Peo in Interest of Knight

26CA0727 Peo in Interest of Knight 10-15-2026
COLORADO COURT OF APPEALS
Court of Appeals No. 26CA0727
Pueblo County District Court No. 26MH30043
Honorable Gregory J. Styduhar, Judge
The People of the State of Colorado,
Petitioner-Appellee,
In the Interest of Jillian Yvette Knight,
Respondent-Appellant.
ORDER AFFIRMED
Division III
Opinion by JUDGE SCHUTZ
Dunn and Martinez*, JJ., concur
NOT PUBLISHED PURSUANT TO C.A.R. 35(e)
Announced October 15, 2026
Brendan Hursh, Interim County Attorney, Kate. H. Shafer, Special Assistant
County Attorney, Pueblo, Colorado, for Petitioner-Appellee
Tezak Law, P.C., Mary Tezak, Florence, Colorado, for Respondent-Appellant
*Sitting by assignment of the Chief Justice under provisions of Colo. Const. art.
VI, § 5(3), and § 24-51-1105, C.R.S. 2026.

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¶ 1 Jillian Yvette Knight appeals the district court’s order
authorizing staff at the Colorado Mental Health Hospital in Pueblo
(the hospital) to medicate her without her consent. We affirm.
I. Background
¶ 2 In Fremont County District Court case number 25CR63,
Knight was charged with six crimes, including two class 3 felonies.
See Harriman v. Cabela’s Inc., 2016 COA 43, ¶ 64 (a court may take
judicial notice of the contents of court records in a related
proceeding).
¶ 3 After being found incompetent to proceed in that case, Knight
was admitted to the hospital in December 2025 to restore her
competency. She exhibited paranoid and seemingly delusional
thought content, including hearing voices telling her that she is an
alien and maintaining a longstanding belief that she is a victim of a
far-reaching conspiracy involving the Mennonite Church and
governmental entities. She also exhibited manic symptoms
characterized by elevated or irritable mood, pressured speech,
circumstantial and tangential thought process, and racing
thoughts. Furthermore, she has a history of episodic depression,

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and she attempted suicide in jail several months before her
admission to the hospital.
¶ 4 Dr. Martin Ahern, the psychiatrist supervising the nurse
practitioner treating Knight, diagnosed her with bipolar I disorder
with psychotic features. At the hospital, Knight consistently
refused to take any antipsychotic or mood-stabilizing medications
to treat her condition. She also refused to take any further
competency evaluations.
¶ 5 In March 2026, the People filed a petition for authorization to
medicate Knight involuntarily with olanzapine and paliperidone,
both antipsychotic medications; and lithium, a mood-stabilizer.
The People sought to restore Knight’s competency to participate in
her criminal case.
¶ 6 At the hearing on the petition, Dr. Ahern and Knight both
testified.
¶ 7 Dr. Ahern testified that Knight’s bipolar disorder with
psychotic features is a substantial disorder that grossly impairs her
judgment or capacity to recognize reality or to control her behavior.
He also testified that although Knight recognizes she has a history

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of depression, she does not have any insight into her mental illness
in terms of her psychosis and mania.
¶ 8 Dr. Ahern explained that he was requesting the two
antipsychotic medications to treat Knight’s psychotic features, such
as her delusional thoughts; and he was requesting lithium to treat
her mania and to prevent future manic and depressive episodes.
He further explained that he was requesting both antipsychotic
medications because he planned to start Knight on olanzapine as
an acute treatment and then transition her to paliperidone as a
maintenance treatment. He also listed the medications’ potential
side effects, which included, for the antipsychotic medications,
dizziness, blood pressure changes with changes in posture,
drowsiness, involuntary movement, weight gain, and tardive
dyskinesia; and for lithium, dizziness, lethargy, slurred speech,
visual changes, and lack of coordination. And he testified that
Knight refused to discuss the risks and benefits of taking these
medications because she does not believe she is psychotic or manic.
¶ 9 Knight testified that she has struggled with depression,
anxiety, and ADHD in the past, but she does not believe she has
bipolar disorder. She also confirmed that she will take no

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medications without a court order. When she was asked if she had
any personal beliefs that precluded her from taking the requested
medications, she responded, “[O]ne of these medications has a
black label warning . . . mean[ing] it can cause coma or death,” and
“[t]here’s no way to determine if my body is going to respond to
these medications with the worst of the side effects.” When she was
asked about her suicide attempt and why she’s no longer a danger
to herself, she discussed the conspiracy involving the Mennonite
Church and governmental entities and that she had been
“extremely desperate” in that moment. She also testified that she
has refused to take competency evaluations because she knows
“without a doubt [she] will pass,” and she will then be transferred
back to Fremont County “where they can continue to do with me
whatever they please, put charges on me that are not real and
everything else.” Finally, she testified, “I understand that I could
potentially spend 17 years on one charge in here if I don’t take the
test. And I’m okay with that.”
¶ 10 Following the testimony, the district court examined the four
elements of the test from Sell v. United States, 539 U.S. 166, 180-81

5
(2003), concluded that the People met their burden of proving all
four elements, and granted the petition.
II. Applicable Law
¶ 11 The parties agree that the four-part test from Sell applies here.
Under that test, the People must prove that:
(1) “important governmental interests,” such as “bringing to
trial an individual accused of a serious crime,” are at
stake,
(2) involuntarily medicating the person will “significantly
further” those interests,
(3) involuntarily medicating the person is “necessary” to
further those interests, and
(4) administering the medication to the person is “medically
appropriate,” in other words, “in the patient’s best
medical interest in light of [their] medical condition.”
Id. (emphasis omitted).
¶ 12 The People must prove these elements by clear and convincing
evidence. People in Interest of R.F., 2019 COA 110, ¶ 16. A
physician’s testimony establishing the Sell elements may constitute
clear and convincing evidence. See People in Interest of Ferguson,

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2025 COA 82, ¶ 13 (involving the somewhat similar four-element
test from People v. Medina, 705 P.2d 961, 973 (Colo. 1985), which
applies to a motion to involuntarily administer medications for a
purpose other than restoring the person’s competency to stand
trial).
III. Analysis
¶ 13 Knight does not contest the district court’s rulings that the
People met their burden of proving the first and third elements of
the Sell test. However, she challenges the sufficiency of the
evidence supporting the second Sell element — that treating her
with the requested medications will “significantly further” the
important governmental interest at stake — and the fourth Sell
element — that treating her with those medications is “medically
appropriate.”
A. The Second Sell Element
¶ 14 Knight does not contest the district court’s conclusion that the
first Sell element was met because the People have an important
governmental interest in timely prosecuting Knight on her “serious
charges.” Turning to the second Sell element, the question is

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whether involuntarily medicating Knight will “significantly further”
that interest. Sell, 539 U.S. at 181.
¶ 15 Both parties state that we should review the district court’s
ruling on the second Sell element de novo. In support of that
proposition, however, they cite only case law from the United States
Court of Appeals for the Tenth Circuit. We are not bound by Tenth
Circuit case law. See M.S. v. People, 2013 CO 35, ¶ 16 n.9.
Moreover, a division of our own court has concluded that the
second Sell element is “factual in nature and [is] therefore subject to
review for clear error.” R.F., ¶ 21. It appears that the Tenth
Circuit’s conclusion that the second Sell element presents a
question of law is somewhat of an outlier. See People v. J.D.B. 2026
WI 5, ¶ 35 (“[W]e join the overwhelming majority of courts and
conclude that the finding required under the second Sell factor is
given to the judgment of the circuit court as the trier of fact.”). But
see State v. Cantrell, 2008-NMSC-016, ¶ 30 (holding that the
second Sell element presents a mixed question of fact and law).
¶ 16 In any event, neither Knight nor the People acknowledge R.F.,
and neither develop an argument addressing why we should review
the second Sell factor de novo or as a mixed question of fact and

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law. Accordingly, we review the district court’s finding on this
element for clear error. Under this standard, we defer to the district
court’s factual findings if they have record support. Ferguson, ¶ 12.
Relatedly, resolving conflicts in testimony and determining the
credibility of the witnesses are matters solely within the province of
the district court. Id.
¶ 17 Knight contends that the People failed to show that the
“significant potential side effects” from the medications “were
substantially unlikely to interfere with [her] ability to assist
counsel” in her criminal trial. Knight then lists some of the
potential side effects and argues that “[t]hese are precisely the types
of side effects that risk impairing a defendant’s ability to think
clearly, communicate effectively with counsel, remain attentive
during proceedings, and meaningfully participate in trial
preparation.”
¶ 18 However, Dr. Ahern specifically opined that the medications
were “substantially unlikely” to create side effects that would
interfere significantly with Knight’s ability to assist her counsel in
conducting a trial defense. Dr. Ahern explained the bases for his
opinion:

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Any side effects that potentially would
[interfere with her ability to participate in her
defense] are something that we would monitor
for closely. They can be addressed through
dose reductions, through alternative
medications, and frankly, in my clinical
experience I don’t find that the medications I
proposed result in significantly impaired side
effects that would prevent her from being able
to participate in the process.
¶ 19 The district court explicitly credited Dr. Ahern’s opinion on
this point, saying that Dr. Ahern credibly testified “that no side
effects would impair . . . [Knight’s] ability to assist counsel.” And
the court found that the hospital would monitor Knight and
immediately respond to any issue that might come up.
¶ 20 Knight also argues that “Dr. Ahern did not provide
individualized testimony explaining why [she] specifically was
substantially unlikely to experience impairing side effects.” Her
specific arguments are that Dr. Ahern did not testify that she has
previously tolerated these medications successfully, and Dr. Ahern
did not identify “individualized clinical findings” demonstrating that
the medications would not interfere with her trial participation.
However, the record is clear that Knight has never taken the

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requested medications before. So it would have been impossible for
Dr. Ahern to testify on those subjects.
¶ 21 Further, Dr. Ahern testified that he did not know of any
underlying medical conditions that Knight might have that could be
exacerbated by the medications. And when Knight was asked if she
had any such conditions, she mentioned only “heartburn” and
“indigestion.” Dr. Ahern acknowledged that the medications can
cause gastrointestinal upset, but the district court implicitly found
that any gastrointestinal upset would not interfere significantly with
Knight’s ability to assist counsel in conducting a trial defense.
¶ 22 Because the district court’s findings on the second Sell
element are supported by Dr. Ahern’s testimony, which the court
credited, we discern no error. See R.F., ¶ 21; Ferguson, ¶ 12.
B. The Fourth Sell Element
¶ 23 Knight also contests the district court’s finding that
administering the medications to Knight was medically appropriate,
in other words, “in [her] best medical interest in light of [her]
medical condition.” Sell, 539 U.S. at 181.

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¶ 24 The parties agree, as do we, that the fourth Sell element is
“factual in nature and [is] therefore subject to review for clear
error.” R.F., ¶ 21.
¶ 25 The district court found that administering the medications to
Knight is medically appropriate, specifically finding that the bipolar
diagnosis and resulting symptoms are very significant and require
treatment with the medications and “any prolonged non-treatment”
with the medications will make it more difficult to treat her
condition in the future.
¶ 26 Those findings are supported by Dr. Ahern’s testimony. See
R.F., ¶ 21; Ferguson, ¶ 12. Dr. Ahern opined that treating Knight
with the medications was medically appropriate because bipolar I
disorder “is a significant mood disorder that does require[]
treatment [with antipsychotic and mood-stabilizing medications] in
order to adequately stabilize individuals.” He further explained that
people with bipolar disorder who remain untreated “can experience
a decreased response to treatment in the future and increase their
likelihood of future manic episodes with a decline in their overall
prognosis.”

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¶ 27 In contending that the district court erred, Knight first argues
that Dr. Ahern only met with Knight once and did not have her
medical history. However, Dr. Ahern testified that when he tried to
meet with Knight a second time, she “indicated to [him] that she did
not want to speak with [him].” Regardless, Dr. Ahern testified that
he “heavily rel[ies] on the treatment team to provide [him]
information” about patients, including the psychiatric nurse
practitioner, the social worker, and the nursing staff. And he
testified that Knight is on a fully staffed unit where “nursing staff
are constantly observing patients.” In addition, he testified that he
could not obtain any medical history for Knight because she did not
want him to speak with any “trusted individuals in her life outside
the hospital.”
¶ 28 Knight also emphasizes that she has “organized functioning,”
such as meeting her basic needs, maintaining her hygiene, being
helpful and respectful, and not being violent toward anyone. But
those arguments do not call into question the district court’s
findings regarding her significant mental illness that requires
treatment with the medications.

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¶ 29 Finally, Knight argues that the district court’s written order
largely consists of only formulaic conclusions rather than
individualized factual findings. However, the court made detailed
individualized findings during its oral ruling at the hearing. Issuing
a detailed oral ruling, and then issuing a written order summarizing
that oral ruling, is permissible. See In re Marriage of Thorburn,
2022 COA 80, ¶ 9 n.1 (treating an “oral ruling as supplementing the
written order”); In re Marriage of Cespedes, 895 P.2d 1172, 1176
(Colo. App. 1995) (considering district court’s oral ruling in rejecting
a contention that its findings and conclusions in its written order
were inadequate).
IV. Disposition
¶ 30 The order is affirmed.
JUDGE DUNN and JUSTICE MARTINEZ concur.