Judge Issues Medication Order After Psychiatrists’ Diagnosis, Dominguez’s Refusal of Medication
By Cynthia Hoang-Duong and Ximena Cesa
WOODLAND, CA – After a week of a jury competency trial, the Yolo County District Attorney’s Office Thursday finally conceded what Judge Samuel McAdam and Deputy Public Defender Dan Hutchinson had already concluded—Carlos Reales Dominguez, on trial for a series of Yolo County stabbings including two murders, is not competent to stand trial at this time.
The acknowledgment came in the afternoon in Yolo County Superior Court after Judge McAdam granted a Riese Motion to enable doctors to involuntarily treat Dominguez with medication. In the ruling by Judge McAdam, the judge noted Dominguez, among other things, “lacks the capacity to consent.”
At the conclusion of a hearing conducted pursuant to Penal Code § 2603—regarding the involuntary administration of psychiatric medication—Judge McAdam issued a medication order for Dominguez.
Dominguez was present in court with his attorney, DPD Dan Hutchinson, with his characteristic appearance, 
donning an anti-suicide smock with long hair concealing his face.
The prosecution team was composed of Deputy District Attorney Matthew DeMoura and DDA Frits Van Der Hoek, and Deputy County Counsel Eric May also made an appearance.
Thursday morning, Judge McAdam proceeded with the hearing before a jury by examining a licensed psychiatrist who testified about Dominguez’s condition on voir dire.
When asked about her diagnosis, the psychiatrist corroborated with two other expert witnesses, finding that Dominguez suffers from schizophrenia. She reinforced her conclusion with her observations about the accused’s lack of speech, delusions and negative symptoms, such as his rigid movements and decreased level of functioning and cognition.
Similar to the expert witness last Thursday, because of Dominguez’s consistent denial of his psychiatric problems, she ruled out the possibility of malingering.
Considering her diagnosis, Judge McAdam noted for the record, “The court is in the midst of a competency hearing and has received testimony from (a) doctor reaching the same diagnosis and (another doctor). This is now the third doctor that has told the court that the defendant suffers from a serious mental disorder, schizophrenia.”
Proceeding further with the conditions of PC § 2603, the judge asked the doctor about Dominguez’s capacity to consent or refuse psychiatric medication and whether he poses a danger to himself or others as a result of his mental disorder.
While declining to comment on his risk to others, the psychiatrist confirmed he is gravely disabled and a danger to himself due to his psychiatric illness. She described the accused’s inability to take care of his basic needs, resulting in potential harm to himself.
She recounted that Dominguez has been admitted to the emergency room four to five times because of concerns about his oral and food intake, evidenced by his kidney difficulties, dehydration, and abnormal vital signs. Further, as exhibited by his appearance in court, the accused refuses to maintain his bodily hygiene, such as bathing or showering, brushing his teeth and combing his hair.
Although he was offered IV medication in the emergency room and encouraged to drink and eat, the accused has “not been cooperative with recommended medical interventions for his difficulty in eating.”
The doctor summarized, “I would view his lack of adequate oral and food intake as another indication of danger to self.”
Moreover, regarding his capacity to refuse treatment, she rejected the possibility that he was on a “hunger strike,” confirming that his lack of appetite does not appear to be purposeful or rational with the intent to gain a preferred outcome.
In response to the judge’s questions about whether she explained to Dominguez the risks and benefits of medication, the psychiatrist noted she has recommended treatment to him on several occasions but he has refused to voluntarily consume medication because he does not believe he has a psychiatric condition.
She also discussed options of Milieu therapy or psychotherapy and psychiatric facilities when asked about alternative forms of treatment, but determined such treatment options are not beneficial to his mental disorder.
Heeding the psychiatrists’ declaration of Dominguez’s capacity and danger to himself, as well as his danger to others based on his felony charges, Judge McAdam determined that the accused qualified under PC § 2603 for involuntary psychiatric medication.
After considering whether involuntary medication would prejudice the accused’s defense, Judge McAdam concluded there was no prejudice, rather required medication to effectively assist his attorney.
“The court finds based on the testimony in the declaration filed by the doctor that there is clear and convincing evidence that Carlos Dominguez has a mental illness or disorder … As a result of that illness, the inmate is greatly disabled and lacks the capacity to consent or refuse treatment with psychiatric medications,” said the judge, adding, “There is no less intrusive alternative to involuntary medication and the medication is in the inmate’s best mental interest.”
With such considerations, Judge McAdam issued a medication order for Dominguez. Although DPD Hutchinson did not object to the order, he clarified, “Your Honor, I want to make clear my client’s position. He is opposing an order for involuntary medication.”
After ensuring the court followed the procedures of the 2603 hearing, the judge set a court date for Sept. 29 for a review of the medication order. He instructed the expert witness to appear in court on Monday, Aug. 7, for the continued competency hearing and examination by the prosecution and defense.
In continuation of the lengthy proceedings related to the recent Davis killings, alleged to be carried out by Dominguez, both the defense team and the People came to an agreement over the heated debate of whether or not Dominguez has the mental competency to stand trial.
Dominguez allegedly stabbed and killed two people in Davis in late April and severely injured a third person.
While attempting to set up a trial for Dominguez, his mental competency came into question in which his attorney, DPD Hutchinson, argued Dominguez was not in the right headspace when the killings took place, as evident through a previous mental illness.
The prosecution initially argued Dominguez was aware of his actions and cognitively carried them out.
The prosecution made this decision based on an older psychiatric evaluation, which the defense challenged.
However, with recent psychiatric evaluations, completed by different doctors, taking place, DDA Attorney Matthew DeMoura and DDA Van Der Hoek
announced to Judge McAdam the People have changed their position.
DDA DeMoura stated, in agreement with the defense, “The People have changed their position and we would agree that Mr. Dominguez is no longer competent to stand trial, while we do believe that Mr. Dominguez understands the nature of the proceedings against him … we no longer believe that he is able to assist his attorney in a rational manner.”
In order to be found fit to stand trial Dominguez would have to meet all three of these requirements, not just two.
Following this revelation, Judge McAdam stated, “The court’s willing to accept that stipulation and agree wholeheartedly. I sat through the trial and watched it and I agree with the defense position all along, here, and with the prosecution position today that Carlos Dominguez does not have the competency to stand trial.”
Judge McAdam added it has been clear through Dominguez’s body language and lack of engagement in the courtroom that he was no longer productive in assisting his defense attorney.
Due to this agreement, new protocols had to be implemented, and Judge McAdam gave a brisk summary on the following procedures as a result.
“There is officially a finding of mental incompetency, I’ve made that finding now based on the totality of the record before us and the stipulation of the parties. He will eventually be sent to a state hospital for restoration of competency, but before that the court must refer this matter to the community program director…an organization called CONREP,” said the judge.
Judge McAdam added, “The court has no expectation that there is any place suited to treat Carlos Dominguez other than the state hospital; in other words, he is not a candidate for outpatient treatment, but the law requires us (to allow) CONREP weigh in, so we’ll do that…”
An involuntary anti-psychosis medication would be administered to Dominguez, who has previously stated that he does not want to be medicated. With this, Dominguez would be staying in a state hospital where he can receive care.
These orders are given in hopes that Dominguez will be “restored to competency” in order to assist his attorney and therefore stand trial, said the judge.
This restoration was given a two-week timeline to see if there is a change in behavior and mentality.
Judge McAdam said, “It is the court’s hope that with proper treatment that Carlos Dominguez will be restored to competency and that he can assist his counsel and that the case would move forward in whatever way both sides see fit, pursuant to law. We’re not there right now, criminal proceedings are suspended until he’s restored to competency.”
Given the two-week timeline and the mental competency ruling, McAdam added a jury is no longer required.
McAdam noted because this trial is so public, high profile, and “well-known. I do not want to skip any steps. I want to look the jury in the eye and give the jury a formal admonition about their rights,” McAdam will thank and dismiss the jury at 9 a.m. on Aug. 4.
