In the Matter of the Civil Commitment of: Nicholas Scott Thompson.

This opinion is nonprecedential except as provided by
Minn. R. Civ. App. P. 136.01, subd. 1(c).

STATE OF MINNESOTA
IN COURT OF APPEALS
A20-1246

In the Matter of the Civil Commitment of:
Nicholas Scott Thompson.

Filed March 15, 2021
Affirmed
Segal, Chief Judge

Jackson County District Court
File No. 32-PR-20-9

Jennifer Thon, Steven D. Winkler, Warren J. Maas, Jones Law Office, Mankato, Minnesota
(for appellant Nicholas Scott Thompson)

Keith Ellison, Attorney General, Drew Bredeson, Assistant Attorney General, St. Paul,
Minnesota (for respondent Minnesota Security Hospital)

Thomas J. Prochazka, Jackson County Attorney, Jackson, Minnesota (for Des Moines
Valley Health and Human Services)

Considered and decided by Segal, Chief Judge; Johnson, Judge; and Larkin, Judge.
NONPRECEDENTIAL OPINION
SEGAL, Chief Judge
Appellant challenges a district court order authorizing medical staff to involuntarily
administer neuroleptic medication, arguing that the record does not support the finding that
the administration of neuroleptic medication is reasonable and necessary. We affirm.

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FACTS
In July 2018, an individual called 911 and informed dispatch that a person required
medical assistance. Law enforcement responded to the address provided and found
appellant Nicholas Scott Thompson’s mother deceased as a result of strangulation.
Thompson was charged with second-degree murder, but was found not competent to stand
trial due to mental illness. In March 2019, Thompson was c ivilly committed as a person
with mental illness for a period of six months. In September 2019, his commitment was
continued for an additional six months , and was continued again in April 2020 for an
additional 12 months . This court affirmed Thompson’s most recent continued
commitment. In re Civil Commitment of Thompson , No. A20-0805 (Minn. App. Nov. 9,
2020).
In July 2020, Thompson’s treating physician at St. Peter Regional Treatment Center,
Dr. Joshua Griffiths, filed a petition seeking a court order authorizing the involuntary
administration of neuroleptic medication pursuant to Minn. Stat. § 253B.092, subd . 8
(2020). At the hearing on the petition, the court heard expert testimony from two witnesses,
Dr. Griffiths and Dr. Georg e Komaridis, the court-appointed examiner. Both agreed that
neuroleptic medication was the best available treatment option. Thompso n presented no
opposing expert testimony. T he district court granted the petition and authorized the
administration of neuroleptic medication. Thompson now appeals.
DECISION
When reviewing a district court’s order to administer neuroleptic medicat ion, this
court “review[s] the record in the light most favorable to the district court’s decision” and

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will “affirm the district court’s findings unless they are clearly erroneous.” In re Civil
Commitment of Raboin, 704 N.W.2d 767, 769 (Minn. App. 2005). “When the findings of
fact rest almost entirely on expert testimony, the district court’s evaluation of credibility is
particularly significant.” In re Civil Commitment of Janckila, 657 N.W.2d 899, 904 (Minn.
App. 2003).
If a patient refuses to take neu roleptic medication, the medication may not be
administered without a court order, except in an emergency. Minn. Stat. § 253B.092,
subd. 8(a). In evaluating a petition for authorization of the involuntary administration of
neuroleptic medication, the district court must first consider whether the individual has the
capacity to make a decision regarding the administration of neuroleptic medication. If a
patient lacks the capacity to make a decision, the district court must then determine whether
“a reasonable person would” agree to take the medication. Id., subd. 7(c) (2020).
In making this determination, the district cour t must consider: “(1) the patient ’s
family, community, moral, religious, and social values; (2) the medical risks, benefits, and
alternatives to the proposed treatment; (3) past efficacy and any extenuating circumstances
of past use of neuroleptic medications; and (4) any other relevant factors.” Id.
Ultimately, a person “seeking to administer neuroleptic medications must prove by
clear and convincing evidence that such medication is necessary.” In re Civil Commitment
of Breault, 942 N.W.2d 368, 378 (Minn. App. 2020) (quotation omitted). If this standard
is satisfied, the district court may authorize the involuntary administration of neuroleptic
medication. Minn. Stat. § 253B.092, subd. 8(e).

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Here, the district court determined that Thompson lacked the capacity to make
decisions regarding the administration of neuroleptic medication .1 The district court then
determined that the administration of neuroleptic medication was “both reasonable and
necessary.” In doing so, the district court observed that the administration of such
medication was not experimental, that there were no available alternative treatments, and
that the medication may decrease Thompson’s symptoms and “allow him to have more
flexibility in his thinking.” The district court further determined that the benefit s
outweighed the risks, and that because Thompson is in good physical health and would be
monitored by medical staff, the risk of Thompson experiencing side effects was relatively
low. Finally, the district court found that there was no evidence that Thom pson had any
moral, religious, or social values related to the administration of neuroleptic medication.
Thompson argues that the record does not support the district court’s determination.
He argues that administration of neuroleptic medication is neither reasonable nor necessary
because of the inherent risk s associated with neuroleptic medication and because the
district court clearly erred by finding that there were no available alternative treatments.
The district court’s order, however, is supported by the testimony of both Dr. Griffiths and
Dr. Komaridis, and Thompson offers no contrary evidence.

1 Thompson’s appeal initially included the argument that the district court failed to make
sufficient findings on the question of Thompson’s decision -making capacity because the
court did not identify the evidentiary burden it applied when making the determination.
See In re Civil Commitment of Spicer, 853 N.W.2d 803, 810 (Minn. App. 2014) (requiring
the district court to make “sufficiently particular findings of fact on the key issues”). At
oral argument, however, Thompson’s counsel abandoned this argument and acknowledged
that the district court did identify the evidentiary burden it applied.

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Turning first to the question of whether the administration of neuroleptic medication
is reasonable, t he district court acknowledged the risks associ ated with neuroleptic
medication, but determined that the potential benefits outweighed those risks. The district
court based this finding on the testimony of Dr. Griffiths , Thompson’s treating physician.
Dr. Griffiths testified that “the most likely out come” of administration of the medication
would be to decrease Thompson’s delusional beliefs, allow Thompson to think more
flexibly, and possibly restore his competency to assist counsel and allow his criminal case
to proceed. He acknowledged that the adm inistration of neuroleptic medication carried a
risk of side effects, but testified that there was no reason to believe that Thompson was
particularly susceptible to side effects based on his age and overall health. Dr. Griffiths
also testified that the potential risk of side effects would be further mitigated by the fact
that Thompson would be monitored by medical staff who would be able to intervene in the
case of an adverse reaction. On this record, we discern no clear error in the district court’s
finding that the potential benefits of the administration of neuroleptic medication
outweighed any potential risks.
Turning to his second argument, Thompson maintains that the district court erred
by finding that there were no alternative treatment options available. He claims that group
therapy tailored to restoring competency is an available option. This is an option that was
offered to and declined by Thompson. Dr. Griffiths testified that Thompson did not believe
he was suffering from delusional beliefs and was thus resistant to any treatment that did
not align with those beliefs, including alternative s to neuroleptic medication such as
therapy tailored to restoring his competency. This type of therapy was therefore not an

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available tr eatment option. Dr. Griffiths ultimately testified that the administration of
neuroleptic medication was the best treatment available.
Dr. Komaridis, the court -appointed examiner, similarly testified that the
administration of neuroleptic medication was necessary. He testified that treatment with
neuroleptic medication was “the only available system at this point that . . . seems to have
any merit” to treat Thompson because talk and behavioral therapy were not effective. He
opined that Thompson’s trea tment was at a “very large impasse” and that there would be
no “movement” or “improvement” in his psychological condition without the
administration of neuroleptic medication. Thus, both Dr. Griffiths and Dr. Komaridis
testified that the administration of neuroleptic medication was necessary to treat
Thompson’s delusional disorder because other forms of treatment were ineffective. We
therefore reject Thompson’s argument that the district court erred in finding that there were
no available alternative treatment options.
We thus conclude that the district court’s determination that the involuntary
administration of neuroleptic medication was reasonable and necessary is supported by the
record and is not clearly erroneous.
Affirmed.