Earline Cozzens
20 EARLENE COZZENS COOPER,
21 CALLED AS A WITNESS, BEING FIRST DULY SWORN,
22 WAS EXAMINED AND TESTIFIED AS FOLLOWS:
23 DIRECT EXAMINATION
24 BY MS. BARLOW:
25 Q. GOOD AFTERNOON. WOULD YOU PLEASE STATE YOUR NAME AND
1418
1 SPELL IT FOR THE RECORD?
2 A. EARLENE COZZENS COOPER. IT'S E-A-R-L-E-N-E,
3 C-O-Z-Z-E-N-S, C-O-O-P-E-R.
4 Q. WHAT IS YOUR OCCUPATION?
5 A. I'M A REGISTERED NURSE.
6 Q. WHERE DO YOU WORK AT THE PRESENT?
7 A. AT MCKAY-DEE.
8 Q. AS A REGISTERED NURSE, WHAT EDUCATIONAL BACKGROUND DO
9 YOU HAVE?
10 A. I HAVE A B.S. IN NURSING.
11 Q. WHERE DID YOU GET YOUR B.S.?
12 A. AT WEBER STATE UNIVERSITY.
13 Q. HOW LONG HAVE YOU BEEN AN R.N.?
14 A. SINCE '82. SO --
15 Q. 18 YEARS?
16 A. 18 YEARS.
17 Q. SINCE 1982, WHERE HAVE YOU WORKED?
18 A. I WORKED AT LAKEVIEW FOR TEN YEARS AND THEN I --
19 Q. AT LAKEVIEW WHAT?
20 A. HOSPITAL.
21 Q. OKAY. WHAT DID YOU DO AT LAKEVIEW?
22 A. I WORKED MEDICAL SURGICAL PATIENTS. I WORKED O.B. I
23 DID NURSING. I STARTED OUT AS A NURSE'S AIDE THERE AND THEN
24 I GOT MY L.P.N. AND THEN MY R.N.
25 Q. IN MED-SURG UNITS AND O.B. --
1419
1 A. AND I DID WORK PSYCH AND I WORKED LABOR AND DELIVERY. I
2 WORKED EVERYWHERE. I FLOATED EVERYWHERE.
3 Q. AFTER THE FIRST TEN YEARS, WHERE DID YOU GO TO WORK?
4 A. I WENT TO MCKAY-DEE. AND I WORKED THERE FOR SEVEN
5 YEARS.
6 Q. WHAT DID YOU DO AT MCKAY-DEE?
7 A. I WORKED IN THEIR PSYCHIATRIC UNITS. THEY HAVE A CHILD,
8 ADOLESCENT UNIT AND THEY HAVE AN ACUTE UNIT AND THEY HAVE
9 A --
10 Q. AND SOMEWHERE IN THERE DID YOU WORK AT DAVIS NORTH?
11 A. I DID. AFTER I LEFT MCKAY, THEN I WENT TO DAVIS NORTH.
12 Q. NOW, THE PSYCH UNIT THAT YOU WORKED ON AT LAKEVIEW, HOW
13 LONG DID YOU WORK THERE?
14 A. OH, PROBABLY FIVE YEARS.
15 Q. WHAT KIND OF PATIENTS DID YOU HAVE AT THAT PSYCH UNIT.
16 A. THEY WERE ADULT PATIENTS.
17 Q. WERE ANY OF THEM ELDERLY?
18 A. YES.
19 Q. WHAT ABOUT WHEN YOU WENT TO MCKAY-DEE IN THE PSYCH UNIT
20 THERE?
21 A. THEN I WORKED WITH CHILDREN AND ADOLESCENTS AND ADULTS
22 AND WHATEVER PSYCHIATRIC PATIENTS THEY HAD, THEY RANGED IN
23 ALL AGES.
24 Q. WHEN DID YOU GO TO THE GEROPSYCH UNIT AT DAVIS NORTH?
25 A. IT WAS '94? I CAN'T REMEMBER.
1420
1 Q. CLOSE --
2 A. I CAN'T REMEMBER.
3 Q. OKAY.
4 A. I'D HAVE TO THINK.
5 Q. WE'RE TALKING ABOUT A TIME FRAME THAT IS DECEMBER '95 TO
6 JANUARY '96?
7 A. I WAS THERE.
8 Q. AND YOU WERE THERE.
9 A. DURING THAT TIME PERIOD, YEAH.
10 Q. HAD YOU BEEN THERE QUITE A WHILE PRIOR TO DECEMBER OF
11 '95?
12 A. YES.
13 Q. WERE YOU THERE WHEN THE UNIT FIRST STARTED?
14 A. IT WAS A COUPLE OF -- MAYBE A MONTH OR TWO AFTER IT
15 STARTED.
16 Q. AND WHEN DID YOU LEAVE THE GEROPSYCH UNIT?
17 A. IN JUNE 19TH OF '96.
18 Q. WHY DID YOU LEAVE THE UNIT?
19 A. I HAD A BACK INJURY.
20 Q. DO YOU RECALL WHAT SHIFTS YOU WORKED AT THE GEROPSYCH
21 UNIT.
22 A. IT WAS MAINLY DAYS, BUT I WORKED EVERY SHIFT. I WORK
23 AFTERNOONS, I WORKS NIGHTS, BUT IT WAS MOSTLY DAYS.
24 Q. AND HOW MANY DAYS A WEEK WOULD YOU WORK?
25 A. I WAS FULL TIME.
1421
1 Q. WOULD THAT BE --
2 A. SO THAT WAS FIVE DAYS A WEEK.
3 Q. FIVE DAYS A WEEK. WOULD IT BE FIVE DAYS STRAIGHT?
4 A. NO. I'D WORK WEEKENDS AND SOME DAY SHIFTS DURING THE
5 WEEK, AND THEN SOME NIGHTS, DEPENDING.
6 Q. WERE YOU THERE WHEN ELLEN ANDERSON WAS ADMITTED TO THE
7 UNIT? I THINK IT WAS DECEMBER 20TH --
8 A. I WORKED THERE, BUT NO, I DON'T RECALL EVER HAVING HAD
9 HER AS A PATIENT.
10 Q. SO -- AND IF THERE ARE NO NOTATIONS THAT HAVE YOUR -- OR
11 NO CHARTING THAT HAVE YOUR SIGNATURE ON 'EM, WHAT WOULD THAT
12 TELL YOU ABOUT WHETHER YOU WERE THERE WHEN SHE WAS THERE?
13 A. THAT I HADN'T BEEN THERE.
14 Q. IF YOU WOULD OPEN UP ENNIS ALLDREDGE, THERE SHOULD BE
15 A --
16 A. IT'S RIGHT HERE.
17 Q. OKAY. IF YOU WOULD OPEN THAT UP TO MEDICAL NUMBER 48,
18 PAGE NUMBER 48, IT'S UNDER NURSES' NOTES.
19 A. I DON'T SEE PAGE NUMBERS ANYWHERE. IS THERE IS A DATE?
20 Q. OH, I'M SORRY, THERE'S A MED NUMBER AT THE BOTTOM THAT
21 SAYS MED-00048?
22 A. OH, OKAY. AND WHAT PAGE?
23 Q. IT'S NURSES' NOTES AND THEN 48.
24 A. 48.
25 Q. IN FACT, I THINK --
1422
1 A. OH, IT'S THE FIRST PAGE, OKAY.
2 Q. -- IT'S THE FIRST ONE AFTER THE TAB, YES. DO YOU
3 RECOGNIZE WHAT THAT DOCUMENT IS?
4 A. IT'S AN ADMISSION ASSESSMENT.
5 Q. AND IT SAYS ORIENTED TO UNIT BY, AND IS THAT YOUR --
6 A. THAT'S MY SIGNATURE, YES.
7 Q. ARE YOU FAMILIAR WITH THIS DOCUMENT? IT'S SEVERAL PAGES
8 LONG. ARE YOU FAMILIAR WITH IT?
9 A. YES.
10 Q. I THINK IT'S ABOUT 12 PAGES.
11 A. YEAH, IT'S OUR ADMISSION ASSESSMENT.
12 Q. WHAT WAS IT USED FOR?
13 A. WHEN A PATIENT WOULD COME ON TO THE UNIT, YOU WOULD GO
14 THROUGH THIS ASSESSMENT TO KIND OF DO A HISTORY AND PHYSICAL
15 ON 'EM AND FIND A HISTORY ON 'EM AND ASSESS THEM TO -- THEIR
16 APPROPRIATENESS ON THE UNIT, THEIR HEALTH.
17 Q. MACHINE'S MAKING STRANGE THINGS. PROBABLY TURNED IT ON
18 THE WRONG WAY, TOO.
19 WHAT WAS THE PURPOSE OF THIS NURSING ADMISSION
20 ASSESSMENT DOCUMENT?
21 A. TO GATHER INFORMATION ON THE PATIENT.
22 Q. NOW, THIS ONE PATIENT'S NAME IS ENNIS.
23 A. UH-HUH.
24 Q. DATE 1/10/96. TIME 1230. WHAT WOULD THAT MEAN?
25 A. THAT WOULD BE THAT HE WAS ADMITTED JANUARY 10TH AT 1230
1423
1 IN THE AFTERNOON. IT WOULD HAVE BEEN A DAY SHIFT.
2 Q. EXCUSE ME, SIGNIFICANT OTHERS LISTED THERE, THEN THERE'S
3 YOUR SIGNATURE, ORIENTED TO UNIT BY, AND THAT'S YOUR
4 SIGNATURE --
5 A. YES.
6 Q. -- I ASSUME? AND SAYS, PERSON INTERVIEWED. PATIENT,
7 THEN IT SAYS WIFE.
8 A. UH-HUH.
9 Q. DO YOU RECALL MR. ALLDREDGE?
10 A. I DON'T.
11 Q. WHERE WOULD YOU GET THE INFORMATION FOR THIS ASSESSMENT?
12 A. I WOULD HAVE ASKED HIS WIFE. IT SAYS RIGHT THERE THAT
13 THAT'S WHO I TALKED TO.
14 Q. IF MR. ALLDREDGE HAD BEEN ABLE TO RESPOND AND ANSWER
15 YOUR QUESTIONS, WOULD YOU HAVE ASKED HIM INSTEAD?
16 A. YEAH, I WOULD HAVE PUT THEM BOTH DOWN HERE. I PROBABLY
17 WOULD HAVE PUT WIFE AND PATIENT.
18 Q. THEN WE HAVE WHAT'S THAT, TEMPERATURE?
19 A. YES.
20 Q. 97. AND THEN P. IS WHAT?
21 A. PULSE.
22 Q. PULSE?
23 A. RESPIRATION.
24 Q. A THAT A HIGH PULSE RATE, 96?
25 A. IT'S A LITTLE HIGH.
1424
1 Q. THEN RESPIRATION, WHAT'S THAT, 20 PER MINUTE?
2 A. 20.
3 Q. YOU DIDN'T -- EVIDENTLY NO BLOOD PRESSURE WAS -- READING
4 WAS TAKEN?
5 A. IT DOESN'T LOOK LIKE IT.
6 Q. THEN HIS WEIGHT WAS 176 --
7 A. POINT 6 POUNDS, YEAH.
8 Q. WHAT KINDS OF INFORMATION WOULD YOU GATHER FOR THIS
9 DOCUMENT?
10 A. ANY MEDICATION THAT THEY HAD BEEN ON, THEIR HEALTH
11 HISTORY, THE BEHAVIORAL PROBLEMS THAT THEY'D BEEN HAVING.
12 AND ANY DIET THEY WERE ON, WHETHER THEY HAD DENTURES.
13 Q. IN FACT, THE SECOND PAGE OF THAT --
14 A. UH-HUH.
15 Q. -- WHAT CAUSED YOU TO HAVE TO COME TO THE HOSPITAL.
16 A. UH-HUH.
17 THE COURT: DO YOU WANNA HIT THAT BUTTON THAT --
18 MS. BARLOW: THERE, THANK YOU. SANDY TAUGHT ME
19 WHICH ONE TO PUSH HERE.
20 Q. BECAME VERY VIOLENT, HITTING AND SPITTING. RIPPED HIS
21 SHIRT.
22 A. UH-HUH.
23 Q. AND THEN WHAT ARE GOALS OF THE HOSPITALIZATION TO, AND
24 THEN THE ARROW DOWN MEANS WHAT?
25 A. TO HAVE A DECREASE IN HIS VIOLENT BEHAVIOR.
1425
1 Q. WAS HE A TERMINAL OR HOSPICE PATIENT WHEN HE CAME IN?
2 A. NOT THAT I RECALL. LIKE I SAY, I DON'T REMEMBER HIM.
3 Q. RIGHT. WHAT WERE THE CRITERIA FOR THIS UNIT AS FAR AS
4 PHYSICAL HEALTH?
5 A. BASICALLY, WE HAD TO BE ABLE TO HELP THEM. WE HAD TO BE
6 ABLE TO --
7 MR. STIRBA: YOUR HONOR, IF I MAY, THE POLICY IS
8 IN. IF SHE JUST WANTS UNDERSTANDING, I GUESS THAT'S FINE,
9 BUT --
10 THE COURT: IS THAT WHAT YOU'RE -- ARE YOU STATING
11 WHAT YOUR UNDERSTANDING OF THE POLICY IS?
12 THE WITNESS: I'M JUST ANSWERING HER QUESTIONS. I
13 WASN'T -- SHE DIDN'T ASK THAT POLICY, THAT I --
14 MR. STIRBA: THIS POLICY'S THE BEST EVIDENCE, YOUR
15 HONOR, I JUST --
16 THE COURT: OKAY. IF YOU WANNA ASK HER HER
17 UNDERSTANDING, THAT'S FINE.
18 MS. BARLOW: I WILL REPHRASE IT THEN.
19 Q. WHAT IS YOUR UNDERSTANDING OF THE CRITERIA FOR PEOPLE
20 BEING ADMITTED ONTO THIS UNIT?
21 A. THAT THEY WOULD -- THAT WE WOULD BE ABLE TO TREAT THEM
22 AND THAT WE WOULD BE ABLE TO HELP THEM GET BETTER.
23 Q. AND WHAT WAS YOUR UNDERSTANDING OF THE POLICY IF, YOU
24 KNOW, AFTER THEY CAME ON TO THE UNIT, IF A PHYSICAL MEDICAL
25 PROBLEM BECAME ACUTE, WHAT WOULD HAPPEN?
1426
1 A. THAT THEY WOULD RECEIVE CARE FOR THAT PHYSICAL PROBLEM,
2 THAT THAT WOULD BE TREATED.
3 Q. EXCUSE ME, ON THE -- ON THE UNIT OR ELSEWHERE OR DO YOU
4 KNOW?
5 A. WHICHEVER WOULD BE THE BEST TO TREAT THAT PHYSICAL
6 AILMENT. The truth outs.
7 Q. AND ON PAGE 3, IT TALKS ABOUT -- IT'S MEDICAL
8 HOSPITALIZATIONS.
9 A. UH-HUH.
10 Q. THEN IT LOOKS LIKE A HERNIA IN 1990. A FIVE-HEART
11 BYPASS. MEANING FIVE ARTERY BYPASS. DIABETIC SINCE THE
12 SEVENTIES. WHERE DID YOU GET THIS INFORMATION?
13 A. IT WOULD HAVE BEEN FROM THE WIFE.
14 Q. AFTER YOU FILLED OUT THIS ADMISSION FORM AND NURSING
15 ASSESSMENT -- WELL, LET'S LOOK AT THE LAST PAGE, THE 12TH
16 PAGE, WHICH IS MEDICAL NUMBER 59.
17 A. OKAY.
18 Q. AT THE TOP IT SAYS, DISCHARGE PLANNING. DO YOU USUALLY
19 DO DISCHARGE PLANNING AS YOU BROUGHT PEOPLE IN?
20 A. YES.
21 Q. AND WHY WAS THAT?
22 A. BECAUSE WE PLANNED ON THEM BEING DISCHARGED. WE PLANNED
23 ON THEM BEING ABLE TO GET BETTER AND IMPROVE AND GO BACK TO
24 EITHER WHERE THEY CAME OR HOME OR --
25 Q. WAS THIS INTENDED TO BE A LONG-TERM UNIT?
1427
1 A. NO.
2 Q. DO YOU HAVE -- DO YOU KNOW WHETHER -- WHETHER THERE WAS
3 ANY POLICY ABOUT HOW LONG PEOPLE WERE SUPPOSED TO STAY IN
4 THE UNIT?
5 A. I DON'T RECALL.
6 Q. AND THEN THIS DISCHARGE WAS TO RETURN TO SUNSHINE
7 TERRACE --
8 A. YES.
9 Q. -- WHICH IS A LONG-TERM CARE FACILITY?
10 A. YES.
11 Q. IF YOU'D TURN TO NUMBER 60, EXHIBIT 60, THIS DOESN'T
12 APPEAR TO HAVE A DATE ON IT AT THE TOP. BUT IT'S THE FIRST
13 NURSING NOTE AFTER ADMISSION.
14 A. UH-HUH.
15 Q. DO YOU RECALL WHEN -- AND IS THAT TOP PART YOUR
16 HANDWRITING?
17 A. YES, IT IS.
18 Q. DO YOU RECALL WHEN YOU WROTE THIS?
19 A. IT WOULD HAVE BEEN THE 10TH WHEN HE WAS ADMITTED. IT
20 WOULD HAVE BEEN JANUARY 10TH OF '96.
21 Q. AND WHAT IS THIS NOTE THAT YOU'VE WRITTEN HERE?
22 A. IT'S JUST A -- THAT HE WAS ADMITTED TO THE UNIT AND
23 MAYBE SOME OF HIS BEHAVIOR.
24 Q. SO YOU GET DOWN --
25 A. AND WHAT WE DID FOR HIM.
1428
1 Q. -- TO HERE, IT SAYS, PATIENT IS VERY COMBATIVE AND
2 AGITATED. PATIENT NOT ORIENTED TO TIME, PLACE, OR PERSON
3 SITUATION. NOT ABLE TO WALK. KEEPS TAKING OFF HIS CLOTHES.
4 REFUSES TO EAT. SO IT GOES DOWN HERE, AND THEN RIGHT HERE
5 IT STARTS, IT SAYS, IS REALLY STRONG --
6 A. IS THAT AND?
7 Q. OH, I'M WAY OFF THE CHART HERE. CAN YOU SEE WHERE IT
8 SAYS IS? IS THAT VERY OR VERY STRONG? IS ABOUT TWO-THIRDS
9 OF THE WAY DOWN. JUST ABOVE YOUR SIGNATURE.
10 A. IS VERY STRONG AND GRABS AT STAFF, HURTING STAFF.
11 Q. DO YOU RECALL HIM BEING A STRONG PERSON WHEN HE CAME ON
12 THE UNIT?
13 A. I SAID I DIDN'T REMEMBER HIM, BUT I DO REMEMBER HIM. HE
14 KEPT TRYING TO TAKE OFF HIS SHIRT, AND IN THE PROCESS, HE
15 WAS RIPPING HIS SHIRT, AND I REMEMBER TRYING TO PUT A
16 PATIENT GOWN ON HIM AND YES, HE WAS VERY -- HE WAS VERY
17 STRONG.
18 Q. IT APPEARS THAT THERE WERE A COUPLE TIMES IN THE NOTE
19 HERE WHICH -- IN WHICH ALL YOU HAVE IS JUST YOUR INITIALS AT
20 THE BOTTOM AND THERE'S NOTHING THAT APPEARS TO HAVE BEEN
21 WRITTEN BY YOU. FOR EXAMPLE, NUMBER 63 HAS YOUR INITIALS AT
22 THE BOTTOM. THAT LOOKS LIKE NOTHING WRITTEN BY YOU.
23 WHAT -- WHY WOULD YOUR INITIALS SHOW ON THE BOTTOM OF THIS
24 PAGE?
25 A. I WAS PROBABLY THE CHARGE NURSE, AND PROBABLY MY TECHS
1429
1 WOULD HAVE GONE AHEAD AND WRITTEN THE NURSES' NOTES. AND
2 THEN I WOULD JUST CO-SIGN.
3 Q. SO YOU WOULD CO-SIGN, IS THAT WHAT YOU SAID?
4 A. YES.
5 Q. WHAT'S A CHARGE NURSE?
6 A. YOU WOULD BE THE TEAM LEADER OF THE UNIT FOR THAT DAY.
7 Q. AND YOUR TECHS YOU SAY WOULD WRITE THIS. WHO WOULD BE
8 THE TECHS, C.N.A.'S OR --
9 A. UH-HUH, IT WOULD BE C.N.A.'S. SOMETIMES YOU'D HAVE
10 R.N.'S AS TECHS. SOMETIMES YOU'D HAVE L.P.N.'S. IT WOULD
11 JUST DEPEND ON WHAT STAFF YOU HAD. BUT MAINLY IT WAS
12 C.N.A.'S.
13 Q. DURING DAYS, WHAT KIND OF PERSONNEL WOULD YOU HAVE ON
14 THE UNIT?
15 A. YOU WOULD USUALLY HAVE MYSELF, THE CHARGE NURSE, AND YOU
16 WOULD USUALLY HAVE THE OTHER NURSE WHO DID MORE
17 ADMINISTRATIVE KINDS OF THINGS AND WOULD HELP WITH PATIENT
18 CARE. AND THEN YOU WOULD USUALLY HAVE A NURSE'S AID, A
19 TECH.
20 Q. AS TEAM LEADER, WERE YOU OVER OCCUPATIONAL THERAPISTS OR
21 RESPIRATORY THERAPISTS OR RECREATIONAL THERAPISTS OR
22 ANYTHING LIKE THAT?
23 A. NO.
24 Q. AND AS A NURSE, WHO DID YOU REPORT TO?
25 A. THE DOCTOR.
1430
1 Q. LET'S TURN OVER TO PAGE 74. THEY CAME IN ON THE 10TH.
2 THAT'S WHEN YOU DID THE ADMISSION, AND THIS IS WHAT DATE?
3 A. IT LOOKS LIKE THE 13TH, JANUARY 13TH OF '96.
4 Q. NOW, THERE'S SOME HANDWRITING AT THE TOP OF THAT.
5 A. UH-HUH.
6 Q. WHICH IS NOT YOURS, LOOKS LIKE.
7 A. UH-HUH.
8 Q. DO YOU KNOW WHOSE HANDWRITING THAT FIRST THREE LINES
9 ARE?
10 A. LOOKS LIKES IT COULD HAVE BEEN LAURIE WILLSON. BUT I
11 DON'T KNOW.
12 Q. BUT THEN IT AT 0800 YOU START WRITING, AND WHAT ARE
13 YOU -- WHAT DID YOU WRITE THERE?
14 A. I WROTE PATIENT UNRESPONSIVE. FAMILY WITH PATIENT.
15 POSEY AND RESTRAINTS TAKEN OFF. I.V. D/C'ED. COMFORT
16 MEASURES GIVEN. AND THEN I HAVE MY SIGNATURE. AND THEN I
17 WRITE, DR. WEITZEL TALKED WITH THE FAMILY. DR. DIENHART WAS
18 NOTIFIED OF PATIENT'S DOWNWARD CONDITION.
19 DO YOU WANT ME TO READ THE 1500?
20 Q. WELL, LET'S NOT GET INTO THE B.I.R.P. RIGHT AT THIS
21 MOMENT. HAD YOU SEEN HIM BETWEEN THE 10TH WHEN YOU WROTE
22 THE ASSESSMENT AND THE 13TH WHEN YOU WRITE THIS REPORT?
23 A. I DON'T RECALL.
24 Q. DO YOU RECALL A DIFFERENCE BETWEEN HIS BEHAVIOR AND
25 PHYSICAL APPEARANCE ON THE 10TH WHEN YOU ADMITTED HIM AND
1431
1 THEN THIS NOTE ON THE 13TH?
2 A. I DO REMEMBER HIM ON THE 10TH BEING VERY STRONG AND
3 RIPPING HIS SHIRT AND TRYING TO GET A GOWN ON HIM, AND IT
4 WAS VERY DIFFICULT. AND HE WOULD HAVE HAD TO BEEN POSEYED
5 TO PROTECT THE STAFF AT THAT POINT. AND IF WE'RE TAKING OFF
6 HIS POSEY AND RESTRAINTS AND HE'S UNRESPONSIVE, HE'S NO
7 LONGER ABLE TO FIGHT US.
8 Q. AND THEN YOU'VE GOT B. WHICH STAND -- AT 1500. B. WHICH
9 STANDS FOR WHAT?
10 A. BEHAVIOR.
11 Q. OKAY. AND THEN YOU LIST WHAT HIS BEHAVIORS WAS.
12 A. UNRESPONSIVE THE WHOLE SHIFT.
13 Q. AND WHAT IS I.?
14 A. INTERVENTION.
15 Q. OKAY. WHAT DOES THAT MEAN?
16 A. THAT WHAT WE DID FOR HIM.
17 Q. OKAY. AND YOU TURNED HIM EVERY TWO HOURS, COMFORT
18 MEASURES. R. STANDS FOR WHAT?
19 A. RESPONSE. HIS RESPONSE TO OUR INTERVENTIONS.
20 Q. AND WHAT DID YOU WRITE THERE?
21 A. RESPIRATORIES -- RESPIRATIONS WERE IRREGULAR WITH
22 PERIODS OF APNEA. APNEA MEANS THERE'S PERIODS OF HIM NOT
23 BREATHING. HIS COLOR'S PALE.
24 Q. AND THEN WHAT IS P.?
25 A. PLAN.
1432
1 Q. AND WHAT DID YOU -- WHAT WAS THE PLAN THAT THE TEAM HAD
2 COME UP WITH FOR HIM AT THAT POINT?
3 A. THAT COMFORT MEASURES AND FAMILY SUPPORT.
4 Q. WHAT DID COMFORT MEASURES MEAN IN THAT CONTEXT?
5 A. THAT WE WOULD MAKE SURE THAT HE WAS TURNED, THAT WE
6 WOULD MAKE SURE THAT -- SOMETIMES WE PUT VASELINE ON THEIR
7 LIPS. WE MAKE SURE THAT HIS FAMILY COULD BE THERE WITH HIM.
8 Q. WERE YOU PRESENT WHEN HE -- WHEN HE PASSED AWAY, I
9 BELIEVE IT WAS ON THE 14TH?
10 A. I THINK I WOULD REMEMBER IF I WAS, BUT I DON'T RECALL.
11 I DON'T RECALL BEING THERE, NO.
12 Q. DO YOU RECALL WHETHER ANYTHING STRUCK YOU ABOUT THE
13 CHANGE IN HIS DEMEANOR, HIS ACTIVITY LEVEL BETWEEN THE 10TH
14 AND THE 13TH?
15 MR. STIRBA: I'M GONNA OBJECT, YOUR HONOR. IT'S
16 VAGUE AND AMBIGUOUS, STRUCK YOU.
17 THE COURT: DO YOU WANT TO --
18 MS. BARLOW: SEE IF I CAN FIND A BETTER WAY TO
19 PHRASE IT.
20 Q. I NEED A THESAURUS I GUESS. LET ME GO ON AND HOPE I
21 COME UP WITH BETTER WORD AS WE GO ON. I DON'T WANT ANYONE
22 SITTING HERE WHILE I'M TRYING TO TRY TO THINK. It might be a while.
23 DID YOU SEE A DIFFERENCE THEN IN --
24 A. YES.
25 Q. -- HIS APPEARANCE?
1433
1 A. YES.
2 Q. WAS THERE ANYTHING UNUSUAL ABOUT THAT IN YOUR MIND?
3 MR. STIRBA: WELL, I'M GONNA OBJECT IN TERMS OF HER
4 MIND AND WHAT IS IN HER MIND. I MEAN IF WE WANNA TALK
5 ABOUT --
6 MS. BARLOW: I'LL WITHDRAW THE IN HER MIND, YOUR
7 HONOR.
8 Q. WAS THERE ANYTHING UNUSUAL ABOUT THAT?
9 A. HE HAD COME IN BECAUSE OF HIS AGITATED STATE AND TO SEE
10 IF WE COULD GET THE AGITATION UNDER CONTROL. AND -- AND TO
11 HELP HIM GET BETTER AND TO GO BACK TO THE -- TO THE CARE
12 CENTER.
13 THIS DEFINITELY WASN'T -- THAT WASN'T IN THE PLAN THAT
14 WE HAD PLANNED FOR HIM.
15 Q. WHEN YOU SAW HIM WITH THE COMFORT MEASURES ON THE 13TH
16 THERE WHEN YOU WERE WRITING THAT YOU WERE GOING TO KEEP
17 COMFORT MEASURES, DID YOU NOTE ANY INDICATIONS OF PAIN?
18 A. NO, I DIDN'T. Obviously. He's on analgesics to prevent that.
19 Q. LET'S -- IF YOU'LL PICK UP MARY CRANE'S BINDER THERE.
20 IF YOU'LL TURN TO THE NURSES' NOTES, THE VERY FIRST PAGE,
21 WHICH IS MED NUMBER 294.
22 A. UH-HUH.
23 Q. DID YOU FILL OUT THAT NURSING ASSESSMENT?
24 A. IT LOOKS LIKE I STARTED IT, BUT THIS WRITING BEHIND
25 THERE, SOMEBODY ELSE MUST HAVE FINISHED IT. BUT THAT IS MY
1434
1 WRITING ON THIS FIRST PAGE, YES.
2 Q. ON THE FIRST PAGE. WHO DID YOU TALK TO TO GET THE
3 INFORMATION?
4 A. THESE -- I BELIEVE THAT THESE WERE PROBABLY HER
5 DAUGHTERS.
6 Q. KAREN BRINGHURST AND KATHY CHARLESWORTH?
7 A. YES.
8 Q. AND AGAIN DOWN HERE WE HAVE TEMPERATURE, PULSE,
9 RESPIRATION, AND THEN YOU DO HAVE THE BLOOD PRESSURE HERE,
10 IS THAT CORRECT?
11 A. YES.
12 Q. IS THERE ANYTHING UNUSUAL ABOUT HER BLOOD PRESSURE AT
13 THAT TIME?
14 A. IT'S SLIGHTLY HIGH WHEN STANDING, BUT NOT REALLY.
15 Q. AND THEN IT APPEARS SHE WEIGHED ABOUT 148 POUNDS.
16 A. YES.
17 Q. AND THEN WHAT IS THAT, 60 AND A HALF INCHES, THAT ABOUT
18 FIVE FOOT?
19 A. YEAH FIVE FOOT AND A HALF INCH.
20 Q. AND THEN ON THE NEXT PAGE YOU, YOU KNOW, WROTE
21 MEDICATIONS, YOUR PERCEPTION OF WHAT -- OF HER -- OR AT
22 LEAST WHAT YOU TOLD OF HER BEHAVIOR.
23 IF YOU'D PULL OUT 296 -- OR NOT PULL OUT, BUT LOOK AT
24 296. DO YOU RECALL, DO YOU SEE UP AT THE TOP WHERE IT SAYS
25 REASONS FOR MEDICAL HOSPITALIZATION?
1435
1 A. YES, I SEE IT.
2 Q. WOULD YOU READ THAT FIRST LINE?
3 A. IT SAYS, HERNIATED DISK IN '84. POOR CONTROL OF PAIN.
4 AND I'M NOT SURE WHAT THAT OTHER WORD IS.
5 Q. UPON WHAT WOULD YOU BASE YOUR STATEMENT THAT THERE HAD
6 BEEN POOR CONTROL OF PAIN?
7 A. REPORT FROM THE FAMILY. I MIGHT HAVE LOOKED AT THE
8 RECORDS, BUT PROBABLY IT WOULD HAVE BEEN FROM THE FAMILY.
9 Q. IS THIS YOUR -- STILL YOUR HANDWRITING THEN?
10 A. NO.
11 Q. OH, OKAY. LET'S GET TO PAGE 12 OF THE -- WHICH IS
12 NUMBER 304. IT APPEARS THAT IS SIGNED BY WHOM?
13 A. LAURIE WILLSON.
14 Q. OKAY. SO LOOKS LIKE MAYBE SHE FINISHED IT UP?
15 A. YEAH.
16 Q. SEE THE DISCHARGE PLANNING, MAY NEED DIFFERENT CARE
17 CENTER AFTER DISCHARGE.
18 A. YES.
19 Q. BUT AGAIN, THE PLAN WAS TO DISCHARGE HER, IS THAT
20 CORRECT?
21 A. YES.
22 Q. NOW, YOU DID SEE HER AS SHE CAME IN ON THE 28TH OF
23 DECEMBER AT 1500, WHICH IS 3:00 O'CLOCK.
24 A. YES.
25 Q. DO YOU RECALL SEEING HER AGAIN AFTER THAT?
1436
1 A. YES.
2 Q. DO YOU RECALL MARY CRANE SPECIFICALLY?
3 A. YES.
4 Q. AND WHAT IS IT YOU RECALL ABOUT HER?
5 A. I ACTUALLY RECALL QUITE A BIT ABOUT HER. SHE DIED ON
6 ME. SHE --
7 Q. WHILE YOU WERE THERE?
8 A. WHILE I WAS THERE. YES, SHE'S ONE OF THEM THAT DIED ON
9 ME. THE DAY THAT SHE DIED, IT WAS JANUARY 7TH. AND
10 APPARENTLY I WAS WORKING A DOUBLE SHIFT AND I WOULD HAVE
11 WORKED THE DAY SHIFT AND THEN FOR SOME REASON EITHER WE HAD
12 A SICK CALL OR SOMETHING AND I ENDED UP WORKING THE
13 AFTERNOON SHIFT. AND I REMEMBER THAT SHE HAD STARTED GOING
14 DOWNHILL. I TRIED TO GET A HOLD OF THE DOCTOR. I WAS VERY
15 WORRIED ABOUT HER, SO I WENT AHEAD AND I CALLED DIENHART.
16 Q. DR. DIENHART?
17 A. UH-HUH. AND SHE -- HER FAMILY CAME IN, HER FAMILY WAS
18 ALL THERE WITH HER.
19 DR. WEITZEL DID COME IN, AND THIS WAS --
20 MR. STIRBA: YOUR HONOR, COULD WE PROCEED BY WAY OF
21 QUESTION AND ANSWER RATHER THAN A LONG NARRATIVE? I'M NOT
22 SURE --
23 THE COURT: OKAY. THAT WOULD BE APPROPRIATE. JUST
24 GO AHEAD AND ASK THE QUESTION MAYBE TO SET --
25 Q. (BY MS. BARLOW) SO DID DOCTOR -- YOU CALLED DR.
1437
1 DIENHART, IS THAT WHAT YOU SAID?
2 A. YES --
3 Q. OKAY.
4 A. -- I REMEMBER CALLING HIM.
5 Q. DID HE COME IN?
6 A. HE DIDN'T CAME IN -- HE DIDN'T COME IN. HE GAVE ME SOME
7 TELEPHONE ORDERS. SO I TALKED WITH HIM ON THE PHONE. AND Deinhart.
8 IF I REMEMBER RIGHT, HE GAVE ME SOME TELEPHONE ORDERS TO DO
9 WHAT THEY CALL SATURATION LEVEL, AND -- I CAN LOOK UP THE
10 ORDERS HERE AND FIND OUT EXACTLY WHAT -- WHAT HE GAVE ME AS
11 FAR AS ORDERS.
12 Q. WOULD THAT BE UNDER PHYSICIAN'S ORDERS?
13 A. YES.
14 Q. I BELIEVE IT'S PROBABLY 249?
15 A. OKAY. WE WERE WORRIED ABOUT HER BREATHING, AND SO HE
16 ORDERED AN 02 SAT LEVEL WHICH CHECKS THE OXYGEN LEVEL OF HER
17 BLOOD, HOW MUCH OXYGEN SHE'S ACTUALLY GETTING TO THE CELLS.
18 AND THEN TO ORDER A CHEST X-RAY TO FIND OUT WHY SHE'S HAVING
19 SUCH A DIFFICULT TIME BREATHING.
20 Q. AND WHAT DID THE O2 SAT LEVEL SHOW?
21 A. SHE WAS HYPOXIC. SHE WAS NOT GETTING ENOUGH OXYGEN.
22 SHE WAS NOT DOING WELL.
23 Q. IS THAT WHAT THAT MEANS, HYPOXIA MEANS NOT GETTING
24 ENOUGH OXYGEN?
25 YOU'LL HAVE TO ANSWER OUT LOUD.
1438
1 A. I AM SORRY. YES, IT MEANS THAT SHE WASN'T GETTING
2 ENOUGH OXYGEN.
3 Q. WAS THE CHEST X-RAY CONDUCTED?
4 A. I DON'T RECALL.
5 Q. LET'S LOOK AT PAGE 249. WE HAVE AT THE TOP ON THE LEFT,
6 02 SAT LEVEL CHEST X-RAY, TELEPHONE ORDER, DR. DIENHART, SO
7 DR. DIENHART DID NOT COME IN TO GIVE YOU THAT ORDER, HE
8 JUST --
9 A. IT WAS ON THE TELEPHONE.
10 Q. TELEPHONE?
11 A. T.O. MEANS TELEPHONE ORDER.
12 Q. AND THEN DOWN HERE, WHAT IS THAT? THAT'S -- AND DO YOU
13 KNOW?
14 A. THAT'S -- I WOULD ASSUME THAT'S THE DOCTOR'S
15 CO-SIGNATURE AFTER, THEY'LL COME IN LATER AND SIGN THE
16 ORDER. AND THEN MY SIGNATURE'S THERE ON THE RIGHT.
17 Q. AND UNDER YOUR SIGNATURE IS 1930.
18 A. YES.
19 Q. WHAT DOES THAT MEAN?
20 A. 7:30 IN THE AFTERNOON.
21 Q. AND WHAT DOES IT MEAN IN RELATIONSHIP TO THIS NOTE?
22 A. THAT THAT'S THE TIME I TOOK THE ORDER OFF, AND I WOULD
23 ASSUME THAT'S THE TIME I TALKED TO HIM ON THE PHONE. I
24 PROBABLY WOULD HAVE TAKEN THE ORDER OFF EXACTLY THE SAME
25 TIME I TOOK IT.
1439
1 Q. AND THEN AT 2100 WHICH APPEARS TO BE WHAT, AN HOUR AND A
2 HALF LATER?
3 A. YES -- NO, IT WAS -- YEAH, IT WOULD BE AN HOUR AND A
4 HALF LATER.
5 Q. YOU HAVE A NOTE IN DR. WEITZEL'S HANDWRITING, HOLD ALL
6 OF THE MEDS, MORPHINE 5 MILLIGRAM I.M. NOW AND EVERY THREE
7 HOURS ROUND THE CLOCK.
8 A. YES.
9 Q. AND DID YOU FOLLOW THAT ORDER?
10 A. I WAS NOT REAL HAPPY WITH THAT ORDER --
11 MR. STIRBA: YOUR HONOR, YOUR HONOR --
12 MS. BARLOW: IF YOU'D JUST ANSWER --
13 THE COURT: YOU NEED TO RESPOND TO THE QUESTION.
14 Q. (BY MS. BARLOW) RIGHT. DID YOU FOLLOW THAT ORDER?
15 WE'LL GET INTO ALL THE REST OF IT LATER. DID YOU FOLLOW
16 THAT ORDER?
17 A. NOT INITIALLY.
18 Q. WHAT DID YOU DO INITIALLY?
19 A. I TALKED WITH DR. WEITZEL. AND I'D LIKE THE JURY TO
20 UNDERSTAND IT WAS DIFFICULT FOR ME TO CONFRONT HIM.
21 Q. WELL --
22 THE COURT: EXCUSE ME, MA'AM --
23 THE WITNESS: I'M SORRY.
24 THE COURT: -- YOU'RE NOT HERE TO GIVE SPEECHES,
25 YOU'RE HERE TO ANSWER QUESTIONS THAT ANY OF THE ATTORNEYS
1440
1 ASK YOU.
2 THE WITNESS: OKAY.
3 THE COURT: SO PLEASE JUST WAIT UNTIL SHE ASKS YOU
4 A QUESTION, THEN ANSWER THE QUESTION.
5 THE WITNESS: OKAY.
6 Q. (BY MS. BARLOW) SO YOU TALKED DIRECTLY TO DR. WEITZEL
7 ABOUT THE ORDER FOR MORPHINE, IS THAT CORRECT?
8 A. YES, I DID.
9 Q. AND WHY DID YOU DO THAT?
10 A. BECAUSE OF HIS PREVIOUS BEHAVIOR --
11 MR. STIRBA: YOUR HONOR -- YOUR HONOR, I'M -- I'M
12 GONNA OBJECT. I DON'T KNOW WHERE WE'RE GOING WITH THIS, BUT
13 IF WE'RE GONNA GET INTO RELEVANT INFORMATION, I THINK I'M
14 ENTITLED TO KNOW ABOUT IT. WE DID HAVE AN ORDER RELATING TO
15 SOME OF THIS MATTER, AND THIS IS ALL NEW TO ME.
16 THE COURT: LADIES AND GENTLEMEN, I THINK IT
17 MIGHT -- OF THE JURY, IT MIGHT BE HELPFUL IF WE JUST CLARIFY
18 SOME LEGAL ISSUES. HOPEFULLY THIS WILL BE YOUR LAST BREAK
19 FOR THE DAY. YOU'RE NOT GONNA BE HOPEFULLY GONE FOR VERY
20 LONG. BUT I'D ASK THE BAILIFF THAT YOU GO OUT FOR -- UNTIL
21 YOU'RE NOTIFIED. AND DURING THAT TIME, PLEASE DON'T
22 CONVERSE AMONG YOURSELVES ABOUT THIS CASE OR ALLOW
23 YOURSELVES TO BE ADDRESSED BY ANY OTHER PERSON ABOUT THE
24 CASE. DON'T FORM ANY OPINION OR EXPRESS ANY OPINION UNTIL
25 THE CASE IS FINALLY SUBMITTED TO YOU. AND WE'LL LET YOU
1441
1 KNOW WHEN THE BAILIFF CALLS YOU BACK.
2 (THE JURY LEAVES THE COURTROOM.)
3 THE COURT: OKAY. YOU MAY BE SEATED. OKAY. THE
4 RECORD SHOULD REFLECT THAT THE JURY IS NOT PRESENT. OKAY.
5 CAN YOU TELL ME -- CAN YOU MAYBE JUST LET -- SAY WHAT YOU
6 EXPECT THIS WITNESS WILL TESTIFY ABOUT DURING THIS --
7 MS. BARLOW: YES.
8 THE COURT: WHERE WE'RE GOING RIGHT NOW?
9 MS. BARLOW: THIS WITNESS WILL TESTIFY THAT WITH
10 THIS PATIENT, SHE QUESTIONED THE ORDER OF MORPHINE. AND SHE
11 WILL THEN TESTIFY AS TO THE RESPONSE OF DR. WEITZEL AND
12 THEN --
13 THE COURT: OKAY. SO SHE'LL -- SHE'LL TESTIFY
14 REGARDING THE CONVERSATION.
15 MS. BARLOW: RIGHT.
16 THE COURT: OKAY. THEN WHAT ELSE?
17 MS. BARLOW: AND THEN I THINK WITH THIS PATIENT --
18 OR PATIENT, EXCUSE ME. WITH THIS WITNESS, WE WILL GET INTO
19 SOME STUFF THAT WE TALKED ABOUT EARLIER IN THE CONTEXT OF
20 THE EXPERT WITNESS. AS TO WHY SHE WENT AHEAD AND DID
21 AGAINST HER BETTER JUDGMENT WHAT SHE WAS ORDERED TO DO.
22 THE COURT: OKAY. AND JUST TELL ME WHAT THAT WILL
23 BE.
24 MS. BARLOW: WELL, LET ME MAKE SURE I UNDERSTAND,
25 IF I GET IT WRONG, EARLENE --
1442
1 THE COURT: WELL, GO AHEAD OR IF YOU JUST WANNA ASK
2 HER QUESTION, IT'S -- THE JURY'S NOT HERE.
3 MS. BARLOW: WHAT -- OKAY.
4 Q. YOU APPROACHED DR. WEITZEL. WHAT DID YOU TELL HIM?
5 A. I ASKED HIM WHY WE WERE GONNA GIVE MARY MORPHINE.
6 Q. AND WHY DID YOU ASK HIM THAT?
7 A. BECAUSE IN MY OPINION, SHE WAS ALREADY HAVING A HARD
8 TIME BREATHING. SHE DIDN'T APPEAR TO BE IN PAIN TO ME. IT
9 SEEMED LIKE WE NEEDED TO DO SOMETHING TO HELP HER. THE
10 MORPHINE WAS NOT SOMETHING IN MY OPINION THAT WAS GOING TO
11 HELP HER.
12 Q. AND WHAT DID DR. WEITZEL SAY TO YOU?
13 A. HE SAID, WHAT MAKES YOU THINK SHE'S NOT IN PAIN? AND I
14 SAID TO HIM, WELL, SHE DOESN'T LOOK LIKE SHE'S IN PAIN. AND
15 HE SAID TO ME, WELL, DID SHE TELL SHE'S NOT IN PAIN?
16 WELL, SHE'S NOT TALKING AT THIS POINT. SHE'S -- NO,
17 SHE DIDN'T TELL ME SHE'S NOT IN PAIN.
18 AND SO -- SO, WELL, ARE YOU WILLING TO LET HER SUFFER?
19 BECAUSE I THINK SHE'S IN PAIN, AND YOU'RE WILLING TO LET HER
20 SUFFER BECAUSE YOU -- YOU DON'T WANT TO THINK THAT SHE'S IN
21 PAIN?
22 Q. AND THAT'S WHAT DR. WEITZEL SAID TO YOU?
23 A. YES.
24 Q. AND WHAT WAS YOUR RESPONSE?
25 A. I DIDN'T WANT HER TO SUFFER. I DON'T THINK I SAID
1443
1 ANYTHING TO THAT. I JUST THINK I WENT OFF AND -- AND AT
2 THAT POINT I WENT AND CALLED THE PHARMACY BECAUSE THERE WERE
3 LOTS OF RED FLAGS GOING OFF HERE FOR ME.
4 Q. WHAT RED FLAGS?
5 A. I WAS AFRAID THAT THIS WAS GOING TO KILL HER. I WAS
6 AFRAID THAT SHE WOULD DIE ON ME, AND I DIDN'T WANT THAT. I
7 WANTED -- I WANTED A DIFFERENT OUTCOME, AND I DIDN'T WANNA
8 BE RESPONSIBLE FOR THAT.
9 Q. DID YOU REFUSE TO GIVE THE SHOT?
10 A. I DID.
11 Q. AND WHAT HAPPENED?
12 A. I CALLED THE PHARMACY TO ASK THEM ABOUT THE DOSE, TO ASK
13 THEM HER -- I SAID, THIS IS AN OLDER LADY, SHE'S HAVING A
14 HARD TIME BREATHING. AND I SPECIFICALLY ASKED THEM -- I --
15 I -- I DON'T WANT IT TO KILL HER. IS THIS GONNA CAUSE HER
16 TO DIE. AND 5 MILLIGRAMS, HE SAID, WELL, YOU KNOW, SHE
17 SHOULD BE OKAY. JUST KEEP AN EYE ON HER.
18 AND SO AT THAT POINT I STILL WAS NOT COMFORTABLE WITH
19 GIVING THIS, AND SO I WAS OUT AT THE DESK AND LYNN LONG AT
20 THAT TIME SAID THAT IF I DIDN'T FEEL COMFORTABLE GIVING IT,
21 SHE FELT COMFORTABLE GIVING IT, AND SHE WENT AHEAD AND GAVE
22 THAT SHOT.
23 Q. SO YOU ENDED UP NOT HAVING TO GIVE IT?
24 A. I ENDED UP NOT GIVING IT.
25 Q. BUT IT WAS GIVEN?
1444
1 A. IT WAS.
2 MS. BARLOW: YOUR HONOR, THAT WOULD BE --
3 THE COURT: OKAY. BUT ARE YOU GOING TO GET INTO
4 REASON WHY -- I THOUGHT WHEN WE HAD THIS OTHER DISCUSSION --
5 MS. BARLOW: WELL, IT --
6 THE COURT: -- THAT WAS -- THIS IS A WITNESS THAT'S
7 GONNA SAY WHY SHE CONFRONTED THE DOCTOR THIS TIME. THIS IS
8 NOT A WITNESS THAT SAYS THEY DIDN'T CONFRONT HIM BECAUSE OF
9 A PRIOR EXPERIENCE. IS THAT --
10 MS. BARLOW: NO, BUT I CAN -- DID -- ARE YOU AWARE
11 OF ANY EXPERIENCES THAT ANYBODY HAD WHO HAD REFUSED, YOU
12 KNOW, AND THE PROBLEM --
13 THE COURT: WELL, I GUESS --
14 MS. BARLOW: -- HOW TO PHRASE IT --
15 THE COURT: -- WHAT I WANNA KNOW IS THIS -- THIS
16 WITNESS, I UNDERSTOOD THERE MAY BE SOME WITNESSES, SOME
17 NURSE WITNESSES WHO WILL TESTIFY THAT THEY DID NOT CONFRONT
18 DR. WEITZEL BECAUSE OF SOME PAST EXPERIENCE THAT THEY WERE
19 AWARE OF. AND THAT'S WHY --
20 MS. BARLOW: AND I THINK WE'LL PROBABLY GET INTO
21 THAT WITH SUBSEQUENT PATIENTS --
22 THE COURT: NOT NECESSARILY -- YOU MEAN THE
23 WITNESS --
24 MS. BARLOW: BUT WITH THIS WITNESS, BUT --
25 Q. AND I CAN ASK YOU, WERE THERE OTHER TIMES WHEN YOU --
1445
1 WHEN YOU DID NOT WANT TO GIVE THE SHOT, BUT YOU DID IT
2 ANYWAY?
3 A. YES.
4 Q. AND WHY WAS THAT?
5 A. BECAUSE IT WAS A DOCTOR'S ORDER, AND HE WOULD TELL YOU
6 AND YOU KNEW THAT YOU HAD -- YOU WERE SUPPOSED TO FOLLOW
7 THOSE ORDERS BECAUSE HE'D BECOME EXTREMELY AGITATED. MY
8 EXPERIENCE WITH JUDITH WAS HE GOT REALLY IRATE BECAUSE WE
9 HAD BEEN HOLDING THE MEDICATION. AND --
10 MR. STIRBA: YOU KNOW -- YOU KNOW, THIS IS NICE,
11 BUT MY -- THERE ISN'T ONE SHRED OF EVIDENCE IN THIS WHOLE
12 CASE, ANY OF THESE DOCUMENTS WITH THE EXCEPTION OF MISS
13 SCHOLL'S TESTIFIED TO THAT THERE WAS WITHHOLDING OF ANY
14 MEDICATION WITH JUDITH LARSEN. THAT'S PART OF THE PROBLEM.
15 SHE CAN TESTIFY AS TO WHAT SHE DID, WHAT SHE OBSERVED,
16 CONVERSATIONS SHE HAD WITH DR. WEITZEL, BUT TO HAVE HER TO
17 NOW TALK ABOUT THIS IS A GROUP THING, IT BELIES THE EVIDENCE
18 BEFORE THE COURT. THERE'S ONLY FOUR INSTANCES IN ALL FIVE
19 MEDICAL RECORDS WHERE THERE WAS ANY WITHHOLDING OF ANY
20 MEDICATION, AND THE COURT'S ALREADY HEARD ABOUT ALL FOUR OF
21 'EM ESSENTIALLY, THE ONE BY MISS KLEI -- KLEE, RATHER, AND
22 THE ONES BY MISS SCHOLL. THAT'S IT. SHE NEVER DOCUMENTED
23 ANYTHING THAT SHE WITHHELD ANY MEDICATIONS, AND NEITHER DID
24 ANY OTHER NURSE. SO I HAVE SOME REAL CONCERN ABOUT HOW FAR
25 WE GO AND HOW MUCH EDITORIALIZING WE ALLOW. I HAVE NO
1446
1 PROBLEM WITH HER TESTIFYING AS TO WHAT SHE DID,
2 CONVERSATIONS SHE HAD, AND WHAT HAVE YOU, BUT WHEN WE TALK
3 ABOUT WE ASK THIS AND THAT, IT BELIES THE EVIDENCE. IT'S
4 JUST NOT FACTUAL.
5 MS. BARLOW: YOUR HONOR, I WOULD LAY THE FOUNDATION
6 WITH HER THAT SHE WAS AT THAT MEETING. WEREN'T YOU?
7 THE WITNESS: YES.
8 THE COURT: WHICH MEETING?
9 MS. BARLOW: THAT MISS SCHOLL TALKED -- OR
10 TESTIFIED ABOUT. THE ONE WHERE -- AND I THINK THAT'S WHAT
11 SHE WAS REFERRING TO, SHE WAS --
12 THE COURT: WELL SHE CAN TALK -- SHE CAN TALK ABOUT
13 THAT MEETING --
14 MS. BARLOW: OKAY.
15 THE COURT: AND THAT'S -- OKAY. AND WHAT ELSE DO
16 YOU ANTICIPATE --
17 MS. BARLOW: WELL, I THINK --
18 THE COURT: I GUESS THE ONE THING, I GUESS THE
19 THING THAT I'M A LITTLE CONCERNED ABOUT IS THAT THIS
20 WITNESS, WHEN NO QUESTION WAS PENDING, TURNED, LOOKED AT THE
21 JURY AND SAYS, I'VE GOT A -- I'VE GOT SOMETHING I'D LIKE TO
22 SAY.
23 MS. BARLOW: WELL, AND SHE'S BEEN ADMONISHED. AND
24 I DON'T THINK SHE WILL DO THAT AGAIN.
25 THE COURT: I UNDERSTAND, BUT I MEAN THAT'S A
1447
1 CONCERN, YOU KNOW. I MEAN WE NEED TO MAKE SURE THAT WHAT
2 WE'RE DOING IS ASKING QUESTIONS AND NOT GIVING SPEECHES.
3 MS. BARLOW: I UNDERSTAND THAT. AND I THINK SHE
4 DOES NOW, TOO.
5 THE COURT: OKAY. SO WHAT YOU'VE TALKED ABOUT,
6 CONVERSATION, YOU KNOW, WHAT -- HOW SHE TALKED TO
7 DR. WEITZEL, WHAT HAPPENED, THAT SHE STILL EVEN AFTER THAT
8 DID NOT WANNA GIVE THE SHOT. BUT WHAT HAPPENED TO GET THE
9 SHOT. THAT'S ALL FAIR GAME. THE CONFRONTATION WITH THE
10 GROUP OR THE DISCUSSION WITH THE GROUP, THAT THE OTHER ONE,
11 THAT'S ALL FAIR GAME. WHAT ELSE DO YOU HAVE A QUESTION
12 ABOUT?
13 MS. BARLOW: WELL, AND I WOULD -- AND I WOULD ASK
14 HER:
15 Q. ARE YOU AWARE OF THE PROTOCOL IF YOU CHALLENGE A DOCTOR
16 AND HE TELLS YOU TO DO IT ANYWAY, ARE YOU AWARE OF ANY
17 PROTOCOL THAT NEEDS TO BE FOLLOWED IF YOU STILL DISAGREE
18 WITH MEDICATION TO BE GIVEN; I.E., GOING UP THE CHAIN OR
19 ANYTHING LIKE THAT?
20 A. I DON'T REMEMBER ANY WRITTEN PROTOCOL, BUT --
21 Q. WELL, ANY ORAL PROTOCOL? WHAT -- WHAT COULD YOU DO IF
22 THE DOCTOR ORDERED YOU TO DO IT ANYWAY AND YOU STILL DIDN'T
23 WANNA DO IT?
24 A. WELL, THIS WAS ON AN AFTERNOON SHIFT. YOU'RE NOT GONNA
25 HAVE YOUR DAY PEOPLE THERE. I BASICALLY CALLED THE PHARMACY
1448
1 TO -- AND CHECKED OUT THE ORDER. I --
2 Q. DID YOU EVER GO HIGHER UP IN THE NURSING HIERARCHY?
3 A. I HAD PREVIOUSLY.
4 Q. WHEN WAS THAT?
5 A. THIS WAS WITH JUDITH AND THEN PREVIOUSLY TO JUDITH.
6 THE COURT: JUDITH --
7 MS. BARLOW: LARSEN.
8 THE WITNESS: LARSEN.
9 THE COURT: A PATIENT?
10 THE WITNESS: YES.
11 THE COURT: OKAY.
12 Q. (BY MS. BARLOW) WHAT HAPPENED WHEN YOU --
13 THE COURT: OKAY. WHEN WAS THAT?
14 THE WITNESS: I DON'T HAVE THE SPECIFIC DATES.
15 THE COURT: I MEAN -- IT WAS WHILE SHE WAS A
16 PATIENT THERE YOU MEAN?
17 THE WITNESS: YES.
18 THE COURT: OKAY. GO AHEAD.
19 Q. (BY MS. BARLOW) AND THEN WHAT HAPPENED WHEN YOU WENT
20 UP THE HIERARCHY WITH THE COMPLAINT -- WITH -- IN JUDITH'S
21 CIRCUMSTANCE? WE'LL HAVE TO LIMIT IT TO THAT.
22 A. WE WERE TOLD THAT --
23 Q. WHEN YOU SAY WE --
24 A. -- DR. WEITZEL WAS THE DOCTOR AND WE WERE TO FOLLOW --
25 THE COURT: WHO DID YOU TALK TO?
1449
1 THE WITNESS: I TALKED TO KAREN CHATELAIN.
2 THE COURT: WHO IS?
3 THE WITNESS: HOSPITAL ADMINISTER OVER NURSES.
4 SHE'S THE NURSING ADMINISTER.
5 Q. (BY MS. BARLOW) DID ANYONE ELSE GO WITH YOU WHEN YOU
6 TALKED TO HER?
7 A. SHEILA MOORE WENT WITH ME.
8 Q. AND WHAT CAME OUT OF YOUR CONVERSATION WITH KAREN
9 CHATELAIN?
10 A. THAT WE NEEDED TO FOLLOW DR. WEITZEL'S ORDERS.
11 Q. DID YOU STILL --
12 THE COURT: AND THAT -- AND THAT WAS BEFORE THIS
13 INCIDENT YOU'RE SAYING WITH MARY CRANE?
14 THE WITNESS: YES.
15 THE COURT: OKAY.
16 MS. BARLOW: YOUR HONOR, AND, YOU KNOW, MAYBE THIS
17 IS A LITTLE OUT OF ORDER, BUT I AM GOING TO TIE IT IN BY
18 HAVING HER TALK ABOUT JUDITH LARSEN, AND SO I WOULD ASK
19 LEAVE TO BE ALLOWED TO GO, YOU KNOW, GO AHEAD --
20 THE COURT: OKAY. WELL, ON THE -- ON THE JUDITH
21 LARSEN, WAS THAT ANOTHER SITUATION WHERE THERE WAS A SHOT
22 THAT WAS ORDERED AND THEN YOU WENT TO MISS CHATELAIN BECAUSE
23 YOU DIDN'T WANNA GIVE IT?
24 THE WITNESS: NO.
25 THE COURT: OKAY. WHAT WAS THE SITUATION?
1450
1 THE WITNESS: WE WANTED HER TO BE TRANSFERRED OFF
2 THE UNIT TO GET BETTER MEDICAL CARE. WE FELT LIKE SHE
3 WASN'T RECEIVING THE MEDICAL CARE. WE WANTED HER TO BE ABLE
4 TO HAVE A CHANCE TO GET BETTER AND -- Doctor Earline.
5 THE COURT: OKAY. SO THAT WASN'T ABOUT SHOTS, THAT
6 WAS ABOUT WHERE SHE WOULD BE IN THE HOSPITAL FOR HER
7 MEDICAL --
8 THE WITNESS: AND WHAT WOULD BE THE BEST PLACE FOR
9 HER TO GET THE CARE SHE NEEDED.
10 THE COURT: OKAY. THAT THE SAME SITUATION OR IS --
11 THE WITNESS: IT WAS ALSO ON MEDICATION. IT WAS --
12 ALSO HAD TOO WITH THE MEDICATION, NOT A SHOT THAT I DIDN'T
13 WANNA GIVE SPECIFICALLY, BUT -- BUT THE FACT THAT THERE WAS
14 A CONFLICT BETWEEN THE NURSING STAFF AND THE DOCTOR ABOUT
15 THE MEDICATION AND HER TREATMENT.
16 THE COURT: OKAY. OKAY. ANYTHING FURTHER?
17 MS. BARLOW: I THINK THAT THAT'S ALL THAT I WAS
18 GOING GET INTO IN THIS AREA.
19 THE COURT: OKAY. ALL RIGHT. ANYTHING FURTHER,
20 MR. STIRBA?
21 MR. STIRBA: YEAH, I WOULD LIKE TO POINT OUT THAT
22 THERE HAVE BEEN -- I MEAN THERE IS A PROCESS BY WAY OF
23 HOSPITAL POLICY IN TERMS OF THE NURSES FILING INCIDENT
24 REPORTS. THERE HAS BEEN A NUMBER OF SUBPOENAS ISSUED TO THE
25 DAVIS HOSPITAL FOR ANY SUCH REPORTS. NOT JUST BY US, BUT BY
1451
1 THE STATE. THE HOSPITAL HAS NONE. AND SO THERE IS SOME
2 QUESTION REALLY ABOUT THE NATURE OF THESE COMPLAINTS AND THE
3 NATURE OF THESE CONVERSATIONS, AND HOW REALLY RELEVANT THEY
4 ARE GIVEN THE FACT THERE'S NO DOCUMENTATION CERTAINLY WITHIN
5 THE HOSPITAL FILES TO ANY SUCH COMPLAINT WAS MADE.
6 THE COURT: WELL, WHETHER THERE'S NO DOCUMENTATION,
7 IF WITNESSES ARE GONNA TESTIFY, YOU CAN CROSS-EXAMINE THEM
8 ON THAT ISSUE. BUT IF THERE ARE CONVERSATIONS, YOU KNOW,
9 THEN -- REGARDING WHAT YOU'VE JUST GONE THROUGH, I MEAN THIS
10 SITUATION, YOU BETTER LAY A FOUNDATION ON THE ONE, THE
11 EARLIER ONE BEFORE THE MARY CRANE. BECAUSE RIGHT NOW,
12 IT'S -- IT'S LIKE IF THERE'S A PROBLEM ABOUT CARE AND
13 TREATMENT, YOU KNOW, IT JUST DOESN'T INVOLVE MEDICATION, YOU
14 KNOW, JUST LAY IT OUT WHAT -- BEFORE YOU START HER INTO A
15 SPEECH.
16 MS. BARLOW: WELL, I'LL TRY NOT TO START HER INTO A
17 SPEECH, BUT YES, YOUR HONOR --
18 THE COURT: NO, AND I WOULD JUST SAY -- AND I'M NOT
19 TRYING TO BE HARSH ON YOU, I'M JUST SAYING THAT THE ONLY WAY
20 THAT THIS PROCESS WORKS IS THAT WE ARE NOT HERE -- THERE ARE
21 STRONG EMOTIONS FROM FAMILY MEMBERS, FROM EVERYONE IN THIS
22 CASE, AND ALL YOU NEED TO DO IS JUST -- SHE WILL ASK YOU ALL
23 THE QUESTIONS SHE WANTS YOU TO ASK -- ANSWER --
24 THE WITNESS: OKAY.
25 THE COURT: -- THEN THERE'LL BE A CHANCE OF
1452
1 CROSS-EXAMINATION. YOU'LL GET A CHANCE TO SAY WHATEVER'S
2 RELEVANT. IF THEY DON'T GIVE YOU A QUESTION THAT GETS OFF
3 TO A THING YOU WANT TO SAY, THE POINT IS, YOU CAN SAY IT
4 SOMEWHERE ELSE, BUT IT WON'T BE HERE. OKAY?
5 THE WITNESS: OKAY.
6 THE COURT: OKAY? DO YOU HAVE ANY OTHER QUESTIONS
7 BEFORE WE START?
8 MS. BARLOW: I DON'T, YOUR HONOR.
9 THE COURT: OKAY. WHY DON'T WE HAVE THE JURY COME
10 BACK PLEASE? WELL, FIRST OF ALL, BEFORE THEY COME BACK, HOW
11 LONG DO YOU ANTICIPATE WE'RE GONNA BE WITH THIS WITNESS? I
12 MEAN I'M PRETTY COMMITTED TO 5:00 O'CLOCK ON A FRIDAY NOT
13 KEEPING THE JURY OVER.
14 MS. BARLOW: YOUR HONOR, IT'S -- IT'S GOING TO TAKE
15 QUITE A BIT OF TIME --
16 THE COURT: OKAY. SO WE'RE NOT GONNA GET DONE
17 TODAY --
18 MS. BARLOW: -- I'M SURE WE'RE GONNA HAVE TO --
19 THE COURT: -- WITH THIS WITNESS?
20 MS. BARLOW: WE'RE NOT GONNA FINISH TONIGHT.
21 THE COURT: OKAY. THAT'S ALL. LET'S GET THE JURY
22 BACK IN.
23 (THE JURY RETURNS TO THE COURTROOM.)
24 THE COURT: OKAY. YOU MAY BE SEATED. LADIES AND
25 GENTLEMEN, WE'RE -- I CAN PROMISE YOU THAT WE'RE GONNA STOP
1453
1 AT 5:00. WE PROBABLY WILL NOT FINISH WITH THIS WITNESS
2 TODAY. AND WE'LL GO -- BUT WE WILL NOT END ANY LATER THAN
3 5:00 TODAY. I DO WANNA EXPRESS, YOU KNOW, MY APPRECIATION.
4 YOU HAVE BEEN EXTREMELY PROMPT. YOU'RE ALWAYS HERE WHEN
5 I'VE ASKED YOU TO BE HERE, AND THAT'S MADE A WORLD OF
6 DIFFERENCE. BUT MORE THAN THAT, I JUST WANNA EXPRESS
7 APPRECIATION TO YOUR ALERTNESS. I MEAN I'VE SAT THROUGH --
8 AND I'VE GOT TO SAY THAT I DON'T KNOW WHAT IT IS, BUT OTHER
9 JUDGES SAY JURIES, YOU KNOW, MEMBERS OF JURIES FALL ASLEEP
10 IN CASES. THIS IS A PRIME CASE WHERE YOU START GOING
11 THROUGH THOSE MEDICAL RECORDS, YOU COULD GET SLEEPY. BUT
12 YOU'VE ALL BEEN ALERT. I NOTICED THAT YOU'VE ALL TAKEN
13 NOTES AND I REALLY NOT -- I VERY MUCH APPRECIATE EVERYTHING
14 THAT YOU'VE DONE, THAT YOU'VE KEPT AWAKE AND YOU'VE BEEN
15 ALERT AND YOU'VE BEEN ON TIME AND THAT HELPS THE PROCESS.
16 OKAY. MISS BARLOW, WOULD YOU LIKE TO GO AHEAD?
17 MS. BARLOW: YES. THANK YOU, YOUR HONOR.
18 Q. LET'S BACK UP A LITTLE BIT IN TIME. DO YOU RECALL
19 JUDITH LARSEN?
20 A. I DO.
21 Q. AND WHAT DO YOU RECALL ABOUT HER?
22 THE COURT: WELL, I THINK THAT'S A BROAD QUESTION.
23 IF YOU WANT TO ASK HER WHAT SHE DID, BUT THAT ELICITED SOME
24 OF THE OTHER --
25 MS. BARLOW: I'LL FOCUS IT IN. THANK YOU.
1454
1 Q. YOU RECALL JUDITH LARSEN. DID THERE COME A TIME BASED
2 ON YOUR NURSING EXPERIENCE AND YOUR OBSERVATIONS OF MISS
3 LARSEN WHEN YOU BECAME CONCERNED ABOUT HER?
4 A. YES.
5 Q. AND WHEN WAS THAT?
6 A. SHE HAD STARTED VOMITING SOME BLACK COLORED STUFF.
7 Q. UH-HUH.
8 A. AND AT THAT POINT, I FELT LIKE SHE NEEDED SOME -- SOME
9 MORE MEDICAL CARE, LIKE MAYBE WE OUGHTA DO SOME SCOPING AND
10 FIND OUT -- SOMETIMES WHEN YOU GET GRANULE --
11 MR. STIRBA: YOUR HONOR, I'M GONNA OBJECT. I THINK
12 SHE'S RENDERING OPINION NOW AND I THINK THAT'S BEYOND THE
13 SCOPE OF THE QUESTION.
14 THE COURT: OKAY. WHY DON'T YOU JUST PHRASE IT AS
15 TO WHAT HER CONCERNS WERE AND WHAT SHE DID.
16 Q. (BY MS. BARLOW) WHAT WERE YOUR CONCERNS? WHAT WERE
17 YOUR CONCERNS ABOUT JUDITH LARSEN?
18 A. I WAS AFRAID THAT SHE MIGHT --
19 MR. STIRBA: I'M GONNA OBJECT. RELEVANCY, YOUR
20 HONOR.
21 MS. BARLOW: YOUR HONOR, IT'S FOUNDATIONAL.
22 THE COURT: OVERRULED.
23 Q. (BY MS. BARLOW) WHAT WERE YOUR CONCERNS? JUST
24 BRIEFLY, WHAT WERE YOUR CONCERNS?
25 A. THAT MAYBE SHE WAS HAVING SOME G.I. BLEEDING.
1455
1 Q. AND WHAT DID YOU DO WHEN YOU BECAME CONCERNED ABOUT
2 THAT?
3 A. WE HAD TALKED --
4 Q. LET'S JUST TALK ABOUT WHAT YOU DID PERSONALLY, NOT WE,
5 BUT WHAT YOU PERSONALLY DID.
6 A. I WANTED HER TRANSFERRED OFF OF OUR UNIT ONTO A MEDICAL
7 FLOOR WHERE THEY COULD DO SCOPES AND FIND OUT WAS MEDICALLY
8 GOING ON.
9 Q. AND WHO DID YOU -- WHO DID YOU EXPRESS THAT TO?
10 A. SOME OF THE OTHER NURSING STAFF.
11 Q. DID YOU EVER EXPRESS IT TO THE DEFENDANT?
12 A. I DON'T REMEMBER.
13 Q. DID YOU EVER TAKE IT UP THE -- UP THE LINE? I MEAN YOU
14 WORK UNDER THE CONTROL OF -- NOT CONTROL, UNDER THE ORDERS
15 OF A DOCTOR --
16 A. UH-HUH.
17 Q. -- BUT DON'T YOU ALSO ANSWER TO SOMEBODY ELSE AS A NURSE
18 IN THE HOSPITAL?
19 A. YOU ANSWER TO ADMINISTRATION.
20 Q. DID YOU EVER GO UP THROUGH ADMINISTRATION ABOUT YOUR
21 CONCERNS ABOUT JUDITH LARSEN?
22 MR. STIRBA: OBJECTION, RELEVANCY, YOUR HONOR.
23 THE COURT: OVERRULED.
24 Q. (BY MS. BARLOW) DID YOU EVER GO UP TO ADMINISTRATION
25 TO YOUR -- ABOUT YOUR CONCERNS?
1456
1 A. I DON'T REMEMBER ON THIS ISSUE.
2 Q. DID YOU EVER GO UP THROUGH THE NURSING ADMINISTRATION?
3 MR. STIRBA: YOUR HONOR, SHE'S TESTIFIED SHE
4 DOESN'T REMEMBER. ASKED AND ANSWERED.
5 MS. BARLOW: YOUR HONOR, AND IT MAY BE THAT MY TERM
6 ADMINISTRATION IS THROWING HER OFF.
7 Q. AS A NURSE IN THE NURSING AREA, NOT ANSWERING TO THE
8 DOCTOR, WHO DID YOU GO TO NEXT IF YOU HAD A PROBLEM?
9 A. I TALKED TO THE OTHER NURSING STAFF TO SEE IF THEY HAD
10 THE SAME CONCERNS AS I DID.
11 Q. YOU CAN'T TESTIFY AS TO THEIR CONCERNS, ONLY YOUR OWN.
12 THE COURT: I THINK WHAT SHE'S ASKING YOU IS, IS
13 THERE A CHAIN OF TITLE THAT A NURSE GOES TO WHEN THERE'S A
14 PROBLEM BASICALLY WITH MEDICATION AND TREATMENT?
15 MR. STIRBA: AND, YOUR HONOR, COULD WE LIMIT IT TO
16 THIS PARTICULAR TIME PERIOD BECAUSE IT'S RELEVANT IN TERMS
17 OF THE PEOPLE WHO WERE THERE, IN TERMS OF THE WITNESSES, THE
18 UNDERSTANDING OF THE CASE.
19 THE COURT: YES. DURING THE TIME PERIOD --
20 MS. BARLOW: WE'RE TALKING ABOUT JUDITH LARSEN --
21 THE COURT: -- DECEMBER THROUGH JAN -- DECEMBER OF
22 '95 THROUGH JANUARY OF '96.
23 Q. (BY MS. BARLOW) DID YOU EVER GO TO THE DIRECTOR OF
24 NURSING WITH ANY CONCERNS ABOUT JUDITH LARSEN?
25 A. I KNOW I TALKED WITH SOME PEOPLE, AND I DON'T REMEMBER
1457
1 WHO, I DON'T RECALL EXACTLY WHO.
2 Q. HOW ABOUT AN ADMINISTRATOR OVER NURSING AT THE HOSPITAL?
3 A. I DON'T RECALL.
4 MS. BARLOW: YOUR HONOR, CAN I HAVE A MOMENT TO
5 SPEAK WITH THE WITNESS?
6 MR. STIRBA: YOUR HONOR, WE'RE IN THE MIDDLE OF
7 DIRECT EXAMINATION HERE.
8 THE COURT: WELL, WHY DON'T YOU GO ONTO SOMETHING
9 ELSE SO THEN WE'RE NOT GONNA BE FINISHING WITH THIS WITNESS
10 TODAY --
11 MS. BARLOW: THAT'S TRUE.
12 THE COURT: -- SO WHY DON'T YOU GO ONTO ANOTHER --
13 Q. (BY MS. BARLOW) DID YOU ATTEND NURSING MEETINGS?
14 A. YES.
15 Q. TEAM MEETINGS?
16 A. YES.
17 Q. DID YOU EVER ATTEND A NURSING MEETING AT WHICH THE
18 DEFENDANT CAME AND TALKED ABOUT HOLDING MEDS?
19 A. YES.
20 Q. DO YOU RECALL APPROXIMATELY WHEN THAT WAS?
21 A. IT WAS DURING THIS TIME PERIOD. I THINK IT -- I THINK
22 IT HAD TO DO WITH JUDITH.
23 Q. DO YOU RECALL WHERE THAT MEETING WAS HELD?
24 A. IT WAS ON THE UNIT. WE HAD A KITCHEN LOUNGE AREA.
25 Q. DO YOU RECALL WHO ELSE WAS PRESENT AT THAT MEETING?
1458
1 A. TODD, DR. WEITZEL --
2 THE COURT: TODD WHO?
3 THE WITNESS: CHAMBERLAIN -- CHAMBERS.
4 Q. (BY MS. BARLOW) CHAMBERS.
5 A. CHAMBERS.
6 Q. AND WHO IS TODD CHAMBERS?
7 A. HE WAS OVER HORIZON.
8 Q. OKAY. AND SO TODD WAS THERE, DR. WEITZEL. DO YOU
9 RECALL --
10 A. I THINK TRACY WAS THERE. SEVERAL OF THE NURSES WERE
11 THERE. I THINK BONNIE WAS THERE. I THINK LYNN WAS THERE --
12 Q. OKAY. TRACY SCHOLL AND BONNIE HARDEY?
13 A. YES.
14 Q. AND LYNN LONG?
15 A. AND I DON'T RECALL BEYOND THAT. I SEEM TO REMEMBER
16 STACEY, AND I DON'T REMEMBER HER LAST NAME. THE TECHS WERE
17 THERE. I THINK NICOLE WAS THERE, NICKI.
18 Q. WHAT DID DR. WEITZEL SAY IN THAT CONTEXT ABOUT
19 WITHHOLDING MEDS?
20 A. HE WAS VERY ANGRY AND AGITATED --
21 MR. STIRBA: YOUR HONOR, I'M GONNA OBJECT --
22 THE COURT: SUSTAINED.
23 MR. STIRBA: -- CHARACTERIZATION --
24 THE COURT: SUSTAINED.
25 Q. (BY MS. BARLOW) WHAT DID HE SAY IN THAT MEETING?
1459
1 A. THAT WE WERE NOT TO HOLD THE MEDS, THAT -- AND TODD
2 BACKED THAT STATEMENT UP, THAT WE WERE NOT TO HOLD THE MEDS.
3 THAT IF WE DID HOLD THE MEDS, WE WERE TO CALL HIM AND LET
4 HIM KNOW, AND THEN HE WOULD LET US KNOW WE NEEDED TO GIVE
5 THE MEDS.
6 Q. DID YOU AFTER THAT HAVE AN OCCASION TO CALL AND TO TELL
7 DR. WEITZEL THAT YOU INTENDED TO WITHHOLD MEDS?
8 A. NO.
9 Q. AND WHY?
10 A. BECAUSE WE HAD BEEN TOLD WE WERE GONNA GIVE 'EM. WE HAD
11 BEEN TOLD THAT HE WAS THE DOCTOR, HE WAS IN CHARGE, AND WE
12 WERE TO GIVE IT.
13 Q. OKAY. OTHER THAN THE OTHER NURSES, SOMEONE HIGHER UP IN
14 THE HIERARCHY, AS IT WERE, DID YOU TALK TO SOMEONE UP --
15 HIGHER UP IN THE HIERARCHY ABOUT THIS ORDER TO GIVE THE
16 MEDS?
17 A. I'M TRYING TO THINK SPECIFICALLY WHO I WOULD HAVE TALKED
18 TO. GIVE ME JUST A MINUTE.
19 I THINK AFTER THAT MEETING, THE HIERARCHIES WERE THERE.
20 TODD WAS THERE --
21 MR. STIRBA: YOUR HONOR --
22 THE WITNESS: -- WE HAD BEEN TOLD TO GIVE THEM --
23 MR. STIRBA: -- YOUR HONOR, THE QUESTION HAS BEEN
24 POSED AND I THINK NOW WE'RE NOT ANSWERING IT.
25 THE COURT: SUSTAINED.
1460
1 Q. (BY MS. BARLOW) DID YOU TALK TO ANYONE IN THE
2 HIERARCHY ABOUT THAT MEETING AFTER IT OCCURRED?
3 MR. STIRBA: I'M GONNA OBJECT. ASKED AND ANSWERED,
4 YOUR HONOR.
5 MS. BARLOW: WELL, SHE DIDN'T ANSWER --
6 THE COURT: NO, I DON'T THINK WE'VE GOT AN ANSWER.
7 I THINK THE PROBLEM IS THE QUESTION HAS BEEN ASKED, AND TRY
8 TO ANSWER THE QUESTION THAT THE ATTORNEY IS ASKING YOU.
9 Q. (BY MS. BARLOW) PEOPLE THERE WERE. DID YOU GO TO ANY
10 OF THE HIERARCHY AFTER THAT MEETING AND EXPRESS YOUR
11 CONCERNS ABOUT BEING TOLD TO GIVE THE MEDS?
12 A. I DON'T RECALL.
13 Q. DO YOU RECOGNIZE NAME KAREN CHATELAIN?
14 A. I DO.
15 Q. WHO IS SHE?
16 A. SHE'S THE ADMINISTRATOR OVER THE NURSES.
17 Q. AND IS SHE WITH HORIZON OR THE HOSPITAL?
18 A. THE HOSPITAL.
19 Q. AND THERE WAS A DIFFERENCE BETWEEN THE TWO, IS THAT
20 CORRECT?
21 A. YES.
22 MR. STIRBA: YOUR HONOR -- YOUR HONOR, WE'RE AT THE
23 POINT WHERE WE HAVE -- IT'S LEADING AND SUGGESTIVE. I MEAN
24 THIS IS DIRECT EXAMINATION.
25 THE COURT: OKAY. JUST ASK QUESTIONS. DON'T LEAD.
1461
1 Q. (BY MS. BARLOW) I'M SORRY, WHO WAS KAREN CHATELAIN
2 AGAIN?
3 A. SHE WAS THE ADMINISTRATOR OVER NURSING.
4 Q. WAS SHE IN YOUR HIERARCHY?
5 A. YES.
6 Q. DID YOU EVER HAVE OCCASION TO TALK TO HER?
7 A. YES.
8 MR. STIRBA: YOUR HONOR, I'M GONNA OBJECT. VAGUE
9 AND AMBIGUOUS. WITH RESPECT TO WHAT, RELEVANCE?
10 MS. BARLOW: WITH RESPECT TO THE MED, YOUR HONOR.
11 THE COURT: WELL, I THINK WE'RE -- WITH RESPECT TO
12 THE MEDS IS AMBIGUOUS. PHRASE THE QUESTION AS IT RELATES TO
13 WHAT YOU JUST ASKED HER.
14 Q. (BY MS. BARLOW) DID YOU EVER TALK TO KAREN CHATELAIN
15 IN RESPECT TO YOUR CONCERNS ABOUT THE CARE OF JUDITH LARSEN?
16 A. YES.
17 Q. AND DO YOU RECALL WHEN THAT WAS?
18 A. NOT EXACTLY, NO.
19 Q. WHEN WAS IT IN RELATIONSHIP TO THE CONCERNS THAT YOU
20 HAVE ALREADY EXPRESSED ABOUT JUDITH LARSEN?
21 A. IT WAS BEFORE SHE DIED, AND SHE WAS ON THE UNIT FOR A
22 LONG TIME. IT WOULD HAVE BEEN -- I'M NOT SURE, I CAN'T TELL
23 YOU EXACTLY.
24 Q. DO YOU RECALL WHERE THAT MEETING TOOK PLACE?
25 A. IN KAREN'S OFFICE.
1462
1 Q. AND WAS THAT AT DAVIS NORTH?
2 A. YES.
3 Q. WAS ANYONE ELSE PRESENT WHEN YOU HAD THAT MEETING?
4 A. IT SEEMS LIKE I TOOK SHEILA. I DON'T RECALL.
5 Q. WHAT DID YOU TELL KAREN CHATELAIN ABOUT YOUR CONCERNS?
6 MR. STIRBA: OBJECTION. IT'S ASKED AND ANSWERED.
7 HEARSAY. IT'S IRRELEVANT.
8 THE COURT: OVERRULED.
9 Q. (BY MS. BARLOW) WHAT DID YOU TELL KAREN CHATELAIN
10 ABOUT YOUR CONCERNS ABOUT JUDITH LARSEN?
11 A. THAT SHE NEEDED A DIFFERENT KIND OF CARE. THAT SHE
12 WAS -- SHE NEEDED SOME MEDICAL CARE. THAT PSYCHIATRIC CARE
13 WAS NOT GONNA HELP HER AT THIS POINT.
14 Q. AND THAT WAS BASED ON YOUR NURSING EXPERIENCE?
15 A. YES.
16 Q. YOU'D BEEN A PSYCH NURSE.
17 A. YES.
18 THE COURT: JUST -- ALL WE'RE DOING IS WHAT WAS
19 SAID DURING THIS CONVERSATION.
20 Q. (BY MS. BARLOW) WHAT DID KAREN CHATELAIN TELL YOU?
21 A. THAT DR. WEITZEL --
22 MR. STIRBA: OBJECTION. HEARSAY, YOUR HONOR.
23 THE COURT: OVERRULED.
24 Q. (BY MS. BARLOW) WHAT DID KAREN CHATELAIN TELL YOU?
25 A. THAT DR. WEITZEL WAS A PHYSICIAN, AND WAS CAPABLE OF
1463
1 HANDLING MEDICAL SITUATIONS.
2 Q. AFTER THAT MEETING, DID YOU EVER TAKE ANY CONCERNS TO
3 KAREN CHATELAIN AGAIN?
4 A. NOT THAT I RECALL.
5 Q. LET'S GO BACK THEN. DID THAT OCCUR PRIOR TO YOUR --
6 WHEN DID THAT OCCUR IN RELATIONSHIP TO -- I DON'T WANNA LEAD
7 YOU HERE. WHEN DID THAT OCCURRENCE, TALKING TO KAREN
8 CHATELAIN, OCCUR IN RELATIONSHIP TO THE -- THE ORDER ON THE
9 7TH OF JANUARY TO GIVE MORPHINE TO MARY CRANE?
10 A. IT WOULD HAVE BEEN BEFORE.
11 Q. AND LET'S GO BACK TO 249, AND WE HAVE OVER HERE, HOLD
12 ALL ABOVE MEDS. MORPHINE. AND LET'S KIND OF GO BACK TO --
13 I DON'T WANNA REPLOW THE GROUND BECAUSE YOU HAVE ALREADY
14 TESTIFIED AS TO WHAT YOU DID APPROACHING DR. WEITZEL.
15 AFTER YOU APPROACHED DR. WEITZEL ABOUT GIVING THIS
16 MORPHINE SHOT TO MARY CRANE, WHAT DID HE SAY TO YOU?
17 A. I EXPRESSED CONCERN THAT -- I ASKED WHY --
18 THE COURT: THE QUESTION IS --
19 Q. (BY MS. BARLOW) WHAT -- WHAT DID HE SAY TO YOU? OKAY.
20 LET'S START WITH, WHAT DID YOU SAY TO HIM?
21 THE COURT: WHY DON'T WE JUST GET THE FOUNDATION AS
22 TO WHO WAS ON THIS CONVERSATION AND WHAT WAS SAID.
23 MS. BARLOW: I WILL BE HAPPY TO DO THAT, YOUR
24 HONOR.
25 Q. DO YOUR RECALL WHERE THIS CONVERSATION BETWEEN YOURSELF
1464
1 AND THE DEFENDANT TOOK PLACE?
2 A. AT THE NURSES' DESK.
3 Q. AND WAS ANYONE ELSE PRESENT?
4 A. I BELIEVE LYNN LONG WAS THERE.
5 Q. AND IT HAPPENED ON THE 7TH OF JANUARY?
6 A. YES.
7 Q. WHEN WAS IT THAT -- THIS WAS AT 2100 THAT THE ORDER WAS
8 NOTED.
9 A. YES.
10 Q. WHEN WAS IT IN RELATIONSHIP TO THAT ORDER?
11 A. IT WAS AT THAT POINT, HE -- HE WROTE THE ORDER. IT
12 WOULD HAVE BEEN AT THAT SAME TIME. I LOOKED AT THE ORDER
13 AND ASKED HIM, WHY ARE WE GIVING HER MORPHINE.
14 Q. SO YOU -- YOU SAID WHAT?
15 A. WHY ARE WE GIVING HER THE MORPHINE.
16 Q. AND WHAT WAS HIS RESPONSE TO THAT QUESTION?
17 A. FOR PAIN.
18 Q. AND WHAT WAS YOUR STATEMENT? OR DID YOU MAKE ANOTHER
19 STATEMENT TO HIM?
20 A. I SAID, I DON'T THINK SHE'S IN PAIN.
21 Q. AND WHAT DID HE SAY?
22 A. HE SAID, HOW DO YOU KNOW SHE'S NOT IN PAIN.
23 Q. AND WHAT DID YOU SAY?
24 A. I -- I SAID, WELL, I -- I DON'T SEE ANY SIGNS OF IT.
25 Q. AND WHAT DID HE SAY?
1465
1 A. HE SAID, DID -- DID THE PATIENT TELL YOU SHE'S NOT IN
2 PAIN?
3 Q. AND WHAT WAS YOUR RESPONSE?
4 A. I DIDN'T RESPOND AT THAT POINT BECAUSE I HAD NO
5 RESPONSE. THE PATIENT WAS NOT ABLE TO RESPOND. I MEAN THE
6 PATIENT WASN'T ABLE TO TELL ME THAT SHE WAS NOT IN PAIN.
7 Q. WAS SHE SPEAKING AT ALL AT THAT POINT?
8 A. NO. SHE WAS COMATOSE.
9 Q. SO WHAT -- DID ANYONE SAY ANYTHING -- YOU DIDN'T
10 RESPOND. DID HE SAY ANYTHING MORE?
11 A. NO. NOT THAT I RECALL.
12 Q. DID YOU SAY ANYTHING MORE TO HIM ABOUT HER BEING IN PAIN
13 OR NOT BEING IN PAIN?
14 A. NO, NOT THAT I RECALL.
15 Q. FINISH UP THAT ARENA AND THEN I HAVE ANOTHER QUESTION
16 BACK ON THAT. IF YOU WOULD TURN TO PAGE NUMBER 290 IN MARY
17 CRANE. DO YOU HAVE THAT IN FRONT OF YOU? IT'S IN THE MEDS
18 AND GRAPHS.
19 A. YES, I DO.
20 Q. AND THIS IS A MARS. AND WHAT IS A MARS?
21 A. MEDICAL RECORD MEDICATION ADMINISTRATION RECORD.
22 Q. AND WHAT DO YOU WRITE ON THIS RECORD?
23 A. IT'S A RECORD OF THE ADMINISTRATION -- THE MEDICATIONS
24 THAT YOU GIVE, YOU WRITE TIMES AND -- AND WHO GAVE IT. THE
25 DOSE --
1466
1 Q. LET'S COME DOWN HERE WHERE IT SAYS 1/7, M.S., THAT'S
2 MORPHINE.
3 A. YES.
4 Q. 5 MILLIGRAM I.M., Q-3 DEGREE, WHICH MEANS WHAT?
5 A. EVERY THREE HOURS.
6 Q. AND THEN THE TIMES ARE LISTED OVER HERE FROM -- LOOKS
7 LIKE 8:00 P.M. AND EVERY THREE HOURS TIMES ARE LISTED. THIS
8 FIRST ONE IS THE 5TH. WAS ANY MORPHINE GIVEN ON THAT DATE?
9 A. YES.
10 Q. AND WHERE DOES IT INDICATE IT WAS GIVEN?
11 A. OH, ON THE 5TH? I'M SORRY. I WAS LOOKING AT 7TH. NO.
12 I DON'T SEE ANY.
13 Q. WHAT ABOUT ON THE 6TH?
14 A. NO.
15 Q. NOW, WE HAVE ON THE 7TH AT 2000 OR TWENTY -- TWENTY
16 HUNDRED, I GUESS, 8:00 P.M., IT SAYS GIVEN, AND THEN IS THAT
17 YOUR INITIAL UNDERNEATH IT?
18 A. YES, IT IS.
19 Q. NOW, IS THIS THE DOSE YOU WERE TALKING ABOUT THAT YOU
20 DIDN'T WANNA GIVE?
21 A. I DIDN'T WANNA GIVE IT, NO.
22 Q. OKAY. AND YOU -- DID YOU TELL THE DEFENDANT YOU DIDN'T
23 WANNA GIVE IT?
24 A. YES, I DID.
25 Q. AND HIS RESPONSE WAS?
1467
1 A. AGAIN, HOW DO YOU KNOW SHE'S NOT IN PAIN. ARE YOU
2 WILLING TO LET HER SUFFER BECAUSE YOU DON'T THINK SHE'S IN
3 PAIN. Seems like a good question.
4 Q. AND WHAT WAS YOUR RESPONSE?
5 A. I DON'T THINK I RESPONDED TO IT. I --
6 Q. WHAT DID YOU DO AFTER YOU GOT THAT RESPONSE FROM THE
7 DEFENDANT?
8 A. I LOOKED AT THE ORDER AND I TOOK IT OVER TO THE PHONE
9 AND I CALLED THE PHARMACY AND ASKED THEM WHAT THEY THOUGHT
10 ABOUT GIVING THIS LADY 5 MILLIGRAMS OF MORPHINE WITH HER
11 RESPIRATIONS DOWN, IF -- I THOUGHT IT WOULD KILL HER. IF
12 THEY THOUGHT IT WOULD KILL HER. AND THEY SAID JUST THAT
13 5 MILLIGRAMS, IT WAS WITHIN NORMAL RANGE AND IT WOULD BE
14 OKAY.
15 Q. DID YOU GO GIVE IT THEN?
16 A. NO. I WAS STILL REALLY UNCOMFORTABLE WITH IT.
17 Q. WHAT DID YOU DO?
18 A. I WAS TALKING OVER WITH LYNN HOW I HAD NOT WANTED TO
19 GIVE IT. AND SHE SAYS, WELL, IF YOU DON'T FEEL COMFORTABLE
20 GIVING IT, I FEEL OKAY ABOUT GIVING IT, I CAN GO AHEAD AND
21 GIVE IT.
22 Q. IS THAT LYNN LONG?
23 A. YES.
24 Q. DID YOU SEE THAT SHOT GIVEN?
25 A. SHE TOOK THE SHOT AND WENT IN THE ROOM. I DON'T RECALL
1468
1 IF I SAW IT GIVEN OR NOT.
2 Q. THIS SAYS GIVEN. IN WHOSE HANDWRITING IS THAT?
3 A. THAT'S MINE.
4 Q. AND THEN IT'S INITIALLED, BUT YOU DIDN'T GIVE THE SHOT?
5 A. NO.
6 Q. WHY IS THAT WRITTEN IN THAT FASHION?
7 A. BECAUSE I WAS WAITING FOR LYNN TO INITIAL IT BECAUSE SHE
8 HAD GIVEN THE SHOT. AND SHE LEFT THE UNIT WITHOUT
9 INITIALLING IT. AND I DID NOT WANT THAT SHOT GIVEN BY
10 SOMEONE ELSE NOT KNOWING THAT IT HAD BEEN GIVEN, AND SO I
11 WROTE GIVEN ABOVE THERE WAITING FOR HER TO INITIAL IT. BY
12 THE TIME I WENT OFF SHIFT, SHE STILL HADN'T INITIALED IT, SO
13 I WENT AHEAD AND PUT MY INITIALS THERE.
14 Q. AND THEN AT 2300, IS THAT YOUR INITIAL?
15 A. YES.
16 Q. DID YOU GIVE THAT SHOT?
17 A. I DID.
18 Q. WHY DID YOU DO THAT?
19 A. BECAUSE IT BECAME VERY APPARENT THAT I WAS NOT GONNA BE
20 ABLE TO HELP THIS PATIENT. THAT THERE -- THAT SHE WAS IN
21 SUCH A STATE THAT SHE WAS GONNA DIE ON ME, IT WAS GONNA MAKE
22 NO DIFFERENCE WHETHER SHE GOT THIS SHOT OR NOT. AND SO --
23 Q. AND DO YOU RECALL WHEN MARY CRANE PASSED AWAY?
24 A. JUST WITHIN MAYBE A HALF HOUR AFTER THAT 2300.
25 MS. BARLOW: YOUR HONOR, I RECOGNIZE IT'S ONLY
1469
1 4:30, BUT THIS -- AS FAR AS GETTING INTO ANOTHER PATIENT AND
2 THEN HAVING TO BREAK OFF --
3 THE COURT: WELL, LET'S KEEP GOING. I MEAN
4 THERE'S -- WE'LL BREAK AT APPROPRIATE TIME.
5 Q. (BY MS. BARLOW) AND WE TALKED A LITTLE BIT ABOUT
6 JUDITH LARSEN.
7 A. UH-HUH.
8 Q. DO YOU HAVE HER BINDER THERE IN FRONT OF YOU?
9 A. I DO.
10 Q. DID YOU HAPPEN TO DO HER INTAKE? NO, IT LOOKS LIKE YOU
11 DIDN'T, SO -- HER ASSESSMENT.
12 DO YOU RECALL WHEN JUDITH LARSEN CAME ON THE UNIT?
13 A. I HAVE TO LOOK AT THE DATE HERE. I DIDN'T RECALL IT
14 WITHOUT LOOKING, BUT IT'S --
15 Q. OKAY. 12/6 --
16 A. -- 12/6/95.
17 Q. AND WHEN'S THE FIRST TIME THAT YOU HAD ANY INVOLVEMENT
18 WITH HER?
19 A. I'LL HAVE TO LOOK FOR MY SIGNATURE TO KNOW.
20 Q. IF YOU'D LOOK AT 528.
21 A. THAT'S MY SIGNATURE.
22 Q. DID YOU WRITE ANYTHING ABOVE IT?
23 A. NO.
24 Q. WHY -- WHAT DO YOU RECALL AT THAT POINT OF JUDITH
25 LARSEN? ON THE 7TH?
1470
1 A. WHEN YOU SAY -- THERE'S NO WRITING ABOVE IT, BUT THIS --
2 THIS ASSESSMENT LOOKS LIKE I WOULD HAVE DONE THIS ASSESSMENT
3 THAT'S ON THE LEFT --
4 Q. CAN YOU OPEN THAT UP AND --
5 A. -- LEFT-HAND SIDE.
6 Q. WHEN YOU SAY THE ASSESSMENT, WHAT ARE YOU TALKING ABOUT?
7 WHAT ON THAT SHEET?
8 A. YOU WOULD GO, YOU WOULD LISTEN TO PATIENT'S LUNGS. YOU
9 WOULD CHECK THEIR PUPILS. YOU WOULD -- YOU WOULD SEE HOW
10 THEY WERE DOING. YOU WOULD ASSESS HOW THEY ARE.
11 Q. AND HOW WOULD YOU CHART THAT?
12 A. BY CIRCLING THE APPROPRIATE INFORMATION.
13 Q. IS THAT IN THE CENTER PART THERE?
14 A. YES.
15 Q. AND I GUESS A LITTLE BIT TO THE LEFT HERE.
16 A. UH-HUH.
17 Q. AT THE BOTTOM, THE ASSESSMENT TIME, YOU SAY THAT'S YOUR
18 HANDWRITING?
19 A. YES.
20 Q. OKAY. ON THE 7TH OF DECEMBER, WHAT DO YOU REMEMBER OF
21 JUDITH LARSEN?
22 A. WHAT'S WRITTEN HERE.
23 Q. OKAY. AND -- AND IF MOST OF THE MEDICAL NUMBERS THAT
24 HAVE YOUR SIGNATURE ON IT ALSO, YOU KNOW, DON'T HAVE ANY
25 FREE TEXT, WOULD WHAT THAT INDICATE TO YOU?
1471
1 A. THAT I WAS CO-SONING -- CO-SIGNING, THAT I WAS THERE AND
2 I WAS -- I WAS ON THE UNIT, BUT THAT EITHER A TECH OR
3 SOMEONE ELSE HAD CHARTED ON THE PATIENT.
4 Q. DO YOU RECALL ANY CHANGE IN JUDITH LARSEN FROM THE TIME
5 SHE CAME ON THE UNIT UNTIL SHE PASSED AWAY?
6 A. YES.
7 Q. DO YOU RECALL WHEN -- I MEAN SHE CAME ON THE 6TH OF
8 DECEMBER. DO YOU RECALL WHEN THERE BECAME A CHANGE?
9 A. THERE WERE LOTS OF CHANGES WITH JUDITH. SHE WOULD GO UP
10 AND DOWN, AND SHE HAD GOOD DAYS AND BAD DAYS.
11 Q. DO YOU REMEMBER HER TOWARDS THE END OF HER LIFE?
12 A. YES.
13 Q. WAS SHE STILL GOING UP AND DOWN AT THAT POINT?
14 A. SHE WAS HEADED STRAIGHT DOWN. SHE DIDN'T COME UP AGAIN.
15 Q. AND WHEN WE SAY HEADED STRAIGHT DOWN, WHAT WERE YOU
16 SEEING IN HER?
17 MR. STIRBA: CAN WE HAVE A LITTLE BIT MORE
18 FOUNDATION, YOUR HONOR, ABOUT WHEN THESE EVENTS TOOK PLACE
19 OTHER THAN JUST AT THE END OF HER LIFE?
20 THE COURT: YES, LET'S REFER TO DAYS OR TIMES THAT
21 YOU SAW HER.
22 Q. (BY MS. BARLOW) OKAY. IT APPEARS THAT -- IF I RECALL
23 CORRECTLY SHE PASSED AWAY ABOUT THE 3RD OF JANUARY, IS THAT
24 CORRECT?
25 A. YES.
1472
1 Q. WHEN IN RELATIONSHIP TO THE 3RD OF JANUARY DID YOU SEE A
2 CHANGE THAT SHE NEVER CAME -- DIDN'T COME UP AGAIN?
3 A. I'D HAVE TO LOOK.
4 Q. OKAY.
5 A. IT MIGHT TAKE ME A MINUTE TO -- TO FIGURE THAT OUT.
6 I DON'T RECALL EXACTLY. IT WOULD TAKE A LITTLE MORE
7 TIME FOR ME TO --
8 Q. LET'S LOOK AT 577, WHICH IS THE 30TH OF DECEMBER.
9 A. OKAY.
10 Q. ANY INDICATION YOU SAW HER THAT NIGHT? OR THAT DAY,
11 EXCUSE ME.
12 A. 577, THAT WOULD HAVE BEEN DECEMBER 30TH?
13 Q. YES.
14 A. I DON'T SEE ME THERE, NO.
15 Q. LET'S TURN TO 574. DO YOU SEE ANYTHING IN THAT -- ON
16 THAT PAGE THAT WOULD INDICATE TO YOU --
17 A. MY SIGNATURE'S AT THE BOTTOM ON THE RIGHT-HAND SIDE.
18 Q. WAS THERE ANYTHING ON THERE INDICATING SHE WAS GOING
19 DOWNHILL?
20 A. NO.
21 MR. STIRBA: YOUR HONOR -- YOUR HONOR -- OKAY.
22 THE COURT: I DON'T THINK DOWNHILL'S QUITE A
23 MEDICAL TERM.
24 MR. STIRBA: AND INDICATING, THESE ARE NURSES'
25 NOTES AND --
1473
1 THE COURT: YEAH, LET'S TRY TO USE MEDICAL PHRASES.
2 Q. (BY MS. BARLOW) LET'S GET OVER INTO -- LET'S TURN TO
3 586. DID YOU WRITE ANYTHING ON THAT?
4 A. IT HAS MY SIGNATURE AGAIN. I DON'T SEE ANY TEXT THAT
5 I'VE WRITTEN THERE.
6 Q. DO YOU SEE ANY INDICATION IN THERE OF HER BEHAVIOR?
7 A. SHE HAS AN IRREGULAR HEARTBEAT.
8 MR. STIRBA: YOUR HONOR --
9 THE WITNESS: SHE --
10 MR. STIRBA: -- YOUR HONOR, I'M GONNA OBJECT. THE
11 QUESTION WAS, DO YOU SEE ANY INDICATION. I PRESUME WE'RE
12 LOOKING AT THE NOTE. IS THERE SOMETHING CHARTED AS TO HER
13 BEHAVIOR. I THINK THE ANSWER IS EITHER YES OR NO, AND THEN
14 OF COURSE, WE CAN READ THE NOTE. THIS ISN'T EVEN HER NOTE.
15 MS. BARLOW: WELL, YOUR HONOR, IT'S --
16 THE COURT: OKAY. LET'S --
17 MS. BARLOW: -- MEDICAL RECORD.
18 THE COURT: WELL, LET'S ANSWER -- THE QUESTION WAS
19 YES OR NO, AND THEN SEE WHAT --
20 Q. (BY MS. BARLOW) IS THERE ANYTHING ON 586 THAT CHARTS
21 HER BEHAVIOR FOR THAT DAY?
22 A. I'VE DONE THE PHYSICAL ASSESSMENT ON HER. I DON'T HAVE
23 ANYTHING CHARTED ON THE RIGHT-HAND SIDE THAT I'VE WRITTEN
24 OUT, BUT I'VE DONE THE ASSESSMENT ON HER.
25 Q. WHEN YOU SAY THE ASSESSMENT, YOU MEAN THE STUFF IN THE
1474
1 MIDDLE COLUMN?
2 A. YES.
3 Q. DO YOU SEE ANYTHING THERE THAT INDICATES THAT HER --
4 THAT HER PHYSICAL HEALTH IS CHANGING?
5 A. IF SAYS, LABORED AND CYANOTIC ON HER BREATHING.
6 CYANOTIC MEANS THERE'S SOME BLUE COLOR. THAT MEANS SHE'S
7 NOT GETTING ENOUGH OXYGEN.
8 Q. SO THAT IS -- I GUESS I NEED TO FIND OUT WHERE THE --
9 OH, OKAY.
10 A. SAYS BREATH, IT SAYS RESPIRATIONS.
11 THE COURT: IT'S AT THE TOP.
12 MS. BARLOW: OH, I'M SORRY. THANK YOU.
13 Q. SO RESPIRATIONS, IT SAYS NO DISTRESS. THEN IT SAYS
14 LABORED AND CYANOTIC. IS THAT YOUR HANDWRITING?
15 A. YES.
16 Q. WHICH MEANS WHAT?
17 A. SHE'S -- SHE'S PRETTY SICK.
18 Q. WELL, WHAT DOES CYANOTIC MEAN?
19 A. SHE'S BLUE. SHE'S NOT GETTING ENOUGH OXYGEN.
20 Q. AND THEN DOWN HERE IN THE PSYCHOLOGICAL UNDER EMOTIONS,
21 YOU'VE CIRCLED CALM. AND THEN BEHAVIOR'S WITHDRAWN. IS
22 THAT A CHANGE IN HER BEHAVIOR?
23 A. YES.
24 Q. JUST -- I'M SORRY.
25 NOW, IF YOU'D TURN TO 589, AND WHAT DATE IS THAT?
1475
1 A. IT IS JANUARY 3RD.
2 Q. DO YOU KNOW WHETHER YOU WOULD BE WORKING DAYS, EVENINGS,
3 OR WHAT THAT -- WHAT SHIFT WOULD YOU WORK THAT DAY?
4 A. I DON'T KNOW.
5 Q. NOW, YOU DIDN'T WRITE ANYTHING OVER IN THE FREE TEXT ON
6 THE RIGHT, IS THAT CORRECT?
7 A. NO.
8 Q. OKAY. DID YOU -- WERE YOU INVOLVED IN FILLING OUT THE
9 ASSESSMENT IN THE MIDDLE?
10 A. NO.
11 Q. WAS THIS ASSESSMENT FILLED OUT UNDER YOUR DIRECTION?
12 A. IT WAS FILLED OUT BY LYNN LONG. SHE'S AN R.N. SHE
13 WOULD HAVE HAD THE AUTHORITY TO -- I WOULDN'T HAVE BEEN
14 TELLING HER WHAT TO DO.
15 Q. BUT YOU SIGNED OFF AS THE CHARGE NURSE, IS THAT CORRECT?
16 A. THAT'S WHAT I -- YES.
17 Q. WHEN YOU SIGN OFF AS THE CHARGE NURSE, DO YOU LOOK AT
18 WHAT'S BEEN PRESENTED THERE TO SEE IF IT'S CORRECT?
19 A. IT JUST DEPENDS. SOMETIMES YOU'RE SIGNING THAT YOU WERE
20 JUST THERE THAT DAY.
21 Q. NOW, UNDER EMOTIONS, IT SAYS, NONRESPONSIVE. BEHAVIOR,
22 WITHDRAWN. IS THIS A CHANGE FROM HER PREVIOUS BEHAVIOR?
23 A. YES.
24 Q. IS THIS THE CHANGE YOU EARLIER TESTIFIED TO THAT YOU SAW
25 A CHANGE IN HER BEHAVIOR?
1476
1 A. YES.
2 THE COURT: HOW MUCH MORE TIME DO YOU THINK YOU'RE
3 GOING TO BE WITH THIS WITNESS?
4 MS. BARLOW: YOUR HONOR, I THINK THAT FINISHES UP
5 JUDITH LARSEN. I THINK THAT IT WOULD BE A GOOD TIME TO
6 BREAK, IF THAT'S WHAT YOU'RE --
7 THE COURT: WELL, HOW MUCH MORE TIME, THOUGH, ARE
8 YOU GONNA TAKE?
9 MS. BARLOW: WITH THIS WITNESS, SHE WILL BE TALKING
10 ABOUT --
11 THE COURT: WELL, TELL ME ABOUT TIME.
12 MS. BARLOW: -- LYDIA SMITH, AND IT'S GOING TO
13 PROBABLY TAKE ANOTHER HALF HOUR OR SO.
14 THE COURT: OKAY. AND HOW MUCH TIME DO YOU
15 ANTICIPATE, MR. STIRBA, IF YOU CAN ANTICIPATE RIGHT NOW?
16 MR. STIRBA: OH, I'D WANT 15, 20 MINUTES, JUDGE, AT
17 LEAST.
18 THE COURT: OKAY. WELL, LADIES AND GENTLEMEN, I
19 THINK WHAT WE'RE GOING TO DO IS RECESS UNTIL MONDAY AT THIS
20 POINT.
24 MS. BARLOW: YES, YOUR HONOR. WE'D RECALL EARLENE
25 COOPER.
1480
1 THE COURT: IF YOU'D COME FORWARD. YOU ARE STILL
2 UNDER OATH.
3 DIRECT EXAMINATION, CONT'D
4 BY MS. BARLOW:
5 Q. MORNING.
6 WE WERE TALKING ON FRIDAY ABOUT -- WELL, PERHAPS IF YOU
7 WOULD RESTATE YOUR NAME FOR THE RECORD.
8 A. EARLENE COZZENS-COOPER.
9 Q. WE WERE SPEAKING OF YOUR EMPLOYMENT AT THE GEROPSYCH
10 UNIT AT THE DAVIS NORTH HOSPITAL LAST FRIDAY. I WOULD LIKE
11 TO TURN YOUR ATTENTION TO SOME MATTERS IN THE MEDICAL
12 RECORDS INVOLVING SOME OF THESE PATIENTS. DO YOU HAVE THE
13 MEDICAL RECORDS UP THERE?
14 A. I DO.
15 Q. WOULD YOU PULL OUT MARY CRANE'S MEDICAL RECORD, PLEASE.
16 AND I THINK FOR THE PURPOSE OF EDIFYING THE JURY A LITTLE
17 BIT, WOULD YOU TURN TO PAGE 231, MEDICAL NUMBER 231. IT'S
18 WAY BACK UNDER PSYCH EVAL.
19 A. OKAY.
20 Q. IT'S ONE OF THE FIRST DOCUMENTS.
21 A. OH, THERE IT IS.
22 Q. AND WHAT IS THAT DOCUMENT?
23 A. IT'S THE -- IT'S DR. WEITZEL'S EVALUATION OF THE
24 PATIENT.
25 Q. DO YOU KNOW WHETHER SUCH AN EVALUATION WAS STANDARD
1481
1 PROCEDURE WITH THESE PATIENTS?
2 A. YES, IT WAS.
3 Q. DO YOU KNOW WHEN THAT WAS DONE IN RELATIONSHIP TO THEIR
4 ADMISSION TO THE UNIT?
5 A. AS SOON AS POSSIBLE.
6 Q. AND THEN THERE'S THE NEXT CATEGORY THERE ARE THESE TABS
7 SAYS CONSULTATION, THE FIRST ONE THERE IS 234.
8 A. WHAT PAGE AGAIN?
9 Q. 234.
10 A. OKAY.
11 Q. REPORT OF CONSULTATION, WHAT IS THAT?
12 A. I WOULD ASSUME THAT ANOTHER PHYSICIAN WOULD HAVE COME IN
13 AND DONE A HISTORY AND PHYSICAL ON HER.
14 Q. WAS THAT A STANDARD PROCEDURE?
15 A. YES.
16 Q. WITH THESE PATIENTS?
17 A. YES.
18 Q. AND THAT HISTORY AND PHYSICAL, WHAT WAS THE PURPOSE OF
19 THAT?
20 A. TO MAKE SURE THAT THE PATIENT WAS HEALTHY ENOUGH TO BE
21 ON THE UNIT. Boy, nurses sure do get it wrong, sometimes.
22 Q. THEN THE NEXT CATEGORY IS CALLED PHYSICIAN'S ORDERS, 238
23 IS THE PAGE NUMBER.
24 A. OKAY.
25 Q. WHAT ARE THOSE?
1482
1 A. THOSE ARE THE ORDERS THE DOCTOR GIVES US TO FOLLOW TO
2 TAKE CARE OF THE PATIENT.
3 Q. AND WHAT KINDS OF ORDERS WOULD THOSE BE?
4 A. MEDICATION ORDERS, LAB ORDERS, VITAL SIGN ORDERS, DIET
5 ORDERS, EVERYTHING THAT HAS TO DO WITH A PATIENT.
6 EVERYTHING YOU DO WITH A PATIENT, THE DOCTOR ORDERS.
7 Q. AND LAB ORDERS ARE USUALLY, I MEAN, WHAT KINDS OF
8 THINGS?
9 A. C.B.C.'S, S.M.A.'S.
10 Q. WHAT'S A C.B.C?
11 A. BLOOD COUNT.
12 Q. WHAT'S IT --
13 A. A CELLULAR BLOOD COUNT. Actually, complete blood count.
14 Q. AND S.M.A., IS THAT WHAT YOU SAID NEXT?
15 A. THAT'S A CHEMISTRY THAT LOOKS AT THE DIFFERENT
16 CHEMISTRIES OF THE BODY.
17 Q. SO DIFFERENT KINDS OF TESTS THE ORDERS WOULD SHOW UP ON
18 THESE DOCUMENTS; IS THAT CORRECT?
19 A. YES, THEY WOULD.
20 Q. THE NEXT CATEGORY IS CALLED PROGRESS NOTES AND THAT'S
21 251.
22 A. YES, I HAVE THAT.
23 Q. WHAT IS THAT?
24 A. THIS IS -- WHENEVER THE DOCTOR CAME AND SAW THE PATIENT
25 HE WOULD UPDATE THE PROGRESS OF THAT PATIENT IN THESE OR THE
1483
1 DIETICIAN WOULD OR THE SOCIAL WORKER. IT WAS A PROGRESS
2 NOTE OF THE PATIENT.
3 Q. WHAT ABOUT OCCUPATIONAL THERAPIST OR RECREATIONAL
4 THERAPIST, DID YOU HAVE ANY OF THOSE ON THIS UNIT?
5 A. YES, AND THEY COULD DOCUMENT THESE PROGRESS NOTES ALSO.
6 Q. THEN LET'S JUMP OVER, WE HAVE LABS, 257.
7 A. YES.
8 Q. WHAT'S THAT CATEGORY OF DOCUMENTS?
9 A. THIS IS THE LABORATORY THAT WAS DRAWN AND AFTER WE GET
10 THOSE RESULTS BACK, THIS IS THE RESULTS OF THAT BLOOD THAT
11 WAS DRAWN.
12 Q. OR THE BLOOD TEST?
13 A. OR THE URINE OR WHATEVER LAB TEST YOU WERE DOING.
14 Q. THEN THE NEXT ONE IS RADIOLOGY AT 270. WHAT ARE THOSE
15 DOCUMENTS?
16 A. THEY ARE DOCUMENTATION OF ANY X-RAYS, M.R.I.'S, C.A.T.
17 SCANS, ANYTHING LIKE THAT WOULD GO IN THIS CATEGORY, ANY
18 PROCEDURES LIKE THAT.
19 Q. WHAT'S AN M.R.I.?
20 A. MAGNETIC RADIANCE IMAGERY IT'S --
21 Q. WHAT'S ITS PURPOSE?
22 A. TO LOOK AND SEE IF THERE'S ANY ABNORMALITIES IN EITHER
23 THE HEAD OR YOU CAN DO AN M.R.I. ON ANY PART OF THE BODY TO
24 LOOK FOR ABNORMALITIES.
25 Q. WHAT ABOUT A C.A.T. SCAN, DO YOU KNOW HOW A M.R.I. AND A
1484
1 C.A.T. SCAN CORRELATE?
2 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT,
3 BEYOND THE SCOPE OF HER COMPETENCY.
4 MS. BARLOW: YOUR HONOR, I ASKED HER IF SHE KNEW.
5 IT'S A YES OR NO QUESTION.
6 THE COURT: OKAY. OVERRULED.
7 Q. (BY MS. BARLOW) BASED ON YOUR TRAINING, DO YOU HAVE
8 ANY KNOWLEDGE OR AM I GETTING FURTHER AFIELD THAN REALLY YOU
9 GET INTO?
10 A. IT'S A LITTLE BIT OUT OF MY FIELD BUT I KNOW THEY ARE
11 DIFFERENT.
12 Q. OKAY. AND THEN THE NEXT WE HAVE CATEGORY IS E.K.G.
13 SWALLOW AND E.E.G. WHAT'S AN E.K.G.?
14 A. IT'S A HEART, YOU ARE LOOKING AT THE HEART TO LOOK AT
15 THE RHYTHMS OF THE HEART, THE ELECTRICAL TRANSMISSION OF THE
16 HEART.
17 Q. AND THEN IT SAYS SWALLOW, WHAT WOULD THAT BE?
18 A. THAT WAS DONE BY SOMEONE WHO COULD FIND OUT IF A PATIENT
19 HAD ANY ABNORMALITIES IN THEIR ESOPHAGUS OR THROAT OR TO TRY
20 TO FIND OUT IF THERE WAS ANYTHING PHYSICALLY WRONG THAT WAS
21 PREVENTING THEM FROM EATING AND SWALLOWING.
22 Q. IS SWALLOWING A PROBLEM WITH THESE PATIENTS?
23 MR. STIRBA: YOUR HONOR, I'LL OBJECT, RELEVANCY.
24 Q. (BY MS. BARLOW) WITH THESE FIVE PATIENTS, WAS
25 SWALLOWING A PROBLEM?
1485
1 MR. STIRBA: I'LL OBJECT, LACK OF FOUNDATION.
2 THE COURT: WHAT'S THE FOUNDATION THAT SHE SAW ALL
3 FIVE PATIENTS?
4 Q. (BY MS. BARLOW) DID YOU SEE ALL FIVE OF THESE
5 PATIENTS?
6 A. YES.
7 Q. WELL, LET'S SEE, ELLEN ANDERSON, DID YOU SEE --
8 A. NO, I DIDN'T.
9 Q. OKAY. THE OTHER FOUR DID YOU SEE?
10 A. YES.
11 Q. DID YOU SEE AT ANY TIME ANY DIFFICULTY THEY HAD
12 SWALLOWING? CAN YOU SPECIFICALLY REMEMBER IF ANY HAD
13 DIFFICULTY SWALLOWING?
14 A. I REMEMBER THEY WOULDN'T EAT AND THE SWALLOWING EVAL WAS
15 DONE OUT TO FIND OUT WHY, IF IT WAS BECAUSE OF DIFFICULTY
16 SWALLOWING AND I DON'T REMEMBER SPECIFICALLY WHETHER THEY
17 DID OR NOT.
18 Q. LET'S GO BACK TO THE CATEGORY E.E.G., I MEAN, IT'S IN
19 THE SAME CATEGORY BUT E.E.G.?
20 A. THAT WOULD BE -- YOU WERE LOOKING AT THE ELECTRICAL
21 FUNCTIONING OF THE BRAIN.
22 Q. AND --
23 A. IT WOULD DENOTE SEIZURES OR SOMETHING LIKE THAT. AN
24 ABNORMAL E.E.G., WOULD BE YOU WOULD BE LOOKING FOR SEIZURES
25 OR ABNORMAL ELECTRICAL ACTIVITY IN THE BRAIN.
1486
1 Q. NOW THESE -- YOU DIDN'T GIVE THESE TESTS; IS THAT
2 CORRECT?
3 A. NO.
4 Q. WOULD YOU READ THESE TESTS?
5 A. NO, THE DOCTOR WOULD.
6 Q. WHAT DOCTOR WOULD READ AN E.K.G.?
7 A. IT COULD BE THE MEDICAL DOCTOR OR IT COULD BE --
8 SOMETIMES THEY HAD DOCTORS SPECIFICALLY IN THAT AREA THAT
9 WOULD READ THEM AND INTERPRET THEM.
10 Q. WHAT ABOUT AN E.E.G., WOULD YOU READ THAT?
11 A. NO.
12 Q. WHO WOULD READ THAT?
13 A. IT WOULD BE A DOCTOR.
14 Q. THEN OUR NEXT CATEGORY IS MEDS AND GRAPHS, WHAT IS THAT?
15 AND THAT'S 279.
16 A. THIS IS THE PATIENT'S VITAL SIGNS, THEIR TEMPERATURE,
17 RESPIRATION, PULSE AND THE MEDICATIONS THAT THEY RECEIVED.
18 Q. THERE'S TWO PAGES AT LEAST IN HERE APPEAR TO BE GRAPHS,
19 I THINK WE'VE SEEN THOSE BEFORE. AND THEN 281, WHAT IS THAT
20 CHART?
21 A. THAT IS AN INSULIN -- RECORD OF INSULIN, A BLOOD SUGAR
22 RECORD.
23 Q. IT SAYS DIABETIC CHART. WHAT WOULD YOU DO TO FILL OUT
24 THIS CHART?
25 A. YOU WOULD CHECK THE PATIENT'S BLOOD SUGAR WITH AN
1487
1 ACCUCHECK, THAT A.C.C.U. STANDS FOR ACCUCHECK. IT'S A
2 MACHINE YOU HAVE. YOU GET A DROP OF BLOOD AND IT INDICATES
3 TO YOU WHAT THEIR BLOOD SUGAR IS WHETHER IT'S HIGH OR LOW.
4 Q. AND IF IT WERE HIGH, WHAT WOULD YOU DO?
5 A. GENERALLY YOU WOULD GET AN INSULIN ORDER, OR YOU WOULD
6 HAVE A STANDING INSULIN ORDER TO GIVE THEM INSULIN.
7 Q. YOU WOULDN'T DO IT AUTOMATICALLY, YOU WOULD HAVE TO HAVE
8 AN ORDER?
9 A. YOU WOULD HAVE TO HAVE AN ORDER, YES.
10 Q. WHAT IF IT WERE LOW?
11 A. YOU WOULD GIVE WHAT WE CALL GLUCAGON OR YOU WOULD GIVE
12 THEM SOME ORANGE JUICE OR SOMETHING LIKE THAT TO SEE --
13 Q. TO RAISE THEIR BLOOD SUGAR?
14 A. TO RAISE THEIR BLOOD SUGAR.
15 Q. AND WE'VE HAD A LITTLE BIT OF TESTIMONY AND I'LL JUST
16 TAKE 282 AS AN EXAMPLE OF SOMETHING THAT'S CALLED A M.A.R.S.
17 AND THIS IS CALLED A MULTIPLE M.A.R.S. IT APPEARS, WHAT IS
18 THAT?
19 A. THAT'S THE MEDICATION THE PATIENT WAS RECEIVING AND A
20 RECORD OF WHEN THEY RECEIVED IT AND WHO GAVE THOSE
21 MEDICATIONS.
22 Q. WHO WOULD PUT THE KINDS OF MEDICATION ON THIS M.A.R.S.?
23 A. THE NURSE WOULD LOOK AT THE DOCTOR'S ORDER AND THEN TAKE
24 THOSE DOCTOR'S ORDERS AND PUT THEM ON HERE ON THE RECORD SO
25 WE COULD HAVE A RECORD OF WHEN THEY WERE TYPICALLY GIVEN.
1488
1 Q. I THINK YOU SAID THERE'S AN ORDER DATE AND A STOP DATE.
2 A. YES.
3 Q. THE NAME OF THE MEDICATION. AND THEN WHAT'S 0817HS?
4 A. THOSE ARE THE TIMES. 8 O'CLOCK WOULD BE 8 O'CLOCK IN
5 THE MORNING. SEVENTEEN WOULD BE FIVE IN THE AFTERNOON.
6 H.S. WAS USUALLY EIGHT AT NIGHT OR NINE AT NIGHT AT BEDTIME.
7 H.S. MEANS BEDTIME.
8 Q. THEN THE TIMES ARE WRITTEN DOWN HERE.
9 A. UH-HUH.
10 Q. AND THEN THERE'S AN INITIAL NEXT TO -- APPEARS TO BE --
11 IT LOOKED LIKE IT WAS 2000, NOW IT'S 2100. WHAT WOULD THAT
12 MEAN?
13 A. THAT MEANS THAT SHE GOT THIS MEDICATION AT BEDTIME.
14 Q. WHOSE INITIALS WOULD THAT BE?
15 A. THAT LOOKS LIKE DO'S.
16 Q. DORENE KLEI?
17 A. YES.
18 Q. AND AT THE TOP THAT SAYS 12/28. THE NEXT ONE OVER HERE
19 SAYS 12/29 IS THAT HOW YOU CHARTED WHETHER THESE DOSES WERE
20 GIVEN?
21 A. YES.
22 Q. DOWN HERE IT SAYS A DURAGESIC PATCH 50 MILLIGRAMS.
23 A. UH-HUH.
24 Q. THERE'S A SQUARE AND THIS ONE HAS INITIALS IN IT, THIS
25 ONE DOES NOT HAVE INITIALS IN IT. DO YOU KNOW WHAT THAT
1489
1 SQUARE MEANT?
2 A. THAT'S WHEN WE WERE TO GIVE THE DOSE. THE OTHER ONES
3 WERE CROSSED OFF BECAUSE YOU ONLY GAVE IT EVERY THREE DAYS
4 SO YOU WANTED TO MAKE SURE THAT IT WASN'T -- SO YOU DIDN'T
5 WANT TO GIVE IT EVERY DAY. YOU MADE A SQUARE TO KNOW THAT
6 WAS THE DAY YOU WERE TO GIVE THE DOSE.
7 Q. JUST AGAIN FOR POINT OF REFERENCE, IF YOU TURN TO 284.
8 A. OKAY.
9 Q. LET'S SEE, WE HAVE THIS MUST BE ACCUCHECK; IS THAT
10 CORRECT?
11 A. YES.
12 Q. SO EVEN WHEN YOU CHECKED THEIR BLOOD SUGAR IT HAD TO
13 COME OFF THIS; IS THAT CORRECT?
14 A. YES.
15 Q. SO THESE LINES THROUGH MEANT THAT AT 7 IN THE MORNING
16 AND 11 IN THE MORNING IT DIDN'T HAPPEN; IS THAT CORRECT?
17 A. YES.
18 Q. AND THEN I DON'T KNOW WHY -- ARE THOSE THE NUMBERS OF
19 THEIR BLOOD SUGAR?
20 A. THAT WOULD BE HIS BLOOD SUGAR OR HER BLOOD SUGAR, YES.
21 Q. I WANTED TO POINT OUT DOWN HERE ON THE 1ST OF JANUARY
22 THERE ARE A COUPLE OF PLACES WHERE THE INITIALS L.L. ARE.
23 A. UH-HUH.
24 Q. DO YOU KNOW WHO THAT IS?
25 A. THAT'S LYNN LONG.
1490
1 Q. AND THEY ARE CIRCLED?
2 A. YES.
3 Q. DO YOU KNOW WHAT THAT MEANS?
4 A. IT MEANS THAT THEY WEREN'T GIVEN AND THERE'S A LITTLE
5 CODE UP HERE IN THE MIDDLE THAT TELLS -- IT HAS A NUMBER BY
6 IT.
7 Q. AND THAT CODE IS SIX?
8 A. SHE'S WRITTEN OTHER, SEE THE NURSES' NOTES. SO SHE'S
9 WRITTEN A REASON WHY SHE DIDN'T GIVE THAT.
10 Q. IN THE NURSES' NOTES?
11 A. IN THE NURSES' NOTES.
12 Q. THE NEXT CATEGORY THAT WE HAVE IS CALLED NURSES' NOTES,
13 294.
14 A. UH-HUH.
15 Q. AND I THINK WE TALKED AND I WON'T GET INTO THIS A GREAT
16 DEAL, BUT THE FIRST THING IN THE NURSES' NOTES IS THIS
17 ASSESSMENT?
18 A. YES.
19 Q. AND I THINK YOU TESTIFIED YOU DID THIS ONE?
20 A. YES.
21 Q. NOW, BEHIND THE ASSESSMENT AND, AGAIN, I THINK YOU --
22 JUST TO SHOW -- I GUESS I SHOULD FINISH MY SENTENCES.
23 JUST TO SHOW WHERE WE ARE WITH THIS. THIS IS THE FIRST
24 PAGE AFTER THE ASSESSMENT AND LET'S NOT GOING INTO GREAT
25 DETAIL BECAUSE YOU DID LAST WEEK BUT WHAT IS THIS AGAIN?
1491
1 A. THIS IS THE NURSES' NOTES AND NURSING ASSESSMENT.
2 Q. THE NEXT SECTION IS CALLED CARDEX. CAN YOU TELL US WHAT
3 THE CARDEX WAS JUST IN GENERAL?
4 A. IT WAS HELD SEPARATE FROM THE CHART AND IT WAS A -- YOU
5 HAD ALL THE PATIENTS' CARDEX TOGETHER AND BASICALLY IT TOLD
6 YOU THE MEDICATIONS THE PATIENT WAS ON, THE DIET SO YOU
7 COULD HAVE A QUICK REFERENCE TO LOOK AT ALL THE PATIENTS AND
8 CHECK ORDERS AND STUFF, RATHER THAN HAVING TO GO THROUGH THE
9 CHART EVERY SINGLE TIME.
10 Q. SO IF YOU WANTED TO MAKE SURE ABOUT THE ORDER YOU
11 WOULDN'T HAVE TO GO BACK TO THE PHYSICIAN'S ORDERS, YOU
12 COULD LOOK AT THE CARDEX?
13 A. YOU COULD LOOK AT THE CARDEX, YES.
14 Q. AND THEY ARE SUPPOSED TO COINCIDE?
15 A. THEY ARE.
16 Q. NOW THE NEXT SECTION IS TERMED MEDICAL/LEGAL. CAN YOU
17 TELL US WHAT IS IN THAT SECTION?
18 A. THIS IS ALL THE CONSENTS TO TREAT. THIS IS ALL THE
19 CONSENTS TO HAVE ANY TEST DONE, THESE ARE THE CONCEPTS TO
20 WHO TO CONTACT, THE FAMILY THAT HAS THE RIGHT TO SAY WHAT
21 GOES ON WITH THE PATIENT.
22 Q. AND THEN THE MASTER TREATMENT PLAN IS THE NEXT SECTION,
23 347.
24 A. UH-HUH.
25 Q. CAN YOU TELL THE JURY WHAT THAT IS?
1492
1 A. YOU WOULD HAVE WHAT YOU CALL TEAM MEETINGS AND YOU WOULD
2 GET TOGETHER AND GO OVER THIS TO TRY AND FIND THE BEST PLAN
3 TO TREAT THIS PATIENT AND TO COME UP WITH WHAT ARE WE GOING
4 TO DO FOR THIS PATIENT, WHAT'S WRONG WITH THE PATIENT AND
5 WHAT ARE WE GOING TO DO ABOUT IT.
6 Q. WHEN YOU SAY TEAM MEETINGS, WHO WOULD BE AT THOSE TEAM
7 MEETINGS?
8 A. GENERALLY A NURSE, THE SOCIAL WORKER, THE DOCTOR, O.T.
9 COULD GO, RECREATIONAL THERAPY.
10 Q. O.T., WHAT IS --
11 A. OCCUPATIONAL THERAPY, I'M SORRY. THE SPEECH THERAPIST
12 COULD GO. IT WAS JUST SO WE COULD SIT DOWN AND LOOK AT THIS
13 PATIENT AND FIGURE OUT AS A TEAM WHAT WAS THE BEST THING TO
14 DO FOR THEM.
15 Q. AND COULD THIS TREATMENT PLAN CHANGE OVER TIME?
16 A. YES, IT WAS MEANT TO CHANGE. IT WAS MEANT TO CHANGE AS
17 THE PATIENT CHANGED, AS THEIR NEEDS CHANGED.
18 Q. AND THEN WE HAVE THE DISCHARGE SUMMARY ON 353, WHAT IS
19 THAT?
20 A. I BELIEVE THIS WAS DONE AFTER THEY WERE DISCHARGED.
21 Q. DID YOU EVER SEE THESE?
22 A. YES, I HAVE SEEN THEM BEFORE BUT IT'S BEEN LONG ENOUGH I
23 DON'T REMEMBER EXACTLY WHEN THEY DID THESE.
24 Q. THANK YOU. LET'S TURN BACK -- NOW THAT WE'VE BEEN
25 THROUGH THE BASICS, LET'S TURN BACK TO 470.
1493
1 A. WHAT'S THAT NUMBER?
2 Q. I'M SORRY, 470 DOESN'T LOOK LIKE THE RIGHT NUMBER FOR
3 ME.
4 A. OKAY.
5 Q. LET ME SEE IF I CAN'T GET A BETTER NUMBER HERE.
6 MS. BARLOW: I APOLOGIZE, YOUR HONOR. I THOUGHT I
7 HAD THE CORRECT NUMBER BUT LET'S SEE IF I CAN'T FIND A
8 BETTER ONE. OH, I RECOGNIZE MY PROBLEM. WE SHOULD BE IN
9 THE JUDITH LARSEN. I'M SORRY, THAT'S WHY THE NUMBER IS
10 CORRECT BUT I'M IN THE WRONG BOOK.
11 Q. (BY MS. BARLOW) DO YOU HAVE JUDITH LARSEN?
12 A. I DO.
13 Q. 470?
14 A. UH-HUH.
15 Q. NOW, THIS IS IN THE SECTION CALLED PROGRESS NOTES AND
16 WHAT IS THAT AGAIN?
17 A. THAT'S WHERE THE DOCTOR WOULD OR THE OCCUPATIONAL
18 THERAPIST WOULD DOCUMENT WHAT'S -- IT'S A RUNNING RECORD OF
19 THE PATIENT.
20 Q. ON 470 THEN WE HAVE SEVERAL WRITINGS ON IT AT 12/14/95
21 O.T., WHAT IS THAT?
22 A. OCCUPATIONAL THERAPY.
23 Q. AND THE OCCUPATIONAL THERAPISTS WRITES, PATIENT WAS
24 UNABLE TO BE ASSESSED TODAY TWO DEGREE MARK MEDICATION.
25 WHAT DOES THAT MEAN?
1494
1 A. I WOULD THINK THAT THE PATIENT WAS NOT AS ALERT TO --
2 MR. STIRBA: YOUR HONOR, YOUR HONOR, I'M GOING TO
3 OBJECT, NOT RESPONSIVE.
4 THE COURT: SUSTAINED.
5 Q. (BY MS. BARLOW) WHAT DOES THE TWO AND THEN THE DEGREE
6 MARK MEAN?
7 A. I'M NOT SURE WHAT HE MEANT.
8 Q. OKAY. THANK YOU.
9 LET'S GO DOWN TO 12/14/95. WHO WROTE THIS?
10 A. THIS IS DR. WEITZEL.
11 Q. AND WHAT DOES IT SAY?
12 A. IT SAYS, HAS MADE A MIRACULOUS RECOVERY, AMBULATED
13 YESTERDAY, TAKING GOOD -- FOOD WELL, VITAL SIGNS ARE
14 AFEBRILE, THAT MEANS SHE DIDN'T HAVE A TEMPERATURE, DOING
15 MUCH BETTER REMAINS -- AND I'M NOT SURE WHAT THAT WORD IS,
16 CONTINUE CURRENT TREATMENT.
17 Q. T.X. IS TREATMENT --
18 A. DEMENTED, THAT'S WHAT THAT WORD IS, REMAINS DEMENTED.
19 Q. T.X. MEANS TREATMENT?
20 A. YES.
21 Q. DO YOU RECALL DOCTOR -- DR. WEITZEL WRITING THAT NOTE?
22 A. I DO.
23 Q. AND IT WAS WHAT, THE 14TH OF DECEMBER, DID YOU SEE HIM
24 WRITE IT?
25 A. YES, I DID.
1495
1 Q. WHERE WERE YOU WHEN YOU SAW HIM WRITE THIS?
2 A. AT THE NURSES' DESK.
3 Q. AND WAS ANYONE ELSE PRESENT?
4 A. YES, BUT I DON'T REMEMBER EXACT NAMES.
5 Q. WHAT DID DR. WEITZEL -- DID HE SAY ANYTHING BEFORE HE
6 WROTE THIS NOTE?
7 A. HE ASKED HOW JUDITH WAS DOING AND WE GAVE HIM THE REPORT
8 THAT SHE WAS -- SHE WAS DOING BETTER, THAT SHE HAD WOKEN UP
9 AND SHE HAD STARTED EATING AND THAT SHE HAD WALKED THE DAY
10 BEFORE AND THIS WAS A BIG IMPROVEMENT FOR JUDITH.
11 Q. WHAT, IF ANYTHING, DID HE SAY TO THAT?
12 A. HE GRABBED THE CHART AND HE SAYS, AREN'T YOU NURSES
13 GOOD, AREN'T YOU JUST PROUD OF YOURSELF AND HE LIFTS IT UP
14 LIKE THIS AND HE WRITES, HAS MADE A MIRACULOUS RECOVERY, HE
15 GOES LIKE THAT AND PUTS THE EXPLANATION POINT AND SAYS
16 AREN'T YOU PROUD.
17 Q. DID HE SAY ANYTHING MORE AFTER THAT?
18 A. NOT THAT I RECALL.
19 Q. DID YOU SAY ANYTHING IN RESPONSE TO THAT?
20 A. NO.
21 Q. WHAT WAS HIS TONE OF VOICE AS HE SAID THAT?
22 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT.
23 THE COURT: SUSTAINED.
24 Q. (BY MS. BARLOW) YOU TESTIFIED FRIDAY THAT YOU HAD
25 QUESTIONED MORPHINE BEING GIVEN TO MARY CRANE. DO YOU
1496
1 RECALL WHEN MARY CRANE WAS DIAGNOSED AS HAVING A FISTULA?
2 A. I DON'T KNOW THE EXACT DATE. I COULD LOOK IT UP IN
3 HERE, IT'S DOCUMENTED.
4 Q. IF YOU WOULD, PLEASE.
5 A. OKAY.
6 Q. IF YOU LOOKED AT 244, I THINK THAT WOULD HELP.
7 A. OKAY. IT'S JANUARY 2ND OF '96 THAT WE HAVE A CONSULT ON
8 THAT.
9 Q. THAT'S WHEN DR. DIENHART CHECKED HER FISTULA?
10 A. IT LOOKS LIKE A STEVEN MECHAM.
11 Q. THAT'S RIGHT. NOT DR. DIENHART. DR. MEEKS. THANK YOU.
12 A. YES.
13 Q. WERE YOU THERE WHEN DEFENDANT LEARNED ABOUT THIS
14 FISTULA?
15 A. YES, I WAS.
16 Q. AND WHERE WAS THAT?
17 A. IT WAS AT THE NURSES' DESK.
18 Q. WAS ANYONE ELSE PRESENT?
19 A. I DON'T RECALL.
20 Q. WHEN WAS THAT IN RELATIONSHIP TO THIS CONSULT, DO YOU
21 KNOW?
22 A. IT WAS BEFORE THIS CONSULT. IT WAS PROBABLY A DAY OR
23 TWO BEFORE.
24 Q. AND HOW DID -- HOW DID THE DEFENDANT LEARN ABOUT THE
25 FISTULA?
1497
1 A. ONE OF THE NURSES WAS TELLING HIM, I BELIEVE IT WAS
2 LYNN, BUT I'M NOT POSITIVE.
3 Q. LYNN LONG?
4 A. I BELIEVE SO.
5 Q. WHAT WAS THE DEFENDANT'S RESPONSE WHEN HE LEARNED OF
6 THIS FISTULA?
7 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT,
8 UNFAIR SURPRISE.
9 THE COURT: GO AHEAD. WE'RE GOING TO HAVE TO DEAL
10 WITH THAT AT A LATER TIME. WHY DON'T YOU GO ON TO SOMETHING
11 ELSE AND WE CAN DISCUSS THAT AT A LATER TIME.
12 Q. (BY MS. BARLOW) YOU TESTIFIED ON FRIDAY ABOUT
13 APPROACHING THE DEFENDANT ABOUT MARY CRANE BEING IN PAIN.
14 A. YES.
15 Q. DO YOU RECALL THAT?
16 A. I DO.
17 Q. LET'S NOW TURN TO LYDIA SMITH. DO YOU RECALL WHEN MARY
18 CRANE PASSED WAY?
19 A. IT WAS 2330 -- 11:30 ON THE 7TH, JANUARY 7TH.
20 Q. WHEN DID LYDIA SMITH PASS AWAY?
21 A. SHE PASSED AWAY ON THE 8TH AT LIKE 12:45 IN THE
22 AFTERNOON.
23 Q. SO IT WAS A LITTLE OVER 12 HOURS LATER?
24 A. UH-HUH.
25 Q. WERE YOU ON DUTY THAT NIGHT THAT MARY CRANE PASSED AWAY?
1498
1 A. YEAH, JANUARY 7TH, YES.
2 Q. IS THAT WHEN YOU HAD THE CONFRONTATION WITH DR. WEITZEL
3 ABOUT --
4 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT, IT'S
5 A LEADING AND SUGGESTIVE CHARACTERIZATION.
6 THE COURT: SUSTAINED.
7 Q. (BY MS. BARLOW) YOU WERE ON DUTY?
8 A. YES.
9 Q. DID YOU HAVE OCCASION TO TALK TO DR. WEITZEL ABOUT THE
10 ADMINISTRATION OF MORPHINE TO MARY CRANE?
11 A. YES.
12 MR. STIRBA: I'M GOING TO OBJECT, ASKED AND
13 ANSWERED, YOUR HONOR, SHE'S ALREADY TESTIFIED.
14 MS. BARLOW: YOUR HONOR, IT'S FOUNDATIONAL.
15 THE COURT: ISN'T THIS WHAT WE DID ON FRIDAY?
16 MS. BARLOW: YES, BUT I'M USING IT AS FOUNDATION TO
17 ASK THE NEXT QUESTION, YOUR HONOR.
18 THE COURT: WELL, JUST ASK THE NEXT QUESTION.
19 Q. (BY MS. BARLOW) WAS DEFENDANT PRESENT WHEN YOU --
20 AFTER TALKING TO THE PHARMACY WHEN YOU CAME BACK AND SAID
21 YOU WEREN'T COMFORTABLE?
22 A. YES, HE WAS.
23 Q. AND WHAT, IF ANYTHING, DID HE SAY WHEN YOU SAID --
24 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT, IT'S
25 GONE OVER.
1499
1 THE COURT: PARDON?
2 MR. STIRBA: IT'S ASKED AND ANSWERED, YOUR HONOR.
3 THE COURT: ISN'T THIS WHAT WE DISCUSSED LAST
4 FRIDAY?
5 MR. STIRBA: YES.
6 MS. BARLOW: YOUR HONOR, LAST FRIDAY SHE HADN'T
7 TESTIFIED THAT THE DEFENDANT WAS PRESENT WHEN SHE --
8 EXPRESSED HER DISCOMFORT WITH GIVING IT. YOUR HONOR, I'LL
9 GO ON. IT'S NOT -- I WAS TRYING TO BE FOUNDATIONAL. I WILL
10 JUST GO STRAIGHT ON.
11 THE COURT: OKAY.
12 Q. (BY MS. BARLOW) AFTER ALL OF THAT HAPPENED, DID YOU
13 SEE ANY ORDERS FOR MORPHINE FOR ANYBODY ELSE?
14 A. YES, I DID.
15 Q. WHEN DID THAT HAPPEN?
16 A. IT WAS RIGHT AFTER LYNN HAD GIVEN THE SHOT TO MARY CRANE
17 I OPENED THE CHART AND THERE'S AN ORDER ON LYDIA TO GET THE
18 MORPHINE.
19 Q. AND DID YOU HAVE -- WELL, DID YOU EXPRESS ANY CONCERN
20 ABOUT THAT?
21 A. I DID.
22 Q. TO WHOM?
23 MR. STIRBA: YOUR HONOR, YOUR HONOR, I'M GOING TO
24 OBJECT. THIS IS UNFAIR SURPRISE.
25 THE COURT: OKAY. LET'S -- WE'LL BE ABLE TO TAKE A
1500
1 BREAK WHEN THE JURY IS NOT HERE AND WE'LL BE ABLE TO DISCUSS
2 THAT AND THE OTHER ISSUE, SO GO ON TO SOMETHING ELSE AND
3 WE'LL COME BACK TO THAT.
4 Q. (BY MS. BARLOW) LET'S TALK ABOUT LYDIA SMITH, THEN, IN
5 TERMS OF HER RECORDS. DO YOU RECALL LYDIA SMITH?
6 A. I DO.
7 Q. AND WAS THERE ANYTHING IN PARTICULAR ABOUT HER THAT MADE
8 YOU RECALL HER?
9 A. THERE WERE A LOT OF THINGS ABOUT LYDIA.
10 Q. NAME SOME OF THEM.
11 A. THIS WOMAN WAS A VERY FEISTY ALIVE WOMAN WHEN SHE CAME Haven't we heard this before?
12 ON TO THE UNIT. THIS WOMAN WAS VERY ACTIVE ON THE UNIT, SHE
13 WOULD PACE, SHE WOULD GO AROUND CONSTANTLY TRYING THE DOORS
14 ON THE UNIT. SHE WOULD GO OVER TO JUDITH AND HOLD JUDITH'S
15 HAND. SHE WOULD WANDER INTO THE PATIENTS' ROOMS. SHE WAS
16 VERY, VERY ACTIVE ON THE UNIT. AND AT ONE POINT WE HAD TO
17 POSEY HER BECAUSE WE WERE AFRAID SHE WOULD WANDER INTO THIS
18 MALE PATIENT'S ROOM, WE WERE AFRAID SHE WOULD GET HURT.
19 ALSO WHEN YOU WOULD TAKE CARE OF JUDITH --
20 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT. I
21 DON'T THINK IT'S RESPONSIVE AT THIS POINT.
22 THE COURT: LET'S JUST PROCEED BY QUESTION AND
23 ANSWER.
24 Q. (BY MS. BARLOW) IS THERE ANYTHING ELSE THAT YOU WOULD
25 DO WITH JUDITH?
1501
1 MR. STIRBA: IRRELEVANT, YOUR HONOR.
2 MS. BARLOW: YOUR HONOR, SHE'S TESTIFIED --
3 THE COURT: OVERRULED.
4 MS. BARLOW: -- WHY SHE REMEMBERED. THANK YOU.
5 Q. (BY MS. BARLOW) WAS THERE ANYTHING ELSE THAT YOU WOULD
6 DO WITH JUDY?
7 A. WHEN JUDITH WOULD CRY OUT AND STUFF SHE WOULD BECOME
8 VERY UPSET AND AGITATED HERSELF AND ULTIMATELY THAT ENDED UP
9 HAVING TO HAVE HER TO BE IN A POSEY AND THIS WAS BECAUSE SHE
10 WAS SO FEISTY AND ALIVE. IT WASN'T BECAUSE SHE WAS UNSTEADY
11 AT THAT POINT OR ANYTHING.
12 Q. COULD SHE WALK BY HERSELF?
13 A. YES.
14 Q. WERE SHE AND JUDITH IN THE SAME ROOM?
15 A. YES.
16 Q. SHE WAS ADMITTED TO THE UNIT ON WHAT DAY IF YOU LOOK AT
17 698 IN LYDIA SMITH'S?
18 A. OKAY. SHE WOULD HAVE BEEN -- IT SAYS 12/20/95 SO THAT
19 WOULD HAVE BEEN DECEMBER 20TH OF '95.
20 Q. DO YOU RECALL WHETHER SHE CHANGED OVER THE TIME THAT YOU
21 WERE WORKING WITH HER?
22 A. YES.
23 MR. STIRBA: OBJECTION, LACK OF FOUNDATION, VAGUE
24 AND AMBIGUOUS.
25 THE COURT: LAY THE FOUNDATION.
1502
1 Q. (BY MS. BARLOW) WHEN DID YOU WORK WITH LYDIA?
2 A. I WORKED WITH LYDIA SEVERAL TIMES. I WAS THERE WHEN SHE
3 WAS ADMITTED AND I WAS THERE AS SHE STARTED GOING -- WHEN
4 SHE STARTED TO WHERE SHE COULDN'T FUNCTION AND HAD CHANGED.
5 Q. LET'S TURN TO 791, I BELIEVE, IN THE NURSING NOTES. DID
6 YOU WRITE ANYTHING ON THIS?
7 A. I DID.
8 Q. AT THE TOP WE HAVE 11 TO 7?
9 A. YES.
10 Q. WHAT DID THAT MEAN?
11 A. THAT WAS THE NIGHT SHIFT, THAT WAS 11 AT NIGHT UNTIL 7
12 IN THE MORNING.
13 Q. SO THINGS THAT WERE WRITTEN DURING ON THAT TIME PERIOD
14 WEREN'T LIMITED TO ANY PARTICULAR HOUR, IS THAT --
15 A. NO. JUST TO THAT NIGHT SHIFT HOURS.
16 Q. AND THEN AT 1300, IS THAT YOUR HANDWRITING?
17 A. YES, IT IS.
18 Q. AND WE HAVE "B",WHAT DOES THAT STAND FOR?
19 A. BEHAVIOR.
20 Q. AND WHAT WAS HER BEHAVIOR?
21 A. PATIENT REFUSED HER A.M. MEDS. PATIENT HAS BEEN VERY
22 AGGRESSIVE, HITTING AND KICKING AND BITING STAFF. PATIENT
23 VERY DIFFICULT TO REDIRECT.
24 Q. WHAT DO YOU MEAN BY REDIRECT?
25 A. WHEN SHE WOULD BECOME AGITATED SOMETIMES YOU COULD
1503
1 SETTLE HER DOWN, SOMETIMES YOU COULD TALK HER DOWN.
2 SOMETIMES LIKE IF SHE WAS BOTHERING ANOTHER PATIENT, YOU
3 COULD REDIRECT HER INTO ANOTHER ROOM, BUT SHE AT THIS POINT
4 DID NOT WANT TO LEAVE THAT ROOM OR DID NOT WANT TO BE -- WAS
5 NOT ABLE TO BE REDIRECTED EASILY.
6 Q. THEN "I" STANDS FOR WHAT?
7 A. INTERVENTION.
8 Q. AND WHAT DOES THAT -- WHAT DID YOU DO THERE?
9 A. SUPPORT, ONE-TO-ONE TIME, I.M. MEDICATIONS, SAFE
10 ENVIRONMENT PROVIDED.
11 Q. WHAT DOES THAT ALL MEAN?
12 A. IT MEANS WE SPENT SOME TIME WITH HER. WE TRIED TO
13 REDIRECT HER AND TALK WITH HER. WE GAVE HER THE MEDICATION
14 AS ORDERED AND WE MADE SURE THAT SHE DIDN'T WANDER INTO
15 ANOTHER PATIENT'S ROOM SO THAT THEY WOULD HARM HER AND WE
16 ALSO MADE SURE THAT SHE DIDN'T HARM OTHER PATIENTS. SO WE
17 PROVIDED A SAFE ENVIRONMENT WHERE SHE OR THE OTHER PATIENTS
18 WOULDN'T BE INJURED.
19 Q. AND THEN "R" STANDS FOR WHAT?
20 A. HER RESPONSE.
21 Q. AND WHAT WAS HER RESPONSE?
22 A. SHE WAS VERY AGGRESSIVE AND AGITATED, SHE WAS PACING AND
23 VERY CONFUSED. SHE WAS NOT ORIENTED TO TIME, PLACE OR
24 PERSON.
25 Q. AND THEN "P" STANDS FOR WHAT?
1504
1 A. THE PLAN.
2 Q. AND WHAT IS THE PLAN?
3 A. MEDICATIONS AS PER DOCTOR, SAFE THERAPEUTIC ENVIRONMENT.
4 SAFE THERAPEUTIC MEANS WE WERE GOING TO PROVIDE GROUPS FOR
5 HER AND HAVE HER INVOLVED IN THE UNIT ACTIVITIES.
6 Q. NOW, THIS WAS THE 3RD OF JANUARY AND IT SAYS MEDS AS PER
7 DOCTOR. CAN WE LOOK BACK AND FIND OUT WHAT THE MEDS WERE
8 THAT THE DOCTOR HAD ORDERED?
9 A. YES.
10 Q. PHYSICIAN'S ORDER START AT 705. IT LOOKS LIKE 710
11 INCLUDES ONE THROUGH...
12 A. 710?
13 Q. UH-HUH.
14 A. OH, AND THIS IS ON LYDIA.
15 Q. YES, WE'RE ON LYDIA.
16 A. MY 710 IS A DOCTOR'S ORDER SHEET, IS THAT WHAT I'M
17 LOOKING AT?
18 Q. YES. YES, I'M SORRY. IS THIS WHAT YOU ARE LOOKING AT?
19 A. YES, IT IS.
20 Q. DOWN HERE AT THE BOTTOM ARE SOME DOCTOR'S ORDERS. WHOSE
21 HANDWRITING IS THAT?
22 A. THAT'S DR. WEITZEL.
23 Q. AND IT'S THE 3RD OF JANUARY, DO WE KNOW WHAT TIME THOSE
24 ORDERS WERE TAKEN OFF OR NOTED?
25 A. IT LOOKS LIKE NOON BUT I DON'T SEE -- THE SIGNATURE IS
1505
1 CUT OFF ON THE BOTTOM OF MINE.
2 Q. SO THE MEDS ARE SERZONE, TRAZODONE, DEPAKENE AND A
3 CLONIDINE PATCH; IS THAT CORRECT?
4 A. YES.
5 Q. ARE THOSE THE MEDS THAT YOU HAD PROVIDED FOR HER?
6 A. YES.
7 Q. DO YOU KNOW WHAT SERZONE IS USED FOR?
8 A. IT'S FOR AGITATION. It's an antidepressant.
9 Q. LET'S TURN BACK TO THE NURSES' NOTES. AFTER THAT
10 AGITATION, LET'S LOOK AT 793, THIS ALSO APPEARS TO BE THE
11 3RD OF JANUARY 1996. WHAT WAS THE CONDITION OF THE PATIENT
12 AT THAT TIME?
13 MR. STIRBA: YOUR HONOR, I'LL OBJECT TO FOUNDATION.
14 THE COURT: OKAY. LET'S LAY A FOUNDATION.
15 Q. (BY MS. BARLOW) WHAT IS THIS DOCUMENT?
16 A. IT'S THE NURSES' NOTES.
17 Q. AND WHO WRITES THESE NURSES' NOTES?
18 A. THE NURSES.
19 Q. DO YOU KNOW WHO WROTE THIS NOTE?
20 A. BONNIE HARDEY.
21 Q. IS THIS KEPT IN THE ORDINARY COURSE OF MEDICAL
22 TREATMENT?
23 A. YES.
24 MS. BARLOW: YOUR HONOR, THESE HAVE BEEN
25 ADMITTED --
1506
1 MR. STIRBA: BUT THE NOTE IS BEST EVIDENCE, YOUR
2 HONOR. SHE DIDN'T WRITE IT, IT'S RIGHT THERE, I MEAN --
3 THE COURT: ARE YOU GOING TO ASK HER TO READ THE
4 NOTE?
5 MS. BARLOW: I WAS GOING TO ASK HER TO READ AT
6 LEAST THE FIRST PART OF IT.
7 THE COURT: OKAY. LET -- HAVE HER READ THE FIRST
8 PART OF IT. IT'S ALREADY IN EVIDENCE.
9 Q. (BY MS. BARLOW) WOULD YOU READ THE FIRST PART OF THAT
10 NOTE DOWN TO ABOUT HERE -- SORRY, DOWN TO THE "I," IF YOU
11 WOULD READ THE "B".
12 A. PATIENT IS VERY DROWSY, IN GERI-CHAIR AT START OF SHIFT.
13 PATIENT DID NOT EAT DINNER. I DON'T KNOW WHAT -- SHE'S
14 LETHARGIC, SHE'S IN A LETHARGIC STATE. PATIENT PLACED
15 IN...AND I'M NOT SURE WHAT THAT WORD IS. WHEN TAKEN TO THE
16 BATHROOM, PATIENT WOULD PICK UP BOTH LEGS AND BEND THEM,
17 STAFF HAD TO SUPPORT FOR ENTIRE AMBULATION TRANSACTION.
18 Q. (BY MS. BARLOW) AND THEN UNDER "I" THE INTERVENTION
19 WAS WHAT?
20 A. GIVE HALDOL, I.M. I'M NOT SURE WHAT THE NEXT PART IS.
21 PATIENT NOT TAKING MEDICATIONS P.O.
22 Q. P.O. MEANS BY MOUTH?
23 A. BY MOUTH.
24 Q. WAS THIS DIFFERENT FROM HOW YOU HAD SEEN HER EARLIER IN
25 THE DAY ON THE 3RD?
1507
1 A. YES.
2 Q. IF YOU TURN TO 794. WHAT DATE IS THAT?
3 A. THE 4TH, JANUARY 4TH.
4 Q. AND THE FIRST TIME IS AT WHAT TIME, FIRST NOTE?
5 A. 4:45 IN THE MORNING.
6 Q. AND WHAT'S THAT FIRST NOTE?
7 A. PATIENT RESTLESS, TOSSING AND TURNING, UP TO THE
8 BATHROOM, BITING AT STAFF, STRIKING OUT, KICKING. I'M NOT
9 SURE -- TO BED, I.M. ATIVAN GIVEN AS ORDERED.
10 Q. AND THEN AT 6 O'CLOCK, WHAT WAS THE NOTE?
11 A. PATIENT CALMER BUT CONTINUES TO HAVE DIFFICULTY
12 SLEEPING.
13 Q. WHEN WE GET DOWN HERE 11 TO 7 AND WHAT DOES IT SAY UNDER
14 "B"?
15 A. PATIENT HAS BEEN LETHARGIC DURING THE SHIFT. PATIENT
16 HAS BEEN UNRESPONSIVE TO STAFF, PATIENT HAS BEEN SLEEPING
17 ALL SHIFT.
18 Q. IS THAT THE WAY SHE APPEARED TO YOU ON THE 3RD OF
19 JANUARY?
20 A. NO.
21 Q. LET'S LOOK AT 796. WHAT DATE IS THAT?
22 A. THE 5TH, IT'S JANUARY 5TH OF '96.
23 Q. AND THE FIRST TIME UP THERE?
24 A. IS 1:30 IN THE MORNING.
25 Q. AND THAT ENTRY IS WHAT?
1508
1 A. A MEDICATION ENTRY. IT'S, PATIENT IS VERY AGITATED,
2 MAKING NUMEROUS ATTEMPTS TO GET OUT OF BED -- I'M NOT SURE,
3 SOMETHING WITH STAFF -- STRUGGLING WITH STAFF. RESTRAINT --
4 I'M NOT SURE WHAT THAT WORD IS. ASSISTED TO THE BATHROOM.
5 Q. SOMETHING IS CROSSED OUT HERE IT LOOKS LIKE ATIVAN AND
6 THEN SOMETHING IS WRITTEN OVER THERE, CAN YOU READ THAT?
7 A. HALDOL ONE MILLIGRAM I.M. GIVEN FOR SEVERE AGITATION.
8 Q. AND THEN AT 2:30 AN HOUR LATER, WHAT WAS THE EFFECT?
9 A. PATIENT HAS BEEN SLEEPING QUIETLY SINCE 1:45,
10 RESPIRATIONS EVEN, I'M NOT SURE -- UNLABORED.
11 Q. THAT'S FAR ENOUGH WITH THAT.
12 A. OKAY.
13 Q. LET'S COME DOWN TO WHAT'S THAT THE 7 TO 3 SHIFT?
14 A. YES.
15 Q. SO AFTER THESE THINGS ARE WRITTEN THIS IS THE SEVEN TO
16 THREE SHIFT, WHAT IS "B" FOR, BEHAVIOR?
17 A. YES, BEHAVIOR.
18 Q. OKAY. AND WHAT THAT WAS HER BEHAVIOR?
19 A. PATIENT WAS VERY LETHARGIC THIS SHIFT, SITTING WITH EYES
20 CLOSED TRYING TO REMOVE CLOTHING, SOCKS, BATTING AWAY ANY
21 OFFERED SNACK OR BEVERAGE, MUMBLING INCOHERENTLY.
22 Q. LET'S JUMP DOWN TO "R" AND WHAT WAS THE RESPONSE?
23 A. PATIENT WAS UNRESPONSIVE VERBALLY, HITTING OUT WHENEVER
24 CARE IS GIVEN. I'M NOT SURE WHAT THAT IS, IT'S CUT OFF, BUT
25 FOOD THAT WAS OFFERED. She is repeatedly documenting the agitation they
were treating. How was Weitzel ever found guilty?
1509
1 Q. IS THAT THE WAY YOU HAD SEEN HER ON THE 3RD?
2 A. NO.
3 Q. LET'S LOOK AT 797. WHAT DATE IS THIS?
4 A. MY 797 IS STILL JANUARY 5TH.
5 Q. OKAY. IT'S NOT EASY TO READ THESE, IS IT? LET'S JUMP
6 DOWN TO UNDER THE "R" AND IF YOU WOULD READ UNDER "R" WHAT
7 THE RESPONSE WAS.
8 A. PATIENT DOES NOT APPEAR TO TOLERATE LIQUID -- I'M NOT
9 SURE WHAT THAT NEXT WORD IS -- VERY WELL. WILL NOTIFY M.D.,
10 REMAINS SOMNOLENT AND AVOIDANT OF PHYSICAL CONTACT,
11 REFLECTIVE MANNER AT COMBATIVE BEHAVIOR, I'M NOT SURE WHAT
12 THAT MEANS.
13 Q. DO YOU KNOW WHAT THE WORD SOMNOLENT MEANS?
14 A. SHE'S NOT HAVING THE AGGRESSIVE BEHAVIOR. SHE'S VERY
15 LAID BACK, THERE'S NOT A LOT OF ACTIVITY GOING ON.
16 Q. IS THIS THE WAY SHE HAD BEEN WHEN YOU HAD SEEN HER ON
17 THE THIRD?
18 A. NO.
19 Q. LET'S LOOK AT 798. WHAT DATE IS THAT?
20 A. THAT IS JANUARY 6TH.
21 Q. AND THE 11 TO 7 SHIFT, WOULD YOU READ THAT FOR US?
22 A. PATIENT AWAKEN TIMES ONE DURING THE NIGHT ATTEMPTING TO
23 REMOVE DIAPERS, TAKEN TO THE BATHROOM ON POTTY CHAIR, VOIDED
24 CONTINENT THROUGHOUT THE NIGHT.
25 Q. WHAT DOES CONTINENT MEAN?
1510
1 A. IT MEANS SHE DIDN'T NEED THE DIAPER. SHE DIDN'T WET THE
2 BED, SHE WAS ABLE TO GO TO THE BATHROOM.
3 Q. OKAY.
4 A. PATIENT RETURNED TO BED, SLEPT QUIETLY, REMAINS --
5 Q. REMAINDER?
6 A. -- DRY, I'M NOT SURE WHAT THAT -- REMAINS, I'M NOT SURE,
7 REMAINDER OF THE NIGHT, OKAY. ZERO PROBLEMS NOTED.
8 Q. AND THEN AT 1450 WE HAVE THE BEHAVIOR AGAIN. WHAT WAS
9 THE BEHAVIOR?
10 A. PATIENT HAS NOT BEEN AGGRESSIVE, SHE HAS BEEN SLEEPING
11 MOST OF THE DAY IS WHAT I'M ASSUMING THAT SAYS. WHEN AWAKE
12 SHE HAS...AND I'M NOT SURE WHAT THAT SAYS. WHEN OFFERED
13 MEALS, SHE HAS SPIT IT OUT AT US.
14 Q. AND WHAT WAS THE INTERVENTION?
15 A. OFFERED GROUPS AND MEALS.
16 Q. AND THE RESPONSE?
17 A. CONTINUES TO --
18 Q. UP HERE AT THE R?
19 A. OH, PATIENT SLEPT, UNRESPONSIVE MOST...WHAT'S THAT? I'M
20 NOT SURE.
21 Q. MOST EVERYTHING. I RECOGNIZE, THIS ISN'T YOUR
22 HANDWRITING.
23 A. WELL, AND IT'S KIND OF CUT OFF ON MY COPY A LITTLE BIT.
24 Q. IS THAT THE WAY YOU HAD SEEN HER ON THE 3RD?
25 A. NO.
1511
1 Q. DID YOU SEE ANYTHING IN THERE INDICATING ANY PAIN?
2 A. NO. I DON'T SEE ANYTHING THAT INDICATES ANY PAIN.
3 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT.
4 SHE'S ALREADY ANSWERED THE QUESTION. IT'S NONRESPONSIVE, MOVE
5 TO STRIKE.
6 THE COURT: THAT WILL BE STRICKEN, AND MEMBERS OF
7 THE JURY, IF YOU'LL DISREGARD THE LAST STATEMENT.
8 Q. (BY MS. BARLOW) LET'S LOOK AT 799 AND THIS IS WHAT
9 DATE?
10 A. THIS IS JANUARY 6TH.
11 Q. AND THE TIME IS WHAT TIME?
12 A. IT'S 2130, THAT'S 9:30 AT NIGHT.
13 Q. WOULD YOU READ THE "B," BEHAVIOR?
14 A. PATIENT HAS BEEN QUIET THIS SHIFT, RESTED QUIET WITH
15 EYES CLOSED MOST OF THE SHIFT. RESPIRATIONS EVEN AND
16 UNLABORED, ATE ZERO OF SUPER. ZERO EPISODES OF COMBATIVE.
17 I'M NOT SURE WHAT THE NEXT WORD IS. TOOK MEDS AS ORDERED.
18 Q. AND THEN "R--" WELL, WHAT WAS THE INTERVENTION, THE "I"?
19 A. ADMINISTERED MEDS AS ORDERED, PROVIDED GROUP, MONITORED
20 BEHAVIOR.
21 Q. WHAT HAVE THE RESPONSE?
22 A. PATIENT APPEARED TO SLEEP MOST OF THIS SHIFT. I DON'T
23 KNOW WHAT THOSE INITIALS ARE. RESTING QUIETLY WITH EYES
24 CLOSED, RESPIRATIONS EVEN AND UNLABORED, SLEPT IN THE CHAIR
25 AT SUPPER, ATE ZERO PERCENT, TOOK MEDS AS ORDERED, DID NOT
1512
1 INTERACT IN GROUP, ZERO COMBATIVE EPISODES THIS SHIFT.
2 Q. AND "P"?
3 A. CONTINUE TO ADMINISTER MEDICATION AS ORDERED, PROVIDE
4 GROUPS, MONITOR BEHAVIOR, BEHAVIORS CONDITION, REORIENT,
5 REDIRECTION AS NEEDED.
6 Q. DO YOU SEE ANY NOTES OF PAIN ON THAT?
7 A. NO.
8 Q. NOW, ON 800, WHAT DATE WAS THIS?
9 A. THIS WAS JANUARY 7TH.
10 Q. YOU HAD THE 11 TO 7 SHIFT, JUST READ THE FIRST THREE
11 LINES.
12 A. PATIENT RESTING QUIETLY THROUGH THE SHIFT, MINIMAL
13 RESPONSE TO A.M. CARE.
14 Q. OKAY. LET'S JUMP DOWN TO 1400.
15 A. OKAY.
16 Q. WHO WROTE THAT?
17 A. I DID.
18 Q. WHAT WAS THE BEHAVIOR THAT YOU SAW?
19 A. PATIENT NOT ABLE TO TAKE HER MEDS, PATIENT LETHARGIC,
20 MEANS SHE WAS VERY SLEEPY AND UNRESPONSIVE. PATIENT NOT
21 SWALLOWING OR RESPONDING TO STAFF.
22 Q. WHAT INTERVENTION?
23 A. THE FAMILY WAS NOTIFIED OF THE PATIENT'S CONDITION. THE
24 PATIENT WAS IN TO BE WITH THE PATIENT -- THE FAMILY WAS IN
25 TO BE WITH THE PATIENT, ORAL CARE WAS GIVEN. DOCTOR HAD
1513
1 BEEN CALLED TIMES TWO WITH OUT CALLING BACK. NO WET
2 DIAPERS, NO P.O. INTAKE.
3 Q. WHAT'S P.O.?
4 A. SHE WOULDN'T TAKE ANYTHING BY MOUTH, SHE HAD HAD NOTHING
5 TO EITHER EAT OR DRINK.
6 Q. OKAY. WHAT WAS YOUR PLAN?
7 A. TO TURN HER EVERY TWO HOURS, TO GIVE GOOD ACTIVITIES OF
8 DAILY LIVING CARE, THAT MEANS BATHING HER, MAKING SURE SHE
9 WAS CLEAN AND FOLLOWING THE DOCTOR'S ORDERS.
10 Q. DO YOU RECALL SPECIFICALLY WHAT LYDIA SMITH WAS LIKE AT
11 THIS TIME?
12 A. SHE WAS VERY, VERY UNRESPONSIVE. THIS WAS NOT THE LYDIA
13 I KNEW, THAT'S WHY I HAD TRIED TO CALL THE DOCTOR. I WAS
14 VERY CONCERNED ABOUT LYDIA AT THIS POINT.
15 Q. WHEN YOU WROTE, PLAN WAS TO FOLLOW THE DOCTOR'S ORDERS,
16 DO YOU RECALL ANY SPECIFIC ORDERS THAT YOU MEANT?
17 A. I WOULD HAVE TO LOOK AT THE ORDERS, I DON'T RECALL.
18 Q. THEN THE 801, WE HAVE AGAIN IN YOUR WRITING, WHAT IS
19 THAT, 2200 HOURS?
20 A. YES.
21 Q. WHAT DID YOU WRITE THERE?
22 A. PATIENT NOT ABLE TO TAKE ANY MEDICATION, PATIENT IS
23 UNRESPONSIVE MOST OF THE SHIFT. FOR INTERVENTION WE DID
24 SUPPORT, WE SPENT ONE-TO-ONE TIME WITH HER. MEDICATIONS AS
25 PER DOCTOR. FAMILY AND DOCTOR NOTIFIED OF PATIENT'S
1514
1 CONDITION, FAMILY AND DR. WEITZEL IN TO SEE THE PATIENT,
2 RESPIRATION SHALLOW, COMPLY WITH COMFORT MEASURES.
3 Q. WHEN DID LYDIA SMITH PASS AWAY?
4 A. IT WAS THE NEXT DAY.
5 Q. YOU WERE NOT ON DUTY THEN?
6 A. I WASN'T.
7 Q. YOU ALSO WRITE HERE MEDS AS PER DOCTOR, DO YOU USUALLY
8 WRITE IT THAT WAY?
9 A. YEAH, I DO.
10 Q. LET'S GO BACK THEN AND LOOK AT THE PHYSICIAN'S ORDERS
11 FOR THE 7TH OF JANUARY. WE HAD TALKED ON 710 THAT THERE
12 WERE ORDERS ON THE 3RD OF JANUARY FOR SERZONE, TRAZODONE,
13 CLONOPIN. IF YOU'LL LOOK AT 710 AND 711, WERE THERE ANY
14 OTHER MEDICINES ORDERED BETWEEN THE 3RD OF JANUARY AND THE
15 7TH OF JANUARY?
16 A. THERE WAS A CLONIDINE PATCH ORDERED.
17 Q. DO YOU KNOW WHAT A CLONIDINE PATCH IS FOR?
18 A. I DON'T RECALL.
19 Q. THAT'S FINE. ANYTHING ELSE BETWEEN THE 3RD AND THE 7TH?
20 MR. STIRBA: I'M SORRY, YOUR HONOR, I'M LOST WHERE
21 WE ARE. COUNSEL, COULD YOU HELP ME?
22 MS. BARLOW: 710 AND 711 IN THE ORDERS.
23 Q. (BY MS. BARLOW) DID YOU SEE ANY OTHER DRUGS ORDERED
24 BETWEEN THE 3RD AND THE 7TH OF JANUARY?
25 A. NO.
1515
1 Q. NOW, THE TIMES THAT YOU SAW LYDIA SMITH BETWEEN THE 3RD
2 AND THE 7TH OF JANUARY, DID YOU NOTE ANY INDICATIONS OF
3 PAIN?
4 A. NO.
5 Q. IN THE NOTES FROM ANY OTHER NURSES IN THESE NURSING
6 NOTES, DID YOU SEE ANY INDICATIONS OF PAIN?
7 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT,
8 THAT'S CHARACTERIZING A CHART.
9 THE COURT: SUSTAINED.
10 Q. (BY MS. BARLOW) DID YOU SEE ANYTHING WRITTEN ON THERE
11 SAYING THE WORD PAIN?
12 A. NO.
13 Q. SO 711, WHICH IS THE 7TH OF JANUARY, WHAT'S THAT TOP
14 ORDER THERE?
15 A. IT'S MORPHINE SULFATE 5 MILLIGRAMS I.M. Q 3 HOURS AROUND
16 THE CLOCK.
17 Q. WHAT DOES THAT MEAN?
18 A. THAT MEANS HE WANTS US TO GIVE THAT MORPHINE EVERY THREE
19 HOURS, DR. WEITZEL HAS WRITTEN THAT.
20 Q. THERE'S NO P.R.N. THERE, WHAT DOES THAT MEAN?
21 A. THAT MEANS YOU GIVE IT EVERY THREE HOURS.
22 Q. AND DID YOU GIVE IT --
23 A. THERE'S NOT AN OPTION WHETHER YOU GIVE IT OR NOT.
24 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT, IT'S
25 NOT RESPONSIVE.
1516
1 THE COURT: PLEASE, LISTEN TO THE QUESTION AND
2 THEN -- PHRASE YOUR NEXT QUESTION, PLEASE.
3 Q. (BY MS. BARLOW) AND THEN UNDERNEATH THAT IT SAYS HOLD
4 ALL OTHER MEDS OTHER THAN M.S., WHICH IS?
5 A. THE MORPHINE.
6 Q. IT SAYS D.N.R., DO YOU KNOW WHAT D.N.R. MEANS?
7 A. DO NOT RESUSCITATE.
8 Q. WHAT DOES DO NOT RESUSCITATE MEAN?
9 A. IT MEANS WE'RE NOT GOING TO DO ANY HEART COMPRESSIONS,
10 WE'RE NOT GOING TO DO ANY RESPIRATIONS ON HER. SHE STOPS
11 BREATHING, WE'RE NOT GOING TO INTERVENE.
12 Q. DO YOU KNOW WHEN THIS WAS WRITTEN OR NOTED AT LEAST?
13 A. I TOOK THAT OFF AT 2130 WHICH IS 9:30 AT NIGHT.
14 Q. DID YOU ADMINISTER ANY OF THE MORPHINE PURSUANT TO THIS
15 ORDER?
16 A. I DID.
17 Q. AND WHY DID YOU DO THAT?
18 A. I WAS TOLD I HAD TO.
19 Q. BY WHO?
20 A. BY DR. WEITZEL.
21 Q. NOW LET'S LOOK AT 712, WHAT DATE WAS THAT?
22 A. JANUARY 8TH OF '95 -- '96 EXCUSE ME.
23 Q. '96. IT LOOKS LIKE THEY WROTE '95 AND THEN CHANGED IT.
24 WHAT TIME OF DAY WAS IT?
25 A. NINE IN THE MORNING.
1517
1 Q. IS THAT DR. WEITZEL'S HANDWRITING?
2 A. YES.
3 Q. WELL, CHECK AGAIN.
4 A. YEAH, RIGHT HERE. OH, IT'S A TELEPHONE ORDER BUT THAT'S
5 HIS SIGNATURE SIGNING IT OFF.
6 Q. OH, IT'S HIS SIGNATURE. OKAY. THANK YOU.
7 HOW DID THIS TELEPHONE ORDER COME AT NINE IN THE
8 MORNING?
9 A. DR. WEITZEL OR IT WOULD HAVE BEEN OVER THE TELEPHONE.
10 Q. AND WHAT IS THE ORDER?
11 A. CHANGE MORPHINE SULFATE ORDER TO MORPHINE SULFATE
12 10 MILLIGRAMS Q 3 HOURS AROUND THE CLOCK.
13 Q. AGAIN, THERE'S NO P.R.N. THERE?
14 A. NO.
15 Q. LET'S GO BACK TO THE NURSES' NOTES TO THAT LAST DAY.
16 802 IS THE NUMBER I'M LOOKING AT SEE IF WE CAN DECIPHER THIS
17 HANDWRITING. THE 11 TO 7 SHIFT, STARTING WITH THE SECOND
18 LINE THERE, WOULD YOU READ THAT?
19 A. PATIENT LYING IN BED WITH EYES OPEN THROUGHOUT --
20 WITH -- OKAY, WITH EYES OPEN THROUGHOUT THE SHIFT.
21 SOMETHING ABOUT THE REFLEXES, GRASPING IN RESPONSE TO
22 PHYSICAL STIMULI, UNABLE TO MAKE ANY VERBAL RESPONSE.
23 MORPHINE SULFATE Q 3 HOURS I.M., AND THEN I'M NOT SURE,
24 SCHEDULED FOR -- AND I'M NOT SURE WHAT THAT IS, 24-HOUR DOSE
25 OMITTED.
1518
1 Q. SO THE MIDNIGHT DOSE WAS NOT GIVEN, IS THAT WHAT THAT
2 MEANS?
3 A. YES.
4 Q. AND READ UNDER THAT -- SO 2400 DOSE OMITTED, DUE...
5 A. DUE TO PATIENT APPEARS IN NO ACUTE DISTRESS AT THIS TIME
6 AND NURSING STAFF WAS ATTENDING ANOTHER DYING PATIENT.
7 Q. WHO WAS THAT OTHER DYING PATIENT?
8 A. MARY CRANE.
9 Q. IF YOU WOULD READ ON THROUGH THAT, DO YOU SEE ANY
10 NOTATIONS OF PAIN OR DISTRESS?
11 A. NOT THAT I CAN SEE. IT'S HARD TO READ.
12 Q. SORRY TO KEEP JUMPING YOU BACK AND FORTH BUT THAT'S THE
13 WAY THE RECORDS ARE WRITTEN.
14 A. THAT'S OKAY.
15 Q. IF YOU WOULD TURN TO 742.
16 A. OKAY.
17 Q. THIS IS THE M.A.R.S.?
18 A. UH-HUH.
19 Q. THAT WE'VE BEEN TALKING ABOUT EARLIER AND WHAT IS THIS
20 JUST BRIEFLY AGAIN?
21 A. MEDICAL RECORD -- THE MEDICATION RECORD.
22 Q. OKAY. SO WE HAVE ON 1/7/96 THE ORDER OF 5 MILLIGRAMS?
23 A. YES.
24 Q. OF MORPHINE. 2100, WHO GAVE THAT ONE?
25 A. I DID.
1519
1 Q. 2400, IT'S CIRCLED, WHAT DOES THAT MEAN?
2 A. THAT MEANS LAURIE DIDN'T GIVE IT, THAT IT WASN'T GIVEN.
3 Q. WHICH IS WHAT WE JUST READ IN THE NURSES' NOTES?
4 A. IN THE NURSES' NOTES.
5 Q. AND THEN AT THREE IN THE MORNING, WHAT DOES THAT MEAN?
6 A. THAT IT WAS GIVEN.
7 Q. AND THEN AT SIX IN THE MORNING, WHAT DOES THAT MEAN?
8 A. THAT LYDIA GOT THE 5 MILLIGRAMS OF MORPHINE.
9 Q. AND LET'S JUMP DOWN HERE TO 1/8, IS THERE A CHANGE IN
10 THE ORDER?
11 A. YES.
12 Q. HOW MUCH?
13 A. TO 10 MILLIGRAMS.
14 Q. NOW, EVEN THOUGH THIS IS WRITTEN UNDER 1/7, AT NINE IN
15 THE MORNING, WAS THAT 10 MILLIGRAMS GIVEN?
16 A. YES.
17 Q. AND WHAT --
18 A. ON THE 8TH.
19 Q. WHAT ABOUT NOON?
20 A. YES.
21 Q. AND DO YOU KNOW WHOSE INITIALS THOSE ARE?
22 A. SHEILA HANSEN.
23 Q. AND TIME DID LYDIA SMITH DIE?
24 A. 12:45.
25 Q. IN THE AFTERNOON?
1520
1 A. YES.
2 MS. BARLOW: YOUR HONOR, I THINK THOSE ARE ALL THE
3 QUESTIONS I HAVE OTHER THAN TO ADDRESS THE TWO THAT WERE --
4 THE COURT: OKAY. LADIES AND GENTLEMEN, WHY DON'T
5 WE TAKE A BREAK. WE'VE BEEN GOING FOR ABOUT AN HOUR. WHILE
6 YOU TAKE THIS BREAK, REMEMBER IT'S YOUR DUTY NOT TO CONVERSE
7 WITH YOURSELVES OR WITH ANYONE ELSE OR ALLOW YOURSELVES TO
8 BE ADDRESSED ON ANY SUBJECT OF THIS TRIAL. IT'S ALSO YOUR
9 DUTY NOT TO FORM OR EXPRESS AN OPINION UNTIL THE CASE IS
10 FINALLY SUBMITTED TO YOU. SO WHY DON'T WE COME BACK TO TEN
11 MINUTES TO TEN.
12 (WHEREUPON THE JURY WAS EXCUSED.)
13 THE COURT: YOU MAY BE SEATED. THE RECORD WILL
14 REFLECT THAT THE JURY IS NOT PRESENT. OKAY. WE HAD TWO
15 OBJECTIONS OF UNFAIR SURPRISE THAT WERE MADE. AS I RECALL,
16 ONE HAD TO DO I THINK WITH THIS FISTULA AND ONE HAD TO DO
17 WITH A MORPHINE SHOT TO LYDIA SMITH, IS THAT WHEN THE
18 OBJECTIONS WERE MADE?
19 MR. STIRBA: YES. YES, YOUR HONOR.
20 THE COURT: OKAY. TELL ME WHAT YOUR OBJECTION IS.
21 MR. STIRBA: YES. WE HAVE REQUESTED INTERVIEW
22 SUMMARIES NOT ONCE BUT TWICE OF WITNESSES AND THESE TWO
23 CONVERSATIONS ARE THE FIRST TIME I'VE HEARD ABOUT THEM WAS
24 RIGHT HERE WHEN THEY WERE GOING TO BE ASKED ABOUT, AND I
25 THINK THERE'S AN OBLIGATION TO PROVIDE THIS INFORMATION.
1521
1 THE COURT IS WELL AWARE THAT WE GOT SOME INTERVIEW SUMMARIES
2 JUST AFTER THE TRIAL STARTED. MS. COZZENS WASN'T PART OF
3 THAT. I'VE NEVER SEEN AN INTERVIEW SUMMARY OF MS. COZZENS,
4 QUITE FRANKLY, AND I'VE CERTAINLY NEVER HEARD ABOUT THESE
5 CONVERSATIONS SO I THINK IT'S UNFAIR SURPRISE. THIS IS NOT
6 SUPPOSED TO BE A TRIAL BY AMBUSH AND ESSENTIALLY THAT'S WHAT
7 THIS IS BY THESE CONVERSATIONS.
8 THE COURT: OKAY. MS. BARLOW?
9 MS. BARLOW: THANK YOU, YOUR HONOR. WE HAVE
10 PROVIDED ALL OF THE INTERVIEW SUMMARIES TO OPPOSING COUNSEL.
11 THESE ARE STATEMENTS THAT HAVE COME TO OUR ATTENTION JUST AS
12 WE WERE PREPARING FOR TRIAL. THEY WERE NOT PART OF ANY
13 INTERVIEW BY ANY DETECTIVE. IT'S JUST AS WE WERE TALKING
14 WITH HER IN RELATIONSHIP TO TRIAL THESE MATTERS CAME TO OUR
15 ATTENTION.
16 THE COURT: OKAY. WELL, HOW DOES THE DEFENDANT --
17 WELL, WHAT IS YOUR UNDERSTANDING OF WHAT THE LAW OF UNFAIR
18 SURPRISE IS IF YOU FIND OUT SOMETHING THE DAY BEFORE YOU ARE
19 GOING TO ASK THIS WITNESS THE QUESTION, THEN YOU ASK THE
20 QUESTION AND THE DEFENDANT DOESN'T HAVE ANY ABILITY TO BE
21 PREPARED FOR THAT.
22 MS. BARLOW: WELL, YOUR HONOR, I DON'T THINK THAT
23 THIS IS OUTSIDE THE REALM OF WHAT HE HAS BEEN INFORMED OF IN
24 DISCOVERY. WE ARE OBLIGATED TO GIVE HIM DISCOVERY. WE'RE
25 OBLIGATED TO TELL HIM WHO OUR WITNESSES ARE AND IF WE HAVE
1522
1 INTERVIEWS, IF WE HAVE POLICE INTERVIEWS WITH THOSE PEOPLE.
2 WE DON'T HAVE TO GIVE OUR WORK PRODUCT. BUT IF WE HAVE
3 POLICE INTERVIEWS, WE ARE, OF COURSE, SUPPOSED TO GIVE THAT.
4 THE DEFENDANT IS ENTIRELY ENTITLED TO TALK TO THESE
5 WITNESSES, NOT THE DEFENDANT, BUT HIS ATTORNEY CAN TALK TO
6 THESE WITNESSES AND FIND OUT THIS SAME MATERIAL. DISCOVERY
7 REQUIRES THAT WE TURN OVER ALL THE INFORMATION THAT WE HAVE,
8 WHICH WE DID. IT DOESN'T REQUIRE THAT WE TURN OVER OUR WORK
9 PRODUCT. AND AS I SAY, DEFENSE COUNSEL HAD EVERY RIGHT TO
10 CALL MS. COOPER AND, IN FACT, I BELIEVE HE'S DONE A
11 DEPOSITION OF HER IN ANOTHER MATTER AND SO HE HAS HAD EVERY
12 OPPORTUNITY TO FIND OUT WHAT SHE WOULD SAY TODAY.
13 AND THESE CONVERSATIONS ARE NOT OUTSIDE THE REALM OF
14 OUR THEORY OF THE CASE, OF THE INFORMATION THAT SHE HAS
15 PRESENTED TO THE POLICE OFFICER AND IN THIS DEPOSITION. IN
16 FACT, I'M NOT SURE IF THE DETECTIVE EVER DID INTERVIEW HER.
17 IF HE DIDN'T PROVIDE A SUMMARY OF THAT INTERVIEW, THEN HE
18 DIDN'T INTERVIEW HER.
19 THE COURT: OKAY. WHAT IS THE -- ON THE FIRST
20 OBJECTION, WHAT IS THE TESTIMONY GOING TO BE? WHAT IS --
21 THE QUESTION WAS ABOUT -- REMIND ME WHAT THE QUESTION WAS
22 AND WHAT THE ANSWER IS GOING TO BE. Kay begins to show his confusion.
23 MS. BARLOW: IF I CAN SAY ONE OTHER THING. THESE
24 ARE CONVERSATIONS THAT SHE HAD WITH THE DEFENDANT. IT'S
25 HARD TO SAY HE WAS UNFAIRLY SURPRISED WHEN HE WAS PART OF
1523
1 THE CONVERSATION, I WANT TO THROW THAT IN. THE FIRST WAS
2 ABOUT THE FISTULA AND I CAN HAVE HER GO THROUGH THAT
3 INFORMATION.
4 THE COURT: WELL, WAS IT -- IT WAS A CONVERSATION,
5 JUST TELL ME WHAT --
6 MS. BARLOW: OKAY. THE CONVERSATION WAS AFTER
7 DEFENDANT WAS INFORMED OF THE FISTULA HE -- I CAN'T REMEMBER
8 THE EXACT WORDS BUT HE WANTED NOTHING MORE TO DO WITH HER.
9 THERE WAS ALSO CONVERSATION ABOUT CALLING IN A SECOND
10 OPINION BECAUSE DOCTOR -- EITHER DR. DIENHART OR DR. MEEKS
11 WAS CALLED IN. I THINK DR. DIENHART WAS CALLED IN FIRST AND
12 THE DEFENDANT WAS VERY ANGRY THAT A SECOND PERSON HAD BEEN
13 CALLED IN -- I'M CONFUSING THIS, YOUR HONOR. LET ME STEP
14 BACK AND LAY IT OUT IN THE TIME FRAME.
15 THE FISTULA WAS -- THE FISTULA WAS NOT FOUND YET.
16 THERE WAS EVIDENCE OF A POSSIBLE FISTULA, THE FECAL MATERIAL
17 COMING OUT THE VAGINA INSTEAD OF THE RECTUM. DEFENDANT WAS
18 INFORMED OF THAT. I BELIEVE THE NURSES CALLED IN DR.
19 DIENHART FOR A CONSULTATION ON THAT. WHEN THE DEFENDANT
20 BEFORE FINDING OUT WHAT THE PROBLEM WAS HEARD THAT DR.
21 DIENHART HAD BEEN CALLED IN, HE BECAME ANGRY, DIDN'T WANT
22 SOMEONE ELSE CALLED IN. AND THEN WHEN HE FOUND OUT WHAT IT
23 WAS AND THEN WHEN IT WAS DIAGNOSED BY DR. MEEKS, HE THEN
24 WANTED -- DIDN'T REALLY WANT TO DEAL DIRECTLY WITH MARY
25 CRANE AFTER THAT. SO THAT'S -- THAT'S THE FIRST ISSUE.
1524
1 THAT'S THE FIRST QUESTION AND AREA THAT I WAS GOING TO GET
2 INTO. AND IT GOES TO SHOW -- IT GOES TO SHOW THE
3 DEFENDANT'S KNOWLEDGE OF THE PROBLEM THAT -- THAT THIS WOMAN
4 HAD, IT GOES TO SHOW HIS INTENT, IT GOES TO SHOW KIND OF
5 MOTIVE, EVEN THOUGH WE AREN'T REQUIRED TO --
6 THE COURT: IT SHOWS KNOWLEDGE AND INTENT OF WHAT?
7 WHAT DOES IT SHOW KNOWLEDGE OF? WHAT DOES IT SHOW INTENT
8 OF?
9 MS. BARLOW: IT SHOWS HIS INTENT TO -- IT'S HARD TO
10 SAY THAT. IT REALLY GOES TO MOTIVE, RATHER THAN TO
11 KNOWLEDGE AND INTENT. IT SHOWS HIS DISLIKE OF THIS PERSON,
12 HOW HIS CONDUCT TOWARD HER CHANGED AFTER SHE DEVELOPED THIS
13 PROBLEM THAT WAS NOT A PLEASANT PROBLEM, PHYSICAL PROBLEM.
14 AND SO THAT IT GOES TO -- IT SHOWS THAT -- HIS CONDUCT
15 TOWARDS HER AND HIS ATTITUDE TOWARDS HER.
16 THE COURT: OKAY. WHAT ABOUT THE OTHER ONE
17 REGARDING LYDIA SMITH, WHAT --
18 MS. BARLOW: REGARDING LYDIA SMITH, MS. COOPER
19 WOULD TESTIFY THAT WHEN SHE -- AFTER SHE HAD HAD THE
20 CONFRONTATION REGARDING GIVING MARY CRANE THE MORPHINE, SHE
21 OPENED UP THE CHART AND SEES MORPHINE ORDERED FOR LYDIA
22 SMITH AND SAYS, WELL, NOW WAIT A MINUTE. WHY DO WE HAVE
23 LYDIA SMITH GETTING MORPHINE, I KNOW THERE'S NO --
24 THE COURT: THIS IS A CONVERSATION WITH THE DOCTOR?
25 MS. BARLOW: THAT SHE HAD WITH THE DEFENDANT.
1525
1 THE COURT: OKAY.
2 MS. BARLOW: AND AGAIN --
3 THE COURT: AND WHAT IS SAID?
4 MS. BARLOW: AND WHAT IS SAID IS ALONG THE LINES OF
5 WHAT SHE SAID WITH MARY CRANE. SHE DOESN'T NEED IT, THERE
6 IS NO PAIN HERE AND THEN THEY GET INTO THE COLLOQUY LIKE
7 THEY DID BEFORE WITH MARY CRANE, HOW DO YOU KNOW THEY ARE
8 NOT IN ANY PAIN. AND EVENTUALLY IT COMES TO, WELL, THE
9 FAMILY MEMBERS ARE IN THERE WITH HER, ARE YOU GOING TO GO IN
10 THERE AND TELL THEM SHE ISN'T HAVING ANY PAIN.
11 THE COURT: ALL RIGHT. MR. STIRBA?
12 MR. STIRBA: YES, YOUR HONOR. I THINK THERE'S AN
13 ABSOLUTE ETHICAL OBLIGATION TO DISCLOSE MATERIAL
14 CONVERSATIONS LIKE THIS ONCE THE STATE BECOMES AWARE OF THEM
15 IN A CRITICAL WITNESS, CRITICAL CONVERSATIONS WITH THE
16 DEFENDANT. TO SUGGEST THAT WE SOMEHOW SHOULD KNOW ABOUT IT
17 BECAUSE IT'S A CONVERSATION WITH HIM, THAT PRESUPPOSES IT'S
18 TRUTHFUL, IT PRESUPPOSES IT HAPPENED.
19 THE FACT OF THE MATTER IS THEY'VE KNOWN ABOUT THIS NOT
20 JUST THIS MORNING. THIS WITNESS WAS ON THE STAND ON FRIDAY,
21 THEY'VE KNOWN ABOUT THIS FOR A FEW DAYS. THEY COME IN HERE,
22 ASK THE QUESTIONS, I DON'T HAVE A CLUE. AND I THINK IT'S
23 CLEARLY UNFAIR SURPRISE, IT'S CLEARLY SOMETHING THAT SHOULD
24 HAVE BEEN DISCLOSED AND CLEARLY IT'S A MATERIAL
25 CONVERSATION.
1526
1 AND ALSO WOULD POINT OUT, YOUR HONOR, THAT HERE WE HAVE
2 A WITNESS AND WE'RE GOING BACK HOW MANY YEARS AND WE'RE
3 TAKING ABOUT RECALLING CONVERSATIONS? AND IT SEEMS TO ME
4 THAT THERE'S NOTHING IN THE DOCUMENTS, THERE'S NO WAY THAT I
5 COULD POSSIBLY SURMISE OR DIVINE THAT SHE WAS GOING TO SAY
6 ANYTHING LIKE THIS. THERE'S NOTHING IN THE DOCUMENTS,
7 THERE'S NOTHING IN ANY OF THE RECORDS THAT WOULD SUGGEST
8 THAT THESE CONVERSATIONS TOOK PLACE. SO THE FIRST TIME I
9 HEAR THEM IS THIS MORNING IN OPEN COURT AND I WOULD SUGGEST
10 THAT IT'S UNFAIR SURPRISE AND THERE REALLY IS NO REASON WHY
11 I WASN'T TOLD ABOUT THESE CONVERSATIONS AND CERTAINLY THEY
12 ARE MATERIAL. IF THEY WERE LESS MATERIAL, PERHAPS IT'S A
13 DIFFERENT ISSUE, BUT THEY ARE CLEARLY MATERIAL FOR PURPOSES
14 OF THIS CASE.
15 THE COURT: OKAY. ANYTHING FURTHER, MS. BARLOW?
16 MS. BARLOW: YES, YOUR HONOR. RULE 16 OF THE UTAH
17 RULES OF CRIMINAL PROCEDURE PROVIDE THAT THE PROSECUTOR
18 SHALL DISCLOSE TO THE DEFENSE UPON REQUEST THE FOLLOWING
19 MATERIAL OR INFORMATION OF WHICH HE HAS KNOWLEDGE.
20 THE COURT: OKAY. WHICH SUBPARAGRAPH ARE YOU
21 READING?
22 MS. BARLOW: I'M STARTING WITH A OF RULE 16.
23 THE COURT: OKAY.
24 MS. BARLOW: RULES OF DISCOVERY. RELEVANT WRITTEN
25 OR RECORDED STATEMENTS OF THE DEFENDANT, WE DON'T HAVE THAT
1527
1 HERE. THE CRIMINAL RECORD OF THE DEFENDANT, WE DON'T HAVE
2 THAT. PHYSICAL EVIDENCE SEIZED FROM THE DEFENDANT, WE DON'T
3 HAVE THAT. SO NUMBER FOUR, EVIDENCE KNOWN TO THE PROSECUTOR
4 THAT TENDS TO NEGATE THE GUILT OF THE ACCUSED, MITIGATE THE
5 GUILT OF THE DEFENDANT OR MITIGATE THE DEGREE OF THE OFFENSE
6 FOR A REDUCED PUNISHMENT, WE DON'T HAVE THAT HERE, THIS IS
7 NOT EXCULPATORY. AND FIVE, ANY OTHER ITEM OF EVIDENCE WHICH
8 THE COURT DETERMINES ON GOOD CAUSE SHOWN SHALL BE MADE
9 AVAILABLE TO THE DEFENDANT IN ORDER FOR THE DEFENDANT TO
10 ADEQUATELY PREPARE HIS DEFENSE.
11 WE HAVE GONE BEYOND JUST NUMBER FOUR HERE BY GIVING --
12 WE HAD AN OPEN FILE. WE HAVE GIVEN EVERYTHING THAT WE HAVE.
13 NOW, THIS MATERIAL CAME TO ME, CAME TO MY ATTENTION JUST
14 THIS WEEKEND AND WE ARE PRESENTING IT IN COURT TODAY. WE
15 DON'T HAVE AN OBLIGATION TO FIND OUT EVERY WORD THAT A
16 WITNESS IS GOING TO SAY AND TURN IT OVER TO THE DEFENDANT
17 BEFORE TRIAL.
18 THE COURT: NO. BUT I GUESS THE QUESTION IS IF YOU
19 FOUND OUT ABOUT IT THIS WEEKEND, DO YOU THINK YOU HAVE AN
20 OBLIGATION OR NOT OBLIGATION TO CALL THE DEFENSE LAWYER AND
21 SAY WE FOUND OUT ABOUT THIS AND WE'RE GOING TO BE
22 QUESTIONING THIS?
23 MS. BARLOW: I DON'T THINK WE HAVE ANY OBLIGATION
24 TO DO THAT. HE HAS THE -- HE HAS THE OPPORTUNITY TO TALK TO
25 THIS WITNESS, JUST AS WE HAD THE OPPORTUNITY TO TALK TO THIS
1528
1 WITNESS PRIOR TO TRIAL.
2 MR. STIRBA: YOUR HONOR, MAY I MAKE ONE OTHER SMALL
3 POINT? I'M NOT SURE -- I'M NOT GOING TO MAKE THE ARGUMENT.
4 I THINK THIS IS BRADY MATERIAL. IF I UNDERSTOOD THE
5 PROFFER, AT LEAST WITH RESPECT TO ONE OF THE CONVERSATIONS,
6 THAT CONVERSATION CERTAINLY CAN BE INTERPRETED TWO DIFFERENT
7 WAYS. AND I THINK BRADY CLEARLY CALLS UPON THE PROSECUTOR
8 TO ASSUME THAT IT IS EXCULPATORY EVEN THOUGH THEY MAY THINK
9 IT'S NOT AND PROVIDE US THAT INFORMATION, WHICH IT WASN'T.
10 IT WAS, AFTER ALL, AS I UNDERSTOOD THE CONVERSATION, IT
11 IS -- IT'S CERTAINLY NOT RADICALLY INCULPATORY AND THERE'S
12 ELEMENTS OF IT WHICH CLEARLY COULD BE EXCULPATORY.
13 MS. BARLOW: I GUESS I DON'T KNOW WHICH STATEMENT
14 HE'S TALKING ABOUT AND --
15 MR. STIRBA: WELL, THE ONE WITH RESPECT TO LYDIA
16 SMITH PROVIDED US WITH PROFFER.
17 MS. BARLOW: WELL, IF THE -- I DON'T SEE HOW IT'S
18 EXCULPATORY BUT I GUESS WE SEE IT DIFFERENTLY.
19 THE COURT: ALL RIGHT. WELL, I'M GOING TO HAVE TO
20 GO LOOK AT SOME CASES. WE MIGHT BE MORE THAN BEFORE TEN TO
21 BUT I'LL LET THE CLERK TELL YOU WHEN I'M READY.
22 (A BRIEF RECESS WAS TAKEN.)
23 THE COURT: DID YOU CALL THEM? DO YOU WANT TO TRY
24 CALLING THEM AGAIN?
25 MS. BARLOW: YOUR HONOR, BEFORE YOU PRONOUNCE YOUR
1529
1 RULING, I HATE TO THROW THE COURT A CURVE BUT MS. COOPER
2 TOLD ME AFTER WE WALKED OUT THAT REMEMBERS SPECIFICALLY IN
3 THE DEPOSITION THAT DEFENSE COUNSEL DID OF HER IN ANOTHER
4 MATTER THIS WAS BROUGHT UP BY DEFENSE COUNSEL, THIS LYDIA
5 SMITH MATERIAL. AND I'M SORRY, I DIDN'T KNOW THAT BEFORE WE
6 BROKE.
7 THE COURT: WELL, BEING AN OLD BASEBALL PLAYER, I
8 CAN HIT FAST BALLS AND CURVES.
9 MS. BARLOW: OKAY.
10 THE COURT: AND HERE IS WHAT I'M GOING TO DO, I'M
11 NOT GOING TO GET INTO ALL OF THE IF PEOPLE KNEW IT OR DIDN'T
12 KNOW IT IN THE FUTURE. AS TO THESE TWO QUESTIONS, I'M GOING
13 TO OVERRULE THE OBJECTIONS AND THEN HERE'S HOW WE'RE GOING
14 TO PROCEED IN THE FUTURE:
15 UNDER RULE 16.5 OF THE UTAH RULES OF CRIMINAL PROCEDURE
16 WHERE IT SAYS, "ANY OTHER ITEM OF EVIDENCE WHICH THE COURT
17 DETERMINES ON GOOD CAUSE SHOULD BE MADE AVAILABLE TO THE
18 DEFENDANT IN ORDER FOR THE DEFENDANT TO ADEQUATELY PREPARE
19 HIS DEFENSE," THAT'S ONE OF THE SUBSECTIONS WHERE IT SAYS,
20 "THE PROSECUTOR SHALL DISCLOSE TO THE DEFENSE," I'M JUST
21 GOING TO SAY IN THE FUTURE, IF THERE ARE NOT INTERVIEWS AND
22 THERE ARE SITUATIONS WHERE WITNESSES ARE GOING TO TESTIFY
23 ABOUT CONVERSATIONS WITH THE DEFENDANT ABOUT ISSUES OF
24 MEDICATION OF MORPHINE OR TREATMENT OF THESE FIVE PATIENTS,
25 THAT THAT INFORMATION IS GOING TO BE MADE AVAILABLE TO THE
1530
1 DEFENDANT PURSUANT TO RULE 16.5 IN THE FUTURE.
2 I'M GOING TO ALLOW THESE TWO AREAS TO BE ADDRESSED.
3 I'VE OVERRULED THE OBJECTION, THEY WILL BE DONE. IN THE
4 FUTURE, THEY ARE GOING TO BE NOTIFIED. IF THEY ARE NOT
5 NOTIFIED IN THE FUTURE AND IT'S NOT IN THE -- ANYTHING THAT
6 WAS PROVIDED, THEN THE UNFAIR SURPRISE IS PROBABLY GOING TO
7 BE SUSTAINED. SO IS EVERYONE CLEAR ON THAT? Why allow it this time?
8 MS. BARLOW: YES, YOUR HONOR. THANK YOU.
9 MR. STIRBA: YES, YOUR HONOR.
10 THE COURT: OKAY. DO YOU WANT TO HAVE THE JURY
11 BACK IN?
12 (WHEREUPON THE JURY ENTERS THE COURTROOM.)
13 THE COURT: PLEASE BE SEATED. THE RECORD WILL
14 REFLECT THAT THE JURY HAS RETURNED. THE WITNESS SHOULD TAKE
15 THE STAND. AND, MS. BARLOW, IF YOU'LL CONTINUE.
16 MS. BARLOW: THANK YOU, YOUR HONOR.
17 Q. (BY MS. BARLOW) MS. COOPER, WITH MARY CRANE DID YOU
18 HAVE A CONVERSATION WITH THE DEFENDANT ABOUT THE FECAL
19 MATERIAL THAT WAS COMING OUT OF THE VAGINA?
20 A. THAT WAS ON JUDITH.
21 Q. OH, I'M SORRY. ARE WE SURE ABOUT THAT? LET'S MAKE SURE
22 WE'VE GOT THE RIGHT PATIENT. SORRY ABOUT THAT. I GUESS I
23 WAS CONFUSED HERE. IF YOU WOULD OPEN MARY CRANE'S TO 244.
24 DO YOU NOTICE THE GYNECOLOGICAL CONSULT THERE?
25 A. OH, IT WAS ON MARY. I'M SORRY. She can't even remember the patient, but she remembers the conversation!
1531
1 Q. THAT'S OKAY. I JUST WANT TO MAKE SURE WE'RE NOT
2 CONFUSING THE JURY. !!!
3 SO WITH MARY CRANE DID YOU -- WERE YOU PRESENT WHEN
4 DEFENDANT WAS INFORMED OF THIS WHAT TURNED OUT TO BE A
5 FISTULA?
6 A. YES.
7 Q. WHAT WAS DONE WHEN THE PROBLEM WAS FIRST SEEN OR
8 NOTICED?
9 A. DR. WEITZEL WROTE AN ORDER FOR ONE OF THE OTHER
10 PHYSICIANS TO COME IN AND CONSULT ON HER.
11 Q. AFTER THE OTHER PHYSICIAN CAME IN AND DID THE CONSULT
12 WHICH IT LOOKED LIKE IT WAS DR. MEEKS.
13 A. UH-HUH.
14 Q. DID YOU HAVE ANY CONVERSATIONS WITH THE DEFENDANT ABOUT
15 THE TREATMENT OF MARY CRANE FOR THIS FISTULA?
16 A. IT WAS NO LONGER --
17 THE COURT: WELL, THAT'S A YES OR NO.
18 Q. (BY MS. BARLOW) YES. DID YOU HAVE ANY CONVERSATIONS?
19 A. YES.
20 Q. YES. WHEN DID THAT FIRST CONVERSATION TAKE PLACE?
21 A. I DON'T RECALL EXACTLY.
22 Q. WAS IT WITHIN DAYS AFTER OR...
23 A. YES.
24 Q. OKAY. AND WHERE DID IT TAKE PLACE?
25 A. AT THE NURSES' STATION.
1532
1 Q. WHO WAS PRESENT?
2 A. MYSELF AND DR. WEITZEL. I DON'T RECALL WHO ELSE WOULD
3 HAVE BEEN PRESENT.
4 Q. AND WHAT WAS THAT CONVERSATION, WHAT DID YOU SAY TO DR.
5 WEITZEL?
6 A. IT WAS ACTUALLY ANOTHER NURSE THAT WAS TALKING TO DR.
7 WEITZEL. I WAS JUST OVERHEARING THE CONVERSATION.
8 Q. DO YOU RECALL WHO THAT OTHER NURSE IS?
9 A. I DON'T.
10 Q. OKAY. OKAY. WHAT -- WHO SPOKE FIRST, THE DEFENDANT OR
11 THE OTHER NURSE?
12 A. I BELIEVE THE NURSE WAS JUST TALKING ABOUT THIS FISTULA
13 AND WHAT SHOULD BE DONE ABOUT IT.
14 Q. AND WHAT DID THE DEFENDANT SAY?
15 A. HE DIDN'T WANT ANYTHING TO DO WITH IT, THAT --
16 THE COURT: WELL, SAY WHAT HE SAID.
17 Q. (BY MS. BARLOW) WHAT DID HE SAY?
18 A. I DON'T REMEMBER EXACT WORDS. HE WAS...
19 Q. AFTER THAT CONVERSATION, DID YOU SEE ANY CHANGE IN
20 DEFENDANT'S BEHAVIOR TOWARDS MARY CRANE?
21 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT,
22 IRRELEVANT, NOT HELPFUL TO THE JURY. IT'S LAY OPINION.
23 THE COURT: WELL, WITHOUT MORE FOUNDATION, IT'S
24 SUSTAINED.
25 Q. (BY MS. BARLOW) WHAT HAD -- HAD YOU SEEN DEFENDANT'S
1533
1 CONDUCT TOWARD MARY CRANE PRIOR TO THIS CONVERSATION?
2 MR. STIRBA: YOUR HONOR, I'LL OBJECT, IRRELEVANT.
3 MS. BARLOW: YOUR HONOR, IT GOES TO THE SAME
4 RELEVANCE THAT WE ARGUED.
5 THE COURT: WHAT ARE YOU SAYING CONDUCT? I MEAN, I
6 THINK IT'S AMBIGUOUS. WHAT DO YOU MEAN CONDUCT?
7 MS. BARLOW: WELL, HOW HE TREATED HER.
8 THE COURT: ARE YOU ASKING THIS WITNESS WHETHER OR
9 NOT THIS WITNESS OBSERVED INTERACTIONS BETWEEN DR. WEITZEL
10 AND MARY CRANE?
11 MS. BARLOW: YES.
12 THE COURT: OKAY. WELL, THEN LET'S ASK IT THAT
13 WAY.
14 Q. (BY MS. BARLOW) DID YOU OBSERVE -- PRIOR TO THIS
15 FISTULA, DID YOU OBSERVE INTERACTION BETWEEN THE DEFENDANT
16 AND MARY CRANE?
17 A. I DID, YES.
18 Q. AND WHAT WERE THOSE INTERACTIONS?
19 MR. STIRBA: FOUNDATION, YOUR HONOR.
20 THE COURT: OKAY. WELL, I THINK HOPEFULLY SHE'LL
21 LAY THE FOUNDATION AS SHE TALKS ABOUT THEM. OVERRULED.
22 Q. (BY MS. BARLOW) WHAT WERE THESE INTERACTIONS?
23 A. THERE WAS NO HESITATION IN GOING INTO HER ROOM. HE
24 OPENLY WOULD LISTEN TO WHAT YOU HAD TO SAY ABOUT HER.
25 Q. DID THAT CHANGE AFTER THE FISTULA?
1534
1 A. IT DID.
2 Q. IN WHAT WAY?
3 A. HE WAS HESITANT TO GO INTO HER ROOM. HE DIDN'T WANT TO
4 DISCUSS THAT PART OF IT. THAT WAS FOR SOMEBODY ELSE TO DEAL
5 WITH.
6 Q. NOW, JUST A LITTLE FOUNDATION, AFTER YOU TALKED -- YOU
7 KNOW, YOU TALKED LAST FRIDAY ABOUT DEALING WITH HIM ABOUT
8 MARY CRANE BEING IN PAIN. DID YOU FIND ANY RECORDS
9 REGARDING MORPHINE FOR LYDIA SMITH?
10 A. YES, I DID.
11 Q. DO YOU RECALL WHEN THAT WAS?
12 A. THAT WAS JANUARY 7TH AND IT WAS RIGHT AFTER LYNN HAD
13 GIVEN THE SHOT TO MARY -- TO MARY.
14 Q. AND WHAT DID YOU FIND?
15 A. THAT HE HAD WRITTEN ANOTHER ORDER FOR LYDIA TO RECEIVE
16 5 MILLIGRAMS OF MORPHINE EVERY THREE HOURS.
17 Q. DID YOU CONFRONT HIM WITH THAT?
18 A. I DID.
19 Q. AND WHERE DID THAT TAKE PLACE?
20 A. AT THE NURSES' STATION.
21 Q. WHO WAS PRESENT?
22 A. MYSELF AND LYNN AND DR. WEITZEL.
23 Q. WHAT DID YOU SAY TO THE DEFENDANT?
24 A. I SAID, OKAY, YOU TOLD ME MARY CRANE IS IN PAIN, BUT WHY
25 IS LYDIA GOT A MORPHINE ORDER TOO BECAUSE I KNOW SHE'S NOT
1535
1 IN PAIN.
2 Q. WHAT DID YOU SAY?
3 A. HE SAID, HOW DO YOU KNOW SHE'S NOT IN PAIN.
4 Q. WHAT DID HE SAY?
5 A. I SAID, I KNOW SHE'S NOT. AND HE SAID, DID SHE TELL YOU
6 SHE WASN'T? AND OF COURSE LYDIA IS NOT ABLE TO ANSWER ME
7 EITHER.
8 MR. STIRBA: YOUR HONOR, YOUR HONOR, I'M GOING TO
9 OBJECT NOT RESPONSIVE.
10 THE COURT: LET'S JUST GO -- WE'RE TRYING TO ASK
11 WHAT THE CONVERSATION WAS BETWEEN YOU AND DR. WEITZEL ABOUT
12 LYDIA SMITH.
13 THE WITNESS: OKAY.
14 Q. (BY MS. BARLOW) WHEN HE ASKED YOU, DID SHE TELL YOU
15 THAT SHE WAS NOT IN PAIN, WHAT DID YOU RESPOND?
16 A. I RESPONDED THAT, NO, SHE DIDN'T TELL ME BUT I KNOW
17 SHE'S NOT IN PAIN.
18 Q. AND WHAT IS THAT KNOWLEDGE, AS IT WERE, BASED ON?
19 A. SHE HAD NEVER COMPLAINED OF PAIN PREVIOUSLY. SHE --
20 THERE WAS NO MOANING, THERE WAS -- I SAW NO SIGNS OF PAIN.
21 Q. ARE YOU TRAINED TO LOOK FOR SIGNS OF PAIN?
22 A. YES.
23 Q. AFTER YOU SAID THAT, WHAT DID DR. WEITZEL SAY?
24 A. HE SAID, WELL, I'VE GONE AND TALKED TO THE FAMILY AND
25 TOLD THEM THAT YOU WILL BE INTO GIVE HER SOMETHING FOR PAIN.
1536
1 Q. AND WHAT DID YOU SAY?
2 A. WELL, THEN HE CONTINUED AND HE SAID, ARE YOU WILLING TO
3 GO TELL THAT FAMILY THAT YOU DON'T THINK THAT SHE'S IN PAIN
4 AND YOU ARE WILLING TO LET HER SUFFER BECAUSE YOU DON'T
5 THINK SHE IS.
6 Q. AND DID YOU SAY ANYTHING TO THAT?
7 A. I DIDN'T.
8 Q. WHAT DID YOU DO?
9 A. I WENT AND GAVE THE SHOT.
10 MS. BARLOW: THAT'S ALL I HAVE, YOUR HONOR.
11 THE COURT: OKAY. MR. STIRBA?
12 MR. STIRBA: YES, YOUR HONOR. THANK YOU.
13 CROSS-EXAMINATION
14 BY MR. STIRBA:
15 Q. ON MS. CRANE, YOU ARE AWARE, ARE YOU NOT, FROM YOUR
16 REVIEW OF THE RECORDS THAT AFTER THE CONSULT BY GYNECOLOGIST
17 THERE WAS AN ORDER ENTERED BY DR. WEITZEL TO HAVE LYNN LONG
18 CONTACT DR. DIENHART; ISN'T THAT TRUE?
19 A. IF IT'S HERE IN THE RECORD. I DON'T RECALL.
20 Q. YOU DON'T RECALL THAT?
21 A. I WOULD HAVE TO LOOK.
22 Q. AND THAT TOOK PLACE ON AFTER THE CONSULT WHICH OCCURRED
23 ON THE 2ND OF JANUARY OF 1996, DO YOU REMEMBER THAT?
24 A. I'M NOT SURE WHAT YOU ARE ASKING, WAS THERE A QUESTION
25 THERE? I'M NOT SURE.
1537
1 Q. YEAH. ARE YOU AWARE THAT AFTER THE CONSULT WHICH TOOK
2 PLACE ON THE 2ND OF JANUARY --
3 A. OKAY.
4 Q. -- OF 1996 THAT DR. WEITZEL ENTERED AN ORDER DIRECTING
5 NURSE LYNN LONG TO CONTACT DR. DIENHART TO TELL DR. DIENHART
6 ABOUT WHAT THE GYNECOLOGIST SAID? ARE YOU AWARE OF THAT?
7 A. OKAY. YOU WANT TO TELL ME WHAT PAGE THAT'S ON AND I'LL
8 LOOK?
9 Q. NO, I'M ASKING THE QUESTION: ARE YOU AWARE OF THAT,
10 MA'AM?
11 MS. BARLOW: YOUR HONOR, OBVIOUSLY THAT QUESTION IS
12 CONFUSING TO HER. CAN HE REPHRASE IT?
13 THE COURT: WELL, SHE CAN -- SHE CAN SAY IF IT'S
14 CONFUSING TO HER. THE QUESTION HAS BEEN ASKED.
15 THE WITNESS: IT'S CONFUSING TO ME. I HEAR ABOUT
16 FIVE QUESTIONS IN THERE, I'M NOT SURE WHICH ONE YOU WANT ME
17 TO ANSWER.
18 Q. (BY MR. STIRBA) SO ARE YOU TELLING THIS JURY THAT
19 UNLESS YOU REVIEW THE RECORDS RIGHT THERE AS YOU SIT THERE
20 ON THE WITNESS STAND, YOU DON'T KNOW WHETHER, IN FACT, THAT
21 OCCURRED, IS THAT WHAT YOU ARE TELLING THE JURY?
22 A. THAT WHAT OCCURRED, THAT SHE RECEIVED A CONSULT?
23 Q. NO. THAT DR. WEITZEL TOLD AND GAVE AN ORDER TO LYNN
24 LONG TO CONTACT DR. DIENHART ON THE 3RD TO ADVISE DR.
25 DIENHART'S OFFICE ABOUT THE CONSULT BY DR. MEEKS?
1538
1 MS. BARLOW: OBJECTION.
2 MR. STIRBA: ARE YOU AWARE OF THAT?
3 MS. BARLOW: OBJECTION, FOUNDATION, YOUR HONOR.
4 THE COURT: OVERRULED.
5 Q. (BY MR. STIRBA) WERE YOU AWARE OF THAT?
6 A. I DON'T RECALL HIM GIVING AN ORDER TO LYNN TO CALL DR.
7 DIENHART.
8 Q. DO YOU RECALL ALSO THAT ON THE 5TH OF JANUARY OF 1996
9 THAT DR. WEITZEL GAVE AN ORDER FOR KEFLEX FOR MARY CRANE,
10 ARE YOU AWARE OF THAT?
11 A. IF IT'S IN THE RECORD. I WOULD HAVE TO LOOK AT THE
12 RECORD.
13 Q. AND KEFLEX, YOU UNDERSTAND IS AN ANTIBIOTIC, ISN'T IT?
14 A. YES, IT IS.
15 Q. AND, IN FACT, ARE YOU AWARE THAT HE ORDERED KEFLEX ON
16 THE 5TH OF JANUARY FOR MARY CRANE TO TREAT THE VAGINAL
17 FISTULA, ARE YOU AWARE OF THAT?
18 A. IF I LOOKED AT THE RECORD AND COULD CONFIRM THAT.
19 Q. ARE YOU AWARE THAT THE CONSULT IN FACT SAID BY
20 DR. MEEKS, ESSENTIALLY IF WE'RE NOT GOING TO DO SURGERY,
21 WE'RE GOING TO TREAT IT WITH A BROAD-SPECTRUM ANTIBIOTIC,
22 ARE YOU AWARE OF THAT?
23 A. YES, I WAS AWARE OF THAT.
24 Q. AND YOU AGREE WITH ME THAT KEFLEX IS A BROAD-SPECTRUM
25 ANTIBIOTIC, ISN'T IT?
1539
1 A. YES, IT IS.
2 Q. NOW, YOU USED THE TERM FEISTY, DID YOU NOT, IN YOUR
3 CHARACTERIZATION OF LYDIA SMITH?
4 A. I DID.
5 Q. FEISTY IS NOWHERES TO BE FOUND IN THE CHARTING WITH
6 RESPECT TO LYDIA SMITH, IS IT?
7 A. I DON'T RECALL.
8 Q. IN FACT, YOU WHEN YOU SAW HER AND CHARTED ABOUT FOUR OR
9 FIVE TIMES, YOU NEVER USED THE WORD FEISTY, DID YOU?
10 A. NOT THAT I RECALL.
11 Q. IN FACT, FEISTY IS NOT A WORD THAT YOU TYPICALLY WOULD
12 ASSOCIATE WITH NURSE CHARTING OR MEDICAL RECORDS, IS IT?
13 A. YOU COULD CHART IT, IT WOULDN'T...IT'S NOT BANNED BY ANY
14 REASON.
15 Q. IS FEISTY A WORD THAT SOMEBODY TOLD YOU TO USE FOR
16 PURPOSES OF YOUR TESTIMONY?
17 A. NO.
18 Q. NOW YOU ARE AWARE, ARE YOU NOT, AS A NURSE THAT YOU HAVE
19 SOME INDEPENDENT DUTIES, CORRECT?
20 MS. BARLOW: YOUR HONOR, I THINK THAT'S AN
21 AMBIGUOUS QUESTION. INDEPENDENT OF WHAT?
22 THE COURT: WELL...
23 MR. STIRBA: I'LL REPHRASE.
24 Q. (BY MR. STIRBA) YOU ARE AWARE AS A NURSE, MA'AM, THAT
25 YOU ARE A PROFESSIONAL CHARGED WITH SOME VERY IMPORTANT
1540
1 RESPONSIBILITIES. YOU ARE AWARE OF, AREN'T YOU?
2 A. YES.
3 Q. AND YOU ARE AWARE THAT THE NURSING PROFESSION, IN FACT,
4 HAS CERTAIN ETHICAL CANNONS OR ETHICAL DIRECTIVES FOR
5 PURPOSES OF THE KIND OF -- THE WAY YOU DO YOUR JOB, YOU ARE
6 AWARE OF THAT?
7 A. YES.
8 Q. AND YOU ARE CERTAINLY AWARE AND YOU AGREE THAT ONE OF
9 THE FUNDAMENTAL FACTS ABOUT NURSING CARE IS YOU ARE NOT
10 SUPPOSED TO DO ANY HARM TO THE PATIENTS, TRUE?
11 A. YES.
12 Q. AND YOU ALSO AGREE, DO YOU NOT, THAT A NURSE MUST BE
13 RESPONSIBLE FOR HIS OR HER OWN ACTIONS, TRUE?
14 A. YES.
15 Q. NOW, YOU ALSO ARE AWARE THAT NURSES WHEN THEY DO THEIR
16 JOB, THEY, OF COURSE, HAVE TO WRITE THINGS DOWN BASED UPON
17 WHAT THEY OBSERVED, TRUE?
18 A. YES.
19 Q. IN FACT, YOU'VE READ A BUNCH OF NURSES' NOTES IN THIS
20 CASE BASED UPON PERCEPTIONS THAT YOU MADE, CORRECT?
21 A. YES.
22 Q. AND IT'S TRUE, IS IT NOT, THAT WHEN YOU TRY AS A NURSE
23 TO CHART CERTAIN THINGS YOU CERTAINLY HAVE A DESIRE TO BE
24 ACCURATE, CORRECT?
25 A. YES.
1541
1 Q. IN FACT, ISN'T THAT A STANDARD IN NURSING CARE THAT WHEN
2 YOU WRITE SOMETHING DOWN YOU ARE SUPPOSED TO BE ACCURATE
3 BASED UPON WHAT YOU PERCEIVE, TRUE?
4 A. YOU TRY AND BE ACCURATE.
5 Q. IN OTHER WORDS, THOSE NURSES' NOTES ARE VERY IMPORTANT
6 FOR PURPOSES OF PATIENT CARE, AREN'T THEY?
7 A. THEY DOCUMENT THE PATIENT CARE.
8 Q. THEY DOCUMENT -- AND ALSO TELL FOLKS WHO ARE COMING ON
9 BOARD KIND OF WHAT HAS GONE ON BEFORE, TRUE?
10 A. YES.
11 Q. AND THAT MIGHT BE VERY IMPORTANT TO A PHYSICIAN OR A
12 NURSE WHO IS CONDUCTING CARE TO SEE WHAT HAS GONE ON BEFORE
13 WITH THE PATIENT; ISN'T THAT CORRECT?
14 A. YES.
15 Q. AND YOU CERTAINLY WANT TO HAVE ACCURATE INFORMATION IN
16 THERE IN ORDER TO MAKE SURE THAT CARE IS APPROPRIATE, ISN'T
17 THAT TRUE?
18 A. YES.
19 Q. AND THAT'S CERTAINLY WHAT YOU TRY TO DO WHEN YOU PUT
20 DOWN YOUR NURSE'S NOTES WITH RESPECT TO EACH ONE OF THESE
21 FIVE PATIENTS; ISN'T THAT CORRECT?
22 A. THERE'S LIKE FIVE QUESTIONS BEFORE THAT, I'M NOT SURE.
23 YOU'LL HAVE TO RESTATE.
24 Q. I WAS ONLY ASKING YOU ONE.
25 A. ASK IT AGAIN.
1542
1 Q. WHEN YOU DID AND CHARTED AND WROTE IN THE NURSES' NOTES
2 WITH RESPECT TO THESE FIVE PATIENTS WHAT YOU DID, YOU
3 CERTAINLY TRIED TO BE ACCURATE; ISN'T THAT CORRECT?
4 A. YES, I DID.
5 Q. CERTAINLY DIDN'T WANT TO MISREPRESENT ANYTHING IN THOSE
6 RECORDS, DID YOU?
7 A. NO.
8 Q. AND THAT WOULD BE BELOW THE STANDARD OF THE NURSING
9 PROFESSION?
10 MS. BARLOW: YOUR HONOR, I OBJECT TO TALK OF
11 STANDARD OF CARE.
12 THE COURT: OVERRULED.
13 MR. STIRBA: I HAVEN'T FINISH THE QUESTION.
14 Q. (BY MR. STIRBA) THAT WOULD BE BELOW THE STANDARD IN
15 THE NURSING PROFESSION TO BASICALLY WRITE SOMETHING IN A
16 MEDICAL RECORD THAT WASN'T TRUE; ISN'T THAT CORRECT?
17 A. YES.
18 Q. NOW, THERE WERE A NUMBER OF PEOPLE WHO WORKED ON THE
19 GEROPSYCH UNIT AS NURSES, CORRECT?
20 A. YES.
21 Q. FOR EXAMPLE, YOU REMEMBER SHEILA HANSEN WORKING THERE
22 DURING DECEMBER AND JANUARY OF '95 AND '96?
23 A. YES.
24 Q. AND SHEILA HANSEN WAS, IN FACT, THE LEAD OR CHARGE NURSE
25 OF THE UNIT DURING THAT TIME, WASN'T SHE?
1543
1 A. YES, SHE WAS.
2 Q. IN OTHER WORDS, SHE WAS SUPERIOR TO YOU ESSENTIALLY IN
3 THE PECKING ORDER; ISN'T THAT CORRECT?
4 A. SHE HAD MORE AUTHORITY.
5 Q. PARDON ME?
6 A. SHE HAD MORE AUTHORITY.
7 Q. SURE. SHE HAD A TITLE, DIDN'T SHE?
8 A. SHE WAS HIGHER IN THE CHAIN.
9 Q. SHE HAD A TITLE, DIDN'T SHE?
10 A. YES.
11 Q. SHE WAS THE CHARGE NURSE OR THE HEAD OF THE UNIT,
12 CORRECT?
13 A. YES.
14 Q. AND YOU REMEMBER LYNN LONG WORKED THERE AS WELL; IS THAT
15 RIGHT?
16 A. YES.
17 Q. AND LYNN LONG ALSO WAS A R.N. JUST LIKE YOU, A
18 REGISTERED NURSE, TRUE?
19 A. YES.
20 Q. AND YOU REMEMBER THAT LAURIE WILLSON WORKED THERE AS
21 WELL, DIDN'T SHE?
22 A. SHE DID.
23 Q. AND LAURIE ALSO WAS AN R.N. OR REGISTERED NURSE, TRUE?
24 A. YES.
25 Q. IN FACT, LAURIE HAD SOME ADDITIONAL SCHOOLING, DIDN'T
1544
1 SHE, IN THAT SHE HAD A MASTER'S IN NURSING DURING THIS TIME
2 PERIOD; ISN'T THAT CORRECT?
3 A. I DON'T KNOW HER EXACT CREDENTIALS.
4 Q. AND IT'S TRUE, IS IT NOT, THAT YOU WEREN'T PRIVY -- IN
5 OTHER WORDS, WHEN YOU WORKED THERE, YOU WEREN'T PRIVY TO
6 EVERY CONVERSATION THAT WENT ON BETWEEN THE DOCTOR AND OTHER
7 NURSES, TRUE?
8 A. TRUE.
9 Q. AND IT'S TRUE, IS IT NOT, THAT THERE WERE CONVERSATIONS
10 THAT WENT ON WITH FAMILY MEMBERS WHICH YOU WEREN'T PRIVY TO
11 OR WERE A PART OF; ISN'T THAT CORRECT?
12 A. YES.
13 Q. FOR EXAMPLE, IN JUDITH LARSEN'S CASE, YOU NEVER SPOKE TO
14 MERLIN LARSEN, DID YOU?
15 A. I DON'T RECALL.
16 Q. THAT WOULD BE JUDITH'S SON?
17 A. OKAY.
18 Q. AND, IN FACT, YOU DON'T KNOW AS YOU SIT HERE TODAY ABOUT
19 CONVERSATIONS THAT MR. LARSEN, THAT IS MERLIN LARSEN HAD,
20 WITH DR. WEITZEL ABOUT HIS MOM'S CARE, DO YOU?
21 MS. BARLOW: YOUR HONOR, I OBJECT ON THE BASIS OF
22 RELEVANCE.
23 THE COURT: OVERRULED.
24 Q. (BY MR. STIRBA) YOU DON'T KNOW AS SIT HERE TODAY ABOUT
25 CONVERSATIONS THAT MERLIN LARSEN HAD ABOUT HIS MOM'S CARE
1545
1 WITH DR. WEITZEL, DO YOU?
2 A. I DON'T RECALL.
3 Q. IN FACT, YOU DON'T EVEN KNOW AS YOU SIT HERE TODAY
4 WHETHER OR NOT MERLIN LARSEN, JUDITH LARSEN'S SON, WANTED
5 HIS MOM MOVED OFF THE UNIT, DO YOU?
6 A. I DON'T RECALL.
7 Q. WELL, YOU DON'T RECALL -- DID YOU EVER HAVE A
8 CONVERSATION WITH HIM LIKE THAT?
9 A. I DON'T RECALL.
10 Q. NOW, YOU ARE ALSO AWARE, ARE YOU NOT, THAT AS A NURSE ON
11 THE UNIT, YOU HAD FREE ACCESS TO THE ENTIRE MEDICAL CHART;
12 ISN'T THAT CORRECT?
13 A. YES.
14 Q. FOR EXAMPLE, IF YOU WANTED TO KNOW ABOUT WHAT HAD
15 HAPPENED PRIOR WITH MS. LARSEN, YOU -- OF COURSE, AS A
16 NURSE, YOU COULD GO BACK AND READ ALL THE NURSES' NOTES AND
17 YOU COULD GO OVER ALL THE VARIOUS THINGS ABOUT HER CARE;
18 ISN'T THAT CORRECT?
19 A. YES.
20 Q. AND THAT WOULD BE TRUE WITH RESPECT TO EACH ONE OF THE
21 PATIENTS; ISN'T THAT TRUE?
22 A. YES.
23 Q. AND, IN FACT, THERE WERE TIMES THAT YOU WOULD DO THAT TO
24 HELP YOU DO YOUR JOB; ISN'T THAT CORRECT?
25 A. I WOULD ASSUME I DID.
1546
1 Q. NOW, YOU ARE ALSO AWARE, ARE YOU NOT, THAT THERE WERE
2 CERTAIN DIRECTIVES ABOUT MEDICAL CARE GIVEN BY THE FAMILY
3 TO --
4 MS. BARLOW: OBJECTION, BEYOND THE SCOPE OF DIRECT
5 EXAMINATION, YOUR HONOR.
6 THE COURT: OKAY. WHAT'S YOUR RESPONSE?
7 MR. STIRBA: WELL, I GUESS IT'S RELEVANT IN TERMS
8 OF THE CARE THAT WAS PROVIDED, YOUR HONOR. I MEAN, I'M
9 GOING TO HAVE TO RECALL HER, SHE'S HERE AND THIS IS ALL PART
10 OF THE MEDICAL FILE.
11 THE COURT: OKAY. WHAT DO YOU WANT TO DO? DO YOU
12 WANT TO HAVE THIS WITNESS RECALLED OR JUST --
13 MS. BARLOW: NO, YOUR HONOR.
14 THE COURT: OKAY. WELL, THEN JUST GO ON.
15 Q. (BY MR. STIRBA) NOW YOU ARE AWARE, ARE YOU NOT, THAT
16 THERE WERE CERTAIN DIRECTIVES THAT WERE PART OF THESE FILES,
17 MEDICAL FILES WHERE THE PATIENT'S FAMILY WOULD DIRECT THE
18 HOSPITAL AND THE PHYSICIANS ABOUT CERTAIN CARE THEY WANTED
19 OR THEY DIDN'T WANT; ISN'T THAT TRUE?
20 A. YES.
21 Q. AND YOU ARE CERTAINLY AWARE THAT IN LYDIA SMITH'S CASE,
22 THERE WAS A DIRECTIVE GIVEN TO THE -- GIVEN BY THE FAMILY,
23 RATHER, TO THE HOSPITAL AND THE DOCTOR ABOUT WHAT CARE SHE
24 WAS GOING TO GET; ISN'T THAT TRUE?
25 A. YES.
1547
1 Q. AND, IN FACT, THAT PARTICULAR DIRECTIVE YOU WOULD BE
2 AWARE OF BECAUSE YOU, IN FACT, SIGNED IT; ISN'T THAT
3 CORRECT?
4 A. I WOULD HAVE TO LOOK AT IT BUT...
5 Q. YOU GOT MS. SMITH'S BINDER THERE? ACTUALLY, MAYBE IT'S
6 EASIER, MA'AM, LET'S DO IT THIS WAY, I'LL JUST DISPLAY IT
7 AND YOU CAN PROBABLY SEE IT FROM WHERE YOU ARE. PUT A
8 LITTLE...
9 NOW, THIS IS A MEDICAL TREATMENT PLAN, IS A HOSPITAL
10 FORM, DO YOU RECOGNIZE THAT?
11 A. YES.
12 Q. AND IF I GO DOWN HERE TO THE BOTTOM, THAT'S YOUR
13 SIGNATURE?
14 A. IT IS.
15 Q. CORRECT?
16 A. YES.
17 Q. UNDER FACILITY REPRESENTATIVE, TRUE?
18 A. YES.
19 Q. AND YOU NOTICE THAT THE DATE OVER HERE SIGNED BY
20 APPARENTLY THE DECLARANT OR AUTHORIZED AGENT IS 1/7 OF '96,
21 DO YOU SEE THAT?
22 A. YES.
23 Q. AND NOW NOTICE IN TERMS WHEN IT SAYS THE FOLLOWING CARE
24 AND TREATMENT IS DIRECTED WITH RESPECT TO THE DECLARANT, YOU
25 UNDERSTAND THAT'S WHERE THE SMITH FAMILY WAS BASICALLY
1548
1 TELLING THE PEOPLE WHO WERE TAKING CARE OF THEIR MOM, THIS
2 IS WHAT WE WANT YOU TO DO AND THIS IS WHAT WE DON'T WANT YOU
3 TO DO, DO YOU UNDERSTAND THAT?
4 A. I DO.
5 Q. AND THAT'S ALSO YOUR SIGNATURE THERE; IS IT NOT?
6 A. IT IS.
7 Q. AND IT SAYS R.N., TRUE?
8 A. YES, YES.
9 Q. NOW, IT SAYS THAT THIS IS WHAT THE FAMILY INDICATED AT
10 THE TIME AND THERE'S A BUNCH CHECKS FOR YES AND THAT MEANS
11 THEY DON'T WANT A RESUSCITATION OF THEIR MOM IN THE EVENT
12 THAT WAS NEEDED; IS THAT RIGHT?
13 A. YES.
14 Q. AND THEN THEY GO DOWN AND THEY ELIMINATE A BUNCH OF
15 OTHER THINGS DOWN HERE WHERE THEY CHECK NO, TRUE?
16 A. YES.
17 Q. BUT MORE IMPORTANTLY, IF YOU GO OVER HERE, THEY SAY
18 RIGHT THERE, NO I.V. FLUIDS, DO YOU UNDERSTAND THAT?
19 A. I DO.
20 Q. AND THEY ALSO SAY NO N.G., NASAL GASTRIC TUBE FOR FLUIDS
21 FEEDING, DO YOU SEE THAT?
22 A. I DO.
23 Q. NOW IT'S TRUE, IS IT NOT, THAT LYDIA SMITH AS YOU'VE
24 CHARTED AND AS YOU'VE READ TO THE LADIES AND GENTLEMEN OF
25 THE JURY, SHE WASN'T EATING, ISN'T THAT RIGHT?
1549
1 A. SHE WASN'T.
2 Q. IN FACT, LYDIA SMITH HASN'T BEEN EATING FOR QUITE SOME
3 PERIOD OF TIME BEFORE SHE EVER GOT TO THE HOSPITAL, ISN'T
4 THAT TRUE?
5 A. THAT'S TRUE.
6 Q. IN FACT, SHE HAD LOST OVER 30 POUNDS IN THE LAST YEAR;
7 ISN'T THAT CORRECT?
8 A. SHE HAD.
9 Q. NOW, IT'S TRUE, IS IT NOT, THAT IF SOME INDIVIDUAL LIKE
10 LYDIA ISN'T EATING, THE ONLY WAY YOU ARE GOING TO GET
11 NOURISHMENT AND FLUIDS TO HER IS THROUGH I.V.'S; ISN'T THAT
12 CORRECT?
13 A. THERE'S OTHER WAYS, BUT, YEAH, THAT'S THE WAY YOU
14 BASICALLY DO IT.
15 Q. AND THE OTHER WAY MIGHT BE RIGHT HERE WHERE IT NASAL
16 GASTRIC TUBE FOR FLUIDS FEEDING, TRUE?
17 A. YES.
18 Q. BUT THAT'S SOMETHING THAT AT LEAST AS FAR AS THIS
19 DIRECTIVE WAS CONCERNED IS ELIMINATED BY THE FAMILY, YOU SEE
20 THAT?
21 A. I DO.
22 Q. AND YOU FELT -- WELL, LET ME STRIKE THAT.
23 YOU BELIEVE THAT THIS IS BINDING WITH RESPECT TO THE
24 PHYSICIAN AND OTHERS WHO ARE PROVIDING CARE TO LYDIA SMITH?
25 A. I DO.
1550
1 Q. NOW --
2 A. COULD YOU JUST --
3 Q. -- SIMILARLY WITH RESPECT TO MS. CRANE --
4 A. JUST ON LYDIA CAN I JUST ASK IF THERE'S A TIME WHEN THAT
5 WAS SIGNED? DID IT HAVE ANY TIME WRITTEN ON THERE?
6 Q. COUNSEL COULD ASK -- I'LL REPRESENT TO YOU THERE ISN'T.
7 A. OKAY.
8 Q. I THINK THE DOCUMENT WAS DISPLAYED.
9 A. OKAY.
10 Q. NOW, WITH RESPECT TO MS. CRANE -- WELL, LET ME ASK YOU
11 THIS: YOU ASK ABOUT TIME. CAN YOU TELL THE JURY WHAT TIME
12 YOU AFFIXED YOUR SIGNATURE TWICE ON THE DIRECTIVES FOR THE
13 SMITHS?
14 A. IT WOULD HAVE BEEN AFTER DR. WEITZEL TALKED TO THEM THAT
15 DAY AND AFTER THE FAMILY CAME IN AND I WAS ABLE TO TALK TO
16 THEM, SO IT WOULD HAVE BEEN LATER IN THE SHIFT.
17 Q. RIGHT. AND THERE'S NO QUESTION IN YOUR MIND THAT THAT
18 WAS SIGNED BY YOU AND ALSO SIGNED BY A FAMILY REPRESENTATIVE
19 CORRECT?
20 A. YES.
21 Q. NOW, WITH RESPECT TO MS. CRANE, WE HAVE ANOTHER SIMILAR
22 DOCUMENT AND UP AT THE TOP WE HAVE 12/28/95, DID YOU WRITE
23 THAT?
24 A. I WOULD HAVE TO SEE THE SIGNATURE. IT LOOKS LIKE MY
25 WRITING BUT I THINK MY SIGNATURE --
1551
1 Q. WELL, LET ME HELP YOU HERE. DOWN AT THE BOTTOM --
2 A. THAT'S MY SIGNATURE, YES.
3 Q. THAT'S YOUR SIGNATURE, SO YOU AGREE, DO YOU NOT, THAT
4 THAT 12/28/95 WAS PUT THERE BY YOU?
5 A. YES.
6 Q. AND, IN FACT, YOU PUT THAT THERE ON 12/28/95, TRUE?
7 A. YES.
8 Q. AND THEN, ONCE AGAIN, THIS PARTICULAR DOCUMENT, THAT'S
9 DR. WEITZEL'S SIGNATURE, TRUE?
10 A. YES.
11 Q. APPEARS TO BE HE SIGNED IT ON 12/30/95, CORRECT?
12 A. YES.
13 Q. AND THEN THERE'S ALSO A SIGNATURE HERE IT LOOKS LIKE A
14 KAREN BRINGHURST, BUT ANYWAY IT'S A SIGNATURE OF THE FAMILY
15 REPRESENTATIVE, CORRECT?
16 A. YES.
17 Q. AND THAT'S YOUR SIGNATURE OVER THERE WHERE I'M POINTING,
18 CORRECT?
19 A. YES.
20 Q. AND, ONCE AGAIN, WE HAVE A SIMILAR SITUATION WHERE
21 CERTAIN THINGS ARE TOLD IN TERMS OF CARE AND TREATMENT THAT
22 ARE GOING TO BE PROVIDED AND CERTAIN THINGS AREN'T; ISN'T
23 THAT TRUE?
24 A. YES.
25 Q. SPECIFICALLY WITH RESPECT TO SURGERY IT SAYS, NO, IT HAS
1552
1 ADVISED FAMILY, DO YOU SEE THAT?
2 A. YES.
3 Q. NOW, IT'S TRUE, IS IT NOT, THAT MARY CRANE YOU TESTIFIED
4 YOU OBSERVED ON THE 7TH OF JANUARY; IS THAT RIGHT?
5 A. YES.
6 Q. AND, IN FACT, YOU HAVE A NOTE AT ABOUT 2 O'CLOCK IN THE
7 AFTERNOON WHERE YOU INDICATE THAT YOU NOTIFIED DR. DIENHART,
8 TRUE?
9 A. YES.
10 Q. AND IT'S TRUE, IS IT NOT, AS YOU'VE TOLD US THE REASON
11 WHY YOU NOTIFIED DR. DIENHART IS BECAUSE YOU WERE VERY
12 CONCERNED ABOUT MARY'S CONDITION AT THAT TIME, CORRECT?
13 A. YES.
14 Q. IN FACT, YOU THOUGHT MARY WAS SERIOUSLY ILL?
15 A. YES.
16 Q. AND, IN FACT, THAT'S WHY YOU ASKED DR. DIENHART TO
17 PROVIDE SOME CARE; IS THAT RIGHT?
18 A. YES, YES.
19 Q. AND, IN FACT, WHAT DR. DIENHART DID, HE DID THREE THINGS
20 AS YOU'VE TESTIFIED PURSUANT TO HIS ORDER. FIRST, HE ASKED
21 FOR AN OXYGEN SYMMETRY TEST TO BE DONE, TRUE?
22 A. YES.
23 Q. IN OTHER WORDS, THAT'S WHERE BASICALLY SOMEBODY COMES
24 IN, THEY CHECK OUT THE OXYGEN SATURATION TO BASICALLY SEE IF
25 THE PATIENT, OR IN THIS CASE MS. CRANE, WAS SUFFICIENTLY
1553
1 OXYGENATED; ISN'T THAT RIGHT?
2 A. YES.
3 Q. SO YOU TESTIFIED TO THIS, YOU ARE NOT AN EXPERT IN IT,
4 SOMEBODY CAME IN, RAN THE TEST AND THEN THEY CAME UP WITH A
5 FIGURE AND I BELIEVE THAT FIGURE WAS 86 PERCENT; ISN'T THAT
6 CORRECT?
7 A. I DON'T REMEMBER THE EXACT FIGURE. I WROTE HERE S.A.T.
8 LEVEL 80 TO 70.
9 Q. THAT'S NOT ON THE REPORT, IS IT, MA'AM? THE REPORT SAYS
10 86, DOESN'T IT?
11 A. I DON'T KNOW WHERE YOU ARE LOOKING. I'M LOOKING AT MY
12 NURSE'S NOTES.
13 Q. AND THEN THE OTHER THING HE DID, HE ORDERED A CHEST
14 X-RAY; ISN'T THAT CORRECT?
15 A. LET ME LOOK AT HIS ORDERS HERE. I SEEM TO REMEMBER HE
16 DID, YES.
17 Q. PARDON ME?
18 A. I WOULD HAVE TO LOOK AT THE ORDER FOR SURE, BUT I SEEM
19 TO REMEMBER THAT HE DID. DO YOU HAVE A PAGE NUMBER?
20 Q. AND THAT CHEST X-RAY WAS ACTUALLY DONE, WAS IT NOT?
21 A. I DON'T RECALL.
22 Q. DID YOU EVER SEE A REPORT OF THAT CHEST X-RAY?
23 A. I DON'T RECALL.
24 Q. IT WAS DONE ON THE 7TH, CORRECT?
25 MS. BARLOW: YOUR HONOR, THAT'S BEEN ASKED AND
1554
1 ANSWERED, SHE DOESN'T RECALL. I OBJECT.
2 MR. STIRBA: I'LL MOVE ON YOUR HONOR. I'LL MOVE
3 ON.
4 Q. (BY MR. STIRBA) NOW, THIS IS AN X-RAY REPORT FROM HER
5 FILE.
6 A. I CAN'T READ THAT. DO YOU WANT TO TELL ME WHAT PAGE
7 WE'RE ON AND I'LL LOOK IT UP?
8 Q. OH, SURE. MED 00272.
9 A. OKAY.
10 Q. YOU GOT THAT IN FRONT OF YOU?
11 A. I DO.
12 Q. AND THAT APPEARS TO BE A CHEST X-RAY REPORT DATE OF EXAM
13 IS 1/7/96, CORRECT?
14 A. YES.
15 Q. AND THAT IMPRESSION WAS, STABLE APPEARANCE OF THE CHEST,
16 HEART SIZE APPEARS MILDLY PROMINENT AND NO LOBAR OPACITIES
17 IDENTIFIED, DO YOU SEE THAT?
18 A. I DO.
19 Q. MORE PARTICULARLY, LUNGS ARE CLEAR WITHOUT EVIDENCE OF
20 FOCAL INFILTRATES, DID I READ THAT CORRECTLY?
21 A. YES, CLOSE ENOUGH.
22 Q. AND THEN THE OTHER THING THAT DR. DIENHART DID IN HIS
23 ORDER IS HE ORDERED BASICALLY A BLOOD TEST, TRUE? IF YOU
24 WANT TO LOOK AT HIS ORDER IT'S MED-00249.
25 A. YES. HE ORDERED WHAT? I'M SORRY, I'M --
1555
1 Q. IN FACT, JUST SO WE HAVE THE RECORD CLEAR, I PLACED THAT
2 PARTICULAR PAGE ON THE ELMO AND I'M REFERRING TO UP HERE
3 WHAT HE ORDERED THOSE THREE THINGS; ONE A BLOOD TEST; TWO,
4 THE OXYGEN SATURATION TEST; AND THREE, THE CHEST X-RAY,
5 CORRECT?
6 A. YES.
7 Q. AND THEN YOU HAVE NOTED IT RIGHT HERE; IS THAT RIGHT?
8 A. YES, YES.
9 Q. NOW, HERE IS THE OXYGEN S.A.T. TEST THAT I WAS REFERRING
10 TO AND
11 A. UH-HUH.
12 Q. NOW, THE BLOOD TEST THAT WAS ORDERED BY DR. DIENHART WAS
13 CALLED A S.M.A.C.; IS THAT RIGHT?
14 A. S.M.A.C., YEAH, S.M.A.
15 Q. NOW, HERE IS A REPORT OF THAT PARTICULAR TEST
16 SPECIFICALLY I'LL DIRECT YOUR ATTENTION TO IT LOOKS LIKE
17 1/7/96, THIS IS MED-00261. DO YOU SEE THAT?
18 A. I ACTUALLY CAN'T SEE THAT. DO YOU WANT TO GIVE ME A
19 PAGE NUMBER AGAIN?
20 Q. YEAH, 00261.
21 A. OKAY.
22 Q. AND THERE IS THE FINDING, IT'S 1/7 AND THERE IS A TIME
23 1335 SO THAT APPEARS AT 1:30 P.M THEY ACTUALLY DID THAT
24 TEST. IS THAT A FAIR STATEMENT?
25 A. YES.
1556
1 Q. AND THERE'S SOME FINDINGS THERE, SPECIFICALLY N.A.
2 STANDS FOR SODIUM, DO YOU SEE THAT?
3 A. YES.
4 Q. AND IT SAYS 159 IT HAS THAT IN THE HIGH LEVEL, "H" FOR
5 HIGH, DO YOU SEE THAT?
6 A. I DO.
7 Q. AND THEN THERE'S SOME OTHER FINDINGS, MOST OF WHICH ARE
8 IN THE HIGH LEVEL; ISN'T THAT TRUE?
9 A. YES.
10 Q. AND ALSO IF I COULD GO BACK JUST TO THIS ONE PAGE THAT I
11 SHOWED YOU BEFORE MED-249, THERE'S A TIME ALSO WHEN THE
12 OXYGEN SATURATION WAS DONE AT 1445, SO THAT'S 2:45 P.M.,
13 TRUE?
14 A. I HAVEN'T FOUND THAT RECORD YET. WHAT NUMBER IS IT?
15 Q. WELL, LET ME ASK YOU THIS, MA'AM: WE HAVE A BLOOD TEST
16 THAT WAS DONE AT 1:35 IN THE AFTERNOON --
17 A. UH-HUH.
18 Q. -- PURSUANT TO THE ORDER --
19 A. UH-HUH.
20 Q. -- BY DR. DIENHART. WE HAVE AN OXYGEN SATURATION TEST
21 THAT WAS DONE AT 2:45 IN THE AFTERNOON PURSUANT TO THE
22 ORDER. IS IT FAIR TO SAY THAT YOU WOULD HAVE TALKED TO DR.
23 DIENHART BEFORE THE BLOOD TEST WAS DONE?
24 A. YES.
25 Q. SO IN OTHER WORDS, SOMETIME PRIOR LET'S SAY 1:30 P.M. IN
1557
1 THE AFTERNOON ON THE 7TH, YOU WERE CONCERNED ABOUT
2 MS. CRANE'S CONDITION AND YOU CONTACTED DR. DIENHART; ISN'T
3 THAT CORRECT?
4 A. YES.
5 Q. AND THEN -- AND I WANT YOU TO TURN TO THIS PAGE BECAUSE
6 YOU ARE PROBABLY GOING TO HAVE TO SEE IT. THIS IS MED-249.
7 A. OKAY.
8 Q. DO YOU HAVE THAT IN FRONT OF YOU?
9 A. I DO.
10 Q. NOW THAT'S DR. DIENHART'S CONSULT NOTE, IS IT NOT?
11 A. IT IS. IT --
12 Q. ON THE RIGHT-HAND SIDE. AND I WON'T EVEN BEGIN TO ASK
13 YOU TO READ IT, BUT UP HERE AT THE TOP IT SAYS 1/7/96 3:10
14 P.M., 3:10, DO YOU SEE THAT?
15 A. I DO.
16 Q. AND THAT'S THE TIME THAT DR. DIENHART ACTUALLY CAME AND
17 SAW MS. CRANE FOR PURPOSES OF MAKING HIS EXAMINATION; ISN'T
18 THAT RIGHT?
19 A. YOU WOULD HAVE TO ASK HIM BUT THAT'S THE TIME THAT'S
20 THERE.
21 Q. AND HAVE YOU REVIEWED THAT NOTE TO DETERMINE THAT, IN
22 FACT, HE STATED ON THE NEXT PAGE THAT HE THOUGHT THE PATIENT
23 WAS DYING? IT'S ON THE NEXT PAGE.
24 MS. BARLOW: YOUR HONOR, I OBJECT. IT'S A
25 MISCHARACTERIZATION OF WHAT IT SAYS.
1558
1 Q. (BY MR. STIRBA) TURN TO THE NEXT PAGE, PLEASE, MA'AM.
2 A. UH-HUH.
3 Q. DO YOU HAVE UP AT THE TOP DR. DIENHART SAYS, THINKS
4 PATIENT IS DYING; ISN'T THAT RIGHT?
5 MS. BARLOW: YOUR HONOR, THAT'S A
6 MISCHARACTERIZATION OF WHAT IT SAYS.
7 Q. (BY MR. STIRBA) ALL RIGHT. WELL, LET'S GET OUT AND
8 WE'LL SEE EXACTLY WHAT HE SAID.
9 IT'S PROBABLY 250, ISN'T IT, MA'AM, MED-250?
10 A. YES.
11 Q. IT SAYS RIGHT HERE, ONCE AGAIN, HE HAS 1/7/96, 3:10
12 P.M., IT SAYS RIGHT HERE, I SUSPECT SHE MAY DIE SOON. DID I
13 READ THAT CORRECTLY?
14 A. YES.
15 Q. SO IT'S TRUE AT LEAST AS OF THIS DATE AND TIME DR.
16 DIENHART HAS ALREADY OPINED THAT HE SUSPECTS THAT SHE MAY
17 DIE SHORTLY BASED UPON WHAT HE HAS NOW ASSESSED AND
18 DETERMINED; ISN'T THAT TRUE?
19 A. YES.
20 Q. AND IT'S TRUE, IS IT NOT, THAT YOU PERSONALLY, BASED
21 UPON YOUR NURSING EXPERIENCE AND BACKGROUND, HAD CONCERNS AS
22 OF THAT POINT THAT SHE WAS DYING AS WELL; ISN'T THAT
23 CORRECT?
24 A. YES.
25 Q. AND THEN IT'S TRUE, IS IT NOT, THAT YOU PROCEED TO HAVE
1559
1 A CONVERSATION AND NOTE AN ORDER BY DR. WEITZEL THAT SAME
2 DAY, CORRECT?
3 A. YES.
4 Q. GO TO MED 00249.
5 A. UH-HUH.
6 Q. AND IT'S TRUE, IS IT NOT, THAT YOU NOTE THAT ORDER BY
7 DR. WEITZEL AT APPROXIMATELY 2130 THAT EVENING, TRUE?
8 A. THAT'S WHEN THE ORDER WAS DONE.
9 Q. THAT'S WHEN YOU NOTED IT, TRUE?
10 A. YES.
11 Q. SO IN OTHER WORDS, WE HAVE ALMOST A FIVE-HOUR LAPSE OF
12 TIME BETWEEN THE TIME THAT DR. DIENHART HAD SUSPICIONS THAT
13 THE PATIENT WAS DYING, YOU HAD SUSPICIONS THAT THE PATIENT
14 WAS DYING, AND YOU NOTE AN ORDER BY DR. WEITZEL; ISN'T THAT
15 CORRECT?
16 A. THE FACT THAT THIS IS NOTED AT 2100 DOES NOT MEAN THAT'S
17 WHEN HE WROTE IT. HE WOULD HAVE WROTE IT MUCH EARLIER.
18 Q. NO, I'M TALKING ABOUT WHEN YOU NOTED IT. YOU NOTED IT
19 AT 2130, DID YOU NOT?
20 A. 2100.
21 Q. 2100. THAT'S WHEN YOU NOTED THE ORDER, TRUE?
22 A. YES.
23 Q. AND IS IT TRUE, IS IT NOT, THAT THERE WERE CERTAIN
24 THINGS THAT OCCURRED WITH RESPECT TO HER CARE BETWEEN THE
25 TIME WHEN YOU AND DR. DIENHART THOUGHT THAT MS. CRANE WAS
1560
1 DYING AND THE TIME THAT YOU ACTUALLY NOTED THAT ORDER; ISN'T
2 THAT CORRECT?
3 A. I'M SORRY, SAY THAT AGAIN.
4 Q. SURE. THERE WERE CERTAIN THINGS THAT OCCURRED BETWEEN
5 3:10 P.M. ON THE 7TH AND WHEN YOU NOTED THAT ORDER AT 2100;
6 ISN'T THAT CORRECT?
7 A. THINGS OCCURRED, I'M --
8 Q. YEAH. FOR EXAMPLE, YOU RECALL THAT DR. DIENHART IN HIS
9 NOTE ADVISED, THE FAMILY SHOULD BE NOTIFIED, DO YOU REMEMBER
10 THAT?
11 A. I DID NOTIFY THE FAMILY.
12 Q. AND, IN FACT, THE FAMILY CAME IN, DID THEY NOT?
13 A. THEY WERE THERE.
14 Q. AND, IN FACT, THERE WAS A CONVERSATION WITH THE FAMILY
15 INVOLVING DR. WEITZEL AND CERTAIN FAMILY MEMBERS; ISN'T THAT
16 TRUE?
17 A. I'M NOT SURE WHAT CONVERSATION YOU ARE REFERRING TO.
18 Q. YOU WEREN'T PART OF THAT CONVERSATION, IS THAT WHAT YOU
19 ARE TELLING US?
20 A. I DON'T KNOW WHAT CONVERSATION YOU ARE REFERRING TO.
21 Q. YOU JUST KNOW THERE WAS A CONVERSATION THAT THE FAMILY
22 CAME IN, TRUE?
23 A. A CONVERSATION BETWEEN WHO, DR. WEITZEL, MYSELF? WHO?
24 Q. NO, LET ME REPHRASE, MA'AM.
25 YOU JUST TOLD US, I THOUGHT, THAT YOU ARE AWARE THAT
1561
1 THE FAMILY OF MARY CRANE CAME TO THE HOSPITAL?
2 A. YES.
3 Q. AFTER DR. DIENHART'S NOTE OF 3:10 P.M. ON THE 7TH?
4 A. I'M NOT SURE WHEN THEY CAME IN. THEY COULD HAVE --
5 Q. I DIDN'T ASK YOU THAT. I SAID, ARE YOU AWARE THEY CAME
6 IN AFTER THAT NOTE AFTER 3:10 P.M.? ISN'T THAT TRUE?
7 A. THEY COULD HAVE BEEN THERE BEFORE THAT NOTE, I DON'T
8 RECALL.
9 Q. AND YOU ARE NOT AWARE THEN THAT DR. WEITZEL TALKED TO
10 THE FAMILY AFTER DR. DIENHART MADE HIS ASSESSMENT AT 3:10
11 P.M.?
12 A. DR. WEITZEL DID TALK TO THE FAMILY.
13 Q. YOU ARE AWARE OF THAT?
14 A. YES.
15 Q. OKAY. AND YOU'RE ALSO AWARE THAT THE ORDER THAT FOR
16 MORPHINE THAT YOU HAVE IDENTIFIED WAS NOTED AT 2100 HOURS,
17 RIGHT?
18 A. YES.
19 Q. THAT'S YOUR SIGNATURE, TRUE?
20 A. YES.
21 Q. 2100 HOURS, DO YOU SEE THAT?
22 A. I DO.
23 MS. BARLOW: YOUR HONOR, THAT'S BEEN ASKED AND
24 ANSWERED.
25 THE COURT: OVERRULED.
1562
1 Q. (BY MR. STIRBA) AND IT'S ALSO TRUE, IS IT NOT, THAT
2 ACCORDING TO THE MEDICATION ADMINISTRATION RECORDS, THAT THE
3 FIRST MORPHINE OF 5 MILLIGRAMS WHICH WAS GIVEN WAS AT 2100
4 HOURS; ISN'T THAT CORRECT?
5 A. I BELIEVE IT WAS 2000. LET ME LOOK.
6 Q. WELL, LET'S JUST SEE WHAT IT SAYS.
7 A. IT'S 2000.
8 Q. PLACED -- IT'S MED-00290 DOWN AT THE BOTTOM. ARE YOU
9 WITH ME?
10 A. I AM.
11 Q. NOW THIS IS -- WE HAVE 1/7 RIGHT HERE, THOSE ARE YOUR
12 INITIALS, CORRECT?
13 A. YES.
14 Q. AND THEN WE HAVE -- BY THE WAY, THERE'S THE KEFLEX OR
15 THE KEFLEX, DO YOU SEE THAT?
16 A. I DO.
17 Q. AND, IN FACT, YOU WERE INVOLVED IN GIVING THE KEFLEX AT
18 LEAST ON THE 6TH AND ON THE 7TH; ISN'T THAT CORRECT?
19 A. YES.
20 Q. AND THEN WE HAVE M.S. 5 MILLIGRAMS I.M. AND THIS IS THE
21 ONE YOU SAID YOU DIDN'T GIVE, THAT'S RIGHT AT 2000 HOURS, DO
22 YOU SEE THAT?
23 A. I DO.
24 Q. THAT'S THE ONE THAT YOU SAID LYNN LONG GAVE; IS THAT
25 RIGHT?
1563
1 A. THAT'S RIGHT.
2 Q. AND IT'S TRUE, IS IT NOT, THAT WHEN YOU TALKED TO LYNN
3 LONG ABOUT GIVING THAT INJECTION, LYNN LONG DIDN'T HAVE ANY
4 UNCOMFORTABLENESS ABOUT DOING IT, ISN'T THAT TRUE?
5 A. THAT'S TRUE.
6 Q. AND, IN FACT, LYNN LONG EVEN THOUGHT AND TOLD YOU THAT
7 SHE THOUGHT IT WAS APPROPRIATE THAT IT BE GIVEN
8 CONSIDERING --
9 MS. BARLOW: OBJECTION, YOUR HONOR, THAT'S HEARSAY.
10 THE COURT: IT'S CROSS-EXAMINATION, OVERRULED.
11 Q. (BY MR. STIRBA) CONSIDERING THE FACT --
12 A. THAT'S NOT WHAT SHE SAID.
13 Q. LET ME FINISH.
14 A. OKAY.
15 Q. LET ME START OVER.
16 AND IT'S TRUE, IS IT NOT, THAT WHEN LYNN LONG TALKED TO
17 YOU, NOT ONLY WASN'T SHE UNCOMFORTABLE BUT SHE THOUGHT IT
18 WAS AN APPROPRIATE THING TO DO; ISN'T THAT CORRECT?
19 A. THAT'S NOT CORRECT.
20 Q. AND THAT SHE ASSESSED THAT THAT PATIENT WAS IN PAIN AND
21 THAT PATIENT WAS SUFFERING; ISN'T THAT CORRECT?
22 A. THAT'S NOT CORRECT.
23 MS. BARLOW: OBJECTION, YOUR HONOR. SHE SAID THAT
24 THAT WASN'T SAID AND FOR HER TO DECIDE WHAT LYNN LONG WAS
25 THINKING IS NOT APPROPRIATE.
1564
1 MR. STIRBA: I DIDN'T ASK THAT. SHE'S ANSWERED IT.
2 THE COURT: THE QUESTION HAS BEEN ASKED AND
3 ANSWERED. MOVE ON.
4 MR. STIRBA: YEP.
5 Q. (BY MR. STIRBA) NOW, IT'S TRUE, IS IT NOT, THAT YOU
6 DID GIVE THE INJECTION THEN ON 2300 HOURS; IS THAT RIGHT?
7 A. YES.
8 Q. NOW LET ME ASK YOU, IT'S TRUE THAT YOU TESTIFIED YOU
9 ALREADY THOUGHT THAT MARY CRANE WAS DYING AS OF THE TIME
10 THAT DR. DIENHART HAD THOSE SUSPICIONS AT 3:10 IN THE
11 AFTERNOON; ISN'T THAT CORRECT?
12 A. YES.
13 Q. AND SO THAT SIMILARLY WOULD HAVE BEEN TRUE AT 2000
14 HOURS; ISN'T THAT CORRECT?
15 A. YES.
16 Q. IN OTHER WORDS, HER CONDITION HADN'T IMPROVED, HAD IT?
17 A. NO.
18 Q. IN FACT, IF ANYTHING, IT HAD GOTTEN WORSE, CORRECT?
19 A. I DON'T RECALL, PROBABLY.
20 Q. AND YOU CERTAINLY HAD SIMILAR FEELINGS AS YOU'VE
21 TESTIFIED, I BELIEVE, THAT AS OF 2300 HOURS YOU THOUGHT SHE
22 WAS DYING AS WELL; IS THAT RIGHT?
23 A. YES.
24 Q. AND THAT'S WHY YOU THOUGHT IT WAS APPROPRIATE TO GIVE
25 THE INJECTION AT THAT TIME BECAUSE YOU TOLD US YOU DIDN'T
1565
1 THINK IT WOULD MAKE ANY DIFFERENCE; IS THAT RIGHT?
2 A. I STILL WAS NOT COMFORTABLE GIVING IT BUT I WAS GIVEN NO
3 CHOICE.
4 Q. NO. BUT DIDN'T YOU TESTIFY ON FRIDAY, YOU WERE ASKED
5 SPECIFICALLY WHY YOU GAVE THE INJECTION AT 2300 HOURS AND
6 DIDN'T YOU TELL THE FOLKS ON THE JURY THAT THE REASON WHY
7 YOU DID IT BECAUSE YOU DIDN'T THINK IT MADE ANY DIFFERENCE?
8 A. BECAUSE I HAD NO OTHER CHOICE AND I FELT LIKE SHE WAS
9 GOING TO DIE AND IT WASN'T GOING TO MAKE A DIFFERENCE.
10 Q. RIGHT?
11 A. THERE WAS NOTHING I COULD DO DIFFERENT AT THAT POINT.
12 Q. AND YOU DIDN'T SAY ANYTHING ABOUT NOT HAVING ANY CHOICE
13 ON FRIDAY, DID YOU?
14 A. GIVEN THE CHANCE, I WOULD HAVE.
15 Q. BUT YOU DIDN'T SAY THAT ON FRIDAY, DID YOU?
16 A. BECAUSE I WAS COMING BACK TODAY.
17 Q. AND SO YOU THOUGHT THAT IT WAS APPROPRIATE AS OF 2300
18 HOURS TO GIVE IT BECAUSE YOU DIDN'T THINK THAT THAT WOULD --
19 MS. BARLOW: YOUR HONOR, THAT'S A
20 MISCHARACTERIZATION OF HER TESTIMONY. SHE'S NEVER SAID SHE
21 THOUGHT IT WAS APPROPRIATE.
22 THE COURT: WELL, I HAVEN'T HEARD THE COMPLETE
23 QUESTION, SO PHRASE THE QUESTION, THEN MAKE YOUR OBJECTION
24 SO I HEAR THE WHOLE QUESTION.
25 Q. (BY MR. STIRBA) YOU GAVE THE 2300 HOUR INJECTION
1566
1 BECAUSE AS YOU TOLD US ON FRIDAY, YOU DIDN'T THINK IT MAKE
2 ANY DIFFERENCE; IS THAT RIGHT?
3 MS. BARLOW: YOUR HONOR, THAT'S BEEN ASKED AND
4 ANSWER.
5 MR. STIRBA: WELL, I'M TRY TO GO GET THERE, JUDGE.
6 THE COURT: OVERRULED.
7 Q. (BY MR. STIRBA) IS THAT TRUE?
8 A. GO AHEAD AND ASK IT AGAIN.
9 Q. YEAH. YOU GAVE THE 2300 INJECTION BECAUSE AS YOU
10 TESTIFIED ON FRIDAY, YOU DIDN'T THINK IT MADE ANY
11 DIFFERENCE, TRUE?
12 A. AND OTHER REASONS.
13 Q. AND THE REASON WHY YOU DIDN'T THINK IT MADE ANY
14 DIFFERENCE IS BECAUSE AT LEAST AT THAT POINT YOU ALREADY
15 ASSESSED THAT MARY CRANE WAS GOING TO DIE, TRUE?
16 MS. BARLOW: YOUR HONOR, THAT HAS BEEN ASKED AND
17 ANSWERED BETWEEN FRIDAY AND TODAY TWO OR THREE TIMES. I
18 OBJECT TO ANY MORE QUESTIONS ALONG THOSE LINES.
19 THE COURT: OKAY. OVERRULED.
20 Q. (BY MR. STIRBA) IS THAT RIGHT?
21 A. AMONG OTHER REASONS.
22 Q. AND SHE CERTAINLY, BASED UPON WHAT YOU ARE TELLING US
23 NOW, SHE WASN'T GOING TO DIE FROM THE MORPHINE, WAS SHE?
24 MS. BARLOW: YOUR HONOR, I DON'T THINK SHE CAN MAKE
25 THAT DETERMINATION OF WHAT --
1567
1 THE COURT: SUSTAINED, LACK OF FOUNDATION.
2 Q. (BY MR. STIRBA) YOU CERTAINLY BELIEVED THAT THE TIME
3 YOU GAVE THE SHOT, DID YOU NOT, THAT YOU DIDN'T THINK THE
4 SHOT WAS GOING TO CAUSE OR CONTRIBUTE TO HER DEATH, DID YOU?
5 A. I DIDN'T HAVE ANY CHOICE IN GIVING THIS SHOT. IT DIDN'T
6 MATTER ANYMORE WHAT I THOUGHT ABOUT THE SHOT, I WAS TOLD I
7 HAD TO GIVE IT.
8 Q. YOU DIDN'T THINK WHEN YOU GAVE THE SHOT, THE INJECTION
9 AT 2300 HOURS THAT YOU THOUGHT IT WAS GOING TO CAUSE OR
10 CONTRIBUTE TO HER DEATH, DID YOU?
11 A. I DIDN'T THINK IT WAS GOING TO MAKE ANY DIFFERENCE IN
12 HER -- IN THE OUTCOME.
13 Q. YOUR ANSWER IS YES OR NO?
14 MS. BARLOW: YOUR HONOR, THAT -- SHE'S ANSWERED IT
15 THE WAY SHE'S ANSWERED.
16 THE COURT: WELL, SHE'S DONE THAT BUT THE QUESTION
17 HASN'T BEEN ANSWERED. EITHER ANSWER IT -- REPHRASE THE
18 QUESTION, THEN ANSWER.
19 MR. STIRBA: YES.
20 Q. (BY MR. STIRBA) WHEN YOU ADMINISTERED OR YOU ASKED
21 LYNN LONG TO ADMINISTER THE INJECTION AT 2000 HOURS, DID YOU
22 BELIEVE THAT THEY WOULD HAVE CAUSED OR CONTRIBUTED TO MARY
23 CRANE'S DEATH?
24 MS. BARLOW: YOUR HONOR, I THINK THIS IS A QUESTION
25 THAT WE NEED TO DISCUSS OUTSIDE THE PRESENCE OF THE JURY
1568
1 WHICH WE CAN'T DO AT THIS TIME. COULD I ASK THAT THIS
2 QUESTION BE HELD UNTIL WE HAVE TIME TO DISCUSS IT OUTSIDE
3 THE PRESENCE OF THE JURY?
4 THE COURT: OKAY. DO YOU HAVE SOME OTHER THINGS
5 YOU COULD GO TO AND COME BACK TO THAT?
6 MR. STIRBA: I DO, JUDGE.
7 THE COURT: OKAY. LET'S DO THAT.
8 Q. (BY MR. STIRBA) THIS IS MED-00293. DO YOU HAVE THAT
9 IN FRONT OF YOU?
10 A. I DO.
11 Q. IT SAYS M.S. 5 IT LOOKS LIKE GRAM BUT IT PROBABLY IS
12 MILLIGRAMS.
13 A. MILLIGRAMS.
14 Q. I.M., THAT'S YOUR WRITING, TRUE?
15 A. IT IS.
16 Q. AND IT HAS 1/7/96 AS THE DATE, CORRECT?
17 A. YES.
18 Q. IT HAS 2000 HOURS, TRUE?
19 A. YES.
20 Q. AND IT HAS I.M. AND THEN YOUR SIGNATURE -- YOUR
21 INITIALS; IS THAT RIGHT?
22 A. YES.
23 Q. NOW, YOU DID THE ASSESSMENT FOR MR. ALLDREDGE, THE
24 NURSING ASSESSMENT, DO YOU HAVE THAT BINDER IN FRONT OF YOU?
25 A. I DO.
1569
1 Q. AND PART OF THAT ASSESSMENT IS TO ASK QUESTIONS ABOUT
2 SOMEBODY'S STATE OF HEALTH AT THE TIME; ISN'T THAT RIGHT?
3 A. YES.
4 Q. AND IT'S TRUE, IS IT NOT, THAT WHEN YOU DID THAT AND YOU
5 ASKED SUCH A QUESTION CONCERNING MR. ALLDREDGE'S HEALTH, YOU
6 WROTE POOR; ISN'T THAT RIGHT?
7 A. WHAT PAGE IS THAT ON?
8 THE COURT: COULD WE GET A PAGE REFERENCE?
9 MR. STIRBA: I'M GETTING IT, YOUR HONOR.
10 Q. (BY MR. STIRBA) IT WOULD BE IN THE NURSES' NOTES
11 SECTION.
12 A. OKAY. RIGHT.
13 Q. AND IT WILL BE MED-00049.
14 A. OKAY. I SEE IT.
15 Q. THE QUESTION WAS ASKED, HOW WOULD YOU DESCRIBE YOUR
16 GENERAL HEALTH, POOR. THAT'S YOUR WRITING; IS THAT RIGHT?
17 A. YES.
18 Q. NOW, YOU DID HAVE OCCASION TO CARE FOR MR. ALLDREDGE; IS
19 THAT RIGHT?
20 A. YES.
21 Q. AND, IN FACT, IN SOME OF YOUR NOTES YOU REFER TO HIS
22 CONDITION, AND SPECIFICALLY IF YOU GO TO MED-0074.
23 A. OKAY.
24 Q. YOU CHART AT 8 O'CLOCK IN THE MORNING AND I'LL JUST READ
25 IT TO YOU, YOU SAY, PATIENT UNRESPONSIVE, FAMILY WITH
1570
1 PATIENT, POSEY AND RESTRAINT TAKEN OFF. I.V. -- I.V.
2 DISCONTINUED, COMFORT MEASURES GIVEN AND THEN YOU HAVE YOUR
3 SIGNATURE. DID I READ THAT CORRECTLY?
4 A. YES.
5 Q. IT'S TRUE, IS IT NOT, THAT THE ENTRY I READ WAS ON 1/13,
6 JANUARY 13 OF 1996 AND YOU HAVE TIME 8 O'CLOCK IN THE
7 MORNING, CORRECT?
8 A. YES.
9 Q. WHAT DID YOU MEAN WHEN YOU SAY "COMFORT MEASURES GIVEN"?
10 A. I COULD HAVE MEANT THAT WE WERE TURNING HIM AND MAKING
11 SURE HE WASN'T GETTING ANY BED SORES, IT COULD HAVE MEANT
12 MEDICATION, IT COULD HAVE MEANT TO MAKE SURE THAT HE
13 WASN'T -- THAT HE WAS BEING TAKEN CARE OF.
14 Q. IT'S TRUE, IS IT NOT, AS OF THE TIME THAT YOU ENTERED
15 THAT NOTE THAT YOU WERE AWARE THAT THERE WERE GOING TO BE NO
16 FURTHER MEDICAL INTERVENTIONS WITH RESPECT TO MR.
17 ALLDREDGE'S CARE OTHER THAN TO KEEP HIM COMFORTABLE; ISN'T
18 THAT CORRECT?
19 A. NO. How could she not? The family decided, and the orders were changed.
20 Q. AND, IN FACT, YOU CERTAINLY WERE AWARE THAT AS OF
21 8 O'CLOCK IN THE MORNING ON THE 13TH THAT HIS I.V. WAS
22 DISCONTINUED; ISN'T THAT CORRECT?
23 A. YES.
24 Q. BECAUSE, IN FACT, YOU WERE THE ONE WHO TOOK HIS I.V.
25 OFF; ISN'T THAT TRUE?
1571
1 A. YES.
2 Q. AND THEN YOU ALSO STATE WITH RESPECT TO THE 13TH, YOU
3 HAVE AFTER THAT IT SAYS, DR. WEITZEL TALKED WITH FAMILY, DR.
4 DIENHART NOTIFIED OF PATIENT'S -- AND THEN YOU HAVE AN ARROW
5 GOING DOWN, MEANING DETERIORATING CONDITION; ISN'T THAT
6 CORRECT?
7 A. YES.
8 Q. AND IT'S TRUE THE REASON WHY YOU CONTACTED OR WANTED DR.
9 DIENHART INVOLVED IS BECAUSE, IN FACT, YOU ASSESSED AS OF
10 THAT DATE AND THAT ENTRY THAT MR. ALLDREDGE'S CONDITION WAS,
11 IN FACT, DETERIORATING; ISN'T THAT TRUE?
12 A. NO. ???
13 Q. IT'S TRUE, IS IT NOT, THAT I READ IT CORRECTLY? DR.
14 WEITZEL TALKED WITH FAMILY. DR. DIENHART NOTIFIED OF
15 PATIENT'S WITH AN ARROW DOWN CONDITION; ISN'T THAT CORRECT?
16 A. YES.
17 Q. SO YOU ADVISED DR. DIENHART OF THE PATIENT'S DECLINING
18 CONDITION; ISN'T THAT TRUE?
19 A. I DID NOTIFY HIM, YES.
20 Q. ARE YOU FAMILIAR WITH THE CONCEPT, HAVE YOU SEEN, FOR
21 EXAMPLE, WHERE PATIENTS AT END OF LIFE THEY GASP FOR BREATH?
22 A. YES.
23 Q. AND IT'S TRUE THAT THAT CAN BE A PARTICULARLY PAINFUL
24 EXPERIENCE AS YOU'VE PERCEIVED IT; ISN'T THAT CORRECT?
25 A. NO. What an answer. It's truly amazing that the jury convicted.
1572
1 MS. BARLOW: YOUR HONOR, I -- WELL.
2 THE COURT: IT'S ASKING HER, WELL, HER BACKGROUND.
3 Q. (BY MR. STIRBA) AND IT'S TRUE, IS IT NOT, THAT THAT
4 WAS ONE OF THE THINGS THAT WAS GOING ON WITH MR. ALLDREDGE
5 THAT YOU, IN FACT, OBSERVED AND ASSESSED; ISN'T THAT RIGHT?
6 A. HE WAS HAVING SOME IRREGULAR RESPIRATIONS.
7 Q. HE WAS HAVING LABORED RESPIRATIONS; ISN'T THAT TRUE?
8 A. I'VE WRITTEN HERE RESPIRATIONS IRREGULAR WITH PERIODS OF
9 APNEA.
10 Q. AND BY IRREGULAR, DID YOU MEAN THAT HE WAS ESSENTIALLY
11 AT TIMES GASPING FOR BREATH?
12 A. NO. I MEANT HIS RESPIRATIONS WERE NOT SEQUENCED.
13 MR. STIRBA: WITHOUT GETTING INTO THE OTHER
14 QUESTION, YOUR HONOR, I'M DONE.
15 THE COURT: OKAY. THEN LADIES AND GENTLEMEN, WHY
16 DON'T WE TAKE OUR OTHER MORNING BREAK AT THIS POINT SO THAT
17 WE CAN DEAL WITH SOME OF THESE OTHER ISSUE AT THIS RECESS.
18 AT THIS RECESS, REMEMBER IT'S YOUR DUTY NOT TO CONVERSE
19 WITH YOURSELVES ABOUT THIS CASE OR CONVERSE WITH ANYONE ELSE
20 ABOUT THE CASE OR EVEN ALLOW YOURSELF TO BE ADDRESSED BY ANY
21 OTHER PERSON ON THE SUBJECT OF THIS TRIAL. IT'S YOUR DUTY
22 NOT TO FORM OR EXPRESS AN OPINION ON THIS CASE UNTIL THIS
23 CASE IS FINALLY SUBMITTED TO YOU AFTER YOU'VE HEARD ALL OF
24 THE EVIDENCE. SO LET'S COME BACK AT 11:15.
25 (WHEREUPON THE JURY WAS EXCUSED.)
1573
1 THE COURT: PLEASE BE SEATED. THE RECORD WILL
2 REFLECT THAT THE JURY HAS LEFT THE COURTROOM. OKAY. GOING
3 BACK, REFRESH MY MEMORY ABOUT THE QUESTION AND THE
4 OBJECTION.
5 MR. STIRBA: YOUR HONOR, THE QUESTION I ASKED TO
6 ASSIST THE COURT, I'LL JUST TELL YOU WHAT THE QUESTION WAS,
7 I ASKED AT THE TIME OF THE ADMINISTRATION OF THE INJECTION
8 AT 2000 HOURS REQUESTED BY THE WITNESS OF MS. LONG AND THE
9 INJECTION AT 2300 HOURS, DID SHE BELIEVE THAT THEY WOULD
10 HAVE CAUSED OR CONTRIBUTED TO MS. CRANE'S DEATH.
11 MS. BARLOW: YOUR HONOR, HE DIDN'T SAY BELIEVE.
12 DID YOU KNOW THAT THEY WOULD CAUSE AND THE CONCERN I HAVE IS
13 I AM NOT --
14 THE COURT: WHAT IF IT'S PHRASED BELIEVE, DOES THAT
15 CHANGE YOUR OBJECTION?
16 MS. BARLOW: I THINK THAT'S STILL A PROBLEM.
17 THE COURT: OKAY. WHAT'S THE OBJECTION?
18 MS. BARLOW: MY OBJECTION IS -- MY OBJECTION IS
19 THAT ALTHOUGH I DON'T THINK THIS WITNESS HAS ANY CRIMINAL
20 LIABILITY FOR GIVING THOSE INJECTIONS, I THINK THAT SHE MAY
21 BE OPENING HERSELF UP TO SOME ALLEGATIONS AND I THINK SHE
22 NEEDS COUNSEL. I THINK SHE NEEDS A CRIMINAL DEFENSE LAWYER
23 TO ADVISE HER WHETHER SHE SHOULD ANSWER THAT UNDER THE FIFTH
24 AMENDMENT OR NOT. LIKE I SAID, WE HAVE NO INTENTION --
25 THE COURT: WELL, SHE CAN MAKE HER OBJECTION, IF
1574
1 THAT'S WHAT SHE WANTS TO DO.
2 MS. BARLOW: WELL, YOUR HONOR, FOR HER TO MAKE THAT
3 OBJECTION IN FRONT OF THE JURY I THINK WOULD BE HIGHLY
4 PREJUDICIAL. AND IF SHE -- AND I DON'T KNOW IF SHE HAS THE
5 BACKGROUND WITHOUT TALKING TO AN ATTORNEY AND I DO -- I
6 MEAN, MR. HARRISON IS HERE ON BEHALF OF THE NURSES AND THE
7 HOSPITAL AND HE COULD PERHAPS --
8 THE COURT: WELL, IF YOU WANT TO TAKE A FIVE-MINUTE
9 BREAK AND ASK THAT IF THEY WANT TO ASSERT THAT. BUT IF
10 THAT'S YOUR ONLY OBJECTION, THAT IT MAY LEAD TO CRIMINAL
11 LIABILITY, THAT'S NOT GOING TO BE A SUFFICIENT GROUND NOT TO
12 HAVE THE QUESTION ASKED AND ANSWERED OR IF SHE MAKES AN
13 OBJECTION THAT SHE WANTS TO STAND ON HER FIFTH AMENDMENT
14 RIGHT --
15 MS. BARLOW: WELL, IF SHE WANTS TO STAND --
16 THE COURT: IF SHE WANTS TO STAND ON HER FIFTH
17 AMENDMENT RIGHT, SHE CAN MAKE THAT IN FRONT OF THE JURY.
18 MS. BARLOW: YOUR HONOR, THAT IS --
19 THE COURT: UNLESS YOU HAVE SOME CASE LAW YOU WANT
20 TO DIRECT ME TO --
21 MS. BARLOW: I WILL FIND IT, YOUR HONOR. YOU
22 CANNOT --
23 THE COURT: WELL, DO IT. GIVE IT TO ME AND LET ME
24 SEE IT. I WILL SAY RIGHT NOW, MR. MAJOR, DO NOT BE
25 SPEAKING -- YOU ARE SPEAKING, MS. BARLOW. LET'S JUST HAVE
1575
1 ONE PERSON SPEAKING PER SIDE, WHOEVER IS DOING THE WITNESS
2 MAKES THE OBJECTION AND WE'RE NOT GOING TO HAVE MUTTERING
3 UNDERNEATH BREATH IN THIS COURTROOM. THIS IS MY LAST
4 WARNING. IF I HEAR IT AGAIN, WHOEVER IS THE OFFENDING PARTY
5 WILL BE REMOVED FROM THE COURTROOM. DOES EVERYBODY
6 UNDERSTAND THAT?
7 MS. BARLOW: CERTAINLY.
8 THE COURT: I WENT OVER THIS LAST WEEK AND I'M
9 MAKING IT ABSOLUTELY CLEAR. I'M NOT GOING TO HEAR -- WHEN
10 I'M MAKING A RULING, I'M NOT GOING TO HEAR SOMEBODY
11 MUTTERING UNDER THEIR BREATH AT COUNSEL TABLE, AND IF IT'S
12 DONE, THE ATTORNEY IS GOING TO BE REMOVED AND WE'RE GOING TO
13 LOOK AT SOMETHING LIKE CALLED CONTEMPT.
14 MS. BARLOW: WE UNDERSTAND.
15 THE COURT: DOES EVERYBODY UNDERSTAND? IT GOES FOR
16 BOTH SIDES BUT IT'S COMING FROM PARTICULARLY ONE SIDE.
17 OKAY. IF YOU WANT TO GIVE ME THAT CASE, GIVE IT TO ME AS
18 QUICKLY AS POSSIBLE SO WE CAN ADDRESS THIS ISSUE.
19 (WHEREUPON A BRIEF RECESS WAS TAKEN.)
20 THE COURT: OKAY. THE RECORD SHOULD REFLECT THAT
21 WE'RE BACK HERE WITHOUT THE JURY. DO I UNDERSTAND -- WHAT
22 IS THE STATUS OF THIS OBJECTION?
23 MS. BARLOW: YOUR HONOR, WE'VE SPOKE WITH THE DAVIS
24 COUNTY ATTORNEY AND WE ARE WITHDRAWING OUR OBJECTION. Apparently given immunity.
25 THE COURT: OKAY. ALL RIGHT. SO THEN LET'S GET --
1576
1 NOTIFY THE JURY THEN TO COME BACK. ARE YOU ABOUT DONE, MR.
2 STIRBA, WITH THIS WITNESS? AND THERE MAY BE SOME REDIRECT,
3 BUT WILL WE GET THIS WITNESS DONE BEFORE NOON DO YOU THINK?
4 MS. BARLOW: I BELIEVE SO.
5 THE COURT: IF YOU HAVE TO GO A LITTLE BIT MORE,
6 WE'LL GO TO FINISH THE WITNESS.
7 (WHEREUPON THE JURY ENTERS THE COURTROOM.)
8 THE COURT: OKAY. PLEASE BE SEATED. THE RECORD
9 WILL REFLECT THAT THE JURY IS BACK AND I THINK, MR. STIRBA,
10 YOU WERE EXAMINING THIS WITNESS?
11 MR. STIRBA: YES. WE WERE, YOUR HONOR, THANK YOU.
12 Q. (BY MR. STIRBA) MS. COZZENS, WOULD YOU TURN TO
13 MED-00290 AGAIN?
14 A. ON MARY?
15 Q. YES.
16 A. 29 WHAT?
17 Q. 290.
18 A. OKAY.
19 Q. NOW, THAT'S THE MEDICATION ADMINISTRATION RECORD AND WE
20 HAVE, OF COURSE, THE 7TH AND WE HAVE AN INDICATION OF
21 MORPHINE 5 MILLIGRAMS I.M. Q 3 AND THE ONE HAS YOUR INITIALS
22 OF 2000 HOURS AND THEN YOU PUT YOUR -- IT SAYS GIVEN, DO YOU
23 SEE THAT?
24 A. I DO.
25 Q. AND THAT'S THE INJECTION THAT YOU ASKED MS. LONG TO
1577
1 GIVE; IS THAT RIGHT?
2 A. SHE TOLD ME SHE -- SHE WOULD GIVE IT. I DIDN'T ASK HER.
3 Q. OKAY. YOU DID NOT ASK HER AND ELICIT HER SUPPORT IN
4 GIVING THAT INJECTION?
5 A. NO.
6 Q. DID YOU BELIEVE AT THE TIME THAT THAT INJECTION WAS
7 GIVEN THAT THAT INJECTION WAS GOING TO CAUSE OR CONTRIBUTE
8 TO THE DEATH OF MARY CRANE?
9 A. I DIDN'T KNOW WHETHER IT WOULD OR NOT, THAT'S WHY I
10 QUESTIONED IT.
11 Q. THE PARTICULAR INJECTION ON 2300 WITH YOUR INITIALS,
12 YOU, IN FACT, GAVE THAT; ISN'T THAT RIGHT?
13 A. YES.
14 Q. DID YOU BELIEVE AT THE TIME OF THAT PARTICULAR INJECTION
15 THAT IT WOULD HAVE CAUSED OR CONTRIBUTED TO HER DEATH?
16 A. I DIDN'T KNOW WHETHER IT WOULD OR NOT.
17 Q. YOU RECALL, MA'AM, THAT YOU WERE DEPOSED IN A RELATED
18 MATTER; THAT IS, TAKE YOUR DEPOSITION ON SEPTEMBER 28TH OF
19 1999?
20 MS. BARLOW: OBJECTION, YOUR HONOR, THAT IS
21 MATERIAL THAT HAS BEEN SUPPRESSED BY THIS COURT.
22 THE COURT: WELL...
23 MR. STIRBA: I'M IMPEACHING.
24 THE COURT: THIS IS IMPEACHING THE WITNESS. HE'S
25 USING IT TO IMPEACH A WITNESS.
1578
1 MS. BARLOW: WELL, WE CAN DISCUSS IT LATER. THANK
2 YOU, YOUR HONOR.
3 Q. (BY MR. STIRBA) DO YOU RECALL THAT YOU HAD YOUR
4 DEPOSITION TAKEN ON THAT DAY?
5 A. I REMEMBER GIVING A DEPOSITION, YES.
6 Q. AND DO YOU RECALL AT THAT TIME THAT YOU WERE UNDER OATH;
7 IS THAT RIGHT?
8 A. YES.
9 Q. AND YOU WERE ASKED CERTAIN QUESTIONS AT THAT TIME?
10 A. YES.
11 MR. STIRBA: MAY I APPROACH, YOUR HONOR?
12 THE COURT: YES.
13 Q. (BY MR. STIRBA) GOING TO HAVE TO LEAN OVER. I'M GOING
14 TO ASK YOU IF AT THAT TIME WHEN YOU WERE UNDER OATH IF THESE
15 QUESTIONS WERE GIVEN AND THESE WERE YOUR ANSWERS AND I'LL
16 DIRECT YOUR ATTENTION TO PAGE 77, LINE SIX.
17 "QUESTION: AND THIS WOULD HAVE BEEN MORPHINE THAT HAD
18 BEEN GIVEN TO MARY CRANE. DO YOU HAVE ANY INDEPENDENT
19 RECOLLECTION OF ADMINISTERING THESE MORPHINE INJECTIONS TO
20 MS. CRANE?
21 "ANSWER, NO.
22 "QUESTION: WHEN YOU ADMINISTERED THESE PARTICULAR
23 INJECTIONS, DID YOU BELIEVE THAT THEY WOULD HAVE CAUSED OR
24 CONTRIBUTED TO HER DEATH?
25 "ANSWER: NO."
1579
1 WERE THOSE QUESTIONS GIVEN AND WERE THOSE YOUR ANSWERS
2 AT THAT TIME?
3 A. YES.
4 Q. DIRECT YOUR ATTENTION TO PAGE 79 OF THE DEPOSITION, LINE
5 18 -- OR 17, RATHER.
6 "QUESTION: OKAY. THEN IT ALSO HAS UNDER MEDICATION
7 DOSE, ROUTE OF ADMINISTRATION, ONCE AGAIN M.S. 5 MILLIGRAMS
8 I.M. AND IT APPEARS TO BE THE DATE IT LOOKS LIKE 1/7/96,
9 TIME 2000. AND THEN IT HAS I.M. AND THEN, ONCE AGAIN, ARE
10 THOSE YOUR INITIALS?
11 "ANSWER: YES.
12 "AND IS THAT YOUR WRITING FOR THAT ENTRY?
13 "ANSWER: YES.
14 "AND, ONCE AGAIN, WHEN YOU ADMINISTERED THAT INJECTION
15 TO MS. CRANE, DID YOU BELIEVE IT WOULD CONTRIBUTE OR CAUSE
16 HER DEATH?
17 "ANSWER: NO."
18 WERE THOSE QUESTIONS PUT TO YOU IN THAT DEPOSITION AND
19 WERE THOSE YOUR ANSWERS GIVEN AT THAT TIME?
20 A. THEY WERE.
21 MR. STIRBA: THAT'S ALL I HAVE, YOUR HONOR.
22 THE COURT: OKAY. ANY REDIRECT?
23 MS. BARLOW: YES, YOUR HONOR.
24 REDIRECT EXAMINATION
25 BY MS. BARLOW:
1580
1 Q. IF YOU WOULD TURN TO LYDIA SMITH TO 811 WHICH I BELIEVE
2 COUNSEL SHOWED TO YOU. DO YOU HAVE THAT IN FRONT OF YOU?
3 A. I DO.
4 Q. WE'VE INDICATED THAT YOU SIGNED IT AT THE BOTTOM?
5 A. YES.
6 Q. DID YOU FILL IN THE DATE 1/7/96?
7 A. YES.
8 Q. WERE YOU PRESENT WHEN DR. WEITZEL SIGNED THIS?
9 A. I THINK I WAS.
10 Q. YOU NOTICE THAT THE PATIENT'S NAME IS NOT ENTERED, THE
11 DATE IS NOT ENTERED; IS THAT CORRECT?
12 A. YES.
13 Q. WHOSE RESPONSIBILITY WAS IT TO ENTER THAT MATERIAL?
14 A. DR. WEITZEL.
15 Q. THEN IT SAYS, I, R. WEITZEL, M.D., CERTIFIED THAT I AM
16 THE ATTENDING PHYSICIAN FOR THE PATIENT LISTED ABOVE. THE
17 DECLARANT, THE ABOVE-NAMED PATIENT IS CURRENTLY SUFFERING
18 FROM THE FOLLOWING DISEASE OR ILLNESS, AND THAT'S LEFT
19 BLANK; IS THAT CORRECT?
20 A. YES.
21 Q. WHOSE OBLIGATION WAS IT TO FILL THAT OUT?
22 A. THE DOCTOR.
23 Q. I CERTIFY I'VE EXPLAINED TO THE DECLARANT TO THE EXTENT
24 HE OR SHE IS ABLE TO UNDERSTAND AND TO ALL AVAILABLE PERSONS
25 ACTING AS PROXY THE REASONABLE AVAILABLE ALTERNATIVES FOR
1581
1 CARE AND TREATMENT. I CERTIFY THAT THE CARE AND TREATMENT
2 ALTERNATIVES DIRECTED BELOW ARE, AND IT'S EITHER DIRECTED BY
3 THE DECLARANT OR THAT THE DECLARANT HAS A PHYSICAL OR MENTAL
4 CONDITION THAT RENDERS HIM OR HER UNABLE TO GIVE PERSONAL
5 DIRECTION AND THERE'S BASICALLY A BOX THERE. IS THERE ANY
6 OBLIGATION TO CHECK ONE OF THOSE BOXES?
7 A. THEY SHOULD HAVE BEEN CHECKED, YES.
8 Q. AND WHOSE OBLIGATION WAS THAT?
9 A. DR. WEITZEL.
10 Q. WHILE WE HAVE THAT ONE, I BELIEVE COUNSEL ASKED YOU SOME
11 QUESTIONS AND I BELIEVE HE SAID THAT LYDIA SMITH HAD NOT
12 BEEN EATING. DO YOU HAVE ANY PERSONAL RECOLLECTION OF THAT?
13 A. SHE WOULD EAT AT SOMETIMES BUT LOTS OF TIMES SHE
14 WOULDN'T.
15 Q. SO IF WE WERE TO SAY SHE HAD NOT EATEN FOR WEEKS BEFORE
16 THAT, WOULD THAT BE CORRECT OR INCORRECT?
17 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT,
18 LEADING AND SUGGESTIVE, THIS IS REDIRECT.
19 THE COURT: I GUESS THE PROBLEM I HAVE IS WEEKS
20 BEFORE WHAT? THE TIME PERIOD THE --
21 MS. BARLOW: THE QUESTION -- EXCUSE ME. THE
22 QUESTION MR. STIRBA ASKED WAS THAT SHE HAD NOT BEEN EATING
23 FOR MONTHS, I THINK IS WHAT HE SAID BEFORE THAT.
24 MR. STIRBA: YOUR HONOR, THAT MISCHARACTERIZES THE
25 QUESTION. IT IS WHAT IT IS. I ASKED ABOUT HER WEIGHT LOSS.
1582
1 THE COURT: MY COMMENT IS JUST, WHAT TIME PERIOD
2 ARE YOU TALKING ABOUT? WEEKS BEFORE WHAT?
3 Q. (BY MS. BARLOW) THE TIME PERIOD THAT YOU SAW BEFORE
4 YOU SAW HER IN THE HOSPITAL, WHAT WERE HER EATING HABITS?
5 A. SOMETIMES SHE WOULD EAT AND SOMETIMES SHE WOULDN'T.
6 Q. DO YOU HAVE ANY PERSONAL RECOLLECTION AS TO WHETHER SHE
7 LOST WEIGHT WHILE SHE WAS AT DAVIS NORTH?
8 A. I DON'T RECALL.
9 Q. AND THEN COUNSEL ASKED YOU SPECIFICALLY POINTING OUT
10 I.V. FLUIDS AND NASAL GASTRIC TUBE I -- WELL, MAYBE HE
11 DIDN'T DO THAT, BUT I.V. FLUIDS AS A WAY OF GIVING
12 NOURISHMENT, DO YOU RECALL THAT?
13 A. YES.
14 Q. DID YOU EVER ASK FOR I.V. FLUIDS OR A NASAL GASTRIC TUBE
15 OR ANYTHING BE GIVEN TO MS. SMITH?
16 A. I DID QUESTION WHY WE WEREN'T GIVING HER AN I.V. SHE
17 WAS VERY DEHYDRATED.
18 Q. AND WHOM DID YOU QUESTION?
19 A. I QUESTIONED DR. WEITZEL.
20 Q. AND WHAT DID HE SAY?
21 THE COURT: WELL, CAN WE HAVE FOUNDATION?
22 Q. (BY MS. BARLOW) WHEN DID YOU QUESTION HIM?
23 A. IT WAS THAT DAY WHEN HE CAME IN ON THE 7TH.
24 JANUARY 7TH, I'M SORRY.
25 Q. WHO ELSE WAS PRESENT?
1583
1 A. I DON'T RECALL.
2 Q. OKAY. WHAT DID HE SAY?
3 MR. STIRBA: I'M GOING TO OBJECT. SAME OBJECTION I
4 HAD EARLIER, YOUR HONOR.
5 THE COURT: OVERRULED.
6 Q. (BY MS. BARLOW) WHAT DID HE SAY?
7 A. HE JUST ORDERED THE MORPHINE AND HE DIDN'T ORDER ANY
8 I.V. FLUIDS. Advance Directive: No IV fluids. Go to>>
9 Q. IF YOU WOULD TURN TO MARY CRANE NUMBER 341. AGAIN, THIS
10 IS ONE THAT YOU SIGNED AS THE FACILITY REPRESENTATIVE; IS
11 THAT CORRECT? 341.
12 A. I'M SORRY. MUST HAVE THE...YES.
13 Q. AND WHO SIGNED IT?
14 A. MYSELF AND DR. WEITZEL.
15 Q. SO HE SIGNED AS ATTENDING PHYSICIAN?
16 A. DR. WEITZEL.
17 Q. IS THERE ANYTHING ELSE FILLED OUT IN THAT TOP PART?
18 A. NO.
19 Q. WHOSE OBLIGATION IS THAT TO FILL OUT?
20 A. DR. WEITZEL.
21 Q. WELL -- AND THEN THIS IS WITH MARY CRANE AND WE'RE
22 TALKING THE FISTULA AND THE POSSIBILITY OF SURGERY AND THE
23 FAMILY HAD MARKED, NO SURGERY, ADVISE FAMILY; IS THAT
24 CORRECT?
25 A. YES.
1584
1 Q. COUNSEL ASKED YOU ON MR. ALLDREDGE ABOUT HIS BREATHING
2 AND THEN COUNSEL ASKED YOU ABOUT GASPING FOR BREATH AND
3 WHETHER THAT CAN BE PAINFUL, DO YOU RECALL THAT?
4 A. I DO RECALL HIM ASKING, YES.
5 Q. DO PEOPLE GASP FOR BREATH AT THE END OF THEIR LIVES?
6 A. THEY WILL HAVE PERIODS WHERE THEY DON'T BREATHE AND THEN
7 PERIODS WHERE THEY ARE BREATHING BUT AS FAR AS GASPING, YOU
8 KNOW, UNLESS THEIR LUNGS ARE FULL OF FLUID...I DON'T RECALL
9 HIM GASPING FOR BREATH SPECIFICALLY.
10 Q. ARE YOU FAMILIAR WITH WHAT MORPHINE DOES TO THE
11 RESPIRATORY SYSTEM?
12 A. IT DEPRESSES --
13 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT.
14 MS. BARLOW: YOUR HONOR, I THINK IT FALLS --
15 MR. STIRBA: -- IT'S BEYOND THE SCOPE OF THIS
16 PERSON'S COMPETENCY.
17 THE COURT: WELL, YOU CAN ASK HER UNDERSTANDING. I
18 DON'T KNOW IF YOU HAVE QUALIFIED HER TO GIVE THAT, SO IF YOU
19 WANT TO LAY -- ASK HER HER UNDERSTANDING.
20 MS. BARLOW: I THINK -- I THOUGHT THAT'S WHAT I
21 ASKED.
22
23 Q. (BY MS. BARLOW) BUT WHAT WAS YOUR UNDERSTANDING ABOUT
24 WHAT -- DO YOU HAVE AN UNDERSTANDING OF WHAT MORPHINE DOES
25 TO THE RESPIRATORY SYSTEM, JUST YES OR NO?
1585
1 A. YES.
2 Q. AND WHAT IS THAT UNDERSTANDING BASED ON?
3 A. EXPERIENCE AND SCHOOLING AND THE EDUCATION THAT I'VE
4 HAD.
5 Q. AND BASED ON THAT, WHAT DOES MORPHINE DO TO THE
6 RESPIRATORY SYSTEM?
7 THE COURT: WHAT IS HER UNDERSTANDING?
8 Q. (BY MS. BARLOW) WHAT IS YOUR UNDERSTANDING OF WHAT
9 MORPHINE DOES TO THE RESPIRATORY SYSTEM?
10 A. IT CAN DEPRESS THE RESPIRATORY SYSTEM.
11 Q. WHAT DOES IT MEAN TO DEPRESS THE RESPIRATORY SYSTEM?
12 A. THE PATIENT DOESN'T BREATHE AS DEEP, THEY DON'T BREATHE
13 AS OFTEN, THEY DON'T GET AS MUCH OXYGEN.
14 Q. AND WHAT SIGNS AND SYMPTOMS DO YOU LOOK FOR AS A NURSE
15 TO SEE IF THAT MIGHT BE HAPPENING?
16 A. DECREASED RESPIRATIONS, CYANOTIC COLOR, THAT BLUISH
17 COLOR THAT SOME PEOPLE GET WHEN THEY ARE NOT GETTING ENOUGH
18 OXYGEN, SHALLOWER RESPIRATIONS THAT AREN'T AS DEEP.
19 MS. BARLOW: THAT'S ALL I HAVE, YOUR HONOR.
20 THE COURT: ANYTHING FURTHER?
21 MR. STIRBA: YES.
22 RECROSS-EXAMINATION
23 BY MR. STIRBA:
24 Q. AND YOU TESTIFIED PREVIOUSLY YOU AGREE THAT A NURSE IS
25 TO DO NO HARM; IS THAT RIGHT?
1586
1 A. YES.
2 Q. AND YOU CERTAINLY KNOW THAT WHEN YOU GIVE MORPHINE YOU
3 HAVE CERTAIN RESPONSIBILITIES AS A NURSE TO MONITOR THE
4 EFFECTS OF THAT DRUG, CORRECT?
5 A. YES.
6 Q. IN OTHER WORDS, ONE OF THE THINGS YOU NEED TO DO AS A
7 NURSE OUT OF CONCERNS ABOUT RESPIRATION DEPRESSION IS TO
8 MONITOR THE RESPIRATION RATE BEFORE YOU GIVE THE DRUG; ISN'T
9 THAT TRUE?
10 A. THAT'S TRUE.
11 Q. AND IT'S ALSO TRUE THAT YOU OUGHT TO DO THAT AFTER TO
12 MAKE SURE THERE'S NOT ADVERSE CONSEQUENCE TO THE PATIENT,
13 TRUE?
14 A. YOU DO THAT, YES.
15 Q. AND IT'S TRUE, IS IT NOT, THAT IF THERE'S ANY CONCERN
16 THAT YOU HAVE AS A NURSE ABOUT SOMEBODY'S RESPIRATORY STATUS
17 BEFORE YOU GIVE THEM MORPHINE, YOU SHOULDN'T GIVE THEM THE
18 DRUG; ISN'T THAT TRUE?
19 A. AND I DID THAT.
20 Q. AND IT'S TRUE, IS IT NOT, THAT MORPHINE IS, IN FACT,
21 GIVEN FOR PEOPLE WHO ARE GASPING FOR BREATH AT THEIR END OF
22 LIFE, ARE YOU AWARE OF THAT?
23 MS. BARLOW: YOUR HONOR, I THINK WE NEED FOUNDATION
24 WHETHER SHE KNOWS THAT.
25 THE COURT: WELL, HE'S ASKING IF SHE'S AWARE OF IT.
1587
1 OVERRULED.
2 MR. STIRBA: WELL, I'M ASKING HER.
3 THE WITNESS: GO AHEAD AND ASK IT AGAIN.
4 Q. (BY MR. STIRBA) SURE. YOU UNDERSTAND THAT MORPHINE
5 IS, IN FACT, A DRUG THAT IS GIVEN FREQUENTLY FOR PEOPLE WHO
6 ARE GASPING FOR BREATH AT THE END OF THEIR LIFE, ARE YOU
7 AWARE OF THAT?
8 A. I THOUGHT IT WAS GIVEN FOR PAIN.
9 Q. SO YOUR ANSWER IS, YES, YOU ARE AWARE OF IT OR, NO, YOU
10 ARE NOT AWARE OF IT?
11 A. I WASN'T AWARE IT WAS GIVEN FOR GASPING.
12 Q. HAVE YOU EVER HEARD OF THE TERM OF DYSPNEA?
13 A. YES.
14 Q. DO YOU KNOW WHAT DYSPNEA IS, IT'S GASPING FOR BREATH,
15 ISN'T IT?
16 A. I'M NOT AWARE OF -- I'VE HEARD OF THE TERM. I'M NOT
17 QUITE SURE WHAT...I HAVEN'T USED THAT TERM IN MY CHARTING.
18 Q. NOW, YOU TESTIFIED ABOUT THE SMITH FAMILY AND FEEDING
19 AND THERE WAS AN ASSESSMENT DONE AND I JUST WANT TO -- IT'S
20 REALLY NOT NECESSARY --
21 A. DO YOU WANT TO GIVE ME A PAGE NUMBER?
22 Q. NO, I REALLY DON'T BECAUSE I WANT TO GET THROUGH THIS
23 AND I THINK IT'S FAIRLY EASY.
24 A. OKAY.
25 Q. BUT HERE IS THE NURSING ASSESSMENT FORM AND IT SAYS,
1588
1 FAMILY STATES, PLEASE DON'T FORCE.
2 A. THIS IS ON MARY?
3 Q. THAT'S ON --
4 A. LYDIA?
5 Q. LYDIA SMITH. DID I READ THAT CORRECTLY?
6 THE COURT: WELL, EITHER GIVE THE WITNESS THE PAGE
7 OR IF THE WITNESS WANTS TO GO TO THE --
8 MR. STIRBA: YEAH, SURE.
9 Q. (BY MR. STIRBA) HERE, I'M REFERRING TO THIS ENTRY
10 RIGHT HERE.
11 A. I REALLY CAN'T SEE.
12 Q. CAN YOU SEE IT IF YOU APPROACH IT? THIS ONE RIGHT HERE,
13 FAMILY STATES, PLEASE DON'T FORCE.
14 A. OKAY.
15 Q. DID I READ THAT CORRECTLY?
16 A. LIKE I SAY, IT'S KIND OF BLURRY BUT...
17 Q. YES OR NO?
18 A. UM...
19 Q. ALL RIGHT. I'LL GIVE YOU THE MED NUMBER.
20 A. THAT WOULD BE GOOD. SORRY.
21 Q. 00750.
22 A. AND THIS IS ON LYDIA?
23 Q. YES.
24 A. FAMILY STATES PLEASE DON'T FORCE. YES.
25 Q. AND THEN IF YOU'LL GO TO 7748, WHICH IS RIGHT NEARBY.
1589
1 DO YOU HAVE THAT IN FRONT OF YOU?
2 A. I DO.
3 Q. IT SAYS RIGHT HERE UNDER FOOD, DISLIKES RESTRICTIONS IT
4 SAYS, CHANGE DRAMATICALLY LAST FOUR WEEK. THEN IT GOES ON
5 TO SAY I THINK MEAT AND POTATOES, SALAD AND FRUIT. AND THEN
6 UNDERNEATH THERE IT SAYS RECENT WEIGHT CHANGES IT HAS CHECK
7 FOR LOSS 30 POUNDS, DO YOU SEE THAT?
8 A. YES.
9 Q. SO IT'S 30 POUNDS IN THE LAST YEAR?
10 A. YES.
11 Q. ALL RIGHT.
12 MR. STIRBA: THAT'S ALL I HAVE. THANK YOU.
13 THE COURT: ANYTHING FURTHER, MS. BARLOW?
14 MS. BARLOW: NO, YOUR HONOR.
15 THE COURT: MAY THIS WITNESS BE EXCUSED?
16 MS. BARLOW: YOUR HONOR, WE'D LIKE TO KEEP HER
17 UNDER SUBPOENA.
18 THE COURT: OKAY. ALL RIGHT.