In re Carol B., 2017 IL App (4th) 160604

Background

Carol B. was admitted to Memorial Medical Center on June 18, 2016, after earlier hospitalization; Memorial filed petitions for involuntary admission and involuntary treatment (psychotropic medication and 12 ECT sessions).
Dr. Sankrant Reddy treated Carol daily, diagnosed severe bipolar depression with psychotic and catatonic features, concluded she lacked capacity to consent, and began psychotropic medications on admission despite believing she was not at risk of serious and imminent physical harm then.
Dr. Reddy authorized emergency ECT on July 1 and began treatments July 5; by the July 22 hearing Carol had received eight of twelve ECT sessions, some given over her resistance.
The State filed an amended involuntary-admission petition 25 days after admission, and the hearing was held July 22 (34 days after admission); counsel had earlier complained about delay and pre-hearing administration of mind‑altering treatments.
The trial court found Memorial violated section 2-107(a) by administering medication before a showing of serious and imminent harm but deemed the violation harmless; it granted 90-day orders for involuntary admission and involuntary treatment.
On appeal the Fourth District reversed both orders, concluding the pre-hearing involuntary medication and delay in proceedings deprived Carol of due process and were not harmless.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether hospital violated 405 ILCS 5/2-107(a) by administering psychotropic meds before court authorization	Carol: meds were given when no serious and imminent physical harm existed; she had right to refuse and was denied the opportunity to refuse	State/Memorial: doctor believed lack of capacity meant patient could not refuse; treatment was necessary and emergency ECT justified urgent action	Court: Violation occurred — Dr. Reddy misapplied section 2-107(a); lack of capacity does not permit unilateral pre-hearing medication absent serious/imminent harm
Whether failure to provide written risks/benefits/alternatives before starting meds violated Code	Carol: written disclosures were given ~4 days after meds began, depriving her of opportunity to refuse and of meaningful court evaluation of capacity	State: delay was de minimis; written materials were provided before the hearing	Court: Delay was prejudicial; written disclosure prior to treatment is necessary to protect due process and evaluate capacity
Whether procedural delay and cumulative errors were harmless	Carol: delay plus pre-hearing treatment altered her mood/behavior, preventing a fair hearing; errors cumulative and not curable	State: any error was harmless because court later granted the same orders on the merits	Court: Errors were not harmless; premature treatment affected the court’s ability to assess capacity and was not easily cured
Remedy for statutory violations (involuntary admission and involuntary treatment orders)	Carol: violations require reversal of both admission and treatment orders	State: even if mistake occurred, orders should stand (harmless error)	Court: Reversed both involuntary-admission and involuntary-medication orders; respondent no longer a "recipient of services" so treatment order also reversed

Key Cases Cited

In re Luttrell, 261 Ill. App. 3d 221 (1994) (discussing balance between liberty and care in mental-health proceedings)
In re Barbara H., 183 Ill. 2d 482 (1998) (mootness doctrine and exceptions)
In re Alfred H.H., 233 Ill. 2d 345 (2009) (public-interest exception to mootness)
In re Amanda H., 2017 IL App (3d) 150164 (2017) (de novo review of statutory procedural protections)
In re Tommy B., 372 Ill. App. 3d 677 (2007) (harmless-error framework for procedural defects)
In re Orr, 176 Ill. App. 3d 498 (1988) (definition of "serious and imminent physical harm")
In re John R., 339 Ill. App. 3d 778 (2003) (statutory rights to written medication information are tied to due process)
In re Cathy M., 326 Ill. App. 3d 335 (2001) (respondent must be informed of risks/benefits before making informed treatment decisions)
In re John N., 364 Ill. App. 3d 996 (2006) (effect of reversing admission on authority to order involuntary treatment)