from the Iowa District Court for Dallas County, Randy Hefner,
defendant argues that the district court erred in failing to
order a competency hearing during trial and in excluding
C. Smith, State Appellate Defender, and Vidhya K. Reddy,
Assistant Appellate Defender, Des Moines, for appellant.
J. Miller, Attorney General, Louis S. Sloven, Assistant
Attorney General, Wayne Reisetter, County Attorney, and Stacy
L. Ritchie and Ronald Forsell, Assistant County Attorneys,
appeal involves an important intersection involving mental
illness and the criminal justice system. In this case, a
criminal defendant's lawyer moved midtrial for a
competency examination of his client who, due to the stresses
of trial was "incapable of aiding [him] in her
defense." The record reveals that the client, among
other things, testified she suffered from paranoid
schizophrenia but had stopped taking prescribed medications
due to lack of funds, stated that she wanted to stab her
lawyer in the neck and wanted to kill him, declared that she
did not know why her lawyer was sitting next to her, told the
court that she had called the FBI and was told she did
nothing wrong, and further declared that she would not write
notes to her lawyer during trial for fear the lawyer would
pass the notes to the prosecution. The district court denied
the motion and the case proceeded to verdict. On appeal, the
defendant claims the district court erred in not ordering a
competency examination and in excluding evidence. For the
reasons expressed below, we reverse the judgment of the
district court and remand the case for further proceedings.
Einfeldt and her two daughters were charged with willful
injury causing bodily injury over a physical altercation
between the three women and a fourth woman named Mulika
Vinson on July 14, 2015. The case went to trial and the
defendants were tried jointly.
to trial, the State sought to exclude all character evidence
about the victim, Vinson. This included evidence related to
Vinson's prior threatening behavior and her convictions
for two assaults and an escape in Nebraska in 2001. She was
fifteen or sixteen years old at the time of the first assault
and nineteen years old at the time of the second assault. At
the time of trial, Vinson was thirty-one years old. Further,
the State sought to exclude evidence of a shooting that
occurred at Einfeldt's apartment complex the evening of
the altercation between Einfeldt, Einfeldt's daughters,
and Vinson. The State asserted that the police found no
evidence of Vinson's involvement in the shooting or that
the shooting was directed at Einfeldt. Finally, the State
sought to specifically exclude testimony by Lacey Chicoine
about Vinson's reputation for violence.
resisted this part of the motion in limine. She argued that
this character evidence was admissible due to her
self-defense justification defense rendering Vinson's
character relevant and probative. With respect to the shots
fired the evening of the altercation, Einfeldt argued that
the evidence was relevant because it supported Einfeldt's
belief that Vinson was a danger to her and others.
pretrial hearing, the district court judge reserved ruling on
the admissibility of Vinson's prior felonies. The court
sustained the part of the State's motion in limine with
respect to the shots fired at Einfeldt's apartment
complex, but emphasized that this was a preliminary ruling
and stated that Einfeldt could make an offer of proof at
trial at which point the court might reconsider its ruling.
With respect to Chicoine's testimony about Vinson's
reputation, the court stressed that proper foundation would
have to be laid to show that Chicoine was aware of
jury selection, but before the presentation of evidence,
Einfeldt again raised the issue of Vinson's prior felony
convictions. The district court found that the probative
value of the evidence was outweighed by its danger of unfair
prejudice, given how long ago the convictions happened and
Vinson's age at the time.
during trial, an attorney for one of Einfeldt's daughters
made an offer of proof concerning Chicoine's testimony
about Vinson outside the presence of the jury. Chicoine
related that at one point she and Vinson were dating the same
man, and Vinson threatened to "kick [Chicoine's]
ass" or "beat [her] up" if Chicoine didn't
stay away from the man. These threats were verbally made to
Chicoine over the course of six months. Vinson never
assaulted Chicoine, however. Chicoine was not aware of Vinson
ever assaulting anyone.
district court found that Chicoine's testimony about
threats was only marginally relevant to the issue of
Vinson's character trait of being prone to physical
aggression. The court noted that Vinson only made threats and
never assaulted Chicoine. The court thus excluded the
evidence as more prejudicial than probative.
Einfeldt made an offer of proof about the shots-fired
incident at her apartment complex, the court ruled that
evidence about the incident was inadmissible. The court found
that the victim's character could not be proven by a
specific instance of conduct in this case or, alternatively,
that there was not clear proof that Vinson was involved in
the shooting, and so the probative value of the evidence was
outweighed by the danger of unfair prejudice.
beginning of the third day of trial, Einfeldt's attorney
advised the court that his client did not remember the events
of the previous day. He called his client to the stand to
further make a record for the purpose of seeking a competency
evaluation under Iowa Code chapter 812 (2015). When asked if
she remembered the events of yesterday, Einfeldt responded,
"No, I guess not. I don't know." She testified
that she did not remember calling the prosecutor a liar or
that she slammed her hand down and was animated with her
lawyer. Further, Einfeldt volunteered, "I just want to
kill you [her lawyer]."
testified that she thought her lawyer was taking her written
notes and giving them to the State and to other
parties. She admitted that she told her lawyer that
she wanted to stab him "with my pen in your neck."
When asked if she could pay attention to the trial, be
helpful to her lawyer, and assist the court when asked to do
things, she responded, "Yeah. Yeah, I don't know, I
don't hear any noises. It's not buzzing. I just
really-I'm in control." Einfeldt volunteered that
someone was "poisoning the water." In light of this
testimony, her lawyer told the court that Einfeldt has
suffered from mental health issues in the past and that
"the stress of the trial has caused her to be incapable
of aiding [him] in her defense."
the district court asked her if she could assist her counsel,
Einfeldt said, "I just, I believe that I don't-I
kind of don't, really. I do, but I don't know who he
is sometimes. Right now I don't know why he's sitting
by me. I don't understand this." Einfeldt
recognized, however, that the person sitting next to her was
her attorney. When the district court asked whether she
understood the charges, she stated, "I don't,
honestly. I called the F.B.I., and they said they don't
think I did anything wrong."
asked by the district court if she understood that she was
being tried for the assault of Vinson, she responded, "I
guess I don't know what assault means, because I think
that I have a right to defend myself." When asked if she
thought she had a defense to the charge, Einfeldt responded,
"Yeah. I don't know."
told the district court that she had been diagnosed with
paranoid schizophrenia, bipolar disorder, posttraumatic
stress disorder, and attention deficit disorder. She stated
she had prescriptions for these disorders but had not been
taking her medication for a couple of months because she did
not have the money.
district court denied the request to suspend the proceedings
and order a chapter 812 examination. The district court
concluded that based on its observations, Einfeldt was
capable of assisting counsel in providing a defense and
understood the nature of the charges against her.
district court revisited the question prior to sentencing. At
this juncture, the district court had the opportunity to
review Einfeldt's medical records as well as a
presentence investigation (PSI) report prepared by the
department of correctional services.
medical records from 2013 showed a provisional diagnosis at
Broadlawns Medical Center (Broadlawns) of paranoid
schizophrenia. The records stated that Einfeldt reported
leaving Minnesota because people wanted to kill her. She
further stated that the television talked to her. Her thought
processes were characterized in the records as delusional. A
regime of drug therapy was prescribed.
report, among other things, noted that Einfeldt had been
diagnosed with "Schizo-Affective Disorder and Bipolar
Depression" at Broadlawns. She had episodes of paranoia
in the past and had received treatment for mental health
issues. Based on Einfeldt's self-report, and corroborated
in the interview, the PSI report stated that Einfeldt was
reporting "psychotic characteristics." The PSI
report recommended an assessment by a licensed professional
"to more thoroughly examine the validity and severity of
these observed features."
district court again declined to order a chapter 812 hearing.
The district court stressed that up until the trial, the
issue of her competency had not been presented by counsel.
The district court stated that while there had been
disruptive behavior, there was no behavior that indicated she
did not understand the charge or was unable to assist counsel
with her own defense.
district court then moved on to sentencing, and Einfeldt was
called to the stand by her attorney. In response to her
attorney's questions, Einfeldt gave rambling, off-topic,
and incoherent answers. For example, when her attorney asked
her to confirm that they were asking the court to sentence
her to probation, Einfeldt denied wanting to ask for
probation and denied that she and her attorney were trying to
seek probation. She announced that she did not care, and then
she launched into a narrative in which she said that she
could not think of three positive things about herself for
the PSI report, that she was hurt by the PSI report author
thinking she would reoffend, and that she would have lower
recidivism because "[m]y prison number is 80655. You
never forget that crap." She then explained that the
first crime she committed was theft in second grade, that her
mother made her stand in the cellar for a week as punishment,
that she was made to feel ashamed in school, that she is
"a fighter" and no one messes with her, and that
she never wanted a jury trial but instead wanted a bench
trial. She concluded by denying that she cares about herself
and stating, "I live my life every day for death. I
don't want to be here."
this allocution, the district court sentenced Einfeldt to a
term of up to five years' incarceration. Einfeldt
Standard of Review.
review whether a trial court should have ordered a competency
hearing de novo. State v. Mann, 512 N.W.2d 528, 531
(Iowa 1994); Jones v. State, 479 N.W.2d 265, 270
rulings are generally reviewed for abuse of discretion."
State v. Tipton, 897 N.W.2d 653, 690 (Iowa 2017);
see also State v. Buenaventura, 660 N.W.2d 38, 50
(Iowa 2003). If a trial court exercises its discretion
"on grounds or for reasons clearly untenable or to an
extent clearly unreasonable, " an abuse of discretion
has occurred. Buenaventura, 660 N.W.2d at 50
(quoting State v. Rodriquez, 636 N.W.2d 234, 239
(Iowa 2001)); see also Tipton, 897 N.W.2d at 690.
Overview of Requirement of Evaluation of Competency to Stand
the United States Constitution, the United States Supreme
Court has declared that the conviction of an incompetent
defendant violates due process. Pate v. Robinson,
383 U.S. 375, 378, 86 S.Ct. 836, 838 (1966). In Dusky v.
United States, a one-page opinion, the Supreme Court
declared that the test for competence to stand trial is
whether the defendant has "sufficient present ability to
consult with his lawyer with a reasonable degree of rational
understanding . . . and . . . a rational as well as factual
understanding of the proceedings against him." 362 U.S.
402, 402, 80 S.Ct. 788, 789 (1960) (per curium).
Supreme Court has also declared that in order to comport with
due process, there must be a procedural mechanism to
determine whether a competency evaluation should be
conducted. Ford v. Wainwright, 477 U.S. 399, 417,
106 S.Ct. 2595, 2605 (1986); Pate, 383 U.S. at 387,
86 S.Ct. at 843. The Supreme Court has said that due process
requires a threshold hearing to be held to determine if there
is sufficient doubt regarding the defendant's mental
capacity to show a need for further evaluation. Drope v.
Missouri, 420 U.S. 162, 172, 95 S.Ct. 896, 904 (1975).
Further, the Supreme Court has made it clear that a defendant
cannot waive the due process right to competency.
Pate, 383 U.S. at 384, 86 S.Ct. at 841.
constitutional commands of due process have been captured in
the ABA's Criminal Justice Standards on Mental Health.
Criminal Justice Standards on Mental Health (Am. Bar
[hereinafter Mental Health Standards]. The ABA standards
generally incorporate Dusky, noting that the test
for determining a defendant's competency when represented
by counsel should be "whether the defendant has
sufficient present ability to consult with defendant's
lawyer with a reasonable degree of rational
understanding" and whether the defendant "has a
rational as well as factual understanding of the
proceedings." Id. standard 7-5.2, at 43. The
standards emphasize that the question of competence may be
raised "at any stage of the proceedings."
Id. standard 7-4.4, at 32. Defense counsel may move
for a competency evaluation even if the motion is over the
defendant's objection. Id. standard 7-4.3(c), at
31. If a motion for a competency evaluation is made by a
represented defendant after probable cause has been found
that a criminal violation has occurred, the court should
enter an order for an evaluation if there is "a good
faith doubt" as to the competency of the defendant.
Id. standard 7-4.4(a), at 32.
like many states, has adopted a statutory procedure to
implement the federal due process requirements as enunciated
by the Supreme Court. Iowa Code section 812.3(1) provides
that "at any stage of a criminal proceeding" a
competency hearing is required when the district court finds
probable cause that there exist "specific facts showing
that the defendant is suffering from a mental disorder which
prevents the defendant from appreciating the charge,
understanding the proceedings, or assisting effectively in
the defense." The court may make a finding of probable
cause either after application by the defendant or the
defendant's attorney, or after holding a probable cause
hearing on its own motion. Id. Probable cause exists
for a competency hearing when a reasonable person would
believe that there is a substantial question of the
defendant's competency. State v. Kempf, 282
N.W.2d 704, 706 (Iowa 1979); see also Moore v. United
States, 464 F.2d 663, 666 (9th Cir. 1972) (noting that
due process requires that when evidence raises a reasonable
doubt about the defendant's competency to stand trial, it
is "substantial evidence" requiring that a
competency hearing be held under the rule of Pate).
When the district court orders an evaluation of competency,
Iowa Code section 812.4 establishes a timetable for the
subsequent competency hearing and the structure of the
emphasized that whether to hold a competency evaluation
presents a legal question. State v. Edwards, 507
N.W.2d 393, 395 (Iowa 1993). As a result, "[t]he trial
court's discretion does not play a role . . . ."
Id. When a constitutional question is raised, our
review of a district court decision regarding whether to
order a competency evaluation is de novo. Id.
connection with application of section 812.3, we have
favorably cited Griffin v. Lockhart, 935 F.2d 926,
930 (8th Cir. 1991), for the proposition that a hearing
should be held when a reasonable trial judge would experience
doubt on whether the defendant was competent to stand trial.
Mann, 512 N.W.2d at 531. Griffin also
stands for the proposition that "an express doubt by the
attorney for the accused is a legitimate factor to
consider." 935 F.2d at 930.
Application of Due Process and Statutory
claims that her constitutional right to due
process as well as her statutory rights under Iowa
Code chapter 812 were violated by the refusal of the district
court to order a competency hearing in this case.
review of the entire record, we conclude the district court
was presented with sufficient reason to order a competency
evaluation under Iowa Code section 812.3, which is a
statutory expression of state and federal due process
requirements. The professional statement of Einfeldt's
attorney regarding the difficulty of representation plays an
important role. See United States v. Sandoval, 365
F.Supp.2d 319, 321-22, 325-26 (E.D.N.Y. 2005) (relying
heavily on the opinions of defense counsel regarding
competence); Jones v. State, 362 So.2d 1334, 1336
(Fla. 1978) (per curiam) (noting role of representations of
counsel in determining competency issues); Richard J. Bonnie,
The Competence of Criminal Defendants: Beyond Dusky
and Drope, 47 U. Miami L. Rev. 539, 563 (1993)
[hereinafter Bonnie] ("[T]he attorney is best situated
to know whether the defendant's impairments compromise
the defense of the case."). Her professed statements
about wanting to kill her lawyer and stab her lawyer in the
neck with a pen, her statement that she did not know why the
lawyer was seated beside her, and her stated belief that her
lawyer would turn over her notes to the State gives one
pause. Einfeldt's lack of memory about what occurred
during the prior day at trial is also troublesome.
the district court, Einfeldt's lawyer made a credible
initial showing that Einfeldt could not have the kind of
relationship with her lawyer to assist in the development of
her legal defense due to her mental state. See
Dusky, 362 U.S. at 402, 80 S.Ct. at 789. Competency
evaluations include a "careful assessment of the
accused's ability to interact with counsel."
See John T. Philipsborn, Searching for
Uniformity in Adjudications of the Accused's Competence
to Assist and Consult in Capital Cases, 10 Psychol. Pub.
Pol'y & L. 417, 422 (2004). Certainly competence to
assist counsel includes a capacity to recognize and relate
pertinent information to counsel concerning the facts of the
case. Bonnie, 47 U. Miami L. Rev. at 561. The ABA standards
stress the need for "present ability" to consult
with counsel. Mental Health Standards, standards 7-4.2, -5.2,
-8.7, at 30, 43, 62. The ABA standards also note that a
finding of incompetence to proceed may arise from any mental
disorder or condition "as long as it results in a
defendant's inability to consult with defense counsel . .
. ." Id. standard 7-4.1, at 30.
the "rational understanding" required under
Dusky means more than being "oriented to time
and place" but includes accurate perception of reality
and proper response to the world around the defendant, not
disruptive behavior and a paranoid relationship with counsel.
Lafferty v. Cook, 949 F.2d 1546, 1550 (10th Cir.
1991) (quoting Dusky, 362 U.S. at 402, 80 S.Ct. at
789). Here, we have evidence of a previous diagnosis of
paranoid schizophrenia, along with contemporaneous testimony
about bizarre thoughts and behavior, including claims of
collusion between defendant's counsel and the
prosecution. See United States v. Ghane, 490 F.3d
1036, 1040-41 (8th Cir. 2007) (finding defendant who suffered
from intermittent periods of delusional paranoia and whose
behavior indicated distrust of his own lawyers incompetent);
United States v. Friedman, 366 F.3d 975, 980-81 (9th
Cir 2004) (finding defendant incompetent because paranoid
schizophrenia directly prevented rational assistance in
defense); United States v. Hemsi, 901 F.2d 293, 296
(2d Cir. 1990) (finding defendant incompetent when record
revealed inability to cooperate rationally in own defense
because of paranoia); Nagi v. People, 389 P.3d 875,
879 (Colo. 2017) (noting "wild accusations of collusion
between his counsel and the prosecution" a factor
indicating need for competency evaluation).
the record shows that the defendant wants to stab her lawyer
in the neck and kill him, believes her lawyer is turning
written notes over to the prosecution, recently has heard
buzzing noises, claims to have been told by the FBI she did
nothing wrong, states she is worried about someone poisoning
the water, and has advised the court that she has had a
history of mental health issues including a diagnosis of
paranoid schizophrenia, yet was noncompliant with prescribed
drug therapy, a reasonable trial court should at least have
some doubts as to the defendant's competency to
effectively assist in the defense as required by Iowa Code
section 812.3(1). See Maxwell v. Roe, 606 F.3d 561,
569-70 (9th Cir. 2010) (holding reasonable doubt of
defendant's competence was created by defendant's
history of mental illness, refusal to take prescribed
antipsychotic medication, inability to control himself in the
courtroom, and exhibition of paranoia impairing
attorney-client relationship). Consistent with ABA Standard
7-4.1(d) related to inability to consult with defense
counsel, the Supreme Court has stated that any one factor
alone may sufficiently raise a reasonable doubt in the mind
of a reasonable trial judge. Dusky, 362 U.S. at 402,
80 S.Ct. at 789; Mental Health Standards, standard 7-4.1(d),
is, perhaps, the question of malingering. The Supreme Court
addressed malingering in the context of competency
evaluations in Cooper v. Oklahoma, 517 U.S. 348, 116
S.Ct. 1373 (1996). In Cooper, the question was
whether a state could impose a heightened "clear and
convincing" standard of proof on a defendant seeking to
show incompetence. Id. at 362, 116 S.Ct. at 1380. In
rejecting a higher standard of proof, the Supreme Court
looked at the consequences of error. Id. at 362-63,
116 S.Ct. at 1381. According to the Cooper Court,
"For the defendant, the consequences of an erroneous
determination of competence are dire. Because he lacks the
ability to communicate effectively with counsel, he may be
unable to exercise other 'rights deemed essential to a
fair trial.' " Id. at 364, 116 S.Ct. at
1381 (quoting Riggins v. Nevada, 504 U.S. 127, 139,
112 S.Ct. 1810, 1817 (1992) (Kennedy, J., concurring)). On
the other hand, "[b]y comparison to the defendant's
interest, the injury to the State of the opposite error-a
conclusion that the defendant is incompetent when he is in
fact malingering-is modest." Id. at 365, 116
S.Ct. at 1382. The teaching of Cooper regarding
comparative interests of the state and the defendant is
particularly compelling in the context of a preliminary
proceeding to simply order a mental health evaluation.
is true that Einfeldt expressed the view that trial should
continue. So did the defendant in Kempf, who
declared he desired to plead guilty and get started on prison
time to "get it over with." 282 N.W.2d at 707. Such
statements did not defeat the assertion of incompetence
advanced by Kempf's counsel. Id. at 707, 710;
see also Sandoval, 365 F.Supp.2d at 324, 328