EBEL, Circuit Judge.
Defendant-Appellant Rigoberto Martinez-Haro was indicted with two counts of possession with intent to distribute methamphetamine. Before trial, MartinezHaro’s counsel requested that a psychiatric examination be performed on Martinez-Haro to determine his mental competency to stand trial, pursuant to 18 U.S.C. § 4241(b). Dr. O’Connor performed a psychiatric examination and concluded that Martinez-Haro was likely not competent to stand trial. But Dr. O’Con-nor also recommended more “psychological and neuropsychological testing in Spanish by a Spanish speaking neuropsychologist” to assist the court in making its competency determination and indicated a willingness to revise her conclusion of incompetency based on the outcome of that examination. Therefore, the Government moved for a second competency examination. Martinez-Haro objected, but the district court granted the Government’s motion. Martinez-Haro filed this interlocutory appeal challenging the district court’s order. For the following reasons, we affirm.
I. BACKGROUND
A grand jury indicted Martinez-Haro with two counts of possession with intent to distribute methamphetamine, in violation of 21 U.S.C. § 841(a) and (b). Before trial, the Government notified MartinezHaro that if convicted he would be subject to a mandatory minimum of twenty years’ imprisonment for the first count of the indictment and a mandatory minimum of ten years’ imprisonment for the second count. After that, Martinez-Haro’s counsel informed the district court that he had “some questions about whether [MartinezHaro] had a mental breakdown.” (Aplt.App., vol. II at 9.) So MartinezHaro’s counsel requested a competency examination under 18 U.S.C. § 4241.
Based
on this request, the district court ordered a psychological examination to be conducted by Dr. Beverly O’Connor, Ph.D.
Dr. O’Connor reviewed relevant records, applied several testing methods, and conducted a clinical interview with the assistance of an interpreter. In that interview, Martinez-Haro explained that he was forty-one years old but only had a fifth-grade education. He had a substantial history of drug abuse, a significant criminal history, and was physically abused by his father. Martinez-Haro was also diagnosed with diabetes in 2009 and feared that a twenty-year sentence would be a life sentence for him because the diabetes would prevent him from living that long.
Martinez-Haro also shared his thoughts on the pending criminal charges against him with Dr. O’Connor. Martinez-Haro wanted a plea agreement that would result in a ten-year sentence, and thus “he would • just ask for another [ajttorney” until he got that deal. (ApltApp., vol. Ill at 4.) Further, he indicated that the court “should just let him go back to Mexico and he would promise not to come back because he doesn’t want to hurt people.”
{Id.)
Based on this information, Dr. O’Connor concluded as follows (we quote Dr. O’Con-nor’s opinion at length because of its significance to the outcome of this case):
Does the Defendant presently suffer from a mental disease or defect that renders him mentally incompetent to the extent that he is unable to understand the nature and consequences of the proceedings against him?
Yes. Mr. Martinezr-Haro appears to be low functioning intellectually and appears to have difficulty with comprehension and abstract reasoning and judgment. Although it is difficult to get a totally accurate assessment of his intellectual functioning with him being tested in English through an interpreter, his IQ test results are in the mild mental retardation range. Given the problems of the language barrier I would judge that his overall IQ is likely in the Borderline Range. Mr. Martinez-Haro appears to have many risk factors for likely organic brain damage including the following: severe physical abuse as a child; long term inhalant use beginning as a child; long term use of methamphetamine and cocaine; multiple mild head injuries; and untreated diabetes. I cannot rule out the possibility that he may have some level o[f] dementia due to these factors, but a neuropsychological evaluation would have to be performed in
Spanish to determine this for sure. While the Defendant has a very basic factual understanding of his case, he appears to lack a rational understanding of his case and believes that because he sees himself as being in poor health he should deserve a very low Plea Agreement offer. He also believes that if he keeps requesting new attorneys that one of these attorneys will be able to get him what he is demanding. Alternatively, he also has an almost fantasy belief that the legal system should just let him go back to Mexico if he promises not to come back. While some of this may be due in part to personality or characterological factors, it appears that at this time his difficulty with comprehension, abstract reasoning, and judgment due to his low IQ may likely render him incompetent to the extent that he is unable to adequately understand the nature and consequences of the proceedings against him. His lack of formal education and his level of severe depression also likely interfere with his ability to rationally understand the proceedings against him.
This is a difficult case to make an absolute statement regarding Mr. Martinez-Haro’s competency due to the language barrier and his unwillingness to discuss certain parts of his history or elaborate on some of his stated psychiatric symptoms. However, given the review of the legal records, his clinical presentation, the neuropsychological screening, and the interview with his Attorney, it is my best opinion that Mr. Martinez-Haro currently is likely not competent to stand trial for the charges pending against him in the United States District Court.
If it were possible to have Mr. Martinez-Haro administered some psychological and neuropsychological testing in Spanish by a Spanish speaking neuropsychologist this may give the Court more complete information to base its opinion regarding competency on. If that more extensive testing were in contrast to my current opinion I would be ivilling to revieiv that material and possibly reconsider my opinion.
(Id.
at 6-7 (second emphasis added).)
Because of Dr. O’Connor’s equivocations in her conclusion about Martinez-Haro’s competency, the Government filed a motion seeking a second competency examination under § 4241. Martinezr-Haro objected to the request, but the district court granted it over his objection and ordered that Martinez-Haro be committed in a suitable Bureau of Prisons facility for the purposes of this examination. MartinezHaro now appeals to this Court.
II. DISCUSSION
A.
This Court generally has jurisdiction only over appeals from final decisions of the district courts. 28 U.S.C.
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EBEL, Circuit Judge.
Defendant-Appellant Rigoberto Martinez-Haro was indicted with two counts of possession with intent to distribute methamphetamine. Before trial, MartinezHaro’s counsel requested that a psychiatric examination be performed on Martinez-Haro to determine his mental competency to stand trial, pursuant to 18 U.S.C. § 4241(b). Dr. O’Connor performed a psychiatric examination and concluded that Martinez-Haro was likely not competent to stand trial. But Dr. O’Con-nor also recommended more “psychological and neuropsychological testing in Spanish by a Spanish speaking neuropsychologist” to assist the court in making its competency determination and indicated a willingness to revise her conclusion of incompetency based on the outcome of that examination. Therefore, the Government moved for a second competency examination. Martinez-Haro objected, but the district court granted the Government’s motion. Martinez-Haro filed this interlocutory appeal challenging the district court’s order. For the following reasons, we affirm.
I. BACKGROUND
A grand jury indicted Martinez-Haro with two counts of possession with intent to distribute methamphetamine, in violation of 21 U.S.C. § 841(a) and (b). Before trial, the Government notified MartinezHaro that if convicted he would be subject to a mandatory minimum of twenty years’ imprisonment for the first count of the indictment and a mandatory minimum of ten years’ imprisonment for the second count. After that, Martinez-Haro’s counsel informed the district court that he had “some questions about whether [MartinezHaro] had a mental breakdown.” (Aplt.App., vol. II at 9.) So MartinezHaro’s counsel requested a competency examination under 18 U.S.C. § 4241.
Based
on this request, the district court ordered a psychological examination to be conducted by Dr. Beverly O’Connor, Ph.D.
Dr. O’Connor reviewed relevant records, applied several testing methods, and conducted a clinical interview with the assistance of an interpreter. In that interview, Martinez-Haro explained that he was forty-one years old but only had a fifth-grade education. He had a substantial history of drug abuse, a significant criminal history, and was physically abused by his father. Martinez-Haro was also diagnosed with diabetes in 2009 and feared that a twenty-year sentence would be a life sentence for him because the diabetes would prevent him from living that long.
Martinez-Haro also shared his thoughts on the pending criminal charges against him with Dr. O’Connor. Martinez-Haro wanted a plea agreement that would result in a ten-year sentence, and thus “he would • just ask for another [ajttorney” until he got that deal. (ApltApp., vol. Ill at 4.) Further, he indicated that the court “should just let him go back to Mexico and he would promise not to come back because he doesn’t want to hurt people.”
{Id.)
Based on this information, Dr. O’Connor concluded as follows (we quote Dr. O’Con-nor’s opinion at length because of its significance to the outcome of this case):
Does the Defendant presently suffer from a mental disease or defect that renders him mentally incompetent to the extent that he is unable to understand the nature and consequences of the proceedings against him?
Yes. Mr. Martinezr-Haro appears to be low functioning intellectually and appears to have difficulty with comprehension and abstract reasoning and judgment. Although it is difficult to get a totally accurate assessment of his intellectual functioning with him being tested in English through an interpreter, his IQ test results are in the mild mental retardation range. Given the problems of the language barrier I would judge that his overall IQ is likely in the Borderline Range. Mr. Martinez-Haro appears to have many risk factors for likely organic brain damage including the following: severe physical abuse as a child; long term inhalant use beginning as a child; long term use of methamphetamine and cocaine; multiple mild head injuries; and untreated diabetes. I cannot rule out the possibility that he may have some level o[f] dementia due to these factors, but a neuropsychological evaluation would have to be performed in
Spanish to determine this for sure. While the Defendant has a very basic factual understanding of his case, he appears to lack a rational understanding of his case and believes that because he sees himself as being in poor health he should deserve a very low Plea Agreement offer. He also believes that if he keeps requesting new attorneys that one of these attorneys will be able to get him what he is demanding. Alternatively, he also has an almost fantasy belief that the legal system should just let him go back to Mexico if he promises not to come back. While some of this may be due in part to personality or characterological factors, it appears that at this time his difficulty with comprehension, abstract reasoning, and judgment due to his low IQ may likely render him incompetent to the extent that he is unable to adequately understand the nature and consequences of the proceedings against him. His lack of formal education and his level of severe depression also likely interfere with his ability to rationally understand the proceedings against him.
This is a difficult case to make an absolute statement regarding Mr. Martinez-Haro’s competency due to the language barrier and his unwillingness to discuss certain parts of his history or elaborate on some of his stated psychiatric symptoms. However, given the review of the legal records, his clinical presentation, the neuropsychological screening, and the interview with his Attorney, it is my best opinion that Mr. Martinez-Haro currently is likely not competent to stand trial for the charges pending against him in the United States District Court.
If it were possible to have Mr. Martinez-Haro administered some psychological and neuropsychological testing in Spanish by a Spanish speaking neuropsychologist this may give the Court more complete information to base its opinion regarding competency on. If that more extensive testing were in contrast to my current opinion I would be ivilling to revieiv that material and possibly reconsider my opinion.
(Id.
at 6-7 (second emphasis added).)
Because of Dr. O’Connor’s equivocations in her conclusion about Martinez-Haro’s competency, the Government filed a motion seeking a second competency examination under § 4241. Martinezr-Haro objected to the request, but the district court granted it over his objection and ordered that Martinez-Haro be committed in a suitable Bureau of Prisons facility for the purposes of this examination. MartinezHaro now appeals to this Court.
II. DISCUSSION
A.
This Court generally has jurisdiction only over appeals from final decisions of the district courts. 28 U.S.C. § 1291. Usually, in criminal cases this rule requires that a defendant await conviction and sentencing before raising an appeal.
See Flanagan v. United States, 465
U.S. 259, 263, 104 S.Ct. 1051, 79 L.Ed.2d 288 (1984). The rationale for the final judgment rule includes preserving respect for trial judges, reducing the ability of litigants to harass each other, and enhancing the efficient administration of justice.
Id.
at 263-64, 104 S.Ct. 1051. Based on these rationales, courts of appeals enforce the final judgment rule “with the utmost strictness in criminal cases.”
Id.
at 265, 104 S.Ct. 1051. So we depart from the final judgment rule only “when observance of it would practically defeat the right to any review at all.”
Cobbledick v. United
States,
309 U.S. 323, 324-25, 60 S.Ct. 540, 84 L.Ed. 783 (1940).
In
Cohen v. Beneficial Industrial Loan Corp.,
the Supreme Court set forth the criteria that an order must meet to be appealable prior to a final judgment. 337 U.S. 541, 69 S.Ct. 1221, 93 L.Ed. 1528 (1949). Under the “collateral order” doctrine, a litigant may only seek immediate review of orders that (1) “conclusively determine the disputed question,” (2) “resolve an important issue completely separate from the merits of the action,” and (3) are “effectively unreviewable on appeal from a final judgment.”
SEC v. Merrill Scott & Assocs., Ltd.,
600 F.3d 1262, 1270 (10th Cir.2010). This Court previously held that a district court order committing a defendant for the purpose of a competency examination meets the
Cohen
factors and is, therefore, immediately appealable.
See United States v. Deters,
143 F.3d 577, 581 (10th Cir.1998) (taking jurisdiction under the collateral order doctrine of an appeal of an order committing a defendant for the purpose of conducting a psychological examination to determine competency to stand trial, pursuant to 18 U.S.C. § 4241(b));
cf. United States v. Boigegrain,
122 F.3d 1345, 1349 (10th Cir.1997) (en banc) (per curiam) (taking jurisdiction under the collateral order doctrine of an appeal of an order committing a defendant for the purpose of determining whether competency to stand trial was likely to be attained, pursuant to 18 U.S.C. § 4241(d)). As this Court explained in
United States v.
Deshazer,
[TJhis court’s precedents indicate an interlocutory appeal in the context of pretrial commitment for competency proceedings is permitted because the “disputed question,” i.e., the defendant’s liberty interest in not being confined during an evaluation, is wholly separate from the merits of the criminal case. That interest cannot be fully vindicated in an appeal from a final judgment.
451 F.3d 1221, 1229 (10th Cir.2006) (internal citations omitted). Thus, we have jurisdiction over this appeal under the collateral order doctrine.
B.
This Court reviews a district court’s interpretation of a statute de novo.
United States v. Becker,
625 F.3d 1309, 1310 (10th Cir.2010),
cert. denied,
— U.S.-, 131 S.Ct. 2961, 180 L.Ed.2d 250, 2011 WL 721043 (June 6, 2011). But we review a district court’s determination of whether to order a competency examination for an abuse of discretion.
United States v. Ramirez,
304 F.3d 1033, 1035 (10th Cir.2002).
Section 4241(b) provides that “[pjrior to the date of the [competency] hearing, the court may order that
a
psychiatric or psychological examination of the defendant be conducted.” 18 U.S.C. § 4241(b) (emphasis added). “[A] psychiatric or psychological examination ordered pursuant to this chapter shall be conducted by a licensed or certified psychiatrist or psychologist, or, if the court finds it appropriate, by more than one such examiner.... ”
Id.
§ 4247(b).
Martinez-Haro contends that the use of the article “a” suggests that the statute only authorizes one competency examination. Martinez-Haro suggests that the district court could have ordered a single examination to be conducted with multiple examiners but not two separate evaluations. We find that argument unavailing.
We look first to the plain language of the statute, and if “the terms of the statute are clear and unambiguous, the inquiry ends and we simply give effect to the plain language of the statute.”
United States v. Sprenger,
625 F.3d 1305, 1307 (10th Cir.2010) (internal quotation marks omitted),
cert. denied,
— U.S.-, 131 S.Ct. 1030, 178 L.Ed.2d 851 (2011). The statute authorizes district courts to order competency hearings as need be. The statute does not contain any language restricting a district court from ordering multiple hearings. The statute does not state that the court may order only one psychiatric or psychological examination. And the statute does not state that the court may order just a single psychiatric or psychological examination. While the statute does not explicitly address the issue raised by Martinez-Haro, it does state that “if the court finds it appropriate, [then the court can order an examination] by more than one such examiner.” 18 U.S.C. § 4247(b). Nothing in this language limits the second examiner to the initial examination of the defendant nor does the language restrict the ability of the court to order a second examination after the initial examination. Therefore, we refuse to read into the statute’s language the restriction suggested by Martinez-Haro. Instead we read the statute to authorize a district court to order a second competency hearing when appropriate.
With that statutory framework in mind, we turn to the question of whether the district court abused its discretion by ordering a second competency examination. We would be concerned if a defendant was found incompetent and the district court then allowed the Government to conduct more competency examinations only for the purpose of “shopping” for a psychologist or psychiatrist who would conclude that the defendant was competent. But that is not the case before us.
Here there were legitimate reasons for the district court to order a second competency examination. Dr. O’Connor specifically recommended further testing in her conclusion: “If it were possible to have Mr. Martinez-Haro administered some psychological and neuropsychological testing in Spanish by a Spanish speaking neuropsychologist this may give the Court more complete information to base its opinion regarding competency on.” (ApltApp., vol. Ill at 7.) Further, Dr. O’Connor questioned her own opinion and expressed a willingness to revise her conclusion based on further testing.
We cannot say that the district court abused its discretion by ensuring that it had sufficient information to evaluate Martinez-Haro’s competency. In fact, based on Dr. O’Connor’s statements, we conclude that in this case it would be prudent for the district court to order an additional competency examination. Therefore, the district court did not abuse its discretion by ordering a second competency examination.
III. CONCLUSION
For the foregoing reasons, we AFFIRM the district court.