Lawyers for a nurse accused of fatally shooting a new mother and speeding away with the dying woman's infant son said she was confused and mumbling in court and they plan to review her mental state.
Verna McClain is facing a capital murder charge over the death of 28-year-old Kala Golden. Investigators said McClain, a mother of three, had suffered a miscarriage and was desperate to find a baby after telling her fiance that she had given birth to their child.
"It will take a while... for her to have an appreciation for what the situation is, if she ever does appreciate it," defence lawyer E Tay Bond said after the brief court hearing in Conroe, Texas.
The judge delayed a bail hearing until Monday to give McClain's lawyers more time to review the case, and McClain will be held until then. The capital murder charge carries a potential death sentence.
McClain is accused of shooting Ms Golden in the car park of a suburban Houston paediatric clinic, then snatching her three-day-old son, Keegan Schuchardt. The infant was found safe hours later with McClain's sister, who told investigators that McClain told her she planned to adopt the baby.
McClain intends to plead not guilty, Mr Bond said, adding that a plea of not guilty by reason of insanity was "certainly something we will be visiting".
Handcuffed around her waist and wearing a pink-and-white striped prison uniform, McClain spoke softly and looked down during the hearing. Texas District Judge Fred Edwards asked her several questions, including whether she owned a house or car, or had any savings, to which she responded "No, sir". McClain told the judge she understood the charge against her.
McClain is being held in a jail cell by herself under 24-hour watch, and Mr Bond said he did not believe any of her relatives had visited. He said he hoped McClain would be granted a reasonable bail bond so she could take care of her three children, who are being looked after by a relative in Houston.
The shootings occurred outside the Northwoods Paediatric Centre in Spring, about 20 miles north of Houston, where McClain had taken her three children for check-ups. But investigators believe Ms Golden was randomly targeted.
Authorities said McClain parked next to Ms Golden's vehicle and as Ms Golden was placing Keegan into her pick-up truck, McClain repeatedly shot her, snatched the baby from the truck and sped off. Witnesses reported that the dying woman leaned into McClain's vehicle and tried to take the boy back, screaming: "My baby!" Ms Golden died in hospital. Her son has been reunited with family members.