The opinion of the court was delivered by: Surrick, J.
Upon consideration of reports submitted by the psychologists and psychiatrists who have evaluated Defendant Dante Tucker pursuant to 18 U.S.C. § 4241 to determine whether he is competent to stand trial, and after a hearing in open court, we find that Dante Tucker is competent to stand trial.
On February 21, 2007, a grand jury returned a 194-Count Fifth Superseding Indictment charging twenty-two defendants, including Defendant, with offenses related to their alleged participation in a drug conspiracy. Defendant was charged with conspiracy to distribute narcotics in violation of 21 U.S.C. §§ 841(a)(1), 841(b)(1)(A), 846, being a felon in possession of a firearm in violation of 18 U.S.C. § 922(g)(1), possession of a firearm in furtherance of a drug trafficking crime in violation of 18 U.S.C. § 924(c), distribution and possession with intent to distribute narcotics in violation of 21 U.S.C. § 841(a)(1), and related offenses.
Prior to a hearing held on December 13, 2007, on a motion to withdraw by Defendant's counsel, Carina Laguzzi, Esq., we were advised that Defendant potentially had mental health problems and had been treated in the past for paranoid schizophrenia.*fn1 Consequently, on December 21, 2007, we entered an Order granting the Government's request to have Pogos Voskanian, M.D., examine Defendant for the purpose of evaluating his competency to stand trial. (ECF No. 597.)
Dr. Voskanian, a clinical and forensic psychiatrist, examined Defendant on December 27, 2007, and submitted a report dated December 31, 2007 ("Voskanian Report"). Dr. Voskanian was unable to definitively diagnose Defendant, concluding that he possibly suffered from a thought disorder but that malingering*fn2 could not be ruled out. Dr. Voskanian recommended close monitoring and follow-up in a psychiatric facility to develop a better understanding of Defendant's mental state. On January 18, 2008, based on Dr. Voskanian's report, we issued an Order directing Defendant's transfer to a psychiatric facility for 30 days, for a psychiatric or psychological examination to be conducted and a report filed with the Court, in accordance with 18 U.S.C. §§ 4241(b) and 4247(b)-(c). (ECF No. 643.)
Defendant was admitted to the Metropolitan Correctional Center in New York City ("MCC-NY") on February 20, 2008. In a report dated March 27, 2008 ("Ryan Report"), after evaluating Defendant, forensic psychologist William J. Ryan, Ph.D., provided a diagnosis of Psychotic Disorder Not Otherwise Specified and Polysubstance Dependence, In Partial Remission in a Controlled Environment. Dr. Ryan concluded that Defendant was not competent to stand trial and recommended that he be committed for the purpose of restoring his competency. Based upon Dr. Ryan's recommendation, the Government filed a motion requesting that Defendant be committed for a period of treatment in order to restore his competency to stand trial. (ECF No. 829.) On May 5, 2008, based upon the medical reports and other information before us, we found that Defendant was not competent to stand trial and ordered that he be hospitalized for treatment pursuant to § 4241(d). (ECF No. 830.)
On June 2, 2008, pursuant to our Order, Defendant was admitted to the Mental Health Unit of the Federal Medical Center in Butner, North Carolina ("FMC Butner"). At FMC Butner Defendant was evaluated by staff psychologist Carlton Pyant, Ph.D. In a report dated October 15, 2008 ("FMC Butner Report I"), Dr. Pyant stated that he was unable to offer a definitive opinion regarding Defendant's competency to stand trial. Dr. Pyant recommended that Defendant undergo an additional period of hospitalization and treatment while he attempted to obtain additional medical records and other information concerning Defendant's mental health. The Government then filed a motion requesting that Defendant be committed to the custody of the Attorney General for an additional 120 days for the purpose of further evaluating his competency. (ECF No. 1040.) We granted the Government's motion on February 4, 2009, finding that a period of close monitoring and follow-up in a psychiatric facility would assist us in adequately assessing Defendant's competency. (ECF No. 1041.)
On March 13, 2009, Defendant was readmitted to FMC Butner. Defendant was again evaluated by Dr. Pyant, with input from a different staff psychiatrist. In a report dated July 28, 2009 ("FMC Butner Report II"), Dr. Pyant diagnosed Defendant with Malingering and concluded that he was competent to stand trial. The Report noted that "[w]ith the passage of time, evidence of malingering became apparent" and concluded that Defendant was competent to stand trial. (Id. at 6, 9.)
On August 17, 2009, Defendant's counsel moved to retain forensic psychologist Kirk Heilbrun, Ph.D., to conduct a competency evaluation of Defendant. (ECF No. 1193.) We granted Defendant's motion on August 19, 2009. (ECF No. 1204.) Dr. Heilbrun evaluated Defendant and rendered a report dated October 12, 2009 ("Heilbrun Report").*fn3 Dr. Heilbrun offered the opinion that Defendant was not competent to stand trial, but that treatment with medication may remedy his condition and restore his competency.
On November 17, 2009, we held a competency hearing in accordance with §§ 4241(c) and 4247(d). Dr. Pyant, Dr. Heilbrun, and Defendant's mother, Shelly Tucker, testified at the hearing. At the conclusion of the hearing, we granted defense counsel's request for additional time to obtain Defendant's juvenile mental health records to supplement the record and to provide a more complete picture of Defendant's mental health. By letter dated June 2, 2010, defense counsel informed us that he was unable to locate any such records. Counsel advised that a firm retained to conduct an investigation did not discover anything, and "it appears that if these records existed, they are no longer available."
The criminal trial of a defendant who lacks mental competency violates the defendant's due process right to a fair trial. See Cooper v. Oklahoma, 517 U.S. 348, 354 (1996); United States v. Renfroe, 825 F.2d 763, 765-66 (3d Cir.1987) (citing Drope v. Missouri, 420 U.S. 162, 172 (1975)). The basic standard for competency, set forth by the Supreme Court in Dusky v. United States, requires that, in order to plead guilty or to stand trial, a defendant must have a rational and factual understanding of the proceedings and a "sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding." 362 U.S. 402, 402 (1960) (per curiam); see also Taylor v. Horn, 504 F.3d 416, 430 (3d Cir. 2007) (citing Dusky, 362 U.S. at 402). Requiring a criminal defendant to "be competent has a modest aim: It seeks to ensure that he has the capacity to understand the proceedings and to assist counsel." Godinez v. Moran, 509 U.S. 389, 402 (1993); see also Riggins v. Nevada, 504 U.S. 127, 139-40 (1992) (Kennedy, J., concurring) ("Competence to stand trial is rudimentary, for upon it depends the main part of those rights deemed essential to a fair trial, including the right to effective assistance of counsel, the rights to summon, to confront, and to cross-examine witnesses, and the right to testify on one's own behalf or to remain silent without penalty for doing so." (citing Drope, 420 U.S. at 171-72 (1975))).
Congress codified the competency standard in 18 U.S.C. § 4241, which provides that:
If, after the [competency] hearing, the court finds by a preponderance of the evidence that the defendant is presently suffering from a mental disease or defect rendering him mentally incompetent to the extent that he is unable to understand the nature and consequences of the proceedings against him or to assist properly in his defense, the court shall commit the defendant to the custody of the Attorney General.
18 U.S.C. § 4241(d). "At the competency hearing, the Government has the burden to prove the defendant's competency." United States v. Velasquez, 885 F.2d 1076, 1089 (3d Cir. 1989) (citing United States v. DiGilio, 538 F.2d 972, 988 (3d Cir.1976)). Pursuant to § 4241, psychiatric or psychological examinations of the defendant may be conducted, psychiatric or psychological reports prepared, and a hearing held, in accordance with 18 U.S.C. § 4247(b), (c), and (d), respectively. 18 U.S.C. § 4241(b)-(c). Accordingly, "court[s] must examine the unique circumstances of the case and decide whether the defendant '(1) has the capacity to assist in her or his own defense and (2) comprehends the nature and possible consequences of a trial.'" United States v. Jones,336 F.3d 245, 256 (3d Cir. 2003) (citations omitted). When evaluating a defendant's competency, we "must consider a number of factors, including 'evidence of a defendant's irrational behavior, his demeanor at trial, [and] any prior medical opinion on competence to stand trial.'" Id. (quoting United States v. Leggett, 162 F.3d 237, 242 (3d Cir. 1998)).
A. Conclusions of Mental Health Professionals
Dr. Voskanian examined Defendant at the Federal Detention Center in Philadelphia ("FDC") on December 27, 2007, for approximately two hours. (Voskanian Report at 1.) He also reviewed several documents, including our Order for Competency Examination and Hearing Under 18 U.S.C. § 4241 (ECF No. 597), the Indictment, and the Government's Motion for Pretrial Detention. (Id.)
Dr. Voskanian's report indicated that his examination of Defendant was essentially an interview. (Id. at 2.) Dr. Voskanian reported that for over thirty minutes at the start of the interview, Defendant "expressed his opinions regarding systemic issues." (Id. at 2.) For example, Defendant was adamant that a criminal defense attorney who had previously worked as a prosecutor, as had his previous counsel, Ms. Laguzzi, could never be loyal to a client. (Id.) He was also convinced that a defense attorney who is a government employee works together with prosecutors to prosecute defendants. (Id.) Defendant "would not accept alternative explanations." (Id.)
During the interview, Defendant recounted hearing voices when he was a child, which had led his grandmother to send him to a psychiatric hospital. (Id. at 3-4.) With regard to the voices, Defendant stated: "It's like they inform you . . . it's like telling you what's going on . . . ." (Id. at 6.) He explained that he was not sure if the voices were "coming from [his] ears" and that the voices he heard were male "but it's not the same person." (Id.) Defendant also mentioned having had implants, such as a tracking device, installed in, and then removed from, his body. (Id. at 4.) Defendant admitted to using drugs, but only for the purpose of "mak[ing] voices and headaches go away . . . if apple juice did it I would use apple juice." (Id. at 6-7.) In response to further questions about his drug use, Defendant became very suspicious and guarded and refused to answer the questions in detail, leaving the interview room after stating that Dr. Voskanian was "trying to incriminate him and [was] setting him up." (Id. at 7.)
In summarizing his opinion, Dr. Voskanian stated that Defendant "had expressed a considerable amount of paranoid ideation [and] believed that he is being unjustly persecuted."
(Id. at 7.) He noted that Defendant had stated that he experienced auditory hallucinations. However, Defendant "made statements that indicated he had understanding of his legal charges [and] knew the reason his common-law wife had received a sentence." (Id. at 7-8.) In addition, Defendant "clearly understood who [Dr. Voskanian] was and the purpose of the current evaluation." (Id. at 7.) Dr. Voskanian concluded that "it would be difficult to definitively diagnose the defendant": while "his presentation was suggestive of a serious thought disorder . . . , malingering cannot be ruled out." (Id. at 8.) Dr. Voskanian ultimately did not offer an opinion regarding Defendant's competency, instead recommending close monitoring and follow-up in a psychiatric facility to acquire a better understanding of Defendant's mental state. (Id.)
On February 20, 2008, Defendant was admitted to MCC-NY, where Dr. Ryan evaluated him over a period of a little more than a month, until March 27, 2008. Dr. Ryan was assisted by two psychology externs. (Ryan Report at 1.) Dr. Ryan's evaluation included four clinical interviews, conducted on February 28, 2008, and March 11, 19, and 25, 2008. (Id. at 2.) In addition, Dr. Ryan and his team reviewed several documents from this proceeding, including the Voskanian Report, and conducted telephone interviews with Ms. Laguzzi, Mr. George, and one of the attorneys for the Government. (Id.) Dr. Ryan noted that because of Defendant's lack of cooperation, the opinions expressed in the Ryan Report "are offered with less than the usual degree of psychological certainty." (Id. at 8.)
Dr. Ryan noted that Defendant "appeared very paranoid and guarded throughout the current evaluation," as he had with Dr. Voskanian, and that he "also reported many of the same delusional beliefs . . . as he did to Dr. Voskanian." (Id. at 4.) He "refused to speak at length with evaluators" (id. at 1) and "was only marginally cooperative during interviews" (id. at 2). For example, he refused to answer questions about his childhood, "display[ing] the capacity to withhold almost all meaningful information" during several interviews. (Id. at 2.) As a result, Dr. Ryan collected most background information about Defendant from discussions with attorneys and the Voskanian Report. (Id. at 8.)
According to Dr. Ryan, Defendant "voiced vague paranoid ideation about why the evaluation was being conducted." (Id. at 1.) This was after Defendant was told who would perform the evaluation, that its purpose was to assist the Court in evaluating his competency, that neither the interviews nor the results of the testing would be confidential, and that he could consult his attorney at any time. (Id.) Defendant refused to participate in any psychological testing even after the nature and purpose of all attempted tests were explained to him. (Id. at 4.)
The MCC-NY psychiatrist met with Defendant on February 22, 2008. (Id.) She noted that Defendant "was extremely paranoid, refused to answer many questions, and whispered, 'they are always watching me.'" (Id.) Her diagnosis was Psychosis Not Otherwise Specified (NOS), history of Polysubstance Abuse, and a possible history of Schizophrenia. (Id.)
The Ryan Report briefly summarizes the first two interviews of Defendant. During the first interview, Defendant expressed his discomfort because a particular extern was in the room. (Id. at 5.) "After answering a few questions for several minutes [Defendant] refused to answer anymore [sic] questions or make eye contact with the evaluators." (Id.) The second interview with Defendant "was similar to the first." (Id.) Defendant was "paranoid, suspicious, angry, and anxious." (Id.) He accused the evaluator of "playing mind games" with him and appeared to suggest that the evaluator and some other people were conspiring against him "to assist in [his] demise." (Id.) When offered the opportunity to speak with another forensic psychologist, Defendant refused, claiming he did not want to speak with anyone. (Id.) Dr. Ryan related that "[w]hen [Defendant] looked depressed and was ...