for the government to
satisfy before it may forcibly medicate solely to render an inmate competent to stand trial”:
the government must establish each of the Sell factors by clear and convincing evidence.
Id. at 420. Under this standard, the government must put forth “evidence of such weight
that it produces in the mind of the trier of fact a firm belief or conviction, without hesitancy,
as to the truth of the allegations sought to be established, or evidence that proves the facts
at issue to be highly probable.” Id. (internal quotation marks omitted).
4 The issue here is whether we should consider the merits of Tucker’s arguments
challenging the Sell order or remand the case to the district court so that it may reconsider
the Sell order based on the events that have occurred during the pendency of this appeal.
Recognizing the factfinding responsibility of the district court and the caution that must be
exercised before ordering forcible administration of antipsychotic medication, we conclude
that remand is appropriate in this case and grant the Government’s motion.
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UNPUBLISHED
UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT
No. 19-4805
UNITED STATES OF AMERICA,
Plaintiff - Appellee,
v.
CHRISTOPHER LEWIS TUCKER,
Defendant - Appellant.
Appeal from the United States District Court for the Middle District of North Carolina, at Greensboro. Thomas D. Schroeder, Chief District Judge. (1:17-cr-00221-TDS-1)
Submitted: September 13, 2021 Decided: September 24, 2021
Before KING, DIAZ, and FLOYD, Circuit Judges.
Remanded with instructions by unpublished per curiam opinion.
Christopher R. Clifton, Michael A. Grace, Greer B. Taylor, GRACE, TISDALE & CLIFTON, P.A., Winston-Salem, North Carolina, for Appellant. Matthew G.T. Martin, United States Attorney, Eric L. Iverson, Assistant United States Attorney, OFFICE OF THE UNITED STATES ATTORNEY, Greensboro, North Carolina, for Appellee.
Unpublished opinions are not binding precedent in this circuit. PER CURIAM:
A federal grand jury indicted Christopher Lewis Tucker for two counts of attempted
production of child pornography, in violation of 18 U.S.C. § 2251(a); transportation of
child pornography, in violation of 18 U.S.C. § 2252A(a)(1); receipt of child pornography,
in violation of 18 U.S.C. § 2252A(a)(2)(A); and possession of firearms and ammunition by
an unlawful user of—and a person addicted to—a controlled substance, in violation of
18 U.S.C. § 922(g)(3). After Tucker underwent extensive psychological examinations, the
district court concluded that he was incompetent to stand trial and ordered an additional
evaluation to determine whether there was a substantial probability that he could be
restored to competency in the foreseeable future. During this first restoration period and
the second, Tucker was intermittently compliant with his medication regimen. Tucker’s
failure to voluntarily take his medications on a consistent basis led the Government to move
for an order authorizing the involuntary administration of antipsychotic medication,
pursuant to Sell v. United States, 539 U.S. 166 (2003). The district court concluded that
the Government established each of the four Sell factors by clear and convincing evidence
and ordered the involuntary administration of antipsychotic medication to restore Tucker’s
competency. This Sell order included the specific dosages prescribed by Dr. Logan
Graddy, the Chief Psychiatrist at the Federal Medical Center in Butner, North Carolina
(“FMC-Butner”). The district court stayed the order pending this interlocutory appeal. 1
1 Tucker argues that we should first consider his pro se appeal of the district court’s order finding him incompetent to stand trial and ordering the first period of competency restoration. But the district court never docketed an appeal of that order. Indeed, Tucker’s
2 Proceedings continued in the district court during the pendency of this appeal. The
court committed Tucker for a third restoration period, during which he was compliant
with—and responded well to—his medications. Thereafter, the COVID-19 pandemic
broke out, and Tucker was transferred to a local jail. The medical records from the jail
indicated that Tucker had been compliant with his medications, though his compliance
could not be confirmed. Unfortunately, Tucker’s condition regressed during his stay in the
local jail. Dr. Tanya Cunic, FMC-Butner’s Chief of Psychology, surmised that Tucker’s
regression may have been precipitated by stress caused by the legal proceedings, a recent
altercation, or forced isolation due to the COVID-19 pandemic. Dr. Cunic recommended
an additional restoration period, explaining that defendants who are restored to competency
once are likely to be restored again. Dr. Cunic further suggested that Tucker’s medications
may need to be adjusted, considering that he regressed during a period in which he was
purportedly compliant with his medication regimen. Upon the Government’s motion, the
court ordered a fourth restoration period, but Tucker’s transfer from the local jail to FMC-
Butner was delayed. Tucker consistently refused to take his medications during this fourth
restoration period.
At this point, we asked the parties to submit supplemental briefs addressing whether
recent developments in Tucker’s case require a remand to the district court for
reconsideration of its Sell order. The Government has moved to remand the case so that
motion for an extension of time in which to appeal the order is still pending in the district court.
3 the district court may reconsider its Sell order based on the events that have occurred during
the pendency of this appeal. Tucker opposes the motion.
In Sell, the Supreme Court held that involuntary administration of antipsychotic
medication for the sole purpose of restoring a mentally ill defendant to competency is
appropriate only if the court finds that (1) “important governmental interests are at stake”;
(2) “involuntary medication will significantly further those concomitant state interests”;
(3) “involuntary medication is necessary to further those interests”; and (4) “administration
of the drugs is medically appropriate.” Sell, 539 U.S. at 180-81.
We have emphasized that “the forcible administration of antipsychotic medication
constitutes a deprivation of liberty in the most literal and fundamental sense.” United
States v. Watson, 793 F.3d 416, 419 (4th Cir. 2015) (internal quotation marks omitted).
Accordingly, we have cautioned that the forcible administration of antipsychotic
medication “for the sole purpose of rendering [a defendant] competent to stand trial . . . is
the exception, not the rule,” and that “courts must be vigilant to ensure that such orders,
which carry an unsavory pedigree, do not become routine.” Id. (internal quotation marks
omitted). To that end, “we have set a deliberately high standard for the government to
satisfy before it may forcibly medicate solely to render an inmate competent to stand trial”:
the government must establish each of the Sell factors by clear and convincing evidence.
Id. at 420. Under this standard, the government must put forth “evidence of such weight
that it produces in the mind of the trier of fact a firm belief or conviction, without hesitancy,
as to the truth of the allegations sought to be established, or evidence that proves the facts
at issue to be highly probable.” Id. (internal quotation marks omitted).
4 The issue here is whether we should consider the merits of Tucker’s arguments
challenging the Sell order or remand the case to the district court so that it may reconsider
the Sell order based on the events that have occurred during the pendency of this appeal.
Recognizing the factfinding responsibility of the district court and the caution that must be
exercised before ordering forcible administration of antipsychotic medication, we conclude
that remand is appropriate in this case and grant the Government’s motion. While it is
clear after the fourth restoration period that Tucker has ceased voluntarily taking his
antipsychotic medication, there is some evidence from Dr. Cunic’s testimony that the
dosage or type of antipsychotic originally prescribed by Dr. Graddy is not sufficient to
restore Tucker to competency. Thus, it is unclear at this juncture whether the second Sell
factor still weighs in favor of forcible medication—that is, whether the administration of
drugs, as currently prescribed, “is substantially likely to render [Tucker] competent to stand
trial.” 2 Sell, 539 U.S. at 181; see Watson, 793 F.3d at 420 (stating clear and convincing
standard).
While we remand for further consideration, we do not vacate the district court’s Sell
order or express any view of the merits of the order. Allowing the order to stand will permit
the district court to reopen the Sell process to the extent necessary to consider the
developing evidence in Tucker’s case. We instruct the court to maintain the stay of the
Sell order during its consideration of the developing evidence and during the pendency of
2 Of course, the district court is free to reconsider whether the remaining Sell factors still weigh in favor of forcible medication.
5 any future appeal of the order, in the event the court maintains or revises the order upon
remand.
We dispense with oral argument because the facts and legal contentions are
adequately presented in the materials before this court and argument would not aid the
decisional process.
REMANDED WITH INSTRUCTIONS