State Seeks To Forcibly Medicate Man Charged With Killing Yale Doctor

NEW HAVEN — Doctors at the state’s maximum security psychiatric hospital believe a regular regimen of antipsychotic drugs could help restore Lishan Wang, a former doctor charged with the 2010 killing a Yale University physician, to competency.

But Wang insists he is not mentally ill and is competent to stand trial. He does not want to take any drugs against his will.

A judge is now considering the thorny issue of whether Wang should be given medication forcibly to make him competent to stand trial for the April 26, 2010 murder of Dr. Vajinder Toor, 34, and the attempted murder of Toor’s then-pregnant wife outside the couple’s Branford condominium.

In an unusual hearing Monday in Superior Court, which was continued until next month, a doctor and a nurse testified that Wang would benefit from taking olanzapine and ziprasidone, medication they said would help treat several psychiatric disorders Wang suffers from, including paranoia, persecutory ideation, delusions and depression.

“I don’t see any other way,” said Gail Sicilia, a psychiatric nurse practitioner at Yale and Wang’s court-appointed health care guardian.

Wang, 49, is charged with fatally shooting Toor and shooting at but missing Toor’s wife. Wang and Toor had worked together at Kingsbrook Jewish Medical Center in New York City. Wang had a history of confrontations with Toor and other colleagues that led to his dismissal from Kingsbrook in 2008 and the filing by Wang of a federal discrimination lawsuit against the medical facility.

After the shooting, police found Wang in his van with documents that referred to two other people involved in his job dismissal. About a thousand rounds of ammunition, a wig, a hammer and a knife also were found in his van. Wang has represented himself in court.

A judge in 2010 ruled Wang incompetent to stand trial but Wang was ruled competent after treatment without medication at Connecticut Valley Hospital in Middletown. Earlier this year, a judge ordered a second competency hearing after New Haven Chief Public Defender Thomas J. Ullmann filed a motion asking the court to terminate Wang’s self-representation.

Ullmann said that Wang is mentally ill and not able to handle the case pro se, an assertion that Wang has countered with his own blistering court filings against Ullmann and his office in which he accuses the public defenders of working against him. After balancing Wang’s right to represent himself with making sure he gets a fair trial, Judge Thomas V. O’Keefe ruled in April that Wang was incompetent and could not represent himself, and ordered him transferred back to CVH.

Since then, doctors said, Wang’s condition has not improved and they are recommending he take the medication. Wang has filed several papers with the court with a long list of complaints, including that CVH has a bias against him.

Sicilia testified Monday that she met four times with Wang to try to discuss the medical plan but Wang was not always cooperative as she tried to talk about the benefits and side effects of the medication. She said she favored starting Wang off with small doses to see how he would react to the medication and if he adjusted well and needed more, physicians could increase the dose. She said there is no record of Wang ever taking any medications for mental illness.

She said the hospital would keep a close watch on Wang and how he responded to the medication but she said it would be difficult to do that voluntarily since Wang has not cooperated with prior testing.

“He absolutely does not want medicine and doesn’t believe he should be at CVH,” Sicilia said. She said if Wang refused to take medication orally, it would likely be injected by hospital personnel.

At one point in Sicilia’s testimony, Wang appeared to become agitated and yelled, “You’re lying. You’re lying.”

Through Ullmann, O’Keefe pressed Wang on whether there would be more outbursts. While discussing the question with Ullmann, Wang said, “I care about my body.”

Ullmann told O’Keefe that he could not answer whether there would be more outbursts.

“Put the handcuffs back on him,” O’Keefe told the judicial marshals. Wang, a Chinese citizen with three children, spent the rest of Monday’s hearing quiet, staring ahead, but not in the direction of the judge.

Both Ullmann and the prosecutor, Eugene R. Calistro Jr., cited case law in their closing arguments Monday, including a 2003 U.S. Supreme Court ruling that placed strict limits on the government’s ability to medicate mentally ill defendants forcibly to make them competent to stand trial. Defendants have argued that their right to a fair trial is undermined by the dispensing of antipsychotic drugs because of the side effects from the medication.

Calistro argued that the court could order the medication, saying the state in its evidence Monday proved that use of the antipsychotic drugs is “medically appropriate,” would not pose serious health risks and is in Wang’s best medical interest. He said the government has “an important interest” in bringing the case to trial because Wang is accused of such a serious crime.

Calistro said evidence showed the drugs would likely help make Wang competent to stand trial and any less intrusive, alternative measures were unlikely to achieve similar results. Though medical professionals testified that they were not 100 percent certain that the medication would help Wang, Calistro said there is strong medical evidence that shows it could help restore Wang’s everyday functions and ultimately, his competency.

“You’re not going to know unless you try,” Calistro said.

Ullmann, however, said the state did not prove that its plan to medicate Wang would restore him to competency, saying “it’s anybody’s guess.”

Ullmann said Wang’s right to a fair trial could be jeopardized if the antipsychotic medication he was given caused major side effects that hindered his ability to communicate with his lawyers and assist in his own defense.

Those side effects could include hypertension, dizziness, hyperglycemia, weight gain and other physical ailments, according to testimony.

O’Keefe continued Wang’s case to next month to give attorneys time to argue legal points in the case.