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In re M.L.

Court of Appeals of Iowa

May 16, 2018

IN THE MATTER OF M.L., Alleged to be Seriously Mentally Impaired, M.L., Respondent-Appellant.

          Appeal from the Iowa District Court for Johnson County, Paul D. Miller, Judge.

         A prison inmate appeals an order for involuntary hospitalization.

          Sandra R. Hart of Hart Law, North Liberty, for appellant.

          Thomas J. Miller, Attorney General, and Gretchen W. Kraemer, Assistant Attorney General, for appellee State.

          Considered by Vaitheswaran, P.J., and Potterfield and Tabor, JJ.

          TABOR, Judge.

         The Iowa Department of Corrections (DOC) successfully sought an involuntary hospitalization order against M.L. after the offender engaged in a series of aggressive acts toward prison staff. On appeal, M.L. contends the record does not support the district court's finding he would be likely to injure others if allowed to remain at liberty (within the prison system) without treatment. See Iowa Code § 229.1(20) (2017). Because the State offered clear and convincing evidence M.L. suffered from a serious mental impairment, we affirm the involuntary hospitalization order.

         I. Facts and Prior Proceedings

         M.L. was incarcerated after his 2012 conviction for theft in the first degree. While in DOC custody, M.L. has been diagnosed and treated for bipolar disorder type I and antisocial personality disorder. In February 2016, M.L. refused to take prescribed medications and attempted to assault a DOC staff member. As a result, the DOC transferred M.L. to the Iowa Medical and Classification Center (IMCC) and treating physician Gary Keller initiated the civil commitment process.[1] M.L. showed signs of improvement and expressed a willingness to take his medication. Although M.L. spit on and struck a correctional officer in April 2017, M.L. had made enough progress that Dr. Keller recommended the civil commitment process terminate in May 2017.

         But just a few weeks later, M.L. claimed he overdosed on medication he hoarded in his cell. And then he stopped taking his medication altogether. He again spit on a DOC officer. Following these events, M.L. was transferred back to IMCC for evaluation and treatment. The next day, he threatened to kill a nurse over a disagreement about a nail clipper. Due to M.L.'s erratic behavior and unwillingness to take his medication, the DOC again initiated civil commitment proceedings. Then, a few days later, M.L. made sexual comments to a nursing student prompting the supervising nurse to instruct the student to leave. Angry over the supervising nurse's decision, M.L. threatened the supervising nurse.

         In June 2017, following a hearing and after considering Dr. Keller's written report, a judicial hospitalization referee determined M.L. was seriously mentally impaired, dangerous, and should be involuntarily hospitalized. M.L. appealed to the district court claiming he did not suffer from mental illness and was willing to take his medication to avoid commitment. In his testimony, Dr. Keller expressed concern about M.L.'s willingness to comply with mental-health treatment, noting M.L. previously had the chance to regulate his own medication and he stopped taking it, resulting in his aggressive behavior. M.L. asserted his troubling behavior was the result of his conscious choices and would not be mitigated by medication. The district court concluded M.L. was mentally impaired to the extent he is not able to make responsible decisions regarding his treatment and is likely to physically injure others, making involuntary hospitalization appropriate. M.L. now appeals the district court's findings.

         II. Scope and Standard of Review

         We review challenges to the sufficiency of the evidence supporting civil commitment proceedings for legal error. In re B.B., 826 N.W.2d 425, 428 (Iowa 2013). Claims asserted in the involuntary hospitalization application must be shown through clear and convincing evidence. Iowa Code § 229.13(1) (2017); In re J.P., 574 N.W.2d 340, 342 (Iowa 1998). Clear and convincing evidence "means that there must be no serious or substantial doubt about the correctness of a particular conclusion drawn from the evidence." J.P., 574 N.W.2d at 342 (quoting In re L.G., 532 N.W.2d 478, 481 (Iowa Ct. App. 1995)). The district court's factual findings are binding on this court if supported by clear and convincing evidence. Id.

         III. ...

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