United States of America v. Felipe Lorthridge

United States Court of Appeals
For the Eighth Circuit
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No. 23-1164
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United States of America
Plaintiff - Appellee
v.
Felipe Lorthridge
Defendant - Appellant
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Appeal from United States District Court
for the Eastern District of Missouri - St. Louis
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Submitted: September 22, 2023
Filed: December 5, 2023
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Before COLLOTON, GRASZ, and KOBES, Circuit Judges.
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KOBES, Circuit Judge.
Felipe Lorthridge, Sr., was indicted for being a felon in possession of a
firearm, 18 U.S.C. § 922(g)(1). He was found incompetent to stand trial and later

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diagnosed with schizophrenia. The district court1 ordered that he be involuntarily
medicated to restore his competency. Lorthridge appeals, and we affirm.
I.
The Government alleges that Lorthridge fled a traffic stop before ditching his
car and a gun. He has been detained pending trial since his 2019 arrest.
After Lorthridge moved for a mental competency examination, a forensic
psychologist concluded that a mental disorder impaired his ability to understand the
nature and consequences of his trial and to assist counsel. She noted in her report
that he believed in a widespread conspiracy involving the police, his fellow inmates,
the prosecutor, his attorney, and the judiciary. The magistrate judge2 found
Lorthridge incompetent and ordered further treatment and evaluation to determine
whether he would attain competency in the foreseeable future.
Lorthridge was transferred to the U.S. Medical Center for Federal Prisoners
in Springfield, Missouri, where two more psychologists evaluated him and issued
another report. The psychologists diagnosed him with schizophrenia and found that
without antipsychotic medication, he was substantially unlikely to be restored to
competency in the foreseeable future. Lorthridge refused to participate in
competency restoration treatment and declined to take antipsychotic medication. In
an administrative hearing, the facility found that Lorthridge was not a danger to
himself or others in a correctional setting, so he could not be involuntarily medicated
under Washington v. Harper, 494 U.S. 210 (1990).
The Government moved to involuntarily medicate Lorthridge to restore his
competency under Sell v. United States, 539 U.S. 166 (2003). The magistrate judge
1 The Honorable Stephen R. Clark, Chief Judge, United States District Court
for the Eastern District of Missouri.
2 The Honorable Nannette A. Baker, United States Magistrate Judge for the
Eastern District of Missouri.

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held a Sell hearing by video conference, which Lorthridge refused to join, and
recommended granting the motion. Lorthridge objected, and the district court held
a de novo, in-person hearing. Fearing that the in-person hearing was a veiled attempt
to get him in a position vulnerable to attack, Lorthridge again refused to attend until
the court ordered him to do so.
Three doctors from the Springfield facility testified: Dr. Gary Sarrazin, then
Chief of Psychiatry; Dr. Elizabeth Tyner, Chief of Psychology; and Dr. Amanda
Reed, one of the Springfield report’s authors. Drs. Tyner and Reed interacted with
Lorthridge during weekly rounds and described his behavior and condition. They
said that his delusions kept him confined to his cell and sometimes unwilling to eat
for fear of poisoning. Dr. Sarrazin, who retired before the Sell hearing, met with
Lorthridge monthly and testified about a proposed treatment plan he developed. All
agreed that Lorthridge suffers from schizophrenia and that he is unlikely to attain
competency without antipsychotic medication. Dr. Sarrazin testified that in his 20
years at the facility, involuntary administration of antipsychotic medication restored
competency to over 75% of people with psychotic disorders. And he believed that
medication would improve Lorthridge’s life by helping him function better, leave
his cell, and interact with others.
The court found that the Government carried its burden under Sell, and it
ordered that Lorthridge be involuntarily medicated consistent with Dr. Sarrazin’s
treatment plan. Lorthridge timely appealed, and we have jurisdiction under the
collateral order doctrine. United States v. Coy, 991 F.3d 924, 926 (8th Cir. 2021).
II.
Lorthridge has “a significant constitutionally protected liberty interest in
avoiding the unwanted administration of antipsychotic drugs.” Sell, 539 U.S. at 178
(cleaned up) (citation omitted). But the Government may forcibly medicate a
defendant if it shows “(1) that an important governmental interest is at stake; (2) that
involuntary medication will significantly further that governmental interest; (3) that

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involuntary medication is necessary to further that interest; and (4) that
administration of the drugs is medically appropriate.” United States v. Mackey, 717
F.3d 569, 573 (8th Cir. 2013) (citing Sell, 539 U.S. at 180–81).
Lorthridge challenges the district court’s conclusions on the first, second, and
fourth Sell elements. We review the first element de novo and the remaining
elements for clear error. Id.
Bringing “an individual accused of a serious crime” to trial is an important
governmental interest. Sell, 539 U.S. at 180. And possessing a firearm as a felon,
for which Lorthridge faces a ten-year statutory maximum sentence, is a serious
crime. See Mackey, 717 F.3d at 573 (finding a crime with “a maximum term of ten
years’ imprisonment . . . [was] ‘serious’ under any reasonable standard” (citation
omitted)); United States v. Fazio, 599 F.3d 835, 840 (8th Cir. 2010) (being a felon
and an armed career criminal in possession of a firearm is “very serious”).
Lorthridge’s suggestion that it is a “victimless, non-violent status offense” does not
make it less serious, nor does it weaken the governmental interest in prosecution.
See Mackey, 717 F.3d at 573–74.
We do not think the “special circumstances” Lorthridge cites undermine this
interest. See Sell, 539 U.S. at 180 (“Special circumstances may lessen the
importance of [the Government’s interest in prosecution].”). Two of those
circumstances attempt to undermine governmental interests that the district court did
not rely on. He says that the court should have considered the lack of connection
between his mental disease and alleged crimes, which we said in United States v.
Nicklas is relevant to a different interest—“protecting the public from [an accused’s]
future crimes.” 623 F.3d 1175, 1179 (8th Cir. 2010). He also argues that the court
should have considered the Harper finding that he was not a danger to himself or
others. But a Harper finding goes to yet another interest—“reduc[ing] danger that
an inmate poses to himself or others while incarcerated.” Mackey, 717 F.3d at 575.
Neither the risk of recidivism nor an inmate’s dangerousness while confined bears

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on the important governmental interest at stake here—bringing an accused to trial
for a serious crime. So the district court was not required to consider them.
We leave for another day whether the length of Lorthridge’s pre-trial
detention, which he estimates is over half the maximum sentence, is “significant”
such that it weakens the governmental interest. See Sell, 539 U.S. at 180 (holding
“significant” pre-trial detention is a special circumstance that may affect the
governmental interest). Even if it were, it would “not totally undermine[] the
strength of the need for prosecution.” Id.; see also Mackey, 717 F.3d at 574–75.
With no other special circumstances lessening the interest, the Government has
satisfied the first Sell element.
And the record supports the district court’s findings on the second and fourth
Sell elements. The court carefully considered the experts’ testimony, psychologists’
reports, and proposed treatment plan. It reasonably credited testimony that
involuntary medication with antipsychotics was substantially likely to restore
Lorthridge to competency and that his treatment team could manage the risks of
negative side effects and of his condition deteriorating when he is transferred for
trial. It did the same in finding that involuntary medication was medically
appropriate and in his best medical interest. Lorthridge may disagree with the
experts’ opinions, but the court’s reliance on them was not clearly erroneous.
Nicklas, 623 F.3d at 1180–81.
III.
The district court’s judgment is affirmed.
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