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State v. R.G.

Superior Court of New Jersey, Appellate Division

July 31, 2019

STATE OF NEW JERSEY, Plaintiff-Appellant,
R.G., Defendant-Respondent.

          Argued June 4, 2019

          On appeal from an interlocutory order of the Superior Court of New Jersey, Law Division, Somerset County, Indictment No. 17-04-0189.

          Paul Henry Heinzel, Assistant Prosecutor, argued the cause for appellant (Michael H. Robertson, Somerset County Prosecutor, attorney; Paul Henry Heinzel, of counsel and on the briefs).

          Joseph J. Russo, Deputy Public Defender, argued the cause for respondent (Joseph E. Krakora, Public Defender, attorney; Joseph J. Russo, on the brief).

          Alexander R. Shalom argued the cause for amicus curiae American Civil Liberties Union of New Jersey (American Civil Liberties Union of New Jersey Foundation, attorneys; Alexander R. Shalom and Jeanne M. Locicero, on the brief).

          Before Judges Fisher, Suter and Enright.


          SUTER, J.A.D.

         The State appeals the January 7, 2019 order of the trial court that denied its request for an order to involuntarily medicate defendant R.G. to restore him to competency to stand trial. We affirm the trial court's order. We agree with the trial court that the State did not satisfy the test under Sell v. United States, 539 U.S. 166 (2003), because the first factor is determined by consideration of defendant's probable sentence not simply the maximum sentence exposure for the offense charged. The trial court also must consider the potential effect of the medication on defendant's right to a fair trial when applying Sell. Because the Sell test was not satisfied, we have no occasion to determine whether our State Constitution would afford a defendant greater protection of individual liberty or privacy rights.


         Defendant's mother was attending a wedding in California when she asked the police to check on her husband's welfare because she had not heard from him. Defendant answered the door when the police arrived dressed only in a blanket. The police inquired about his father. Defendant pointed to the floor where his father was lying. A pool of blood was near his father's mouth. He had vomit on his face, was breathing but with difficulty, and had a mild pulse. There were no visible signs of trauma. Defendant told the police his father had been laying there for about twelve to twenty-four hours. Defendant was waiting to summon help because his father had a similar gastrointestinal bleed in the past and recovered. Defendant also told the police illogical things about developing weapons for the government. Defendant's father died at the hospital the next day of natural causes.

         Defendant was charged with third-degree neglect of an elderly or disabled person, N.J.S.A. 2C:24-8(a). He remained in jail from mid-December 2016 until the end of May 2017, when his bail was reduced and he was released. More than eight months later, and following a request by his attorney, the trial judge entered an order under N.J.S.A. 2C:4-5(a)(2) that required defendant to take a fitness to proceed (competency) examination. The examining psychologist recommended conducting the examination in a hospital.

         On June 1, 2018, defendant was remanded to the Somerset County Jail without bail and later admitted to Trenton Psychiatric Hospital (TPH) for the competency evaluation that was conducted in October 2018. He was found not competent to stand trial. To our knowledge, he remains a patient at TPH.

         In October 2018, the State filed a motion for an order to require defendant to be involuntarily medicated because defendant refused to take antipsychotic medication voluntarily. The State claimed it had an important interest in restoring defendant to competence, that he would likely become competent with medication and that medication was in his best interest.

         At the competency hearing in December 2018, Dr. Jonathan L. Rapaport, a forensic psychologist, testified, based on his examination, that defendant had a delusional disorder and psychosis because he believed his father was still alive even though he had been shown the autopsy photographs. Defendant's mental illness was impairing his ability to assist his attorney with a defense. Dr. Rapaport testified defendant was not competent to stand trial.

         He recommended steps to restore defendant to competency: defendant should attend a competency restoration group at TPH to assist in understanding the legal process and take antipsychotic medication. Dr. Rapaport opined that medication would "help greatly" to alleviate defendant's psychosis and "very likely" improve defendant's mental state. Defendant was not participating in any groups at TPH. Although defendant remained competent to decide his own medical issues, he was refusing to take any antipsychotic medication.

         Dr. Rapaport testified the medication was a necessary treatment for defendant and the lack of medication was preventing him from becoming competent to stand trial. He claimed that defendant "possibly" was a danger to himself or others because he had become physically agitated when they were discussing the medication issue, and because he allegedly had a history of assault and domestic violence. Dr. Rapaport testified that medication would help defendant's delusions "to gradually dissipate" although there was "no guarantee." Defendant's psychosis was severe. Dr. Rapaport was of the view that although defendant's participation in group therapy would be helpful, antipsychotic medication was "necessary."

         Dr. Yves George Dubois, an attending psychiatrist at TPH, also examined defendant. He testified that defendant did not have the mental capacity to stand trial. Defendant had a delusional disorder with a "disorganized" thought process and "bizarre" thinking. With this "chronic psychosis," defendant was "losing brain cells" that eventually could impair his memory and affect his activities of daily living. Defendant could become dangerous. Dr. DuBois recommended that defendant take medications such as Haldol or Prolixin to gain competence to proceed to trial and for his mental health. Either medication was medically appropriate for his condition. Because Prolixin could cause a rise in "blood pressure, weight gain [and] diabetes," Dr. Dubois recommended prescribing Haldol.

         He testified that both antipsychotic medications could cause "abnormal movement, like shaking, tremors" and "rigidity," but there were other medications to control that. In his opinion, the side effects from the medication would not undermine the fairness of a trial. For drowsiness, he suggested decreasing the dosage. He testified the medication would not prevent defendant's rapid reaction to events that happened on the stand. Dr. Dubois acknowledged that Haldol could decrease defendant's ability to express emotions, but he testified, "we have other medication to counteract that and we can also decrease the dosage."

         Dr. Dubois testified that defendant was becoming more delusional although he was not declining cognitively, meaning that defendant could appreciate the necessity to take medication to improve his life. He was not violent. He did not pose an imminent danger at TPH. Because of this, Dr. Dubois could not ...

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