Todd Grey, MD
9 TODD CAMERON GREY,
10 BEING FIRST DULY SWORN, WAS EXAMINED AND TESTIFIED
11 AS FOLLOWS:
12 DIRECT EXAMINATION
13 BY MR. MAJOR:
14 Q. DOCTOR, WILL YOU STATE YOUR NAME AND SPELL YOUR LAST
15 NAME FOR THE RECORD?
16 A. TODD CAMERON GREY, G-R-E-Y.
17 Q. AND, DOCTOR, WHERE ARE YOU EMPLOYED?
18 A. I'M EMPLOYED BY THE OFFICE OF THE MEDICAL EXAMINER FOR
19 THE STATE OF UTAH.
20 Q. AND WHAT ARE YOUR DUTIES WITH THE MEDICAL EXAMINER WITH
21 THE STATE OF UTAH?
22 A. IN ADDITION TO BEING THE CHIEF ADMINISTRATIVE OFFICER
23 FOR THE MEDICAL EXAMINER'S OFFICE, I ALSO ACT AS A FORENSIC
24 PATHOLOGIST INVESTIGATING SUDDEN AND UNEXPECTED DEATH.
25 Q. CAN YOU EXPLAIN, BASICALLY, WHAT THAT IS, WHAT THAT
1910
1 ENTAILS?
2 A. A FORENSIC PATHOLOGIST IS A PHYSICIAN WHO IS TRAINED IN
3 THE GENERAL BRANCH OF MEDICINE PATHOLOGY, WHICH IS THE
4 INVESTIGATION OF DISEASE. A FORENSIC PATHOLOGIST IS A
5 PATHOLOGIST WHO HAS RECEIVED FURTHER SUBSPECIALTY TRAINING
6 RELATED TO INVESTIGATING SUDDEN AND UNEXPECTED DEATH.
7 Q. AND WHAT -- CAN YOU BRIEFLY GO OVER YOUR HISTORY AND
8 YOUR TRAINING?
9 A. CERTAINLY. I RECEIVED AN UNDERGRADUATE DEGREE FROM YALE
10 UNIVERSITY. I RECEIVED MY MEDICAL DEGREE FROM DARTMOUTH
11 MEDICAL SCHOOL. MY TRAINING IN ANATOMIC PATHOLOGY AT THE
12 UNIVERSITY OF CALIFORNIA IN SAN DIEGO, AND TRAINING IN
13 FORENSIC PATHOLOGY AT THE DADE COUNTY MEDICAL EXAMINER'S
14 OFFICE IN MIAMI, FLORIDA.
15 Q. AND AFTER THE TRAINING, WHAT EMPLOYMENT DID YOU HAVE?
16 A. I -- AFTER COMPLETING THE FELLOWSHIP IN FORENSICS IN
17 MIAMI, I CAME TO UTAH AS AN ASSISTANT MEDICAL EXAMINER, AND
18 THEN WAS PROMOTED TO CHIEF MEDICAL EXAMINER IN 1988.
19 Q. NOW, AS A MEDICAL EXAMINER, WE OFTEN HEAR THE WORDS
20 AUTOPSY. YOU DO PERFORM AUTOPSIES; IS THAT CORRECT?
21 A. YES.
22 Q. AND WHAT EXACTLY IS AN AUTOPSY?
23 A. AN AUTOPSY IS AN EXAMINATION OF A DECEASED PERSON. WHAT
24 IT ENTAILS IS, FIRST, A CAREFUL EXTERNAL EXAMINATION,
25 LOOKING AT THE OUTSIDE OF THE BODY; FOLLOWED BY AN INTERNAL
1911
1 EXAMINATION WHERE WE EXAMINE ALL OF THE BODY ORGANS.
2 Q. AND OVER THE COURSE THAT YOU'VE BEEN EMPLOYED WITH THE
3 MEDICAL EXAMINER'S OFFICE, HOW MANY AUTOPSIES HAVE YOU
4 PERFORMED?
5 A. I'VE PERSONALLY PERFORMED ON THE ORDER OF ABOUT 3,800 TO
6 4,000 AUTOPSIES.
7 Q. HAVE YOU ALSO ASSISTED OR AIDED IN OTHER AUTOPSIES?
8 A. YES.
9 Q. APPROXIMATELY HOW MANY OF THOSE?
10 A. AS CHIEF MEDICAL EXAMINER I SUPERVISED THE WORK OF TWO
11 OTHER PHYSICIANS WHICH WOULD BRING THE TOTAL NUMBER OF
12 AUTOPSIES THAT I'VE BEEN INVOLVED IN UP TO AROUND ABOUT
13 10,000.
14 Q. AND ARE YOU OFTEN CALLED UPON TO TESTIFY IN COURT
15 CONCERNING YOUR AUTOPSIES?
16 A. YES.
17 Q. AND HOW OFTEN HAVE YOU DONE THAT?
18 A. HUNDREDS OF TIMES.
19 Q. OKAY. AND HAVE YOU BEEN QUALIFIED AS AN EXPERT WITNESS
20 IN PRIOR CASES?
21 A. YES, I HAVE.
22 MR. MAJOR: YOUR HONOR, WE'D MOVE THAT THIS WITNESS
23 BE QUALIFIED AS AN EXPERT TO TESTIFY AS TO THE AUTOPSIES IN
24 THIS CASE.
25 THE COURT: JUST GO AHEAD.
1912
1 MR. MAJOR: OKAY.
2 Q. (BY MR. MAJOR) JUST AS SOME BACKGROUND AND SOME
3 FOUNDATION, YOU MENTIONED IT BRIEFLY. CAN YOU KIND OF IN
4 MORE DETAIL GO OVER WHAT NORMALLY OCCURS WHEN AN AUTOPSY IS
5 PERFORMED, HOW THE BODY COMES TO YOU, WHAT TYPE OF THINGS
6 YOU DO?
7 A. THE -- WE RECEIVE THE BODIES FROM WHEREVER USUALLY DEATH
8 OCCURS. OCCASIONALLY WE MAY HAVE CASES WHERE THE PERSON HAS
9 BEEN BURIED AND AN EXHUMATION IS NECESSARY TO GET THE BODY.
10 AFTER THE BODY IS TRANSPORTED TO OUR OFFICE, THE FIRST
11 THING WE'LL DO IS PHOTOGRAPH IT AND SHOW THE CONDITION OF
12 THE BODY AS RECEIVED. THEN THE EXAMINATION OCCURS. WE'LL
13 LOOK AT WHATEVER CLOTHING IS ON THE INDIVIDUAL, DOCUMENT ANY
14 INJURIES THAT MAY BE PRESENT ON THE CLOTHING.
15 THE BODY IS THEN UNDRESSED. WE LOOK AT THE OUTSIDE OF
16 THE BODY, AGAIN DOCUMENTING ANYTHING THAT IS ABNORMAL IN ANY
17 WAY.
18 AND THEN PROCEED WITH THE INTERNAL EXAMINATION AND THAT
19 WILL ENTAIL MAKING INCISIONS SO THAT WE CAN EXPOSE THE HEART
20 AND LUNGS, AS WELL AS THE ABDOMINAL CAVITY, AND INCISIONS SO
21 THAT WE CAN REMOVE THE TOP OF THE SKULL AND EXAMINE THE
22 BRAIN.
23 Q. OKAY. AND THAT ENTAILS -- AND THEN AFTER YOU HAVE DONE
24 THAT, WHAT -- WHAT, IF ANYTHING, IS ENTAILED IN THE AUTOPSY?
25 A. WHAT I'LL DO IS AFTER WE'VE COMPLETE -- DURING THE
1913
1 PROCESS OF THE AUTOPSY, I'LL MAKE NOTATIONS ON DIAGRAMS AND
2 ON VARIOUS FORMS TO RECORD MY FINDINGS. I WILL THEN GO AND
3 DICTATE A REPORT OF ALL OF THOSE FINDINGS AND THAT WILL BE
4 TRANSCRIBED BY THE SECRETARIES. I WILL CORRECT IT AND THEN
5 A FINAL VERSION OF IT WILL ESSENTIALLY BE OUR FINAL REPORT
6 OF WHAT WE FOUND AND THAT WILL BE PUT IN THE CASE FILE.
7 Q. AND DO YOU ALSO TAKE SAMPLES OF THE DIFFERENT BODY
8 ORGANS AND SO FORTH?
9 A. YES. WE'LL DO A NUMBER OF DIFFERENT THINGS. WE'LL TAKE
10 SAMPLES TO LOOK AT UNDER THE MICROSCOPE, ESSENTIALLY
11 BIOPSIES OF THE VARIOUS TISSUES THAT WE LOOK AT. WE'LL ALSO
12 SUBMIT SAMPLES FOR TOXICOLOGIC TESTING, LOOKING FOR DRUGS OR
13 POISONS.
14 Q. AND YOU ALSO MENTIONED THAT YOU ON OCCASION HAVE BODIES
15 THAT HAVE BEEN EXHUMED OR HAVE BEEN BURIED AND THEN DUG UP.
16 APPROXIMATELY HOW MANY OF THOSE HAVE YOU HAD?
17 A. FORTUNATELY THAT'S NOT A VERY COMMON EXPERIENCE. I
18 THINK OVER THE COURSE OF MY CAREER I'VE PROBABLY DONE 20 TO
19 25 EXHUMATIONS.
20 Q. NOW, LET ME SHOW YOU WHAT'S BEEN MARKED FOR
21 IDENTIFICATION AS PLAINTIFF'S EXHIBIT NUMBER 19 AND ASK YOU
22 IF YOU CAN IDENTIFY THAT. (TENDERS DOCUMENT TO WITNESS.)
23 A. YES.
24 Q. AND WHAT IS THAT?
25 A. THIS IS A COPY OF THE AUTOPSY REPORT, INCLUDING THE
1914
1 TOXICOLOGY FINDINGS, ON A MR. ENNIS ALLDREDGE.
2 Q. IS THAT A TRUE AND CORRECT COPY OF THE ORIGINAL THAT YOU
3 HAVE?
4 A. IT APPEARS TO BE, YES.
5 Q. AND DID YOU PERFORM THE AUTOPSY ON MS. ALLDREDGE --
6 MR. ALLDREDGE?
7 A. YES, I DID.
8 Q. WHEN WAS THAT PERFORMED?
9 A. I PERFORMED THAT ON JULY 21ST OF 1999 STARTING AT 9:15
10 IN THE MORNING.
11 Q. NOW, SOMETHING I DIDN'T ASK YOU WHEN WE WERE DISCUSSING
12 JUST SORT OF THE GENERAL BACKGROUND, BUT YOU ALSO -- YOU
13 RECEIVE THE BODY AND YOU DO YOUR BASIC AUTOPSY ON THE BODY.
14 IS THERE ANY OTHER INFORMATION YOU RECEIVE ALONG WITH THE
15 BODY?
16 A. YES. IN ORDER TO UNDERSTAND WHAT'S GOING ON IN A
17 PARTICULAR CASE WE WILL NEED INVESTIGATIVE INFORMATION.
18 THAT INFORMATION MAY COME FROM A VARIETY OF SOURCES,
19 INCLUDING FROM THE POLICE, FROM MY OWN OFFICE'S
20 INVESTIGATORS, FROM MEDICAL RECORDS ABOUT THE DECEDENT'S
21 CONDITION. ALL OF THOSE SOURCES OF INFORMATION WILL BE USED
22 TO HELP US COME TO AN UNDERSTANDING OF WHAT'S GOING ON.
23 Q. OKAY. AND IN THE CASE OF MR. ALLDREDGE, WHAT WERE THE
24 CIRCUMSTANCES OF HIS BODY COMING TO YOU?
25 A. MR. ALLDREDGE WAS AN INDIVIDUAL WHO DIED ON JANUARY 14TH
1915
1 IN 1996. INVESTIGATION INDICATED THE POSSIBILITY THAT HIS
2 DEATH WAS NOT DUE TO NATURAL DISEASE, AND AS SUCH OUR OFFICE
3 BECAME INVOLVED IN THE INVESTIGATION. AND AS PART OF THAT
4 PROCESS, AN EXHUMATION WAS ORDERED AND THE BODY WAS BROUGHT
5 TO OUR OFFICE FOR AUTOPSY.
6 Q. OKAY. DID YOU RECEIVE ANY OTHER RECORDS OR ANYTHING
7 ELSE ON MR. ALLDREDGE?
8 A. YES. I LOOKED AT HIS MEDICAL RECORDS.
9 Q. LET ME SHOW YOU WHAT HAS BEEN MARKED AS IDENTIFICATION
10 AS PLAINTIFF'S EXHIBIT NUMBER 7 AND ASK YOU IF THAT
11 APPEARS -- DO YOU RECOGNIZE THAT?
12 A. WITHOUT GOING THROUGH EACH AND EVERY PAGE --
13 Q. YEAH. AND LET ME REPRESENT -- IF I CAN TO SAVE TIME
14 MAYBE REPRESENT THAT THAT HAS BEEN INTRODUCED AS BEING THE
15 MEDICAL RECORDS FOR ENNIS ALLDREDGE FROM DAVIS NORTH
16 HOSPITAL.
17 A. AND, AGAIN, WITHOUT LOOKING AT EACH AND EVERY PAGE, THIS
18 APPEARS TO BE A COPY OF WHAT I ALSO SAW.
19 Q. AND YOU ALSO REVIEWED THAT -- THE COPY THAT YOU HAD,
20 EITHER PRIOR TO OR DURING THE TIME OF THE AUTOPSY?
21 A. YES.
22 Q. OKAY. SO AFTER MR. ALLDREDGE'S BODY WAS DELIVERED TO
23 YOUR OFFICE, WHAT OCCURRED?
24 A. THE AUTOPSY WAS PERFORMED AND FINDINGS THAT I DOCUMENTED
25 WERE TRANSCRIBED INTO A REPORT.
1916
1 Q. AND GOING OVER -- LET'S GO OVER THAT REPORT. WHO WAS
2 PRESENT DURING THE AUTOPSY?
3 A. IN ADDITION TO MYSELF AND MY AUTOPSY ASSISTANT,
4 DETECTIVE JOE MORRISON FROM I BELIEVE THE LAYTON P.D. WAS IN
5 ATTENDANCE.
6 Q. SO WHAT WAS THE FIRST THING YOU DID AS FAR AS
7 MR. ALLDREDGE'S BODY IS CONCERNED?
8 A. THE FIRST THING WOULD BE TO LOOK AT IT AS IT WAS
9 RECEIVED AND DOCUMENT THE CONDITION OF THE BODY AND THE
10 CLOTHING OF THE BODY.
11 Q. AND WHAT WAS THE CONDITION? CAN YOU DESCRIBE WHAT YOU
12 OBSERVED OR WHAT YOU PLACED IN YOUR REPORT?
13 A. CERTAINLY. WHAT WE FOUND -- WHAT WE SAW WAS THAT
14 MR. ALLDREDGE WAS IN AN INTACT CASKET. HE WAS CLAD IN
15 TEMPLE GARMENTS. I SAW NO EVIDENCE OF INJURY OR DISTURBANCE
16 OF THE CLOTHING, BUT THERE WAS SOILING OF THE CLOTHING BY
17 DECOMPOSITION OF FLUIDS, ESSENTIALLY FLUIDS THAT LEAKED FROM
18 THE BODY AS PART OF THE DETERIORATION THAT OCCURS AFTER
19 DEATH.
20 Q. AND THEN WHAT WAS THE NEXT STEP THAT YOU TOOK?
21 A. WE UNDRESSED THE BODY AND THEN LOOKED AT THE EXTERNAL
22 SURFACES TO DOCUMENT ANY ABNORMALITIES AT THAT POINT.
23 Q. DID YOU FIND ANY ABNORMALITIES? CAN YOU DESCRIBE WHAT
24 YOU OBSERVED?
25 A. THERE WERE, AGAIN, THE KINDS OF CHANGES THAT WE SEE IN A
1917
1 BODY THAT HAS BEEN EMBALMED AND BURIED. THERE WAS FUNGUS
2 GROWING ON PORTIONS OF THE BODY, THERE WAS DISCOLORATION OF
3 THE BODY. ADDITIONALLY, I FOUND EVIDENCE OF EMBALMING AND I
4 FOUND OLD SCARS CONSISTING OF A SCAR OVER THE CENTRAL CHEST
5 BONE, THE STERNUM, AS WELL AS A SCAR ON THE FRONT OF THE
6 LEFT THIGH.
7 Q. NOW, AT THIS POINT JUST SORT OF SOME FOUNDATION. YOU
8 MENTIONED YOU SAW SOME EVIDENCE OF EMBALMING. CAN YOU
9 GENERALLY DESCRIBE WHAT THE PROCESS IS OF EMBALMING A BODY?
10 A. EMBALMING IS ESSENTIALLY A PROCESS OF INTRODUCING
11 PRESERVATIVE CHEMICALS INTO THE BODY AFTER DEATH IN ORDER TO
12 PRESERVE IT BEYOND THE NATURAL TIME THAT IT WOULD STAY
13 INTACT.
14 THE PROCESS IS ONE OF EXPOSURE OF THE ARTERIES AND
15 VEINS, USUALLY DONE AT THE BASE OF THE NECK. AND THEN
16 ESSENTIALLY TRANSFUSING THESE CHEMICALS THROUGH THE VASCULAR
17 SYSTEM SO THAT THE TISSUES ARE PROFUSED WITH THIS
18 PRESERVATIVE MATERIAL.
19 SOMETIMES THERE MAY ALSO BE AN INTRODUCTION OF A VERY
20 LARGE BORE NEEDLE INTO THE TORSO AND PERFORATION OF THE
21 INTERNAL VISCERA AND INJECTION OF PRESERVATIVE VIA THAT
22 MEANS.
23 Q. SO THEY INJECT SOME OF THE EMBALMING FLUID INTO THE
24 DIFFERENT ORGANS OF THE BODY?
25 A. YES.
1918
1 Q. DID YOU NOTICE -- HAD THIS BEEN DONE WITH MR. ALLDREDGE?
2 A. YES. I SAW WHAT'S CALLED A TROCAR BUTTON, A SITE WHERE
3 THAT LARGE BORE NEEDLE HAD BEEN INTRODUCED INTO HIS ABDOMEN.
4 Q. DID YOU ALSO FIND EMBALMING FLUID INTO THE BODY CAVITY
5 ITSELF?
6 A. AT THIS POINT, NO. I MEAN, THIS HAS BEEN SO LONG
7 SINCE -- AFTER THE ACTUAL INTRODUCTION OF THE FLUID THAT IT
8 HAD ESSENTIALLY BEEN ABSORBED SO THERE WAS NO LOOSE FLUIDS
9 LEFT.
10 Q. WHAT WAS THE NEXT THING YOU DID?
11 A. AFTER DOCUMENTING WHAT WE SAW EXTERNALLY, THEN I
12 PROCEEDED WITH THE INTERNAL EXAMINATION, LOOKING AT ALL OF
13 THE VARIOUS ORGANS, BOTH OF THE TORSO AS WELL AS THE BRAIN.
14 Q. AND WHAT WAS SOME OF THE SIGNIFICANT THINGS YOU FOUND
15 WITH MR. ALLDREDGE?
16 A. WHAT I FOUND IN MR. ALLDREDGE WAS FIRST OFF HE HAD
17 FAIRLY SEVERE HARDENING OF THE ARTERIES. THIS WAS MOST
18 NOTICEABLE IN THE ARTERIES OF THE HEART. HE HAD UP TO
19 90 PERCENT BLOCKAGE OF THE MAIN ARTERIES THAT SUPPLY BLOOD
20 TO BOTH THE RIGHT AND LEFT SIDES OF THE HEART.
21 THERE WAS EVIDENCE THAT HE'D HAD CORONARY ARTERY BYPASS
22 GRAFTS IN THE PAST. I SAW THREE IDENTIFIABLE GRAFT SITES
23 WHERE THEY HAD TAKEN BLOOD VESSELS AND MADE CONNECTIONS FROM
24 THE AORTA PAST THE AREAS OF MOST SEVERE OBSTRUCTION TO TRY
25 TO GET BETTER BLOOD FLOW TO HIS HEART. HE HAD EVIDENCE OF
1919
1 HAVING A HEART ATTACK IN THE PAST WITH SCARRING OF THE
2 MUSCLE OF THE HEART INVOLVING THE MAIN PUMPING CHAMBER OR
3 THE LEFT VENTRICLE OF THE HEART.
4 Q. OKAY. AND YOU DID THIS BY AN ACTUAL EXAMINATION OF THE
5 HEART?
6 A. YES.
7 Q. PERHAPS WHAT WE CAN DO IS -- LET ME PLACE THIS ON THE --
8 ON OUR PROJECTOR HERE.
9 MR. STIRBA: YOUR -- YOUR HONOR, I'M GOING TO
10 OBJECT. IT'S NOT IN EVIDENCE. HASN'T EVEN BE OFFERED.
11 MR. MAJOR: IT'S THE DOCUMENT HE'S TESTIFYING TO,
12 YOUR HONOR, JUST FOR THE BENEFIT OF THE JURY.
13 THE COURT: ARE YOU OFFERING THE EXHIBIT?
14 MR. MAJOR: WE WILL BE OFFERING IT ONCE HE'S
15 COMPLETED --
16 THE COURT: OKAY. IS THERE ANY OBJECTION?
17 MR. STIRBA: YES. IT'S NOT -- IT'S NOT ADMISSIBLE
18 WITH ANY -- WITHIN AN EXCEPTION OF THE HEARSAY RULE. IT'S
19 HEARSAY. PLUS, I'VE NEVER SEEN THE EXHIBIT BEFORE SO I'M
20 NOT SURE WHAT IS EXACTLY CONTAINED IN IT.
21 MR. MAJOR: YOUR HONOR, I WOULD REPRESENT -- I'LL
22 GIVE A COPY TO THE DEFENDANT. I WOULD REPRESENT THAT HE HAS
23 HAD DISCOVERY OF THIS MATTER --
24 THE COURT: OKAY. WELL, LET'S JUST HOLD ON.
25 MR. STIRBA: WELL, THE OBJECTION ON HEARSAY, NOT
1920
1 WITHIN THE EXCEPTION, YOUR HONOR.
2 THE COURT: OKAY. WELL, CAN YOU GO ON TO SOMETHING
3 ELSE?
4 MR. MAJOR: WELL, IF THE COURT WANTS WE CAN GO ON
5 WITH THE REST OF -- REST OF HIS DISCUSSING OF THIS DOCUMENT
6 WITHOUT PLACING IT BEFORE THE JURY.
7 THE COURT: OKAY. LADIES AND GENTLEMEN, I THINK
8 WHAT WE COULD DO IS -- IT WILL PROBABLY BE QUICKER SINCE
9 WE'LL HAVE THIS SAME LEGAL ISSUE COME UP WITH EACH OF THE
10 AUTOPSIES, SO THAT I THINK WHAT WE'LL DO IS LET YOU GO OUT
11 FOR JUST A FEW MINUTES, RESOLVE THAT ISSUE, AND THEN YOU'LL
12 BE BACK IN AND THEN WE WON'T HAVE TO HAVE BREAKS ON THE
13 OTHER ISSUES.
14 DURING THIS SHORT BREAK, REMEMBER NOT TO TALK ABOUT
15 THIS CASE AMONG YOURSELVES OR WITH ANYONE ELSE AND DON'T
16 FORM OR EXPRESS AN OPINION UNTIL THE CASE IS FINALLY
17 SUBMITTED TO YOU.
18 (WHEREUPON, AT THIS TIME THE JURY LEAVES THE
19 COURTROOM.)
20 THE COURT: THE RECORD WILL REFLECT THAT THE JURY
21 HAS LEFT THE COURTROOM.
22 ALL RIGHT. WHAT IS THE -- OKAY. THE OBJECTION IS THAT
23 THIS IS HEARSAY, AND WHAT IS THE RESPONSE?
24 MR. MAJOR: WELL, THE RESPONSE IS, YOUR HONOR, HE
25 HAS ESTABLISHED, NUMBER ONE, THAT THIS IS -- AND IF NOT, I
1921
1 CAN PROFFER. IF NOT, I CAN QUESTION HIM CONCERNING IT.
2 IT'S A REPORT THAT HE MADE. HE MADE IT FROM THE NOTES
3 AS HE WAS DOING -- DICTATED THE NOTES AS HE WAS DOING THE
4 AUTOPSY. HE INDICATED IT'S A TRUE AND CORRECT COPY OF WHAT
5 HE HAD AND WHAT HE DID.
6 IF WE'RE TALKING ABOUT HEARSAY, HEARSAY IS A STATEMENT
7 BY OUT OF COURT -- STATEMENT MADE OUT OF COURT AND THE
8 PERSON IS NOT AVAILABLE TO BE -- TO BE QUESTIONED CONCERNING
9 IT. IN THIS CASE, THIS IS HIS REPORT. HE'S HERE --
10 THE COURT: YEAH, I DON'T THINK THERE'S ANY
11 QUESTION IT'S HIS REPORT. THE QUESTION IS THOUGH THE REPORT
12 IS AN OUT-OF-COURT STATEMENT. IT WASN'T MADE IN COURT. HIS
13 STATEMENTS IN COURT ARE IN-COURT STATEMENTS. ANY RECORD --
14 THIS IS -- YOU KNOW, IS THIS ANY DIFFERENT FROM AN EXPERT'S
15 REPORT -- THAT AN EXPERT DOES A REPORT AND THEN AN EXPERT
16 TESTIFIES? AND THEN, YOU KNOW, DOES THE REPORT COME IN OR
17 NOT? THAT'S THE --
18 MR. MAJOR: WELL, I GUESS -- I GUESS MY
19 UNDERSTANDING -- MY UNDERSTANDING OF HEARSAY, YOUR HONOR, IS
20 THAT IT HAS TO BE AN OUT-OF-COURT STATEMENT AND THE PERSON
21 MAKING THE STATEMENT IS NOT AVAILABLE TO BE QUESTIONED
22 CONCERNING THAT STATEMENT.
23 AND THIS WITNESS IS PRESENT, THESE ARE HIS STATEMENTS.
24 I MEAN, THERE'S NO DIFFERENCE BETWEEN HIM TESTIFYING FROM
25 THE REPORT, READING FROM THE REPORT, AND HAVING THE REPORT
1922
1 ADMITTED INTO EVIDENCE. I MEAN, IT'S NOT A HEARSAY
2 SITUATION. IF IT'S HIS REPORT, IF IT'S MY STATEMENT, I'M IN
3 COURT, I CAN BE QUESTIONED ABOUT IT. SO I DON'T THINK IT
4 FALLS UNDER THE HEARSAY PROBLEM, YOUR HONOR.
5 THE COURT: OKAY. MR. STIRBA?
6 MR. STIRBA: WELL, THERE'S A HUGE DIFFERENCE
7 BETWEEN THE ACTUAL DOCUMENT IN EVIDENCE AND THE TESTIMONY.
8 OBVIOUSLY, DR. GREY CAN TESTIFY AS TO WHATEVER HE DID. HE
9 CERTAINLY CAN REFER TO HIS REPORT, IF THAT HELPS HIM. I
10 DON'T HAVE ANY PROBLEM WITH THAT. IT'S THE -- IT'S THE
11 DOCUMENT IN EVIDENCE WHICH IS HEARSAY.
12 AND THE COURT IS QUITE RIGHT. IT'S DIRECTLY ANALOGOUS
13 TO AN EXPERT REPORT. THAT EXPERT REPORT DOESN'T GO IN. THE
14 EXPERT TESTIFIES, THE EXPERT CAN REFER TO THE REPORT. AND
15 QUITE FRANKLY, THE WAY THE REPORT CAN BE USED IS CERTAINLY I
16 COULD USE IT FOR PURPOSES OF CROSS-EXAMINATION OF DR. GREY
17 OR ANY OTHER EXPERT. BUT THE REPORT ITSELF IS HEARSAY, NOT
18 WITHIN AN EXCEPTION; AND, THEREFORE, INADMISSIBLE.
19 MR. MAJOR: AND JUST IN CONCLUSION, YOUR HONOR, I
20 SEE NO DIFFERENCE BETWEEN THIS PARTICULAR REPORT AND WHAT
21 WE'VE DONE WITH ALL THE MEDICAL REPORTS UP UNTIL THIS POINT
22 IN TIME.
23 THE COURT: WELL, THERE'S A DEFINITE SITUATION FOR
24 A MEDICAL RECORD WHICH IS A CLEAR EXCEPTION TO THE HEARSAY
25 RULE.
1923
1 MR. MAJOR: AND THIS IS ALSO A MEDICAL RECORD BEING
2 TESTIFIED TO BY A MEDICAL DOCTOR.
3 THE COURT: OKAY. WHAT IS YOUR RESPONSE TO THAT?
4 MR. STIRBA: WELL, HE'S NOT A TREATING PHYSICIAN.
5 THAT -- THAT EXCEPTION RELATES TO ESSENTIALLY PEOPLE
6 PROVIDING MEDICAL INFORMATION FOR PURPOSES OF TREATMENT. I
7 DARE --
8 MR. MAJOR: WELL --
9 MR. STIRBA: EXCUSE ME. I DARE SAY THEY WEREN'T
10 GOING TO DR. GREY FOR PURPOSES OF TREATMENT.
11 MR. MAJOR: BUT OUR MEDICAL RECORDS CONTAIN
12 STATEMENTS FROM SOCIAL WORKERS AND DIETICIANS, FROM NURSES,
13 ALL OF THOSE WHO WERE NOT TREATING PHYSICIANS. I DON'T -- I
14 DON'T -- MY ARGUMENT TO THE COURT, I DON'T SEE ANY
15 DISTINCTION BETWEEN THIS DOCUMENT AND ALL OF THE OTHER
16 MEDICAL DOCUMENTS WE'VE PUT IN AT THIS TIME.
17 THE COURT: WELL, THE DISTINCTION BETWEEN -- THE
18 EXCEPTIONS TO A HEARSAY RULE ARE BASICALLY BASED ON THE
19 PREMISE IN THE LAW THAT PEOPLE ARE TELLING THE TRUTH IN
20 CERTAIN CIRCUMSTANCES. ONE OF THOSE CIRCUMSTANCES ARE THAT
21 WHEN YOU GO TO A DOCTOR FOR CARE -- IT'S SECTION 8 -- RULE
22 803, PARAGRAPH 4.
23 IT SAYS: STATEMENTS FOR PURPOSES OF MEDICAL DIAGNOSIS
24 OR TREATMENT. STATEMENTS MADE FOR THE PURPOSE OF MEDICAL
25 DIAGNOSIS OR TREATMENT AND DESCRIBING MEDICAL HISTORY, OR
1924
1 PAST OR PRESENT SYMPTOMS, PAIN, OR SENSATIONS, OR THE
2 INCEPTION OR GENERAL CHARACTER OF THE CAUSE OR EXTERNAL
3 SOURCE THEREOF INSOFAR AS REASONABLY PERTINENT TO DIAGNOSIS
4 OR TREATMENT IS AN EXCEPTION TO THE HEARSAY RULE.
5 AND THE -- AND THE REASON BEHIND THAT IS THAT WHEN A
6 PERSON GOES TO A DOCTOR FOR CARE, THEY'RE GOING TO TELL THE
7 DOCTOR THE TRUTH SO THAT THEY CAN GET OVER WHATEVER PROBLEM
8 THAT THEY HAVE.
9 NOW, THAT IS THE REASON WE'VE ALLOWED THE MEDICAL
10 EVIDENCE IN, BESIDES CERTAIN THINGS BEING STIPULATED, OTHER
11 THINGS BEING A HEARSAY EXCEPTION.
12 BUT DO YOU HAVE AN EXCEPTION THAT YOU POINT TO BESIDES
13 THE -- THAT SECTION 4 AS A RESULT OF -- OF THIS?
14 MR. MAJOR: I DON'T -- I'M NOT SAYING THAT THIS IS
15 AN EXCEPTION. I'M SAYING THIS IS NOT HEARSAY BY ITS VERY
16 DEFINITION.
17 THE COURT: WELL, IT IS HEARSAY BECAUSE THE REPORT
18 IS AN OUT-OF-COURT STATEMENT. THIS WITNESS CAN USE THE
19 REPORT, HE CAN REFER TO THE REPORT, BUT I DON'T SEE ANY
20 DIFFERENCE BETWEEN THAT THAN HAVING AN EXPERT DO A WRITTEN
21 REPORT. AND THE PROBLEM OF THE WRITTEN REPORT COMING INTO
22 EVIDENCE, JUST LIKE ANY OTHER EXPERT'S WRITTEN REPORT, IS
23 THAT IF THAT COMES INTO EVIDENCE, IT GIVES MORE EMPHASIS TO
24 THAT THAN ANY OTHER TESTIMONY.
25 AND SO I'M GOING TO SUSTAIN THE OBJECTION. HE CAN
1925
1 REFER TO IT, BUT IT'S NOT GOING TO COME INTO EVIDENCE.
2 MR. MAJOR: THANK YOU, YOUR HONOR. NO PROBLEM WITH
3 THAT.
4 THE COURT: OKAY. THEN WHY DON'T WE GET THE JURY
5 BACK IN.
6 (WHEREUPON, AT THIS TIME THE JURY ENTERS THE COURTROOM.)
7 THE COURT: THE RECORD WILL REFLECT THAT THE JURY
8 HAS RETURNED.
9 AND MR. MAJOR, WOULD YOU LIKE TO CONTINUE?
10 MR. MAJOR: YES.
11 Q. (BY MR. MAJOR) DOCTOR, LET'S CONTINUE TO WHERE WE
12 WERE -- WE WERE TALKING ABOUT -- LET'S GO BACK A LITTLE BIT.
13 YOU INDICATED THAT YOU INITIALLY OPENED THE BODY CAVITY; IS
14 THAT CORRECT?
15 A. YES.
16 Q. CAN YOU JUST GENERALLY GIVE US A DESCRIPTION OF WHAT
17 WAS -- WHAT YOU OBSERVED WHEN YOU FIRST OPENED THAT BODY
18 CAVITY?
19 A. WHAT I SAW WAS THE BODY ORGANS WERE PRESENT. THERE WAS
20 EVIDENCE OF INJURY FROM THE TROCARING, WHERE THAT LARGE
21 NEEDLE HAD BEEN INSERTED. SO THERE WERE MULTIPLE HOLES IN
22 SOME OF THE -- IN THE BODY ORGANS SECONDARY TO THAT.
23 THERE WAS DETERIORATION OF SOME OF THE ORGANS, AND
24 THAT'S SECONDARY TO DECOMPOSITION. THERE WAS SOME
25 DISCOLORATION OF THE INTESTINES BECAUSE THE GALL BLADDER HAD
1926
1 BEEN PERFORATED BY THAT LARGE NEEDLE.
2 Q. AND THEN YOU INDICATED THAT YOU BEGAN AN EXAMINATION OF
3 THE HEART, I BELIEVE WE WERE TALKING ABOUT.
4 A. YES.
5 Q. AND, AGAIN, FOR THE BENEFIT OF THE JURY, CAN YOU GO INTO
6 SOME DETAIL ABOUT HOW YOU DID THAT, WHAT -- WHAT'S INVOLVED
7 IN DOING THAT?
8 A. WHAT WE DO IS AFTER THE FRONT OF THE CHEST PLATE HAS
9 BEEN REMOVED WE LOOK AT THE ORGAN INSITU, BASICALLY WHERE IT
10 LIES. MAKE SURE THAT IT'S -- LOOK AT ITS SIZE AND SHAPE.
11 WE THEN OPEN THE SAC THAT IT SITS WITHIN, WHICH IS CALLED
12 THE PERICARDIUM. WE THEN LOOK AT THE OUTSIDE OF THE HEART.
13 WE THEN REMOVE IT, WEIGH IT, AND THEN DISSECT IT. AND THE
14 DISSECTION ENTAILS LOOKING AT THE VARIOUS ARTERIES THAT
15 PROVIDE BLOOD AND THEN OPENING ALL OF THE CHAMBERS AND
16 LOOKING AT THE MUSCLE TISSUE.
17 Q. AND THAT'S WHAT YOU DID ON THIS OCCASION?
18 A. YES.
19 Q. AND, AGAIN, AS WE BROKE OFF, CAN YOU DESCRIBE WHAT YOU
20 FOUND WHEN YOU DID THAT WITH THE HEART?
21 A. AS I SAID, WE FOUND -- WE FOUND THE SEVERE BLOCKAGE OF
22 THE CORONARY ARTERIES, THE EVIDENCE THAT HE'D HAD SURGERY TO
23 TRY TO BYPASS SOME OF THAT BLOCKAGE. WE FOUND EVIDENCE OF
24 HAVING OLD -- OLD SCARS IN THE MAIN PUMPING CHAMBER OF THE
25 HEART.
1927
1 Q. NOW, WHAT DID THE OLD SCARS -- HAVE ANY SIGNIFICANCE TO
2 YOU?
3 A. IT WOULD INDICATE THAT THIS IS A PERSON WHO'D HAD A
4 HEART ATTACK IN THE PAST.
5 Q. AND WERE YOU ABLE TO DATE HOW LONG AGO THAT HEART ATTACK
6 WOULD HAVE BEEN?
7 A. BOTH LOOKING AT IT WITH MY NAKED EYE, AS WELL AS LOOKING
8 AT IT UNDER THE MICROSCOPE, WHAT I SAW WAS THAT THIS WAS
9 VERY WELL HEALED. THESE WERE NOT ACUTE, NOT SOMETHING THAT
10 HAPPENED RECENTLY. PROBABLY ON THE ORDER OF MONTHS TO YEARS
11 OLD WOULD BE -- I WOULD SAY, FROM THE APPEARANCE.
12 Q. OKAY. WHAT ELSE DID YOU FIND AS FAR AS THE HEART WAS
13 CONCERNED?
14 A. IN ADDITION TO THESE PROBLEMS WITH THE BLOOD SUPPLY TO
15 THE HEART, MR. ALLDREDGE'S HEART WAS ENLARGED. IT WEIGHED
16 570 GRAMS. NORMALLY I WOULD EXPECT AN INDIVIDUAL'S HEART TO
17 BE BETWEEN 350 AND 400 GRAMS, SO THIS WAS MUCH BIGGER THAN
18 NORMAL. THERE WAS THICKENING OF THE MUSCLE, THE PUMPING
19 MUSCLE OF THE -- OF THE HEART. IT WAS 1.9 CENTIMETERS IN
20 THICKNESS. NORMALLY YOU WOULD EXPECT IT TO BE ABOUT 1.4.
21 BOTH OF THESE FINDINGS OF A HEAVY HEART WITH THICKENED
22 MUSCLE GOES ALONG WITH A PERSON WHO HAS HIGH BLOOD PRESSURE
23 OR HYPERTENSION.
24 Q. AND WHAT ELSE DID YOU DO?
25 A. ON THE HEART?
1928
1 Q. YEAH.
2 A. THAT WAS IT.
3 Q. THAT WAS IT. OKAY. WHAT WAS THE NEXT AREA THAT YOU
4 LOOKED AT?
5 A. THE NEXT AREA THAT WE LOOKED AT WAS THE LUNGS. AND WHAT
6 WE FOUND WAS THAT THERE WAS EVIDENCE OF THE EMBALMING. IT
7 HAD THE -- THE LUNGS HAD THAT APPEARANCE OF TISSUE THAT HAS
8 HAD THIS PRESERVATIVE INJECTED INTO IT. I DID NOT SEE
9 ANYTHING WITH MY NAKED EYE THAT WAS THAT SURPRISING. I
10 DIDN'T SEE ANY BIG SCARS, I DIDN'T SEE ANYTHING ABNORMAL
11 JUST BY LOOKING AT THE LUNGS THAT WAY.
12 WHEN I LOOKED AT THE LUNG UNDER A MICROSCOPE, I DID
13 FIND EVIDENCE THAT THIS WAS A PERSON WHO WAS DEVELOPING A
14 PNEUMONIA. THERE WAS INFLAMMATION OR WHITE BLOOD CELLS IN
15 AREAS OF THE LUNG INDICATING THAT THERE WAS AN INFECTION IN
16 THAT REGION.
17 Q. OKAY. AND HOW ACUTE WAS THAT? WERE YOU ABLE TO
18 DETERMINE?
19 A. IT WAS QUITE ACUTE. IT'S SOMETHING THAT COULD HAVE BEEN
20 THERE FOR A MATTER OF DAYS AT MOST. AND IT WAS FOCAL. IT
21 WASN'T SOMETHING THAT WAS THROUGHOUT EVERY SECTION I SAW.
22 IT WAS PATCHY.
23 Q. OKAY. AND HOW LIFE-THREATENING WOULD THAT HAVE BEEN?
24 A. IN AND OF ITSELF IT WASN'T A -- AN EXTENSIVE PROCESS.
25 IT WASN'T SOMETHING THAT I WOULD SAY WAS SOLELY, BY ITSELF,
1929
1 A LIFE-THREATENING PROCESS.
2 Q. OKAY. AND WHAT -- WHAT, IF ANYTHING ELSE, DID YOU LOOK
3 AT AS FAR AS THE LUNGS WERE CONCERNED?
4 A. AGAIN, UNDER THE MICROSCOPE I ALSO SAW SIGNS OF EARLY
5 EMPHYSEMA, BASICALLY LOSS OF SOME OF THE TISSUE OF THE LUNGS
6 SO THAT THE AIR SPACES HAVE BECOME ENLARGED.
7 Q. OKAY. AND ANYTHING ELSE THAT YOU DISCOVERED?
8 A. IN THE LUNGS, NO.
9 Q. OKAY. AND WHAT WAS THE NEXT AREA THAT YOU LOOKED AT?
10 A. WE LOOKED AT ALL OF THE BODY ORGANS. I LOOKED NEXT AT
11 THE LIVER. FOUND EVIDENCE OF BOTH THE EMBALMING AND SOME OF
12 THE DETERIORATION FROM BEING BURIED FOR THAT PERIOD OF TIME,
13 BUT NO OTHER ABNORMALITIES.
14 THE GALLBLADDER WAS ALSO LOOKED AT AND SHOWED NO
15 EVIDENCE OF GALL STONES OR SOMETHING LIKE THAT.
16 I LOOKED AT THE ALIMENTARY TRACT WHICH IS BASICALLY THE
17 ESOPHAGUS, THE STOMACH, THE INTESTINES. SAW THE CHANGES
18 RELATING TO THE EMBALMING PROCESS AND DECOMPOSITION, BUT NO
19 OTHER ABNORMALITIES THAT I CONSIDERED PATHOLOGIC OR DISEASE.
20 I LOOKED AT THE KIDNEYS. THE KIDNEYS WERE REMARKABLE
21 FOR SCARRING OF THE OUTER SURFACE, AS WELL AS A NUMBER OF
22 SMALL CYSTS OR CLEAR FLUID-FILLED CAVITIES. THESE KINDS OF
23 CHANGES ARE THINGS WE SEE IN PEOPLE WHO HAVE BOTH HIGH BLOOD
24 PRESSURE, AS WELL AS THE HARDENING OF THE ARTERIES THAT I'VE
25 ALREADY TALKED ABOUT.
1930
1 Q. AGAIN, WERE THEY THINGS THAT WERE SIGNIFICANT TO YOU?
2 A. THEY WENT ALONG WITH THIS INDIVIDUAL'S HISTORY. THEY
3 WERE NOT THE KINDS OF THINGS THAT YOU WOULD POINT TO AND SAY
4 THIS ABNORMALITY WOULD KILL A PERSON, NO.
5 Q. WOULD THOSE ABNORMALITIES, BASED ON YOUR TRAINING AND
6 EXPERIENCE, CAUSE PAIN FOR THE PERSON?
7 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT.
8 BEYOND THE SCOPE.
9 MR. MAJOR: BASED ON HIS TRAINING AND EXPERIENCE,
10 IF HE CAN'T ANSWER IT --
11 THE COURT: WELL, LET'S LAY A FOUNDATION.
12 Q. (BY MR. MAJOR) DO YOU HAVE THE TRAINING AND EXPERIENCE
13 IN LOOKING AT BODIES --
14 A. YES.
15 Q. -- AND DETERMINING WHAT EFFECTS YOU SEE?
16 A. YES.
17 Q. AND WOULD YOU BE ABLE TO DETERMINE IF YOU SAW PARTICULAR
18 ITEMS IN THE BODY WHETHER THAT WOULD BE PAINFUL OR NOT
19 PAINFUL?
20 A. YES.
21 Q. AND WERE YOU ABLE TO DO THAT ON THIS OCCASION?
22 A. YES.
23 MR. MAJOR: MAY WE PROCEED, YOUR HONOR?
24 MR. STIRBA: MAY I VOIR DIRE, YOUR HONOR?
25 THE COURT: YES. GO AHEAD.
1931
1 MR. MAJOR: WELL, IF HE HAS A QUESTION I'D RATHER
2 PERHAPS HAVE HIM INDICATE WHAT THE PROBLEM IS.
3 THE COURT: WELL, THE ISSUE -- THE ISSUE GOES TO
4 FOUNDATION, SO HE CAN VOIR DIRE.
5 MR. MAJOR: THANK YOU, YOUR HONOR.
6 VOIR DIRE EXAMINATION
7 BY MR. STIRBA:
8 Q. DR. GREY, YOU'VE TESTIFIED YOU'RE A FORENSIC
9 PATHOLOGIST, TRUE?
10 A. YES.
11 Q. AND IT'S TRUE, IS IT NOT, THAT IN TERMS OF ACTUAL
12 TREATMENT OF PATIENTS OR CLINICAL EXPERIENCE, THAT WAS
13 LIMITED TO THE TIME THAT YOU WERE IN MEDICAL SCHOOL; ISN'T
14 THAT RIGHT?
15 A. YES.
16 Q. AND IT'S TRUE, IS IT NOT, THAT WITH RESPECT TO KIDNEY
17 PROBLEMS THAT SOMEBODY MIGHT EXPERIENCE, YOU HAVE NOT
18 TREATED SOMEBODY FOR THAT PARTICULAR PROBLEM, HAVE YOU?
19 A. NO.
20 Q. AND, IN FACT, BECAUSE YOU DON'T HAVE CLINICAL EXPERIENCE
21 AND YOU'RE NOT A TREATING PHYSICIAN, THAT'S NOT SOMETHING
22 THAT TYPICALLY YOU WOULD SEE FOR PURPOSES OF SEEING SOMEBODY
23 SUCH AS A PATIENT WHO MIGHT HAVE THAT PROBLEM; IS THAT
24 RIGHT?
25 A. WOULD I -- I GUESS I DON'T UNDERSTAND THE QUESTION. I
1932
1 WOULD NOT RENDER TREATMENT TO PATIENTS. I WOULD BE ABLE TO
2 INTERPRET PATHOLOGIC FINDINGS AND DISCUSS WHAT THE SYMPTOMS
3 OF THOSE FINDINGS MIGHT BE.
4 Q. AND -- AND YOU WOULD AGREE, WOULD YOU NOT, THAT
5 QUINTESSENTIALLY PAIN IS A CLINICAL ASSESSMENT?
6 A. PAIN IS A CLINICAL ASSESSMENT IN TERMS OF HOW THE
7 PATIENT COMPLAINS OF IT. THE PATHOLOGY THAT MAY CAUSE PAIN
8 IS SOMETHING THAT I CAN ASSESS.
9 Q. IT'S TRUE, IS IT NOT, THAT IT'S A SUBJECTIVE SYMPTOM
10 SELF-REPORTED BY THE PATIENT?
11 A. CERTAINLY.
12 Q. THERE'S NO SUCH THING AS A, QUOTE, OBJECTIVE FINDING OF
13 PAIN, IS THERE?
14 A. THERE IS NO WAY THAT SOMEBODY CAN MEASURE PAIN
15 EXTERNALLY, NO.
16 MR. STIRBA: THAT'S ALL. I'D RENEW MY OBJECTION.
17 BEYOND THE SCOPE OF THIS WITNESS'S EXPERTISE, YOUR HONOR.
18 THE COURT: OKAY. OVERRULED. GO AHEAD.
19 DIRECT EXAMINATION, CONT'D
20 BY MR. MAJOR:
21 Q. SO BASED ON WHAT YOU OBSERVED, THESE CYSTS THAT YOU
22 DESCRIBED ON THE KIDNEYS, WOULD THAT, IN YOUR TRAINING AND
23 EXPERIENCE, HAVE CAUSED PAIN?
24 A. NO. I DID NOT SEE ANYTHING THAT -- PATHOLOGICALLY THAT
25 WOULD CAUSE PAIN.
1933
1 Q. SO AFTER WE HAD DONE THIS WITH THE KIDNEYS, WHAT WAS THE
2 OTHER THINGS YOU GOT INTO?
3 A. WE THEN WOULD LOOK AT THE BLADDER AND PROSTATE. THE
4 PROSTATE IS THE GLAND AT THE BASE OF THE BLADDER. IT WAS
5 SLIGHTLY ENLARGED, WHICH IS NORMAL FOR AN INDIVIDUAL OF THIS
6 AGE. I ALSO LOOKED AT THE SPLEEN AND SAW NOTHING ABNORMAL
7 IN THE SPLEEN. WE LOOKED AT THE ENDOCRINE SYSTEM WHICH
8 WOULD BE THE GLANDS THAT PRODUCE CERTAIN TYPES OF COMPOUNDS
9 OR HORMONES.
10 THE ONE ABNORMALITY I FOUND WAS THAT THIS INDIVIDUAL
11 HAD A VERY SHRUNKEN THYROID GLAND WHICH WOULD INDICATE THAT
12 HE PROBABLY WAS HYPOTHYROID.
13 Q. OKAY. AND DID YOU DO ANY OTHER EXAMINATIONS?
14 A. YES. THE FINAL THING WE DID IN THE TORSO WAS LOOKING AT
15 THE BONES THAT WERE VISIBLE, AND SAW NO ABNORMALITIES, NO
16 FRACTURES OR OTHER PROBLEMS.
17 Q. SO IN YOUR EXAMINATION OF THE INTERIOR, I GUESS, OF
18 THE -- OF THE TORSO OF THE BODY, DID YOU FIND ANYTHING BASED
19 ON YOUR TRAINING AND EXPERIENCE THAT WOULD LEAD YOU TO
20 BELIEVE THIS PATIENT WOULD HAVE BEEN IN PAIN?
21 A. I FOUND NO PATHOLOGIES THAT I WOULD SAY WERE
22 PAIN-CAUSING DISEASE PROCESSES, NO.
23 Q. DID YOU FIND ANYTHING IN YOUR EXAMINATION OF THE TORSO
24 THAT WOULD HAVE BEEN LIFE-THREATENING?
25 A. YES.
1934
1 Q. WHAT WAS THAT?
2 A. THE HEART DISEASE IS CLEARLY A CONDITION THAT COULD
3 EXPLAIN THIS INDIVIDUAL'S DEATH.
4 Q. OKAY. AND ANYTHING ELSE?
5 A. THE FINDING OF THE PNEUMONIA AND THE EMPHYSEMA, THE
6 DEGENERATION OF THE LUNG TISSUE, ARE THINGS THAT IN
7 CONJUNCTION WITH THE HEART DISEASE MAY HAVE OR COULD HAVE
8 CONTRIBUTED TO DEATH.
9 Q. OKAY. AND WHAT WAS THE NEXT AREA THAT YOU EXAMINED?
10 A. THAT WOULD BE THE BRAIN.
11 Q. OKAY. WHAT DID YOU DO AS FAR AS EXAMINATION OF THE
12 BRAIN?
13 A. THE PROCESS? IS THAT WHAT YOU'RE ASKING?
14 Q. YEAH, THE PROCESS.
15 A. THE PROCESS IS ONE WHERE WE FIRST REFLECT THE SCALP,
16 ESSENTIALLY PEEL THE SCALP BACK, LOOK AND SEE IF THERE'S ANY
17 EVIDENCE OF SKULL FRACTURES OR DAMAGE. WE THEN REMOVE THE
18 TOP OF THE SKULL AND EXPOSE THE BRAIN, LOOK AT IT INSITU --
19 BASICALLY, AS IT SITS THERE -- AND THEN WE REMOVE IT, WEIGH
20 IT, AND DISSECT IT TO SEE IF THERE'S ANY ABNORMALITIES
21 INTERNALLY.
22 Q. OKAY. AND WHAT WAS THE CONDITION OF THE BRAIN IN
23 MR. ALLDREDGE?
24 A. THE BRAIN HAD DECOMPOSITION OR THE DETERIORATION THAT
25 OCCURS AFTER DEATH. IT WAS SMALLER THAN EXPECTED AND HAD
1935
1 ESSENTIALLY PUDDLED TOWARDS THE BACK OF THE HEAD.
2 Q. OKAY. AND WHAT TYPE OF THINGS ARE YOU LOOKING FOR WHEN
3 YOU'RE LOOKING AT THE BRAIN?
4 A. ESSENTIALLY I'M LOOKING FOR ANY ABNORMALITY I CAN FIND.
5 I LOOK FOR SUCH THINGS AS BLEEDING; SUBDURAL HEMATOMA, OR
6 COLLECTION OF BLOOD BETWEEN THE INNER SURFACE OF THE SKULL
7 AND THE BRAIN; HEMORRHAGE ON THE MEMBRANES THAT COAT THE
8 BRAIN, WHICH IS CALLED SUBARACHNOID HEMORRHAGE. I LOOK FOR
9 BLEEDING WITHIN THE SUBSTANCE OF THE BRAIN. IF I CAN, I TRY
10 TO FIND IF THERE'S EVIDENCE OF A LACK OF BLOOD FLOW TO THE
11 BRAIN AND DEATH OF BRAIN TISSUE. THOSE ARE THE THINGS
12 THAT -- KINDS OF THINGS I'D BE LOOKING FOR.
13 Q. OKAY. AND ARE -- WE COMMONLY REFER TO THOSE AS BEING
14 STROKES?
15 A. THE BLEEDING INTO THE -- INTO THE BRAIN OR THE LACK OF
16 BLOOD FLOW TO THE BRAIN CAUSING DEATH OF THE TISSUES ARE THE
17 TWO KINDS OF CONDITIONS THAT ARE GENERALLY CALLED STROKE.
18 Q. AND HOW DO YOU DETERMINE WHETHER THERE'S BEEN A STROKE?
19 A. BY LOOKING AT THE BRAIN, ESSENTIALLY.
20 Q. AND WHAT IS IT THAT YOU -- THAT TELLS YOU THAT?
21 A. AS I SAID, THERE'S TWO KINDS OF STROKES. ONE IS WHAT'S
22 CALLED A HEMORRHAGIC STROKE WHERE THERE'S ACTUAL RUPTURE OF
23 THE BLOOD VESSEL AND BLEEDING INTO THE BRAIN ITSELF. THAT
24 IS SOMETHING WHICH IS FAIRLY DRAMATIC AND QUITE DIAGNOSABLE
25 BY LOOKING AT THE BRAIN. THE OTHER KIND OF STROKE WHERE
1936
1 THERE'S NOT ENOUGH BLOOD FLOW TO THE BRAIN, WHAT THAT CAUSES
2 IS SOFTENING OF THE BRAIN, SOME DISCOLORATION, AND
3 EVENTUALLY, AS TIME GOES BY, AN ACTUAL LOSS OF TISSUE SO
4 THAT THERE BECOMES A VOID OR A HOLE LEFT IN THE BRAIN.
5 Q. AND WHAT DID YOU FIND WHEN YOU EXAMINED MR. ALLDREDGE'S
6 BRAIN?
7 A. I DID NOT SEE ANY OF THOSE PROCESSES OR CONDITIONS THAT
8 WE'VE JUST DISCUSSED. THE PROBLEM THOUGH IS THERE WAS A LOT
9 OF SOFTENING OF THE BRAIN SO THAT THE QUALITY OF THE EXAM
10 WAS NOT AS GOOD AS IT WOULD HAVE BEEN IF I'D HAD A BRAIN
11 WHICH WAS FRESH OR WELL PRESERVED.
12 Q. OKAY. AND WHAT, IF ANYTHING, DID YOU DETERMINE AS FAR
13 AS THAT WAS CONCERNED?
14 A. I COULD NOT SEE ANY PATHOLOGY -- IDENTIFIABLE PATHOLOGY
15 IN THE BRAIN.
16 Q. OKAY. DID YOU SEE ANYTHING THAT INDICATED TO YOU
17 THERE'D BEEN A STROKE?
18 A. NO, I DID NOT.
19 Q. DID YOU SEE ANYTHING THAT -- IN EXAMINING THIS BRAIN
20 THAT YOU WOULD CALL AN ACUTE CONDITION?
21 A. NOT THAT I COULD IDENTIFY, NO.
22 Q. DID YOU SEE ANYTHING THAT --
23 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT. THIS
24 IS LEADING AND SUGGESTIVE.
25 THE COURT: SUSTAINED.
1937
1 Q. (BY MR. MAJOR) DID YOU SEE ANYTHING AS FAR AS -- WELL,
2 LET'S STRIKE THAT.
3 WHAT ELSE -- WHAT WAS THE NEXT THING THAT YOU DID AS
4 FAR AS THE EXAMINATION WAS CONCERNED?
5 A. THE -- THAT -- WHAT WE'VE DISCUSSED SO FAR ESSENTIALLY
6 IS THE END OF THE AUTOPSY. WE'VE LOOKED -- I LOOKED AT ALL
7 OF THE VARIOUS ORGANS. AS PART OF THAT PROCESS, AS I SAID,
8 I TOOK BIOPSIES. THOSE WOULD BE PLACED IN FORMALDEHYDE AND
9 THEN PROCESSED AND TURNED INTO SLIDES SO THAT I COULD LOOK
10 AT THEM UNDER THE MICROSCOPE.
11 THE OTHER THING I WOULD -- I DID WAS SUBMIT SAMPLES OF
12 TISSUES TO THE TOXICOLOGY LAB TO SEE IF THEY COULD FIND ANY
13 DRUGS OR POISONS.
14 Q. OKAY. NOW, WHAT WERE YOU LOOKING FOR WHEN YOU SUBMITTED
15 THOSE SAMPLES?
16 A. I WAS LOOKING FOR ANYTHING THAT THE TOX LAB COULD FIND.
17 SPECIFICALLY, I WAS CONCERNED ABOUT THE ISSUE OF WAS THERE
18 MORPHINE DETECTABLE IN THIS INDIVIDUAL.
19 Q. NOW, AS A PATHOLOGIST AND MEDICAL EXAMINER, ARE YOU
20 EXPERIENCED IN LOOKING FOR DIFFERENT TYPES OF DRUGS IN THE
21 SYSTEM?
22 A. THE PROCESS OF ACTUALLY DOING THOSE TESTS, I DO NOT DO.
23 I DO INTERACT WITH THE TOXICOLOGISTS. I DECIDE WHAT SAMPLES
24 ARE THE ONES THAT I WANT TO HAVE ANALYZED, AND THEN I AM
25 FAMILIAR WITH INTERPRETING THE RESULTS OF THE TESTING THAT'S
1938
1 DONE.
2 Q. AND YOU'RE ALSO FAMILIAR WITH WHAT SAMPLES ARE BEST TO
3 SEND TO TEST?
4 A. YES.
5 Q. OKAY. IF YOU'RE LOOKING FOR DRUGS, SPECIFICALLY
6 OPIATES, OR MORPHINE, WHAT NORMALLY ARE THE BEST TISSUE
7 SAMPLES OR THINGS TO BE SENDING TO THE LAB?
8 A. WHAT I WOULD BE -- IF WE'RE -- WHAT I WOULD WANT TO HAVE
9 ANALYZED IN A SUSPECTED OPIATE DEATH WOULD BE BLOOD, LIVER,
10 BILE, AND URINE. THOSE ARE SORT OF THE BIG FOUR OF THE
11 SAMPLES THAT I WANT TO HAVE ANALYZED TO UNDERSTAND AN OPIATE
12 INTOXICATION DEATH.
13 Q. OKAY. WERE THOSE PRESENT IN MR. ALLDREDGE'S SITUATION?
14 A. WHAT WE FOUND WAS A SMALL AMOUNT OF BLOODY MATERIAL
15 WITHIN THE HEART, SO THERE WAS A RESIDUE OF BLOOD IN THE
16 HEART. THERE WAS LIVER. THERE WAS NO URINE, AND THE BILE
17 WAS ABSENT BECAUSE OF THE PUNCTURING FROM THE EMBALMING
18 PROCESS.
19 Q. NOW, HAD THE -- HAD THERE BEEN ANY EMBALMING PROCESS
20 INVOLVING THE HEART?
21 A. YES. REMEMBER I SAID THAT THERE WERE TROCARING INJURIES
22 INTO THE HEART.
23 Q. RIGHT. WHAT WAS THE RESULTS OF THE TOXICOLOGY REPORT?
24 A. THE -- THE PROCESS OF DOING THE TOXICOLOGY IS -- IS SORT
25 OF A TWO-STEPPER. THE FIRST THING THEY'LL DO IS WHAT'S
1939
1 CALLED A SCREEN. NOW, THIS IS A TYPE OF TESTING THAT IS NOT
2 VERY SPECIFIC. IT DOESN'T -- IT DOESN'T TELL YOU EXACTLY
3 WHAT'S THERE, BUT IT CAN INDICATE SORT OF THE BROAD -- A
4 BROAD CATEGORY OF CLASS OF DRUGS MAY BE PRESENT.
5 IN THIS CASE THEY -- THE TOX LAB DID A SCREEN ON THE
6 HEART AND THAT SHOWED THE POSSIBILITY OF OPIATES BEING
7 PRESENT. THE NEXT STEP IS WHEN YOU HAVE A POSITIVE SCREEN
8 LIKE THAT IS TO NARROW IT DOWN AND SAY OKAY, WHAT DOES THIS
9 REALLY MEAN? ARE WE -- WHAT ARE WE SEEING? AND SO THEY
10 WILL DO A MUCH MORE SPECIFIC TEST TO SEE IF THEY CAN
11 IDENTIFY THE COMPOUND THAT MAY HAVE MADE THIS SCREEN BECOME
12 POSITIVE.
13 AND IN THIS CASE THEY -- EVEN THOUGH THEY HAD A
14 POSITIVE SCREEN FOR OPIATES, THEY COULD NOT IDENTIFY THEM
15 SPECIFICALLY ON THAT QUANTIFICATION TEST.
16 Q. NOW, HAVE YOU HAD ANY -- DONE ANY STUDIES OR DONE ANY
17 RESEARCH OR HAVE ANY KNOWLEDGE AS TO WHAT EFFECT AN
18 EMBALMING AND INTERMENT IN THE GROUND HAVE ON DETECTING
19 THOSE TYPE OF OPIATES?
20 A. AGAIN, THE SPECIFICS OF THE TESTING PROCEDURE AND HOW
21 THAT AFFECTS THE PROCEDURES, NO, I'M NOT ABLE TO ANSWER THAT
22 QUESTION. WHAT I HAVE LOOKED AT IS THE ISSUE OF POSTMORTEM
23 MORPHINE ANALYSIS IN EMBALMED BODIES. SO I HAVE A GENERAL
24 IDEA OF THAT ISSUE, BUT NOT THE SPECIFIC COMPLICATIONS OF
25 THE TESTING.
1940
1 Q. THE TESTING. AND WHAT IS, BASICALLY, YOUR FEELING ON
2 THAT?
3 MR. STIRBA: YOUR HONOR -- YOUR HONOR, I THINK I'M
4 GOING TO OBJECT. HE'S NOT A TOXICOLOGIST, AND I BELIEVE THE
5 TOXICOLOGIST WAS HERE YESTERDAY CALLED BY THE STATE. AND I
6 THINK HE'S CONCEDED HE DOESN'T HAVE EXPERTISE IN THIS AREA.
7 THE COURT: OKAY. EITHER LAY MORE OF A FOUNDATION
8 OR --
9 MR. MAJOR: WELL, YOUR HONOR, IF I MIGHT, I THINK
10 HIS TESTIMONY WAS HE -- THE TOXICOLOGIST DOES THE TESTS. HE
11 DOES THE INTERPRETATION.
12 THE COURT: WELL --
13 Q. (BY MR. MAJOR) YOU -- YOU GENERALLY DO THE
14 INTERPRETATION OF WHAT THE TOXICOLOGY BRINGS BACK.
15 A. YES.
16 Q. AND YOU'RE TRAINED AND EXPERIENCED IN DOING THAT?
17 A. YES.
18 Q. HOW MANY TIMES HAVE YOU -- SAY HAVE YOU DONE TESTS FOR
19 DIFFERENT TYPES OF OPIATES AND MADE THOSE INTERPRETATIONS?
20 A. SEVERAL THOUSAND.
21 MR. MAJOR: WITH THAT, YOUR HONOR, I THINK HE WOULD
22 BE QUALIFIED TO --
23 MR. STIRBA: SAME OBJECTION. FOUNDATION, YOUR
24 HONOR, AND IT'S NOT INTERPRETATION OF THE TESTS. IT'S --
25 IT'S SOMETHING MORE THAN THAT THAT I'M CONCERNED ABOUT.
1941
1 THE COURT: OKAY. SUSTAINED.
2 Q. (BY MR. MAJOR) DO YOU HAVE ANY PARTICULAR -- WELL,
3 LET'S GO ON.
4 PART OF WHAT YOU'RE DOING FOR THE AUTOPSY -- WELL,
5 STRIKE THAT QUESTION.
6 WAS THERE ANYTHING ELSE YOU DID AS FAR AS THIS AUTOPSY
7 IS CONCERNED?
8 A. BEYOND THE -- WHAT WE'VE TALKED ABOUT, NO.
9 Q. WAS THE FACT THAT YOU -- THERE WAS NO DETECTABLE
10 MORPHINE IN THE SYSTEM, DOES THAT CAUSE YOU ANY CONCERN?
11 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT.
12 RELEVANCY.
13 MR. MAJOR: WELL, I THINK IT'S RELEVANT.
14 THE COURT: OVERRULED.
15 A. COULD YOU REPEAT THE QUESTION, PLEASE?
16 Q. (BY MR. MAJOR) YES. DID THE FACT THAT THE
17 TOXICOLOGIST DID NOT DETECT ANY MORPHINE IN THE -- COULD NOT
18 DETECT ANY MORPHINE IN THE BODY SYSTEM, DID THAT CAUSE YOU
19 ANY CONCERNS?
20 A. NOT REALLY.
21 Q. WHY NOT?
22 A. BECAUSE I WAS NOT CONVINCED THAT A NEGATIVE TEST AFTER
23 THIS -- AFTER EMBALMING AND INTERMENT FOR THIS PERIOD OF
24 TIME NECESSARILY WAS AN ACCURATE REFLECTION OF WHAT WAS
25 PRESENT AT THE TIME OF DEATH.
1942
1 Q. OKAY. AND DO YOU HAVE ANY REASON FOR THAT?
2 A. BECAUSE OF THE UNCERTAINTY OF WHAT THAT EMBALMING AND
3 DETERIORATION PROCESS WOULD DO TO THE TOXICOLOGY OR THE
4 PRESENCE OF MATERIALS IN THE BODY FROM DEATH TO WHEN THE
5 SAMPLING OCCURRED. Basically no information was found.
6 Q. OKAY. NOW, ONE OF THE THINGS THAT YOU MENTIONED THAT
7 THE MEDICAL EXAMINER DOES IS TO DETERMINE THE CAUSE OF DEATH
8 OR THE MANNER OF DEATH.
9 A. YES.
10 Q. AND WHY IS THAT AND WHAT DOES THAT ENTAIL?
11 A. THE TWO THINGS WE'RE TALKING ABOUT ARE CAUSE OF DEATH,
12 WHICH IS THE PATHOLOGY OR THE DISEASE OR INJURY THAT HAS LED
13 TO THIS PERSON'S DEATH. AND THEN THE MANNER OF DEATH IS AN
14 OPINION AS TO WHAT THE CIRCUMSTANCES SURROUNDING THAT DEATH
15 ARE.
16 SO THE TWO THINGS ARE MY -- AS THE MEDICAL EXAMINER
17 IT'S MY JOB TO DO BOTH OF THOSE, SAY WHY THE PERSON DIED,
18 AND RENDER AN OPINION AS TO HOW THAT PERSON CAME TO THEIR
19 DEATH.
20 Q. OKAY. AND AS FAR AS MANNER OF DEATH?
21 A. THAT'S WHAT I'VE JUST DESCRIBED.
22 Q. OKAY. AND WHAT TYPES OF MANNERS OF DEATH DO YOU HAVE?
23 A. THE MANNERS -- THE CLASSIFICATION OF MANNER ARE NATURAL,
24 SUICIDE, ACCIDENT, HOMICIDE, OR UNDETERMINED.
25 Q. OKAY. NOW, WHAT DOES UNDETERMINED MEAN?
1943
1 A. BASICALLY UNDETERMINED MEANS THAT ON THE BASIS OF THE
2 INFORMATION THAT WE HAVE BOTH FROM THE AUTOPSY AND THE
3 INVESTIGATION, WE CANNOT COME TO A -- A CONCLU -- A
4 CONCLUSION THAT ALLOWS US TO PUT IT INTO ONE OF THE OTHER
5 CATEGORIES.
6 Q. OKAY. AND LET ME SHOW YOU WHAT'S BEEN MARKED FOR
7 IDENTIFICATION AS PLAINTIFF'S EXHIBIT NUMBER 24 AND ASK YOU
8 IF YOU CAN IDENTIFY THAT?
9 A. YES.
10 Q. AND WHAT IS THAT?
11 A. THIS IS A SERIES OF THREE COPIES OF A DEATH CERTIFICATE
12 AND AMENDMENTS FOR MR. ALLDREDGE.
13 Q. OKAY. AND ON THE FIRST PAGE OF THAT --
14 A. YES.
15 Q. -- EXHIBIT, WHAT IS THAT?
16 A. THIS WAS THE ORIGINAL CERTIFICATE OF DEATH THAT WAS
17 COMPLETED FOR MR. ALLDREDGE.
18 Q. AND WHEN WAS IT COMPLETED?
19 A. IT WAS SIGNED ON THE 18TH OF JANUARY, 1996; FILED ON THE
20 24TH.
21 Q. OKAY. AND WHAT'S ON THE SECOND PAGE?
22 A. THE SECOND PAGE IS AN AMENDMENT INDICATING CERTAIN
23 CHANGES FROM -- IN THE INFORMATION RECORDED ON THE ORIGINAL
24 CERTIFICATE.
25 Q. NOW, TURNING BACK TO THE ORIGINAL CERTIFICATE, WHO
1944
1 SIGNED THAT ORIGINAL CERTIFICATE?
2 A. THAT WAS BY DR. WEITZEL. IS THAT THE CORRECT
3 PRONUNCIATION?
4 Q. YES.
5 A. OKAY.
6 Q. AND WHAT DID HE INDICATE ON THAT DEATH CERTIFICATE?
7 MR. STIRBA: YOUR HONOR, IS IT -- IS IT GOING TO BE
8 OFFERED?
9 MR. MAJOR: WE WILL OFFER IT, YOUR HONOR.
10 THE COURT: ANY OBJECTION?
11 MR. STIRBA: MAY I SEE IT, PLEASE?
12 (MR. MAJOR TENDERS EXHIBIT TO MR. STIRBA.)
13 MR. STIRBA: NO OBJECTION. THANK YOU.
14 THE COURT: OKAY. THAT'S PLAINTIFF'S EXHIBIT 24?
15 MR. MAJOR: THAT IS PLAINTIFF'S EXHIBIT 24, YOUR
16 HONOR.
17 THE COURT: OKAY. IT WILL BE RECEIVED.
18 Q. (BY MR. MAJOR) AND THEN GOING BACK AGAIN, WHAT WERE
19 THE CAUSES OF DEATH LISTED BY DR. WEITZEL?
20 A. THE FIRST LINE READS CARDIAC ARREST, THE SECOND LINE
21 READS RESPIRATORY ARREST, AND THE THIRD LINE IS C.V.A.
22 Q. NOW, DID YOU FIND ANYTHING BASED ON YOUR AUTOPSY TO
23 SUPPORT ANY OF THOSE CAUSES OF DEATH?
24 A. THE FIRST TWO, CARDIAC ARREST AND RESPIRATORY ARREST,
25 ARE BASICALLY SAYING THAT THE PERSON DOES NOT HAVE A HEART
1945
1 BEAT AND IS NOT BREATHING. SO YES, I DID FIND THAT.
2 Q. OKAY.
3 A. C.V.A. IS CARDIOVASCULAR ACCIDENT. I DID NOT FIND
4 ANYTHING TO SUPPORT THAT.
5 Q. OKAY. SO THEN YOU FILED -- BASED ON YOUR AUTOPSY, YOU
6 FILED AN AMENDED DEATH CERTIFICATE; IS THAT CORRECT?
7 A. THAT IS CORRECT.
8 Q. AND WHAT WAS YOUR RESULTS OF THAT?
9 A. WHAT I DID WAS I CHANGED THE CAUSE OF DEATH FROM THE
10 FIRST -- FROM THE THREE THINGS LISTED ON THE ORIGINAL
11 CERTIFICATE TO UNDETERMINED, AND THEN I PUT OTHER
12 INFORMATION IN CONCERNING A CHANGE IN THE MANNER OF DEATH.
13 Q. AND WHAT DID YOU CHANGE AS FAR AS THE MANNER OF DEATH?
14 A. I CHANGED THE MANNER OF DEATH FROM NATURAL TO, ALSO,
15 UNDETERMINED.
16 Q. AND WHY WAS THAT?
17 A. THE REASON IS BECAUSE OF THE QUESTION OF THE ROLE OF
18 MORPHINE -- THAT MORPHINE PLAYED IN THIS INDIVIDUAL'S DEATH.
19 Q. OKAY. AND YOU REALLY COULDN'T DETERMINE WHAT ROLE THAT
20 PLAYED?
21 A. THAT IS CORRECT.
22 Q. OKAY. MOVING ON, YOU ALSO CONDUCTED SOME OTHER
23 AUTOPSIES; IS THAT CORRECT?
24 A. YES, I DID.
25 Q. AND LET'S TALK ABOUT LYDIA SMITH?
1946
1 A. DO YOU WANT THIS?
2 Q. YEAH, I'LL TAKE THAT BACK. THANK YOU.
3 TURNING NOW, AS WE'VE INDICATED, TO LYDIA SMITH. YOU
4 ALSO PERFORMED THE AUTOPSY ON HER?
5 A. YES, I DID.
6 Q. AND WHEN AND HOW DID THIS BODY COME TO YOUR CARE?
7 A. THE BODY CAME TO US FROM THE MOR -- OR FROM THE
8 CEMETERY. IT WAS ANOTHER EXHUMATION WHERE THEY DUG THE
9 COFFIN UP AND THEN BROUGHT THAT IN FOR US, AND WE LOOKED AT
10 THE BODY. THE EXAM WAS PERFORMED ON THE 3RD OF MAY OF THIS
11 YEAR, STARTING AT 8:15.
12 Q. AND WHO WAS PRESENT DURING THIS AUTOPSY?
13 A. IN ADDITION TO MYSELF AND MY ASSISTANT, DETECTIVE JOE
14 MORRISON OF LAYTON P.D., AND DR. ROBERT ROTHFEDER, WHO WAS
15 AN EXPERT HIRED BY THE DEFENSE.
16 Q. OKAY. AND WHAT WAS THE PROCEDURE THAT YOU FOLLOWED IN
17 THIS CASE?
18 A. THE SAME PROCEDURE THAT WE FOLLOWED IN -- IN THE
19 PREVIOUS AUTOPSY.
20 Q. OKAY. AND WHEN YOU DID YOUR EXTERNAL EXAMINATION, WHAT,
21 IF ANYTHING, DID YOU FIND?
22 A. THE EXTERNAL EXAMINATION WAS REMARKABLE FOR THE FACT
23 THAT THIS INDIVIDUAL'S DEGREE OF PRESERVATION WAS MUCH, MUCH
24 WORSE THAN WHAT WE SAW IN MR. ALLDREDGE.
25 Q. AND DID THAT AFFECT THE ABILITY TO PERFORM THE AUTOPSY?
1947
1 A. NOT TO PERFORM IT, BUT DEFINITELY TO INTERPRET ITS
2 RESULTS AND FINDINGS.
3 Q. OKAY. CAN YOU DESCRIBE A LITTLE BIT ABOUT WHAT HAPPENED
4 AS FAR AS YOUR AUTOPSY IS CONCERNED?
5 A. WE DID THE SAME THING AS I'VE DESCRIBED WHERE WE LOOKED
6 AT THE OUTSIDE OF THE BODY. I FOUND PRETTY EXTENSIVE
7 DECOMPOSITIONAL CHANGE.
8 WHAT -- WHAT I COULD IDENTIFY WAS SHE ALSO HAD A
9 STERNAL SCAR -- A SCAR OVER THE FRONT OF THE CHEST -- AS
10 WELL AS THE EVIDENCE OF EMBALMING WITH A INCISION AT THE
11 BASE OF THE NECK AND THE BUTTON WHERE THE LARGE NEEDLE WAS
12 INSERTED IN HER ABDOMEN.
13 Q. OKAY. AND DID YOU DO ANYTHING AS FAR AS TORSO OR A
14 CAVITY EXAMINATION?
15 A. YES. WE DID THE SAME THING WHERE WE OPENED UP THE TORSO
16 AND THEN LOOKED AT THE VARIOUS ORGANS.
17 Q. AND WHAT DID YOU FIND?
18 A. THE DEGREE OF DECOMPOSITION AND DETERIORATION IN THIS
19 BODY WAS MUCH MORE SEVERE. THE ORGANS OF THE -- THE CHEST,
20 AS WELL AS THE ABDOMEN, WERE MUCH, MUCH MORE ROTTEN,
21 ESSENTIALLY. THEY'D ALL FLATTENED OUT ONTO THE BACK
22 SURFACES OF THE BODY CAVITIES SO THAT THE -- AGAIN, AS I
23 SAID, THE QUALITY OF THE EXAM WAS NOT VERY GOOD. I COULD
24 IDENTIFY ORGANS, BUT THEY WERE QUITE SEVERELY ROTTING.
25 Q. OKAY. AND SO WHAT -- WHAT, IF ANYTHING, WERE YOU ABLE
1948
1 TO ACCOMPLISH WITH THIS AUTOPSY?
2 A. WHAT I FOUND WAS I LOOKED AT THE HEART AND FOUND
3 EVIDENCE THAT THIS INDIVIDUAL HAD HAD A -- ONE OF HER VALVES
4 REPLACED. THE VALVE TO THE AORTA, THE MAIN ARTERY THAT
5 DISTRIBUTES BLOOD TO THE BODY HAD BEEN REPLACED. THIS
6 PROSTHETIC OR MANMADE VALVE WAS INTACT, IT WAS IN THE RIGHT
7 PLACE, IT DID NOT APPEAR TO HAVE BEEN BROKEN IN ANY WAY.
8 LOOKING AT HER CORONARY ARTERIES, THERE WAS LOTS OF
9 DETERIORATION. I FOUND EVIDENCE OF SOME PLAQUING, THE --
10 THE BLOCKAGE, BUT HOW MUCH I COULDN'T TELL BECAUSE THEY WERE
11 SO SEVERELY DETERIORATED.
12 Q. DID YOU FIND ANYTHING ELSE?
13 A. AGAIN, LOOKING AT ALL OF THE OTHER ORGANS OF THE BODY:
14 THE LUNGS, THE LIVER, THE SPLEEN, KIDNEYS, ALL OF THESE HAD
15 THE DETERIORATION THAT I'VE DESCRIBED MAKING IT VERY
16 DIFFICULT TO SEE ANY SORT OF FINE PATHOLOGY. I DID NOT SEE
17 ANYTHING THAT I COULD POINT TO AND SAY CLEARLY THIS IS
18 ABNORMAL, BUT IT WAS A POOR EXAM.
19 Q. DID YOU TAKE ANY TISSUE SAMPLES --
20 A. YES.
21 Q. -- FOR THE TOXICOLOGIST?
22 A. YES, I DID.
23 Q. AND WHAT SAMPLES DID YOU TAKE?
24 A. WE SUBMITTED LIVER, KIDNEY, SPLEEN, BRAIN, AND THEN SOME
25 OF THE DECOMPOSITIONAL FLUID THAT WAS PRESENT WITHIN THE
1949
1 CHEST CAVITY.
2 Q. OKAY. AND WAS THAT SUBMITTED FOR TOXICOLOGY?
3 A. YES, IT WAS.
4 Q. WHAT WERE THE RESULTS OF THE TOXICOLOGY?
5 A. THOSE TESTS USING THE SPECIFIC TESTING, THE
6 QUANTIFICATION TESTS, WERE ALL NEGATIVE FOR MORPHINE.
7 Q. OKAY. THANK YOU. LET ME SHOW YOU WHAT'S BEEN MARKED
8 FOR IDENTIFICATION AS PLAINTIFF'S EXHIBIT NUMBER 25 AND ASK
9 YOU IF YOU CAN IDENTIFY THAT.
10 A. YES.
11 Q. AND WHAT IS THAT?
12 A. THIS IS A COPY OF THE ORIGINAL DEATH CERTIFICATE ON
13 MS. SMITH, AND THE AMENDMENT THAT I SUBMITTED.
14 Q. OKAY. AND WHO SIGNED THE ORIGINAL DEATH CERTIFICATE?
15 A. THIS WAS SIGNED, ALSO, BY DR. WEITZEL.
16 Q. AND WHAT DID HE LIST AS CAUSES OF DEATH?
17 A. FIRST LINE WAS CARDIAC ARREST, SECOND LINE WAS
18 RESPIRATORY ARREST, THIRD LINE WAS HYPOTENSION -- BASICALLY
19 MEANING LOW BLOOD PRESSURE -- AND THE FINAL LINE WAS REFUSAL
20 OF FLUIDS.
21 Q. OKAY. THANK YOU. AND BASED ON YOUR AUTOPSY, DID YOU
22 FILE AN AMENDED DEATH CERTIFICATE?
23 A. YES, I DID.
24 Q. AND WHAT WAS YOUR DETERMINATION OF THE CAUSE OF DEATH?
25 A. AGAIN, IN THIS CASE I CERTIFIED THE CAUSE OF DEATH AS
1950
1 UNDETERMINED.
2 Q. AND THE MANNER OF DEATH?
3 A. ALSO UNDETERMINED.
4 Q. AND WHY WAS THAT?
5 A. FOR THE SAME REASONS THAT WE'VE TALKED ABOUT. I WAS
6 CONCERNED ABOUT THE POSSIBLE ROLE MORPHINE PLAYED IN THIS
7 INDIVIDUAL'S DEATH.
8 Q. THANK YOU.
9 MR. MAJOR: YOUR HONOR, WE'RE MOVING ON TO THE
10 OTHER PATIENTS HERE. IT'S 9:30, IF THE COURT WOULD LIKE TO
11 TAKE A BREAK.
12 THE COURT: WHY DON'T WE JUST KEEP GOING FOR ABOUT
13 ANOTHER 10 OR 15 MINUTES BECAUSE WE'VE HAD THE JURY OUT.
14 MR. MAJOR: THAT'S FINE, YOUR HONOR.
15 THE COURT: IF YOU WANT TO GO ABOUT 10 OR 15
16 MINUTES, AND THEN WE'LL TAKE A BREAK.
17 Q. (BY MR. MAJOR) LET'S MOVE ON THEN TO THE NEXT AUTOPSY
18 PERFORMED AND THAT WAS ELLEN ANDERSON.
19 A. GIVE ME TWO SECONDS HERE.
20 Q. OKAY.
21 A. OKAY.
22 Q. OKAY. AND DO YOU HAVE YOUR REPORTS FOR MS. ANDERSON?
23 A. YES.
24 Q. AGAIN, HOW -- WHAT WERE THE CIRCUMSTANCES OF
25 MS. ANDERSON'S BODY COMING INTO YOUR CARE?
1951
1 A. THE SAME THING. SHE WAS EXHUMED AND THEN BROUGHT TO OUR
2 OFFICE, AND WE DID THE EXAMINATION ON THE 4TH OF MAY
3 STARTING AT 8:40.
4 Q. OKAY. AND WHO WAS PRESENT DURING THAT EXAMINATION?
5 A. AGAIN, DETECTIVE JOE MORRISON AND DR. ROTHFEDER.
6 Q. OKAY. AND WOULD YOU DESCRIBE WHAT YOU DID AS FAR AS THE
7 AUTOPSY IS CONCERNED?
8 A. THE SAME THINGS THAT WE'VE TALKED ABOUT BEFORE. WE
9 LOOKED AT THE OUTSIDE OF THE BODY AND THEN DO THE INTERNAL
10 EXAMINATION.
11 Q. AND WHAT WAS THE CONDITION OF THE BODY? CAN YOU
12 DESCRIBE WHAT YOU FOUND?
13 A. THIS INDIVIDUAL WAS IN MUCH BETTER SHAPE THAN MS. SMITH.
14 ESSENTIALLY, HER DEGREE OF PRESERVATION WAS QUITE GOOD.
15 THERE WAS SOME DISCOLORATION OF THE OUTSIDE OF THE BODY
16 RELATING TO THE FUNGUS GROWTH AND EMBALMING, BUT SHE WAS IN
17 REMARKABLY GOOD SHAPE OR APPEARANCE.
18 Q. OKAY. AND THEN WHAT WAS THE NEXT -- WHAT DID YOU DO
19 THEN?
20 A. WE DID THE SAME THING WHERE WE LOOK AT THE INTERNAL
21 ORGANS AND DO THE DISSECTIONS AS I'VE -- I DESCRIBED IN
22 TALKING ABOUT MR. ALLDREDGE.
23 Q. OKAY. AND WOULD YOU DESCRIBE WHAT YOU OBSERVED AS FAR
24 AS THE BODY CAVITY ITSELF WHEN YOU OPENED THAT?
25 A. WHEN WE DID THE INITIAL OPENING, I FOUND THAT THE BODY
1952
1 ORGANS WERE ALL IN PLACE NORMALLY. THERE WERE NO ABNORMAL
2 COLLECTIONS OF FLUID OR ANYTHING ELSE THERE. SHE DID HAVE
3 SOME TROCAR FINDINGS.
4 Q. AND WHAT DOES -- WHAT DOES TROCAR MEAN?
5 A. JUST THAT LARGE NEEDLE THAT GETS INSERTED THROUGH THE
6 ABDOMINAL WALL. BUT OTHER THAN THAT, THINGS LOOKED PRETTY
7 NORMAL WHEN WE DID THE FIRST OPENING.
8 Q. WHAT WERE THE CONDITIONS OF THE INTERNAL ORGANS?
9 A. THEY WERE WELL PRESERVED.
10 Q. AND WHAT WAS THE NEXT THING THAT YOU DID AFTER YOU HAD
11 OPENED THE BODY CAVITY?
12 A. WE LOOK AT THE HEART.
13 Q. AND HOW DID YOU DO THAT? EXPLAIN THAT TO THE JURY.
14 A. SAME PROCESS OF OPENING THE SAC, LOOKING AT THE OUTSIDE,
15 THEN DISSECTING THE ARTERIES, LOOKING AT THEM TO SEE HOW
16 MUCH OCCLUSION OR ANYTHING ELSE WAS THERE. OPENING THE
17 CHAMBERS AND THEN LOOKING AT THE MUSCLE TISSUE.
18 Q. OKAY. AND I DID FORGET TO ASK YOU ON THIS PARTICULAR --
19 ON THIS WITNESS BEFORE WE GET INTO IT. YOU ALSO RECEIVED
20 THE BODY. WAS THERE ANY DOCUMENTS OR ANYTHING ELSE THAT YOU
21 RECEIVED AS PART OF YOUR AUTOPSY?
22 A. AS WITH MR. ALLDREDGE AND WITH MS. SMITH, WE DID LOOK AT
23 THE MEDICAL RECORDS AS PART OF OUR INVESTIGATION.
24 Q. AND GOING BACK, DID YOU ALSO DO THE SAME THING FOR LYDIA
25 SMITH?
1953
1 A. YES.
2 Q. OKAY. AND I HAD FORGOT TO ASK YOU THIS, BUT LET ME SHOW
3 YOU WHAT'S BEEN MARKED FOR IDENTIFICATION AS PLAINTIFF'S
4 EXHIBIT 4 REPRESENTING THAT THAT IS WHAT HAS BEEN INTRODUCED
5 AS EVIDENCE AS THE HOSPITAL RECORDS FOR LYDIA SMITH, AND ASK
6 YOU IF YOU RECOGNIZE THOSE?
7 A. AND, AGAIN, WITH THE SAME CAVEAT THAT WITHOUT LOOKING AT
8 EACH AND EVERY PAGE, IT DOES LOOK -- APPEAR TO BE THE SAME
9 THINGS THAT I LOOKED AT ON MS. SMITH.
10 Q. AND THE SAME TYPE OF QUESTION WITH WHAT'S BEEN MARKED
11 FOR IDENTIFICATION AS EXHIBIT NUMBER 6, REPRESENTATION
12 THAT'S BEEN INTRODUCED AS THE MEDICAL RECORDS FOR ELLEN
13 ANDERSON FROM THE DAVIS HOSPITAL.
14 A. AGAIN, WITH THE SAME CAVEAT, IT DOES LOOK LIKE THE SAME
15 RECORDS THAT I SAW.
16 Q. DID YOU REVIEW THOSE BEFORE OR AFTER YOU DID YOUR
17 AUTOPSY?
18 A. BOTH.
19 Q. OKAY. OKAY. SO WE GOT -- WITH MS. ANDERSON YOU WERE
20 LOOKING AT -- I THINK YOU TALKED ABOUT PULLING THE HEART
21 OUT. WHAT DID YOU DO AS FAR AS THAT WAS CONCERNED?
22 A. WHAT DID I FIND?
23 Q. YEAH.
24 A. I FOUND THAT SHE DID HAVE SOME MILD HARDENING OF THE
25 CORONARY ARTERIES, BUT THAT THE DEGREE OF BLOCKAGE WAS NOT
1954
1 VERY SIGNIFICANT. I DID, IN LOOKING AT THE HEART -- WITH MY
2 NAKED EYE I DID NOT SEE ANY SCARRING, BUT LOOKING AT THE
3 BIOPSIES UNDER THE MICROSCOPE THERE WAS SOME FINE AREAS OF
4 SCARRING IN THE MUSCLE TISSUE.
5 Q. AND WHAT SIGNIFICANCE DOES THE SCARRING HAVE?
6 A. IT PROBABLY INDICATES THAT THIS IS AN INDIVIDUAL WHO'S
7 HAD SOME DEGREE OF COMPROMISE OF BLOOD FLOW TO THEIR HEART,
8 BUT HAS NOT HAD A FULL BLOWN MYOCARDIAL INFARCTION OR HEART
9 ATTACK.
10 Q. NOW, WHEN YOU SAY "COMPROMISE," WHAT -- WHAT DO YOU
11 MEAN?
12 A. MEANS THAT THEY'RE NOT GETTING ENOUGH BLOOD INTO THEIR
13 HEART MUSCLE, BUT NOT SO SEVERE OF A RESTRICTION THAT LARGE
14 AREAS OF HEART TISSUE DIE.
15 Q. OKAY. WHAT ELSE DID YOU DO?
16 A. SHE DID HAVE THE HARDENING OF THE ARTERIES INVOLVING THE
17 AORTA, AND I SAW EVIDENCE THAT AT SOME POINT THIS -- THE
18 DEGREE OF OBSTRUCTION WAS ENOUGH TO CAUSE A SMALL AREA OF
19 INFARCTION, DEATH OF TISSUE IN THE SPLEEN. IT'S NOT A --
20 IT'S A -- IT WAS AN OLD FINDING, VERY WELL HEALED, AND
21 SMALL.
22 Q. OKAY. WHAT WAS THE NEXT THING THAT YOU DID?
23 A. I LOOKED AT THE LUNGS, AND THEN IN LOOKING AT THEM WITH
24 MY NAKED EYE I SAW ONE AREA OF THE RIGHT LUNG THAT LOOKED
25 LIKE IT MAY HAVE HAD SOME SCARRING IN IT. OTHER THAN THAT I
1955
1 DIDN'T SEE ANYTHING THAT ABNORMAL WITH MY NAKED EYE.
2 LOOKING AT THE LUNG UNDER THE MICROSCOPE, I SAW THAT
3 THAT AREA OF SCARRING WAS DUE TO THE FACT THAT SHE HAD
4 SOMETIME IN THE PAST HAD A BLOOD CLOT THAT LODGED OUT IN HER
5 RIGHT LUNG AND CAUSED A SMALL AREA OF TISSUE DEATH.
6 ADDITIONALLY, UNDER THE MICROSCOPE I SAW ACUTE PNEUMONIA, AN
7 INFECTION IN THE LEFT LUNG, NOT IN THE RIGHT.
8 Q. NOW, WHEN YOU TALK ABOUT ACUTE, WHAT DOES THAT MEAN?
9 A. THAT MEANS THAT IT'S SOMETHING THAT IS DEVELOPING. IT'S
10 AN EARLY PROCESS. IT'S NOT SOMETHING THAT HAS BEEN THERE
11 FOR A LONG TIME.
12 Q. OKAY. BASED ON YOUR TRAINING AND EXPERIENCE, WOULD
13 YOU -- WOULD THAT APPEAR TO HAVE BEEN LIFE-THREATENING?
14 A. IT WAS NOT VERY EXTENSIVE. IT DID NOT INVOLVE THE
15 ENTIRE LUNG, SO PROBABLY NOT. THE REASON FOR THE HESITANCY
16 IS HER LUNGS HAD SOME OTHER PROBLEMS, SO THAT A PNEUMONIA
17 WAS NOT A GOOD THING TO HAVE IN THOSE LUNGS.
18 Q. WE UNDERSTAND THAT. AND THEN WHAT WERE THOSE OTHER
19 PROBLEMS THAT YOU OBSERVED TO THE LUNG?
20 A. WHAT SHE HAD WAS BOTH EMPHYSEMA -- THE LOSS OF TISSUE OF
21 THE LUNGS -- AS WELL AS SOME SCARRING OF THE TISSUES THAT
22 SUPPORT THE LUNG ITSELF, WHAT'S CALLED THE INTERSTITIAL
23 TISSUES.
24 Q. OKAY. AND WHAT DID THAT SAY TO YOU, IF ANYTHING?
25 A. WHAT IT SAID WAS THAT THIS IS A PERSON WHOSE RESPIRATORY
1956
1 STATUS, HER ABILITY TO BREATHE, IS SOMEWHAT COMPROMISED
2 BECAUSE OF THESE DISEASES AND PROCESSES IN HER LUNG.
3 Q. OKAY. AND WHAT WAS THE NEXT AREA THAT YOU EXAMINED?
4 A. THE -- WE LOOKED AT ALL OF THE OTHER ORGANS AND DID NOT
5 FIND ANYTHING ABNORMAL IN THE ORGANS OF THE TORSO.
6 I LOOKED AT HER BRAIN. HER BRAIN WAS REMARKABLE FOR
7 ATROPHY, BASICALLY SOME LOSS OF TISSUE. THIS WOULD GO ALONG
8 WITH HER REPORTED HISTORY OF DEMENTIA. I DID NOT SEE ANY
9 ACUTE PATHOLOGY SUCH AS BLEEDING OR TISSUE DEATH LIKE WE'VE
10 TALKED ABOUT WITH STROKE.
11 Q. OKAY. AND WHAT ELSE WAS DONE?
12 A. FINALLY, WE LOOKED AT HER -- HER BONES AND FOUND
13 EVIDENCE THAT SHE HAD OSTEOPOROSIS -- BASICALLY LOSS OF
14 SUBSTANCE OF THE BONES. SHE HAD DEGENERATIVE CHANGES IN HER
15 SPINE. HER SPINE WAS CURVED ABNORMALLY. FOUND EVIDENCE
16 THAT SHE'D HAD A COMPLETE HIP REPLACEMENT ON THE RIGHT SIDE,
17 AND HAD HAD A PIN INSERTED INTO THE HIP JOINT ON HER LEFT
18 SIDE.
19 Q. OKAY. NOW, LOOKING AT THE OSTEOPOROSIS, AGAIN, CAN YOU
20 EXPLAIN IN A LITTLE MORE DETAIL WHAT THAT IS? DEFINE THAT A
21 LITTLE BIT BETTER?
22 A. OSTEOPOROSIS IS A DEGENERATIVE CONDITION OF THE BONE
23 WHERE YOU ESSENTIALLY ARE LOSING BONE MASS, SO THAT INSTEAD
24 OF HAVING A SOLID, FIRM BONE, IT BECOMES SPONGY OR WEAK OR
25 THINNER.
1957
1 Q. OKAY. AND DID YOU SEE ANYTHING UNUSUAL ABOUT THAT IN
2 HER?
3 A. NO, IT'S A -- UNFORTUNATELY A COMMON CONDITION IN
4 ELDERLY PEOPLE, PARTICULAR ELDERLY WOMEN.
5 Q. ANYTHING UNIQUE ABOUT IT?
6 A. NO.
7 Q. DID YOU NOTICE ANY FRACTURES?
8 A. THERE WAS ONE FRACTURE OF THE LEFT 6TH RIB, AND THAT
9 APPEARED TO ME TO BE SOMETHING THAT HAPPENED AFTER THIS
10 INDIVIDUAL DIED. AND THE REASON I SAY THAT IS THERE WAS NO
11 BLEEDING AROUND IT, NO ASSOCIATED HEMORRHAGE, AND THERE WAS
12 ABSOLUTELY NO EVIDENCE OF THE BODY TRYING TO HEAL THIS AREA
13 OF DAMAGE.
14 Q. OKAY. NOW, YOU TALKED ABOUT THE SPINE. WAS THERE
15 ANYTHING UNIQUE OR UNUSUAL ABOUT THAT?
16 A. YES. AS I SAID, THERE WAS -- AS PART OF HER
17 DEGENERATIVE BONE DISEASE, HER SPINE WAS OUT OF TRUE COLUMN.
18 THERE WAS SOMETHING WHAT'S CALLED SCOLIOSIS, SO INSTEAD OF
19 HAVING A STRAIGHT UP AND DOWN SPINE, IT HAD SOMEWHAT OF AN S
20 SHAPE TO IT.
21 SHE ALSO HAD A CONDITION CALLED KYPHOSIS WHERE THERE'S
22 AN ABNORMAL CURVATURE GIVING YOU SOMEWHAT OF A HUNCHBACK
23 APPEARANCE TO THE UPPER SPINE OR THE THORACIC SPINE.
24 Q. OKAY. GIVEN HER AGE AND CONDITION, DID YOU FIND THIS TO
25 BE UNIQUE?
1958
1 A. NO.
2 Q. WAS THERE ANYTHING UNUSUAL ABOUT IT --
3 A. NO.
4 Q. -- GIVEN HER AGE?
5 A. NO.
6 Q. OKAY. YOU ALSO INDICATED THAT YOU EXAMINED HER HIP
7 REPLACEMENT.
8 A. YES.
9 Q. WHAT DID YOU DO AS FAR AS THAT EXAMINATION WAS
10 CONCERNED?
11 A. THE HIP REPLACEMENT WHERE THE ENTIRE TOP OF THE FEMUR
12 AND HIP SOCKET WERE REPLACED, WE LOOKED AT THAT UNDER --
13 WITH AN X-RAY AND SAW NOTHING ABNORMAL. IN TERMS OF THE
14 PIN, WE ACTUALLY DISSECTED DOWN AND LOOKED AT THAT AND FOUND
15 THAT THERE WAS NO BLEEDING IN THAT AREA. THE BONE WAS
16 INTACT, BUT THE PIN ITSELF WAS QUITE MOBILE, SO ONCE YOU
17 FREED UP ALL OF THE TISSUE, THAT PIN COULD BE QUITE EASILY
18 EXTRACTED.
19 Q. OKAY. AND GOING BACK TO THE HIP REPLACEMENT, DID YOU
20 NOTICE WHETHER OR NOT THE REPLACEMENT WAS INTACT?
21 A. ON THE X-RAY IT APPEARED INTACT, YES.
22 Q. DID YOU SEE PROBLEMS WITH THE SUBMITTING OF THE PIN?
23 A. NOT THAT I COULD SEE ON THE X-RAY, NO.
24 Q. THANK YOU. WHAT ELSE, IF ANYTHING, DID WE DO WITH
25 MS. ANDERSON AT THAT TIME?
1959
1 A. THE SAME THINGS THAT WE'VE TALKED ABOUT. I TOOK THE
2 BIOPSIES TO LOOK AT UNDER THE MICROSCOPE, AND THEN THE
3 TISSUES FOR TOXICOLOGY.
4 Q. OKAY. AND WHAT TISSUES DID WE TAKE FOR TOXICOLOGY?
5 A. WE SUBMITTED -- OR I SUBMITTED LIVER, A HARDENED CLOT OF
6 BLOOD THAT WE FOUND IN THE HEART, SPLEEN, BRAIN, AND KIDNEY.
7 Q. OKAY. NOW, AGAIN, ALL OF THESE HAVE BEEN EMBALMED?
8 A. YES.
9 Q. AND WHAT WERE THE RESULTS OF THE TOXICOLOGY?
10 A. WHAT THEY FOUND WAS THAT THERE WERE DETECTABLE AMOUNTS
11 OF AMITRIPTYLINE -- WHICH IS A ANTIDEPRESSANT MEDICATION --
12 IN THE LIVER AND THE CLOT. AND THE SPECIFIC TESTS FOR
13 MORPHINE WERE NEGATIVE, BELOW THE DETECTION LEVELS.
14 Q. OKAY. THANK YOU. NOW, WITH THE AUTOPSY THAT YOU
15 PERFORMED ON MS. ANDERSON, DID YOU FIND ANYTHING THAT YOU
16 WOULD -- THAT APPEARED TO BE ACUTE?
17 A. THE PNEUMONIA WAS THE ONLY ACUTE CONDITION THAT I COULD
18 IDENTIFY.
19 Q. DID YOU FIND ANYTHING THAT WOULD APPEAR TO YOU TO BE
20 LIFE-THREATENING?
21 A. GIVEN HER TENTATIVE RESPIRATORY STATUS BECAUSE OF THE
22 SCARRING AND LOSS OF TISSUE IN HER LUNGS, THE PNEUMONIA MAY
23 POSSIBLY HAVE BEEN LIFE-THREATENING. IN A HEALTHY
24 INDIVIDUAL, THAT DEGREE OF PNEUMONIA WOULD NOT BE. SO WITH
25 THAT CAVEAT, THE PNEUMONIA MAY HAVE BEEN. OTHER THAN THAT,
1960
1 I FOUND NOTHING THAT I COULD POINT TO AND SAY THIS WOULD
2 EXPLAIN A PERSON DYING SUDDENLY AND UNEXPECTEDLY.
3 Q. NOW, YOU'RE FAMILIAR THEN, I GUESS, HAVING REVIEWED THE
4 MEDICAL RECORDS, WITH THE CIRCUMSTANCES SURROUNDING HER
5 DEATH?
6 A. YES.
7 Q. DID YOU FIND ANYTHING IN YOUR AUTOPSY THAT WOULD LEAD
8 YOU -- THAT YOU COULD FIND THAT WOULD CAUSE THAT QUICK OF A
9 DEATH?
10 A. WITH THE CAVEAT THAT THE PNEUMONIA IS AN ISSUE, NO.
11 Q. OKAY. WAS THERE ANYTHING THAT YOU INDICATED THAT YOU
12 FOUND THAT MIGHT HAVE BEEN CAUSING PAIN?
13 A. THE BONE CONDITION THAT SHE HAD MAY HAVE CAUSED SOME
14 DEGREE OF PAIN.
15 Q. OKAY. BUT ANYTHING OTHER THAN THAT?
16 A. NO.
17 Q. AND WAS THERE ANYTHING ELSE UNUSUAL ABOUT THIS AUTOPSY?
18 A. NO.
19 Q. OKAY. LET ME SHOW YOU WHAT'S BEEN MARKED FOR
20 IDENTIFICATION AS PLAINTIFF'S EXHIBIT NUMBER 26 AND ASK YOU
21 IF YOU CAN IDENTIFY THAT?
22 A. THIS IS A COPY OF THE ORIGINAL DEATH CERTIFICATE ON
23 MS. ANDERSON, AND MY AMENDMENT.
24 Q. AND WHEN WAS THE ORIGINAL DEATH CERTIFICATE FILED?
25 A. IT WAS FILED ON JANUARY 2ND -- THERE ARE TWO DAYS, ONE
1961
1 IS JANUARY 2ND AND ONE IS JANUARY 5TH FOR THE FILING DATE.
2 IT WAS SIGNED ON 12/30.
3 Q. AND WHO SIGNED IT?
4 A. THAT WAS DR. WEITZEL.
5 Q. AND WHAT DID HE INDICATE WAS THE CAUSE OF DEATH?
6 A. THE FIRST LINE WAS CARDIAC ARREST, THE SECOND LINE WAS
7 MYOCARDIAL INFARCTION, AND THE THIRD LINE WAS SINUS
8 ARRHYTHMIA.
9 Q. NOW, WHAT IS THE SECOND ONE -- BASED ON YOUR TRAINING
10 AND EXPERIENCE, WHAT DOES THAT MEAN?
11 A. MYOCARDIAL INFARCTION?
12 Q. UH-HUH.
13 A. THAT IS ESSENTIALLY A HEART ATTACK. IT MEANS THAT THE
14 PERSON'S HEART MUSCLE HAS NOT GOTTEN ENOUGH BLOOD AND HAS
15 DIED, AND SO YOU HAVE DEAD HEART TISSUE WHICH IS MYOCARDIAL
16 INFARCTION.
17 Q. DID YOU FIND ANY EVIDENCE OF THAT ON YOUR AUTOPSY?
18 A. NO.
19 Q. AND WHAT WAS THE SECOND CAUSE -- OR THE THIRD CAUSE?
20 A. THE THIRD CAUSE IS SINUS ARRHYTHMIA. TECHNICALLY,
21 THAT'S NOT A CAUSE OF DEATH. IT'S A DESCRIPTION OF A
22 PHYSIOLOGIC ABNORMALITY. IT ISN'T A DESCRIPTION OF
23 PATHOLOGY. False. Just not anatomical pathology.
24 SO IT'S -- WHAT IT MEANS IS THAT THERE IS AN ABNORMAL
25 BEATING OF THE HEART. OBVIOUSLY, THAT'S NOT SOMETHING I CAN
1962
1 DIAGNOSE OR PROVE BY LOOKING AT A DEAD HEART.
2 Q. OKAY. THANK YOU. AND BASED ON YOUR AUTOPSY AND REVIEW
3 OF THE MEDICAL RECORDS, WHAT DID -- YOU AMENDED THE DEATH
4 CERTIFICATE?
5 A. YES, I DID.
6 Q. AND WHAT DID YOU AMEND THAT TO?
7 A. SAME THING AS WE'VE SAID BEFORE. IN THIS CASE I AMENDED
8 THE CAUSE OF DEATH TO UNDETERMINED, AND THE MANNER OF DEATH
9 TO UNDETERMINED.
10 Q. THANK YOU.
11 MR. MAJOR: YOUR HONOR, I THINK WE -- WE WOULD
12 MOVE -- I DON'T KNOW IF WE'VE PUT IN THE 25, 26, AND 27, THE
13 THREE DEATH CERTIFICATES WE'VE HAD TO THIS POINT.
14 THE COURT: I THINK WE DID 24. IS THERE ANY
15 OBJECTION TO 25 AND 26?
16 MR. STIRBA: NO, YOUR HONOR.
17 THE COURT: OKAY. EXHIBITS 25 AND 26 ARE ALSO
18 RECEIVED.
19 MR. MAJOR: THANK YOU.
20 Q. (BY MR. MAJOR) NOW, DOCTOR --
21 MR. MAJOR: LET ME ASK A QUICK QUESTION.
22 THE COURT: IS THAT -- ARE YOU DONE WITH THAT
23 PORTION?
24 MR. MAJOR: WE WOULD BE DONE WITH THIS PORTION. WE
25 HAVE ONE MORE.
1963
1 THE COURT: OKAY. THEN -- OKAY. THEN WHY DON'T WE
2 TAKE A BREAK RIGHT NOW, LADIES AND GENTLEMEN. WE'VE BEEN
3 GOING A LITTLE BIT OVER AN HOUR.
4 AS I MENTIONED BEFORE, IT'S YOUR DUTY NOT TO CONVERSE
5 EITHER AMONG YOURSELVES OR TO CONVERSE WITH ANYONE ELSE OR
6 TO BE ADDRESSED BY ANY OTHER PERSON ON THE SUBJECT OF THIS
7 TRIAL. AND IT'S YOUR DUTY NOT TO FORM OR EXPRESS ANY
8 OPINION UNTIL THE CASE IS FINALLY SUBMITTED TO YOU.
9 SO LET'S COME BACK AT 10 O'CLOCK.
10 (WHEREUPON, AT THIS TIME THE JURY LEAVES THE
11 COURTROOM.)
12 THE COURT: THE RECORD WILL REFLECT THAT THE JURY
13 HAS LEFT. OKAY. THIS WITNESS, THERE'S ONE MORE EXAM?
14 MR. MAJOR: YES, YOUR HONOR, THERE'S ONE MORE.
15 JUDITH LARSEN WOULD BE THE LAST ONE WE'D BE DEALING WITH HIM
16 AND THEN CROSS.
17 THE COURT: OKAY. ALL RIGHT. AND THEN AFTER THIS,
18 IT'S THE OTHER MEDICAL EXAMINER?
19 MR. MAJOR: YES.
20 THE COURT: YOU'VE ALREADY --
21 MR. MAJOR: YEAH. DR. FRIKKE WOULD BE COMING IN.
22 WE HAD HER COMING IN AT 10:00 SO --
23 THE COURT: OKAY.
24 MR. MAJOR: -- SHE'LL BE HERE, AND THEN THAT WILL
25 BE THE LAST ONE WE HAVE.
1964
1 THE COURT: ALL RIGHT. AND THEN WHAT WAS THIS
2 THING -- YOU SAID SOMETHING ABOUT SHEILA HANSEN AND OFFICER
3 MORRISON ON EXHIBITS. ARE THOSE SOMETHING THAT --
4 MR. WILSON: NOT SHEILA HANSEN. WE TALKED ABOUT
5 SHEILA HEWARD.
6 THE COURT: OR HEWARD, EXCUSE ME.
7 MR. WILSON: I THINK, YOUR HONOR, WE'RE STILL
8 TRYING TO FORMALIZE THOSE EXHIBITS. HOPEFULLY WE'LL HAVE IT Finish?
9 PREPARED AND READY FOR SUBMISSION TO THE COURT BEFORE NOON.
10 THE COURT: WELL, WHAT I WAS WONDERING IS IF WE
11 WERE NOT -- IF THOSE -- IT WOULD BE EASIER, I THINK, ON THE
12 JURY IF WE BASICALLY HAD ALL THE TESTIMONY, I COULD SEND
13 THEM BACK, EVEN IF WE GO A LITTLE BIT AFTER 12:00 SO THAT WE
14 HEAR ALL THE TESTIMONY. AND THEN THEY LEAVE FOR THE DAY AS
15 OPPOSED TO LEAVE AT 12:00, COME BACK AT 1:30, BE HERE 15
16 MINUTES AND SEND THEM HOME. I DON'T THINK THEY'RE GOING
17 TO --
18 MR. WILSON: I APPRECIATE THAT, JUDGE.
19 THE COURT: SO IF WE CAN TRY TO DO THAT BEFORE THEN
20 LET'S DO THAT. OKAY. THEN LET'S BE BACK HERE AT
21 10 O'CLOCK.
22 (WHEREUPON, AT THIS TIME THERE'S A RECESS, AFTER WHICH
23 PROCEEDINGS RESUME, AS FOLLOWS:)
24 THE COURT: THE RECORD SHOULD REFLECT THAT COUNSEL,
25 THE DEFENDANT, AND THE JURY ARE ALL PRESENT.
1965
1 MR. MAJOR, WOULD YOU LIKE TO CONTINUE?
2 MR. MAJOR: WE WOULD, YOUR HONOR. THANK YOU.
3 Q. (BY MR. MAJOR) DR. GREY, LET'S TURN NOW TO THE AUTOPSY
4 YOU PERFORMED ON JUDITH LARSEN AND ASK YOU SIMILAR
5 QUESTIONS. HOW DID THAT BODY COME TO YOUR CUSTODY?
6 A. MS. LARSEN'S BODY WAS ALSO AN EXHUMATION, BROUGHT TO OUR
7 OFFICE IN -- IN THE CASKET. AND THE EXAM WAS PERFORMED ON
8 JUNE 22ND OF 1999.
9 Q. AND WHO WAS PRESENT DURING THE AUTOPSY?
10 A. THERE WAS JOE MORRISON FROM LAYTON P.D., AND DAVE HARRIS
11 FROM THE DAVIS COUNTY SHERIFF'S OFFICE, IN ADDITION TO
12 MYSELF AND MY ASSISTANT.
13 Q. AND WHAT WAS THE FIRST THING THAT YOU DID AS FAR AS THIS
14 AUTOPSY WAS CONCERNED?
15 A. FIRST THING IS TO OPEN THE CASKET AND LOOK AT THE
16 CONDITION OF THE BODY. WHEN WE DID THAT, WE FOUND THERE WAS
17 SOME -- THIS WAS A METAL CASKET THAT HAD SOME RUSTING. THE
18 BODY WAS UNDISTURBED, INTACT. THERE WAS DECOMPOSITIONAL
19 FLUID IN THE BOTTOM OF THE CASKET.
20 Q. AND WHAT WAS THE GENERAL CONDITION OF THE BODY?
21 A. THERE WAS DECOMPOSITION WITH SOME BLACKENING OF THE BODY
22 SURFACES, AS WELL AS FUNGAL GROWTH, AND THERE WAS EVIDENCE
23 OF EMBALMING.
24 Q. WHAT DID YOU DO THEN?
25 A. SAME THING AS WE'VE TALKED ABOUT PREVIOUSLY. WE UNDRESS
1966
1 THE BODY, LOOK AT THE EXTERNAL SURFACES, AND THEN DO THE
2 INTERNAL EXAMINATION.
3 EXTERNALLY ON MS. LARSEN THE ONLY ABNORMALITIES I FOUND
4 WERE THE DECOMPOSITION AND A SINGLE INCISION FOR EMBALMING
5 IN THE RIGHT BASE OF THE NECK.
6 Q. NOTHING UNUSUAL?
7 A. NO.
8 Q. YOU THEN, I GUESS, DID AN EXAMINATION OF THE TORSO, THE
9 BODY CAVITY?
10 A. YES.
11 Q. WHAT DID YOU FIND WHEN YOU DID THAT?
12 A. THERE WAS SOME DECOMPOSITIONAL FLUID WITHIN THE CHEST
13 CAVITY AND THE ABDOMINAL CAVITY. ALL OF THE ORGANS WERE IN
14 THEIR NORMAL POSITION AND HAD DECOMPOSITIONAL CHANGE.
15 Q. WHAT DID YOU DO THEN?
16 A. SAME THING AS WE'VE TALKED ABOUT BEFORE. WE LOOK AT THE
17 HEART, THE LUNGS, THE LIVER, ALL OF THE INTERNAL ORGANS OF
18 THE TORSO, AND THEN LOOK AT THE BRAIN.
19 Q. AND SO LET'S GET INTO THAT. WHAT -- WHAT DID YOU DO?
20 WHAT WAS THE FIRST AREA THAT YOU LOOKED AT?
21 A. FIRST THING WAS THE HEART. AND WHAT I FOUND THERE WAS
22 THAT THIS INDIVIDUAL DID HAVE SOME MILD HARDENING OF THE
23 ARTERIES OF THE HEART. I DID NOT SEE SIGNIFICANT BLOCKAGE
24 OF THOSE ARTERIES. AND I SAW NO EVIDENCE EITHER WITH MY
25 NAKED EYE OR UNDER THE MICROSCOPE OF ANY SCARRING OR CELL
1967
1 DEATH IN THE HEART.
2 Q. WHAT IS THAT INDICATIVE OF?
3 A. I DID NOT SEE ANY -- ESSENTIALLY I DIDN'T SEE ANY
4 EVIDENCE THAT THIS PERSON EITHER HAD A RECENT OR OLD HEART
5 ATTACK.
6 Q. AND WHAT ELSE DID YOU DO?
7 A. WE LOOKED AT THE BLOOD -- THE MAJOR BLOOD VESSELS, AND
8 SHE ALSO HAD THE HARDENING OF THE AORTA. SHE ALSO HAD SOME
9 HARDENING OF THE ARTERIES IN -- THAT SUPPLIED BLOOD TO THE
10 BRAIN.
11 Q. NOW, IS THIS UNUSUAL IN AN INDIVIDUAL OF THIS AGE?
12 A. NO. THESE WERE FAIRLY NORMAL FINDINGS FOR AN ELDERLY
13 WOMAN.
14 Q. AND DID THESE APPEAR TO CAUSE -- WOULD HAVE CAUSED ANY
15 PROBLEMS, ANY LIFE-THREATENING CONDITION?
16 A. NO.
17 Q. WHAT ELSE DID YOU -- DID YOU DO?
18 A. I LOOKED AT HER LUNGS, AND OTHER THAN SOME DECOMPOSITION
19 AND THE CHANGES FROM THE EMBALMING, I DID NOT FIND ANYTHING
20 REMARKABLE EITHER WITH MY NAKED EYE OR LOOKING AT IT --
21 LOOKING AT THE BIOPSIES UNDER THE MICROSCOPE.
22 WE LOOKED AT HER LIVER, AND AGAIN, OTHER THAN THE
23 ARTIFACTS OF EMBALMING AND DECOMPOSITION, THERE WAS NOTHING
24 WRONG.
25 I LOOKED AT HER INTESTINAL TRACT AND, AGAIN, FOUND
1968
1 EVIDENCE OF DECOMPOSITION AND EMBALMING. DID NOT FIND ANY
2 EVIDENCE OF ANY PATHOLOGY OR DISEASE IN THE INTESTINAL
3 TRACT.
4 Q. OKAY. YOU ALSO HAD REVIEWED THE MEDICAL RECORDS FOR
5 MS. LARSEN; IS THAT CORRECT?
6 A. YES.
7 Q. LET ME SHOW YOU WHAT'S BEEN MARKED FOR IDENTIFICATION AS
8 PLAINTIFF'S EXHIBIT 3 AND REPRESENT THAT THIS HAS BEEN
9 INTRODUCED AS THE MEDICAL RECORDS FROM DAVIS HOSPITAL, AND
10 ASK YOU AGAIN, DO YOU RECOGNIZE THOSE?
11 A. AND AS WE'VE SAID IN THE PAST, WITH THE SAME PROVISO
12 THAT I'M NOT LOOKING AT EVERY PAGE, THIS DOES APPEAR TO BE
13 THE RECORDS THAT I HAD AND REVIEWED.
14 Q. OKAY. NOW, WHEN YOU HAD REVIEWED THOSE RECORDS OF
15 MS. LARSEN, WAS THERE ANYTHING SIGNIFICANT THAT YOU FOUND AS
16 FAR AS HER INTESTINAL TRACT WAS CONCERNED?
17 A. IN LOOKING AT HER MEDICAL RECORDS THERE WAS SOME
18 NOTATION THAT SHE'D HAD EVIDENCE OF G.I. BLEEDING OR
19 BLEEDING WITHIN THE GASTROINTESTINAL TRACT.
20 Q. DO YOU RECALL WHAT THAT EVIDENCE WAS?
21 A. I BELIEVE SHE WAS HAVING SOME SORT OF BLACK EMESIS, AS
22 WELL INDICANT OF BLOOD IN THE UPPER G.I. SYSTEM.
23 Q. OKAY. IS THIS THE COFFEE GROUND EMESIS --
24 A. YES.
25 Q. -- YOU'RE TALKING ABOUT. AND WHAT DID THAT INDICATE TO
1969
1 YOU?
2 A. IN THE MEDICAL RECORD?
3 Q. IN THE MEDICAL RECORD.
4 A. THE DESCRIPTION OF COFFEE GROUND EMESIS MEANS THAT THIS
5 PERSON HAS HAD SOME BLOOD IN THE -- USUALLY WITHIN THE
6 STOMACH, AND THAT IT SAT THERE FOR SOME PERIOD OF TIME
7 BEFORE THEY'VE THROWN IT UP.
8 Q. AND WHAT DID YOU DO AS FAR AS HAVING THAT INFORMATION?
9 A. BECAUSE OF THAT INFORMATION, OBVIOUSLY I WANTED TO LOOK
10 AT THE ESOPHAGUS, THE STOMACH, THE INTESTINES TO SEE IF I
11 COULD SEE ANY IDENTIFIABLE SITE FOR WHERE THAT BLOOD MAY
12 HAVE COME FROM, AND I COULD NOT IDENTIFY. I ALSO DID NOT
13 FIND ANY BLOOD IN THE STOMACH OR IN THE INTESTINES AT
14 AUTOPSY.
15 Q. OKAY. AND WHAT WAS THE NEXT THING THAT YOU DID?
16 A. THE -- WE LOOKED AT THE KIDNEYS. ONE OF THE THINGS THAT
17 WE'D -- I'D -- I'D SEEN IN HER MEDICAL RECORD WAS THAT SHE
18 MAY -- SHE'D HAD A HISTORY OF RENAL STONES, WHAT'S CALL
19 RENAL LITHIASIS. I DID NOT SEE ANY STONES IN PLACE EITHER
20 IN THE KIDNEY OR IN THE URETERS AT AUTOPSY.
21 Q. AND NEXT YOU LOOKED AT WHAT?
22 A. THE -- I LOOKED AT THE ENDOCRINE ORGANS, THE GLANDS,
23 LIKE THYROID AND ADRENAL. I DID NOT FIND ANY THYROID
24 TISSUE. THERE MAY -- SHE MAY HAVE HAD A THYROIDECTOMY OR AN
25 ACTUAL OPERATION TO REMOVE HER THYROID IN THE PAST. I
1970
1 COULDN'T IDENTIFY SCARRING, BUT I CERTAINLY COULD NOT FIND
2 ANY THYROID TISSUE.
3 Q. DID THAT CAUSE YOU ANY CONCERN?
4 A. NO.
5 Q. NOT A LIFE-THREATENING SITUATION?
6 A. NO. NOT UNLESS -- OR AS LONG AS THE PERSON IS GETTING
7 THYROID REPLACEMENT MEDICINE.
8 Q. WHAT ELSE DID YOU DO?
9 A. THEN WE -- AFTER LOOKING AT ALL OF THE ORGANS IN THE
10 TORSO I THEN LOOKED AT THE BRAIN. THERE WAS THE SAME KINDS
11 OF DECOMPOSITIONAL CHANGES, THE SOFTENING AND FLATTENING OF
12 THE BRAIN, AS WELL AS EVIDENCE THAT IT HAD BEEN EMBALMED.
13 OTHER THAN THAT, I DIDN'T FIND ANY PATHOLOGY, ANY DISEASE
14 THAT I COULD FIND IN THE BRAIN -- HEMORRHAGE OR SOFTENING OR
15 ANYTHING -- THAT INDICATED AN ACUTE EVENT.
16 Q. ANYTHING THAT YOU WOULD -- THAT WOULD INDICATE THAT
17 THERE WAS ANY LIFE-THREATENING CONDITIONS?
18 A. NOT THAT I SAW, NO.
19 Q. WHAT ELSE DID YOU DO?
20 A. WE SUBMITTED THE SAMPLES TO THE LAB FOR THE TOXICOLOGY
21 TESTING. IN THIS CASE I SUBMITTED LIVER, KIDNEY, BILE,
22 MUSCLE, BRAIN, SPLEEN, HEART, AND LUNG.
23 Q. OKAY. NOW, BEFORE WE GET INTO THAT, LET ME ASK YOU
24 THIS. DID YOU FIND ANYTHING IN THIS PARTICULAR AUTOPSY THAT
25 WOULD LEAD YOU TO BELIEVE THAT SHE HAD A LIFE-THREATENING
1971
1 CONDITION?
2 A. NO, I DID NOT.
3 Q. DID YOU FIND ANYTHING IN THIS AUTOPSY THAT WOULD LEAD
4 YOU TO BELIEVE SHE MAY HAVE BEEN IN PAIN?
5 A. I SAW NO PATHOLOGY THAT WOULD -- I WOULD EXPECT TO CAUSE
6 PAIN, NO.
7 Q. NOW, AFTER YOU'D SUBMITTED THESE SAMPLES TO THE
8 TOXICOLOGY, WHAT WAS THE RESULT?
9 A. WHAT WE FOUND WAS THAT THERE WAS DETECTABLE MORPHINE
10 PRESENT IN THE LIVER AT A LEVEL OF 0.09 MILLIGRAMS PER
11 LITER. THERE WAS MORPHINE IN THE BILE AT A LEVEL OF 0.28
12 MILLIGRAMS PER LITER. AND THERE -- THEY COULD NOT DETECT
13 MORPHINE IN THE BRAIN. IT WAS BELOW THEIR LEVEL OF
14 DETECTION.
15 Q. NOW, HAVING REVIEWED THE MEDICAL REPORTS FROM DAVIS
16 HOSPITAL, I GUESS BEFORE AND AFTER YOU DID THIS AUTOPSY ON
17 MS. LARSEN, YOU WERE AWARE, WERE YOU NOT, THE CIRCUMSTANCES
18 SURROUNDING HER DEATH?
19 A. YES.
20 Q. CONDITION AT THE TIME OF HER DEATH?
21 A. YES.
22 Q. DID YOU FIND ANYTHING IN THIS AUTOPSY FROM A
23 PATHOLOGICAL POINT OF VIEW THAT WOULD EXPLAIN THOSE
24 CONDITIONS?
25 A. NO.
1972
1 Q. WHAT IF ANY SIGNIFICANCE DID IT MEAN TO YOU WHEN YOU
2 DISCOVERED THE MORPHINE IN THE BILE AND IN THE -- THE BODY?
3 A. GIVEN THE AUTOPSY FINDINGS WHERE I COULD NOT FIND
4 ANYTHING THAT I COULD POINT TO AND SAY THIS WOULD EXPLAIN
5 WHY THIS INDIVIDUAL DIED SUDDENLY, WITH THE FACT THAT THE
6 MEDICAL RECORDS INDICATED THAT SHE'D GOTTEN LARGE AMOUNTS OF
7 MORPHINE, I FOUND THE TOXICOLOGY FINDINGS QUITE SIGNIFICANT.
8 Q. MORE SIGNIFICANT THAN WITH THE OTHER -- OTHER CASES?
9 A. YES.
10 Q. AND BASED ON THAT, BASED ON YOUR PATHOLOGY, BASED ON
11 WHAT YOU HAVE REVIEWED IN THE MEDICAL RECORD, DID YOU COME
12 TO A CONCLUSION CONCERNING HER MANNER OF DEATH?
13 A. HER MANNER OF DEATH, YES.
14 Q. MANNER OF DEATH.
15 A. YES.
16 Q. AND WHAT WAS THAT?
17 A. I CERTIFIED THIS AS A HOMICIDE.
18 Q. AND AS FAR AS THE CAUSE OF DEATH?
19 A. I CERTIFIED THAT THIS DEATH WAS DUE TO DRUG INTOXICATION
20 WITH MORPHINE.
21 Q. AND WHY WAS THAT?
22 A. BECAUSE, AS I'VE SAID, I FOUND NO PATHOLOGY THAT WOULD
23 EXPLAIN WHY THIS INDIVIDUAL DIED. THERE WAS STRONG EVIDENCE
24 IN THE MEDICAL RECORDS THAT SHE'D GOTTEN LARGE AMOUNTS OF
25 MORPHINE, AND THE PRESENCE OF MORPHINE WAS CONFIRMED AT
1973
1 POSTMORTEM TOXICOLOGICAL TESTING.
2 Q. BASED ON YOUR TRAINING AND EXPERIENCE, WAS THE AMOUNT OF
3 MORPHINE REFLECTED IN THE MEDICAL RECORDS UNUSUAL?
4 MR. STIRBA: YOUR HONOR, I'M GOING TO OBJECT. IT'S
5 BEYOND THE SCOPE OF HIS EXPERTISE. IT'S NOT IN ANY REPORT.
6 THE COURT: SUSTAINED.
7 Q. (BY MR. MAJOR) LET ME SHOW YOU WHAT'S BEEN MARKED FOR
8 IDENTIFICATION AS PLAINTIFFS'S EXHIBIT NUMBER 27. DO YOU
9 RECOGNIZE THAT?
10 A. YES.
11 Q. AND WHAT IS THAT?
12 A. THIS IS A COPY OF THE ORIGINAL DEATH CERTIFICATE AND
13 THEN THE AMENDED DEATH CERTIFICATE THAT I COMPLETED.
14 Q. OKAY. AND WHO SIGNED THE ORIGINAL DEATH CERTIFICATE?
15 A. DR. WEITZEL.
16 Q. AND WHAT DID HE INDICATE AS THE CAUSE OF DEATH?
17 THE COURT: DO YOU WANT TO OFFER THAT FIRST?
18 MR. MAJOR: PARDON?
19 THE COURT: DO YOU WANT TO OFFER THE EXHIBIT?
20 MR. MAJOR: OH, YES. WE'D MOVE TO OFFER THAT
21 EXHIBIT, YOUR HONOR.
22 THE COURT: OKAY. IS THERE ANY OBJECTION?
23 MR. STIRBA: NO, YOUR HONOR.
24 THE COURT: OKAY. PLAINTIFF'S EXHIBIT 27 IS
25 RECEIVED.
1974
1 Q. (BY MR. MAJOR) AND WHAT WAS THE ORIGINAL CAUSE OF
2 DEATH LISTED BY DR. WEITZEL?
3 A. THE FIRST LINE SAID CARDIAC ARREST, THE SECOND LINE SAID
4 RESPIRATORY ARREST.
5 Q. DID YOU FIND ANYTHING ON YOUR PATH -- PATHOLOGY OR YOUR
6 AUTOPSY THAT WOULD CONFIRM THAT?
7 A. WELL, YES. BASICALLY AS I'VE SAID, THOSE TWO DIAGNOSES
8 MEANS THE PERSON DOESN'T HAVE A HEART BEAT AND ISN'T
9 BREATHING.
10 Q. SO IT'S NOT REALLY ANY TYPE OF A DIAGNOSIS?
11 A. NO, IT IS NOT.
12 Q. AND DID YOU FILE AN AMENDED DEATH CERTIFICATE?
13 A. YES, I DID.
14 Q. AND WHAT DID YOU LIST THE CAUSE OF DEATH AS?
15 A. DRUG INTOXICATION.
16 Q. AND THE MANNER OF DEATH?
17 A. HOMICIDE.
18 MR. MAJOR: MAY I HAVE ONE MINUTE, YOUR HONOR?
19 THE COURT: OKAY. MR. STIRBA?
20 MR. STIRBA: THANK YOU. GOOD MORNING.
21 MR. MAJOR: YOUR HONOR, I JUST WANTED TO CONSULT
22 WITH MR. WILSON JUST ONE SECOND.
23 THE COURT: HOLD ON.
24 (WHEREUPON, THERE'S AN OFF-THE-RECORD DISCUSSION.)
25 Q. (BY MR. MAJOR) MR. -- GOING BACK JUST REAL QUICK, I
1975
1 THINK THERE WAS ONE QUESTION THAT I -- WE'D LIKE TO CLARIFY.
2 WHEN YOU WERE TALKING ABOUT I THINK MR. ALLDREDGE AND
3 MS. ANDERSON, YOU TALKED ABOUT EMPHYSEMA.
4 A. YES.
5 Q. CAN YOU EXPLAIN WHAT THAT IS AND HOW THAT'S DETECTED.
6 A. EMPHYSEMA IS A DEGENERATIVE CONDITION OF THE LUNGS WHERE
7 ESSENTIALLY YOU ARE LOSING TISSUES IN THE LUNG SO THAT
8 INSTEAD OF HAVING VERY NICE, SMALL AIR SPACES WHERE THERE'S
9 LOTS OF SURFACE FOR AIR AND BLOOD TO MIX, YOU HAVE MUCH
10 LARGER SPACES SO THAT ESSENTIALLY YOU'RE LOSING THAT SURFACE
11 AREA FOR AIR EXCHANGE. IT IS A CONDITION THAT DEVELOPS BOTH
12 AS AN AGING PHENOMENA, AND CAN BE ACCELERATED BY SUCH THINGS
13 AS SMOKING.
14 Q. CAN YOU DETERMINE WHETHER THIS -- THIS WAS CAUSED BY
15 SMOKING FOR MR. ALLDREDGE OR MS. ANDERSON?
16 A. NO, I DON'T KNOW FOR SURE.
17 Q. AND HOW DOES THAT AFFECT A PERSON'S ABILITY TO BREATHE?
18 A. IT -- IT COMPROMISES IT. BASICALLY YOU'RE NOT GETTING
19 AS MUCH EXCHANGE OF GASES IN THE LUNGS, SO THAT YOU HAVE TO
20 BREATHE HARDER. YOU'RE NOT GETTING AS GOOD OXYGENATION OF
21 THE BLOOD.
22 Q. THANK YOU.
23 MR. MAJOR: I BELIEVE I HAVE NOTHING FURTHER, YOUR
24 HONOR.
25 THE COURT: OKAY. MR. STIRBA?
1976
1 MR. STIRBA: THANK YOU.
2 CROSS-EXAMINATION
3 BY MR. STIRBA:
4 Q. GOOD MORNING, DR. GREY.
5 A. GOOD MORNING.
6 Q. YOU'RE -- YOU'RE AWARE, ARE YOU NOT, THAT AS A FORENSIC
7 PATHOLOGIST THAT IF SOMEBODY IS DEPRIVED OF FOOD AND WATER,
8 THEY WILL EVENTUALLY DIE FROM STARVATION? IS THAT TRUE?
9 A. YES.
10 Q. AND IT'S TRUE, IS IT NOT, THAT IN REVIEWING THE RECORDS
11 CONCERNING MS. LARSEN THAT, IN FACT, MS. LARSEN STOPPED
12 EATING AT SOME POINT IN TIME IN THE HOSPITAL? ISN'T THAT
13 TRUE?
14 A. YES.
15 Q. AND IT'S ALSO TRUE, IS IT NOT, THAT AFTER SHE STOPPED
16 EATING, SHE WAS NOT PROVIDED ANY EXTRAORDINARY MEANS BY
17 WHICH SHE WAS GOING TO GET FOOD OR WATER? ISN'T THAT TRUE?
18 A. YES.
19 Q. AND IT'S ALSO TRUE, IS IT NOT, THAT AS A FORENSIC
20 PATHOLOGIST, IF MS. LARSEN DIED AS A RESULT OF LACK OF FOOD
21 AND LACK OF NOURISHMENT, THAT WOULD NOT BE SOMETHING
22 NECESSARILY YOU COULD FIND IN AUTOPSY; ISN'T THAT TRUE?
23 A. YES.
24 Q. NOW, YOU TESTIFIED ABOUT THESE FINDINGS -- WITH RESPECT
25 TO MS. LARSEN -- MADE BY THE TOXICOLOGIST. REMEMBER THAT?
1977
1 A. YES.
2 Q. JUST SO WE UNDERSTAND, IT'S TRUE, IS IT NOT, THAT THOSE
3 PARTICULAR FINDINGS, AS YOU HAVE ALREADY TESTIFIED, YOU
4 CAN'T CORRELATE TO ANY FINDINGS OR WHAT MIGHT HAVE EXISTED
5 AT THE TIME IN MS. LARSEN'S SYSTEM AS OF THE TIME OF DEATH;
6 IS THAT RIGHT?
7 A. THAT IS CORRECT.
8 Q. IN OTHER WORDS, WHAT -- WHAT THIS TELLS YOU, AND THE
9 ONLY FACT UPON WHICH YOU CAN RELY BASED UPON THESE FINDINGS,
10 IS THAT THERE WAS A FINDING OF SOME LEVEL OF MORPHINE IN HER
11 SYSTEM BASICALLY AT THE TIME YOU DID THE AUTOPSY, TRUE?
12 A. THAT IS CORRECT.
13 Q. AND YOU DON'T KNOW WHETHER THAT -- WHAT THAT LEVEL WAS
14 AT THE TIME OF HER DEATH, CORRECT?
15 A. THAT IS CORRECT.
16 Q. AND YOU CERTAINLY DON'T KNOW AS A RESULT OF THE
17 EMBALMING PROCESS WHETHER THAT MORPHINE LEVEL WAS GOING TO
18 BE INCREASED OR DECREASED, DO YOU?
19 A. NO, I DO NOT KNOW.
20 Q. THAT'S ONE OF THOSE OPEN QUESTIONS WITH TOXICOLOGISTS,
21 CORRECT?
22 A. THAT IS CORRECT.
23 Q. IN OTHER WORDS, ALL YOU DO KNOW IS THAT THERE WAS AN
24 EMBALMING, THERE WAS A PROCESS OF INTERMENT, THERE WAS THE
25 BURIAL, THERE WAS A PERIOD OF TIME AND THEN WE DID THIS
1978
1 TOXICOLOGY TEST AND WE DID FIND SOME MORPHINE. THAT'S ALL
2 WE KNOW.
3 A. THAT IS CORRECT.
4 Q. AND THAT'S REALLY ALL YOU WANT THE JURY TO UNDERSTAND
5 FOR PURPOSES OF THIS FINDING; ISN'T THAT CORRECT?
6 A. IN TERMS OF MY FINDINGS, YES.
7 Q. AND SIMILARLY, IT'S TRUE, IS IT NOT, AS YOU TESTIFIED,
8 THAT THE WAY THESE THINGS WERE SCREENED IS YOU FIRST DID A
9 GENERAL SCREEN FOR OPIATES, TRUE?
10 A. THAT IS CORRECT, YES.
11 Q. AND THE REASON WHY YOU DID THAT IS BECAUSE MORPHINE
12 ESSENTIALLY IS A DERIVATIVE OF AN OPIATE, CORRECT?
13 A. IT IS A TYPE OF AN OPIATE.
14 Q. TYPE OF AN OPIATE. SO IF YOU DON'T HAVE ANY FINDING OF
15 OPIATES, THEN LOGICALLY YOU'RE NOT GOING TO HAVE ANY FINDING
16 FOR MORPHINE, CORRECT?
17 A. ONE WOULD EXPECT THAT.
18 Q. CERTAINLY THAT WOULD BE LOGICAL, TRUE?
19 A. LOGICAL, YES.
20 Q. AND SO YOU DID THE SCREENS TO SEE WHETHER OR NOT IT WAS
21 EVEN WORTH PURSUING THEN A MORE SPECIFIC TEST TO SEE WHETHER
22 YOU COULD FIND MORPHINE, CORRECT?
23 A. THAT IS THE USUAL PROCESS, YES.
24 Q. AND IT'S TRUE WITH RESPECT TO THE OTHER FOUR PATIENTS IN
25 THIS CASE; THAT IS, LYDIA SMITH, ENNIS ALLDREDGE, MARY
1979
1 CRANE -- AND I'M FORGETTING --
2 MR. MAY: ELLEN ANDERSON.
3 MR. STIRBA: PARDON ME?
4 MR. MAY: ELLEN ANDERSON.
5 MR. STIRBA: AND ELLEN ANDERSON. THANK YOU.
6 Q. (BY MR. STIRBA) THERE WAS A SIMILAR TEST CONDUCTED
7 TOXICOLOGY WISE, AND NO MORPHINE WAS DETECTED, TRUE?
8 A. IN ENNIS ALLDREDGE THE SCREEN WAS POSITIVE, BUT THE
9 QUANTIFICATION TEST WAS NEGATIVE OR BELOW THEIR DETECTION
10 LIMITS. WITH SMITH AND -- AND ANDERSON, THE QUANTIFICATION
11 TESTS WERE NEGATIVE. MARY CRANE, I WAS NOT -- I DID NOT DO
12 THE AUTOPSY, SO I'M NOT UP EXACTLY ON THE TESTING RESULTS.
13 Q. OKAY. AND WHAT YOU JUST TOLD US WITH RESPECT TO
14 MR. ALLDREDGE WAS THE SCREEN FOR OPIATES WAS POSITIVE, AND
15 THEN THE MORE SPECIFIC TEST WAS DONE FOR MORPHINE AND THERE
16 WAS NO FINDING OF MORPHINE, TRUE?
17 A. THAT IS CORRECT.
18 Q. AND, SIMILARLY, WITH RESPECT TO MS. ANDERSON AND
19 MS. SMITH, THERE WASN'T A PRELIMINARY SCREEN OF OPIATES,
20 THERE WAS A SPECIFIC FINDING OF NO DETECTABLE LIMITS OF
21 MORPHINE. ISN'T THAT ALSO TRUE?
22 A. YES.
23 Q. NOW, IT'S TRUE, IS IT NOT, THAT MS. ANDERSON -- YOU
24 CONDUCTED THAT AUTOPSY; IS THAT CORRECT?
25 A. YES.
1980
1 Q. AND -- AND JUST SO WE UNDERSTAND, WHEN -- WHEN YOU TALK
2 ABOUT FINDINGS AS A FORENSIC PATHOLOGIST, WHAT -- WHAT YOU
3 DO ESSENTIALLY IS EXAMINE CERTAIN BODY PARTS OR THE ANATOMY
4 OF AN INDIVIDUAL IN AN AUTOPSY, AND YOU LOOK FOR CERTAIN
5 THINGS. PARTICULARLY, YOU LOOK FOR ANOMALIES; IS THAT TRUE?
6 A. YES.
7 Q. YOU LOOK FOR CHANGE IN CHARACTERISTIC OF AN ORGAN, TRUE?
8 A. CORRECT.
9 Q. AND YOU DO THIS PRIMARILY BY A PROCESS OF ESSENTIALLY,
10 SHALL WE SAY, THE GROSS EXAMINATION; THAT IS, PHYSICALLY
11 EYEBALLING THE ANATOMY OF THE ORGAN, TRUE?
12 A. THAT IS PART OF IT, YES.
13 Q. AND THEN THE OTHER THING YOU DID IN THIS CASE IS YOU CAN
14 GET MORE SPECIFIC AND USE A MICROSCOPE AND TRY TO HAVE A
15 MICROSCOPIC FINDING; ISN'T THAT CORRECT?
16 A. YES.
17 Q. AND SO WHEN YOU SAY FINDING, WHAT YOU'RE REALLY TALKING
18 ABOUT IS SOMETHING THAT YOU OBSERVED OR A CONDITION THAT YOU
19 OBSERVED BASED UPON WHAT YOU WERE LOOKING FOR; ISN'T THAT
20 CORRECT?
21 A. NOT SPECIFICALLY.
22 Q. WELL, MAYBE NOT BASED UPON WHAT YOU'RE LOOKING FOR, BUT
23 IT'S SOMETHING THAT YOU ACTUALLY OBSERVED OR SAW EITHER BY
24 GROSS EXAMINATION OR BY MICROSCOPIC EXAMINATION; ISN'T THAT
25 TRUE?
1981
1 A. RIGHT. THE FINDINGS ARE BASED ON AN EXAMINATION.
2 Q. SO IN OTHER WORDS, IF YOU HAD A SITUATION LIKE YOU'VE
3 ALREADY TOLD US, FOR EXAMPLE WITH MS. SMITH, AND YOU
4 EXPLAINED THAT THE CIRCUMSTANCES OF HER PRESENTATION TO YOU
5 WERE SEVERELY COMPROMISED DUE TO THE DETERIORATION OF THE
6 BODY; IS THAT TRUE?
7 A. WHAT I STATED WAS THAT THE PHYSICAL FINDINGS WERE VERY
8 LIMITED BECAUSE OF THE DEGREE OF DETERIORATION.
9 Q. RIGHT. IN OTHER WORDS, IF AN ORGAN IS DEGRADED OR
10 DETERIORATED, IT'S GOING TO IMPAIR YOUR ABILITY AS A
11 FORENSIC PATHOLOGIST TO MAKE ANY FINDING, CORRECT?
12 A. THAT IS CORRECT.
13 Q. SIMILARLY, WITH RESPECT TO MR. ALLDREDGE, YOU'VE
14 TESTIFIED ABOUT A CONDITION OF HIS BRAIN AND YOU TESTIFIED
15 HOW IT WAS PUDDLED, TRUE?
16 A. YES.
17 Q. AND THAT WAS IN PART -- PARTS OF THE BRAIN; ISN'T THAT
18 RIGHT?
19 A. (NO RESPONSE.)
20 Q. ISN'T THAT RIGHT?
21 A. I'M JUST CHECKING.
22 Q. WELL, LET ME -- LET ME -- LET ME REFER YOU TO YOUR
23 REPORT.
24 A. RIGHT.
25 Q. AND IF WE LOOK UNDER WHAT YOU DESCRIBE WITH RESPECT TO
1982
1 MR. ALLDREDGE'S BRAIN, YOU INDICATED THE BRAIN IS MARKEDLY
2 SOFTENED AND ESSENTIALLY PUDDLES IN THE POSTERIOR AREAS OF
3 THE CRANIAL VAULT.
4 A. RIGHT.
5 Q. YOU FOUND THAT, TRUE?
6 A. CORRECT.
7 Q. YOU GO ON TO SAY THAT THE SYMMETRY OF THE CEREBRAL
8 HEMISPHERES CANNOT BE ASSESSED SECONDARY TO SOFTENING AND
9 MOLDING OF THE BRAIN.
10 A. CORRECT.
11 Q. DID I READ THAT CORRECTLY?
12 A. CORRECT.
13 Q. ESSENTIALLY THERE WAS -- THERE WAS A DEGRADATION THERE
14 THAT IMPAIRED YOUR ABILITY TO MAKE A FINDING; ISN'T THAT
15 TRUE?
16 A. YES.
17 Q. AND IT'S ALSO TRUE -- YOU GO ON TO SAY, THE VESSELS AND
18 CRANIAL NERVES CANNOT BE ASSESSED SECONDARY TO MARKED
19 DECOMPOSITION. YOU FOUND THAT.
20 A. THAT IS CORRECT.
21 Q. IS THAT RIGHT?
22 A. YES.
23 Q. SO -- SO IT'S TRUE, IS IT NOT, THAT WITH RESPECT TO ANY
24 FINDING, THE FINDING OF A STROKE EVENT WITH RESPECT TO
25 MR. ALLDREDGE, IT WOULD HAVE BEEN COMPROMISED BY CERTAIN
1983
1 DETERIORATION OF THE ACTUAL BRAIN ITSELF WHICH YOU FOUND ON
2 EXAMINATION, TRUE?
3 A. YES.
4 Q. IN OTHER WORDS, YOU CAN'T MAKE A FINDING IF THE BRAIN
5 TISSUE IS ESSENTIALLY PUDDLED, CORRECT?
6 A. NOT QUITE. AND IF YOU WANT ME TO EXPLAIN, I'D BE HAPPY
7 TO.
8 Q. LET ME ASK IT THIS WAY. YOU CERTAINLY CAN'T MAKE A
9 GROSS FINDING; THAT IS, JUST AN EXAMINATION FINDING
10 GENERALLY IF THE BRAIN TISSUE IS PUDDLED; ISN'T THAT TRUE?
11 A. AGAIN, NOT QUITE, AND I'LL BE HAPPY TO EXPLAIN WHY.
12 Q. GO AHEAD.
13 A. THE DETERIORATION THAT WE'VE BEEN TALKING ABOUT WAS
14 CLEARLY THERE. A GROSS FINDING OF, FOR EXAMPLE, A VERY
15 LARGE BLEED INTO THE BRAIN, I COULD STILL MAKE. A MORE
16 SUBTLE OR SMALLER FINDING, I COULD NOT MAKE.
17 Q. AND -- AND IT'S ALSO TRUE, IS IT NOT, THAT THE MORE
18 SUBTLE FINDING, CAN -- CAN WE CALL THAT A SUBACUTE EVENT?
19 A. THAT -- I'LL ACCEPT THE TERM.
20 Q. IN -- IN OTHER WORDS -- IN OTHER WORDS, STROKE EVENTS,
21 THEY CAN BE BASICALLY LARGE HEMORRHAGES OR LARGE BLEEDS,
22 RIGHT?
23 A. CORRECT.
24 Q. AND -- AND THAT'S SOMETHING GENERALLY YOU COULD SEE JUST
25 BY LOOKING AT THE BRAIN TISSUE ITSELF, TRUE?
1984
1 A. CORRECT.
2 Q. BUT THERE ARE ALSO STROKE EVENTS WHICH ESSENTIALLY ARE
3 MICROSCOPIC OR CAN ONLY BE IDENTIFIED BY MICROSCOPIC
4 EXAMINATION; ISN'T THAT CORRECT?
5 A. THAT IS CORRECT.
6 Q. THOSE WOULD BE THOSE SUBACUTE EVENTS, TRUE?
7 A. THAT'S ONE WAY OF DESCRIBING IT, YES.
8 Q. AND IT'S TRUE IRRESPECTIVE OF THE CONDITION OF
9 MR. ALLDREDGE'S BRAIN IN THIS CASE, IT'S TRUE, IS IT NOT,
10 THAT THERE WAS NO MICROSCOPIC ANALYSIS OF THE BRAIN TISSUE?
11 A. THERE WAS NOT.
12 Q. NOW, MS. ANDERSON. THAT'S AN AUTOPSY THAT YOU PERFORMED
13 AND YOU TOLD US THAT THE MANNER OF DEATH WAS UNDETERMINED
14 AND THE CAUSE OF DEATH WAS UNDETERMINED, CORRECT?
15 A. THAT IS CORRECT.
16 Q. AND IT'S TRUE, IS IT NOT, THAT IN MS. ANDERSON'S CASE,
17 BASED UPON THE FINDINGS THAT YOU DID, THERE WERE
18 CIRCUMSTANCES THAT YOU FIND WHICH YOU BELIEVE COULD HAVE
19 RESULTED IN HER SUDDEN DEATH, CORRECT?
20 A. IN HER DEATH, YES.
21 Q. IN HER DEATH. THAT YOU COULD NOT RULE OUT BASED UPON
22 THE FINDINGS YOU MADE; IS THAT RIGHT?
23 A. THAT IS CORRECT.
24 Q. FOR EXAMPLE, ONE OF THE THINGS THAT YOU COULDN'T RULE
25 OUT WAS DEATH CAUSED BY CORONARY ARTERY DISEASE OR HARDENING
1985
1 OF THE ARTERIES; ISN'T THAT TRUE?
2 A. THAT IS TRUE.
3 Q. I THINK WHAT WE'LL DO, DOCTOR, IS I'M GOING TO WRITE
4 THESE DOWN SO WE HAVE SOME WAY OF REFERRING TO THESE.
5 THE COURT: IF THE -- IF ANYBODY NEEDS TO GO OVER
6 THERE TO SEE THAT SO THAT IT CAN FACE THE JURY, YOU CAN JUST
7 GO OVER SIT -- STAND BY THEM.
8 MR. STIRBA: I DIDN'T KNOW A GOOD PLACE TO PUT
9 THIS, JUDGE.
10 THE COURT: WELL, THAT'S FINE, JUST SO THEY CAN SEE
11 IT.
12 Q. (BY MR. STIRBA) I'LL PUT AT THE TOP ELLEN ANDERSON.
13 AND ONE THING THAT YOU COULDN'T RULE OUT CAUSING HER DEATH
14 WAS, AS YOU JUST TESTIFIED, CORONARY ARTERY DISEASE.
15 MR. MAJOR: YOUR HONOR, IF I MIGHT INTERRUPT. CAN
16 THE WITNESS SEE? CAN YOU SEE WHAT HE'S WRITING?
17 THE WITNESS: YEAH, I CAN SEE.
18 MR. STIRBA: I -- IT'S HARD TO PLEASE EVERYBODY
19 WITH THIS PAD. I'M SORRY.
20 Q. (BY MR. STIRBA) BUT ANYWAY, I'M JUST WRITING DOWN,
21 DOCTOR, WHAT YOU JUST TOLD ME.
22 A. CORRECT.
23 Q. AND PROBABLY MISSPELLING IT IN THE PROCESS. OKAY.
24 CORONARY ARTERY DISEASE. NOW, IT'S TRUE, ALSO, AND YOU
25 TESTIFIED TO IT ON DIRECT, THAT YOU COULDN'T RULE OUT IN HER
1986
1 CASE THAT SHE MIGHT HAVE DIED FROM A HEART ARRHYTHMIA; IS
2 THAT RIGHT?
3 A. I DON'T REMEMBER TESTIFYING ABOUT ARRHYTHMIAS ON DIRECT,
4 BUT WE HAVE TALKED ABOUT THIS IN THE PAST.
5 Q. BUT YOU -- YOU AGREE WITH THAT?
6 A. YES.
7 Q. AND, ONCE AGAIN, ON DIRECT YOU DID -- YOU DID DESCRIBE
8 AN ARRHYTHMIA AS BEING A --
9 A. PHYSIOLOGICAL --
10 Q. -- AN EVENT THAT OTHERWISE COULDN'T BE FOUND ON AN
11 AUTOPSY; IS THAT RIGHT?
12 A. YES.
13 Q. AND THE REASON FOR THAT IS ESSENTIALLY IT'S AN
14 ELECTRICAL EVENT THAT OCCURS WITHIN THE HEART MUSCLE ITSELF,
15 CORRECT?
16 A. IT'S A PHYSIOLOGIC EVENT OF THE LIVING HEART THAT I
17 CAN'T SEE IN A DEAD HEART.
18 Q. AND THAT ARRHYTHMIA CAN BE THE CAUSE OF SUDDEN DEATH;
19 ISN'T THAT TRUE?
20 A. YES.
21 Q. I'LL NEVER SPELL THIS ONE. DO YOU KNOW HOW TO SPELL IT?
22 A. A-R-R-H-Y-T-H-M-I-A.
23 Q. T-H-M-I-A. OKAY. SO WE HAVE AN ARRHYTHMIA. I'LL JUST
24 PUT HEART HERE.
25 HOW ABOUT ALSO THAT YOU COULDN'T RULE OUT SINUS
1987
1 TACHYCARDIA?
2 A. THAT'S PART OF AN ARRHYTHMIA.
3 Q. OKAY. WOULD YOU TELL US WHAT -- WHAT IT IS IN TERMS OF
4 BEING A PART OF A HEART ARRHYTHMIA?
5 A. ARRHYTHMIA IS A GENERIC TERM MEANING ABNORMAL RHYTHM.
6 SINUS TACHYCARDIA IS A SUBCLASSIFICATION OF ONE OF THOSE
7 ABNORMAL OR FUNNY RHYTHMS.
8 Q. AND, ALSO, WITH RESPECT TO THE AUTOPSY YOU CONDUCTED,
9 YOU'VE TESTIFIED YOU FOUND SOME PULMONARY OR LUNG
10 INFILTRATES OR COMPLICATIONS; IS THAT RIGHT?
11 A. YES.
12 Q. AND IT'S TRUE, IS IT NOT, AS YOU INDICATE IN YOUR
13 REPORT, YOU DESCRIBED THAT AS ACUTE BRONCHOPNEUMONIA,
14 CORRECT?
15 A. IN THE LEFT LUNG, YES.
16 Q. AND IT'S TRUE, IS IT NOT, THAT YOU CANNOT RULE THAT OUT
17 AS A CAUSE OF MS. ANDERSON'S DEATH?
18 A. NO, I CANNOT EXCLUDE IT.
19 Q. OKAY. BRONCHO --
20 A. O-N --
21 Q. O-N --
22 A. -- C-H --
23 Q. -- C-H --
24 A. -- P-N --
25 Q. -- P-N --
1988
1 A. -- E-U --
2 Q. -- E-U --
3 A. -- M-O-N --
4 Q. -- M-O-N?
5 A. CORRECT. I-A.
6 Q. I-A. OKAY. THEN IT'S ALSO TRUE THAT YOU FOUND SOME
7 EVIDENCE IN THE EXAMINATION OF THE LUNG TISSUE OF SOME
8 ADDITIONAL LUNG DISEASE; IS THAT RIGHT?
9 A. THAT IS CORRECT.
10 Q. AND THAT LUNG DISEASE WAS EMPHYSEMA; IS THAT RIGHT?
11 A. THAT'S ONE OF THEM, YES.
12 Q. AND CAN YOU RULE OUT EMPHYSEMA AS A CAUSE OF DEATH WITH
13 RESPECT TO MS. ANDERSON?
14 A. BY ITSELF?
15 Q. IN -- IN -- IN CONJUNCTION WITH OTHER FINDINGS THAT YOU
16 MADE.
17 A. IN CONJUNCTION IT MAY PLAY A ROLE. E-M --
18 Q. E -- THANK YOU. E-M --
19 A. -- P-H --
20 Q. -- P-H --
21 A. -- Y --
22 Q. -- Y --
23 A. -- S-E-M-A.
24 Q. -- S-E-M-A. EMPHYSEMA. ALSO, ON YOUR AUTOPSY FINDINGS
25 YOU -- AND I THINK YOU TESTIFIED TO THIS ON DIRECT -- YOU
1989
1 FOUND SIGNIFICANT ATROPHY? CEREBRAL ATROPHY WITH RESPECT TO
2 MS. ANDERSON?
3 A. YES.
4 Q. AND IT'S TRUE, IS IT NOT, THAT DEMENTIA OR SEVERE
5 DEMENTIA IS A CAUSE OF -- OF DEATH OR CAN BE A CAUSE OF
6 DEATH?
7 A. YES.
8 Q. AND, IN FACT, YOU AS A MEDICAL EXAMINER HAVE AT TIMES
9 INDICATED AS A CAUSE OF DEATH, FOR EXAMPLE, ALZHEIMER'S
10 DISEASE; ISN'T THAT TRUE?
11 A. YES.
12 Q. AND IN -- IN MS. ANDERSON'S CASE, YOU CAN'T RULE OUT AS
13 HER CAUSE OF DEATH DEMENTIA?
14 A. AS A CONTRIBUTORY FACTOR OR PLAYING A ROLE IN ALL OF
15 WHAT WE'VE TALKED ABOUT, NO, I CANNOT.
16 MR. MAJOR: WELL, YOUR HONOR, I'M GOING TO HAVE TO
17 ASK FOR SOME FOUNDATION. IS THERE ANY EVIDENCE THAT'S BEEN
18 ADMITTED THAT SHE HAD DEMENTIA AT THIS POINT?
19 MR. STIRBA: HE REVIEWED THE MEDICAL RECORDS AND
20 ALSO DID THE AUTOPSY, YOUR HONOR.
21 MR. MAJOR: BUT I DON'T THINK HE WAS EVER ASKED
22 WHETHER THERE WAS DEMENTIA PRESENT. I KNOW HE WAS NOT ASKED
23 ON DIRECT, SO I WOULD LIKE TO HAVE HIM PERHAPS ADDRESS THAT
24 QUESTION, WHETHER OR NOT THERE'S ANYTHING IN THE REPORTS
25 THAT HE SAW THAT INDICATED THAT.
1990
1 THE COURT: WELL, WHY DON'T YOU LAY A LITTLE MORE
2 FOUNDATION.
3 Q. (BY MR. STIRBA) WELL, IN -- IN MS. ANDERSON'S CASE, AS
4 YOU JUST TESTIFIED TO, YOU OBVIOUSLY WERE APPRISED OF
5 SOMETHING SUCH THAT YOU'RE ABLE TO MAKE A FINDING THAT THAT
6 COULD HAVE PLAYED A ROLE THAT CONTRIBUTED TO HER DEATH; IS
7 THAT RIGHT?
8 A. YES.
9 Q. AND COULD YOU TELL US, WAS THAT ONE OF THE -- THE
10 MEDICAL RECORDS THAT WAS PROVIDED TO YOU FROM THE DAVIS
11 HOSPITAL?
12 A. YES. HER MEDICAL RECORDS INDICATED THAT SHE WAS
13 SUFFERING FROM DEMENTIA.
14 Q. IS IT D-I OR D-E?
15 A. D-E-M-E-N-T-I-A.
16 Q. NOW, YOU -- YOU TOLD US ABOUT THIS HIP REPAIR THAT YOU
17 OBSERVED ON EXAMINATION DURING THE AUTOPSY, CORRECT?
18 A. YES.
19 Q. AND I BELIEVE YOU TOLD US IT WAS THE LEFT HIP THAT
20 YOU -- YOU FOUND THAT WAS REPAIRED BY A PIN?
21 A. THAT IS CORRECT.
22 Q. AND IT'S TRUE, IS IT NOT, THAT THAT WAS NOT A -- AN
23 APPARATUS THAT YOU HAD TYPICALLY SEEN IN YOUR AUTOPSIES; IS
24 THAT RIGHT?
25 A. THAT IS CORRECT.
1991
1 Q. AND YOU ALSO DETERMINED, BASED UPON YOUR EXAMINATION OF
2 THAT, THAT IT WAS UNUSUAL IN THAT WHEN YOU GOT DOWN TO IT,
3 YOU COULD EASILY PULL THAT PIN OUT; ISN'T THAT RIGHT?
4 A. I FOUND THAT AN -- AN INTERESTING FINDING, YES.
5 Q. IN FACT, IT'S TRUE, IS IT NOT, THAT -- THAT BASED UPON
6 THAT FINDING, YOU DID NOT DETECT MUCH NATURAL CEMENTING OF
7 THAT PIN TO THE BONE; ISN'T THAT TRUE?
8 A. CLEARLY. IT WAS FREELY MOBILE.
9 MR. STIRBA: MAY THE WITNESS COME DOWN TO THE PAD,
10 YOUR HONOR?
11 THE COURT: ARE YOU GOING TO HAVE HIM DRAW
12 SOMETHING OR --
13 MR. STIRBA: IT'S DRAWN. I JUST WANT TO MAKE SURE
14 WE'RE TALKING ABOUT THE SAME THING.
15 THE COURT: YES. IF YOU'D LIKE TO APPROACH.
16 Q. (BY MR. STIRBA) DR. GREY, IF YOU COULD COME DOWN HERE,
17 PLEASE.
18 A. UH-HUH.
19 (WHEREUPON, THERE'S AN OFF-THE-RECORD DISCUSSION BETWEEN
20 MR. STIRBA AND MR. MAJOR.)
21 MR. STIRBA: THAT'S WHAT I'M GOING TO ASK HIM.
22 MR. MAJOR: OKAY. I JUST WANTED YOU TO KNOW SO YOU
23 WOULDN'T BE EMBARRASSED.
24 MR. STIRBA: WELL, I'M JUST ASKING. I'M NOT ABOUT
25 TO BE EMBARRASSED BY FINDING OUT WHAT HAPPENED.
1992
1 Q. (BY MR. STIRBA) THIS IS -- THIS IS A DRAWING MADE BY
2 DR. SUMKO.
3 A. UH-HUH.
4 Q. AND HE DESCRIBED THE REPAIR THAT WAS DONE ON
5 MS. ANDERSON IN JUNE OF 1995. AND HE DESCRIBED
6 ESSENTIALLY -- CAN YOU IDENTIFY THIS AS THE HIP SOCKET?
7 A. IT'S THE --
8 Q. BALL AND SOCKET?
9 A. -- THE HEAD OF THE FEMUR, YES.
10 Q. THE HEAD OF THE FEMUR. AND THEN HE DESCRIBED FOR THE
11 JURY THAT ESSENTIALLY HE CARVED THIS AREA OF THE BONE OUT
12 AND HE PLACED A PIN HERE. IS --
13 A. WELL, I THINK WHAT HE -- WHAT HE -- IF THIS IS THE RIGHT
14 HIP WE'RE TALKING ABOUT, THIS IS THE ONE WHERE THERE'S AN
15 ARTIFICIAL BALL THAT IS ATTACHED TO THIS LONG, METAL PLUG
16 THAT HAS BEEN DOWN -- INSERTED DOWN INTO THE FEMUR.
17 Q. OKAY. AND THIS IS NOT -- THIS IS NOT THEN WHAT YOU WERE
18 TALKING ABOUT IN TERMS OF YOUR FINDING OF THAT PIN BEING
19 EASILY MOVEABLE; IS THAT RIGHT?
20 A. NO.
21 Q. IT'S TRUE, IS IT NOT, THAT THE PIN THAT YOU FOUND THAT
22 WAS EASILY MOVEABLE, BECAUSE IT WAS EASILY MOVEABLE, YOU
23 THOUGHT THAT WAS A RESULT OF A RECENT REPAIR?
24 A. YES.
25 Q. THIS OCCURRED AS -- WELL, THIS OCCURRED IN JUNE OF 1995.
1993
1 AND I BELIEVE --
2 A. WELL, I'M GETTING CONFUSED. ARE WE TALKING ABOUT THE
3 RIGHT HIP OR THE LEFT HIP NOW?
4 Q. WELL, LET ME FINISH MY QUESTION. I DON'T WANT TO
5 CONFUSE YOU, DOCTOR.
6 THE REPAIR THAT DR. SUMKO WAS ADDRESSING OCCURRED IN
7 JUNE OF 1995. AND I BELIEVE MS. ANDERSON PASSED AWAY
8 DECEMBER 30 OF 1995.
9 A. UH-HUH.
10 Q. WOULD -- WOULD THE FINDING THAT YOU MADE IN THE AUTOPSY
11 BE CONSISTENT WITH THAT TIME FRAME IN TERMS OF IT BEING A
12 RECENT REPAIR?
13 A. AND I'M STILL CONFUSED ABOUT WHICH SIDE WE'RE TALKING
14 ABOUT.
15 Q. WELL, I'M ASKING YOU, WOULD YOU CONSIDER SIX MONTHS
16 PRIOR TO AUTOPSY BEING A RECENT REPAIR?
17 A. RELATIVELY.
18 Q. OKAY. TELL -- TELL US, PLEASE, WHAT YOU MEAN BY -- YOU
19 WERE THE ONE WHO DID THE FINDING. YOU HAVE NOW TESTIFIED
20 THAT IT WAS A RESULT OF A RECENT REPAIR. WHAT DO YOU MEAN
21 IN TERMS OF A RECENT REPAIR?
22 MR. MAJOR: YOUR HONOR, COULD I JUST INTERJECT?
23 I'M -- I'M A LITTLE CONFUSED. I'M NOT SURE, ARE WE TALKING
24 ABOUT THE -- THE HIP WITH THE PIN IN IT OR ARE WE TALKING
25 ABOUT THE HIP REPLACEMENT?
1994
1 THE COURT: WELL, JUST ONE OTHER THING. ARE YOU
2 GOING TO NEED HIM AT THE BOARD ANYMORE?
3 MR. STIRBA: NO, I -- I DON'T, YOUR HONOR. I
4 APPRECIATE THAT. THANK YOU.
5 THE COURT: OKAY. THEN WHY DON'T YOU TAKE YOUR
6 SEAT AND THEN JUST MAYBE REPHRASE YOUR QUESTION.
7 MR. STIRBA: SURE.
8 Q. (BY MR. STIRBA) DOCTOR, WHAT -- WHAT I'M ASKING YOU IS
9 THAT YOU DID FIND, DID YOU NOT, WITH RESPECT TO THE REPAIR
10 AND THE PIN, THAT BASED UPON WHAT YOU FOUND ON THE
11 AUTOPSY -- AND THAT IS THAT THERE WAS NOT MUCH NATURAL
12 CEMENTING OF THAT PIN TO THE BONE -- YOU BELIEVED IT WAS OF
13 RECENT ORIGIN, TRUE?
14 A. YES.
15 Q. THE QUESTION I'M ASKING YOU IS TELL THE JURY WHAT YOU
16 MEAN BY RECENT ORIGIN.
17 A. WHEN I SAY "RECENT" WHAT I'M MEANING IS THAT AS -- WHEN
18 ANYTHING GETS PUT INTO THE BODY, THE BODY'S REACTION TO IT
19 IS TO TRY TO WALL IT OFF AND LOCK IT. I DID NOT SEE ANY
20 EVIDENCE OF THAT -- THAT WALLING OR LOCKING OR BLOCKING
21 PROCESS.
22 IN TERMS OF A SPECIFIC TIME LINE, I CAN'T BE THAT -- I
23 CAN'T GIVE YOU A REAL NUMBER BECAUSE PEOPLE HEAL AT
24 DIFFERENT RATES. I WOULD EXPECT THAT IN SIX MONTHS YOU
25 WOULD SEE SOME LOCKING FIBROSIS, SCARRING IN THE AREA. BUT
1995
1 SOMETIMES OLD PEOPLE WILL NOT HEAL FOR MUCH LONGER THAN
2 SOMEONE WHO IS NOT AGED. SO I DON'T KNOW WHAT -- IF I CAN
3 GIVE YOU A SPECIFIC TIME LINE.
4 Q. SURE. AND ASSUME THAT THERE WAS, IN FACT, A HIP REPAIR
5 DONE IN JUNE OF 1995. WOULD THE FINDING THAT YOU'RE TALKING
6 ABOUT OF WALLING OFF, WOULD THAT BE CONSISTENT WITH THAT?
7 A. I WOULD EXPECT WITH A SIX-MONTH PERIOD OF TIME THAT ONE
8 WOULD SEE MORE THAN THAT, BUT I CAN'T BE -- AS I SAID, I
9 CAN'T BE SURE.
10 Q. NOW, MR. ALLDREDGE YOU CONDUCTED AN AUTOPSY ON; IS THAT
11 RIGHT?
12 A. YES.
13 Q. AND IT'S TRUE THAT WITH RESPECT TO MR. ALLDREDGE, YOU
14 ALSO DETERMINED THE EXISTENCE OF CORONARY ARTERY DISEASE,
15 TRUE?
16 A. YES.
17 Q. I'M LOOKING FOR MY MAGIC MARKER. OH, HERE IT IS. AND,
18 IN FACT, AS YOU INDICATE IN YOUR REPORT, YOU INDICATE -- TWO
19 L'S -- YOU INDICATE THAT YOU FOUND A SEVERE STENOSIS IN ONE
20 OF HIS CORONARY ARTERIES, TRUE?
21 A. ACTUALLY IN -- IN BOTH THE RIGHT AND LEFT MAIN.
22 Q. AND IT'S TRUE, IS IT NOT, THAT WITH RESPECT TO
23 MR. ALLDREDGE, YOU CANNOT RULE OUT, BASED UPON YOUR FINDINGS
24 AT THE AUTOPSY, THE CAUSE OF DEATH OF CORONARY ARTERY
25 DISEASE; ISN'T THAT TRUE?
1996
1 A. THAT IS TRUE.
2 Q. IT'S ALSO TRUE, IS IT NOT, THAT WITH RESPECT TO
3 MR. ALLDREDGE YOU CANNOT RULE OUT DEATH RESULTING FROM THE
4 COMPLICATIONS OF HIS DEMENTIA? ISN'T THAT TRUE?
5 A. THE -- AGAIN, THE BRAIN WAS SMALL IN THIS INDIVIDUAL. I
6 COULD NOT EXCLUDE ATROPHY IN THIS, SO I COULD NOT EXCLUDE
7 DEMENTIA AS PLAYING A ROLE.
8 Q. D-E, RIGHT?
9 A. D-E-M-E-N-T-I-A.
10 Q. NOW, YOU'RE AWARE, ALSO, FROM THE MEDICAL RECORDS THAT
11 MR. ALLDREDGE SUFFERED FROM OR HAD EVENTS -- ESSENTIALLY
12 CEREBROVASCULAR DISEASE. ARE YOU AWARE OF THAT?
13 A. YES.
14 Q. AND IT'S TRUE, IS IT NOT, THAT THERE ARE TIMES WHEN A
15 STROKE EVENT CAN BE FATAL? CORRECT?
16 A. OF COURSE.
17 Q. AND IT'S TRUE, IS IT NOT, THAT SOMETIMES THOSE FATAL
18 EVENTS CAN BE SUBACUTE? TRUE?
19 A. TO PRODUCE SUDDEN DEATH I WOULD EXPECT THAT YOU WOULD
20 HAVE A MUCH MORE EXTENSIVE PROCESS THAN SOMETHING VERY SMALL
21 AS WE'VE DESCRIBED SUBACUTE EVENTS.
22 Q. BUT IT'S TRUE, IS IT NOT, THAT SUBACUTE EVENTS MAY
23 RESULT IN SUDDEN DEATH? ISN'T THAT TRUE?
24 A. IN THE BRAIN?
25 Q. YES.
1997
1 A. NOT THAT I'M AWARE OF THAT YOU GET SUCH A SMALL AREA OF
2 THE BRAIN DAMAGED THAT YOU WOULD PRODUCE SUDDEN DEATH, NO.
3 Q. COULD THAT HAVE -- A SUBACUTE EVENT CONTRIBUTED TO
4 MR. ALLDREDGE'S DEATH?
5 A. COULD IT CONTRIBUTE? YES.
6 Q. CAN YOU RULE THAT OUT AS A CONTRIBUTION IN HIS CASE?
7 A. NO.
8 Q. SIMILARLY, ARE YOU AWARE BASED UPON YOUR REVIEW OF THE
9 MEDICAL RECORDS THAT ON THE 12TH OF JANUARY THERE WAS A
10 CONCERN THAT MR. ALLDREDGE WAS DEHYDRATED?
11 A. I'M NOT SPECIFICALLY AWARE OF THAT, NO.
12 Q. AND ARE YOU AWARE THAT IN RESPONSE TO THAT CONCERN, SOME
13 I.V. FLUIDS WERE ORDERED BY DR. WEITZEL TO BE STARTED TO
14 HYDRATE MR. ALLDREDGE?
15 A. AGAIN, THAT SPECIFIC ORDER I'M NOT AWARE OF.
16 Q. AND YOU -- AS YOU TESTIFIED EARLIER, YOU CERTAINLY AGREE
17 WITH ME, DO YOU NOT, THAT IF SOMEBODY -- ESPECIALLY SOMEBODY
18 WHO IS MR. ALLDREDGE'S AGE, WHICH I BELIEVE WAS 81 AT THE
19 TIME, IF HE WAS DEHYDRATED, THAT CONDITION ALONE COULD CAUSE
20 HIS DEATH? ISN'T THAT TRUE?
21 A. CAUSE OR CONTRIBUTE, YES.
22 Q. AND, SIMILARLY, IF HE IS DEPRIVED OF NUTRITION, THAT
23 SIMILARLY COULD CAUSE HIS DEATH; IS THAT RIGHT?
24 A. IF THE DEPRIVATION WENT ON LONG ENOUGH, YES.
25 Q. AND ONCE AGAIN, THE -- THE FACT OF WHETHER OR NOT
1998
1 MR. ALLDREDGE DIED AS A RESULT OF LACK OF WATER OR FLUIDS OR
2 LACK OF FOOD IS NOT SOMETHING THAT YOU AS A FORENSIC
3 PATHOLOGIST WOULD FIND IN THE AUTOPSY, TRUE?
4 A. NOT AT THIS STAGE WHEN WE'VE HAD THE BURIAL, EMBALMING,
5 ET CETERA, NO.
6 Q. NOW, YOU ALSO TESTIFIED YOU FOUND SOME -- ONCE AGAIN,
7 SOME LUNG TISSUE THAT APPEARED TO BE DISEASED IN YOUR
8 AUTOPSY; IS THAT RIGHT?
9 A. I FOUND BOTH FOCAL PNEUMONIA, AS WELL AS EMPHYSEMA, YES.
10 Q. OKAY. AND THOSE -- THOSE ARE LUNG DISEASES, TRUE?
11 A. YES.
12 Q. AND IT'S TRUE, IS IT NOT, THAT YOU CANNOT RULE OUT
13 MR. ALLDREDGE'S DEATH AS A RESULT OF THE COMPLICATIONS OF
14 YOUR FINDINGS RELATING TO HIS LUNGS; ISN'T THAT CORRECT?
15 A. AGAIN, AS A CONTRIBUTORY FACTOR, I CANNOT EXCLUDE IT.
16 AS A SOLE FACTOR, I WOULD BE VERY SURPRISED IF THOSE WOULD
17 CAUSE IT.
18 Q. OKAY. SO YOUR TESTIMONY IS IT'S A CONTRIBUTING, BUT NOT
19 NECESSARILY A SOLE CAUSE; IS THAT RIGHT?
20 A. A POSSIBLY CONTRIBUTING, YES.
21 Q. OKAY. AND THAT WOULD BE BOTH THE PNEUMONIA AND THE
22 EMPHYSEMA?
23 A. YES.
24 Q. I'M GOING TO MAKE THIS EASY. I'M GOING TO PUT LUNG
25 PROBLEMS, AND THEN I'M GOING TO PUT DOWN HERE CONTRIBUTING.
1999
1 I WROTE "LUNG PROBLEMS, CONTRIBUTING." THAT'S -- THAT'S
2 YOUR TESTIMONY, TRUE?
3 A. POSSIBLY CONTRIBUTING, YES.
4 Q. CAN'T RULE THAT OUT, CAN YOU?
5 A. I CANNOT.
6 Q. NOW, YOU ALSO -- GIVEN THE FACT THAT YOU'VE TESTIFIED
7 THAT YOU -- YOU DID FIND THAT PREVIOUSLY MR. ALLDREDGE HAD A
8 HEART ATTACK; IS THAT RIGHT?
9 A. YES.
10 Q. IN FACT, THE WAY YOU DID THAT IS YOU -- YOU FOUND SOME,
11 ESSENTIALLY, TISSUE THAT HAD BEEN GROWING IN AN AREA OF
12 HEART MUSCLE WHICH IS CONSISTENT WITH A HEALING MECHANISM,
13 TRUE?
14 A. YOUR DESCRIPTION IS SOMEWHAT INACCURATE. I FOUND SCAR
15 TISSUE INDICATING THAT MUSCLE TISSUE HAD BEEN REPLACED BY
16 SCAR.
17 Q. THANK YOU. THAT -- THAT'S WHAT I WAS TRYING TO SAY.
18 BUT ESSENTIALLY THAT'S A HEALING -- A HEALING MECHANISM, AND
19 THAT INDICATES TO YOU AS A FORENSIC PATHOLOGIST THAT THERE
20 WAS AN EVENT; NAMELY, A HEART ATTACK, CORRECT?
21 A. THAT IS CORRECT.
22 Q. AND GIVEN THE FACT THAT YOU FOUND THAT, AND GIVEN YOUR
23 FINDINGS RELATING TO THE CORONARY ARTERY DISEASE, AND GIVEN
24 THE OTHER COMPLICATIONS WHICH YOU'VE TESTIFIED TO, SIMILARLY
25 WITH RESPECT TO MR. ALLDREDGE, CAN YOU RULE OUT THAT A
2000
1 POSSIBLE CAUSE OF DEATH IN HIS CASE WAS, ONCE AGAIN, AN
2 ARRHYTHMIA?
3 A. NO, I CANNOT.
4 Q. OKAY. I THINK I SPELLED IT CORRECTLY NOW.
5 A-R-R-Y-T-H --
6 A. H-Y.
7 Q. OKAY. A-R-R-H-Y?
8 A. YES.
9 Q. H-Y-T-H-M-I-A?
10 A. CORRECT.
11 Q. AND IT'S TRUE, IS IT NOT, THAT IN TERMS OF BOTH
12 MS. ANDERSON AND MR. ALLDREDGE, THERE WERE EKG'S DONE IN THE
13 HOSPITAL?
14 A. YES.
15 Q. AND THOSE EKG'S WHICH ARE ESSENTIALLY A TESTING OF
16 CERTAIN ELECTRICAL FUNCTIONS OF THE HEART WERE ABNORMAL?
17 A. YES.
18 Q. NOW, YOU DID AN AUTOPSY OF LYDIA SMITH, PATIENT LYDIA
19 SMITH; IS THAT RIGHT?
20 A. YES.
21 Q. AND YOU -- YOU DO NOTE ON YOUR REPORT A FINDING THAT ON
22 1/7 OF '96 SHE BECAME WEAK AND UNRESPONSIVE, REFUSING TO
23 TAKE FLUIDS AND NOURISHMENT. DID I READ THAT CORRECTLY?
24 A. YES, YOU DID.
25 Q. AND IT'S TRUE, IS IT NOT, THAT ALSO IN MS. SMITH'S CASE
2001
1 THE MANNER OF DEATH IS UNDETERMINED? TRUE?
2 A. YES.
3 Q. AND THE IMMEDIATE CAUSE OF DEATH YOU HAVE UNDETERMINED
4 CAUSES, CORRECT?
5 A. YES.
6 Q. AND YOU'VE TESTIFIED THAT THERE WAS -- THERE WAS SOME
7 DIFFICULTY IN TERMS OF YOUR AUTOPSY HERE BECAUSE OF THE
8 CONDITION THAT YOU FOUND IN TERMS OF THE DEGRADATION OF
9 CERTAIN -- CERTAIN PARTS OF THE BODY; IS THAT RIGHT?
10 A. YES.
11 Q. THERE WAS SOME DETERIORATION AS A RESULT OF THE
12 INTERMENT PROCESS, CORRECT?
13 A. THAT IS CORRECT.
14 Q. SO YOU HAD -- YOU MADE SOME LIMITED FINDINGS, BUT IS IT
15 FAIR TO SAY THAT BECAUSE OF THE SCOPE OF YOUR EXAMINATION,
16 YOU JUST ARE NOT IN A POSITION TO DETERMINE A CAUSE OF
17 DEATH?
18 A. NOT BECAUSE OF THE SCOPE, BUT BECAUSE OF THE CONDITION
19 OF THE MATERIALS I WAS EXAMINING.
20 Q. FINE. IN OTHER WORDS, CONSISTENT WITH THAT, YOU
21 COULDN'T DO A FULL-BLOWN EXAMINATION AS YOU NORMALLY WOULD
22 BECAUSE THE AVAILABLE MATERIAL WAS COMPROMISED?
23 A. I DID A FULL-BLOWN EXAMINATION, BUT WHAT I WAS LOOKING
24 AT WAS SO BAD I COULDN'T MAKE DIAGNOSES WITH MUCH CERTAINTY.
25 Q. OKAY. THAT'S FAIR.
2002
1 AND IT'S TRUE, IS IT NOT, THERE WAS A TOXICOLOGY
2 ANALYSIS DONE ON VARIOUS TISSUE SAMPLES AS WELL CONCERNING
3 MS. SMITH, AND THOSE ALSO DID NOT DETECT THE EXISTENCE OF
4 ANY MORPHINE, TRUE?
5 A. YES.
6 Q. AND, IN FACT, THERE WERE TISSUE SAMPLES FROM HER LIVER,
7 HER KIDNEY, HER SPLEEN, HER BRAIN, AND ALSO THERE WAS SOME
8 CHEST FLUID, CORRECT?
9 A. YES.
10 Q. NOW, IT'S -- YOU ALSO DID AN AUTOPSY OF JUDITH LARSEN?
11 A. YES.
12 Q. I'M JUST GOING TO WRITE LYDIA SMITH HERE CONSISTENT WITH
13 WHAT WE WERE DOING. AND, BASICALLY, YOU -- YOU REALLY --
14 WERE YOU IN A POSITION TO -- FOR EXAMPLE, YOU TESTIFIED THAT
15 YOU -- YOU WERE ABLE TO IDENTIFY HER HEART VALVE, CORRECT?
16 A. YES.
17 Q. AND WERE YOU -- WERE YOU AWARE THAT ABOUT FOUR WEEKS
18 BEFORE SHE WENT INTO THE DAVIS HOSPITAL THAT SHE HAD A
19 SEVERE STROKE?
20 A. YES.
21 Q. IS IT FAIR TO SAY, TOO, THAT THAT EVENT IS DIAGNOSTIC OF
22 SOMEBODY WHO HAS CEREBROVASCULAR DISEASE?
23 A. YES.
24 Q. AND IS IT ALSO TRUE THAT -- THAT AS A RESULT OF YOUR
25 EXAMINATION OF THE HEART MUSCLE, YOU WERE ABLE TO DETERMINE
2003
1 THAT SHE HAD OTHER HEART DISEASE PROCESSES IN ADDITION TO
2 JUST THE VALVULAR ONE?
3 A. I DID SEE THAT THERE WAS CALCIFICATION IN ONE OF THE
4 CORONARY ARTERIES. HOW SEVERE THAT WAS, I COULDN'T ASSESS.
5 Q. GIVEN WHAT YOU FOUND, CAN YOU RULE OUT AS A CAUSE OF
6 PATIENT LYDIA SMITH'S DEATH, CORONARY ARTERY DISEASE?
7 A. NO.
8 Q. SIMILARLY, CAN YOU RULE OUT THAT PATIENT LYDIA SMITH
9 DIED AS A RESULT OF AN EVENT WHICH IS RELATED TO
10 CEREBROVASCULAR DISEASE?
11 A. NO, I CANNOT.
12 Q. I'M JUST GOING TO PUT C.V.A. C.V.A. STANDS FOR
13 CEREBROVASCULAR ACCIDENT?
14 A. THAT IS CORRECT.
15 Q. AND I'M GOING TO PUT C.V.A. AND THEN DISEASE.
16 HOW ABOUT IN HER CASE, CAN YOU RULE OUT THAT SHE DIED
17 AS A RESULT OF A CARDIAC ARRHYTHMIA?
18 A. NO.
19 Q. DO YOU WANT TO SPELL IT AGAIN?
20 A. A-R-R --
21 Q. A-R-R --
22 A. -- H-Y --
23 Q. -- H-Y --
24 A. -- T-H --
25 Q. -- T-H --
2004
1 A. -- M-I-A --
2 Q. -- M-I-A. THANK YOU.
3 BASED UPON WHAT YOU HAVE REVIEWED, CAN YOU RULE OUT
4 THAT PATIENT LYDIA SMITH DIED FROM THE COMPLICATIONS OF A
5 CONDITION CONGESTIVE HEART FAILURE?
6 A. NO, I CANNOT.
7 Q. NOW, IN TERMS OF YOUR EXAMINATION AND AUTOPSY OF PATIENT
8 JUDITH LARSEN -- AND YOU'VE TESTIFIED THAT YOU HAD SOME
9 MEDICAL INFORMATION THAT WAS PROVIDED TO YOU, AND THAT IS
10 THE FORM OF THE DAVIS HOSPITAL RECORDS; IS THAT RIGHT?
11 A. YES.
12 Q. AND IT'S TRUE, IS IT NOT, THAT YOU WERE AWARE THAT
13 JUDITH LARSEN HAD A STROKE IN JANUARY OF 1995?
14 A. YES.
15 Q. AND WERE YOU ALSO AWARE AS YOU DID YOUR AUTOPSY AND
16 PREPARED YOUR REPORT THAT MS. LARSEN ALSO HAD ANOTHER STROKE
17 IN AUGUST OF 1995?
18 A. REPORTEDLY, YES.
19 Q. YOU'RE AWARE OF THAT. WERE YOU AWARE THAT THAT STROKE
20 EVENT IN AUGUST, 1995, ALMOST RESULTED IN HER DEATH AT THAT
21 TIME?
22 A. THAT SPECIFIC INTERPRETATION I'M NOT AWARE OF, NO.
23 Q. OKAY. BUT IT'S TRUE, SIMILARLY, AS I'VE ASKED YOU WITH
24 THE OTHER PATIENTS INVOLVED, THAT THE STROKES CERTAINLY
25 WOULD INDICATE CEREBROVASCULAR DISEASE; IS THAT RIGHT?
2005
1 A. YES.
2 Q. AND IT'S ALSO TRUE THAT YOU -- YOU TESTIFIED ABOUT A
3 GASTROINTESTINAL BLEED, RIGHT?
4 A. THAT'S CORRECT.
5 Q. AND YOU DID SOME EXAMINATION OF HER GASTROINTESTINAL
6 SYSTEM TO LOOK FOR CERTAIN THINGS RELATED TO THAT EVENT; IS
7 THAT RIGHT?
8 A. YES.
9 Q. AND ONE THING, BASED UPON WHAT YOU SAW, IS THAT YOU
10 RULED OUT AND COULD RULE OUT AN ACUTE OR LARGE HEMORRHAGE;
11 IS THAT RIGHT?
12 A. YES.
13 Q. AND THAT YOU DID ON VISUAL OBSERVATION, CORRECT?
14 A. YES.
15 Q. NOW, IT'S TRUE, IS IT NOT, THAT A GASTROINTESTINAL BLEED
16 MEANS THAT THERE IS SOME AREA WITHIN ESSENTIALLY THE GUT
17 THAT THERE IS BLEEDING, RIGHT?
18 A. YES.
19 Q. AND IT'S TRUE, IS IT NOT, THAT BASICALLY AT SOME POINT
20 THERE -- THERE MAY BE A CIRCUMSTANCE WHERE THAT BLEED IS
21 REPAIRED AND ESSENTIALLY THE BLOOD IS EXCRETED IN THE NORMAL
22 EXCRETORY PROCESS OF THE BODY; ISN'T THAT TRUE?
23 A. YES.
24 Q. AND, IN FACT, WHAT YOU TYPICALLY SEE -- AND I THINK YOU
25 DESCRIBED IT -- IS THAT THERE'S SORT OF A -- A BLACK TARRY
2006
1 STOOL ASSOCIATED WITH THAT; ISN'T THAT RIGHT?
2 A. YES.
3 Q. AND IT'S TRUE, IS IT NOT, THAT -- THAT ONCE THAT OCCURS
4 YOU MAY NOT HAVE -- AS A FORENSIC PATHOLOGIST BECAUSE YOU --
5 IF YOU DON'T HAVE A HEMORRHAGE, YOU MAY NOT SEE ANY BLOOD
6 ESSENTIALLY IN THE SYSTEM BECAUSE IT HAS BEEN EXCRETED,
7 TRUE?
8 A. YES.
9 Q. AND IT'S ALSO TRUE, IS IT NOT, THAT WHEN THAT BLOOD IS
10 EXCRETED, THAT MEANS THE BODY HAS LOST SOME BLOOD VOLUME,
11 CORRECT?
12 A. YES.
13 Q. AND IT NEEDS TO BE REPLACED, TRUE?
14 A. THE BODY SHOULD COMPENSATE FOR THAT, YES.
15 Q. SO THE COMPLICATIONS OF A GASTROINTESTINAL BLEED MAY
16 STILL EXIST IN THE PERSON'S SYSTEM, EVEN THOUGH THERE'S NO
17 EVIDENCE OF THE BLOOD NOW BEING IN THE BODY, CORRECT?
18 A. YES.
19 Q. NOW, IN -- YOU'VE TESTIFIED -- AND I THINK I ASKED YOU
20 THIS -- YOU WERE AWARE THAT MS. LARSEN STOPPED EATING,
21 CORRECT?
22 A. YES.
23 Q. AND SHE WAS 93-YEARS-OLD AT THE TIME; IS THAT RIGHT?
24 A. YES.
25 Q. AND YOU'VE TESTIFIED THAT YOU CANNOT RULE OUT DEATH IN
2007
1 HER CASE FROM LACK OF FLUIDS, TRUE?
2 A. YES.
3 Q. AND YOU ALSO CANNOT RULE OUT IN HER CASE DEATH FROM LACK
4 OF FOOD, CORRECT?
5 A. THAT'S TRUE.
6 Q. SIMILARLY, CAN YOU RULE OUT DEATH FROM CEREBROVASCULAR
7 DISEASE OR THE COMPLICATIONS OF THAT, ATTENDANT WITH HER
8 DEHYDRATION AND HER LACK OF NUTRITION?
9 A. INSOFAR AS I DID NOT SEE ANYTHING IN THE BRAIN, ANY
10 MAJOR CEREBROVASCULAR EVENT, YES, I CAN -- I CAN SAY THAT.
11 THE FACT THAT SHE MAY HAVE HAD A SUBACUTE EVENT AS WE'VE
12 TALKED ABOUT, I CAN'T EXCLUDE; AND THAT POSSIBLY PLAYING A
13 ROLE, I CANNOT EXCLUDE.
14 Q. I'M GOING TO WRITE HERE, DOCTOR, SUBACUTE EVENT, AND I'M
15 GOING TO WRITE ON HERE, CONTRIBUTING.
16 NOW, IT'S TRUE, IS IT NOT, THAT IN -- IN YOUR SITUATION
17 IN CONDUCTING, FOR EXAMPLE, THE AUTOPSY ON PATIENT LARSEN,
18 YOU -- I CAN'T RECALL, WAS -- DID YOU HAVE A BLOOD -- BLOOD
19 AVAILABLE TO ANALYZE?
20 A. BLOOD ITSELF, NO.
21 Q. OKAY. AND IT'S TRUE, IS IT NOT, THAT IF YOU DON'T HAVE
22 BLOOD THEN THERE ARE CERTAIN TESTS, FOR EXAMPLE, THAT YOU
23 COULD NOT RUN WHICH MIGHT BE HELPFUL IN IDENTIFYING CERTAIN
24 PROBLEMS OR A DISEASE PROCESS; ISN'T THAT CORRECT?
25 A. YES.
2008
1 Q. FOR EXAMPLE, ISN'T -- ISN'T -- ISN'T IT TRUE THAT --
2 THAT SOMETIMES BLOOD IS VERY HELPFUL TO HAVE IN ORDER TO
3 DETERMINE AN -- AN INFECTIOUS DISEASE PROCESS?
4 A. YES. THAT WOULD BE ONE THING YOU COULD USE.
5 Q. CERTAINLY A WHITE BLOOD CELL COUNT OR SOMETHING SIMILAR
6 TO THAT IS DIAGNOSTICALLY HELPFUL IN DETERMINING WHETHER
7 SOMEBODY'S SUFFERING FROM AN INFECTION.
8 A. YES.
9 Q. AND YOU CAN ONLY DO THAT IF YOU HAVE BLOOD, TRUE?
10 A. YES.
11 Q. SIMILARLY, IF MS. LARSEN WAS SUFFERING FROM A
12 SIGNIFICANTLY MAJOR ANEMIC CONDITION, YOU WOULD HAVE TO HAVE
13 BLOOD IN ORDER TO DETERMINE THAT; ISN'T THAT CORRECT?
14 A. THAT WOULD BE HOW YOU'D MAKE THE DIAGNOSIS, YES.
15 Q. AND, ONCE AGAIN, IN THIS CASE BECAUSE YOU DIDN'T HAVE
16 THAT BLOOD, YOU COULD NOT MAKE SUCH A FINDING; ISN'T THAT
17 CORRECT?
18 A. THAT IS CORRECT.
19 Q. CAN YOU -- BASED UPON WHAT YOU KNOW AND BASED UPON WHAT
20 YOU HAD AVAILABLE TO YOU FOR PURPOSES OF THIS AUTOPSY, CAN
21 YOU RULE OUT AN ANEMIA OR AN ANEMIC CONDITION AS EITHER
22 CAUSING HER DEATH OR CONTRIBUTING TO HER DEATH?
23 A. CAUSING PROBABLY I CAN RULE OUT. CONTRIBUTING I CANNOT
24 EXCLUDE.
25 Q. AND I'M GOING TO WRITE ANEMIA AND CONTRIBUTING.
2009
1 SIMILARLY, ARE YOU AWARE, BASED UPON THE RECORDS THAT
2 YOU HAVE IN FRONT OF YOU, THAT THERE WAS AN E.K.G.; THAT IS,
3 ONE OF THESE HEART ELECTRICAL TESTS THAT WAS RUN ON
4 MS. LARSEN, AND THAT WAS ALSO ABNORMAL?
5 A. YES.
6 Q. AND GIVEN -- GIVEN THAT FINDING AND GIVEN THE OTHER
7 FINDINGS THAT YOU MADE ON AUTOPSY, CAN YOU RULE OUT AN
8 ARRHYTHMIA AS A CAUSE OF DEATH IN HER CASE?
9 A. I CANNOT EXCLUDE IT, NO. H-Y.
10 Q. THANK YOU.
11 A. T-H.
12 Q. M-I-A?
13 A. M-I-A.
14 THE COURT: WE'LL HAVE TO KEEP YOU FOR THE REST OF
15 THE TRIAL.
16 Q. (BY MR. STIRBA) I'M JUST GOING TO WRITE HEART -- WHICH
17 I CAN SPELL -- NEXT TO THAT, DOCTOR.
18 IN MS. ANDERSON'S CASE -- AND YOU HAD THE RECORDS IN
19 FRONT OF YOU -- YOU ARE AWARE, ARE YOU NOT, THAT AT ABOUT
20 9 O'CLOCK ON THE 29TH A NURSE TALKED TO DR. WEITZEL AND
21 REPORTED THAT --
22 MR. MAJOR: OBJECTION, YOUR HONOR. I THINK THIS IS
23 GETTING INTO HEARSAY.
24 THE COURT: WELL, IT'S A RECORD --
25 MR. MAJOR: WHAT THE NURSE SAID.
2010
1 THE COURT: WELL, THIS IS A RECORD HE REVIEWED?
2 MR. STIRBA: YES. HE -- HE SAID HE REVIEWED THE
3 DAVIS MEDICAL RECORDS.
4 MR. MAJOR: WELL, WE'D REQUEST HE REVIEW -- REFER
5 TO THE PAGE NUMBER SO WE HAVE THE EXACT WORDING THAT WAS
6 SAID.
7 THE COURT: WELL, YOU -- YOU CAN ASK HIM THE
8 QUESTION, IF HE'S AWARE.
9 MR. STIRBA: SURE.
10 Q. (BY MR. STIRBA) ARE YOU AWARE THAT ABOUT -- IT'S ABOUT
11 9 O'CLOCK ON THE 29TH IN THE EVENING THAT A NURSE REPORTED
12 THAT MS. ANDERSON WAS IN SEVERE PAIN?
13 MR. MAJOR: I OBJECT, YOUR HONOR. I DON'T -- I'D
14 LIKE -- THAT'S WHY I'D LIKE TO HAVE IT. I DON'T RECALL IT
15 SAYING SEVERE PAIN. I MIGHT BE MISTAKEN, BUT THAT'S MY
16 RECOLLECTION.
17 THE COURT: WELL, HE'S ASKING HIM A QUESTION, AND
18 THEN IF HE NEEDS A REFERENCE TO THE RECORD, WE CAN DO THAT.
19 A. THE -- THE ONLY NOTATION I HAVE IS THAT THERE WAS A
20 RECORDING DONE ON 12/29 AT 2330 NOTING THAT MORPHINE 10
21 MILLIGRAMS I.V. AT 2000 -- WHICH WOULD BE 8 O'CLOCK -- FOR
22 SEVERE PAIN.
23 Q. (BY MR. STIRBA) AND I THINK THAT'S THE REFERENCE
24 THAT -- THAT I WAS DIRECTING YOU TO.
25 A. BUT I DON'T KNOW WHO SPECIFICALLY MADE THE DIAGNOSIS OF
2011
1 SEVERE PAIN.
2 Q. I SEE. DO YOU HAVE THE RECORDS IN FRONT OF YOU?
3 A. NO.
4 Q. THE -- THE -- IS THE BINDER --
5 A. WE'RE TALKING ABOUT ANDERSON?
6 Q. YES. DO YOU HAVE THAT?
7 A. OH, LET'S SEE. WE DO HAVE AN ANDERSON BINDER. OKAY.
8 DO YOU KNOW WHICH PAGE IT WAS?
9 Q. YES. IT'S -- IT HAS THOSE LITTLE BATES STAMP NUMBERS
10 DOWN AT THE BOTTOM. IT'S MED-00190.
11 A. 190?
12 Q. YES.
13 A. ALL RIGHT.
14 Q. AND UNDER -- UNDER -- THERE'S TO THE -- YOU'LL SEE
15 THERE'S AN ENTRY THERE ON 12/29/95 AT THE TOP. AND THEN IF
16 YOU'LL GO DOWN TO THE MIDDLE, THERE'S A MED NOTE.
17 A. RIGHT.
18 Q. DO YOU SEE THAT?
19 A. YES.
20 Q. AND IT SAYS M.S. 10 MILLIGRAMS I.M. AT 2000 FOR SEVERE
21 PAIN RELATED TO PROFOUND OSTEOPOROSIS GIVEN TO PATIENT, PER
22 ORDER DR. WEITZEL.
23 DID I READ THAT CORRECTLY?
24 A. THAT'S WHAT I READ, WITH THE EXCEPT -- WITH THE ADDITION
25 OF THERE'S A --
2012
1 Q. THERE IS.
2 A. -- A LITTLE IN -- OR INDENT WHICH SAYS, PATIENT BECOMES
3 RIGID AND SCREAMS WHEN TOUCHED.
4 Q. THANK YOU. I -- I WAS AFRAID TO READ THAT BECAUSE I
5 COULDN'T READ IT, BUT THANK YOU FOR READING IT FOR ME.
6 THANK YOU, DOCTOR.
7 MR. STIRBA: THAT'S ALL I HAVE.
8 THE COURT: OKAY. MR. MAJOR?
9 REDIRECT EXAMINATION
10 BY MR. MAJOR:
11 Q. DOCTOR, GOING BACK TO -- CAN YOU SEE THAT OR HAVE I
12 TURNED IT SO YOU CAN'T SEE IT?
13 A. YEAH, I CAN SEE IT FINE.
14 Q. GOING BACK TO THIS, AS YOU'VE INDICATED ON THIS CHART,
15 YOU'VE INDICATED THAT ONE OF THE PROBLEMS WITH MARY -- OR
16 ELLEN ANDERSON WAS A CORONARY ARTERY DISEASE. YOU INDICATED
17 YOU COULD NOT RULE THAT OUT. BASED ON YOUR EXAMINATION OF
18 THE RECORD AND THE CIRCUMSTANCES ON WHICH HER DEATH
19 OCCURRED, IS THAT CONSISTENT WITH YOUR FINDINGS?
20 A. NO, NOT REALLY.
21 Q. AND WHY NOT?
22 A. IN DEATH DUE TO CORONARY ARTERY DISEASE, USUALLY WHAT
23 HAPPENS IS YOU HAVE A PERSON WHO'S GOING ALONG AT THEIR
24 USUAL STATE OF HEALTH AND THEN SUFFERS A VERY SUDDEN EVENT,
25 USUALLY RELATED TO AN ARRHYTHMIA, WHERE THEY WILL EITHER
2013
1 HAVE SEVERE CHEST PAIN AND FINDINGS OF A HEART ATTACK, OR
2 THEY MAY ACTUALLY HAVE A FULL-BLOWN CARDIAC ARREST. THEIR
3 HEART STOPS AND THEY HAVE TO BE RESUSCITATED, IF POSSIBLE.
4 Q. DID YOU FIND THAT WITH ELLEN ANDERSON, BASED ON HER
5 MEDICAL RECORD? This is completely inconsistent with the hospital course.
6 A. NO. A demented patient can't tell you they're in pain.
7 Q. NOW, ALSO, WITH THE ARRHYTHMIA OF THE HEART, AGAIN,
8 HAVING REVIEWED THOSE RECORDS, DID YOU FIND THAT CONSISTENT
9 WITH THE MANNER OF HER DEATH?
10 A. AGAIN, A DEATH DUE TO AN ARRHYTHMIA USUALLY IS A VERY
11 SUDDEN EVENT. THE PERSON IS GOING ALONG IN THEIR USUAL
12 STATE AND SUFFERS AN EVENT WHERE THEY RAPIDLY LOSE
13 CONSCIOUSNESS AND THEY HAVE TO BE RESUSCITATED.
14 Q. OKAY. AND WE'VE ALREADY DISCUSSED THE PNEUMONIA AND THE
15 EMPHYSEMA. WHAT ABOUT THE DEMENTIA?
16 A. DEMENTED INDIVIDUALS CAN ESSENTIALLY LAPSE INTO A
17 COMATOSE CONDITION AND DIE BECAUSE OF THEIR BRAIN CONDITION.
18 Q. OKAY. AND WOULD THAT HAPPEN -- WOULD THAT BE CONSISTENT
19 WITH WHAT HAPPENED WITH ELLEN ANDERSON?
20 A. IN SOME WAYS POSSIBLY, BUT IN OTHER WAYS NOT.
21 Q. NOW, WITH MS. ANDERSON YOU ALSO COULD NOT RULE OUT THE
22 DEATH BY MORPHINE.
23 A. NO.
24 Q. DOCTOR, BASED ON YOUR REVIEW OF THE RECORDS AND YOUR
25 TRAINING AND EXPERIENCE, HAVING THESE CONDITIONS FOUND AT
2014
1 THE AUTOPSY, WHAT EFFECT WOULD GIVING SOMEONE IN ELLEN
2 ANDERSON'S CONDITION MORPHINE, WHAT WOULD HAPPEN? WHAT
3 WOULD --
4 MR. STIRBA: I'M GOING TO OBJECT. THAT CALLS FOR
5 AN EXPERT OPINION BEYOND THE SCOPE OF WHAT HE'S HERE FOR.
6 MR. MAJOR: YOUR HONOR, HE'S -- HE'S OPENED THE
7 DOOR GOING INTO THESE CONDITIONS AND DISCUSSING WHAT CAN BE
8 AND CAN'T BE. I THINK IT'S WITHIN HIS SCOPE TO TESTIFY TO
9 THAT.
10 THE COURT: OKAY. LADIES AND GENTLEMEN, WHY DON'T
11 WE -- I THINK WE'VE BEEN GOING FOR A LITTLE WHILE AND -- WE
12 HAVE THE OTHER WITNESS HERE; IS THAT CORRECT?
13 MR. MAJOR: I BELIEVE. SHE WAS SUPPOSED TO BE HERE
14 AT 10:30.
15 THE COURT: AND HOW LONG DO YOU ANTICIPATE THAT SHE
16 WILL BE?
17 MR. MAJOR: I DON'T ANTICIPATE MORE THAN A HALF
18 HOUR.
19 THE COURT: OKAY. LADIES AND GENTLEMEN, WHAT I'D
20 LIKE TO DO IS WE'LL TAKE A SHORT BREAK NOW, BUT WHAT I'D
21 LIKE TO DO IS WE MAY GO PAST NOON WITH THE UNDERSTANDING
22 THAT WITH THIS NEXT WITNESS, THERE MAY NOT BE ANY OTHER
23 WITNESSES AND YOU WOULD BE SENT HOME AFTER THAT FOR TODAY.
24 SO WHAT I WOULD SAY IS LET'S TAKE A -- JUST TAKE YOUR
25 15 MINUTE BREAK NOW TILL 11:25. WE'LL COME BACK AND FINISH
2015
1 THIS WITNESS AND THEN WE'LL CALL PROBABLY THE LAST WITNESS
2 OF THE DAY. AND THEN YOU WOULD BE IN RECESS AFTER THAT.
3 SO WHILE YOU'RE ON -- OUT RIGHT NOW, IT'S YOUR DUTY NOT
4 TO CONVERSE AMONG YOURSELVES OR TO CONVERSE WITH ANYONE ELSE
5 ABOUT THIS TRIAL. DO NOT ALLOW YOURSELVES TO BE ADDRESSED
6 BY ANY OTHER PERSON ON THE SUBJECT OF THE TRIAL. AND IT'S
7 YOUR DUTY NOT TO FORM OR EXPRESS AN OPINION UNTIL THE CASE
8 IS FINALLY SUBMITTED TO YOU. SO WE'LL BE IN RECESS UNTIL
9 11:25.
10 (WHEREUPON, AT THIS TIME THE JURY LEAVES THE
11 COURTROOM.)
12 THE COURT: THE RECORD WILL REFLECT THAT THE JURY
13 HAS LEFT THE COURTROOM.
14 OKAY. WHAT IS THE -- OKAY. COULD YOU REPHRASE OR TELL
15 ME AGAIN THE QUESTION AND THEN THE OBJECTION?
16 MR. MAJOR: THE QUESTION WE HAD, YOUR HONOR, WAS
17 THAT HE HAS GONE OVER ON CROSS-EXAMINATION THE CONDITIONS
18 THAT EACH AND EVERY ONE OF THESE PATIENTS HAD. IT WAS ASKED
19 CONCERNING WHETHER OR NOT THIS COULD HAVE CAUSED THE DEATH
20 OR CONTRIBUTED -- CONTRIBUTED TO THE DEATH. MY QUESTION
21 JUST SIMPLY FOLLOWS UP AND THAT IS, WHAT EFFECT WOULD
22 MORPHINE HAVE ON A PERSON WHO HAD THESE CONDITIONS?
23 THE COURT: OKAY. AND --
24 MR. STIRBA: WELL, THAT'S A LITTLE BIT DIFFERENT
25 THAN WHAT THE FIRST QUESTION WAS, TO WHICH I DIDN'T OBJECT,
2016
1 AND TO WHAT I WAS DOING. I MEAN, HE'S HERE, HE'S MADE SOME
2 FINDINGS. HE SAID CERTAIN THINGS ARE UNDETERMINED. HE'S
3 MADE A DETERMINATION AS TO OTHER THINGS. AND, OBVIOUSLY,
4 THE BASIS FOR HIS UNDETERMINED IS THERE ARE OTHER
5 CIRCUMSTANCES WHICH MAY HAVE CAUSED THE DEATH FOR WHICH HE
6 CAN'T DELINEATE ONE FROM THE OTHER.
7 THE FIRST QUESTION MR. MAJOR ASKED, CAN YOU RULE OUT
8 MORPHINE, IS A FAIR QUESTION. I DIDN'T OBJECT TO IT BECAUSE
9 I THINK THAT'S WELL WITHIN THE SCOPE OF DR. GREY TO TESTIFY
10 ABOUT BECAUSE ESSENTIALLY THAT'S WHAT HE'S DONE. BUT TO NOW
11 GO ON TO SAY, WHAT EFFECT WOULD MORPHINE HAVE -- AS IF HE'S
12 A TREATING PHYSICIAN OR AN EXPERT OR WAS THERE -- IS WELL
13 BEYOND THE SCOPE OF WHAT HE'S HERE FOR AS A FORENSIC
14 PATHOLOGIST WHO DID AN AUTOPSY. HE'S NOT A TREATING
15 PHYSICIAN, HE'S NOT AN EXPERT. HE'S HERE TO BASICALLY TALK
16 ABOUT WHAT HE DID. AND THAT'S REALLY ALL I WAS ASKING HIM
17 ABOUT. I DIDN'T ASK HIM ABOUT ANYTHING THAT HE DIDN'T DO.
18 THE COURT: OKAY. YOU DID ASK THE QUESTION, CAN
19 YOU RULE OUT MORPHINE AS A CAUSE OR CONTRIBUTING --
20 MR. STIRBA: MR. MAJOR DID.
21 THE COURT: I MEAN, MR. MAJOR DID, AND HE ANSWERED
22 NO, HE COULDN'T.
23 MR. STIRBA: AND I DIDN'T OBJECT.
24 THE COURT: OKAY. AND THEN THERE WAS -- THE OTHER
25 QUESTION WAS?
2017
1 MR. MAJOR: YEAH. AND BECAUSE OF THAT, YOUR HONOR,
2 BECAUSE ONE OF THE REASONS THAT HE TESTIFIED ON DIRECT, ONE
3 OF THE REASONS WHY THIS IS UNDETERMINED IS BECAUSE OF THE
4 MORPHINE.
5 THE COURT: WELL, HE SAID HE CAN'T RULE THAT OUT.
6 MR. MAJOR: I KNOW, BUT WE'VE ALSO GOT IN HERE, DID
7 THIS CONTRIBUTE -- COULD THIS HAVE CONTRIBUTED TO THE DEATH,
8 COULD THIS HAVE CONTRIBUTED TO THE DEATH? AND I'M SIMPLY
9 ASKING BASED ON HIS TRAINING AND EXPERIENCE --
10 THE COURT: WELL, YOU CAN ASK THE QUESTION, CAN YOU
11 RULE OUT MORPHINE AS CAUSING OR CONTRIBUTING --
12 MR. MAJOR: RIGHT.
13 THE COURT: -- TO EACH ONE OF THESE PEOPLE'S DEATH?
14 THAT'S AN APPROPRIATE QUESTION.
15 MR. MAJOR: APPROPRIATE. BUT I BELIEVE HE DOES
16 HAVE THE QUALIFICATIONS AND THE ABILITY TO SAY THAT THAT IS
17 PART OF WHAT HE'S SAYING. MAYBE I NEED TO ASK THAT
18 QUESTION. YOU KNOW, HOW WOULD -- BASED ON YOUR UNDETERMINED
19 FINDING, WAS THAT BASED ON THE MORPHINE, AND HOW WOULD THAT
20 MORPHINE AFFECT THESE CONDITIONS TO LEAD YOU TO THAT
21 UNDETERMINED CAUSE?
22 I THINK -- I'M JUST SAYING, I THINK HE HAS THE
23 QUALIFICATIONS AS AN EXPERT TO SAY, BASED ON MY PATHOLOGY --
24 THE COURT: WELL, GIVE -- GIVE ME THE QUESTION
25 THAT -- THAT YOU'RE GOING TO ASK.
2018
1 MR. MAJOR: OKAY. WHAT I'M SIMPLY GOING TO ASK IS
2 GIVEN YOUR FINDINGS -- FOR EXAMPLE, ELLEN ANDERSON, HAVING
3 MADE THESE FINDINGS BASED ON THE AUTOPSY, WHAT EFFECTS WOULD
4 MORPHINE HAVE HAD IN CONTRIBUTING TO THAT DEATH?
5 MR. STIRBA: SEE -- SEE --
6 MR. MAJOR: BUT I THINK I CAN GO BACK AND SAY --
7 THE COURT: HOLD ON.
8 MR. MAJOR: -- HE'S TALKING ABOUT WELL, THIS HEART
9 CONDITION COULD HAVE CONTRIBUTED TO THE DEATH. WE COULD GO
10 BACK AND SAY HOW? HOW WOULD THIS HEART CONDITION HAVE
11 CONTRIBUTED TO HER DEATH? HOW WOULD NOT EATING OR NOT
12 TAKING FLUIDS CONTRIBUTED TO HER DEATH? HOW WAS THE
13 SUBACUTE EVENT -- HOW WOULD THAT HAVE CONTRIBUTED TO HER
14 DEATH, ADDING ALL OF THESE OTHER EVENTS ON HERE? AND I
15 THINK WE COULD SIMPLY ADD MORPHINE AS ONE MORE STEP AND SAY,
16 HOW WOULD MORPHINE HAVE AFFECTED THE CAUSE OF THIS DEATH?
17 THE COURT: OKAY. WHAT IS THE RESPONSE TO THAT?
18 MR. STIRBA: WELL, IF IT'S PUT IN THAT CONTEXT,
19 YES. BUT IF IT'S PUT IN SOME OTHER CONTEXT -- I MEAN, I
20 HAVE TO HEAR THE QUESTION. BUT I DIDN'T HEAR THAT TO BE THE
21 QUESTION. I MEAN, THE DOCTOR'S ALREADY TESTIFIED HE CAN'T
22 DETERMINE THE CAUSE OF DEATH. AND I THINK HE'S ALSO
23 TESTIFIED THE REASON WHY HE CAN'T IS BECAUSE, OBVIOUSLY,
24 THERE ARE A NUMBER OF FACTORS FOR WHICH HE CAN'T DETERMINE
25 CONCLUSIVELY THE CAUSE OF DEATH.
2019
1 SO IF THE QUESTION IS PUT, IF YOU CAN'T RULE OUT
2 MORPHINE; AND THEN YOU WANT TO SAY, ASSUMING MORPHINE TO BE
3 THE CAUSE OF DEATH, WHY DO YOU SAY THAT? I GUESS -- I GUESS
4 THAT'S A FAIR QUESTION IF THAT'S SOMETHING HE CAN'T RULE
5 OUT.
6 THE COURT: OKAY. ALL RIGHT. SO DO YOU --
7 MR. MAJOR: I -- I'D SUBMIT IT.
8 THE COURT: OKAY. WELL, I MEAN, IF THAT'S THE
9 QUESTION YOU'RE GOING TO ASK, YOU KNOW, PHRASED IN, YOU
10 KNOW, ALONG THOSE LINES, I DON'T HAVE ANY PROBLEM WITH IT
11 AND THERE DOESN'T SEEM TO BE ANY OBJECTION.
12 MR. MAJOR: AND I -- I MISSED WHAT EXACTLY THAT
13 QUESTION WAS. I'M SORRY, YOUR HONOR. I MEAN --
14 MR. STIRBA: YOU CAN'T RULE OUT MORPHINE.
15 ASSUMING -- AND, YOU KNOW, YOU CAN'T RULE OUT MORPHINE AS
16 THE CAUSE OF DEATH. ASSUMING MORPHINE WAS THE CAUSE OF
17 DEATH, WHY DO YOU SAY THAT?
18 MR. MAJOR: OKAY. THAT'S FINE.
19 MR. STIRBA: I THINK -- I THINK THAT'S A FAIR
20 QUESTION. I CAN'T OBJECT TO THAT ONE.
21 THE COURT: OKAY. IS THERE ANYTHING ELSE WE NEED
22 TO -- TO DISCUSS?
23 MR. MAJOR: NO.
24 THE COURT: OKAY. THEN LET'S COME BACK AT 11:25.
25 AND THEN HOW MUCH LONGER DO YOU THINK YOU'LL BE ON THIS
2020
1 WITNESS ON REDIRECT?
2 MR. MAJOR: TEN MINUTES.
3 THE COURT: OKAY. AND THEN IF YOU CAN JUST HAVE
4 THE OTHER WITNESS AND LET'S JUST FINISH THAT WITNESS BEFORE
5 WE BREAK.
6 MR. MAJOR: I HOPE SO.
7 THE COURT: AND THEN WHAT -- WHAT ABOUT THE
8 OTHER --
9 MR. WILSON: YOUR HONOR, I THINK AT THIS JUNCTURE
10 WHAT WE'RE GOING TO DO IS WE'RE GOING -- THEY WOULD BE
11 TESTIFYING AS TO SOME EXHIBITS WE'VE PREPARED. I THINK WE
12 CAN SUBMIT THEM IN THE COURSE OF OUR CONVERSATIONS LATER
13 RELATING TO EXHIBITS.
14 THE COURT: SO WE WOULDN'T ACTUALLY CALL THEM?
15 MR. WILSON: SO WE WOULDN'T NEED TO CALL THEM AT
16 THIS TIME.
17 THE COURT: OKAY. THEN WHAT I WOULD EXPECT THAT WE
18 WOULD DO THEN IS THAT WE'LL HEAR -- FINISH WITH DR. GREY,
19 AND THEN WE'LL HAVE THE NEXT WITNESS, DIRECT AND
20 CROSS-EXAMINATION, ANY REDIRECT, AND THEN WE'LL SEND THE
21 JURY HOME.
22 MR. WILSON: THANK YOU, JUDGE.
23 MR. STIRBA: THANK YOU.
24 THE COURT: SO WE'LL BE BACK AT 11:25.
25 MR. MAJOR: THANK YOU, JUDGE.
2021
1 (WHEREUPON, AT THIS TIME THERE'S A RECESS, AFTER WHICH
2 PROCEEDINGS RESUME, AS FOLLOWS:)
3 THE COURT: THE RECORD WILL REFLECT THAT THE JURY
4 HAS RETURNED.
5 MR. MAJOR, IF YOU'D LIKE TO GO AHEAD?
6 MR. MAJOR: THANK YOU.
7 Q. (BY MR. MAJOR) DR. GREY, WE WERE TALKING JUST BRIEFLY
8 ABOUT ELLEN ANDERSON BEFORE THE BREAK.
9 A. UH-HUH.
10 Q. I ASKED YOU WHETHER OR NOT YOU COULD RULE OUT MORPHINE
11 AS THE CAUSE OF DEATH.
12 A. AND I SAID NO.
13 Q. YOU SAID NO. AND ASSUMING THAT MORPHINE WAS THE CAUSE
14 OF DEATH, WHY COULDN'T YOU RULE IT OUT?
15 A. A NUMBER OF REASONS. FIRST OFF, WE HAVE DOCUMENTATION
16 IN THE MEDICAL RECORD OF THIS PERSON RECEIVING MORPHINE.
17 THE ABSENCE OF FINDINGS ON TOXICOLOGY, WE'VE TALKED ABOUT
18 HOW THE DETERIORATION THAT OCCURRED IN THE BODY AFTER DEATH
19 AND DURING THE BURIAL AFFECTS THE TESTING.
20 THE WAY MORPHINE KILLS PEOPLE IS THROUGH A SUPPRESSION
21 OF THE BRAIN, AND PARTICULARLY THE AREAS OF THE BRAIN THAT
22 CONTROL RESPIRATION. THAT IS -- AS WE'VE TALKED ABOUT WITH
23 THE ARRHYTHMIAS, THE ABNORMAL BEATING OF THE HEART -- A
24 PHYSIOLOGICAL FUNCTION THAT I CAN'T SEE OR DIAGNOSE AFTER
25 DEATH. THERE'S NO PHYSICAL FINDINGS THAT ALLOW YOU TO
2022
1 SPECIFICALLY SAY THIS IS CONSISTENT WITH MORPHINE KILLING A
2 PERSON.
3 Q. OKAY. THANK YOU. NOW, AGAIN, GOING OVER TO I BELIEVE
4 ENNIS ALLDREDGE, YOU ARE ALSO FAMILIAR, HAVING READ THE
5 MEDICAL RECORDS, ABOUT THE CIRCUMSTANCES OF HIS DEATH?
6 A. YES.
7 Q. YOU INDICATED THAT CORONARY ARTERY DISEASE YOU COULD NOT
8 RULE OUT AS A CAUSE OF DEATH. BUT IS THAT CONSISTENT WITH
9 THE CIRCUMSTANCES SURROUNDING HIS DEATH?
10 A. NOT BY WHAT I'VE SEEN IN THE RECORD. AGAIN, AS WE
11 TALKED ABOUT EARLIER, PEOPLE WHO DIE AS A RESULT OF THEIR
12 BAD HEART PROFUSION OR BAD BLOOD FLOW TO THE HEART GENERALLY
13 TEND TO BE GOING ALONG IN THEIR NORMAL STATE OF HEALTH AND
14 THEN SUFFER A VERY ACUTE EVENT: CHEST PAIN AND A HEART
15 ATTACK, OR A SUDDEN ARRHYTHMIA AND LOSS OF CONSCIOUSNESS
16 REQUIRING RESUSCITATION.
17 Q. AND HOW ABOUT THE DEMENTIA? WOULD THAT BE CONSISTENT
18 WITH THE CIRCUMSTANCES?
19 A. DEMENTIA, THE CASES I'VE SEEN OF PEOPLE WHO DIE SOLELY
20 AS A RESULT OF THE CHANGES IN THEIR BRAIN, THE ATROPHY OF
21 THEIR BRAIN, WHAT YOU SEE WITH THEM IS THEY TEND TO HAVE A
22 VERY GRADUAL DOWNHILL COURSE BECOMING MORE AND MORE
23 UNRESPONSIVE. WHAT TENDS TO -- TO KILL THEM USUALLY IS A
24 MORE ACUTE EVENT. THEY LOSE CONTROL OF SWALLOWING, FOR
25 EXAMPLE, AND THEY MAY ASPIRATE FOOD OR FLUIDS AND THEN THEY
2023
1 GET A PNEUMONIA AND THEY DIE.
2 Q. OKAY. THANK YOU. AND WE'VE ALSO TALKED ABOUT THE
3 C.V. -- THE SUBACUTE EVENT?
4 A. AGAIN, EVEN WITH A SUBACUTE EVENT, A SMALL AREA OF
5 SOMETHING HAPPENING IN THE BRAIN, THERE TENDS TO BE A FAIRLY
6 DRAMATIC CHANGE IN THE CONDITION OF THE PATIENT BECAUSE OF
7 THAT EVENT SO THAT YOU'RE GOING ALONG AND THEN THERE IS A
8 CHANGE IN THE WAY THIS PERSON IS BEHAVING, THE ABILITY TO
9 MOVE, THINGS LIKE THAT.
10 Q. AND YOU DID -- YOU DID NOT SEE THAT WITH MR. ALLDREDGE?
11 A. NOT IN THE RECORDS, NO.
12 Q. OKAY. AND HOW ABOUT THE DEHYDRATION? HOW LONG DOES
13 THAT USUALLY TAKE FOR SOMEONE OF HIS AGE?
14 A. COMPLETE WITHHOLDING OF ALL FLUIDS COULD LEAD TO DEATH
15 IN A MATTER OF DAYS.
16 Q. OKAY. NOW, I THINK WE ALSO HAVE -- AND I -- I BELIEVE
17 WE ALSO ASKED ON THE ARRHYTHMIA. THAT WOULD BE THE SAME AS
18 YOU TESTIFIED ON ELLEN ANDERSON?
19 A. YES.
20 Q. AND LYDIA SMITH. I -- I HAVE NO REAL QUESTIONS ON THE
21 SITUATION WITH HER BECAUSE OF THE AUTOPSY.
22 JUDITH LARSEN, AGAIN, HAVING -- JUST QUICKLY, GIVING
23 THE INDICATIONS HERE OF WHAT YOU'VE TESTIFIED MAY HAVE
24 CAUSED HER DEATH, WAS THERE ANYTHING THERE THAT YOU FOUND
25 WITH -- THAT WOULD BE CONSISTENT WITH THE CIRCUMSTANCES THAT
2024
1 YOU OBSERVED WITH THE RECORDS?
2 A. THE -- AS WE'VE TALKED ABOUT, THE KINDS OF THINGS WHERE
3 THE SUBACUTE EVENT FROM -- IN THE BRAIN TEND -- WOULD TEND
4 TO PRODUCE A FAIRLY SHARP DEMARKATION IN THE CONDITION OF
5 THE -- OF THE PATIENT. LACK OF FLUIDS, THAT COULD PRODUCE A
6 MORE GRADUAL DETERIORATION IN THE CONDITION OF THE PATIENT.
7 THE SAME THING WITH LACK OF FOOD. THE FLUIDS WOULD BE THE
8 MUCH MORE SIGNIFICANT AND RAPIDLY FATAL PROCESS. PEOPLE CAN
9 LIVE WITHOUT CALORIES FOR QUITE A LONG TIME; WITHOUT FLUID,
10 YOU GET INTO TROUBLE PRETTY SOON.
11 Q. NOW -- SORRY.
12 A. IN TERMS OF THE ANEMIA, AGAIN, A PERSON WHO IS ANEMIC,
13 DOESN'T HAVE ENOUGH BLOOD, WILL SEEM WEAK. THEY MAY NOT BE
14 ABLE TO -- MAY NOT HAVE THE ENERGY LEVEL THAT THEY NORMALLY
15 HAD AND IT COULD BE A GRADUAL PROCESS.
16 THE ARRHYTHMIA, AS WE'VE TALKED ABOUT, TENDS TO BE A
17 FAIRLY DRAMATIC EVENT FROM A NORMAL STATE -- THEIR NORMAL
18 STATE OF HEALTH TO A VERY SUDDEN LOSS OF CONSCIOUSNESS OR
19 CHEST PAIN, ET CETERA.
20 Q. OKAY. AND, AGAIN, GOING BACK WITH ENNIS ALLDREDGE, YOU
21 COULD NOT RULE OUT MORPHINE AS A CAUSE OF THAT DEATH?
22 A. ON ENNIS ALLDREDGE?
23 Q. ON ENNIS ALLDREDGE.
24 A. I COULD NOT.
25 Q. NOW, YOU'RE ALSO AWARE OF THE LEVEL OR THE AMOUNT OF
2025
1 MORPHINE THAT MR. ALLDREDGE RECEIVED; IS THAT CORRECT?
2 A. YES.
3 Q. ASSUMING THAT HE HAD RECEIVED EACH AND EVERY ONE OF
4 THOSE DOSES AS DOCUMENTED, AND YOU HAD PERFORMED AN AUTOPSY
5 AT THE TIME OF HIS DEATH PRIOR TO THE EMBALMING OR THE
6 INTERMENT, WOULD YOU HAVE EXPECTED TO FIND MORPHINE IN HIS
7 SYSTEM?
8 MR. STIRBA: YOUR HONOR, IRRELEVANT HYPOTHETICAL.
9 THE COURT: SUSTAINED.
10 MR. MAJOR: THANK YOU.
11 Q. (BY MR. MAJOR) WITH ELLEN -- AGAIN -- GOING ON AGAIN,
12 THE SAME THING WITH LYDIA SMITH. YOU COULD NOT RULE OUT
13 MORPHINE AS A CAUSE OF DEATH; IS THAT CORRECT?
14 A. I COULD NOT.
15 Q. AND THAT IS FOR THE SAME REASONS YOU'VE DESCRIBED WITH
16 ELLEN ANDERSON?
17 A. YES.
18 Q. AND JUDITH LARSEN, YOU DID INDICATE -- WHY IS THERE A
19 DIFFERENCE BETWEEN HER AND THE OTHER THREE?
20 A. THE REASON THAT I -- I CERTIFIED MS. LARSEN'S DEATH AS
21 BEING RELATING TO HER -- TO THE MORPHINE THAT SHE WAS GIVEN
22 IS I COULD NOT SEE ANYTHING IN THE PATHOLOGY THAT WOULD
23 EXPLAIN SUDDEN DEATH IN HER. GRANTED, I COULD NOT EXCLUDE
24 CERTAIN CONDITIONS, BUT GIVEN THE HISTORY OF THE VERY LARGE
25 AMOUNT OF MORPHINE THAT THIS PATIENT WAS GIVEN PRIOR TO HER
2026
1 DEATH, ALONG WITH THE FINDING OF MORPHINE DETECTABLE EVEN
2 AFTER THIS LONG PERIOD OF DETERIORATION AND BURIAL, I FELT
3 THAT MORPHINE WAS THE MOST LIKELY CAUSE OF THIS INDIVIDUAL'S
4 DEATH.
5 Q. THANK YOU.
6 MR. MAJOR: WE HAVE NO FURTHER QUESTIONS, YOUR
7 HONOR.
8 THE COURT: OKAY. MR. STIRBA?
9 RECROSS-EXAMINATION
10 BY MR. STIRBA:
11 Q. DID YOU THOUGH CONSIDER -- WELL, AS A FORENSIC
12 PATHOLOGIST YOU'VE ALREADY TESTIFIED WITH RESPECT TO
13 MS. LARSEN THAT DEATH FROM LACK OF FLUIDS OR FOOD IS NOT
14 SOMETHING THAT OTHERWISE YOU COULD FIND IN AUTOPSY, TRUE?
15 A. AT AUTOPSY, NO. THAT IS CORRECT.
16 Q. AND IT'S TRUE, IS IT NOT, AS YOU JUST TESTIFIED, IF
17 SOMEBODY IS DEPRIVED OF FLUIDS, THEY MAY VERY WELL DIE
18 WITHIN A FEW DAYS? TRUE?
19 A. YES.
20 Q. ASSUMING THAT MS. LARSEN STOPS EATING AND DRINKING ON
21 THE 30TH OF DECEMBER OF 1995, AND SHE EXPIRES ON
22 DECEMBER 3RD OF 1996 --
23 THE COURT: DECEMBER 3RD?
24 MR. STIRBA: I'M SORRY. THANK YOU, YOUR HONOR.
25 Q. (BY MR. STIRBA) JANUARY 3RD OF 1996, WOULD -- WOULD
2027
1 THAT BE CONSISTENT WITH SOMEONE DYING WITHIN A FEW DAYS FROM
2 LACK OF FLUIDS OR LACK OF FOOD?
3 A. IT'S CERTAINLY POSSIBLE, YES.
4 Q. I'M JUST GOING TO ADD, DOCTOR, ONE THING. AS FAR AS
5 LYDIA SMITH IS CONCERNED, YOU DID DETERMINE AS A CAUSE OF
6 DEATH THAT WAS UNDETERMINED; IS THAT RIGHT?
7 A. THAT'S WHAT I CERTIFIED, YES.
8 Q. IN OTHER WORDS, AS YOU SIT HERE RIGHT NOW, YOU CAN'T
9 TELL US WHAT SHE DIED FROM, TRUE?
10 A. NOT WITH CERTAINTY, NO.
11 Q. AND WITH RESPECT TO MR. ALLDREDGE, YOU ALSO CERTIFIED
12 HIS CAUSE OF DEATH AS UNDETERMINED, CORRECT?
13 A. THAT IS CORRECT.
14 Q. JUST WRITING "UNDETERMINED" ON THESE.
15 AND MS. ANDERSON WAS ALSO SIMILARLY UNDETERMINED?
16 A. THAT IS CORRECT.
17 Q. THANK YOU.
18 MR. STIRBA: THAT'S ALL I HAVE, YOUR HONOR.
19 THE COURT: ANYTHING FURTHER?
20 MR. MAJOR: ONE -- ONE SECOND, YOUR HONOR.
21 (WHEREUPON, THERE'S AN OFF-THE-RECORD DISCUSSION.)
22 MR. MAJOR: WE HAVE NOTHING FURTHER, YOUR HONOR.
23 THE COURT: OKAY. MAY THIS WITNESS BE EXCUSED?
24 MR. MAJOR: HE MAY, YOUR HONOR.
25 MR. STIRBA: YES.