Did POTS Really Cause Mackenzie Shirilla’s Fatal Crash?

Did POTS contribute to Mackenzie. Shirilla crashing a car that killed. Dominic Russo and Davion Flanagan? We're. going through the text messages with. Shirilla to see if we can find any. evidence of this condition and what the. courts had to say about this supposed. diagnosis. [music] Welcome to Sidebar. presented by Law & Crime. I'm Jesse. Weber. You know, as I was recording this. episode, I looked at the data. I was. like, "Oh my gosh, Father's Day is. around the corner. Where did the time.

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Shirilla case. The case that has. captured the national attention, the. case that has blown up on social media, the case that everybody has been talking. about, the case that we have been. focusing a lot here on Sidebar. But I. want to explore POTS a little bit more. That is something we haven't taken the. time to do. And I want to explore it. because it was the defense that she put. forward. So I want to explore it in the. text messages between Shirilla. I want. to explore how it was put forward in the. trial because at the end of the day the.

convicted murderer has claimed that it. was this condition that contributed to. the crash when she drove a car a 100. miles per hour into a wall killing her. two passengers, her boyfriend Dominic. Russo and his friend Davion Flanagan. This is back on July 31st, 2022. Chrillo. was found guilty by a judge in a bench. trial of four counts of murder, four. counts of felonious assault, two counts. of aggravated vehicular homicide, one. count of drug possession and one count.

of possessing criminal tools. >> She had a mission and she executed it. with precision. The mission was death. McKenzie alone decided to push the pedal. to the floor and demand the ultimate. speed of that vehicle to 90 to 100 miles. per hour. She alone decided what was to be. McKenzie decided death was the ultimate. goal that day. And she alone made that decision for. Dominic and Davion and she continuously. acted in a manner to achieve her.

purpose. >> Yeah, the evidence showed she held that. accelerator down that she never tried to. brake. Chrillo though has insisted ever. since then she doesn't remember what. happened. She didn't remember the crash. She didn't remember what led up to it. She and her family have suggested that. this is POTS that POTS this medical. condition that can cause dizziness and. fainting that contributed to what. happened that she may have blacked out. Now a trial and we're going to talk. about this more, there was no official.

medical diagnosis that was presented by. her team. No medical expert took the. stand. There was also no evidence of the. car malfunctioning. There was no. presentation of a severe intoxication. So the evidence that was presented was. essentially or at least by the. prosecution that she did this purposely. And after her 2023 trial where she was. convicted, she was sentenced to life in. prison with the possibility of parole. starting in 2037. And now she's in the. news a lot because of the Netflix. documentary The Crash where she said.

she's not a monster. There was no intent. behind this crash, that she loved Dom. One of the things she said in the. documentary was quote, "The most logical. speculation seems to be a medical. emergency." But when she was asked, "Okay, so how do you maintain control. over the car if you're suffering this. medical emergency, right? There's no. breaking." She responds, "I'm unsure. because I have no recollection of that. morning, but I know nothing about it was. intentional because that's not in my. character." I want to explore that a.

little bit. I want to explore is there. anything there? Now in a little bit I'm going to bring. on Dr. Daniel Bober forensic. psychiatrist to analyze this. My. understanding is he has actually treated. patients with POTS. So when you hear. what Sherilla has claimed, does it match. up? Okay? But first I want to do. something different. I want to go. through the text messages from Sherilla. to Sherilla where. it's interesting. I was trying to find. we were trying to find messages that are. about POTS. I mean to be clear, we went.

through all these messages, we couldn't. find anything specifically about POTS. per se, but there are mentions of. medical issues here. And is she. describing POTS? And we're going to get. to this later, but you listen to the. dates of these exchanges in relation to. the July 31st, 2022 crash. And for. example, McKenzie's mother Natalie would. testify. We're going to talk more about. this as well, but she would testify that. McKenzie was diagnosed with POTS in.

2017. And yet again, as far as we could see, there don't seem to be messages. specifically describing this, but the. symptoms that McKenzie does seem to. describe. is this POTS? So let me give you an. example what I mean. From Shirilla, July 2nd, 2022, so this. is just weeks before the crash, quote, "The one I just had was probably the. worst blackout like pain level I've had. I'm scared it's just going to get.

worse." Now, Dom writes to Shirilla on. July 2nd, 2022, "But you can take. vitamins that will help blood flow.". Also, another message from Dom, "What. I'm saying is your blood vessel aren't. working right to get enough blood to. your brain. That's why you black out.". Also from Dom, "Main causes of blackouts. is blood flow. Let's try getting you. vitamins that support that." Shirilla. responds at one point, "So, are you. saying I'm vitamin deficient or.

something I don't even know?" Dom. replies, "No.". Now, here's the thing. These blackout. conversations were actually happening. well before the crash. I'm talking years. before. Look this from February 8th, 2020. Shirilla writes, "I had a really. bad blackout today, FR." Dom writes, "How? What happened?" Shirilla, "IDK, meaning I don't even know. I straight. passed out.". And there's a lot of conversations about. tests, which is interesting considering.

her mom would claim that she was. diagnosed in 2017, but you go to 2021, for example, June 25th, 2021, Dom. writes, "When did you start feeling like. s? Is it cuz you haven't ate?" Shirilla. responds, "Pretty much my back just. started burning like super bad." April. 29th, 2021, Shirilla writes, "Do you. know how many times I've taken a test. for them to tell me it's nothing?". February 9th, 2021, "It's hard to do. anything when your stomach is in. constant pain." February 18th, 2021,

Shirilla again writes, "I've taken every. test in the book. No one cares about my. pain. I don't even think anyone believes. it." February 8th, 2021, "If you me you. were in pain no matter what the bleep it. was, I would be with you right by your. side, ready to lay with you and do. whatever you need. I guess you can't. match that though. Again, this is. Shrilla writing. March 18th, 2021. Shrilla writes, "Sorry, babe. I had you just fall. asleep. I literally couldn't even walk.

around. My back was in so much pain.". February 18th, 2021. Shrilla writes, "Everyone acts like I just want to curl. up in a ball with a heating pad all. day." Dom writes, "Are there better. doctors that you can see?" Shrilla. responds, "No doctors is going to be. able to help.". June 25th, 2021. Shrilla writes, "Then. it got really bad and literally nothing. was making the pain go away and then all. of a sudden I just threw up.". March 3rd, 2022. Shrilla writes, "They.

trying to put me on anxiety meds. Like, what the bleep?" March 3rd, 2022. The. doctor is telling me weed is bad for me. Now, I'm going to talk more about these. text messages and I want to get Dr. Bober's perspective on this to analyze. what he makes of it and whether or not. she is describing the conditions of. POTS. But, I want to go to the court for a. second. I want to go to the appellate. court, how they looked at what happened. at the trial level, at the trial. regarding POTS and whether Mackenzie. Shrilla's conviction should be.

overturned. Remember, she appealed them. So, this is from the appellate court and. they write in their opinion, quote, "Shrilla contends that the weight of the. evidence establishes that Shrilla and. Russo's relationship was in a good place. at the time of the fatal crash. Burlinghouse and Raja saw them shortly. before the crash and did not report. anything out of the ordinary. Others who. knew Shrilla and Russo, Grolao, Shipley, Shrilla's mother, also. testified that the two seemed to be in. love. Shrilla points out that her POTS.

condition may have led to a medical. issue that caused the accident or she. may have had some other medical. emergency like a heart attack or. seizure. Sherilla posited that the crash. could have been caused by distracted. driving or simple recklessness contrary. to the testimony of Detective Hazell. that Sherilla often drove distracted or. recklessly according to her social. media. She argues that in light of all. these possible other explanations, the. manifest weight of the evidence weighs. against the verdicts. Esther Sang testified that she is.

employed as a trauma surgeon at. MetroHealth Medical Center. The parties. stipulated that Dr. Sang is an expert in. the field of trauma medicine. Sherilla. was examined on July 31st, 2022 after. the crash. According to medical records, Sherilla reported pain, {quote}. everywhere. An exam determined that her. airway was intact, her breathing and. circulation were normal, and her pupils. were reacting normally. She was alert. and oriented. Sherilla's mother informed medical. personnel that Sherilla had a history of.

POTS, which can cause a patient to have. an unusually elevated heart rate. Medical personnel did not note any. cardiovascular, neurological, joint, or. muscle symptoms. No symptoms related to. sleep disturbances, anxiety, memory. loss, disorientation, inattention, or. depression were noted, and. electrocardiogram, which was performed, revealed that the electrical function of. Sherilla's heart was normal. On. cross-examination, presumably by the. defense, Dr. Sang admitted that a blood.

oxygen level of 82 would be abnormally. low for most people. Dr. Sang further. admitted that a patient with POTS may. experience dizziness or headache. Medical personnel evaluated Sherilla. approximately 2 hours after the reported. time of the crash. A person who has. suffered a seizure or a mini stroke. could possibly have recovered within 2. hours. So, namely meaning, hey, there's. a reason that when she was evaluated, it. didn't look like she had POTS or didn't. suffer from POTS, but maybe there's an.

explanation for that. Court goes on to say, "With respect to. Sherilla's physical health, Natalie, again, this is uh Sherilla's mother who. testified, has seen Sherilla suffer. symptoms from POTS at least twice. Natalie described her understanding that. the condition can cause low blood. pressure and an increased heart rate and. can cause someone to lose consciousness. On cross-examination, Natalie testified. that Sherilla was diagnosed with POTS in. 2017 at the Cleveland Clinic. Natalie. could not remember the name of the. doctor who made the diagnosis. Natalie.

took Sherilla to the doctor after. Sherilla fell to the kitchen floor on. one occasion. The doctors made the. diagnosis and gave Sherilla salt tabs to. treat the condition. Sherilla would take the tablets or eat a. salty food, {quote} as needed. Since the. diagnosis, there have been a couple. occasions where Sherilla would feel. herself feeling low in salt or woozy and. would sit down and eat some crackers or. another salty food. Natalie admitted. that she helped Sherilla apply for a. driver's license twice since the POTS. diagnosis was made and neither time.

disclosed the condition. Natalie. testified that Sherilla had experienced. a POTS episode a week or two before the. crash and reported that it was really. bad and it hadn't been that bad in a. long time and she was scared it was. going to get worse. Natalie admitted. that she did not take Sherilla to a. doctor or limit Sherilla's driving. privileges. While Dr. Sang testified. that it is possible that Sherilla could. have suffered a medical emergency like a. seizure or mini stroke while still.

appearing normal in the medical. examination, other evidence makes this. potential explanation seem unreasonable. For example, Sherilla denied having. adverse medical conditions when applying. for a driver's license both before and. after the crash. Moreover, someone. manually moved the gear shift back into. drive after it was moved to neutral in. the seconds before the crash. There was. no evidence presented that any medical. condition could have caused Shirilla to.

simultaneously lose the ability to take. her foot off the accelerator or hit the. brakes while also intentionally. manipulating the gearshift. A distracted. driving incident is also not consistent. with the forensic evidence which shows. that Shirilla never took her foot off. the accelerator even as the car hit a. curb, went airborne, landed, and. continued toward a brick wall. Shirilla. argued her case to the trial court and. the court was permitted to reject any. portion of the state's evidence or. witness testimony that was inconsistent.

or otherwise unbelievable. We cannot say. that this is the exceptional case in. which the evidence weighs heavily. against the court's verdicts. Okay, like I said, now I want to bring. on Dr. Daniel Boba, forensic. psychiatrist, to talk about this. Thank. you so much for taking the time, sir. Let's start here. What exactly is POTS? What are the symptoms of POTS? >> So, POTS is postural orthostatic. tachycardia syndrome. And this is essentially a syndrome where. when you stand up, your heart rate.

increases, but your blood pressure does. not change. And the symptoms of POTS can. be light-headedness, tremulousness, fatigue, and actually passing out or. fainting is somewhat uncommon. So, normally you don't see that. >> So, the idea of blacking out, fainting, not remembering what happened, you're. telling me uncommon in your experience. if someone has POTS or because it's POTS.

because of POTS. >> So, very often POTS will co-occur with. something called vasovagal syncope, where syncope, which is a transient loss. of consciousness, does occur, and they do pass out. What's interesting. about this case is that in true POTS, passing out is not a common thing to. occur, and it's even less common in. someone who is recumbent or sitting down. as they would be when they're driving a. car. Normally, you expect to see POTS.

symptoms in someone who is standing up. >> I'm so glad you mentioned that because. that was the part that I for the past. few weeks I've been trying to. understand. Like, I understand that when. I've been researching POTS, it's it's a. lot about if you're standing up or in a. position, you're walking. But, sitting down in a car. Now, let's. play devil's advocate for a second cuz I. was I was always wondering. I was like, how can it be effective if you're. sitting there, you're not. If someone's in a heated argument or. they're angry. and they're sitting and driving, could. there be an episode of severe POTS where.

there is a complication and someone does. get dizzy or someone does get. light-headed or someone does black out. driving in some sort of argument? Just playing devil's advocate. >> It's possible, but it's not probable, okay? You would have to have that occur at. precisely. the right time or the right moment, okay? And you wouldn't have purposeful. movement. You couldn't steer a car.

You couldn't accelerate or decelerate. You couldn't, you know, turn on an. angle. So, if you're truly passed out. and you've lost consciousness, uh you wouldn't be able to engage in. these purposeful motor activities that. she supposedly did. >> Let me ask you this. Is it possible? Is it possible someone. can have a POTS episode and they really. don't have a memory? They they they. don't have a memory of what happened? >> If someone had a syncopal episode and. they blacked out, it is possible during.

a blackout to lose your memory. >> How do you treat people with POTS, by. the way? >> So, you there's different medications. that you use. For example, one of them. is called midodrine. to try to treat it symptomatically, but. the pathophysiology of POTS is very. complicated. It involves the immune. system, the cardiac system, the nervous. system. It's a very difficult thing to. treat. And as a psychiatrist, what I can. tell you is is that POTS frequently is. comorbid with other conditions like.

depression, like anxiety, like. somatization syndrome. And what. somatization is is essentially it's a. physical expression of psychological. distress. So, people with POTS. frequently do have. psychiatric symptoms. And interestingly. enough, females are affected five times. the rate as males are. >> And that's interesting when you think. about Mackenzie Shirilla, right? There. have been. a conversation of. you know, was she trying to kill herself.

during this episode? Was she, you know, anxious? Was she depressed? You know, I mentioned earlier what her. mother had testified to or spoke about. that she took Shirilla to the doctor, that she had been diagnosed by the. Cleveland Clinic in 2017 as having POTS, that the doctors gave her. salt tabs to treat the condition and to. eat salty food as needed. Does that make. sense to you? >> Well, certainly that would raise your.

blood volume and that might be one of. the things that would protect you. against having these POTS symptoms. But I think unfortunately for her, she. wasn't really a very sympathetic figure. based on some of her behavior after the. crime. And I think in some ways she has. become emblematic of the older. generation looking at the younger. generation who has you know, essentially. lived their lives through social media. And I think they interpreted a lot of. her behavior.

as having a lack of remorse. So, I do. think there's a generational divide here. in how older people view it and how. people in the Gen Z generation view it. >> There There no doubt that the evidence. against her was also not just about the. accelerator and the gear shift and the. way that the car was positioned and how. it hit the wall. It was also evidence. about yes, how she behaved afterwards. you know, showing this lack of remorse. So that's what the prosecutor said and. also there was evidence that she was. staking out that road beforehand, right? It was the idea of planning it. So there.

was a a lot here. Going back to the. messages and I went through that earlier. where she writes about having stomach. pain and she writes about having back. pain according to her very very severe. uh severe. Is that consistent with. somebody who has POTS? >> That is the somatization we talked. about. Uh people who have physical. symptoms that are often an indicator of. psychological distress. That could be. somatization. >> So in other words, if I'm understanding. correctly, it's not outside the realm of.

possibility that she might have had POTS. coupled with other conditions, but it. would be unlikely, very improbable that. that was the the contributory factor for. the crash at that moment in time. Just. want to make sure I'm understanding it. correctly. >> Yes. Yes, that's correct. Now, obviously. the appeal now is not based on guilt or. innocence, it's based on things that are. procedural. Uh was there ineffective assistance of. counsel? If POTS was in fact at play. here, did her defense counsel have an.

obligation to put on a medical expert to. bring up records, uh maybe to speak with. her treating physician who was treating. her for the POTS? These are all things. that I think the parents would argue. should have been done. >> Do you think it was interesting they. didn't call a medical expert? >> I do uh and I think it makes me think. that at this point sort of throw. anything against the wall and see what. sticks. It doesn't mean necessarily that. POTS was not a factor here, uh but I do.

think it's curious that that was never. presented as a defense strategy from. from. >> And again, unless someone could write. me, say, you missed this Jessie, I went. through messages, um, and I didn't see. text messages. from Sherilla to Sherilla. May Again, correct me if I'm wrong, let me know. Where over the years she specifically. addresses POTS. And if I'm right about. that, is that strange? Because again, you have this kind of testimony about. her being diagnosed with it.

But at the same time, um, you know, in her conversations about the. pain she's experiencing, doesn't mention. it. Is that strange to you? Or maybe is. it possible she didn't know she had it? >> It's strange to me, and also these are. things I would want to know. How often. did she see this doctor that was. treating her POTS? What was the. frequency of her visits? What did those. records say about how active her. symptoms were, or how frequently they. occurred, or to what degree they. impaired her life functioning? These are.

all important questions, but you know, let's not forget here. that this defendant is 17 years old, and. it was the Supreme Court in Roper v. Simmons that recognized the relative. immaturity. and reduced culpability of people in. this age group. And it doesn't mean she. wasn't responsible, and it doesn't mean. she shouldn't be punished, uh, but there. are, as what the Supreme Court said, evolving standards of decency, and the. recognition of the fact that people in. this age group sometimes act without.

thinking, sometimes act without weight. weighing the future consequences of. their actions. And so, I think we also. have to look at it through that through. that lens, uh, as much as the behavior. after the crime was off-putting to. people. >> And just real quick, before I let you. go, I don't know if you saw what she had. to say. in the documentary, or how she behaved. during the trial. Um, I know you haven't. had an opportunity to interview her. yourself, but. something stand out to you about her her.

the way she, uh, acts? Uh, what what do. you take away from it? >> Well, again, right? It's all how you. tell the story. Uh if, you know, if you. and I looked at it, we might find that. behavior is callous, lacking remorse, cold, uh that she was unaffected by her. actions. Uh but in that generation, who. really does live their life uh on social. media and spends an average of 3 to 4. hours a day doing it, uh that might be. just business as usual. So, it really. depends on how you interpret it, uh but.

I do think that uh she didn't do herself. any favors uh by behaving that way uh. given the implications of what she did. >> Dr. Daniel Bober, thanks for coming on, giving your thoughts. As always, appreciate it. >> Thanks, Jesse. >> And that's all we have for you right now. here on Sidebar, everybody. Thank you so. much for joining us. And as always, please subscribe on YouTube, Apple. Podcast, Spotify, wherever you should. get your podcast. You can also check us. out on NBC's Peacock as well. If you. want to follow me, X, Instagram, my. NewsNation show, Jesse Weber Live, Monday through Friday, 11:00 p.m.

Eastern. I'll see you [music] next time, everybody.