Peo in Interest of Hall

25CA0050 Peo in Interest of Hall 03-27-2025

COLORADO COURT OF APPEALS

Court of Appeals No. 25CA0050
Pueblo County District Court No. 24MH30125
Honorable Timothy O’Shea, Judge

The People of the State of Colorado,

Petitioner-Appellee,

In the Interest of Tyler Jordan Hall,

Respondent-Appellant.

ORDER AFFIRMED

Division III
Opinion by JUDGE TOW
Dunn and Martinez*, JJ., concur

NOT PUBLISHED PURSUANT TO C.A.R. 35(e)
Announced March 27, 2025

Cynthia Mitchell, County Attorney, Kate H. Shafer, Special Assistant County
Attorney, Pueblo, Colorado, for Petitioner-Appellee

Tezak Law, P.C., Mary E. 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. 2024.
¶1 Tyler Jordan Hall appeals the district court’s order authorizing

staff at the Colorado Mental Health Hospital in Pueblo (the hospital)

to medicate him involuntarily. We affirm.

I. Background

¶2 The record indicates that before Hall’s admission to the

hospital in November 2024, he was a patient at the Colorado Mental

Health Hospital in Fort Logan from November 2023 to March 2024.

There, his symptoms included agitation, hostility, and grandiose

delusions; and he assaulted his treating physician and repeatedly

hit himself on the head. He was eventually stabilized on a

combination of the antipsychotic medication olanzapine (Zyprexa)

and the mood-stabilizing medication valproic acid (Depakote).

¶3 Eight months after Hall’s discharge from the hospital in Fort

Logan, he was admitted to the hospital in Pueblo after being found

incompetent to proceed in a criminal case. Upon his admission, he

presented with impulsive behaviors, delusions, paranoia, and

aggression. Due to his escalating behaviors — which included

saying that he was going to “start murdering nurses” — he was

placed on emergency medications.

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¶4 The People petitioned the district court to authorize the

involuntary administration of Zyprexa, Depakote, and

chlorpromazine (Thorazine). However, at the hearing on the

petition, the People, through the testimony of Hall’s psychiatrist at

the hospital, effectively amended their request by dropping the

Thorazine and adding the antipsychotic medication ziprasidone

(Geodon), which Hall had taken in the past.

¶5 At the hearing, Hall’s psychiatrist, an expert in clinical

psychiatry, testified that Hall’s diagnosis was an unspecified mood

disorder. In discussing the medication change mentioned above,

which was based on Hall’s complaint that Zyprexa was causing a

rash on his back, the psychiatrist testified that he was seeking to

treat Hall with Geodon and Depakote as scheduled medications and

Zyprexa as needed for episodes of acute agitation. The psychiatrist

explained that Geodon and Zyprexa can improve psychotic

symptoms such as delusions and paranoia, and Depakote can

improve symptoms of mania and prevent depressive episodes.

¶6 The psychiatrist testified that Hall had been successfully

treated in the past with Geodon, Zyprexa, and Depakote, and,

during this hospital stay, Hall had “significantly improved” on the

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medications and was “on his way to returning to his baseline.” The

psychiatrist opined that, off the medications, Hall would be a

danger to both himself and others at the hospital and would suffer

a significant and likely long-term deterioration of his mental

condition. But, according to the psychiatrist, Hall did not have any

insight into his mental illness and did not want to take any

medications.

¶7 During Hall’s testimony, when asked whether he had a mental

illness, he responded, “I don’t.” He also repeatedly testified that he

did not need the medications and would not take them without a

court order. In terms of medication side effects, Hall testified that

when he previously took Zyprexa, he gained a lot of weight, had a

fatty liver, and had bumps all over his back. He then added, “I

think I got my liver back — I got my weight back. I worked out

really hard, and I cut down food.” He also testified that he did not

like Depakote because it makes him tired and hungry all day long.

¶8 Following the testimony, the district court found that the

psychiatrist had testified credibly and persuasively, and it expressly

adopted the psychiatrist’s opinions. The court then examined each

of the four elements of the test from People v. Medina, 705 P.2d

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961, 973 (Colo. 1985), concluded that all four elements were met,

and granted the petition.

II. Applicable Law and Standard of Review

¶9 Under the Medina test, a district court may authorize the

involuntary administration of medication if the People demonstrate

by clear and convincing evidence that (1) the person is incompetent

to effectively participate in the treatment decision; (2) the treatment

is necessary to prevent a significant and likely long-term

deterioration in the person’s mental health condition or to

prevent the likelihood of the patient causing serious harm to

himself or others in the institution; (3) a less intrusive treatment

alternative is not available; and (4) the person’s need for treatment

is sufficiently compelling to override any bona fide and legitimate

interest of the person in refusing treatment. Id.

¶ 10 Application of the Medina test involves mixed questions of fact

and law. People v. Marquardt, 2016 CO 4, ¶ 8. We defer to the

district court’s factual findings if they have record support, while we

review the court’s legal conclusions de novo. Id. Resolving conflicts

in testimony and determining the credibility of the witnesses are

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solely within the province of the district court. People in Interest of

Ramsey, 2023 COA 95, ¶ 23.

¶ 11 We must affirm the district court’s ruling if the evidence,

viewed as a whole and in the light most favorable to the prevailing

party, is sufficient to support the court’s order. People in Interest of

R.K.L., 2016 COA 84, ¶ 13. The testimony of the physician seeking

to administer treatment may be sufficient, without more, to satisfy

the Medina test. Id. at ¶ 30.

III. Analysis

¶ 12 Hall concedes that the first, second, and third elements of the

Medina test were met. However, he challenges the sufficiency of the

evidence supporting the fourth Medina element — that his need for

treatment was sufficiently compelling to override any bona fide and

legitimate interest he had in refusing treatment.

¶ 13 Hall first argues that his interest in avoiding side effects from

the medications was bona fide and legitimate. He then argues that,

because the district court did not sufficiently acknowledge that

interest, it could not properly balance it against the State’s interest

in medicating him.

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¶ 14 The district court noted that, though Hall vaguely identified a

religious basis for resisting medications, these views were

undeveloped and unsupported by the evidence. Noting Hall’s

repeated assertion that he does not need the medications, the court

concluded that “he just has a general preference to not take

medications.” However, the court never actually considered

whether Hall’s stated concerns about side effects were bona fide

and legitimate. This was error — but not reversible error.

¶ 15 This is because the court went on to balance Hall’s interest in

not taking the medications and the State’s interest in administering

them. The court found that, even if Hall’s interest in not taking the

medications was bona fide and legitimate, his need for the

medications was sufficiently compelling to override that interest. In

other words, though the court erred when it did not assess the

sincerity of Hall’s claim that he wished to avoid the side effects of

the medications, it abrogated the effect of that error when it treated

Hall’s concerns as legitimate during the next step of the analysis.

¶ 16 We agree with the district court’s determination. Even if Hall

had legitimate concerns that the medications had certain side

effects, the psychiatrist’s and Hall’s testimony called into question

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the significance of those side effects. In terms of Hall’s concern

regarding developing a fatty liver, the psychiatrist testified that

Hall’s liver functioning was being monitored through lab work; and

if Hall were to develop any liver issues, his medications would be

adjusted accordingly. In terms of Hall’s weight, when he was asked

at the hearing whether he had gained any weight since this

admission to the hospital, he responded only, “I’ve been walking

around a lot.” Further, the psychiatrist testified that the bumps on

Hall’s back were “more consistent [with] acne,” and that he has not

seen any specific cases where these medications caused acne in a

patient. And finally, in terms of Hall’s sedation, the psychiatrist

confirmed that Hall “may be more sedated than if he were not

taking the medications,” but it was not a severe side effect that

affects his daily functioning. The psychiatrist also testified that the

sedation might improve the longer that Hall is on the medications.

¶ 17 More importantly, though, the psychiatrist’s testimony

regarding the severity of Hall’s symptoms, behavior, and prognosis

without the medications, which the district court credited, provides

ample support for the court’s determination that Hall’s desire to

refrain from taking these medications “must yield to the legitimate

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interest the State has in preserving his life and health and

protecting the safety of those in the institution.” We thus discern

no basis for reversal. See Marquardt, ¶ 8; Ramsey, ¶ 23; R.K.L.,

¶¶ 13, 30.

IV. Disposition

¶ 18 The order is affirmed.

JUDGE DUNN and JUSTICE MARTINEZ concur.

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