Dingeman v. F.M.G. (In re Interest of F.M.G.)

Decision Date16 May 2017
Docket NumberNo. 20170136,20170136
Citation894 N.W.2d 850
Parties IN the INTEREST OF F.M.G. Raymond Dingeman, Petitioner and Appellee v. F.M.G., Respondent and Appellant
CourtNorth Dakota Supreme Court

Brian L. Johnson, Assistant State's Attorney, Bismarck, N.D., for petitioner and appellee.

Donald Sauviac, Jr. (argued) and Steven Balaban (appeared), Bismarck, N.D., for respondent and appellant.

McEvers, Justice.

[¶ 1] F.M.G. appeals the district court's order authorizing involuntary treatment with prescribed medication. F.M.G. argues the district court erred in granting the request to treat her with prescribed medications, because the proper medical providers did not testify at the hearing under N.D.C.C. § 25–03.1–18.1(1)(a), and the mandatory certification requirements under N.D.C.C. § 25–03.1–18.1(1)(a)(2) were not met. We conclude N.D.C.C. § 25–03.1–18.1(1)(a) does not require both treating and non-treating physicians to testify at the hearing, and F.M.G. did not adequately raise the issue of whether the form used to request involuntary treatment with medication met the certification requirements under N.D.C.C. § 25–03.1–18.1(1)(a)(2) before the district court. Therefore, we affirm the district court's order.

I

[¶ 2] On January 10, 2017, the State petitioned to involuntarily commit F.M.G. Following a preliminary hearing on January 13, 2017, the district court found F.M.G. was a mentally ill person requiring treatment and ordered commitment with the Sanford hospital in Bismarck, North Dakota. After a treatment hearing on January 27, 2017, F.M.G. was transferred to the North Dakota State Hospital. On February 7, 2017, Dr. Eduardo Yabut, one of F.M.G.'s treating psychiatrists at the State Hospital, filed a signed "Request to Treat with Medication." Dr. Clark Herniman also signed the request as a medical professional not involved in the current diagnosis or treatment of F.M.G. The request was submitted on a form stating:

The patient is a person requiring treatment and the proposed medication, (identify each medication)(Risperidone, Haloperidol, Paliperidone, Olanzapine, Aripiprazole )
is clinically appropriate and necessary to effectively treat the patient.
( ) The patient was offered the treatment and refused it
or
( ) The patient lacks the capacity to make or communicate a responsible decision about the treatment with medication.
The proposed medication is the least restrictive form of intervention necessary to meet the treatment needs of the patient.[ ]
The benefits of the treatment outweigh the known risks to the patient.

[¶ 3] The form contained boxes to check regarding the refusal of medication and the capacity to make a responsible decision about the treatment with medication. Neither box was checked, and the form was not dated. Attached to the form was a letter dated February 3, 2017, signed by Dr. Yabut. In his letter, Dr. Yabut stated "[F.M.G.] was medication noncompliant." The letter continued, "[F.M.G.] remains medication noncompliant. Thus, we are petitioning the court for involuntary medication so she can finally be treated. The medications that we are going for are Haloperidol, Risperidone, Paliperidone, Olanzapine and Aripiprazole." (Emphasis added.)

[¶ 4] On March 6, 2017, a hearing was held. The State called Dr. William Pryatel, another of F.M.G.'s treating physicians, to testify regarding the request to involuntarily treat F.M.G. with medication. Dr. Pryatel testified he was F.M.G.'s psychiatrist, but he was on vacation in early February, and was aware Dr. Yabut and Dr. Herniman signed the request to treat with medication in his absence. Both the State and the district court questioned Dr. Pryatel as to the statutory requirements under N.D.C.C. § 25–03.1–18.1. Dr. Pryatel testified each requirement under N.D.C.C. § 25–03.1–18.1 had been met in F.M.G.'s case.

[¶ 5] At the close of the State's argument, F.M.G. moved for a "directed verdict" on the grounds the requirements under N.D.C.C. § 25–03.1–18.1(1)(a) had not been met. Specifically, F.M.G. argued the State failed to call a doctor not involved in her treatment or diagnosis to testify and, therefore, the State did not meet the "requisite" under N.D.C.C. § 25–03.1–18.1(1)(a). The district court denied F.M.G.'s motion. The district court found the requirements under N.D.C.C. § 25–03.1–18.1 had been met and granted Dr. Yabut's request to treat F.M.G. with medication. F.M.G. filed this expedited appeal.

II

[¶ 6] F.M.G. argues the district court erred in granting Dr. Yabut's request to treat her with medication because the proper medical providers under N.D.C.C. § 25–03.1–18.1(1)(a) were not called to testify at the hearing, and the certification requirements under N.D.C.C. § 25–03.1–18.1(1)(a)(2) were not met.

[¶ 7] At the hearing, F.M.G. moved for a "directed verdict." "A directed verdict is granted as a matter of law and is fully reviewable on appeal." Knoff v. Am. Crystal Sugar Co. , 380 N.W.2d 313, 318 (N.D. 1986) (superseded by statute on other grounds). However, F.M.G. improperly moved for a directed verdict in a bench trial. See Larson v. Unlimited Bus. Exch. of N.D., Inc. , 330 N.W.2d 518, 520–21 (N.D. 1983) ("A motion for a directed verdict ... is not applicable to a case tried without a jury"). Although F.M.G. used inapplicable phrasing, we understand the motion was a motion to dismiss the request for involuntary treatment with medication under N.D.R.Civ.P. 41(b). In reviewing a district court's ruling on a N.D.R.Civ.P. 41(b) motion, this Court uses the clearly erroneous standard under N.D.R.Civ.P. 52(a). Shark v. Thompson , 373 N.W.2d 859, 867–68 (N.D. 1985).

[¶ 8] This Court's review of an appeal from a mental health hearing is well-established:

Our review of an appeal under N.D.C.C. ch. 25–03.1 is "limited to a review of the procedures, findings, and conclusions of the trial court." Interest of D.A. , 2005 ND 116, ¶ 11, 698 N.W.2d 474. We review the findings of the district court under the more probing clearly erroneous standard of review. Id. A finding of fact is clearly erroneous if "it is induced by an erroneous view of the law, if there is no evidence to support it, or if, although there is some evidence to support it, on the entire evidence this Court is left with a definite and firm conviction ‘it is not supported by clear and convincing evidence.’ " Id. (quoting Interest of J.D. , 2002 ND 50, ¶ 13, 640 N.W.2d 733 and Interest of R.N. , 513 N.W.2d 370, 371 (N.D.1994) ).

In re B.L.S. , 2006 ND 218, ¶ 10, 723 N.W.2d 395.

[¶ 9] Section 25–03.1–18.1(1)(a), N.D.C.C., governs court-authorized involuntary treatment with medication, providing:

Upon notice and hearing, a treating psychiatrist may request authorization from the court to treat an individual under a mental health treatment order with prescribed medication. The request may be considered by the court in an involuntary treatment hearing. As part of the request, the treating psychiatrist and another licensed physician, physician assistant, psychiatrist, or advanced practice registered nurse not involved in the current diagnosis or treatment of the patient shall certify.

Section 25–03.1–18.1(1)(a)(2), N.D.C.C., goes on to require the proper medical provider to certify "[t]hat the patient was offered that treatment and refused it or that the patient lacks the capacity to make or communicate a responsible decision about that treatment."

[¶ 10] The purpose of N.D.C.C. ch. 25–03.1 is "to ensure that mentally ill persons, who present a serious risk of harm to themselves or others, obtain appropriate treatment while their due process rights are protected." State v. Nording , 485 N.W.2d 781, 786 (N.D. 1992) (citing Interest of Nyflot , 340 N.W.2d 178, 182 (N.D. 1983) ). Section 25–03.1–18.1(1)(a), N.D.C.C., protects a mentally ill person's due process rights by providing them notice and a hearing when a request for authorization to treat with medication is sought. The party seeking court authorization must give notice they are seeking to treat the mentally ill person with prescribed medication, and "[a] request to treat with prescribed medication requires two signatures." Interest of G.A.S. , 2016 ND 136, ¶ 6, 881 N.W.2d 615 ; see also N.D.C.C. § 25–03.1–18.1(1)(a). One signature must be from the patient's treating physician and one from another medical professional not involved in the patient's current diagnosis or treatment. Id.

[¶ 11] F.M.G. does not argue the district court erred in finding Dr. Pryatel provided clear and convincing evidence through his testimony at the hearing that F.M.G. meets the criteria under N.D.C.C. § 25–03.1–18.1(1)(a)(1)(4). The only argument made at the hearing was the proper medical providers under N.D.C.C. § 25–03.1–18.1(1)(a) were not called to testify at the hearing, therefore the requirements under N.D.C.C. § 25–03.1–18.1(1)(a)(2) were not met. At the hearing, Dr. Pryatel testified the proposed medication was appropriate and necessary, and that F.M.G. was a person requiring treatment. Dr. Pryatel further testified F.M.G. was medication non-compliant, in that F.M.G. refused medication and did not have the capacity to consent. Dr. Pryatel testified that the prescribed medication is the least restrictive form of treatment to meet F.M.G.'s needs, and that the benefits of the treatment outweighed the risks.

[¶ 12] At the close of the State's argument, F.M.G. effectively moved for dismissal of the request to involuntarily treat with medication:

District Court: Alright. Did you have any other witnesses or anything else to present?
State: No, your honor.
District Court: Alright. And, [Respondent], did you have anything else to present?
Respondent: Ah, Judge, I would move for a directed verdict against the request of the state because under 25–03.1–18.1 requires under section (1)(a), that there be this treating psychiatrist, and another licensed physician....
District Court: Are you looking at the amended provision?
Respondent: I'm looking at the ones that I....
State: Your honor, it requires two and in
...

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