Surrebuttal - Robert Rothfeder, MD
7 ROBERT KEITH ROTHFEDER,
8 CALLED BY THE DEFENDANT, HAVING BEEN DULY
9 SWORN, WAS EXAMINED AND TESTIFIED AS FOLLOWS:
10 DIRECT EXAMINATION
11 BY MR. STIRBA:
12 Q. I'LL REMIND YOU, YOU ARE STILL UNDER OATH.
13 A. I UNDERSTAND.
14 Q. YOU REVIEWED THE RECORDS FOR ELLEN ANDERSON. YOU
15 PREVIOUSLY TESTIFIED CONCERNING A PULMONARY COMPLICATION?
16 A. THAT'S CORRECT.
17 Q. WHICH YOU OBSERVED BASED UPON YOUR REVIEW OF THE
18 RECORDS?
19 A. THAT'S CORRECT.
20 Q. BRIEFLY JUST TELL US WHAT YOU FOUND.
21 A. WELL, AT AUTOPSY THE PATIENT WAS FOUND TO HAVE PNEUMONIA
22 PRESENT. IN REVIEWING THE MEDICAL RECORDS PRECEDING THAT
23 THERE WAS AN INFILTRATE SHADOW OR DENSITY ON THE CHEST
24 X-RAY, BOTH ON THE CHEST X-RAY TAKEN DURING THE
25 HOSPITALIZATION AND ONE TAKEN MAYBE FOUR OR SIX WEEKS PRIOR.
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1 I BELIEVE IT WAS IN NOVEMBER. THAT SHOWED -- THAT SHOWED
2 THE SAME DENSITY. IT WAS MY CONCLUSION THAT THAT SHADOW ON
3 THE CHEST X-RAY REPRESENTED A PNEUMONIA THAT HAD BEEN
4 PRESENT SINCE AT LEAST THE TIME OF THAT FIRST CHEST X-RAY
5 THAT I REFERENCED.
6 Q. DO YOU HAVE AN OPINION AS TO WHETHER OR NOT THE
7 PNEUMONIA WHICH YOU OBSERVED COULD HAVE STARTED UPON HER
8 ADMISSION AT THE HOSPITAL AND INCREASED TO THE INFECTION
9 WHICH WAS INDICATED IN THE CHEST X-RAY AT FIVE A.M.?
10 A. I DO.
11 Q. AND WHAT IS YOUR OPINION?
12 A. I DON'T BELIEVE THAT WAS THE CASE.
13 Q. WHY IS THAT?
14 A. PNEUMONIA JUST SIMPLY IS NOT GOING TO DEVELOP OVER THAT
15 SHORT A PERIOD OF TIME, IN MY OPINION. THE DISEASE PROCESS
16 IS GOING TO TAKE A LONGER PERIOD OF TIME.
17 Q. DOCTOR, IS THERE A WAY THAT YOU CAN TEST FOR KIDNEY
18 FUNCTION?
19 MR. MAJOR: OBJECTION, YOUR HONOR. I DON'T THINK
20 HE HAS QUALIFICATIONS TO REPLY TO THAT.
21 THE COURT: DO YOU WANT TO LAY A FOUNDATION?
22 Q. (BY MR. STIRBA) DOCTOR, IN YOUR PRACTICE OF MEDICINE
23 HAVE YOU HAD OCCASION TO TEST OR PERFORM CERTAIN TESTS,
24 DIAGNOSTIC, FOR KIDNEY FUNCTION?
25 A. TENS OF THOUSANDS OF TIMES PROBABLY.
4243
1 Q. AND GENERALLY WHAT DOES THAT TEST ENTAIL?
2 A. THAT INVOLVES BASICALLY DOING BLOOD TESTS WHICH MEASURE
3 THE LEVEL OF SUBSTANCES CONTAINING NITROGEN WHICH THE
4 KIDNEYS ELIMINATE FROM THE BODY. THE NAMES OF THOSE
5 SUBSTANCES ARE THE B.U.N., OR BLOOD UREA NITROGEN, AND THE
6 CREATININE SPECIFICALLY.
7 Q. AND HOW ARE THOSE SUBSTANCES RELEVANT TO A DETERMINATION
8 OF KIDNEY FUNCTION?
9 A. THERE'S A RANGE OF NORMAL FOR THOSE SUBSTANCES IN THE
10 BLOOD WHEN THE KIDNEYS ARE FUNCTIONING NORMALLY, WHEN THE
11 KIDNEYS ARE CLEARING THOSE NITROGEN CONTAINING COMPOUNDS
12 FROM THE BLOOD. WHEN THE KIDNEYS BEGIN TO FAIL AND DON'T
13 FUNCTION PROPERLY, THE LEVEL OF THOSE CHEMICALS WHICH THE
14 KIDNEYS ELIMINATE GOES UP AND THE LEVEL TO WHICH THEY RISE
15 INDICATES THE DEGREE OF DYSFUNCTION OF THE KIDNEY.
16 Q. WERE TESTS SUCH AS YOU JUST DESCRIBED PERFORMED ON THE
17 PATIENTS INVOLVED IN THIS CASE?
18 A. I BELIEVE THEY WERE PERFORMED ON ALL OF THE PATIENTS IN
19 THIS CASE, TO MY RECOLLECTION.
20 Q. AND WHAT KIND OF TESTS ARE THEY AGAIN?
21 A. THERE'S A B.U.N., BLOOD UREA NITROGEN, AND CREATININE.
22 THOSE ARE PART OF THE USUAL CHEMISTRY PANEL THAT'S PERFORMED
23 ROUTINELY ON HOSPITALIZED PATIENTS.
24 Q. AND BASED UPON YOUR REVIEW OF THOSE SPECIFIC TESTS
25 CONCERNING THESE SPECIFIC PATIENTS, DO YOU HAVE AN OPINION
4244
1 AS TO THE DEGREE OF KIDNEY FUNCTIONING CONCERNING THESE
2 PARTICULAR PATIENTS?
3 A. I DO.
4 Q. WITH THE EXCEPTION OF -- AND I BELIEVE IT WAS MARY
5 CRANE, THE PATIENT WHO ULTIMATELY DEVELOPED SEPSIS AND WHO
6 HAD AN ELEVATION OF THOSE CHEMICALS FROM KIDNEY FAILURE AS
7 AN IMMEDIATE PRETERMINAL EVENT?
8 A. THE MEASURABLE KIDNEY FUNCTION ON ALL OF THE PATIENTS,
9 INCLUDING MARY PRIOR TO HER DEMISE, WAS NORMAL.
10 Q. NOW, YOU TESTIFIED PREVIOUSLY CONCERNING MR. ALLDREDGE
11 AND WHAT YOU IDENTIFIED AS A FORM OF CANCER OR LYMPHOMA. DO
12 YOU RECALL THAT?
13 A. MYCOSIS FUNGOIDES WAS THE TERM AND I BELIEVE I TESTIFIED
14 THAT THAT WAS A RELATIVELY RARE TYPE OF SYSTEMIC DISEASE.
15 Q. BASED UPON YOUR REVIEW OF HIS PARTICULAR RECORD, DO YOU
16 HAVE AN OPINION AS TO WHETHER OR NOT THAT PARTICULAR DISEASE
17 PROCESS HAD BEEN CURED OR RESOLVED AT THE TIME OF HIS DEATH?
18 A. WELL, THE MEDICAL RECORDS CERTAINLY INDICATED THAT IT
19 HAD NOT BEEN RESOLVED. AND IN FACT I BELIEVE DR. DIENHART,
20 IF THAT'S THE CORRECT PRONUNCIATION, NOTED THAT THAT
21 CONDITION WAS END STAGE AS ONE OF HIS MAJOR DIAGNOSES.
22 MR. STIRBA: THANK YOU. THAT'S ALL I HAVE.
23 THE COURT: MR. MAJOR.
24 CROSS-EXAMINATION
25 BY MR. MAJOR:
4245
1 Q. DOCTOR, YOUR INDICATION IS THAT -- YOU ARE AWARE, ARE
2 YOU NOT, THAT THE X-RAY TAKEN BY DR. KELLER INDICATED
3 INFILTRATE OR POSSIBLE PROBLEM WITH BREATHING IN BOTH OF
4 MARY -- ELLEN ANDERSON'S LUNGS ON NOVEMBER 18?
5 A. THAT'S CORRECT.
6 Q. YOU ARE ALSO AWARE, ARE YOU NOT, THAT THE AUTOPSY
7 PERFORMED BY DR. GRAY SHOWED THERE WAS ONLY THE PNEUMONIA IN
8 THE ONE LUNG?
9 A. THAT'S CORRECT.
10 Q. THANK YOU. NOW, YOU ALSO INDICATED, DOCTOR, THAT YOU
11 HAD A CHANCE TO REVIEW THE MEDICAL RECORDS ON SOME OF THESE
12 PATIENTS ON B.U.N., I BELIEVE YOU CALLED IT; IS THAT
13 CORRECT?
14 A. THAT'S RIGHT.
15 Q. AND THAT'S WHAT? WHAT DOES THAT STAND FOR?
16 A. THAT STANDS FOR BLOOD UREA NITROGEN.
17 Q. DO YOU HAVE ENNIS ALLDREDGE'S FILE THERE?
18 A. I DO.
19 Q. PLEASE TURN TO PAGE 0023.
20 A. GIVE ME A MINUTE. UNDER WHICH TAB WOULD THAT BE, MR.
21 MAJOR?
22 Q. PARDON?
23 A. WHICH TAB WOULD THAT BE UNDER?
24 Q. I BELIEVE THAT'S UNDER LABS.
25 A. OKAY. 0023. ALL RIGHT.
4246
1 Q. AND YOU RECOGNIZE THAT AS BEING BLOOD WORK OFF THE LAB
2 TEST THAT WAS DONE ON ENNIS ALLDREDGE?
3 A. THAT'S CORRECT.
4 Q. AND BASED ON THIS LAB RESULT THEY INDICATE THAT THE
5 B.U.N., OR THE BLOOD UREA NITROGEN, IS SIX WITH A RANGE UP
6 TO 20; IS THAT CORRECT?
7 A. THE NORMAL IS BETWEEN SIX AND 20, THAT'S CORRECT.
8 Q. THAT IS CORRECT. AND YOU AGREE WITH THAT, THAT WOULD BE
9 THE NORMAL RANGE?
10 A. IT CAN VARY FROM LAB TO LAB, BUT I WOULD AGREE THAT THAT
11 IS A TYPICAL NORMAL RANGE, THAT'S CORRECT.
12 Q. YOU ALSO INDICATED THAT THE TEST THAT WAS DONE ON ENNIS
13 ALLDREDGE ON THE 13TH OF JANUARY, 1996, SHOWS THAT HE HAS A
14 B.U.N. OF 22?
15 A. THAT'S CORRECT.
16 Q. AND IT ALSO SHOWS AS BEING HIGH, DOESN'T IT, BASED ON
17 THE MEDICAL RECORD?
18 A. THAT'S MINIMAL ELEVATED, THAT'S CORRECT.
19 Q. BUT THEY HAVE AN "H" WHICH STANDS FOR HIGH?
20 A. THE COMPUTER PRINTS THAT "H", THAT'S CORRECT.
21 Q. NOW, DOCTOR, WILL YOU TURN TO PAGE 0007. I BELIEVE THIS
22 IS UNDER THE ONE MARKED CONSULTATION.
23 A. ON MR. ALLDREDGE?
24 Q. ON MR. ALLDREDGE.
25 A. ALL RIGHT.
4247
1 Q. AND 0007 IS THE REPORT OF THE CONSULTATION DONE BY DR.
2 DIENHART; IS THAT CORRECT?
3 A. CORRECT.
4 Q. AND THIS IS WHERE YOU INDICATED THAT HE HAD THE SKIN
5 CANCER THAT YOU INDICATED WAS END STAGE; IS THAT CORRECT?
6 A. CORRECT.
7 Q. BUT IF YOU TURN OVER TO PAGE 0009 AND THE CONSULTATION
8 NUMBER SEVEN HISTORY OF MYCOSIS FUNGOIDES, UNKNOWN STAGE,
9 THE STATUS IS POST-THERAPY WITH TOTAL BODY RADIATION; IS
10 THAT CORRECT?
11 A. THAT'S CORRECT.
12 Q. SO AT THAT POINT IN TIME DR. DIENHART IS SAYING THAT
13 IT'S AN UNKNOWN STAGE OF CANCER; IS THAT CORRECT?
14 A. IT'S NOT CLEAR TO ME WHAT HE'S REFERENCING THERE.
15 Q. OKAY. OBVIOUSLY HE'S NOT REFERENCING THAT IT'S END
16 STAGE?
17 A. WELL, IT WOULD APPEAR THAT THERE WOULD BE AN
18 INCONSISTENCY FROM THAT TO THE EARLIER STAGE OF THE REPORT.
19 HOWEVER --
20 Q. LET ME ASK YOU THIS. PLEASE TURN TO PAGE OO11.
21 A. OKAY.
22 Q. AND ON THE RIGHT SIDE OF THAT ABOUT, I GUESS, A THIRD OF
23 THE WAY DOWN, DR. DIENHART BEGINS TO LIST SOME OTHER THINGS
24 IN THE PROGRESS NOTE; IS THAT CORRECT?
25 A. THAT'S CORRECT.
4248
1 Q. AND SEE WHERE IT STARTS, I BELIEVE THAT'S MYCOSIS
2 FUNGOIDES, ABOUT ONE, TWO, THREE, FOUR, FIVE, SIX, SEVEN,
3 EIGHT, NINE, TEN, 11, ABOUT THE 11TH LINE DOWN. DO YOU FIND
4 THAT REFERENCE?
5 A. I DO.
6 Q. AND THAT ALSO INDICATES THAT THE MYCOSIS FUNGOIDES IS AT
7 UNKNOWN STAGE; IS THAT CORRECT?
8 A. THAT'S WHAT THE WRITING SAYS, THAT'S CORRECT.
9 Q. AND WERE YOU AWARE THAT VONDA ALLDREDGE TESTIFIED ON THE
10 STAND ABOUT --
11 MR. STIRBA: I WOULD OBJECT, YOUR HONOR.
12 THE COURT: SUSTAINED.
13 Q. (BY MR. MAJOR) WOULD IT MAKE ANY DIFFERENCE TO YOUR
14 OPINION IF YOU WERE AWARE THAT TESTIMONY HAD BEEN GIVEN THAT
15 MR. ENNIS ALLDREDGE HAD RECEIVED THE RADIATION, HAD BEEN
16 GOING IN ONCE EVERY SIX MONTHS TO HAVE THAT CANCER CHECKED
17 ON, AND IN FACT THE INDICATIONS WERE THAT THE CANCER WAS NOT
18 PRESENT?
19 A. I SUPPOSE IT WOULD DEPEND UPON WHO WAS TELLING ME THAT
20 AND WHETHER I HAD THE OPPORTUNITY TO QUESTION THEM REGARDING
21 THE DETAILS THEREOF.
22 Q. BUT ASSUMING IT WAS TRUE, WOULD THAT MAKE A DIFFERENCE
23 IN YOUR OPINION?
24 A. ASSUMING WHAT WAS TRUE, NOW?
25 Q. THAT HE HAD RECEIVED RADIATION FROM THE UNIVERSITY OF
4249
1 UTAH AND IT HAD BEEN INDICATED THAT THE CANCER WAS IN
2 REMISSION. HE HAD BEEN GOING EVERY SIX MONTHS TO HAVE IT
3 CHECKED ON AND THEY INDICATED THE CANCER WAS STILL IN
4 REMISSION UP UNTIL THE TIME HE WENT INTO THE DAVIS NORTH
5 HOSPITAL?
6 A. MY OPINION WAS BASED UPON MY REVIEW OF DR. DIENHART'S
7 RECORDS, SO I GUESS MY OPINION WOULDN'T CHANGE GIVEN THE
8 INFORMATION THAT I BASED IT UPON.
9 Q. AND THAT WAS SIMPLY THAT DR. DIENHART PUT END STAGE?
10 A. CORRECT.
11 Q. YOU DON'T KNOW WHETHER END STAGE MEANS THAT HE'S END OF
12 HIS LIFE OR CANCER, END OF THE STAGE BEING CURED?
13 A. WELL, IT MIGHT HAVE MEANT BOTH, I SUPPOSE. IT MIGHT
14 HAVE MEANT THAT HE WAS AT THE END OF HIS LIFE AND THAT THE
15 CANCER WAS END STAGE AS WELL.
16 Q. THAT COULD HAVE ALSO MEANT THAT THE CANCER WAS AT END
17 STAGE AND THERE'S NO MORE CANCER?
18 A. I'VE NEVER HEARD THAT TERMINOLOGY USED. END STAGE ISN'T
19 USED AS A TERMINOLOGY TO REFERENCE REMISSION.
20 Q. BUT YOU ARE NOT SPECIALIZED AND BOARD CERTIFIED AS A
21 CANCER SPECIALIST, ARE YOU?
22 A. I'M NOT A CANCER SPECIALIST, THAT'S RIGHT.
23 Q. TURN TO THE PAGE IN THE MEDICAL RECORD FOR LYDIA SMITH.
24 A. ALL RIGHT.
25 Q. AND TURN, IF YOU WILL, TO 722, WHICH IS ALSO UNDER THE
4250
1 LABS.
2 A. ALL RIGHT. 722.
3 Q. 722.
4 A. OKAY.
5 Q. NOW THIS ALSO -- LET ME ASK, YOU AGREE THIS IS THE LAB
6 WORK FOR LYDIA SMITH?
7 A. CORRECT.
8 Q. AND YOU'VE TESTIFIED THAT THE NORMAL FOR THE B.U.N. IS
9 SIX TO 20 AND HER B.U.N. IS 24. SO THAT'S ELEVATED?
10 A. THAT'S CORRECT.
11 Q. AND THAT'S ALSO BEEN MARKED BY THE COMPUTER, AS YOU SAY,
12 BEING HIGH?
13 A. CORRECT.
14 Q. ELLEN ANDERSON WASN'T IN THE HOSPITAL LONG ENOUGH TO
15 HAVE THE WORKUP, WAS SHE, SHE HAD NO BLOOD WORK, SO WE DON'T
16 KNOW WHAT THE FUNCTION OF HER KIDNEYS WERE?
17 A. I COULD LOOK TO CONFIRM THAT. I DON'T RECALL WHETHER
18 SHE HAD HAD THOSE BLOOD TESTS OR NOT.
19 Q. OKAY. SO YOU WOULDN'T BE ABLE TO SAY WHETHER ELLEN
20 ANDERSON'S KIDNEYS WERE FUNCTIONING NORMALLY OR NOT
21 NORMALLY?
22 A. DO YOU WANT ME TO LOOK IN THE RECORD TO SEE?
23 Q. I'M SAYING THAT BASED ON YOUR TESTIMONY -- YOU TESTIFIED
24 EARLIER THAT THESE PATIENTS, OTHER THAN MARY CRANE, HAD
25 RENAL PROBLEMS, KIDNEY PROBLEMS. I'M JUST SAYING YOU HAVE
4251
1 NOT REVIEWED ELLEN ANDERSON'S RECORD -- RIGHT NOW, WITHOUT
2 REVIEWING THAT RECORD, YOU COULDN'T SAY WHETHER SHE DID OR
3 DIDN'T?
4 A. WELL, I HAVE REVIEWED THE RECORD AND I DON'T RECALL
5 SPECIFICALLY THOSE TESTS BEING DONE. BUT WHAT I'VE
6 TESTIFIED WAS THAT I COULD LOOK AND DETERMINE THAT FOR YOU,
7 IF YOU WISH.
8 Q. THAT'S FINE. LET ME ASK YOU THIS. YOU ALSO TESTIFIED
9 THAT IN FACT MARY CRANE DID HAVE A HIGH B.U.N.?
10 A. AS A PRE-TERMINAL EVENT, THAT'S CORRECT.
11 MR. MAJOR: THANK YOU. WE HAVE NO FURTHER
12 QUESTIONS, YOUR HONOR.
13 MR. STIRBA: REDIRECT.
14 REDIRECT EXAMINATION
15 BY MR. STIRBA:
16 Q. DO YOU HAVE MR. ALLDREDGE'S BINDER THERE IN FRONT OF
17 YOU?
18 A. YES.
19 Q. TURN BACK TO THE LABS, PLEASE.
20 A. ALL RIGHT.
21 Q. AND THEN SPECIFICALLY PAGE 21.
22 A. YES, I HAVE THAT IN FRONT OF ME.
23 Q. AND THAT IS A LAB THAT WAS DONE ON ADMISSION ON 1/10 OF
24 '96?
25 A. THAT'S CORRECT.
4252
1 Q. DO YOU SEE THE B.U.N. DETERMINATION THERE?
2 A. YES.
3 Q. IS IT WITHIN THE NORMAL RANGE?
4 A. YES; AS IS THE CREATININE.
5 Q. AND THEN THE ONE YOU WERE ASKED ABOUT IS ANOTHER TEST
6 THAT WAS DONE, I BELIEVE, ON THE 13TH?
7 A. THAT'S CORRECT.
8 Q. IS THERE ANY SIGNIFICANCE TO THE FACT THAT THE
9 CREATININE IS IN THE NORMAL RANGE AND THE B.U.N. IS MILDLY
10 ELEVATED IN TERMS OF YOUR OPINION AS TO KIDNEY FUNCTION?
11 A. THAT'S QUITE SIGNIFICANT. THE CREATININE IS A MUCH MORE
12 SENSITIVE TEST OF KIDNEY FUNCTION. THE B.U.N. CAN BE
13 ELEVATED DUE TO THINGS OTHER THAN KIDNEY FUNCTION, KIDNEY
14 FAILURE. AND THE INTERPRETATION OF THIS COMBINATION OF
15 RESULTS WITH A NORMAL CREATININE AND A VERY, VERY MINIMALLY
16 ELEVATED B.U.N, IN MY OPINION, WOULD BE THAT THE KIDNEY
17 FUNCTION WAS NORMAL BASED UPON THE CREATININE BEING A MORE
18 SENSITIVE MEASURE.
19 Q. WOULD YOU ALSO GET LYDIA SMITH'S BINDER OUT, PLEASE?
20 A. YES.
21 Q. AND THE PAGE I WOULD LIKE YOU TO TURN TO IS 722.
22 A. I HAVE IT.
23 Q. THAT WAS THE LAB TEST YOU WERE ASKED ABOUT WHICH APPEARS
24 TO BE DONE ON 12/20 OF '96?
25 A. CORRECT.
4253
1 Q. WHAT IS THE -- I CAN'T PRONOUNCE IT -- CREATININE?
2 A. THEY ARE TONGUE TWISTING. CREATININE.
3 Q. WHAT IS THE RANGE REPORT ON THAT TEST?
4 A. NORMAL RANGE OF CREATININE IS 0.5 TO 1.5.
5 Q. IS THERE A FINDING THERE THAT THAT CREATININE IS IN A
6 NORMAL RANGE?
7 A. NOT ONLY IS IT WITHIN THE NORMAL RANGE, IT'S RIGHT IN
8 THE MIDDLE OF THE NORMAL RANGE AT 1.0, WHICH WOULD INDICATE
9 THAT THE PATIENT HAD NORMAL RENAL FUNCTION.
10 Q. AND GIVEN THAT FINDING AND THE B.U.N. READING THAT IS
11 INDICATED THERE, DOES THAT HAVE ANYTHING SIGNIFICANT, IN
12 TERMS OF YOUR OPINION, AS TO WHETHER OR NOT RENAL FUNCTION
13 WAS NORMAL?
14 A. IT DOES. MY INTERPRETATION OF THAT COMBINATION OF
15 FINDINGS, WHICH IS NOT UNCOMMON, IS THAT THE PATIENT HAD
16 NORMAL RENAL FUNCTION.
17 MR. STIRBA: THANK YOU. THAT'S ALL I HAVE.
18 THE COURT: ANYTHING FURTHER?
19 RECROSS-EXAMINATION
20 BY MR. MAJOR:
21 Q. A COUPLE OF QUESTIONS. DOCTOR, JUST TALKING -- YOU
22 INDICATED THAT MARY CRANE DID HAVE A HIGH B.U.N. AND THAT
23 SHE PROBABLY DID HAVE SOME RENAL OR KIDNEY PROBLEMS,
24 CORRECT?
25 A. IMMEDIATELY PRIOR TO HER DEMISE WHEN THE SEPSIS WAS
4254
1 RAPIDLY DEVELOPING, AS IS USUALLY THE CASE --
2 MR. STIRBA: YOUR HONOR, I THINK IT'S BEYOND THE
3 SCOPE.
4 THE COURT: OVERRULED.
5 THE WITNESS: -- AS IS USUALLY THE CASE WHEN
6 KIDNEYS BEGIN TO FAIL.
7 Q. (BY MR. MAJOR): SO WOULD YOU PLEASE TURN TO PAGE --
8 MARY CRANE'S BINDER. TURN TO PAGE 258 UNDER THE LABS.
9 A. OKAY.
10 Q. IF I READ THIS RIGHT, AND CORRECT ME IF I'M WRONG, ON
11 12/28 THERE WAS A TEST DONE, SHOWS B.U.N. WAS 35. CORRECT?
12 A. THAT'S CORRECT.
13 Q. AND THAT'S HIGHER THAN THE OTHERS?
14 A. CONSIDERABLY, RIGHT.
15 Q. AND THEN IF YOU TURN OVER TO THE NEXT PAGE, 259, IT
16 INDICATES THAT HER B.U.N. WAS TAKEN ON 1/1 OF '96. THAT
17 B.U.N. IS 31?
18 A. CORRECT.
19 Q. THAT'S ALSO HIGH, IS IT NOT?
20 A. CORRECT.
21 Q. AND THEN, TURNING OVER TO PAGE 260 -- I'M SORRY. MAKE
22 THAT 261. IT INDICATES THAT HER B.U.N. IS 42 ON 1/7 OF '96;
23 IS THAT CORRECT?
24 A. CORRECT.
25 Q. SO BASICALLY MARY CRANE HAD A VERY HIGH ELEVATED B.U.N.
4255
1 FROM THE TIME SHE WAS IN THE HOSPITAL -- SHE ENTERED THE
2 HOSPITAL, CORRECT?
3 A. HER B.U.N. WAS ELEVATED WHEN SHE ENTERED THE HOSPITAL,
4 THAT'S CORRECT.
5 Q. AND SO SHE DID HAVE PROBLEMS WITH HER KIDNEYS?
6 A. MY CONCLUSIONS REGARDING THAT WERE BASED UPON ELEVATION
7 TO 42 OF THE B.U.N. AND THE -- BUT MORESO UPON THE
8 CREATININE OF 1.9. IF YOU'LL LOOK AT THOSE LAB TESTS, THE
9 CREATININE, WHICH I'VE TESTIFIED IS THE MORE SENSITIVE
10 INDICATOR, WAS WITHIN THE NORMAL RANGE UP UNTIL THE VERY
11 END.
12 Q. AND NORMAL RANGE IS .5 TO 1.5?
13 A. RIGHT. AND ON 1/7 IT HAD RISEN TO 1.9.
14 Q. THANK YOU.
15 A. YOU ARE WELCOME.
16 MR. MAJOR: WE HAVE NO FURTHER QUESTIONS.
17 THE COURT: ANYTHING FURTHER?
18 MR. STIRBA: NO, YOUR HONOR. THANK YOU.
19 THE COURT: MAY THIS WITNESS BE EXCUSED?
20 MR. STIRBA: YES.