Peo in Interest of Pilove

26CA0235 Peo in Interest of Pilove 04-09-2026

COLORADO COURT OF APPEALS

Court of Appeals No. 26CA0235
Pueblo County District Court No. 26MH30006
Honorable Amiel Markenson, Judge

The People of the State of Colorado,

Plaintiff-Appellee,

In the Interest of Matthew Pilove,

Respondent-Appellant.

ORDER AFFIRMED

Division V
Opinion by JUDGE LIPINSKY
Welling and Tow, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e)
Announced April 9, 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
¶1 Matthew Pilove appeals the district court order authorizing

staff at the Colorado Mental Health Hospital in Pueblo (CMHHIP) to

medicate him against his will. We affirm.

I. Background

¶2 Pilove was admitted to CMHHIP after being found not guilty by

reason of insanity in a criminal case. According to the affidavit and

testimony of Dr. Hareesh Pillai, the physician supervising Pilove’s

treatment, Pilove had a long history of mental illness and

psychiatric hospitalizations. Dr. Pillai testified that he diagnosed

Pilove with schizoaffective disorder and that, “[w]hen not adequately

treated with medications, he exhibits symptoms, including

paranoia, delusional ideation, and hallucinations that affect his

thinking and behavior.” In late December 2025, Pilove began

refusing his psychiatric medications. At that time, he also became

agitated and aggressive toward staff and, according to the medical

staff at CMHHIP, “required seclusion and restraint.” Pilove was

involuntarily medicated on an emergency basis before the State

petitioned for a six-month order permitting the involuntary

administration of (1) Zyprexa and lithium on a daily basis and

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(2) Haldol, if needed for acute agitation or if Pilove refused to take

lithium orally.

¶3 At the evidentiary hearing in this case, Dr. Pillai testified that

an involuntary medication order was warranted under the four

elements set forth in People v. Medina, 705 P.2d 961 (Colo. 1985),

because (1) Pilove is incompetent to effectively participate in his

treatment decisions; (2) the requested medications are necessary to

prevent a significant and likely long-term deterioration in his

mental health condition and to prevent the likelihood that he would

pose a serious risk of harm to himself and others; (3) a less

intrusive treatment alternative is not available; and (4) Pilove’s need

for treatment with psychiatric medications outweighs any bona fide

interest in refusing treatment. See id. at 973. The district court

found that Dr. Pillai’s testimony was credible and persuasive and

adopted his opinions. Pilove testified that he objected to taking the

requested medications because (1) using drugs to treat mental

illness is contrary to his Rastafarian religious beliefs; and

(2) Zyprexa causes him to become hungry and have an increased

appetite, and lithium makes him sleepy and “a little more

depress[ed].” The district court concluded that Dr. Pillai’s affidavit

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and testimony provided clear and convincing evidence for each of

the four Medina elements. It therefore authorized CMHHIP staff to

administer the requested medications to Pilove involuntarily.

II. Discussion

¶4 On appeal, Pilove only challenges the sufficiency of the

evidence supporting the fourth Medina element — whether his need

for treatment is sufficiently compelling to override his bona fide and

legitimate interest in refusing treatment. See id. Pilove’s sole

argument is that the district court erred by finding he had not

demonstrated a bona fide and legitimate interest in refusal.

¶5 The record refutes the factual basis for Pilove’s argument. In

both its ruling from the bench at the evidentiary hearing and its

written order, the district court found that Pilove’s interest in

refusal was bona fide and legitimate based on his “religious

preference” and the alleged side effects he described. But in

applying the fourth Medina element, the court found by clear and

convincing evidence that Pilove’s prognosis without treatment was

so unfavorable that his “personal preference must yield” to the

state’s “legitimate interest in preserving” his “life and health” and

protecting the safety of those in CMHHIP. Id. at 974. The court

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pointed to Dr. Pillai’s testimony that, without medication, Pilove

was at risk of significant long-term deterioration. The court

specifically noted Pilove’s suicide attempts; refusal to eat at times,

which required placement of a feeding tube; aggressiveness toward

others; and inability to care for himself. Because ample evidence in

the record supports the district court’s findings and conclusion

regarding the fourth Medina element, we perceive no basis for

reversal. See People in Interest of A.J.L., 243 P.3d 244, 255 (Colo.

2010).

III. Disposition

¶6 The order authorizing the involuntary administration of

psychiatric medication is affirmed.

JUDGE WELLING and JUDGE TOW concur.

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