United States v. Nna Onuoha
2016 U.S. App. LEXIS 7124
| 9th Cir. | 2016Background
- Onuoha, a former TSA screener and National Guard veteran, was indicted for making telephonic threats and hoaxes at LAX around 9/11/2013; alleged conduct disrupted airport operations and was perceived as terrorism.
- After arrest, BOP evaluators diagnosed him with schizophrenia and found him incompetent to stand trial; BOP psychiatrists recommended involuntary antipsychotic treatment to restore competency.
- Government moved under Sell v. United States to forcibly medicate Onuoha; district court granted the motion adopting Dr. Lucking’s plan (initial 10 mg short‑acting haloperidol, then three 150 mg long‑acting injections at two‑week intervals, then 150–200 mg monthly).
- Onuoha appealed the Sell order interlocutorily; the Ninth Circuit reviews Sell orders and requires clear and convincing proof of four Sell factors.
- The Ninth Circuit agreed the government’s interest in prosecution was important (first Sell factor) but vacated the order because the district court clearly erred on the fourth Sell factor: the proposed regimen was not shown to be in Onuoha’s best medical interest given higher‑than‑recommended dosing and departure from community standard (stabilization on short‑acting drug before long‑acting).
Issues
| Issue | Plaintiff's Argument (Onuoha) | Defendant's Argument (Government) | Held |
|---|---|---|---|
| Whether the crime is sufficiently serious to satisfy Sell’s first factor | Onuoha: low Guidelines range and no criminal history mean government interest is not important | Government: threats to airport near 9/11 anniversary, disruption, and deterrence justify prosecution | Held: Crime is sufficiently serious; first Sell factor satisfied |
| Whether special circumstances (time in custody) diminish governmental interest | Onuoha: lengthy pretrial incarceration reduces need for prosecution | Government: conviction and general deterrence still serve important interests beyond incapacitation | Held: Time served does not displace prosecutorial interest |
| Whether proposed involuntary medication is medically appropriate (Sell’s fourth factor) | Onuoha: proposed doses exceed BOP/PDR recommendations; long‑acting haloperidol without prior short‑acting stabilization departs from standard of care and risks serious side effects | Government: BOP internal guidance are non‑binding recommendations; higher doses achieve therapeutic levels faster and custodial setting favors long‑acting injections for safety | Held: District court clearly erred; government failed to show by clear and convincing evidence that the plan is in Onuoha’s best medical interest |
| Whether district court properly weighed expert testimony against record standards | Onuoha: court ignored BOP and PDR guidance and miscalculated initial dosing | Government: relied on treating doctors’ experience and testimony | Held: Court erred by crediting testimony without resolving contradictions with other medical guidance; remand required for further factfinding |
Key Cases Cited
- Sell v. United States, 539 U.S. 166 (2003) (establishes four‑factor test permitting involuntary medication to restore competency)
- Ruiz‑Gaxiola v. United States, 623 F.3d 684 (9th Cir.) (Sell factors require clear and convincing proof)
- Gillenwater v. United States, 749 F.3d 1094 (9th Cir.) (applying Sell to threats and evaluating best medical interests)
- Hernandez‑Vasquez v. United States, 513 F.3d 908 (9th Cir.) (Sentencing Guidelines as starting point for seriousness analysis)
- United States v. Rivera‑Guerrero, 426 F.3d 1130 (9th Cir.) (involuntary medication orders are disfavored)
- Washington v. Harper, 494 U.S. 210 (1990) (standard for involuntary medication to reduce dangerousness distinct from Sell)
- United States v. White, 620 F.3d 401 (4th Cir.) (discussion of prosecution interest in forcible medication context)
- United States v. Brooks, 750 F.3d 1090 (9th Cir.) (weighing special circumstances against government interest)
- United States v. Watson, 793 F.3d 416 (4th Cir.) (criticizing similar treatment recommendations)
- United States v. Grigsby, 712 F.3d 964 (6th Cir.) (finding proposed treatment failed Sell analysis)