United States v. Christopher Tucker ( 2023 )


Menu:
  • USCA4 Appeal: 22-4025   Doc: 55        Filed: 02/24/2023      Pg: 1 of 18
    PUBLISHED
    UNITED STATES COURT OF APPEALS
    FOR THE FOURTH CIRCUIT
    No. 20-4537
    UNITED STATES OF AMERICA,
    Plaintiff-Appellee,
    v.
    CHRISTOPHER LEWIS TUCKER,
    Defendant-Appellant.
    No. 21-4166
    UNITED STATES OF AMERICA,
    Plaintiff-Appellee,
    v.
    CHRISTOPHER LEWIS TUCKER,
    Defendant-Appellant.
    No. 22-4025
    UNITED STATES OF AMERICA,
    Plaintiff-Appellee,
    USCA4 Appeal: 22-4025      Doc: 55         Filed: 02/24/2023      Pg: 2 of 18
    v.
    CHRISTOPHER LEWIS TUCKER,
    Defendant-Appellant.
    No. 22-4026
    UNITED STATES OF AMERICA,
    Plaintiff-Appellee,
    v.
    CHRISTOPHER LEWIS TUCKER,
    Defendant-Appellant.
    Appeals from the United States District Court for the Middle District of North Carolina, at
    Greensboro. Thomas D. Schroeder, Chief District Judge. (1:17-cr-00221-TDS-1)
    Argued: January 27, 2023                                      Decided: February 24, 2023
    Before GREGORY, Chief Judge, and WILKINSON and HEYTENS, Circuit Judges.
    Affirmed by published opinion. Judge Heytens wrote the opinion, in which Chief Judge
    Gregory and Judge Wilkinson joined.
    ARGUED: Eric J. Brignac, OFFICE OF THE FEDERAL PUBLIC DEFENDER, Raleigh,
    North Carolina, for Appellant. Julie Carol Niemeier, OFFICE OF THE UNITED STATES
    ATTORNEY, Greensboro, North Carolina, for Appellee. ON BRIEF: G. Alan DuBois,
    Federal Public Defender, Jaclyn L. Tarlton, Assistant Federal Public Defender, OFFICE
    OF THE FEDERAL PUBLIC DEFENDER, Raleigh, North Carolina, for Appellant.
    Sandra J. Hairston, United States Attorney, Eric L. Iverson, Assistant United States
    2
    USCA4 Appeal: 22-4025   Doc: 55   Filed: 02/24/2023   Pg: 3 of 18
    Attorney, OFFICE OF THE UNITED STATES ATTORNEY, Greensboro, North
    Carolina, for Appellee.
    3
    USCA4 Appeal: 22-4025      Doc: 55         Filed: 02/24/2023      Pg: 4 of 18
    TOBY HEYTENS, Circuit Judge:
    This case involves a criminal defendant who has been declared mentally
    incompetent to stand trial and languished in pretrial custody for more than five years. The
    district court found that involuntary medication is substantially likely to render the
    defendant competent and ordered a final extension of confinement to permit that
    medication to work. We affirm.
    I.
    The Fifth Amendment declares no person “shall be . . . deprived of . . . liberty . . .
    without due process of law.” U.S. Const. amend. V. The issues in this case concern several
    overlapping strands of that guarantee.
    A criminal prosecution may not proceed unless the defendant is competent. See Pate
    v. Robinson, 
    383 U.S. 375
    , 378 (1966). For constitutional purposes, the test “is whether the
    defendant has sufficient present ability to consult with his lawyer with a reasonable degree
    of rational understanding and has a rational as well as factual understanding of the
    proceedings against him.” Godinez v. Moran, 
    509 U.S. 389
    , 396 (1993) (quotation marks
    omitted). A person who is not competent may not be tried for—or plead guilty to—a crime.
    See 
    id. at 391
    .
    The Due Process Clause also limits the government’s efforts to restore a person’s
    competency. On the one hand, “the Constitution permits the [g]overnment involuntarily to
    administer antipsychotic drugs to a mentally ill defendant facing serious criminal charges
    in order to render that defendant competent to stand trial.” Sell v. United States, 
    539 U.S. 166
    , 179 (2003). But because doing so implicates “a significant constitutionally protected
    4
    USCA4 Appeal: 22-4025        Doc: 55        Filed: 02/24/2023     Pg: 5 of 18
    liberty interest,” the Due Process Clause imposes restrictions as well. 
    Id. at 178
     (quotation
    marks omitted). Under Sell’s four-factor test, involuntary medication may be ordered
    “only” if: (1) “important governmental interests are at stake”; (2) “involuntary medication
    will significantly further those . . . interests”; (3) “involuntary medication is necessary to
    further those interests”; and (4) “administration of the drugs is medically appropriate.” 
    Id.
    at 179–81 (emphasis removed). “The government must establish each element of this test
    by clear and convincing evidence.” United States v. Chatmon, 
    718 F.3d 369
    , 374 (4th Cir.
    2013).
    Similarly, the Due Process Clause allows civil commitment to restore a defendant’s
    competency but “requires that the nature and duration of commitment bear some
    reasonable relation to the purpose for which the individual is committed.” Jackson v.
    Indiana, 
    406 U.S. 715
    , 738 (1972). For that reason, a person charged “with a criminal
    offense who is committed solely on account of his incapacity to proceed to trial cannot be
    held more than the reasonable period of time necessary to determine whether there is a
    substantial probability that he will attain that capacity in the foreseeable future.” 
    Id.
    “Furthermore, even if it is determined that the defendant probably soon will be able to stand
    trial, his continued commitment must be justified by progress toward that goal.” 
    Id.
    Congress has enacted procedures for implementing Jackson’s requirements. At any
    time before sentencing, a court may hold a hearing “to determine the mental competency
    of the defendant.” 
    18 U.S.C. § 4241
    (a). If the court finds by a preponderance of the
    evidence that the defendant “is unable to understand the nature and consequences of the
    proceedings against him or to assist properly in his defense, the court shall commit the
    5
    USCA4 Appeal: 22-4025       Doc: 55          Filed: 02/24/2023      Pg: 6 of 18
    defendant to the custody of the Attorney General,” who “shall hospitalize the defendant for
    treatment in a suitable facility.” § 4241(d).
    Consistent with the Supreme Court’s decision in Jackson, however, such periods of
    hospitalization must be limited. The defendant may initially be hospitalized “for such a
    reasonable period of time, not to exceed four months, as is necessary to determine whether
    there is a substantial probability that in the foreseeable future he will attain the capacity to
    permit the proceedings to go forward.” § 4241(d)(1). The defendant may then be
    hospitalized “for an additional reasonable period of time until” the “earlier” of two events.
    § 4241(d)(2). The first is if the defendant’s “mental condition is so improved that trial may
    proceed,” so long as “the court finds that there is a substantial probability that within such
    additional period of time he will attain the capacity to permit the proceedings to go
    forward.” § 4241(d)(2)(A). The second is if all “pending charges . . . are disposed of
    according to law.” § 4241(d)(2)(B).
    II.
    Christopher Lewis Tucker was arrested almost six years ago and has been in federal
    custody ever since. Under the controlling indictment, Tucker is charged with two counts
    of attempting to persuade people he believed to be minors to produce child pornography;
    one count of transporting or shipping child pornography; one count of receiving child
    pornography; and one count of possessing a firearm while being addicted to a controlled
    substance. The first two counts carry sentences of “not less than 15 years nor more than 30
    years.” 
    18 U.S.C. § 2251
    (e). The other two child pornography offenses authorize sentences
    of “not less than 5 years and not more than 20 years,” § 2252A(b)(1), with the firearms
    6
    USCA4 Appeal: 22-4025      Doc: 55          Filed: 02/24/2023     Pg: 7 of 18
    offense having a potential sentence of “not more than 15 years,” § 924(a)(8). Following
    any incarceration, the four child pornography offenses would each require a supervised
    release term of “not less than 5” years and up to life. § 3583(k).
    In August 2017—three months after Tucker was arrested—his lawyer moved to
    have him declared mentally incompetent. In September 2017, the district court found
    Tucker incompetent and committed him to the custody of the Attorney General.
    Tucker spent the next seven months being evaluated at correctional institutions in
    Chicago and San Diego. In May 2018, the district court held another hearing, at which it
    recommitted Tucker to the custody of the Attorney General for a restoration of
    competency. At no point before or during that hearing did Tucker’s lawyer “object to the
    length of [Tucker’s] evaluation” or “challenge the court’s authority to order a subsequent
    period.” JA 954 n.4. To the contrary, defense counsel “agreed with . . . the court’s intention
    to commit Tucker to the custody of the Attorney General for restoration of competency.”
    JA 954.
    In June 2018, Tucker was admitted to the Federal Medical Center in Butner, North
    Carolina. Just over five months later, a forensic psychologist submitted a report concluding
    Tucker was still not competent to stand trial but there was “a substantial likelihood . . .
    Tucker [could] be restored to competency in the foreseeable future with [a] combination
    of ” medication and individualized treatment. JA 955. The forensic psychologist thus
    “requested an additional period of evaluation and treatment to continue restoration efforts.”
    JA 956. Once again, Tucker’s counsel “did not object,” and the district court ordered “that
    Tucker’s period of restoration of competency be extended.” JA 956.
    7
    USCA4 Appeal: 22-4025       Doc: 55        Filed: 02/24/2023      Pg: 8 of 18
    In May 2019, the forensic psychologist submitted another report detailing the efforts
    to restore Tucker’s competency. That report described Tucker as only intermittently
    compliant with his medication regimen but stated that his symptoms “responded well to
    medication treatment with antipsychotics and antidepressants in the past” and there was
    “substantial probability that his symptoms would be further attenuated with ongoing
    medication treatment.” JA 957. The report said Tucker was “right at the threshold of
    competency, and likely would have been restored had he complied with medication
    treatment.” JA 958. The report recommended another period of evaluation and treatment,
    as well as an order permitting the involuntary administration of medication should Tucker
    continue to resist taking it.
    The government requested an involuntary medication order and the district court set
    a hearing. Before that hearing could take place, however, Tucker’s mother hired a new
    lawyer to represent Tucker, who requested a delay. The district court reset the hearing for
    August 30, 2019.
    Before the hearing, the government moved for a further extension of the time for
    evaluation and treatment and withdrew its request for an involuntary medication order. On
    August 12, 2019, Tucker filed a written objection to that motion, arguing that, absent a
    request for involuntary medication, there was no basis for his continued detention. Two
    days later, the government renewed its request for an involuntary medication order, citing
    a report from the medical facility’s chief psychiatrist that Tucker had “firmly and
    unequivocally told us . . . he was stopping all of his psychiatric medications going forward”
    and was insisting that he was “competent to stand trial.” JA 961. The hearing was delayed
    8
    USCA4 Appeal: 22-4025      Doc: 55         Filed: 02/24/2023      Pg: 9 of 18
    again after Tucker had “a physical altercation with another inmate,” and his attorneys
    requested a continuance. JA 962.
    The district court ultimately held two hearings in September 2019, at which three
    medical professionals testified, two for the government and one for Tucker. On October
    22, 2019, the district court issued a 49-page opinion finding “the Government ha[d] shown,
    by clear and convincing evidence, that involuntary medication under Sell is appropriate
    and that an additional [four-month] period to restore Tucker to competency through mental
    health treatment is warranted.” JA 545–46.
    Tucker filed a notice of appeal and asked the district court to stay its order pending
    that appeal. The district court granted Tucker’s request, staying its order “until such time
    as Defendant’s appeal to the Fourth Circuit is resolved.” JA 548. Almost two years later,
    this Court granted the government’s motion to remand the case to the district court for
    further consideration of “whether the administration of drugs, as currently prescribed,
    [wa]s substantially likely to render Tucker competent to stand trial.” United States v.
    Tucker, No. 19-4805, 
    2021 WL 4352382
    , at *2 (4th Cir. 2021) (per curiam). This Court’s
    mandate issued on October 18, 2021.
    After the case was remanded, Tucker moved to dismiss the indictment and argued
    for his immediate release. The district court conducted another hearing, at which it again
    heard testimony from the chief psychiatrist. Less than a month later, the court issued a 42-
    page opinion concluding an involuntary medication order was appropriate and granting the
    government “four months within which to” restore Tucker’s competency. JA 987. The
    9
    USCA4 Appeal: 22-4025       Doc: 55          Filed: 02/24/2023   Pg: 10 of 18
    district court also stayed its involuntary medication order “until such time as [Tucker’s]
    appeal to the Fourth Circuit is resolved.” JA 987.
    Tucker appeals anew, challenging both the involuntary medication order and his
    continued detention. We have appellate jurisdiction to consider both under 
    28 U.S.C. § 1291
    . See Sell, 
    539 U.S. at
    175–77 (appeals from involuntary medication orders fall
    within the collateral order doctrine); United States v. Curbow, 
    16 F.4th 92
    , 115 (4th Cir.
    2021) (appeals from commitment order entered under 
    18 U.S.C. § 4241
    (d)(2) also fall
    within the collateral order doctrine). 1
    III.
    Our role is confined by the applicable standards of appellate review. The first Sell
    factor—whether “important governmental interests are at stake,” 
    539 U.S. at 180
    (emphasis removed)—presents “a legal conclusion that we review de novo, although we
    review any factual findings relevant to this legal determination for clear error.” United
    States v. Evans, 
    404 F.3d 227
    , 236 (4th Cir. 2005) (citation omitted). In contrast, “[t]he
    remaining three [Sell] factors”—which seek to predict the likely success of an involuntary
    medication order and to assess alternatives—“present factual questions subject to clear
    error review.” United States v. White, 
    620 F.3d 401
    , 410 (4th Cir. 2010). The district
    court’s determination that Tucker’s continued hospitalization is reasonable under
    1
    Tucker also filed several pro se notices of appeal that have been consolidated with
    his counseled appeal in No. 20-4537. We also have jurisdiction over these appeals under
    the collateral order doctrine. We conclude any challenge to the district court’s competency
    order is forfeited because it was not raised in Tucker’s opening brief. See Grayson O Co.
    v. Agadir Int’l LLC, 
    856 F.3d 307
    , 316 (4th Cir. 2017). Tucker’s remaining pro se
    challenges are subsumed by our reasons for rejecting the arguments raised by his attorneys.
    10
    USCA4 Appeal: 22-4025       Doc: 55         Filed: 02/24/2023      Pg: 11 of 18
    
    18 U.S.C. § 4241
    (d)(2) is also “a finding of fact that we review for clear error.” Curbow,
    16 F.4th at 109.
    A.
    We hold the district court committed no reversible error in entering an involuntary
    medication order. Tucker challenges two facets of the district court’s decision. First,
    Tucker contends the district court failed to properly consider that he has already spent more
    than five years in federal custody. Second, Tucker asserts the district court clearly erred in
    concluding the government’s proposed treatment plan is likely to restore his competency.
    We are not persuaded by either argument.
    1.
    The first Sell factor asks whether “important governmental interests are at stake.”
    
    539 U.S. at 180
    . Not surprisingly, the Supreme Court has emphasized the government has
    an “important” interest “in bringing to trial an individual accused of a serious crime.” 
    Id.
    At the same time, “[c]ourts . . . must consider the facts of the individual case in evaluating
    the [g]overnment’s interest in prosecution,” including whether “[s]pecial circumstances
    may lessen the importance of that interest” in a particular situation. 
    Id.
    “[T]he central consideration when determining whether a particular crime is serious
    enough to satisfy [the first Sell] factor is the ‘maximum penalty authorized by statute.’”
    Chatmon, 
    718 F.3d at 374
     (quoting Evans, 
    404 F.3d at 237
    ). This Court has declared it
    “beyond dispute” that the government has “an important interest in trying a defendant
    charged with a felony carrying a maximum punishment of 10 years imprisonment.” Evans,
    
    404 F.3d at 238
    . Here, the offenses Tucker is charged with carry maximum penalties
    11
    USCA4 Appeal: 22-4025       Doc: 55        Filed: 02/24/2023      Pg: 12 of 18
    ranging from 15 to 30 years of imprisonment. See pp. 5–6, supra.
    The circumstances of this case, taken as a whole, do not eliminate the government’s
    otherwise substantial interest in prosecuting Tucker. Tucker emphasizes he has already
    been detained for more than five years. He also notes that, before he was even arrested, the
    government agreed to let him plead guilty to a single count of transporting child
    pornography—an offense whose penalty range would have been between five and 20 years
    of imprisonment. Had he ultimately decided to plead guilty, Tucker argues, “he would
    likely have had an advisory Guidelines range at or near the minimum sentence of 60
    months.” Tucker Br. 43.
    Without question, the fact that Tucker “has already been confined for a significant
    amount of time” cuts against the government. Sell, 
    539 U.S. at 180
    . Tucker is also right
    that this Court has considered the length of a defendant’s “likely prison sentence” in
    assessing whether an extended period of pretrial detention undermines “the government’s
    interests in protecting the public, in general and specific deterrence, and in obtaining just
    punishment.” White, 
    620 F.3d at 413, 415
    . And although Tucker cites no decision of any
    court that has considered evidence of previous potential plea agreements in assessing the
    strength of the government’s interest, we need not—and do not—treat such evidence as
    irrelevant to the Sell analysis.
    Instead, we hold only that—under “the facts of th[is] individual case”—the
    government retains a substantial interest in prosecuting Tucker. Sell, 
    539 U.S. at 180
    .
    Tucker is charged with five felony offenses, two of which carry minimum sentences of 15
    years of imprisonment. See pp. 5–6, supra. Unlike White, then, this is not a situation where
    12
    USCA4 Appeal: 22-4025       Doc: 55         Filed: 02/24/2023      Pg: 13 of 18
    Tucker’s pretrial detention will last “considerably longer than [his] likely sentence.”
    
    620 F.3d at 418
    .
    In addition, the offenses with which Tucker is charged are not comparable to the
    purely financial crimes at issue in White. See 
    620 F.3d at 405
     (describing charges). Despite
    often being shorthanded as “child pornography,” this Court has recently emphasized that
    the term “child sexual abuse material” more “accurately reflect[s] what is depicted—the
    sexual abuse and exploitation of children.” United States v. Morehouse, 
    34 F.4th 381
    , 384
    n.1 (4th Cir. 2022) (quotation marks omitted). Tucker is not only charged with knowingly
    possessing or transferring such materials. Rather, Tucker is accused of twice seeking to
    convince “a person whom [he] believed to be a minor to engage in . . . sexually explicit
    conduct for the purpose of producing [a] visual depiction of such conduct, knowing and
    having reason to know that such visual depiction[] would be transported” in interstate or
    foreign commerce. JA 81. While “[n]ot every serious crime is equally serious,” White,
    
    620 F.3d at 419
    , the ones charged here are grave by any measure.
    Finally, this is not a situation when “[t]he defendant’s failure to take drugs
    voluntarily” will result in “lengthy confinement in an institution for the mentally ill.” Sell,
    
    539 U.S. at 180
    . To some extent, that fact cuts both for and against Tucker because the
    reason he may be ineligible for indefinite civil commitment is that the government cannot
    show his release would create a substantial danger to others. See Oral Arg. 32:10–33:46;
    see also 
    18 U.S.C. §§ 4246
    (d), 4247(a)(5), 4248(d). At the same time, however, the
    unlikelihood of future confinement absent an involuntary medication order means “the
    risks that ordinarily attach to freeing without punishment one who has committed a serious
    13
    USCA4 Appeal: 22-4025      Doc: 55         Filed: 02/24/2023     Pg: 14 of 18
    crime” are not eliminated. Sell, 
    539 U.S. at 180
    . Here, such risks would notably include an
    inability to provide “appropriate monitoring” through a period of supervised release.
    United States v. Bush, 
    585 F.3d 806
    , 815 (4th Cir. 2009).
    2.
    We also conclude the district court committed no clear error in finding an
    involuntary medication order would significantly further the government’s interest in
    prosecuting Tucker. Under the second Sell factor, the government must show
    “administration of the drugs is substantially likely to render the defendant competent to
    stand trial” and that administration of such drugs “is substantially unlikely to have side
    effects that will interfere significantly with the defendant’s ability to assist counsel in
    conducting a trial defense.” Sell, 
    539 U.S. at 181
    . “[T]he government must not only show
    that a treatment plan works on a defendant’s type of mental disease in general, but that it
    is likely to work on this defendant in particular.” Bush, 
    585 F.3d at 816
    .
    Tucker’s argument has two parts. First, Tucker asserts the district court “basically
    ordered the same medication course (with a slight dosage alteration)” that had been tried
    previously without an involuntary medication order. Tucker Br. 37. Second, Tucker insists
    “we know” the treatment plan ordered by the district court “would be unlikely to work” for
    him “because it ha[s] already been tried and failed.” Id. at 38.
    Had we been sitting as the court of first instance, we might have agreed with Tucker
    on these points. But the parties competing arguments delve deep into the particulars of
    Tucker’s extensive medical history and the intricacies of treating a severe mental illness—
    areas where the district court’s comparative expertise is at its zenith and ours its nadir.
    14
    USCA4 Appeal: 22-4025      Doc: 55          Filed: 02/24/2023     Pg: 15 of 18
    What is more, the ultimate question before the district court was not what happened in the
    past or why. Instead, as the government correctly observes, the district court was tasked
    with “evaluating Tucker’s current prognosis and the likelihood that the currently
    recommended treatment would render him competent.” U.S. Br. 36. Having scrutinized the
    parties’ arguments and the record, we are not left “with the definite and firm conviction
    that a mistake has been committed.” United States v. United States Gypsum Co., 
    333 U.S. 364
    , 395 (1948). We thus hold the district court committed no reversible error in finding
    the second Sell requirement was satisfied.
    B.
    We also conclude the district court made no clear error in finding Tucker’s current
    confinement “reasonable” under 
    18 U.S.C. § 4241
    (d)(2)(A) and thus denying his motion
    for immediate release. 2
    In assessing whether a period of confinement can be justified, “precedent and the
    governing statutory framework require the [g]overnment to act with reasonable speed”
    rather than “in the quickest possible manner.” Curbow, 16 F.4th at 112. Thus, a
    commitment period under Section 4241(d)(2)(A) is generally reasonable so long as it is not
    attributable to more than “reasonable explainable administrative delays.” United States v.
    Wayda, 
    966 F.3d 294
    , 308 (4th Cir. 2020); see Tucker Br. 25 (acknowledging Curbow and
    Wayda provide the governing standard). In addition, because “the proper time and place to
    contest [any] alleged unreasonable delays” is at the time of the relevant delay, a defendant’s
    2
    Although Tucker asserts his continued detention also violates the Due Process
    Clause, he develops no separate argument on that point.
    15
    USCA4 Appeal: 22-4025      Doc: 55          Filed: 02/24/2023     Pg: 16 of 18
    failure to lodge a timely objection to a particular period forfeits or waives any later
    challenge. See Curbow, 16 F.4th at 115–16 & n.11. This remains true even if the defendant
    “has been deemed mentally incompetent and unable to understand and assist in the
    proceedings against him,” so long as the defendant “has continuously been represented by
    counsel responsible for choosing his legal strategy and protecting his interests.” Id. at 117.
    Under Curbow, we must begin by identifying which—if any—periods we may
    properly review. And, like the district court, we conclude Tucker has forfeited (if not
    waived) any challenge to most of his confinement. See United States v. Olano, 
    507 U.S. 725
    , 733 (1993) (describing the difference between waiver and forfeiture).
    Tucker acknowledges he made no objection to his detention until August 12, 2019.
    At that point, the district court was scheduled to hold a hearing on August 30—just 18 days
    later. That hearing, however, was delayed for several more weeks at Tucker’s request,
    before ultimately being held on dates suggested by Tucker’s counsel. Less than a month
    after the final hearing, the district court issued a comprehensive order finding involuntary
    medication was warranted and ordering Tucker detained for four months to carry out such
    treatment. The next day, Tucker moved to stay the involuntary medication order pending
    appeal, and that stay has been in place ever since. After this Court remanded for further
    proceedings, the district court scheduled a new evidentiary hearing for 30 days later, but
    delayed the hearing for 16 additional days “at the request of both parties.” JA 967 n.16.
    Once the remand hearing was held, the district court issued a new decision less than a
    month later, concluding involuntary medication remained appropriate and ordering another
    four-month period of confinement to facilitate efforts to restore Tucker’s competency.
    16
    USCA4 Appeal: 22-4025        Doc: 55         Filed: 02/24/2023     Pg: 17 of 18
    Since then, the case has been before this Court on Tucker’s various appeals. See note 1,
    supra.
    Under the circumstances of this case, we conclude the district court did not clearly
    err in finding Tucker’s continued detention was reasonable. Even were we to grant
    Tucker’s premise that he has continually objected to his detention since August 2019, the
    vast majority of that time occurred after the district court concluded (and then re-
    concluded) an involuntary medication order was appropriate and while Tucker pursued two
    rounds of appeals to this Court. Tucker was, of course, well within his rights to challenge
    the district court’s involuntary medication order and seek a stay of that order until its
    lawfulness was resolved. See Sell, 
    539 U.S. at 177
     (emphasizing the “severity of the
    intrusion and corresponding importance of the constitutional issue[s]” raised by
    involuntary medication orders). At the same time, the delays associated with those appeals
    do not fatally undermine the district court’s finding that an additional period of
    commitment is reasonable to give its involuntary medication order an opportunity to work.
    *      *      *
    Involuntary medication orders “carry an unsavory pedigree,” and prolonged pretrial
    detention of a presumptively innocent person “is serious business.” Chatmon, 
    718 F.3d at 374
     (first quote); United States v. Williams, 
    53 F.4th 825
    , 832 (4th Cir. 2022) (second
    quote). Given the deferential standards of review, we conclude the district court committed
    no reversible error in deciding an involuntary medication order was warranted and finding
    it appropriate to grant one final four-month period of confinement to attempt to restore
    Tucker’s competency. We emphasize, however, that “[a]t some point [the government]
    17
    USCA4 Appeal: 22-4025       Doc: 55        Filed: 02/24/2023      Pg: 18 of 18
    can’t keep trying and failing and trying and failing, hoping to get it right,” JA 481, and we
    trust no further extensions will be sought once the current appeal is finally resolved. The
    orders of the district court are
    AFFIRMED.
    18