People v. Sheila N. (In re Sheila N.)

• Decision Date: 19 March 2014
• Docket Number: NO. 4-13-0416,4-13-0416
• Parties: In re: SHEILA N., a Person Found Subject to Involuntary Administration of Psychotropic Medication, THE PEOPLE OF THE STATE OF ILLINOIS, Petitioner-Appellee, v. SHEILA N., Respondent-Appellant.
• Court: United States Appellate Court of Illinois

2014 IL App (4th) 130416

In re: SHEILA N., a Person Found Subject to Involuntary Administration of Psychotropic Medication,THE PEOPLE OF THE STATE OF ILLINOIS, Petitioner-Appellee, v. SHEILA N., Respondent-Appellant.

NO. 4-13-0416

APPELLATE COURT OF ILLINOIS FOURTH DISTRICT

Filed: March 19, 2014

NOTICE

This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances allowed under Rule 23(e)(1).

Appeal from

Circuit Court of

Sangamon County

No. 13MH243

Honorable

Steven H. Nardulli,

Judge Presiding.

JUSTICE HOLDER WHITE delivered the judgment of the court.

Justices Pope and Steigmann concurred in the judgment.

ORDER

¶ 1 Held: (1) The trial court did not violate the separate hearing requirement of section 2-107.1 of the Mental Health and Developmental Disabilities Code (Code) by taking judicial notice of testimony presented at a previous hearing; (2) the court did not err by questioning the State's witness; (3) the court's oral statement provided sufficient factual findings to satisfy section 3-816 of the Code; (4) the State proved by clear and convincing evidence the factors required under section 2-107.1 of the Code; and (5) the court erred by authorizing the drug Clonazepam because the record does not show the treating physician gave respondent written information on the drug, as required under section 2-102 of the Code.

¶ 2 Following an April 12, 2013, hearing, the trial court entered an order authorizing the administration of psychotropic medication to respondent, Sheila N. Respondent appeals, arguing that, although her claim is moot, it fits within two recognized exceptions to the mootness doctrine. On the merits, respondent argues (1) the court erred by taking judicial notice of evidence presented in respondent's previously held involuntary commitment hearing, (2) the trial court improperly questioned the State's witness, (3) the trial court's order contained insufficientfactual findings, (4) the evidence was insufficient to prove by clear and convincing evidence, the factors contained in section 2-107.1(a-5)(4) of the Mental Health and Developmental Disabilities Code (Code) (405 ILCS 5/2-107.1(a-5)(4) (West 2012)), and (5) the order's authorization of the drug Clonazepam should be voided because the treating physician did not provide respondent with written information on the drug.

¶ 3 We find the "capable of repetition yet avoiding review" exception to the mootness doctrine applies to respondent's claims. We hold (1) the trial court did not violate section 2107.1 of the Code's separate hearing requirement by taking judicial notice of testimony presented at the involuntary commitment hearing (405 ILCS 5/2-107.1(a-5)(2) (West 2012)); (2) the court did not err by questioning the State's witness; (3) the court provided sufficient factual findings to satisfy section 3-816 of the Code (405 ILCS 5/3-816(a) (West 2012)); (4) the State proved by clear and convincing evidence the factors required under section 2-107.1 (405 ILCS 5/2-107.1 (a-5)(4) (West 2012)); and (5) the court erred by authorizing Clonazepam because the record does not show the treating physician gave respondent written information on the drug, as required under section 2-102. 405 ILCS 5/2-102 (West 2012).

¶ 4 We affirm in part and vacate in part as to the authorization to administer the drug Clonazepam.

¶ 5 I. BACKGROUND

¶ 6 On April 5, 2013, Dr. Kasturi Kripakaran, respondent's treating psychiatrist at McFarland Mental Health Center (McFarland), filed a petition for the involuntary administration of psychotropic medication under section 2-107.1 of the Code. 405 ILCS 5/2-107.1(a-5) (West 2012) On April 12, 2013, the trial court first held a hearing on another petition filed in regard torespondent's involuntary admission at McFarland. At the hearing on involuntary commitment, Dr. Kripakaran testified she believed respondent would suffer mental and emotional deterioration unless she was treated at McFarland. Evidence was presented indicating respondent had no food in her house, was dehydrated, and was taken to the emergency room. Respondent testified people were coming into her house and stealing from her and gave incoherent testimony about how she provided for her own daily needs. The court granted the petition for involuntary commitment. Later that day, the trial court held a hearing on the petition for the involuntary administration of psychotropic medication (hereafter referred to as the hearing) before the same trial judge. During the hearing, Dr. Kripakaran testified she diagnosed respondent with schizoaffective disorder. Respondent's symptoms included paranoia, "grandiose delusions, *** hyper-talkativeness, agitation, and aggression." During discussion of respondent's symptoms, the court stated: "I am going to take judicial notice of the hearing we just had [referring to the involuntary commitment hearing], the Doctor's testimony with regard to symptoms. We can move through that." Counsel for the State, Sheri Carey, then moved to questions related to the requested medications.

¶ 7 Respondent interrupted Dr. Kripakaran many times at the beginning of her testimony. The court noted "[respondent] is becoming increasingly agitated" and requested respondent be removed from the hearing room. Respondent was escorted outside the hearing room. Respondent continued to make disturbances outside the courtroom, and the court asked she be escorted to her room.

¶ 8 The first medication Dr. Kripakaran requested was Olanzapine, or alternatively Risperidone and Mellaril. These medications reduce delusions, hallucinations, and agitation, butpotential side effects include "weight gain, change in metabolic profile, lipid profile, changes in [electrocardiogram (EKG)]," and potential "extrapyramidal symptoms." Next, Dr. Kripakaran chose Depakote, or alternatively Lithium, to help stabilize respondent's mood, agitation, and aggression. These drugs had similar side effects, including weight gain, changes in metabolic profile, and changes in blood counts. Dr. Kripakaran also requested Lorazepam, or alternatively Clonazepam, for agitation on either a daily or an as-needed basis. The main side effect of Lorazepam and Clonazepam was sedation. Last, Dr. Kripakaran requested Cogentin, or alternatively Benadryl, to help alleviate any extrapyramidal symptoms. Cogentin can cause sedation and also dull cognition. Based on Dr. Kripakaran's review of respondent's medical records, she had previously taken these medications but Dr. Kripakaran did not know if she had suffered any side effects.

¶ 9 Dr. Kripakaran testified she attempted to talk with respondent about the medications and the side effects, but "she was in no position to listen to what I [had] to say, but [respondent] did take all the information about the meds in her hands." The petition filed by Dr. Kripakaran includes the written information given to respondent on the risks and benefits of the proposed drugs and includes information on all requested drugs except Clonazepam. Dr. Kripakaran also believed the medication would benefit respondent so "she can think rationally and I think do really well in the community when she is on medication."

¶ 10 The State then shifted its questions to the issue of less restrictive services and the following exchange transpired:

"[STATE'S COUNSEL]: Have other less restrictive services been explored?

[DR. KRIPAKARAN]: Not at this time because of—

THE COURT: They have been explored and they have been rejected?

[DR. KRIPAKARAN]: Yes."

Dr. Kripakaran elaborated, explaining respondent could not benefit from group or individual therapy in her current state because her symptoms prohibited her from participating. Dr. Kripakaran also asked the court to order testing to assure the safe and effective administration of the medication. The testing included respondent's "complete blood count, metabolic profile, lipid profile, thyroid function and EKG."

¶ 11 Respondent did not call any witnesses. The trial court then stated its findings as follows:

"[B]ased upon the evidence, based also upon my in-court observations of [respondent], I do find that she is an individual who suffers from serious mental illness. She exhibits deterioration of her abilities to function, and she engages in threatening and disruptive behavior. This illness has existed for a period of time, which has been marked by the continuing presence of these symptoms and repeated episodic occurrence of the symptoms. Benefits of the treatment outweigh the harm. She lacks the capacity to make a reasoned decision about the treatment. Other less restrictive alternatives services have been explored and found inappropriate. Testing is necessary for safe and effectiveadministration of the treatment. She has been notified of the benefits and side [effects] and alternatives to treatment..."

The court also entered a written judgment, in a form order, tracking the language of the legal conclusions required under section 2-107.1 of the Code. See 405 ILCS 5/2-107.1 (a-5)(4) (West 2012). On its form order, the court filled in the name of the respondent, the petitioner, the physician, and the facility administering treatment in the spaces provided on the order. This appeal followed.

¶ 12 II. ANALYSIS

¶ 13 A. Mootness

¶ 14 We first note respondent's claims are moot. The involuntary medication order was a 90-day order entered on April 12, 2013, which expired by its own terms on July 10, 2013. Respondent is no longer subject to this order. See In re Alfred H.H., 233 Ill. 2d 345, 351, 910 N.E.2d 74, 77-78 (2009) (noting that an expired 90-day commitment order, whether valid or not, could not authorize any adverse action against the respondent). As the supreme court noted in Alfred H.H., "[a]s a general rule, courts in Illinois do not decide moot questions, render advisory opinions, or consider issues where the result will not be affected regardless of how those issues are decided." Alfred H.H., 233 Ill. 2d at 351, ...