United States Court of Appeals, District of Columbia Circuit
September 6, 2019
from the United States District Court for the District of
Columbia (No. 1:17-cr-00065-1).
B. Wright, Assistant Federal Public Defender, argued the
cause for appellant. With her on the briefs was A.J. Kramer,
Federal Public Defender. Tony Axam Jr. and David W. Bos,
Assistant Federal Public Defenders, entered appearances.
Nicholas P. Coleman, Assistant U.S. Attorney, argued the
cause for appellee. With him on the brief were Jessie K. Liu,
U.S. Attorney, and Elizabeth Trosman, and Chrisellen R. Kolb,
Assistant U.S. Attorneys.
Before: Rogers and Pillard, Circuit Judges, and Randolph,
Senior Circuit Judge.
Randolph, Senior Circuit Judge.
Senior Circuit Judge: This is a criminal case. The
defendant, Jean-Paul Gamarra, appeals from an order of the
district court. The order authorized the government to
medicate him without his consent for the purpose of rendering
him competent to stand trial.
about Gamarra's soundness of mind arose from these
largely undisputed circumstances of his arrest on March 28,
2017. Gamarra approached a Secret Service Agent stationed
near the Treasury Department Building, adjacent to the White
House. Gamarra told the Agent that he had a package
containing a "nuclear bomb detonator or defuser."
The Agent ordered Gamarra to place his package on the ground.
On the package were messages: "Warning this is a
tre threat on the President and
Senator life Secure Keyboard to be Reversed Engineered,"
and "Warning 100% threat Brand New Electronic Detonator
Device president Secrete Servisce Explosive technology
Department." On the package's label was this:
"Blue tooth Bomb Explosion Component."
response, the Agent arrested Gamarra while other law
enforcement officers closed the surrounding areas to
pedestrian and vehicular traffic for an hour and a half. When
officers examined Gamarra's package they found only an
ordinary Bluetooth keyboard.
jury indicted Gamarra for threatening bodily harm to the
President (18 U.S.C. § 871) and for conveying false
information concerning the use of an explosive (18 U.S.C.
actions raised doubts about whether he was competent to stand
trial. On the government's motion, the magistrate judge
ordered Gamarra committed to custody for the purpose of
evaluating his competency. A forensic psychologist examined
Gamarra and concluded that he suffered from a
'schizoaffective disorder' and that he was not
competent to stand trial. After a hearing, the Magistrate
Judge agreed and issued an order under 18 U.S.C. §
4241(d) committing Gamarra to continuing custody for the
purpose of determining whether he could become competent.
This subsection provides, in part:
The Attorney General shall hospitalize the defendant for
treatment in a suitable facility . . . 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[.]
some delay, Gamarra was transferred to the Federal Medical
Center, Butner, North Carolina. A psychology intern at Butner
and her supervisor, a forensic psychologist, attended to
Gamarra and signed a report. From multiple clinical
evaluations, interviews and observations, they concluded that
Gamarra suffered from delusional thinking and disorganized
speech. His medical history and the accounts of his family
members indicated that he could not become competent without
anti-psychotic medicine. At Butner, Gamarra started taking
the prescribed medication, but within a short time became
government therefore moved for an order authorizing
involuntary medication. After a three-day evidentiary
hearing, the Magistrate Judge recommended denying the motion
on the ground that the government failed to provide treatment
to Gamarra within the four month period specified in 18
U.S.C. § 4241(d)(2). The district court rejected the
recommendation and granted the government's motion,
concluding that under Sell v. United States, 539
U.S. 166 (2003), "the government had met its burden of
proof with respect to each of the four Sell
factors." United States v. Gamarra, 2018 WL
5257846, *9 (D.D.C. 2018).
appeal is limited to the district court's rulings on two
of the four Sell factors the second and the fourth.
The second Sell factor requires the government to
establish that "the administration of the drugs is
substantially likely to render the defendant competent to
stand trial" and "substantially unlikely to have
side effects that will interfere significantly with the
defendant's ability to assist counsel in conducting a
trial defense, thereby rendering the trial unfair."
Sell, 539 U.S. at 181. The fourth Sell
factor requires the government to establish that
"administration of the drugs is medically
appropriate, i.e., in the patient's best
medical interest in light of his medical condition."
district court's conclusions in favor of the government
must rest on "clear and convincing evidence."
United States v. Dillon, 738 F.3d 284, 291 (D.C.
Cir. 2013). Our review of those conclusions is for
"clear error." Id. Under this standard, we
may reverse only "if (1) the findings are 'without
substantial evidentiary support or … induced by an
erroneous application of the law'; or if (2) 'on the
entire evidence [we are] left with the definite and firm