Heard: November 9, 2016.
and Disorderly Person. Self-Defense. Practice, Criminal,
Instructions to jury.
received and sworn to in the Central Division of the Boston
Municipal Court Department on July 19, 2011.
case was tried before Annette Forde, J.
Supreme Judicial Court granted an application for direct
appellate review. Jeffrey A. Garland, Committee for Public
Counsel Services, for the defendant.
Jalbert Patalano, Assistant District Attorney (Neil J. Flynn,
Jr., Assistant District Attorney, also present) for the
Bettina Toner, Robert D. Fleischner, Jennifer Honig, Chetan
Tiwari, & Phillip Kassel, for Center for Public
Representation & another, amici curiae, submitted a
Present: Gants, C.J., Botsford, Lenk, Hines, Gaziano, Lowy,
& Budd, JJ.
defendant, Richie Accime, appeals from his disorderly conduct
conviction under G. L. c. 272, § 53, claiming there was
insufficient evidence to support it. The charge was brought
against him in relation to his conduct as a patient in the
psychiatric area of the emergency department at a hospital in
Boston. Accime argues that in the circumstances of this case,
the Commonwealth failed to prove he consciously disregarded a
"substantial and unjustifiable risk of public
inconvenience, annoyance, or alarm." Emphasizing the
setting-specific inquiry required by our case law, we agree
with the defendant and reverse the judgment of
the facts in the light most favorable to the Commonwealth,
the jury could have found the following. In the afternoon of
June 5, 2011, the defendant was brought by ambulance and
against his will to the emergency department of a hospital.
There he was involuntarily detained in a small room in the
psychiatric area of the hospital's emergency department.
Although this detention was purportedly pursuant to G. L. c.
123, § 12 (a.), which allows the temporary restraint and
hospitalization of persons posing a serious risk of harm by
reason of mental illness, according to the defendant, who
testified at trial, he was shown no evidence of compliance
with the procedures required by § 12 (a.), nor was any
such evidence produced at trial.
told he would likely be held in the hospital for two or three
days, the defendant began to shout. Medical staff requested
assistance from hospital security officers and, on their
arrival, instructed the officers not to allow the defendant
to leave. At approximately 8 P..M., a security officer called
for additional assistance; at least four other security
responded. At least one officer was armed with a baton and
handcuffs in addition to the pepper spray that was carried by
at least three officers.
officers attempted to persuade the defendant to take
medication that he told them he did not want. Having heard
the defendant repeatedly say, "I don't want to take
the medication. I want to get out of here, " the
officers told him that if he refused to take the medication,
he would be restrained, and later, that if he did not comply
with orders he would be pepper sprayed.
response to the officers' orders, the defendant stated,
"I'm not taking any medications. You can't hold
me here against my will"; "I don't want to fuck
anybody up, but I guarantee I'm leaving one way or the
other"; "if anybody puts their hands on me, I'm
going to fuck them up"; and "if anybody pepper
sprays me I'm going to beat the fuck out of them."
Furthermore, when the officers first entered the room, the
defendant had said, "The first person in, I'm going
to break their arm. And then the next person in, I'm
going to break theirs, and then the next, and then the
next." Other patients were "looking on"; as a
precautionary measure, officers directed anyone in the
hallway to an alternate route "just in case something
happened if [the confrontation] spilled out" of the
room. The officers asked the defendant to calm
down, and repeated their request that he accept medication.
defendant took his shirt off,  and began pacing with clenched
fists, hitting the open palm of one hand with the clenched
fist of the other. He repeated his desire to leave, insisted
no one was going to stop him, and refused to sit on a