Lindsay Clancy murder trial continues after psychiatrist testimony

So, uh, we set the jury at this point. All.

right, George enter.

Hey, hey, hey. The honorable William Sullivan, justice. of the superior court now sitting in. Plymouth and for the call. Draw near, give your attention and you shall be. heard. God save Massachusetts. This. court is now in session. Please be. seated. >> Good morning, your honor. May I proceed?

>> Yes, please. Your. >> honor, before the court today, we have. the continuation of the jury trial in. the matter of Commonwealth versus. Lindseay Clancy. Miss Clancy is present. She is represented by attorney Kevin. Readington. The Caramel Office is. represented by Assistant District. Attorney Jennifer Sprag and Assistant. District Attorney Shannon Buckingham. >> All right. Well, thank you, Madam Clerk. Uh, good morning everyone. >> What I'm going to do, as you know, going. to ask you those questions uh to make. sure everybody was able to follow my. instructions and then at that point. we'll talk a little bit about uh today's.

schedule. All right. So, uh so we'll get. to the questions. First question, has. any member of the jury read, seen, heard, or overheard anything from any. source about any aspect of this case. that would affect your ability to be. fair and impartial? Uh, last question. Is there any other. serious matter or concern bearing on. your service as a juror in this case. that anybody needs to bring to my. attention? All right, great. Um, thank. you for following those instructions. Uh, today, uh, we're going to continue.

with the Commonwealth presentation of. evidence. Uh the anticipation is that we. will go probably similar to we had the. last couple of days uh into the. afternoon. All right. And then uh after. that uh before I send you home, I'll. talk again with council uh in regards to. uh the schedule for the rest of the week. and kind of where we are. All right. So. I'll when you leave here today, I you. probably have a little bit better idea. as a schedule for the rest of the week. and into next week. All right. So, um,

and so with that, I think we'll return. to the Commonwealth's case. Um, attorney. Buckingham. call Daniel to the stand. Stop right there. Morning.

>> Thank you, sir. Have a seat. >> Hi. Good morning, sir. >> Good morning. >> All right, council. >> Thank you. >> Good morning. >> Good morning, ma'am. >> Could you please tell the jurors your. first and last name? >> Yes. Uh, first name is Dan, last name's.

Lawler. >> And where are you employed? >> With the Massachusetts State Police. >> What's your rank with the state police? >> Sergeant. >> And how long have you worked for the. state police? >> Nine years. >> Um, at some point did you work um in an. assignment with the Plymouth County. District Attorney's Office as part of. the state police detectives unit? >> Yes. >> And how long were you with the Plymouth. County DA's office state police. detectives unit? from March 2021 until. June 2025. >> I'm going to draw your attention back to.

January of 2023. Do you recall um. going out or responding to an incident. that occurred in Dubberry? >> Yes. >> And um that was the incident occurred at. 47 Summer Street in Dubberry? >> Yes. And um you're aware that that involved a. death investigation where two children. um had been declared deceased and at the. time there was another child that was. being treated at the hospital. >> Yes.

>> Um what were you asked to do or what was. the first thing you did in um relation. to this investigation? >> I responded to the Southshore Hospital. in Weimouth. >> And why did you go there? >> I was advised by my supervisor to. respond. >> Okay. And were you aware that um a woman. by the name of Lindseay Clancy had been. transported there to Southshore. Hospital? >> Yes. >> And when you arrived at Southshore. Hospital um was a Ducks police detective. already on scene?

>> Yes. >> And do you recall who that was? >> Uh Detective Matthew. Um now. when you meaning the state police. detectives unit um are involved in an. investigation is it common that you. would utilize the services of the crime. scene services section of the state. police? >> Yes. >> And the crime scene response unit? >> Yes. >> And in this case did members of those. two units respond as well to the. Southshore hospital at the time that you. were there? >> Yes. Do you recall who um from the crime.

scene services in the response unit. responded? Uh. >> chemist uh Maren Hartnett and trooper. Rotoers. [cough]. [clears throat]. >> Did you have the occasion to observe. Lindsay Clancy at the social hospital? >> Yes. >> And um she was in the emergency. department. Correct. >> Correct. >> And um was she um able to speak or was. she intubated? >> Uh she was unable to speak. Did you observe her to have u medical. equipment and being treated while you.

were there? >> Uh she had met equipment attached to her. person. Yes. >> And did you observe her to have um. injuries, visible injuries? >> Yes. >> Um at the Southshore Hospital in. addition to um you know speaking to. Detective Mafio and and assessing um. Lindsay Clancy, did you do or serve. anything on the hospital themselves? >> Yes. >> What did you do? >> A preservation notice. >> And what is a preservation notice? Uh. the preservation notice is to preserve. um the defendant's uh urine and blood.

Okay. >> And you provide that to staff at the. hospital um to ensure that the blood is. saved unless and until a warrant is. obtained for that material. >> Correct. [clears throat]. >> And in addition to serving the. preservation order, did you collect some. items that were um removed from medical. staff um that were on Lindsay Clancy, the defendant? >> Yes. >> What did you um collect or what did they. provide you? Uh, it was her clothing and. a wedding ring and wedding band.

>> If I may approach the. >> Well, she's putting her gloves on. I. have no objection to any of this. >> Okay.

>> As far as um Sergeant Lola, as far as. the items collected, um when they. received from the hospital staff, um. what do you guys do with them? >> Uh so it goes originally went to about. the Tat Mafio from Ducksbury Ple. Uh. then it went to me and then uh it was. documented by trooper softers and then. some of it will go to uh the the office. or will go to the crime lab. In this. case uh went to the crime lab. >> Okay. Um but as the state police trooper.

on scene, the investigator on scene, you. at some point um retain custody of the. item. >> Correct. >> And I'm just showing you a a paper bag. Is that familiar to you? >> Yes. And is this a the bags that. generally um the detective unit or crime. scene uses to put particular pieces of. evidence inside of it? >> Yes. >> Since I just struggled to put the gloves. on, I'm just going to show you the item. if that's okay.

[snorts]. Showing you one item. Is that familiar to you? >> Yes. >> What do you know this item to be? >> Uh, not sure. >> Is it a piece of clothing that you. obtained from the hospital? >> Yes. >> Does it appear to be a woman's tank top? >> Yes. >> And are you able to observe um some. staining on the front? Looking close.

>> Yes. >> And again, it's cut down the middle. >> Correct. >> This how it was received from the. hospital. >> Yes. I would move the tank top. >> All right. That may be admitted. >> 223. >> Thank you. >> Showing you another item.

Is that familiar to you? >> Yes. >> And what are these. >> jeans? And these were also cut and um. off the defendant and received by the. medical staff at social hospital. >> Yes. >> And on these um jeans you see a little. bit of staining on the front. >> Yes. >> I would move to admit these as. >> that may be admitted.

>> Thank you. Just showing one more item. Is that familiar to you? >> Yes. >> Appears to be a woman's bra. Correct. >> Correct. >> Cut down the middle. >> Yes. >> And it has some staining in the front in. the middle where the cuts are. >> Correct. >> And is this uh an item that was. collected that was on Lindsay Cry's body. on January 24th, 2023? >> Yes.

that may be admitted. >> Thank you. >> You indicated there was also um some. rings that were collected. Correct. >> Correct. And um eventually they these items were. then taken by um forensic scientist. heartnet and eventually um they get. returned to the state police detectives. unit in your experience. Is that fair to.

say? >> Fair to say. >> Now um in addition to going to the. Southshore hospital on January 24th, 2023, did you go to any other hospitals? >> Yes. >> Which hospital did you go to? >> Boston Children's Hospital. And um why. did you go there? >> I was advised to go there by my. supervisor. >> Okay. And were did you learn that one of. the children, Ken Clancy, had been. transported to the Boston Children's. Hospital? >> Yes. >> And were you there to just obtain what. his current status was at that time?

>> Yes. >> And the time that you were there at the. Boston Children's on January 24th, fair. to say he was still alive but noted to. be in critical condition? >> Yes. Okay. Now, um, in the early morning hours of. January 25th of 2023, were you aware. that a search warrant was obtained for. the home of 47 Summer Street in. Ducksberry? >> Yes. >> And in your time with the State Police. Detective Unit and and during that time. in January of 2023, um, how did you guys. approach the execution of a search.

warrant? >> Uh, so the house would have been frozen. pending the um, search warrant being uh, signed. Uh once it's signed uh we begin. the execution and crime scene would. document the uh the residents uh inside. and outside before we would go in. >> Okay. So when crime scene um goes in and. they document, you're familiar they use. um photographs and video, right? >> Correct. >> And once they've gone through and. documented the scene as it was secured, do you as part of the detectives unit.

team then go in the house to begin. search? >> Yes. And fair to say um there are a lot. of uh hands on deck during something. like this. >> Correct. >> And in this instance, [clears throat]. the the detective unit was searching the. entire home at 47 Summer Street, including three floors, basement, first. floor, second floor, as well as any um. vehicles that were on the property. >> Correct. And um. in addition to people or troopers with. the detectors unit, were there other.

local law enforcement also assisting? >> Yes. >> And um what was your role that night or. that morning in the execution of the. warrant? >> I was the evidence officer. >> And what does that mean? >> I document evidence that is located by. investigators during the search warrant. And so, um, at that time period when. you're executing a search warrant and, um, searching a a a place like a home, um, is the information that you know at that. point what guides the search.

>> Yes. >> So, you don't know what you're looking. for unless you know what happened, right? >> Correct. >> So, in this circumstance, um, fair to. say the state police had limited. information about what had actually. transpired in that house. Correct. >> Um, but each and every room was searched. to your knowledge. >> To my knowledge, yes. >> And your role was just to document items. that um were going to be collected and. returned to the state police detectives. unit. >> To document items that would be.

collected and either go back to the. state police detective unit or to the. crime lab. Okay. And fair to say when um the crime lab. takes items back to the lab, they have. an entirely different process on how to. monitor, track them, and inventory the. items. Correct. >> Correct. >> So in this um particular warrant. execution, did you um engage in the. search? >> Yes. >> And you said you documented what other. members of the um group see um found and.

located where they located it. Correct. >> Correct. >> And so you um as the evidence officer. were aware that Trooper Rabbit located. some prescription pill bottles in the. kitchen um that that morning. Correct. >> Correct. >> And so um as the evidence officer, were. you responsible for kind of keeping. custody of those bottles? >> Correct. >> At some later point after those bottles. were um photographed and collected, did.

you inventory those bottles? >> Yes. I'm going to just show you what's been. marked as exhibit 155 if I may. >> So, sorry. Um, just showing you this bag. here. It's already been marked exhibit. 155. I'm going to show you four. bottles.

You can take a look at them. So, they. look familiar to you? >> Yes. >> Okay. >> So, the first one I'm looking at is. labeled Trazadone. And as far as how you inventory these, what do you do when you inventory them? >> Just count them.

>> Okay. So, do you also review the. information on the label as to what. should be in the bottle or what the. original prescription was? >> Yes. >> So, as far as the trazadone says built. um on January 12th, >> 2023. with 30 in it. And so, you counted to. determine how many were left, right? >> Correct. >> And so, fair to say there were 20. remaining in this bottle when you um. inventoried it. >> Correct. the um dazipam 5 milligrams. date filled January 9th of 2023 with 14.

as the quantity you counted what was in. this bottle. >> correct. >> and there's two and a half left in there. correct. >> correct. >> and dazipam 2 mg date filled January. 16th 2023 it has three listed on there. right. >> in type yes. >> but there appears to be like a pink mark. through it correct Correct. >> Did you put that pink mark on there? >> No. >> Would that have been there when the. bottle was seized?

>> It could have been. >> Okay. Um, but regardless of how many it. says we're supposed the quantity, you. counted how many were actually in this. bottle. >> Correct. >> And fair to say there were nine and a. half remaining in that bottle. >> Correct. >> And the last one, amatipptalene 10 mg. It says um date filled January 16th, 2023. Quantity 30. And you counted how. many were left in this bottle as well. >> Correct. And there were 22 in this. bottle. >> Correct. >> And you documented that um as this was.

put into evidence from the state police. >> Yes. Did you search in the upstairs master.

bedroom of the house during the search. warrant? >> Yes, I assisted with the search. >> Did you locate anything that you. documented or collected to take back to. the state police? >> Yes. >> In the master bedroom? >> Yes. >> Okay. >> What did you locate? Uh, I believe it. was a a baby monitor and a uh Google. Nest camera. >> Okay. Did you um observe the room, the. master bedroom? >> Uh, yes. >> And um did you search in a nightstand.

that was next to the bed? >> I don't recall a search on a nightstand. next to the bed. >> Were there other investigators that were. also in the room searching other areas. of the bedroom? >> Uh, yes. And as far as any additional um work you. did on this particular investigation, again, fair to say the detective unit. works as a team and divides up work and. and for followup. >> Correct. >> And um you participated in um some. follow-up investigation by speaking to. some witnesses. Correct. >> Correct. And um at some point you were.

also asked to um go to the Bighamin. Women Women's Hospital um where the. defendant was uh following the sheriff's. department keeping watch of her. >> Correct. >> Do you recall what day you went there? >> I don't recall the exact date. >> Okay. Um when you went to the Brigham. Women's Hospital, was she in um her own. room or was she in like a open area? >> Uh she was in her her own room. Did when. you were there on watch, did you um go.

into the room or were you outside the. room? >> Outside the room. >> And um as far as your memory of whether. anyone else besides medical staff went. in there, at any point when you were. there at the Brigham Hospital, did you. observe um another individual come in to. visit with her or meet with her? >> Yes. >> And um were you advised that that person. was coming in? >> Yes. >> And were you advised that that person um. was. allowed in with a court order?

>> Yes. >> When the person went in, did you know if. it was an attorney, a doctor, somebody. else? >> Uh, it was not an attorney. It wasn't a. doctor. It was believe a psychiatrist. >> And when that person went into the room, um, did you go in the room as well? >> No. >> And where did you where did you stay? >> Outside the room. >> And when this man went into the room, did he leave the door open or close the. door? If you. >> I believe it was closed. And um. when he came out um did he speak with. you?

>> I don't recall. >> Okay. Um but as far as you knew at that. time period, that person was permitted. to be in there and could close the door. >> Correct. And you don't know what was said or what. was done in that room? >> No. No. >> Thank you, >> Mr. Remington. >> So your your uh your position was as a. sergeant uh for the state police on.

these dates that you testified to? >> Uh no sir, at the time I was a trooper. >> Trooper? Yes, sir. >> Were you assigned to the district. attorney's office? >> Yes, sir. >> It would be the Plymouth County DA's. office, meaning these prosecutors here, right? >> Correct sir. >> Actually, you have an office in their. office, right? >> Correct, sir. >> Um you have to call me, sir. So on on. the first time you got involved with. this case was on the evening of was it. the 24th or 23rd? >> Uh Tuesday. >> I think it was the 24th.

>> Okay. And do you recall what time it was. that you went there. >> to Southshore Hospital? >> Yes. I'm sorry. uh approximately. 7:30 p.m. >> Now, at that point, you had known. obviously that this was a a major. investigation involving the death of two. children and one serious injury to. another child. Is that correct? >> Correct. >> The media was absolutely insane all over.

the the location of the house and in the. hospitals and everywhere. Isn't that. right? Uh I recall media at the house. I'm not sure about the hospitals though. >> Okay. Uh it was a fairly. horrific and and large lar largely. attended to if you will event. Is that. correct? >> Yes. >> Um and Lindsay was um. when you went to the Southshore. Hospital, that's where you saw her. before she was transferred to the. Brigham Woman's, right? >> Yes. >> When you went in to see her um at the.

Southshore Hospital, she was in the. emergency room, right? Yes. >> Would you agree with me that she was. pretty well uh she had the intubation. tube in her in her mouth. She had tape. on her face. She had her arms all taped. up and wires and tubes and everything. else. Right. >> Yes. >> And it was a very confusing and quite. frankly shocking sight to walk into that. room and see her there in that. condition. Right. >> Yes. >> Um and you about your duty um collected. clothing and her wedding band. Correct.

>> Yes. You went through all that with the. items you seized and you introduced. those into evidence and noted what. government said appears to be stains, but it was blood on on her clothing. Is. that right? >> I would say. >> Yeah. >> In your experience? >> Yes. >> Okay. >> Uh any shoes? Did she have any shoes? Sneakers, slippers, anything like that? >> I don't recall shoes. I think uh two. black socks, but I don't recall shoes. >> Right. If there were shoes uh on her. person brought to the hospital, the odds.

are that when they saved the clothing, they would have saved the shoes as well, right? >> Yes. >> Um so you took the clothing and then you. went to the Boston Children's Hospital, right? >> Yes. >> Then after you left the Boston. Children's Hospital, um you went back to. the house and then assisted in the. search of the property with a search. warrant. >> Yes. And um were you were you the lead. investigator at that point or were you. one of the guys just searching? >> I was not the lead investigator,

>> but there was a court order. search warrant, right? >> Yes. >> And you you meaning collectively you. knew that you had a search warrant that. authorized a search for a number of. items including medications or pills or. pill bottles, right? >> Yes. >> I don't have to grab this and ask if you. saw this. You never did see that, did. you? I did not recall seeing that, sir. >> You don't know what if anything is. inside that that item, right? >> I don't know. >> And and council asked you whether or not. it's a collaborative effort uh on the.

part of the uh detective units and that. you all uh collaborate and work. together. Um can you explain that? Do. you report to each other? Do you keep. each other advised as to what you get. for evidence? >> Yep. So um when we go into a house, we're not familiar with the layout. um. we'll walk the house and figure out. where veterans are located and then. essentially we kind of just break up. into teams if you will and uh search the.

residents um as evidence is located and. at that time as the evidence officer I. would be alerted that hey there's. evidence here we're going to document. and collect it. >> Okay. Um and and you videotape the scene. and you take photographs of of the areas. the different rooms right? Uh I I do not. but the crime scene does. >> But you did you were in the house and. you were able to observe the rooms. You. could see all sorts of wall hangings and. paintings and fingerprints and. handprints and all that stuff on the. wall, right? >> Yes. >> Um downstairs you you saw in the.

basement or the finished basement that. there was an area that was an office or. appeared to be an office. Is that. correct? >> I don't recall the exact layout of the. basement. Um, >> do you remember that uh items were. seized from the basement like a Mac Pro. [snorts] um laptop? Something like I. have right here. Um, two of them that. were seized. You remember that? >> Yes. >> And from your investigation, you're. aware that those would have been Pat. Clancy's laptops, his business and. personal laptop. Correct. >> At the time, I'm not sure who the.

laptops belong to, but I I know they. were collected. >> Okay. And uh how about Lindsay Clancy's. um her cell phone? Was that seized if. you know? >> I believe that was seized um from the. master bedroom. >> In the master bedroom. And uh was do you. remember? Was it located on the bed? >> Um there was a phone located on the bed. I think there was another phone located. in a dresser drawer. I'm not sure which. phone was what, though. >> All right. So, both of those phones, regardless which one was what, did. either one of them had blood on them? >> I don't recall. But if if if you guys.

were seizing the items in the property, such as a cell phone, it had blood on it. in your experience, you you probably. would have remembered that, right? >> Correct. >> And you don't remember that? >> I don't. >> Okay. Um, you did notice a lot of blood. on the floor and on the walls, on the. mirror and the window ledge and that. area. Is that fair? >> I recall blood on the floor by the. mirror and then blood on the floor going. towards that back right window. >> Okay. At no time did you ever come. across or discover a uh what do you call.

it? Apple watch, right? >> No, sir. >> Um and after you all concluded your your. search of of the the home. Um and how. long did that take? A couple of hours. >> probably. I don't recall the exact time. we concluded. Okay. >> Um the next thing you did was to go to. the Brigham Women's Hospital. Is that. right? uh after this search warrant. >> Yeah, she had asked you a question about. bringing a woman's. I mean, did you do.

something else in between? I don't know. >> Uh. I don't recall exactly what I did uh. after the the search warrant, but at. some point I did go to the Brigham. >> Okay. Can you tell us when you went to. the Brigham? >> I don't recall the exact date. I was. >> So whatever date you went to the. Brigham, you went there for what. purpose? um she would transferred to that. facility and uh it was to maintain. custody of her at that point.

>> So you were going to maintain custody of. her? >> Uh so the sheriffs I believed. >> had custody of her and then our unit was. tasked to uh facilitate uh providing. coverage over the next couple of days. >> Right. And and she was actually in the. bed um with all again tubes and all. sorts of things coming out of her body. when you saw her, right? >> Uh yeah, she was in the hospital bed. >> and she was in a in like an emergency. room. It's a little small room with a. lot of machines in it that took up a lot.

of space. Right. >> I don't think she was in the emergency. room. Uh she was in one of the floors, >> one of the floor rooms, but it was an. intensive care unit, right? >> Uh I believe it could have been this the. surgical intensive care unit. >> Surgical intensive care. And when you. went there to facilitate custody, um who. were you facilitating custody for? The. DA's office? >> Uh yes, essentially. >> Okay. Um and whatever day do you. remember how many days was it like two. days, a week, two weeks after the.

incident that brought you to the house. in Dubberry? Do do you recall how long it was before. you went to the hospital to maintain. custody, facilitate? I don't recall how. many days. Uh maybe two or three. I'm. not sure the exact count. >> All right. So, she had been transferred. out of um Southshore Hospital. She was. transferred to Brigham Women's Hospital. You went to Brigham and Women's. Hospital. I imagine you had to go. through security to get in there, right? Well, you bad, right?

>> Uh at some point, yeah, we were probably. assisted with security to get, >> right? Well, you know, you know that. nobody could get access to Lindseay. Clancy in that hospital. And I mean. nobody, right? >> Correct. Um, and this went on for day. after day after day to your knowledge, facilitating, right? >> Correct. >> Her parents couldn't get in to see her. Correct. >> Uh, I don't believe so. >> She had an attorney that that had. difficulty, not me, but another guy that. had difficulty getting in to see her. Isn't that right? >> I'm not aware of that difficulty. >> I had to get a court order to get a.

doctor in there to see her, didn't I? >> Uh, yes. It was a court order. And when. I got the court order, a doctor came in. and and met with Lindsay pursuant to. that judge's order. Um, and that was. Paul Zazelle. Correct. >> I believe that's the name. I'm not sure. if he was a doctor, but I believe that. was a gentleman that came on the court. order. >> Okay. Cuz only because in your direct. you said that he was not a doctor, but. he was a psychiatrist. So, I mean, it's. just he you knew that he had something. to do with head doctor, psychiatrist,

psychologist, something like that. Correct. >> Okay. >> Did he have to clear it with you to get. into the room? >> Uh, he checked in with myself and the. other trooper. Uh, we were advised that. he was coming and to let him in on the. court order. >> All right. Now, I wasn't there on that. occasion, right? >> No. >> And when Dr. Zazel or whoever it was. went into the room to see her, it's your. memory that he was allowed to shut the. door. Is that correct? >> Uh, I believe he shut the door. >> Now, you were involved. You were.

involved in this investigation pretty. intensely working with the DA's office. Right. >> Correct. >> Isn't it fair to say that one of the. contentions of the district attorneys is. that Paul Zazelle, my doctor, that I got. a court order to get in to see her, told. her to call Pat and tell him that that. she heard voices. Can. >> I see council sidebar in regards to. this?

All.

right. So, members of the jury, uh, like. I said, I think a couple weeks ago, sometimes I got to talk to the lawyers. for a little bit longer, uh, than it. takes over here at the sidebar. So, this. is one of those situations. So, I'm. going to ask you back to the jury room. uh just for a couple of minutes, I. think. Then we'll bring you right back. in and we'll resume with the testimony.

Okay. >> All right.

session. Please be seated. >> All right. So, council, what we're going. to do is we'll have it, just so the. record's clear, the jury's out of the. room at this point. uh we will just. conduct a short of wad dear um on the. issue that we talked about over sidebar.

Um so uh I'll allow uh Mr. Readington to. uh ask questions at this point and I'll. allow calm um to also ask questions. Go. ahead council. >> Okay. Thank you. So um you're in the. hospital at Brigham and Women's correct? >> Yes. And when you're there, um, with the. purpose of obviously with other law. officers to enforce the fact that she's. in custody, Dr. Zazelle or a doctor came.

in. pursuant to a court order, right? >> Yes. >> All right. And obviously had been. cleared through security and went into. the room where Lindsay was laying on the. bed. Right. Yes. >> You don't know. You don't recall if he. closed the door or if he kept the door. open or if it was half open. You just. don't remember, right? >> Yes. >> Okay. Um would you agree with me that in.

the course of preparing this case for. trial that that you have worked and. collaborated with the prosecutors, the. uh the two district attorneys. Correct. >> Yes. And you guys would talk about. theories of the case and evidence that. they want you to run down perhaps as an. investigator or try to obtain or. interviews and things of that nature, right? >> Yes. >> And one of the theories that they had. indicated to you is that Patrick Clancy.

had indicated to um to the investigators. and to the grand jury, I believe, that. Lindsay called him from the hospital. Right. >> I recall that. and that Lindsay used. that doctor's cell phone to call him. from the hospital. Right. >> Yes. >> And they basically had a theory that. they wanted to run with that Zazelle. told her Lindsay to say that she heard. voices. Right.

>> I don't know if it's a theory or not. I. just recall that conversation at some. point. >> Okay. So, when was the conversation? >> I don't recall exactly when. >> You remember where you remember where. the conversation was? >> Uh, no. You don't Okay. >> I'm assuming at the office. I just don't. recall specifically what. >> And who was it you were talking to? >> Um. >> probably could have been one of the. troopers in the office working the case. >> One of the troop is it Miguelan? >> Um probably he's the case officer. So.

I'd imagine it probably would have went. to him, sir. >> Probably could have been him. >> Yeah. >> How about any of the prosecutors? You. talked to the DAs about that? I don't. recall specifically speaking to a. prosecutor about this. Well, how about. not necess.

conversation. Lindsay community. If the facts are. >> Okay, you already said that. I know. And.

>> right. >> Yes. She had told Patrick on.

The voices.

again. Pretty.

buck. anything about a theory.

Did you. had a conversation with the prose. anything that youation. with another troop. testimony today?

that incident. After. um or. husband, do you?

>> No. >> All. the call was and who he said the call. was from and how the call occurred. Correct. >> Correct. >> Thank you. >> So, so. >> yeah, please. So basically, >> my contention is that that you're you're. obviously up here testifying as honestly. as you can. It's pretty apparent, right? >> Yes. >> Um and and you're very consistent with.

with your oath and you understand that. it's important and you're trying to it. may be difficult, but you're trying to. explain what your memory is about. conversation with the lead investigator, McKelen, right? >> I mean, you're trying to tell us what. your memory is, right? >> Yes. Um, so your testimony pertains to. your conversation with the lead. investigator, Mcelan. It's got nothing. to do with the fact that you don't. recall this or you don't recall that. What you've testified to is for the. judge to consider, right?

>> Yes. >> Okay. That's all we have. >> All right. All right. Why don't we do. this? I'm going to take about a. 10-minute break at this point. Uh, and. we'll come back out and we will uh. resume crossexamination. Okay. All right. >> All right.

Your honor, for the purpose of the. record, we return back to the matter. versus Lindsay clamping. All parties are. present, excluding the jury. >> All right. Council Gibbar.

All right.

This court is now in session. Please be. seated.

Justice Lindsay Clancy. All parties are. present, including the defendant and. including the 18 juror. >> All right, members of the jury, thanks. for your patience. We're able to uh deal. with that issue. Uh and so we're going. to return now to the crossexamination. Uh we're We're going to take a morning. uh break as I' I've told you before. Might just be a little bit affected by. the fact that we just took that that you. took that break. We didn't take that. break. Um so with that um we're going to. return to the cross examination.

>> Mr. R. Uh so um Sergeant Lawler um. we're at the point where you are. assisting if you will in the custody of. Lindsay at Brighamin Women's Hospital. when you observed a doctor enter into. that area and ultimately into her room. Is that correct? >> Yes. >> All right. And the door was either. closed or open or halfway. You don't.

recall, which is understandable, but you. just don't remember if it was closed. completely or open a little bit. Right. >> Correct. >> But either way, you weren't. eavesdropping or trying to hear. anything, were you? >> No. Um, and then when when the doctor. finished talking with Lindsay, at some. point you as investigators were aware. that the doctor had allowed her to call. her husband and use his cell phone to. speak to her husband. Correct. >> I later learned that. Yes. And you later.

learned and and knew from the. investigation that it was fairly. recently to that point that the tubes. had been removed from her mouth and she. was able to at least talk to a degree. Um and then she talked on the phone. Correct. >> Correct. >> And after that, um fair to say that you. did not, when I say you, I mean. collectively all the police officers. investigating for the DA's office. You. you did not uh see any reports or. anything that would indicate.

what if anything was said between Dr. Zazelle and Lindsay in that room. Right. >> Correct. >> And who is uh Sergeant? Is it. McGilligan? >> Uh Sergeant McKelanigan. Yes, sir. >> And Sergeant McGeligan Joshua? >> Yes. >> He's the lead investigator in this case. Is that correct? >> Correct. >> And at the time he was a sergeant. You. were a trooper, right? >> At the time we were both troopers. >> Oh, both troopers. Okay. Okay. So, you. both got promoted. Um, and and he as the. lead investigator told you in a.

conversation or or perhaps more than one. that the government theory is that. Dr. Zizel told Lindsay to say to her. husband that she heard voices, right? >> Yeah. If you can rephrase that. >> Okay. Did you talk to Mcdeligan about. the theory that Dr. Zazelle. is the reason that she told her husband.

that she heard voices. >> Yes. >> And do you remember where or when that. conversation occurred or how many times. that you guys discussed that? >> Uh I believe it would have been at the. office. I don't recall exactly when. >> Okay. And there's no. investig investigator basis for that. That's uh McEligan speculation. Is that. correct? >> Correct. Um when you went there and you observed. Lindsay after the doctor left. um she's still obviously in the bed.

because she's paralyzed, right? >> Correct. She's still in the bed. >> Was she restrained by either soft. restraints or handcuffs or whatever? Do. you remember where her hands or her. wrist restraints of the bed post? I. >> don't recall specifically restraints. >> Okay. And you mentioned that the state. police were there. That would be people. that were obviously working with you, right? >> Correct. And do you remember how many. state police were there that you were. coordinating or assisting? >> Uh per shift there was two of us. >> Two. >> Yes, sir. >> Okay. And also there were sheriffs from. the Fmouth County Sheriff's Department.

that were there, right? >> Uh so we relieved the sheriffs. >> Okay. And how many sheriffs did you. relieve? >> Uh I don't recall exactly. Probably two. though. >> Okay. And how about Dexbury police? You. recall the Dexbury police being there? >> Uh I do not recall Dexbury police there. How about the security uh cops for the. uh the hospital? Do you recall them. being there either in the room or. outside the room? >> Uh I don't recall them being outside the. room. >> Do you recall coordinating with the. security boss, the head guy for the. hospital security?

>> I recall having some assistance at some. point from security to get up there. >> Okay. And do you remember how many days. it was that you were assisting in the. custody situation of Lindsay before she. was allowed to have family and me and. different people visit with her? >> I don't recall exactly how many days. >> About a week maybe or less or longer. >> Less than a week. >> Less than a week, >> I I think. Yeah. I don't remember. exactly though. >> And even though she was allowed to have. visitors um still the police presence. was there. Is that correct?

>> Um. after I left. I'm not sure after I left. what the visitation was like. >> So when you when you say after you left, you mean when you left the hospital? You. mean after you were finished with your. tasked duty of dealing with her security. and being under arrest? >> Correct. After my assigned shifts. I. don't. >> So after you were involved, obviously. you don't know what happened after that. >> Correct. Okay. That's all I have. Thank you, sir.

>> Thanks, sir. redirect. Miss Buckingham, >> Sergeant Lawler, in your experience. working um in the detectives unit as a. trooper, is it fair to say you oftent. times will have conversations as. investigations are unfolding with other. investigators that you're working on a. case with about the case, potential. evidence, theories of the case? >> Yes. >> And it's al also fair to say that. theories change over time based on your. investigation, what evidence you find.

Correct. >> Is there anything about a conversation. that you had with um Trooper Miguelan. about this theory that affects your. testimony as you stand here today? >> No. >> And you didn't hear anything that. occurred in that room that day that you. were there when Dr. Zizel was there, did. you? >> I did not hear anything. >> Nothing further. >> Just briefly, well, your testimony. basically unobjected to was talking. about clothes that were seized at the. house and the other investigation going. to the hospital. That's it, right?

>> Objection. >> Sustain. All right. All right. Anything further? >> All right. Thank you, sir. >> Thanks, your honor. >> Thank you. The Commonwealth would call Leticia Duke. as next witness, please.

Good morning. >> Good morning. [snorts].

Good morning. >> All right. I'm going to ask you to keep. your voice up and speak into that. microphone. Okay. >> All right. Thank you. Yes, councel. >> Thank you. Um, could you please tell the. jury your first and last name? >> My name is Leticia Dukes. >> And how do you spell your first name? >> L A T I E S H A. >> And how how do you spell Dukes? D U K E. S.

>> What do you do for work? >> So, I'm a licensed mental health. counselor. Um, I worked as a perinatal. clinician at Southshore Hospital. >> And, um, what kind of education did you. receive in order to do that? >> So, I have a bachelor's in psychology, a. master's in mental health counseling, and a master's of education in mental. health counseling. >> And you mentioned um the Southshore. Paranatal Clinic. Um, do you still work. there? No, I do not currently still work. there. >> How long did you work there?

>> I worked there for about five years. >> What did you do there? >> I at the perinatal clinic. Um I worked. as a perinatal clinician um which. involves like short-term therapy uh from. prior to birth, birth to postpartum. and supported with connection to care. whether that be therapy or higher levels. of care. So, intensive outpatient. therapy, partial hospitalization or. inpatient care.

>> And do you often um collaborate with. patients and other um clinicians at the. clinic or nurses about treatment plans. for patients? >> Yes. >> And do you help to manage the treatment. plans with the patient? >> Yes. How do patients or strike that um for. your role at the clinic um doing the. therapy and um being the clinician? Are. you often referred patients by the nurse. practitioners or somebody else who had.

um seen the patient or did an intake. with the patient? >> Yes. >> And um do you work with that prescriber. or practitioner over the course of the. treatment with that patient? >> Yes. And as far as your role um and what you. do with patients, is it fair to say that. a large amount of your ability to work. with a patient is based on your. relationship and rapport that you. develop with the patient? >> Yes. >> And do you rely heavily on things that. they report to you when you're assessing.

them diagnostically and trying to help. them come up with a treatment plan and. offering therapy? >> Yes. And one of the things that um might be. important in that is to assess a. patient's presentation each and every. time you um meet with them. Right. >> Yes. >> So do you do that in each um appointment. or each interaction with a patient? Assess them for various things. >> Yes. >> And what kinds of assessments do you. perform? So I typically perform a.

psychosocial assessment which is getting. their behavioral health history um as. well as their current presentation and. reason for coming in for therapy. So. whether that be a specific diagnosis or. current concern um or recent like crisis. or trauma um and also a risk assessment. that assesses how they're doing in that. moment. >> Okay. And um as far as the therapy. component of your interactions, is that. largely based on the patient? >> Yes.

>> And um what kinds of therapy can you. offer in that um short-term therapy? >> In that short-term therapy, we offer um. cognitive behavioral therapy, dialectical behavioral therapy. I also. offer something called EMDR, eye. movement, desensitization, and. reprocessing therapy for patients that. have gone through trauma. um as well as. it could be even short-term support like. a couple of weeks until they're. transferred to the appropriate level of. care. >> And um in your sessions with patients,

is there a minimum or a maximum time. limit? >> Um typically our program would go from. birth to postpartum up to two years. Um. if it did go a little bit over two years. because of lack of connection to care, then it would go a little beyond that, but typically it's two years. >> Okay. And that's the duration of your. treat your treatment or your interaction. with patients. But what about in each um. appointment that you have? Is there a. minimum or maximum of time set by the. clinic of when you see a patient.

in a particular visit? >> Yes. Um so do you mean as far as like. weekly or like hour, half an hour? Well, I guess the question is if a patient's. coming into you because they've referred. and um you're meeting with them on a. regular basis, how long are the. appointments in duration? An hour, half. an hour? >> So, appointments could be anywhere from. a half an hour to an hour based on the. patient need at that time. And when you're um interacting with a.

patient and you're making all those. assessments, um are there tools. available to you if you feel or you. experience that a patient is needs a. higher level of care or is heading or is. in some sort of crisis? What tools are. available to you for that? >> So tools that are available to me is. connection to my direct supervisor as. well as um crisis coordination um as. well as like the crisis support numbers. that are in that area. So, I could. either call with the patient or um sit.

with the family, create a safety plan, and the patient can call later on if. they feel like they're safe to go home. and they have supports at home. >> Okay. Um and at some points um could it. be that you would need to involve. authorities like the police? >> Yes. >> And um you also are familiar with the. section 12? >> Yes. >> And then that it's an involuntary um. procedure where the court gets involved. >> Yes. Um. now as far as when you do meet with.

patients on that regular basis um either. for a follow-up or an intake um is it a. telealth situation, an in-person. situation? >> It depends on what the patient is. comfortable with and what the patient is. able to do as far as like access. So we. offer both inperson and virtual. appointments. >> Okay. As far as when you first meet with. a patient when they've been referred to. you, um that first intake procedure, is. there a recommendation for whether that. be in person or tellahalth? >> All uh the perinatal behavioral health.

appointments for mental health. counseling are in person that initial. visit. >> And then um the subsequent appointments. are oftentimes directed by the patient. >> Correct. Would there be instances where. you would um insist or prefer that the. patient actually come in person if. they've elected for teleaalth? >> Um typically you prefer someone to come. in person because they have either like. fallen out of care or there are concerns.

for their safety for some reason. >> Okay. And if you don't have those. immediate concerns and it's the. preference of the patient um do you. often engage via teleaalth? >> Yes. [cough]. [clears throat] I'm going to draw your. attention to um a particular patient by. the name of Lindsay Clancy. Do you. remember when your first contact was. with her? >> I remember it was around late November, early December. >> Okay. And you're aware that she came to. the perinatal clinic um and was being. initially treated by Julie Paul.

>> Yes. >> And um by the time you engaged with her, she had trans um her care had been. transferred to Rebecca Gelato. Correct. >> Yes. >> So, fair to say you had the most contact. with Rebecca Gelatada about this. particular patient. >> Yes. >> And um if I mention December 2nd, does. that sound um familiar as the first. intake with um. Lindsay Clancy? >> Yes. As I said, around late November,

early December. So, that sounds about. right. >> Okay. And the intake appointment, was it. in person with um Lindsay Clancy? >> Yes, it was in person. And what were the services that were um. being offered for her? Why was she um. referred to you? >> So she was referred to me for uh. postpartum anxiety and depression. symptoms. Um she Yeah, that's what she. was referred for. >> And in this first intake, did you go. through that psychoso psychosocial.

history with um Lindsay Clancy? >> Yes. And um did you have some previous. information from an intake with Rebecca, excuse me, with Julie Paul or did you do. it fresh on your own? >> Fresh on my own. >> Okay. And um so again, this is. information that the patient is. reporting to you about their history? >> Yes. >> And um so in this instance um you noted. that um the defendant told you or uh. Lindsay Clancy told you that she had.

she had been. had some prior contact with uh mental. health, right? >> Yes. >> That she had engaged with a psychiatrist. in nursing school and that she had been. prescribed medication at that point. Correct. >> Yes. >> Um and that um she prior to coming to. the clinic that she had been engaged. with a psychiatrist. >> Yes. Um, did she identify what her um,

concerns were or what her presenting. concerns were to you? >> Yes, she did. >> And what were the concerns? >> Her presenting concerns were anxiety, lack of sleep, um, depression symptoms, uh, frequent, uh, passive suicidal. ideiation, thoughts of wanting to die. and no longer be here. Okay. And um had. she reported to you that she had been on. a number of different medications? >> Yes. >> And you're aware that she was those. medications were being managed by um the.

nurse practitioners in the clinic? >> Yes. >> And as far as your role as a social. worker, do you often um kind of get into. the weeds with patients about their. medication? >> So I'm not a social worker. I'm a mental. health counselor. >> I'm sorry. >> Yeah, no problem. Um, but I typically. have an overview of medications, but I. don't particularly get into prescribing. or how to take medications. >> Okay. And so what's the focus of your. role in um offering counseling services. to women with postpartum anxiety and.

depression at the clinic? >> Yes. Um, so my role would be to create a. treatment plan to address the concerns. which would be like the anxiety and. depression symptoms and work on coping. skills and building community supports. around that or if she needed a referral. to a higher level of care, I would do. that. >> And do you come to your own conclusions. um as far as diagnos diagnosis goes. based on your interaction with the. patient? >> Yes. >> And in this first interaction with um. Miss Clancy, you uh got her history. You.

also did some of those assessments, correct? >> Mhm. >> And so as far as assessing her um. present condition um kind of how she. presented to you, did you um make. observations of her mood? >> Yes. >> And do you recall her mood being low. that she was felt numb and unable to. laugh? >> I apologize if it's medical record. I. don't have any objection, but I prefer. not deleting. I have no problem if she. reads from the record, though. >> All right. If you could just There's.

objection. In fact, leading leading. question sustained. Uh but is there any. So there's no objection. Uh if this. witness if you want to look at your. notes. I don't know if you have your. notes with you. >> I do not. Do they have a copy? >> I don't know if the parties have a a. copy that she could uh look at. I do. >> Do you have a blank copy? >> Well, I mean it has like a date on it. Doesn't have a lot of notes on it.

I can approach page by page. It's fine. >> Sure. That's fine. >> So, if you need or want to look at the. wreck, just let us know. We'll do that. >> Sure. Thank Thank you. >> Just going to show you that page. >> Sure. >> Sure. Yeah. >> [clears throat]. >> So, Miss Dukes, on this um particular. visit on 122, um what was her mood? >> So, she reported having low mood and.

feeling numb. >> Okay. And so, um you said she reported. So, in the note that you're reviewing, these particular um questions or these. observations that you noted, are they. based on her reports to you about these. areas? Yes. And as well as my observation of. her. >> Okay. So, did it appear that her mood. was consistent with what she was. reporting to you based on your. observations? >> Um, she appeared to.

have, if you can say, like normal mood. There was no like tears or sadness or. like there was no blunted interaction. She was able to make contact, eye. contact. >> Okay. and kind of moving to what's identified. in your in your record as mental status. exam. Yes. >> What is a mental status exam? So, a. mental status exam is an exam that's. assessing how the patient is appearing. Um, what she is reporting as well as any.

concerns about safety, which would be. any, uh, suicidal ideiation, homicidal. ideiation, um, as well as any intrusive thoughts or. worry, um, any hallucinations or. delusions. >> Okay. And so, in this exam, is it a. mixture of what the patient tells you. and what you're observing? Correct. >> Okay. And if I can perch you with. another page. three.

>> Thank you. >> In regards to on this particular first. encounter on December 2nd, um when it. comes to the mental status exam, were. you able to observe her facial. expressions? >> Yes. >> And what were your observations of her. facial expressions? She was cheerful when discussing her.

anxiety symptoms. Okay. Um and were you. did you also ask those questions about. um thought. thought content? >> You just have to answer out loud. >> Yes. >> Okay. Um and so what did she say about. thought content? So thought content um worry about her. infant and that she had an addiction to. Adavan. >> And you said you also in this assessment. um assess suicidal thoughts. Correct.

>> Correct. >> And so did you ask her anything more. about those passive thoughts that you. indicated she um reported? >> Yes. And what she reported as far as. like passive thoughts were thoughts of. not wanting to be here or no longer. wanting to live but no plan. >> And is that significant to you? the fact. that um she identified there was no. plan. >> Yes. >> And why is it significant? >> Because if she identified that she in. fact had a plan, then that would. escalate me to see it as a crisis and.

request higher level of support at that. time. >> Um as far as. your observations of um her thought. process, were those within normal. limits? >> Yes. And her intellectual functioning. was were those within normal limits? >> Yes. >> Um. did she report to you any past attempts. to harm herself or others? [snorts]. >> No.

>> Um. did you go through with her um her. behavioral health history? >> Yes. And. other than what you indicated as the um. anxiety and sleep, did she identify um. any concerns for around substance abuse. issues? >> So she did identify um concerns about. not in her history but in that visit uh.

about misuse of Adavan. And if somebody. expresses concern about that substance. use, do you have a tool available to you. to assess whether um they have substance. use issues? >> Yes. So there is a an assessment within. the initial intake appointment that has. a specific section to further assess. substance use disorder. >> Okay. And did you identify whether she.

presented with any substance use. disorder issues? I did assess that she. did not present with any substance use. disorder issues. >> And as far as her expressed concern to. you, um fair to say it was focused on. the one particular medication, the. medication Adavan, correct? >> And um why were you why did you not find. that that to be an issue based on your. assessment? based on my assessment and.

how she stated she was supposed to be. using it, it was used correctly to um. remedy the anxiety symptoms. >> Okay. And after this initial intake, well, I guess the first question is. approximately how long is this initial. intake appointment? >> The initial intake appointment is. typically an hour. Okay. And um after. having spent the hour, gone through. these assessments, spoken to her about. her history, were you able to um come up.

with or give an opinion about diagnosis? >> Yes. >> And based on her presentation to you, what was your opinion about diagnosis? >> At the time, my opinion about her. diagnosis was postpartum anxiety because. she had a lot of anxiety about. most things. >> Okay. And so what were your. recommendations as far as a treatment. plan for her? My recommendations at that. visit was um outpatient therapy um. continued medication and weekly visits.

with me. Okay. >> And why would you why did you recommend. outpatient therapy on top of therapy. with you? >> So outpatient therapy was kind of like a. blanket therapy but more so like. intensive outpatient therapy, partial. hospitalization therapy. And um was your. role in offering her weekly sessions um. an attempt to kind of bridge services. and make sure she was getting everything. she needed or something different. >> to bridge services.

And so after that meeting with the. recommendation for weekly visits um did. you begin to schedule additional visits. with her? >> Yes. Um, and after that particular visit. on December 12th, did you send her any. particular information? >> Yes. >> And how do you do that? How do you send. patients information if you if they're. not able to you're not able to give it. to them? >> I can send it through my chart. messaging. >> And on this particular day, um, after. your meeting with her, you sent her some.

resources about cognitive behavioral. cognitive behavioral therapy, did you. not? >> Yes. um your next contact with her was. December 5th. Why um December 5th if you. had just met with her on the 2nd? >> That may have been the soonest available. appointment that week for her. >> Okay. And um it it was shy of the one. week, right? >> Mhm. >> Did you Was there anything in your. meeting with her on the the second that. made it necessary to have a shorter.

appointment? >> No. Um this next contact on the 5th was that. in person or tellaalth? >> Tellaalth. >> And um on this day on the 5th um when. you met with her did she report some. additional information or report how. things had gone over the weekend to you? >> Um may I see my notes? >> Sure.

If it's okay, I'm just going to give her. all the pages from that note. >> That's fine. >> Thank you. Yep. >> Thank you. Okay. >> I'm just reviewing the note. >> Sure. Take your time.

And can you repeat the question? >> Sure. In that um visit on December 5th, did she indicate to you or did she. report to you how the weekend went for. her? >> Yes, she did. >> And what did she say about the weekend? Uh she reported that over the weekend. she had a difficult weekend having.

intrusive thoughts about wanting to die. and that she had contacted Aspire Crisis. Support. Um she met with the clinician. virtually um and was told that she did. not meet the criteria for inpatient. treatment due to having no SI plan, suicidal ideiation plan. >> And so when she reported um the. intrusive thoughts and having a tough. weekend, did you follow up with her and. begin to kind of talk with her about. that? Yes. And um what did she tell you. about what she was feeling and those. intrusive thoughts?

>> So in those times what she reported was. that it was continuous intrusive. thoughts of not wanting to be there but. no plan. Okay. >> Kind of like the same report that she. gave to crisis. >> Okay. And as far as kind of the. difficulty of the weekend and how she. was failing, did she um tell you how she. was feeling? >> No. Um, in that particular meeting, um, when she.

had talked about wanting to die or not. wanting to be there anymore, did you. kind of follow up with her about those, um, statements and whether she had any. sort of intent or plan? >> Yes. >> And did you ask her additional. information and complete that um, full. mental status exam? Yes. Yes. On that. meeting. >> And were there any um signs of um. psychosis or signs of mania or homicidal. or homicidal ideiation? >> No. >> And at the time that you met with her on.

the 5th, was she currently having those. thoughts about wanting to die? Do you. know? >> Just Sure. In that visit, she had no suicidal. ideiation. >> And on this particular visit on the 5th. um via teleahalth, did somebody else. participate in the visit as well?

I could direct you to page 45. 45. >> Yeah. >> Okay.

[cough]. Yes, her husband joined the visit. >> And um this visit approximately how long. was it? If you recall, >> this visit was approximately 30 minutes. >> Okay. and Freddy focus of the visit was. to kind of um deal with that bad weekend.

in calling the crisis center. >> So what did you offer her as far as um. recommendations or assessments or or. assistance during this meeting? >> So support during this meeting um I. offered her support and connecting to it. seemed like she needed a higher level of. care. So, intensive outpatient therapy, partial hospitalization therapy, um as. well as we reviewed um one of her main. concerns was also issues with sleeping. So, we reviewed sleep hygiene and how to. support better sleep to see if that.

would help with some of the intrusive. thoughts. >> Okay. And as far as the recommendation. for um intensive outpatient or partial. hospitalization, um was did she want to connect with with. those programs at that time? At that. time, she didn't decline services, but. she was interested in the information. >> Okay. And so, did you agree to send her. some information? >> At that time, I did not agree to send. her information. Okay. >> Did she ask for any other um information.

in that meeting? >> Um, she did ask for information and. support connecting to psychological. testing. >> And is that something that you do at. your clinic do psychological testing? >> Yes. >> Okay. And so did you make a referral to. for her to see somebody else in the. clinic or did you provide her other. information? >> So. I discussed this information with a. provider at the time which was the. psychiatrist and medication provider at.

the time. >> And would that have been Rebecc Rebecca. Gelato? >> Yes. >> And so um did you subsequently send uh. Lindsay Clancy some information about. psychological testing? >> Yes. Um, but there was no recommendation for. it to be done at the clinic. >> No. >> Do you know why? >> At the time it sounded like she wanted. extra support or like outside opinion as. far as like diagnosis and medication. >> Okay. And was the the testing something that.

she brought up or did it come out. naturally in your conversations with. her? >> That's something she brought up. Um, in your meetings, did she want to or. did she discuss medication side effects. with you? >> Yes. >> Okay. And, um, what were your. observations of her demeanor during the. this visit on the 5th? >> On the 5th. One second.

Her.

presentation overall was it was with. within normal limits. Um she didn't. appear like anxious or different than in. any other visit I had with her. >> And in in the this is kind of your. second meeting with her, right? And how. many meetings did you have overall with. her during the time she's at the clinic. if you know? >> Four. >> Four. So um but you had spent an hour. with her on that intake where there's a. lot of information exchange, right?

>> Yes. So, was there anything different. about how she presented, how she um. spoke to you or answered questions. during this um follow-up on the 5th? >> No. >> And as far as the conversations about. the bad weekend and calling crisis, did. you have any um concern that. she was in crisis? >> No. >> And you made those recommendations for. higher level of care, correct? >> Yes. But nothing that would have. prompted you for those other.

interventions that you've previously. described to us. Right. >> Right. >> Did you ever in this visit see signs of. um mania? >> No. >> And is that something you look for? >> Yes. >> And did you ever see signs of um. delusions or paranoia? >> No. >> How about psychosis? >> No. >> Um now your next contact with her was. December 12th, correct? Yes.

And was that in person or tellahalth if. you recall? >> Tella health. >> And on the 12th um. did you have further conversation with. her about your previous recommendations. about partial mental uh partial. hospitalization programs? >> May I review? >> Yep.

Thank you. >> Yes, we did have further conversation. about recommendations. >> Okay. And um did she indicate to you. that she would be starting a program. soon? >> Yes, she indicated that she would be. starting a partial hospitalization. program in Norwell um on December 20th,

2022. >> Did she provide you any details about. that program? >> Do you know? >> No, that just that she would be starting. a program in Norwell. >> Was that had you refer referred her to. any programs in Norwell? >> No. And um in this in in this meeting. with her, did you um continue to talk. about her need for higher level of care? >> Yes. >> And did you make recommendations on a a.

different program? >> Yes, I did make a recommendation on. women and infants. And why did you. recommend women and infants or why were. you recommending this um higher level of. care? >> Um I was recommending this higher level. of care because of continued passive.

suicidal ideiation even with um crisis. intervention. um as well as women and infants was more. so for postpartum women um and the. infant would be able to come to the. program with her. And so the program at. Woman and Infants is something that. you're familiar with working through. your clinic, correct? >> Yes. >> And you often make referrals over there. >> Yes. >> Do you require the patients consent to. make a referral? >> Yes. >> Did Lindsay Clancy consent to the. referral at that time?

>> Yes. And so did you work to make that. referral after that visit? >> Yes. >> Now you mentioned that she had continued. passive suicidal ideiation in a meeting. in this meeting that you had with her. Did you assess that. >> her suicidal ideation.

>> in this visit particularly? Did she have. passive suicidal ideation? >> Well, do you ask if they still have. that? >> Yes. >> Or if they currently have thoughts of. suicide? >> Yes. And in this instance, did she um. have thoughts of suicide or wanting to. die? Just reviewing. Hold on.

>> So yes, she reported like continued. suicidal ideation at the time. >> And but did she ever indicate a plan? No. [sighs]. >> Having um met with her on the 12th, did she ever articulate to you that she. had made any attempts? >> No. >> And in your conversation with her on the.

12th, were you able to identify any. protective factors based on everything. that you knew about her at this time? Now, this is your third time with her, right? >> Yes. So what were you able to identify. as protective factors for this. particular patient? >> Um at this time she had supports which. were her husband and her mother-in-law. Um at this time she was able to from the. past visit I had with her able to. contact crisis when she felt like she.

needed extra support. So she was able to. follow through with suggestions that I. had given her in the previous visit. >> Okay. And um based on your visit with. her on the 12th, she accepted a. willingness to go to one of those. programs, right? Or be at least be. referred. >> Yes. >> So was there anything about your. interaction with her on December 12th. that warranted um any of those higher. levels of intervention from you? >> No. >> Um now the the next time you met with. her was on December 19th, correct?

>> Yes. >> And was that the final time that you met. with her? >> Yes. on that day of um December 19th. Was that a in person or a telealth? >> May I review the note? >> Sure. Thank you.

that visit was virtual and what was the. question? >> That was the question. Thank you. Um so. on this particular um visit on the. December 19th um did she report any. further issues or anything that had. happened between the 12th and the 19th. that were of concern? >> So she was continuing to have low mood. and numbness. Um,

she did not have any SI and had no need. for crisis intervention over that. weekend. >> Okay. And did she indicate to you that. she had been doing things at home to try. to help with her mood? >> Yes. >> What was she doing? >> Um, let's see. She was spending time with family. ch and her children um and exercising. Now, at this point, as the December 19th. rolled around, had you already put in.

that referral to women and infants? >> Yes. >> And did you know if she engaged with. women and infants by that point? >> Uh, by that point, um, women and infants had reached out to. her, but she had missed the call, but. said she would contact them back. >> Okay. Now, um, one of the concerns that. you often talked about in your meetings. with her was sleep, right? >> Yes. And in this meeting with her on. December 19th, did she report any. improvements in her sleep?

>> No. Um, well, if I direct your attention. to page 13 at the top of the page where. it says risk assessment, >> there's a category for neurovveitative.

disturbances. >> Do you see that? >> Yes. >> Can you show me what you mean by page. 13? >> Oh, I'm looking at prior ones and those. don't have page numbers. The one I gave. her has. It's December 19th. the last page. >> This one here, right? >> Yeah. >> Okay. >> There should be three pages.

>> What did you note under neurovveetative. disturbances? >> I reported that sleep has improved. >> And um that would be information that's. reported to you, correct? >> Yes. >> You can't make observations of whether. somebody's sleep has improved, can you? >> No. >> Okay. Um, so in this instance, um, she. told you she was going to follow up with. the referral, that she was waiting for a. call back, that she had improved sleep, um, but that her mood kind of had. remained the same, low mood, numbness, right? >> Yes.

>> Okay. Um, anything about your. interaction with her that day that was. different from the prior interactions? >> That day she seemed to be more engaged. She was able to smile. She was able to. laugh. Um and she. was enjoying time with family. >> And so did you um look look at that as. something positive? >> Yes. >> Um was there anything about your. interaction with her on this day on. December 19th that made you um think.

that you needed to invoke a higher level. of care? >> No. [clears throat]. As far as in-person visits, um, did you. have any other in-person visits with. Lindsay Clancy after the 19th? >> No. >> Um, fair to say your contact with her. was very limited after that point? >> Yes. >> And on December 27th, did you um have. some interaction with her and her.

husband? >> Yes. >> And why why did you have interaction. with them? >> May I see the note? >> Sure. this four.

Thank you. Can you repeat the question? >> On December 27th, um, why did you have. contact with her? Why why did you make. contact with Lindsay? >> I was calling her to inform her that her. referral had been completed. >> Okay. Um, and so.

you had um a call with her at 10. 23. 1017. going back 9:44. Do you see that in the. records that you have? The four notes. that you have in front of you, they kind of go in a reverse order. >> Yes. But um prior to the contact about. the referral being completed and and. [clears throat] just reaching out to her. and letting her know um did you have a.

conversation with her husband? >> Yes. >> And was that at um Lindsay's request? Did she give consent to for that? >> She did give consent for that. >> Okay. And um fair to say he was. reporting concerns of prescriptions, right? >> Yes. And um that's not your area in the. clinic, is it? >> No. >> So did you refer her refer him to the. prescriber? >> At this time, yes, I redirected him to.

speak to the prescriber. >> Okay. And again, um in each and every. encounter that you've had, did you. further recommend um that she engage. with a higher level of care, either a. partial hospitalization program or an. outpatient program? >> Yes. Now, at any point that you um were. interacting with her between December. 2nd and um the last contact with. December 27th, albeit limited, did you.

ever have any concerns about her. physical well-being? >> No. >> Did you ever have any concerns about the. physical well-being of others in her. presence? >> No. >> Did you ever ex see or observe any signs. of mania, delusion, or paranoia? >> No. any signs of psychosis observed by. you? >> No. >> Did you ever have any difficulty. understanding what she was saying or. notice any differences in her speech. patterns? >> No. >> Um, did you ever have any concerns that. she wasn't accurately reporting things. to you?

>> No. >> And did you ever feel the um need to. collaborate with your provider for. higher level of care or an additional. intervention? when I did. Yes. >> And so would that be for the calling the. police um section to have our safety? >> Hold on. Go ahead. We'll ask that and. then we'll. >> My question was in in any of the times. that you um engaged with her, did you.

ever. engage with your provider to come up. with a plan for safety planning, section. 12, or any other of those interventions. you discussed before? >> No safety or section 12. No. So as far. as recommendations, would you agree that. those were the recommendations for. higher level of care? >> Yes, for IOP or PHP services. >> Okay. >> And on that last um visit that you had. with her um she reported doing things.

outside of the home, right? >> Yes. >> And that stood out to you? >> Yes. >> As what? >> As an improvement in mood and ability to. connect with others. Okay. Thank you. If I may to have a moment to. put these back together. >> What we take the delayed morning break. at this point. So, uh hopefully be a. little bit shorter than normal, but. we'll get you. We can stretch their. legs. We'll have you back here in a. couple minutes. Okay.

>> All rise, please. Close the door. >> Yeah, I just have to put them back. together cuz they're a little out of. order.

So, we'll be in a short recess at this. time. Thank you. Thank you.

Let's.

close back session. All right, >> we all set for the jury. >> Yes.

All right, George.

This court is now session. Please be. seated. Your. >> honor, for the purpose of the record, we. return back to the trial. Commonwealth. versus Lindsay Clancy. All parties are. present, including the defendant and. including the 18 juries. >> All right. Council. >> Thank you, your honor. Um, morning. Good morning. >> So, can you tell me is it four times.

that you yourself actually met with. Lindsay or more? >> Can you repeat that? >> I'm sorry. Was it four times that you. actually met with Lindsay or more? And. that would include Tella Health. >> Four. >> Four times. Okay. Um, you met with her. on the. 2nd of December, right? >> Yes. And you met with her on the 12th of. December. Is that right?

>> Yes. >> You met with her on the 19th of. December, right? >> Yes. >> And is it the 27th as well? Was it was. there another one? Do you remember when. that was? >> That was by phone. >> By phone. Would that be the 27th? >> Yes. >> Okay. So, what I'm going to do is give you the. documents that the district attorney is. questioning you from.

in front of you. Okay. >> Thank you. >> And you can just. >> And if I if I get confused or something, just let me know that I'm on you're on a. different page than me. Um, couple of background questions. When you. met with Lindsay, for example, on the. 2nd of December, you were at least able. to look at the records of nurse Paul as. well as nurse Gelato, right?

>> No. >> Oh, I you guys work in the same place. though, right? >> Yes. >> Okay. So when a woman is in postpartum. and comes to social health for help, um. when you're trying to help them, you. can't see the medical records from what. the other people like nurse Paul and. Nurse Gilleta have have written down. >> You can see the records. Yes, >> you can. >> Yes. >> Okay. So, you did look at the records.

>> I did not look at the records. >> Okay. um on on the 2nd of December and you can. look along with it if you wish. Um. looking under what would be referred to. as behavioral health intake. Your pages are numbered. Mine are not. So if you can find that one page, behavioral health intake on December. 2nd. And the jurors will have this as an. exhibit, but just going through the. pages. You have it? >> One second.

Yes, I have it. >> Okay. Now, one of the things that you. would be interested in when you're. interacting with a patient that that. comes to your facility for help is how. honest they are, right? >> Yes. [snorts]. >> Especially in psychiatry, you want to. make sure that the person is not lying. to you or hiding something. You want. them to be honest, right? >> Yes. And for example, Lindsay disclosed.

um to you and to the others that uh back. in 2012 while she was in nursing school, she actually had uh Prozac because she. was very nervous actually about public. speaking, but she was on Prozac, right? >> One second. >> Sure. I think it's right under behavioral. health history first paragraph. >> Yes.

Yes. >> Okay. And um she also told you that she. had been prescribed Adavan for example. by uh a psychiatrist Jennifer Tus. Right. >> Just reviewing. >> second paragraph.

So, no, that's not what I see here. >> Okay. Do you see where it says prior to. attending the shore program? Sentence, second paragraph. >> Yes. >> Patient was prescribed Adavan by. psychiatrist Jennifer Tus. >> It says here, "She was prescribed. Zoloft.". >> Well, I must be misreading something. I. apologize. approach you. This is what I This is what I have here.

History and current functioning, right? History. Okay. And then behavioral. health history paragraph one, right? References to Prozac, >> right? >> Yes. >> Okay. >> But it doesn't say. >> you said Dr. Tus. No, I was saying the. second paragraph. Prior to attending. Shore program, she disclosed to you that. she was prescribed Adavan, right? >> So, which one are you want? >> Second paragraph right here. >> Okay. >> Yeah. Prior to attending SH program,

patient was prescribed Adavan, right? >> Yes. >> Okay. And that was by uh Dr. Tus, right? >> Yes. So she she told you that she was. prescribed a benzoazipene. by her treating psychiatrist and further. on into your interaction with her she. told you that she was very concerned. about taking medication. Right. >> Yes. >> And she was really concerned about. becoming addicted to medication such as. a benzo like like Adavan. Right.

>> She was concerned about. becoming addicted to medication. Yes. >> All right. In the very last paragraph it. says when no longer taking Adavan. You. see that one? >> Yes. >> Okay. She then explained that you know. she had issues with the sleep and she. started having heart palpitations and. she went to the ER for anxiety. Is that. right? >> Correct. >> And at that time she told you that she. felt that she had an addiction to. Adavan. That's why she couldn't sleep.

Right. >> Yes. >> And she was stressing about that. Was. really concerned about that. Right. Yes. >> Um she then said that uh she had weight. loss. Right. >> Yes. >> No appetite. Right. >> Correct. >> Panic attacks. Right. >> Right. >> Couldn't sleep. Right. >> Yes. >> Next page. December 2nd. Office visit. The same. visit. First paragraph. She was prescribed Remarran and. Cerakquil in the past four days. Right.

>> I'm sorry. This is a different date on. this one. What date do you have? >> Okay. Um, so the next page. >> it goes to 12. >> Okay. All right. Let's look at this one. then. Is this Would you agree that this. is a record from Southshore Health and. talks about continuing your appointment. December 2nd?

>> Yes. >> Okay. If you can find. >> I think they were just out of order. >> Okay. Okay, >> that's fine. No problem. That's not your. fault. >> Um, so are you with me on that? That she. was prescribed around. >> Yes. >> Okay. And that was within the past 4. days. Is that right? >> Yes. So when you saw her on December 2nd. after telling you about the Adavan and. telling you about her weight loss and. her anxiety and everything else, she.

told you that she had been prescribed. Remaron and Cerakquil and I understand. you don't do the drugs so you don't. really have. >> No, I don't do medic. >> Very difficult to get the brand names. and the other names and but we have a. chat for that. Um, so she started Remaron and Cerakquil. and then she told you that since. starting the medication, she's had. thoughts that she no longer wants to be. here. Meaning I guess what on on the. earth, >> no longer want here.

>> could mean anything. Um, but in that. instance when assessing for suicidal. ideiation, no longer want to be here. qualifies as passive suicidal ideiation. >> Okay. And then she indicates further. that this week she was seeing you uh. feels like she's going to die. That's. what the DA read to you, right? >> Yes. >> But then it goes on and says, "But she. doesn't care if she dies." Basically, she feels like she's going to die, but. she doesn't care. She said that, right?

>> Yes. >> Um she then talked about how the Remrron. and Cerakool were not helping her sleep. Yesterday she took Adavan. She told you, right? Yes. >> Due to intrusive. SI suicidal ideiation thoughts, right? >> Yes. >> Uh do you did she indicate what the. intrusive. suicidal ideiation thoughts were. yesterday, which should be December 1st? Did she tell you what that meant? Did. you ask her what she meant by that? >> I did ask her what she meant, and that.

would mean that she had the thoughts. that she told me about about no longer. wanting to be here. >> Okay. Um, and you then told her that she. could go to the ER and that you then. sent her local crisis contact. information. Is that right? >> Yes. >> Um, and then talks about onset. Says 3. months after the baby was born, she had. unmanageable anxiety. Correct. >> Correct. And. >> what what did she tell you the anxiety. was about?

>> One second. >> Yep. It's under uh onset. And what was the question? [clears throat] Um,

and onset she indicated 3 months after. the baby was born, she had unmanageable. anxiety is what the district attorney. asked you. >> And then it continued on with a. sentence. What was her anxiety about? >> About about her children, especially the. baby. >> And what did she what does that mean. that she was having unmanageable. anxiety? Do you know what does. unmanageable mean? >> So constantly worried that something was. going to happen to her children or. something bad was going to happen to the.

baby. >> Um and at that time the children were. four, three, and six months. Right. >> Correct. under social. uh the notes indicate that she reported. she talks about her anxiety all the time. with her mom, husband and mother-in-law. Correct. >> Correct. >> And one of the questions the DA asked. you is about her support family supports. or collateral contacts and you indicated. the mother-in-law. She also had her. mother and father as family support as. well. Right.

>> Correct. And you knew that her mother. and father had actually lived in. Connecticut but moved up or came up and. stayed with her for at least a week if. not longer during December, right? If. you know, and I know it's difficult if it's not in. the notes for you to remember. I'm just. asking, do you remember at all that she. said that her mother and father came up. and stayed with her to help out? >> I don't remember that. >> Okay. Um, she further went on and said that. she's uninterested in other topics from.

friends. What did that mean? She just. didn't want to talk to her friends about. anything. >> She just had a lack of interest in. conversation with friends. >> And that would be her social circle. She. just didn't care. Right. >> Right. >> Uh, she said that she felt numb. Right. >> Yes. >> She had a lack of attention. Right. >> Right. >> Confusion. Right. >> Right. Um, under mood it says, uh, well, of course, you have disturbed sleep. She's only sleeping 2 to four hours a. night is what she told you, right? >> Correct.

>> Uh, and then it says supports. Uh, mother and father have been staying with. her for the past week. Does that refresh. your memory that you did get that info. that they were staying with her for the. past week? >> Yes, >> that's that's fine. I just saw that, too. So, no problem. Um. uh you you took her history that she was. a nurse that she had been on leave and. and she told you that she lost 10 pounds. in the past month. Right. >> Correct. >> Now, can you flip to the next page and. make sure we're both on the same page?

Does under substance use assessment? Do. you have that? >> One second. >> Yep. >> Yes. >> Okay. So, one of the things that you're. concerned about is whether or not your. your patient uh has a substance abuse. problem like drugs or alcohol or. something like that. Right. >> Correct. >> And you've already told us that your. opinion was that Lindsay did not have.

any substance abuse problems other than. her fear about the prescribed Adavan. Right. >> Correct. >> So, did you ask her about alcohol? >> Yes. >> Can you tell me what she said about. alcohol? She said the last time she. drank alcohol was in October of 2019. Um, >> go ahead. >> Yeah. >> Did she tell you how much what it is. that her alcohol of choice was? >> Uh, she said her alcohol of choice was. wine. Um, she would have one to two. glasses. >> Did she say why she would do that?

>> Um, to cope with anxiety. >> Okay. And this is back in 2019, right? >> Correct. >> That would be 3 years before you. actually met with her in December of 22, right? >> Correct. cannabis, the weed, the devil's. lettuce. How about that? >> Did she confess that she was uh using. marijuana? >> Yes, she said she did use marijuana. >> when. >> uh last use was November 15th, 2022. >> Why?

>> I'm sorry. >> Why did she say that she used it? >> It's under comments. >> Yes, I'm taking it away. >> That's okay. She said she tried a marijuana gummy to. help with sleep. >> And uh that was on November 15th of 22, right? >> Yes. >> Uh go to the next page. Assessment and. recommendation. If you have that, make sure we have it. Let's see.

>> Yes. >> Okay. And I think the district attorney. had asked you about the mental status. exam facial expression and you indicated. that her facial expression showed um. anxiety, right? >> Correct. >> Fear, right? Do you know what the fear. was?

>> Just going back to that part of the. >> Y facial expression. >> And you said facial expressions, right? >> Yes, please. Yeah. >> Um, anxiety, fear, apprehension, sadness. Um, >> okay. So if I can I apologize if you. just keep your you're very soft spoken. >> Yes. I'll walk. >> voice up so the jurors can hear you.

>> Yeah. >> Thank you. And um you said that facial. expression exported to you anxiety, right? >> Correct. >> Fear of something, right? >> Yes. >> Apprehension, right? >> Yes. >> Sadness. >> Yes. >> Depression. >> Yes. >> And she expressed that she was having. anxiety and numbness. Right. >> Yes. And she was crying when she was. telling you this, right? >> Yes. >> And again indicated that her thoughts.

were worried about her baby, the new. baby she had, the infant, as well as if. she's being addicted to Adavan is what. she told you, right? >> Yes. >> And again, thoughts of wanting to die, but there was no plan. >> Correct. >> Next page. Uh risk assessment. There's a whole lot of stuff on it these. pages. I'm just trying to cut to the. chase here. So, you see where it says. risk assessment? >> I am trying to find it. One second. >> Yep.

Under current medic. I'm sorry. It's. under a risk assessment. >> I'm taking a look. >> Okay. >> Um. >> I see protective factors but I don't see.

risk assessment. >> Okay. Let me ask you uh. under risk assessment on December 2nd. when you asked me about that. Um at that. point she just you can see here she. again admitted to suicidal ideiation. right? >> Yes. >> It was passive. Yes. >> Says plan to go to ER if she feels. unsafe or has a plan, right? >> Yes. >> And then farther down, you have current. medications and she was on quitipene or.

or cerakquil, right? >> Yes. >> Floatitine or Prozac, right? >> Correct. >> Orzipam or Adavan, right? >> Yes. >> Tazipene or Remaron, right? >> Yes. >> And they were all that was all active. prescriptions that she had on December, right? >> Yes. told you that she is seeking counseling. for postpartum anxiety, right? >> Yes. >> Do you have on December 2nd, continuing. on with your evaluation where it says.

clinical notes, do you have the clinical. notes? >> One second. What I could do is read what I have. rather than stand next to you. And if. you trust me that I'm not. misrepresenting it. I mean, I'm just. reading off of this to make it quicker. for you. If it refreshes your memory, >> if it doesn't, I can walk up and show it. to you. Okay.

>> Okay. >> Um, on that date, your notes say patient. requested addiction support services. Do. you recall that? >> Yes. And that you indicated that you. would be sending predict patient. addiction support resources by my chart. or the message thing. Right. >> Correct. >> You then indicate that based on history. reported patient meets the criteria for. postpartum anxiety. Right. >> Yes. >> That she would benefit from OP therapy. What does that mean? >> Yes. From outpatient therapy services.

>> Uh PHP. >> Yes. Partial hospitalization program. >> IOP. >> Intensive outpatient program. and that. you then helped her out by bridging the. therapy services, right? >> Yes. >> Um, you then noted again postpartum. anxiety on December 2nd according to. your notes, right? >> Yes. >> Okay. Now, [clears throat]. did you know that she had been.

seeking and receiving therapy? I don't. know if that's is therapy or uh. counseling or that type of thing. like like there's a woman that works in. your your business that provides. therapy, right? >> Yes. So that person would be me. >> So did she come to see you for therapy? >> Yes. >> How many times? >> Four. >> So is it fair to say that she was more.

than willing to accept help from. somebody like you? >> Yes. She didn't appear to be avoiding. any therapy when recommended. Right. >> Um, if you could, uh, Miss Dukes, please. look at I think it was December 12th was. the next time perhaps that you saw her. >> Okay. >> Unless it's uh there's another inter. intervening period. >> So there's [clears throat] there's. December 12th and then there's December. 5th. Oh,

>> okay. So, if you could pull out December. 5th. >> Yes. >> And if I can come up and look at it. >> Yeah. >> Yep. >> All right. So, on December 5th, again, you were meeting with her. [clears throat] for therapeutic. intervention, right? >> Yes. >> Um and on this occasion, she reported. she had a difficult weekend, right? >> Yes. >> Intrusive thoughts of wanting to die, right? >> Yes. that she contacted Aspire crisis.

support, right? >> Yes. >> She met with an Aspire clinician, right? >> Yes. >> And what happened when she met with the. Aspire clinician? >> She met with the clinician virtually and. was told that she did not meet the. criteria for inatient treatment due to. not having any suicidal ideation plan. So if she said in addition to the fact. that she's been in counseling and. therapy and seeing psychiatrists and on.

medications for the past 3 months or. whatever the period ultimately would be. and that she wanted to kill herself, didn't want to be here, couldn't care if. she died. They told her because she. didn't have a plan that they couldn't. help her. >> Correct. >> Did they to your knowledge make any. recommendations or did they suggest. recommended that she attend a day. program? Yes. >> All right. And that person from Aspire. then said he would send her patient. resources, right?

>> Correct. >> But but nothing never happened. He never. sent her any You did, but but he never. sent her any patient resources, right? If you know, >> not to my knowledge. >> Okay. All right. So, she had you at least to. talk to and counsel and and advise her. You continued on to make your. observations. She had to say that pretty. much things stayed the same as far as. her appearance, appearing anxious, appearing sad, unable to relate to. people, that type of thing.

>> Correct. >> Okay. Um, then you have is a chief complaint of. present illness. And again, that was Oh, wait a minute. That's not my note. That's not you. Okay. >> All right. So, you can hold on to that. >> Yep. Thank you. Next time you saw her would be December. 12th. Is that correct? >> Correct. >> All right. Now, on December 12th, that.

was a teleconference that she had called. by an appointment with you. >> Yes. >> Um, and at that point, this is she. reported that she had a difficult. weekend and was in experiencing. intrusive thoughts of wanting to Do you. have it in front of you? I don't want to. take advantage of it. >> Hold on one second.

I don't see the 12th in here. >> Okay. Page 28. >> Page 28.

And just for the record, I think your. honor that she's looking at the actual. exhibit. Am I right? That's the exhibit. That's an evidence. No, it's not. Okay. Can it be an. evidence? Can I offer that? Yeah. Okay. Can I offer that any objection? >> Sure. Yeah. >> If I could just.

Um, do you have December 12th? >> Again, I could do what I did before. >> She probably had it before, >> right? >> It references providers interventions. That and that would be Would that be you. provider?

>> Correct. Okay. And you're talking about. symptom management. And yet again, she's. reporting she had a difficult weekend, experienced intrusive thoughts, wanted. to die, didn't have a plan for suicidal. uh plan, but she contacted crisis over. the weekend. And that would be again a. spire apparently. Right. There were two. times she contacted a spray. Not once. >> Correct. >> Twice. Both times they told her that there's. nothing they could do for her. Right. >> Correct.

And uh she told you that she was going. to start a PhD in Norwell on December. 20th, right? >> Correct. >> But in fact, you were able to knowing. people that you may have and pull. strings, you were able to try to get her. into the Rhode Island. Women and Infants program, right? >> Correct. >> Which is a really pretty good program. >> Correct. Um and and did you know that. she did in fact go to women and infants. on December 20th? She didn't go to the.

Norwell program. She went to women and. infants program um and that she was. there for the day and that they. basically turned her away. >> I did know that she went to the women. infants program. I was not sure of the. date. >> Okay. So if I suggest to you it was the. same date that she had told you that she. was going to go to the program in. Norwell on December 20th and then that. you and Nicole Harden Francis uh.

reviewed various options. One of which. was that. which made sense to to attend the woman. and infants program IOP or PHP program. Right. >> Correct. >> And that she patient provided you with. verbal consent. >> Correct. >> To sign whatever had to be signed and. get her into that program. Right. >> Correct. >> So you know that she did on December. 20th after not getting anywhere with. Aspire times 2 and after dealing with. Gelato for all those times that she. dealt with her I'm sorry the other one.

toughs. You were trying to get her into this. program which would be pretty good for a. woman that had postpartum problems. Right. >> Correct. >> And you made your referral. You you. opened the door for her and she got in. there to at least be interviewed. Right. >> Correct. And they didn't take her, right? >> Correct. >> You know why? >> I am not aware as to why. >> Would you be surprised if I told you. that they that they indicated that they. could not help her out because their. diagnosis or secondary diagnosis was.

that she was over medicated? >> Repeat the question. Would it surprise you to know that they. indicated that they couldn't treat her. as a woman with postpartum psychosis or. postpartum depression or postpartum. anxiety or any of that because their. opinion was that she was suffering from. a an over medication? >> It would surprise me. Yes. >> But you don't know? >> I do not know. >> Okay. Did you know that um the records.

from women and infants indicate that in. fact on that very same day they reached. out to uh nurse Gelada and asked her to. call them so that they could discuss the. medication and Gelata never got back to. her. >> I was not aware of [clears throat] that. >> I'm sorry. >> I was not aware of that. >> Okay. I think the district attorney had asked. you a question about the last time that. you saw her or had any activity with her.

was on December 19th. Is that right? >> Correct. >> Okay. And I may have misunderstood. Did. she ask you did like did you call. Lindsay four times and she never got. back to you that day or is that just a. list of different things that you did. for her? >> That's a list of different things that I. did for her that day. >> Okay. So you were calling other. contacts, you were talking to Patrick, you would contact her. I mean, she. certainly was not avoiding you. That's. >> Yes, we were in communication. >> All right.

Um, you're familiar with, maybe you are, the. uh what's called the Edenberg scale. >> I'm aware of it. Yes. >> And did she have the Edenberg scale. administered to her to your knowledge? >> To my knowledge, no. >> Okay. Um, what is polyfarm pharmacy? What does. that mean? >> Polyfarm pharmacy? >> Yeah. You ever heard of that? Polyfarm.

pharmacy? >> I've heard of it, but [clears throat]. not sure of the exact. >> Okay. definition. >> Is it something to do with having too. much medications thrown at you all at. once? If you know. >> No, I'm not sure. >> Not sure. Okay. Um, excuse me for one minute.

>> [clears throat]. >> Apologize. I just had something pulled up and it. just went back to default on me. So, I. just had need a second. I apologize.

Okay, I get it. Um, and how long have you been working. in your particular field? >> Since 2011. >> Okay. And you have obviously a very. impressive background as far as your. educational background and your. experience. Do you continue to like with.

continuing education? >> Yes. >> Um. have you ever been aware are you aware. of the Mass General Hospital Center for. Women's Mental Health? >> I am aware of it. Yes. >> Do they offer seminars and programs as. well as research articles? I believe they do. >> Okay. Do you know that uh Mass General. uh Center for Women's Mental Health. about a year ago issued a fairly major.

study and various recommendations for. people that are dealing with women that. have postpartum periods. u and how they break up the periods? You. familiar with that? >> No, I'm not familiar with that. So if I. suggest to you that in that particular. Mass General Hospital article, it goes. on about postpartum period. and is it do you agree that the. postpartum period 85%.

of women that are pregnant exper or. after pregnancy experience some type of. mood disturbance? Would you agree with. that? >> No, I wouldn't agree with that. >> All right. Um would you agree that 10 to. 15% of women develop more significant. symptoms of depression or anxiety? >> I agree. >> Okay. Um and then postpartum psychiatric. illness is then divided into three.

categories. One sounds like something out of the. 50s. Postpartum blues. Would you agree. with that? >> Yes. >> You've heard that expression before? >> Correct. And that's it can be. bothersome. It can be aggravating. It. can be intrusive. But it's not. threatening the life of the of the. mother or baby or anybody else. Right. >> Correct. >> And it's fairly common. Right. >> Correct. >> Number two would be postpartum.

depression. That's a different issue. Correct. >> Yes. >> And number three would be postpartum. psychosis. Is that right? >> Yes. >> All right. Now, postpartum depression. prior to morphing if you will into. postpartum psychosis consists of a. number of symptoms, symptomology, right? For you to diagnose a woman, whether.

she's pregnant, has the baby, or after. having the baby, with postpartum. depression, there are certain things. that are symptoms that you look for, right? >> Correct. >> Okay. Uh, one of which would be. depressed or a sad mood, right? >> Yes. >> Lindsay had that, right? >> Yes. >> Next would be tearfulness, right? >> Yes. >> Lindsay had that, right? >> Correct. Next one would be loss of. interest in social activities or usual. activities or or friends. She had that,

right? >> Correct. >> Feelings of guilt. She had that, right? >> She didn't express feelings of guilt. >> Okay. Um feelings of uh worthlessness. Did she express that she felt worthless? >> She did not express that. >> How about fatigue? Did she have that? >> She did not express fatigue, but lack of. sleep. >> I know the lack of sleep. Were you aware. that in fact that she had indicated that. she was so wiped out that she couldn't. even get out of bed, couldn't put her. feet on the ground, and if she did, she.

felt heavy. >> I did not hear that from her. >> Okay. How about you mentioned it, you. got it? Sleep disturbance is another. issue, correct? >> Correct. >> She had that, right? >> Yes. >> Change in appetite. She had that. Lost. 10, 15 pounds, right? >> Yes. >> Poor concentration. She had that, right? She said she was numb. She could not. focus. >> Suicidal thoughts. >> We know she didn't have a plan, but she. had suicidal thoughts. Right. >> Correct. >> So, under the Mass General Hospital um.

research project for women that are. suffering from postpartum. issues. She pretty much hit every one of. the postpartum depression symptoms. Correct. >> Correct. And then it talks about if it increases. in severity, significant anxiety. symptoms may occur. Not generalized. anxiety, significant anxiety symptoms. can occur. Is that right?

>> Correct. >> And one of the ways that you you. determine that is by the test that it. can be administered to a person who is. in a postpartum status. And that would. be what we talked about, the uh Edenberg. test. Right. >> Correct. And you're aware that she was. given the Edenberg test and had a 23 out. of 30, I think it was. >> I was not aware. >> Okay. Um, and some women develop panic. attacks referred to as hypocchondriasis.

You'd agree with that, right? >> Agree with that in reference to. >> Lindsay. She had panic attacks and. complained of having panic attacks. Yes. >> Okay. Um and then you can get into the various. diagnosises of which on a postpartum. person in that time frame obsessive. compulsive disorder OCD right. >> correct. >> or bipolar one or bipolar two right. >> are you using them interchangeably or.

could develop. >> trust me I bip let's say bipolar one. okay. >> so that would be one mental disease. correct. >> correct. >> and it's Pretty serious stuff, right? >> Yes. >> And if a person is diagnosed as bipolar, one of the things that you shouldn't, if. you know, is is prescribe SSRI such as. Prozac or Zolaf, right? >> If you know, >> I'm not sure of that. >> Okay. Um would you agree that uh with. with various cases dealing with.

postpartum depression um all of the. symptoms that we talked about. they utilize the Edenberg postnatal. depression scale which is a 10 item. questionnaire that can identify women. that have postpartum depression and the. severity that they have and on the scale. a score of 12 or greater. um raises concern and indic indicates a. need for for more thorough evaluation. Right. >> Correct.

>> Do you know whether she was thoroughly. evaluated by anybody other than TUS and. Gelato? >> I'm only aware of TUS and Gelatoa. >> Okay. I mean, you were trying to do the. best you could with what you had to work. with, right? >> Correct. >> Okay. Um, now we get to postpartum. psychosis. That's the third category, right? Postpartum psychosis you'd agree is the. most severe form of postpartum. psychiatric illness. Is that right? >> Correct. >> Would you agree that it occurs in.

averages about two out of a thousand. women? Right. >> Correct. >> And its presentation can be very. dramatic with onset of symptoms and that. can be within a year according to the um. CDC center for disease control. Right. Okay. >> And when it hits you, it just hits you. Bang. quick, right? >> Correct. And when you think about two. out of a thousand people, seems like a. daunting number, but if I if I tell you.

that Fenway Park when they're full, when. they're playing the Yankees, they have. 37,700. people. If you take the 37,000 people, and you multiply it by two, that would. mean as you're sitting there behind. first base, 74 women. possibly have postpartum psychosis, right? Not sure of that number, but. >> well, if you agree that it's two out of. a thousand according to the studies and. the statistics, and if Enway Park has.

37,000. seats, times two would be 74. >> Okay, >> that's a pretty large number of people, right? 74 people out of that crowd. Okay, it's not that un horribly unusual. I mean, it's something that perhaps. you've dealt with in your practice, right? >> Yes. And when you're dealing with people. with postpartum psychosis, do you agree. that generally they present with an. episode of bipolar illness if you know?

>> No. >> No, they don't. Or no, you don't know. >> No, I don't know. >> Okay. Um, bottom line is from your dealing with. Lindsay, she appeared to be sincere, right? >> Correct. >> She appeared to be help looking for. help, right? >> Correct. >> She appeared to be hurting, right? >> Yes. >> Turning in every direction she could for.

help. Right. >> Correct. [clears throat]. And the last time you saw her was when? >> December 19th. >> Okay. Thank you very much. >> Bucky, briefly, please. [clears throat]. >> Um, Miss Dukes, you indicated that um. you didn't review the records of um. Nurse Paul or Nurse Gelato.

>> Correct. >> Why? I wanted to have a fresh set of eyes to. look at the situation and to assess it. when she came in for her visit. That's. typical practice. >> And that's why you do an entirely new. process, right? Where you do your own. intake, you assess diagnostics for um. determining whether there is any sort of. um mental illness. Right. >> Correct. And while you co you can. collaborate or speak with the providers. about an overall treatment for the. patient, your therapy is your therapy.

>> Correct. >> And um as far as um your role, you don't. have any role in medication management, do you? >> No, I don't. >> Okay. And so when it the note read. current medications, is that just based. on what prefills for the patient based. on their um historical records for the. clinic? >> Yes. >> Okay. >> And so you don't know what she was. prescribed and when and if all of those. prescriptions were active. You just know. what's in the computer.

>> Correct. >> And um as far as the timeline here for. the um recommendations for partial. hospitalization, I just want to make. sure that we're clear. you um had been. for some time recommending some sort of. partial hospitalization program. Correct. >> Correct. >> Um and on December 12th, you had already. talked to Lindsay Clancy about the women. and infants program, had you not? >> Correct. >> And so, um.

when she told you on the 12th that she. was starting that program in Norwell, that wasn't from your referral, right? No. >> And you still recommended women and. infants, >> correct? >> And you got her consent on that visit, right? >> Yes. >> And um on the 19th when you saw her, were you aware that she had been at the. Mass General ER on December 15th for. evaluation? >> No. >> And that she had reported then to them. that she opted for an outpatient program.

at Women and Infants as opposed to going. inpatient to MLAN. Did you know that? >> I wasn't aware of that. >> Okay. And when you met with her on the. 19th after the visit to the ER, um she. still hadn't engaged with women and. infants, had she? >> No. >> And so you had to re-refer her? >> Yes. >> But you weren't aware that she had. already gotten a referral from Mass. General. >> No. >> And so um you did later learn she um. went on December 20th. Correct. >> Correct. And.

were you able to review those records. about this visit to the 20th? So, you. don't know the the that the ultimate. plan and assessment for her um was that. they didn't think she qualified for the. program, but they provided her with um. several options for other inpatient. treatments for medication management, partial hospitalization, and general. mental health. Did you know that?

>> No. And as of your last meeting with her on. December 19th, um ultimately what were. your impressions of how she was doing? >> My impression was that her. symptoms were improving because of the. social aspect, spending time with family. and friends and able to exercise when. before it was difficult for her to. engage or pay attention. And your.

observations of her while you were. interacting with her, they were they. more positive than on previous. occasions? >> Yes. Um, she was able to smile and. laugh. >> Okay. Thank you. >> What was she laughing about? >> When was it she was laughing with you? >> Um, I believe that was the last visit, the 19th. >> So on the 19th it was on television or. was it in person? >> It was a virtual visit. A video. >> virtual visit. Yes. And and on the 19th. on the virtual visit, what was the.

purpose of that visit? >> The purpose of that visit was to see if. she was able to connect with care. >> Okay. So, you would have I guess in your notes. or reference to the fact that on the. 19th of December. that she was laughing. >> Not that she was laughing, but that she. was able to laugh. able to laugh. Okay, because I'm looking here on December. 19th, tele medicine,

>> Latasha Leticia, I apologize, Dukes, >> perinatal behavior health program and. you talk in that form about the date of. the service, December 19th, psychotherapy, PCP, Margaret, that would. be the primary care. Margaret Anastasia, perinatal behavioral health program. You. talk with the quote, if this is telealth. visit, please dot the phrase video. visit, whatever. um therapeutic. intervention. She's 32 years old, married, female, presents for postpartum.

anxiety. Uh symptom management. Patient. continues to have low m low mood and. numbness. P numbness. Was she laughing. when she had numbness? >> What date are you looking at? >> December 19th. The last day you saw her. or the last time you had any contact. with her? >> She didn't appear to have that. No. >> She didn't appear to have what? Laughing. or numbness? >> Numbness. Well, it says right in the. notes, does it not? The patient. continues to have low mood and numbness.

[cough]. >> Yes. [clears throat]. >> Okay. I don't want you to say yes unless. I show it to you. So, patient continues to have low mood and. numbness, right? >> Correct. >> Patient has not had suicidal ideation. and does not need did not need crisis. intervention over the weekend. Otherwise, she didn't kill herself, right? >> Correct. Um to help with the mood, patient has been spending time with her. husband, children, and exercising. Right. >> Yes. >> And exercise is one of the things that.

you would generally your your people. would generally recommend that the. mother do, right? >> Correct. >> That's a good thing to try to do is to. exercise, right? >> Correct. So, if the fact that the. government has records that show that. she would take her kids or her husband. would take her kids and they would go to. a local gym and exercise or swim, that. that's consistent with what she was. advised, right? >> Correct. >> It doesn't mean that she's just out. there having a good time exercising, right? >> Objection. >> No. Overall,

>> she was told that's a good thing to do, right? She was told that that was a good thing. to do, but the fact that she's able to. follow through and do it shows. improvement. >> Oh, okay. So, when did she go to the. gym? >> She didn't give me exact dates. These. are things that she told me she did. >> You ever ask her? If you're telling me. that, you know, this is showing. improvement, is it in the records? Does. it indicate that you asked her if she. was exercising? And if so, where and. when? >> So, we don't write down every thing that.

we talk about in the meeting is. particularly a summary of that visit. Okay. And all I did was ask you about. patient was spending time with her. husband, children, and exercising. And. then you said that that's an indication. that she's improving. >> Correct. >> Okay. Then I asked you if she's going to. a gym. That's not a bad thing, is it? >> No, it's not. >> Okay. Um, and then it says that she. received a call and council asked you. about this. She received a call from.

women and infants but missed the call. Do you remember that? Remember. the DA asking you that question? You. said that she missed the call. >> Yes. >> She didn't continue to read that the. reason she missed the call is that she. was at another medical appointment, right? >> Correct. >> And she called you back, right? >> Yeah. >> Okay. Uh clinician, maybe you provided contact. information for women and infants. patient reported that she would contact.

them today, meaning December 19th, but. in fact she did and you did with sheep. back it up. She did with your help and. she then went the following day on the. 20th, right? >> Correct. >> Okay. And finally, um. fair to say that nowhere in here does it. say that she was laughing? >> Um you would have to go to the. assessment, the risk assessment. >> Okay.

Got it. >> Please. >> Okay. >> Now, what's a mental status exam? >> So, a mental status exam is to assess. how the person is appearing that day. Um, their mood and their interaction. with you in that visit and how you. perceive them. Okay.

So. with the help from the DA, we have. December 19th, the tele medicine form, clinical notes, right? >> Yes. >> Uh the laughing wouldn't be in the in. that area, would it? >> No, it would be more so in this area. >> Okay. Yes. >> Mental status exam, right? >> Mhm. >> Appearance, hygiene, WNL. >> Within normal limits. >> Okay. Clothing normal, eye contact. normal, build normal, posture normal, body movement normal. Right.

>> Yes. >> Behavior is cooperative. Right. >> Yes. >> And speech is within normal limits. Is. that correct? >> Correct. >> Emotional state. affect patient reports feeling numb and. having low mood for most of the day. Right. >> Yes. >> Facial expression. Other facial. expression. H was able to laugh and. smile, right? >> Yes. >> Would that be in response to you saying. something funny or why was she laughing?

>> That would be in response to me saying. something funny. >> So, you guys were kind of bonding a. little bit. >> Yes. >> All right. Um, but she basically still. continued to report that she was numb, having low mood, and basically the. symptomology that she had already. reported. Right. >> Correct. >> Okay. Thank you, ma'am. I appreciate it. >> All right. Coming. >> All right. Thank you. Thank you. You may. sit down. Thank you.

>> Call your next witness. >> I'm also call daily as it next witness, please. >> [snorts].

[clears throat]. >> Good afternoon. Thank you, sir. You may have a seat. All right. Good afternoon, sir. >> Afternoon, you are. >> All right, Miss Buck in, please.

>> Thank you, sir. Could you please tell. the jury your first and last name? >> Cameron Daily. >> And how do you spell your first name? >> C A M E R O N. >> And can you just spell your last name. for the record? >> D A L E Y. >> And where do you work? >> Ducks Police Department. >> How long have you been there? >> 6 and a2 years. >> And back in January of 2023, what was. your assignment then? >> Uh, patrolman. And I'm going to draw. your attention specifically to January. 24th, 2023. Um, were you asked to do a. particular assignment out of Dubberry in.

that evening? >> Yes. >> And what were you asked to do? >> Uh, report to Brigham Women's Hospital. >> And why were you going there? >> Uh, for hospital watch of the suspect. >> And that individual um was Lindsay. Clancy. >> Correct. >> Was there already a Dubberry officer um. on scene at Bergamin Women's um when you. got there? >> Yes. Two. >> Two. >> Yes. And um who were they? >> Officer Leard and Officer Broadick. >> And um. when you arrived at the Bergamman Women.

Hospital, were you by yourself or was. there somebody else with you? >> I was with another officer, Officer. Thomas Johnson. >> Okay. And um were you able to make. observations of the suspect of the. defendant, Lindy Lindseay Clancy, on. that day? >> Yes. >> And she was asleep, was she not? >> Correct. And she had medical um devices. attached to her. >> Yes. >> Was she being treated by um the medical. staff there at Brigham? >> Yes, periodically. >> Okay. And were you inside or outside the.

room if you know? >> Outside the room. >> And were any uh visitors or any other. people other than the medical staff um. in that room with her while you were. there? >> No. and um in from the. 24th into the 25th. What time did you leave the next day on. the 25th? >> So I reported to the hospital on the. 25th. Oh,

>> okay. >> I was there I arrived at 10:00 a.m. >> So your shift there at the hospital was. what? Uh, I got there at 10:00 a.m. I. left about 700 p.m. that night, but it. was an 8 to 4 scheduled patrol shift. >> Okay. And you said that was on the 25th. >> Correct. >> And you took over for um, Officer Leard, >> correct? Who were there on the overnight. previous? >> Okay. Thank you for clarifying. Um, and. when you left that next evening on the. um, 25th at 7:00 p.m., was there another.

Dex officer who came to relieve you or. who came to relieve you? No, at that. time um state police detective McDonald. um arrived on scene with his crime scene. team and then Plymouth County Sheriff. deputies came to take over the um. hospital watch. >> And during that entire shift that you. were there um were any attorneys or any. other individuals um in the room to see. Miss Glansancy? >> No. >> And um did you go back to the hospital. at for any shifts after that day?

>> No. >> Thank you. Nothing further. Were you in. uniform? >> Yes. >> Had your gun on? >> Correct. >> Had your badge? >> Yes, sir. >> The other guy, too? >> Yes, sir. >> You were going to what? Guide the woman. that was tied to the bed. >> Correct. >> Probably have anything. >> Nothing. >> All right. Thank you, sir. Let me step. down. Thank you. >> All right. And so members of the jury, rather than start another witness for. just a couple minutes, we're going to.

break uh take the afternoon recess at. this point. The plan would be to come. back approximately 2:00, come right. back, resume uh with the Calmwell's case. and remind you again. I think you. probably know what I'm going to say. No. talking about this case. Don't do any. research about this. Don't read anything. about it. Uh while you're on a break, don't go anywhere that has anything to. do with this case. uh take the next hour. just kind of put this out of your head. We'll see you. [snorts]. >> Okay. Thank you.

>> All right.

All right, council f just for one. second. Sorry for a minute.

This court is back in session. You may. be seated. >> Your honor, for the purpose of the. record, we return back to the matter of. commonwealth for us is Lindsay Clancy. All parties are present excluding the. jury. >> All right, council. Can I see it? Sidebar.

>> [clears throat]. >> Um, we could just go back to.

while we're waiting uh. for the jury, I just kind of remind. again that there were we've got people.

coming in and out at all times. I want. to remind everybody of the pending media. order regarding certain pieces of. evidence. I also want to remind uh the. warning that I gave I think it was last. week that there are to be no disruptive. statements uh or anything that's going. to disrupt these proceedings. Uh if. that's done they will be dealt with. summarily as we say. All right. So just. a warning uh in regards to that. Okay.

Thank you.

We all set. Yeah. Ready for the jury. >> [cough and clears throat]. >> All right, George.

[clears throat]. This court session, please be seated.

>> Your honor, for the purpose of the. record, we return back to the trial of. Commonwealth versus Lindseay Clancy. All. parties are present, including the. defendant and including the 18 jurors. >> All right, everybody. Thank you for your. patience. We give you a couple extra. minutes to look at the solar eclipse. while you're up. Um, so what we're going. to do is we're going to return now to. the Commonwealth's case. Um, and. Commonwealth, can I call your next. witness, please? >> Prior to the witness, your honor, I just. moved to enter in the next exhibit. Um,

she. excerpted pages from the Southshore. Health System um, perinatal behavioral. health program regarding the last. witness, Leticia Dukes. >> Okay. Any objection? >> By agreement, >> so it's by agreement. >> We would call Nicole Bradley as the next. witness. >> Thank you. >> Just for the record, your honor, >> I object. It's not contested. I don't.

think it's necessary, so I object. All. right. >> Same same finding. >> Yes. Good afternoon. [clears throat]. >> Stop right here. >> What happened?

>> Watch your stuff, please. >> Hey, [snorts] good afternoon. >> Good afternoon. How are you? >> Good, thanks. Just going to ask you keep. your voice up so the jury could hear you. and speak into that microphone. Okay. >> Okay. >> Thank you. Yes. Come on. >> Thank you. Could you please tell the. jury your first and last name? >> Yeah. >> Nicole Bradley. >> And um where do you work? >> Division. >> And as one of the um roles of the field. services division, um does the sheriff's.

department engage in what's called. hospital watch? >> Yes, we do. >> Can you tell us very briefly what that. is? >> Yep. So if any safekeep detainee or. inmate goes over to the hospital, we use. our deputies and matrons to cover them. on a security watch. And are the. employees from the sheriff's department. who are um on those watches required to. um log the activity of um who comes and. goes from the individuals who they are. there to watch? >> Yes, they are. >> And are those records um kept in the.

normal course of business at the. sheriff's department? >> Yes, they are. >> And you're familiar with those records. and what they look like? >> Yes, I am. If I may approach. you want to approach and then. >> Yes, please. Thank you. >> Then there'll be no objection. >> Just going to show you a packet if you. could take a quick look at that. >> Yep. >> Yeah. >> And does do those does that packet. reflect um the hospital hospital logs um.

that are kept by the sheriff's. department? >> Yes, they are. >> And you're familiar that um between. January 25th, 2023 and December, excuse. me, February 3rd of 2023 that the. sheriff's department engaged in hospital. watch on a patient by the name of. Lindsay Clancy. >> Yes, I am. >> Those may be admitted. >> No further questions. Thank you, Mr.

Thank you, man. >> Thank you very much. [clears throat]. come of cause Dr. Renee Stonebridge. >> Same objection as decided by a judge. It's not contested. It's not necessary. >> All right. Same same finding, same. analysis. Thank you.

Good afternoon. >> Good afternoon.

Good afternoon. >> Good afternoon. >> All right, Miss Bragg. >> Thank you, your honor. Good afternoon. Can you please state and spell your name. for the record? >> Yes. My name is Renee Stonebridge. R N E. S T O N E B R I D G E. >> Where do you work? >> I work at the Commonwealth of. Massachusetts at the Boston office. Um, and what what department do you work. for? >> I work for the chief medical examiner's. office. >> And how long have you worked there? >> I have worked there since uh July of. 2017.

>> And um, can you describe your. educational background? >> Yes, I did four years of college at. Sunni at Stonybrook in New York. I was a. double major in German languages and. literature and biology. And then I did. four years at the American University of. Antida where I got my medical degree. I. also graduated with honors magnaum lad. After that I did a four-year combined. anatomic and clinical pathology. residency program at NYU Wintharp. hospital in Long Island, New York. I.

also serve ser served as chief resident. during my final year there. So 2016 and. 2017. After that I did a one-year forensic. pathology fellowship at the Boston. office of the chief medical examiner. And then after that, I did a two-year. neuropathology fellowship program. through Brown University at Rhode Island. Hospital. And I am board certified in. forensic pathology, anatomic pathology, clinical pathology, and neuropathology. >> What is neuropathology? >> Neuropathology is the study of the.

brain, the dura, the eyes, and spinal. cord and muscle. >> What is your role at the office of the. chief medical examiner here in. Massachusetts? My role there is the. director of cardiac and neuropathology. Uh I'm also a medical examiner, but my. primary focus is uh brains and hearts. And so will there be an occasion um. where a medical examiner is doing an. autopsy and they will send you um either. a brain or eyes um or things of that.

nature to examine? >> Yes. And why are those things sent to. you in particular? We have certain. criteria that is followed in order for a. neuropathology consult to occur. Uh some. occasions are uh any children under the. age of two I am to receive the brain. typically the spinal cord depends on. circumstances uh the eyes and the dura. as well. [snorts] Uh also if there is. any suspicion of some type of homicidal. injury to the head uh blunt trauma.

typically those cases will typically. come to me as well. Sometimes there are. cases in which it may just be something. that is surprise person one of the ME is. doing the autopsy the head is opened up. and they see something unexpected. They. see something that may be hard to. diagnose as someone who is not. neuropathology trained or it may be. something like um a tumor that is. unexpected or a rare neurologic disease,

neurogenerative disease that requires. fur further neuropathologic evaluation. And um were you um tasked with um doing. some examinations regarding um core. clans, Dawson Clansancy, and Kalen. Clansancy? Yes. Um, and specifically for. Cora Clansancy, um, what did you. examine? >> For Cora Clansancy, I examined the eyes. >> And what were your findings when you. examined her eyes? The findings when I.

examined the eyes were that there was. acute hemorrhage of the extra ocular. muscles and atapost tissue. So when the. eyes are taken out, this happens after. the brain comes out of the skull and. there is a thin portion of bone in the. bottom frontal portion of the skull. where that bone is broken and the eyes. can then be examined on the inside of. the head. Obviously they are examined. also on the outside of the head as well. but you can look at the optic nerve and.

you can look at the tissue that is. surrounding the eyes. So the eyes are. within the head with some muscle and. some atapost tissue. So there was. hemorrhage in these portions of um. atapost tissue and muscle that is. surrounding the eye itself. And then. also one of the findings was that the. optic nerve sheath on the left side has. some punctate hemorrhage. So the eyes, they're sitting in the head and then.

there's the optic nerve that connects to. the back of the eye and goes to the. brain which sends these signals so. people can see. And there was some. hemorrhage in this portion surrounding. the nerve that connects the left eye. >> And um are you able to determine um by. seeing these hemorrhages um what caused. them? >> Hemorrhages themselves are are very. general finding. However, given the. entirety of the case, uh knowing what I.

know from the uh autopsy findings, I can. say it is consistent with something. espixial. >> And why is it that when um there's. something excial that means. strangulation of some type? Correct. >> Yes, it can be. >> Um why is it that these types of. hemorrhages occur in the eye? >> What happens when there's some sort of. esphixxial element to a person? uh it. could be from many different things but. what happens is the the blood in [sighs]. the head uh if there's say some type of.

compression of the neck or or something. else that causes this fixia there's many. things but if there's some sort of. compression the blood basically gets. kind of stuck in the head area and. because the blood can't flow back down. through the body what happens is there's. little tiny blood vessels they're in the. eyes they're in the skin the mouth mouth. all over the head region, they basically. get blocked up with this blood because. it can't move. And these little blood. vessels will burst which leads to these.

little hemorrhages. And um. in terms of Dawson Clansancy, what did. you examine um with Dawson Clansancy? For Dawson Clansancy, I examined the. eyes as well. >> And what were your findings? The. findings were that there was also some. acute hemorrhages in these muscle and. atapose tissue surrounding the eyes. And. then the right eye had some small small. hemorrhages in the posterior retina and.

the optic nerve sheath. So the back of. the eye there's uh the retina within the. eye and the retina connects with the. optic nerve at the back portion of the. eye. And in this case, there was a. little bit of hemorrhage at that. connection point where the retina. connects to the optic nerve. >> And and what is hemorrhage? >> Hemorrhage itself is just blood that is. no longer contained in a blood vessel. >> So it's burst from that vessel. >> Correct. >> And then in terms of kalen clansy, what. did you examine with kalen clansy?

>> For kalen clansancy, I examined the. brain, the dura, the spinal cord, and. the eyes. >> And what were your findings? The findings were that there was hypoxic. eskeemic changes. Essentially that means. that there has been some sort of. incident which has caused the brain to. have a certain period of time in which. blood and oxygen flow were not. appropriate. So in this case there was a. time frame in which there was no blood. going to the brain. There wasn't enough. oxygen going to the brain and the brain.

will show certain findings in these sort. of circumstances. Uh one of the things I. note is that there's edema. Edema is. when the brain starts to swell. Uh edema. is also a very general finding. It can. happen in many instances. But the edema. basically means that the brain starts to. swell. So you don't have the nice uh. kind of bumpy pattern on the brain. It. it starts to swell up and it gets a. little more flattened because the brain. is encased in the skull. So now it's.

pressing against the skull because it's. swelling up and getting bigger. Um, one of the other things I noted with. that was that there was compression of. ventricles. So the ventricles are almost. like a tunnel system inside the brain. that [snorts] allow for the cerebral. spinal fluid to flow through the brain. and go into the spinal cord. And when. the brain starts [snorts] to swell up, it not only swells up outwards but. swells inwards on itself as well. So. these ventricles that are located in the. inside portion of the brain are starting. to get kind of squashed because the.

brain is swelling. Uh, another thing I noted was that the. brain was diffusely fryable, meaning. that it's very soft. So, one of the. things I do on all my brain cases is. they go into formulin. The formulin. allows them to fix, which basically. firms up the tissue and it makes the. tissue more easy to manipulate. U a. brain, a fresh brain coming out of a. skull is is very soft. It's very easy to. damage it. It's very easy to put your. fingers through it if you're not. careful. So, one of the things that gets.

done is these brains will go into. formulin. I typically will let them fix. for about 2 weeks or so. And sometimes, regardless of the fixation time of the. formulin, sometimes the brain still will. not firm up the way it should because if. I'm receiving a brain and it's already. has hypoxic eskeemic changes, the. formulin is only going to penetrate the. tissue so much because the tissue is. essentially already dead. >> Can I just stop you for a second? What. is hypoxic eskeemic changes?

>> Hypoxic eskeemic changes is when you are. getting lack of blood and oxygen flow. So hypoxic is the um oxygen portion and. eskeemic is the blood portion. >> So what you saw with Kellum's brain was. consistent with a lack of blood and. oxygen. >> Correct. Yes. >> Which then led to brain death. >> Correct. Yes. Um, how long based on your. training and experience does it take for. a brain to start dying after the loss of. blood flow and oxygen? >> It varies based on different sources.

Uh, most sources say it's it's between. about 6 to 8 minutes. If there is no. oxygen flow, then the brain will. essentially start dying. It depends on, you know, if there's resuscitation that. occurs afterwards, but it's it's. generally in the frame of of 6 to 8. minutes or so. And once brain tissue. dies, it it can't be brought back. Correct. >> Correct. Yes. >> I have nothing further. Thank you. >> You're welcome.

All right. >> Come on. Call us. >> Hold on here, council. Hold on. We're. going to take a short break. All right. So, why don't we This will be a very. short break. Come out. We'll come right. back. Okay. >> All right. Close the notebooks.

Please.

There's a Mexican session. We'll be in a short recess. in the courtroom. Everybody.

Hi session, I see.

All. right, George.

This court session, please be seated. >> Your honor, for the purpose of the. record, we return back to the trial of. Commonwealth versus Lindseay Clancy. All. parties are present, including the. defendant and including the 18 jurors. >> All right. Well, members of the jury, I. I just kind of want to revisit an. instruction I've given you a couple.

times. I think uh during the course of. this trial, uh it's important to. understand and remember that uh. sometimes there's evidence that's. presented in the trial that creates an. emotional reaction. And uh but as jurors. who have taken an oath to follow the. law, I'm instructing you that the law. says you must separate any emotional. reaction on your part from uh the. informationational value and weight that. the evidence produces. Uh your verdict. in this case is going to have to be.

based solely on the evidence and it is. not going to be it cannot be based uh on. sympathy or anger or passion or. prejudice. So you've got to uh keep that. in mind. Uh and so with this we're going. to go to the next witness. Okay. >> Commer. Olsen.

>> Same finding and analysis. >> Good afternoon. You saw that the. testimony of the evidence is. >> All right. Good afternoon, doctor. >> Good afternoon. >> All right. I'm going to ask you also to. keep your voice up so the jury can hear. you uh and speak into that microphone if. you would.

>> Okay. >> Okay. All right. Miss Frank. >> Thank you, your honor. Good afternoon. Can you please state and spell your name. for the record? >> My name is Dr. Barbara Olsen. B A R B A. R A O L S O N. I previously practiced. under my maiden name, Barbara Vidal. B I. D A L. >> Can you describe for us your educational. background, please? >> I completed my undergraduate studies at. the University of New Mexico. I also. completed four years of medical school. at the University of New Mexico School. of Medicine. Afterwards, I came to.

Boston to study the field of pathology. at Beth Israel Deacon Medical Center. I. completed a 4-year residency program. there studying both anatomical pathology. and clinical pathology. And after my. residency, I did a surgical pathology. fellowship studying the gastrointestinal. tract, liver, and pancreas. And I ended. my training doing a fellowship of. forensic pathology at the Boston Office. of the Office of the Chief Medical. Examiner. I am um board certified in. anatomical pathology, clinical pathology. and forensic pathology.

>> And what is forensic pathology? >> Uh it is essentially the study of uh. causes that or diseases, disorders or. trauma that results in sudden unexpected. or non-natural deaths. >> And um do you currently work at the. office of the chief medical examiner? >> Yes, I'm a medical examiner at the Cape. Cod Office of the Office of the Chief. Medical Examiner. >> How long have you worked there? >> Since 2021. And approximately how many. autopsies have you performed? >> I have examined over 1,900 bodies and. performed over 800 autopsies.

>> And um when performing an autopsy, is. there a specific um process or procedure. that you follow? >> Um yes. So an autopsy is composed of. many parts. Um the first part being. documentation review and the second part. being the examination of the body which. is broken up into two parts. The first. part being the external examination. where I look for identifying. characteristics of a deedent such as eye. color or hair color. I also look for any.

evidence of natural disease or trauma on. the outside of the body. And the second. part is the internal examination where I. create a yl like incision on the chest. and abdomen and examine the soft. tissues, bones and organs looking for. any evidence of natural disease and. trauma. Um I [snorts] also examine uh. the brain. And did you perform an. autopsy on Kora Clansancy on January. 25th, 2023? >> Yes. And did you follow that same. process um with Cororac Clansancy? >> Yes.

>> And so that started with a document. review. Is that correct? >> Yes. >> And what type of documents are you. reviewing when you do that? >> Um typically I have a preliminary police. report to review as well as um either. EMS records or records from the. emergency department. >> And did you start with an external. examination of Kora? Yes. And what did. you observe during that external um. examination? >> The external examination of Kora, I saw. evidence of medical intervention. Uh she. was intubated, had various EKG pads and.

defibrillator pads on her body. She also. had a catheter on her right hand and. puncture sites on her left hand and her. left groin. She had uh her neck. stabilized with a cervical collar and. she had an intraosius catheter which is. a type of IV that they put directly into. the bone on her right lower leg. Her. hands at the time of my external. examination were uh covered by police. evidence bags and they were secured at. the wrist with tape. Um when I removed. those, the fingers showed no evidence of.

injury and the fingernails were all of. equal length and intact. And then I. noted evidence of trauma of the neck. with associated injuries of her head and. um minor injuries of her right arm and. of her legs as well. And um in terms of the um the injuries. um that you observed um. evidence of trauma to her neck. Were. there also um injuries to her face um.

to her face and neck area that seemed to. go along with the the trauma to her. neck? >> Yes, there were uh findings with of the. head that were associated with the. trauma of the neck. >> And what were those? Um so on her neck. uh she had a liature furrow. A liature. is an object used to apply external. force to the neck or compress the neck. And a furrow is simply the pattern of. injury that develops underneath the side. of compression. So for Kora, her liature.

furrow consisted of a linear um. horizontally oriented area of palar or. palenness around her neck with distinct. superior and inferior edges. On the. front part of her neck, the lower half. of the liature furrow was associated. with additional red abrasions ranging. from 1 to 2 millimeters in size. And on. the back of her neck, the superior and. inferior edges of the liature furrow had. developed some linear bruising as well. >> Um, and what what do you mean by a.

furrow? Um, so again, the furrow uh is a. liature is when you have external. compression by an object on the neck and. a furrow is simply a pattern of injury. that occurs beneath it. It can be an. imprint, it could be a pattern or it. could be more developed types of. injuries such as bruising or abrasions. [snorts] And what what about um. >> injuries? >> All right, council could. want me to take a break this time. All.

right. >> All right, George. Close your notebooks. Place them on the chairs, please. Wait. [crying]. >> [snorts].

>> recess for a few minutes. I got to come. back. We'll speak to council in regards. to uh schedule. >> Okay. One second.

session. Please be. >> seated. For the purpose of the record, we return back to the matter of Lindsay. All parties are present excluding the. jury. Council. >> [clears throat].

>> Yeah.

All second. Yes, I am still on earth.

>> [snorts]. >> All right.

>> [cough]. [snorts]. >> session. Please proceed.

>> For the purpose of the record, we return. back to the trial of law [clears throat]. including the defendant and the 18. jurors. >> All right, attorney. >> Thank you. [clears throat]. You had described previously the. injuries to Kora's neck. Were there also. injuries on her face that correlated um. to those marks? >> Yes. Uh on examination of her face, she. showed diffused particular hemorrhages. of the skin of the face, most. prominently around the skin of the eyes.

She showed particular hemorrhages on the. inside of her eyelids as well as the. inside of her lips. And if I could have. um photo. 2246, please. There's a remote here. Um, if you press. and hold the top button, you can. highlight what you're talking about in. the photo when it comes up. Um, what are we seeing here? Is that the.

area of the particular hemorrhage? >> Yes. In this photo, I have the lower lip. pulled down and on the inside of the. lower lip, we can see punctate. hemorrhages, which are the particular. hemorrhages. >> Okay. And if you could um Is that. working for you? >> I can see that. this area here. >> Yes. >> Okay. Um you just hold that top button. and hold it down. Um and so we can. remove that photo. Um when you talked. about hemorrhaging um in the eyes um and.

eyelids, was did it look similar to. that? >> Yes. Um, and basically it's those those. red marks all around the mouth and then. those same red marks were on the eyes um. eyelids. You tell me where they were. >> Uh, so they are pinpoint hemorrhages uh. that occur and again they were located. on the inside of the eyelids. So I. inverted the eyelids and I looked open. the inside of the lips and they were. also in those locations. And if we could have um photo of 7784.

please. If you could tell us um what injuries. we're seeing here in this photo. In this. photo we are looking uh at the body from. the left and you can see the liature. furrow in this photo. Here is the linear. area of palar with the distinct superior. and inferior edge. You can also. appreciate in this photo some small. punctate hemorrhages or the peticial. hemorrhages of the face. >> And if you could show um photo 7782.

please. What are we seeing here in terms of. injuries? >> In this photo we are looking at the. front of the neck again focused on the. liature furrow which is this distinct. area linear area of palar. And on the. front of her neck, the lower half of. this liature furrow had scattered uh red. abrasions associated with it. >> Take down the photo. Um what are. abrasions in terms of um what you do? >> Um so abrasion occurs when there is.

sufficient friction against the skin to. cause a superficial a removal of the. superficial layer of the skin. >> Is it basically a scrape? >> Yes. [snorts]. >> And can we have photo 2256 please? you can uh tell us what we're looking at. here, please. >> Uh this is a close-up photo of the back. of the neck. Here is the linear area of. PAR with the distinct superior and. inferior linear edges. You can. appreciate that the linear edges in this. photo started to develop linear.

bruising. >> And um were there other injuries on the. body other than those on the neck and. the face? >> Yes, she had injuries to her right arm. and on her legs. And if I could show you um photograph. 7789. Are you able to tell us what we're. looking at here? Um this is an uplose. photo where we can see a very small. faint bruise. Uh all of the bruises on. her legs as well as her right arm.

consisted of small scattered bruises. >> And if we could have photo 770. 7770. What are we seeing here? Uh this is an. image focused on her right leg. Here we. see three bruises on her knee and two. bruises on her left lower leg. This is. an site of medical intervention, the. intraosius catheter site where the. needle enters the bone. >> And if we could um see 7790, please.

>> What are we seeing here? >> This is a photo a close-up photo of her. left leg. Again, we can see a bruise. here as well as a bruise here on her. left lower leg. And then um the last. photo um 2233. I'm sorry, one more after that. What are. we seeing here in this photograph? >> Um in this photo, we can see the bruises. I described earlier as well as the. inside of her left ankle. We're seeing. two additional bruises. And if we could see um photograph 7794,

what is shown in this photo? >> This is a image of her left leg. Again, showing the two bruises close to her. left ankle and then additional bruises. on her left lower leg. >> And then um 7775, please. What are we seeing in this photo? This. is an image of her right arm extended. and I have the image focused on her. right bicep where there was three small.

bruises. >> And um. >> in terms of bruising um are you able to. tell the age of a bruise by looking at. it? >> No. Um can you tell whether it's a fresh. or an old bruise? Um so generally. speaking we can appreciate the color of. bruises. So red, blue, purple bruises. tend to be bruises that occur more. recently and as they heal over time they. start to take on a yellow or green. appearance. And um the bruises that you.

observed on Kora's body did um how did. they appear? Uh they all had versions of. red appearance uh to their shapes. So. because um they had red appearances that. mean um that they are fresh moons. uh. they occurred recently. >> and again [snorts] you can't tell how. they occurred or what the exact time and. date they occurred. >> Correct. >> Is there any information you can glean. from um the the location of the wounds. where some of the bruises were close.

together um like the the three on the. knee or the two on the lower right leg? >> Uh no, I can only document where they. are and their measurements. Now, um. if I may have a moment. >> Sure. >> Going back to the um injuries um on her. neck. Um what do those tell you um when.

based on your training experience um. when you're trying to determine the. cause of death? What do those wounds um. tell you? Um when I see a liature furrow. that is horizontally oriented in. association with significant particular. hemorrhages, those findings are. consistent with a liature strangulation. And what is liature strangulation? Again, a liature is an object used to. apply external force to the neck and a. strangulation is when it is done by. someone else. >> And when when that happens, what effect.

um does it have on the body? How does it. um what is the mechanism of death? Um so. uh liature strangulation uh results in a. category of asphixxial type of deaths. Asphixxia uh means that the body is. deprived of oxygen and in this case. specifically the brain. So when you have. compression on the outside of the neck. um well blood is how oxygen is delivered. to throughout our body. So the right. side of the heart delivers blood to our. lungs where during breathing and. respiration we then put oxygen into our.

blood. It then moves to the right side. of our heart and gets pushed out to our. body through blood vessels. we call. arteries. Once the oxygen is released at. its targeted site, it then recirculates. to the right side of the heart through. blood vessels called veins. And the. process uh starts all over again. It's a. continuous circulation. But when you. have compression of the neck um first. and foremost, your airways um reduce. this it's compressed. So you can have a. reduction in your ability to breathe or. complete inhibition in your ability to. breathe. When you have compressions of.

the veins of the neck, there's no the. blood cannot drain from the head. And so. then the blood actually has a backwards. flow of pressure that meets the arterial. blood and that results in an increase of. blood pressure within the blood vessels. as well as an overall increase in. intraraanial pressure. And with the. compression of the artery, there's no. oxygenated blood being delivered to the. brain. And as this blood is gathering um. in the face and head area, um is that. kind of um causing the same type of.

pressure as a balloon filling up? Um yes. or like a water pipe as well. Okay. >> And what happens as that blood um pulls. in and causes that pressure in the face. and the head? >> Um what normally happens is uh first and. foremost the brain just has a reduced uh. ability to take in oxygen and in the. smallest vessels in the face and brain. such as capillaries or venules they are. subject to rupture. And as that pressure is building in.

those um veins and are are rupturing, is. that painful? >> Um so uh just like our blood vessels run. throughout all of our body, there are. nerves throughout all of our body as. well. And so there is a component of. pain present until loss of consciousness. occurs. >> And um how long can it take or does it. take for loss of consciousness to. happen? >> Um I cannot put a specific time on it uh. for the interval. There is m multiple. variables to consider in a case- by case.

basis. The type of liature used, the. force of the ligature uh used against. the neck as well as the intensity and. duration of the altercation. Um, however, in situations where there's. complete oxygen deprivation, loss of. consciousness can occur as early as 10. to 30 seconds with uh brain damage. beginning at the 1 minute mark and. irreversible brain damage and uh. subsequent death occurring around as. early as 5 minutes. Again, with the. caveat that there are variables that.

might accelerate or decelerate that time. frame. >> Is is there a type of constant pressure. that's required to cause that loss of. consciousness? Um I ultimately the once. the brain has a critically low level of. oxygen a loss of consciousness will. occur. Um it takes an average of 4 lbs. to compress the veins of the neck and an. average of around 10 lbs to compress the. arteries of the neck. And so if. someone's um squeezing something or. pulling something around the neck at.

that four pounds or 10 pounds of. pressure in a consistent basis without. any resistance, does unconsciousness. happen faster? >> Um it could occur faster. Yes. What if. someone's resisting or struggling or. pulling away? Could that take longer? [clears throat] Uh when the body is in a. state of stress, uh you have a stress. response that demands an actual increase. in oxygen utilization by our body. So in. the presence of an increased demand with. a decreased amount being delivered to. the brain, it can accelerate the.

timeline to loss of consciousness. >> What do you mean by accelerate the time. to loss of consciousness? >> What she means? >> No, overall you can ask. >> Uh it would just make it occur faster. >> And so if if that pressure isn't. constant, um say someone struggles and. is able to get free a little bit and. then you have to tighten it again, does. that make it take longer? >> Sustained. Sustained. You said anywhere from 5 to 30 seconds. What are the factors? I'm sorry, you. said 10 to 30 seconds. Is that correct?

>> Uh yes, for loss of consciousness. >> What are the factors that are at play. for whether it's 10 seconds or 30. seconds? >> Uh again, there's multiple variables. So. the the the force of the liature against. the neck, the actual liature itself, and. the intensity and duration of the. altercation. >> And once someone loses consciousness, do. they immediately die? >> Um no. So, uh, if there's no. intervention, the brain continues to. have a lock lack of oxygen. And so, until the brain cells start to die, there it's irreversible injury to the. brain, um, the person is alive until um,

the body can no longer sustain the lack. of oxygen. >> If someone is strangled to the point of. unconsciousness and the strangulation. stops, can they wake up. >> without intervention? Is very unlikely. So, do you recall testifying previously. that when asked um if a person were to. use a liature around someone's neck to. the point where they pass out? >> Council we we we've we've had that. answer, right?

>> It's an inconsistent statement. >> This is your witness. >> I know. And I can impeach with an. inconsistent statement. >> I see sidebar.

Doctor, do you have to continue to apply. to strangle someone past the 30 seconds. to cause death? >> Uh, no. Once the brain is subject to.

oxygen deprivation and brain cells start. to die, um, there it's irreversible and. so it will continue to progress towards. death if there is no intervention. What. do you mean by intervention? >> Um resuscitative efforts if somebody. tried to give CPR. it would be your opinion that pressure. would be continually applied even after. losing consciousness to cause death. >> Sustain. >> Uh if.

>> hold on sustain. Next question. So your testimony is that you can. strangle someone for 30 seconds, let go. and then they die. >> Uh I said that in this presence of uh. complete oxygen deprivation there is a. general time frame and so 30 seconds I. cannot give a specific number to that. Once strangulation occurs again the. brain starts to be subjected to a lack. of oxygen. So whether the ligature is.

present or whether the ligature is not. present those the oxygen deprivation and. irreversible brain damage is already. occurring. >> and there's no coming back from that. >> Um not without intervention. It's very. unlikely again the brain um cannot heal. those cells. >> Did you form an opinion to a reasonable. degree of professional certainty medical. certainty as the cause of death of Kora? >> Yes. >> And what was that? esphixia. >> and um was that by um manual.

strangulation? >> Oh, by strangulation. >> Mechanical strangulation, I mean. >> Yes. Um. did you also examine or do an autopsy on. Dawson Clansancy? >> Yes. >> And when was that? >> January 25th. >> And did you observe um injuries on. Dawson Clancy when you did the external. examination? I did observe injuries to. Dawson. Uh he had trauma to his neck.

with associated injuries of the head as. well as minor injuries to his left arm. and his legs. And if we could uh pull up photo 2166. What are we seeing in this photo? >> This photo is uh a picture of the lower.

lip of Dawson being pulled down. And we. can see again similar to Kora, these. peticial hemorrhages on the inside of. the mouth. >> And can you also see them on the eyes in. this photo? >> Uh you can see perorbital peticial. hemorrhages. So the skin around the eye. >> And were there also um those same type. of hemorrhages when you lifted the. eyelid? >> Yes. And if we could have um photo 2149. What are we seeing here? Um Dawson on.

his neck similar to Kora had a linear. horizontally oriented liature furrow. consisting of a area of pour around the. neck. He had distinct superior and. inferior edges uh to his furrow as well. This is on the back side of the neck. where we can also appreciate abrasions. that are in line or parallel with the. inferior and superior edges of the. furrow. >> And if we could have photo 2147 please. >> What are we seeing in this photograph?

>> Uh in this photograph we can appreciate. the distinct uh area of palar here on. the neck again representing the liature. furrow with diffused peticial. hemorrhages of the skin of the face. And. what are we seeing there on his. shoulder? >> Uh, this is just some dried body fluid. >> And if we could um see photo 2151, please. What is depicted in this photograph? Uh.

this is a similar photograph to the one. just se shown here where you can see the. distinct area of palar representing the. liature furrow with superior inferior. edges and again the diffused peticial. hemorrhages of the face. >> And these photos of um Dawson's face the. the hemorrhaging on the face um appear. to be darker than those and more. expansive than those on Kora's face. Correct. >> They appear more prominent in Dawson. than in Kora. Yes. Um and what can cause. um the damage being more prominent um.

and more um dispersed over the face? >> Um again, particular hemorrhages occur. as a result of rupturing of small. vessels in the skin. And so the fact. that there are more present in Dawson is. indicative that there were moments where. some blood did reach um or push through. the furrow or the ligature um in little. spikes or peaks which would just result. in momentary uh increases in blood. pressure that would result in more. particular hemorrhages. >> And what would cause that blood being.

able to flow? >> Um any movement against uh the corateed. arteries. The corateed arteries are. thicker and more muscular than the. veins. So they're more likely to push. through with the blood. Um so that could. be movement of the liature or movement. of um the person handling the liature or. movement of Dawson himself. >> So could it could be um from Dawson. struggling or it could be from more. pressure or force of the liature. >> Uh yes, changes in the pressure of the. liature. >> And if I could see uh photo 2143, please.

>> What are we seeing in this photo? Um, this is the back of his left forearm. Um, it is a little uh pale with the. light, but there were um three small. bruises on the back of his left forearm. And um. going to photo 2155. >> What are we seeing in this photo? >> Uh this is a picture of us. Uh so at. this point position, Dawson is face.

down. So, we're looking at the side of. his right leg, and we can see a small. faint bruise here. And then going to photo 2144. What are we seeing in this photograph? >> Um, this is an up close photograph, but. I can appreciate that there are small. bruises in the uh center of the image. >> And photograph 2156, what are we seeing in this photograph?

Um, in this photograph, we're looking at. the back of the legs. The one closest to. us is the left leg. The one farthest. from us is the right. You can see. bruises here, here, and here, as well as. the inside of the right knee. And so, when you said here, here, and here, that. was the outer portion of the. >> of the left upper leg. >> Thank you. We could have um photo 2119, please. What is depicted in this photograph? >> Uh, this is an up close photo of his. hands. And um is there any significance.

to the um the blessness of the. fingernails? >> Um I would not have called these uh. necessarily blue or cyanotic. Um that. would be more of the discoloration of. his face. There is some subtle bless uh. to the nail beds which is again a sign. of cyanosis which is just reflective of. a decrease in oxygen in the body. >> And the last photo um is the PDF please. >> What are we seeing here? Uh this image. uh Dawson is face up and we can see his.

left right and left legs. Here on his. right lower leg we see small bruises. On. his right knee we're seeing or left knee. we are seeing a bruise. And here is a. site of medical intervention the. intraosius catheter site. >> And um what are you able to tell us. about the bruises on Dawson in terms of. whether they're fresh or old? Uh they. were all red and purple in appearance. So they were more recent.

And based on your examination um of. Dawson, were you able to uh determine a. cause of death? Yes. And um did you uh. determine that to a reasonable degree of. medical certainty? Yes. And what was. that? asphixia.

>> Your honor, I'd move to submit um the. original photos of Cora and Dawson um as. for identification and the other the. ones that were just shown to the jury as. exhibits. >> So mark the first set for identification. and. >> O for identification. All right. Then over the defense objection.

um. using the same analysis as stated. sidebar um those other photographs may. be admitted. >> The photos of Cora and then Dawson as. the next exhibits please.

And then. excuse [clears throat] me certificate of. Kora Marie Clancy yesterday's exhibit. >> that may be admitted. >> and the death certificate of Dawson. William as the next. I have nothing further. Thank you. >> Nothing. >> All right. Thank you, Dr. May. Step. down. >> Thank you, honor.

>> All right, members of the jury, we're going to uh. break at this time. I'm going to ask you. to come back tomorrow um at 9:00. Uh, I. would expect the schedule. similar to what we had today. I'm going. to remind you again, don't talk about. this case. Don't read about this case. Don't read about any similar cases. Uh,

don't watch anything. Don't do any. research. Put this out of your head. tomorrow morning. All right? And I'll. see everybody tomorrow morning. Thank. you so much. >> All right. Please.

[snorts]. in session council. >> Anything we need to address before. tomorrow morning? >> No, thank you. So, we'll be in recess on. this matter until uh tomorrow at 9:00. Thank you.