Peo in Interest of Osse

26CA0668 Peo in Interest of Osse 06-25-2026

COLORADO COURT OF APPEALS

Court of Appeals No. 26CA0668
Pueblo County District Court No. 26MH30038
Honorable Gregory J. Styduhar, Judge

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of Michael Donald Osse,

Respondent-Appellant.

ORDER AFFIRMED

Division V
Opinion by JUDGE BERNARD*
Yun and Schutz, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e)
Announced June 25, 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 Respondent, Michael Donald Osse, is charged with second

degree murder in Jefferson County Case No. 22CR0310. In 2022, a

court found he was incompetent to stand trial, and it committed

him to the care and custody of the Colorado Mental Health Hospital

in Pueblo. In a March 30, 2026, order, the district court authorized

the hospital to treat respondent, against his will, with antipsychotic

medication to restore his competency. He appeals. We affirm.

I. Background

¶2 According to the affidavit of respondent’s treating psychiatrist,

respondent’s competency has been evaluated twelve times between

2022 and 2025 by the hospital staff. Each of these evaluations

found he was incompetent to proceed.

¶3 The hospital’s staff recommended medications to treat

respondent’s diagnosed psychiatric condition: unspecified

schizophrenia spectrum and other psychotic disorder. He has only

intermittently taken the medications; he mostly refuses to take

them.

¶4 Prompted by respondent’s most recent refusal to take his

prescribed medications and the long duration of his incompetency,

the People asked the district court to authorize the hospital’s staff

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to administer medication — including daily dosages of Zyprexa

(olanzapine) up to 40 mg orally or intramuscularly — involuntarily,

along with all necessary laboratory work and testing to monitor

medication levels in his system and side effects.

¶5 Following a hearing on March 30, 2026, the court found the

People had satisfied the four factors set out in Sell v. United States,

539 U.S. 166 (2003), to justify the involuntary administration of

medication to restore a person’s competency. The court therefore

granted the petition. By its express terms, and “unless otherwise

ordered by the court,” the court’s order “continue[s] through the

completion” of respondent’s criminal trial.

II. Discussion

¶6 Respondent does not contest the first Sell factor, thus

conceding the government has a substantial interest in restoring

his competency so he can receive a fair and timely trial. Rather, he

contends the People’s evidence was insufficient to support the

court’s findings concerning the second, third, and fourth Sell

factors. We disagree.

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A. Governing Law and Standards of Review

¶7 When, as in this case, the government seeks to involuntarily

medicate a defendant for the sole purpose of rendering him or her

competent to stand trial, the People must satisfy the four-part test

articulated by Sell. People in Interest of R.F., 2019 COA 110, ¶¶ 10-

11. First, they must demonstrate that important governmental

interests are at stake. Sell, 539 U.S. at 180. Bringing to trial an

individual accused of a serious crime is an important governmental

interest. Id.; R.F., ¶ 12. Second, involuntary medication must

significantly further those interests. Sell, 539 U.S. at 181. Third,

the medication must be necessary to further those interests. Id.

Fourth, the medication must be “medically appropriate,” that is, “in

the patient’s best medical interest in light of his medical condition.”

Id. The People must prove each factor by clear and convincing

evidence. R.F., ¶ 16. But a physician’s testimony alone may meet

this evidentiary standard. See People v. Pflugbeil, 834 P.2d 843,

846-47 (Colo. App. 1992).

¶8 When evaluating whether the evidence was sufficient to

support an involuntary medication order, we view the evidence as a

whole and in the light most favorable to the prevailing party. See

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People in Interest of R.K.L., 2016 COA 84, ¶ 13. We review the

court’s legal conclusions de novo and review its factual findings for

clear error. See R.F., ¶ 21.

B. The Second Sell Factor

¶9 The People satisfy the second Sell factor by showing that

(1) administering the medication is substantially likely to restore

the defendant’s competency, and (2) the medication is substantially

unlikely to have side effects that will interfere with the defendant’s

ability to assist in his or her defense. Sell, 539 U.S. at 181; R.F.,

¶ 13.

¶ 10 Respondent asserts the People did not meet their burden to

prove either of these components of the second Sell factor.

¶ 11 Addressing the first component of the second Sell factor,

respondent submits the psychiatrist’s testimony relied on two short

periods when respondent voluntarily took Zyprexa, but the

psychiatrist also acknowledged that respondent “had only taken low

doses for short periods and had never received an adequate

treatment dosage for an extended time.” As a result, respondent

continues, the psychiatrist’s testimony did not “show a

substantially likely restoration outcome”; rather, he submits, it

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shows the People were “asking the court to force a medication trial

based on an unproven assumption.” So, respondent goes on, the

People’s position “was necessarily predictive and speculative rather

than supported by demonstrated individualized treatment success.”

Respondent finishes up by contending that “the lengthy history of

unsuccessful restoration efforts required far more rigorous

individualized proof than was presented here.”

¶ 12 We disagree with this assertion because the record contains

the following information concerning the first component of the

second Sell factor:

• The symptoms of respondent’s psychiatric condition

included disorganized thinking, delusional ideation, and

paranoia.

• The psychiatrist thought respondent had no insight into

his mental illness.

• The psychiatrist’s opinion was that, if respondent were

treated with Zyprexa, it was substantially likely he would

be rendered competent to stand trial.

• Respondent had voluntarily taken Zyprexa twice.

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• When respondent stopped taking Zyprexa the first time,

the psychiatrist thought there was a slight deterioration

in his condition coinciding with two “incidents of

agitation” involving angry confrontations with other

patients; such incidents did not occur while respondent

was taking Zyprexa.

• When he took Zyprexa the second time, respondent told

the psychiatrist he thought the drug was helping with his

disorganized thinking; after he stopped taking the drug,

he denied his thinking had been disorganized.

• The psychiatrist and the authors of the twelve

competency evaluations thought respondent would not

be restored to competency without receiving psychiatric

medication.

¶ 13 Concerning the second component of the second Sell factor,

whether the medication is substantially unlikely to produce side

effects interfering with a defendant’s ability to assist in his or her

defense, Sell, 539 U.S. at 181; R.F., ¶ 13, respondent points to his

testimony that he has experienced side effects — in particular,

weight gain and a “dulling effect” — while taking a 5-10mg dose of

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Zyprexa. And he refers to his testimony that this “dulling effect”

would affect his ability to work with his criminal defense attorneys:

I do feel that it would hinder my ability to work
at the level and success we’ve had so far. I
think it would hinder even reading or the
organizational thought process that I have
excelled [at] my whole life. I also feel that the
dulling effect would increase and it would
almost give me a feeling of being high.

¶ 14 The district court, however, found that the administering the

requested medication “is substantially unlikely to have side effects

that will interfere significantly with [respondent’s] ability to assist

counsel in conducting a trial defense.” In doing so, the court

credited the treating psychiatrist’s testimony that this was the case

and that respondent had “denied any significant side effects like

over sedation or tiredness” while on Zyprexa, and “there was

nothing observable in his presentation that indicated [that taking

the medication] would conflict with his ability to interact with legal

representation.”

¶ 15 In addition, the court relied on the psychiatrist’s testimony

that (1) while compliant with the medication, respondent had

reported an improvement in his thought organization; (2) the

psychiatrist had noticed a slight improvement in his ability to do so;

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and (3) it was only after abruptly discontinuing Zyprexa that

respondent denied ever experiencing improvements.

¶ 16 Given that the court relied on the psychiatrist’s testimony,

which it found credible and persuasive, we conclude that sufficient

evidence supports the court’s challenged finding. See Pflugbeil, 834

P.2d at 846-47; see also People in Interest of R.C., 2019 COA 99M,

¶ 7 (acknowledging we 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).

¶ 17 We are not persuaded otherwise by respondent’s assertion

that the psychiatrist’s testimony was “generalized” or “conclusory.”

The psychiatrist testified to both his personal observations of

respondent while he was medicated and to respondent’s reports

that he was not experiencing the types of side effects he had

reported once he stopped taking the medication. And we are not

persuaded that the People had to present testimony establishing

that “substantially higher doses” of Zyprexa “would not impair

[respondent’s] cognition or ability to communicate with counsel.”

The order authorizes dosing of Zyprexa up to 40mg; it does not

require that amount from the start. And the district court was

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permitted to rely on the psychiatrist’s medical opinion that this

administration of Zyprexa was substantially unlikely to create side

effects that would significantly interfere with respondent’s ability to

assist counsel in conducting a trial defense.

C. The Third Sell Factor

¶ 18 As noted, the third Sell factor requires the People to prove that

involuntary medication is necessary to further the governmental

interest. Sell, 539 U.S. at 181; R.F., ¶ 14. The People satisfy this

factor by showing, as is relevant to this appeal, that any alternative,

less intrusive treatments are unlikely to achieve substantially the

same results. Sell, 539 U.S. at 181; R.F., ¶ 14.

¶ 19 Respondent asserts that that the evidence presented at the

hearing does not support this showing because the psychiatrist

admitted that respondent had not “significantly deteriorated” in the

time he remained off antipsychotic medication. Respondent argues

the psychiatrist’s opinion that he would not continue to deteriorate

without antipsychotic medication undermines the People’s claim

that involuntary medication is necessary.

¶ 20 But preventing deterioration is not the governmental interest

at issue here. Rather, the governmental interest in treating

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respondent is to bring him to trial in a criminal proceeding, for

which competency is a prerequisite. And, although the psychiatrist

acknowledged respondent’s participation in competency restoration

groups for years, he thought that respondent had received the

“maximum benefit that he c[ould]” from such non-medication-based

therapies. The psychiatrist also noted that the evaluators from

respondent’s twelve competency evaluations “have also indicated

that without medications” he would not be restored to competency.

This evidence clearly and convincingly supports the court’s

determination that involuntary medication is both necessary to

further the governmental interest of restoring respondent to

competency to stand trial and that any alternative, less intrusive

treatments are unlikely to achieve substantially the same results.

D. The Fourth Sell Factor

¶ 21 Last, respondent contends that the court erred in finding the

requested medication is “medically appropriate.” Sell, 539 U.S. at

181; R.F., ¶ 15. He discounts the psychiatrist’s medical opinion to

this effect, and he notes his own testimony regarding adverse side

effects, arguing that the People did not meaningfully explain why

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the proposed medication regimen was in his best medical interest

considering such side effects.

¶ 22 The court, however, credited the psychiatrist’s testimony that

(1) the proposed medication was medically appropriate, and (2)

respondent has exhibited little or no significant side effects while

taking it. We are not at liberty to disregard this credibility

determination. R.C., ¶ 7.

¶ 23 And we are not persuaded that the psychiatrist’s testimony

was insufficiently individualized. Contrary to respondent’s

suggestion on appeal, the psychiatrist did not only testify that the

requested medication is commonly prescribed for respondent’s

condition; he testified about his personal, medical observations of

respondent and about respondent’s own reports that he

experienced improvement while on the requested medication.

¶ 24 The order is affirmed.

JUDGE YUN and JUDGE SCHUTZ concur.

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