Trial Day 12

Summary

Podcast Summary: Full Trial Audio – Lindsay Clancy Triple Murder

Episode: Trial Day 12
Date: August 12, 2026
Podcast: Full Trial Audio
Host: Full Trial Audio

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Overview

Trial Day 12 in the case of Commonwealth vs. Lindsay Clancy offers a detailed exploration of key evidence, witness testimonies, and critical forensic findings. The episode focuses on the continuing presentation of the Commonwealth’s case, particularly through testimony from law enforcement officers, mental health professionals, and forensic pathologists. Central topics include police procedures post-incident, Lindsay Clancy's treatment and mental health history, and the forensic evidence regarding the deaths of her three children. The proceedings are marked by meticulous questioning, cross-examinations, and in-depth analysis of both the psychological and physical circumstances surrounding the tragedy.

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Key Discussion Points & Insights

1. Court Proceedings and Case Status

• The trial session opens with procedural formalities, including confirming all parties' attendance and reminding jurors of their responsibilities (00:06–02:39).
• Judge Selvich outlines the trial schedule and sets expectations for the day.

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2. Testimony: Sergeant Dan Lawler (Massachusetts State Police)

Initial Response and Evidence Collection

• Lawler details his arrival at South Shore Hospital on the night of the incident, where Lindsay Clancy was admitted (03:00–13:37).

• Observed Clancy in the emergency department, intubated, surrounded by medical equipment, and with visible injuries (05:18–05:44).

• Collected and documented key evidence: Clancy’s clothing (tank top, jeans, bra—all cut by hospital staff) and jewelry, all of which showed bloodstains or were related to her immediate post-incident status (07:43–08:58).

  “She was unable to speak. She had medical equipment attached to her person … There was staining [on the clothing].” – Sgt. Lawler (05:29–08:04)

Crime Scene and Home Search

• Lawler described police procedures for searching the Clancy home at 47 Summer Street in Duxbury, including execution of a search warrant and preservation of the crime scene (10:23–12:37).

• Evidence collected from the home included pill bottles (trazodone, diazepam, amitriptyline, among others), personal electronics, and security equipment.

  “So the house would have been frozen pending the search warrant being signed. Once it's signed, we begin the execution. … Crime scene would document the residence inside and outside before we would go in.” – Sgt. Lawler (10:33–10:47)

Police Procedures During Hospital Watch

• Lawler clarified logistics and legalities of hospital watch over Clancy, describing the presence of law enforcement and limited visitor access.

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3. Mental Health Care Testimony: Leticia Dukes (Perinatal Mental Health Counselor)

Professional Background and Care Approach

• Licensed counselor specializing in perinatal mental health, previously at South Shore Hospital’s Perinatal Clinic (48:16–50:10).
• Explained standard intake/assessment processes, therapy modalities, crisis assessment tools, and collaboration with other medical professionals.

Lindsay Clancy’s Mental Health History and Treatment

• Dukes met Clancy for an in-person intake on December 2, 2022, due to postpartum depression/anxiety symptoms (56:05–61:10).

• Clancy consistently reported anxiety, insomnia, passive suicidal ideation (no plan), and expressed significant concern over medication side effects/addiction (58:22–66:54).

• Sleep issues and lack of energy dominated Clancy’s complaints; she described feeling “numb,” “unable to laugh,” and disconnected from her social circle (63:03, 99:56).

  “Her presenting concerns were anxiety, lack of sleep, depression symptoms, frequent passive suicidal ideation, thoughts of wanting to die and no longer be here.” – Leticia Dukes (58:22)

Therapy Progression & Recommendations

• Dukes recommended outpatient therapy, intensive outpatient/partial hospitalization, and weekly follow-ups (67:45–68:32).

• Noted Clancy’s willingness to receive help, participate in therapy, and follow recommendations (106:53).

• Detailed Clancy’s repeated attempts to access crisis resources—two contacts with Aspire Crisis—and efforts to enter partial hospitalization programs (PH, Women and Infants, Norwell) (110:26–112:43).

• On final encounters (Dec 19), Clancy was reported as slightly more engaged, able to laugh/smile, but still struggled with mood and numbness (83:31–83:59, 132:11–132:19).

  "She appeared to be help looking for help, right? ... She appeared to be hurting, right? ... Turning in every direction she could for help, right?" – Attorney Reddington (124:31–124:40; Leticia Dukes: "Correct.")

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4. Testimony: Cameron Daley (Duxbury Police Patrolman)

• Daley assigned to hospital watch over Clancy at Brigham and Women’s on Jan 25, 2023 (135:54–138:28).
• Observed Clancy asleep, with medical equipment; no visitors except medical staff; confirmed strict law enforcement supervision during custody.

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5. Testimony: Nicole Bradley (Assistant Deputy Superintendent, Plymouth County Sheriff’s Dept.)

• Described hospital watch procedures and meticulous recordkeeping during Clancy’s hospital stay (141:53–143:14).

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6. Forensic Testimony: Dr. Renee Stonebridge (Director of Cardiac and Neuropathology, Commonwealth of MA) & Dr. Barbara Vidal Olson (Forensic Pathologist)

Neuropathological Findings – Dr. Stonebridge

• Conducted examinations of Clancy children’s brains, eyes, and other tissues (147:00–153:33).

• Found hemorrhages in eye tissues consistent with asphyxial (strangulation) deaths in Cora and Dawson.

• Callan’s brain showed hypoxic-ischemic injury—consistent with prolonged lack of oxygen, leading to irreversible brain death (150:48–153:33).

  “There was acute hemorrhage of the extraocular muscles and adipose tissue ... given the entirety of the case ... consistent with something asphyxial.” – Dr. Stonebridge (147:12–148:49)

Forensic Pathology Autopsies – Dr. Olson

• Performed autopsies on both Cora and Dawson Clancy.

• Detailed injuries: distinct ligature furrows on necks, petechial hemorrhaging on faces, eyelids, and lips—all classic findings in manual/ligature strangulation (159:08–163:30).

• Bruising on extremities indicated additional trauma during the assaults (166:03–167:56).

  “When I see a ligature burrow that is horizontally oriented in association with significant petechial hemorrhages, those findings are consistent with a ligature strangulation.” – Dr. Olsen (169:25)

• Mechanism of death: asphyxia by ligature strangulation, with loss of consciousness possible in as little as 10–30 seconds, irreversible brain injury in ~5 minutes without intervention (172:10–174:31).

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Notable Quotes & Memorable Moments

On the crime scene and evidence:

• “She was in the emergency room. Would you agree with me that she was pretty well, she had intubation tube in her mouth, she had tape on her face. She had her arms all taped up and wires and tubes and everything else, right?”
  – Attorney Reddington to Sgt. Lawler, (21:20–21:32)

On mental health and patient honesty:

• “One of the things that you would be interested in when you're interacting with a patient ... is how honest they are, right? Especially in psychiatry. You want to make sure that the person is not lying to you or hiding something.”
  – Attorney Reddington to Leticia Dukes (91:22–91:44)

On postpartum mental illness:

• “Would you agree that 10 to 15% of women develop more significant symptoms of depression or anxiety?”
  – Attorney Reddington (116:59–117:09; Leticia Dukes agrees)

On the nature of the wounds and the manner of death:

• “Ligature strangulation results in a category of asphyxial type of death. ... Once the brain has a critically low level of oxygen, a loss of consciousness will occur.”
  – Dr. Olson (169:45–173:12)

Juror Instruction:

• “The verdict in this case ... cannot be based on sympathy or anger or passion or prejudice—you must separate any emotional reaction from the informational value and weight that the evidence produces.”
  – Judge Selvich (155:06)

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Key Timestamps

• 00:06–02:39 – Opening schedule and jury instructions
• 03:00–13:37 – Sgt. Lawler on hospital response/evidence
• 13:37–41:13 – Sgt. Lawler on crime scene, custody, and cross-examination
• 48:16–84:10 – Testimony of Leticia Dukes: mental health evaluation, Clancy’s therapy
• 90:03–135:04 – Cross-examination and redirect of Leticia Dukes, focus on diagnostic subtleties
• 135:31–138:28 – Testimony: Cameron Daley, Duxbury Police (hospital watch)
• 141:53–143:30 – Testimony: Nicole Bradley, Sheriff’s Dept. (hospital watch records)
• 144:01–153:33 – Forensic testimony: Dr. Stonebridge (neuropathology)
• 157:20–184:18 – Forensic testimony: Dr. Olson (autopsies, mechanism of death)

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Conclusion

Trial Day 12 is a pivotal day in the Commonwealth v. Lindsay Clancy trial, featuring extensive foundational testimony that establishes the chain-of-custody of evidence, Clancy’s history of severe postpartum mental illness, attempts at treatment, and the unequivocal forensic findings supporting the prosecution’s theory of asphyxial death by strangulation. Through the voices of officers, clinicians, and pathologists, the day dramatizes both the human tragedy and the rigor of legal inquiry.

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Transcript

[Attorney Reddington]

Full trial, audio.

[Attorney Buckingham]

Everything hurting court.

[Court Clerk]

No silences to skip.

[Attorney Reddington]

This court is now in session. Please be seated.

[Court Bailiff]

Good morning, your honor. May I proceed?

[Judge Selvich]

Yes, please.

[Court Bailiff]

Trying to. Before the court, we have the matter of commonwealth for us is Lindsay Clancy. Ms. Clancy is present. She is represented by attorney Kevin Reddington. And the commonwealth is represented by assistant district attorney Jennifer Sprague and assistant district attorney Shannon Buckingham.

[Judge Selvich]

All right, well, good morning, everyone, and good morning, counsel.

[Attorney Reddington]

Morning.

[Judge Selvich]

Good morning, Ms. Clancy. All right, so before we get going, let me talk to counsel about today's schedule and kind of where we go. So if I could see everybody's sidebar, please. So step to the jury at this point.

[Attorney Reddington]

All rise. Jurors entering

[Judge Selvich]

all verses, having anything to do before the honorable William Selvich, justice

[Attorney Reddington]

of the superior court, now sitting in Plymouth within and for the Cornwall draw near.

[Judge Selvich]

Give your attendance, and you shall be heard.

[Attorney Reddington]

God save the Cornwall of Massachusetts.

[Judge Selvich]

This court is now in session.

[Attorney Reddington]

Please be seated.

[Court Bailiff]

Good morning, your honor. May I proceed?

[Judge Selvich]

Yes, please.

[Court Bailiff]

Your honor, before the court today, we have the continuation of the jury trial in the matter of Commonwealth versus Lindsay Clancy. Ms. Clancy is present. She is represented by attorney Kevin Reddington. The commonwealth is represented by assistant district attorney Jennifer Sprague and assistant district attorney Shannon Buckingham.

[Judge Selvich]

All right, well, thank you, madam clerk. Good morning, everyone. What I'm going to do, as you know, going to ask you those questions to make sure everybody was able to follow my instructions, and then at that point, we'll talk a little bit about today's schedule. All right, so we'll get to the questions. First question. Is 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? Last question. Is there any other serious matter of concern bearing on your service as a juror in this case that anybody needs to bring to my attention?

[Leticia Dukes]

All right, great.

[Judge Selvich]

Thank you for following those instructions. Today we're going to continue with the commonwealth presentation evidence. The anticipation is that we will go probably similar to what we had the last couple of days into the afternoon. All right. And then after that, before I send you home, I'll talk again with council in regards to the schedule for the rest of the week and kind of where we are. All right, so I'll. When you leave here today, you probably have a little bit better idea as the schedule for the rest of the week and into next week.

[Leticia Dukes]

Thank you.

[Judge Selvich]

All right, so. And so with that, I think we'll return to the commonwealth case. Attorney Buckingham

[Attorney Buckingham]

lawler to the stand.

[Court Bailiff]

All right.

[Attorney Reddington]

Good morning, sir.

[Judge Selvich]

All right, council, thank you.

[Attorney Buckingham]

Good morning.

[Sergeant Dan Lawler]

Good morning, ma'.

[Judge Selvich]

Am.

[Attorney Buckingham]

Could you please tell the jurors your first and last name?

[Sergeant Dan Lawler]

Yes. First name is Dan. Last name is Lawler. And where are you employed with the Massachusetts State Police?

[Attorney Buckingham]

What's your rank with the State Police?

[Sergeant Dan Lawler]

Sergeant.

[Attorney Buckingham]

And how long have you worked for the State Police?

[Sergeant Dan Lawler]

Nine years.

[Attorney Buckingham]

At some point did you work in an assignment with the Plymouth County District Attorney's office as part of the State Police Detectives Unit?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And how long were you with The Plymouth County DA's office?

[Sergeant Dan Lawler]

State Police detectives unit from March 2021 until June 2025.

[Attorney Buckingham]

I'm going to draw your attention back to January of 2023. Do you recall going out or responding to an incident that occurred in Duxbury?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And that was the incident occurred at 47 Summer street in Duxbury?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And you're aware that that involved the death investigation where two children had been declared deceased and at the time the there was another child that was being treated at the hospital?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

What were you asked to do or what was the first thing you did in relation to this investigation?

[Sergeant Dan Lawler]

I responded to the South Shore Hospital in Weymouth.

[Attorney Buckingham]

And why did you go there?

[Sergeant Dan Lawler]

I was advised by my supervisor to respond.

[Attorney Buckingham]

Okay. And were you aware that a woman by the name of Lindsey Clancy had been transported there to South Shore Hospital?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And when you arrived at South Shore Hospital, was a Duxbury Police detective already on scene?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And do you recall who that was?

[Sergeant Dan Lawler]

Detective Matthew.

[Attorney Buckingham]

Now, when you, meaning the State Police Detectives Unit, are involved in an investigation, is it common that you would utilize the services of the Crime Scene Services section of the State Police?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And the Crime Scene Response Unit?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And in this case, did members of those two units respond as well to the South Shore Hospital at the time that you were there?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

Do you recall who from the crime scene services and the response unit responded?

[Sergeant Dan Lawler]

Chemist Maureen Hartnett and Trooper Roast offers.

[Attorney Buckingham]

Did you have the occasion to observe Lindsey Clancy at the South Shore Hospital?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And she was in the emergency department, correct?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And was she able to speak or was she intubated?

[Sergeant Dan Lawler]

She was unable to speak.

[Attorney Buckingham]

Did you observe her to have medical equipment and being treated while you were there?

[Sergeant Dan Lawler]

She had medical equipment attached to her person?

[Attorney Reddington]

Yes.

[Attorney Buckingham]

And did you observe her to have injuries, visible injuries?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

At the South Shore Hospital, in addition to know speaking to Detective Mafio and assessing Lindsey Clancy, did you do or serve anything on the hospital themselves?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

What did you do? A preservation notice what is a preservation notice?

[Sergeant Dan Lawler]

The preservation notice is to preserve defendant's urine and blood.

[Attorney Buckingham]

And you provide that to staff at the hospital to ensure that the blood is saved unless and until a warrant is obtained for that material.

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And in addition to serving the preservation order, did you collect some items that were removed from medical staff that were on Lindsey Clancy, the defendant?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

What did you collect or what did they provide you?

[Sergeant Dan Lawler]

It was her clothing and wedding ring and wedding band.

[Attorney Buckingham]

If I may approach the way.

[Judge Selvich]

Thanks.

[Attorney Reddington]

Well, she's putting her gloves on. I have no objection to any of this.

[Judge Selvich]

Okay.

[Leticia Dukes]

All right.

[Attorney Buckingham]

As far as sergeant Lawler, as far as the items collected when they're received from the hospital staff, what do you guys do with them?

[Sergeant Dan Lawler]

So it goes originally went to the Tata Mafia from Duxbury pleading. Then it went to me, and then it was documented by trooper staffers. And then some of it will go to the office or we'll go out to the crime lab. In this case, went to the crime lab.

[Attorney Buckingham]

Okay. But as the state police trooper on scene, the investigator on scene, you at some point retain custody of the item?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And I'm just showing you a paper bag. Is that familiar to you?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And is this the bags that generally the detectives unit or crime scene uses to put particular pieces of evidence inside of it?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

Since I just struggled to put the gloves on, I'm just going to show you the end, if that's okay. Showing you one item, is that familiar to you?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

What do you know this item to be?

[Sergeant Dan Lawler]

Not a shirt.

[Attorney Buckingham]

Is it a piece of clothing that you obtained from the hospital?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

Does it appear to be a woman's tank top?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And are you able to observe some staining on the front, looking close?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And again, it's cut down the middle.

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

This is how it was received from the hospital?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

I would move Tomita tank top.

[Judge Selvich]

All right. That may be admitted.

[Attorney Buckingham]

Showing you another item, is that familiar to you?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And what are these?

[Sergeant Dan Lawler]

Jeans.

[Attorney Buckingham]

And these were also cut off the defendant and received by the medical staff at social hospital?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And on these jeans you see a little bit of staining on the front?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

I would move to admit these as the next exhibit.

[Judge Selvich]

That may be admitted. Thank you.

[Attorney Buckingham]

Just join one more item. Is that familiar to you?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

Appears to be a woman's bra, correct?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

Cut down the middle?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And it has some staining in the front, in the middle where the cuts are?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And is this an item that was collected that was on Lindsey Clancy's body on January 24, 2023?

[Sergeant Dan Lawler]

Yes.

[Judge Selvich]

That may be admitted. Thank you.

[Attorney Buckingham]

You indicated there was also some rings that were collected, correct?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And eventually they these items taken by forensic scientist Hartnett, and eventually they get returned to the State Police detectives unit. In your experience, is that fair to say?

[Sergeant Dan Lawler]

Fair, sir.

[Attorney Buckingham]

Now, in addition to going to the south shore Hospital on January 24, 2023, did you go to any other hospitals?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

Which hospital did you go to?

[Sergeant Dan Lawler]

Boston Children's Hospital.

[Attorney Buckingham]

And why did you go there?

[Sergeant Dan Lawler]

I was advised to go there by my supervisor.

[Attorney Buckingham]

Okay. And did you learn that one of the children, Callan Clancy, had been transported to the Boston Children's Hospital?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And were you there to just obtain what his current status was at that time?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And the time that you were there at the Boston Children's on January 24, fair to say he was still alive but noted to be in critical condition?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

Now, 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 Duxbury?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And in your time with the State Police detectives unit and during that time In January of 2023, how did you guys approach the execution of a search warrant?

[Sergeant Dan Lawler]

So the house would have been frozen pending the search warrant being signed. Once it's signed, we begin the execution. And crime scene would document the the residents inside and outside before we would go in.

[Attorney Buckingham]

Okay, so when crime scene goes in and they document, you're familiar, they use photographs and video, right?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And once they've gone through and documented the scene as it was secured, do you, as part of the detective unit team, then go in the house to begin search?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And fair to say there are a lot of hands on deck during the something like this.

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And in this instance, the detectives unit was searching the entire home at 47 Summer street, including three floors, basement, first floor, second floor, as well as any vehicles that were on the property?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And in addition to people or troopers with the detectors unit, were there other local law enforcement also assisting?

[Attorney Reddington]

Yes.

[Attorney Buckingham]

And what was your role that night or that morning in the execution of the warrant?

[Sergeant Dan Lawler]

I was the evidence officer.

[Attorney Buckingham]

And what does that mean?

[Sergeant Dan Lawler]

I document evidence that is located by investigators during the search warrant.

[Attorney Buckingham]

And so at that time period, when you're executing a search warrant and searching a place like a home, is the information that you know at that point what guides the search?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

So you don't know what you're looking for unless you know what happened, Right?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

So in this circumstance, fair to say, the State police had limited information about what had actually transpired in that house.

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

But each and every room was searched, to your knowledge?

[Sergeant Dan Lawler]

To my knowledge, yes.

[Attorney Buckingham]

And your role was just to document items that were going to be collected and return to the state police detectives

[Sergeant Dan Lawler]

unit to document items that would be collected and either go back to the state police detectives unit or to the crime lab.

[Attorney Buckingham]

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[Court Reporter]

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[Attorney Reddington]

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[Attorney Buckingham]

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[Court Reporter]

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[Attorney Buckingham]

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[Attorney Buckingham]

And fair to say, when 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?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

So in this particular warrant execution, did you engage in the search?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And you said you documented what other members of the group see found and located where they located it, Correct?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And so you as the evidence officer, were aware that Trooper Rabbit located some prescription pill bottles in the kitchen that that morning, Correct?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And so as the evidence officer, were you responsible for kind of keeping custody of those bottles?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

At some later point after those bottles were photographed and collected, did you inventory those bottles?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

I'll just show you what's been marked as Exhibit 155. If I may approach the witness. Just a second. Just showing you this bag here. It's already been marked exhibit 155. I'm going to show you four for take a look at them. Do they look familiar to you?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

So the first one I'm looking at is labeled Trazodone. And as far as how you inventory these, what do you do when you inventory them?

[Sergeant Dan Lawler]

Just count them.

[Attorney Buckingham]

Okay. So you also review the information on the label as to what should be in the bottle or what the original prescription was?

[Judge Selvich]

Yes.

[Attorney Buckingham]

So as far as the Trazodone says, filled on January 12, 2023 with 30 in it. And so you counted to determine how Many were left, right?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And so fair to say there were 20 remaining in this bottle when you inventoried it?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

The diazepam, 5 milligrams, date filled January 9th of 2023 with 14 as the quantity, you counted what was in this bottle?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And there's two and a half left in there?

[Court Bailiff]

Correct.

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And diazepam, 2 milligrams, date filled January 16, 2023, it has three listed on there, right? In type?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

There appears to be like a pink mark through it.

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

Did you put that pink mark on there?

[Sergeant Dan Lawler]

No.

[Attorney Buckingham]

Would that have been there when the bottle was seized?

[Sergeant Dan Lawler]

It could have been.

[Attorney Buckingham]

Okay. But regardless of how many it says we're supposed to were, the quantity, you counted how many were actually in this bottle?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And fair to say there were nine and a half remaining in that bottle?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And the Last 1, Amitriptyline, 10 milligrams, it says date filled January 16, 2023, quantity 30. And you counted how many were left in this bottle as well?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And there were 22 in this bottle?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And you documented that as this was put into evidence in the state police?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

Did you search in the upstairs master bedroom of the house during the search warrant?

[Sergeant Dan Lawler]

Yes, I assisted with the search.

[Attorney Buckingham]

Did you locate anything that you documented or collected to take back to the state police?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

In the master bedroom?

[Sergeant Dan Lawler]

Yes.

[Court Reporter]

Okay.

[Attorney Buckingham]

What did you locate?

[Sergeant Dan Lawler]

I believe it was a baby monitor and a Google Nest camera.

[Attorney Buckingham]

Okay. Did you observe the room, the master bedroom?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And did you search in a nightstand that was next to the bed?

[Sergeant Dan Lawler]

I don't recall searching. On a nightstand next to the bed.

[Attorney Buckingham]

Were there other investigators that were also in the room searching other areas of the bedroom?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And as far as any additional work you did on this particular investigation, again, fair to say the detective unit works as a team and divides up work for follow up?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And you participated in some follow up investigation by speaking to some witnesses?

[Court Bailiff]

Correct.

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And at some point you were also asked to go to the Brigham and Women's Hospital where the defendant was following the sheriff's department, keeping watch of her?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

You recall what day you went there?

[Sergeant Dan Lawler]

I don't recall the exact date.

[Attorney Buckingham]

Okay. When you went to the Brigham and Women's Hospital, was she in her own room or was she in, like, an open area?

[Sergeant Dan Lawler]

She was in her own. Her own room.

[Attorney Buckingham]

When you were there on watch, did you go into the room or were you outside the room?

[Sergeant Dan Lawler]

Outside the room.

[Attorney Buckingham]

And 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 another individual come in to visit with her or meet with her?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And were you advised that that person was coming in?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And were you advised that that person was allowed in with a court order?

[Attorney Reddington]

Yes.

[Attorney Buckingham]

When the person went in, did you know if it was an attorney, a doctor, somebody else?

[Sergeant Dan Lawler]

It was not an attorney, wasn't a doctor. It was, believe, a psychiatrist.

[Attorney Buckingham]

And when that person went into the room, did you go in the room as well?

[Sergeant Dan Lawler]

No.

[Attorney Buckingham]

And where did you. Where did you stay?

[Sergeant Dan Lawler]

Outside the room.

[Attorney Buckingham]

And when this man went into the room, did he leave the door open or close the door?

[Sergeant Dan Lawler]

I believe it was closed.

[Attorney Buckingham]

And when he came out, did he speak with you?

[Sergeant Dan Lawler]

I don't recall.

[Attorney Buckingham]

Okay, but as far as you knew at that time period, that person was permitted to be in there and could close the door?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And you don't know what was said or what was done in that room?

[Judge Selvich]

No.

[Attorney Reddington]

Thank you, Ms. Rankin. So your position was as a sergeant for the state police on these dates you testified to?

[Sergeant Dan Lawler]

No, sir. At the time, I was a trooper.

[Attorney Reddington]

Trooper?

[Sergeant Dan Lawler]

Yes, sir.

[Attorney Reddington]

You assigned to the District Attorney's office?

[Sergeant Dan Lawler]

Yes, sir.

[Attorney Reddington]

It'll be the Plymouth County DA's office. Meaning these prosecutors here, right?

[Sergeant Dan Lawler]

Correct, sir.

[Attorney Reddington]

Actually, you have an office in their office, right?

[Sergeant Dan Lawler]

Correct, sir.

[Attorney Reddington]

You have to call me sir. So the first time you got involved with this case was on the evening of. Of. Was it the 24th or 23rd?

[Sergeant Dan Lawler]

Tuesday? I think it was the 24th.

[Judge Selvich]

Okay.

[Attorney Reddington]

And do you recall what time it

[Sergeant Dan Lawler]

was that you went there to the South Shore Hospital?

[Attorney Reddington]

Yes, I'm sorry.

[Sergeant Dan Lawler]

Approximately 7:30pm now, at that point, you

[Attorney Reddington]

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?

[Sergeant Dan Lawler]

Correct.

[Attorney Reddington]

The media was absolutely insane all over the location of the house and in the hospitals and everywhere, isn't that right?

[Sergeant Dan Lawler]

I recall media at the house. I'm not sure about the hospital stuff.

[Leticia Dukes]

Okay.

[Attorney Reddington]

It was a fairly horrific and largely attended to, if you will, eventually, is that correct?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And Lindsey was, when you went to the South Shore Hospital, that's where you saw her before she was transferred to the Brigham and Women's, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

When you went in to see her at the South Shore Hospital, she was in the emergency room, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

Would you agree with me that she was pretty well, she had the intubation tube in her mouth, she had tape on her face. She had her arms all taped up and wires and tubes and everything else, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And it was a very confusing and quite frankly, shocking sight to walk into that room and see her there in that condition, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And you, about your duty, collected clothing in her wedding band, correct?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And you went through all that with the items you seized, and you introduced those into evidence and noted what the government said appears to be stains, but it was blood on her clothing, it that, right?

[Sergeant Dan Lawler]

I would say, yeah.

[Attorney Reddington]

In your experience?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

Any shoes? Did she have any shoes, sneakers, slippers, anything like that?

[Sergeant Dan Lawler]

I don't recall shoes. I think two black socks, but I don't recall shoes.

[Attorney Reddington]

Right. If there were shoes on her person or brought to the hospital, the odds are that when they saved the clothing, they would have saved the shoes as well, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

So you took the clothing and then you went to the Boston Children's Hospital, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

Then after you left the Boston Children's Hospital, you went back to the house and then assisted in the search of the property with a search warrant?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And were you the lead investigator at that point, or were you one of the guys just searching?

[Sergeant Dan Lawler]

I was not the lead investigator, but

[Attorney Reddington]

there was a court order. Search warrant, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

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?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

I don't have to grab this and ask if you saw this. You never did see that, did you?

[Sergeant Dan Lawler]

I did not recall seeing that, sir.

[Attorney Reddington]

You don't know what, if anything, was inside that item, right?

[Sergeant Dan Lawler]

I don't know.

[Attorney Reddington]

And council asked you whether or not it's a collaborative effort on the part of the detective units and that you all collaborate and work together. Can you explain that? Do you report to each other? Do you keep each other advised as to what you get for evidence?

[Attorney Buckingham]

We the ones still showing up holding

[Court Reporter]

hands when times are done.

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[Attorney Buckingham]

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[Sergeant Dan Lawler]

Yep. So when we go into a house, we're not familiar with the layout. We'll walk the house and figure out where veterans are located, and then essentially you kind of just break up into teams, if you will, and search the residents 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.

[Attorney Reddington]

Okay, and you videotape the scene and you take photographs of the areas, the different rooms, right?

[Sergeant Dan Lawler]

I do not, but a crime scene does.

[Attorney Reddington]

But you were in the house and you were able to observe the rooms. You could see. See all sorts of wall hangings and paintings and fingerprints and handprints and all that stuff on the wall, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

Downstairs, 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?

[Sergeant Dan Lawler]

I don't recall the exact layout of the basement.

[Attorney Reddington]

Do you remember that items were seized from the basement, like a Mac Pro laptop, something like. I have right here, two of them that were seized. Remember that?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And from your investigation, you're aware that those would have been Pat Clancy's laptops, His business and personal laptop, Correct.

[Sergeant Dan Lawler]

At the time, I'm not sure who the laptops belong to, but I know they were collected.

[Attorney Reddington]

Okay, and how about Lindsey Clancy's? Her cell phone, was that seized? If you know.

[Sergeant Dan Lawler]

I believe that was seized from the master bedroom.

[Attorney Reddington]

In the master bedroom. And was. Do you remember, was it located on the bed?

[Judge Selvich]

Bed.

[Sergeant Dan Lawler]

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.

[Attorney Reddington]

All right, so both of those phones, regardless which one was what. Did either one of them have blood on them?

[Sergeant Dan Lawler]

I don't recall.

[Attorney Reddington]

But if. If. If you guys were seizing the items in the property, such as the cell phone that had blood on it, and you're. You probably would have remembered that, right?

[Sergeant Dan Lawler]

Correct.

[Attorney Reddington]

And you don't remember that?

[Sergeant Dan Lawler]

I don't.

[Attorney Reddington]

Okay. 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 there?

[Sergeant Dan Lawler]

I recall blood on the floor by the mirror and then blood on the floor going towards that back right window.

[Attorney Reddington]

Okay. At no time did you ever come across or discover a. What do you call it? Apple Watch, right?

[Sergeant Dan Lawler]

No, sir.

[Attorney Reddington]

And after you all concluded your search of.

[Judge Selvich]

Of the.

[Attorney Reddington]

The home. And how long did that take? A couple of hours,

[Sergeant Dan Lawler]

probably. I don't recall the exact time.

[Attorney Reddington]

We concluded the next thing you did was to go to the Brigham and Women's Hospital.

[Sergeant Dan Lawler]

Is that right after the search warrant? I don't recall exactly what I did after the search warrant, but at some point I did go to the Brigham.

[Attorney Reddington]

Okay, can you tell us when you went to the Brigham?

[Sergeant Dan Lawler]

I don't recall the exact date. I was.

[Attorney Reddington]

So whatever date you went to the Brigham, you went there for what purpose?

[Sergeant Dan Lawler]

She would transfer to that facility, and it was to maintain custody of her at that point.

[Attorney Reddington]

So you were going to maintain custody of her.

[Sergeant Dan Lawler]

So the sheriffs, I believed, had custody of her. And then our unit was tasked to facilitate, providing coverage over the next couple of days.

[Attorney Reddington]

Right. And she was actually in the bed with all, again, tubes and all sorts of things coming out of her body when you saw her, right?

[Sergeant Dan Lawler]

Yeah, she was in the hospital bed

[Attorney Reddington]

and she was in a. In like an emergency room. It was a little small room with a lot of machines in it that took up a lot of space. Right.

[Sergeant Dan Lawler]

I don't think she was in the emergency room. She was in one of the floors,

[Attorney Reddington]

one of the floor rooms. But it was an intensive care unit, Right.

[Sergeant Dan Lawler]

I believe it could have been the surgical intensive care unit.

[Attorney Reddington]

Surgical intensive care. And when you went there to facilitate custody, who were you facilitating custody for? The DA's office?

[Sergeant Dan Lawler]

Yes, essentially.

[Attorney Reddington]

Okay. And whatever. 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 Duxbury. Do you recall how long it was before you went to the hospital to maintain custody? Facilitate.

[Sergeant Dan Lawler]

I don't recall how many days. Maybe two or three. I'm not sure the exact count.

[Attorney Reddington]

All right, so she had been transferred out of South Shore Hospital. She was transferred to Brigham and 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, your dad.

[Judge Selvich]

Right.

[Sergeant Dan Lawler]

At some point, yeah. We were probably assisted with security to get there, right?

[Court Reporter]

Correct.

[Attorney Reddington]

And this went on for day after day after day, to your knowledge, facilitating, right?

[Sergeant Dan Lawler]

Correct.

[Attorney Reddington]

Her parents couldn't get in to see her, correct?

[Sergeant Dan Lawler]

I don't believe so.

[Attorney Reddington]

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?

[Sergeant Dan Lawler]

I'm not aware of that difficulty.

[Attorney Reddington]

I had to get a court order to get a doctor in there to see her, didn't they?

[Sergeant Dan Lawler]

Yes, it was a court order.

[Attorney Reddington]

And when I got the court order, a doctor came in and. And met with Lindsay pursuant to that judge's order. And that was Paul Zyzel, correct?

[Sergeant Dan Lawler]

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.

[Attorney Reddington]

Okay. Because. Only. Because in your direct, you said that he was not a doctor, but he was a psychiatrist. So, I mean, it's just you. You knew that he had something to do with head doctor, psychiatrist, psychologist, something like that?

[Judge Selvich]

Correct.

[Attorney Reddington]

Okay. Did he have to clear it with you to get into the room?

[Sergeant Dan Lawler]

He checked in with myself and the other trooper. We were advised that he was coming and to let him in on the court order.

[Attorney Reddington]

All right, Now, I wasn't there on that occasion, right?

[Sergeant Dan Lawler]

No.

[Attorney Reddington]

And when Dr. Zeisella, whoever it was, went, went into the room to see her, it's your memory that he was allowed to shut the door, Is that correct?

[Sergeant Dan Lawler]

I believe he shut the door.

[Attorney Reddington]

Now, you were involved. You were involved in this investigation pretty intensely, working with the DA's office, right?

[Sergeant Dan Lawler]

Correct.

[Attorney Reddington]

Isn't it fair to say that one of the contentions of the district attorneys is that Paul Zeisel, my doctor, that I got a court order to get in to see her, told her to call Pat and tell him that she heard voices.

[Leticia Dukes]

Objection.

[Judge Selvich]

Can I see Council Sybar in regards to this? All right, so members of the jury, like I said to you, I think a couple weeks ago, sometimes I got to talk to the lawyers for a little bit longer 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 just for a couple of minutes, I think, then we'll bring you right back in, and we'll resume with the testimony. Okay.

[Attorney Reddington]

Court. All right. Good.

[Judge Selvich]

Session.

[Attorney Buckingham]

Please be seated.

[Judge Selvich]

All right, so council, 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, we will just conduct a short of wadir on the issue that we talked about over at sidebar. So I'll allow Mr. Reddington to ask questions at this point, and then I'll allow Commonwealth to also ask questions. Go ahead, counsel.

[Attorney Reddington]

Thank you. So you're in the hospital at Brigham and Women's, correct?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And when you're there, with the purpose of, obviously, with other laws, our officers who enforce the fact that she's in custody, Dr. Zeisel, or a doctor, came in pursuant to a court order, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

All right. And obviously had been cleared through security and went into the room where Lindsey was laying on the bed, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

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?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

Okay. Would you agree with me that in the course of preparing this case for trial that you have worked and collaborated with the prosecutors, the two district attorneys, correct?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And. 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?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And one of the theories that they had indicated to you is that Patrick Clancy had indicated to the investigators and to the grand jury, I believe, that Lindsey called him from the hospital.

[Sergeant Dan Lawler]

Right, I recall that.

[Attorney Reddington]

And that Lindsay used that doctor's cell phone to call him from the hospital, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And they basically had a theory that they wanted to run with that Zyzel told her. Lindsay to say that she heard voices, Right?

[Sergeant Dan Lawler]

I don't know if it's a theory or not. I just recall that conversation at some point.

[Attorney Reddington]

Okay, so when was the conversation?

[Sergeant Dan Lawler]

I don't recall. Jaffe 1.

[Attorney Reddington]

You remember where. You remember where the conversation was?

[Sergeant Dan Lawler]

No.

[Court Bailiff]

You don't?

[Attorney Reddington]

Okay.

[Sergeant Dan Lawler]

I'm assuming at the office. I just don't recall specifically.

[Attorney Reddington]

And who was it you were talking to?

[Sergeant Dan Lawler]

Probably could have been one of the troopers in the office working the case.

[Attorney Reddington]

One of the trooper, is it McGilligan?

[Sergeant Dan Lawler]

Probably. He's the case officer, so I'd imagine it probably wouldn't win him, sir.

[Attorney Reddington]

Probably could have been him. How about any of the prosecutors you Talked to the DAs about that?

[Sergeant Dan Lawler]

I don't recall specifically speaking to a prosecutor about this.

[Attorney Reddington]

Well, how about not. Not necessarily specifically, but do you have any memory of talking to the prosecutor about, quote, this? End quote.

[Sergeant Dan Lawler]

No.

[Attorney Reddington]

So what is it that your memory is that the trooper, whoever it may have been, or the investigator for the state police may have been? What did that person tell you?

[Sergeant Dan Lawler]

That at some point, all beautiful through

[Attorney Buckingham]

all of us Hands in the dirt hearts in the dust let's be the people yeah we enough to build again from the broken trust we the ones

[Court Reporter]

still showing up holding hands when times are tough you and me yeah, we're

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[Sergeant Dan Lawler]

When Lindsey was in the hospital with the doctor and the court order that she made a phone call to Patrick, and they discussed circumstances of the case, and then he was interviewed later on and communicated this phone call to, I believe, Trooper McKellagan.

[Attorney Reddington]

And what did McElligher tell you about the conversation? What the theory or the understanding was that that.

[Sergeant Dan Lawler]

That during the conversation, Lindsey communicated to Patrick that she had heard voices in her head.

[Attorney Reddington]

And there was also the conversation regarding the psychologist is basically the one that planted that idea in her head. Right.

[Sergeant Dan Lawler]

The conversation between Trooper Kelligan and I. Yeah, I don't recall that specifically. I just recall the facts that the facts are communicated to me that there was a phone call between Lindsey and Patrick.

[Attorney Reddington]

Okay, you already said that. I know, and I apologize. I don't mean to cut you off, but let's cut to the chase.

[Sergeant Dan Lawler]

Yeah.

[Attorney Reddington]

What I'm asking you are voices. You know what that means when someone hears voices, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

You may not hear voices, I may not hear voices, but some people might hear voices, right?

[Sergeant Dan Lawler]

Yeah.

[Attorney Reddington]

That was discussed with McElligan, wasn't it?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And what is it that he discussed with you about Lindsey hearing voices?

[Sergeant Dan Lawler]

That. That's what she had told Patrick on the phone call, that she heard voices.

[Attorney Reddington]

And when she told Patrick that she heard that on the phone call, the prosecution determined that it was Zell or whoever that doctor was. You don't recall that told her to say that for some type of a defense, right?

[Sergeant Dan Lawler]

I don't know what the prosecution determined. All I can say that's what I recall. The conversation between Lindsay and Patrick.

[Attorney Reddington]

Okay. The voices, the voice.

[Sergeant Dan Lawler]

Yeah.

[Attorney Reddington]

And the conversation also included the fact that it was the psychologist that planted that idea in her mind. That's the theory, isn't it?

[Sergeant Dan Lawler]

That would be the theory, but I don't recall having.

[Attorney Buckingham]

Wait, wait.

[Attorney Reddington]

Your answer is that would be the theory, Right?

[Sergeant Dan Lawler]

Correct.

[Attorney Reddington]

Okay.

[Sergeant Dan Lawler]

Agreeing with you that that's what was discussed.

[Attorney Reddington]

All right. And this would be you and is it McElligan, McKelligan, McKelligan?

[Sergeant Dan Lawler]

Yes, sir.

[Attorney Reddington]

And you're unable to assist us, though, with any of the detail. You do recall that there was a conversation about that, Correct. And in the conversation, it was about the conversation that Lindsey had with her husband indicating about voices, right?

[Judge Selvich]

Correct.

[Attorney Reddington]

Using the psychologist's cell phone, right?

[Sergeant Dan Lawler]

Correct.

[Attorney Reddington]

And there was an indication that the psychologist told her to basically say that you just told us.

[Court Bailiff]

Yes.

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

Okay. That's all I have.

[Judge Selvich]

Attorney Buckingham,

[Attorney Buckingham]

Sergeant Lawler, at the time that you were at The Brigham Hospital. And at the time the doctor came in, you didn't know anything about a theory of the case, correct?

[Sergeant Dan Lawler]

No.

[Attorney Buckingham]

And you didn't know or overhear anything in outside that room about conversations between the doctor and the defendant, did you?

[Sergeant Dan Lawler]

Corrected.

[Attorney Buckingham]

And you indicated that you never had a conversation with the prosecution about their theory of the case, did you?

[Sergeant Dan Lawler]

Did not.

[Attorney Buckingham]

So anything that you recall was simply conversation with another trooper in the unit.

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

And as you sit here in your testimony today and testify about your memory of that particular night, is anything about that conversation with Sergeant McElligan guiding your testimony?

[Sergeant Dan Lawler]

No.

[Attorney Buckingham]

You changed, or has your memory changed as to that incident after you had this conversation with Trooper McElligan, with Sergeant McAlligan. And in fact, you don't know anything about whether there's any evidence about Dr. Zeisel giving or prompting the defendant to have that conversation with her husband, do you?

[Sergeant Dan Lawler]

No.

[Attorney Buckingham]

All you know factually is what came out of the investigation from what Patrick said the call was and who he said the call was from and how the call occurred, correct?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

Thank you.

[Attorney Reddington]

So, yeah, please. So basically my contention is that you're obviously up here testifying as honestly as you can. It's pretty apparent, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And you're very consistent 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, McElligan.

[Judge Selvich]

Right?

[Attorney Buckingham]

Right.

[Attorney Reddington]

You're trying to tell us what your memory is, right?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

So your testimony pertains to your conversation with the lead investigator, McElligan. 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?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

Okay. That's all they have. All right.

[Judge Selvich]

All right, why don't we do this? I'm going to take about a 10 minute break at this point and we'll come back out and we will resume cross examination. Okay. Court. All right.

[Attorney Reddington]

All right, please.

[Court Bailiff]

For the purpose of the record, we return back to the matter, Commonwealth versus Lindsay Clancy. All parties are present, excluding the jury.

[Judge Selvich]

All right, Council, I see you sidebar. Court.

[Attorney Reddington]

All right, ju is entering. This court's now a session. Please be seated.

[Court Bailiff]

All parties are present, including the defendant and including the 18 jurors.

[Judge Selvich]

All right, members of the jury, thanks for your patience. We're able to deal with that issue. And so we're going to return now to the cross examination. We're still going to take a morning break, as I 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. So with that, we're going to return to the cross examination.

[Attorney Reddington]

Mr. Rank. So, Sergeant Lawler, we're at the point where you are assisting, if you will, in the custody of Lindsey at Brigham and Women's Hospital, when you observed a doctor enter into that area and ultimately into her room. Is that correct?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

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?

[Sergeant Dan Lawler]

No.

[Attorney Reddington]

And then when the doctor finished talking with Lindsey, 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?

[Sergeant Dan Lawler]

I later learned that, yes.

[Attorney Reddington]

And you later learned 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, and then she talked on the phone, correct?

[Court Reporter]

Correct.

[Attorney Reddington]

And after that, 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 see any reports or anything that would indicate what, if anything, was said between Dr. Zeisel and Lindsey in that room, right?

[Judge Selvich]

Correct.

[Attorney Reddington]

And who is sergeant, is it it? McElligan.

[Sergeant Dan Lawler]

Sergeant McElligan, yes, sir.

[Attorney Reddington]

And Sergeant McElligan, Joshua?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

He's the lead investigator in this case, is that correct?

[Sergeant Dan Lawler]

Correct.

[Attorney Reddington]

And at the time, he was a sergeant and you were a trooper, right?

[Sergeant Dan Lawler]

At the time, we were both troopers.

[Attorney Reddington]

Oh, both troopers. Okay. So you both got promoted, and. And he, as the lead investigator, told you in a conversation, or perhaps more than one, that the government theory is that Dr. Zyzal told Lindsey to say to her husband that she heard voices.

[Court Bailiff]

Right.

[Judge Selvich]

If you could rephrase that.

[Attorney Reddington]

Okay. Did you talk to McDulligan about the theory that Dr. Zeisel is the reason that she told her husband that she heard voices?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And do you remember where or when that conversation occurred, or how many times that you guys discussed that?

[Sergeant Dan Lawler]

I believe it would have been at the office. I don't recall exactly when.

[Attorney Reddington]

Okay. And there's no investigator basis for that? That's McElligan speculation, is that correct?

[Sergeant Dan Lawler]

Correct.

[Attorney Reddington]

When you went there and you Observed Lindsey after the doctor left. She's still obviously in the bed because she's paralyzed, right?

[Dr. Renee Stonebridge]

Correct.

[Sergeant Dan Lawler]

She's still in the bed.

[Attorney Reddington]

Was she restrained by either soft restraints or handcuffs or whatever? Do you remember whether her hands or her wrists restrained to the bedpost?

[Sergeant Dan Lawler]

Don't recall specifically restraints.

[Attorney Reddington]

Okay, and you mentioned that the state police were there. That would be people that were obviously working with you, right?

[Judge Selvich]

Correct.

[Attorney Reddington]

And do you remember how many state police were there that you were coordinating or assisting per shift?

[Sergeant Dan Lawler]

There was two of us.

[Attorney Reddington]

Two?

[Sergeant Dan Lawler]

Yes, sir.

[Attorney Reddington]

Okay. And also there were sheriffs from the Plymouth County Sheriff's Department that were there. Right.

[Sergeant Dan Lawler]

So we relieved the sheriffs.

[Attorney Reddington]

Okay, and how many sheriffs did you relieve?

[Sergeant Dan Lawler]

I don't recall exactly. Probably two, though.

[Attorney Reddington]

Okay, and how about Duxbury police? Recall the Duxbury police being there?

[Sergeant Dan Lawler]

I do not recall Duxbury police there.

[Attorney Reddington]

How about the security cops for the. The hospital? You. Do you recall them being there either in the room or outside the room?

[Sergeant Dan Lawler]

I don't recall them being outside the room.

[Attorney Reddington]

Do you recall coordinating with the security boss, the head guy for the hospital security?

[Sergeant Dan Lawler]

I recall having some assistance at some point from security to get up there.

[Attorney Reddington]

Okay, and do you remember how many days it was that you were assisting in the custody situation of Lindsey before she was allowed to have family and me and different people visit with her?

[Sergeant Dan Lawler]

I don't recall exactly how many days.

[Attorney Reddington]

About a week maybe. Or less or longer?

[Sergeant Dan Lawler]

Less than a week?

[Attorney Reddington]

Less than a week, I think.

[Sergeant Dan Lawler]

Yeah. I don't remember exactly at all.

[Attorney Reddington]

And even though she was allowed to have visitors, still the police presence was there, is that correct?

[Sergeant Dan Lawler]

After I left? I'm not sure after I left what the visitation was like.

[Attorney Reddington]

So when you. When you say after you left, you mean when you left the hospital, you mean after you've were finished with your tasked duty of dealing with her security and being under arrest, Correct?

[Sergeant Dan Lawler]

After my assigned shift. I don't.

[Attorney Reddington]

So after you were involved, obviously you don't know what happened after that?

[Sergeant Dan Lawler]

Correct.

[Leticia Dukes]

Okay.

[Attorney Reddington]

That's all we have. Thank you, sir.

[Leticia Dukes]

Thanks, sir.

[Judge Selvich]

Redirect, Ms. Buckingham.

[Attorney Buckingham]

How beautiful. For all of us. Hands in the dirt hearts in the dust let's be the people yeah we enough to build again from the broken

[Court Reporter]

trust we the ones still showing up holding hands when it's time to tough you and me yeah we're enough show

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[Attorney Buckingham]

sergeant Lawler, in your experience working in the detectives unit as a trooper, is it fair to say you oftentimes 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?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And it's also fair to say that theories change over time based on your investigation, what evidence you find?

[Sergeant Dan Lawler]

Correct.

[Attorney Buckingham]

Was there anything about a conversation that you had with Trooper McElligan about this theory that affects your testimony as you stand here today?

[Sergeant Dan Lawler]

No.

[Attorney Buckingham]

And you didn't hear anything that occurred in that room that day that you were there when Dr. Zeissel was there, did you?

[Sergeant Dan Lawler]

I did not hear anything.

[Attorney Buckingham]

Nothing further.

[Attorney Reddington]

Briefly, where your testimony basically unobjected to, is talking about clothes that were seized at the house and the other investigation going to the hospitals. That's it. Right.

[Attorney Buckingham]

Objection beyond sustained.

[Judge Selvich]

All right. All right.

[Attorney Reddington]

Anything further?

[Judge Selvich]

All right, thank you, sir.

[Sergeant Dan Lawler]

Thank you, Honor.

[Judge Selvich]

Thank you.

[Attorney Buckingham]

The Commonwealth would call Leticia Dukes as its next witness, please.

[Judge Selvich]

Good morning. Nice. I'm going to ask you to keep your voice up and speak into that microphone, okay? Sure. All right. Thank you.

[Attorney Buckingham]

Yes, counsel, thank you. Could you please tell the jury your first and last name?

[Leticia Dukes]

My name is Leticia Dukes.

[Attorney Buckingham]

And how do you spell your first name?

[Leticia Dukes]

L, A, T, I, E, S, H, A.

[Attorney Buckingham]

How do you spell Dukes?

[Leticia Dukes]

D, U, K, E, S. What do

[Attorney Buckingham]

you do for work?

[Leticia Dukes]

So I'm a licensed mental health counselor. I worked as a perinatal clinician at South Shore Hospital.

[Attorney Buckingham]

And what kind of education did you receive in order to do that?

[Leticia Dukes]

So I have a bachelor's in psychology, a master's in mental health counseling, and a master's of education and mental health counseling.

[Attorney Buckingham]

And you mentioned the South Shore Perinatal Clinic. Do you still work there?

[Leticia Dukes]

No, I do not currently still work there.

[Attorney Buckingham]

How long did you work there?

[Leticia Dukes]

I worked there for about five years. What did you do there at the perinatal clinic? I worked as a perinatal clinician, which involves like short term therapy 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.

[Attorney Buckingham]

And do you often collaborate with patients and other clinicians at the clinic or nurses about treatment plans for patients?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And do you help to manage the treatment plans with the patient?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

How do patients, or strike that for your role at the clinic, doing the therapy and being the clinician, are you often referred patients by the nurse practitioners or somebody else who had seen the patient or did an intake with the patient?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And do you work with that prescriber or practitioner over the course of the treatment with that patient?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And as far as your role and what you do with patients, is it fair to say that a large amount of your ability to work with the patient is based on your relationship and rapport that you develop with the patient?

[Leticia Dukes]

Patient, yes.

[Attorney Buckingham]

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?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And one of the things that might be important in that is to assess a patient's presentation each and every time you meet with them, right?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

So do you do that in each appointment or each interaction with a patient, assess them for various things?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And what kinds of assessments do you perform?

[Leticia Dukes]

So I typically perform a psychosocial assessment, which is getting their behavioral health history as well as their current presentation and reason for coming in for therapy. So whether that be a specific diagnosis or current concern or recent, like crisis or trauma, and also a risk assessment that assesses how they're doing in that moment.

[Attorney Buckingham]

Okay. And as far as the therapy component of your interactions, is that largely based on the patient?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And what kinds of therapy can you offer in that short term therapy?

[Leticia Dukes]

In that short term therapy we offer 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, 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.

[Attorney Buckingham]

And in your sessions with patients, is there a minimum or a maximum time limit?

[Leticia Dukes]

Typically our program would go from birth to postpartum up to two years. If it did go a little bit over two years because of lack of connection to care, than it would go a little beyond that. But typically it's two years.

[Attorney Buckingham]

Okay. And that's the duration of your treatment or your interaction with patients. But what about in each appointment that you have, is there a minimum or maximum time set by the clinic of when you see a patient in a particular visit?

[Leticia Dukes]

Yes. So do you mean as far as like weekly or like hour, half an hour?

[Attorney Buckingham]

Well, I guess the question is, if a patient's coming into you because they refer to and you're meeting with them on a regular basis, how long are the appointments in duration? An hour, Half an hour.

[Leticia Dukes]

So appointments could be anywhere from a half an hour to an hour based on the patient need at that time.

[Attorney Buckingham]

And when you're interacting with a patient and you're making all those assessments, are there tools available to you if you fill or you experience 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?

[Leticia Dukes]

So tools that are available to me is connection to my direct supervisor as well as crisis coordination as well as like the crisis support numbers that are in that area. So I could either call with the patient or 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.

[Attorney Buckingham]

Okay. And at some points, could it be that you would need to involve authorities like the police?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And you also are familiar with the section 12? Yes. And then that it's an involuntary procedure where the court gets involved?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

Oh, beautiful. For all of us Hands in the dirt hearts in the dust let's be the people yeah we enough to build again from the broken trust we the

[Attorney Reddington]

ones still show enough holding hands when

[Court Reporter]

times are tough you and me yeah, we're enough

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[Attorney Buckingham]

Picture U.S. now, as far as when you do meet with patients on that regular basis, either for a follow up or an intake, is it a telehealth situation, an in person situation?

[Leticia Dukes]

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 in person and virtual appointments.

[Attorney Buckingham]

As far as when you first meet with a patient, when they've been referred to you, that first intake procedure, is there a recommendation for whether that be

[Leticia Dukes]

in person or telehealth, all the perinatal behavioral health appointments for mental health counseling are in person.

[Attorney Buckingham]

That initial visit and then the subsequent appointments are oftentimes directed by the patient?

[Leticia Dukes]

Correct.

[Attorney Buckingham]

Would there be instances where you would insist or prefer that the patient actually come in person if they've elected for telehealth?

[Leticia Dukes]

Typically, you prefer someone to come in person because they have either like, fallen out of care or their concerns for their safety for some reason.

[Attorney Buckingham]

And if you don't have those immediate concerns, and it's the preference of the patient, do you often engage via telehealth?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

I'm going to draw your attention to a particular patient by the name of Lindsay Clancy. Do you remember when your first contact was with her?

[Leticia Dukes]

I remember it was around late November, early December.

[Attorney Buckingham]

Okay. And you're aware that she came to the perinatal clinic and was being initially treated by Julie Paul?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And by the time you engaged with her, her care had been transferred to Rebecca Gelada, correct?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

So fair to say you had the most contact with Rebecca Gelada about this particular patient?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And If I mention December 2nd, does that sound familiar as the first intake with Lindsey Clancy?

[Leticia Dukes]

Yes, as I said, around late November, early December. So that sounds about right.

[Attorney Buckingham]

Okay. And the intake appointment, was it in person with Lindsey Clancy?

[Leticia Dukes]

Yes, it was in person.

[Attorney Buckingham]

And what were the services that were being offered for her? Why was she referred to you?

[Leticia Dukes]

So she was referred to me for postpartum anxiety and depression symptoms? She. Yeah, that's what she was referred for.

[Attorney Buckingham]

And in this first intake, did you go through that psychosocial. Psychosocial history with Lindsey Clancy? Yes. And 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?

[Leticia Dukes]

Fresh on my own.

[Attorney Buckingham]

Okay. And so again, this is information that the patient is reporting to you about their history? Yes. And so in this instance, you noted that the defendant told you or Lindsey Clancy told you that she had. She had been. Had some prior contact with mental health, right?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

That she had engaged with a psychiatrist in nursing school and that she had been prescribed medication at that point, correct?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And that she, prior to coming to the clinic, that she had been engaged with a psychiatrist? Yes. Did she identify what her concerns were or what her presenting concerns were to you?

[Leticia Dukes]

Yes, she did.

[Attorney Buckingham]

And what were the concerns?

[Leticia Dukes]

Her presenting concerns were anxiety, lack of sleep, depression symptoms, frequent passive suicidal ideation, thoughts of wanting to die and no longer be here.

[Attorney Buckingham]

And had she reported to you that she had been on a number of different medications?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And you're aware that she Was those medications were being managed by the nurse practitioners in the clinic?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And as far as your role as a social worker, do you often kind of get into the weeds with patients about their medication? So.

[Leticia Dukes]

I'm not a social worker. I'm a mental health counselor.

[Attorney Buckingham]

I'm sorry.

[Leticia Dukes]

Yeah, no problem. But I typically have an overview of medications, but I don't particularly get into prescribing or how to take medications.

[Attorney Buckingham]

Okay. And so what's the focus of your role in offering counseling services to women with postpartum anxiety and depression?

[Leticia Dukes]

Yes. 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.

[Attorney Buckingham]

And do you come to your own conclusions as far as diagnosis goes based on your interaction with the patient?

[Court Reporter]

Yes.

[Attorney Buckingham]

And in this first interaction with Ms. Clancy, you got her history. You also did some of those assessments. Correct. And so as far as assessing her present condition, kind of how she presented to you, did you make observations of her mood?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And do you recall her mood being low, that she was felt numb and unable to laugh?

[Judge Selvich]

All right, if you could just. This objection. Effect. Leading. Leading question. Sustained. But is there any. So there's no objection if this witness. If you want to look at your notes. I don't know if you have your notes with.

[Court Reporter]

With you.

[Leticia Dukes]

Did not. Do they have a copy that they could.

[Judge Selvich]

I don't know if the parties have a. A copy that she could look at.

[Attorney Reddington]

I. I do. I could.

[Judge Selvich]

I could.

[Attorney Buckingham]

Do you have a blank copy?

[Attorney Reddington]

Well, I mean, it has, like, a date on it. It doesn't have a lot of notes on it, just has a name.

[Attorney Buckingham]

I can approach page by page. It's fine.

[Attorney Reddington]

Sure.

[Judge Selvich]

That's fine. So if you need or want to look at the rec, just let us know.

[Attorney Buckingham]

We'll do that.

[Attorney Reddington]

Sure.

[Leticia Dukes]

Thank. Thank you.

[Attorney Buckingham]

Just going to show you that page.

[Leticia Dukes]

Sure,

[Judge Selvich]

sure. Yeah.

[Attorney Buckingham]

So, Ms. Dukes, on this particular visit on 12 2, what was her mood?

[Leticia Dukes]

So she reported having low mood and feeling numb.

[Attorney Buckingham]

Okay, and so you said she reported. So in the note that you're reviewing, these particular questions or these observations that you noted, are they based on her reports to you about these areas?

[Court Reporter]

Yes.

[Leticia Dukes]

And as well as my observation of her.

[Attorney Buckingham]

Okay, so did it appear that her mood was consistent with what she was reporting to you? Based on your observations,

[Leticia Dukes]

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.

[Court Bailiff]

Okay.

[Attorney Buckingham]

And kind of moving to what's identified in your record as mental status exam.

[Leticia Dukes]

Yes.

[Attorney Buckingham]

What is a mental status exam?

[Leticia Dukes]

So a mental status exam is an exam that's assessing how the patient is appearing, what she is reporting, as well as any concerns about safety, which would be any suicidal ideation, homicidal ideation, as well as any intrusive thoughts or worry, any hallucinations or delusions.

[Attorney Buckingham]

Okay. And so in this exam, is it a mixture of what the patient tells you and what you're observing?

[Leticia Dukes]

Correct.

[Attorney Buckingham]

Okay. And if I can approach you with Another page, page 53, In regards to. On this particular first encounter on December 2, when it comes to the mental status exam, were you able to observe her facial expressions?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And what were your observations of her facial expressions?

[Leticia Dukes]

She was cheerful when discussing her anxiety symptoms.

[Court Reporter]

Okay.

[Attorney Buckingham]

And were you. Did you also ask those questions about thought, thought content? You just have to answer out loud.

[Leticia Dukes]

Yes. Okay.

[Attorney Buckingham]

And so what did she say about thought content?

[Leticia Dukes]

So thought content, worry about her infant and that she had an addiction to Ativan.

[Attorney Buckingham]

And you said you also, in this assessment, assessed suicidal thoughts, correct?

[Leticia Dukes]

Correct.

[Attorney Buckingham]

And so did you ask her anything more about those passive thoughts that you indicated she reported?

[Leticia Dukes]

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.

[Attorney Buckingham]

And is that significant to you, the fact that she identified there was no plan?

[Court Reporter]

Yes.

[Attorney Buckingham]

And why is it significant?

[Leticia Dukes]

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.

[Attorney Buckingham]

As far as your observations of her thought process, were those within normal limits?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And her intellectual functioning, were those within normal limits?

[Judge Selvich]

Yes.

[Attorney Buckingham]

Did she report to you any past attempts to harm herself or others?

[Judge Selvich]

No.

[Attorney Buckingham]

Did you go through with her, her behavioral health history?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And other than what you indicated as the anxiety and sleep, did she identify any concerns around substance abuse issues?

[Leticia Dukes]

So she did identify concerns about. Not in her history, but in that visit, about misuse of Ativan.

[Attorney Buckingham]

And if somebody. Oh, beautiful. Spreading love everywhere we go all of my everyday people we're the proof.

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[Attorney Buckingham]

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[Attorney Buckingham]

Expresses concern about that substance use. Do you have a tool available to you to assess whether they have substance use issues?

[Court Clerk]

Yes.

[Leticia Dukes]

So there is an assessment within the initial intake appointment that has a specific section to further assess substance use disorder.

[Attorney Buckingham]

And did you identify whether she presented with any substance use disorder issues?

[Leticia Dukes]

I did assess that she did not present with any substance use disorder issues.

[Attorney Buckingham]

And as far as her expressed concern to you, fair to say it was focused on one particular medication. The medication Ativan? Correct. And why were you, why did you not find that that to be an issue based on your assessment?

[Leticia Dukes]

Based on my assessment and how she stated she was supposed to be using it, it was used correctly to remedy the anxiety symptoms. Okay.

[Attorney Buckingham]

And after this initial intake? Oh, I, I guess the first question is approximately how long is this initial intake appointment?

[Leticia Dukes]

The initial intake appointment is typically an hour.

[Attorney Buckingham]

And after having spent the hour, gone through these assessments, spoken to her about her history, were you able to come up with or give an opinion about diagnosis?

[Court Reporter]

Yes.

[Attorney Buckingham]

And based on her presentation to you, what was your opinion about diagnosis at the time?

[Leticia Dukes]

My opinion about her diagnosis was postpartum anxiety because she had a lot of anxiety about most things.

[Attorney Buckingham]

Okay. And so what were your recommendations as far as a treatment plan for her?

[Leticia Dukes]

My recommendations at that visit was outpatient therapy, continued medication, and weekly visits with me.

[Attorney Buckingham]

And why would you, why did you recommend outpatient therapy on top of therapy with you?

[Leticia Dukes]

So outpatient therapy was kind of like a blanket therapy, but more so like intensive outpatient therapy, partial hospitalization therapy.

[Attorney Buckingham]

And was your role in offering her weekly sessions 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, did you begin to schedule additional visits with her?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And after that particular visit on December 12, did you send her any particular information?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

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?

[Leticia Dukes]

I can send it through my chart messaging.

[Attorney Buckingham]

And on this particular day, after your meeting with her, you sent her some resources about cognitive behavioral. Cognitive behavioral therapy, did you not?

[Court Bailiff]

Yes.

[Attorney Buckingham]

Your next contact with her was December 5th. Why December 5th? If you had just met with her

[Leticia Dukes]

on the 2nd, that may have been the soonest available appointment that week for her.

[Attorney Buckingham]

Okay. And it was shy of the one week. Right. Did you. Was there anything in your meeting with her on the second that made it necessary to have a shorter appointment?

[Judge Selvich]

No.

[Attorney Buckingham]

This next contact on the 5th, was that in person or telehealth?

[Leticia Dukes]

Telehealth.

[Attorney Buckingham]

And on this day on the 5th, when you met with her, did she report some additional information or report how things had gone over the weekend to you?

[Leticia Dukes]

May I see my notes?

[Court Reporter]

Sure.

[Attorney Buckingham]

If it's okay, I'm just going to give her all the pages from that note.

[Judge Selvich]

That's fine.

[Leticia Dukes]

Thank you.

[Judge Selvich]

Yep.

[Attorney Buckingham]

Thank you. Okay.

[Leticia Dukes]

I'm just reviewing the note.

[Attorney Buckingham]

Sure. Take your time.

[Leticia Dukes]

And can you repeat the question?

[Attorney Buckingham]

Sure. In that visit on December 5, did she indicate to you or did she report to you how the weekend went for her?

[Leticia Dukes]

Yes, she did.

[Attorney Buckingham]

And what did she say about the weekend?

[Leticia Dukes]

She reported that over the weekend she had a difficult weekend, having intrusive thoughts about wanting to. To die, and that she had contacted Aspire Crisis Support. She met with the clinician virtually and was told that she did not meet the criteria for inpatient treatment due to having no si Plan. Suicidal ideation plan.

[Attorney Buckingham]

And so when she reported the intrusive thoughts and having a tough weekend, did you follow up with her and begin to kind of talk with her about that?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And what did she tell you about what she was feeling in those intrusive thoughts?

[Leticia Dukes]

So in those times, what she reported was that it was continuous intrusive thoughts of not wanting to be there, but no plan.

[Attorney Buckingham]

Okay.

[Leticia Dukes]

Kind of like the same report that she gave to Crisis.

[Attorney Buckingham]

Okay. And as far as kind of the difficulty of the weekend and how she was failing, did she tell you how she was feeling?

[Leticia Dukes]

No.

[Attorney Buckingham]

In that particular meeting, 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 statements and whether she had any sort of intent or plan?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And did you ask her additional information and complete that full mental status exam from that meeting? And were there any signs of psychosis or signs of mania or homicidal or homicidal ideation?

[Leticia Dukes]

No.

[Attorney Buckingham]

And at the time that you met with her on the 5th, was she currently having those thoughts about wanting to die? If, you know, just reviewing it, sure.

[Leticia Dukes]

In that visit, she had no suicidal ideation.

[Attorney Buckingham]

And on this particular Visit on the 5th, via telehealth, did somebody else participate in the visit as well? I could direct you to page 45.

[Leticia Dukes]

45, yes. Her husband joined the visit.

[Attorney Buckingham]

And this visit, approximately how long was it?

[Leticia Dukes]

If you recall, this Visit was approximately 30 minutes.

[Attorney Buckingham]

And fair to say, focus of the visit was to kind of deal with that bad weekend in calling the crisis center. So what did you offer her as far as recommendations or assessments or assistance during this meeting?

[Leticia Dukes]

So support. During this meeting, I offered her support in connecting to. It seemed like she needed a higher level of care. So intensive outpatient therapy, partial hospitalization therapy, as well as we reviewed, 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.

[Attorney Buckingham]

Okay. And as far as the recommendation for intensive outpatient or partial hospitalization was, did she want to connect with those programs at that time?

[Leticia Dukes]

At that time, she didn't decline services, but she was interested in the information.

[Attorney Buckingham]

Okay, and so did you agree to send her some information at that time?

[Leticia Dukes]

I did not agree to send her information.

[Attorney Buckingham]

Did she ask for any other information in that meeting? And is that something that you do at your clinic, do psychological testing?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

Okay, and so did you make a referral for her to see somebody else in the clinic, or did you provide her other information?

[Leticia Dukes]

So I discussed this information with a provider at the time, which was the psychiatrist and medication provider at the time.

[Attorney Buckingham]

And would that have been Rebecca Gelada? Yes. And so did you subsequently send Lindsey Clancy some information about psychological testing? Yes. But there was no recommendation for it to be done at the clinic?

[Leticia Dukes]

No.

[Attorney Buckingham]

Do you know why?

[Leticia Dukes]

At the time, it sounded like she wanted extra support or like outside opinion as far as, like, diagnosis and medication.

[Attorney Buckingham]

Okay. And was the testing something that she brought up or did it come out naturally in your conversations with her? That's something she brought up in your meetings. Did she want to. Or did she discuss medication side effects with you?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And what were your observations of her demeanor during this Visit on the 5th?

[Leticia Dukes]

On the 5th, 1 second. Her presentation overall was within normal limits. She didn't appear like, anxious or different than any other visit I had with her.

[Attorney Buckingham]

And 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.

[Leticia Dukes]

4. 4.

[Attorney Buckingham]

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 spoke to you, or answered questions during this follow up on the 5th?

[Court Bailiff]

No.

[Attorney Buckingham]

And as far as the conversations about the bad weekend and calling crisis, did you have any concern that she was in crisis?

[Leticia Dukes]

No.

[Attorney Buckingham]

And you made those recommendations for higher level of care, correct?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

But nothing that would have prompted you for those other interventions that you've previously described to us, Right?

[Leticia Dukes]

Right.

[Attorney Buckingham]

Did you ever in this visit see signs of mania?

[Leticia Dukes]

No.

[Attorney Buckingham]

And is that something you look for?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And did you ever see signs of delusions or paranoia?

[Court Bailiff]

No.

[Attorney Buckingham]

How about psychosis?

[Leticia Dukes]

No.

[Attorney Buckingham]

Now, your next contact with her was December 12th, correct? Yes. And was that in person or. Telehealth, if you recall?

[Leticia Dukes]

Telehealth.

[Attorney Buckingham]

And on the 12th, did you have further conversation with her about your previous recommendations about partial. Partial hospitalization programs?

[Leticia Dukes]

May I review.

[Attorney Buckingham]

Yep.

[Leticia Dukes]

Yes, we did have further conversation about recommendations.

[Dr. Renee Stonebridge]

Okay.

[Attorney Buckingham]

And did she indicate to you that she would be starting a program soon?

[Leticia Dukes]

Yes, she indicated that she would be starting a partial hospitalization program in Norwell on December 20, 2022.

[Attorney Buckingham]

Did she provide you any details about that program? Funeral. Hello, I'm here during the lunch rush with Janice, who owns her own food truck.

[Leticia Dukes]

Best cheesesteaks in town.

[Attorney Buckingham]

Janice traded up to Geico Commercial commercial auto insurance for her food truck business. We're here where she needs us most.

[Court Reporter]

They sure are.

[Attorney Buckingham]

We make it so easy for her to save with customized coverage that grows with her business. Sorry, I just get so emotional talking about saving folks money.

[Leticia Dukes]

Not this onion I'm chopping.

[Attorney Reddington]

It's just so beautiful.

[Leticia Dukes]

Oh, yeah, Nice.

[Advertisement Voice]

The onion.

[Attorney Reddington]

Get a commercial auto insurance quote [e-mail] and see how much you could save.

[Advertisement Voice]

It feels good.

[Sergeant Dan Lawler]

To geico.

[Leticia Dukes]

No, just that she would be starting a program in Norwell.

[Attorney Buckingham]

Was that. Had you referred her to any programs in Norwell?

[Leticia Dukes]

No.

[Attorney Buckingham]

And in this. In this meeting with her, did you continue to talk about her need for higher level of care?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And did you make recommendations on a different program?

[Leticia Dukes]

Yes, I did make a recommendation on women and infants.

[Attorney Buckingham]

And why did you recommend women and infants or why were you recommending this higher level of care?

[Leticia Dukes]

I was recommending this higher level of care because of continued passive suicidal ideation. Even with crisis intervention, as well as women and infants was more so for postpartum women and the infant would be able to come to the program with her.

[Attorney Buckingham]

And so the program at Women and Infants is something that you're familiar with, working through your clinic, correct?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And you often make referrals over there?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

Do you require the patient's consent to make a referral?

[Judge Selvich]

Yes.

[Attorney Buckingham]

Did Lindsey Clancy consent to the referral at that time?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And so did you work to make that referral after that visit?

[Judge Selvich]

Yes.

[Attorney Buckingham]

Now, you mentioned that she had continued passive suicidal ideation in a meeting. In this meeting that you had with her, did you assess that her suicidal

[Leticia Dukes]

ideation in this visit particularly, did she have passive suicidal ideation?

[Attorney Buckingham]

Well, do you ask if they still have that?

[Judge Selvich]

Yes.

[Attorney Buckingham]

Or if they currently have thoughts of suicide?

[Dr. Renee Stonebridge]

Yes.

[Attorney Buckingham]

And in this instance, did she have thoughts of suicide or wanting to die?

[Leticia Dukes]

Just reviewing. Hold on. So yes, she reported like continued suicidal ideation at that time.

[Attorney Buckingham]

But did she ever indicate a plan?

[Court Reporter]

No.

[Attorney Buckingham]

Having 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

[Leticia Dukes]

at this time? She had supports which were her husband and her mother in law 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 find follow through with suggestions that I had given her in the previous visit.

[Attorney Buckingham]

Okay. And based on your visit with her on the 12th, she accepted a willingness to go to one of those programs, Right. Or at least be referred?

[Court Reporter]

Yes.

[Attorney Buckingham]

So was there anything about your interaction with her on December 12th that warranted any of those higher levels of intervention from you?

[Leticia Dukes]

No.

[Attorney Buckingham]

Now, the next time you met with her was on December 19, correct?

[Court Reporter]

Yes.

[Attorney Buckingham]

And was that the final time that you met with her?

[Court Reporter]

Yes.

[Attorney Buckingham]

On that day of December 19, was that in person or a telehealth?

[Leticia Dukes]

May I review the note?

[Attorney Buckingham]

Sure.

[Leticia Dukes]

That visit was virtual. And what was the question?

[Attorney Buckingham]

That was the question. Thank you. So on this particular Visit on the December 19, did she report any further issues or anything that had happened between the 12th and the 19th that were of concern?

[Leticia Dukes]

So she was continuing to have low mood and numbness. She did not have any si and had no need for crisis intervention over that weekend.

[Attorney Buckingham]

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?

[Leticia Dukes]

See, she was spending time with family and her children and exercising.

[Attorney Buckingham]

Now, at this point, as the December 19th rolled around, had you already put in that referral to women and infants?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And did you know if she engaged with women and infants by that point?

[Leticia Dukes]

By that point, women and infants had reached out to her, but she had missed the call, but said she would contact them back.

[Judge Selvich]

Okay.

[Attorney Buckingham]

Now, one of the concerns that you often talked about in your meetings with her was sleep, right?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And in this meeting with her on December 19, did she report any improvements in her sleep? No. 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 neuro vegetative disturbances. Do you see that?

[Judge Selvich]

Yes.

[Attorney Reddington]

Can you show me what you mean by page 13?

[Attorney Buckingham]

I'm looking at prior ones. I don't know. Those don't have page numbers. But the one I gave her has. It's December 19th. This is the last page.

[Attorney Reddington]

It's this one here, right?

[Attorney Buckingham]

Yeah.

[Court Reporter]

Okay.

[Attorney Buckingham]

There should be three pages. What did you note under neuro vegetative disturbances?

[Leticia Dukes]

I reported that sleep has improved.

[Attorney Buckingham]

And 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?

[Leticia Dukes]

No.

[Attorney Buckingham]

Okay, so in this instance, 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, but that her mood kind of had remained the same? Low mood, numbness, right?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

Okay. Anything about your interaction with her that day that was different from the prior interactions?

[Leticia Dukes]

That day she seemed to be more engaged. She was able to smile, she was able to laugh, and she was enjoying time with family.

[Attorney Buckingham]

And so did you look through. Look at that as something positive? Yes. Was there anything about your interaction with her on this day, on December 19th, that made you think that you needed to invoke a higher level of care?

[Judge Selvich]

No.

[Attorney Buckingham]

As far as in person visits, did you have any other in person visits with Lindsey clancy after the 19th?

[Leticia Dukes]

No.

[Attorney Buckingham]

Fair to say your contact with her was very limited after that point?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And on December 27, did you have some interaction with her and her husband?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And why. Why did you have interaction with them?

[Leticia Dukes]

May I see the note?

[Attorney Buckingham]

Sure.

[Attorney Reddington]

Thank you.

[Leticia Dukes]

Can you repeat the question?

[Attorney Buckingham]

On December 27, why did you have contact with her? Why. Why did you make contact with her with Lindsay?

[Leticia Dukes]

I was calling her to inform her that her referral had been completed.

[Attorney Buckingham]

Okay. And so you had a call with her at 1023, 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 reverse order.

[Leticia Dukes]

Yes.

[Attorney Buckingham]

But prior to the contact about the referral being completed and just reaching out to her and letting her know, did you have a conversation with her husband? Yes. And was that at Lindsey's request? Did she give consent for that?

[Leticia Dukes]

She did give consent for that.

[Attorney Buckingham]

And fair to say he was reporting concerns of prescriptions, right?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And that's not your area in the clinic, is it?

[Judge Selvich]

No.

[Attorney Buckingham]

So did you refer her, refer him to the prescriber at this time?

[Leticia Dukes]

Yes, I redirected him to speak to the prescriber.

[Attorney Buckingham]

Okay. And again, in each and every encounter that you've had, did you further recommend that she engage with a higher level of care, either a partial hospitalization program or an outpatient program program?

[Judge Selvich]

Yes.

[Attorney Buckingham]

Now, at any point that you were interacting with her between December 2 and the last contact with December 27, albeit limited, did you ever have any concerns about her physical well being?

[Court Bailiff]

No.

[Attorney Buckingham]

Did you ever have any concerns about the physical well being of others in her presence?

[Leticia Dukes]

No.

[Attorney Buckingham]

Did you ever see or observe any signs of mania, delusion or paranoia?

[Judge Selvich]

No.

[Attorney Buckingham]

Any signs of psychosis observed by you?

[Leticia Dukes]

No.

[Attorney Buckingham]

Did you ever have any difficulty understanding what she was saying or notice any differences in her speech patterns?

[Leticia Dukes]

No.

[Attorney Buckingham]

Did you ever have any concerns that she wasn't accurately reporting things to you?

[Leticia Dukes]

No.

[Attorney Buckingham]

And did you ever feel the need to collaborate with your provider for higher level of care or an additional intervention?

[Leticia Dukes]

When I did? Yes.

[Attorney Buckingham]

And so would that be for the calling the police section, Tabular safety.

[Judge Selvich]

Hold on. Good. Last set. And then we'll.

[Attorney Buckingham]

My question was, in any of the times that you engage 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?

[Leticia Dukes]

No. Safety or section 12?

[Judge Selvich]

No.

[Attorney Buckingham]

So as far as recommendations, would you agree that those were the recommendations for higher level of care?

[Leticia Dukes]

Yes, for IOP or PHP services. Okay.

[Attorney Buckingham]

And on that last visit that you had with her, she reported doing things outside of the home, right?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

And that stood out to you?

[Judge Selvich]

Yes.

[Attorney Buckingham]

As what?

[Leticia Dukes]

As an improvement in mood and ability to connect with others.

[Attorney Buckingham]

Thank you. If I may have a moment to put these back together.

[Judge Selvich]

What? Why don't we take the delayed morning break at this point? So I hope it'll 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.

[Attorney Reddington]

All rise, please.

[Attorney Buckingham]

Yeah, I just have to put them back together because they're a little out of order.

[Judge Selvich]

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

[Attorney Reddington]

Thank you. All right,

[Judge Selvich]

we all sit for the jury?

[Attorney Reddington]

Yes. All right, jurors, enter. This court's now assessed.

[Judge Selvich]

Please be seated.

[Court Bailiff]

Your Honor, for the purpose of the record, we return back to the trial. Commonwealth versus Lindsey Clancy. All parties are present, including the defendant, and including the 18 jurors.

[Judge Selvich]

All right, Counsel.

[Attorney Reddington]

Thank you, you, Honor. Morning.

[Leticia Dukes]

Good morning.

[Attorney Reddington]

So can you tell me, is it four times that you yourself actually met with Lindsey or more.

[Leticia Dukes]

Can you repeat that?

[Attorney Reddington]

I'm sorry? Was it four times that you actually met with Lindsey or more, and that would include telehealth?

[Leticia Dukes]

Four.

[Attorney Reddington]

Four times. Okay. You met with her on 2nd December, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And you met with her on 12th December, is that right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

You met with her on 19th December, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And is it the 27th as well? Was there another one? Do you remember when that was?

[Leticia Dukes]

That was by phone.

[Attorney Reddington]

By phone. Would that be the 27th?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Okay, so what I'm going to do is give you the documents that the district attorney is questioning you from.

[Leticia Dukes]

Thank you.

[Attorney Reddington]

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. 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 Gelada, right?

[Judge Selvich]

No.

[Attorney Reddington]

Oh, you guys work in the same place though, right?

[Court Reporter]

Yes.

[Attorney Reddington]

Okay. So when a woman is in postpartum and comes to Social Health for help, when you're trying to help them, you can't see the medical records from what the other people, like Nurse Paul and Nurse Jolada have written down.

[Leticia Dukes]

You can see the records?

[Attorney Buckingham]

Yes.

[Attorney Reddington]

You can?

[Attorney Buckingham]

Yes.

[Attorney Reddington]

Okay, so you did look at the records.

[Leticia Dukes]

I did not look at the records.

[Attorney Buckingham]

Okay.

[Attorney Reddington]

On the 2nd of December, you can look along with it if you wish. 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 2, and the jurors will have this as an exhibit. But just going through the pages. You have it.

[Leticia Dukes]

One second. Yes, I have it.

[Attorney Reddington]

Okay. Now, one of the things that you would be interested in when you're interacting with a patient that comes to your facility for help is how honest they are, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

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?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And, for example, Lindsay disclosed to you and to the others that back in 2012, while she was in nursing school, she actually had Prozac because she was very nervous, actually, about public speaking. But she was on Prozac. Right.

[Leticia Dukes]

One second.

[Attorney Reddington]

Sure. I think it's right under behavioral health history, first paragraph.

[Judge Selvich]

Yes.

[Attorney Buckingham]

Yes.

[Attorney Reddington]

Okay. And she also told you that she had been prescribed Ativan, for example, by psychiatrist Jennifer Tufts.

[Sergeant Dan Lawler]

Right.

[Leticia Dukes]

Just reviewing.

[Attorney Reddington]

Second paragraph.

[Leticia Dukes]

So, no, that's not what I see here.

[Attorney Reddington]

Okay. Do you see where it says, prior to attending the shore program. Sentence, second paragraph.

[Judge Selvich]

Yes.

[Attorney Reddington]

Patient was prescribed Ativan by psychiatrist Jennifer Tufts.

[Leticia Dukes]

It says here she was prescribed. So loft.

[Attorney Reddington]

Well, I must be misreading something. I apologize. Let me approach you. This is what I. This is what I have here. History, recurrent functioning. Right. History and current. Okay, and then behavioral health history, paragraph one.

[Judge Selvich]

Right.

[Attorney Reddington]

References to Prozac.

[Judge Selvich]

Right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Okay.

[Leticia Dukes]

But it doesn't say. You said Dr. Tufts.

[Attorney Reddington]

No, I was saying the second paragraph. Prior to attending short program, she disclosed to you that she was prescribed Ativan.

[Judge Selvich]

Right.

[Leticia Dukes]

So which one are you?

[Attorney Reddington]

Second paragraph, Right here.

[Leticia Dukes]

Okay.

[Attorney Reddington]

Yeah. Prior to attending short program, patient was prescribed Ativan, right?

[Court Reporter]

Yes.

[Attorney Reddington]

Okay. And that was by Dr. Tufts, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

So she told you that she was prescribed. Prescribed avenzodiazepine by her treating psychiatrist. And further on into your interaction with her, she told you that she was very concerned about taking medication, right?

[Attorney Buckingham]

Yes.

[Attorney Reddington]

And she was really concerned about becoming addicted to medications such as a benzo like Ativan, Right.

[Leticia Dukes]

She was concerned about becoming addicted to medication.

[Judge Selvich]

Yes.

[Attorney Reddington]

All right. In the very last paragraph, it says when no longer taking Ativan. You see that one?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Okay. She then explained that she had issues with the sleep, and she started having heart palpitations and she went to the ER for anxiety. Is that right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And at that time, she told you that she felt that she had an addiction to Ativan. That's why she couldn't sleep, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And she was stressing about that. Was really concerned about that, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

She then said that she had weight loss, right?

[Court Reporter]

Yes.

[Attorney Reddington]

No appetite, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Panic attacks, right?

[Leticia Dukes]

Right.

[Attorney Reddington]

Couldn't sleep, right?

[Attorney Buckingham]

Yes.

[Attorney Reddington]

Next page. December 2nd, office visit, the same visit, first paragraph. She was prescribed Remeron and Seroquel in the past four days. Right.

[Leticia Dukes]

Sorry. This is a different date on this one. What date do you have?

[Attorney Reddington]

Okay, So the next page. All right, let's look at this one, then. Is this. Would you agree that this is a record from South Shore Health? Talks about continuing your appointment December 2nd?

[Judge Selvich]

Yes.

[Sergeant Dan Lawler]

Okay.

[Attorney Reddington]

If you can find.

[Leticia Dukes]

I think they were just out of order.

[Court Reporter]

Here it is.

[Court Clerk]

Okay.

[Leticia Dukes]

Okay.

[Attorney Reddington]

That's fine.

[Judge Selvich]

That's your problem.

[Attorney Reddington]

That's not your fault. So are you with me on that? That she was prescribed Remeron and cervical.

[Leticia Dukes]

Yes.

[Attorney Buckingham]

Okay.

[Attorney Reddington]

And that was within the past four days, is that right?

[Judge Selvich]

Yes.

[Attorney Reddington]

So when you saw her on December 2, after telling you about the Ativan and telling you about her weight loss and her. Of anxiety and everything else, she told you that she had been prescribed Remeron and Seroquel. And I understand you don't do the drugs, so you don't really have.

[Leticia Dukes]

No, I don't do medications.

[Attorney Reddington]

Very difficult to get the brand names and the other names, but we have a chat for that. So she started Remeron and Seroquel, 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 the earth?

[Leticia Dukes]

No longer wanting to be here could mean anything. But in that instance, when assessing for suicidal ideation, no longer want to be here qualifies as passive suicidal ideation.

[Attorney Reddington]

Okay. And then she indicates further that this week she was seeing you feels like she's going to die. That's what the DA read to you, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

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?

[Leticia Dukes]

Yes.

[Attorney Reddington]

She then talked about how the Remeron and Seroquel were not helping her sleep. Yesterday she took Ativan. She told you, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Due to intrusive si. Suicidal ideation thoughts, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

Did she indicate what the intrusive suicidal ideation thoughts were yesterday, which would be December 1st? Did she tell you what that meant? Did you ask her what she meant by that?

[Leticia Dukes]

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.

[Attorney Reddington]

Okay. And you then told her that she could go to the error and that you then sent her local crisis contact information, is that right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And then talks about onset. Says three months after the baby was born, she had unmanageable anxiety, correct?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And what did she tell you the anxiety was about

[Leticia Dukes]

one second.

[Court Bailiff]

Yep.

[Attorney Reddington]

It's under onset.

[Leticia Dukes]

And what was the question?

[Attorney Reddington]

And to onset? She indicated three 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?

[Leticia Dukes]

About her children, especially the baby.

[Attorney Reddington]

And what did she, what does that mean? That she was having unmanageable anxiety? What does unmanageable mean?

[Leticia Dukes]

So constantly worried that something was going to happen to her children or something bad was going to happen to the baby.

[Attorney Reddington]

And at that time the children were four, three and six months, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Under social, the notes indicate that she reported she talks about her anxiety all the time with her mom, husband and mother in law, correct?

[Court Bailiff]

Correct.

[Attorney Reddington]

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?

[Leticia Dukes]

Correct.

[Attorney Reddington]

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 stood, stayed with her to help out?

[Leticia Dukes]

I don't remember that. Okay.

[Attorney Reddington]

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.

[Leticia Dukes]

She just had a lack of interest in conversation with friends.

[Attorney Reddington]

And that would be her social circle. She just didn't care. Right?

[Leticia Dukes]

Right.

[Attorney Reddington]

She said that she felt numb, right?

[Court Reporter]

Yes.

[Attorney Reddington]

She had a lack of attention, right?

[Leticia Dukes]

Right.

[Attorney Reddington]

Confusion, Right?

[Leticia Dukes]

Right.

[Attorney Reddington]

Under mood, it says, well, of course you have disturbed sleep. She's only sleeping two to four hours a night is what she told you, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And then it says supports 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. You took her history that she was a nurse, that she had been on leave, and she told you that she lost 10 pounds in the past month, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Now, can you flip to the next page and make sure we're both on the same page? Does. And the substance use assessment, do you have that

[Leticia Dukes]

one second?

[Attorney Reddington]

Yep.

[Judge Selvich]

Yes.

[Attorney Reddington]

Okay. So one of the things that you're concerned about is whether or not your patient has a substance abuse problem like drugs or alcohol or something like that, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And you've already told us that. Your opinion was that Lindsey did not have any substance abuse problems other than her fear about the prescribed Ativan, Right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

So did you ask her about alcohol?

[Judge Selvich]

Yes.

[Attorney Reddington]

Can you tell me what she said about alcohol?

[Leticia Dukes]

She said the last time she drank alcohol was in October of 2019.

[Attorney Reddington]

Go ahead.

[Judge Selvich]

Yeah.

[Attorney Reddington]

Did she tell you how much. What it is her alcohol of choice was?

[Leticia Dukes]

She said her alcohol of choice was wine. She would have one to two glasses.

[Attorney Reddington]

Did she say why she would do that?

[Leticia Dukes]

To cope with anxiety.

[Attorney Reddington]

Okay. And this is back in 2019, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

That would be three 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 using marijuana?

[Leticia Dukes]

Yes, she said she did use marijuana.

[Attorney Reddington]

When?

[Leticia Dukes]

Last use was November 15, 2022.

[Attorney Reddington]

Why?

[Leticia Dukes]

I'm sorry?

[Attorney Reddington]

Why did she say that she used it? It's under comments.

[Leticia Dukes]

Yes, I'm taking it.

[Attorney Reddington]

That's okay.

[Leticia Dukes]

She said she tried a marijuana gummy to help with sleep.

[Attorney Reddington]

And that was on November 15th of 22, right?

[Court Reporter]

Yes.

[Attorney Reddington]

Go to the next page. Assessment and recommendation. If you have that, make sure we have it.

[Judge Selvich]

Yes.

[Attorney Reddington]

Okay. And I think district attorney had asked you about the mental status exam, facial expression, and you indicated that her facial expression showed anxiety, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Fear. Right. Do you know what the fear was?

[Leticia Dukes]

Just going back to that part of the assessment.

[Court Bailiff]

Sure.

[Attorney Buckingham]

Yeah.

[Attorney Reddington]

It's under facial expression.

[Leticia Dukes]

And you said facial expressions, right?

[Attorney Reddington]

Yes, please. Yeah.

[Leticia Dukes]

Anxiety, fear, apprehension, sadness.

[Attorney Reddington]

Okay, so if I can. I apologize. If you just keep your voice. You're very soft spoken.

[Attorney Buckingham]

Yes.

[Attorney Reddington]

I'll walk voice up so the jurors can hear you.

[Leticia Dukes]

Yeah.

[Attorney Reddington]

Thank you. And you said that facial expression exported to you anxiety, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Fear of something, right?

[Court Reporter]

Yes.

[Attorney Reddington]

Apprehension, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

Sadness?

[Judge Selvich]

Yes.

[Attorney Reddington]

Depression?

[Judge Selvich]

Yes.

[Attorney Reddington]

And she expressed that she was having anxiety and numbness, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

And she was crying when she was telling you this, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

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 Ativan, is what she told you, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And again, thoughts of wanting to die, but there was no plan.

[Leticia Dukes]

Correct.

[Attorney Reddington]

Next page, risk assessment. There's a whole lot of stuff on these pages. I'm just trying to cut to the chase here. So you see where it says risk assessment?

[Leticia Dukes]

I am trying to find it. One second.

[Attorney Reddington]

Yep. Under a current medic. I'm sorry? It's under a risk assessment.

[Leticia Dukes]

I'm taking a look. Okay, I see Protective factors. But I don't see risk assessment.

[Attorney Reddington]

Okay, let me ask you under risk assessment, on December 2nd, when you asked her about that, at that point that she. So you can see here, she again admitted to suicidal ideation, right?

[Court Reporter]

Yes.

[Attorney Reddington]

It was passive.

[Court Reporter]

Yes.

[Attorney Reddington]

It says plan to go to ER if she feels unsafe or has a plan, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

And then farther down, you have current medications and she was on Quetipine or Seroquel, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Fluoxetine or Prozac, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Lorazepam or Ativan, right?

[Court Reporter]

Yes.

[Attorney Reddington]

Mirtazapine or Remeron, right?

[Court Reporter]

Yes.

[Attorney Reddington]

And they were all. That was all active prescriptions that she had on December 2, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

Told you that she is seeking counseling for postpartum anxiety, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

Do you have. On December 2nd, continuing on with your evaluation, where it says clinical notes. Do you have the clinical notes?

[Leticia Dukes]

One second.

[Attorney Reddington]

What I could do is read what I have rather than stand next to you. And if you trust me, then 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.

[Leticia Dukes]

Okay.

[Attorney Reddington]

On that date, your notes say patient requested addiction support services. Do you recall that?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And that you indicated that you would be sending patient addiction Support resources by MyChart or the message thing, right? Correct. You then indicate that based on history reported, patient meets the criteria for postpartum anxiety, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

That she would benefit from OP therapy. What does that mean?

[Court Bailiff]

Yes.

[Leticia Dukes]

From outpatient therapy services.

[Attorney Reddington]

Php.

[Leticia Dukes]

Yes. Partial hospitalization program, iop, intensive outpatient program.

[Attorney Reddington]

And that you then helped her out by bridging the therapy services, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

You then noted again postpartum anxiety on December 2nd according to your notes, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

Okay. Now, did you know that she had been seeking and receiving therapy? I don't know if that's therapy or counseling or that type of thing. Like. Like there's a woman that works in your. Your business that provides therapy, right?

[Leticia Dukes]

Yes. So that person would be me.

[Attorney Reddington]

So did she come to see you for therapy?

[Leticia Dukes]

Yes.

[Attorney Reddington]

How many times?

[Leticia Dukes]

Four.

[Attorney Reddington]

So is it fair to say that she was more than willing to accept help from somebody like you?

[Leticia Dukes]

Yes.

[Attorney Reddington]

She didn't appear to be avoiding any therapy when recommended. Right. If you could, Ms. Dukes, please look at. I think it was December 12th. Was the next time perhaps that you saw her? Unless it's there's another inter intervening period.

[Leticia Dukes]

So there's. There's December 12th and then there's December 5th.

[Attorney Reddington]

Oh, okay. So if you could pull out December 5th.

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

And if I can come up and look at it. All right, so on December 5th, again, you were meeting with her for therapeutic intervention, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And on this occasion, she reported she had a difficult weekend, right?

[Attorney Buckingham]

Yes.

[Attorney Reddington]

Intrusive thoughts of wanting to die, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

That she called, contacted Aspire Crisis support, right?

[Court Reporter]

Yes.

[Attorney Reddington]

She met with an Aspire clinician, right?

[Court Reporter]

Yes.

[Attorney Reddington]

And what happened when she met with the Aspire clinician?

[Leticia Dukes]

She met with the clinician virtually and was told that she did not meet the criteria for inpatient treatment due to not having any suicidal ideation plan.

[Attorney Reddington]

So if she said, in addition to the fact that she. She's been in counseling and therapy and seeing psychiatrists and on medications for the past three 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.

[Court Reporter]

Correct.

[Attorney Reddington]

Did they, to your knowledge, make any recommendations? Did they suggest. Recommended that she attended day programs?

[Court Reporter]

Yes.

[Court Bailiff]

All right.

[Attorney Reddington]

And that person from Aspire then said he would send her patient resources, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

But. But nothing ever happened. He never sent her any. You did. But. But he never sent her any patient resources.

[Sergeant Dan Lawler]

Right.

[Attorney Reddington]

If, you know.

[Leticia Dukes]

Not to my knowledge.

[Attorney Reddington]

Okay.

[Court Bailiff]

All right.

[Attorney Reddington]

So she had you at least to talk to and counsel and advise her. You continued on to make your observations fair 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.

[Leticia Dukes]

Correct.

[Attorney Reddington]

Okay. Then you have, as a chief, complaint of present illness. And again, that was. Wait a minute.

[Leticia Dukes]

That's not my note.

[Attorney Reddington]

That's not you. Okay. All right, so you can hold on to that.

[Judge Selvich]

Yeah.

[Attorney Reddington]

Next time you saw her would be December 12th, is that correct?

[Leticia Dukes]

Correct.

[Attorney Reddington]

All right. Now, on December 12th, that was a teleconference that she had called by an appointment with you.

[Leticia Dukes]

Yes.

[Attorney Reddington]

And at that point, this is. She reported that she had a difficult weekend and was experiencing intrusive thoughts of wanting to. Do you have it in front of you? I don't want to take advantage of it.

[Leticia Dukes]

Hold on. On one second. I don't see the 12th in here.

[Court Bailiff]

Okay.

[Attorney Reddington]

Page 28.

[Leticia Dukes]

Page 28.

[Attorney Reddington]

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 in evidence. No, it's not.

[Court Bailiff]

It.

[Sergeant Dan Lawler]

Okay.

[Attorney Reddington]

Can it be in evidence? Can I offer that? Yeah.

[Court Bailiff]

Okay.

[Attorney Reddington]

Can I offer that Any objection?

[Attorney Buckingham]

Can we approach on the issue?

[Judge Selvich]

Sure, yeah.

[Leticia Dukes]

If I could just add that.

[Court Clerk]

Yes.

[Attorney Reddington]

Do you have December 12th again? I could do what I did before.

[Judge Selvich]

She probably had it before, right?

[Attorney Reddington]

Yeah. It references providers interventions. 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 plan. But she contacted Crisis over the weekend and that would be again Aspire, apparently. Right. Because there were two times she contacted Aspiring. Not once.

[Leticia Dukes]

Correct.

[Attorney Reddington]

Twice. Both times they told her that there's nothing they could do for her, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And she told you that she was going to start a PHP in Norwell on December 20, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

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?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Which is a really pretty good program.

[Leticia Dukes]

Correct.

[Attorney Reddington]

And did you know that she did in fact go to Women and infants on December 20? She didn't go to the Norwell Program. She went to Women and Infrastructure Infants Program. And that she was there for the day and that they basically turned her away?

[Leticia Dukes]

I did know that she went to the Women Infants Program. I was not sure of the date.

[Attorney Reddington]

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 20, and then that you and Nicole Harden Francisco reviewed various options, one of which was that which made sense to attend the Women and Infants Program, IOP or PHP program, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And that she patient provided you with verbal consent to sign whatever had to be signed and get her into that program, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

So you know that she did on December 20, after not getting anywhere with a school expire times two, and after dealing with Joada, for all those times that she dealt with. I'm sorry, the other one, Tufts, you were trying to get her into this program, which would be pretty good for a woman that had postpartum problems, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And you made your referral, you opened the door for her and she got in there to at least be interviewed, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And they didn't take her, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

You know why?

[Leticia Dukes]

I am not aware as to why

[Attorney Reddington]

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?

[Leticia Dukes]

Repeat the question.

[Attorney Reddington]

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. Any of that, because their opinion was that she was suffering from an over medication.

[Leticia Dukes]

It would surprise me, yes.

[Attorney Reddington]

But you don't know.

[Leticia Dukes]

I do not know.

[Attorney Reddington]

Okay. Did you know that the records from Women and Infants indicate that in fact, on that very same day, they reached out to Nurse Gelada and asked her to call them so that they could discuss the medication? And Jalada never got back to her?

[Leticia Dukes]

I was not aware of that.

[Attorney Reddington]

I'm sorry?

[Leticia Dukes]

I was not aware of that.

[Attorney Reddington]

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?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Okay. And I may have misunderstood. Did she ask you, 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?

[Leticia Dukes]

That's a list of different things that I did for her that day.

[Attorney Reddington]

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.

[Leticia Dukes]

Yes, we were in communication.

[Attorney Reddington]

All right, You're familiar with. Maybe you are the. What's called the Edinburgh scale?

[Leticia Dukes]

I'm aware of it, yes.

[Attorney Reddington]

And did she have Edinburgh scale administered to her, to your knowledge?

[Leticia Dukes]

To my knowledge, no.

[Attorney Reddington]

Okay. What is polypharmacy? What does that mean?

[Leticia Dukes]

Polypharmacy?

[Attorney Reddington]

Yeah. You ever heard of that? Polypharmacy?

[Leticia Dukes]

I've heard of it, but not sure if the exact.

[Attorney Reddington]

Okay, definition. Is it something to do with having too much medications thrown at you all at once, if you know.

[Leticia Dukes]

No, I'm not sure.

[Attorney Reddington]

Not sure. Okay. Excuse me for one minute. Apologize. I just had something pulled up and it just went back to default on me, so I just need a second. I apologize. Okay, I get it. And how long have you been working in your particular field?

[Leticia Dukes]

Since 2011.

[Attorney Reddington]

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?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Have you ever been aware. Are you aware of the Mass General Hospital center for Women's Mental Health?

[Leticia Dukes]

I am aware of it, yes.

[Attorney Reddington]

Do they offer seminars and programs as well as research articles?

[Leticia Dukes]

I believe they do.

[Attorney Reddington]

Okay. Do you know that Mass General 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 partum periods and how they break up the periods. You familiar with that?

[Leticia Dukes]

No, I'm not familiar with that.

[Attorney Reddington]

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 after pregnancy experience some type of mood disturbance? Would you agree with that?

[Leticia Dukes]

No, I wouldn't agree with that.

[Dr. Renee Stonebridge]

All right.

[Attorney Reddington]

Would you agree that 10 to 15% of women develop more significant symptoms of depression or anxiety?

[Leticia Dukes]

I agree.

[Attorney Reddington]

Okay. And then postpartum psychiatric illness is then divided into three categories. One sounds like something out of the 50s, post pattern blues. Would you agree with that?

[Leticia Dukes]

Yes.

[Attorney Reddington]

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 mother or baby or anybody else, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And it's fairly common, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Number two would be postpartum depression. That's a different issue, correct?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And number three would be postpartum psychosis. Is that right?

[Judge Selvich]

Yes. All right.

[Attorney Reddington]

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. One of which would be depressed or sad mood, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Lindsey had that, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Next would be tearfulness, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Lindsay had that, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Next one would be loss of interest in social activities or usual activities or friends. She had that, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Feelings of guilt. She had that right.

[Leticia Dukes]

She didn't express feelings of guilt.

[Attorney Reddington]

Okay. Feelings of worthlessness. Did she express that she felt worthless?

[Leticia Dukes]

She did not express that.

[Attorney Reddington]

About fatigue, did she have that?

[Leticia Dukes]

She did not express fatigue, but lack of sleep.

[Attorney Reddington]

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.

[Leticia Dukes]

I did not hear that from her.

[Attorney Reddington]

Okay, how about you mentioned it? You got it. Sleep disturbance is another issue, correct? Correct. She had that, right?

[Attorney Buckingham]

Yes.

[Attorney Reddington]

Change in appetite. She had that. Lost 10, 15 pounds, right?

[Attorney Buckingham]

Yes.

[Attorney Reddington]

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?

[Leticia Dukes]

Correct.

[Attorney Reddington]

So under the Mass General Hospital research project for women that are suffering from postpartum issues, she pretty much hit every one of the postpartum depression symptoms, correct?

[Leticia Dukes]

Correct.

[Attorney Reddington]

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?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And one of the ways that 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 Edinburgh test, right? Correct. And you're aware that she was given the Edinburgh test and had a 23 out of 30? I think it was.

[Leticia Dukes]

I was not aware.

[Attorney Reddington]

Okay. And some women develop panic attacks, referred to as hypochondriasis. You'd agree with that, right?

[Leticia Dukes]

Agree with that in reference to Lindsay,

[Attorney Reddington]

she had panic attacks and complained of having panic attacks.

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

Okay. And then you can get into the various diagnoses of which on a postpartum person in that time frame. Obsessive compulsive disorder, ocd, Right? Correct. Or bipolar one or bipolar two.

[Advertisement Voice]

Right.

[Leticia Dukes]

Are you using them interchangeably or could develop.

[Attorney Reddington]

Trust me, let's say bipolar one.

[Leticia Dukes]

Yeah.

[Attorney Reddington]

Okay. So that would be one mental disease, correct?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And it's pretty serious stuff, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And if a person is diagnosed as bipolar, one of the things that you shouldn't, if you know, is prescribe SSRIs such as Prozac or Zoloft.

[Advertisement Voice]

Right.

[Attorney Reddington]

If you know, I'm not sure of that. Okay. Would you agree that with various cases dealing with postpartum depression, all of the symptoms that we talked about, they utilize the Edinburgh Postnatal Depression Scale, which is a 10 item questionnaire that can identify women that have postpartum depression in the severity that they have. And on the scale, a score of 12 or greater raises concern and indicates a need for more thorough evaluation, right? Correct. Do you know whether she was thoroughly evaluated by anybody other than Tufts and Gelada?

[Leticia Dukes]

I'm only aware of Tufts and Gelata.

[Attorney Reddington]

Okay. I mean, you were trying to do the best you could with what you had to work with, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Okay, 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?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Would you agree that it occurs in averages about 2 out of 1000 women? Right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And its presentation can be very dramatic with onset of symptoms, and that can be within a year, according to the CDC center for Disease Control. Right. Okay. And when it Hits you. It just hits you bang quick, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And when you think about two out of 1,000 people, seems like a daunting number. But 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?

[Leticia Dukes]

Not sure of that number, but.

[Attorney Reddington]

Well, if you agree that it's two out of 1,000, according to the studies and the statistics, and if NWAY PAC has 37,000 seats, times two, would be 74.

[Court Bailiff]

Okay.

[Attorney Reddington]

That's a pretty large number of people, right? 74 people out of that crowd. Okay. It's not that horribly unusual. I mean, it's something that perhaps you've dealt with in your practice, right?

[Attorney Buckingham]

Yes.

[Attorney Reddington]

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.

[Leticia Dukes]

No.

[Attorney Reddington]

No, they don't, or no, you don't know?

[Leticia Dukes]

No, I don't know.

[Attorney Reddington]

Okay. Bottom line is, from your dealing with Lindsay, she appeared to be sincere, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

She appeared to be help looking for help, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

She appeared to be hurting, right?

[Court Reporter]

Yes.

[Attorney Reddington]

Turning in every direction she could for help, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

And the last time you saw her was when?

[Leticia Dukes]

December 19th.

[Attorney Reddington]

Okay, thank you very much, Attorney Bucky.

[Attorney Buckingham]

Ms. Dukes, you indicated that you didn't review the records of Nurse Paul or Nurse Gelada.

[Attorney Reddington]

Correct.

[Attorney Buckingham]

Why?

[Leticia Dukes]

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.

[Attorney Buckingham]

And that's why you do an entirely new process, right. Where you do your own intake, you assess diagnostics for determining whether there's any sort of mental illness, right?

[Leticia Dukes]

Correct.

[Attorney Buckingham]

And while you can collaborate or speak with the providers about an overall treatment for the patient, your therapy is your therapy.

[Leticia Dukes]

Correct.

[Attorney Buckingham]

And as far as your role, you don't have any role in medication management, do you?

[Leticia Dukes]

No, I don't. Okay.

[Attorney Buckingham]

And so when the note read current medications, is that just based on what pre fills for the patient? Based on their historical records for the clinic?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And so you don't know what she was prescribed and when and if all the of of those prescriptions were active, you just know what's in the computer?

[Leticia Dukes]

Correct.

[Attorney Buckingham]

And as far as the timeline here for the recommendations for partial hospitalization, I just want to make sure that we're Clear. You had been for some time recommending some sort of partial hospitalization program, correct?

[Leticia Dukes]

Correct.

[Attorney Buckingham]

And on December 12, you had already talked to Lindsey Clancy about the Women and Infants program, had you not?

[Leticia Dukes]

Correct.

[Attorney Buckingham]

And so when she told you on the 12th that she was starting that program in Norwell, that wasn't from your referral, right?

[Leticia Dukes]

No.

[Attorney Buckingham]

And you still recommended Women and infants, Correct. And you got her consent on that visit, right?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And on the 19th, when you see, were you aware that she had been at the Mass General ER on December 15 for evaluation?

[Judge Selvich]

No.

[Attorney Buckingham]

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 McLean, did you know that?

[Leticia Dukes]

I wasn't aware of that.

[Attorney Buckingham]

And when you met with her on the 19th after the visit to the ER, she still hadn't engaged with Women and Infants, had she?

[Judge Selvich]

No.

[Attorney Buckingham]

And. And so you had to re. Refer her?

[Leticia Dukes]

Yes.

[Attorney Buckingham]

But you weren't aware that she had already gotten a referral from Mass General?

[Court Bailiff]

No.

[Attorney Buckingham]

And so you did later learn she went on December 20, correct?

[Leticia Dukes]

Correct.

[Attorney Buckingham]

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

[Leticia Dukes]

No.

[Attorney Buckingham]

And as of your last meeting with her on December 19, ultimately, what were your impressions of how she was doing?

[Leticia Dukes]

My impression was that her symptoms were improving because of the social aspects, spending time with family and friends and able to exercise when before it was difficult for her to engage or pay attention.

[Attorney Buckingham]

And your observations of her while you were interacting with her, were they more positive than on previous occasions?

[Leticia Dukes]

Yes. She was able to smile and laugh.

[Attorney Buckingham]

Okay, thank you.

[Attorney Reddington]

When was it she was laughing with you?

[Leticia Dukes]

I believe that was the last visit, the 19th.

[Attorney Reddington]

So on the 19th, it was on television or was it in person?

[Leticia Dukes]

It was a virtual visit.

[Attorney Reddington]

Virtual visit? Yes. And on the 19th, on the virtual visit, what was the purpose of that visit?

[Leticia Dukes]

The purpose of that visit was to see if she was able to connect with care.

[Attorney Reddington]

Okay, So you would have, I guess, in your notes a reference to the fact that on the 19th of December that she was laughing.

[Leticia Dukes]

Not that she was laughing, but that she was able to laugh.

[Attorney Reddington]

Able to laugh?

[Attorney Buckingham]

Yeah.

[Attorney Reddington]

Okay, because I'm looking here on December 19th. Telemedicine. Latasha. Latisha. I apologize. Dukes Perinatal Behavioral 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 telehealth visit, please dot the phrase video visit. Whatever therapeutic intervention. She's 32 years old, married, 40, female. Presents for postpartum anxiety symptom management. Patient continues to have low mood and numbness. Patient numbness. Was she laughing when she had numbness?

[Leticia Dukes]

What date are you looking at?

[Attorney Reddington]

December 19th. The last day you saw her or the last time you had any contact with her?

[Leticia Dukes]

She didn't appear to have that. No.

[Attorney Reddington]

She didn't appear to have what? Laughing or numbness?

[Leticia Dukes]

Numbness.

[Attorney Reddington]

Well, it says right in the notes, does it not? The patient continues to have low mood and numbness.

[Court Reporter]

Yes.

[Attorney Reddington]

Okay, I don't want you to say yes unless I can show it to you.

[Judge Selvich]

So

[Attorney Reddington]

patient continues to have low mood and numbness, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Patient has not had suicidal mediation and does not need. Did not need crisis intervention over the weekend. In other words, she didn't kill herself or.

[Court Reporter]

Right.

[Leticia Dukes]

Correct.

[Attorney Reddington]

To help with the mood, patient has been spending time with her husband, children, and exercising, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

And exercise is one of the things that you would generally.

[Court Reporter]

Your.

[Attorney Reddington]

Your people would generally recommend that the mother do, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

That's a good thing to try to do is to exercise, right?

[Court Bailiff]

Correct.

[Attorney Reddington]

So if the fact that the government has records that show that she would take her kids or her husband would take her kids, that they would go to a local gym and exercise or swim, that that's consistent with what she was advised, right?

[Attorney Buckingham]

Correct.

[Attorney Reddington]

It doesn't mean that she's just out there having a good time exercising, right?

[Attorney Buckingham]

Objection.

[Judge Selvich]

No.

[Attorney Reddington]

Overall, she was told that that's a good thing to do, right?

[Leticia Dukes]

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.

[Attorney Reddington]

Oh, okay. So when did she go to the gym?

[Leticia Dukes]

She didn't give me exact dates. These are things that she told me she did.

[Attorney Reddington]

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?

[Leticia Dukes]

So we don't write down. Every thing that we talk about in the meeting is particularly a summary of that visit.

[Attorney Reddington]

Okay. And all I did was ask you about. Patient was spending time. Time with her husband, children, and exercising. And then you said that that's an indication that she's improving.

[Leticia Dukes]

Correct.

[Attorney Reddington]

Okay. And then I asked you if she's going to a gym. That's not a bad thing, is it?

[Leticia Dukes]

No, it's not.

[Judge Selvich]

Okay.

[Attorney Reddington]

And then it says that she received a call. And Council asked you about this. She received the 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.

[Attorney Buckingham]

Yes.

[Attorney Reddington]

She didn't continue to read that the reason she missed the call is that she was at another medical appointment, right?

[Leticia Dukes]

Correct.

[Attorney Reddington]

She called you back, right?

[Attorney Buckingham]

Yeah.

[Attorney Reddington]

Okay, clinician, maybe you provided contact information for Women and Infants. Patient reported that she would contact them today being 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?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Okay. And finally, fair to say that nowhere in here does it say that she was laughing.

[Leticia Dukes]

You would have to go to the assessment, the risk assessment. Okay,

[Attorney Reddington]

got it. Okay. Now, what's a mental status exam?

[Leticia Dukes]

So a mental status exam is to assess how the person is appearing that day, their mood and their interaction with you in that visit, and how you perceive them.

[Judge Selvich]

Okay.

[Attorney Reddington]

So with the help from the DA, we have December 19th, the telemedicine form, clinical notes, right?

[Court Bailiff]

Yes.

[Attorney Reddington]

The laughing wouldn't be a note in that area, would it?

[Leticia Dukes]

No. It would be more so in this area.

[Attorney Buckingham]

Yes.

[Attorney Reddington]

Mental status exam, Right. Appearance, hygiene, wnl, within normal limits. Okay. Clothing, normal. Eye contact, contact normal. Build, normal. Posture, normal. Body movement, normal, right?

[Attorney Buckingham]

Yes.

[Attorney Reddington]

Behavior is cooperative, right?

[Judge Selvich]

Yes.

[Attorney Reddington]

And speech is within normal limits, is that correct?

[Leticia Dukes]

Correct.

[Attorney Reddington]

Emotional state affect. Patient reports feeling numb and having low mood for most of the day, right?

[Leticia Dukes]

Yes.

[Attorney Reddington]

Facial expression? Other facial expression, Calm. Was able to laugh and smile, right?

[Court Reporter]

Yes.

[Attorney Reddington]

Would that be in response to you saying something funny or why was she laughing?

[Leticia Dukes]

That would be in response to me saying something funny.

[Attorney Reddington]

So you guys were kind of bonding a little bit.

[Court Reporter]

Yes.

[Attorney Reddington]

All right. But she basically still continued to report that she was numb, having low mood, and basically the symptomology that she had already reported, Right?

[Leticia Dukes]

Correct.

[Judge Selvich]

Okay.

[Attorney Reddington]

Thank you, ma'.

[Court Bailiff]

Am.

[Attorney Reddington]

Appreciate it.

[Court Bailiff]

All right.

[Judge Selvich]

Como.

[Attorney Buckingham]

Nothing further. Thank you.

[Judge Selvich]

All right. Thank you. Thank you. You may step down.

[Attorney Buckingham]

Thank you.

[Judge Selvich]

All right, come call your next witness

[Attorney Buckingham]

will call Cameron Daly as its next witness, please.

[Court Reporter]

Madam.

[Court Bailiff]

Now pending between the common. Welcome and. Thank you, sir.

[Attorney Buckingham]

You may have a seat, please.

[Judge Selvich]

All right. Good afternoon, sir.

[Sergeant Dan Lawler]

Afternoon. Yes.

[Judge Selvich]

All right, Miss Bucky.

[Attorney Buckingham]

In, please. Thank you. Sir, could you please tell the jury your first and last name?

[Sergeant Dan Lawler]

Cameron Daley.

[Attorney Buckingham]

And how do you spell your first name?

[Sergeant Dan Lawler]

C, A, M E, R, O, N.

[Attorney Buckingham]

And can you just spell your last name for the record?

[Sergeant Dan Lawler]

D, A, L, E, Y.

[Attorney Buckingham]

And where do you work?

[Sergeant Dan Lawler]

Duxbury Police Department.

[Attorney Buckingham]

How long have you been there?

[Sergeant Dan Lawler]

Six and a half years.

[Attorney Buckingham]

And back in January of 2023, what was your assignment then?

[Sergeant Dan Lawler]

Patrolman.

[Attorney Buckingham]

And I'm going to draw your attention specifically. January 24, 2023, were you asked to do a particular assignment out of Duxbury in that evening?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And what were you asked to do?

[Sergeant Dan Lawler]

Report to Brigham Women's Hospital.

[Attorney Buckingham]

And why were you going there?

[Sergeant Dan Lawler]

For hospital watch of the suspect.

[Attorney Buckingham]

And that individual was Lindsey Clancy?

[Leticia Dukes]

Correct.

[Attorney Buckingham]

Was there already a Duxbury officer on scene at Brigham and Women's when you got there?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

Two. Two?

[Judge Selvich]

Yes.

[Attorney Buckingham]

And who were they?

[Sergeant Dan Lawler]

Officer Lepard and Officer Broderick.

[Attorney Buckingham]

And when you arrived at the Brigham and Women Hospital, were you by yourself or was there somebody else with you?

[Sergeant Dan Lawler]

I was with another officer. Officer Thomas Johnson.

[Leticia Dukes]

Okay.

[Attorney Buckingham]

And were you able to make observations of the suspect of the defendant, Lindy Lindsay Clancy, on that day?

[Sergeant Dan Lawler]

Yes.

[Attorney Buckingham]

And she was asleep, was she not? Correct. And she had medical devices attached to her?

[Judge Selvich]

Yes.

[Attorney Buckingham]

Was she being treated by the medical staff there at Brigham?

[Sergeant Dan Lawler]

Yes, periodically.

[Attorney Buckingham]

And were you inside or outside the room, if you know?

[Sergeant Dan Lawler]

Outside the room.

[Attorney Buckingham]

And were any visitors or any other people other than the medical staff in that room with her while you were there?

[Sergeant Dan Lawler]

No.

[Attorney Buckingham]

And from the 24th into the 25th, what time did you leave the next day? On the 25th?

[Sergeant Dan Lawler]

So I reported to the hospital on the 25th.

[Attorney Buckingham]

Oh, okay.

[Sergeant Dan Lawler]

I was there.

[Attorney Buckingham]

I arrived at 10:00am so your shift there at the hospital was what?

[Sergeant Dan Lawler]

I got there at 10am I left about 7pm that night. But it was an 8 to 4 scheduled patrol shift.

[Attorney Buckingham]

Okay. And you said that was on the 25th? Correct. And you took over for Officer Lepard? Correct.

[Sergeant Dan Lawler]

Who were there on the overnight previous.

[Attorney Buckingham]

Okay, thank you for clarifying. And when you left that next Evening on the 25th at 7pm Was there another Duxbury officer who came to relieve you or who came to relieve you?

[Sergeant Dan Lawler]

No. At that time, State Police Detective McDonald's arrived on scene with his crime scene team, and then Plymouth County Sheriff deputies came to take over the hospital watch.

[Attorney Buckingham]

And during that entire shift that you were there, were any attorneys or any other individuals in the room to see miss Clancy?

[Leticia Dukes]

No.

[Attorney Buckingham]

And did you go back to the hospital for any shifts after that day?

[Sergeant Dan Lawler]

No.

[Attorney Buckingham]

Thank you. Nothing further.

[Attorney Reddington]

In uniform?

[Sergeant Dan Lawler]

Yes.

[Attorney Reddington]

Had your gun on?

[Attorney Buckingham]

Correct.

[Attorney Reddington]

Had your badge yes, sir. The other guy, too?

[Sergeant Dan Lawler]

Yes, sir.

[Attorney Reddington]

You were going to what, guard the woman that was tied to the bed?

[Attorney Buckingham]

Correct.

[Attorney Reddington]

That's all I have.

[Judge Selvich]

Anything?

[Attorney Buckingham]

Nothing, brother.

[Judge Selvich]

All right. Thank you, sir. Let me sit down.

[Attorney Reddington]

Thank you, your honor.

[Judge Selvich]

All right, so, members of the jury, rather than start another witness for just a couple minutes, we have break, take the afternoon recess. At this point, the plan would be to come back approximately 2 o', clock, come right back, resume with the commonwealth's case. I'll remind you again, I think you probably know what I'm going to say. No talk about this case. Don't do any research about this. Don't read anything about it while you're on break. Don't go anywhere that has anything to do with this case. Take the next hour. Just kind of put this out of your head. See you. All right, council, figures for one second.

[Attorney Reddington]

Sidebar for a minute. This court is back in session.

[Attorney Buckingham]

You may be seated, your honor, for

[Court Bailiff]

the purpose of the record, we return back to the matter, Commonwealth versus Lindsay Clancy. All parties are present, excluding the jury.

[Judge Selvich]

All right, council, can I see it?

[Court Reporter]

Sidebar, your honor, we can just go back to

[Judge Selvich]

waiting for the jury. 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 the warning that I gave, I think was last week that there are to be no disruptive statements or anything that's going to disrupt these proceedings. If that's done, they will be dealt with summarily, as we say. All right, so just a warning in regards to that. You're all set. All right.

[Sergeant Dan Lawler]

Yep.

[Attorney Reddington]

Ready for the jury. This court's job session. Please be seated.

[Court Bailiff]

Your honor, for the purpose of the record, we return back to the trial of Commonwealth vs Lindsey Clancy. All parties are present, including the defendant and including the 18 jurors.

[Judge Selvich]

All right, everybody, thank you for your patience. That would give you a couple extra minutes to look at the solar eclipse while you're up. So what we're going to do is we're going to return now to the commonwealth case and Commonwealth, did I call you? Next witness, please.

[Attorney Buckingham]

Prior to the witness, your honor, I was just moved to enter in as the next exhibit. He excerpted pages from the south shore health system perinatal behavioral health program. Regarding the last Witness, Leticia Dukes, 226. We would call Nicole Bradley as the next witness, please.

[Judge Selvich]

Thank you.

[Attorney Reddington]

Just for the record, your honor, I object. It's not contested. I Don't think it's necessary, so I object. Aye.

[Judge Selvich]

Same. Same finding?

[Attorney Reddington]

Yes.

[Leticia Dukes]

Stop right here.

[Attorney Reddington]

Where's your right hand,

[Court Reporter]

Please?

[Judge Selvich]

Hey. Good afternoon.

[Court Clerk]

Good afternoon.

[Court Bailiff]

How are you?

[Judge Selvich]

Good, thanks. Just gonna ask you keep your voice up so the jury could hear you and speak into that microphone.

[Attorney Reddington]

Okay?

[Court Bailiff]

Okay.

[Attorney Buckingham]

Thank you.

[Judge Selvich]

Yes, Carmel.

[Attorney Buckingham]

Thank you. Could you please tell the jury your first and last name?

[Court Reporter]

Yeah.

[Dr. Renee Stonebridge]

Nicole Bradley.

[Attorney Buckingham]

And where do you work?

[Dr. Renee Stonebridge]

Plymouth county sheriff's department.

[Attorney Buckingham]

What do you do there?

[Dr. Renee Stonebridge]

I'm an assistant deputy superintendent of the field services division.

[Attorney Buckingham]

And as one of the roles of the field services division, does the sheriff's department engage in what's called hospital watch?

[Court Bailiff]

Yes, we do.

[Attorney Buckingham]

Can you tell us very briefly what that is? Yep.

[Dr. Renee Stonebridge]

So if any safekeep detainee or inmate goes over to the hospital, we use our deputies and matrons to cover them

[Attorney Buckingham]

on a security watch. And are the employees from the sheriff's department who are on those watches required to log the activity of who comes and goes from the individuals who they are there to watch?

[Court Reporter]

Yes, they are.

[Attorney Buckingham]

And are those records kept in the normal course of business at the sheriff's department? Yes, they are. And you are familiar with those records and what they look like?

[Court Reporter]

Yes, I am.

[Attorney Buckingham]

If I may approach.

[Dr. Renee Stonebridge]

Approach.

[Judge Selvich]

And then.

[Court Bailiff]

Yes, please.

[Attorney Buckingham]

Thank you.

[Judge Selvich]

Then there'll be no objection.

[Attorney Buckingham]

Just going to show you a packet, if you could take a quick look at that.

[Dr. Renee Stonebridge]

Yep.

[Attorney Buckingham]

And does that packet reflect the hospital. Hospital logs that are kept by the sheriff's department?

[Court Bailiff]

Yes, they are.

[Attorney Buckingham]

And you're familiar that between January 25, 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?

[Court Bailiff]

Yes, I am.

[Court Clerk]

All right.

[Court Reporter]

Those.

[Judge Selvich]

Those may be admitted.

[Attorney Buckingham]

No further questions. Thank you.

[Attorney Reddington]

All right.

[Judge Selvich]

Thank you, ma'.

[Court Bailiff]

Am.

[Judge Selvich]

Thank you.

[Court Reporter]

Common calls. Dr. Renee Stonebridge.

[Attorney Reddington]

Same objection as decided by a judge. It's not contested. It's not necessary.

[Leticia Dukes]

All right.

[Judge Selvich]

Same. Same finding. Same analysis.

[Attorney Reddington]

Thank you.

[Judge Selvich]

Good afternoon.

[Attorney Reddington]

Good afternoon.

[Judge Selvich]

All right, Ms. Sprague.

[Court Reporter]

Thank you. Your honor. Good afternoon. Can you please state and spell your name for the record?

[Court Clerk]

Yes. My name is Renee Stonebridge. R E N E E S T O N E B R I D

[Court Reporter]

G E. Where do you work?

[Court Clerk]

I work at the commonwealth of Massachusetts at the Boston office.

[Court Reporter]

And what. What department do you work for?

[Court Clerk]

I work for the chief medical examiner's office.

[Court Reporter]

And how. How long have you worked there?

[Court Clerk]

I have worked there since July of 2017.

[Court Reporter]

And can you describe your educational background?

[Court Clerk]

Yes, I did four Years of college at SUNY at Stony Brook 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 Antigua where I got my medical degree. I also graduated with honors Magna Cummings Laude. After that I did a four year combined anatomic and clinical pathology residency program at NYU Winthrop Hospital in Long Island, New York. I also served as chief resident during my final year there. So 2016 to 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.

[Court Reporter]

What is neuropathology?

[Court Clerk]

Neuropathology is the study of the brain, the dura, the eyes and spinal cord and muscle.

[Court Reporter]

What is your role at the office of the chief medical examiner here in Massachusetts?

[Court Clerk]

My role there is the director of cardiac and neuropathology. I'm also a medical examiner, but my primary focus is brains and hearts.

[Court Reporter]

And so will there be an occasion where a medical examiner is doing an autopsy and they will send you either a brain or eyes or things of that nature to examine?

[Court Clerk]

Yes.

[Court Reporter]

And why are those things sent to you in particular?

[Court Clerk]

We have certain criteria that is followed in order for a neuropathology consult to occur. Some occasions are any children under the age of two, I am to receive the brain. Typically the spinal cord depends on circumstances. The eyes and the dura as well. Also, if there is any suspicion of some type of homicidal injury to the head, blunt trauma, typically those cases. Cases will typically come to me as well. Sometimes there are cases in which it may just be something that is surprise a person. One of the MEs 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 maybe something like a tumor that is unexpected or rare. Neurologic disease, neurodegenerative disease that requires further neuropathologic evaluation.

[Court Reporter]

And were you tasked with doing some examinations regarding Kora Clancy, Dawson Clancy and Callan Clancy?

[Dr. Renee Stonebridge]

Yes.

[Court Reporter]

And specifically for Kora Clancy, what did you examine for Kora Clancy?

[Court Clerk]

I examined the I eyes.

[Court Reporter]

And what were your findings when you examined her eyes?

[Court Clerk]

The findings when I examined the eyes were that there was acute hemorrhage of the extraocular muscles and adipose 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 adipose tissue. So there is hemorrhage in these portions of adipose tissue and muscle that is surrounding, 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.

[Court Reporter]

And are you able to determine by seeing these hemorrhages what caused them?

[Court Clerk]

Hemorrhages themselves are very general finding. However, given the entirety of the case, knowing what I know from the autopsy findings, I can say it is consistent with something asphyxial.

[Court Reporter]

And why is it that when there's something asphyxial, that means strangulation of some type, correct?

[Court Clerk]

Yes, it can be.

[Court Reporter]

Why is it that these types of hemorrhages occur in the eye?

[Court Clerk]

What happens when there's some sort of asphyxial element to a person? It could be from many different things, but what happens is the blood in the head, if there's, say, some type of compression of the neck or something, something else that causes asphyxia, 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, in the 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.

[Court Reporter]

And in terms of Dawson Clancy, what did you examine with Dawson Clancy?

[Court Clerk]

For Dawson Clancy, I examined the eyes as well.

[Court Reporter]

And what were your findings?

[Court Clerk]

The findings were that there was also some acute hemorrhages in these muscle and adipose 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 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.

[Court Reporter]

And what is the hemorrhage?

[Court Clerk]

Hemorrhage itself is just blood that is no longer contained in a blood vessel.

[Court Reporter]

So it's burst from that vessel.

[Court Clerk]

Correct.

[Court Reporter]

And then in terms of Callan Clancy, what did you examine with Kalyn Clancy

[Court Clerk]

For Callan Clancy, I examined the brain, the dura, the spinal cord, and the eyes.

[Court Reporter]

And what were your findings?

[Court Clerk]

The findings were that there was hypoxic ischemic 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. One of the things I note is that there's edema. Edema is when the brain starts to swell. 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 kind of bumpy pattern on the brain. 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. 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 allow for the cerebral spinal fluid to flow through the brain and go into the spinal cord. And when the brain starts 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. Another thing I noted was that the brain was diffusely friable, meaning that it's very soft. So one of the things I do on all my brain cases is they go into formalin. The formalin allows them to fix, which basically firms up the tissue, and it makes the tissue more easy to manipulate a brain. A fresh brain coming out of a skull 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 formalin. I typically will let them fix for about two weeks or so. And sometimes, regardless of the fixation time at the formalin, 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 ischemic changes, the formalin is only going to penetrate the tissue so much because. Because the tissue is essentially already dead.

[Court Reporter]

So stop you for a second. What is hypoxic ischemic changes?

[Court Clerk]

Hypoxic ischemic changes is when you are getting lack of blood and oxygen flow. So hypoxic is the oxygen portion and ischemic is the blood portion.

[Court Reporter]

So what you saw with Callum's brain was consistent with a lack of blood and oxygen.

[Court Clerk]

Correct.

[Court Reporter]

Which then led to brain death.

[Court Clerk]

Correct. Yes.

[Court Reporter]

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?

[Court Clerk]

It varies based on different sources. Most sources say it's between about six to eight minutes. If there is no oxygen flow, then the brain will essentially start dying. It depends on if there's resuscitation that occurs afterwards. But it's generally in the frame of six to eight minutes or so.

[Court Reporter]

And once brain tissue dies, it can't be brought back, correct?

[Court Clerk]

Correct. Yes.

[Court Reporter]

I have nothing further. Thank you.

[Attorney Buckingham]

You're welcome.

[Judge Selvich]

Hold on, 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? Of course.

[Attorney Buckingham]

All right.

[Attorney Reddington]

All right. Closing notebooks,

[Court Reporter]

please.

[Court Bailiff]

Session.

[Judge Selvich]

All right, we'll be in a short recess. The courtroom. Everybody in the courtroom.

[Attorney Reddington]

Hi, council.

[Judge Selvich]

Can I see? It's sidebar.

[Attorney Reddington]

This court's now in session. Please be seated.

[Court Bailiff]

Your Honor, for the purpose of the record, we return back to the trial of Commonwealth vs Lindsay Clancy. All parties are present, including the defendant, and including the 18 jurors.

[Judge Selvich]

All right, well, members of the jury, I just kind of want to revisit an instruction I've given you a couple times. I think during the course of this trial, it's important to understand and remember that sometimes there's evidence that's presented in the trial that creates an emotional reaction. 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 the informational value and weight that the evidence produces. 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 on sympathy or anger or passion or prejudice. All right? So you've got to keep that in mind. And so with this, we're going to go to the next witness.

[Leticia Dukes]

Okay?

[Court Reporter]

Commonwealth calls Dr. Babra Vidal Olsen.

[Judge Selvich]

All right. Same finding and analysis.

[Court Bailiff]

All right.

[Judge Selvich]

Good afternoon, doctor.

[Court Clerk]

Good afternoon.

[Judge Selvich]

All right, I'm gonna ask you also to keep your voice up so the jury can hear you and speak into that microphone, if you would.

[Court Bailiff]

Okay.

[Judge Selvich]

All right. Have a sprig.

[Court Reporter]

Thank you, your honor. Good afternoon. Can you please state and spell your name for the record?

[Dr. Renee Stonebridge]

My name is Dr. Barbara Olson. B A R B A R A O L S O N I P. Previously practiced under my maiden name, Barbara Vidal. V I D A L Can you

[Court Reporter]

describe for us your educational background, please?

[Dr. Renee Stonebridge]

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 deaconess medical center. I completed a four year residency program there studying both antigone 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 board certified in anatomical pathology, clinical pathology and forensic pathology.

[Court Reporter]

And what is forensic pathology?

[Dr. Renee Stonebridge]

It is essentially the study of causes that are diseases, disorders or trauma that results in sudden, unexpected or non natural deaths.

[Court Reporter]

And do you currently work at the office of the chief medical examiner?

[Dr. Renee Stonebridge]

Yes, I'm a medical examiner at the Cape Cod office of the office of the chief medical examiner.

[Court Reporter]

How long have you worked there?

[Dr. Renee Stonebridge]

Since 2021.

[Court Reporter]

And approximately how many autopsies have you performed?

[Dr. Renee Stonebridge]

I have examined over 1900 bodies and and performed over 800 autopsies.

[Court Reporter]

And when performing an autopsy, is there a specific process or procedure that you follow?

[Dr. Renee Stonebridge]

Yes. So an autopsy is composed of many parts. 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 for identifying characteristics of a decedent, 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 Y like incision on the chest and abdomen and examine the soft tissues, bones and organs, looking for any evidence of natural disease and trauma. I also examine the brain.

[Court Reporter]

And did you perform an autopsy on Cora Clancy on January 25, 2020, 23?

[Court Clerk]

Yes.

[Court Reporter]

And did you follow that same process with Cora Clancy?

[Dr. Renee Stonebridge]

Yes.

[Court Reporter]

And so that started with a document review, is that correct?

[Dr. Renee Stonebridge]

Yes.

[Court Reporter]

And what type of documents are you reviewing when you do that?

[Dr. Renee Stonebridge]

Typically, I have a preliminary police report to review, as well as either EMS records or records from the emergency department.

[Court Reporter]

And did you start with an external examination of Cora?

[Attorney Buckingham]

Yes.

[Court Reporter]

And what did you observe during that external examination?

[Dr. Renee Stonebridge]

The external examination of Cora. I saw evidence of medical intervention. 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 her neck stabilized with a cervical collar. And she had an intraosseous catheter, which is type of iv they put directly into the bone on her right lower leg. Her hands at the time of my external examination were covered by police evidence bags, and they were secured at the wrist with tape. 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 minor injuries of her right arm and of her legs as well.

[Court Reporter]

And in terms of the injuries that you observed, evidence of trauma to her neck, were there also injuries to her face, to her face and neck area that seemed to go along with the trauma to her neck?

[Dr. Renee Stonebridge]

Yes, there were findings with the of the head that were associated with the trauma of the neck.

[Court Reporter]

And what were those?

[Dr. Renee Stonebridge]

So on her neck, she had a ligature furrow. A ligature 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 site of compression. So for Cora, her ligature furrow consisted of a linear, horizontally oriented area of pallor or pale around her neck, with distinct superior and inferior edges on the front part of her neck. The lower half of the ligature 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 ligature furrow had developed some linear bruising as well.

[Court Reporter]

And what do you mean by a furrow?

[Dr. Renee Stonebridge]

So again, the furrow is a ligature 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.

[Court Reporter]

And what about injuries?

[Judge Selvich]

All right, council. Want me to take a break this time?

[Attorney Reddington]

All right, all right. All right. Close your notebooks, place them on the chairs, please.

[Judge Selvich]

Recess for a few minutes. I'm going to come back. We'll speak to council in regards to schedule. Okay.

[Court Bailiff]

Lindsay Clancy, all parties are present, excluding the jury.

[Judge Selvich]

All right.

[Attorney Reddington]

Council, cyber?

[Judge Selvich]

Yeah, please. All said

[Dr. Renee Stonebridge]

yes, I am still under oath.

[Attorney Reddington]

Courts now session please proceeded.

[Court Bailiff]

Your honor, for the purpose of the record, we return back to the trial of con off first. All parties of present, including the defendant and the 18 jurors.

[Judge Selvich]

All right, Attorney Sprague, thank you.

[Leticia Dukes]

Your honor,

[Court Reporter]

you had described previously the injuries to Cor's neck. Were there also injuries on her face that correlated to those marks?

[Dr. Renee Stonebridge]

Yes. On examination of her face, she showed diffuse 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.

[Court Reporter]

And if I could have photo 2246, please. Doctor, there's a remote here. If you press and hold the top button, you can highlight what you're talking about in the photo when it comes up. What are we seeing here? Is that the area of the petechial hemorrhage?

[Dr. Renee Stonebridge]

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 petechial hemorrhages.

[Court Reporter]

Okay. And if you could. Is that working for you? I can see that. This area here. Yes. Okay, you just hold that top button and hold it down and so we can remove that photo. When you talked about particular hemorrhaging in the eyes and eyelids, did it look similar to that?

[Dr. Renee Stonebridge]

Yes.

[Court Reporter]

And basically it's those red marks all around the mouth. And then those same red marks were on the eyes eyelids. You tell me where they were.

[Dr. Renee Stonebridge]

So they are pinpoint hemorrhages that occur. And again, they were located on the inside of the eyelids. So I inverted did the eyelids and I flipped open the inside of the lips and they were also in those locations.

[Court Reporter]

And if we could have photo of 7784, please, you could tell us what injuries we're seeing here in this photo.

[Dr. Renee Stonebridge]

In this photo, we are looking at the body from the left and you can see the ligature furrow in this photo. Here is the linear area of pallor with the distinct superior and inferior edge. You can also appreciate in this photo some small punctate hemorrhages or the petechial hemorrhages of the face.

[Court Reporter]

And if you could show photo 7782 please, what are we seeing here in terms of injuries?

[Dr. Renee Stonebridge]

In this photo we are looking at the front of the neck, again focused on the ligature furrow, which is this distinct area, linear area of pallor. And on the front of her neck, the lower half of this ligature furrow had scattered red abrasions associated with it.

[Court Reporter]

Take down the photo. What are abrasions in terms of what you do?

[Dr. Renee Stonebridge]

So abrasion occurs when there is sufficient friction against the skin to cause a superficial. A removal of the superficial layer of the skin.

[Court Reporter]

Is it basically a scree?

[Dr. Renee Stonebridge]

Yes.

[Court Reporter]

And can we have photo 2256 please? You can tell us what we're looking at here, please.

[Dr. Renee Stonebridge]

This is a close up photo of the back of the neck. Here is the linear area of pallor with the distinct superior and inferior linear edges. You can appreciate that the linear edges in this photo started to develop linear bruising.

[Court Reporter]

And were there other injuries on the body other than those on the neck and the face?

[Dr. Renee Stonebridge]

Yes, she had injuries to her right arm and on her legs.

[Court Reporter]

And if I could show you Photograph 7789, are you able to tell us what we're looking at here?

[Dr. Renee Stonebridge]

This is an up close photo where we can see a very small faint bruise. All of the bruises on her legs and as well as her right arm consisted of small scattered bruises.

[Court Reporter]

And if we could have photo 770, what are we seeing here?

[Dr. Renee Stonebridge]

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 a site of medical intervention, the intraosseous catheter site where the needle enters the bone.

[Court Reporter]

And if we could see 7790, please, what are we seeing here?

[Dr. Renee Stonebridge]

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.

[Court Reporter]

And then the last photo, 2233. I'm sorry, one more after that. What are we seeing here in this photograph?

[Dr. Renee Stonebridge]

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.

[Court Reporter]

And if we could see photograph 7794 what is shown in this photo, this

[Dr. Renee Stonebridge]

is an image of her left leg, again, showing the two bruises close to her left ankle and then additional bruises on her left lower leg.

[Court Reporter]

And then 7775, please. What are we seeing in this photo?

[Dr. Renee Stonebridge]

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.

[Court Reporter]

In terms of bruising, are you able to tell the age of a bruise by looking at it?

[Dr. Renee Stonebridge]

No.

[Court Reporter]

Can you tell whether it's a fresh or an old bruise?

[Dr. Renee Stonebridge]

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.

[Court Reporter]

And the bruises that you observed on Cora's body, how did they appear?

[Dr. Renee Stonebridge]

They all had versions of red appearance to their chase.

[Court Reporter]

So because they had red appearances that mean that they are fresh wounds, they occurred recently. And again, you can't tell how they occurred or what the exact time and date they occurred.

[Court Clerk]

Correct.

[Court Reporter]

Is there any information you can glean from the location of the wounds where some of the bruises were close together, like the three on the knee or the two on the lower right leg?

[Dr. Renee Stonebridge]

No, I can only document where they are and their measurements.

[Court Reporter]

Now, can I have a moment?

[Judge Selvich]

Sure.

[Court Reporter]

Going back to the injuries on her neck, what do those tell you? Based on your training experience, when you're trying to determine the cause of death, what do those wounds tell you?

[Dr. Renee Stonebridge]

When I see a ligature burrow that is horizontally oriented in association with significant petechial hemorrhages, those findings are consistent with a ligature strangulation.

[Court Reporter]

And what is ligature strangulation?

[Dr. Renee Stonebridge]

Again, A ligature is an object used to apply external force to the neck, and a strangulation is when it is done by someone else.

[Court Reporter]

And when that happens, what effect does it have on the body? How does it. What is the mechanism of death?

[Dr. Renee Stonebridge]

So ligature strangulation results in a category of asphyxial type of death. Asphyxia 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, well, blood is how oxygen is delivered throughout our body. So the right side of the heart delivers blood to our lungs, where during breathing and respiration, we then put oxygen to 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 starts all over again. It's a continuous circulation. But when you have compression of the neck, first and foremost, your airways reduce, 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 intracranial pressure. And with the compression of the artery, there's no oxygenated blood Being delivered to the brain.

[Court Reporter]

And as this blood is gathering in the face and head area, Is that kind of causing the same type of pressure As a balloon filling up?

[Dr. Renee Stonebridge]

Yes. Or like a water pipe as well.

[Court Reporter]

And what happens as that blood pools and causes that pressure in the face and the head?

[Dr. Renee Stonebridge]

What normally happens is, first and foremost, the brain just has a reduced 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.

[Court Reporter]

And as that pressure is building in those veins and are rupturing, Is that painful?

[Dr. Renee Stonebridge]

So, 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.

[Court Reporter]

And how long can it take, or does it take for loss of consciousness to happen?

[Dr. Renee Stonebridge]

I cannot put a specific time on it for the interval. There is multiple variables to consider In a case by case basis. The type of ligature used, the force of the ligature used against the neck, as well as the intensity and duration of the altercation. However, in situations where there's complete oxygen deprivation, Loss of consciousness can occur as early as 10 to 30 seconds, with brain damage beginning at the 1 minute mark, and irreversible brain damage and subsequent death Occurring around as early as five minutes, Again, with the caveat that there are variables that might accelerate or decelerate that timeframe.

[Court Reporter]

Is there a type of constant pressure that's required to cause that loss of consciousness?

[Dr. Renee Stonebridge]

Ultimately, once the brain has A critically low level of oxygen, A loss of consciousness will occur. It takes an average of 4 pounds to compress the veins of the neck, and an average of around 10 pounds to compress the arteries of the neck.

[Court Reporter]

And so if someone's squeezing something or pulling something around the neck at that 4 pounds or 10, 10 pounds of pressure in a consistent basis without any resistance. Does unconsciousness happen faster?

[Dr. Renee Stonebridge]

It could occur faster, yes.

[Court Reporter]

What if someone's resisting or struggling or pulling away? Could that take longer?

[Dr. Renee Stonebridge]

When the body is in a state of stress, 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, delivered to the brain, it can accelerate the timeline to loss of consciousness.

[Court Reporter]

What do you mean by accelerate the time to loss of consciousness overall?

[Judge Selvich]

You can ask.

[Dr. Renee Stonebridge]

It would just make it occur faster.

[Court Reporter]

And so if that pressure isn't constant, 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?

[Judge Selvich]

Sustained. Sustained.

[Court Reporter]

You said anywhere from five to 30 seconds. What are the factors? I'm sorry? You said 10 to 30 seconds. Is that correct?

[Dr. Renee Stonebridge]

Yes. For loss of consciousness, what are the

[Court Reporter]

factors that are at play for whether it's 10 seconds or 30 seconds?

[Dr. Renee Stonebridge]

Again, there's multiple variables. The force of the ligature against the neck, the actual ligature itself, and the intensity and duration of the altercation.

[Court Reporter]

And once someone loses consciousness, do they immediately die?

[Dr. Renee Stonebridge]

No. So. So if there's no intervention, the brain continues to have a lack of oxygen, and so until the brain cells start to die, it's irreversible injury to the brain. The person is alive until the body can no longer sustain the lack of oxygen.

[Court Reporter]

If someone is strangled to the point of unconsciousness and the strangulation stops, can

[Dr. Renee Stonebridge]

they wake up without intervention is very unlikely.

[Court Reporter]

So do you recall testifying previously that when asked if a person were to use a ligature around someone's neck to the point where they pass out.

[Judge Selvich]

Counsel, we had that answer right.

[Court Reporter]

It's an inconsistent statement.

[Judge Selvich]

This is your witness.

[Court Reporter]

I know. And I can impeach with an inconsistent statement.

[Judge Selvich]

I see.

[Attorney Reddington]

It's sidebar, Doctor.

[Court Reporter]

Do you have to continue to apply to strangle someone past the 30 seconds to cause death?

[Dr. Renee Stonebridge]

No. Once the brain is subject to oxygen deprivation and brain cells start to die there, it's irreversible. And so it will continue to progress towards death if there's no intervention.

[Court Reporter]

What do you mean by intervention?

[Dr. Renee Stonebridge]

Resuscitative efforts. If somebody tried to give cpr, if they were hooked up to oxygen machines,

[Court Reporter]

do you recall testifying previously that it would be your opinion that pressure would need to be continually applied even after losing consciousness, to cause death?

[Judge Selvich]

Sustained.

[Court Reporter]

So your testimony is that you can strangle someone for 30 seconds, let go, and then they die?

[Dr. Renee Stonebridge]

I said that in this presence of 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, not without intervention. It's very unlikely. Again, the brain cannot heal those cells.

[Court Reporter]

Did you form an opinion to a reasonable degree of professional certainty, to medical certainty, as the cause of death of Kora?

[Dr. Renee Stonebridge]

Yes.

[Court Reporter]

And what was that?

[Dr. Renee Stonebridge]

Asphyxia.

[Court Reporter]

And was that by manual strangulation?

[Dr. Renee Stonebridge]

By strangulation?

[Court Reporter]

Mechanical strangulation, I mean.

[Attorney Buckingham]

Yes.

[Court Reporter]

Did you also examine or do an autopsy on Dawson Clancy?

[Dr. Renee Stonebridge]

Yes.

[Court Reporter]

And when was that?

[Dr. Renee Stonebridge]

January 25th.

[Court Reporter]

And did you observe injuries on Dawson Clancy when you did the external examination?

[Dr. Renee Stonebridge]

I did observe injuries to Dawson. He had trauma to his neck with associated injuries of the head as well as minor injuries to his left arm and his legs.

[Court Reporter]

And if we could pull up photo 2166, what are we seeing in this photo?

[Dr. Renee Stonebridge]

This photo is a picture of the lower lip of Dawson being pulled down. And we can see, again, similar to Cora, these petechial hemorrhages on the inside of the mouth.

[Court Reporter]

And can you also see them on the eyes?

[Dr. Renee Stonebridge]

In this photo, you can see periorbital petechial hemorrhages. So the skin around the eye.

[Court Reporter]

And were there also those same type of hemorrhages when you lifted the eyelid?

[Dr. Renee Stonebridge]

Yes.

[Court Reporter]

And if we could have photo 21:49, what are we seeing here?

[Dr. Renee Stonebridge]

Dawson, on his neck, similar to Cora, had a linear, horizontally oriented ligature furrow consisting of an area of pallor around the neck. He had distinct superior and inferior edges to his furrow as well. This is on the backside of the neck where we can also appreciate abrasion that are in line or parallel with the inferior and superior edges of the furrow.

[Court Reporter]

And if we could have photo 2147, please, what are we seeing in this photograph?

[Dr. Renee Stonebridge]

In this photograph, we can appreciate the distinct area of pallor here on the neck, again representing the ligature furrow with diffuse petechial hemorrhages of the skin of the face.

[Court Reporter]

And what are we seeing there on his shoulder?

[Dr. Renee Stonebridge]

This is just some dried body fluid.

[Court Reporter]

And if we could see photo 2151, please, what is depicted in this photograph?

[Dr. Renee Stonebridge]

This is a similar photograph to the one just shown here, where you can see the distinct area of pallor representing the ligature Furrow with superior and inferior edges. And again, the diffuse petechial hemorrhages of the face.

[Court Reporter]

And these photos of Dawson's face, the hemorrhaging on the face appear to be darker than those and more expansive than those on Cora's face.

[Leticia Dukes]

Correct.

[Dr. Renee Stonebridge]

They appear more prominent in Dawson than in Cora.

[Judge Selvich]

Yes.

[Court Reporter]

And what can cause the damage being more prominent and more dispersed over the face?

[Dr. Renee Stonebridge]

Again, petechial hemorrhages occur as a result of rupturing of small vessels in the skin. And so. So the fact that there are more present in Dawson is indicative that there were moments where some blood did reach or push through the furrow or the ligature in little spikes or peaks which would just result in momentary increases in blood pressure that would result in more petechial hemorrhages.

[Court Reporter]

And what would cause that blood being able to flow?

[Dr. Renee Stonebridge]

Any movement against the carotid arteries. The carotid arteries. Arteries are thicker and more muscular than the veins. So they're more likely to push through with the blood. So that could be movement of the ligature or movement of the person handling the ligature or movement of Dawson himself.

[Court Reporter]

It could be from Dawson struggling or it could be from more pressure or force of the ligature.

[Dr. Renee Stonebridge]

Yes, changes in the pressure of the ligature.

[Court Reporter]

And if I could see photo 21:43, please, what are we seeing in this photo?

[Dr. Renee Stonebridge]

This is the back of his left forearm. It is a little pale with the light, but there were three small bruises on the back of his left forearm.

[Court Reporter]

And going to photo 2155, what are we seeing in this photo?

[Dr. Renee Stonebridge]

This is a picture of us. 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.

[Court Reporter]

And then going to photo 2144, what are we seeing in this photograph?

[Dr. Renee Stonebridge]

This is an up close photograph, but I can appreciate that there are small bruises in the center of the image.

[Court Reporter]

And photograph 2156, what are we seeing in this photograph?

[Dr. Renee Stonebridge]

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.

[Court Reporter]

And so when you said here, here and here, that was the outer portion

[Dr. Renee Stonebridge]

of the of the left upper leg.

[Court Reporter]

Thank you. We could have photo 2119, please. What is depicted in this photograph?

[Dr. Renee Stonebridge]

This is an up close photo of his hands.

[Court Reporter]

And is there any significance to the blueness of the fingernails?

[Dr. Renee Stonebridge]

I would not have called these necessarily blue or cyanotic. That would be more of the discoloration of his face. There is some subtle blueness to the nail beds, which is again a sign of cyanosis, which is just reflective of a decrease in oxygen in the body.

[Court Reporter]

And last photo is the PDF, please. What are we seeing here?

[Dr. Renee Stonebridge]

This image, 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 intraosseous catheter site.

[Court Reporter]

And what are you able to tell us about the bruises on Dawson in terms of whether they're fresh or old?

[Dr. Renee Stonebridge]

They were all red and purple in appearance, so they were more recent.

[Court Reporter]

And based on your examination of Dawson, were you able to determine a cause of death?

[Court Clerk]

Yes.

[Court Reporter]

And did you determine that to a reasonable degree of medical school uncertainty?

[Dr. Renee Stonebridge]

Yes.

[Court Reporter]

And what was that?

[Dr. Renee Stonebridge]

Asphyxia.

[Court Reporter]

Your Honor, I'd move to submit the original photos of Core and Dawson as for identification.

[Judge Selvich]

So mark the first set for identification.

[Attorney Reddington]

Right.

[Judge Selvich]

Then over the defendant's objection, using the same analysis as stated sidebar, those other photographs may be admitted.

[Court Reporter]

The photos of Cora and then Dawson

[Attorney Buckingham]

as the next exhibits, please.

[Dr. Renee Stonebridge]

228 and 229.

[Court Reporter]

And then the. Excuse me. Death certificate of Cora Marie Clancy as the next exhibit.

[Judge Selvich]

That may be admitted.

[Court Reporter]

And the death certificate of Dawson William Clancy as the next exhibit. Have nothing further. Thank you. All right.

[Judge Selvich]

Thank you, doctor. May step down.

[Attorney Reddington]

All right,

[Judge Selvich]

We're going to break at this time. I'm going to ask you to come back tomorrow at 9 o'.

[Court Reporter]

Clock.

[Judge Selvich]

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, 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, Court.

[Attorney Reddington]

All right. Thanks for the call.

[Judge Selvich]

This court in session. Council, anything we need to address before tomorrow morning?

[Court Bailiff]

No.

[Attorney Reddington]

Thank you.

[Judge Selvich]

So we'll be in recess on this matter till tomorrow at 9 o'.

[Attorney Reddington]

Clock.

[Judge Selvich]

Thank you.