JAI\,{E S EAGAN HOLIv{ES

Case Number: l2CRl522 DATE FILED: June 29, 2018 5:57 PM

SANITY EYALUATIOI{CASE NUMBER: 2012CR201522
Jet i'e1, L. l\.{elzner.
l.'{. D. . Consultin g Psychia trist. CMHIP
Septeurber 3. 3013
Page I of69

This psychiatric exarninatiol r.vas requesled to address the legal issres of sanit-r,, competency to proceed and
uritigatilg tact*rs" ifaly, related io urental disease or defbct.

SOTIRCES OF IXTORI,IATION

Soruces of inf,crnriation included review of tlie {bllowilg documelts:

1. transcdpts of the preliruinary hearilgs (January 7-9, 2013),

?. medical records of marty of the victiux lvlto werp physically rujr:red durirrg the shooting,
3. voluminous police reporls P 50,000 pages-*see Appeldices I & tr tbr a partial listing). rvhich
included extensive D\iD recordings of vartous key inte:views {e.g., Mr. Holmes- Officer Oviatt,
O{ficer Srveeley) and observational videos of Mr. Hohues in cnslody at the Arapahoe Couuty Jail
and at tbe Denver Health Medical Celter,
4. a'"totebook" vritter) byh{l. Hohnes during Jrme-July ?013 relevant to the allegetl cdmes,
5. healthcare records re: Mr. Hohnes &oru tlrc follorving agencies/providers:
a. Uaiversity of Colorado Denverl Aaschutz Medical Canrprxo
t). Alapahoe Corurty Jail,
c. Denver Healtir lvIedica1 Ceater,
d. PsyCare (Mel tipsey),
e. Aetion Care Ambulance,
f. Family Serr,'ices Agetcy (Salia*s, Califiornia),
g. Calorado }.{ental Health lnstitute at hrebio (CMHI-P),
6. a Ju*e 17, 2013 neuropsychiakic report ryritter by Raquel Gu', M.D., Ph-D.,
7 " a Jrme 8, ?013 neuropsychological rqport writtel by Robert Haulon, Pb.D.,
8. telephone interr.iews with the followingmental health clinicians, r,vho lrave had clilical corrtaet in
sorue olaruter with I,{r'. Hohrrcs:
Erwin Mozer, M"D,,
Karen Fukataki. M.D-"
Elizabeth Sather, Psy.D-
Eiizatreth Lowde:milk. M.D.,
Rachel Davis,lv{.D.,
Philippe S/eintra*b, M.D.,
Jonathan'$/aodcock, M.D.,
J. Craig Hollard M.D.,
Margalet Roath. M.S.W.,

JAUESEAGfu\ HOLMES
100936 B!.2lt3n987 F
0810412013 RC-.q,RAr,iIIOE
E?002 Color*do li[e:rt*l Ileallh Institute at Purhlo Crit _]'2_
A,RA.?ABOE SA.}TTYEXAM OBSXRYATION REPORT 150 i10/e3i
 JAh,{ES EAGAN HOL]t.{ES
Case Nurxber: l2CRl522
SA\I-ITY f YALtlATIOlti
Jefkey t. Ir{etzner. h,{.D.. Cor:sulting Psychiah'ist. CMHIP
Septeurber 3. l0l3
Page ? of69

j- Lynne Fenton, M,D..

k. Roberl Fei$stei*, IU.D.,
l. Richard Porurds, M.D. {in persoll coutact at CMHI-P),
9. a PowerPointpresentation by Chief Oakes.
10. a docrmrent ettitled "Ja$les Eagan Social Historf' provided by the attomeys (i.e.. Offrce of tlie
hrblic Defende{ forMr. Ho'lnres,
I L addition*l records provided by the Oifice of the Public Defereder that included the fbllowiug:
a. videotaped iaterviews of }.fi'. Holmes druing his l.{ovearber 2018 hospitalization at the
Delver Health Medical Center.
b. iuvestigators'intervierv reporls of UC Delver faculty memtrers re: Mr. Hohnes.
s. healthcare records pedinent to Mr. Burton Eagau, ${s. Clrris Holmes and Mr. Robert lv{iltou
Holnies, Sr,.
1 ?. an August 26" 2013 psycliological aod lerrnpsychological evaluation reporl prepared by B. Thomas

Gray. Ph.D. *ud Rose N{*uuxo, Ph"D.

I also nret wilh the disajct attomeys and public defendem irrvoh.ed in this case in sepmafe ureetings.

Duriag August 8. 3013, infoir:ration was abtained via telephaae Ilom lv{r- Holmes' parerts, Robe.rt and Arlene
Hokues"

Dnriug August 8, 9, 10, 17, 20r3,I psychialically evaluated lr{r. Hohnes at the Colorado Meatal Health
Institute at hreblo {CMHI-P) for a total of 25.50 hours. in additicn to about t00 hours reviewing the previously
listed discovery data- Prior to beginuing most of the interviervs, I expl*ined to Mr. Holmes the purpose of this
exa:nfulation and the limits of corfidentialify.

THE ATLTGE} CRIMSS

On July ?0. ?012 at approximately 12:39 A-M.. the Aurora Police Dispateh Ceater received several phone calls
reporting multiple gurxhots being fired inside fhe Ce*trry 16 Theake. During this tragic shooting sprea, twelve
people were killed and at least 70 other persons had physical injuries, rvhich included 58 gunshot worurds,

Mr, James Hohnes was arrested at the crime scene ah*ost inxnediately after the leaving the theater and was
subsequently charged with the f,ollowing crimes:

JA}IES EN.GN.N EOI*1IIES

1&0936 8121131198? F
08/04/2013 RC.ARAPAHOE
E?002 Color*do Melt*l Ee*lth Iastitute at Pueblo
ARAPAIIOE SA}{ITYEXAM OBSERVATICI]Y RSFORT
 JAIVIES EAGAN HOLI,{ES
Case Nrmber: l2f'R1522
SANr'ITY EtrrALI-jATIOli
Jet'key L. lv{etzner. h.I.D.. Consultitg Psychiatilst. Ch,{HIP
Septeurber 3. :0ll
Page 3 of69

r Mrrder in lhe First Depree (Fl) 24 cormts total {12 corrnts atler deliberation, 13 counfs
exherne ildiflbrelce)
Criminal Atternpt to Comr:rit Murder ir the First. 140 corults tctal (70 corurts CATCM
atler deliberation. 70 counts CATCM extrene iudiffererice)
a Possession of Explosive or Inceudiary Device (F4), I count
a Crime of Violeuce- I count

Atlachrnent I provides arr estimated timeline of sigrrificant events flom tbe time of the initial anival of &e
Arapahoe Cormty Police Depa:tment at the Century l6 Theater to the tiure of the arest of Ir&'. Hohues.

Ihis sectioa of the report will suunarize infon ratioa obtairred 6'orn lr{r'" Hohnes druing my nuitiple interyiews
cf hirn aloug with so:ne of the relevant excerBts from the large nunber of records reviewed-

During early lvlay ?012. Mr- Holrnes began plarudlg ard preparing to carry out a "nlass muder" at a urovie
theater lbr reasous that r.vill be deseribed in later sectious of this report entitled "The Notebook" aild "The Gmail
Chat." This 'hotebook" was rryritlen by Mr, Holmes to explairr 'lvhy t did what I did... starle.d wliting it after I
got out of [medal health] treahnent ldmjng Juue 3012]... ." As documenterl ir his notebook, he chose to do a
"ruass murder/spree {maximrmr casualties, easily perfonued rrith fireanus although priruitive in rature... ."

BeJween May arld July of 281?, the police documented that lv{r. Hohnes pxchased four fireauns, which
ilcluded two Glock pistols, an 870 Remington slrotgnn and an AR. 15 {i.e., ar assault rifle). Duri:rg the same
period cf time he pruchased 6,295 rouads of various calibers of ammrurifion (2.600 ramrds of .40-caliber. 335
shctpnur rounds and 3370 rormd* of -2?3-caliber amrnurition). Attachme*t ? provides a visual timeline re: his
pruehases of {irearrns aud Attaclunelt 3 provides a detailed summary of arnmo. accessories, explosives,
incetdiary parts, gear arid firearms purchases" Onliue purchases rnade by L{r'- Hohnes l,yere based rylot price
ald in-store purchase* were based oa proxinriff to his apartment. Mr. Hshnes bouglt fireamrs aad related
equipmenf over tiure in order to avaid suspicioa that could be raised by brryiltg everytliing at once"

Mr. Holmes had no experieace with {irearms prior to the everts leading to &e shooting. He researched fireamx
throu€h the web, which took about a month" He chose the Byers Canyon Range for piactice slrootilg purposes
becaxe this shooting range was rrot supervised, which meart il was rurlikely that suspiciols would be aroused if
he *equented it often. Mr. Holmes reported going to the Byers Calyon range on about a five occasious during
late Jrxre and early July" It was about a 211/2 horu drive for hirrr.

Mr'. Hohnes reporled usiag about 50Yo of the fi]unds sf arnmnnition he had purchased for practice pnlposes. He

JA}{ES EAGAN IIOLMES

r00936 Blz/r3trgs't r
0$04n013 RC-nRAPASOE
Er0{2 Colorado Meuttl fi*alth lnstitute *t ]ueblo Uuit_F2_
ARATAHOE S,{,FiITYEXAM OBSERVATION RSPORT 150 (10193)
 JAh{ES EACAN HOLIv{ES
Case Nu*rber: I2CRI522
SAMTY 8tr.'ALf?ATIOIi
Jetfi'ey L. I.{etzner. l\'I.D.. Cor:s:rlting Psychiah'ist. CMHIP
Septeurber 3^ ?013
Page 4 of69

described being a really bad rhol although it did not &latter for his prxloses due to the closed and snall setturg
of the {reater.

Reseatchitrg other mass shootings in order to get an idea of iaw eaf*rceurent respoilse time aud horv rnuch
anunuritior mighl be needed was reported by Mr. Holtres. &.{r, Holmes was very vague re: to r,vhat end tlre
arnmrmiti+rn research rvoukl be used. He rec*lls researching ihe Columtrine sehool shooting but did not
rernember which other shcctings ire researched.

Arornd the time that he was researching fireanns. &.1r. Eohues thoug&t abaut rxing variorx irrcendiary devices
for diversiotl pu{poses. Specifically. he wanted io divert the police to his apartrueat to delay their response to
fhe r:rovie {reater iu order for hirn to have niore tirue to kill people al the tireater.

The inceridiary devices included the tbllowing:

l. filervork shells filled with grrnpowder

2. pickle jars filled with n*palm and gmrpowder
3. ?-Up bottles tilled with gasolile
4. 2 srnall propane tanks
He spread on the floor of his aparlrnert abod 500 grams of ammoniun ehloride powder in order to delay larv
enforcement eutrance iato his apartment and becarue it also potentially would provide a srnoke screen. Mr.
Holnres attempted to combine glycerin a:rd potassium pemanganate via * trip wire :nechauism for creating
sparks.

Many of the components of the ineendiary devices werc purchased by Mr, Holmes during July 3, 14, 2012. He
had not tesfed out tlie incendiary device system because he did aot bave a site lo do snch testing. He thought
lhere was about a 25Yo chance that the system rvould work. Tliis system was desigpred by hi:n and not based on
specific ideas &om various websites.

kuing June and July Mr- Hoknes "ease[d] the place [i,e., Cenfury 16 Theater]."'f]is invo]ved sitting tlnough a
movie in nine different fhe*ters over a two-month period of tirne. Mr. Holnaes stated he chose this movie thealer
*ue to ifs isolatioa, proximity and size. He eventually plamed to start at &eafer 10 or 9 and later chose fheater 9
because the show ia theater 10 was nof starling until l?:15 PM ald basically was beiag used for overflor,v
purposes. These theaters were chosen as primary targets related to the lirnited tumber of exits, "excellent spatial

JA}TES EJ.GIIN EOL}TES

100936 Br2t13tt987 I'
O8IO4I2O1f, RC.ARAPAI'OE
EPOO2 Color*do Mental Ile*lth Institute at ?leblo I3rif _F2_
A,R-{.PAHOS SAXITYEXA.M OBSTRVATIOXREPORT 150 t10/93)
 IA},{E S EAG,{N HOLN,.IES
C'ase Nrunber: l2CRl522
SA\:ITY EVALTjATIOI{
Jefliey L. L.{etzner. h,{.D.. Cr:nsult'ing Psycliiatrist. C}v{HIP
Septeurber 3.3013
Page 5 of69

apprnach. most uroviegoers take riglrt path arrd urecliuul-size." He indicated that he had not uaile any plans
regarding wltether he rvould gp ilto any other tLeaters after he started shooling.

The tirrri*g of tlie siror:tilg rvas related to the prcurier showing of the uovie "Dark Knigl* Rises" because L.{r,
HoLnes knerv it was goiug to be a popul*r rnovie and th*t the thealer would be frrll" He said he had little
klorvledge regarding the cooterls of flie urovie althouprh he had seen trailerx. The poiice investigatiou iridicated
tlrat Mr. Holutes bought his ticket for this rnovie orr July 7,2A1?. Mr'. Hoknes leported bnyirig tlu'ee different
tickets over a 2 to 3 rveek period of tirue because he rvas atteruptilg to get a tieket iu theater 9. Horvever, all of
the theater tickels he bought rvere for tireater 8. lVhen he arrived at the rnovie theater ou hrly 20 arorurd
*idoigltt. he used his ticket to etter theater 9 since &o one was checking tickets.

Druing July 19, 201? N{r. Holmes took variorx pichu'es af himself on his iPhoue. The decision to take these
photos rvas precipitated by receiving black coutact lenses tlrat he Lad ordered about oue month ear{ier. He
initially stated he did nol remenrber the rea$on for ordering fhe lenses aud did not kaorv the reason for taking
these pictures, Mr. Hoiues later stated that soruetime du*rg Iune 201? he went anline to look at special etl'ect
ctntact lsases- He chose the black contact lenses. called possessiol lenses, "as a way to differentiate myself
&cm my nonual self... ." He repcrted tbe appeaL of these leaser was a feeling "like I'm possessed... just felt
right. .. possessed il sorne lraruler like I had to go througfr with it.. " ." He stated that the pictrues ircluded poses
of "sticking my tongue out.. . holding a erui... wearirg my body almor... ." He fliought that they lyould "look
good to whoever viewed them.-- I doa't know why,.. ."

Mr. Hohnes dyed his hair red sometirx.e after Jtme I l, ?012. He stated he did nol hrow rviiy he dyedhis hair red
although he reporled it had nothing to do with the "Joker" or a ftllow classmate and friend lraviag previously
dyed his hail red. Wheu asked to speculate why he dyed his hair, Mr. Hoknes stated "to diffsrentiate myself
Eom who I uonnally was... becarxe I wa* not ury nor:ual self... ,"

Questioas were asked to Mr- Hohnes regarding his afl'erupts io physic*liy and rnentally differentiate himself
&om his "aotmal selfl' via dyrng his hair red, black eye cont*cts and not studpng (which will be described
fruther in the sectians entitled "The Notebook" and "Urriversify of, Colarado Denverl Anschutz }lledical
Canrprx'). When asked why he felt the teed to differexixe these parl* of hirrr, he replied 'obecause the
to the mental.". ." He described this as a way of protecting his nrn:ral self because
phtrrsical attributes are tied
the "other me did everything... ."'He thioks that this protection worked beearxe u'I car blame it on the
possessed James... ." When asked how he rvas proteetiug his "nor:nal self," Mr. Holnes stated that he was
makhg sule "I was distinet from my crary self." t{e reported being unable to state wby this was import*nt to
hin:.

JAMES EA.GAII$ }IOLMES

1CI09s6 312/1311987 r
08l04a011 RC-AXAP]THOE
E?002 Colorsdo Meut*l Eealth lnstitufe at Pupblo
ARAPAHOE SANITYEXAM OBSERVATIO}Y REPORT
 IAII,{ES EAGAN HOLN{ES
Case Nuruber: l2CRl522
SAN1ITY IYALIiATIOI\
Jettiey L. L{etzner. IvI.D., Consultitg Psychiatrist. CN{HIP
Septenlbff 3. 3013
Page 6 of 69

Tltere was uol a historl of recnrrent gaps in the recall of everyday everts. impofiant personal iuior:natiou"
au#or traunatic events that are irconsistent rvith everyday tbrgetlirg, Syuptours of depersonalizatioa (e.g..
experiences of detaclirnent, distofied sense of seli ernotional andlor physical mrmi:urg)) rlid appear to be
presett rtuiig tire tiare srul"sundirg the alleged crimes. Nfr. Holues did not thilk he had difficulties i'om June-
July 2012 in telliug the dif&rence behreen his "xor:nal self'and this "otler self-"

lMr" Hohnes arrived at the theater complex about midnight on July 20. 201 2. tvhich was l0 minutes ialer than he
had origirally planned because it took him longer to put together vadous incendiary devices at his aparhuent-
He par*ed his car rrear the exit door of theater 9. Mr- Hobnes trld rne thal upon enterilg the theater he was
wearing Kely*r Chaps ibidlet resistant clotliing) rxrder bis pants and a poin guard. After enterirg the theater
tluough fhe &r:nt entlanee" he brtefly sat dolvn ir the fi'ont of the iheatrr for a rrrinute or two irefore leaving the
theaier drring the previews via an exit door by preteuding to have received a phone call. He stated that he
pretended to have a phone call in order to not eppeff suspiciou* to others" which could have precipitated
iltervenfiou by a sectrity guard" He propped the exit door open by usi:rg a tablecloth holder that he had
previcusly prucirased online abo*t one month earlier.

Mr. Hohnes calleel the Uaiversity of Colorado at Detver (Anschutz Carrpus) shrdert mental healtb emergency
hotliue from his car at the theater at 12:30 AM (10 ruinutes be{bre re-eatering the iheater')- "I called for one last
chance to turn back... I fido't lrear a&ytlrrg [for about l0 seeouds]... I hung up... ." He was uot sure who he
would have asked to falk to or what he would have said. A police rqrorl indicated {hat fhe operator stated there
was only sileuce on ihe other end of the line, which rvas cousisteut $rith Mr. Hokues' r'epor"[ that he did not say
anyrhing on the phone. When asked in a later iafewiew rvly he rvanted one "last chauce to tum back," Mr.
Holmes teplied I doa't know... donbts f goress... ."

By his car he pr* on a ballistie 3i\' jacket furolects &om handgrm fire) and an aml proteclor on one ann, a belt
r.vith ammunition {350 mrxrds for his handgrn and six rounds for the shotgm) and a tactical yest that held 400
tounds of AR 15 ammo. Mr Hslmes also put on a gas nrask and helmef in additiol to anning himself with a
Glock pistol, AR 15 and a Reudngton 12 g*uge shotg;un. Dtring this tirne Mr. Hokues put ou a wireless
headphone in order to lisien io techno music because he did not want to hear anSdring during the shoating "so it
wauld:r't be per*oral." He hnoed up the vslume to its uraxinumr level.

Wlrea asked why he did rct rvant it to be personal. hfr. Hahues stated '"so there would not be a connection
betlveen me and the victim... I rvanted it to be geueralize&[it] being a crowd ol group of people... then it
would rot be like l was achrally mwdering somebody-if ao personal interaction-.. just random people... ."

J.d}IES EAG.dN EOLI/IES

1S0936 B12/1311987 g
0810{12013 RC-ARAr,{SOE
E1002 Calorsdo Sdeatql Ile*lth lnstitute at Puebtro Unit _F2_
ANA.PAIIOE SAXITY EXA:'TiI OBSERYA"TICINREPORT 150 {10/e3)
 rAlvIES EAGAN HOLI,{ES
Case Nrulber: l2CR1522
SANITY 81.'AL[: ATIOlii
Jetliey L. L.Ietzner. I\'I. D. . C onsulting Psl.chia trist. CMHIP
Septeurber 3. 3013
Page 7 of69

lvlr" Holnres stated he did lot make e1,e contact with auy of his victirls related. in par1. because he was rvearing
a gas mask. I{e also reporteri nr:t saying anl.thing druing the sirootiug.

Mr. Hohnes staterl that he rvole afluor to protect hirr. fi'oni gettilg shot, which would have preveuted hin fioru
killiag ruore people. He reported diffrculties in ansr.vering the questiorr regardirg rvhy it rvas so inrportant to kill
so umny peopie. "[IfJ I cauld get to kill everybody i* the rvorld that would put ar eld to the question of why
people rreeded to l:e alive irr the first place... that was the qr:estion I r.vanted to ansrver ever since I was a kid... I
was ai rock*boitom-.. things couldn't get ary 1vorse... ."

I reviewecl ivith Mr. Holmes selecied excerpts &our llie report by Raquel Gur, IvLD. There appeared to be at
least one sigaificant discrepaucy iu the history obtaineil {:y Dr. Gur as corupared to the history I obtained &om
Ml, Holmes regading the shaothg. Specifically, Dr. Gu'repofied the following:
He said he euded up choosing a movie tleater because he liked nrovies, i* addition to strategy compu{er
sanres, where he rxcelled. He thorglt he would lvorurd some. but didn't knorv he wo*ld kitl... .

When asked tc explain the discrepancy beflveen these frvo histories, Mr. Holmes initially *tated that things
change wiih tirne. When pressed further" he was unable to p:ovide an explanation for this di&reace.

Dr- Gru's rep*rt indicates that lt{r. Holmes described experieacirg a "call for actiou" that rvas directly relaled to
his shoofirg spree. A,ltliougb Mr. Hohnes did tell me that talkilg with another person (as rviil be described in
the section entitied "tlie Gmail Chat") led lo him lteling the ueed to take "actior" he made it clem ihat lie has
aot used the phrase "call for actior."

Duing the shsotilg, Mr. Holmes predorxinately fired or a random basis. He did fue six rorurds at people
nrnning iaward a* exit in order to make sru'e oiher people did not follow. He inifi*lly used tear gas for "cfowd
cootrol." He emptied his londed shotgrm of five or six rcunds, which hs had chosen because it unas optimal in
that setting for killing people. He stated that the AR 15, which was capable of shooting lO0 rouads, bec.ame
jamrued after 15 rouad*. (Horvever, the police reports irdicated that sixty-tive (65) .223 shell casings were
formd in the the.ater). He stated lre then fired about l0 roiurds via bis Glock. (Ihe police reporls indic*ted five
.40-caliber sliell casings rE e{e forurd}" Mr. Holnnes said he was about 10 feet &am the exit door druiug the
sliooting and then walked torvards the aisle in an attempt to fix the jammed AR 15, which was uosuccessful. lle
tliea walked out of the exit to his car-

At his car, Mr. Hohnes put the AR 15 on the ground and the handgrrn oa &e top of his cm. He put down his
weapons so "I rvould not get shot." He ilitially described such actions as being irxtinctual. He clarified in

JAMES EACAN gOLX{SS

100936 812/131198? v
08J04/2013 RC-JtRAP.ttgOE
8r002 Eerlth lnstitute at Pu*blo
Colorado:1ltrea1cl
.A,NA.PAHOE SA}{ITY BXAM OBSERVATIOX REPORT
 ;A?I,{ES EACAN HOL {ES
Case l.lulrber: I 2CR I 522
SA}ITY EVALUATIOI{
Jefti'ey L. I.{etzler. }.'{.D.. Constlting Psychialrisl. C}V{HIP
Septeurber 3, 2013
Page 8 of69

anoiher i*teruiew that he essentially did an assessrnent which indicated he was outuumbered by the police and
lhat was tire best available option for hirn at that ti:ne. N{r'. Hohnes thet removed his tool belt, which had been
used for holdilg anumurition, and his headphones. He rryatclied the police inr.estigate the area surrounding the
erlergency door of theater I and rvas shortly thereatler ar:ested. He did not attempt to escape relateel to his
assessfiieut tliat it r,voulcl not be successful due to the police h*ving akeady arrived ard alticipated dilficrrities
driviag away while he was still dressed il his annor.

ivIr. Holues also had "road stars'" in his car. which arc tire prurcfuring devices, thai he had previously puchased
oirline ilraf could have beer used if had ar oppo:llulity to drive away froni the erirue scerre, The road stars could
have been used by lrirrr if a car chase had elsued.

He reported feeling empty in mood (i.e., lack olteelings) ald tlioupst inunediately atler the shootiug.

Excerpts irom tlie preliminary hearing transcript included the following:

Officers Jason Oviatt ard Jasos Sweeley made Ihe initial police contact with Mr. Holmes very near tlre
back entrance of Thealer I at lhe Celnly l6 Theater &rirg the early mcming hou's of July 20, ?01?. Mr.
Xolmes was slill rvearing a gas mask in addition to his other protective gamrents {e.g"- ballistic chaps or
pants, hehnet). He was described as being conrpletely compliant with the officer's directions. His pupils
were reported ro be widely dilated" A semi-autornatic handgun was on the roof of Mr, Holnres' car a*d a
rnagazine rvi:h amurunition &ll out of one of his prckets" Other items rerunved fiom lv{r. Holures
included a magazite carrier with nine tragazines coritaining live rcxrds, a ri{le case in his car and a green
coloted plastic doot-slop. Another haudgrul was fbrurd iu tbe passeager-door rxp pockrt of &{f. Holmes'
car. An assault rifle was fo**d near rhe lhsater eflrergency exit door,

There was a lreen plastic doorstop attached to fhe emergency exit door,

Mr. Holmrs informed Officer Blue, without any pronrpting &om the ofticer, that there rvere improvised
explosive devices at Mr. Hofunes' borse.

His lnir rvas dyed orange al that tiDe.

Detective Maghew Ingui testified thar a witness described seeing the shooter in the lower corner in dark
clotldng walking up and down the rig}t aislr and slrooting randotrly, hearing the shols *om all arorutl-

JA'WESEAGAN HOLMSS
100936 812/1311987 r
08lo4l?0ll RC.ARATAHOE
E?002 Coloredo rYextal te*lth Institute at ?ueblo Linit _El_
S.RAPAIIOS SA}fITYEXAM OBSEItYA,TION REPORT 150 (10/93)
 JAMES EAGAN HOLil,{ES
Case Nulrber: l2CRl522
SA\TTY {YALTJATION
Jeitiev L. I,{etzrer. h,'I.D.. Consrilting Psychiatrist. CMHIP
Septeurber 3.3013
Page 9 of69

Fi&eeu (15) live rouuds of 40-caliber handgnrn rounds. five .40+aliber shell casilgs. 209live ruulds of
.233 aauuo. sixty-{ive {65} .223 shell casings and six s}rotgJrm shells or hulls were fourd at the crime
lcene along with two canisters of teal gas.

S{r. Hohnes repo(ed that he told the otficer about flre bombs at his apartment ia response to someone asking
him "if there were bomlrs at the movie theater".. I said na-just at my aparlmenf..- ." He said that he told them
about tliis "because the diverxion thing trv*s over... -"

.{.ttaclunent 4 provides excerpts &-orn the transcript of the preliminary liearing testimony by Special Ageut
Gan'ett Grunbirurer regarding iris iriterview of Mr. lIokues that was precipitated by his d'isclosure regarcling fhe
improvised explosive devices al his aparlment.

Af Mr. Hok:res' aparluerrl. lar,v enforcerneut identified a booby k*p arrd various devices/substauces desigrred to
catse a& explosioa. lire aldr'or smoke. Six-iach firervork shells, homemade tliermite. homenade napal.ur"
gll,cerin. gasoliae and oil lvere arnong the substanceslobjects forurd iu his apafimetrl. A stereo in the duupster
or uear the drunpster of 1690 Palis Slreet (the locatioa of Mr. Holrnes' apartment) was also fourd.

Atler Mr. Holn:es was arrested and druing the initiol iutervie,sr by detectives, he uras read his N{iranda rights.
Mr- Holmes request*d an attor:rey because "that's what you're sxpposed to do." He knew he was i:n trouble
because "I shot a lct ofpeople".

Druilg the inte*'ierv with the detectives, before his Miraada rip&ts were read to him, he asked whether any
chikken had beea htu1. Mr. Hol-ures told me that fhis questiau was prompted by seeing some sorl of sigrr about
children in the police slation, He reported being coucer:red whelher any childret had been hurl because
"cliildret were very inrrocert... ." He learred during lhe next day when watchiug the rerrs that he had killed a
six-year-oid gld.Mr. Ho&nes reporled feeling sad about this loss.

Mr, Holures did uot use aoy alcoirol or skeet drugs during the time iaunediately surroutding the shoofing
during July 20, 2012. He took a Yicodin about one hour before the shooting for pain relief ptrposes in
anticipatior of getring injrued at the crime scene.

THE GMAIL CHAT

A transeript af an onliae Gmail chat sessior MarcL ?5,2012 between Mr. Hohnes arld his female friend at that
time, Ms. D. was reviewed" It included the following:

J*}IES EACAN SOL}TES

r009s6 gt2/13tr987 F
08104/2013 RC-.A,RAPAHOE
Ero02 Color*do &{eatsl Ee*lth Institute at Pueblo Llait _F2_
ANAPAHOE SA}IITYEXAM OBSER\TATION RSPORT 1s0 tr0/e3)
 JAIVIES EAGAN HOL&{ES
Case Number: 12CR1522
SANTTY IVALL:ATIOII{
Jefi'ey L. h,letzler, l\,.I.D., Constltitg Psychiah{st. Ch{HIP
September 3. 3013
Page I0 of69

lr'Js. D.: . .. do rvhai vou {bel like doing, it's a Sunday afiemoon

lv{r. Holmes: Well rvhat I feel like doilg is evil so cao't do that.

Ms. D.: rvhat do you feel like doing?

*{r- Hohnes: Video gar}res are the next best thing tlxrugh escapism

Ms. D": what is so evil that you want to do?

Mr". Hoknes: Kill people of course. That is why I live in the fufure,

Ms. D: kiliing people is too uruch eflorl. You'li etd up locked W t. ] most people are nof wor{r rvhat might
happen to you coz ofthe act

Mr. Holmes: That's why you kill rnany people

Subsequent questions are asked by Ms. D. regarding his r*a*ons for wanting to kill others, lvhich results ia an
excharge irdtiated by Mr. Hohnes about'"burnan capilal."

During ury exaruination of Mr. !fuknes, I obtained more idoruration from hirrr rgg6r'ding the coucept of 'lbrunan
capital." He indicated that he was refeuing to "fhe concept of worth-how ruuch a person's time is rvorlh. . . e.g.,
asurgeon'stirneisworlhmorethanajani;6s'sfime..-.'Inthechatsessionhewrote"butlifeispriceless,.. you
take away life and yom hrunan eapital is liruitless..- ." He fiuther indicated ihat having human capital would
eaable hhrl tc have a more meaaingful life.

Mr. Holmes explained that it is more important for a killer to kill rnore thal just one person because it i*creases
the worth of the person daing the killing in a rnathematical rvay. I asked questions that afternpted to provitie
clarificatio* of Mr" Holmes' urethod of measuring a person's worth. He slated that it ineluded th* followilg
faetors:

l. number of peaple killed

2. yoru'own perceptitxrs of rvh*t a life is worth
-). your coltdbutioa to society (*.g., i* a meaningfirl way and positive way)

JAMES EAGAJ\ EOLIITES

100936 Bt2tr3n987 7
08/0412013 RC-ARAPj,SOE
EPO02 Calorsdo &Ieatal Eealth lastitutp at Pleblo Uuit_F2_
ARATAAOS SA}{ITYEXAM OBSERVATION REPORT 150 (10193)
 }Ah,{ES EAG^"\N HOLI,{ES
Case Nrulber: I 2CR I -522
SAMTY EITALT:ATIO}{
Jef&ey L. Melzner. l,{.D., {lonsulting Pslchiatrist. CMHIP
Septeurber 3.3013
Page I I of69

Other excerpts from this chat sessian included the follorving:

ivIs. D: how r,r'ould ycu have a lrtore ureaningful life by kilting people?

Mr:, Holmes: Because if there is a r:reatiog fo life, alcl you taiie tllal away froru other people you have prernented
their pupose

Ms. D: someooe else will firlfill the purpose thet

it doesn't help you
it may satis$r yox but it d<resa't help trou fulfill yoru puryose

L{r'. Holmes: It still rrraftss my life morc meaningful

Ms. D. srrbsequently esseltially indicated that she cloes urderstarid his thinking or corcepl of "hunmrr
capital -n' Additional excerpts included the f,ollowing:

Ms. D.: If you want to kill people, why don't yau kill rne ald Ben and other people who are aronad you ald
have wronged yotr?

Mr. Holmes: Destuuctior: may make it ruore uegalive which is just as suitable ir terms of rnearring
I told you I can't do that

Ms. D.: wiry?

Mr. Hoknes: I would be caught and cauld not kili morc pecple, I would also lose the rest of my life. Those
experiences you speak of would be goue. Thal is why I won't kill until ruy tife is nearly over.

The cbal then iucludes exchanges concernirg the meaning of deatb. Mr. Hoknes explained ta ane that "before
life and after life is the same tbirrg.,. .'"

Tlte chat ends as follows:

Mr. Holnres: I am not inheren*y evil -^^ llry outlsok on destroyiug life is plan B. I also found a prupose for
"good"

JAi{SS EAGAN SOIAITSS

100936 312/13n987 r
08104/2013 RC-^dRAPAgog
E?OO2 Color*do ldeatal Eenlth Institute at Pueblo fTnit_F2_
A.RA.PAI'OE SAI{ITY EXAM OBSEEV',TIO'i REPORT 150 (10193)
 JAI'\{E S EAGAN HOL\.{ES
Case Nntrl'rer: lZCR 1522
SA\-ITY EYALLIATIOI{
Jetliey L. l,{etzner. i\,I.D.. {iotsulting Psychiatrist. CMHIP
Septelrber 3^ 3013
Page I2 of69

Ms. D.: I lurow y.ou are not inherentl_v evil

Ir{r- Holues indicated during this psychiairic exanrinatiot thal his plarr A rvas to "live a happy life." However.
he felt that there was no poilt in plal A because lit'e was not rneaningfill to hiru.

tr&. Holmes rcpor{ed that he cr:ntintes to hold his beliet} abnut human rvorth, killitg other people and
increasing one's o1ilo worth. However. he said he has leanied that he wa$ wrong in his belief prior to the
shoolilg that ilcreasin*i one's worlli ia this maruler rvould rid oneself of depressioa- He stated his depression is
rooled in having aplupose arrd he does not have a plulose in life.

I also disc**sed with h,{r. Hohnes issues relevalt to t}re concepts ol right and vrrotg il the context of his
statement during the ehat session that r.vhat ]re was thinking about rvas evil. He said he thoug$t kifiing people at
that time was evil because it rvas against the law. With regards to killing f iends, it was not rigfrt because they
were real people in eonkast to peaple he did not knorv who were described as just beiag'"crowd people."

Mr, Holmes stated thaf children were wofih more than other people "because they have the rest of their life fo
live." He did not thitk it was right to kill cbil&en evea thougb they had prore worth tha:r adults. He thouglrt it
was alrtgbt to kill adults but c*uld not explain his reaso*iug regarding this belief in the cortext of believing it
was l}ot rigbt to kill ehildrerl.

Wh*a asksd why he had not previously killed people (sirice it would have inereased his worth based oa this
conceptualization). be replied "because of fear,.. fear of consequences - jail, prisori, dealh penalty... ."

Wlren asked wlr*t changed that led to his killing rnaoy pecple, Mr. Holures stated 'uI losf the fear... while I was
in treahnent with Fentoa... ." Althoug:h Mr. Holmes had difficulty providing an accurate timelile, it was clear
that he bad "lost fhe feat''by at least early May ?012. which cofurcided rvith the period of tirne when he rvas
experieacing wlr*t he called "dysphoric ilrania." In respoase to hor.v he felt about losi:rg this fear (e.g", did it
rnake lrim feel better since now he could have more self-worth), he replied "1 jtxt continued along,.. I .ivas
iridi{ferent about it-..." He did not iufonn Dr'. Fenton about this change beeause "she would've locked 1ne up...
I would not be able to kill geople".. would not have been atrle to get out of this depressiaa aad increase rny
wor1b...."

Mr. Hohnes had difliculties affwerjog rny questions that attenrpted to clarify issues relevanl to losing "the
feal." Over the course of the psychialic exami-:ration he was able to better clari$, some of these issues- He had
pleviously beeri fu*r&rl of &e cor$equences he would face if he killed people (i"e., he would be killed or be

JA1IIESE.4.GA,N EOI-}TES
1tlo936 812/1311987 r
08104/2013 RC-ARAPTASOE
E?002 Color*do ffeltal Eealth Institute et Puello Unit *F2_
3,R,{.PITIIOE SAIflTYEXAM OBSERVA"TIO}.{ RSPORT 150 {10/e3)
 JAMES EACAN HOLfuIES
Case Nurnber: 12CRI522
SAMTY EVALTATIOI{
Jeffu'e-v L. iVetzner. L,LD., Consulting Psychiahist. CMHIP
Septeuber 3. 2013
Page 13 of69

incarcerated on a long-ten:r basis). Or:ce lhis tbar lvas goae" although the saule corsequences were presenl, h{r.
Holmes perceived theur &orn a dill'erent perspectir.e. As a result of lbeling so bad, tle pofential colsequeuce of
losing lris iife did not appeff to I,{r. Holures as being rnuch wome tiran how be felt at that tir:re- A similar
perception was presett rnlative tr: l'aeing long-temr ilcalceratiol. The otlier factor tioar liis perspective r,vas his
belief that his wordr would be increased zurrl he would feel better as a resr{t,

Arouad t}e same tirne he reported bei*g very deprersed aud liar.'iag "hit rock-bottorn." The intensity of his
depression was due to having "lost rny ptufiose h life." Ivfu. Hohnes described the cfilhibufiilg factors lo tliis
loss to be the'"breakup wittr [ruy girltiend]. poor lab rotations aud poor overall gr*duate school [experiences]""

Ms" D rvas tlre fir'st person that Ir&'. Holnes ever tallied lo about his concept of wortli aud other lnrman beings.
He rtated that talking abclt it rc/ith another"persoo rnade his thoupdrts "more real... because somebody else
knew abaut it. . . becarxe it existed outside of my thouprlrts... ." He stated tirat havirg spoken these thoughts out
lotrd everhmlly led lc an actiol regarding these thoughts brfi could n*t provide an explanation of horv this
piocess occurred.

Aftachmeut 5 provides the conrplete fi'anscript of this "chal session."

THN *EAI} FTNlff$'TE,XT

Ms. IIA was iutemiewed during July 20. 2A1,3-The police reporl iacluded rhe following:

On July 8*. rlA texted Hohires a*d asked if he rveul back to Califomia or was he still in lown" {ftq,l gor
back * reply where Ho}nes said he had "dysphoric :r:snia." Holmes i*dicated HA shauld stay clear of him
and lhal he rvas i.n a bad place. IlA. asked Hokues if he was OK. HA stated Holnres replied that the flood
galcs lvere open and HA should stay clear of hirn.

This texting actually occtured druing July 9, ?012. Attachment 6 provides a h'anscript of the exact texting
nrcssage, rvhichincludedMr, Hohues textiug HA the followiag:

It's in your best interests to avoid me, am liad news bsars

Il{l, H*knes indicatsd fhat his reference ta the flood gates was refering to his emotional state at the ti:ne tiat he
rvas irnplementing plans lbr the shooting.

JAMES EAGAN IIOL}TES

100936 Bt2/I3/1987 F
0810412013 RC-AXAPAHOE
EPOO2 Colorsdo ldeatsl He*lth hstituta at Pueblo {init _F?_
3.R,I.PAIIOE SANIT'Y EX.{.M OBS-rRVATION REPORT 1s0 (10/93)
 JAMES EAGA}I HOLh..IES
Case Nunber: I2CRI522
SAI{ITY EYALTATIO]I{
Jetfley L, h{etzler. }..I.D., Cr:nsulring Psychiatrist. CMHIP
Septeuber 3" l0l3
Page 14 of69

}IATCI{,CO*{/ADULT FRIE}TD FII{DER

Sornetime after April 16, 2012 Mr. Holures paid eru'ollmert fees for natch.com and adr:lt friend filder, He
estinated that he logged iuto each of these sites sr*eater thal l0 times- The purpose ofjoinilg the sites was to
fi:rd a new relationship" He mtde proiiles on each of the sites, rvhich incltrded pictures of hin and a dating
headline that asked '\,vill you visii me h prison?" He med the saye functiol for potential matches but did not
send furvites ta any of tJrese potential rnatcltes. He did not r"eceive auy invites fiorn rnatch.com bnt did receive
several &om atlult fiiend furtler. bur elid not respond due to l'eeling relvous. lt{r. Holues }yas very vague in
providing itfomratiou specific to the 'lvill you visit me ilr prison?" question. He provided arr inconect birthdate
ol adult friesd finder in au attearpt to prevert his personal irrtbi:lation used by otlrers.

Mr. Hohnes has received rlunerorr.s {i.e., 100's} letters fioxr wcanen otYering supporl ald wantilg to establisli a
relationship with hirn silce his iacarceralior. lle perceived these lefters fo be due to his profile postiug on the
above sites, rvliich is extremely unlikely.

THE lfCIT3BOOK

A uotebook rv*s written by Mr. Holmes to explain'khy I did what I did... starfed writing it a&er I got out of
treatme,at. ", after failiag exants... wrote it iatemdttently.. . oilce or twice per week... so that psycliiatrists could
heat people like me effectively. ^. [by listing] syrnptoms. -. ."

As vrill be sr.urularized in a later seciion of this rep*r1, l,{r'. Hohues was receiving psyc}riakic treatment through
tire shrdent heal& services at the {-hiiversity of Colorado at Denver {A:rscbutz Campus) &om lr{arch ?l to June
ll. 2013. Mr. Holrre* described difficultie* explainiag his s3auptorns to his psychialrist, Lymre feutou, M.D.
for a aumber of reaso[s that inchrded hirn "not being a courmunicative per*on." He also perceived Dr- Fenton
did noi try to commlnicate with hirn because "she had already ptescdbed the dnrgs.,. ." Howeveq he did
aclciorvledge that she attempted to elicit his feelings and symptours from him- His dilliculties in courmunicalioa
were due to "that is part of wbo I am. .. ." fhe lofebook was his atter:tpt to put i* rrriting what Dr. Fenton did
not ask abouf asd wh*t he perceived he could not tell lier aboui.

Subjects that Mr. Holures tholght he could not kik to Dr. Fenton about included "that I was buying weapous"..
tbat I thought f was crazy {[becauseJ killing people was cmzy)".. drat I wauted to be locked op-"" specific
details of the plan... ." He felt that he coulcl not talk about drese subjects with her because "she locked :ne up...
then I can't do it... I'd still lrc depressed.,."

JAtrlIES EJIG.{N EOL.IITES

1s0936 812/13/1987 r
0810412s13 RC-ARAPAIIOE
8r002 Colorrdo l{rntsl Ilaalth Institutr at Pueblo thit _F2_
^$,XirPAIIOE EAI{ITYEXAM OBSXRVATION RETORT 1s0 {10/93)
 JAfuIES EAC,,\N HOLT,{ES
flase Nuurber: l2CRI522
SA\TTY E TALUATION
Jetfi'ey L. I'{etzner. IU.D., f.onsultirrg Psychiahist. CMHIP
Seplenrber 3" ?013
Page 15 of69

Mr. Holures nailed ihe notebook ro Dr. Fenton dru-ing the everiilg of July 19. ?013. He knerv that she rryould
uot receive this package urrtil after the shr:oting. Wlien nsked rvhy lre mailed tbe rrotebook to Dr. Fentol, he
replied "because she had been my prirnary ps1'chiatrist... she said she'd be available,,. .- When asked what he
thoupilrt her reaction rvould be io rcceiving the notebook. I{r. Hcknes stated "I didn't thinlc about her reaction
[to receiving it]."

Mr. Holures' nofebook (page 54) iricluded tiie folloiving infonuation relevant to his psychi*tric treatrnent
tllrouglr the sfirdeut health services:

Prevent builditg false reuse of rapport. Speak tnrthiully and deflected incrimiaatirg questions. Oddly.
they don't pursue or deive further irxo hamrirl omissiots. Afteillpi to see if can pa$s exails as try:elf and
nol by fear. Fail. I was i"ear incar*ate. Love prone. motivation dileeted to hate and obsessiols. which di&l't
disappear for rvhatever reasor with the dnrgs. l.{o cor)sequer}ce. no fear, alone, isolated. no work for
distractiols. no reason to seek self-actualizatior. Euibmce tile hat{ed, a dark ktnight rises.

He stated that the above was rvritten about ole rveek before the shooting.

The conteals of his chat session witir ilrIs. D (see Attachmeat 5) was very similar to the conteots or pages 27Ag
{eutitled "Tnrig&ts into the }v{ind of }vladness) of the rotebook" whieh only became apparett affer detailed
questioning of Mr, Holmes ie: the notebook" Mr. Holmes lrad simggled for many years (i.e., since the age of t0)
regardiag the meaniug of life and death. He reported this strugg{e {br hir:r was related to '-fiatling a purpsse.".
sourething that is meaningful to do.-- ." Wher asked rvliy he fhought otlrer people did not have similar skr:ggles
for such a l*ng period of time. Mr. Hohnes replied "becar$e ruy mild is di.{fererrt-.. ."

Arourd March 2012 Mr. Hoknes repbrted becoming rnore depressed related to his relationship difficulties rvi&
his fonner g.irif:iend and problems in his graduate school studies. Syrptoms of depression included depressed
mood (rated by e{r. H*knes as a 9 on a scale of 0 to 10" wi& 10 being ihe most sever€ depression), a sleep
disturbance (trouble going to sleep). decreased energy level, decreased sexual drive, feelings ofbelple*xress,
hopelessness aud worthlessness, ard loss of interest iu activities that xsed to be important to him such as
schoolrryork.

Mr. Holmes thea tregan developing theories aLrout the worlh of people fur respo*se to feeling worthless in order
to decrease his feeliugs of worthlessless. His thinkilg regarding the worth of persous beea:ne dehxio*al, qihich
were partially evide:ri duririg his clrat with lv{s. D and in pages 27-29 of his aotetrook" In his uotebook he
atlempted to convey tirat by killing people lie could increase his worth. Alt3o,rgh not in his noteboah Mr.
Hohnes was thiaking about killilg people both to increase his worth arid to alleviate his depressioa. He was

JA]XES EACAN SOL:}IES

100936 7121t3n987 r
OUO4AO13 RC-ARAPA]IOE
Er00? Color*do Mentsl Ee*lth Instifirte at Pueblo firit _F2_
A,R,{P3,IIOE S.AXITY EXAM OBSERVATION REPORT 150 (1e$3)
 ]A]I{ES EAG,{N HOLh,.IES
Case N*rnber: l2CR1522
SANIITY [1'ALI?ATIO}{
Jeifrey t. I,{etzner. IU. D.. Consultilg Psycliiatrist. CMHIP
Septeurber 3. 3013
Page l6 of69

aware at that lime thai this thinkiupr was "abnormal... oif tlre beaten path..." as evidetced b,v the lotebook title
of this section beilg "lnsights into the Mind of Madness."

His level of clepressiot decreased to a o'5" after he began faking sfeps 10 implearent his plan tbr the shooting.

About a rryeek after the shooiirig. lrrtr. Holures believed tliat his wodh was increased as a result of the shootilg.
He stiil maintains that trelief. Mr. Hofunes is aware drat other people think that his worth has decreased related
to tlie shooting "Birce it is againsl society's rrom1s." He thoug{rt that society's nofins did lot inrpact his
perceptiou regardilg his worth because "tllere is no rigfit or wrong."' Wheu asked rvhat lie meant by rip&f or
\Ylollg. Mr. Hoines slated'tliings are relative... ihey are oot absohde... -" He rvas unable lo explni,t firrther
what lie meant by this explauation.

Regarding pages ?8-29 ol the uotebook, Mr. Hohnes interpreted ihese rvfitings to tbcus ou tlle questicn cf
"what is the meatting of life.,. If you deshoy all life then there is no questiou to be asked... ."

Page 30 of the notebook surnuarizes Mr. Holures' options il de*ling wi& t&e 'lroblem" {i.e.- the me,auing of
life and not having a purpose). The notebook includ*s the following:

A1{eruatives to deadr.

1. Ignorc thr proble*r.

If the probleni or qurstion doesrr't mist ihen the solltioli is irrelevant" Didn't wort- Fonns of expression
trird inchrded reading, televisim aad alcohcl.

2. Delay the problen. Live in {he r:romert withou: corc€fl} for answerfuig tbe problem at prcsent. Didtr'a
work. Pursuit l*rowledge tn increase the rapacity for answering the qneslion with irnproved cognitive
flmctiorr.

Parvl the problem. If one can anslver the question themselves. get someone else to ansl{er it- Didn-t
work Everyorre elte didn't know the solutiou either.

4. n-oire. HaIe. Despite ktowing deafh is false and suboptimal respor$s, I can"t fuid a working alteiaative. If
all of Life is dead. tlien the quesfions-

Wlry should lile exist?

Wlat is the purpose of living?
Ale thel0. irrelevant.

JAMES EAGAI\; EOL}TES

100936 Bt2ll3l198? r
081041201.3 RC-.{.RATAIIOE
E?002 Colorsdo Mentcl Eenlth Iastitute at Pueblo
^A'RAPAIIOE SAIiITY EXrrM OBSERI/ATIOI.i REPORT
 JAMES EAGitN HOLI!{ES
Case Nruuber: 12CR1522
SA\ITY EI/:{LTjATION
Jeiliey L. l.{etzler. h'L D., {ionsulting Psychia htst. CMHIP
Septeurber 3, 2013
Page I7 of69

Mr- Holrnes reported that ipmoring the problem did not r,vork based oo rnruly y.ears of tr].i1g to do so. Delayilg
the problern r.vas also rursuccessfiil. His hferest in neuroscieuce. which initially developed druing tris trigb
school -Years. was il pad based on his petception since middle school fhat he rvas diff-erent from other people.
Specifically. he t'elt different ia social aspects (e.g., "inifiating conversation [has ah.vavs been] dilticult to do")
and due lo his chronic homicidal thinking. He rvas hopiag that learning about rerroscience would help hin to
itrprove hirrrsqif bslh irr the coutext of his corununieatio* skills ald learnitg in geueral.

He *bsequenfly rvas admitted fo the Udversity of Califoruia at Rivexide on a irll scholarship, where he r.vas in
the honors proerarn. He excelled academically, enjoyed school, bui stated that his studies did not help hirn at
that time to irnprove hislself.

h.{r"- Holmes subsequeutly applied to top tier graduate sclrool where he r.varted to pursue a Pii.D. in
neuosciences. However. was or{y interviewed at oue school. UC kviue. rvhich did not go r.vell relaterl to his
difiiculty corurecting with aly of the st*tT.

Mr. Hohnes retrnted to live r.vilh his pareuts tbllowirrg graduation and afier abo*t six months he obtaiaed a job
as a pill coater ior h{ar-ical in Vista California, where he remained employed for tlrree rnonths. Mr. Hobnes was
eventually accepted at the University of Colorado at Denver"

It becariie apparent to him during his third rotation at the Universify of Colorado at Denver a:ourd Aprit 201?
that the kt*rvledge gained iri ppaduate school wonld not help hinr imprcyg his communicatioo skills or decrease
his cluanic hocdcidal thinking.

Page 3 i of the notebook described his '"Self Diaguasis of Brokeu fuIind" to include dysphoric mania. "I got
really seriously depressed. .. once it stopped I get really manic-. . ." Other sSmptours ilrcluded racing thoug&ts.
higb energy level and decreased ueed fsr sleep {e.g., six hours). These episodes would last one or two days rvith
aboui one week between episodes. He described experiencing 3-4 such episodes, which al} occuned after lre
began tahing at antidepressant medication, sertraline, around March 20l?.

Among the many sympforus listed in ihe notebook included the following:

This obsession to kill. Siuce I rvas a kid. With age became more nnd nrore realistic- Started as the enfire
world rvith nuclear bombs" Thea shifted lo the biological agent tlut destroys lhe mind. Most recently
seiial nrurder via a cell phoue slun grm & folding knife io national forests. And finally, the last escaps,
mass n:rrder at r}e mcvies. First obsession onset >10 years ago" So anyways. that's nry nrind. If is
brokeu. I uied to fix it. I made it my sole csnviction but using somethfug that"s broken to fix itself proved

JA}{ES EAGAIi BOLMIS

100936 Bl2/13i1987 F
0$0{n013 RC.ARAP]THOE
E?002 Colorado Mrntsl He{lth Institute at Pueblo
AR{.PAITOE SA:\iITYEXAM OBSXRVATIT}I\iREPORT
 IAh.{ E S EAGAN HOLj'.IE S
Case Nlmber: 12CR1522
SANITY EYALT?ATIOI{
Jeffi'ey L. I.{etzner. h'I.D.. Consultilg Psychiahist" Ch{HiP
Septerrrber 3.3013
Page 18 of69

insru:nountable. Neurosciences seern like the way to go but it didr't pan out. In order to rehabilitate tlre
broke* nrild ruy soul must be eviscerated. I could ltot sacrilice my soul to lmve a "nonual" rnind. Despire
ny biological shortcortritgs I have fougtrt and fouglrt. Ahvays <leieiding against pre-detenninatiol ald
tlte lallibility of nun. There is one rrlore trattle to fight with life. To face death. enrbrace a long-staurling
halled of marikinrl alrd overcome all feu'cefiain dcailr.

Pages 48-5? of the notebook described Mr, Holrnes' thinking relative to his options regarding targets, rnethods.
ard lrentte, He chose "mass mur-de/spree {maximruu casualties, easily perforned with firear:ns a}thor:gh
prirnitive in natrue. No fear of ccuseqtences, being caug}t 9991* of times)."

His plan had nor'v become "realistic" and he had decided he was going 1o kill people althouglr he.was only 7596
srue that he was going to do it- He rrras plalning 1o dc a ruass crurtler vers$s a sing:tre ulrrder because - "back to
all titr:se lself-Jwodh calculatioxs frve discussed] in the begirming- I walted to get better-beyorrrl ilte
depressiol."

\lrlien asked why he kiiled people, Mr Holmes replied that he does not have aa answer. When asked a variefy
of dit?erent sfitchued questions and sceaarios, he sfated thai he thougfrt by killing rnany people he irad a 50-50
chance that it i.voxld work and amke him not feel'tvarthless and feel belter" h&- Hohnes was clear tliat he lurew
such actious were against the law bnt he thrught *t tle time ttiat it lvas "okay to do it... that's why I did if ...
thought I'd get arested or die."" that is what Irappels to people who kill people..- I dido't think of prison as a
coosequence.. . becarue tr was so depressed that uothing mattered, -. ."

Ml. Hoknes statecl that be wonld uow aot kill people far similar reasons becarxe "it doesn't wol*." If killing a
person or persors wauld raake him feel better aad not wcrthless, he stated he rvculd agaiu do so arrd rvould
think that it was okay to do eve* thoug& be kaerv it was legally lryroog. He had difficdry explainiug why he
thought s*ch artions would r:ct be wroug frorn his perspeclive" However, he did state that "nobody has a
prupose sr mssning-wby rioes it matter if they die then?"

Whel asked whether he has aay repels regarding his actions, he replied'}'es and ro." He stated yes "becau*e I
didn't get better and jail is sot a very good place to be." He stated lo because "I increased my rvorth." When
asked if he had any regrets regardiag the irnpact on other people, he replied he did becarxe "killed other
people". " it took away &eir frurdarnental right to iive. .. I woxld want that kiod of cboice... ." 'When I p:inted
out to him that he initially did not i*clude other people in his regrets, he stated it was because "I don't know
firem.'"

JAjI{ES EAGAN HOLSIIES

100936 B12/13[98it g
081041?013 RC-AXAPAEOE
EPOO2 Colorado il[e*t*I Ile*lth Instituta at Pueblo tirit _F2_
AR]LPAIIOE SA}TTYEXAM OBSERVA,TION REPORT 1s0 (10/93)
 JAhIES EAGAN HOLi".{ES
Case Nurnber: l2CRl522
SAMTY EYALUATIO}{
Jetkey L, N{etzner. h,I.D., fionsultiag Psychiahist. CI\.{HIP
Septe*ber 3.3013
Page I9 of69

Having cluorric suicidal thinking that preceded his chrolic homicidal thilkilg rvas <lescriberl by Mr, Holmes. "I
usually tralsfened tirese [suicidal]'s rhoug*rts into fhe homicidal thitking.,. ." He described one suicide afteupt
around the age of 10 by cutting his wlists. rvhich he indicated \yas a cry for help. He denied any other suicidal
atteulpis. He reported tlmt jumping off his bed in the jail dtuing November 201? was aot a suicide atteurpt bxi
il r"espanse to visual hallucilations.
He has thought of a variety of ways kitling hirrrself that have ilcluded strangulation, overdose aud juurping in
fi*nt of the car. He thinks he would atieurpt to kill hirlrs*lf if givel the opportrurity. He stated he has not tried to
kill hinself in the past due to his fear of the involved paiu.

*fu'. Hollnes stated he was not cotcemed about &e death peualty because "dler€ is no reason lo live." He feels
bore<l}:ecarue "thele's nothiug to do thal is r,vorthwhile alrd meaning&1l." tr"lL'- Holmes states that his depression
is agail at al 8/10 level.

Page* 52-53 suumarize aspects of Mr. Hokues' prior meotal health treatmeot. Ir iacluded tlie following:

,{nxiety and depression bot}r serotouergic system aoyway though. No effect when teeded. First
appearfflce of mania otcurs, not gocd mania" Anxieg and fear disappeax. No more ftar- ro nrore fear Bf
failure. Fear of failure &ove detenuiuation to improve. better and succeed ix life. No fear of
consequeficrs. Prfuuary drove reversion to hatred of niariliild, Ilteffie aversion of peoplr, cause *nknown.
tsegan long ago. suppressrd by greater ftar of others. No uore fear. hatrrd unchecked. Slart srull. Buy
stffil €trm ald folding lurife. Research fireanns laws and mental illness. Buy handguns. Cotlnircd-
Shotgm. AR-15, and ha*dgrxr. Wildcxd: explosives. Simplest and least srspicious: gasoline and oil.
Aequire rearote detonation system ald body armor, prarticilg shooting at Byers Canyon rifle ra*ge- Can't
tell the mind rapist"s plan. If plari is disclssed both
*noru:af' Iitb and ideal enactment on hafed failed.

?v{r. Hohues said '1f I told t}ren then I woxld be locked up and could not cany out the mis*icu [i.e., the
shooting]. I had to cornplete it ir order to not suicide." Mr. Hohues explained that the *urind rapist" qras "the
psycldatrist."'His anger towards psychiatry lvas appareat ia the above rvriting and was consistent with other
refelences made by hirn druing the examination, such as the &eld of menlal healih had failed him,

Appendix III provides a parlial transcription of entries writte:r by Mr. Holnes ia the notebook with a Metvtcr
cormtenl sectiol that su$narizes various respo&ses by Mr. HoLnes to some of nry questioas regarding various
entries, many of whicb have beel incorporafed into this section of the report.

JAtrtIES EAGAN IIOL]VIES

180936 312t13tr987 i
08104/2013 RC,ARAT"{SOE
EPOO2 Color*do lL[ertal Ee*ltL Institut* at Pueblo
A,RAP]$IOg S},fiITY EX.{M OBSERYATIO'i REPORT
 JAtuIES EAG;\N H0LI,'{ES
Case Nrulber: l2CRl52?
SAI{ITY [VALtjATIOlt(
Jetfi ey t. I\.{etarer. },I. D.. fionsultit g Psychiatrist. CMHIP
Septeurber 3" l0ll
Page 20 of69

PAST ${EDICAL IIISTORY

Cturent uedications i:rcluded rispeddone, Cogentin. Lexapro and tetracycli:re" He began taking risperidone
during November 1012 in ord*r to "cah11me tlarvu and prer.elt hallueilatiorls.,. ." lv{r'. Hoknes indicated that
this *redicatiou lias been helpf,rl.

He first experieuced visual hallucinatiorm during Noverrrber 2013 rvhich *nded shorlly atler his hospitaliza*ion
at the Delver Health Medical Center {DHb{C) drxiag November 2013. He denied a histcry of aurlitory
hallucilations, which was not consisteut with records from DHb{C.

lr{r'. Hokues denied a history of any current or past uredical problems. His rnother reported that he rvas
diaparosed as liaviag mououucleosis druing December ?01 l.

It'k. Holnres said he had experienced prrandiose ihinking since at least age 10. *[I thought] I corrld do souretlri:rg
that would kill everybody in the world... didn't know rvhy i was havilg [tbese thoug*rts] ".. ." The fi'equency of
such thoughts was gerierally on a monfhly basis althougS they occruled mare frequently wiih stress,

Mr" Holmes soug$t rrrerital health keaturent througlr the Student Health Center at the University af Colorad<r
(Anschutz Canrprx) druing hlarch ?012 due to a lifelong problem with public speakiag. "I was just anxious and
nexvor.ls-.. I warited to inrprove my public speaking skills",. ." The precipitant for his self-referral was the
beginniag of his ead-af-rotation talks il gpaduate school. "I just finished olre [talk]... got aegative feedback.. " I
called thern up after tiraf ... ."

Infomration rvas obtaiued froru Mr. Hohnes relevaut fo his tu'eatruent with Dr. Fentou. "It mostly was jusf
fuding out wliat medication to !!Ive. .. seeing the side effects and effectiveress,.. saw her about once every two
weeks... truled out to be lrot helpfirl-.. didr"t thiik it was helpfirl at the tine. -, I was still depressed- *. ."

lv{r'. Hohnes thrught that the freahnent might have been helptll had he beeri prescribed altipsychotic
uiedication. He stated that Dr" Fenton's superrrisor. Dr. Feinstein, talked to him "aborit antipsyehotic medication
that they wanted to put me o$... I said it was too late because t had already failed out of graduate scliool--. I
rvould have rot have insurarce-was rurable able to pay 98O per hour [for psychofherapy]... they said [the
iasurance] could be contiuued in the srnlmer.-- but [I thouglrr] the [insurauce] probleni would still be there
[r'vhen tlre sruruner ended]."

Questions were asked to Mr. Holnres reg*rdiag his rurderstanding of psychosis. He irdieated that psyclrosis

JAMES EACAIS-HOL}IES
100936 3,72t13n987 g
08/0.t/2013 RC-AX.APILHOE
E1002 Calor*do Mental Health lnstitut* at Puello Unit _F2_
A,RA.PAHOE SA,}'ITY EXAM OBSERY.&TION RSPORT 150 {10193)
 JA}\,{ES EAG,{N HOLI.,IES
Case Number: l2CRl522
SA\'ITY EYALL:ATIOI{
Jeiliey L. I{etzner. L,I-D.. Consulting Psychiatrist. Cb{HIP
Septeuber 3. 3013
Page 2l of69

included "in'atioual behavior." He ihouglit that he was psychotic when at Delver Health Medical Center
because he had an out of rnind expetietce that involved "lookilg dorvu at my ol,rn keatmett." He thoug&t thal
he nripfit have been psychotic al the tinre of the shooting because "looking back I can see m-vself i* the third
pel:on." He did aol have such an experience at {re tirne of the shootiag,

Drilkilg up tc 4 to 5 beers every hvo rveeks rvas reported by lr{r. Holmes. There lvas no history of alcohol
abuse or treatment. He has had ruiliural experience rryith the use of rnarijuana. There rvas rrot a lristory of street
dnrg or prescription drug abuse,

Vegetative symptoms of depressioo were abseat at the tirxe of rny exanrin*tion of Mr, Hohres- Mr- Holmes has
gained atrout 30 porurds during tbe pasi year. He continues to feel very depressed.

I\{r'. Hohnes reported a loug historl of triclrotillomania {hair-pulling disorder)" The essential featrue of this
disorder is the recrulent pr:llirg out of one's own hair that leads to hair loss althauglh it rnay not be clearly
visible- H* reported that he did not experieuce feeliugs of erubarrassment aad shame related to his hair pulling
behavior. However. he did atteurpt to avoid other people kxowing about it becarxe "thete was oo reasol for
them to kf,Iolry." His hair pnlling behaviol started in lrigh school aud was precipitated by stress. l,{r-. Holmes
desc.r'ibed sueh behaviors as being a diskacfion from stress.

ANT,?ESITY OF COLO&ADO DE NY'ER/ AN,S CHUTZ MEDICAT C,4,AP{SS

Records &om tire University of Colorado Denverl Alschutz Medical Campus were reviewed. The June 17,
3013 neuropsychiatric repart wrilten by &aquel Gur, M.D., Ph.D. provided a usefuI suuunary of these recolds as
follows iwith additicaal "Mel:r?et'cor?tfiry]x/s" based orl my exarnination):

Mr. Holues made an appcintrnent at Saudent Hralth University of Colorado and was seen by Margarel
Roath. MSW oa Friday. March 16. 3012- On Monday, March 19, 201?, Ms. Roath emailed Lyrne
Fenton. M.D. "I sarv a strdeaf late Friday who I hope you wotrld be able to see. aud soon if possible. He
is the most anxious guy I have seen and has symptoms of OCD. But most ccrrcemilg is that he has
though* of killirrg peopk. thouglr I do not tbirk he is dargerous. He said lre did tlot \yafi to tell me
everything he is erperiencilg as I might have to report. The reason I &i* it ntigbt br best for you lo see
hitr n5I think it migilt be best to krep him ia fir system. lMhat do you think? I am leaving rip{tt now to
go have some work done on rny cff - should be back about loon or 12:30".'This is followed by an eintil
thar early afiemoon rcting. "His nanre is Jarnes Hol*res and he uray eruail yori b*ause lte lms suclt
trouble talking on the phone." The notes indicate. "Hs said it was very hard to come in, problens
conceulrating, arlKiety

JA.\IES EAGA,N TIOLUES

100936 Bt2/r3tL9S7 F
0810412013 RC-ARAP"{EOE
r?00? IIe*ltI Inttitute at Pueblo
Colorndo lltreat*l Linit _F2_
ARATAHOS SA.XITYEXAU OBffRvATIOt'i REPORT 150 (10193)
 iAN{ES EAG,{N HOL}!{ES
Case Nuuber: l2CR152?
SAT\-ITY f }'ALIiATIO}{
Jeftiey L. Metzner. IvI.D., Consultirg Psychialrisi. CMHIP
Septeruber 3,30I3
Page ?? of69

arorurd people and public speak.ilg. He has trichotillouania. He says he wants to kill other prople- It was
veiy hard Io irteryierr hinas he rvouldjust stare atd take a lorg tine to answer."

&{et:ner conr$wtts Iiitbmratiou rvas otrtained from Margalet Roath. M-S.W. by telepbone durilg Auprrxt l.
2013. h,{r. Holmes, witholi promptir:g. told Ms. Roath thal "he had tric}rotillomauia.,. had thoughls of wantiug
to hut other people but *ever had burt anybody ald never would... ." Mr. Holmes' chief coruplainf was his
significant anxiety druiiig public speaking, He described becorning slrort of breath and very anxious drring such
times he had such sl"rupiours during interview witb Ms" Roath iu additisn to having significant dilliculty
arxwering questions lvithcut lcug ireriods of lresitation. Ms. Roath discr:ssed a refen'al to Dr- Fentou ard
possible use of medicatiols with h{r- Hohnes. He rvas very receptive to &ese reeommetilaliols becanse he
thought that he needed medications.

On March 3i. 2012 Dr. Ferrton saw Mr. Holmes for irxake evalualion, Thr notes iudicate "arxiefy.
mminative thoughts. 2 weeks relatiorship problems. Girlftiend broke up and came baclc decrease il
nrood and energy. Occasional insoruria, Eating - fine. Co;eritive - decrease focus past 2 wed$'". Fruther
notes include "hrcreased stress" gid*iend problenx - OCD syupfoms, worst they have beea. Pas: history
is lored for "5e grade 'got glassrs' - re*lized he rvanted to 'overcsme biol*gy' in all otirer ways..."
Solution to "biological probleiu" would be to eliminate probleru- "hsuricide"- but un"t kill everyoire so
*ot an effectivr :oluion.

&{el*rcr cofirmenls: "Biolcgical shorlcomiags" descr-ibed by Mr. Hshnes duriug my exarniaation included
difficulty communicatitg, depressioo, arxiety and OCD (obsessive-compulsive disorder). He was unnble to
provide an explanatioa hcrv hourieide would have solved these problems fur him.

Dr" Feffon's March 2l, 201? pragress noie included the following:

D*fes any suicidal ideatio:i. No specific plans or largets. Thirlk of &is 3-{ tirues a day. Distracts self
with TV antl movies. Other synptoms: orderly rime of deparnre, pre&rs repetition. no washirr$genu
phobia, no panic." soue odd thought processes...fear of ptblic speaking. Explored homicidal thinking-
mminations. but not e$tkely ego dystonic. Deiries plan or target & denies suicidal ideation. Appears nol
curently dangerous but warants finther understanding & following. Assessnrent: social plrobia,?
psychotic level thinking, schiz*id pusonality disorder? Plar: Sertraline 50 rnglday {plau to increase to
100-300) Klonopia {0.25 rng po b.i.d.} comider au antipsychotic" would use Seroquel for anxiolytic
properties. follow-up iu a rveek

During the Marcir 27. 2A1.,2 visit, Klompin was discontinued arid lre was started on propr:molol 10 mg
twice a day [prn]" sertraline 100 mg/day was continued aad Seroryrel was discussed.

,A}IES E.dGA.I{ EOL}TEs

100936 812/13/1987 g
0810412013 RC-ARAP"\IIOE
E?002 Color*do ${eatsl Eealth lnstitute at }urblo Lrit _I2_
AAAPASOE SA,}fITYEXA.M OBSERYATION REPORT 1s0 {10/93}
 IAh{ES EAGAN HOLN.{ES
Case Nuurber: l2CRl522
SA}{ITY EI.iALL?ATION
JetA'e1, L. h'f etzrier. IVI.D., Consulting Psychialrist. Clv{HIP
Septeurber 3, 3013
Page 23 of69

i{el;ner cofitnteilt: The Klonopil had been discolrtinued became it was not he\>ing with lv{r. Holmes anxiety
${r'- Hokles rvas $rorried about the sedative eff'ect cf Seroquel. which was the reaton it rvas not prescribed.

ln the rext *ppoiltruent or Apnl 3, 2012 it rvas noted that Mr. Hohues reponed that proplanolol
iuterfered with memory druing lab rneeting presertaiiolt and ihe dose rvas decreased to 5 rug rwice a day.

On April 1?. 2013. Sertraliue rvas increased to 15CI rng daily as nc clanges rvere lote<l. Following tlre
tennination by lv{r'. Holmes of the &iendslrip with his girltiead, iucreased obsessive thoughts rvere noted
"Doing ok bnt increased 'obsessive thoughls regarding women (one of 3 tlpes of thouglrts- male. feinalr.
all. W'on't eive aay drtails. Won't rulswer regarding plans, homicidal ideatioa. No suicidal idealiou). Dr.
Feirfor roted "furgn1'that I rvor'I tell hirn rrry philosophical ideas ofpurpose of life, 'I've told you all
mim. Are you jrst a pill prxher?' Can give m [advice] for treaunent other than "-learl a new philosoplty
of life." Her assessmell indicated "Psychotic level of fhinking- prarded, paranoid- hostile thorrghts he
wol't elabomte or. Very tentatiye therapeutic relationship- is takirg sa:ae meds but reluclantly. Is corrhg
in for appts. Seen:s to be frmctioning at work." Diaprostic formulations cocsidered were:

Schizotlpal personality disorder +l- fru* psyehotic disorder

Rule out OCD- obsessive thotights. but don't sefin to be egodystonic. No appareot rinrals.
Social plrcbia vs. a nanifestation of his psychotic level tfiinking.

Safety- No evidence of imminent rireat {I'm worrird abott homicidal ideation >> suicidal
ideation in tbis patiert7 thong} he is very ppurded and doesu't reveal much.

Flau- try to maintaiu alliaace to allowflutlrr evaluation and perhaps idlueirce him to ry an
antipsychotic. At this point, would try for risperidole as more potentlless sedaling than
Seroquel. Meaawhile, increase Sertraline to 150 mg and sonfinue Fropranolol at 10nry 3x day.

*Asked if it rvould be ok to lmve anotlrer doc

In the follow*rp apprinuneut on May l, 20i2. Dr. Fenton
joiu us for an eval. He's woried it will be tc '"lock him up." Asked him various ways how he sees his
problenr" rvhat he 'd like to do about honricidal ideation thougllrts" etc. bnl never g{ves a roherenf answer. "

A{*tmer aorrtrrent: Dr. Fentou's May 1,2Ar2 proetress note also iacluded the following:

My lab experiment not workiog. Says he rvill have to n:ake up so:ne builshit. Comps in Jurie and he will
iuve to pick lab. 3d lab told him not {o bot}rer applyiug:-*"not a good fit"... Relationships [wi]hl others-
usually lasts *bout 4 utonths-then'"I stop talking to thetr-

This session also addressed sooe issues re: his fonner girlfriend and some viole:rt thiaking.

JA:ITES Ei.GA.Ni EOLMES

100936 Br2/t3/198? r
08t0412013 RC-ARAP.{EOE
E1002 Cclorsdo Meatsl Ilealth lnstitute at Pueblo L:ri{ _F2_
AR{PAHOE SAIiITY EXA.}I OBSERVT,TION REPORT 150 (10193i
 JAhIES EACAN HOL$.{ES
flase Nuuber: l2CRl522
SAMTY EYALUATIOIT{
Jetfrey L. h'{etzrer. },1.D., Consultilg Psychialrist. CIUHIP
Septeuiber 3, 3013
Page 24 of69

On ktay 31. 2012 h{r. Hohnes repofie<l tha: he "get addicted to games" Diablo 3- 100 lm pa-st lrvo weel:s.
i.{ot srudl.ing for prelirus. Has read Nietzsche. Kaczynski. Tylelol terrorisl. Hate "sheeple" and
shepher<ls. "

h{er*er coilfirrer$: Duling this session }vIr. Holmes told Doctors Fetton and Feinstein that "most people are
sheeple.'" which was a coudensation of slieep and people. This was said to itdicate thal 'freople ale ibllowers."
Mr. Hoirles explained drring any examiuation of hinr that he rxes this ter:n to reier to "people witltout
meauilg."

Dr. Feulou's pro$ess note also iricluded the tbllowing:

lntroduced the idea thal patient may be very anpy/troubled. Does not have a seaxe of what others tbink of
hirn. RF worked fi'om rnentalizatior staodpoint and transfb:e*ce. Patiet: a:rees tc conte back and talk
more. RF ploposes talk and perlaps another nied lantipsychotic]. Hlpollesis- anger from bullying? RF
:aid to patient- cor*dn't really prevent suicide,&omicide in long rrur if person is intent on it. Answers why
he rvannd t* go ilto [psychintry] {one-sided conversafiols) and his values (htlp peoplei}

[Notc: the above is the end of excerpts &'orn Dr. Gru's reportl

M*ttpr roniln€]rt: Mr. Hohues deiries * history of ever baviug been bullied-

Dr. Featon's docruuentation re: her June 11, ?012 appoiatment rvith M:. Holmes included tlie following:

Appointment Date: 06/ll/2012 3:58:?1 PM

i.Itr{e Date: 0611?12012 4:39:02 PM
Fi|st yeal Nemo:ciences Erad student retnrrs todny for sclreduied follow-rrp visit with l]r. Feilsteil and
rnyself- After I ask how his cornp exar] lvert, he rrports he &iled it. Test was last Thrurday, he forurd out
Sarurday. As usul. he seenx inappropriately norxbalant about &is. Says he doesnl really like tlt
pro€raili anyway and &at he doesn't plan to retake the lest" Thin*s he'll quit ihe proppam aud look for a
job. Knowing his history of aupr and homicidal ideatior (torvards seemingly lrost of the hrunan race) we
proceed to asress his level ofdalgeronsness. He acnrally seen$ not a$gry at the pad school. and perhaps
a bit relieved to be leaving the progrun Neither does he appear snicidal or eyen depressed. However. he
continues to make hostile cornmeflfs to both of us arrd seerns mor€ paranoid tban on previous visits. Ftx
exanrple. whea askd if he is aware tlmt some of his cornnrents and demeanor rr:ay frigfrten or coo(erl
others. he says "well Fe*cn is clearly afraid of me - that's why she asked you here to protect her or
sorrething. And liren that one time she locked the door and had a coaqpicuous package bebind her chair."
But he also maintains that sther see bim as "florrnal""

J{1{ES EAGAT{ HOI*I{E 5

100936 812/131198? F
o8/0412013 RC-A.RAr"iSOE
Er002 Colorado SIe.at*l Ilealth lartitut* at Pueblo Cnit _F2_
ARAPAI]OE SA?{ITY tr.XAM OBSERYA,TIO}f REPORT 150 (r0$3)
 IAfuIES EAGAN HOLil,{ES
Case Nruuber: 12f,'Rl 52?
SA\TTY IYALUATIOI{
Jeit'ey L. l.{etzner. M-D.. Consultilg Psychiatrist. Ch&{IP
Septeurber 3, 3013
Page 25 of69

Regarding specific $ressors that might ircrease his level of dangerousnrss: he stated he hacl ro snrdent
loar debt and ltad ir fact about $l0K of
savings rhat would last for a rvhile. He plarured to stay irr
Colomdo "becailse ruy lease gors rulfil Novemtrer. I sigrred a corltract and I probably rvon't break that"
and that he'd look for a job. Thought that his parerts would help suppon hill if ueed be. Said he irad told
one &ield in the proggan tlrat ire had faikd (because slre asked hiuri arld timf he plarured to tell his
paxents. He did xot seeltt too corlcsroid about their reaction. "I told them a while ago I uright rrrt stay in
the propam" They will suppofi whatever nry decisior is."

We lestaaed drat r,ve \reie very concemed about Jarnes and thought that lie would benefit &'om a
medicalion like risperidone and coolinued psychrtherapy. He said his irxurance was going lo end and lrye
said that would not be a barrier. He saw no poinr in gettil.g treatment if lie rvasn'f going :o contir:ue r.vith
lhe ppad proglarn. He ilid pause to consider Dr Feinsteins question about "what about getting help fol
1nullife" but restated he wasn't intersted.

After about 30 minutes. James said lie had to leave ro go talk to his ggad school advisor ald got up and
left wilhout thanks. goodbye or other parting reurarks, as.per his usual derneanor- Significart wories
reurafured about the daugcrousness o{ &is snrdent. particularly the potential for r,"iolence agailrst others
given:

l. His long-staorling fantasies of killing as rnany people as possible.

2" His caginess in discussing any details regprding metllods, targets" tirning.
3. itris refusal to give us peirlission to contsct anyooe who could give collateral info or speak on his
behalf.
4. Tbe ruclear limeline of,his ruent*l health slatus and past history. Has he always been this odd and
flngry or is this nerv, suggrsting a psycho*c break, substance*related psychosis or lredical rllness.

Due to the above concerrrs. Dr. Fentoa activaled the BETA (tkreat assessnrent) team io investigate &ltlier and
help hnnulate a plan. Her assessruenl included the following:

At fhis point, it
appears thal Jarnes has schizoid personality disorder ard is intsmiiteltly S:nctiodng at *
psychotic level. His abiliry to menlalize about others' states of mind is very irxpailetl a*d he may be on
&e aulism spBctrurn. He rnay be shifting insidiously into a *ank psychotic disorder such as schizoplxeda,
though daes nol have the nrore rapid rvorsening of finctiouing lypical of most psychotic breaks. His
fear&atred of }urnans has rr:arkedly irnpaired hini - though he see.ms very intlligent if *ppea$ he will
drop out of grad school pro€ram due to his impairrd interactions.

nettal health hold" Hs is not lravely disabled and has no evidelce

Does not currently meel criteria for a
of suicidal ideatio:r- Lonptanrli*g hcmicidal ideation but denies any specific targrts aad there is no

JA}{ES EAGAN EOLnltES

100936 812/13/1987 F
08/s4/2013 RC-JLRAPASOE
EPOO2 Colorsdo l!{cntal Ee*lth lnrtitufp at Pueblo Gnit _f2_
A.R{.PAITOE SANITYEXN,M OBSERVATION REPORT 150 (ro/e3)
 rAI!,{ES EAG.{N HOLI,{ES
Case Nuuber: I2CRl522
SA\ITY I1.'ALUATIOI{
Jeftiey L. lv{etzner. I\,'I-D.. Consultilg Psychiatrist. CMHIP
Septeurber 3. ?013
Page 26 of69

curent evidence &ar he is angy at tlie grad school (or anyo:re rlse) frr his faihue. He has made many
Iu:stile rennrks to myself and Dr. Feinstein. but no {lreat:. This is sirnilar behavior to what his *rother
descritres. No evidence of past violent acts. No el'iderce of subsfarice abuse. thoughno dnrgtestinghas
been done.

BETA tranl pafient's utother- director and adl'isor in NS ggad pro!5am ali noti{ied of esseutial concen$
and lrave rry contact infonnation (and campus police ilfo) should arlytlirg colne up. Snrdent MH Service
wiil be happy to assisi Janrs should he req*est uealrent. rl,en if his insurance has expired.

DLdGNOSIS AND S}ANPTOMS

Schizoid Personality Disorder 301 .?0
no Aspergrr3 Disolder 399.80
rlo Sclizoplxeidfonn Disorder 295 .48

Attacluuent 7 provides a copy r:f Dr. Fentol's complete Jule 12- 2013 progress note.

Ilf*r:r:atioa was obtained from S,{r. Holmes regardiupr his treatcrent witll Dr. Fer:tan- He had lroped t}rat the
treaknent lvould give hirr. an altemative fo acting on his homicidal thoug&ts. He &equently was vague aud
needed strucfule ia ansrvering questions relevant to the rrffhre of tlre questionslassessrnsrt xrade by ]r, Fetton
regar-dirrg to his clunnic houdcidal thilking. "I told her I wa:rted to replace hornicidal ideation with sourething
else-.. I tald her oilce.. " She didnt say anything... ,"

Mr"" Hohues indicated that he had asked Dr. Fenton oll ser.eral occasions whether she was goi$g to lock hirn up
it tbe context of his chrnnic homicidal tliiniriag, I{e thoug$t that Dr. Feinstein was in oae of the sessions with
Dr. Fenton wlren he asked about beiug locked ap. Mr. Hohues stated that his quesfions, relevant to vrhether he
would be locked up, occurred after he started urakirg plans t* act on his homiridal thinking. "f was asking
them. in a way? to lock ure up by asking ti:eu if they were goilg to lock me q)." He rvas not surprised tbat he
was not lockedup because "I didn't tell them outright I had a plaa and what I rvas going io do.u

Mr. Holmes stated that Dr. Featon did ask him whether he had any specific person rniad ia the conlext of his
hornieidal lbir*irg. He woxld tell her "no-just people in general-" When asked if he had a plal he would teply
"yeah,.^ but l said it wasn't a realistic plat because I did not have a plan-". [*rd] that involved the whole
world.,- but that was before I started buying shrff-". I [theri] told her it got to be more reallstic...." He did aot
remember his response to any foliow-up questions Dr. Fenton would have made tc such staternents. He stated "f
doa't reuenrber what I said or if I didn't give an answer,.. ." He described Dr. Fentou becornirg c.oncemed as
evideaced by her sssrni$g more neivous arormd bim. It xras during fti5 tinre that he began to buy weapons and
pick out the locatiot of the sbootiug.

JAMES EAGAN IIOL*TES

1$0936 312/13J198? r'
08/0{4013 RC-A,RAr"{IIOE
rr002 Calor*do Mentrl He*Ith Institute at Pueblo Ltrit_F2_
AJLq.PAHOE SA}{ITYEXAM OBSERVr{TIOI{ Rf,PORT 1sr) (10193)
 EACAN HOLil,{ES
'ANIES
Case Nu*rber: l2CR1522
SAI\TTY EYALTiATION
JetA'ey L. L'letzner. I,{ D. . Coasultin g Pslchia trist. CI\'IHIP
"

Septeurl:er 3^:013
Page 2? of69

Two sessiots ,r,vith

both Dr. Fenton arrd Dr. Feiristein in the roorrl were described by Mr. Holmes as involving
psychothempy because "Dr. Feinstein rvoulcl ask ure questions." He stated his sessiots rEith Dr. Fentou and
Feinsteiri lasted about 30 mirutes each"" He clescribed most of his sessions r,vith Dr. Fenton to be 5-l5 minules
in druation and the interaction being medication fucused.

Retrospectively" lre thougtrt tliat psycliotherapy rvr:uld have been helpflil to him. He indicaled tbat Dr. Feirxteiu
r.vas the person wlio talked to him about psychotherapy" He stated that he had aot previously talked rvith Dr.
Feuton aboul psyclxrtherapy. He did not thinh tbat be has ever hail psychotherzpy irr the pa*t.

IlVF ORilIATI ON FROitI L\?fNE F ENT ON, lt{. D, AND ROBE R{ F E trNS TE IN, li{" D.

Intbnnation was obtained via telephole r.vith Lynne Fenton, lr{.D" and Roberl Feiasteir, M.D. oa August 9,
2013.

The discov*ry infonuatior iridicated Rcbert Feiaslefur, N{.D" told larv eafrrcerneat offrcials tbat he had
important irrfomration rvhich could be ccnveyed to theur if he obtained proper authorization to da so. Holveter,
Dr- Feinsfeia told rue this siatemelt was made in the conlext of issues related to a borub tlreat at an outpatieut
clinic at the Univerxity *nd Dr. Feilstein's general knorvledge of Mr. Holnres via his treatu:ent tlrougdr the
studeut health services- It sras tot in reference to aly speci{ic threats mede by Mr. Holmes relevant to the
shooting"

hr response to a very specific question re: her cornuunicatiorx rvith Sukrunar" Yijayaraghavan" Ph.D., Dr.
Feuton r,yas clear that she had not comnnrnicated ilr aoy lvay r,vith Dr. Vijayarag&avan intbrrnation to the effeci
that Mr. Hohues had told her since he could ao{ urake his marh on the wor{d in scieace thaf he could blaw up
people and becoure famous {referenced in an intercierv iu the diseovery docurnents)-

Mr. Holmes infonned Dr- Fenton that he would like to kill people aud that he tlrinlrs about killing people.
follow-up questions by Dr. Fenton would usrially elicit no other relevant iafor:nation? ao teqpoase, or Mr.
Hohnes would say sor::ething off-topic. At times irc would state that he wsuld not say a:rything furdrer because
']ou'd lock rue up [fu a psychiafic hospital]."

Mr. Hohnes's preseutation was generally characterized by very shod statements, smirks and stares. He also
desc.ribed wantiag to "overeoore biology by horuicide... but you have to kill everyore."

Druing tlre sessioa on Mareh 27, ?Al3 Dr. Fenton speci.fically talked with Mr- HoLnes abou{ fhe use of aa

JAMESEACAN HOLryTES
100936 Bt2tt3t1987 r
08104/2013 RC-AXATASOE
E3002 Color*do Mestrl H*alth lastitute at Pueblo Iiuit _F2_
AR{.PAIIOE SAXITY EXTTM OBSERV,A,TION REPORT 150 {10193}
 IAIVIE S EAGAN HOLi'.{ES
Case Nurnber: I2CRl -522
SAN'ITY EYALI:ATIO]I{
Jett'ey t. b{etzner. }.{.D.. Constlting Psychiahisi. CMHIP
Septeurber 3.l0l3
Page 28 of69

antipsychotic, Seroquel, However. he declined a trial rvith this medication due to his concer-n about sedatioa.

Dr. Fenton stated that her sessions with Mr- Hohres becanre essentially lnedication rnartagerleut sessions
clespite her afiempts to engage him io verbal therapy" Sl:e scheduled ole-hour sessioas rvith him. rvhich rvere
shorfened due to his lack of engagernelt-

Druing the last two sessious with lv{r. Holmes. which rvere attended by both Dr. Fentol and Dr. Feinstein, the
use of antipsychotic uredications was again offered to him. It rvas explained to him that he and they rvere
troubled by his horuicidal tliinkiug and were corcemerl that lre r:righi tre having a neryolrs breakdown. He gave
a definite 'ono" to such a trial and stated thnt there was :]o reasou to do so because be was &cpping out ol
graduate school. Evea i.vhen asked atrout wbat he was goiug to do about the resf of his iife, he declrled further
trealment.

Mr'. Hoknes had told Doctors Fenton and Feinstein tliat he rvas plapng lots of videogames and rvas not
preparing for his exarrrs, lvk. Hoknes told them that "'[{ was prepared enong&... [I] studied this way often.. . [I]
wasxstrrorried about it,-- Iknor.v what I aru doirg.." done this before"-, I'11be {ine.-- ."These statemenfsrvele
made by lv{r. Hohnes in a sornervhat arogant filaru}er.

1r{r. Hohnes had aever discrmsed "dysphoric :naria" with Dr. Fenton or Dr. Feinstein. Serkaline harl been
irritialiy prescribed by Dr. Feulon duriug the sessiol of March 21, 2012 for spptoms of obsessive-courpulsive
disorder and social phobia (i-e., arxiety), ra*rer than for spnptoms of depressioa, since depressive synptorns
had not been reported by Mr. Hohnes. Propranolal was prescribed for anxiety. These uredications were
subsequeatly adjusted ir tblloiv-up visits r.vith Dr. Fertan. &uing lv{ay 1, 2012 Mr. Hoknes reported feeling
cahner and talking ruore easily with people" Manic-like synptoms were neither <rbserved rror reported by Mr.
Holmes to Dr- Feiltolr-

Druing rny examinatiou of Mr'. ltrolmes. he was srrprised to leam that sedraline had not beer: prescribed for
slmptorns of depression and that Doctorc Fenton and Fefurstein were uot aware of his depressive synlptoms and
how bad he rvas feelirg about hirnself- He stafed that on one occasion he told one or botir of theru, in response
to a questinn, that he was being treated for depression.

Mr. Hohnes never talked with either Dr. Feiustein or Dr. Fentoa about how bad he felt about hirnself. Dr.
Feinstein indicated that "'r,ve got the arrogalt [presentation of] hin^"

As documented in her Aprtl 17, 7012 propress note. Dr. Fer:tor described Mr. Hohnes as getling angry wheu

JA}{ES{AGAN HOL}IES
100936 812/1311987 F.
O#O4NO13 RC-ARAPAITOE
8r002 Colorsdo Mert*l Eealth Institut* at ?ueblo
ARAPAIIOE SA}'ITYEX,{.M OBSERVATION REPORT
 IAL,{ES EAC,,\N HOLMES
Clase Nmnber: 12CR1522
SAMTY EI.'ALTJATION
Jeft'e}. L. h'Ietzner. L.I"D.. ffonsrdtilg Psychiah"ist. CfuIHIP
Septeurber 3.3013
Page 29 of69

she did not directly answer his qnestion about her philosophy of litb.

Mr. Holures never tlreatened either Dr. Fenton or Dr. Feirrstein.

A psycirotic disorder rvas cousidered in their di{Ierential diagrrosis related to his intermittent odd answex and
sollrrnerts- For example, rvhel asked during an early iuterr."ier,v questions about his childhood, he recalled the
tifth grade when lte gof eyeglasses. His comulefits regardi:rg the need to overcorne biology had a strong flavor
of illogical thinkirrg. In additior to his history of trichotillomauia, he described compulsive behaviors after
eating. Mr. Hohues described a conpulsive need to rvash dishes, which were used durirrg rueals, soou after
eatiag. He dispiayed aa angry and hatetirl perceptiol of huuranity to Dr. Felton thai had been preseaf fbr a very
long tirue- Howevet', attentpts {o obtain fruther clarificalion regarding these perceptious were unsuccessful.
There was a hiut of paranoid thi*king related to a box that l,{r'. Holmes observed on oue occasion in Dr.
Fentou's office.

Tlre last two sessions of his h'eahnett was described by Dr. Feinstein to have had more of a feel of
psychotherapy sessions compa-red to his previorx sessions due to his willingrress to increase his participation in
ansrvering questious, He appeared to feel relieved about droppir:g out of school ancl described plans of obtaining
a job.

Dr. Fqrton attempted to clarify rvitir lvL". Hohnes what he rvanted to obtai* &om mental health keahneut but
was xaable fo do so.

Page 31 of the rotebook {see Appendix lII) summarized new synptoms experienced by Mr. Holmes drring
May-July201?. They included the followilg:

1. Calatolia- Developed recently, often lasts for 3-5 hor:rs in the middle of the day. If present i:r
moming urd I knorv it isa"t particularly bad. can goad myself to move by thinking "Bambi gel up,
you must get up." [Jllae 3012, lasted about two weeks. &equency * ? tinres per week]
?. Erief periods of inviucibiliry, actions are irr hyperspeed. Developed iu last three nronths, oecurs
typically ihree or four days a week lasting all day with possible interhdes of catal.onia,lMay-July
201?l
3. Tire&ress mosl of ti*re for about an lrour. onset uuknowu.
4. Diffieulty il conceatating or fiocusirg on arythirg longer rlian 15 minutes. Created a learaing
strategy of studying 15 minutes then watching TV ar:d repeat. Very effective but oaly iu
isolation. [May-July 30 1 ?]

JA,}IES E,A.G.Ai{ HOLI1ISS

100936 D12fi3/1987 r
O8I84I2OI3 RC-ARAPAHOE
Er002 trCleatal lleslth 1n$itute at Pueblo
Colorrdo &rii_F2_
A,RA.PAIIOE SA.!\'fTYfXrlM OBSXRVATIOI\i REPORT 150 (101e3)
 JAI\,{ES EAGAN HOLN{ES
Case Nutrber: I2CR1522
SA}TTY EY,{.LTJATIOI{
Jetliey L. ]r,{etzner. L,{.D., Consulting Psychiairisl. CIVIHIP
Septeuber 3, ?013
Page 30 of69

Unlbffruately, Mr. Hol*res did not effectively conununicate these synptoms to Dr. Fenton basetl on
infcnnaiion obtained &"oni both Dr. Fenton and L{l" Hoknes. In addition, he experienced other chronic
synptoms that are also su*unarized in his lolebook.

The previously referenced rvriting otl page 54 of the notebook (see section er:titled "The Notebook') was
ildicative of lvtr. Hoknes not bei*g very cooperative in answering questions posed by his heating and
corxrdling ps3'chiatrists. Doctors Feuton and Feinstein.

INFOR*{ATION OBTAINED FROM JONAI}I"d;Y WOODCOCN, M.D.

During July 6, 20i3 I spoke by telephone rvilh Jonadran Woodcock M.D., r*gardilg his limited two-horu
psychiatric cansultatiol re: lv{r'. Holues at the request of defease eouusel t}at occuned 3-4 clays following tlre
alleged criures. The major pru?ose of this cousultatiol rvas for safeiy purposes and ruental stahts screeniog {e.g..
psychotic sliurptoms present?) pluposes. Dr. Woorlcock, who is botb a neurologist and a psychiahisi" rvas
instrercfed by defense counsel not t<r ask questions specific to the alleged crimes.

Dr. Woorlcock describerl tbe lrost strikfurg cliriical malifestations deuroasfrated by Mr. Hohnes to include the
t-latness of his alTect and dissociation of affect. For example, midway througih the inierview Mr, Hokues
appeared to be unc*m{br1able and possibly a little angry. At that point, I}r'. Woodcock asked him how he frk.
lu{r. Hs}rres was reporled to have "looked at me with disdain.." lhe said he was] bored." I]r. Woodcock
bficated Mr. Hohnes' dissociation of aifect was profound tlroughout the interview. He appeared to be
geuerally without ary sense of angst, coutlict or regret regarding his actions. Horvever, affect was demonstrated by
Mr. HoLnes wher asked about the impact of his actions oa his faniily. He appeared ts demonslrate a getuine seme of
regffil coocerning 1he effect it would have on his faurity. He appeared to inlelleclualize and dissociate his afftct when
asked to lalk about the inpact of his actions on the families of tlre victirns.

Dr. Sy'ootlcock said that "he talke,cl a lot about his history of suicidal ideation altl bomiciial ideatisn that he had
for mauy years. It was the preoccrrpatior of bis life... consruued by suicidal ideatiou anrl bow to deal with it." It
was Dr. W'oodcock's asses$neat tlat N{r'. Halmes' iong-standing homicidal thhking appeared to be a w;ry of
deating with his chronic suicidal thinking. His clronir preoccnpation rvith suicidal thinking wa* described as a
very dilficult stnrggle for hirn- Mr. Holures had reporfedly covered up the intensiS of his suicidal and homicidal
tldnking from everyone in his life, His snicidal fartasies ri{ere very uucomfofiable for him and he described a
sigrrificant struggle with them- Mr- Hohnes' houricidal preoccrrpation appeared to tre a mea:rs of redirecting his
thoughts and atientiorl away fiom sricide"

JAMES E,{GAN IIOLMES

100936 812/13/1987 F
08t0412013 RC-ARAPI|,gOE
E?002 Colorndo S{ent*l Eedth Institute at Pueblo Enir _F2_
S.RAPASOE SA}fI']TY EXAM OBSERVATION REPORT 150 {10193}
 ]Ab,IES EAG.{N HOLil{ES
Case Nrxnber: I2CR1522
SA}TTY TVALIiATION
Jef ir ey L. Melzner. Iv{. D.. Constlting Ps1'chialrist" CL'IHIP
Septeurber 3.3013
Page 3l of69

During this intervierv. b.Ir. Holures was described as being coherent artcl orieuted, He appeared fo understand his
legal situatiorr. He denieri the presence of halhrcinatiols. He appearerl vely reluctanl to discuss the presence of
possible dehxional thinking. His answem to questiom rvere not spoutaneous but clearly tlrought tluough before
speaiiing. Dl. Woodcock tbouglrt that trvfr'. Hobues was probably "filtering a lot [of his answers]."

Mr. Holmes talked about havitg a Plan A, which ilvolved killirg hiurself and a Plau B. which ilvolved killing
otlrers ald lhen killirig hiurself.

His preseatatior was consistent with a rnajor psychiatrtc disorder, urost likely a schizoaffective disorder
althoup& his presentation was clearly tnusual in tbe context of his very flat alTect and bis dissociation of affect.

Dr. Woodcock hlpothesized *rat 1r{r. Holmes experienced a sigrliflcalt clfuiicai decorupensatiori. r.vhich had
uade it very diilicult fbr hirn to prepare for his preliuinary exarrinaliqns iu praduate school. He thoug*rt fhat
S{r'. Hohnes had given rp or} r'esistiug his compulsioa lo kill himself and to kill other people. r,vhich resulted in
lrinr becoarilg consurued by the planrirrg for the actions that ocermed duing July ?0. 2012.

It was hlpotlresized by e'. Woodcock that ssruething happeaed in his relationship with Dr. Feltou aud via the
cousultation by Dr. Feinstein ilmt inpa*ted Ml" Halmes. Mr. Halmes perceived that the pr-escdbed medicafions
made him syrnptomatically worse.

A,&{?AHOE CO{,WTY JAIL MEDICAL RECORilS

A Jnly 26"2A1? note dictaledbyErwin Mozer. M,D. iicluded the following:

h my telephone discrxsion with Dr. Woodcock 7/?2117,he infornied me after a tlree-bour interview with
his patiurt, thal he considered him to have a psychotic diagrrosis (e.g. tltoug{lt disorder} possibly
schizoaffective or bipolar rype and likely requiretl antipsychoric aredicaliotts. We discussed those
altipsyclrotics which are oa the formulary, ald he considrred using risperidone. However. ht was waiting
to confinu thst he has es*blished a doctoraafient relationship with his patient and plan to prescribe
(tlrrong! rlre) o* 7/30ll2 when he reappeared at the jail to evaluate the palient agail. He did not fetl that
the patient required placenent on thc suicide watch al this time and felt *rat his current locaticn {in the
infinuary monitored by camera) is sriffrcieut. He noted what he considered be some featrues of psychosis
in this pafient. namely, "aJfective blockiag (he rvasu'! "in touch"') and referential thinking. He noted that
thr patient lus had {"long-starding srdcidal and homici&I ideation, and that crur.ntly th:re was rnore
tromicidatity than suicitlality. At the request of a&ninistratistr I was asked to coffac: Dr. Woodcock
agair, but was rmable to reach furn s:t 7125f l?.

JN.}IES EAGA}i I{OLTITES

100936 812/13i19$7 r
08/04/u 013 RC-ARAPAHOS
EPOO2 Color*do trltreat*I E**lth Inrtitut* at Pueblo
ARJTPAHOE S,{}fITY EX?IM OBSERVATION REPORT
 IAN{ES EAGAN HOL$,,IES
Case N*ruber: l2flRl 522
SAIfITY IYALTATIOII{
Jetliey L. I,{eizner. },{.D., Consulting Psychiah-ist. C}'{HIP
Septeurber 3.3013
Page 3? of69

Elizabeth Sather, Psy.D, spoke r,viiir Mr. Holn:es briefly during Jrrl-v- 26. 2013 al 2126 lus. Her note included the
follorving:

S: Explamed the role of this writer. to check and see horv he is faririg, and lo see ii any urental lttalth
infervenfion is needed at this time. Imnate appeared cor&xed and staled that he has his "orvn psycliiatrisl"
who can rerc botlr roles of attelding to cou$ lssres and his cun'elt mental llurctioning. He also stated
thar his utderslerding is that his psychiatrtst rvould corxruxicate with jail stalTregarding any of intlale's
clurent needs. This *riter affirmed that this had been the initial plan but that &il rwiter lmd rccently been
asked by jail staffto do an internal evaltatiol as rvell. This vniter infonned irxra(e fhat fhe pupose of tlx
ureeting this evening was to clreck on how he was doing now ia his cell and to ree if he needed an1'tbing
fron: ihe mental health staff. This rvriter tlrcn paused for iru:Nte to offer any t"eedback. Inurate did not
ofler a rcspoose. This roriter attenrpted to clarify wi& inmate whether he did not want to talk with this
writerjust this everdng. or rlot at ali. To this. irunate replied. "well. thanks for checking on rle. I think one
psychiatrist is e*ougdr." This writer thanked irnnate for lieing co*rperative, and endtd the conversatiou by
rxitilg the cell.

O: \tu'lien this wrier arrived at irunaie cell door. irnute was laying on his back on Lis mattress" reading a
book rvirh his anrx elevated to hold tire booh His legs were *lso rlcvated. with his lower legs resti&g
against the wall. When this writer en{ere<l the cell and made an iulroduction. imiate sat up imnrediately
atld uroved toward tllr end of tln nrattress :iear lhe door, as if to stsnd up. s:{lly sayi*g. "so I gtess it is
rnandato$" Whea rhis writer e4plaired lhat he was not required to merl, inmate sat back on rratrress.
Ilunate n:aintaiaed eye contact thmughout the brief conversation" wiih eyebrows raised and eyes fixed
directly oil ihis writer. He appeared puzzled by the prrrpose of tlre ureeting. but was lucid. logical. and
able to trark the conversafion appropriately. Rate md tone of speech were wilhin tcnual limits" $ofr-
spoken and cooperative.

A: xmb,le to form diagrosis as evalualion was not completed

Druing June ?5, 3013 I obtained iniomratioa from Er.win Mozer, M.D. relevant to his clinical contacts with Mr.
Hr:kles dru'ing his incarceration at the Arapahoe Cormty Jail. Dr. Mozer's psychiatric assessment of Mr.
Holmes"w{ts very liruited due tc legal issues. Dr. Mozer's as$essnrents were essenfially lirnited fo assessing
relevant safely- issues duriag Mr, Holmes' incarcerafion. During November 20i2 L't. Holmes begaxl lot eatiag
due to becoming paranoid that his food was being poisoned. Mr. Holnres stated tliat he had been moved to
another cell and started receiving a sack hmch that had been labeled with a S.S., whicli he interpreted as
referring to the Gestapo. He now thinks that S.S. was an abbreviation for suicide sack lunch, He subsequeritly
required hospitalization at fhe Denver Health Medical Center due to aa appalent delirium that appeared to have
beel rnelabolically caused by dehydration ard electrolyte ab*:r:ualities. At that time he rvas also started on ar
antipsychotic rnedieation, Risperidone , ar antidepressant rnedicatiou, Lexapro aad Cogentia tbr helping to

J{}IES EAGAN EOL*TES

t00936 812/13/1987 F
08104/2013 RC-.'LRAP,I,EOE
EPOO2 Color*do *trert*l He*ltL Institute at Pueblo Suit_FI_
ARAPAEOE SAXITYEX.S$ OBSERYA,TION REPT}RT 150 (10/93i
 .IAfu{ES EAGAN HOLT,{ES
Case Nuurber: l?CRl522
SAI\'ITY IYALIJATIOII{
Jett'ey L. h'letzner. I\,{.D., Cr:tsulturg Psychiatrist. C}vIHIP
Septeurber 3" 3013
Page 33 of69

ntauage side effects i'orn the Risperidone . b{r. Hohnes was ccttinuing to receive those medications at the tinre
that this infonnation r,vas obtained fiuur Dr. h{ozer.

il.{l. Hohnes rvas rlescribed by Dr. M*zer as exhibiting a sipgrificaritly flat affect. nol corurectirig iritelpersolally
rvith anyone at tlie jail aud appnren{ly riot wanting lo do so. Yery little spontaueity had been demonstrated by
N{r. H*lmes. Despite having the opp*rtunity to bave recrealional time outsitle of his cell in the irfimary, he had
rar"ely exercised such an optiou-

hrloruration was oblained &or:r Elkabeth Sather, Psy.D. liy telephorte during July 2. 2013. For rea$ous sirnilar
io those ret-erenced by Dr. Mozer. Dr. Satlrer's clinical involvemelt with tr{r". Holmes was geoerally lirnited to
brief rnontbly checks to atterupt tc assess how he was doing witldn tlre facility (i.e., assessing his level
liurcfioning) and for assessmenfs relevant to safe$ issues.

Dr. Sather had at least two clinic*l coatacts with Mr. Holmes durilg Noveutber 2012 dr.re to his self-injurious
bebaviors and ideation. This was around the tiure prior to his transfbr to Denver Health Medical Center
(DFilv{C). whic}r will be srunmarized in the next section. He was observed by a de.puty to be jrunpilg offof his
brurk around thai time. Ir{r. Hohnes tsld me that he was likely trying to hut hiurself but not to kill himself.
Drutng &is period of time he also deuroirstlated overt psychofic thirrkiug- Specifically, Mr. Hoknes stated that
he thouglrt th*t druiag the previous week he had beea in a puzzle game that apparenily somehow involved Peter
Pan in a greeu vest. It was Dr. Sather's impression that s*ch thinkhg represented psychotic thinking iu contrast
to malingering. Ia fact. she was about to initiate a process to tralster him to the Colorado lv{ental Healdr
fustitute-Pueblo {br fruther evaluation/ireahtent. H*wever, this process was uot carried ouf beca*se he rvas
subsequeatly transferred to DHMC.

'V/hile at DllMC, ${r. Holmes was leported to have made bizan'e cornrnents aboui puiling away fiorn people
and dr:inking their blood. When be was back at the Arapahoe Corurty Jail. Mr. Hohnes did nol rernernber
niaking such staterreats but did rernember having such thouglrts-

Mr. Holures was apparently unable to provide Dr Sather with an explanation for liis rea$ons that he stopped
eating rhriag the days prior fir bis admissioa to DHMC"

Throuprhout his incareeration, at the Arapahoe Cormty Jail Ml. Hobnes hss demoustrated a very ilBt affect- Iu
addition. his appearance was remarkable for pupil dilatation and usually looking very alarmed. He generally
stays il liis cell most of the time aod was reported rot to have made aoy conaeclions with oiher people {iamates

JA]'}{ES EAGAN EOI}IX5

100936 Bt2/t3il987E
0810412013 RC-ARAP"{,HOE
E?002 Calor*do Mertal Et*lth lsstitutp *t Pueblo
itR.4.f^{IIOE S.{}fITY EXA:}I OBSEILVATIOI{ RErORT
 EACAN HOLIV{ES
JAi,^,IES
l2CRl522
Case Nruuber:
SANITY EYALTJATION
Jet"fley L. h'fetzner. lvI.D., Consulting Psychiahisl. Ch'IHIP
Septeurber 3^ 30ll
Page 34 of69

or stafl) at the jail antl seem to have lo interest in doi:rg so. There have beea fwo incidenls of hirn iu:rging at a
nurse for reasofls that rvere uneleal- He subsequeltly reported lo mernory of these evetls.

Aftenrpting to converse rvith h,{r". Holues was described as a very rliffleult process due fo his obvious di{ficulty
in cornrxrnicating rvith people. He frequeltly *ppems very cotfused when asked eveu sirnple questions. His
elifficulty in comoLuricating appeared to be due to a thoup{rt disorder and he reportedly bad a vetY autistic-like
quality.

DENI'ER TTEALTI{ MEDTCAL CENTER

Mr- Hohnes lvas initially evaluated al DHb{C druing Novemtrer 13, 201?. The reaso*s for this assessment were
rvell summarized in the Acliol Care Ambulance records as foilows:

H: NIIRSING STAEF I}{FORMED EMS THAT PT, TRIED TO HLIRT HI}IISELF 2 DAYS AGO BY
F'ALLING BACKWAR}S FROM STANDINC POSITION, AS OBSERI,'ED BY SECURITY
FOOTAGE. PI, CAUGHT HIMSELT MID.FALL .{ND DID NOT STRIKE HEAD, PT. T}IEN
PROCEEDED TO STAND ON BED THAT WAS APPROX, 2 FEET FROM GROTND AND FELI IN
THE SAME FASHION WTTH SAME PROTECTIYE REFLEX OBSERI,ED. STAFF DTNIES LOC
BUT STATE THE PT STARTED TO BEHAVE ERRATIC AND NOT HlS BASELINE COHERENT
SELF, W. BECOfufES COMBATI1IE i[; TH STALF iI/HEN AGITATED V/ITH ROUTINE
ASSESSMENTS. PT. WAS PLACED IN FROTECTIVE ROOM WiTH PADDED WALLS DUE TO
SUTCIDAL TENDENCIES DISPLAYED. PT, PROCEEDED TO STRIKE HEAD ON II/ALLS AND
SELF ASUSIVE ACTIVITIES STOPPED T}IA.T DAY. WITH PT. BE}L{VIOR STILI ALTERED
TODAY, JAIL DOCTOR REQUESTED pT, BE T&A.}ISPORTED TO DEIII{SR HEALTH rOR CT
SCAN OF HE.{P. P?. }IAS NO KNOWN MEDICAL HX. MEDICATIONS. DR ALLERGIES.

A: PT WAS FOUND AMBULATORY IN 'SUICIDE GOWN WrrH H.AND{:{JFFS SECURINC

WRISTS TOCETIIER AND S}IACKLES SECITRING ANKLES TOGETHER. PT. IS A.A.OXI TO
PERSON ONLY AND NON.VER,BAI- WITH THE EXCIPTION OF YES/]''IO ANSV/ERS AND
EFISODES OF INCOHERE}IT SPEECH. PT. WAS ABLE TO REPEAT PHRASE WITH NO NOTED
SLI]RRED SPEECH PT, CA}.l SMILE W}IEN PROMPTED WITHNONOTED FACIAL DROOP. T.
CANNOT FOLLOW COMMANDS TO PERFORM GRIP TEST. AND HANDCI'EFS PREVENT
ASSESSMENT OF PRONATOR DRIFT. HEAD HAS OLD APFEARING BASEBALL SIZE}
CONTI-}SION OVER THE CENTER OF }trS FRONTAL REGION, PT }1AS NO PAINFUL
RESPONSE UPON PALPATION OF ENTIRE }IEAD 1#ITH NO NOTED CREPITUS OR
ADDITIONAL DEFORMITIES. PUPILS ARE PEARLA AT 5M},{ DILATiON. NECK iS MIDL]NE
AND INTACT WITH NO JVD. TD OR TENDEKI.{ESS NOTED. CHEST HAS BILATER-CL RISE
AND FALL WTTH NO SOB AND IS SPEAKING I}.i FI.ILL SENTENCES. CHEST HAS }{O

JA.'UES EACAN EOL}TES

1009s6 812/1311987 r
08t0412013 RC-AnAP]I'H0E
EPOO2 Colorsdo Meutal Ee*lth lnstitutt at Pueblo Unii _F2_
ARAP.{HOE SA}TITYEXA,M OBSERYATION RSPORT 150 (r.0/93)
 IA]\,{E S EAG,,\N HOLh{ES
Case Numher: l2CRl522
SA\ITY EITALUATIO}{
Jefiiey L. h,{etzuer. I\,I.D. . Cr:nsriltin g Psychia h isi. C}VIHIP
Septeurber 3. 3013
Page 35 of69

INST"{BILIT}'OR DEFORMITIES TJPON \TISUALIZATION AND PALPATION. ABO ]S SOFT

}.{ONTENDER WITH NO RIGIDITY. GUARDING OR DISTENSION. EXTRE}'{ITIES ARE
ATR{LA(A.TIC vlrITH NO NOTED NELIRA.L DETICITS. C?r{S INTACT X4, SKIN IS ACYANOTIC.
ATEBRILETDRY. PT \fAS Pti.CED ON PULSE OXIIv{ETRY AND CARDT{C MONITOR 3 LEAD
WTTH SII{US TAC}IYCARDIA. PRESENT. IV ACCESS WAS ESTABLiSHED BY PAL{MEDIC
HERR VtA. l8c MN THE RAC. PT RECEI"SED 500CC NS FLUID BOLUS DUE TO
TACHYCARDTq AND PRIOR DEHYDRATION REPORTED BY JAIL RN. PT. TACTTYCARDIA
IMPROVED FROM 136 BPM TO 93 BPM AFTER TLUID BOI-US AND DECREASE IN
AGITATION. BLOOD LABS WERE DLA.\[,T.I FROM II' SITE. GLUCOMETER READING WAS
TAKEN FROM TV SITE WITH I IOMGIOT . -. .

T: PT" $/,q.S BROUGHT ST&{IGHT TO CT SCAN... .AFTER NEGATM HEAD CT FINDINGS

DEI\NER HEALTH P}IYSlCtdN REQUESTED PT TRANSPORT BACK TO JAIL AFTER
CONSULT WITH JA]I- PHYSICIAN. PT WAS RETURNED TO JAIL.

Mr. Hofunes vias admitted to the DHMC drurng Novenber 15, ?0lZ.In{bnnation rvas obtained fiom Rachel
D*vis, M.D. druing July 3, 2013 by telephorre. Dr. Davis did tire adruission psychiatrie evalu*tion of Mr.
Hokues. About 1.5 hours prior tr: her assessrneat" Mr. Holmes had received Haldol 5 mg IM. Ilr. Dar;is
described Mr. Holmes as being very disorgalized and "definitelypsychotic-,- he had odd body posturer"." gave
randou anslrers to questions,. . stickiag his firiger up his anus-srnearitg feces-. . ." Her admissioa note included
the following:

?4-year-old nale bro*ght irr by police ftom jail to CCIvIF who presruts with altered arental slatrs, Patie:rt
has fever, [rne*bclic dishr6ances]. Psychiaty was con:rdted to assess altered mental status. self-hanaing
behavior, discrganization and to nuk€ *red recou:rrndations-.. Per notes ftom jail, patienl has b*en
eilgagrng in increasing bizare, disorgaaized and self-hanning behaviors. He has intennittent$ been
reflrsing to wrff clothilg or ea#drink He was &oted lo be lickbg the walls. deferating or the floor,
surearing feces. The ?atieot was noted to eat paper. He was recently seefl at DHl,rC fior a CT head S$
standilg on brd in jail while facing backwards and junping off bed onto his btck sustaining a head
injruy... He lias also been bangng his head against the rvall ns well as rauxuirg lorvards &e wall *nd
head buning it. Patient was noted to be talking to hirrself in jail and told pecple he w*s lot sure if they
were real or not... Ou exarn, tlre patient rvas disorganized" appeared to be depressed as well is respondiag
*I
to intemal stiruuli. When asked why he has not been eatin$&inkiry" lrr said don't know whal the jdce
is" and '"I was in a box without aay juice and couldn't reach it-" When asked why he didn-t need
yesterday. he said "w was yesterday" how long was yesterdaf'..- He complained of his thougltts ttct
uukiag selse and needing "lo be on line with what other people thitrk"...

Wlrm asked why he was in jail, he said "because I pulled away tom the people I krew" ald
*I drank

JA,'I{ES E;IGAN EOI-}TE,S

10093d B12t1stt987 F
08104/2013 RC-ARATASOE
EPOO2 Color*do Meut*l Hedth lastitute at Pueblo
A,RAP]TIIOE SA}iITYEX.{.M OBSERVATION REPORT
 lAh'IE S EAG,{N HOLi,-IE S
Nunber: l2CRl522
Clase
SAMTY EYALUATION
Jeff}ey L. l.{etzner. h{.D.. Colsulting Psychiah-isl. CMHIP
Septeurber 3, 3013
Page 36 of69

their blood." He said 'T tcok the blood that was nof ruite to take" and "it was unfair." He said "I was
selfish." The patient denies wantillg 1o coruuit suicide. so he can "help people llnl take things fri:m other
people." Per the police in the room. the patient was r*arkedly dilltrent after receiving the IM Haldol-
Prior to the Haldol. he was repeatilg nonsensical pluases sucb as "sbadow point" over and over, They
also said he was rnore engaged a*d orgrutize after receiving the Haldol... ,

Inrpressiol: Patient presents as psychotic with caiat*nic feafi:res. He hns been engaging il bizarre
belxvior, has a disorganized thought process af tiilles. perseveratilg on foodldrink. He appeared to be
responding to iiemal sillxuli ald erdoxed audit*ry halluci*ations. Catatonic feafures ilclude seleclive
fiitirislll. rigid posruring al rirnes. echr:lalia. Tlre eriology of psychofic sympt{JCI}s is tutclear al this point
and requires flirrher mediral worlarp aud psychiauic evaluatiou... [hk, Hohnes was loled to have a
positir..e response to Haldol and Ativan]. Diaprostic iurpression: Psychosis NOS. Dehydration.
taclrycardia ard leukocytosis

Soft limb restraints rverc requi.red upot arlmissisll due to Mr'. Hohnes' disorientafiort- agpressiveuess, prabbing
l:ehaviors arid otrviorx conftisiot. These restraints rvere ftvo point resfuairits by the secoxl day of his
hospitalizatiou, He r.vas noted to pull at his r\l' if he was not restrzired- By November L7 . zA}2 r:eskaitts were
removed for medical lrasons silce the staff tlmugftt they 1ryere ro lorger needed fo prevent hirn fiom injiring
hirnself such as pulliug mrt bis IV, although restraiuts were continued by con'ectional officers due to secrrity
regnlations,

A Novernber 16, 2012 note by Jermifer Fraser, M.D. iadicated that Mr. Xolmes did not know vrhere he rvas.
Electroly*e inrbalance and ruiaary retention were prese$t. Psycirotic symptomq continued to be pres*nt. A
Noverrber 16, 20L2 psychiatric propess note co-siplred by J- Craig Holland, M.D- docruuerted that h'Ir.
Hol:res st*ted that 'he had not been eating for a few days be.c*use it made hiru sick aud that lire voices
sometirues totd him rot to eat." He continred to demonstrate poor iasigbt a*d judpneat. Ri*peridoue was
plescribed for acute agitatiorfpsychosis, Tbis propuess note alss iacluded the follorving ilfoxnation:

[Patient] repofis he is il
a "shadow-box" and lhal voices tell him to "get water." Patient also reports when
asked about self-hann that he has "bitten his ann for food" before; wben asked what kind of fao4 palient
' reported'-proteinaceorx."

hdtial assessmeot was psychasis uot olherwise specified aud hypernatremia, delirium:esolving.

Urinary retention was ro longer preselt by Novernber 17,2012. His metabolic abnoaralities were beginning to
resolve at that tirne. Nomral labor:atory results included liver frrnctioa tests and thyroid stimulating hor:loae.
During N*vember 18, 2012 his acute delirium was improviag aud he reeured io be responding to the eonection

JAMES EAGA}{ EOI*}[ES

100936 zt2/13il987 r
0$04n013 RC-.{Rj.PASOE
EPOO2 Colorsdo Melt*l Ee*lth Inrtitute at Pupblo
!.NAT.{IIOE SA}ilTYEXN,M OBSERVATION REPORT
 JAl,"{E S EAGAN HOLfuIES
Case Nurnber: l2CRl522
SAhTTY EYALTJATION
Jetfrey L. N'fetzner. h{.D., Coustltiag Psychiatrisl. CMHIP
Septeurber 3. 3013
Page 37 of69

of electrolyes and dehycL"atiou. His risperidone rvas again increased to ? urg po qd. His leukocl'tosis had
rcsolved arrd he lemained afebrile.

A November 18. 2012 psychiatry consult attending note by Elizabeth Lorvderurilk, I'{.D. indicaled that t}re
repeat CT scan rvas preliurinarily read as being rvithout any acute inkacraaial abnonuality. \Ihen asked if he
uwoczy' for
klew rvhy he was iir the hospital. lv{r. Holnies "said he fell aad }rit iris head. Described feelilg
approximately the day prior to falling." When asked, b'Ir. Holuies continued to repofi fhe presence of auditory
hallucigations, which included corlr.r61f halluciaations {e.g., voices telling him to get up and waik arcrurd),
Since trre was irr restraints at thal time, fr:rther inforrrialion:elevant to these conuna*d hallucinations rvas not
obtained- He was alerl to the molth and 1.ear bul rrot 1o the exaet date or day of the week. His mertal stahrs had
siguilicattly improved as courparcd to prior exarninatiorrs- His preseutation was consisteut with pslahosis NOS
and resolvinpr delirirnn. Risperidore was increased to 3 mg po qd"

Dr. Lowdennillr's clinical assessurent rvas that Mr. Hoknes lva$ experiencing both a psychotic disorder ald a
delirirun related lo his rnetabolic imbalalce. In addi:ion to tha nor:nal CT scal, a lumbar prmcture rvas also
withiri nonnal lirnits. His behavior lvas very consisteaf with a rnental disorder associated with psychotic
feahres, which respoaded to antipsycbotic rnedicatiorx,

Duriug tbe evening of November 19, ?012 an attempt r,vas made to rernove Ml. Hohnes &orn resh'ainls due to
tbe cliniral impression that restraints were makiug him clinically vrorxe- However, his lower extlemities were
placed back ia restraints atler he used them to "flip [the] blanket over head and [effecfivelyJ obscure
observalion ofpatieut." N{r. Holnies reporled thaf
o'he
was trying tc 'hide &oru the shadows.' "

Philippe S/eintraub. lv{.D.. evaluated ${r. Hohnes during November 19, 2AlZ. He was loled to have
sigrrificantly clilically improved aud to have his fV discontimred. He continued to deu:onsirate filernory
problems. The Noveruber 19. 2012 progress note co-sigred by Dr. Weiatreub included the following:

When interviewed this ruomfurg, patient is alert aad oriented to nlonfh. year. election results, and e:rnent
Iocation aird qype of lhcility tha: DHMC is. Patienr repsris thst "voices" recently starled arorurd the tinre
he hit hesd and reporlr that lhe voires are occurr:iag mnch less frequently and that at the time of intewiew
he is not hearing any. Pariefi does not recall ever beilg Aeated with psychiatric medications while at
correctioml facility. He reporls his moods have bt*n "all over t&e plaee'" in jail. Patiert rePorts
medicatiots have bees helpful. Pati*nt did require restraints on lower extremities Iast evening after witg
them to flip bla:rliet over head aad eftctively obscuring observalion CIf patient. Patient repofis he was
trying to 'tide from the shadorvs." Patient denies currer$ thoughts of self-harm or hann to others. Denies
visual hallucinatiorx. Rrports he lns been well freated at this ftcility and that he is not coocersed about

J*T}IES Ei.G.AN IIOL}IE S

100936 812/13i198? r
0Sl0,l/20r3 RC-A,RAPAHOE
E?002 Colorado trdrat*I Eealth lnstitute at Pueblo tidr _F2_
AX"{PAHOE SA,}TITY TXA}I OBSETVAfiONREPORT 1s0 (10193)
 JAo-IES EAGAN HOLI.{ES
Case Nutrber: l2CRl522
SANTTY EYALIiATIOI{
Jetl}ey L. l\,{eizner. IvI.D.. Constlting Psychiahist. C}vIHIP
Septeurber 3. ?013
Page 38 of69

an)'one lmning hirn. Patient is atrle state that he is rursrue what E:estio* hr should aruwe{ given legal
proceedilgr.

Litbnnation rvas otrtained E'orn Dr. Weinfraub by phone dulilrg July 8. 2013. Sirnilal tr: information obtained
from the other attendilg psychiatrists at DHMC, Dr. Weintraub's cliuical assessmelt rvas that lVfu'. Holmes was
experieacing bath a psychotic disorder and a delirium related fo hi* metabr:}ic irubalance.

Dr. Hollald co-sigued a plogress note duritg November 30, ?012 docture*ting that Mr. Holures "no longer has
visual liallucilmtions and that the auditory lralllcinatious have decreased to hearing rninimal 'shadorv voices'
after other people talk." He r,vas uoted to have clinically improved and reported tlmt the medications were very
-'keepilg biru rela.red a*d caim" and that he wants to "keep the halluciliations away." He was also
helpful in
aoted io have been appropriate silce the reslraiuts had beeu removed-

lufor:latioa was obtained frorr. Dr. Holland via a telephone csnversation during July 8, 2013. He indicated that
the docurnent*lian regarding lhe presence or abseuce of visnal hallucinatious in the DHMC record was '"soft."
His clinical assessurent was consistent with the infarmntion akeady summm'ized in this sec{ion. h siroulel be
noted that rone of the psychiatrists at DHMC who assessed Mr. Holmes thought that he was arali:rgering.

A dischalge snulrnary dictated by Jennifer Fraser. M.D., irictruded the follcwiag infui:nation:

ADMIT DATE: 1111513012

DISCHARGE DATE: 1 l/?tll2Ol 3

ATTE}-TDING NAME: Dr. Jmdfer Fraser

DISC}I{RGE DIACNOSES:
1. Acule delirium.
2" Psychosis, NOS.
3. Hlpentatrernia.
4. Hypokalemia"
5. HSpophosphatenria.
6. Leuliocytosis.
1. Urinaryretertiou.

INtrrASIllE PROCEDURES : Ncne.

PERTTNENT IMAGING:

IA}IES EAGAN ITOLMSS

100936 812/1s1198? F
08104/?013 RC-ARAr"ISOE
Els0? Color*do llleat*l Health Institute et Pueblo Unit f2_
A,RAPAI{OS SA}{ITY EX.*.M OBSERYA,TION REPORT 150 (10/93)
 JAkIES EAGAN HOLIv{ES
Case Nr:mber: l2CRl522
SAI\I'ITY EYALTIATION
Jettey L. I,{etzner. tr{.D., Cotsulting Psychiatrist" Cil{HIP
Sepie.uri:er 3, 3013
Page 39 of69

U Cihest x-ray dared l lr'1-5,12012 that deinonslrated no acute carrlopuhnonary <lisease.

2) CT head on I lr'18120t2 that demonsffated no fraclrue, heuorhage. :ncss, midlioe shifl. or evidence of
ter:itor-i al iniarction.

BRIEF H AND P: This is a ?4-year-old male who was lxought in to the erxer€rcncy departrcnt front jail
wilh iricrea:ed alteration in ruental $arus a*d refu:al to eat and drink times several days. There had been
roted self-hann belmvicr, Please see Initial H and P for full details.

HOSPITAL COLIRSI BY PROBLEM:

l) Acute deliriuur: With cotcems for self-hanu behavior. Psychi*try was consulted and follorved along
drui:rg his stay. Laboratory values" at the tinre of adnrissio* wei'e consistent *"ith starvaaion electrolyte
disaubances with hypellalreinia" hypokalemia. arid aa anion gap metabolic acidosis. A tu'inalysis was
cherked and demonsu"afed no krfection but did have 3+ ketones consirlent witb starvation kelosis. The
patiert was managed medically lvith D5LR aad Di nonnal saline drip that irnproved his sodiuur lo *'ithit
nor:nal linrils 3s rvrll as receired potassiuru suppleinen:ation. His lytes were ntonitored daily until they
nor:nalized at the time of discharge. Evahmtion fur underlying causes incl*ded urinalysis and cliest x-ray.
lhat denrcnrtraled no infection. There was no meningisruus on exam ald ro LP rrras perfomred. RPR a:rd
FI$/ were negative. TSH. Bl2 and Folare were witbin norxal linrits. His rrental stanrs hnd inproved
sipriticantly flt flte time of discharge. at which tirr:e he war aleil aud oriented x3, requiling :ro additioaal
IV' nredications or resraints ?4 holu's prior to discfuarge.

2) Psychosis, NOS: The patielt irritially rcmplained of auditory and visual hallucinations as well as self-
in3rn'r:rg thoughls and behaviors. He was follcwed by psychiahy and was stsrted oo an antipsychotic
regimen rvhich initially included Haldol, Ativan, and benztropine for extrapyr-*niidal syrnpforns. This
rvet*mlly w*s adjusted to Risperidoue I ng q" a.ln. aud 2 mg q Ls. witlt 0.5 mg p.r.u. for agitation. The
benztropine was :houglt to possibly be related to urinary retsrtion. Therefore, i{ was discontimred and t}e
patimt was stafied on p-r.r]. Benadryl. A1 the time of discharge" the patient d*:ried suicidal or homicidal
ideatiol. He r;rras orieated to place. self and iilrE He will contiaue to be followed by psycltiaay at tlie tinre
of transfcr.

l) Acute urinary reenriorr: Thought s*condary to benztropine. This was discontinred. The patient is now
able to urirate norrrrally at tlie time of discharge.

4) Hypematremia: Thought likely hpovoleinie hyper:ratremia secondary to poorp.o. lntake. This resolved
rvith aggressive IV fluid rehydration. The patientls sodium has now beeir within normal limi* for griater
than 48 hours ard the patient is taking adequate p.o.

JA.VIES EAGAN EOL]VIES

100936 8121131198? r
O8IO4I2O13 RC-ARAPAIIOE
EPOO2 Color*do ldelt*l Henlth Institutt at Pueblo Lrrit _F2_
AR,d.PAI{OE SAI{ITY 3XA.M OBSERVATION REPORT 1s0 {10193)
 JAIUES EACAN HOLI\.'IES
Case Nruxber: l2CRl522
SA}YITY EYALT:ATIOI{
Jett'ey L. Metzner, I,{.D.. Cor:sultiag Psycliiatrist. CfuIHIP
Septeurber 3, ?013
Page 40 of69

5) Hypolc.rleuria: Also thougirt secondaryn, to poor p.o. inrake. This has also been corrected *,ith
supplementation and nraintutance of p.o. intakt.

6) A:rion *ap :uetabolic acidosis: Secoxdary to star-mtion ketosis. confu'rned by urinalysis. This resolved
rvith ]-5W ddp arrd has remained dosed as ilre patient is eatilg.

7) Leukc,cyosis: The patient had an initial elevated white blood cell court thal resolved the uror:ritg
following adnission. He h*d rn evidence of infection with a regative UA and negative cltest x-ray, Had
no meningistllus on exarn and, theretbre, uo &rther evaluation for infection was performed. Hts whitt
bload cell corur rerlaimd *ornnl and dx patient mmafured afebriie tlrougCrout the rernainder of Lis stay.

8i Hypophospbatemia. Srcorrdary to poor p.a. Intake. This was monitorcd closely for v and rernaiued
rvithin norural limits for ;lrEaler lharl 4S horus prior to tra&sfer.

9) DVT prophylaxis: Tlre patienl was placed on sr:bcutaneous heparil dlring his stay-

MEDICATIONS: Please see uredicatioa reconciliation.

MEDICATION CHANGES: Tlre parient was sta$ed on Risperido*e Iiry PO every morxilg and 2mg
eveiy evening. bem&yl 35mg PO every 6 borrs as needed and Ativan ling F0 every .6 horus as meded
for agitation.

DiSPOSITION. AND FOLLOIIf UP PLAN: The patient will be discharged to jail In fair condition. He
will rontinue to be follorved by psychiaflry at that time He is disrharged on a regular diet and fu]s*ucted ts
seek medical affention wi& fruttrer fevers. Chills, sig$ficant decreased p-o- Intalie. fix1her hallucinations
or rlehuiols. or ofirer corrcenx.

FAM ILy S En p?rrs "4

Gltrrcr rs,{rrnri, cALr F oRNrA}
Mr- and Ms. lloknes and their'8 year-old sono Jaoles, and 3 yearold dauglrter, Ch:is, participated in 7 farnily
sessiorx from Jauuary 19 until March ?, 1996. His par:e,ats described him as being very initable and not wanting
to €ngage with his yorulger sisfer, whs wanted to be very involved with lrirn. They thouglit that this treatrnent
was nof helpful.

The intake note included the fiollowing:

Jin:my.8 yo...no in-school problenrs, Peer respect? Non-verbal. Throws things- Oppositioml.
Plrysically actiye. Appeus to create seosory iryut if it's otherwise missfurg. Provisioual diagrcsis-

JAMES EAGAI'i HOLllEs

1011936 812/131198? r
08l8{,?01t RC-ARAPAHOE
Er002 Colorado Mentel Ilealtb Institutr at Pueblo tiuif _F2_
ARAPASOE S.A}EITYEX.4,M OBStrRVATION RSPORT 150 (:0193)
 ]AN{ES EAG^A.N HOL {ES
Case Nurnber: I 2(-R I 522
SA.I{ITY IYALIJ ATIOITT
Jetli'ey L, I.{etzler'. hI.D.. f-oustlltmg Psychiatrist. ClvIHIp
Septerrber 3. ?013
Page 4l of69
oppositional defi ant disorder.

The disclrarge note stated the following:

Worked with lamily arourd disciplinary sfirctr$e. efc. per clraracter skills proggaur.

b{other stared that goals r,vere large}y achiel'ed,

Mr. Holnres relrorted that he did uot rcrnenrber this treatr*ent.

TREATME{VT WITII MEL LIPSEY

After the family nroved back to Sarr Diego" they participated ir the family keatment rvith Mel Lipsey related, iu
part, to Mr'" Hokues uot uraking friends. Diapnoses rvere lisled as adjusturent disorder witb mixed distur*ralce of
ernotianslconduct and adjustment fisorder. depressed rnood. This treatrnent lasted for about one yeff and rvas
though at the time by his pareats to lrave beeu lielpful. Mr'. Hollies did trot thiak this treatment was helpful and
indicated lre did not ren:ernber tlre reasons for the treatment"

FA*I,IILY TIISTORT

Sources of infrnnation utilized in obtaining L&'. Hohrres' falrily history included review of pasf psychiairic
records, a documenl eafitled "James Eagan Social History" prnvided by the aitomeys (i.e., 0fiice of the Ptrblic
Defender) for Mr. Hohnes, aad an August 8, 2013, telephone conversation with Mr. Hoirnes' parents. Robert
and fuleae Hnlmes.

Mr. Hoknes rras bcr:r in San Diego, Califomia on 121131198?- His younger sister, Chris Hqlmes, was born
12l?611992. The thmily moveel to a new holse in San Diego on Prairie Dog Aveuue rvhen Mr- Holmes lr.as
about ane year old" During 1995, the family, which now iricluded hjs sister, moved to Salinas, Cali{bmia"

Befcre their moved to Salinas, Califomia, Mr. Hohnes was deseribed by his parents as having issues with
temper taatrums- Iilowever, such issues were resolved by the tirue he starled kindergarteu.

His family ruoved rather suddenly from Salinas back to San Diego related to his mother wanting to be liviag
closer to her family atd the qualify of the school system il tlie Salhas area. iUr. Holmes ftrished the final hvo
weels of his Sth grade school year at an elementary school ia San Diego. His parer:ts described this rnave to
have been diffieuit for him, r.vhich apparently contributed to his increasilg social isolation. It was difflc*lt for

JAI,{ESEAGAN HOL}IES
100936 812/13/1987 r
O8/O4I2OT3 RC-ARAPAIIOE
8r002 Color*do i\Iextal Eealth Institut* at Pueblo tirit _F2_
AR*.TAIIOE SA}fITY 3X.{,M OBSERY,{TION REPORT 150 (10193)
 ]Ah,{ES EAGAN HOLfuIES
C'ase Nuarber: l2CR 1522
SAIYITY EYALUATIO}{
Jet&ey L. L'{etzner, h{.D., Consultitg Psychiahist. C}vmIP
Septeurber 3" 3013
Page 4? of69

hirn to leave his ijends in Salinas and make new fiiends ir San Diego. However,Ir.{r. Hohnes sfated that he ilid
make ttew frierids in SaIr Diego but r,vas rurable to reconriect r,vitlr his former f ieods in San Diego.

Mr. Hoknes' lbmily began to nolice that he r,vas becoming intrcverled rvhen he was in lhe sixttrr geade. This
perception was corrsisteul rvith infonuatiori provided by Ml" Hohnes. This was also lhe beginaing of his
difficulties irr speaking rvith other people.

His mother lepofied that lvfr. Hokues generally prefered to play video garnes on the coupr:ter in conh'ast to
socializing wi:h Eiends. He eveutually becarue involved irr playing "free to play" utassive ruultiplayer ouline
role playiug games (MMORPG) on tbe faarily courputer. takirg up large amounts of his &ee tiure and trther
reduci*g his face-to-iace social interaction rvith others. lrk. Hr:knes was good at these games and iiked theru a
1ot because it rvas "an escape fi'orn rcality... yorr ccntrol the hero and live out hero's lifu... ." He also
comrrunicafed with other piayers onli*e via chattilg, whicir he fcurd to be a comfortable couunruricatiort
technique for hirn.

His parents deseribed their son as cahner mrd happier durilg his high school years as cornpared to his middle
scliool years. He was il agreeuert with this assessrnent, which he th*ught was due to becouing focused or his
studies. h{r. }Iolmes reported that he had 4 to 5 close f iends during his high school years.

In Salinas aad in Sa:r Diego, Mr. Hoknes played soccel'. He was on the soccer tearrr druirg his fresluuan year
aad later played soccer in recreational leagrres. He also lar cross-coturtry &ring his second yeal of higb school
but stopped due to the training involved irr tlis spor1.

Duricg his college years Mr. Holmes continued to lie irvolved il farnily outiogs althoup{r *r:rch less frequeritly
due to living in Riverside. Califomia.

His father, who is 62 years old. rvas described as beilg "euergetic, nice and kind."'He wodrs as a senior scientist
in software credit card &xud analysis. Mr. Holures described always having a good relationship with his father-

His mother, who is 57 year: o14 was described in a similar rlarltrer. She rvorks as a ourre, Mr. Hohnes also
reported a good relationship with his mother. He thouglit he was somewhal closer to his nrolher fhan his {hther,

His relatiouship with his younger sister was charzcterized by sibling rivahy although he repotls that they like
eaeh other-

JAMES EAGAN TIOIIVIES

100936 B12/13/1987 r
O8IO4I2OI3 RC-ARAPAIIOE
EPO02 Color*do Mental Ee*lth Institutt et ?ueblo Lrrit
ARAPAEOE SAXITYEXAM OBSER\.ATION RSPORT -F2_
150 (10193)
 JAl,'{ES EAGAN HOLN{ES
Case Number: l2CRl522
SA}'ITY T,ITALUATION
Jeft'ey L. l,{etzner. h'{.D.. ff onsultiag Psychiatrisl. CMHIP
Septeuber 3, ?013
Page 43 of69

Ml. Holures describe<l his parents' marriage as being excelleat, Foud meuories regarding his childhood -vears
were rcported by h{r. Holmes. Therc was not a history of phy5ig6l or sexual atruse.

F.,-Ib{I LY PSY CI{ IA TRTC H I S T O Rl'

There wss a positive fauily history of psychiairic illness. His father's fratenial sister was reported lo have
schizoplu'erria, rvhich appareltly became apparent drring her 20's. Records iudicate that Mr. Holmes' patenral
pgandfather had a psychiatr-ic history. Between 1984 aud 1990 he rvas hospitalized numerous titres at the
Couuuunity Hospital of the Monterey Penilsula lvith "d:isabling obsessive-cornpulsive disorder."

His mother's fadrer tvas hospilalized twice for ps1'cliah'ic reasons related to the preserce of a rnental disorder
associated with psl.chotic features. S;mptoms ilclrrded persecutoty delmions ald gmndiose drinkirig.

INTERPERSOilAL RELATIONSIIIP HISTORY

Mr:" Holmes repofied that he is ahvays had elose ti'iends. He had uraintained sotne contact with sevsral of his
fiieads fram his college yea$.

His fu-st etatiog experience occurred durilg his college years- He reporled being too nerYslls to date durhg higll
school.

Mr. Hohues longest relaiiotship rvas with a gn'aduate student for abouf six monfhs while attending UC*Denver.
He described this relationship as having beel eljoyable. She initiated tLe ending of the relatiausbip araund
Febnrary 2012. "She dirl not see a fliiure with me... .n' Tle endirg of relatiouship was uot utexpected trrecause
she bad been prowitg distant. Mr. Holmes reporled that they got back together for several moaths about 2 to 4
weeks later before lre elded tlre relationship.

BI}UCATIONAL }IISTORY

Mr. Holmes was reported to have been al above aver?ge student druiag his elementa:y school years with
regular attendance and lack cf behaviorai problerns at school. His pa:ents described him as having been weil
liked byteachers. Mr. Holmes stated lie got along witli his classruates duing his school yeers.

lvlr. Holmes did l.ery r,vell acadelrically at Westview High Schooi h Saa Diego, where he graduated duririg
2006withaGPA of3.TT.HisrankwasS2"dinbisclassof53l.Nodisciplinaryproblemswerereported.

JA.}TES EAGAN EOLIIIE,S

100936 812/13/1987 r
O8IO4/2013 RC-ARAP,LIIOE
EPOO2 Colorrdo $fen&l Hpalth lsstitute ct Pueblo Iinit _F2_
iRJIPAHOE SAIIITY EXrtM OBSERYATION RETORT 15$ i10/93)
 IAI\{E S EAG.{N HOLi'.IES
Case Nurnber: 12CRl522
SA\iITY EITALUATIO}I
Jetfi'ey L. I,{etz*er. h'I.D.. Consulting Psychiahist. CMHIP
Septeurlrer 3. 3013
Page 44 of69

Some of his hig& school teachers interyier.ved iry staff &om the Office of the State Ftrblic Deftnder repofied
provided tbe tbilolving infonnation (as excerpted fo'our a siullrlmry prepared of the Ot'fice of the State Put]lic
Defe*der):

h] tligh school. James worted hard to ar.oid fttterlion- He maintained good grades and did nst get inlo
trolble. Teacher who r"emember lfm state that he worked hard to al'oid al.entiott. [His cross country
coach] skted {rat he levrr talked to alyone or introduced hinaelf to anyol}e- She reporled that he
appeareri detached ald awkrvard in social settings and tlmt he was seleclively ruute. Sfue describtd him as
"near the gro*p but never in it-"

Tlre above referenced suunrily also iucluded the follorving iafonuation:

In undergraduate school at University of Califor:ria. Riverside. [Mr. Hohnes'] &llow students repofied
that he ofterr prefen'ed to keep to liirnself. He engaged ia social garheriflgs that othels in the donl
paflicipated in but ordy atler receiving nruch encoruagemelt fi'our everyone" A ftllow student desrlibed
James as haviug a "spacing out stari" more often than she could remeuber. She stated that he appeared
this way so nmch that he rvould look "sleepy." A fonnrr roonunate srated that Janres was a "loner" and
liked to go offby hiuself. He stated that Janes was usrally qtiet *nd did mt like to socinlize...

Mr. Holmes atteaded the U*versity of Cali{bmia a1 Riverside in the tall of 2006 aud enroiled in the honorc
p:sggam. lvk. Hohnes lived irr a donnitory during his {irst year aad in a four-person aparhuent during his secsrtd
and third years on carnprs" Druing his last year he lived by hiniself ia eo off-campus apartmeat" Mr. Holnies
continued to play soccer il an intramr*al leapnre"

He initialiy was going to obtah a Bacbelor of Arts deg:'ee in Ne.uroscieuce but changed his focus to Bachelor of
Science in 2009 when he begal to corrsider applyilg to ggaduate schools- He pgaduated wifh a Bachelor of
Science iu Neuroscience deglee in the spriag af ?010 rvith a cru*ulative GPA of 3,949. His GRE scares in 2009
lvere as fallor.vs: Verbal -710; Quantitative - 800: Analytical Writing - 4.0"

AJter graduating &oru UC-Riverside, ]rik'. Holmes applied to nrany top tier neuroscienee schools in 2009 bttt
was rejected by all r:f them. He ther uoved home to San Diego to live with his pareffs. Ilis family reporls that
he slept all day. watched television and failed to show urotivatiou towards anyhing until they strongly
eacoruaged him to find a job, Li speaking with me, Mr, Holmes trinimized bis lack of motivatioa and indicated
thaf he did not sleep as rnuch as was repofied by his parents, At their sirong eucourageraent he begmr to apply to
graduate schools that his pareots felt he would have an easier time gaining a&nissiou-

JA.'I{ES EACAiY HOLMES

100936 312/1311987 r
O8IO4/2S13 RC-AXAPAIIOE
8r002 Colorrdo Ment*I lle{lth Institute et ?ueblo udt_F2_
ARAPAIIOE SAXITYEXTIId OBSERVATION RE?OTT 130 (10lesi
 JAT{ES EAGAN HOLI'.,IES
C"ase Nurnber: l2ClRl 522
SAIfITY E1.'ALUATIOI{
Jeitiey L. I,{etzner. IvI.D.. Consulting Psycirialrist. CMHIP
Septenrber 3, 3013
Page 45 of59

He *pplied to tlre Universit-v of Iowa. University of lllinois Urbala-Charnpaiggr, University of Alabama

Binningharl. Kansas State Uaiversiry*. Texas A&M, and University of Colorado Denver. James rvas accepted fo
two of the schools he applied to. tlre Uliversity of lllinois and the Universiiy- of Colorado. Repafis fi"onr
cliscovery ildicate that he presented as "bizame, discorurected. ard aloof' rvith a "global lack of atfect" rvhen
iuterru'iewi:rg at the University af Iorva. His record, accordiug to professar and research psychologisi Dr. Marlt
S. Bhunberg, tvould have nade lim a "slam dunk," but based on his irtervie'iv, Dr. Bhunberg enailed lhe
adxrissiolrs tearrr to not adruit Jarues "rurder any circumstances." Otherx on the admissiotts team stated, "l autee
with fDi. Blurnberg], don't adrnit."

Mr'. Holmes was oflered adurissiou to the Univemity of Illinois at Ulbana-Ctrratrpaigu and to tlie Universitl of
Colarrdo af Denver |UCD). He accepted the adurissior olfer to the University of Colorado.

llniversity of Colorado at Denver

The neuoscierrce program at UCD started in June 2011 and lequiled him to participate il a core proup of
classes that included first year gmduate sh:dents from other disciplines- He rlras also required to rotate tluouprh 3
research labs of his cboosilg in search of a lab that mig{rt be a good fit for lrirn to wort in for the reruairiing
years of his enrollment in the prograin. A total of six students had been accepted to the neuroscience propraul
but f<n the firct year he parlicipated in lechres and small classes with all new gpaduate shtdeats from the various
disciplines.

Mr- Holnres was descr-ibed by his parents as iuitially beilg very positive about his future following his move fo
Calorado- For example. he rvas talking about eveahully living ia the Stapleton area. However. after a period of
time (i.e., atler Clrristrnas accordiug 1o b{r'. Ho}nes) he did not waat to follow his ititial plan tira: included
liidng il Stapletoa.

During Jrure 201i, L{r. Holures repcrled to his patents really liking his first gxaduate school advisor. Hot{ever,
Mr'" Hoh*es reparted to me fbeling indifferent about hiru.
Durrng Decernber 201I he rehrmed horne during Chrisknas break but was very ill. He evathmllyrvas diaprrosed
with monoaucleosis.

Mr. HoLnes reportedly performed merely satisfactorily overall in his leclure classes. His GPA for Fail of 2011
was 3.368. He did not receive grades or GPA points far three of his Sprilg2Al2 semester classes. {Mr. Hoknes
reported that "this v/as aetvs to me")- His cutrulative GPA for the school year tvas 3.413, siglificantly poore{
thaa in past academic endeavors.

,A}{ESEAGAN EOLIITES
100936 812/13/1987 F
OUO4NO13 RC.JTRAPAHOE
x?002 Cclorsdo Meatal trIe*lth Institute at Pueblo Urit _F2_
ARA?AHOE SA,N.ITY EXAM OtsSERVATION RE?ORT 150 {10193)
 }AMES EAGAN HOLiUES
CaseNu*rber: I2CRI522
SANITY EYALUATIOI{
Jetli'ey L. Metzner. I\'I - D.,
onsr.rltil g Psychi ahtst. Ch{HIP
C
September 3, 3013
Page 46 of69

The follorving srurunary was provided by tlre Oflice of the Public Defender rvith Metzner cornsrents that
srunurarize tr{r. Holmes response to rne regarding variotrs aspects of tbe sulrruary

fuIr. Hoh:es sutggled in all his research lab rotatiors. Research assislanls reported that Jam* appeared
disinterested or distractcd lrom his rvork atrd they stated that he h*d difficulty perfonnhg the processes lre
needed to pertomr for the experime*s. Assistalts described him as leaving the lab in the miridle of
experimelfs to go home. mt following tlucugh rvith experirnents, and lackirrg motivation. He did not
courplete the experiruents {lat were asrigned lo hirn by the end of his rstation ... James presenterl
infomralion and results based on literafure *om the previous ?0 ycars. rather tlun explaini:rg resrilts lrr
received ir: his experiments. Dr" Klug and his lnb nates descritred his pre:entation as "arvkw*rd"
coltaini*g jokes that fell flat on the audience and cartoorx inserted ilto the Power?oint.

*.{el:ner coiltn?enls: Mr- Hokues stated that the aboye sumrnary was not an accurate description of his
perfannance. He stated that he rvar iutercsted but prob*bly appeared disinterested related to his reserved style.
He slated that he did not leave lhe laboratory in the uriddle of experiments aud did follow throrgh rvith
experinents. He thouglit that &e discrepancy betryeen the smurnnry ald his perception of events was relatecl to
the schocl's retrospeetive assessment].

kr his serond lsb rotatioa which w*s in the lab of Mark Dell"Acqua. Ph.D" Mr. Holnrcs was reportedly
diffic*lt to engage and had had little il the way of social interaction with the research assistants. He often
only respolded to inquiries with ote-word iulswers, and that wlren they tried ro explain the processes for
conducting exprrinrents in tlle lab it appeared as if things were "sot conputing." His daneanor was
describe.d as "flat,'" "definitely socially awkward and made some people rxrcomfortable," and
"disinterested." His end of rotafionpresertation was sir*ilarly awkward with jokes lhat were "oif'or "ill-
timed" and it was explained to him a1 the erd that *re lab was not an optioo for him to join based on his
perfonnarce.

&{el?er cotttnteilt: ilrlr. Holnes iudicated the above s'mnmary was accurate-

ir.{r. Holmes struggled tutlrer in his third lab rotation, with Curt Freed, Ph,D" Dr. Frerd repofied that he
felr that Jarnes eventually uade sorl progress b$ not the progress he should have sade. Janres also was
receiving help frour Dr. Sukumar Vijayarag&avan ryho bad been assi;rred to follow Janres throupih all of
his rolations to supelise his propess and assisl him rl*en needed. h'. Vdayaraghavan stated that he
worted with Juues to elinrinate his "idiosyncrasies," referritg to his awhrard joking behaviors. Dr.
Freed indicaled thal his rotation presettation $rent fairly well.

Met:ner comril&r,t{: Mr. Hokues indicated the ab<lve srunmaly was aecur*te-

JA:lITEs E.A.GA!\i E OIJYTES

100936 B12/t3tt987 E
08/0412013 RC-ARATASOE
xP002 Colorodo lil*atal lle*lth Institut* at Pueblo Gnit _f2_
AIIAPAEOE SANilTYEXA-+T OBSTRVATIO}I REPORT 150 t10/e3)
 JAN{ES EAG,'!N HOL}v{ES
CaseNumber: l2(R1522
SANTTY EYALI?ATIO}{
Jeiliey L. h'{elzner. X,LD.. Consultirrg Psychiahist^ CMHIP
Septeurber 3, ?013
Page 47 of69

b.Ir. Holures' plelirninary oral exaux rvere a<lurinislered on Jrue 7. 2012. A panel of tlxee professors
asked Jan:es questiols a*d raied hirn on his urderrtanding of the concepls and verbal atrswer's. Jarrcr did
not pflss tlte prelimilary oral exams. Professors rcport lhat Janles rvas '"rumble to get from A to G it a
timely, organized ua:urer" in his ansrvers. They stated tltat they were concemed that he udght not have
rnore than a superficial hrowletlge sf the material or ilut he sirnply hrerv the words to use rvithout
rmcietstanding the co*cepts. They s{at€d that he performed po*rly rudfor:lly. nol on r:le parlicular portion
ol topic. Dr. Vijayarap*xvan indicated thar the professors rvho a&ninistered fhe exaur cane to him
becarxe they did not lurorv what to do as no one lmd failed the preliminary oral exarn before, Dr.
Vijayaraghavan aad the panel decided that they wonld allow James to relake the exa:t but otr tl:is
occasion they would give hirn the topics and subjects imu which they would ask quesiiotx. Dr.
Vijayaraghavan stated tha{ Jarnes 'was ro{ kicked out of the program and that dte University works vety
hald to keep irs smdents. Dr. !'ijayaraghnvan rffhred to James tlmt lle would be allorved to take an easier
version of the exam bnt on June I l. Janies indicated in an email tlat he would prefer to resipr i'om the
proptrfim. He reporred tlmt James did uot appear nxd or defen:ive rvhen lold that he ltad lot passed the
exam. His resigrration papcrwork lqas never completed as he did not gel the requistte sig$atures asked of
iriru.

This srunmarY $ras consistent with ilfanuation reiriewed in &e discovery infor:uation provided to me by tbe
0ffice af the Dishict Atlorney.

Druing his iaterviews with me, Mr- Hol:nes stated that he did riot study at all for his prelimi:rary oral
exarnitatiols. "I got &is belief that I ueeded to do it on ruy own-witbout studying-that studying was a rcsult of
alxiety... I kind of figrred that the medicated me was who I really was... so if I shrdied for the test it rvouJd
just be the fearful me doilg the lest... ." He thoup{it at the tirue that he had a 50-50 chance of passilg the test
rvithaut studyirg.

Dunng ilre prelimirrary oral exa*rination it became appare*t to him thai he would not pass arrd he was nof
surprised that he &iled. He felt morose because he had lost his caleer path. Mr. Hohres stated that his
exarniners were stoic duriug the oral exaruination process. He was iuforured by his advisor, Dr. Vijayaragliaval
about oae week later tbat he had not passed &e examiration. He was told he could retake the test sr leave the
program- "I chose to leave..- don't know why... I failed so I had to leave... ."

Mr. Hohues thought that a factor in his gocd academic history prior to paduate school lYas an rurcolscious
motive to shrdy a lct both far academic pulposes but also as a diversion to tlie distress caused by his inner
hrnioil {e.g., clroaic houricidal thinking, difficulties in courmunicathg. etc.) slmrnarized elsewbere in this
reporl. However, due to the nafiu'e of the coursewor{i in graduate school, which included public speaking, he
was not so suecessfi:l academieally which conkibuted to his increased inuer t*rmoil.

JA.}IES EAGAN EOL.UES

100936 Bt2/t3tr987 r
08/0412013 RC-.{RAPAHOE
E?002 ColoradoMeatsl Eealtb Institute st Pueblo Uoit _F2_
.A&APAI'OE SA}iTTY EXAM OBSERV,A,TIOTY REPORT 150 (10193)
 JAI{E S EAGI\N HOL:''IES
CaseNumber: IzfRl-522
SAI\ITY IVALIJATION
Jetir ey L. Metzner. I\'I.D., fionsultiag Psychiatrist. Clv{HIP
Septeurber 3. 3013
Page 48 of69

LEGAL IIISTORY

il{r. Holmes legal hisfory rvas c}raracterized by one prior speedilrg ticket-

RELIGIOUS HISTORY

${r" Holmes reporls thal he has always beerr an agnostic {i.e". "you believe wliat you rvant to believe") althougih
he rvas raised as a Plesbyterian aad Lutheran.

OCCUP.{,TIO]YAL I{ISTORY

}.1'. Hohnes' employment history cotsists of esse&tially a variety differelf srunmer jobs. Drring one suuuner in
big& school he wolked as a lgocery bagger. $urfuig fhe sunr4'Ier o12006 he rvolted as an intem at the Salk
Institrrte for Biological Shrdies as a cornputer pro€r?rnmer, Other jobs included being a ca:np cox:selor at a
school lbr underprivileged childrea, a Deat's fellow at UC Riverside il a research project involviug
hummilgbirds, and on a ftll-tinre basis at Marical. where he coated pills-

*IX}STAL STATUS EXA*TINATION

Mr. James Holmes is a 25-year-old siugle Caucasian rnan who was neatly dressed in hospital cl*lhing, *lerl and
ortented in all three spheres. Memory testiag demonstrated a capacily to recall the past tbru presidents, tpell the
word '\xorld" forward and backward, and recall tlrree out of tlxee objects after five mirrutes. His memory fur
mary of tlre evetts leadiug to the alleged cri:nes r.vas difficult to assess because he &'equently wor*d iaitially
report not lemerubering specific events br{ with repeated structure and urging frorn me, Mr- Holmes would
provide some iafonnation lelevalt to the question asked. Fcr example- when talking abcut his depression that
led io his eonceptualkiag huraan wodh, he initially was rmable to provide al approximate clronologyregarding
the oaset of the depression. By r:ry rcferencing his chat session witlr his girl&iend a:rd tle date tliat he initially
was seen by Dr. Fenton, he was able to provide an approximate cluonology to this qrtestion. Anot&er example
was his va€ruetess it answering questions specific to the circumstalces surrounding the decision to dye his hair
(e.g., wliy did you dye yorx lrair red?). His ilitial ansrxer was that he did uot know or did aot remember.

Concenkatio* lyas intenuittently, but :rot &equently, impaired duri*g the various interviervs with me. Mr,
Hobnes riescribed himself is becoming "spaced out" when he gets bored- Serial severls subfu'actions were
adequate.

JA}IES EAGAN IICIL?tgS

?00936 812/1311987 r
08104/2013 RC-A.RAPiHOE
EPOO2 Color*do Mental Ee*lth lastitutr at Pueblo Lsdt_F2_
AX.ATAIIOE SA}iITY EXAM OBSERVA,TIOIi RSPT}RT 150 {10le3)
 JAh,{ES EAGAN HOLIV{ES
Case Number: l2CRl522
SA\'ITY EYALT:ATIOI{
Jettiey L. Meizner. L,{.D.. {lonstlting Ps1'chiahist. CL.{HIP
Septenrber 3.3013
?age 49 of69

Affect rvas geuerall-v flai tlu'oughouf the inler"v"iews. N{r. Holrnes expressed very little amiet-v, conflict or regret
regardi:rg the shootings. He did surile, at tirnes. during iiis interactions with staff when not bei*g interuielved by
fire or rvhen rvatching a lturnorot:s movie-

Similari$ and prorrerb lesting demoasirated sorue concrcle ttrinking. In response to the proverb tirat "the tongue
is lhe eirerny ot'the neck," lie replied "they are two sepamte things." During the first ittervierv, he was uuable to
abstractly inlerpret the proverb 'people in glass houses should not throrv stol1es"" Holever, dru"ing the last
intewielv he was able to provide ao appropriate abstract interpretatiori. h'fr. Holrres assumed that letters sent to
bim since his arresl from many feitales not knawn by him r,vere il response to his adult frieud finder ald
lratch.cour postirgs, rvhich rvas likely au exaruple of his concrete thinking.

Yerbai behavior demanstrated &'eqreut difticulties in answering questious in a direct rtalrrer. He frequently
would ailswer questious with vagnre ar:swers. which he acklowledged was siurilar to the "rletlection" process he
described in his notebook that he had used with Drs. Fentorr and Feinstein- Spoataneity irr lris speech was
atrseat. The coutent of lris speech was sparse. Flight of ideas {i.e., a nearly continuous florv of rapid speech that
jun:ps frorn topic tn tapic, usually based on discemible associations. fistractiolls, or plays on words) was absent.
A thought disorder {i.e., disorgaaized thhking as evidenced by poverty of speech and illo,gicality} was preseot
as evidenced by his psyehotic thinki:rg re: hurnan worlh aad hansference of worlh by kiiliug others. He
coatinues to believe fhat worth can be fraasf,erred by killirg altirouglr he rec*grizes oihers do not share this
perception as he does. His perceptior results {iour his mental illness a*d is nct just a di{Ierent value systern
ulrelaled ts rnental illness.

Iv{r. Hohnes did not reeall a history of auditory liallucinatious akhougdr records &oni DHMC described him to
hal"e experieuced auditory hallucinations. He experienced visual hallucirutiorx dulhg Noveruber 2012.
Thoug}t withdrawal (the perception tliat other people can take thoughts or feelings kom oaeus mind) was
plesent drring the same period of time. Thought iusertiou (fhe perception that other people can irsert thoughts
or feelings into one's rnind) and thought broadcasting (the perception that one's tliougSts or feelings are being
broadcast on the r-adio or T$ were abselt. ThougLt withdraixal was not present durhg this exarxination.
Paraaoid &inking has been present in the past. For exanrple. he perceived ihe FBI was following him during the
time his homicidal tlilkirrg became "more realistic." Paraaoid thinking was also present dtring November
201?. I\&. Holures thonght ihst his fbod rvas being pcisoned which precipitated liim not eating as previoustry
surumarized-

Psychomotor behavior was hypoactive (i.e.. tress thaa aor:ually active). No evideuce of manic-1ike syurptoms
rvas preseut.

JAMES EAGA}i EOL}TES

r00936 Bt2/r1198? r
08/0412013 RC-AR.APAIIOE
EPOO? Color*do .ll[euf*l Ilc*lth Issfitute at Pueblo Linit_F2_
AX*{.PAI{OE SA]fNYEXAM OBSERVATION RSFORT 150 {10193)
 JAMES EAGAN HOL},{ES
Case Nrulber: I2CR1522
SAMTY EYA.LT:ATIOI{
Jetley L. lvletzner. IU.D.. Cr:nsultitg Ps1'chiatrist- CMHIP
Septeurber 3, 3013
Page -50 of 69

Istelligence was above avemge. His level of insight re: the nahrre of his illness was poor as dernonstrated by his
perceptiols re: the inpact of his acts ol otL:ers.

L{r. Hohnes appearcd to make efforts in cooperating with rue tlu'oughout the psychiatric examirratiou. He was
cordial i1 a distant sense irl his ir:teractions r,vith uie, His level of iaterest in the exarrination process ranged
fionn beiag bored to appearing tc be interested in the process.

Mr. Holmes cr:utimres to have chr"odc hornicidai thinking very similar to the houicidal thi*kiug that had been
present for mosl of his life (i.e., va€Lle uretlrod ald targets). His suicidal ttrinkrng ltas become more prondnent
with a plffl aod method (strarigrrlatioa by a sheet)- He states lliat l:eiug ou constaut observation and the pain
associated rvifh strangrrlation are barriers to ldm crnrenfly criurnitting suicide.

PSYCHOTOGICAL/NET'ROP$YCHOLOGICAL TEST RSSI"ILTS

Psychological and ueuropsychological testiog of S,k. Hohues was obtained via corxr.rltation *om B. Thomas
Gray, Ph.D. and Rose Maucttso, Pb-D" Their report included the follorving:

Results of previous (April 2013) nnuopsychological testing by Dr" Hanlon indicatsd thatMr. Holmcs
possessed "*otably advarced" intellecnral fiurctioning a:rd displayed variabiliry among coguitive domains
but generally nonrul newocopritive &uictioning overall- Results of crurenl leuropsychological testing
were largely consisteirt with the April ?0!l pq!1en4lqglflre cun'ent profile did yield evideure of subtle
neuropsychological dy:fiqqlgg for Mr, Holnres. based on his dernographic
ttofl]r $ollp. However, ir First. relative to the
sverage intlividual frour .e.. not someotls x] dnnographic group
with advanced education)" tlre large majority and are noi reflective
of aly basic impairrnent in the ability to pay attention. re ason. llse . or probleru-solve.
Second, it is impo*alt to enrphasize that il,{r'. Holmes was maintained on altipsychotic medicatistr aa tke
time of this ev*luatiot, as wsll as at the time of Dr" Hadot's evaluslior in April of 2013. It is very
possible, a*d pertaps quitc likely, &at his neuropsychological functionirig rvould be differentially worse
if lre rras experiencing active psychotic synptoms that r.vere not contnlled rryith nredicatiou.

Mr. Holmes significa:x psychological dishxtance. which is parricularly

noteworth ffig psychianic nedications for several monlhs. Most proulinenl
lu of a complex illness including marked depressive synptoilts accompanied

perlmps also sonufization. This sia:arion was frrther complicated by notable perceprml distortions
reflrciive of very poor reality testilg abilities. The possibihty of personality patlrology involviag

JAMES EAGAtri EOI-}tES

1S0936 Bt2/13fi987 r
0810412013 RC-ARAP.{gOE
E?002 Colorodo Mentol lle*lth lrstitute at Pueblo &tri, _trz_
ARAPAHOS SAilITYEXAM OtsSEKVATIO}f REPORT 1s0 (10/93i
 JAh,{ES EAGAN HOL}v{ES
Case Nuuber: I2CRl522
SA}'ITY I\TALT:ATION
Jef li'ey L. l\"{etzner. I\.'{. D.. C otsulting Psycliiatrist. CMHIP
Septeurber 3. 3013
Page 5l r:f 69

narcissisur rvas also pr'astnt-

In revierving some of his iUh{PI-2 respoilses rvith luu:. Mr- Holmes providerl infonnation that sllggested a
proggessive developneirt of psycbia{r:ic spnptours. He ildicated that he ims ahvays liad episodes dtlring
which he "zone[s] or:t sometiues." By fhe tinre he started hig]r school he had beconre quile amious and
also suspicious of others aad their motives. As an undergradtate student irost same feelings of pamnoia
colliiltued. and he also began experiencing somatic symplonrs. While in gradnate school lds anxiery
reportedly becaure increasingly problematic and be became increasfutgly depressed. He also
achiorvledged heightened paranoia druing his tiue in gaduate school. It is noiervorthy that he generally
teaded to minidze his expenetces inl,olvfug Dnrc se\rere synptorus. particularly those indicative of
psychosis.

Several possibilities eflerge diagrostically. There is goo$ evidence to indicatt tlre presence of a
depressive ilhress" and also psychotic syrnptorm" Inadequate dala are available to detenuiue wltether ilris
rvould best be categodzed as independent conditions (e.9., schizophrenia together with major depressionJ.
or a nmod disonler rvith psychotic feanres. or a schizoaffective illness. Regardless. the clfurical picture is
cou:plirated frutlrer by consideratrle auiety ard by possible person*lity patholory. Althoug& he reported
experiencing souts consequeoce$ as a result of his use of alcohol, there is insuf$cieat infonution lo
warra$t a subsfancr use <liagnosis.

Ir nrrrst be pointed out that Mr. Holtres has clearly ald con:istently repo*ed oagoiag suicidnl fhirking.
There are no known instances of overtly suicidal behavior other tharl that which rccurred h Novernlier
201? rvhile he w*s housed at ACDF. Ho*'ever. it is quite possible tlur rhoug&ts of killiag himself will
increase as the sEesses of the adjudicative process ald polential leagthy bcarceiatian accnre. It is
strolgly reconrmended that lre be routinely morlitored fur sxch ideation- and that appropriate prcvelliive
steps be talien.

Appendix fV is a copy of the complete CMHI-P psycliological aadneuropsychological evaluation repofi.

Competency to Stand Trial

Mr. Holmes demomtrated an adequate understanding of the roles of the varisus coulroom participants {e.g., his
attorneys. tlie district a6onre1r. judge. jury and wihresses). His uaderstanding of tbe eharges agaiut hini was
also adequate. He also rmderstood the nahre a:rd implicatioas of the various pleas available to him. The above
assessmeut was consistent with Mr- Holmes' assessmeut using the Evaluaticn of Competency to Stald Trial *
Revised {ECST-R) (see Apperdix IV).

JA}IES EACAN EOLI{ES

100936 312/13/198? F
O8IO4I2O13 RC-ARAPAIIOE
E?002 Colorado rYent*l E*altlt lnstitut* at Putblo L:rit _32_
^A,KLPAHOE SA.]YITYEXAM OBSERVATIONREPORT 150 (ror93)
 JAfuIES EAGAN HCILh,{ES
Case Number: 12CR1522
SANTTY EYALT?ATION
JetA'ey L. N{etzner. I'*{.D., Comulting Psychiatrist. CIvmIP
Septeuber 3,3013
Page -52 of 69

SU}.T},TARY AND OPINIO}T

h{r. Janes Halmes is a ?-5-y'ear-old silgle Caucasian rnan who rvas psychiahically evahtated in order to address
the legal issues of sadty. cornpetency to proceed. and mitigating factors, if auy. related to a ureltal disease or
defecf"

It is ver_v clear ihal bL'. Hohnes suffers frour a clxonic (i.e. persisteut) artd serious mental ilhiess associated witir
psychotic feafures (e.g., dehxiorx. hallueiuatiors ard disorde:ed tbinkirg). Synptorns of his uental illness have
included the following:

t. delusiorx (a false belief based on incorrect infereuce about extemal reality thal is fimly held despite
what almost everl*oue else believes and despite what constitutes inconh'overlible and obvious proof
or eviderce to tlie coltrary),
2. hallucinations {percepiion-like experiences with the clarity and impact of a ture perception br:t
rvithout the extenral stinulation of the relevanl seosory organ),
3. catato:ric lrchavior {rnar*.ed decrease irl reactivity to the envirorunerit) by history,
4. negatil.e slmrptorxs rvhich iaclude the follorving:
a" dirnlrished emctional expression,
b. ar,'olitioa {decrease in r:rotivated, ssltinitiated, purposefrrl activities),
c- alogia {diminished speech output).
d. anLedotia (decreased ability to experience pleasure &om positive stimnli).
e. asociality {lack of iuteresf in social interac.tions),
5. a niat*edly decrease in his level 6f frilg{isning oceun'ed (e.g., as evidenced by his failure to achieve
expected level of academic perfonnaace in graduate school).
6. deprcssive synptomatologry tlial incltrrles feelings ofwor{rlessr}sss, helplessness, aud hopelesstess.
7. manic-like slnnptoax by history.
8. obsessive-cornpuisive behaviors that include hail pulliag (trichotillornania) and numerous souatic
collcems,
9. chronic auxielr, especially whe.n arcund people a*d durirg public speakirg,
10" clunnic suicidal tbinking, and
I l. clronic homicidal tlfnkhg.

M-r".Holmes' presentation wa$ cousisterrt with the differential diagnosis of schizophrenia. schizoaffective
disorder, bipolar disorder, social anxiefy disorder. trichotitrlomania and obsessive-eompulsive disorder. In

J{"T,IES trAGAN EOLMES

100936 812/13/198? F
08104/2013 RC-ARAPiHOE
E?002 Color*do -rlde:rtal Eealth lnstitut* at Pueblo
AiAPASOE SA.IYITYEXAIII OBStrftV3,TION REPORT
 JAII{ES EAGAN HOL?vIES
Csse Nu*rber: 12CR1522
SANITY fYALtjATIOITi
Jeftiey L. Metzner, Iv{.D., Couultitg Psychialrisi. CMHIP
Septeurber 3, 3013
Page -53 of 69

adclition- lr.{r. Hohnes has recor.ered fi-our a deliriurn secondary to stanation restilting iil urefabolic
abnounalities, lvhich lvas slrccessfully treated al tlie DHMC druii:g November 20i2.

M-v exarlination also consirlered tle possibility that Mr. Hohnes was maliagering, experiencing a dissociative
disorder. and/or ruet criteria lbr a personality disolder-

Il is gry opinicn that rualingerilg has been mled out (i.e., he has not been malingering) based on consistencies
desrorxtmted in his preseatation over time as tlocumented in nltmerous records that have ak'eady been
refelenced. Psyclological testirrg was colsistent with rnalingering not being present.

h{r'. Hoirues does rrot rueel criteria for a dissociative disorder altiir:uprh he has e"xperienced depersonalizatiott
{e.g., perceptions of um'eai self. emotional muubiug).

Il is very likely that prior to the onset of his serious mental ilhess, Mr'. Hohnes r*et criteria for a schizoilpal
personalify rlisotder (premorbid). Syrnpiatx inclnded a pervasive paffern of sacial and interpersonal deficits
lrarked by acute discornforl with, and reduced capacity for. close relatiouships as rvell as by cogrritive or
perceptual distortions and eccentdcities of behavior. begi:xliBg by early adulthood that included excessive
social anxiety. odd or ecce*tric behavior and constricted affect.

l tld*k his most likely curent diagncses are as follows:

1. SchizoatTective disorder, first episode" currently in acute episode, bipolar type. with a bistory of
calatoaia
2. Trichotilloruania
3. Social Anxiety Disorder
4" Staflrs-post delirirun secondary to uretabolic problerns due to starvation.

His prognosis is very guarded altlmug& he has not yet had an adequate kial of treatmeot. He is in need of lo*g
tenn inpafient psychiatric treatment

Regardless of his specilic diagnoses. it is very clear that Mr" Holmes has experienced a chronic mental illness
associated with psychotic features. lvly *ssessruent that Mr. Hohnes has a persisfent and sericus oental illness is
based on my psychi*kic examination of hirn, which ilcluded obtaining relevant infonnatiou &our other mental
health professionals who had evaluated andlor treated hirrr fcrr clinical pu{poses (nine psychiatrists" aae
psychologist, a:rd oue ps-vchiatric social worker). discussion with uursing and secruity staff at CMHiP-P
regarding tireir constani observation and interactions rvith Mr. Hohnes drring his hospitalizatiou. my mdtiple

JAXESEA.GA}$ EOL}TES
100936 812/13/1987 F
0v0{n013 RC-ARArASOE
E?002 Color*do Meat*l Ee*lth lnstitutt at Pueblo Unit _F2_
.A,R3.P]TIIOE SAXITYEXA,M OBSERVATION REPORT 1s0 (10193)
 JAMES EAGAN HOL},{ES
Case Nulrtrer: l2CR1 522
SAIfITY EITALUATIO}q
Jet't'ey L. Metzner, M-D., Cr:nsulting Psychiatr"isi. CIvIHIP
Septeurber 3. ?013
Page 54 of69

ilteniews of him that totaled over 2-5 houls in drralion, r'evielv of coruprcheusive ps1'chological and
aeruopsl,'chological testing restlts, ald close to 100 hours revierring the exte:rsive discovery data proroiderl to
rue by boih the Offlce of the Dislrict Attomey and the Office of the Public Defender.

This case is unique in rna:ry aspects- which includes the comprehensiveress of tlre scope ol the ir:vestigations
that were per*br:ued separately and independently et the directioa of the districi attor:reys and putrlic defenders
involved iu this case and the Aurora Police Departrnent {r.vith valuab}e assista:rce frorn mauy other law
enforceurent agercies)" The notebook wriften by Mr. Hobnes during Jrure and July 2012 provided e very
urrusual opporturity 1o betler rurderstand iris state of xind during ilre time leadiug up to tbe alleged crimes. The
i:rformation resulting from the police rvorlc provided very important timeliries i* the eontext of {ilear:ns and
other relevaut pnrchases by lr{r'" Holmes in additioa to obtaining dacurnentation pel"tineut lc "cltats" and texts
involving Mr. Holmes. hrior:nation provided to me by both the district attomeys and the prfilic defenders
regarding his educatiolal Listory rvas atr*o very iufor:native.

Based on all of the above, it is ver;,* clear fo me that the h'agic and horrjble shootilg sprce drrilg July 20,201?
was a direct restlt of Mr, Hoknes'clrouicpsychotic mental ilhress. In otherwords. but for his r*eltal illless,
tlrese crimes rvould not have occrured.

However, &e issue of whether Mr. Hohnes met the criteria for legal insanity at the tiuie of the corxnission of
the alleged acts is a very dilficult assessment {br several di{Ibrent reasons" rvhich include the following:

l. dif{iculties obtailing i*fonuation &om Mr. Holmes related to some very long-standirig sJurptous of
his illness (e.g.. alogia and poor camrmxricatiou skiils), that made it di{ficult for liim to provide me
with irnportant dala abouf his state of mind duritg July 3S, 2O12,
2. his relucianee to ao$1ver certaiu questiorx irdependeut of his synrytoms described above, and
3. the tine that has elapsed since the alleged crirne.

There is no question that Mr. Hohnes at the time of the eornmission of the alleged acts was capable of
distinguishing dght *orn wrong. in the costext of legal rig}t from $no$g. with respect lo those acts- Ihe
difficdt question is whether he was ineapable of distitguishing right from wrolg as measured by a societal
staudard of morality {in contrast to a purely pers*nal and sulrjective standard of morality) due to a mental
disease or defect. ever though he was ayrare tbat the colduct in question is grirninal.

There a:e several key factors to coasider iamnkiag sueh an as$essmelrt. They hclude the followilig:

JA}IES EAGAN EOLryTES

100936 812t13t1987 r
0810412013 RC-{RAr]ISOE
E?002 Colorado Meut*l E*alth Institute at Pueblo Unit *F2_
ARAPAEOE SAHITY EXrf.vI OBSERYATION REPORT 150 {10/93)
 JAIyIES EAG.{N HOLtulES
Case Nrulber: I2CR1522
SA}itTY EYALUATION
Jetkey L. Melzuer. M.D.. Consulting Psychiahist. CMHIP
Septeurber 3.3013
Page 55 of69

1. Mr, Hohnes' chronic. no*specific ho*ricidal thinking.

2. I{r. Holmes' extleil}e social awkwardaess arid loug-standing interpers*nal relatiouship prcblems.
3. The significauce of having his first iltimate relatiousl4r and the subsequent loss of this relationship,
4. lvfu'. Hohnes' delusional belieft involving worlh and lnunan capital.
5, The content of his March ?5. 201? chat session rvith his rrow fcrrmer girlfiield. rvhich iucluded tire
reasons for not acting on his homieidal thinking.
6. hft'- Hohxes' corrse of psycliiakic treatnrent throug& the Student Health Selices at the University of
Calorado at Denver (Anscliutz Carnpus).
7. l,{r. Holnres' reported "dysphoric ulania" ilrat was associatetl with his losing his fear of
corlseqrrences for acting ori his homicidal lhinking.
8. &{r'- Hobnes' self-reported severe depression associated with riot calilg aboul potential consequences
if he acterl on his houricitlal thi"r*iap!.
9- His atrbivalence regarding his plarured actious as evidenced by his staternents to Doctors Ferton and
Feinstein regarding his eoncerrr about beir:g locked up,
10.l,{r" HoLne*' decisiol to write the notebook plior lc the alleged crimes il order to help psychiatrists
treat people like him effectively in tlre fuhue"
I1. Tlre coltents of lvk. Holmes'notebook.
12. His gradual ar/areress that pursuing knowledge fluoug*r gradnafe sehool in leurosciences wotld not
pravide him with &rlsuiers to questions that had caused him ioag-stalding intrapsychic distress.
13. Tlie academic difliculties experienced by Mr. Hohnes, which evenhrally cuhuilated in his :rot
passing {re preliminary oral examinations ard dr*ppilg out of graduate school.
14. Ttrre text rne*s*ge to IlA durirg July 9, ?012.
15. The phcne eall made by Mr. Hohnes to the student r:reatal health emergeacy hotline at 12:30 AM ori
July ?S. 2012.
16. Mr. Hokaes' actions irxnrediately follorving the shooting.
17. L&'. Hohnes' coocem whether any children had been hrut irnmediately after tiie alleged crimes.
18. ,4, significant tliscrepancy in &e history provided by lr{r- Hohnes regaldilg the alleged crir:res (i.e.
tlie historyprovided to Dr. Gur is different than the historyprovided to lne regalding the intelt of the
shoating)

It is inrportanl to noie that lv{r. Hohnes' delusior:al lrclief* abnut his wonh arid about hrnnan capital. which are
outlfued dxring the March 2012 ckat session, were es*entially unclalged dru{ng the tirre leadiag up to t}e
alleged crimes as referenced in his notebook. The narrow aud diffieuli question to a*swer is r.vbat changed that
resulted in lr{r'- Hohaes acting on ihese lrcmicidal tlroug}ts and delusional beliefs. Possitrilities iriclude the
following:

JA}IE,S EAGAN IIt)LlltE,S

100936 812i13/198? r
08/0412013 RC-.A,RApAIrOE
8r002 Colorado tritreut*l Eealt! Isstitute a{ ?urblo L:rit_F2_
ARA}AHOE SANITYEXAM OBSERYA,TION REPORT 150 (10/93i
 JAMES EAGAN HOLil,{ES
CaseNunber: l2CRI522
SA}TTY EYALLiATIO}{
JetYrey L. I,{etzrrer. h,I"D.. C.r:nsulting Psychialrist. CIVIHIP
Septeurber 3. l0l3
Page 56 of69

1. Mr. Holures alwal:s believed it rvas morally $/roilg to kill people despite his delusiolal beliefs. He
hari not acted cr these ireliets due to his l'ear of the legal consequeilces.

However, Mr'. Holmes becarue so depressecl ariei ir such psychic pain that he thougbt the legal
corsequerces of such au act could not be any lvorse than liow he was ctxrently feeling md that
cocuuitting such an act would rnnke hirn feel better as a result of increasing his worth, which would
outrveig*r the legal consequences of killiug otler people despite hrawing that such an act rvas both
mor,ally and legally wlong.

2_ Mr. Hoknes previously believed it r.vas morally lrl org ta kill people in the ccntext of his delusional
beliefs. His delusional beliefs changed ia a way that made hiur law thiuk thaf killing peopie rvas
rrorally right despite obviously knowing il rvas legally wrong.

3. Mr. Holures always believed that it rvas norally rig&t to kill others irr the conteKt of his delusiounl
beliefs liut previously did rot act or these beliefs due to his feal of the legal cansequerces.

However, ${r-. Holmes beeame so rlepressed and ia srrch psychic pain that he tha,ugfrt tire legal
corrsequerlces of such ari acl could not be arry worse th*n lrcw he rvas cuuently feelhg n:rd that
gemnriffilg such an aci would make hirn feel better as a re*ult of ilcreasir,g Lis worth. which rvolld
outweigh the legal consequences of killing other people.

Based ou ruy psychiatric exanrination rvhich included care&ll consideratioir of key factors. it is uryprcfessional
opiaioa that Mr. Holures always had the capability to untlerstand that, if he acted on his treliefs regardinghuman
worth and killing, it would be both legally and morally rwoog fo do so. Sorue exarnples r:f haviug this capacity
were demonstrated by tu{r'. Hoimes in the following circumstanees:

l. The content of his March 25,2012 chat session lvith liis now former girltier:d, which included the
reasoos for uot acting on his homicirlal thinking.
2- His arxbivalence regarding his plarured actions as evidenced by his staternenls to Doctors Fenton and
Feinstein regarding his conceni abor* beiug locked up.
3. Mr. H*lure*' decision to wrife the uoiebook prior to the aileged crjrues iu order to help p*ychiakists
keat people like him effectively il the &rhre.
4. The text rnessage to HA drxi:rg July 9. 2012.
5" The phone call lrrade by Mr. Holmes tc the siudent meotal healttr emergency hotlite at 12:30 AM ou
July20.201?.

JA.TIES EACAN EOI*}IES

100936 812/13/198? r
08/04/2013 RC-ARATAIIOE
EPOO2 Colorado Meirtal Eealth hstitute et Pueblo
3.R"{.PAIIOE SANITYEXAM OBSTRVATION REPORT
 IA${ES EAGr\N HOL]I{ES
C'ase Nuuber: I2CRl522
SAI{ITY E TALIjATIOII{
Jetfi'ey L. N,{etzuer. h.:t.D.. Consllturg Psychiatrist. CIvIHIP
Septeurber 3.3013
Page 57 of69

6. Mr, Hoknes' actions iuunediately follorving tlte sliooting.

7. L&'. Hohnes' coneeill rvhether any chiidrer hati been ltud irnmediately after the alleged crimes.

il{r. Holmes afteurpted to block, ipnore audrbr rlecrease his capaciry to lell the ditlereoce between right frout
\rfforlg rvith respect ta ilre acts iu qrestion by ciroosing victirns that he did not know and minimizing aly fbnn of
"perso[al" cor:tact with thern during the sh*oting such as hu:ring r:p the vohune of his headset prior to ihe
sliootirig. His attempts to differeutiate his "olher self" tom his "nonnal self'were likely another example of
such a process-

It is ury professional cpiniou that L&'- James Halmes rvas not so diseased or delective in mird at ihe tixre of the
commissiou of the acts as to be incapable of distinpndshing right ficm \{rol}g with respect to those acts.
It is also rny opinion that Mr- Holmes did nct suifer fiom a coldition of r*irrd caused by :nental disease or
defect that preveated him finm for:rring the culpable mentai states that are the essential elements of the cr-imes
for which ire has been charged.

It is, thercfore! my opinion that Mr" Hohles met the criteria fi:r legai sanity at tha time of &e corxmission of tlre
alleg*d acts.

It is my opinion Mr. Holmes does rot har,e a rnental disability or developmental disability that preveats him
&om having snllicient p{eseilf abiliry- to corsult r,vith the lis lawyer with a reasoaable depee of rational
understanding ia order to assist in his defense ol preverts hiur fronr hal'inpt * rationnl and factual urderstanding
of the criruinal proceedings. It is, ffrerefore, ury opinion tliat L{r'. Hohnes ureets the criteria for legal competeacy
to ploceed.

In my plo{bssional opiniol, t}ere are clear rnitigating factors that ar"e directly related to Mr. Holmes' serious
urental illless. I thitk it is very clear, but for the preseace of his urental illness associated with psycbotic
featur"es. the shootiug would noi have occured. Altbough it is rny opirriol that he does aot meet criteria for
legal insarity, it is also very clear tlmt his appreciation of tlre wrougfirlness of his actioas rver-e sigprificautly
iuryaired {fiom a clinical perspective} as a result of his psychotic thirking. His depression and psychosis was a
cause of srrbstantial druess to him, trihiclr contributed lo decision to irnplemen{ fhe pla:ured shootings.

Sincerely,*

t$s tN**
JA}IESLAGAI$ HOL}iTES
r00936 pt2/13tr987 r
O8/04/2013 RC-ARAPAIIOE
EPOO2 Colorsdo Mr:rtsl Ee*lth lnstitufe at Pueblo Ihit F2_
ARd.?AHOE SANII-YEXAM OBSERVATION REPORT 15rl {10193)
 ,AI\,{ES EAG,{N HOLIV{ES
Case Nutrber: I2CRI522
SA\ITY IY:{LLjATION
Jefti'ey L. l{etzner. I.{.D., Comultilg Pslchiatrist. CMHIP
Septeuiber 3, ?013
Page 58 of69

Jeffrey I-. Metzner. M.D.

Consultant, Colorado Mettal Health lnstihtte at Rleblo
Diplonate, Amedcan Boar:d of Psychiatry and Neruology.I*c-
*This r*porf was dirtaled ria the use of uoice softrvare. *'hich rnay explain ihe presence of any flgographical errors

ADDITIOI{AL II\'TOR}IATION
Appendix I
Appendix II
Appe*dix Itr
Appendix IV
Aftaclunert I
Attachmeut 2
Attachment 3
Atiachment 4
Atlachment 5
Attachment 6
Attachmeal T

,A}IES EAGAN EOLIIES

100936 Bl2/13/198? F
08104/2013 RC-.A,RAP"{rIOE
E?002 Colorado Mental Eealth lnstitute at ?ueblo Gnit _F2_
ARA}AIIOE S.$IITYEXAM OBSERYATIONREPORT 150 (10193)
 JAl'\{ES EAG,{N HOL}V{ES
Case Nrnlber: l2[Rl522
SA]TITY trYALTlATIO}i
Jetfre_v L. l.{etzner. I,1. D. . C onsultil g Psychialrist. CMHIP
Septeurber 3^ ?013
Page 59 of69

Appendix I

JAMESEAGA}* IIOL}TSS
100936 Bt2fi3/t987 r
0810412013 RC-A.RAP"{rrOE
E?002 Color*do Meafal Eealth Institute at Puebio Unit_F2_
ARA.PAIIOE SA}{ITYEXAM OBSERYATION REPORT 150 {10/93)
 Office of the District Attorney, 18th Judicial District
MEDIA LOG: LIST OF MEDIA DISCS FOR THIS CASE
DEFENDANT: James Holmes Case #: 12CR1522
**DISCS RECEIVED THROUGH 06107 113**

Disc # Descriotion
Discovery Scanned Discovery in case
Disc 1 of 3
(2 copies)
Discovery Scanned Discovery in case
Disc 2 of 3
(2 copies)
Discovery Scanned Discovery in case through page 45,152
Disc 3 of 3
(2 cooies)

DVDl Inter,riew w h Jason Sweenev 07120112

DVD2 Interview w h Jason Oviatt 07120112
DVD3 Interview with Jarnes Holmes 07120112
DVD4 Audio Files: Interviews with Aleiandra Cardona and David Duarte 07120112
DVD5 Interview with Mariah Coler 07122/12
DVD6 Security Video from Gander Mountain #42l,Thornton CO, 06107112 (788010-12-
0072 #000008)
DVDT Photos & Video: Disoosal Oneration 36001 E Ouincv
DVDS Bass Pro Video of Holmes 07106112 (788010-12-0072)
DVD9 AMC Hishlands Ranch Suspicious Person at Movie 07113112 time: 1158-1201
DVD1O APD Crime Lab disc:
Photos - Gateway HS witnesses, witnesses at hospital, suspect, crime scene
Audio interviews - witnesses at Gateway HS
DVDI 1 APD Crirne Lab disc:
Photos - victims/witnesses at hospital, vehicles in theater parking lot, aerial photos
ofoutside oftheater, evidence outside oftheater, evidence inside oftheater, inside
of patrol vehicles, autopsies, witnesses on scene, computer equipment in APD lab
Audio interviews - witnesses
DVD12 APD Crime Lab disc:
Photos - victims/witnesses at hospital, victim clothing, witnesses on scene,
vehicles in parking lot, evidence in theater 9 (before and after processing)
Audio interviews - CU medical staff(1). various witnesses
DVD13 APD Crime Lab disc:
Photos - victim clothing, evidence inside theater
Audio interviews - witnesses
DVD1 4 APD Crime Lab disc:
Photos - victirn clothing, victims/witnesses at hospital, witnesses on scene, aerial
photos of inside theater
Audio interviews - witnesses
DVDI 6 APD Crime Lab disc:
Photos - 1690 Paris St #5. van in oarkins lot. inside of suspect apt. CU buildine
Page I of13
Updated 612412013
Disc # Descriptiott
and lab, suspect presentation at CU 05/1 7112, vicltms/witnesses at hospital, victim
clothing, suspect vehicle,
Audio interviews - witnesses
Video- susDect oresentation at CU 05117112
DVDIT lnteruiew with James Holmes - Coban Copy
DVD18 lnterview with Officer Oviatt - Coban Copv
DVD19 Interview with Officer Sweeney - Coban Copy
DVD2O Arapahoe County jail: booking and sally port07l20l12, 05:08:35 - 05:32:00 PM
Video pulled 07125112 bv Deputy Kraus. #01 070. disc 1
DVD2l -
Arapahoe Countyjail: MCI & Hallways 07/20/12,07:30:25 I l:59:59 PM
Video pulled 07125112 by Deputy Kraus, #01070, disc 2
DYD22 Arapahoe County jail: med to bk, then bk to med 07121112, 08:08:35 - 05:32:00
PM
Video pulled 07126/12 by Depury Kraus, #01070, disc 3
DVD23 Arapahoe County jai ,: MC2 & MC4 07121112: A7:19:48PM, 1 l:29:10 PM
Video pulled 0712511 2 by Deputy Kraus, #01070, disc 4
DVD24 Arapahoe County ja l: Med Bk, Bk Med 07 /21/12: A9:23 - 09:36
Video pulled 071261 2 by Depufv Kraus, #01070. disc 5
DVD25 Arapahoe County jail: MCl 07121112: 00:00 -23:59
Video pulled 07/26/12 by Deputy Kraus, #01070, disc 6
DVD26 Alapahoe County jail: MC1, M4, M5 07122112:07:52 - 08:15
Video pulled 07127 /12 by Deputy Kraus. #01 070, disc 7
DYD27 Arapahoe County jai [: MC1, M5, Ml out, Ml in, Cl, B2 07122112: 10:30 * 12:22
Video pulled A7l2711 2 by Deputy Kraus, #01070, disc 8
DVD28 Arapahoe Countyja l: MC1, MC207122/12: 13:16-13:55
Video oulled A7D7/ 2 by Deputv Kraus. #01070. disc 9
DVD29 Arapahoe County jail: MC1 07 122112: 00:00-23'.59
Video pulled 07/27112 by Deputy Kraus, #01070, disc l0
DVD3O Arapahoe County ja l: MCl, MCz07122/12:21:41 *22:55
Video pulled 071271 2 by Depu8 Kraus, #01070, disc 1 1
DVD3 ] Arapahoe County jail: MCl07l23ll2: 00:00 -23:59
Video pulled A7Bll12 by Deputy Kraus, #01070, disc 12
DVD32 Arapahoe County jail: MCI 07 /23112: 0900: 1 0:05
Video pulled 07/31112 by Deputy Kraus, #01070, disc 13
DVD33 Arapahoe County jail: MC1, MC2 07/23112:11:11 l2:00 -
Video oulled 07131/12 by DepuW Kraus. #01070, disc 14
DVD34 Arapahoe County jail: MC1, MC2 07123112:22:07 -22:47
Video pulled 07/31/12 bv Deputv Kraus, #01070, disc 15
DVD35 Arapahoe County jail: MCl 07 124/12: 00:00 - 23:59
Video pulled 07131/12 bv Deputy Kraus, #01070, disc 16
DVD36 Arapahoe County jail: MCI to Pod 5 07/24112:09:29 - 12:28
Video pulled 07131112 by DepuU Kraus. #01070, disc 17
DVD37 Arapahoe County jail: MCl, MC2 07124112: 13:15 - 14:.12
Video pulled 07131112 by Deputy Kraus, #01 070, disc I 8
DVD38 Arapahoe County jail: MCl, MC2 07/24112'.22:07 -22:53
Video pulled 07131/12 by Deputy Kraus. #01070, disc 19
DVD39 Araoahoe Countv iail: MCI 07/25112:00:00 -23:59
Page 2 of 13
Updated 6/2412013
Disc # Descriotion
Video pulled 07R|112 by Deputy Kraus, #01070, disc 20
DVD4O Arapahoe County jail: MC1, MC2 07125112:08:00 - 09:00
Video prrlled 07131112 by Depury Kraus, #01070, disc 21
DVD41 Arapahoe County jail: MC 1, MC2 07125/12: 21:08 - 22:11
Video pulled 07131112 by Deputy Kraus, #01070, disc22
DYD42 Arapahoe County jail: MCI to Pod5 07125112 11:24 - V:A7
Video pulled 07131112 by Deputy Kraus, #01070, disc 23
DVD43 Video from mail room robot at CU
DVD44 Video from CU PD
DVD45 Video from University Hospital mail room #l (with Intellex playe )
DVD46 Video from University Hospital mail room #2
DVD47 Crime Scene Video
DVD48 REDACTED DVD15 - photos/audio from APD Crime Lab (l photo redacted)
DVD49 FBI Bomb Squad Photos: Suspect Apt
DVD5O Theater Surveillance:Too DVR 0001 to 0200.07120112
DVD51 Theater Surveillance: Top DVR 2200 to 0001 . 07i1 9 I 12 - 07 120112
DVD52 Theater Surveillance: Bottom DVR 2200 to 0001 . 07120112
DVD53 Theater Surveillance: Top DVR 0200 to 0400.07/20112
DVD54 Theater Snrveillance: Top DVR i200 to 1400,07119112
DVD55 Theater Surveillance: Too DVR 1400 to 1600.071191 2
DVD56 Theater Snrveillance: Top DVR 1600 to 1800.07119/ 2
DVDs7 Theater Surveillance: Too DVR 1 800 to 2000. 07 /191 2
DVDs8 Theater Surveillance: Top DVR 2000 to 2200.07 ll9l 2
DVD59 Theater Surveillance: Bottom DVR 2000 to 2200,071 9112
DVD6O Theater Surveillance: Bottom DVR 1800 to 2000.07/ 9112
DVD6I Theater Surveillance: Bottom DVR 1600 to 1800. 07l 9112
DVD62 Theater Surveillance: Bottom DVR 1400 to 1600, 07/ 9ll2
DVD63 Theater Surveillance: Bottom DVR 1200 to 1400.071 9112
DVD64 Theater Surveillance: Bottom DVR 0200 to 0400, 07/20112
DVD65 Theater Surveillance: Bottom DVR 0032 to 0100
DVD66 Theater Surveillance: Bottom DVR 0001 to approx 0200,07/20/12
DVD67 Disc containine APD Crime Lab Examination of defendant lPhone and Computers
DVD68 Araoahoe Countv iail: video surveillance of Defendant on 07 /261 2. disc 24
DVD69 Arapahoe CounW iail: video surveillance of Defendanton0T126l 2" disc 25
DVDTO Araoahoe Countv iail: video surveillance of Defendant on 07 126l 2. disc26
DVD71 Aranahoe Countv iail: video surveillance of Defendant on 07/26/ 2. disc 27
DYD72 Arapahoe County iail: video surveillance of Defendant on 07 /26/ 2. disc 28
DVD73 Arapahoe County iail: video surveillance of Defendant on 07127/ 2. disc29
DVD74 Araoahoe Countv iail: video surveillance of Defendanton0Tl2T/ 2. disc 30
DVD75 Araoahoe Countv ia video surveillance of Defendant on 07 /27 I 2, disc 3l
DVD76 Araoahoe Countv ia video surveillance of Defendant on07l27/ 2. disc 32
DVD77 Araoahoe County iail: video surveillance of Defendant on 0'1/28/ 2, disc 33
DVD78 Aranahoe Countv iail: video surveillance of Defendant on 07 /28/ 2. disc 34
DVD79 Araoahoe Countv iail: video surveillance of Defendant on 07 /281 2, disc 35
DVDSO Araoahoe Countv iail: video surveillance of DefendantonATl29l 2. disc 36
DVD81 Aranahoe Coun8 iail: video surveillance ofDefendant on07l29/ 2, disc37

Page 3 of13
Updated6D4l20l3
Disc # Description
DVD82 Arapahoe County iail : video surve illance of Defendant on 07 13 0 I 2. disc 38
DVD83 Araoahoe Countv iail: video surveillance of Defendant on 07 /301 2- disc 39
DVD84 Arapahoe County iail: video surveillalce of Defendant on 07 /301 2. disc 40
DVD85 Arapahoe County iail: video surveillance of Defendant on 07/301 2. disc 41
DVD86 Arapahoe County iail: video surveillance of Defendant on 071301 2. disc.42
DVD87 Arapahoe County iail: video surveillance of Defendant on 071311 2- disc 43
DVD88 Araoahoe Countv iail: video surveillanc,e of Defendant on 07 l31l 2. disc 44
DVD89 Arapahoe County iail: video surveillance of Defendanton0Tl3Tl 2. disc 45
DVD9O Arapahoe County iail: video surveillance of Defendant on 08/01/ 2, disc 46
DVD91 Arapahoe Countv iail: video surveillance of Defendant on 08/01/ 2. disc 47
DYD92 Arapahoe County iail: video surveillance of Defendant on 081021 2, disc 48
DVD93 Arapahoe County iail: video surveillance of Defendant on 08/021 2, disc 49
DVD94 Arapahoe County iail: video surveillance of Defendant on 08/021 2, disc 50
DVD95 Arapahoe County iail: video surve lance of Defendant on 081021 2, disc 51
DVD96 Arapahoe Coun8 iail: video surveillance of Defendant on 08/03/ 2, disc 52
DVD97 Araoahoe Countv iail: v deo surveillance of Defendant on A8/031 2.d sc 53
DVD98 Arapahoe Counry iail: v deo surveillance of Defendant on 08/031 2, disc 54
DVD99 Arapahoe County iail: video surve lance of Defendant on 08/041 2. disc 55
DVD1OO Araoahoe Countv iail: video surveillance of Defendant on 08/04/ 2- disc 56
DVD1O1 Arapahoe Coun8 iail: video surveillance of Defendant on 08/04/12. disc 57
DVD102 Aranahoe Countv iai video surveillance of Defendant on 08/04112. disc 58
DVD103 Arapahoe County iai video surveillance of Defendant on 08i05/12. disc 59
DVDI04 Arapahoe County iai video surveillance of Defendant on08/05/12" disc 60
DVD105 Arapahoe County iai video surveillance of Defendant on08/05112. disc 61
DVDl06 Araoahoe Countv iai video surveillance of Defendant on08106l12. disc 62
DVDl07 Arapahoe Coun8 iai video surveillance of Defendant on 08/06/ 2. disc 63
DVDI08 Arapahoe Countv iai video surveillance of Defendant on08106112. disc 64
DVDr09 Arapahoe County iai video surveillance of Defendant on A8107112. disc 65
DVDI 0 Arapahoe County iai video surveillance ofDefendant on08107/12. disc 66
DVDl I Arapahoe Countv iai video surve lance of Defendant on ABl07l12- disc 67
DVDl 2 Arapahoe County iail: video surve lance of Defendant on 08107/12. disc 68
DVDl J Arapahoe Counf iail: video surve lance of Defendant on 08/08/lZ. disc 69
DVDl 4 Araoahoe Countv iail: video surve Iance of Defendant on 08108/12. disc 70
DVDl 5 Arapahoe County iail: video surve Iance ofDefendant on A8108112. disc 7l
DVDl 6 Araoahoe Countv iail: video surve lance of Defendant on 08109112- disc72
DVDl 7 Arapahoe County jail: video surve lance of Defendant on 08109112. disc 73
DVDl 8 Arapahoe Countv iai video surveillance of Defendant on 08/09/ 2. disc 74
DVDl 9 Arapahoe Counfy iail video surveillance of Defendant on 08/09/ 2. disc 7 5
DVD120 Arapahoe Coun8 iai video surveillance ofDefendant on 08/09/ 2. disc 7 6
DVD121 Arapahoe Countv iai video surveillance of Defendant on 08/09/ 2. disc 77
DyD122 Arapahoe Counfu iai video surveillance of Defendant on 08/10/ 2. disc 78
DVDl23 Arapahoe Countv iai video surveillance of Defendant on 08/ 0t 2. disc 79
DVD124 Arapahoe County iai video surveillance ofDefendant on 08/ 0l 2. disc 80
DVDl25 Arapahoe County iai video surveillance ofDefendant on 08/ 0t 2, disc 81
DVD126 Arapahoe County iail: video surve llance ofDefendant on 08/ 0/ 2. disc 82
DYDI27 Arapahoe County iail: video surveillance ofDefendant on 08/ I 2. disc 83

Page 4 of 13
Updated6D4D0l3
Disc # Descriotiott
DVDI28 Araoahoe Countv iail: video surveillance of Defendant on 08/11/12, disc 84
DVDI29 Araoahoe Countv iail: video surveillance of Defendant on 08/11/12, disc 85
DVDl30 Araoahoe Countv iail: video surveillance of Defendant on 08/11/12, disc 86
DVD131 Araoahoe Countv iai video surve lance of Defendant on 08/12/12, disc 87
DVDl32 Aranahoe Countv iail: video sur"ve lance of Defendant on 08ll2l12, disc 88
DVD133 Arapahoe County iail: video surve lance of Defendant on 08/ 2112, disc 89
DVDl34 Aranahoe Countv iai video surve lance ofDefendant on 08/ 3/12. disc 90
DVD135 Araoahoe Countv iai video surve lance of Defendant on 08/ 4112, disc 9l
DVDI36 Arapahoe Coun8 iai video surveillance of Defendant on 08/ 4112, disc 92
DVD137 Araoahoe County iail: video surve lance of Defendant on 08/ 4112, disc 93
DVDI38 Araoahoe Countv iail: video surve lance of Defendant on 08/ 4112, disc 94
DVDI39 Araoahoe Countv iai video surve ance ofDefendant on 08/ 5/12, disc 95
DVD140 Araoahoe Countv iai video surve ance ofDefendant on 08/ 5112, dtsc 96
DVD14I Araoahoe Counfv iai video surveillance of Defendant on 081 5112. disc 97
DYD142 Arapahoe Countv iai video surveillance of Defendant on 081 5/12, disc 98
DVDl43 Araoahoe Countv iai video surveillance of Defendant on 08/ 5/12, disc 99
DVD144 Araoahoe Countv iail: video surveillance of Defendant on 08/ 6/12, disc 100
DVD145 Araoahoe Countv ia video surveillance of Defendant on 08/ 6/12. disc 1 0l
DVDl46 Araoahoe Countv ia video surve lance of Defendant on 08/ 6112, disc L02
DVD147 Arapahoe County iai video surveillance of Defendant on 08/ 6/12. disc I 03
DVD148 Aranahoe Counw iail video surveillance of Defendant on 08117/12, disc 104
DVD149 Arapahoe County iail: video surveillance of Defendanton08ll7l12, disc 105
DVD15O Araoahoe Countv ia video surveillance ofDefendant on08/77/12, disc 106
DVDI5l Araoahoe Countv ia video surveillance ofDefendant on08/77/12, disc 107
DVDI52 Aranahoe Countv ia video surveillance ofDefendant on08177/12, disc 108
DVDl53 Araoahoe Countv ia video surveillance of Defendant on08ll8l12, disc 109
DVDI54 Araoahoe Counw ia video survei lance of Defendant on 08118/12, disc I 10
DVD155 Araoahoe County iail: video surveillance of Defendant on 08/18/12, disc 111
DVD156 Araoahoe County iail: video surve lance of Defendant on 08119112, disc I 2
DVDI57 Aranahoe Countv iail: video surve lance ofDefendant on 08/19112, disc I l3
DVDI58 Araoahoe Countv iail: video surve lance of Defendant on 08/ 9112. disc 1 4
DVDI59 Araoahoe Countv iail: video surve lance of Defendant on 08120112, disc 1 5
DVD160 Arapahoe County iail: video surve llance ofDefendant on08l20ll2, disc 1 6
DVD161 Araoahoe County iail: video surveillance of Defendant on 08/20i12, disc 7
1

DVDI62 Arapahoe County iail: video surveillance of Defendant on 08121/12, disc 1 8

DVD163 Araoahoe County iail: video surveillance of Defendant on 08121112, disc 1 9
DVDI64 Araoahoe Countv iail: video surveillance of Defendant on 08121112, disc 120
DVD165 Arapahoe County iail: video surveillance of Defendant on 08l2ll12, disc 121
DVD166 Arapahoe County iail: video surveillance of Defendant on08122112, disc 122
DVD167 Araoahoe Countv iail: video surve illance of Defendant on 08122112, disc 123
DVD168 Arapahoe County iail: video surveillance of Defendant on 08122/12, disc 724
DVDl69 Arapahoe Coun8 iail: video surveillance ofDefendant on08123/12, disc 125
DVD170 Arapahoe County iail: video surveillance of Defendant on 08/23112, disc 126
DVDl7I Araoahoe Countv iail: video surveillance of Defendant on 08123/12, disc 127
DYDl-|2 FBI Photos: Theater 9 and Outside of Theater bv T. Payne
DVDl73 FBI Photos: Theater 8 bv T. Payne
Page 5 of 13
Updated 6f2412013
Disc # Descrintion
DVDl74 FBI Photos: Theater 8
DVDl75 Bomb Robot Video Disc I of 4: Aurora Aot. Sesments 1-4
DVDI76 Bomb Robot Video Disc 2 of 4: Aurora Apt. Sesments 5-12
DVDI77 Bomb Robot Video Disc 3 of 4: Aurora Apt. Segment I3
and Mailroom Segments I and2
DVD 78 Bomb Robot Video Disc 4 of 4: "Aurora Shootine for SherifP'
DVD 79 James Holmes in interview room:07/20112.total time 4:48:28
DVD 80 Records: James Holmes hotmail.com accounl
DVD 8l Interview: Tori Everhart 07124112
DVD 82 Interview: Garsi Datta with Det. Hansen & Agent Phelps, 08123112
DVD 83 ERT Photos: I 690 Paris St Apt 1 0, photos by SA Carle Schlaff (25 7 photos)
DVD 84 Ben Garcia Gmail Chat08l24l12
DVD 85 Adams County Sheriff Bomb Squad photos and video
DVD 86 Interview: Pierce O'Farrill
DVI) 87 lnterviews: Maria Carbonell. Anna Padilla- Armando Padilla
DVD 88 Arapahoe Counw iail: video surve Iance of Defendant on 08/24/12" disc 28
DVD 89 Araoahoe Countv iail: video surve lance of Defendant on 08124/12. disc 29
DVD 90 Arapahoe Coun8 iail: video surue lance of Defendant on 08124112. disc 30
DVD 91 Araoahoe Counfy iail: video surveillance of Defendant on 08125112, disc 31
DVD 92 Arapahoe County iail: video surveillance of Defendant on 081251 2, disc 32
DVD 93 Araoahoe Countv iail: video srrveillance of Defendant on 081251 2. disc 33
DVD 94 Arapahoe County iail: video surveillance of Defendant on08126l 2. disc 34
DVD 95 Arapahoe CounW iail: video surveillance of Defendant on 08126/ 2. disc 35
DVD196 Arapahoe Countv iail: video surveillance of Defendant on08126/ 2, disc 36
DVD197 Aranahoe Countv iail: video surveillance ofDefendant on08127/ 2. disc JI
DVD198 Aranahoe Countv iail: video surveillance of Defendanton0Sl2'll 2. disc 38
DVD199 Arapahoe County iail: video surveillance of Defendant on 081271 2- disc 39
DVD2OO Araoahoe Countv iail: video surveillance ofDefendant on 08/28l 2. disc 40
DVD2OI Arapahoe County iail: video surveillance of Defendant on 081281 2, disc 4t
DYD202 Arapahoe County iail: video surveillance of Defendanton0S/28/ 2, disc 42
DVD2O3 Arapahoe County iail: video surveillance of Defendanton0S/291 2, disc 143
DVD2O4 Araoahoe Countv iail: video surveillance of Defendant on A8129/ 2. disc 44
DVD2O5 Araoahoe County iail: video surveillance of Defendant on A8/291 2 disc 145
DVD2O6 Araoahoe Countv iail: video surveillance of Defendant on 08/29/ 2. disc 46
DVD2O7 Arapahoe CounW iail: video surveillance of Defendant on 08/30/ 2. disc 147
DVD2O8 Arapahoe County iail: video surveillance of Defendant on 08/30/ 2. disc 148
DVD209 Araoahoe Countv iail: video surveillance of Defendant on 08/31/ 2, disc 49
DVD2lO Araoahoe Countv iail: video surveillance of Defendant on 08/30/ 2. disc 50
DVD2 1 Coroner Photos on DVD (from Arapahoe County Coroner)
DVD2 2 Gander Mountain video and photos ftom 07101/12
DVD2 3 Copy of disc sent to Pathways Church
DVD2 4 Interview: Ben Garcia at APD
D\rD2 5 Universitv of Colorado Emails for James Holmes: Emails Pursuant to Court Order
DVD2 6 Cell phone download: Gargi Datta's I Phone
DVD2 7 Araoahoe County Sheriff Bomb Robot Camera Video
DVD218 Holmes emails released bv CU (CORA Requests) on l2l05ll2 (1 of 2)

Page 6 of 13
Updated 6/2412013
Disc # Description
DVD2I9 Holmes emails released by CU (CORA Requests) on 12/05/12 (2 of 2)
DYD22O lnterview of Ty Dickens by Denver PD Det. R. Ford
DYD221 Holmes Web History: Screen Shots, From FBi
DVD222 CU Hospital Surve lance: Ambulance Bay Fixed 1 of 3
DVD223 CU Hospital Surve lance: Ambulance Bav Fixed 2 of 3
DVD224 CU Hospital Surveillance: Ambulance Bay Fixed 3 of 3
DVD225 CU Hospital Surve lance: Ambulance Bay Entrv
DVD226 CU Hospital Surve lance: Ambulance Bay PTZ
DVD227 CU Hospital Surve lance: Aviglon Player System and Videos
DVD228 Arapahoe Countv iail: video surveillance of Defendant on 11/13/12 use of Force
DVD229 Arapahoe county iail: video strveillance of Defendant on ll/l4llz Use of Force
DVD23O Crime Scene Video from Denver Police Dept.
DVD231 Video frorn ACSo:copy of video disk, tag 63005, recording of lobot/car 07120/12
DVD232 Video from ACSO: copy of video disk, tag 63075, jail surveillance video (MCI
and hallways\ 07120112
DVD233 video from ACSO: copy of video disk, tag 63074, jail surveillance video (booking
and sally porr) 07120112
DVD234 High School Video by Holmes, Bird and Others (Inv. Eliassen)
DVD235 APD Crime Lab Disc: Assets Added AFTER 08108112
DVD236 Update Presentation with all edits as of 04/A9/B frorn APD
DVD237 Interview: Kelsee Sidebottom

BLU-RAY1 Cellphone download: Ben Garcia's IPhone

BLU.RAY2 Cell phone download REVISED: Ben Garcia's IPhone

CD1 James Holmes Second Interview. received 08108/12

CD2 Interviews with Jacqueline Bishop and Brenton Lowak 07120112
CD3 911 Calls
CD4 Interviews by Det. S. Robertson
CD5 Interview: Karl Ulrich Bayer. Univ Professor 07/25112
CD6 Interviews: Muniriah Gravelly & Jasmine Kennedy at Children's Hospital
CD7 Photos of injuries to Jasmine Kennedy at Children's Hospital
CD8 Photos: Cardona & Duarte / email" Craisslist
CD9 lnterview: Kaylyn Juranek at Gateway HS (Det. R. J. Wilson)
CDlO Photos: Juranek ln ury (2 photos)
CD1 1 Interviews: Michael White, McKayla Hicks, Amanda Hemandez, Juan Gonzales
CDI2 Photos: victims/witnesses at Gateway HS (PT2)
CD13 Interviews by Det. Steve Conner (APD)
CD14 Interview: Dr. Viiavaraghavan (Det. Hinton\ 07/20112
CD15 Interview: Hillarv Allen (Inv. Betts)
CD16 Misc. Photos and Audio through 07/22/12 (Det. Frederickson)
CD17 Photos: Iniuries to Hailee Hensky & Stephen Barton (Det. Hardin\ 07/20/12
CD18 Adult Friend Finder: Classic Jimbo Profile
CD21 ATF Disc: photos taken ofstun zun by SA Messner A7/20/12

Page 7 of13
Updated.6124120ll
Disc # Description
CD22 Interview: BPS Employee Dermis Renes 07124112
CD23 Photo: Bass Pro Shops DVR Label 07123112
CD24 Photo: Product and Label from Bass Pro Shoos 07120112
CD25 CU Officer Whitten's voicemails
CDz6 CU Suspicious Packase Dispatch Recordins
CD27 Interview: Professor Sukumer (bv S*. Wesner) 07122112
CD28 Interview: Lvm Whitten ftv Set. Wesner) 07/21/12
CD29 Interview: Lauren Ellis (Det. Perrv & Det. Wilson\ 07/22112
CD3O Misc. Photos and Audio through 08101112 (Det. Frederickson)
CD3I UPS Delivery Records
CD32 Gas Mask Photos By Galleeos
CD33 lnterview: Kimber Avra
CD34 Interview: Katie Medley
CD35 Interview: Bobbi Goldner
CD36 lnterview: Corbin Dates
CD37 Interview: Earl Bickel
CD38 Photos: EarlBickel
CD39 Interview: Victor Hava
CD4O Interyiew: Donald Lader
CD41 Interview: Professor Angie Ribera 07121112
CD42 Interuiew: Professor Curt Freed 07 121/12
CD43 Interview: Professor Mark Dell Acqua 07/22/12
CD44 FBI Photos: CU Packaee
CD45 FBI Photos and Video: Suspect Apt bv FBI Bomb Tech Goodennan
CD46 Discovery from ATF & Postal Inspector: Timeline, Reports, Color Photos,
Spreadsheet
CD47 Theater Surveillance: Top DVR 0001 to approx 0034
CD48 Theater Surveillance: Top DVR 0034 to 0130.07 /30/12
CD49 FBI Photos: From Casebook on trash dumpster 07120/12
CD5O Phone call to CU 07/20112
CD51 Century l6 Blue Prints
CD52 Fed Ex Ground Packase Svstem Inc. Records
CD53 FBi Photos: Theaters 1-4 and 10-16
CD54 FBI Casebook- Century 16 Theaters 07DA/n.84 oases
CD55 FBI Reoort: Centurv 16 Theaters 8 and 9
CD56 FBI Casebook: Century l6 Theaters A7/21112.46 pases
CD57 FBI Photos and Casebook: Paris St Apt 07121/12
CD58 lnterview: Erick Novo and Det. Prince" 07120/12
CD59 APD Property Sheets with Item Numbers (2135 items total)
CD6O Interview with Chris Russell 07/25/12
CD61 Interview with Bass Pro Emolovee Brian Penninston 07/26/12
CD62 Interview with Mariah Coler 07122112
CD63 Interview with Isaac Garcia 07/21/12
CD64 Interview with Stephanie Davies 07/20/12
CD65 Interview with Tuons Nsuyen 07120/12
CD66 Interview with Maroues Dunklin 07120112

Page I of 13
Updated 6124f2013
Disc # Description
CD67 Interview with Osmin Mercado 07/20/12
CD68 lnterview w h Isiah Bow 47120172
CD69 Interview with Alfred Herrador 07/20112
CDTO Interuiew with Brianna Dozier 07/20112
CD71 Intervieww th Joseph Soto 07120112
CD72 Interview w th Michael Lord 07120112
CD73 Interview with Reseena Cowan 07/20/12
CD74 Interview with Bridset Dovle 07127/12
CD75 Interview with Charles Patrick 07124/12
CD76 Interview with Tara Bahl07l20l12
CD77 Interviews: with Det. Wolf on 07120112
CD78 Misc photos and audio throush 08/21112: Det. Todd Frederickson
CD79 Joseph Heck: DPD Jail,07/23112
CDSO Vicki McT,ain phone messase 07/22112
CD81 Surveillance Video: Best Buy 07118/1218:36:50 - l8:37:01,
recovered bv TFO Otto
CD82 Surveillance video and stills: Target0Tll4/12, recovered by TFO W. Gallegos
CD83 CU Presentation by Suspect on05177112 converted to MPEG format by Cammie
Kennedy
CD84 Dispatch: Traff,rc stop of James Holmes in Winter Park on 07102/12 at 1410 hours
CD85 EBay Pay Pal Records 08115/12
CD86 Records : DSherlockB@smail.com. Re: 63 I 1 5 -248202
CD87 Records: ClassicJimbo@smail.com. Re: 63115-248204
CD88 AIex Espinoza09l27/12
CD89 Chemya Brown-Georqe
CD9O William Oswald
CD91 Ethan Rodrizuez
CDg2 Michael White
CD93 Jerel Sangster
CD94 CynthiaKalam
CD95 F refighter Robert Kominek Station 5
CD96 F refishter Kellv Stewart Station 8
CD97 Firefiehter Emma Lee Moore Station 8
CD98 Fire Station Engineer Mark Cottrell
CD99 Coroner F le Photos (emailed from Coroner's Office)
CDlOO Coroner F le Photo Disc I
CD1Ol Coroner F le Photos Disc II
CD102 Coroner F le Photos Disc III
CDl03 Audio lnterviews from Det.A. Reed: Caitlin Peddicord, Stefan Nikodemski,
Devon Suits. Henrv Miranda- Savanah Hookins. Jenalise Danise. Ana Garcia
CD104 Kins Soopers Info for Holmes
CDl05 Voicemail from Dorothv Price-Hill 09128112
CD106 Color Photos and Documents from Scanned Discoverv 10112/12
CD107 VideolPhotos from cell ohone of Alexander Vanacore
CD108 Audio Interview: Desira Kevs l0/10/12
CD109 91 1 - Noise Disturbance Call #1 1690 Paris Street

Page 9 of 13
Updated 612412013
Disc # Descrintion
CDllO 9l I - Noise Disturbance Call #2 1 690 Paris Street
CDl11 Phoros: I 690 Paris St #6. l0/08/l 2
CDI12 Audio nterview: Fire Capt. Robert Foos, Station 5
CDl13 Audio nterview: Firefiehter Nick Chase, Station 6
CDl14 Disc Containins Arapahoe Countv SheriffOffice Repofts
CDl15 Photos of text messases (from H. Allen's phone) between J. Holmes and H. Allen
CD116 Audio Interview: Hannah Scarborough (CU Student)
CD117 Photos by Deputy Lukens: Packase at CU Campus 07123112
CDl18 Audio Interviews: Diego Restrepo 08/28112, William Sather 08127ll2,Emir
Alvarado 0813lll2, Hillary AIlen 08/29112, and Ryan Lurnba (with photos)
48122112
CDI19 Audio Interview: Ivan Romo
CDI20 Steven Unruh on the Tom Martino Show 10116112
CD121 lnterview: Steven Unruh in Arapahoe Counry Jail10118112
CDl22 University of Colorado Emails for James Holmes: Production Log Pursuant to
Court Order
CD 23 Hillarv Allen cell phone download
CD 24 Medical Records from Univ. of Colo Hospital: Ryan Lumba
CD 25 lnterview: Garsi Datta 11129112
CD 26 9 News Story
CD 27 Photos: Fed Ex Office (Inv. Hevlin)
CD 28 Photos: Liquor Stores & Zephyr Lounge (Inv. Heylin)
CD 29 Medical Records from Univ of Colo Hospital: Ethan Rohrs
CD 30 Medical Records from Univ of Colo Hosoital: Jamie Rohrs
CD 31 Medical Records from Univ of Colo Hospital: Pierce O'Fanill
CD 32 Medical Records from Univ of Colo Hospital: Paficia Legarreta
CD JJ Medical Records from Univ of Colo Hospital: Yousef Gharbi
CD134 Medical Records frorn Univ of Colo Hospital: Farrah Soudani
CD 35 Medical Records from Un v of Colo Hospital: Dion Roseborough
CD 36 Medical Records from Un v of Colo Hospital: Jansen Young
CD 37 Voicemail messase: to Inv. Knisht from Troy Southern A1nO/B
CD 38 Medical Records from Univ. of Colo Hospital: Katie Medley
CD 39 Medical Records from Univ. of Colo. Hospital: Anssiat Mora
CD 40 Medical Records from Univ. of Colo. Hospital: Prodea Patria
CD141 Medical Records frorn Univ. of Colo. Hospital: Nickelas Gallup
CDI42 Medical Records from Univ. of Colo. Hospital: Alleen Young
CD 43 Medical Records from Univ. of Colo. Hospital: Rita Paulina
CD 44 Audio Interview: Julio Molina. 09/20112
CD 45 Properfy Sheets with Item Numbers Through X-329,01115/13
CD 46 Photos of defendant vehicle search by Borquez 08103112
CD 47 FBI Casebook in PDF Format: 1690 Paris St. Apt. 10
CD148 Holmes Witness Evidence Chart. 0112312013
CD 49 Holmes Web History Spreadsheet, from FBI
CD 50 Medical Records from Univ. of Colo. Hospital: Caleb Medley
CD 5l Photos of Farrah Soudani
CD 52 Videos of CU Hosoital Surveillance: Mps and Mp4 Formats

Page l0of13
tJpdared 612412013
Disc # Descrintiorr
CD153 Federal Exoress Video Surveillance: 07 103112
CDl54 Audio of Troy Southern and Inv. Mike Knight
CD155 Voicemail messaqe from Trov Southern to Inv. Kellv Eliassen, A1115113
CDl56 Ben Garcia interview with Inv. Heylin 01117113
CDl57 Photo ofvictims'x-rays from scanned discovery 02111113
CD158 Medical records: Lauren Ellis
CD159 License Plate Reader Data: Officer Sheldon Irons
CDl60 Voicema from Kevin Purfield 02-11-13
CDl61 Voicemails from Kevin Purfield: 02-12-13 to DA's Office, 02-25-13 to Caren
Teves
CDl62 Medical Records: Michael White Jr.
CDI63 Power Point Presentation: Chief Oates 09120112
CDl64 Power Point Presentation: Chief Oates 02106113
CD165 Power Point Presentation: Chief Oates 02116113
CDI66 Photos from Inv. Mike Hevlin 02/04113: Camp Max Straus in California
CDI67 Araoahoe Countv iail: video surveillance of Defendanl on 11111112
CDl68 Inmate Mail Spreadsheets (From APD)
CD169 Latent Print File/Repofis from Sandra Wiese (APD)
CDl7O Stills and Video: Red Lieht Violation (Holmes) on07ll0l12
CD171 Dispatch: Denver Police Dept.
CD172 91 1Call: Denver Police Deot.
CD173 Photos: from Denver Police Dept
CDl74 ACSO Photos: Patrol Car
CD175 DMV Photos of Victims (from APD)
CD176 California Photos 02D5/13
CDI17 Bruce Hubschmitt interview
CDl78 Shaan AAbaan interview
CD179 Nicholas Spiess intervrew
CDl80 Matt Christooher interview
CDl81 Maurie Scrugqs intervtew
CDI82 Tom Oliver interview
CDl83 Chett Youkel interview
CDl84 Claudia Varrios intervtew
CD185 Adoloh Belver interview
CD186 David Muldanado interview
CD187 Gabriel Menchaca interview
CD188 James Posteraro interview
CD189 James Bird interview
CDI90 Steve Armacost interview
CD191 Bruce Steel interview
CD192 Steohanie Vandierbv interview
CDl93 Bob McHeffey interview
CD194 Terri Ackernan interview
CDI95 CBI Discovery Disc, Discovery 0312013
CD196 Medical Records: David Williams
CD]97 Medical Records: Bonnie Pourciau

Pagellof13
Updated 612412013
Disc # Descriotion
CD198 Voicemail: Troy Southern 03128113
CDI99 Color Photos from Scanned Discovery 04119113
CD2OO Spreadsheet frorn APD: "VCC Lead Sheet''
CD2Ol Verizon Records 858-449-73 48
CD2O2 Disc From ATF Re: ATF Report 74 -Tear Gas Grenade website pages and video
demonstration
CD203 Color Photos Received in Discovery 04-25-13
CD2O4 Photos: FB Dallas Photo Unit
CD205 Littleton Po ice Dept Dispatch 1 of 3
CDZO6 L ttleton Po ice Deot Disoatch 2 of 3
CD2O7 L ttleton Po ice Deut Dispatch 3 of 3
CD208 Thomton Police Dent Disoatch
CD2O9 Castle Rock Police Dept Dispatch
CD2iO Boulder Police Dept Dispatch
CD2l I Glendale Police Dept Dispatch
CD212 Enelewood Police Dept Dispatch
CD2I3 Parker Police Dept Dispatch
CDzI4 FBI - color photos of Citv of Aurora Employees
CD215 Westminster phone/radio for Aurora Theater Shooting
CD216 Jefferson Countv Disoatch
CD217 Colorado State Patrol Dispatch
CD2I8 Arvada Police Department Disoatch
CD2I9 Phone interview: Anthony Cooper (lnv. Eliassen)
CD22O lnterviews 1 of 2: University of Illinois (Inv. Eliassen)
CD221 Interviews 2 of 2: Universitv of Illinois Onv. Eliassen)
CD222 Photos: University of Illinois (Inv. Elissen)
CD223 Broomfield Police Dept Dispatch
CD224 Aurora Dept of Public Safety Communications Disc 1 of 8 Received 06i05/13
CD225 Aurora Deot of Public Safetv Communications Disc 2 of 8 Received 06/05/13
CD226 Aurora Dept of Public Safety Communications Disc 3 of 8 Received 06/05/13
CD227 Aurora Dept of Public Safety Communications Disc 4 of 8 Received 06/05/13
CD228 Aurora Dept of Public SafeW Communications Disc 5 of 8 Received 06/05/13
CD229 Aurora Dept of Public Safety Communications Disc 6 of 8 Received 06/05/13
CD23O Aurora Deot of Public Safetv Communications Disc 7 of 8 Received 06/05/13
CD23I Aurora Dept of Public Safety Communications Disc 8 of 8 Received 06/05/13
CD232 CIAC Videos obtained by media sources
CD233 CIAC-IVCC Disc: Law Enforcement Online Virtual Command Center Disc:
Aurora Mall Shootins (CIAC) 07120/12 - 12107112
CD234 Uodate Presentation with all edits as of 05121/13 fiom APD

** The following Discs have NOT been provided because the original discs were
refurned to the Court. These discs are no longer in possession of the Office Of
The District Afforney: DVDI5, CD19, CD20.
Page 12 of13
Updated 612412013
The Above-Referenced Discs Hand-Delivered to a representative of the
Colorado Mental Health Institute on :

Representative Name and Title (Printed):

Signature:

Date:

I dentification Veri fi ed :

Investigator name:

Signature:

Date:

Re: People v. Holmes, 12CR1522

Page l3 of13
Updated 612412A13
 JAN,{ES EAGAN HOLI,{ES
Clase Nuruber: I 2fRl 522
SAMTY EYALL:ATIOIT
JetA'ey L. lr'{etzler. i\,'I.D. . {i onsultin g Psychiatr-ist. CMHIP
Septeurber 3.3013
Page 60 of69

Appendix II

JA}IES EAGAN EOL}IES

:00936 812/1311987 F
O8I$4/201] RC.A.RAPAIIOE
Er002 Color*do Ment*l E"*lth lnstitute et Puello Ltnit _F2_
ARAPAI{OE SAIEITYEXAM OBSERVATION RSPORT 150 (10193)
 JAMES HOLMES I2CR-I522
DISCOVERY INDEX OF DOCUMENTS (PARTIAL LIST)

Paee No. Description of Documents

1-7 Warrantless Arrest Warrant (unsigned by Judge) and Warrantless Arrest
Affidavit: sisned by Det. Appel and Sst. Fyles 07120112
8-1 303 Reports from first responders and written statements for victims
1655-1689 FBI Report: Interview with Gargi Datta
r Interview in India with FBI Agent Rachel Ptfer,07126112
. Includes report on interview, instant messages of conversations between
Datta/Holmes, and FBI questionnaire completed by Datta regarding her
observations on Holmes
2807-301 I Additional reports from first responders (officers)
2909-29r5 APD Report: Det. Joseph Betts
. Follow-up interviews with various people including Hillary Allen
607s-6078 APD Report: Det. Craig Appel
o Interview with suspect Holmes at APD with FBI Agent Garrett
Gumbinner,07l20ll2 (audio recorded); start of interview 3:45 p.m., end
of interview 4:22 p.m,
7237 ATF Timeline: Holmes Acquisition of Firearms, Ammunition, Accessories and
Explosives or lncendiary Parts
7238-7239 ATF Timeline - written format: Holmes Acquisition of Firearms, Ammunition,
Accessories and Exolosive or Incendiarv Parts
t3219-13221 APD Report: Det Appel
r Interview with Hillarv Allen with Det. Todd Fredericksonon03/29/12
t3230-13243 APD Report: Det. Charles Mehl
r assisted in attempted interview of suspect Holmes
o interviewed Officer Jason Sweenev and Jason Oviatt
1655-1689 FBI Report: Interview with Gargi Datta
o Interview in India with FBI Agent Rachel Pifer,07126112
. Includes report on interview, instant messages of conversations between
Datta./Holmes, and FBI questionnaire completed by Datta regarding her
obsenrations on Holmes
t7723 FBI Report: Interview with Ben Garcia
o Interview at APD with FBI Asent James Colyer, 08l23lTz
17724 FBI Report: Interview with Ben Garcia
o Interview at Denver FBI Officer with FBI Agent James Colyer, 08124112
. Email chats (Gmail account) provided to FBI from Garcia on this date;
additional consent to search IPhone 45 - attempt to locate message on
the phone but could not be completed (no way to download info from
this type of phone)
24360-24362 RMRCFL Report: Findings from phone of Ben Garcia
. Report date09l13ll2
o RMRCFL Examiner: FE Eric Black
26488-26s43 APD Report.: Det. Appel
 a Investigation on case; spoke with Jason Sweeney and Jason Oviatt about
arrest, behavior and statements from Holmes, observed evidence inside
and outside of theater 9
29391-29394 FBI Report: SA Garrett Gumbinner and Miles Gooderham
o assisted in investigating suspect vehicle at scene at theater; assisted in
render-safe procedures and with bomb robot in defendant apt
o assisted in interview of defendant at APD regarding explosives in his apt
29395-29399 APD Report: Det. Appel
o Interview with Ben Garcia with FBI Asent Colyer at. APD, 08121112
30906-30913 ATF Chart printed from CD148: Timeline in Excel Spreadsheet format
32333-32358 Transcript of Interview: James Holmes, Garrett Gurnbinner and Craig Appel

Disc # Descrintiort
DVDl Interview with Jason Sweenev 07/20112
DVD2 Interview with Jason Oviatt 07120112
DVD3 lnterview with James Holmes 07120112 (video in black and white)
DVDlO APD Crime Lab disc:
Photos - Gateway HS witnesses, witnesses at hospital, suspect at time of arest,
crime scene
Audio interviews - witnesses at Gateway HS
DVD16 APD Crime Lab disc:
Photos - 1690 Paris St #5, van in parking lot, inside of suspect apt, CU building
and lab, suspect presentation video and photos at CU O5ll7l12, victims/witnesses
at hospital, victim clothing, suspect vehicle,
Audio interviews - witnesses
Video- susoect oresentation at CU 05ll7ll2
DVD17 Interview with James Holmes - Coban Copy (video in color)
DVD18 lnterview with Officer Oviatt - Coban Copy
DVD19 Interview with Officer Sweeney - Coban Copy
DVD2O Arapahoe County jail: booking and sally portl7l20ll2, 05:08:35 - 05:32:00 PM
Video pulled 07125112 by Deputy Kraus, #01070, disc 1
DVD21 Arapahoe County jail: MCl & Hallways 07120112,0730:25 - 11:59:59 PM
Video pulled 07125112 bv Deputy Kraus, #01070, disc 2
DVD47 Crime Scene Video
DVD5l Theater Surveillance: Top DVR 2200 to 0001, 07ll9ll2-07120112
DVD52 Theater Surveillance: Bottom DVR 2200 to 0001, 07120112
DVD67 Disc containine APD Crime Lab Examination of defendant IPhone and Computers
DVD179 James Holmes in interview room: 07120112. total time 4:48:28
DVD182 Interview: Garei Datta with Det. Hansen & Asent Phelps, 08123112
DVD183 ERT Photos: 1690 Paris St Apt 10, photos bv SA Carle Schlaff (257 photos)
DVD184 Ben Garcia Gmail Chat08l24/12
DVD214 Interview: Ben Garcia at APD
DVD216 Cell phone download: Garsi Datta's I Phone
DYD228 Araoahoe Countv iail: video surveillance of Defendanton lllL3l12 Use of Force
Disc # Description
DYD229 Arapahoe County iail: video surveillance of Defendant on 1l/14/12 Use of Force
DVD23O Crime Scene Video from Denver Police Dept.
DYD232 Video from ACSO: copy of video disk, tag 63075,jail surveillance video (MCI
and hallwavs\ 07120112
DVD233 Video from ACSO: copy of video disk, tag 63074,jail surveillance video (booking
and sally porL) 07120112
DVD235 APD Crime Lab Disc: Assets Added AFTER 08/08/12; photos of suspect at time
of obtainins non-testimonial evidence

BLU-RAY1 Cell phone download: Ben Garc a's IPhone

BLU-RAY2 Cell phone download REVISED: Ben Garcia's IPhone

CD1 James Holmes Second lnterview, received 08/08/12

CD3 911 Calls
CD15 Interview: Hillary Allen (Inv. Betts)
CD44 FBI Photos: CU Packase
CD45 FBI Photos and Video: Suspect Apt by FBI Bomb Tech Gooderman
CD46 Discovery from ATF & Postal lnspector: Timeline, Reports, Color Photos,
Spreadsheet
CD48 Theater Surveillance: Top DVR 0034 to 0130,07130112
CD5O Phone call to CV A7/2Al12
CD83 CU Presentation by Suspect on05/17ll2 converted to MPEG format by Cammie
Kennedy
CDI15 Photos of text messages (from H. Allen's phone) between J. Holmes and H. Ailen
CD118 Audio lnterviews: Diego Restrepo 08128112, William Sather 08127ll2,Emit
Alvarado 08/31/12, Hillary Allen 08/29 t12, and Ryan Lumba (with photos)
08t22112
CD123 Hillarv Allen cell phone download
CD125 Interview: Garei Datta tllzgl12
CD146 Photos of defendant vehicle search by Borquez 08103112
CD156 Ben Garcia interview with Inv. Hevlin 01l17ll3
 Jfu,A{ES EAGAN HOLil,{ES
Case Nuuber: l2f,lRl522
SANITY EI/ALT:ATIOI\i
Jettiey L. h{etzner. IU.D.. Consultitg Psychiatrist. Ch'{HIP
Septeutber 3. 3013
Page 6l of69
Appendix trI

JAMES EAGAIf EOLMES

1s0936 312/131198? r
081$412013 RC-ARA}AS0E
E?002 Colorsdo MentelEealth Ilstitu(e at Paeblo Erit _F2_
ARA.PAIIOE SA}{IT'Y EXAM OBSETVATION REPORT 150 {10/93)
 {ppendix III
The Notebook

This appendix contains transcriptions of excerpt from the notebook written by Mr. Holmes.

Note: Sentences in brackets are not in the notebook but are tlased on information provided by Mr.
Holmes during my psychiatric examination of him re: various portions of the notebook

Page ?

The Questions

What is the meaning of Life?

What is the meaning of death?

Symbol: 01 infinity

Metzner comment: Mr. Holmes named this symbol "ultraception," which represented "an alternate
concept or idea... ." He stated he did not remember much about his thinking around the symbol at the
time although he was trying to find a purpose to life or reason to live.

Page

To Goober, Chrissy, Bobbo Love yuhs

Metzner comment: Goober is a term of endearment he has used since young adulthood to reference his
mother. He wrote the above to "say I love them in case I died."

Page 27

Insights into the Mind of Madness!

What is equal equal to?

*All men are created equal.

All men are uncreated equal

[Stick figures] no affiliation [with the #1 under each figure]

Equal:l
I (Distinct measurable value) death

[Stick figures] no affrliation [with the #0 under each figure]

=?
I or ll or-9
Regardless, value ofmurder [does not equal] to the dead. Equal [is not equal] I
[A stick figure] [2 series of l0 0s in quotes]
Equal:00
00 (priceless/unlimited value) good

Another series of zeros in quotes

:?

00 or 0 or-00 Murder value may be : to dead. Equal may : priceless*similar reasoning, Equal : 00
(unequal value evil) may be possible
Equal :0 (valueless No value no difference from death)
:0

Two other sets of zeros. Murder value cefiainly : to dead. Equal by definition no value

Metzner comment: The" no affiliation" reference indicates that none of the people have an1'thing to do
with each other. The above writing was done in order to "get to the wofth of a person's value. . . 1 means
[they are] wofih something+hey have a value. 0 means they are dead and have no value.

:?
1 or 1l or-9
meant that you could add to a person's value or not. Add the 10 people who died to your value or if a
negative perception subtract from your value.

"A person's self-worth can change with murder-can increase or decrease or stay the same."

Mr. Holmes indicated that this page was dealing with an explanation of self-worth-"when you're
depressed you do not feel valuable."

At the present time and at the time of the shooting he was aware that murdering people meant
"intentionally killing somebody."

Page 28

Equal:0Novalue
Equal may = 00 ultimate good
Equal may:-00 ultimate evil

Can a person have both no value AND be ultimately good AND/OR ultimately evil?
in value *unknown

What does the value of a person even matter?

*Justice

People are ultimately good or evil in value, then one may suffer from injustice.

If life has no value:

-All is just
 -Life-and death are not demarcated.
-Any and all actions have no impact on anything

Moral imbeciles are those who side with 0 or -infinity [worthlessness or evil]. The ideals of society are
founded on +infinity [priceless or ultimate good].

Page 29

Why do persons commit to 0 or -infinity?

All men are created equal, and all men are uncreated equal but in between there is inequality.

My mind: e-----------------------)
-00 0 +00

Life's fallback solution to all problems-Death

Multiplying both sides of the equation by 0.

When mankind can't find truth, untruth is converted to truth the of violence (x0)
problem:? 0x problem : (?) x0
xbased on incorrect theorem 0:0 problem: solved 0--0

Violence is a false response to truth while giving the illusion of truth. This is widely understood with
murder being unjust. However, mankind has found a better alternative & there is still mass violence, war,
and unfofiunately these forms of violence are misleadingly still justified.

I have spent my entire life seeing this alternative so that the question of how to live and what to live for
may be addressed.

Metzner comment: This page conveys that violence can be used to solve problems-all problems. Mr.
Holmes also explained that persons commit to being worthless or evil because "all men are created equal
and all men are uncreated equal but in between there is inequality." The checkmark over the zero conveys
the above.

Page 30

Altematives to death.

1. Ignore the problem.

If the problem or question doesn't exist then the solution is irrelevant. work. Forms of
expression tried included reading, television and alcohol.

2. Delay the problem. Live in the moment without concern for answering the problem at present.
Didn't work. Pursuit knowledge to increase the capacity for answering the question with
improved cognitive function.

3. Pawn the problem. If one can answer the question themselves, get someone else to answer
Didn't work. Everyone else didn't know the solution either.

4. Love. Hate. Despite knowing death is false and suboptimal response, find a working
alternative. If all of Life is dead, then the questions-
 Why should life exist?
What is the purpose of living?
Are then 0, irelevant.

Metzner comment: Mr. Holmes reported that ignoring the problem did not work based on many years of
trying to do so. Delaying the problem was also unsuccessful. His interest in neuroscience, which initially
developed during his high school years, was in parl based on his perception since middle school that he
was different from other people. Specifically, he felt different in social aspects (e.g., "initiating
conversation [has always been] difficult to do) and due to his chronic homicidal thinking. He was hoping
that learning about neuroscience would help him to improve himself both in the context of his
communication skills and learning in general.

He subsequently was admitted to the University of Califomia at Riverside on a full scholarship, where he
was in the honors program. He excelled academically, enjoyed school, but stated that his studies did not
help him at that time to improve himself.

Mr. Holmes subsequently applied to top tier graduate school where he wanted to pursue a Ph.D. in
neurosciences. However, was only interviewed at one school, UC Iruine, which did not go well related to
his difficulty connecting with any of the staff.

Mr. Holmes returned to live with his parents following graduation and after about six months he obtained
a job as a pill coater for Marical in Vista California, where he remained employed for three months. He
subsequently reapplied to middle tier graduate schools and stopped working in order to interview at about
five graduate schools. Mr. Holmes was eventually accepted at the University of Illinois at Urbana and the
University of Colorado at Denver. He chose the latter school due to being offered more financial aid than
what was offered at University of lllinois. He indicated that the other interviews did not go very well.

Itbecame apparent to him during his third rotation around Aprll 2012 that the knowledge gained in
graduate school would not help him improve his communication skills or decrease his chronic homicidal
thinking.

If everyone is dead, there's no need to answer the question of what is the meaning of life.

Page 3 I

Self Diagnosis of Broken Mind

Note: bracketed timeline inforrnation was not in the notebook but obtained from Mr. Holmes during my
psychiatric examination of him

a Dysphoric mania [post-sertraline]

a Generalized anxiety disorder/social anxiety disorder/OCDIPTSD (chronic) flifetime]
a Asperger's syndrome/Autism [childhood]
a ADHD [childhood]
a Schizophrenia [post-sertraline]
a Body dysmorphic disorder [childhood]
a Borderline, narcissistic, anxious, avoidant and excessive compliant personality disorder
Ichildhood]
a Chronic insomnia [young adult]
a Psychosis [post-sertraline]
 a Trichoti ll omania [teenager]
a Adjustment disorder fchildhood]
a Pain disorder [young adult]
a Reslless leg syndrome [young adultl

Page 3 I

Symptoms attributed to Self Diagnosis

o Catatonia. Developed recently, often lasts for 3-5 hours in the middle of the day. If present in
moming and I know it isn't particularly bad, can goad myself to move by thinking "Bambi get up,
you must get up." [June 2012]
. Excessive fatigue. Present since beginning undergraduate studies. Can move but typically "need"
to lie down for I hour.
o lsolationism. Removing myself from social settings. Being around others is tiring with no
apparent reason. Perhapsjust an extreme form ofintroversion.
Avoid social interactions. 99o/o of the time will not initiate a conversation. If discourse rs
unavoidable or avoidant action socially unacceptable responses will be short or in question fotm
to have other person be the one talking.
Brief periods of invincibility, actions are in hyperspeed. Developed in last three months, occurs
typically three or four days a week lasting all day with possible interludes of catatonia.[May-July
20r21
a Tiredness most of time for about an hour, onset unklown.
a Quick fleeting moments in peripheral vision. Kind of like a light flicker. Other times dark spotchy
movement in peripheral vision like a crow or beetle. Occurrence rate usually 1 to 3 times per
daylnight. Onset unknown but > 1 year ago. When gaze is shifted to identi$r movement no
source, or potential source for its cause present.
Proclivity to scan environment with no target or object in mind. Typically occurs alongside
apathy in a boring situation when someone is giving a presentation or otherwise rambling about
the frivolous information. Rate-often. Onset-child
Recurring return to mirror to look at appearance. Particular attention focused on hairstyling. 10+
times a day. Onset >l year ago.
Concem with teeth. Only chewed with less side ofjaw to preserve right side of teeth. Occurred as
a child, not present after getting braces.
Concern with nose. Often trippy, a leaky faucet requiring continuous wiping. When nose
interferes with quality of living, [pores] are squished to the point of skin peeling. Occur
situationally since child.
a Concerned with ears. Can not hear very well. [child]
a Concern with eyes. Imperfect biology, had to wear glasses. [Occulus] sinister is dominant eye.
a Concemed with cock. Suffered accidents as child. Allergic reaction to soap-scaring. Excessive
stimulation in response to "most beautiful woman in world" I had read in a book. Other event-a
slab of skin tore away, did not heal. Results of accidents not prevalent to absent in appearance
when erect.fteen][small]
Inability to communicate what I want to say though I can understand it. Typically have an image
in my mind but can't say images or draw them, would be nice if there was some forrn of telepathy
to transfer the image.
Difficulty in concentrating or focusing on anything longer than 15 minutes. Created a learning
strategy of studying 15 minutes then watching TV and repeat. Very effective but only in
i solation. [May -luly 20 12]
 Odd sense of self. View myself as divided. There's a biological one, which is drawn by biological
needs. e.g. hunger drives are to go eat, thirst... to drink etc. The real me is fighting the biological
rne. The real me, namely thinking me does things not because I'm programmed to, but because I
cl'roose to. The latest battle I lost was when I finally succumbed to following in love. Evolution.
the biological program's [coder] is very difficult to fight. Can't fall asleep when I want to fall
asleep. Sometimes my legs and arms will twitch involuntarily -1 per month. Much more common
is having to adjust sleeping position-10+ times a night because of physical
Ich i I dh ood]
d i scomforl.
a Random, no apparent cause stepping back pain. More typical is throbbing achy lower back pain.
a Hair pulling. First was back of head at "bald spot" -10'h grade, when someone mentioned it was
going bald. I switched location. SidebumsJate high school. Widows peak early college. Under
chin and jaw late college. Most recently eyebrows and eyelashes.
This obsession to kill. Since I was a kid. With age became more and more realistic. Stafted as the
entire world with nuclear bombs. Then shifted to the biological agent that destroys the mind.
Most recently serial murder via a cell phone stun gun & folding knife in national forests. And
finally, the last escape, mass murder at the movies. First obsession onset >10 years ago. So
anyways, that's my mind. It is broken. I tried to fix it. I made it my sole conviction but using
something that's broken to fix itself proved insurmountable. Neurosciences seem like the way to
go but it didn't pan out. In order to rehabilitate the broken mind my soul must be eviscerated. I
could not sacrifice my soul to have a "normal" mind. Despite my biological shortcomings I have
fought and fought. Always defending against pre-determination and the fallibility of man. There
is one more battle to fight with life. To face death, embrace a long-standing hatred of mankind
and overcome all fear certain death.
O* I [ultraception] [the killing thoughts]

Page 37

Crazy Concepts

Futilitv
The mind is a prison of uncertainty. Trillions of cells guarded for eternity. O' where arl thou master key?
Destroy the mind and be free.

Homo Sapiens
Mythical biblical Garden of Eden-consumed fruit of knowledge-cast out of Utopia

Myhical Greek Prometheus steals fire from God's-gives knowledge of fire demand-etemal torfure,
Eagle eating liver

Nothing

Easil-'r recognized but can it be understood? As soon as nothing is described nothing contains features of
something. Even the very symbolic encapsulation of the word nothing is a description many people may
view it as black or darkness but these are things in of themselves. Nothing

Comments: sometimes knowledge is not very beneficial.

Page 38

The Blind
cheap closure eyes, leave them close. Open them. The sightful know when their eyes are open. The
insightful know not whether they see with their eyes open or closed.

Melzner commenl: you cannot always trust your senses

The Number Line

Weak average stronq

The weak are most likely to perish in trying times. Likewise, the strong most likely to overcome.

Why do the average and strong suppoft the weak?

This is easily answered. In trying times the weak will fall. They act as a buffer. Furthermore, when the
weak died, the average and strong become weaker.

[Diagram follows]

Survival fitness is fixed when compared to Man v Nature. But man versus man is relative.

Metzner comment: number line is about why people support the misfortunate and unfortunate. When
disasters strike the weak people die, which impacts the remaining stronger people who become weaker as
a result.

Not relevant to treatment, just things I thought of.

Page 39

Everythins
Everything suffers the same paradoxical quandaries as nothing

The Ripple/Butterfly Effect & Unity

Reference to the butterfly flapping its wings and causing a tornado halfway around the world.

Space and time are inextricably linked. Go ahead and attempt to visualize or understand time without
some sort of matter depiction attached. Similarly space is nonexistent without time. Imagine space.
You've probably imagined a snapshot, a single time point of physical objects.

Every being is a unique particle set of spacetime. Between or filler amongst beings established continuity
of the universe. Any action or lack of action ripples throughout the entire universe at a given spacetime.
In one's own selfish nature, we choose to view ourselves as distinct or separate from the universe. A
single universe ourself, per se. This is incorrect. We are all one, unity. As such, there is no difference
between life and death or spacetime. All things, actions and phenomena are not multiple ripples. Instead
the universe is a single unitary preponderance of which we are each a part of. This may be unfathomable
to some and result in the seeking of escapism and attempt at reductionism of unity into fractured entities.
To me, this unity is infinitely complex. Much more preferable is a single system. Unity through nil.

Metzner comment: still concepts that "I thought were interesting. Everything is a paradox because inside
everything is nothing."
Pages 40-47

Why? Why'? Why? Why? Why?

Why? Why? Why? Why? Why?
Why? Why? Why? Why? Why?
Why? Why? Why? Why? Why?
Why? Why? Why? Why? Why?
Why? Why? Why? Why? Why?
Why? Why? Why? Why? Why?
Why? Why? Why? Why? Why?
Why? Why? Why? Why? Why?
Why? Why? Why? Why? Why?
Why? Why? Why? Why? Why?

Metzner comment: either June or July. "Why should I live? Why does anybody need to live? You can
essentially ask why to any question."

Page 48

Metzner comment: late May. Cased the place in June & July. Cinemark near me, isolated and large.

His plan had now become "realistic" and he had decided he was going to kill people although he was
only 75oh sure that he was going to do it. He was planning to do a mass murder versus is a single murder
because-"back to all those [self-]worth calculations [we discussed] in the beginning. I wanted to get
better-beyond the depression."

When asked why he killed people, Mr. Holmes replied that he does not have an answer. When asked a
variety ofdifferent structured questions and scenarios, he stated that he thought by killing many people he
had a 50-50 chance that it would work and make him not feel worthless and feel better. Mr. Holmes was
clear that he knew such actions were against the law'but he thought at the time that it was "okay to do it...
that's why I did it... thought I'd get arrested or die... that is what happens to people who kill people... I
didn't think of prison as a consequence... because I was so depressed that nothing mattered... ."

Mr. Holmes stated that he would now not kill people for similar reasons because "it doesn't work." If
killing a person or persons would make him feel better and not worthless, he stated he would again do so
and would think that it was okay to do even though he knew it was legally wrong. He had difficulty
explaining why he thought such actions would not be wrong from his perspective. However, he did state
that "nobody has a purpose or meaning-why does it matter if they die then?"

Mr. Holmes currently feels sad that he killed people because he took away their choice whether to live or
die because "I would want that kind of choice." He feels bored because "there's nothing to do that is
worthwhile and meaningful." He reported feeling very depressed (10/10 on a scale of 0 to 10 with l0
being the worst depression) prior to beginning to plan for the mass murder. His depression lessened to a
5/10 during the planning process. Mr. Holmes states that his depression is again at an 8/10 level.

Having chronic suicidal thinking that preceded his chronic homicidal thinking was described by Mr.
Holmes. "I usually transferred these [suicidal]'s thoughts into the homicidal thinking... ." He described
one suicide attempt around the age of l0 by cutting his wrists, which he indicated was a cry for help. He
denied any other suicidal attempts. He reported that jumping off his bed in the jail during November 2012
was not a suicide attempt but in response to visual hallucinations.
He has thought of a variety of ways killing hirnself that have included strangulation, overdose and
jumping in front of the car. He thinks he would attempt to kill himself if given the opportunity. He stated
he has not tried to kill himself in the past due to his fear of the involved pain.

Mr. Holmes stated he was not concemed about the death penalty because "there is no reason to live."

Page 52-53

Summarizes aspects of prior mental health treatment.

Immediately prescribed antidepressants (fast acting-benzos, long-acting SSRls-sertraline). Seftraline

primarily antidepressant not anxiolytic.

Anxiety and depression both serotonergic systeln anyway though. No effect when needed. First
appearance of mania occurs, not good mania. Anxiety and fear disappears. No more fear, no more fear of
failure. Fear of failure drove determination to improve, better and succeed in life. No fear of
consequences. Primary drove reversion to hatred of mankind. Intense aversion of people, cause unknown.
Began long ago, suppressed by greater fear of others. No more fear, hatred unchecked. Start small. Buy
stun gun and folding knife. Research firearms laws and mental illness. Buy handguns. Committed-
Shotgun, AR-15, and handgun. Wildcard: explosives. Simplest and least suspicious: gasoline and oil.
Acquire remote detonation system and body arrnor, practicing shooting at Byers Canyon rifle range. Can't
tell the mind rapist's [the psychiatrist] plan. If plan is disclosed both "normal" life and ideal enactment on
hatred failed. [if I told them then I would be locked up and could not carry out the mission-a mission(the
shooting) I had to complete in order to not suicidel.

Page 54

Prevent building false sense of rapport. [A one way relationship-- the patient is being evaluated]. Speak
truthfully and deflected incriminating questions. Oddly, they don't pursue or delve further into harmful
omissions. Attempt to see if can pass exams as myself and not by fear. Fail. I was fear incarnate. Love
gone, motivation directed to hate and obsessions, which didn't disappear for whatever reason with the
drugs. No consequence, no fear, alone, isolated, no work for distractions, no reason to seek self-
actualization. Embrace the hatred, a dark k/night rises.

[A flame in a window represented destruction being released and the ultraception symbol was present.]

Metzner comment: The above was written about one week before the shooting. The above was indicative
of Mr. Holmes not being very cooperative in answering questions posed by Doctors Fenton and Feinstein.
Mr. Holmes stated that he chose the movie "Dark Knight rises" because he knew it was going to be a
popular movie and that he had little knowledge regarding the contents of the movie although he had seen
trailers. He knew the movie theater would be full.

Mr. Holmes dyed his hair red sometime after termination of therapy. Indicated that he does not know why
he dyed his hair red although he stated it had nothing to do with the "Joker" or [a friend] having
previously dyed his hair red. [Mr. X] was a friend of his and a fellow student. When asked to speculate
why he did dye his hair, Mr. Holmes stated "to differentiate myself from who I normally was.. . because I
was not my normal self... ."

Page 55

Faith
what kind of God commands his people not to murder it cowers behind free will?

Reason
The reason why life should exist is as arbitrary as a reason why it should. Life shouldn't exist.

Metzner comment: Mr. Hohnes stated that he was trying to convey that "faith and reason doesn't work."

The burnt currency was included for the following reasons: "I wouldn't be needing money anymore... It
was kind of related to the insurance problem. . . the reason I did not continue on there is because I would
not have insurance. . . I was looking ahead at the end of the sumrner when the insurance would no longer
be there.
 JAh,{ES EAGAN HOL]I{ES
C'ase Number: I2CRI522
SA}{ITY I\TALUATIO}{
Jetl}ey L. h.{etzner. h,{.D., Consulting Psycliiatrist. CMHIP
Septeurber 3. 3013
Page 62 of69

.{.ppeldix I\.-

JAIITES EA.G.AN HOLilIES

100936 312/1311987 F
O8l$4N013 RC.ARAPA.gOE
EPO02 Color*do r1deat*I IIe*ltL Institute al Pueblo Enit _F?_
A,RA.P]IIIOE SAfiITYEXAM OBSERVATION RSPORT 1s0 (10193)
 PSYCHOLOGICA.L AND NEURCIPSYCFIOLOGICAL EVALUATION

Patient Name: James fagan Holmes HIMS No.: 100936

Daies of Testing: A811212013 - 0Bl15,2A13
Date of Report: AU26|2O13

lde,ntifying lnfqrrnqtion and Reason for Referralt

James Eagan Holmes is a 25 year old right-handed White rnale who was remanded to CMHIP for a
sanity examination pertaining to multiple felony charges of Murder 1 and Atiempted Murder 1 in
Arapahoe County. He was referred for evaluation by Jeffrey Metzner, M.D., the psychiatrist conducting
the sanity examination, to clarify Mr. Holmes' psychological and neuropsychological status.

$qursqg o{ lnfqrmation:
Mr" Holmes was seen by both of us for approximately 30 rninutes an AU12/2013, during which time his
p*rsonal history was reviewed. A numberof psychologicaltests were administered between 08/12/?013
and 08/1512013: \

An A811212013, the following were administered by Dr. Gray over the course of approximately 3 hours
and 20 minutes (2 hours and 20 minules in the morning; t hour in the afternoon):
.Minnesota Multiphasic Personality lnventory * 2"d edition {MMPI-2}
'Personality Assessment lnventory (PAt)
'Rorschach lnkblot Test,
and

Neuropsychological testing was conducted by Dr. Manguso for 3 hours and 10 minutes on B/13/2013 (2
hours and 20 rninutes in the morning; 50 minutes in the afternonn):
.
Digit Vigilance Test
$tory Memory Test (Learning and four-hour delay trials)
Figure Memory Test {Learning and four-hour delay trials)
Validity lndicator Profile {Verbal and Nonverbal subtests}
Booklet Category Test
Thurstone Word Fluency Test
Trail Making Test
Wisconsin Card So(ing Test
Speech Sounds Perception Test
Seashore Rhythm Test
Boston Naming Tesi
Grooved Pegboard Test
I rnperceptio n Testing (Tactile, Aud itory, Visua l)

,A&IE$ EAGAN HOLMES

100938 812/i3/1987 F
OB/A4/2A13 RC.ARAPAHOE
EPOO2 Colorado Mentat Health Inrtitute at Pneblo UEit F'2
ARAPAHOE SANITT EXAM PSYCHOI,OGICAL A$SESSMEHT 154 (09r'93)
Prge 1
 . Boston Diagnostic Aphasia Examination !
. Aphasia Screening Test (including spatial i ons railng

Dr, Manguso continued with Neuropsychological testing for approxirnately t hour and 15 minutes on
a811412013.
, Test of Memory Malingering
". ilTest
Tactual Performance Test
r Finger Tapping Test
. Woodcock Johnson lll Tests of Cognitive Abilities * Verbal Comprehension.

Finally, the Evaluation of Competency to Stand Trial - Revised was adrninistered by both of us on
08/15/2013, and clarification was sought for some of his respon$es on the MMPI-2 and the PAI. during a
session lasting approximately t hour and 20 minuies.

We consulted with Dr. Metzner; with Richard Pounds, M.D", the attending psychiatrist; and with ward
staff and treatment team members familiar with Mr. Holrnes. We reviewed the CMHIP Medical Record
pertaining to his stay here. We also reviewed numerous additional documents, including;

n Records from Family Service Agency ol the Monterey Peninsula, dated 01119/1996 to 04/2611996
. Limited records from PsyCare pertaining to therapy session in 2001 and 2002
. Records from Action Care Ambulance lnc., dated 11tfiD}12 and 1 1fi5n}12
. Mr. Holmes'Journal{also referred to as "The Notebook")
" Medical and mental health records from Arapahoe County Detention Facility, dated Jul;y ?A12
through May 2013
. Medical records from Denver Health pertaining to events in Novernber of 201?
r Medical and mental health records fiom University of Colorado Student Health Service, dated
March through June 2012
Transcript of Preliminary Hearing, A1/A7l2A13 * AU09JZA13
.' Neuropsychological Evaluation authored by Robert Hanlon, Ph.D., ABPP, dated 06108120'13
. Neuropsychiatric Evaluation Report authored by Raquel E. Gur, M.D., Ph.D.., dated AilfinO1.3

{otificatioln of" 3 urpose:

At the beginning of our first meeting, on 08112!2013, Mr. l{olmes was informed by us:

r'
of the nature and purpose of the evaluation;
of the absence of a therapeutic relationslrip;
'. of the absence of confidentiality;
that a written report would be submitted to Dr. Metzner and would become part of his medical
record; and further lhat the report woutrd likely be obtained by his attorney and the District
Attorney prosecuting his case; and,
' that either or both of us might be called to testifo, and that data we gathered could be considered
at any point in the proceedings against him, includirig the penalty phase if he is found guilty.

IAIr{ES EAGAT{ HOLMES

10093S 812113/1987 r
O8IO4/2013 RC-ARAPAHOE
EPOO2 Colorado Hent*l lleallh Institute at Paeblo Unif _{2 *
ARAPAIiOE S.aNrfYE(AIl{ PSYCSOLOGIC.dI. ASSSSS}IENT 154 {0s/s3)
P:rge 2
This information was repeated at the beginning of each subsequent meeting. He stated he understood
what we had told him and on each occasion he agreed to continue with the evaluation.

Backqrounr!:
Mr. Holmes' personal history is thoroughly reviewed in Dr. Metzner's report and in other sources, and
only a brief review of available information is provided here. The interested reader is refened to other
documents for a more thorough accounting of his past.

James Eagan Holmes was the older of two children born to an intact family in California. There is a
notable history of mental illness in the family, including a severe obsessive-compulsive disorder in his
paternal grandfather, an unspecified psychotic illness in his maternalgrandmother, and schizophrenia in
a fraternal aunt. He began to exhibit signs of social withdrawal as early as the sixth grade, a tendency
that had become quite noticeable by his high school years. He was an excellent student, graduating in a
timely fashion. Mr. Holmes went on to earn top grades in the Neuroscience program at the University of
California at Riverside, where he graduated with a B.S. degree in 2010. Behavioral oddities were
observed by persons around him during this time, as well. After staying at his parents' home for a year,
he was accepted into the Neuroscience graduate program at the University of Colorado at Denver,
where he was enrolled in the fall of 2011. His academic performance in graduate school was
considerably below the level he had previously demonstrated.

His work history has been somewhat limited, and has included bagging groceries for one summer while
in high school, serving as a camp counselor during one summer when he was an undergraduate
student, being a research laboratory intern for two years during his undergraduate education, and a few
months working night shift in a pharrnaceutical manufacturing facility before moving to Colorado. He has
never married, nor has he fathered any children. He reported having been involved in one romantic
relationship, which occurred while he was in graduate school and ended not long before the events
leading to his arrest.

Mr. Holmes was taken forfamily therapy related to oppositional behaviors when he was eight years old,
which he said he does not recall. He was again taken for therapy when he was 14 due to his parents'
concern regarding social isolation and parasuicidal behavior (scratching his wrist with a piece of
cardboard). He was assigned a diagnosis of an adjustment disorder, and the family was involved in
multiple therapy sessions in later 2001 and early 2002. ln the spring of 2012 Mr. Holmes presented to
the University of Colorado Department of Psychiatry due to mental health concerns. He was initially
seen by a social worker, and was then referred to Lynne Fenton, M.D.; Dr. Fenton in turn brought in
Robert Feinstein, M.D., and the two psychiatrists then met with Mr. Holmes together. He was prescribed
the antidepressant sertraline and the anticonvulsant (with mood-stabilizing properties) clonazepam; the
latter was subsequently disconiinued and he was started on propranolol. lt is unclear the extent to which
he adhered to the prescribed medication regimen.

JAMES EAGAN HOLMES

100936 812/13/1987 F
08/04/2013 RC-ARAPAHOE
EPOO2 Colorado Mental Health lnstitute at Pueblo Unit F2
ARAPA.HOE SANITY EXAM PSYCHOLOGICAL ASSESSMENT 1s4 (09/93)
Page 3
ln mid-November of 2012 Mr. Holmes began exhibiting very odd and potentially self-injuriouJ-benaviors
while incarcerated. On 1111312012 he was transported from the ACDF to Denver Health after potentially
self-injurious behaviors including running head-first into the wall of his cell. He was returned to ACDF
after a CT scan of his brain on that date showed no indication of injury. Two days later he was
transferred back to Denver Health due to escalation of odd and dangerous behaviors. He was
diagnosed with both an unspecified psychotic disorder and a delirium, the latter related to him not eating
or drinking properly likely due to paranoid thinking. A follow-up CT scan of the brain on 1111812012 was
also reported to show no acute intracranial abnormality, While hospitalized he was prescribed
antipsychotic and antidepressant medications, and these were continued after he was returned to
ACDF" At the time of our evaluation, he was taking risperidone for psychotic symptoms, escitalopram for
depression, and hydroxyzine on an as needed basis for anxiety. He was also prescribed doxycycline for
acne and acetarninophen on an as needed basis for pain.

Regarding medical history, Mr. Holmes denied any unusual childhood health problems and indicated
that, to the best of his knowledge, he achieved early developmental milestones norrnally. He denied any
history of traumatic brain injury as well as other neurological conditions, including meningitis,
encephalitis, seizures, stroke, or toxic chemical exposure, Per the report of Robert Hanlon, ph.D.,
ABPP, Mr. Holmes sustained mild closed head injury without loss of consciousness at age 16 when he
ran into a pole on a basketball court.

He has reported only very limited substance use involving alcohol and experimentation on a few
occasions with marijuana. Although he asserted that he drank only on social occasions, he also
indicated reasonably high tolerance for the drug, and also said that his alcohol consumption had caused
some difficulty in his relationship with his ex-girlfriend.

In April 2013 he underurent neuropsychological evaluation by Dr. Hanlon, who administered lQ testing in
the context of the ne-uropsychological evaluation. He reported that Mr, Holmes' Full Scale le was 123
(Superior Range; 94h percentile), with Superior nonverbal intelligence and High Average verbal
intelligence. Dr. Hanlon reported that additional test results revealed "significant variability among
neurocognitive functions, however despite such variability his neurocognitive functions are generally
within normal limits and intellectualfunctions are notably advanced."

Mental Status:
James Holmes is a well-nourished right-handed White male of average stature who would likely appear
younger than his documented age of 25 years were it not for a moustache and full beard. He was attired
for all sessions in a dark-green institutional-issue jumpsuit with a white t-shirt beneath the top. Hygiene
was good, and grooming adequate. ln addition to hls facial hair, his appearance was othenruise
distinctive for his rather unruly curly hair. He wore contact lenses during all meetings. Gait, posture, and
other psychomotor activity were within normal limits. He used his right hand for all drawing and writing
tasks. His verbal output was largely limited to brief answers when questions were posed directly to him,
and he offered little in the way of spontaneous statements. Speech was normal for pace, tone, and

JAMES EAGAN HOTMES

r00936 812/13/1987 y
OB/04/2O13 RC-ARAPAHOE
EPOO2 Colorado Mental Health Institute at Pueblo Unit F2
ARAPAHOE SANTiY EXAM PSYCHOLOGICAL ASSESSMENT 1s4 (09/93)
Prge 4
volume. He was fluent and articulate, and could be readily understood, wiah no beha,/ioral tpdicia of
expressive or receptive language deficits.

His interpersonal manner was initially distant and reserved. but as evaluation sessions progressed he
became somewhat more interactive and responsive, including engaging in minimal soclal pleasantries
and smiling at appropriate times on several occasions. He was polite and cooperative, willingly
responding, albeit briefly, to all questions asked of him and attempting all testing tasks without
complaint. His manner was forthright and matter of fact, At no time did he demonstrate any propensity to
exaggerate or embellish his symptoms or problems.

He described his mood as "slightly depressed." He stated that since being incarcerated he has gained
30 pounds and would sleep alt day if allowed to do so. He reported that since his arrest, up to and
including the present time, he has had recurring thoughts of suicide by "strangulation with sheets." He
stated that because he has been closely supervised at the jail and in the hospital, he has not attempted
to act on these ideas. He denied symptoms consistent with mania and stated that since beginning
graduate school, his mood has generally been "stuck in a low rut."

ln terms of perceptual disturbances consistent with hallucinations, he initially reported that he does not
hear voices of unseen others and has never experienced this symptom. During testing, however, he
endorsed an item referring to auditory hallucinations, and when questioned further, acknowledged that
he had heard imaginary voices while hospitalized at Denver Health. Jail records suggest he was likely
experiencing auditory hallucinations for at least a few days prior to his transfer to Denver Health in
November 2012. He stated that just before his psychiatric hospitalization at Denver Health, he saw
"shadows moving around" but he has not had this experience since that time. He denied past and
present experiences of smelling or tasting anything unusual or bizarre, as well as feeling anything
unusual on his skin or body.

Regarding thought content consistent with delusions, he reported that before beginning treatment with
risperldone, he believed that the television was broadcasting special messages meant onty for him
(although he does not now recall the content) and that that his thoughts were being broadcast outside
his head so that others could read his mind. He stated that since beginning risperidone, he no longer
believes these things to be true. He denied believing, both now as well as prior to his treatment with
risperidone, that he had special powers, that any entity was trying to plant ideas in his mind against his
will, that he was being persecuted, or that he had a special mission in life that others did not understand.

He was alert and oriented, correctly stating the day of the week, month, and year. He was off by one on
the date of the month but self-corrected easily with a minimal cue. He knew the name of this facility as
well as the city in which we were located. His thought process was coherent and logical. His long-term
memory for personal history information appeared intact, based on comparison with informationln
available records. Additional aspects of his cognition are discussed below.

JAMES EAGAN HOTMES

I00936 BIZ/13/1987 F
08/04/20t3 RC-ARAPAHOE
EPOO2 Colorado Mental I{ealth Institute at Pueblo Unit F2
ASAPAHOE SANITY EXAM PSYCHOLOGICAL ASSESSMENT 1s4 (09/93)
Fage 5
?.gvcholgpical Test Results:
Multiple tests were administered over the course of the four d we met with Mr. Holmes. Results of
many are reported- which are !
Rorschach data are which are

N e u rqery g ilo log.i ? ?!J e St i n s :

Validity Testing
On the Test of Memory Malingering (TOMI\I) Mr, Holmes with no
indication of any attempt to feign memory impairrnent for new information. On the
he His
pattern of performance on both subtests indicated that he intended to respond correctly, and he made a
concerted and consistent effort to do so throughout the entire test administration. Results of the b Test
showed
combination with behavior observation$ as described above, indicale that Mr. Holmes cooperated well
with the evaluation, and the following test results are considered reliable and valid representations of his
current neuropsychological status.

Normative Refurence Base

Neuropsychologicaltests comprising an expanded Halstead Reitan Neuropsychologicaltest battery
-
were adminislered and compared to a norrnative group corrected for specific demographic factors, such
a$ age, gender, ethnicity, and educational level. The Woodcock Johnson lll Tests of Cognitive Abilities -
Verbal Comprehension provided age and grade equivalent scores based on a general population-based
normative sample.

Attention and Processing $peed

He performed
reflecting speed and
accuracy of visual search and scann reflecting auditory
attention and discrimination; and roflecting psychomotor speed on a
simple, numeric visual sequencing test. The only measure with performance in the below average range
*r* , assessing nonverbal auditory attention^

Language
0n measures of la scores showed some v Audi comprehension on the

HisI
However, review
of the pattern of responses on this measure
that,inthecontextofhisothertes1performancesappeartobe
reflective of attentional variabilitv and/or e. On the Woodcock Johnson lll Tests of
Ability Verbal Comprehension,

JAMES EAGAN HOL,ilIES

r00936 812/13/198? r
AB/O4/ZAL3 RC-A}AFA}TOE
Epso3 Colorado Mentr* I{ealth In$titute rt Puetrlo Unit {2
ARAPAHOE SANTIY A(AM TSYCMOLOGICAL ASSESSME T r54 (09/93)
I'agr 6
 mildly lower
than would be expected based on his aEe and education.

Spatial Skills
Mild variability was evident.
f.fotaltime score on the
Memory Testing
Verbal me with the Story Mernory Test showed below av to mildly impaired $cores.
as was the
and the
ln contrast, memory testing with

Mernory testinc for tactile material

Executive Functions
On the Trail Making Test Pafi B,
J. Written verbalfluency on
Perforrnance on

and It is noteworthy that he remembered this test from the April 2013
administration in I with Dr. Hanlon. On the Booklet Category Test,

Sensorimotor Testing
No lateralized pattern of deficits was present, although essentially mild bilateral motor impairment wa$
evident on $orne, but not all, rnotor tasks. Fine finger dexterity and psychomotor speed were ln the

Performance 0n

*q{sonalitv Teqtins:
Mr. Holmes' responses on the MMPI-Z and the PAI yielded valid and interpretable profiles. There was
some inconsistency in his pattem of answelg rn thefAl firyhich he completed after having undergone a
clinicai interview and finishing the nllnnpt-z;I; the distortion was not so seyere as to
preclude derivation of meani results. Alt h his scoreson-onthe MMpl-2
were this was considered most likely related to him

JAMES EAGAN HOLMES

100s36 812/13/i98? F
08104/e013 R.c-AaApAHoE
EPOO? Colorado lllental llenlth Institute at Puelrlo Unit f?
ASAPAHOE $A$iTY E(AM Ps}.CH OLOGICAL A$SBSS}IEIiT rs4 {09i93}
Page 7
responding honestiy to qr.restions regarding genuine sympioms, and there was no
f
His MMPI-Z and PAI profiles both showed

I. Persons with similar response patterns typically manifest depressive symptoms,

although in this case he did not endorse common physical indicators ol depression. lnstead, he reported
phenomena related to sadness and anxiety, with difficuliy in concentration and feelings of hopelessness.
Those who produce comparable profiles tend to avoid social engagement ind close attachments, and
often pose slgnflAnt risk of suicidal thinking and behavior. Episodes of frank psychosis are also not
uncomm0nThereisoftenatleastSometendencyiosomatization
and to development of obsessive-compulsive behaviors. Although on interview he did nol complain of
excepiional physical ills, he

The most salient findlgle-m_h5_Egrschach was problems in the areas of thinking and perception,
particularly lndeed, the most striking aspect of his responses was a higher
than expected frequency indicative of
difficulty in accurately interpreting situations or events, including the actions of others. Keeping in mind
that this man has been receiving antipsychotic and aniidepressant medication for several months, this
finding is even more significant given that the overall level of complexity of his respon$es f
I was generally below what would bo expocted from sCImeone of his intellectual Hu
produced more than one response that fuil "rp*ity. nut
which nonetheless conveyed a ganeral oddity of thought. Protocols in which perceptual abilities, and by
sxtension, reality testing, are irnpaired, can well be indicative of a leyel of personality pathology, likely
including sorne levelof narcissism, a finding that was also suggested by his MMPI-Z profile-
Jrrliscombinationofpersonalityfeatureshaslikelycontriuuteotohisgenerallyavoidantffi
interpersonal interaction "

eq{,qgfengg 1o Froceg{:
The ECST-R was administered to supplement Dr. Metzner's evaluation of Mr. Holmes' competency to
proceed. His scores on scales maasuring his factual understanding of the courtroom proceedings, his
rational understanding of the courtroorn procoedings, his ability to consult with counsel, and his overall
rational ability were all well within normal limits, with no evidence of psychopathological symptoms that
impacted any of these areas. There was no indication of malingering, as measured

DiscrlEsion:
James Eagan Holmes is a 25 year old right-handed White male who was remanded - to CMHIP far
evaluation of his sanity on multiple serious felony charges in Arapahoe County, He was referrerJ for
-psychological and neurop$ychological evaluation by Jeffrey Metzner, M.D., the psychiatrist v/ho is
completing the sanity examination.

,AMES EAGA$ IIOr,]vrES

100986 Bt211311987 F
ASIO*IZOI3 RC*ARA}AHOE
EPOOE Colorado lf{ental Hcalth Institute at Pueblo linit F'2
A3APAHOE SANTTYE(AM. TSYCHOI-OGICAI, ASSISSI!{$f; T r54 (091s3)
Page 8
Results of previous (April 2013) neuropsychological testing by Dr. Hanlon indicated tMi MrL{otme;
possessed "notably advanced" intellectualfunctioning and displayed variability among cognitive domains
but generally normal neurocognitive functioning overall. Results of current neuropsychological testing
were largely consistentwith the April 2013 testfindings. The current profile did yield evidence of suble
neuropsychological dysfunction relative to expected levels for Mr. Holmes, based on his demographic
norm group. However, in reviewing these scores, two factors are critical to consider: First, retative to the
average individual from the general population (i.e., not someone in Mr. Holmes' demographic group
with advanced education), the large majority of his scores are within normal limits and are not reflective
of any basic impairment in the ability to pay attention, reason, use language, remember, or problem-
solve. Second, it is important to emphasize that Mr. Holmes was maintained on antipsychotic medication
at the time of this evaluation, as well as at the time of Dr. Hanlon's evaluation in April of 2013. lt is very
possible, and perhaps quite likely, that his neuropsychological functioning would be differentially worse if
he was experiencing active psychotic symptoms that were not controlled with medication.

Mr. Holmes' personality testing revealed significant psychological disturbance, which is particularly
noteworlhy given that he has been receiving psychiatric medications for several months. Most prominent
iR the test data were indications of a complex illness including marked depressive symptoms
accompanied by a good deal of anxiety, a proneness to psychoticism and to obsessive-compulsive
behaviors, and perhaps also somatization. This situation was further complicated by notable perceptual
distortions reflective of very poor reality testing abilities. The possibility of personality pathology involving
narcissism was also present.

ln reviewing some of his MMPI-2 responses with him, Mr, Holmes provided information that suggested a
progressive development of psychiatric symptoms. He indicated that he has always had episodes during
which he "zone[s] out sometimes." By the time he started high school he had become quite anxious and
also suspicious of others and their motives. As an undergraduate student those same feelings of
paranoia continued, and he also began experiencing somatic symptoms. While in graduate school his
anxiety repo(edly became increasingly problematic and he became increasingly depressed. He also
acknowledged heightened paranoia during his time in graduate school. lt is noteworthy that he generally
tended to minimize his experiences involving more severe symptoms, particularly those indicative of
psychosis.

Several possibilities emerge diagnostically. There is good evidence to indicate the presence of a
depressive illness, and also psychotic symptoms. lnadequate data are available to determine whether
this would besi be categorized as independent conditions (e.g., schizophrenia together with major
depression), or a mood disorder with psychotic features, or a schizoaffective illness. Regardless, the
clinical picture is complicated further by considerable anxiety and by possibte personality pathology.
Although he reported experiencing some consequences as a result of his use of alcohol, there is
insufficient information to warrant a substance use diagnosis.

It must be pointed out that Mr. Holmes has clearly and consistently reported ongoing suicidal thinking.
There are no known instances of overtly suicidal behavior other than that which occurred in November
2012 while he was housed at ACDF. However, it is quite possible that thoughts of killing himself will

iAMES EAGAN HOLMES

100936 B7Z/13/L987 F
A8/04/2013 RC-ARAPAHOE
EPOO2 Colorado Mental Health Institute at Pueblo Unit l'2
ARAPAHOE SANTTY H(AM PSYCHOLOGICAL ASSESSMENT 1s4 (09/93)
Page 9
increase as the stresses of the adjudicative process and potential lengthy incarceration accrue. lt is
strongly recommended that he be routinely monitored for such ideation. and that appropriate preventive
steps be taken.

Thank you for the opportunity to participate in the evaluation of this interesting man. please contact
either of us if you have any questions, or if we can be of further assistance. Dr, Gray can be reached at
{719) 546-f, and Dr. Manguso at {719) 546-I.

,{slf
B. ThWray, PhD, ABPP Rose lManguso, Ph.D., ABPP
Clinical Coord inator, Court $ervices Departmeni Forensic Evaluator, Court Services Department
CMHIP CMHIP
Board Certified in Forensic Psychology Board Certified in Ctinical Neuropsychology
American Board of Frofessional Psychology Board Certified in Forensic Psychology
American Baard of Professional Psychology

IAMES EACAI{ HOtMeS

r00g3s Bt2/13/i987 r
AB/O4/aArc RC.A"nAPAHOE
EPOO2 Colorado $Iental lleatth trnstitute at Prreblo L,nit tr'2
ANAPAHOE SANTTTE(AM PSYCHOLOGICAI ASSTSS}IENT 154 (09193)
Fage l{)
 JAb{ES EAG;IN HOL}\.'IES
Case Nurnlier: l2CRl 522
SANITY EVALUATIO}{
Jettey L. Meizner. I,'{.D., Constltilg Psychiahist. CMHIP
Septenrber 3. ?013
Page 63 of69

Attachrnent I

JAMES EAGAN EOI}IES

100936 812/1311987 r
08104/2013 RC-ARAP-dIEOE
EPOS2 Colorado Meatsl Ee*lth lnstitute at Pueblo Unit _F2_
AR,.LPAIIOE SA$ITY EXAM OBSERVATION REPORT 150 (10193)
 Timeline of Significant Events
APD Unit KB
APD Unlt 453 communlcales anerye
discovors indlvidual got anotlrer petson
wath gunshot APD Unlt 316 reports
gas spralEd inside ou,side sho, ln ,he lag
wound ln tront ot -a femare. lvegot
theate. auditorium 9 peopla runnlng out of
APD UnIt L25 the theeler lhat ara
arives, s6t6 up shot ln toom 9.n
on north side, APD Unii L25
dlrecis cops to Requesl ior
and assumos
backside of tfieater mutual ald
on-5cenE APD Unlt 2,t 6
command tlrsi requesl for
APD Unli 316 ga8 masks lnside
RM 1O9 arrives rcports auditorium 9
lndlvldual ne€ds
on-scene
rescue fust
(Flrct Rural oulside Estimaied tlme
Melro a;rlyd, audltorium I ol suspect arrast

4P238606 APZU606 4P2fi606 A838606 AH38&6

PDz e, PD2 & METBONET.l PDz & PDzA PDz& PDz &
Patches-1 Patches-f E llt Patclrael PatclB*7 Patch.6-f Palcheel
Edit tt Edfi g HITAA EdIID Edtt I EdIT E

APD Units Noted On This Stide:

L25 - Jad Lanigan
Color Key: CR,IO - Bryan Buflet
453 - Everett Wltltams
APD dlspatch, arrivalr and transport
entrles hightighied in btue
3{6- Rotand Albert
K6 - i/lichelle Hanley
All other entries ln while 216-John Gonzales
flota 2'16 I5 thc flEt knoh unlt msa. (tlmo unknowr).
H@ovcrr of lhe u,ls notcd 6 this timfine, CRll wrs thl
oily mo tftat aaFd arlval on.acenc, All olher arrtval $m!

8 CONFIDENTIAL
LAW ENFORCEMENT SENSITIVE
arc b&d on datr obtained lrem GpS funct'Enc.
Only thc flEt tlvc oFrenG units (with known a.dval ttmB)
arc notcd on lhls tlmellne
 JAMES EAG,EN HOLIV{ES
Case Niunber: llCRl522
SANITY EITALUATIO}{
Jeffley L. I,{etzner. h'{.D.. Consultiag Psychiahist. Ch.{HIP
Sepleurber 3. l0l3
Page 64 of69

Attachrnenl2

JAMES EAGAN EOL*TES

100936 312/13/198? r
O8IO4/2013 RC.ARAPAHOE
E?002 Color*do Meatal trlealth Institute at ?leblo Unii_F2_
ARAPAEOE SA}'iITYEXAM OBSERVATION REPORT 150 i10/93)
 WeaPons
Purchases
magazin""'..1ld
^' weaPons' were legallY
All
-'P.ricrtased
"i-unition bY Holmes

Pulchasei anoth6r
Glocl(.40 canber
Purchases a handgun ffom a local
nemlngton'12 gauga Ea83 Pro ShoP
Purchas€5 a Glock
-40 callber handgun shotgun from a local
tuo$ a local 8;$6 Pro ShoP
Gandol Mountaln

WS
 Ammo and Gear
Purchases
Between 5l1O -2114 Other
(Not all inclusive)
Misc mgdel
rocketry Electrodes
suppties
.40 caliber
Rounds .223 Rounds
Petri dish Glycerin
22-round lS.round 3O-round 4O-round IO0-round
magazines Potassium Ammonlum
magazine€ magazlnes magazinE drum magazine Permanganate Ghlorlde

{0 15 4 {0 1 Magnesium
ribbon Gord

,223 l2.gauge shot & Mortar and Pesfle

{2-gauge slugs .4O callber
Rounds Rounds
combined

3,370 Weapon Accessorles

325 2,590 Body Armor

Laser Sight
Bauistic Pants (2)

Gas Mask istic arm, nect</torso,

Ball
and groin protectlon
Hearing Protecfion
Helmet

@s GONFIDENTIAL
LAW ENFORGEMENT SENSITIVE
 JAh,{ES EAG;\N HOLtuIES
Case Nuuber: I2CRI522
SA\TTY E TALUATION
.Ietli'ey L. I.,{etzner. hI. D.. Coasulting Psychialrist. CMHiP
Septeurber 3, ?013
Page 65 of69

Aflachrnent 3

JAMES EAGANi IIOLryTES

100936 }12/t3tr987 F
OSI04/20T3 RC-AXAPAHOE
xro02 Color*do &Ieut*l H*alth Inrtitute at Pueblo IJnit _F2_
^A,RA.T.{AOE SA}{ITY EXAM OBSERVATIOT.f RSFORT 150 (10S3)
 Holmes Acquisition of Firearms, Ammunition, Accessories and
Explosive or Incmdiary Parts

Event/lVitnesslExhibit Matrix
Date Event Wltnesdsl tvld€nce/Efilblts ATF ROI
05llul2 Ptrrchasof two (2) 60z SAThorms Daley Tv,a (2) 602 CXear Out tear ATf Rsponof
Clear Out tear gas grenades gas tEEades r€cover€d at Investigation (ROI)
from BTP Arms located in Brian PIut - owner of tbeater i67
Waldorf, t{6ry1snd. BIP Arlts (DBA
IGepShooring.com via KeepShootingcom
wc$43.79 Internpt) Iovoicc#10003O498

Back OfEce System

Oder# I0ffi32148

Mastercard
Account#
549123727019vn7

UPS Shipping Records??

Email account ideatified as

.l.h.dmk CDhnhril..om
05n2t20l2 Purchase ofa Glock, Model TFO Paul Ba6en ATFForm4473 (Fiearm ft,
22, .40 coliber pistol, serirl Transaction
number SWS224 from Car.la Rodriguez, Record#3 l5E8) signed by
Gander Mountain t1420 Gander Mouatain 11420 JalrnsHolrrs
localed at 140fi) Esst JerBl Store Ivtanag€r
in Aurora, Col,orado. Colorado Bureau of
Shaun Brornlee, Invetigatioo (CBI)
Idlc $647.99 CanderMormrain #42() InstaCheck Records
Sales Assochle
Gander Mountain Firearm
Tmnsrction Form signed
byJanesHolmes

State oi Colorsdo Driv€rs

Dcase# Il-291.0401
bearinglhe nanre and
photograph ofJarnx
Fagen Holms

Masracard
AccotEl#
549t23727019X217

Clock, l,lodd 22. .40

cafiberpisrol. scri8l
numberSWS224
recov€rcit 8t lhitEf€r

@
o5n8n? Purcbase ofReminglon, SA Mart FelE ATF Fornr,f473 (Fireaon $3,
Model 5Z6a6stical ,12 Transaction
guge shorguo, sial nurrber Angela Pell4 Bass Pm RecordftT6E6) sigDed by
RS77l40R Shop Operarions James Holrres
Manager
Efty (50) rouods of 12 gauge Colorado Burtau of
amsunition Jerry Rodgers, Bass Investigatioo (CBI)
Pm Shop Gereral IoshCheck Records
Fifty ( J0) ,Duods of.4O Maaager
caliber arnmrmition from Bass Pro Shopc firearns
Bass Pro Shops in Denver, Duane Greening Bass trmsfer form signed gy
Colorado. Pro Shop Sales JanEs Holmes
Associate
Mrc$459.1s Bass Pm Shops Receipt
dated0snSll?

State of Coloado Drivers

Ucense # I I-291-040I
beariug the narne and
photograph ofJarnes
Eagan Hohnes

Maslercard
Accout#
5ry1237270192217

Remingbn, Idodel870
Tactical , 12 guge
shotguo, serial number
RSZI40F recov€red ar
thegler

12 gaugc aud .rl0 caliber

ammudtion recovered at
therreratd htris stseei

wMtm,2 Puchase of tq,o (2) silver SA Mart Siitds Shorncr-Tec Inrcice# ROI
handcuffs, tqo (2) road st8rs 71935
and one (l) military firstaid Joelaffe- Ocmer of
&xsing ftoo $homer-Tec fur Shuer-Tec.Ilc Elect rooic In$ioe#
BcllitrthrrE, WaihirgbL m0034r6

t{lc $80,94 IrPS Shippi4 Records and

ProofofDdivcq*
t79735fi346it6f/;t53

Mastctcard
Account #
549|217TIABX2|7

Ernail account llendfied as

dsherloct@ lpunail,com

l&ndcuffs, road stes and

fust aid dressing recorrcrcd
il '117
 \t6utnot? Rrchaseof Smilh & SA ShaoeAbraham ATFFormgT3 (Firearm ATF S,H #6
Wessotr, Model M&P15, Transaction
223 caliberri0e serial TFOPsuI Barb€u Record#30292) siped by
trumb€rSP43179, Janes Hol.nes
JaLe Hendriclsqn -
Sundard fuearm ho Plan Firearns Manager, Cotorado Burcau of
warrauy for ihe Smi& & Gander Momtainil42l Investiguiou (CBI)
Wessor M&P15 rifle I$ErcheckRecord
ke McGinley - Sales
Tlr(ee (3) BusluasterAR- Asrociate, Gandtr State of Colorado Drivers
15114-16 30 mund Mounlain l*421 I-icenrc # I l-291-0401
magazines, onc (I) black bearing lhe name and
padded shotgun sliag, one {l ) AlaoTague- Vice plotograph ofJanes
neoprene rifle sling, ona (1) President of Loss Ea8ao }trolmes
safe shot gcsnomy single Eun Conuol, Gander
case md 1(X) roulds of ,223 Mountain, Inc MastE Card
amrnunition from Acoount #
s4912y210192217
Gander Mounrein #421
localed at9923 Crsnt Sreet Security Video footage
in Thomton, Colorado. dcpictiDg rafies I-IOLMES
colducting tmnsaoion
MC - $968.3E
Smith & Wcsson,Model
M&Pl 5, .223 caliber rifle,
serial nucibtr SP{3I79

0&Bno1z Purchase ofone (1) Ifi) SA Kylie Williarnson Sponsmrn's Guide ATF {)
rouad AR-15 magazina 5fi) Inrmet WerDeail
roruds of ,40 calitrr Jay C. Beclin- Chief #90534446 plarod by
mmunition, 250 roulds of Erecutive Offrcer, Jarnes Holws in 0Ol?12
12 gauge amrunition, 820 Sponsman's Guidc
rourds of2al caliber SporBman's Guich Oracle
aDmunitioo, one (l) set of Ioseph I- Skwim - Orrder Detail ideotlfoing
lrcarhg proiection, trr (I0) Chief Fnarrial OfEcer JannsHolres,
AR-15 tlO rurnd magozines and Yice hesidedof D0Btl2ll2ll9Bl u
one (l) beBE $hor lassrsighq Eimme' Sponsrnn's purchser
ftom Sportsman's Guide in Gride
St Pad,Mimesora. UPS Shippingrecords

Tual Prmhasq $1,f60?9 Msstcrcard

MC Accour#
54972372707qn17

Enail sccount identificd as

dsherloctghotsmil.com

lfi)rorud AR-15
nugazine recovered Bt
lh€ater

12 gauge, .223 ad ..(}

caliber arnmunitio
reovered at drelt€r atrd
Paris SEe€t

@
 Irser sight recovercd at
thcatsr

lriarind ffitdi^n ?rt

061finn12 huchase of225 variqs SALeviticus Desrosier I-aw EnforDenEtrt TargeB ATF #77
tactical papa targes, 2,000 Invoicc# 0l9493GIN
rarSBt oastrrs, one (l) talset Brad Ross - Division
pastcr spplicator, one (1) Marager, l.aw I-aw EtrforceDBntTaryets
rarBpt staD4 and rwo (2) Enforcement TargeB, Confi rnntion email dated
rarget stand replacsrent Inc 06t17t2012
arrns from ItwEnforcefiEot
Targe6 lrc, in Blain, UPS Shipping Records fi
MiDresola, l255:l4E0O35O5E.l6l9
tzs534F,o1510g2623
Mtcs29z^'t0
MmterCard
Accomt*
549123Tn019T217

Email accomtidentified as
dsh€dock@houndl.com

Targets rEcov€rcd from

Pris Street??
wDna|z RrcDlle otone (1) CRL SA l-evitisus Desrosier Ma$ercarg ATF #80
riple duty red larcr sigltr, tco Account#
(10)22 rornd.40caliber David Dean" 549r23TnOry72t7
Glock sugazincs ard 6rE (11 Bo*nells,Iac
right hsrded Gloct l7n2 Corpliance Mm"ger Btounells Irr Invoicei
holster fron Broc/nell's Inc. o765E483.00
in Mostezuma.Iowa"
UPS Sldgping Recods and
IWC $547.E4 Prmf of Dclivery#
rz$0675030E649970

Enuil 4rolrsr id€0tified as

dsherlock@hotmail-mm

I-aser Sigh recovered at

tlreater

,q) caliberGhce
magazines rccoveredafi

Frctle Holsfet recovered

^t7?
061:28D072 hrchase of 2,050 rouodt of SA Jonatton Gray fucrDetait
.l() call$sf arEnunition,
2250 munds of 223 caliber David Chandler-
ammunition atrd 25 ormds of Manager, Fulfillnrent FEDEXShipplng
12 aarge arnrnudtion from Certerdba Webgistix R€cqds??
BuIk AamoflebBistix ia
Adurta, furgia Ryam Eros - CuslorDer EnBil acsount ideDtiii€d as
Support dsherlock @lptmail,com
Dat*nrotiur
 Webgisti.x l2 gauge, ,zlo caliber aad
-223 caliber aorunitioa
mvmrl
ouzEnolz Purchase of Unired Shield SA HcrculesFatrdioo Msste(rru ATFROI
MICH bvel IIIA advanced SA Any Ewing Aacoutrt #
combat hclmet fmm Security 54912372701y22t7
Pto USA in Los Angetes AlEvan -Chief
Califiornia Executive Officer, S€curity PIo USA Invoice#
s€curity Pm tsA zv20-2ns4
loc $336.e9
Eli E chenblaB * Secudty PIo L.tsA Receipt
erployee, Security Pm setrt to ,anre3 }lolnres
lJSA
Email account ideadfied as
Nelson Miranda .- dsher{ock@ hotnail.com
fornrr employee,
Securily Pro USA UPS Shippisg Recods
*940551120rc8w9774

MICH Irvel IIIA corrbar

hrlme, mErsl rr rh.rttr
07rctnot2 Purcbase of onc (l) 12 gauge SASharc Abmham GanderMdrohin S€cudty ATF #ffi
sholgun snrp caps 2 pac&, Vftho footage depicting
one (l ) 223 caliber soap cag AndrewBartorak - JamsHOLMES
2 pack, one (l) ,/l() catib€r GaoderMornuil coducdng Eaosactim
snap pact 5 pack aad one (I) Senior Ioss Prcvention
scqpcwithAR mouElftom Ilrnager Rifle Scope mcorered u
GanderMountain #420 theater
locatcd at 14000 Essr Jervel GanderMoudai.n
in Aurora, Colorado. SaIs AssocialcFNU Snap Caps rccovered
INU at???
leTC S233.23
Visa Credit Card ending in
8522

GanderMormuit
Transaction JoumaI datpd
Ml0lnotz
wtul20t2 Purchase ofbalistic SAJe[tlaMaguire SIueIJerc[Se, Lh- #61
Pantr/chaps level IIIA fiom Ttansrtion Dmruneats
Blue Defente rnanufacnued Justin lrvecl- rDr 333
and shipped by lnternatioml Co,Owner, BIue
Arnor Cups in San Defuxe, If,Cad htcm8tiond Arrmr
CletrE[ts Crlifofiia. Inemuional Armor Corporadou Inwiec #
Co4poration l6rtrn
rdrc$858.m
Mohmnredr,rsalan- PryPaI Transaction ID#
ChiefExecutive 9342214ryX55273rrn
Offic€r,IntffnalioDal
Amor Colporation FEDEX Grurd SUpping
Records

Ernail rcmunt identified as

dshedoct@holrnait.com
 BsllisFc pants rE{ovetEd at
thattr
ona20t2 hrrchase ofone (I) lorso SA GrrgCowan Buller ProofBody Arnnr ATF #63
tr€ck ForecrioD, one (I) HQlnvoice # 545
bullet proof arm prdectioD, ChristoplBr Russe[ -
one (l) flat KeYlarmA groin Owrcr, BulletProof PayPal Transaction IDP
protef,tor, and one (l) cup Body AmnrHQ 7E895693U3108662Y
goin protector fiom BuIIet
Prmf BodyArmorHQin FEDEX GroundShipping
Terrpe, fuizona- Record Tackiog *
58 16109 I 5{10747 bearing
IWC $903.67 tlle signaore of Jares
Holmes

Email account identified as

dshedock@hotmail,com

Ballistic proection
mveFi a, tlEetpf,
vilw{zulz Purchase of explosirae oad SAwilliamRshsey Cannonn$o,cortr Im,oice
inc€fldiary Ffis to itrclude 76379
five (5) Iaunch Konrol F- TonyBvans- Oumcr,
Clip refiIl, one (l) Sanrrn Camonfiise,com Cgnmnfirse.com Meschmt
Missile Tube, eleveo (t I ) 6" Email ReceiFt daled
plaslic ba[ shells, orle ( I ) wlo3l12
premium tirne fue /r", six
(6) 3"plastic boll sbells (l/8 IJPS ShippingRecord-
tuse hoIQ, one (l) fallirg Trac&iry#
leaf ftse @luegucrt) and 94346192W82942?347181
one (l) additioul launch
Konrol rcceiver fmm Made(ca(d
Camonfiisc.com in Accounf #
Millbum, Yqabna 549t237n019nfi

M/C $183.97 Emnil lcsoun,6endfied as

dshcrlock@hohail.om
mfidtm,2 Itrchas€ oforr (l) (ibc*, SAMartFeltr ATF-Form4473 (Flrearm
lvtrodet 23, .,tO calibef pislol, Trsnsaction
serial nrunberTFP695, Brian Peanington - Reoord#2Sffi siglodby
Bass Plo Slrtpa Saler JarnesHoltrEs
Ole (l) package oflargcls, Associale
CdoradoBureauof
200 rounds of.223 Dennis Rcnes- Bass hvesligatior (CBI)
ammunitiorl ko ShopsSales Itrgaclreck Rccords
AssGiat€
Four (4) poundt ofsrtrokeless Bass ko Shopo firearmr
gunpowder, tansGrfarmaigned by
Jarres l{ohtes
Orc (l) contaircrof
synthetic gun oil, one (l) Sbp6 Rtceipt
Bass Pro
boro cleaner, oac (l) gun d^tqdO5nA12
cleanlng chth aud one (l)
gun cleaoing and sigfuing kit Statc of Colorado Drivers
tom f
Lio€ose 1 l-29I-04O1
bearilg the mme and
Bass Pm in Denver- rihotoEa*ofJam3s
Cdorado. Eagan Holrnes

'
Visa - $l 149.24 BrosPro Shops Sectrity
Video fooage depicting
JampsHOI.}vIES
cooducting tonsaction

Visa Credit Card endirg i-o

E522

Glock, Model 23,.40

caliber piso[ serial
nunrberTFP@S rccovered
al theater

Four (4) pounils of

smokeless gunpowder
recovered at Paris Street

.223 aDmunitiotr
fecov€red ff &eater ard
Paris Street

Bore clcaner, clesnhg

cloth ard sighitg kit
recovercd at???

Purchase offiw (5) SA Benjarnir Byd

alumioum fl at electodcs, flgtlt7!
trto (2) ifon flat clecrodes, Stevetr W. Grebe-
Iive (5) brass flat elechod€s, Oemeral Managcr, Ttre Sci€oce Corqatry Rec€ipt
t€r ( l0) zinc iatelectrod.q Scieocc Gorryaay #071 173 bearing cedit
one (l) l{Dmm glass pelri cad infonnatioa
dish with lid, orp (l) 16 oz DB?? - salaspcrsoo,
conrainer of gltccril, one Tle Scieoce Company MasterCard
(l) 5009 container of Accountrl
POtaSSiUm p€rlllargatrate, oE 5491237270t9i(217
(l) 5009 containet of
affinnium clilotide. tcio (2) Expbsive/Inccndiary parts
l2-5g magnesium ribbons, rocoverEd at Paris Sts€ct
three (3) lDv to 3v mtss
with leads, one (l) blarl cord
with alhgator dips aod oue
{l) l30mm porcetaio rnour
and pesile ftom the Sciarce
Company inDenver,
Colordo-

lt,firiElF
 JA},TE SEAGAN H OLi'.IE 5
Case Nrunber: 12CR1522
SAMTY EYALLTATION
Jetliey L, hletzner. IU-D., Consulting Psychiairist. CIUHIP
Septenrber 3.3013
Page 66 of69

.tttachme&t 4

JA,YIES EACAN SOLMES

100936 3t2lt3lL987 r
08/t141201f, RC-ARATASOE
E?002 Color*do Meirtal lle*lth Institute at Puehlo Unit _F2_
.A3AP^&SOE SANITY 3XA.M OBSERVATICIFi REPORT 150 (10193)
Testimony by Special Agent Garrett Gumbinner included the following:

[Mr. Holmes] said that he had rigged his aparlment to explode or catch fire in order to
send resources to his apartment instead of the theater. And by "resources." I mean law
enforcement. He told us that most of the devices were located in his living room area.
And he said that prior to leaving for the theater, he put his computer on a 25-minute
delay. His computer was going to play silence for 25 minutes, and then loud music was
going to start playing on his computer. He told us that he was hoping that that would
cause a disturbance and that someone would call the police and that police would respond
to his apartment. . ..

He said that he had made improvised napalm, that he placed in the bottom of the jars
numerous rounds of .40-caliber and .223 ammunition. Smokeless powder was put in the
jar, and then you could see on top of the jar, the half shells sitting on top. The defendant
stated that he had rnade improvised thermite and put the thermite on top of the jars and
then connected all three jars with a quick fuse... .

He stated that he purchased numerous Styrofoam cups. He mixed it with gasoline

and made napalm by mixing the Styrofoam with the gasoline... .

The defendant stated that the pyrotechnic firing box -- most of the devices in his living
room were connected to the pyrotechnic firing box in the kitchen. There was a remote
control system that he armed prior to leaving his apartment. He placed it above his
refrigerator, armed the system, and then left his apartment. The defendant stated that he
placed the remote control to the pyrotechnic firing box outside his apartment. The
pyrotechnic firing box being a remote-control system can be initiated using the remote
control, which means that the devices inside his apartment would be initiated. The
defendant stated that after he armed the box, he placed outside of his aparlment by the
Dumpster a white trash bag.

Inside the trash bag, the defendant stated he had placed a boom box. ln this boom box,
the defendant made a CD with 40 minutes of silence; and then after the 40 minutes, it
started playing music. On top of this white trash bag, the defendant placed a remote
control car, just a toy. He then placed the remote control to the pyrotechnic firing box
next to the remote control car.

He stated that he was hoping the music would cause a bystander to come by, try to play
with the remote control car with the remote control to the pyrotechnic firing box, thus
hitting the button to the pyrotechnic firing box would cause the apartment to explode or
catch fire... .

He stated that he'd spread the white ammonium at the front of the door to scare us. And
also, that produces a lot of smoke if there's a fire.

He stated that he tried to procure ammonium nitrate, which, again, is an oxidizer used in
explosives. He went to five or six different stores in order to purchase cold packs. The
cold packs I refer to are the kind that if you sprain your ankle, you break -- what's in the
cold pack is a water bladder. When you break that, that water mixes with the ammonium
nitrate and provides a cooling sensation. What the defendant stated is that he went to
purchase those cold packs in order to get access to the ammonium nitrate, but all the cold
packs that he purchased were not ammonium-nitrate-based; so tl-rey could not be used in
an explosive.
 JAMES EAGAN HOLIv{ES
Case Nrunber: I2CRl522
SAN:IITY EYALUATIOII{
Jetliey L. Melzner. IvI. D., Consultin g Psychia hist. Ch,{HIP
Septeuber 3" ?0I3
Page 67 of69

Attachmenl5

JAHESEAGAN EOLMEE
100936 B12fi3tr987 r
081041201f, RC-ARAP"{HOE
E?OO2 Coloredo Meutal He*lth Institutc at Pueblo Urit _F2_
.A.R^IT?AI'OS SAXITYEXAM OBSERVATION REPORT 150 i10/93i
 L2:51 AM me: hey

you rlckolli'ts the worrd?

12:52 AM dshedclb@gmall.com: did yeuclid it J

me: oope:P

it Byi beiw the linkwhat il is:)

12r53 AM dsherlrlbogmril.com: slill aSood s8 iei

12;54 AM me: you 5hould incorpoEte hat mrld fumout pantr rc3rlnt
'bde:P
12:55 AM dlherlocl(bg8m.il.com: I am debatlng wlrether to 9kp. slyrlm or read,

ft: tky.iml

)
daythE damn draton!

12:5?AM dsherlockb@6m!tl.sm: lwuld n rllbul it ppbably won't b. vetyu*fulfortia

ftrture

me: how much ir readin8 o, tleQpinSSoln8 to hslp?

12;58 AM d5herbctbegmail.om; Morctnn itlo Sames I suppose

me: its somethlnS i,n ihat you like lo do.to ah..d do lt, fucl lhe future for ore
do shat you teel llkedoing, lts a 5unday afternoon

12:59 AM dsherlckb@tmail.(om: Wellehat I l€allile doln8 B evil g En't do th.t

ms what do youfeel liledolnS?

d:trcrtoclb@gmail,om: Vldm Bamer an the next &st thi B throuSh et6pitm

l:mAM me: what i3$ eilthar yo( Ent to do?

1:O1 AM d5herloctb@8mail.com: Xill peopl€ o, roum

tiat b wtry I t'n! ln lhe furor€

me: kllint psople k too much effort, you'llend up locked up

1:02 AM most pcople aro rct worir what hl8lrt happrn to you cor of ihe ac

t
1:03AM dsherlorkbe8mall.com: That'twlvyou killmrtryp@Db

E@ @
 me.even then, at lea3t pemnallY im *lfsh and have t@ much of an i.red of *lf-
importane'

mort peopl€ aEnt worlh idcl shn

ewn il you go gostal, what5 il wodb? what do you Sain?

1:(N AM dsberloctb@gmail.com:TtEre's m waylo do it and not ta cauthr

Bul

The only way iuslke (an be Frued is by tnklnB away your tim or llte

me: wtry do you ca.e I much abom iustlse?

1:O5AM.diberlockb@Email.com: tfyouwaltto kill untrl the end olyour life, than theE ls
oothinSto lose

1OO AM mei but phywould you want to kif,

ae ln wiy would you dxUe thls ls the end, and lill

when you could llc more, exgBtene mde things?

whywouH tho* plople be worth endlrgyour lie?

dsherlekb@gmail-.om: lt's the etrd then lhgLgh, no more erperiences

me: s,hY?

how do you decide lhat i5 the end?

1lO7 AM and why are thoe p€ople wonh the.neillon?

d5herlskb@tmail.@mi You're I gld theE s nolhlnS eBe left

oo you b€llew humrn life has value?

1:08 AM re: i belleve vaiuri, detemined byeach p€En

dsherlockb@tmil.om: What is moie valuable fh.n life?

mer ifyou {e e old therc's nothing letL }6u plobably dont hrve th€ $rength ro kfll a
bunrh ofpeoDle

il you a.e )oung rnd want lo dle, why not go try a darirS srunt rnd die havinS fun?

1:Og AM sioriet erperience5,. thal'r moBYaluable

rerembrance ls als somewMt Eluable

r@@ @
 dshcrlckbe8.mail.com: Experletre and remories ail wnfuh

poof

dead

1:10 AM me: dcPendS

you documenl thm

wrlle lhem up

have stEntert read them

lhey dont vanish

trke darian'r brolhcl mark ior erampb

l;1r AM dsherlockb@tmrii.6m: taklnt a lite will prevcnt thrt persn from havln8.ry of
tho* cxpariEnc6

me: he wpni and wroE up a book ofsiorles of erperlencs dlffennt p€ople h?E

mw those experiEn@s sontYanish

how would that helpyou thouSh?

what wouldtakln8 a llte glve you?

dshedockb@Sma,laomi rl1! erperirrer aEgoN, ist symbolsof the erprylencca remaln

1:12 AM re: they cas bc teliwd by olhcrDeopie

that's ehy book5 erlst

dsherlockb@gmDil..om: Hum.n @pilrl

some people m.y make l million dollaB

otheE 10O,00O

8ut lile is pricelegs

1i13 AM you take away liE andyourhuman opltal is limitlps

me: lifr ls pricelerr be.aGe lou lhinl s

to $me psple lt i5 not

people put moneyon a llfe

itdepends 9n t E peBpestiE

rT.r,lrlilritEgll @
 Bhet wouldyou do whhtiG human 6pitBl?

dshed6kbeBmall.com: Have. more meaninSful ftfe

1:14 AM me: how does that wut?

1:15 AM how wouldyou h.re a more meerinBful ltf€ by killlm p€ople

?'
1:16 AM dsherledbegmil.sm: 8€c.uP l, th.re is a oeaning to ltf€, and you tElr lhrt
away troB othcr people you haE prewnled thair purpose

1:17 AM me: emne el* willtulfillthc FJtpoxllw

il doesnt help yd
it m.y sdsry you

bla h dmmt hclpyou[lffilyour purpore

1;18 AM d5herlctb@gm.il.@m: lt stin m,ke! my lire mre reanh8ful

.me: ilyou want to klil people, why dont you ki! m and brn md oth€r psdc wtlo.E
around you end haw w.onged you?

I dont k how that h.pDeos?

dsherltrtbgtmail.@m: lncEasl8n rny hmn cphalby iakinB rh€lrs

oe: i doht urdersland thc ffirepr of human crphal

l:19 AM Idont $e hm it is 6!irl

dsherlodbgEmalLrom: fhe Ehre of e hutrrtn beint

Th! import?nc€ of your llf!

me: itr not beint incorpoated lnlo you

its nota5 if by tillin8emsreyou rre makingyourplf nmntsr

you areiEr tJdlB ryaf alitu

that slms b b€ like deslruction

1:20 AM anysray, you dld not rnswcr By pEviou queslion

dsherlorlb@tm! il,@m: whkh me

I:21 AI\, t don't bellw€ ther€'s abslut€ tood or Nll

@ @
 De: lf ygu snt totill peoplc, wlry dont You kill mc and be! and othar [*ople who 'r'
around you and have w@n8ed You?

Desuu{tlon m.Y mate it fiore ne8atbe whidl is justas

1:22 AMdshcrttctb@8ru]l.com:
5ultable in terfr3 of rcanlo8

I rold you why t eD'l do that

1:14 AM me: why?

1:26 AM dsherlo*bgBmall.com: I wouH b€ €ught and could not klll motc p'ode, I suld
abo loe thc re* of 8y liie- Tho* splrl!tres ygu 5p€al ol muld be aone' Thit h whl I
won'tlill untit my llre ls neilly owr.

1:26 aM Your mranlot ot lifa as beit€ 3 irumcy does\ addre$ the reanlng of d"th'

1:29 AM me: idont kmw the me..{o8 ofdeath

d5hBlodb@6mBit.cm: lf lltew.s meantto b€ llved rnd eryerlEned thanwhyrhorld tt

end

re:slne I harc not aDarlrEd itYct

thE i dont sony about at

beer ewrythinS @mes lo an sd

1:30 AM drh.rtodb@Emall.com: A([de

.1:33
gyin8th€ mEnlnt of llf! ir to llve is a tautolo8t I rmEnired lonSago. lt i5I
teagn'rMto live bur nor a purpo*-

1:34 AM mei a purpop Ir smethio8 yoo find

ils pErcnal

to m lt ls€xDerlcntlngthinF

dshlilGhb@Emil.comi Life €me into beln3 .od ercr siru has beetr a carcEr upotr death,

m; iB ot to have ditfcr"nr vlm! o, llf! and hrye . diffsnnl purpo*

thal is your vlew, not minc

1:35 AM idont urdetrland tie pqlok ofyqurvlB

but dlat could just be b.caus i d6t think thE say you do

1:37 AM drherldlbegmil.com: LitC tnd death an conrcrt.d

llyou dor't El€ lnto arount the ffinlntotboth thrnyouron'tbaaue lo undlrstsnd

@ @
 7 minutEs

1:44 AM me:5ure

btu you and i dontknqw what happens atletdeath

1:45 AM I why not exreilere itwh8ntt coEes

why rcrryabeut it mw

1:48 AM dsherloctb@8mall.co m: were we not dead b€lolr we were aliYe?

me: we did;t exlst

1i49 Airl i dst bel-€ve ln reblnh elc

dlherlockb@Bmail-com: rtEt It daath

tt is dE same

we hare alreedy nexperlen(3d'lt

1:50 AM me: we weientonrlous th€n

w htE no memory
s ldont coNider lt

i dor* thlnk pre-exi5lene i5 &ath

1:51 AM dstrrrloctb@gman.com: Why nol

pr&post therc h no difteanre

l:55 AM me: you dont knowthat

dsherloclb@gmail.com: I don't kmw a4'thing

I berse In a proh.billstic universe

SonF oot@mes ara more Bkety than oth6

1i56 AM m: and how is prc and pod.ri.t€fi€ probrbillsticiny the sre?
dsherlockb @8m rll.com: They both lh.rc o re bit thlnB ln co mmoD, and th.t I ! the a btefte
of life

1:59 AM I !m not inheteotly dil Grrg, my ootl@k on destroylnS litG b plil B, I allo fouod.
plIpole lor 'good"

2S0 AM me : i lmw you are not Inhenntly evil

IE@@ @
 JAh{ES EAG;\N HOLfuIES
Case Ntulber: I2ClRl522
SANIITY EYALTiATION
JetAey L. Melzner. hr.D., Comulting Psychiatrist. CL,IHIP
Septeurber 3. ?013
Page 68 of69

Attacluuent 6

JAMES E.A.GAN HOL}TES

100936 3t2tr3tl987 r
O8JO4I2O13 RC-ARA.PAIIOE
E?002 Color*do id[eatal Ea*lth Iastitute at Pueblo Uuit _F2_
A.RA.P]UIOE SAhTTY EXAM OBSEItVATIONRSPORT 150 (:.0193)
 chat- S. txt
Pfft takes two to make it happen ;p
From: From: +18584497348
rimestamp: 7 /9 /20L2 4i25iz0 AM(Lrrc+o)
Source Abplication:
Body:
why the interest a'l'l of a sudden?
From: From: +19704439340
Timestamp: I /9/2OlZ 4126. 40 All(uTc+0)
Source Application:
Bo6y:
NOt as busy
From: From: +18584497348
Timestanp; 7 /9/2OL2 4:30:30 AM(uTc+o)
source App'lication:
Body:
I:y_"-f !_:l::_i::-::[:r-li th dv'pt'o.^i c mani a?
From: Fronr +19704439340
Timestanir: 7 /9/2072 4: 50:08 AM(uTc+o)
Source App'lication:
aody:
No. what 'is that
From: From: +18584497348
TJmestarp: 7 /9n0n 4: 55;24 AM(Lrrc+o)
source Application:
eody:
It'3 what rrve got. Anways A it's in your best interest to avoid me, am bad news
bears
Fron: From: +19704439340
rimestanp: 7 /9/2012 4:56:32,1u(urc+O)
source application:
eodv:
r jlst looked i-!- up. rS it manage4ble? r've struggled w'ith depression too (cones
from other stuff) its hard to deal vrithA
From! From: +18584497348
rimestamp: 7 /9/2072 5:00: 58 Al,t(urc+o)
Source App'lication:
Body:
rt wasr floodgates open now.A
--a----------
From: Frofl: +19704439340
rirnestamp: 7 /9/2072 5 :39: 12 au(uTc+0)
Source Application!
Body:
Are lou ok? r'm not scared of that stuff,.,. r've been there Selieve me ... Not the
exact sarE. But I €an understandA
From: Fromr +L8584497348
rirEstamp: 7 /9/2Oa2 5:48: 13 AM(Urc+o)
source Application:
sody:
Yep.

From: From: +19704439340

Timestamp:_ 7/9 /2012 5:54iOB AM(UTC+0)
source Application:
eage ZB

@ Driithn
 JAIUES EAGAN HOLI.{ES
Case Number: l2CRl522
SAN'ITY E}'ALUATIOI{
JetA'ey L. Metzrrer. tr{.D., Consulting Pslchiah"ist, C}.{HIP
Septe*rber 3" l0l3
Page 69 of69

Attaclunent 7

J&'IitES EAG.{N EOL}TSS

100936 Br2lt3$987 F
08/0412013 RC-ARAPAEOE
Er002 Color*do lileatal Ee*lfh Institute at Pueblo Urit_F2_
S.RATAIIOE SAAXITY EXAM OBSERYATION RSPORT 1s0 (10193)
 '-'j I

lReport HeaUer (lnstltutions NamB) MRN: 127984X Edrom: 130801

Holmes, Jarreg
I oOB:12n3l1gB7
^l
Ll Client Summary
1690 Pada Slraal Apt loAulDn CO 8@10

I Pase t Appdnlrenl D8te: 06171+2012 3:5821 PM

I Note Dato: 0812/20124:39:02 PM

filhtDale:t7lAlfrE
t; rrees HoIE€3 DOBI12/]-3/1987 !RN:127984Jt
:1690 FariB Str€t AI)t 10 Arora CO 8OO1O
age Progross Note PrcgxeEE Nora 05./1.1/2012 3:58:21 Plt
: Fstor, tf'De l.rD
: Fentoa, llrrtlta I'D

o lihl.te oale.
AUB.]ECIIVE;
Efre-ElEaFHeurosciences g.rad student returns today for scheduled folloH-up vislt wlth
Dr. EeinsEeln and myself. A.f,ter I ask how hls cornp exam went, he reporEs he f,alled it.
last If[rsday'
Test was -Last llrrsday' he found
tound out Saturday. As usual, he Eeems ina inappropdat€lyly
.alant about this.
nonchalant reallv.like
Savs he doesntt really
this, Says like the progr&m anv$rav and that he
proqram any$ray
plan to tetake
doeBn't D-lan thc t€st,
rEtake the t€st- Thinks he'Il guit
Thtnks he'll proorm and looh
mit tha progrem lo for a job.
I(nowing h1shistory of anger and homicldal ideation (towards seearlngly nost of the ht![an
race) we proceed !o assess his lerel of dangerousness. tle acEually seejns not angry at
the grad achool, arld perhaps a blt relieved to 5s leavj.ng the ptogram. Neithet does he
appear suicLdal or even depregsed. However, he mntinues to make hostltB caments to
both of us and seatrs mgre paranold than on prevlous vlsits. Eo! E!ra!El-e, when agked lf
is aware that scme of his c(ments and demeanor may frighten or concern others, he
"BelI Fenton is cloarly afratdof mB . t'hatrs t{hy she as}ed you here toproteet h€r
or sonethi.ng. And then that one tine shs locked the door and had a consplcuous package
behind her chair.t Bu! he alao naintains that other see hi:n as "normal'.
Begatding specLfic streasors that nlght lncrease his lerel of, dangBrousness; he stated
h€ had no siuaent loaD debt aud had ln f,act about $10K of savinqg that i{puld last f,or a
wbile- ne planned to stay ln Colorado ,,because fty lease goes until Noveober. I siEned a
contract and I probably wonrt break that'r and tlEt herd look for a lob, ThouEht that
his parents would help support hin if need be. Said he had lold on€ frlend ln the
progra$ thac tre had faiLed (because she asked h:ir) and that he plamed to tell ILis
patinEs. tle did. not se€m too concerned about thel.r feaction- i'I tol"d them a while ago
I might not stay in the;xogxau, TheywlJ.I support wlEt€ver ny declsioD is.,r
restat€d that we here very concerned about J€nes and thought that he uou!.d beneflt
frorn a nedlcaEion lilce risp*ldone and continued psycbocherapy, He said his:insursce
tas going to ehd and we said that l{ou].d not be a baitler, Ile-sall no polnt in:gettlng
treatnent Lf he sasn?t golng to coatlnue Hibh the g.rad program. fle dld pause to
ider Dr. FeinsLein's guestLon about ',what about getting help for your life,t but
ated he wasn'E lntere;ied,
about 2onins, .Ianes saj.d he had to leave to go talk to bis grad sohooL adYigor and
up afidleft HLthout thanks, goodbye or ottrer partlng rernarks, a, per his usual

Significant worrles re$ained about the dangerousness of this student. palticularly Ehe
al for vlolence against others given:
gis
is fong-standiDg fantaeies of }iLl.inc
long-standiag fatrtasies k1L1ing as many people as poasible.
IIls caglness
Ills discuseing any detal.ls regarding llothocs,
caginess in diseuseing &ethocs, targets, tiInldg-
timlDq-
llis refusal. to glve us p€rmissl.on to contict ani one who cou1d qrive coLl;tglal
at speak on his behalf-
4. The lraclear timeline of hLs mental hea].tb status and past llistoly- Eas he
alnays been this odd and angly or is thls new, sugEestLng a-psychotic 6r"a!,
substance-rclated p,sychoslsr or nedical l.llness.
0023
 : -',

lReport HeaUer (lnstltutions Name)

A,RN: 127984X Ednum; 130601
I Holm$, Jameg
I

I DOa: ,2i13lr097

(. i Clleni Summary 1590 Parb StEstApt l0 ArroE CO 80010

i! eagez Aptoidr')elrl Dats: 00.h1r2012 3;54:21 PM

Nols Dab: mfl2/2012 4:3902 PM
I
I PlintDal6tg7agn0l2

iciven tlese concerDs. I activdted the BETA (threat aesessment) Eeam to investigate
lfurther and help fohulate a plan.
it spoke Hlth the director of the Neu.rosciences progre and also with .rmes. adrisor.
:Neither had heard of him mking any threating remarks. goHever. they both noted his
le:<tremely awkward social lnterictilns and od6 cornnents he nould-make-in 1ab
{presentations. In retrospect, he had be{ }ike that even at his interview for the
lPmgre, but that facultY thought he eras juet very anrlious, The Labs he rotat€d through
ih,ere eithar not interosted in having'htu join them or pere very concerned about the
Ipossibility.
,
[Aetn t.u* background chec] revealect no cr!,rninat lecord nor Feapons pelnlts. He bad a
lvalid drivers .Licen6e at the address he provlded, No hllitary servlce.
I

toot the edded stsp of contactiog.IEnes'mothgr in San Dlego, againsE James, slshes as
lf fett
lI lt pas crucial to know nore about hl.s msntaJ. health htstory to deternlne whether
Ithis was a new illnass or a longstandlng one. She wrs appraclative of the caII, seemed
lappropriately concerned and engaged, and added 'Irve worried abou! hlm every day of hls
lufe.. I Justs don't knotr,, Bhat to do to help hi"ut. This is likB a llf€tine oE guilt l'n
f
one phone convssatlon.
!
reportecl Jsas' nha6 aJ,ways been like thiss but that it became worse when he pas l,o
(-Jshe
.tand they
-*lwho. moved fron a snal-L tom t6 the city of 6an Dlego. Bhey took him to D couN€Ior
helped hln adJust to- the nes school but dldnrt addieoo any uodertrying psychological
iproblems, She feels he has scne sott Df extrEbe soeial. phobla and iE-,bislcilly
itsrrifted." No other relativea are lLke.Tares, though hi; father ls "v6ry introierted,"
1

Ishe notes that she ls the reclplent of most of Jarnes' anger, and wasD't sure Hhy. !{hen
lhe didnrt get into grad schm]- the fl,rst year. he }l?ed at home end rplayed video gres
laJ-I day." She got angry and told him he had to get a jo,b or move out (he did get a'Job.)
I He was furious at her, but no physical violence. Sha says he says such rean thing; to
ustops
lher that she xithdxaws frffi hiff and trylng.x lle apparently gets along bett;r
lwith his faEher,
I

if guo. her my contact info should she have any concerns or f,urther questions. she
Ithought she rcu1d talk to James! f,athar and perhaps -have hilt eall to check on.hin-
t
I
iAt this polnt, it appears that ,rames ha8 schtzoid p€rsonality disorder and is
iiitenittently funcEioning at a psychotic lcvel, Hls abillty to nsntalize about
iothers'
istates of mind 16 very irnpaired and he may be on the auttsm spectrum. fle may be
'ucf,i".pUr."i",'-inoug],
lstrifting insidlously into a frank psycnoiic aisoralr su"[ "u a"et
inot havs the mor€ raPid Horsening of funstlon tlplca!. of nost psyctrotic breaks. -Hls
ifeax,/hatred of hunans has ma.rkedly impalrBd hi:n - though he seenri very Intelllgent 1t
ldppears he wtll drop out of the g;ad ichoor program du6 to his impalrid lnteraEttons,
not. curr€nt1y meet criEeria for a m€ntal health hold. He ls not gEavely d.tsabted
io*" has
iand no cvidencs of suicidal ideation. l,ongstanding horicldal idea[ion h]t denl.es
iany speciftc targets and there is no current eridence that he is angry at the grad
. ischool. (or anyone €lse) for his failure. H€ has Eade Mny hostite ie6;rrks to iyself and
/-.-.lDr, Feinstein, buf Do fhreats. This is sJ.Di.l,ar behavlor Ea, uttat hls rlogher desiribes,
..
,,No evidence of past violent acts. No eridence of su.bstance 8buse. though no drug
'--itestj.ng has been done-

Itatn t.*, patient's nother, direcEor End advisor 1n NS grad program all notlfied of
I
oo21
 MRI.f, 127984X Ednw: 130601
llcures, Jamg6
DOB:121311987

Cllent Surnmary 1690 Parb SheetADt l0Aumra CO 80010

Page 3 Appolnuflent Dds:ocfl 1r2ol2 3:58:2t PM

Itl,oto Date: 08122012 4:39:@ m,
P.mtDale:0712312012

ial concerns and have my contact lnformation (and campus police info) should
lng crme up. Student l'r0 Sepice will be bappy to assist ,fues should he reguest
treatment, even Lf his insurance has expired,

DTAGNOSTS e}!D SY|4PXiOMS: lreseEt traat wl-eli- lla-cal i na

lschi3r._o-1d P€reona].ity Disolder 301. 20

Dl6ord*

a} Hosptl.tallzatlons: O,
ISK FACTORS:
Hisiory of butPatlent Treatm€nt,
No. history of SuicLdalityr Violence/Assau1t, Self-lrutilatlon,
ssivo-Codrpulsiee Disorder ( -- g6/L2/20f2)

HISIOR!:
: Einancial Problens3 Financlal
Development Academlcs: Acadenic problere: Failing grad.es
Environnent/Spiritual : Environmental problems : Eivironment
]lousing: Housing Problensi HousLng
Oecupatlonal: present Occupation: Graduate School
Occupatlonal: Occupational prcblems: Ocopatioml
lrly5v-synggrt/IPirv: Maritar Hlstory; larent is sinsre
Relationships : Rel.arionel probt6rnsi -niiiti"nif
'
Social

t w:lsit

GraduaLe School.
 \'..; ii

lReport Header (lnstitutions Name) MRN: 127984X Ednm: 130601

Holms, Jamg
I OOB:1213h987

]i ctient summary 1690 Pads sft6q Apt 10Aurcra co @010

Page 3 AppdnrMt Odo: 08/trr20l2 3:58:21 PM

Noto Dato: 06112012 4:39:m PM
ftlnlDale: O7D3t2012

essential concerns and have my contact Lnfor$atign (and campus police info) shouLd
anythlng come up- student tvrg service wirr be happy to assisi Jaies shouLd he requ€st,
treatnent, eyen if hi6 insurance hae expired.

R/o schirol,hrqrifo)d DisoldEi 295. iO

EifSltOFJ!

al Hospltalizations: 0,
RISN EACaORST
Hlstoly of, Outpatlent Treatment,
No.history of suicidaliCy, Violence/Assautt, self-Mutilation,
sslv€-Conpulslve D.Lsorder ( -- O6/LZ.ZOL2|

Financial; Financial problamsi Elnanclal

elopnent .Acadenics: Acadentlc probleEs: Failing gredes
lromrent/Spiritual r Envlrorun€ntal problema : givirorunent
Houslng: tlouaing problems: Bousino
Occupatlonal: presst Occupatign: Graduate School
Occupational: Occupational probL ems : Occupatlonii
l:lT:Iv_s:pp:=t/Feily: F.tc"t Htstory,
socral' Relationship:: Relational
i,arenL is stngte
problems: BelatioiaL -

SIRESSORS/ I gRE.lqc4rl r

sooial

Occupatlonal: Graduate School.

HIStrORI: