HAMILTON — A Butler County judge has ruled doctors may forcibly administer medication to a man accused of shooting and killing his neighbor. The suspect is in treatment for restoration to competency to stand trial.
The defense team opposed the measure in a hearing earlier this month, arguing doctors at Summit Behavioral Health in Cincinnati have a large list of medications they want authorized, some of which may have side effects, and they are not sure of Austin Combs’ diagnosis.
Defense attorney Chris Pagan told the Journal-News he will immediately appeal Judge Michael Oster Jr.’s decision to the 12the District Court of Appeals.
The judge’s ruling is a final appealable order, which means it can be appealed straight to the appellate court before the case moves any further. There is no trial date set.
Unless Combs agrees to take his medication, the Summit staff cannot treat him at this point.
Combs, 27, was arrested hours after the fatal shooting on Nov. 5, 2022, and was indicted for aggravated murder a week later.
Anthony Lee King, 43, died of multiple gunshot wounds in his yard that neighbored Combs’ residence. King was doing yard work at the time he was shot, according to investigators.
In March, Oster declared Combs incompetent to stand trial after reviewing evaluations from two forensic psychologists. He was deemed restorable with treatment. The court by law has a year to restore a defendant to competency.
Incompetent for trial means the accused does not understand the charges and proceedings and cannot assist in their own defense.
Oster ordered Combs be treated at the Hamilton County facility.
Combs arrived at Summit in May and has exhibited different behavior both on and off treatment, but at the end of June he began refusing to take medication and in July was accused of assaulting a worker at the facility, according to prosecutors and court records.
The misdemeanor assault charge against Combs involving the worker is pending in Hamilton County.
Combs was in court for the Aug. 3 hearing to force his treatment with medication. He was pale, very thin and looked out the courtroom window during much of the three-hour hearing.
Psychiatrist Dr. Jarrod Warren, who is treating Combs at Summit, testified when Combs entered the facility they did not observe expected “gross” mental illness behavior given his history of mental health issues as an adolescent.
“He was polite and cooperative,” Warren said, adding because of past mental health diagnoses, they expected him to display more of that behavior. “We were trying to understand what was actually going on with him.”
Four weeks later, Warren said Combs’ meal intake had “dropped off,” he had staring spells and was not receptive to anyone. At one point he was found on the floor with a sheet wrapped around his neck.
When the facility initiated a plan to keep him safe, Warren said Combs attacked the person monitoring him.
Combs was taken to UC Medical Center to determine if anything physically was wrong, and nothing was found.
“We determined his behavior was from a mental health condition,” Warren said, that’s when they believed his catatonia was part of a diagnosis of schizophrenia.
Combs was treated with Ativan and it helped, Warren said. Combs was coming out of his room and eating.
When Combs began refusing medication, he got worse, according the doctor. He has been given multiple opportunities to take the meds, but is refusing.
“He is worse,” Warren said. “He got better, he has regressed,” Warren said. “I feel (if he is not treated with medication) he would actually end up hospitalized. I am most worried about his food and water intake right now.”
Combs’ attorney Chris Pagan pointed to the long list of medication that the facility wants the court to approve for forced treatment and to the multiple diagnosis of Combs’ mental condition. He noted many have serious side effects.
Warren said all the drugs would not be used for treatment, but they did not want to come back to the court for an additional hearing for use of individual drugs.
The defense attorney pointed to Combs’ multiple mental health diagnoses over the years and several at Summit.
“You want to force mood altering medication on him,” Pagan said. “(But) you can’t say he has a mood altering diagnosis at this point.”
Oster did issue specific guidelines in the ruling including “close monitoring of defendant’s health, with the understanding that treatment should stop in the face of major side-effects or other problems and a report made to the court.”
The judge also ordered because of the risk associated with certain drugs, the court should be notified immediately if Lithium and Depakote are to be utilized and “reports (are to) be submitted to the court at approximately an eight-week maximum interval to include progress towards competency and any side-effects experienced.”