Judge: Metzker-Madsen “dangerous to himself and others”

An Iowa man who attacked and killed his 5-year-old foster brother will stay in the state’s medical care after a judge ruled this month that he remains “dangerous to himself and others.”

In November, Cody Metzker-Madsen was found not guilty of murder by reason of insanity in the death of Dominic Elkins. Dominic died after Metzker-Madsen attacked and drowned him while the two played alone on their foster parents’ rural property in western Iowa. Metzker-Madsen was 17 at the time.

District Court Judge Kathleen Kilnoski ruled on Dec. 4 that the teen will remain for the time being at the Iowa Medical and Classification Center in Coralville. He will be kept at the prison’s forensic psychiatric hospital unit.

“(Metzker-Madsen) poses a great danger to others, and indirectly to himself, because of his limited functioning and mood instability,” Kilnoski wrote in the order.

At the weeklong trial, Metzker-Madsen, now 18, testified that he was in his “own world” when he killed Dominic. The teen believed the younger boy was a goblin during the attack.

Metzker-Madsen went to the Coralville facility after the verdict for a psychiatric evaluation, a move required by state law. A psychiatrist diagnosed him as having an unspecified psychotic disorder, Kilnoski wrote.

The psychiatrist also diagnosed Metzker-Madsen with oppositional defiant disorder and intermittent explosive disorder. Both can cause violent temper tantrums and aggression, according to the Mayo Clinic. Iowa law requires Metzker-Madsen to remain in state custody until a judge rules he is no longer a danger to himself or others.

In her ruling, Kilnoski wrote Metzker-Madsen will likely need to stay in a “highly-structured and secure environment” throughout his life.

“In general, he will need lifelong monitoring and structure to help minimize his risk to the public and to himself,” she wrote.

Kilnoski ordered another evaluation of Metzker-Madsen that will be submitted to her in early January. After that, evaluations will be submitted every 60 days.

At trial, Metzker-Madsen’s biological mother admitted that she smoked methamphetamine while she was pregnant with her son. A forensic psychologist called by the defense testified that Metzker-Madsen had trouble understanding the consequences of his actions. Former teachers said he was obsessed with fantasy games and sometimes had violent episodes.

In the trial’s final day at the Harrison County Courthouse, Kilnoski ruled that the teen showed an “extreme indifference” to human life. However, he ultimately could not tell the difference between right and wrong at the time of Dominic’s death.

Not guilty by reason of insanity verdicts are rare in Iowa. Metzker-Madsen’s attorney was not immediately available to speak with a reporter.