Santa Fe Shooter’s Competency Restoration Reviewed by Galveston County Officials
KGTX 7 News
Jan 22, 2026
GALVESTON COUNTY – Officials recently visited North Texas State Hospital to assess the status of Dimitrios Pagourtzis, the former Santa Fe High School student charged in the May 18, 2018 mass shooting that killed 10 people and wounded more than a dozen others.
The visit involved Interim Galveston County District Attorney Kenneth Cusick, defense attorney Nick Poehl, and visiting Judge Lonnie Cox, who met with medical staff at the hospital’s Vernon campus, where Pagourtzis has been undergoing treatment after being declared incompetent to stand trial in 2019. Judge Cox is expected to sign an order recommitting Pagourtzis to the facility for up to another year. Details of the visit and the officials’ statements were first reported by KPRC 2 Investigates.
Pagourtzis faces capital murder and aggravated assault charges related to the deaths of students Chris Stone, Aaron McLeod, Angelique Ramirez, Jared Black, Kimberly Vaughan, Sabika Sheikh, Christian Garcia, and Shana Fisher, as well as educators Cynthia Tisdale and Ann Perkins. The criminal case remains paused unless doctors determine his competency has been restored.
Cusick, speaking to KPRC 2 following the visit, said he does not plan to challenge the recommitment order. He added that if Pagourtzis’ competency is not restored after the next two-to-three-month treatment cycle, he may seek an independent psychiatric evaluation. He also acknowledged uncertainty about whether Pagourtzis’ symptoms could be exaggerated, though medical professionals currently do not believe malingering is occurring. Cusick said doctors reported progress in treatment and expressed hope that competency restoration could occur soon, while noting he would pursue additional expert opinions if necessary.
Defense attorney Nick Poehl, who accompanied Cusick and Judge Cox during the hospital visit, told KPRC 2 that doctors described Pagourtzis as the most severely mentally ill patient at the Vernon facility, which houses more than 200 individuals. He said medical staff indicated the likelihood of restoring competency is low and emphasized that multiple evaluations over several years have consistently found Pagourtzis incompetent to stand trial. Poehl noted that Pagourtzis currently works in the hospital’s library but said such duties do not indicate legal competency. He explained that competency requires a defendant to rationally understand the charges, assist legal counsel, and meaningfully participate in their defense.
State records show Pagourtzis has been hospitalized for 2,234 days, far exceeding the average 158 days it took North Texas State Hospital patients to regain competency in 2025. He is one of 11 patients statewide who have remained at the facility for five years or longer. The average daily cost of treatment at the hospital was reported as $949 in 2025.
State law requires hospital doctors to inform the court annually whether competency restoration appears imminent or whether continued treatment is necessary.
Cusick also said that if Pagourtzis is ultimately found competent, he will seek to move the trial back to Galveston County. Prior to the incompetency ruling, a judge had granted the defense a change of venue, relocating the trial to Fort Bend County.
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