In re: W.R.D. , 248 N.C. App. 512 ( 2016 )

IN THE COURT OF APPEALS OF NORTH CAROLINA
No. COA15-1316
Filed: 2 August 2016
Buncombe County, No. 15SPC943
IN THE MATTER OF: W.R.D., III
Appeal by respondent from order entered 11 June 2015 by Judge Andrea Dray
in Buncombe County District Court. Heard in the Court of Appeals 25 May 2016.
Attorney General Roy Cooper, by Assistant Attorney General Elizabeth
Guzman, for the State.
Appellate Defender Glenn Gerding, by Assistant Appellate Defender Daniel L.
Spiegel, for respondent.
DIETZ, Judge.
Respondent appeals from the trial court’s order of involuntary commitment.
Following a hearing, the trial court found that Respondent was a danger to himself
and others and ordered him to be institutionalized for 30 days.
As explained below, we reverse the commitment order. The record indicates
that Respondent suffers from schizophrenia; that he refused to take his prescription
medication both for his mental illness and an unrelated heart condition; that he lost
some “unknown amount” of weight but remained at a healthy weight; that he warned
his guardian to stay away from him or he would sue him; and that he was angry and
rude to hospital staff after being involuntarily committed.
IN RE W.R.D. III
Opinion of the Court
This evidence cannot support the trial court’s ultimate findings that
Respondent posed a danger to himself or others. Our holding today does not mean
that Respondent is competent, or that he cannot properly be committed at some
future hearing. We simply hold that the evidence in the record on appeal is
insufficient to satisfy the statutory criteria for involuntary commitment. Accordingly,
we reverse the trial court’s order.
Facts and Procedural History
In 2003, Respondent was diagnosed with schizophrenia. Respondent always
has disputed this diagnosis and continues to do so today.
Because of Respondent’s health issues and his failure to attend to his basic
needs, Respondent’s mother was appointed as his guardian and Social Security payee.
She continued in that capacity until 2015, when Hope for the Future, an organization
that offers guardianship services, began working with Respondent and ultimately
assigned Kevin Connor to serve as his guardian.
Respondent refused to meet with Connor, who was a complete stranger to him.
Connor tried to arrange an in-person meeting with Respondent on four different
occasions with no success. Respondent spoke to Connor several times on the phone.
During those calls, Respondent denied having a mental illness and denied needing
any assistance from Connor. According to Connor, Respondent also left him voice
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Opinion of the Court
messages, which included statements such as “You’d better back off, Jack,” and “Don’t
you come around me. I will sue you into the ground.”
On 29 May 2015, Connor filed an affidavit and petition to have Respondent
involuntarily committed. Respondent was hospitalized at Mission Hospital
Copestone in Asheville. Dr. Martha Moore examined Respondent upon admission to
the hospital and recommended he receive inpatient treatment for 30 days. Dr. Trace
Fender performed a second examination on 1 June 2015 and also concluded that
Respondent was in need of inpatient treatment for 30 days. Three days later, on 4
June 2015, Connor had his first and only in-person meeting with Respondent.
The trial court held a hearing on the involuntary commitment petition on 11
June 2015. Three witnesses testified at the hearing. First, the Court heard from
Connor, Respondent’s guardian. Connor testified that Respondent had acted in a
“menacing” way towards representatives from Hope for the Future, although he
conceded Respondent was never violent and never threatened violence. He also
testified that Respondent had allegedly written and left a letter for his ex-wife at her
home despite not being permitted onto his ex-wife’s property. Finally, Connor
testified that Respondent was not taking his medications to treat his schizophrenia
and a serious heart condition. Connor conceded on cross-examination that
Respondent had never shown any indications of physical violence and had never
engaged in any self-harming behavior.
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IN RE W.R.D. III
Opinion of the Court
Respondent also testified. He expressed confusion regarding his
hospitalization. He claimed that he had “not broken any law or anything,” and he
thought that his hospitalization stemmed from an issue with his Social Security
payments. He testified that he was no longer in need of a guardian; that he had
plenty of food in his house; that he was able to work odd jobs to earn additional money;
that he had purchased his own vehicle; and that he was willing to take his heart
medication but would not take any medication prescribed to treat mental illness.
Finally, Dr. Frederick Weigel, a staff psychiatrist at Copestone, testified as an
expert witness in general psychiatry. He testified that in his opinion Respondent was
schizophrenic and that he was unable to “maintain his own nourishment and medical
care.” Dr. Weigel’s opinion concerning Respondent’s nourishment was based solely
on his understanding that Respondent had lost some “unknown amount” of weight
before his involuntary commitment. Dr. Weigel acknowledged that Respondent’s
current weight was not unsafe. Dr. Weigel’s opinion that Respondent could not
maintain his own medical care was based on Respondent’s refusal to take his
prescription medications for schizophrenia and his heart condition.
At the conclusion of the hearing, the trial court found that Respondent “is
mentally ill, poses a threat to himself and others, is unable to take [sic] maintain his
nutrition, that it is not medically safe for Respondent to live outside of an inpatient
commitment setting, and that no less restrictive treatment measure than inpatient
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Opinion of the Court
treatment would be medically appropriate.” As a result, the trial court ordered
Respondent to undergo 30 days of involuntary commitment at Mission Hospital
Copestone. Respondent timely appealed.
Analysis
Respondent argues that the trial court’s determination that he is a danger to
himself or others is not supported by competent record evidence. As explained below,
we agree and therefore reverse the trial court’s commitment order.
As an initial matter, we note that Respondent’s appeal is not moot although
his 30-day commitment period has lapsed. The possibility that Respondent’s
commitment might “form the basis for a future commitment, along with other obvious
collateral legal consequences,” preserves his right to appellate review despite the
expiration of his commitment period. In re Hatley, 291 N.C. 693, 695, 231 S.E.2d 633,
635 (1977).
To support an involuntary commitment order, the trial court is required to
“find two distinct facts by clear, cogent, and convincing evidence: first that the
respondent is mentally ill, and second, that he is dangerous to himself or others.” In
re Lowery, 110 N.C. App. 67, 71, 428 S.E.2d 861, 863–64 (1993); N.C. Gen. Stat.
§ 122C–268(j). These two distinct facts are the “ultimate findings” on which we focus
our review. See In re Moore, 234 N.C. App. 37, 43, 758 S.E.2d 33, 37–38 (2014). But
unlike many other orders from the trial court, these “ultimate findings,” standing
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alone, are insufficient to support the order; the involuntary commitment statute
expressly requires the trial court also to “record the facts upon which its ultimate
findings are based.” In re Collins, 49 N.C. App. 243, 246, 271 S.E.2d 72, 74 (1980);
N.C. Gen. Stat. § 122C–268(j).
We review the trial court’s commitment order to determine whether the
ultimate finding concerning the respondent’s danger to self or others is supported by
the court’s underlying findings, and whether those underlying findings, in turn, are
supported by competent evidence. See In re Booker, 193 N.C. App. 433, 437, 667
S.E.2d 302, 305 (2008).
I. Danger to Self
Respondent first challenges the trial court’s ultimate finding that he was
“dangerous to himself.” To find danger to self in these circumstances, the trial court
must find that Respondent “would be unable, without care, supervision, and the
continued assistance of others not otherwise available, to exercise self-control,
judgment, and discretion in the conduct of his daily responsibilities and social
relations, or to satisfy his need for nourishment, personal or medical care, shelter, or
self-protection and safety” and that “there is a reasonable probability of his suffering
serious physical debilitation within the near future” without involuntary
commitment. N.C. Gen. Stat. § 122C–3(11).
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IN RE W.R.D. III
Opinion of the Court
The trial court’s commitment order contains only two findings of fact that could
be construed to support these statutory criteria. First, the trial court found that “it
is not medically safe for Respondent to live outside of an inpatient commitment
setting” because “Respondent maintains a belief that another doctor is his treating
physician and will not be treated by Dr. Weigel”; “Respondent is diagnosed with
paranoid schizophrenia, for which Respondent has refused treatment”; and
“Respondent has heart health related issues, for which he is not compliant with
prescribed medical treatment.” Second, the trial court found that Respondent was
“unable to take [sic] maintain his nutrition.” The trial court did not include any
additional findings of fact concerning Respondent’s nutrition.
Neither of these findings is sufficient to support the trial court’s ruling. With
respect to Respondent’s refusal to acknowledge his mental illness, and refusal to take
his prescription medication, the record does not demonstrate a “reasonable
probability of his suffering serious physical debilitation within the near future”
without immediate, involuntary commitment. To be sure, Dr. Weigel testified that
Respondent’s refusal to take his heart medication “could be deadly,” but he did not
testify that ceasing that medication would create this serious risk “within the near
future.” In similar cases, this Court has held that the evidence must demonstrate “a
reasonable probability” that the health risk will occur in the “near future,” not simply
that it could place the respondent at risk at some future time. See, e.g., In re Whatley,
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224 N.C. App. 267, 273, 736 S.E.2d 527, 531 (2012). Here, there is no evidence that
Respondent’s refusal to take his medication creates a serious health risk in the near
future.
Second, the trial court’s finding that Respondent was unable to “maintain his
nutrition” is not supported by competent evidence. It is apparently based solely on
the following opinion testimony of Dr. Weigel:
Q: Have you reached a conclusion, to a degree of medical
certainty, as to the respondent’s ability to maintain his own
nourishment and medical care?
A: I do not think he can maintain that independently.
In an involuntary commitment proceeding like this one, “the premises underlying an
expert’s opinion must be made known to the trier of fact in order that the trier of fact
may properly evaluate the opinion.” In re Collins, 49 N.C. App. at 247, 271 S.E.2d at
75. In the record, Dr. Weigel’s only testimony concerning Respondent’s
“nourishment” is that he lost some “unknown amount” of weight but that his current
weight was safe. That testimony is not sufficient to support a finding that
Respondent could not “satisfy his need for nourishment” and faced a “reasonable
probability of his suffering serious physical debilitation” without involuntary
commitment. Accordingly, the trial court’s findings concerning Respondent’s
inability to “maintain his nutrition” are not supported by competent evidence.
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II. Danger to Others
We next turn to the trial court’s finding that Respondent posed a danger to
others. Under N.C. Gen. Stat. § 122C–3(11)(b), an individual is “dangerous to others”
if “within the relevant past, the individual has inflicted or attempted to inflict or
threatened to inflict serious bodily harm on another, or has acted in such a way as to
create a substantial risk of serious bodily harm to another, or has engaged in extreme
destruction of property” and “there is a reasonable probability that this conduct will
be repeated.”
The trial court’s commitment order contains only two findings of fact that could
be construed to support these statutory criteria. First, the trial court found that
“Respondent made a threat, although not of physical violence, towards Mr. Connor.”
Second, the trial court found that “Respondent displayed hostile, aggressive
behaviors in interviews” at the hospital. But, importantly, neither of these findings
of fact indicates that Respondent “inflicted,” “attempted to inflict,” “threatened to
inflict,” or “acted in such a way as to create a risk of serious bodily harm” to another.
Indeed, the first finding expressly acknowledges that the “threat” Respondent made
to Connor was not a threat of “physical violence,” much less “serious bodily harm.”
Rather, Respondent warned Connor to stay away or “I’ll sue you into the ground.”
While one might experience some emotional (or metaphorical) pain from being sued,
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the threat to sue someone simply cannot be viewed as a threat to inflict “serious bodily
harm.”
Likewise, Dr. Weigel’s testimony concerning Respondent’s “intrusive” and
“aggressive” behavior does not support the trial court’s finding that he is a danger to
others. Dr. Weigel testified, in essence, that Respondent was angry and rude after
being institutionalized, and refused to cooperate with the hospital staff:
[Respondent] has been persistently hostile and intrusive
and aggressive with [hospital] staff. He has been refusing
treatment or medications. He has largely refused to be
interviewed . . . . He was very hostile repeatedly sticking
his finger in our face yelling paranoid thoughts that his
guardian—well, that he had no guardian; that his guardian
was sent by the government to take pictures of his house
and steal his money; was very forcefully insistent that he
would refuse treatment and fight it if it was given to him.
Nothing in this testimony indicates that Respondent “has inflicted or attempted to
inflict or threatened to inflict serious bodily harm on another.” See N.C. Gen. Stat. §
122C–3(11)(b).
Simply put, the record does not support the trial court’s findings that
Respondent was a danger to himself or others. Accordingly, we reverse the trial
court’s commitment order. We note that our holding today does not mean that
Respondent is competent, or that he cannot properly be committed at some future
hearing. We hold only that, on the record in this appeal, the trial court’s findings are
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insufficient to satisfy the statutory criteria for involuntary commitment. Accordingly,
we reverse the trial court’s order.
Conclusion
The trial court’s involuntary commitment order is
REVERSED.
Judges ELMORE and DAVIS concur.
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