USA v. Brown

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF MISSOURI
WESTERN DIVISION
UNITED STATES OF AMERICA,
Plaintiff,
vs.
KEITH T. BROWN,
Defendant.
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Case No. 21-00147-01-CR-W-DGK
REPORT AND RECOMMENDATION
Before the Court is the issue of Defendant Keith T. Brown’s mental competency to stand
trial. On October 16, 2024, the undersigned entered a report recommending the District Court find
Defendant Keith T. Brown is incompetent to understand the nature and consequences of the
proceedings against him and assist properly in his defense, and enter and order committing him to
the Attorney General’s custody for hospitalization and treatment in a suitable facility for a
reasonable time up to 120 days to determine whether there is a substantial probability that in the
foreseeable future, he will attain the capacity to permit the trial to proceed. Doc. 91. On November
8, 2024, District Judge Greg Kays entered an Order adopting the undersigned’s report and
recommendation in its entirety. 	Doc. 93. 	Defendant Brown arrived at Federal Medical Center
(FMC) – Devens on May 7, 2025.
On September 19, 2025, the Court received a forensic psychiatric report from Miriam
Kissin, Psy. D. Doc. 100. Therein, Dr. Kissin stated Defendant’s “persisting psychotic symptoms
continue to impair his ability to participate effectively in legal proceedings.” Id. at 30. However,
Dr. Kissin also explained “[w]hile Mr. Brown’s symptoms currently persist, they are noted to have
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decreased in the context of medication treatment and his competency-related skills have likewise
improved.” Id. Dr. Kissin requested an additional period of competency restoration. Id. at 30-31.
On September 30, 2025, the undersigned held a status conference. Doc. 102. The Court
entered an order granting the request from FMC – Devens for another period of treatment and
restoration for Defendant. Docs. 102-103. The undersigned ordered Defendant hospitalized at
FMC – Devens for an additional period of time not to exceed 120 days. Doc. 103.
On February 6, 2026, the Court received a letter from Dr. Kissin with an update on
Defendant. Doc. 106. Therein, Dr. Kissin opined Defendant’s “competency-related skills remain
significantly compromised by symptoms of mental illness, such that he is unable to understand the
nature of the proceedings against him or to assist properly in his defense.” Id. at 3. She explained
“given [Defendant’s] limited treatment response to date, it is unlikely psychotropic medication
would help him to become competent in the foreseeable future.” Id.
On February 17, 2026, the undersigned held a competency hearing. Doc. 108. With no
objection, Defendant appeared by videoconference. Id. Defendant’s counsel, Razmi Tahirkheli,
and Government counsel, Jessica Jennings, were present in person. 	Id. 	Defense counsel and
Government counsel stipulated that the Court could consider Dr. Kissin’s updated report as if she
had appeared in person and testified under oath. Id. No additional evidence was offered by either
party.
As set forth in Dr. Kissin’s unchallenged report, Defendant’s competency remains
significantly compromised by symptoms of mental illness, he is unable to understand the
proceedings against him or to assist in his defense, and psychotropic medication in unlikely to help
him become competent in the foreseeable future. Doc. 106. Accordingly, it is
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RECOMMENDED that the Court find Defendant continues to suffer from a mental
disease or defect rendering him mentally incompetent to the extent he is unable to understand the
nature and consequences of the proceedings against him or to assist properly in his defense. It is
further
RECOMMENDED that, pursuant to 18 U.S.C. §§ 4246(b) and 4247(b), the Court order
Defendant undergo a psychiatric or psychological examination, conducted by a licensed or
certified psychiatrist or psychologist employed by FMC – Devens, to determine whether
Defendant is presently suffering from a mental disease or defect as a result of which his release
would create a substantial risk of bodily injury to another person or serious damage to property of
another. It is further
RECOMMENDED that the Court continue Defendant’s commitment to the custody of
the Attorney General for a period of forty-five days, unless that time is extended for an additional
period of time not to exceed thirty days upon a showing of good cause that the additional time is
necessary to observe, evaluate, and examine Defendant. It is further
RECOMMENDED that the Court order the examining psychiatrist or psychologist to
promptly prepare a report for filing with the Court.
Counsel are reminded they have fourteen days in which to file any objections to this Report
and Recommendation. 	A failure to file and serve objections by this date shall bar an attack on
appeal of the factual findings in this Report and Recommendation except on the grounds of plain
error or manifest injustice.
IT IS SO ORDERED.
DATE: February 17, 2026 	/s/ W. Brian Gaddy
W. BRIAN GADDY
UNITED STATES MAGISTRATE JUDGE
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