Background
The Massachusetts Appeals Court reversed Salvatore Dicostanzo’s disorderly-conduct conviction because an outburst inside a hospital trauma room was not shown to be reasonably likely to affect the public. The court nevertheless affirmed his convictions for disturbing the peace and assault. The unpublished Rule 23.0 decision draws a useful line between two offenses that can arise from the same disruptive episode: disturbing the peace can be proved when conduct actually infringes even one person’s right to be undisturbed, while disorderly conduct requires the additional public-impact and culpable-intent elements defined by Massachusetts precedent.
Dicostanzo was taken voluntarily to a hospital and became combative in a trauma room. Viewed favorably to the Commonwealth, the evidence showed him waving his arms, yelling obscenities, refusing a gown and monitoring, raising an arm toward a nurse, attempting to bite the nurse, and trying to strike an emergency medical technician. Hospital security and a police officer intervened, and staff eventually placed him in soft restraints. A jury convicted him of disorderly conduct, disturbing the peace, and assault. The disorderly-conduct and disturbing-the-peace convictions were placed on file without sentence, but the Appeals Court reviewed them because the record did not show that Dicostanzo had consented to that procedure.
On appeal, Dicostanzo challenged the sufficiency of the evidence for the two public-order offenses. He also argued that the trial judge should have instructed the jury on self-defense and mental impairment. Because he did not object after the requested self-defense instruction was omitted from the final charge, the appellate court reviewed that issue for error creating a substantial risk of a miscarriage of justice.
The Court’s Holding
The panel found the disorderly-conduct evidence insufficient. Under General Laws chapter 272, section 53, the Commonwealth had to prove qualifying fighting, threatening, violent, tumultuous, hazardous, or physically offensive conduct; that the conduct was reasonably likely to affect the public; and that Dicostanzo intended public inconvenience, annoyance, or alarm, or recklessly created that risk. His conduct could satisfy the first element, but the prosecution did not prove the public-impact and intent components. There was no evidence that he left the trauma room, knew of any disruption beyond it, saw onlookers, attracted a crowd, or caused people outside the room to abandon their activities.
The court treated the Supreme Judicial Court’s decision in Commonwealth v. Accime as materially analogous. The fact that staff summoned an officer did not establish that Dicostanzo consciously disregarded a risk of public disruption. His conduct was combative, but no evidence showed the kind of effect on members of the public required for disorderly conduct. The court rejected the Commonwealth’s proposed distinctions based on the type of hospital unit and Dicostanzo’s voluntary arrival. It reversed the conviction, set aside the verdict, and ordered judgment for the defendant.
Disturbing the peace required a different result. That common-law offense asks whether most people would find the activity unreasonably disruptive and whether it actually infringed someone’s right to be undisturbed. The Commonwealth did not need to prove that a group was disturbed. Dicostanzo’s flailing, screaming, and attempts to bite or strike staff in a busy hospital permitted the jury to find both requirements satisfied. The court also upheld the refusal to instruct on self-defense. Even viewing the evidence favorably to Dicostanzo, nothing showed a reasonable concern for his safety or that he used all reasonable means to avoid physical combat. His statements that he did not want treatment and might sue did not provide evidence that hospital staff threatened him, and the jury would have had to speculate to find self-defense.
Key Takeaways
- Disorderly conduct requires proof beyond threatening or combative behavior: the Commonwealth must establish likely public effect and the defendant’s intent or recklessness concerning public inconvenience, annoyance, or alarm.
- Conduct confined to a hospital room does not become a public disturbance merely because staff summon additional help; evidence of awareness, onlookers, rerouting, or broader disruption can be decisive.
- Disturbing the peace has a distinct test and may be established when unreasonably disruptive conduct actually disturbs one or two people, including hospital staff.
- A self-defense instruction requires evidence supporting every element. Refusing treatment or threatening litigation does not itself show reasonable fear or reasonable efforts to avoid combat.
Why It Matters
Although issued under Rule 23.0 and therefore persuasive rather than binding, the decision is a focused application of Massachusetts public-order doctrine in a healthcare setting. Defense counsel should test each statutory element separately instead of treating disorderly conduct and disturbing the peace as interchangeable labels. Prosecutors, likewise, need evidence connecting behavior inside a controlled room to likely disruption of the public if they charge disorderly conduct.
The ruling also highlights two record-preservation points. A conviction placed on file ordinarily lacks a final judgment for appeal, so the defendant’s consent should be documented. And requesting an instruction before or during trial does not necessarily preserve the issue if counsel fails to object after the charge. Here, the sufficiency argument still produced an acquittal on one count, but the unpreserved instructional claim received the more demanding substantial-risk review.