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In re Linda W.

June 15, 2004

[5] IN RE LINDA W., A PERSON ASSERTED TO BE SUBJECT TO INVOLUNTARY ADMISSION (THE PEOPLE OF THE STATE OF ILLINOIS, PETITIONER-APPELLEE, V. LINDA W., RESPONDENT-APPELLANT).


[6] Appeal from the Circuit Court of Madison County. No. 02-MH-106. Honorable Lewis E. Mallott, Judge, presiding.

[9] The opinion of the court was delivered by: Justice Maag

[10]   The respondent, Linda W., was involuntarily admitted into a psychiatric facility in December 2002. The State's first petition for involuntary admission was dismissed by the circuit court. The State immediately filed a second petition. A hearing was held on the second petition. The circuit court determined that the respondent was a person subject to involuntary admission and ordered that she be hospitalized in the Department of Human Services. The respondent filed a timely notice of appeal. We reverse.

[11]   The relevant facts are as follows. According to the respondent, she had been receiving medication for mental illness for 28 years. She had been diagnosed with schizoaffective disorder. Although the respondent had been in and out of several mental health institutions over the years, she apparently did not believe that she had a mental illness and she refused to take medication for her condition.

[12]   The respondent was involuntarily admitted to Gateway Regional Medical Center (Gateway) on December 6, 2002. On December 9, 2002, a petition for involuntary admission was filed in Madison County case No. 02-MH-103. According to a certificate that was attached to the petition, the respondent had refused to take her psychiatric medication for two weeks. The respondent was angry and belligerent toward "KK and ex[-]husband." The respondent's ex-husband was attempting to care for her, but due to his own physical problems, he was unable to do so. The respondent was "morbidly obese" and unable to meet her basic needs of food, clothing, and personal hygiene without assistance. The respondent refused a voluntary placement in shelter care and offers for assistance in the home. The respondent was "exceedingly paranoid" and "delusional" about her family and anyone in the medical profession and believed that they were only trying to "control her."

[13]   The petition was involuntarily dismissed on December 19, 2002. Although the record does not show why the petition was dismissed, the respondent states that the petition was dismissed "for failure to comply with statutory pleading requirements."

[14]   On the same date, at 2:40 p.m., the State filed another petition for involuntary admission to a facility, in Madison County case No. 02-MH-106. The respondent tore up that copy of the petition and hit a nurse in the face with her fist. The first certificate to support the second petition was executed by another registered nurse following an examination on December 19, 2002, at 4 p.m. The first certificate stated that the respondent was "extremely angry, agitated, cursing, yelling, [and] throwing papers" when she was presented with a copy of the petition. The respondent tore up the petition and threw it in the nurse's face. She proceeded to strike the nurse's cheek with her fist. The respondent threatened to kill the nurse. She also threatened another nurse and told her that she would "burn in hell for a million years." The respondent physically pushed security personnel and verbally abused them. The respondent was unable to stay on one topic and screamed and yelled. She made irrational statements such as "I bleed for my kids, but they will not bleed for me," and "Why don't you kill me? I would be better off." The respondent also claimed that the hospital staff was sending air through the vents that caused all the respondent's medical problems. The respondent was later observed "shouting out" and then denied wanting anything. She claimed that she needed medical assistance and that the staff at Gateway was incompetent. She then refused medical help. The respondent told her psychiatrist that "they enjoy controlling [her]" and later told Carol Dugan Faulk, a licensed clinical social worker, that she and the Gateway staff were poisoning her. The certificate stated that the respondent required immediate hospitalization due to her inability to care for herself and the failure to comply with both medical and psychiatric medications. For all these reasons, the certificate stated that the respondent is "at risk to self and others." A second certificate was signed by a psychiatrist, Dr. Narishma Muddasani, on December 19, 2002, at 10 p.m. Dr. Muddasani stated in the certificate that the respondent had delusional beliefs that "people are trying to poison her with the vents." He also said that the respondent was in denial about her mental illness despite her 30 years of psychiatric treatment. Dr. Muddasani stated that the respondent also had delusional beliefs that her ex-husband was "trying to kill her" and she is unable to care for herself.

[15]   The respondent filed a motion to dismiss the second petition. She claimed that it was void because she had been unlawfully detained between the time that she was served with a copy of the second petition on December 19, 2002, at 2:40 p.m. and the time that the first certificate to support the petition was executed on December 19, 2002, at 4 p.m. The circuit court denied the motion and conducted a hearing on whether the respondent was subject to involuntary admission and involuntary administration of psychotropic medication.

[16]   The testimony at the hearing was as follows. Faulk testified that the respondent had been diagnosed with schizoaffective disorder. Faulk stated that the respondent was very paranoid and disorganized. She said that the respondent threatened to kill one of the nurses. The respondent believed that the staff at Gateway was poisoning her by piping something through the air vents. The respondent also claimed that the doctors were giving her silicone and that it caused her to have medical problems. The respondent stated that her current doctor is reincarnated. The respondent also believed that the food that Gateway fed her caused her medical problems. The respondent threatened the staff and the doctor, and she almost hit a patient. She threatened to kill a nurse. Faulk recommended that the respondent continue to reside at Gateway until her condition was stabilized with medication. Faulk stated that if the respondent complied with the medication orders, she would be released on February 3, 2003.

[17]   Faulk testified that no less-restrictive facility than Gateway was available to serve the respondent's needs. Faulk opined that the respondent was unable to care for herself and was dangerous to herself and others. The respondent refused to participate in treatment or take medication.

[18]   Faulk also stated that on December 19, 2002, when the first petition was dismissed, the respondent's attorney called a cab for her. When the cab arrived, the respondent refused to get in. The respondent asked to go upstairs and gather her belongings. By the time that the respondent was ready to go, the second petition was finished, and she was readmitted. We note, however, that the petition states that within 12 hours after admission, the respondent was given a copy of the petition. Hence, the respondent was readmitted prior to 2:40 p.m., when the petition was given to her.

[19]   The respondent testified that she was 59 years old at the time of the hearing. The respondent stated that she had four admissions to psychiatric hospitals within the previous two years. She said that her legs were semiparalyzed and that she had "awful pain" in her legs due to the Haldol injections. The respondent stated that the stiffness in her legs was "severe" and that she was fearful of falling and getting hurt. She said that she was unable to get out of a bathtub. Prior to her current admission, the respondent had been staying with her ex-husband because he had a shower.

[20]   The respondent testified that she had not been overweight prior to the time that the doctors began giving her shots. She claimed that after the shots, she weighed 300 pounds. The respondent agreed that she was loud but denied that she was vicious or ferocious. She denied that she threatened to kill anyone and denied that she thought about harming herself or anyone else.

[21]   Dr. Muddasani testified that he was the respondent's treating psychiatrist. He stated that the respondent suffered from schizoaffective disorder. He opined that her disease was characterized by depression and paranoid delusions. Dr. Muddasani stated that the respondent does not believe that she has a mental illness and that, therefore, she does not understand the need for the medication. The respondent had been given Haldol and other medications for her condition. Because the respondent was refusing medication, Dr. Muddasani wanted to administer Haldol because it could be given by injection once a month. Although the respondent claimed that Haldol caused her leg paralysis, Dr. Muddasani stated that it was not a side effect of the medication. Even though the respondent was having problems with her weight, Dr. Muddasani stated that it could be controlled by diet, exercise, and good judgment. Dr. Muddasani's treatment goal was to stabilize the respondent so she could leave the hospital. He stated that the benefits of the medication outweighed the risks and that the respondent did not have the capacity to make a reasoned and informed decision regarding whether she should take the medication.

[22]   After Dr. Muddasani testified, the respondent took the stand again. She testified that prior to her admission to Gateway, she had been taking Celexa, Topamax, and Zyprexa. These medications were prescribed by Dr. McCormick after she was released from Alton Mental Health Center. The respondent stopped taking the medications approximately one to two weeks prior to her admission to Gateway. The respondent claimed that she had been forced to take shots for 28 ...


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