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Chief Coroner Dr. Cohen testimony. Pages 1279-1304.
Citation preview
Sonja A. Hudson, CSR
SUPERIOR COURT - STATE OF CALIFORNIACOUNTY OF RIVERSIDE
PEOPLE OF THE STATE OF CALIFORNIA,Plaintiff,
vs.KRISTOFER MICHAEL MCCAUSLAND, JAMESANDREW FENT, MIGNON HERNANDEZ DEAN,JERROD NATHAN MENZ, TAMI DAWNSCARCELLA, ABTTC, INC., dba ABETTER TOMORROW TREATMENT CENTERS,FORTERUS, INC., and FORTERUS HEALTHCARE SYSTEMS, INC.,
Defendants.
))))))))))))))))
CASE NO. SWF1501351
Volume 7 of 9Pages 1118-1336
S-E-A-L-E-D
REPORTER'S TRANSCRIPT OF CRIMINAL GRAND JURY PROCEEDINGSJULY 15, 2015
APPEARANCES:FOR THE PLAINTIFF: DEPARTMENT OF JUSTICE
OFFICE OF THE ATTORNEY GENERALDIVISION OF CRIMINAL LAWBUREAU OF MEDI-CAL FRAUD & ELDER ABUSEBY: JOEL SAMUELS1425 River Park Drive #300Sacramento, California 95815
REPORTED BY: SONJA A. HUDSON, CSR NO. 13150
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Sonja A. Hudson, CSR1118
RIVERSIDE, CALIFORNIA; JULY 15, 2015.GRAND JURY FOREPERSON: Good morning, everyone. The
grand jury will now come to order.Will the secretary please take roll.GRAND JURY SECRETARY: Juror No. 1.GRAND JUROR NO. 1: Here.GRAND JURY SECRETARY: Juror No. 2.GRAND JUROR NO. 2: Here.GRAND JURY SECRETARY: Juror No. 3.GRAND JUROR NO. 3: Here.GRAND JURY SECRETARY: Juror No. 4.Juror No. 5.GRAND JUROR NO. 5: Here.GRAND JURY SECRETARY: Juror No. 6.GRAND JUROR NO. 6: Here.GRAND JURY SECRETARY: Juror No. 7.GRAND JUROR NO. 7: Here.GRAND JURY SECRETARY: Juror No. 8.GRAND JUROR NO. 8: Here.GRAND JURY SECRETARY: Juror No. 9.GRAND JUROR NO. 9: Here.GRAND JURY SECRETARY: Juror No. 10.GRAND JUROR NO. 10: Here.GRAND JURY SECRETARY: Juror No. 11.GRAND JUROR NO. 11: Oh, here.GRAND JURY SECRETARY: Juror No. 12.GRAND JUROR NO. 12: Here.GRAND JURY SECRETARY: Juror No. 13.
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Sonja A. Hudson, CSR1119
GRAND JUROR NO. 13: Here.GRAND JURY SECRETARY: Juror No. 14.GRAND JUROR NO. 14: Here.GRAND JURY SECRETARY: Juror No. 15.GRAND JURY FOREPERSON: Here.GRAND JURY SECRETARY: Juror No. 16.GRAND JUROR NO. 16: Here.GRAND JURY SECRETARY: Juror No. 17.GRAND JUROR NO. 17: Here.GRAND JURY SECRETARY: Juror No. 18.Juror No. 19.GRAND JUROR NO. 19: Here.GRAND JURY FOREPERSON: The record will reflect all
17 jurors are present.Counsel, you may begin.MR. SAMUELS: Thank you. Good morning.THE GRAND JURY: Good morning.MR. SAMUELS: It's my memory we were finished with
Sergeant Gomez last night, so I will bring another witness in.GRAND JURY FOREPERSON: Please remain standing and
raise your right hand.You do solemnly swear that the evidence you shall
give in this investigation now pending before the grand juryshall be the truth, the whole truth, and nothing but thetruth, so help you God?
THE WITNESS: Yes.GRAND JURY FOREPERSON: Please be seated.I have a statement acknowledging a secrecy order that
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I would like you to read, sign and print your name at thebottom.
(Pause in proceedings.)Please state and spell your full name for the record.THE WITNESS: Larry Steve Albert, Jr. First is
L-a-r-r-y, middle S-t-e-v-e, last A-l-b-e-r-t, and last ofJr., J-u- -- I'm sorry. Go ahead.
GRAND JURY FOREPERSON: Thank you.Counsel, you may begin.MR. SAMUELS: Thank you.
LARRY STEVE ALBERT, JR.,called as a witness by the People, was sworn and testified asfollows:
DIRECT EXAMINATIONBY MR. SAMUELS:
Q. Good morning.A. Good morning.Q. How are you employed?A. I am employed with the Riverside Sheriff's Department
as a sergeant with the coroner's bureau.Q. So are you sworn law enforcement?A. Yes, sir.Q. And how long have you had the position with law
enforcement?A. I have been law enforcement since 2005.Q. And do you know what POST training is?A. Yes.Q. P-O-S-T?
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Sonja A. Hudson, CSR1121
A. Yes, sir.Q. What is it?A. It's Police Officers Standards Training, which is
something that is required by the State of California for allof its sworn peace officers to meet certain requirements.
Q. As part of your POST-certified training, did you takea class on writing reports?
A. Yes, sir.Q. Did you pass that class?A. Yes, sir.Q. Were you on duty as a Riverside sheriff's coroner in
July of 2010, the 26th of July, to be specific?A. Yes, sir.Q. And do you remember getting a call for service?A. Yes, I do.Q. Do you remember where you went?A. I went to the -- to an Iron Gate address in the City
of Murrieta regarding an unattended death.Q. And do you remember who summoned you there by any
chance?A. It was Murrieta PD. I'd have to refresh my memory as
to the officer's name.Q. Okay. So do you know what time you got there, to
this address? Do you remember the address by any chance?A. Not offhand. I do remember it was on Iron Gate, but
I don't remember the exact address.Q. All right. Do you remember what time you arrived at
the house you were summoned to or the address you were
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Sonja A. Hudson, CSR1122
summoned to?A. I would have to look at my report to refresh my
memory.Q. Would it refresh your recollection to look at your
report?A. Yes, sir.Q. Is that a copy of your report in front of you?A. Yes, sir.Q. And it's been sitting there facedown?A. Yes, sir.Q. I see some other documents here. I'm going to put
those to the side and ask you not to review them during yourtestimony. Is this your report?
A. Yes, sir, it is.Q. Okay. You may refresh your recollection, which means
if reading your report or looking at it brings it back intoyour present memory, you may testify as to what you rememberin your own mind.
A. About approximately 0935 hours, I arrived at theaddress.
Q. So 0935, is that morning or evening?A. That's military time for morning.Q. Okay. Thank you.A. 9:35 in the morning.Q. And I'm going to show you some portions of an
exhibit, Exhibit 43. It's got multiple pages. I'm going toask you if you recognize a page marked 000154.
A. Yes, I do.
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Q. And what is it?A. It's my photographs from the scene.Q. You took this photograph? You believe you took this
photograph?A. Yeah, I believe I did.Q. Okay. And what's that in the upper portion of this
page that I'm showing you from this exhibit?A. A sober living residence.Q. Well, what kind of -- what kind of building are we
looking at?A. It's a single-family home.Q. And is it related to what you've testified to?A. Yes, sir.Q. How?A. It is a single-family home that is used by a
company --Q. No, no. What you've already testified to.A. I'm sorry. This is the address that I responded to
for an unattended death.Q. Okay. Thank you. And is that number there -- did
you take that picture of the address plate?A. Yes.Q. Okay.
MR. SAMUELS: I have a question about the climatecontrol in here. I'm going to go ask the grand jurysecretary. If I may be excused to do that?
GRAND JURY FOREPERSON: Thank you, sir.(Brief recess.)
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Q. BY MR. SAMUELS: Okay. Now, did you go in this houseon Iron Gate?
A. Yes, sir.Q. And do you recall where in the house you did any
investigation there?A. I conducted some interviews which occurred in the
kitchen area.Q. Okay.A. And I also conducted my investigation in a bedroom,
which, if I remember correctly, was located in the northeastcorner of the residence.
Q. All right. Do you remember -- I'm going to show youa portion of this exhibit that has a Bates stamp of 000161 onit. Do you recognize that?
A. Yes. That's the decedent's bedroom right here.Q. And I'm going to show you what's been Bates stamped
as 000162. Do you recognize that?A. Yes, sir. Still the decedent's bedroom.Q. So I'm projecting up here for the grand jury's view,
page 000161. There are two pictures on it; one on the upperhalf, one on the lower half. We're looking at the lower halfbeing depicted. Is that a view that you recall?
A. Yes.Q. What is it?A. The decedent's bedroom.Q. And the area that I'm pointing toward, this, do you
remember that?A. Yes.
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Q. What is it?A. That's the -- where the decedent slept.Q. Okay. And this darker area here that's under my pen
hovering over the picture, can you tell us what that objectis?
A. Comforter.Q. A comforter. Okay. And may I have the next one that
you were holding onto? This is -- excuse me. This is apicture of top and bottom. The bottom picture has now beenturned 90 degrees so it's oriented properly in terms of itsspacial orientation. What's that?
A. The picture on the right, a bedside table with anumber of personal items on it, decedent on the floor, andthen the -- near the decedent's head, an 02 tank and atraveling pouch.
Q. Okay. So it's not just a tank, it's in what again?A. I don't know what they refer to them as, but it's
usually used as a little traveling pouch they can -- it has astrap so they can carry the 02 around with them.
Q. What's 02?A. I'm sorry. Oxygen, an oxygen tank.Q. All right. And are you -- are you -- I'm going to
give you a laser pointer and let you point out what you'rereferring to. There's a red dot on this. If you push thatand point it at the wall, it should display.
A. There we go.Q. Okay.A. Right here, the 02 tank. We often see individuals
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Sonja A. Hudson, CSR1126
that have very small 02 tanks and they have a little zip-upcontainer that usually has a strap that allows them to carrythe 02 container around with him as they travel through theirday. And right up here you see a few personal items,cigarettes, watch, clock. This is -- I don't remember whatwas in this. Right back here is a nebulizer, which is a drugdelivery system. A nebulizer is basically used as -- todeliver a drug as a mist, and it's almost like an oxygen maskthat one wears and it delivers that over time.
Q. Do you know if the nebulizer delivers oxygen or areyou just referring to the mask?
A. Just to the -- it's like -- it's like an oxygen mask.It does not, as far as I know, deliver oxygen.
Q. Did you see anything -- talking about the oxygentank, the 02 tank that you said was in the black pouch thereby the decedent's head, was there anything hooked up to that?
A. If I remember correctly, a nasal cannula.Q. All right.A. Which is basically when you have a person that is
taking oxygen, it can be delivered a couple of different ways,just with a mask that's placed over the face, and somethingelse that's called a nasal cannula, which is little tubingthat fits over the nose right in here, which you've often, I'msure, seen in medical shows.
Q. Do you remember if there was a regulator of any typeon that tank?
A. No, I don't.Q. Okay. I'm going to show you another picture here.
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This is the one that's marked Bates stamped 000164, ask you toidentify it, and then I'll project it.
A. This is still the decedent's bedroom, the floor ofthe decedent's bedroom.
Q. Okay. Let me project that and we can discuss it.A. Sure.Q. We're looking first -- this is a page with two
pictures. We're looking first at the upper picture. Now, isthis the condition that you observed when you arrived?
A. Yes.Q. So what do you see on the wall there?A. A plug right here.Q. Is that also called an electrical outlet?A. Yes.Q. Is there anything attached to that electrical outlet?A. No.Q. And I see some things on the floor there. Can you
describe them?A. This right here would be the cable that runs up to
the nebulizer. It's unplugged and on the floor. This tubingright here is tubing that's commonly used for oxygen and mayor may not be attached with a nasal cannula.
Q. So is it attached to anything at either end?A. I don't recollect at this point if he had the nasal
cannula on him but, no, on this end, as far as I can tell, no,it is not.
Q. So it's not attached to either the nebulizer or theoxygen bottle?
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Sonja A. Hudson, CSR1128
A. Correct.Q. Okay. And here this is the other picture on 000164.
I'm turning the page so that it orients correctly. What'sthis picture depict?
A. This is a nebulizer.Q. And how do you know that?A. I don't recognize this particular model, but I
recognize it as a nebulizer, as a delivery system fordelivering drugs.
Q. Do you have training and experience with regard tonebulizers?
A. For visualizing in numerous cases and being out onnumerous unattendeds.
Q. Okay. In your job?A. Yes, sir.Q. I'm handing you what's Bates stamped as 000166. Do
you recognize that?A. Yes. This is the --Q. Okay. Let me project it so you can discuss it.A. Okay.Q. There are two pictures here. I'm going to show what
I'm referring to as the top one. The Bates stamp is in thelower right-hand corner. This is the top one. What do yousee there?
A. This is the gentleman's luggage and that is an 02mask. And this right here, I believe, falls into the secondphoto, but it is the 02 tubing, if I --
Q. All right. I'm showing you the lower tubing now.
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Sonja A. Hudson, CSR1129
A. I can see the mask here. And then the containerright here, this packet, I believe, contains 02 tubing.
Q. All right. And when you say 02, you mean oxygen?A. I'm sorry. Yes, oxygen.Q. It's just an abbreviation or --A. Yeah, it's an abbreviation.Q. And these photos, you said they were taken of items
in his luggage. Can you explain what you mean by that?A. When I come in and I do my investigation, what I do
is I come into, for example, an area where I'm doing myinvestigation in this particular room, and I will do overalls.Everything should be as was. Nothing should be moved. And Iwill not move anything when I walk into the room. I'll shootoverall photos and then I will shoot photos of anything ofparticular interest.
This gentleman required 02. So when I opened up hisluggage, I took photographs of what was in his luggage.
Q. Okay. I'm going to show you the picture that's got aBates stamp of 167. Just tell me if you recognize it.
A. Yes, I do. This is the decedent's bedroom and --Q. Okay.A. I'm sorry. I keep reading on.Q. Sure. I'm going to show you the lower picture first
on 167. What's that depict?A. The decedent in the bedroom where he was found.Q. Now, to your knowledge, has he been moved to this
point?A. No, he had not.
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Sonja A. Hudson, CSR1130
Q. And do you see an object by -- I'll turn it to makeit a little clearer. Is this how the decedent was orientedwhen you entered?
A. Yes.Q. What's that immediately to his left? Well, behind
him is a better way of saying it. Behind him, I'm sorry.Now, immediately behind him.
A. Behind him?Q. By his seat. By his bottom.A. I'm not sure where you're referring to.Q. I'm referring to here on the left side.A. Oh, I'm sorry, the bed. I was looking for something
on the floor. I apologize.Q. Okay. What's that on the floor?A. That is a water bottle.Q. And so was he touching the bed?A. Yes, he was.Q. And his foot in this photo, it may appear to be under
the bed, but did you check to see if it was under the bed?A. It's very slightly under the bed.Q. All right. And is this picture a proper depiction of
what you saw at that time?A. Yes, sir.Q. And did you make a closer inspection of the decedent?A. Yes, sir.Q. And is this a photo of that inspection -- from that
inspection?A. Yes.
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Q. Why did you take this?A. Every single body exam we do, again we shoot overalls
of the room, but when we come to the body, we -- basically wecone in and we move closer to photos of the body just as itis, and then I will move the body after that and do my bodyexam, shoot overalls of the individual front and back.
Q. Okay. Looking at these two photos together, is thereanything remarkable about the condition of the decedent'sbody?
A. Yes.Q. What's that?A. The lividity present, which you can see right away.Q. All right. Let me stop you. What does your training
and experience tell you lividity means?A. Lividity is the -- when someone passes away, your
heart stops pumping. The easiest way to explain it is thatyour body settles to the lowest point. So if you're laying onyour back, the blood is going to settle to your back. Andthis gentleman right here, he was almost kneeling and it lookslike he's slumped forward, so everything settles in the chestarea and in the dependent areas.
Q. Okay. And how do we see that in these picture?A. You can see the very dark red that is right in the
areas around here.Q. And it goes higher or lower in his body?A. Lower. He also had a couple of things going on with
his skin. He had some injuries from -- from his dogs andthings like that.
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Q. Well, how would you know they were from his dogs?A. The gentleman at the facility told me when I had
asked him.Q. So it wasn't based on your inspection that you knew?
You just saw injuries?A. I saw injuries and I asked about them because I
wanted to make sure. They were healing. But I wanted to knowwhat they were from.
Q. Okay. But from your own inspection, your own eyes,your own training and experience, you saw injuries. Can youdescribe those injuries? You said they were healing. Whatdoes that mean?
A. You can -- you know, you can often see -- whensomebody gets a cut, you see that fresh kind of redness to it.You can see when it's starting to heal over, just like whenyou get a cut, you see that scab kind of healing over it soyou get a kind of general idea of how well-healed somethingis. This gentleman had quite a few injuries that were allhealing that were apparently from his dogs.
Q. Okay. But you don't know about that from personalknowledge?
A. No.Q. Okay. I'm handing you what's been Bates stamped as
000168. Do you recognize that?A. Yes, sir, I do. This is the decedent.Q. Okay. All right. And I'm going to display this.
It's again two pictures on one page. This time what I willrefer to as the bottom picture, the one closer to the Bates
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Sonja A. Hudson, CSR1133
stamp number, what's this?A. This is the decedent in his found position.Q. And this picture, which I've reoriented to place the
decedent's head at the top of the picture.A. This is what you'll note is the plastic right under
here, it's plastic that I had my transport guys put down. Hewas moved onto the plastic from his found position so I coulddo a body exam.
Q. Now, is his position, once he's been moved onto theplastic, suggestive of anything?
A. Oh, yes. Rigor mortis --Q. Okay. Let me stop you. What is rigor mortis?A. Rigor mortis is the stiffening of limbs. When you
pass away, what happens is the -- your -- whatever positionyou're in, your limbs start to stiffen and the body starts tostiffen, and it will become more and more prominent over time.And it actually will eventually leave. You will -- it startsgoing away.
Q. So is this progressive? The body becomes stiffer.If I'm understanding you, you said more and more over time.Does that mean it's progressively stiffer until it goes away?
A. Yes. Progressively stiffer until it goes away. Andthere are some varying factors which are very complicated andbeyond me. When somebody is febrile, when they have a veryhigh temperature, you'll see this occur very quicklysometimes. But there's other factors that may cause it tooccur. But it gives us a general sense as to how long aperson has been dead.
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Q. Okay. Are you familiar with the concept of differentstages of rigor mortis?
A. Yes.Q. What does that mean?A. The different stages of rigor mortis, if you're
referring to just general over time, what we refer to in thesimplest terms is that when someone passes away and the rigoris present but easily breakable, that kind of gives us ageneral time frame as to how long they have been dead. Ifthey are very stiff in this manner and rigor mortis -- if Ihave to literally take their arm and push it down and itreally won't go all the way down, that tells me that rigormortis has set and it's probably on the very outside of thewindow of how long this person has been deed.
Q. What do you mean on the outside of the window?A. Probably close to the stages where rigor mortis is
going to start leaving the body. Within probably severalhours, it will probably start leaving the body.
Q. And are there numeric values for these stages?A. General numeric values, yes. I mean, we see rigor
mortis sometimes occur very quickly. I mean, I've seen itoccur incredibly quick. But we've felt --
Q. Let me stop you.A. Sure.Q. Do you say it's stage 1, stage 17, stage 105 rigor
mortis? That's what I'm referring -- the numeric values thatyou use to say to associate with whatever stage rigor mortisis in.
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A. Yeah. And generally what we refer to is we do --yes, there are. We refer to the stages as just being easilybreakable and things like that. We see that rigor mortisusually starts occurring in approximately two hours. In eighthours, it reaches -- probably reaches about this point.
Q. Okay. I'm sorry. So when it's easily breakable, doyou call that stage 1 or stage 2 or stage 3 or something, ordo you just call it easily breakable?
A. We call it easily breakable in our notes for simpleterms, yes.
Q. Okay. That's what I was getting at. So you don'tuse numbers?
A. No.Q. All right. Sorry. Anything else you need to add?A. No, no, no. It's out there, but we just -- we
generally don't use it. I mean, it's something that when wewrite our reports or things like that, what we're looking foris to communicate to the public in simpler terms. And even inour notes when we write it in house, we don't use those.Nobody really does in house.
Q. Okay. So you use the terms easily breakable and whatelse?
A. Easily -- the beginning stages of rigor mortis werepresent, and rigor mortis present and easily breakable withgentle pressure, with moderate pressure, with heavy pressure.
Q. How would you characterize the rigor mortis that youfound in this subject on that day?
A. I would have described it as rigor mortis being set
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and breakable with heavy pressure.Q. All right. Now, I want you to look at this picture
that's projected and I want you to tell us about thecoloration of the decedent.
A. That's the -- that's the extreme for lividity. Thatis set. Now, what happens with lividity is that when it veryfirst starts, you see those areas -- like if my hand were downlike this and the blood were settling right here, if you couldsee a little bit of redness, you know -- if I press down andyou see white, what we call blanching, if you see that whiteon there, then you know that it hasn't been there that long.And then you can press down and you can see that it may nothold as much white and may be a lot more red. This is justcompletely red. There's no blanching. What we call blanchingwould just be, again, the pressure of when you push down, itwill go white. So if you push down on your arm, you'll seeit.
Q. What about this area here near the decedent's kneewhere I'm showing you with the pen?
A. Those are called pressure marks. And what happens isis that lividity is setting but what happens is that was theheaviest pressure areas where his body was resting, so youwon't see the lividity in those areas.
Q. All right.A. Excuse me.Q. Are you familiar with the term cyanosis?A. No.Q. Okay. So I'm going to show you what's been Bates
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stamped 000170. Do you recognize that?A. Yes.Q. And 000169. Do you recognize that?A. Yes.Q. First, the one that's 169, upper portion. Now, the
mark on his arm here, is that consistent with the mark thatwas on his knee --
A. Yes.Q. -- that you just described? And that's due to, once
again, could you describe -- tell me?A. That's going to be where you're seeing the heaviest
parts of the body pressing down where all that pressure is andwe call this pressure marks.
Q. Okay. And his arm was pressing down where, if youcan associate it with a part of his body with a part of theroom? Do you need to go back?
A. If I remember correctly, the floor.Q. Okay. And I'm going to put up -- first, the lower
portion of 000170, what do you see in this picture?A. The pressure marks on the -- near the knee.Q. And I'm going to point out a portion of this picture
with the tip of my pen here. Do you see where I'm indicating?A. Yes, that's --Q. What is that?A. That would be -- if you're pointing to exactly this
right here?Q. I am.A. Okay. If I remember correctly, that's one of the
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injuries from his -- from his dog.Q. Well, I'm asking you what you saw at that time. You
didn't see any dogs, did you?A. Right. It's an injury.Q. Okay.A. It's a well-healed injury.Q. Well-healed injury.A. Correct.Q. And one last picture. This picture, can you describe
what that shows us?A. After moving him onto the plastic, and as you saw him
as he was, I broke rigor and was able to get his legs down andhis arms down.
Q. Okay. Now, do you create a report based on yourinvestigation?
A. Yes, sir.Q. And you actually -- do you do investigation beyond
what you showed us with regard to the decedent's body?A. Yes. Depending on the case, yes.Q. In this case, did you do any investigation beyond
what is described in handling the deceased's body?A. Yes.Q. What did you do?A. Interviews with the staff. I attempted to interview
the other guests of the detoxification house. And thenspeaking to the wife to confirm social and medical history.
Q. Okay. Do you remember any of the staff youinterviewed?
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A. Yes.Q. Can you give me any names?A. Mr. McCausland, if I'm pronouncing that correctly.Q. And do you remember a first name for Mr. McCausland?A. Not offhand, I do not.Q. I'm going to show you what has been marked as
Exhibit 11. It's a one-page photo. You can turn it over andlook at it. Do you recognize that person?
A. That looks like Mr. McCausland.Q. All right. Thank you. Is that the individual
projected on the wall to your left?A. Yes, sir.Q. Okay. Thank you. And what did Mr. McCausland have
to tell you that you recall?A. The gentleman that passed away flew into San Diego
airport, was picked up by a staff member of the detoxificationhouse at the San Diego airport. They brought him back to thedetoxification house, arriving approximately 1730 hours, whichis 5:30 in the afternoon. At that time, they began theirintake process. They took all of his prescribed medications,which they were going to dispense to him over time. He saw adoctor.
Q. Okay. Hold on. Let me stop you occasionally.A. Sure.Q. They took all of his prescribed medications. Did
Kris McCausland tell you what those prescribed medicationswere?
A. Yes. I'd have to look at my report to refresh my
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memory exactly to what all of them were.Q. Okay. If it will refresh your memory, you may look
at your report. Is that your report on the table facedown?A. Yes, sir.Q. Okay. Turn it over, read it to yourself. If it
refreshes your recollection, if you'd indicate it to me.A. Sure.Q. Okay.A. Okay.Q. So do you remember the meds they took into their
possession?A. Theophylline, Chantix, hydrocodone, Digoxin,
Levaquin. I'm missing a couple. If you don't mind, if Icould look again?
Q. Would it refresh your recollection?A. Yes, sir, it would.Q. You may. You've turned your report upside down.
What do you remember now?A. Cardizem and prednisone. I think I covered them all.Q. Now, when you looked in his room in his luggage, did
you find any -- are you fam- -- well, let me go back.Do you know what an inhaler is?
A. Yes.Q. Describe it for me.A. Inhalers generally have different drugs or they do
have different drugs and it's just a little canister that'splaced inside a little plastic inhaler. When you press downon it, it sends out a puff of the medication and the
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individual just breathes the medication in.Q. All right. You held your hand out with your
forefinger and thumb in the shape of a C. What did that mean?A. Just about the size. They're pretty small. I mean,
they're not very large at all. They're generally kind of in avery small L-shape with the -- with the delivery down rightdown here. So the canister is just placed inside in theplastic delivery system. And again, you just press down on itand it sends a little puff of the medication out and youinhale it.
Q. Through your nose or your mouth?A. Through your mouth.Q. Did you see any inhalers when you did an inventory of
the personal possessions in Gary Benefield's room?A. No. I don't remember any inhalers in there.Q. Okay. And did you actually see the drugs or the
prescription medications that had been taken by KrisMcCausland from Gary Benefield?
A. No. If I remember correctly, they had them lockedand they couldn't get the key for it.
Q. And did -- you didn't mention these, but do yourecall whether or not Kris McCausland told you they had takenprescribed medications including a Spiriva HandiHaler?
A. Yes.Q. You do recall that now?A. Yes. That was -- I'm sorry, I thought I mentioned
that one when I went through all of those.Q. Okay. Do you know what a Spiriva HandiHaler is?
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A. The -- he had a couple or different medications,heart medications and medications for -- he had chronic -- hehad chronic obstructive pulmonary disease.
Q. How do you know that?A. That was given to us by the -- or given to me by the
staff as part of his medical history. Additionally, Iconfirmed that with his wife. Chronic obstructive pulmonarydisease is something that is basically a lung issue. When youhave somebody that smokes a lot, they have troublebreathing --
Q. Okay.A. -- and you'll see -- I'm sorry.Q. Let me stop you. There's no question about chronic
obstructive pulmonary disease.My question is, I think I asked you if you know what
a Spiriva HandiHaler is.A. Yes.Q. Okay. Go ahead.A. It's for his chronic -- his -- for his COPD, for his
chronic obstructive pulmonary disease. It's a -- one of themedications that would help him breathe easier.
Q. Okay. Thank you. Now, did Mr. McCausland tell youabout any tests he did on Gary Benefield when Gary Benefieldarrived at the house on Iron Gate?
A. Yes. They did a breathalyzer and they did a drugtest.
Q. And what did the breathalyzer show? What didMcCausland tell you it showed?
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Sonja A. Hudson, CSR1143
A. It was .059, if I remember correctly, for thebreathalyzer.
Q. And what does that measure to you?A. That's a fairly --Q. What it measures, not what the --A. Oh, I'm sorry.Q. -- not what the numbers are.A. Okay.Q. What does it measure?A. Alcohol.Q. Alcohol and what, if anything?A. In the -- when you exhale, it measures the alcohol
molecules and gives you a number as to how much a person hasbeen drinking.
Q. Okay. And did he say anything about any other tests?A. They did a drug test.Q. And did Mr. McCausland tell you if it was indicative
of anything?A. It was positive for marijuana.Q. Okay. Now, I think I interrupted you to talk about
the medications just when you said that Mr. McCausland toldyou something about Mr. Benefield and the doctor.
A. Yes. As part of their intake process, he said thatMr. Benefield had seen a doctor upon intake, which was --
Q. Go ahead.A. -- Dr. Noreen Bumby.Q. Now, had you ever heard of Dr. Noreen Bumby up until
that time?
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A. No.Q. So would you have any reason to know that name other
than Mr. McCausland telling it to you?A. No. And I asked him several times about it, because
I wanted to make sure. Because when they had the doctor -- Imean, I didn't think it was too unusual. But I thought, youknow, this doc saw him so quickly upon arrival, and I wouldhave thought that the doctor would have seen him the next dayor something like that.
Q. All right. Did he say if he, Mr. McCausland, didanything with regard to the deceased and medication?
A. Yeah. He dispensed out two medications to him.Q. And did he say what they were?A. I would have to refresh my memory from my report, but
they were part of the detoxification process.Q. So you believe that the names of the medications are
in your report but you can't remember them specifically oryou'd have to refer to your report to --
A. I would have to refer to my report to remember themspecifically.
Q. Okay. I'm just asking if you know that they arelisted in there.
A. Yes, they are. They are listed in there.Q. Okay. Would you look at your report and let me know
if it refreshes your recollection.A. Those two medications were trazodone and Serax or
Serax.Q. Do you know how to spell that now that you've looked
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at it?A. It's S-e-r-a-x. And to be honest with you, it's not
a medication I'm familiar with.Q. Okay. Did Mr. McCausland tell you about any
interactions he had with Gary Benefield after he -- I thinkyou said he did intake, he gave him some detox medications.Any interactions after that?
A. The only interaction that he told me about after thatwas that he saw Mr. Benefield leave his bedroom to go to thebathroom. Mr. Benefield went to the bathroom. Upon returningfrom the bathroom, Mr. McCausland said that he, Mr. Benefield,did not have a shirt on, and because of their policies, hetold him that he needed to put a shirt when he was leaving hisroom. And that was approximately -- he said it was about0030 hours, which is 12 -- 30 minutes after midnight.
Q. Did he say -- did Kris -- did Mr. McCausland tell youanything about going into Gary Benefield's room with anotherworker named Andrea Powell and finding Gary Benefield seatedon the floor next to his bed?
A. I don't remember him saying that he went in withAndrea Powell, but he did give a wake-up call, I believe itwas about 0800 to zero --
Q. Okay. Nope. I'm just asking about whether he saidanything to you about going in with Andrea Powell.
A. No, not that I remember.Q. Would that be something you would have noted in your
report?A. Yes.
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Q. Would it have been an important piece of informationfor you as an investigator?
A. Oh, yeah, because it would have been between the lasttime that he was seen alive and the time that he -- I was toldthat he was found dead. If there was something in betweenthere, then that narrows -- that's very significant for mebecause it narrows the time of death now.
Q. What about if it was before the last time he wasseen, would it still -- but after he was given themedications, would it still be significant?
A. If it was -- if it was after he was given themedications and before Mr. McCausland told him to put a shirton, it wouldn't have been very significant to me. It would besomething that I would have wanted to know and would havenoted in my report, and depending on what their reason was forgoing into the bedroom together.
Q. Well, if they found him on the floor and needingassistance to be placed back --
A. That's very significant to me.Q. Okay. And so let me finish --A. I'm sorry.Q. Okay. I think you answered it anyway. So it's very
significant to you why?A. Well, the gentleman would have been in distress at
that time. And my questions would have been, why didn't youhelp him? What time was that? What occurred after that? Imean, what did you -- what did you do to help him and whydidn't you?
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Q. Okay. Now, did Mr. McCausland tell you the next timehe saw Gary Benefield after he saw him with no shirt on andtold you it was 12:30, in other words, 30 minutes pastmidnight?
A. Approximately 8:00 in the morning is when he saidthat he was making rounds to do wake-up calls, as they oftendo in these homes. And they go to each individual's door andknock on the door and make sure they get up.
Q. And what did he say he noticed when he went to thedoor?
A. There was no answer at the door, so he went in and hefound Mr. Benefield on the floor.
Q. I'm sorry. Did you say what time he said that was?A. I'd have to refresh my memory to the exact time. It
was 0800 -- I'm sorry, 8:00 in the morning. I apologize.Q. So that's from your memory. You didn't look at
your --A. That's from my memory. I can look at my report and
give you the exact time he told me.Q. Did you check to see what time 911 was called?A. I believe I did.Q. Well, I guess I'm getting ahead of myself. Do you
know whether or not 911 was called?A. Yes.Q. How do you know that?A. Well, because law enforcement was there and they
reported the death to me and they came out and pronounced thegentleman prior to my arrival.
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Q. What does pronounce the gentleman mean?A. That means that when either law enforcement comes out
or, let's say, paramedics or the fire department and theyeither monitor the person through an EKG or there's obvioussigns of death, what they'll do is they pronounce the death.That means that that's the time that they're actuallypronounced. It doesn't mean that that's the time that theydied.
Q. Okay. So would it refresh your recollection as tothe time Mr. McCausland told you that the police were called?
A. Yes.Q. What time did Kris -- I'm sorry, Mr. McCausland --
tell you that he had gone to the door of Gary Benefield?A. Approximately 800 -- 0800 hours. Again, about
8:00 in the morning.Q. Now, did you speak with any person who identified
himself as having pronounced him?A. I don't remember if I spoke to the individual that
actually pronounced or not.Q. Okay. Are you familiar with the terms within the
context of your work of foam, froth, blood, and purge?A. Uh-huh.Q. What do those terms mean?A. It's a -- every single case that we do, whether it's
a case that's being reported to us over the phone and we maynot respond out to it or if we respond out, it's a commonquestion that we always ask, foam, froth, blood, and purge.
Foam is something that we may see in an overdose case
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and will set off alarm bells that the officers that are -- ordeputy that's reporting to us says that they see what we calla foam cone.
Froth is probably -- it's just a different way ofasking the same question. It's repeated in there twice.
Blood, it -- you know, we're looking for any possibletrauma or anything like that. Do you see any blood?
Purge, any vomit or anything like that, significantamounts.
Each one of these, for different reasons, kind of setoff alarm bells for us.
Q. So do you -- in a typical death investigation, do youlook for signs of foam, froth, blood, or purge?
A. Every single one.Q. And in this particular one, do you recall what you
saw in regards to foam, froth, blood, and purge?A. I don't remember seeing anything.Q. I'm sorry, could you --A. I don't remember seeing anything, any foam, froth,
blood or purge.Q. All right. And did you interview anyone else at the
residence who was associated with the services that wereprovided there?
A. Mr. Ortega, which was the --Q. Hold on. Hold on. Are you sure it was Ortega?A. I would need to refresh my memory.Q. Okay.A. Is that okay?
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Q. You may. In other words, you don't remember?A. No, I do not.Q. Okay.A. I don't remember his exact name. Mr. Ochoa.Q. All right. What do you remember, if anything, about
your interaction with Mr. Ochoa?A. Specifically, my interaction was a little difficult
with him because he didn't want to give me the intakepaperwork and his medical records, which they had, whichincluded the dispensing of the medications.
Q. Okay. His medical records, who's "his"?A. The decedent, Mr. Benefield.Q. Okay. So he didn't want to give you the intake
records and the medication records; is that what you'resaying?
A. Correct.Q. Did you eventually get them or did you not get them?A. I eventually got them. Actually, he -- I had to
explain to him that as the coroner's office, we're exempt fromall of that, from HIPAA, that he had to give them to me, hewas going to give them to me. He went back to his office tomake my copies. He was taking so long. He had apparentlyalready given the officer that was on scene, the Murrieta PD,copies of these documents. And the officer from Murrieta PDwas kind enough to make copies for me at their station and Igot those from him.
Q. Okay. And did you speak to anyone else associatedwith the facility itself?
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A. Ms. Powell.Q. And did you do a formal interview with her?A. Yes. The interview process was not broken up into
individuals. The interview process that was conducted was inthe kitchen, was gathering of information from theindividuals. And my primary interaction was withMr. McCausland.
Q. Okay. Was Ms. Powell standing there when you spoketo Mr. McCausland?
A. Yes.Q. Did she make any additions or corrections or go
beyond Mr. McCausland's statement?A. Not that I remember. No, none at all.Q. Did you make any calls to anyone associated with the
facility?A. Yes. I spoke to a gentleman from their corporate
offices and he had told me that he had called Ms. Benefieldand notified her of the death, which I was upset about becausethat's something that we do as the coroner's office, ourresponsibility. But I -- you know, I wanted to be able togive her the news and be able to get all the information thatI needed.
Q. Now, is that just territoriality? Is that important?Why did it upset you?
A. Well, it's not territoriality and it's not somethingthat is broken down in the law that says that we have to do itor anything like that. It can often make the process moredifficult for us because what happens is is that maybe the
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Sonja A. Hudson, CSR1152
individual is notified and then they quit taking phone calls.They will -- they will -- a lot of times they'll go tofamily's house, a friend's house. We can't reach them andsometimes for days. And it's very important for us to be ableto gather the necessary information that we need, which is,for our medical investigation, medical history, socialhistory, and, of course, also the story of what was going onwith this gentleman. So it can make it difficult to do that.
Q. All right. Now, do you know if any samples weretaken from the body for analysis?
A. Yes.Q. What do you know about that?A. Every single body that comes in to the coroner's
office is processed in the same way. And part of that processthat's done by our forensic techs is that they take a bloodsample upon intake and that blood sample is labeled and thenstored with the body on the table. And then after the -- whenthe body goes in for autopsy or an external examination, thedoctors will notate that the blood sample is on the table.
They'll take a look at the label, verify that it isthe correct label, the correct person, and then they will --the coroner technicians will take it from the table, aftereverything is done, and all the other -- all the other samplesthat are gathered also, because the doctor will gather blood,bile, urine, other samples from the body. Those go into arefrigerator and, of course, every one of those being labeledwith the gentleman's name.
And then after that, they are eventually sent to
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Bio-Tox, which is our contract company, which is a laboratorythat we use to process all of our samples. Once a week theycome out and they will pick up everything and then thosesamples are logged by our coroner technicians and then placedin a lockbox for Bio-Tox. And then Bio-Tox will take it totheir laboratory for processing.
Q. Okay. And how do you know this process sothoroughly?
A. I was a coroner technician prior to being a deputyand so I'm very familiar with the process.
Q. And when were you last a coroner technician?A. Back in 2003 to 2005.Q. And, to your knowledge, your personal knowledge, had
that process that you just described for us, the handling ofthe samples, changed at all by 2010?
A. No. I'm a sergeant now with the coroner's office andmost definitely not. That's part of our policy and procedure.
MR. SAMUELS: Okay. So at this time, I'll ask if anymembers of the grand jury have any questions for this witness?
A question from Grand Juror No. 17. I'm afraid thatthis question, while it may be appropriate later in thetestimony of other witnesses, it is beyond the scope of thiswitness' expertise, so I'm not going to ask him.
Q. BY MR. SAMUELS: This is a question from Grand JurorNo. 15. And the question is, in your opinion, based on yourtraining and experience, was there anything significantregarding the position -- the position you found the decedentin?
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A. Significant in that what his position suggested isthat the gentleman was very likely on the edge of the bed andhad collapsed down to the floor forward, slumping forward. Itwas a -- significant in that there was a very prominentpresentation of lividity and then eventually -- and also rigormortis. They were extremely prominent.
Q. All right. And do you know who moved the comforterthat was pictured in some of the photos?
A. No, I do not.Q. Would you have moved it?A. Definitely not.Q. Well, do you move objects that are around a deceased
in order to take pictures of the deceased's body?A. Not when I -- what -- what you saw as a progression
is literally when I walk in that room. My first photo, that'swhen I'm first stepping in the room to do my overall photos.That's when I start and I shoot my photos from there.
Q. Okay.A. So prior to -- prior to -- and that is a very big no
no with us, that we get very upset with law enforcement oreven individuals, hospice nurses, anyone tampering with thescene, moving anything or moving the body. And I would nothave done any -- anything to change the scene, move the body,move anything in there without doing my overalls first. Andthen eventually when I did do my overalls, then, yes, I wouldhave definitely started moving things around to start myinvestigation.
Q. Okay. So going through those photos, were they
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progressive as you did your investigation?A. Yes.Q. So as you did your investigation, would someone, with
your permission, have moved the comforter?A. With my permission?Q. Yes.A. As I move through, yes. If I had a reason for them
to move it from my transport or something along those lines,yeah. I don't -- I don't remember removing the comforter.Oh, you're talking about the comforter as to from when I firstcame in and to -- to later, or are you speaking of prior frommy first photos prior to that comforter being moved?
Q. Well, let me clarify.A. Because I may be answering the question wrong.Q. Well, let me clarify the question. You're not
answering it wrong, I'm asking it wrong.If you recall -- and I can show you again if it helps
you recall -- when you entered the room, there was a bed andthe decedent's body. I asked you if his bottom was up againstthe bed and I heard you say it was. And there was a comforterin those early photos that we see.
A. Okay.Q. And then in the later photos, the comforter was not
in the photos. So I believe the thrust of the question waswhether that comforter was moved by -- with your knowledge andat your direction. So that's two questions.
A. Okay. So I answered the question incorrectly. Ithought you were referring prior to my arrival and taking my
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overall photos. Most definitely when I walked in the room andI started shooting the photos and the comforter would havebeen moved by myself. That way I could get a clearer shot ofthe gentleman's position. And also to move everything out ofthe way, that way I could do a better exam of him.
Q. Okay. And did you see any fresh injuries on the bodyof the deceased?
A. No.Q. Do you remember what the room temperature was when
you entered?A. Cool. It was air conditioned, but I could not tell
you what the exact temperature was.Q. Can you tell me what you mean by cool?A. Comfortable. Somewhere within the range of easily
within 70, 78 degrees, somewhere in there, what you would seta normal home at.
Q. So 70 to 78?A. Yeah, somewhere in there.Q. And I -- there's another question, but I believe it
is another way of asking the question that I asked you aboutposition so I'm going to leave it at that.
MR. SAMUELS: Are there any further questions?GRAND JURY FOREPERSON: Yes, Counsel.MR. SAMUELS: Thank you.
Q. BY MR. SAMUELS: It's a question from Grand Juror No.3. Do you ever delegate the taking of photos to other lawenforcement personnel?
A. Most definitely not.
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Q. So do you believe you took these particular photos?A. Definitely.
MR. SAMUELS: All right. Grand Juror No. 7 has aquestion that is going to be covered in subsequent testimonyand so it's outside the scope of this witness' personalknowledge. I'm going to defer that question until later.
Juror No. 2 has a question. It's also dependent uponthe testimony of a later witness and not subject to thiswitness' personal knowledge.
So I'm going to ask Grand Juror No. 2 and theprevious question of Grand Juror No. 7 to bear their questionsin mind. If they are not satisfied, to raise them with meagain at a later time.
Are there any further questions?GRAND JURY FOREPERSON: No more, Counsel.MR. SAMUELS: All right. May this witness be
excused?GRAND JURY FOREPERSON: Yes.Before you leave, I have an admonition to read to
you. You are admonished not to discuss, at any time outsideof this jury room, the questions that have been asked of youin regard to this matter or your answers until authorized bythis grand jury or the Court, or until such time as thesegrand jury proceedings become a matter of public record. Youwill understand that a violation of these instructions on yourpart may be the basis for a charge against you of contempt ofcourt.
This admonition, of course, does not preclude you
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from discussing your legal rights with any legally employedattorney representing you, should you feel that your personalrights are in any way in jeopardy.
Do you understand, sir?THE WITNESS: Yes, sir, I do.GRAND JURY FOREPERSON: Thank you. You are excused.THE WITNESS: Thank you.GRAND JURY FOREPERSON: The grand jury will take a
ten-minute break, so we should be back by 9:15.(Brief recess.)
GRAND JURY FOREPERSON: The grand jury will now cometo order.
MR. SAMUELS: I'll get the next witness.GRAND JURY FOREPERSON: Yes, Counsel.
(Pause in proceedings.)GRAND JURY FOREPERSON: Please remain standing and
raise your right hand, please.You do solemnly swear that the evidence you shall
give in this investigation now pending before this grand juryshall be the truth, the whole truth, and nothing but thetruth, so help you God?
THE WITNESS: I do.GRAND JURY FOREPERSON: Please be seated.I have a statement acknowledging a secrecy order that
I would like you to read, then sign and print your name at thebottom.
(Pause in proceedings.)GRAND JURY FOREPERSON: Please state and spell your
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full name for the record.THE WITNESS: Anne Patton, A-n-n-e, P-a-t-t-o-n.GRAND JURY FOREPERSON: Thank you.Counsel, you may begin.
ANNE PATTON,called as a witness by the People, was sworn and testified asfollows:
DIRECT EXAMINATIONBY MR. SAMUELS:
Q. Good morning, Ms. Patton.A. Good morning.Q. Could you please make sure that when you answer
questions, you speak right up so everyone all the way in theback of the room can hear you.
A. Okay.Q. All right. Do you remember in July of 2010 seeking
any treatment in Murrieta, California?A. Yes.Q. What was that treatment for?A. For alcohol.Q. And do you remember where you were treated in
Murrieta, California?A. I think it was called Stone Gate.Q. Do you remember what it was, what kind of building or
hospital or --A. It was called A Better Tomorrow.Q. All right. Now, there's a young lady here taking
down all of the things we ask and your responses, but we can't
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talk at the same time. So please wait for me to finish aquestion before you begin to answer. All right?
Have you ever been a witness before?A. No.Q. Okay. And are you sure that the facility you were in
was called Stone Gate?A. Yes, the place I was placed at.Q. All right. Have you ever heard of a place called
Iron Gate?A. Maybe that was it.Q. Is your answer then you don't remember the exact
name?A. Not exactly.Q. Okay. But you're sure that the company was A Better
Tomorrow; is that what you said?A. Yes.Q. Okay. Now, do you remember what part of the month of
July 2010 you were in a facility run by A Better Tomorrow?A. No.Q. Do you remember the day separately?A. All I know was I was sent there for five days by my
son.Q. Okay. Do you remember whether or not you saw a
doctor on the very first day?A. A counselor.Q. All right. Is a counselor a doctor, an M.D. to you?A. The next day.Q. Okay. Wait. My question was, was that counselor a
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doctor to you?A. No.Q. All right. You shook your head. You have to answer
in words. And you said no; is that right?A. No. Correct.Q. And then you said the next day.A. Yes.Q. So the first day you saw a counselor who was not an
M.D., and the next day you saw a doctor --A. Correct.Q. Let me finish.A. Oh.Q. Okay. Now, do you remember on that first day whether
you were given any medications that you had not brought to thefacility?
A. Yes.Q. What do you remember in that regard?A. They had given me a -- something to help me sleep and
something for my anxiety. I don't know what it was called.Q. Were those different things?A. Yeah, two different medications.Q. All right. Now, you say you had a five-day stay
there. Do you remember a patient who was also there at thehouse where you were treated named Gary Benefield?
A. Yes.Q. And do you remember when you met Gary Benefield?A. I don't remember if it was the second day or the
third day I was there, but he arrived in the evening.
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Q. Do you remember what time he arrived?A. I think -- I believe it was around 7:30, 8:00 because
it was still daylight out.Q. Now, when you say "arrived," would you necessarily
see someone the first moment they came in the door?A. Yeah. We were sitting in the living room and he came
in the front door.Q. Okay. And did you have any interaction with him the
night he arrived, the evening he arrived?A. Yes.Q. What kind of interaction?A. He sat on the couch and I asked him where he was
from. And he had mentioned that the altitude was differenthere. And I asked him why, and he said he was from Arizona.
Q. What else did he say about the altitude there?A. The altitude?Q. Yeah.A. He just said he just couldn't breathe, the altitude
was different here. And I said, "Well, where are you from?"He said, "Arizona." And I said, "Well, that's not muchdifferent."
Q. Let me break it down.A. That's what he said.Q. Okay. That's what he said.
So did he introduce himself?A. Yes, when he sat on the couch.Q. All right. Was he doing anything while he sat on the
couch?
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Sonja A. Hudson, CSR1163
A. No.Q. Was there a TV on?A. We -- me and somebody else -- yeah, the TV was on.Q. Okay. Now, I want you to listen carefully to the
question and answer it as best you can from your memory. Whatdid he say about altitude?
A. He was sitting there -- he had just came in, he satdown by another girl and I that were -- we were playingMonopoly. And he was having a hard time breathing. I said,"Are you okay?" And he said, "Well, the altitude is differenthere." I said, "Why? Where are you from?" He said,"Arizona." I said, "Well, it's not that much different."
Q. Okay. Let me stop you right there.A. Okay.Q. Okay. During your answer, you said he was having a
hard time breathing. Why do you say that?A. Because he was (untranslatable sound), like wheezing.Q. And how deeply was he breathing?A. Just like he couldn't catch his breath.Q. I'm sorry, I'm writing some notes as we go so that's
why -- I'm not ignoring you. I'm just writing myself a note.A. Okay.Q. And what else did you notice about his breathing, if
anything?A. Just that his face was red and that he didn't know
why he was there.Q. Did he say that?A. Yes.
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Sonja A. Hudson, CSR1164
Q. Did you ask him what he meant by that?A. I said -- no, I didn't ask him what he meant by that.Q. All right. Now, going back to the altitude. If I
understand your testimony, was he talking about thealtitude -- well, let me ask you because I'm unclear. Was hetalking about the altitude there at the house where you weresitting on the couch?
A. Yes.Q. In Murrieta, California?A. Yes, correct.Q. And do you have any personal knowledge of where he
lives in Arizona?A. No, I don't.Q. So when you say the altitude is similar between
Murrieta and Arizona. Do you know that for sure?A. No. I was just -- that was just being demographic.
When he had said that to me, he goes, "Well, the altitude isdifferent here." I'm going, "Well, Arizona is not that far."
Q. Okay. Just conversation?A. Yeah.Q. Did you notice if he was hooked up to any tubes?A. No. He had nothing, no tubes.Q. Have you ever seen people using supplemental oxygen?
You never have?A. Never.Q. You're shaking your head.A. No.Q. Okay. Did you see any tubes around his face?
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Sonja A. Hudson, CSR1165
A. No.Q. Anything covering his mouth?A. No.Q. Now, you said that the first day you were there,
someone gave you two medications, one to help you sleep andone for your anxiety.
A. Correct.Q. Do you remember who gave you those?A. A black lady. That's all I know. I can't remember
her name.Q. Uh-huh. And was there anybody else there at the --
who was running the house while you were there?A. A gentleman named Kris.Q. Did he ever give you any medications that weren't
prescribed to you?A. Just those two.Q. Well, who -- okay. I'm sorry, maybe I was unclear.
You said the people who were there were a black lady and agentleman named Kris. On the night you were first there,before you had seen a doctor, someone gave you medications; isthat what you testified to?
A. Yes.Q. Which of -- was it one of these two people?A. Yes. It was the lady.Q. Okay. African-American?A. Yes.Q. Okay. Do you remember how many clients were at the
house when you were there during those five days, "clients"
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Sonja A. Hudson, CSR1166
being people like yourself there for treatment?A. I believe there were five.Q. And on the morning of the 26th of July, do you
remember anything -- from 2010, anything occurring on the 26thof July, which would have been a Monday?
A. I don't even know how many days I was in there, so Idon't know the days I was there.
Q. Okay. You said five. Can you reconcile that withwhat you just told me?
A. Well, the fourth day I remember. That was the nighthe arrived.
Q. Okay. Are you sure about that?A. I'm sure it was either the third or the fourth night.Q. And what do you remember about the evening he arrived
through the next morning?A. The evening when he arrived, when he came in, like I
said, he came in and he said the altitude was different hereand that he couldn't breathe. And then he had sores on hisarms and I asked him why he had sores on his arms and he saidbecause he had some kind of a dog rescue that he runs inArizona. And I went, "Oh, okay." And then I asked him if hewanted to play Monopoly with me and Erin, the other girl thatwas there. He said, "No." We went out and we smoked acigarette out in the back.
Q. Now, when you went out with Gary Benefield to smoke acigarette, did his breathing change?
A. No. He just said he was have a hard time breathingand he didn't even want to smoke the cigarette because he
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Sonja A. Hudson, CSR1167
couldn't breathe.Q. But he did?A. But he finished it anyway.Q. Okay. And that was where again?A. Excuse me?Q. Where did you go to smoke a cigarette?A. Right out in the back of the backyard.Q. Okay. And did you go to bed that night?A. They put -- we came back in and sat down and they had
changed rooms around so he could have his own room that wouldbe across from Kris, the night manager, or the night guy.
Q. All right.A. So they put him in there. They -- before that, when
we were sitting on the couch, he had all these medications,like three or four different kinds of bottles of medication,and they noticed -- they said, "Well, we don't know how muchyou're supposed to take."
Q. Who is "they"?A. The -- Kris, the night manager that stayed there, and
the black lady.Q. Uh-huh.A. They said, "Well, we don't know what your dose is.
You haven't told us, so we don't know what to give you. Sowe're just going to go ahead and give you what we think youshould have tonight and monitor you in the room by yourself."
Q. Do you remember that specifically?A. Yeah. I was sitting there right next to him when
they said that.
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Sonja A. Hudson, CSR1168
Q. What bottles were --A. I --Q. Well, are you familiar with the bottles that
prescription drugs come in? Have you ever gone to a pharmacyand filled a prescription?
A. (Inaudible response.)Q. Never?A. No.Q. Never. Okay. Well, has a doctor ever given you
drugs to take?A. Excuse me?Q. Has a doctor, a licensed doctor, ever given you drugs
to take?A. Ibuprofen.Q. Okay. Nothing else?A. (Inaudible response.)Q. All right. These bottles that you saw on the table,
can you describe them?A. They were in the -- Kris' hand. There was three of
them. They each had a white cap on them. One of them had alittle orange tab on the side. And then I remember himshaking them. And he goes, "Well, there's not the rightamount in this one and I don't know how many you've taken outof this one, so we're just going to just go when it's yourmedication time," which I don't know what time that wasbecause we had to be in bed at 10:00, "And I'll give you yourmedications and I'll put you in the room right across from meso I can monitor you."
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Sonja A. Hudson, CSR1169
Q. And you heard this?A. Yes, I heard that.Q. Okay. Have you ever told anyone about this before?A. (Inaudible response.)Q. This is the first time you've told --A. Yes.Q. -- what you saw and heard?A. Yes.Q. And you said they put you to bed at 10:00. Is
that --A. Yes. That's our curfew.Q. When you saw "our," what do you mean?A. All the girls that are in that group.Q. What about the boys?A. The boys had their side over there. They had to go
too.Q. So their curfew was?A. 10:00. They closed it down.Q. Okay. You mean the whole house?A. Yes.Q. Now, these bottles -- I want to go back to that for a
moment. You said they had white caps. And at one time yousaid four and one time you said three. Do you remember howmany there were?
A. I know for sure there were three.Q. Okay. And they were in Kris' hand; is that what you
said?A. Yeah. Kris had them in his hand.
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Sonja A. Hudson, CSR1170
Q. Could you see whether there was any labeling on thebottles?
A. I don't know what kind of labels they were.Q. Well, my question wasn't what kind of labels. Were
there labels?A. They were white labels.Q. Okay. Could you see if there was printing on the
labels?A. No.Q. It's been five years, so are you sure about that,
that there was white labels on these bottles?A. Yes.Q. You said there was a wing for girls and a wing for
boys. What do you mean by that?A. Well, it was just a regular house and it had one
bedroom over here that had four beds in it.Q. Okay. And which direction? You were motioning.A. For the girls.Q. Okay. And you're motioning with which hand to show
where the girls were. You're making a motion with one of yourhands. I'm just asking you --
A. Left side over here was for girls. They had four --four beds in there.
Q. Uh-huh.A. And then on the right side of the house there was
one, two -- there was four bedrooms on that side. Two of thembelonged to the house managers and then the other two were forthe other guys that stayed in there.
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Sonja A. Hudson, CSR1171
Q. And was -- which bedroom did you associate with GaryBenefield?
A. Gary was right across from the manager and thebathroom. They put him in his own room by himself.
Q. Did you see him go in there?A. Seen him go in there.Q. Okay. Did you ever see Kris go into his room?A. Yep.Q. So did you see that these rooms were oriented in a
certain way to each other?A. Yes. There was one bedroom here for the -- four beds
in there for the gentleman; there was a desk right here; therewas a bathroom right here; there was Kris' room. And thenright up against that wall was the black lady's room. Andthen here is where Gary was staying in this room, rightacross.
Q. Right across from Gary's room?A. Yes.Q. You made a bunch of motions with your hand there
which can't be taken down by this young lady. Would you beable to draw a little diagram of this if I gave you a blankpiece of paper and a writing utensil?
A. Okay. I can try.Q. Okay. Well, let's try then. I'm giving you a single
sheet of yellow lined paper.A. Okay.Q. Are you an artist?A. No.
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Sonja A. Hudson, CSR1172
Q. Are you a draftsman?A. No.Q. So are you just going to try your best?A. I'm just going to --Q. Okay. Well, you draw.A. Okay.Q. I'll give you an opportunity to do that.
(Pause in proceedings.)Q. BY MR. SAMUELS: Are you finished? I am going to
have this marked as the next exhibit in line. Now, have youand I met before?
A. No, sir.Q. Didn't we meet in the lobby of this building earlier
today?A. Yes, sir.Q. And did you discuss the content of your testimony?A. Yes, sir.Q. In what way?A. Just to be honest and tell them -- tell the truth.Q. Right. Did we discuss the content --A. No.Q. -- meaning what you said here today?A. No.Q. Do you remember being interviewed by the Department
of Justice agents about this series of events you've beentelling me about?
A. Yes.Q. Do you remember when that was?
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Sonja A. Hudson, CSR1173
A. No. Just when I had talked to another gentlemanregarding this case before I came here.
Q. All right.A. Months back.Q. Months back you said?A. Well, yeah, almost a year ago.Q. Could it have been in August of 2013?A. Could be, yes.Q. All right. Now, I'm just waiting for this projector
to warm up a little bit so we can look at what you've drawnfor us.
A. Okay.Q. Okay.A. My fancy work.Q. Well, we'll see.
Now, on the desk there in the corner --A. Yes.Q. The desk you're sitting at, there's a thing that
looks like a TV clicker over here in front of you and there'sa red dot on it. If you point that at the wall and press thered dot, you'll see that it shoots out a laser. There you go.See that red dot on the wall?
A. Oh.Q. Okay. So I'm going to ask you to describe what
you've drawn and show us what you're talking about.What's that? Thank you.Okay. Now, is what's being projected on the wall to
your left the drawing you just made? Ma'am, could you answer
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Sonja A. Hudson, CSR1174
with a word or two? Is this the drawing you just drew?A. Yes, sir.Q. Okay. I want to orient it so that we can figure out
where the front door is. Can you tell me -- can you point outwhere the front door is?
A. Way back over here.Q. Okay. So this isn't the entire house, is it?A. No.Q. All right.A. The front door is way back here.Q. Okay. What are we seeing here? Tell me about what
you've drawn.A. Okay. You walk in the front door right here.Q. Okay. And so that's to the very --A. Yeah.Q. -- bottom of the photo where I've got the pen now.A. Right.Q. Okay. Go ahead.A. So you walk into a little area that's right here.
That's where they have a desk and chairs where they do yourintake.
Q. Uh-huh.A. And then, like I said, right there's a kitchen.
Girls' room is back over here.Q. How many beds in that girls' room?A. There was one, two, three, four bedrooms.Q. Four bedrooms or four beds?A. Excuse me?
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Sonja A. Hudson, CSR1175
Q. Four bedrooms or four beds?A. Four bedrooms.Q. Okay. Thank you.A. And there were four beds in this room right here.Q. All right. Keep going, please.A. And then the kitchen was right here. We weren't
allowed to cook anything in the kitchen; they had to cook forus. The living room is here where we watched TV, and thehallway. You could see right here where this bedroom was andthen a little table like this sitting there, the bathroom,Kris' room, and then that lady's room.
Q. So where was the room Gary Benefield was in?A. Right here.Q. Okay. Now, you haven't drawn anything there.A. No.Q. Okay.A. But that's where his room was because it was right
across from the bathroom.Q. So is that right across from Kris' room or --A. It would be -- it would have been -- actually, this
is how bad my drawing is.Q. That's okay. It's your drawing.A. So, yeah, it's the hallway. Kris' room would have
been right here because this lady -- the black lady's room wasright at the end of the hallway direct.
Q. Straight back.A. Yeah.Q. So is this, what I'm drawing my pen on --
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Sonja A. Hudson, CSR1176
A. That's the hallway.Q. That says "hallway"?A. Yeah.Q. Okay. So would it have been more correct for this
square that says "black lady," for that to be right at the endof the hallway where my pen is now?
A. Yeah.Q. And would Kris' room have been back toward where it
says "bathroom"? I'm asking. I'm just trying to understand.A. Yes.Q. Okay. And so where it says "living room," were there
bedrooms on that side of the hallway?A. No. There was a -- just a laundry room.Q. So where was Gary's bedroom? I'm unclear on that.
Okay. You're making a square with the laser pointer at thebottom of the area, the bottom right corner of the area whereit says "living room."
A. Right.Q. Okay. If I give this back to you, can you draw in
Gary's bedroom?A. Yeah. I can do it a little bit better.Q. Well, I want you to --A. Draw his room? Okay.Q. Yeah, because we've been talking about this, I'd like
you to try to make modifications if that matches your memoryto this drawing, not to make a new drawing.
A. Right.Q. Okay.
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Sonja A. Hudson, CSR1177
A. Okay.Q. Let me turn on the light for you.
(Pause in proceedings.)Q. BY MR. SAMUELS: Have you ever been back in this
house since July of 2010?A. No. It shut down.Q. Okay. I'm not asking about that.A. Oh, no.Q. I'm just asking if you've been back.A. Okay.Q. Okay. So you have the laser pointer. You've made
some changes in the drawing that is marked as Exhibit 86. Canyou describe the changes you've made, point them out to themembers of the jury.
A. Yeah. I moved Gary's room right across from Kris'room, put the bathroom back down here a little way where it'ssupposed to be --
Q. Okay.A. -- because the bathroom, it was here, it's down here.
He was right across from Kris.Q. All right. And --A. And then that lady is still right there.Q. Okay. And what's that on the far left side of the
page? You seem to have made an addition.A. That was the front door that I put in to make sure.Q. Okay.A. And that was the first bedroom where there was four
beds in there.
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Sonja A. Hudson, CSR1178
Q. Was that on the men's or the women's side?A. Men's.Q. Okay. And where was that little desk where they did
intake?A. That was in between the bathroom and Kris' room. It
was just like a little desk with cabinets.Q. I thought you said there was a -- if I may, next to
the front door, didn't you describe an open area where therewas a desk where intake was?
A. Yeah. That's way over here.Q. Okay. Now, let me ask you to clarify, was intake
down in this area where there's a rectangular area near whereit says "front door," or in this area next to the bathroom?Which one of these, because I think you've said it was done inboth. Was it done in one or the other or both?
A. Both.Q. Okay. So did you -- where did your intake take
place?A. Right here at the front door, then I had to go over
here to the bathroom where they give me a little urine test soI could do a urinalysis.
Q. All right. Where did you sit down and do paperwork,if anywhere? Describe where that is, please.
A. There was just a desk with six -- I mean, a tablewith six chairs and that black lady with her paperwork.
Q. Right.A. And that was all.Q. Where is that in relation to the front door? I want
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Sonja A. Hudson, CSR1179
you to describe it in relation to what you've drawn for ushere so there's a record. This lady takes down words but shecan't take down where the laser pointer is. So I want you totell us in words where you did your paperwork.
A. I did my paperwork right as I entered the front doorand sat down at the desk -- at the table and chairs that shehad sitting there.
Q. Okay. Thank you. Now, after 10:00, the curfew foreverybody in the house, did you see Gary Benefield again thatnight?
A. No.Q. What's the next thing that you found out or saw --
what's the next thing you saw happen at that house inMurrieta?
A. We were woken up at 6:30 in the morning by the housemanager and we looked out -- we came out all to the livingroom and there was a fire truck, ambulance there. And we allasked what happened, and they said that Gary had passed awayand that we had to all go get in a bus and go to the officeand stay there and get Starbucks while they handled this --his death.
Q. Okay. How do you know it was 6:00 in the morningwhen you were awakened?
A. Because there's an alarm clock right there.Q. All right. And when you went to -- did you go --
when you got up, what was the first thing you did?A. They told us to get dressed and get ready and lined
up because we were going to the office.
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Sonja A. Hudson, CSR1180
Q. So where did you go after you got dressed?A. We went and lined up by the front door for the bus to
get there to take us back to the office.Q. And did you see any emergency personnel there when
you were still at the house?A. Yes.Q. Do you remember what kinds of emergency personnel?A. There was a fire truck, there was an ambulance, and
they were in the house.Q. Did you see any law enforcement personnel?A. Yes.Q. Do you remember how many?A. No, not right offhand.Q. When I say "law enforcement personnel," what's that
mean to you?A. A police officer.Q. All right. And how do you recognize a police officer
when they'd come to the house?A. He's got his uniform on.Q. Okay. And did you ever go back to that house after
you left on the bus?A. We went back later on that afternoon.Q. How long did you stay when you went back later on
that afternoon?A. We were at the office for, I think, five hours.Q. Uh-huh. Did anyone at the office ask you about your
interactions with Gary Benefield?A. No.
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Sonja A. Hudson, CSR1181
Q. What did you do at the office for those five hours?A. Sat outside in the little waiting area and they
gave -- got us Starbucks coffee.Q. Did you get any therapy or --A. No. We just --Q. While you were still at the house, the treatment
house, did you ever see Gary Benefield's body?A. Yes.Q. How did that happen?A. The morning of the incident, they -- we all was
curious and wanted to know what was going on, right, and theywouldn't tell us, so the managers let us go see him. And hewas in between a little nightstand and the bed stiff.
Q. Okay. He was --A. And it was his birthday.Q. Okay. Please just stick with the question you're
asked. Okay?When you went to see him, did you enter the room he
was in?A. No.Q. So where did you see him from?A. Just peeked around the corner.Q. Of what?A. Of the hallway.Q. Okay. So you peeked around the corner of the
hallway. Was he in his own room still?A. Yes.Q. So when you say the corner of the hallway, what do
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Sonja A. Hudson, CSR1182
you mean?A. I just peeked like I was at a hallway and I would
just -- I just peeked in.Q. Through the doorway or --A. Yeah, through the doorway.Q. Okay.A. Because the door was open.Q. You said he was between the bed and a --A. -- nightstand.Q. All right. Do you remember if he was oriented in any
way? What I mean by that, was he sprawled out? Was he on hisback, on his side, or on his face, like, you know, curled up?What did you notice about him, if anything?
A. He was on his side and it looked like he was pinnedin between the nightstand and the bed.
Q. How long did you look at him in there?A. Just for a glance, a quick second.Q. Okay. Now, because I'm not you, I don't know what
you mean by a quick second.A. Just a look and then --Q. So less than a count of 1,001?A. 1,001.Q. Okay. Did you ever look again?A. No.Q. And you didn't enter the room?A. No.Q. When you say you didn't enter, does that mean you did
not enter?
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Sonja A. Hudson, CSR1183
A. Did not enter.Q. Now, when you were at this house, do you remember if
you were there for -- you said you were there for alcohol butyou didn't say whether you were there for -- what kind ofservices you were there for. Do you remember what theservices you were receiving at the house were called?
A. No.Q. Are you familiar with the term rehabilitation?A. Yes.Q. Are you familiar with the term detoxification?A. Yes.Q. Are you familiar with the term sober living?A. Yes.Q. Was it any of those?A. Nope.Q. Okay. So you don't have any independent recollection
of the services -- of the term for the services you werereceiving at that house?
A. No.Q. Okay. When you were there, during all of the nights
you were there, did anyone ever come check on you during thenight?
A. No.Q. When you first entered, do you know what getting your
blood pressure checked is?A. Yes.Q. Do you remember if anyone checked your blood
pressure?
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Sonja A. Hudson, CSR1184
A. Yes.Q. So you remember or they did?A. They did.Q. And did they ever do that again?A. No.Q. So one time?A. One time.Q. Now, you said you got sent there by your son. I
don't mean to pry. I'm not trying to embarrass you in anyway, but can you describe what your situation was with regardto alcohol at that time?
A. Yeah. I was living in Northern California and I camedown to visit my son and my grandkids and I had got up at10:00 in the morning. By 11:00, I had a beer. Well, hedidn't like that because I had two beers at 11:00. So myoldest son was in this rehab already, A Better Tomorrow, doinga sober living. And so he said, "Mom, if you ever want to seeyour grandkids again, you're going to go to this place." Isaid, "I'll go. I'll go for five days if that's what youwant." So I checked in for five days.
Q. All right. And when you checked in, did you say --did you say what you were there for?
A. Yeah. I said, "My son says that I'm alcoholic."Q. Okay. And so what did they say they were going to do
for you, if you recall?A. They wanted to send me to a 28-day program.Q. Okay. So were the five days that you were there for
at the house you were in part of the 28-day program?
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Sonja A. Hudson, CSR1185
A. It was -- they wanted it to be.Q. Okay.A. But I left.Q. Right. So here's my question. Those five days, to
your understanding, they were part of the 28-day program?A. After the five-day detox.Q. Okay. What's the five-day detox?A. Where I was at.Q. All right. Were you going to -- were you supposed to
do more days beyond that, to your understanding?A. No. After the five-day detox, I was supposed to do a
28-day program.Q. Okay. Thanks. I don't mean to frustrate you, I'm
just trying to understand.A. No, that's --Q. Okay. So if I'm understanding you -- and correct me
if I'm wrong -- you were at that house to do a five-day detox?A. Correct.Q. Okay. So let me ask you this: It's been five years
since these events occurred. Was your memory of these eventsclearer closer to the time they occurred or is it clearertoday?
A. Not as clear today.Q. So when you spoke with agents from the Department of
Justice maybe in August of 2013 or maybe a year ago, somewherein there, was your memory better or worse than it is today?
A. Probably better then.Q. All right. Did you tell them about everything that
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you've told us about today?A. Yes.Q. But you told us that you had never told anybody about
the prescription drug bottles, I believe it was, that KrisMcCausland had in his hand that had the white caps that youcould see. Do you remember saying that?
A. I might have. I can't remember.Q. Okay. I mean, you remember saying that here today?A. Yes.Q. And I asked you if you had ever told anybody before.A. And I can't remember. I might have. I can't be sure
and I'm not going to --Q. Okay. All right. All I'm asking you now is
everything you've said to us here today clear in your memory?A. Today, yes.Q. Does your memory vary from day to day?A. Yeah. I'm getting old. I think I'm getting
Alzheimer's.Q. Okay. Well, that's -- the important thing I'm trying
to get to, ma'am, is whether or not you have an independentrecollection of everything you've spoken about.
A. Pretty much so, yes.Q. All right. You say, "Pretty much so, yes." What
parts, if any -- and I'm not in your head, I can't tell, so Ihave to ask you, what are you not clear about you've testifiedto today?
A. At what time that he arrived and -- his arrival time.Q. Anything else?
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Sonja A. Hudson, CSR1187
A. No.Q. Okay. All right. Just one moment.
MR. SAMUELS: I'm going to ask the grand jurors ifthey have questions for this witness.
Q. BY MR. SAMUELS: Question from Grand Juror No. 15.During the time you were with Gary Benefield in that house,did you ever see him, Gary Benefield, without a shirt on?
A. No.Q. When you were in that house, did you notice and do
you remember -- well, let me ask it this way. I'll startover.
Do you remember if you could hear sounds in thathouse from other rooms?
A. No.Q. Does that mean you couldn't hear sounds or you don't
remember?A. I don't remember.Q. Have you ever been to the A Better Tomorrow's office
for group sessions?A. No.Q. Did you have any group sessions that you remember?A. That I remember? No, I had none.Q. Did you have any individual counseling?A. No.Q. Well, didn't you say --A. I was only there for five days just for detox, so I
didn't -- there was no counseling, there was no going toclasses.
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Sonja A. Hudson, CSR1188
Q. I'm sorry?A. There was no counseling, there was no going to
classes because I was in the detox.Q. Okay. This question is what time were you woken up
on the day of Gary's death?A. 6:30, quarter to 7:00.Q. Do you remember who woke you?A. It was the black lady. I can't remember her name.Q. Why did you leave the detox program at A Better
Tomorrow?A. Because I felt I didn't even need to be there.Q. Did the fact that anyone -- that someone had died in
the house where you were have anything to do with it?A. No.Q. This is a question from Grand Juror No. 3. Did you
have any thoughts about the fact that you were given drugs tohelp you sleep and drugs for your anxiety without aprescription on the first day?
A. Yeah. I didn't like that.Q. Why?A. Because I don't take drugs and I didn't think I
needed anything for anxiety or to help me sleep.Q. Did you take those pills?A. Yes, I did.Q. Okay. How were they offered to you? Were they --
I'm just going to ask you were they in someone's hand? Werethey in a bottle? Were they on a plate? Do you remember howthey were offered to you?
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Sonja A. Hudson, CSR1189
A. A little cup.Q. Paper or plastic?A. It was a little plastic cup.Q. Did it have a lid?A. Excuse me?Q. Did it have a lid?A. No lid.Q. Did you take any prescription drugs with you when you
were admitted to this facility?A. No.Q. Did you see where the pills you were given -- well,
how many pills were you given? Do you recall?A. Two. Two a night.Q. Okay. Two a night?A. Yes.Q. Now, is that two of each medication or two total?A. Two total.Q. And did you see where they came from? I mean, you
got them in a cup. Did you see how they got into the cup iswhat I'm asking.
A. No, I really didn't.Q. Okay. Now, did this cup have your name on it or
anything?A. No.Q. Can you describe the cup?A. It was just a little clear little white cup.Q. Okay. So is it clear or is it white?A. Just a little clear cup like that.
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Sonja A. Hudson, CSR1190
Q. All right.A. It was only like this big.Q. All right. How far apart are your fingers when you
say this big?A. About an inch.Q. All right. And then you indicated, I think, a
circular --A. Just a circular like a Vicks bottle of medicine or
something you would take.Q. Okay. So if you take Vicks --A. Or, yeah, a little Nyquil or something, that size
bottle.Q. Okay. Bottle or cup?A. Well, cup.Q. Okay.A. Cup. Sorry.Q. Let me clarify, if I may.A. Okay.Q. So if I took over-the-counter Vicks medication and I
used the cup that came with the Vicks medication, are yousaying that that's the size cup it was?
A. Yes.Q. Okay. Thank you. And was that the size you were
indicating with your hands?A. Yes.Q. Okay. This question is from Grand Juror No. 6. The
morning of Gary Benefield's death, before you left the housewhere you were to go to the corporate A Better Tomorrow
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Sonja A. Hudson, CSR1191
office, were you interviewed by any law enforcement personnel?A. No.Q. Were you interviewed by any law enforcement personnel
that day that you recall?A. No.Q. You don't recall or you weren't interviewed?A. I was never interviewed by anybody in that facility.Q. From that facility or in that facility?A. From that office or anything.Q. Okay. We're not talking about people from the
office, we're talking about law enforcement personnel.A. No.Q. Okay. So that includes people who were in plain
clothes who show you a badge as well as people who are inuniforms.
A. Correct.Q. All right. No law enforcement --A. No.Q. During the time that you were in Gary Benefield's
presence, you were together on the couch and you were togetherin the back and wherever else you were, did you see GaryBenefield with an inhaler?
A. No.Q. Do you know what an inhaler is?A. Yes.Q. Can you describe an inhaler for us?A. It's a little gadget that you inhale.Q. Okay. And you were holding your hand up in front of
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Sonja A. Hudson, CSR1192
your face with your thumb --A. Yeah, like because it's got a little press on it --Q. Okay.A. -- an inhaler.Q. So you're closing your hand --A. Yes (untranslatable sound).Q. -- and you made a sound of inhaling?A. Correct.Q. Okay. Did you form the belief that you had to take
the medication that you were getting in the evenings, the twopills that you described to be participating in the detoxprogram?
A. Yes.Q. How did you get that impression?A. Because that's what they did when they came in and
said, "We're going to give you something for your anxiety." Isaid, "I didn't know I had anxiety." "And to help you sleep."
Q. Okay.A. And they said, "We're going to give you these." I
went --Q. Did they say you had to take them?A. They said it was part of the program.Q. Okay. And that's not quite the same thing, though.
Did you ever say I don't want to take them?A. No, I didn't, because they were authority and I
figured they know what they were doing.Q. You said that you left A Better Tomorrow after five
days. Do you remember that?
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Sonja A. Hudson, CSR1193
A. Excuse me?Q. You said you left the A Better Tomorrow house after
five days.A. Correct.Q. Did you have any trouble getting your personal
belongings and taking them with you when you left?A. No.Q. Had you handed in any personal belongings when you
went to this house?A. To the office.Q. So you went to the office?A. The office first had my phone, had all my money, had
all my belongings. The only thing that was at the house thatI stayed was my clothes and suitcase.
Q. All right. So when you left, how did you get yourphone and other belongings?
A. I had to walk from that house all the way to theoffice.
Q. Why is that?A. Because they would not furnish me a ride.Q. Who did you ask for a ride?A. The house managers.Q. Is that Kris and --A. Kris and that other lady, yes.Q. And what happened when you got to the office?A. I told them that I wanted my stuff, that I was
leaving. And they made me sign a piece of paper saying I gotmy stuff and I left.
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Sonja A. Hudson, CSR1194
Q. Do you remember who you spoke with at the office?A. No. There was all kinds of people in there that day.Q. Man or woman? You can't recall?A. Both. There was both men and women in there working.Q. I'm sorry, I asked my question poorly. Do you
remember who you spoke with?A. It was a male.Q. Tall, short? Anything you remember about him?A. Probably about your size.Q. Okay. Am I tall or short?A. Well, you're kind of like short.Q. Okay. So you spoke to a short man in the office. Do
you remember his hair at all?A. No.Q. Do you remember if he was Caucasian or
African-American or Hispanic or anything like that?A. Might have been Asian.Q. All right. And did you have to -- how long was your
conversation with this man to get your personal belongings?A. It was a total of maybe ten minutes from the time I
went in there and asked them that I'm checking out and I needmy things.
Q. Did you tell them about having to walk?A. Yes.Q. What did he say about that?A. He didn't care. That wasn't his problem.Q. Okay. What did you do after you got your phone and
your other personal belongings?
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Sonja A. Hudson, CSR1195
A. I got my phone and I called the taxi and I went tothe airport and I went back home to Northern California whereI live.
Q. Do you remember how many days after the day GaryBenefield was found dead this was?
A. The next day.Q. All right. So if I tell you it was a Monday when he
was found dead, this would have been Tuesday?A. The next day I left.Q. Okay. Okay. This next question is from Grand Juror
No. 17, and it's almost exactly the same subject matter thatwas covered in the last question.
MR. SAMUELS: Are there any other questions, ladiesand gentlemen?
GRAND JURY FOREPERSON: No more questions, Counsel.MR. SAMUELS: May this witness be excused,
Mr. Foreman?GRAND JURY FOREPERSON: Before you leave, Ms. Patton,
I have an admonition to read to you.You are admonished not to discuss, at any time
outside of this jury room, the questions that have been askedof you in regard to this matter, or your answers, untilauthorized by this grand jury or the Court, or until such timeas these grand jury proceedings become a matter of publicrecord. You will understand that a violation of theseinstructions on your part may be the basis for a chargeagainst you of contempt of court.
This admonition, of course, does not preclude you
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Sonja A. Hudson, CSR1196
from discussing your legal rights with any legally employedattorney representing you, should you feel that your personalrights are in any way in jeopardy. Do you understand that?
THE WITNESS: Yes.GRAND JURY FOREPERSON: Thank you. You're excused.THE WITNESS: Thank you.MR. SAMUELS: That means you can get up.THE WITNESS: Oh. That's all?MR. SAMUELS: Please. That's all.THE WITNESS: Thank you.MR. SAMUELS: You are subject to recall. Your
subpoena lasts until the 24th.THE WITNESS: Okay.MR. SAMUELS: If you get called back.THE WITNESS: All right. Thank you so much.MR. SAMUELS: Mr. Foreman, if you remember, I asked
yesterday if the grand jurors could take their break at 11:30today, because we had the witness coming promptly at 1:00because of travel arrangements. So there's a witness who'sready right now, but I just wanted to remind folks that it's10:15-ish now. So if -- I'd like to take this witness and goas close to 11:30 as we can to maximum your time. If you needa break, I suggest that you take it right now rather thancount on one between now and 11:30.
GRAND JUROR NO. 7: Juror No. 7. May I talk to you,Mr. Foreman?
MR. SAMUELS: If you're going to have discussions,then I should leave the room.
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Sonja A. Hudson, CSR1197
GRAND JUROR NO. 7: Okay.(Grand jurors have discussion off the record.)GRAND JURY FOREPERSON: Counsel, we need a ten-minute
break.MR. SAMUELS: All right. What time for return?GRAND JURY FOREPERSON: We return at 10:35. Thank
you.(Brief recess.)
GRAND JURY FOREPERSON: The grand jury will now cometo order.
Counsel, we have some questions for you, or requests.MR. SAMUELS: Yes.GRAND JURY FOREPERSON: Number one is one of the
jurors has a question to Detective Gomez or to lawenforcement. And again I have some questions from the lawenforcement.
MR. SAMUELS: We can have Detective Gomez summoned toreappear.
GRAND JURY FOREPERSON: Okay. The second one is ajuror suggests that the maximum time in the afternoon is onlyuntil 4:30 due to other obligations, especially at home.
MR. SAMUELS: That's up to you. Yesterday I didask -- it's my recollection I asked and got your consent.
GRAND JURY FOREPERSON: Okay.MR. SAMUELS: I don't mean to impose and I don't mean
to rush this grand jury. So if at any time you think you needmore time with a witness, you need to inform me and I willmake arrangements for that.
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Sonja A. Hudson, CSR1198
GRAND JURY FOREPERSON: It was only made aware to metoday.
MR. SAMUELS: Okay.GRAND JURY FOREPERSON: Today we are good until
11:45 a.m. and be back by 1:00 p.m.MR. SAMUELS: Okay. Very good.GRAND JURY FOREPERSON: And for next week, we have
one of the jurors requesting July 21 -- that's a Tuesday --that we recess early at 4:00 p.m. so she would be able to pickup family arriving at the airport.
MR. SAMUELS: Okay. I would prefer to put offdeciding that until Monday.
GRAND JURY FOREPERSON: Okay.MR. SAMUELS: And I don't see any problem with it.
I'm not saying no, I'm just saying it might be helpful to seewhere we are. Is that all right?
GRAND JURY FOREPERSON: Are we satisfied? Just nodyour head.
We're good, Counsel. We're good, Counsel.MR. SAMUELS: I just want to stress again, the grand
jury has its independent authority with regard to the thingsthat the judge told you you could have and have beeninstructed. And if you feel that you are being kept fromhearing full testimony, you should inform me so the witnesscan be returned to your presence, all right?
GRAND JURY FOREPERSON: Thank you, Counsel.MR. SAMUELS: Can I get the next witness?GRAND JURY FOREPERSON: Yes, please.
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Sonja A. Hudson, CSR1199
(Pause in proceedings.)GRAND JURY FOREPERSON: Please remain standing and
raise your right hand, please.You do solemnly swear that the evidence you shall
give in this investigation now pending before this grand juryshall be the truth, the whole truth, and nothing but thetruth, so help you God?
THE WITNESS: I do.GRAND JURY FOREPERSON: Please be seated.I have a statement acknowledging a secrecy order that
I would like you to read, then sign and print your name at thebottom.
(Pause in proceedings.)GRAND JURY FOREPERSON: Please state and spell your
full name for the record.THE WITNESS: Janelle Ito-Orille, J-a-n-e-l-l-e, last
name I-t-o, hyphen, O-r-i-l-l-e.GRAND JURY FOREPERSON: Thank you.Counsel, please proceed.MR. SAMUELS: Thank you.
JANELLE ITO-ORILLE,called as a witness by the People, was sworn and testified asfollows:
DIRECT EXAMINATIONBY MR. SAMUELS:
Q. If I get your name wrong and say Orille-Ito, pleaseexcuse me. But it's Ito-Orille?
A. Yes.
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Sonja A. Hudson, CSR1200
Q. You're somewhat soft-spoken, so please be sure tospeak up loudly so the folks in the back can hear you.
A. Okay.Q. All right. How are you employed?A. Currently I'm employed with the Department of Health
Care Services.Q. What's your job with them?A. Staff Services Manager II.Q. And is that a department of the State of California?A. Yes.Q. And how long have you held this position?A. I've been in this current position for about
14 months.Q. Before that what did do you?A. I was a Staff Services Manager I.Q. Okay. And was that with the California Department of
Health Care Services?A. Yes. And Department of Alcohol and Drug Programs.Q. All right. Did you change departments? How did --
what does that mean?A. Our Department of Alcohol and Drug Programs was
merged with Department of Health Care Services in July of2013.
Q. So before that, was it a stand-alone program, theDepartment of Alcohol and Drug Programs?
A. Yes.Q. And did you work for them?A. Yes.
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Sonja A. Hudson, CSR1201
Q. When did you start with them?A. In 2008.Q. And can we call it ADP for short?A. Yes.Q. What did you do for ADP when you started there in
2008?A. I was hired as a complaint analyst.Q. What did you do as a complaint analyst?A. Investigated complaints in regards to facilities that
are licensed and/or certified by the department, as well asinvestigate complaints against counselors who are registeredor certified.
Q. All right. Now, you used the terms certified andlicensed with regard to what -- who gets certified andlicensed? Who or what gets certified?
A. A licensed program would be a facility that provides24-hour residential, nonmedical drug and alcohol treatmentservices.
Q. 24-hour --A. Residential, nonmedical substance use or alcohol and
drug treatment services.Q. Would that cover a detoxification facility?A. Yes.Q. As long as it had 24-hour and residential?A. Yes.Q. Would that cover a rehab facility?A. Yes.Q. So what's the difference? You said certified as
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Sonja A. Hudson, CSR1202
well. What's that mean?A. A certified program would be a program --
predominantly they are outpatient programs, so they arenonresidential programs. A lot of times they are programsthat do groups and one-on-ones. They -- the clients will comefor services and then leave. But a licensed program can alsocarry a certification as well. Certification is voluntary, soprograms can opt in and decide if they want to carry thecertification. However, a license is required by the State ofCalifornia.
Q. So if I want -- I or my buddy wants to run a 24-hourresidential, nonmedical detox facility, do they need to becertified?
A. Licensed.Q. Okay. So you're saying they don't need to be
certified unless they voluntarily decide to be there?A. Yes.Q. Okay. And is that -- what's your understanding of --
when you say a license is mandatory, what does that mean?A. That services cannot be provided without first
obtaining a license.Q. All right. And you said you were a complaint analyst
from 2008 on.A. Until 2010, and then I became a Staff Services
Manager I.Q. All right. And what does a staff services manager
do?A. I supervised still within the complaints unit, so I
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Sonja A. Hudson, CSR1203
supervised four to five staff at the time, four to fivecomplaint analysts.
Q. Okay. So now you're a supervisor?A. Yes.Q. Do you know what a custodian of records is?A. Yes.Q. And are you a custodian of records for the records of
alcohol and drug -- the Department of Alcohol and DrugPrograms that was in existence before and after its mergerwith the Department of Health Care Services?
A. Yes.Q. And are you familiar with the way records are
generated both during that time when it was the Department ofAlcohol and Drug Programs and under DHCS or Department ofHealth Care Services?
A. Yes.Q. And are records generated by you as the supervisor or
by investigators?A. It could be both. It depends on who actually
conducts the investigation. So predominantly it's going to bethe complaint analyst; however, if as a supervisor you go outand conduct investigation, you might be the one generating therecord.
Q. And when are those records created by theinvestigator or the supervisor, whoever is doing the work?
A. I'm sorry, could you repeat the question?Q. When are those records generated?A. Generally, they're created very timely after the
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Sonja A. Hudson, CSR1204
investigation. I would say within a few months of theinvestigation, but it depends on the amount of documentationthat needs to be reviewed and analyzed. But we work to getthe reports done very timely after our site visits to get theinvestigation concluded.
Q. Okay. Are you trained to take notes about the thingsyou do while you're doing an investigation?
A. Yes.Q. And do you know whether or not those notes are used
to create these reports?A. Yes.Q. Do you know what -- you know. So what -- how are the
notes used?A. A lot of times the notes will be used so that you can
write your report. You might take notes during an interviewto be able to document everything quickly, but then when youreturn to the office, you'll put all of your notes into thereport.
Q. Okay. So the notes are done at the time and thenreduced to a report later?
A. Yes.Q. Are these writings required of the investigators as
part of the business of being in ADP or DHCS?A. They're not required. Some analysts actually might
use video -- or not video, recording. They might recordinterviews, but they're not required, I would say, but it'svery difficult to remember everything accurately withoutwriting things down.
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Sonja A. Hudson, CSR1205
Q. Okay. Are the reports required as part of what youdo?
A. Reports are, yes.Q. And are the investigators trained that these reports
need to be trustworthy, in other words, accurate and timely?A. Yes.Q. Is that important?A. Yes.Q. And so it's a -- is it a -- let me ask you, is it a
priority?A. Yes.Q. And as a custodian of records, are you familiar with
the records of a detoxification and rehabilitation servicethat was doing business under the name of A Better Tomorrow?
A. Yes.Q. And did you personally have any dealings with A
Better Tomorrow?A. Yes.Q. Can you describe your personal dealings with A Better
Tomorrow prior to July of 2010, if any?A. Prior to July of 2010, I had no involvement.Q. All right. So your first involvement was when?A. Was when -- in July when I was informed of a death
that had occurred at one of their facilities.Q. Okay. Now, you say you were informed. Were you
called directly by someone reporting the death?A. I don't exactly recall, but I believe I was informed
by a supervisor that a death had occurred and that I needed to
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Sonja A. Hudson, CSR1206
investigate it.Q. All right. And do you remember when that was with
any -- you know, give or take, when was that?A. I would guess that it was around the end of July.Q. 2010?A. 2010.Q. All right. And what did you do to investigate?A. Prior to going out on the site visit investigation, I
made contact with the Murrieta Police Department and detectiveby the name of Phil Gomez and obtained some information fromhim, made arrangements with him to meet with him because hewas going to accompany me on my site visit to the location.
Q. Why was that?A. We were going -- we were working in collaboration in
regards to the investigation, so I believe the Murrieta PoliceDepartment was also looking into the death at the facility.
Q. Is it normal to have law enforcement accompany you onan investigation?
A. Not normally, no.Q. Okay. What's a site visit?A. Site visit would be when we actually physically go to
the location of our facility and generally we will do awalkthrough, investigate -- you know, observe the facility,talk with clients, talk with staff, conduct interviews.
Q. Okay. And so after you spoke with Murrieta PoliceDepartment Detective Gomez, what did you do next?
A. We then went to the facility located on Iron GateLane.
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Sonja A. Hudson, CSR1207
Q. Do you remember what date that was?A. I believe it was August 9th, 2010.Q. And what was your understanding of when the death had
occurred?A. It was -- I believe it was on July 25th of 2010.Q. Okay. And so when you went to Iron Gate on
August 9th, 2010, what did you find, if anything?A. That the facility had -- was shut down. There were
no clients, no people in the facility. We were able to kindof peer in the windows and we could see that there were nopeople in there, the furniture looked -- it looked prettycleaned out when we looked in from the front. We went aroundto the back of the house because the side gate was open andthere was a sliding glass door and there were no curtains andso we were able to get a pretty good view of the full livingroom and kitchen. And the facility appeared empty.
Q. Did it appear empty or was the part you could seeempty or did it have things in it?
A. There was, I believe, a few furniture pieces but itdefinitely appeared that there was no one living there.
Q. Okay.A. But the doors were locked. We did try to open the
doors just to check and we weren't able to get in.Q. Now, did you -- as part of your investigation, did
you review the files that ADP -- it would have been ADP inJuly of 2010?
A. Yes.Q. Did you review the files that ADP had on the facility
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Sonja A. Hudson, CSR1208
at Iron Gate?A. I don't recall all of the documents. I looked at
some general licensing documents for the Iron Gate, but Idon't remember if I reviewed the whole file.
MR. SAMUELS: Okay. Can I have this marked, please.Thank you.
Q. BY MR. SAMUELS: I'm handing you what has been markedas Exhibit 87. It's a one-page document. Would you just lookat that and tell me if you recognize it.
A. Yes.Q. What do you recognize it as?A. This is a copy of the licenses that we issue to
programs that are generally hung in the facilities.Q. Do you know if it's required that a license be hung
in a licensed facility?A. It is required by regulations.Q. Okay. Now, did you ever see this -- you said you
never entered Iron Gate, so did you ever see this particulardocument at Iron Gate?
A. I did not.Q. Did you ever see this particular document or a copy
of it in the file?A. I don't recall.Q. I don't mean to be snippy, but why do you say you
recognize it?A. Because it's very -- all of our licenses for any
program looks -- is in this format.Q. Okay.
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Sonja A. Hudson, CSR1209
A. With the seal on the bottom. The original will havea gold sticker seal on it.
Q. Okay. Now, on the table, there is a laser pointer.It has a red button. Could you show where the seal is on thisdocument, please, using the laser pointer? Okay. So is thatthe laser -- is that the seal?
A. Yes.Q. And on the original it's what?A. This would be like a gold foil sticker and I believe
this said ADP on it. It has like embossing of ADP.Q. Okay. Now, is this license -- the information that
is in print on this copy of this license consistent with whatyou learned about the facility on Iron Gate you wereinvestigating?
A. Yes.Q. So who was -- who's the licensee per this particular
document?A. So the licensee would be A Better Tomorrow, ABTTC,
Inc.Q. All right. And what other information are we looking
at here?A. So this would be the name of the facility and the
address, the location of the facility. This ABTTC, Inc. isthe legal entity or corporation.
Q. What's the name of the facility though?A. A Better Tomorrow.Q. And the address?A. 42368 Iron Gate Lane, Murrieta, California 92562.
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Sonja A. Hudson, CSR1210
Q. It looks good to me. We've had trouble with theprojector. I'll ask you to confirm that when we take this offthe projector and I can return it to you. What's the nextsection refer to?
A. So the next section, which states, "individualsessions, recovery, or treatment planning, detoxificationgroup sessions, and educational sessions." This is a summaryof the services that could be provided at the program.
Q. Now, does that indicate whether it's a residentialfacility or not?
A. This information does not indicate that it's aresidential; however, what is indicative that it is aresidential program is the fact that it is a license.
Q. Okay. Below that paragraph you just read, what's thenext portion describe?
A. So then the next portion right here is thelimitations or conditions, and it's the treatment recoverycapacity, which states six, and the total occupancy is eight.What that indicates is treatment recovery capacity is theamount of clients that the program can serve, which is sixclients. The total occupancy for the location is eight, whichmeans that generally the people above the treatment capacityare going to be staff, which in most cases it is, which wewould say that the eight in the house would be two peoplewould be house managers or live-in staff.
Q. Okay. And just below that, what does it say?A. Males and females, which is indicating that it's a
co-ed facility.
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Sonja A. Hudson, CSR1211
Q. And below that?A. The license numbers. So all of our programs that are
licensed or certified have a number and it's a high number.Q. Could you read that number?A. 330071CP.Q. Is that as in Charles Paul?A. Correct.Q. And over to the right, just kind of below and to the
right of that number you read?A. Effective date. So the effective date is the day
that this license was issued. And its effect- -- theirlicense is effective as of that date. And then the expirationdate, which is when the license will expire.
Q. Now, that effective date, is that the originalissuing date or could it be a reissue date or a reissue dateafter a reissue after a reissue?
A. It could be a reissue date. So this -- thateffective date is just what is effective for this licensingperiod. Our licenses are effective for two years and thenthey're required to renew.
Q. Okay. And do you recognize the signature on thisform?
A. Yes.Q. Who's that?A. Her name is Ann McDowell and she was the supervisor
in the licensing and certification branch.Q. Was she personally known to you?A. I had brief dealings with her.
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Q. Okay. Did you see her signature?A. Yes.Q. Do you recognize this as her signature?A. Yes.Q. All right. I'm going to return this to you just so
you can make sure that you read the zip code correctly.A. Yes, 92562.Q. All right. Hold on to that for a moment. Now, you
said you were a custodian of records for this facility, butyou also said that you didn't start until 2008 with ADP; isthat right?
A. Correct.Q. Okay. This is the next exhibit. It is a paper
clipped document with eight pages. And the secretary is goingto staple it so they don't get moved around.
Now, in your job as the investigator, if you foundthings that weren't consistent with the rules of alcohol anddrug programs, did you notify the folks that ran the facility?
A. Yes.Q. And was there a formal process for this?A. Yes.Q. Can you describe that?A. So once we do an investigation and determine there
have been deficiencies in the program, any regulationviolations, then we will do our report and the report is givento the program and they're made aware of the deficiencies.
Q. Okay. I'm handing you what has been marked asExhibit 88. Would you tell me if -- look at all the pages of
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it and tell me if you recognize what that is.A. Yes.Q. What is it?A. It is the program investigative report or what we
call the PIR.Q. And what entity or facility is it for?A. For ABTTC/A Better Tomorrow.Q. And is there a license number on that?A. Yes.Q. Could you read that into the record, please.A. 330071AP.Q. So that's Adam Paul at the end?A. Yes.Q. Now, those two letters at the end of the number that
you read, what do they mean, if you know?A. So generally the first letter --Q. Uh-huh.A. -- will indicate if a program has the -- so if an
entity might have, say, three facilities.Q. Uh-huh.A. So the first facility that we receive a license for,
the first one that the department might license will be giventhe letter A and then the next facility will be given the Band so on and so forth, so it will go down the alphabet thatway. The P stand for profit and that's what that indicates.So other programs that are nonprofit will end -- will have anN there.
Q. Okay. Now, the designation for a particular address,
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will that change over time like if they get re-licensed orrecertified if I -- can I re- -- you know, reorder thefacilities?
A. Generally, I -- no, I don't believe so. So if afacility changes location, they would take that number withthem.
Q. All right. So can you tell from that exhibit whatfacility was under investigation in this report?
A. A Better Tomorrow.Q. And does it have an address for the A Better Tomorrow
facility that was the focus of this investigation?A. Yes. 40465 Erica Avenue.Q. All right. So this was not Iron Gate?A. No.Q. But it has A Better Tomorrow?A. Correct.Q. All right. Now, I want to look at a page. In the
exhibit in the lower right-hand corner of the pages are somenumber indicators. This one says page 5 of 8 and the nextpage says page 6 of 8. And I'm talking about a deficiencythat's described in an area that's got a 3 next to it. Do yousee what I'm indicating?
A. Yes.Q. And can you tell me what deficiency that was reviewed
and describe them?A. The program's website advertises that they provide
medically managed detoxification at this facility.Q. All right. And what program was that again?
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A. A Better Tomorrow.Q. And is that page initialled by someone at the bottom
or was there a signature of any kind?A. There are initials.Q. And do you know how initials -- is this a form you're
familiar with?A. Yes.Q. And did you ever use this kind of form?A. Yes.Q. And did you have people fill in initials -- were
there initials on this page on other forms that you generated?A. Yes.Q. And so what's the purpose of those -- that initial
space being there?A. The purpose of having someone initial this is that
it's indicating that they have read and understand the aboveinformation and it needs -- the initials need to be by aprogram or facility representative.
Q. Okay. So they are not filled in by you or anotherinvestigator, they're filled in by a program representative?
A. Correct.Q. Or a facility representative?A. Correct.Q. All right. Did you do this investigation?A. I did not.Q. All right. But is it part of the A Better Tomorrow
file?A. Yes.
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Q. There was -- the report, was it performed per thedirections that we described earlier that the person write itin a certain way, things like that?
A. Yes.Q. Do you recognize who did this investigation?A. Yes.Q. Who was that?A. Cindy Jamison.Q. Did you personally know Cindy Jamison?A. Yes.Q. And do you know where she worked in 2008?A. She was working with Alcohol and Drug Programs, ADP.Q. Do you know what her position was?A. Complaint analyst.Q. Same as you?A. Yes.Q. Okay. And what's the date on this report?A. July 15th, 2008.Q. Okay. Now, it says that -- I believe you read that
this is a deficiency sighting because there was computeradvertising that said there was medical treatment at thisfacility; is that a fair kind of summary?
A. Yes.Q. Why is this a deficiency, to your understanding?A. Because our facilities -- when I say "our," I mean
the Department of Alcohol and Drug Program. The facilitiesare nonmedical and it would be a deficiency to advertise orprovide services, medical services.
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Q. Okay. So the facilities that Alcohol and DrugPrograms supervised and licensed could not be medicalfacilities?
A. Correct.Q. Can you describe for the members of the jury what you
as an investigator were told and trained were medical servicesin that context?
A. So how we were trained would be that medical servicesare really services that need to be performed or within ahospital setting, hospital-type setting. So they could alsobe if services -- if a program -- you know, sorry. Let meback up a little bit, slow down.
Q. It's okay. Go ahead.A. I guess I would just summarize it that we've been
trained that if they need to -- if a client, or any type ofservices that need to be performed in a hospital setting, theycannot be performed in our programs.
Q. Okay. So in a hospital setting. What about thingslike just seeing a doctor? Could they be done in yourprograms?
A. They could be seen -- they could see a doctor in ourprograms as long as it was at the choice of the client. Theclient has the right to choose to see a doctor and whichdoctor they would want to see.
Q. Okay. What if they were just assigned a doctor?Would that be consistent with your understanding of what wasallowed under the medical services that ADP licensed?
A. If the program were to assign them a doctor, it would
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still have to be a client's choice, and it has to be anagreement that the client makes directly with the doctor.
Q. All right. Now, were ADP -- so what -- if they werenonmedical services, how would you characterize the servicesthat ADP licensed facilities were allowed to provide? Isthere a term for it?
A. Yes. It was -- we, the department, follows a socialmodel recovery program.
Q. Social model recovery program. Does this coverdetoxification as well?
A. Yes.Q. Now, what about something like taking a blood
pressure? Is that something that can happen in a social modeldetoxification program?
A. Yes.Q. So it's not the level of medical services that are of
concern?A. No.Q. Is that no, it's not the level or --A. No, it's not a concern.Q. I'm sorry, I asked the question poorly. That's why I
didn't understand your answer, so my fault.If a -- if a person had a medical condition and
wanted to enter a detoxification program, were there stepsthat the department wanted licensed detoxification programs toundertake to make sure whether the person was medicallyappropriate for the detoxification program?
A. Yes. They should -- the program should have the
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client go through some form of medical assessment by adoctor -- by a licensed doctor, and clear them for treatmentin a program that is not -- that doesn't provide medicalservices. So if a client is in need of medical treatment,they should go to an appropriate facility.
Q. Okay. And when should that occur?A. It should occur prior to entry. And if not prior to
entry, immediately upon entering, physically entering theprogram.
Q. So that's an assessment by a doctor?A. Yes. Per our regulations, it is the program -- the
programs are accountable for the health and safety of theirclients. And one way to ensure the health and safety of theclients is to have clients go through and get a medicalclearance.
Q. Okay. Now, would it be appropriate for a client tooffer medical services in the licensed program?
A. I'm sorry. Could you restate the question?Q. Would it be appropriate for the programs to offer
medical services like the services of a doctor during thelicensed program's provision of detox services?
A. No, because that would make them a medical facility.Q. Okay. Because they'd have a doctor there, is that
what you're saying?A. Yes. And that would be a part of the treatment is
the treatment would be inclusive of medical care.Q. All right. What if a program had a house where detox
took place and another house where they had a doctor who would
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see patients? Would that be okay because it was off site?A. It still couldn't be inclusive of the treatment, so
it would really have to be that the client chooses to go tothis doctor and they have -- the client has their ownagreement with the doctor for treatment.
Q. Okay. What if it was for assessment?A. The same.Q. They'd have to choose the doctor?A. Yes.Q. You said assessment was supposed to take place prior
to or immediately upon entry. So how long does immediatelylast upon entry, 24 hours?
A. There's -- it's not specific in our regulations;however, it needs to be very timely. I would say within theirarrival, so --
Q. So it's not specific?A. It's not specific.Q. And you can't put a time on it?A. No.Q. Can you say when -- can you -- well, does it
immediately expire at some point?A. Yes.Q. Okay. Is that a you know when you see it kind of
thing, or is there an exact number of hours or days, or what?A. I would say it's more you know it when you see it.Q. Okay. So it's nonspecific?A. Right.Q. So would it be fair to say that these regulations are
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a bit unclear?A. Yes.Q. Okay. Now, you said you went out to interview or to
do an investigation at the address on Iron Gate where a personhad died. I believe you put the date as July 25th, 2010. Andthere was nobody there and the place looked like it had beenvacated. What did you do to further your investigation?
A. So after that, I went over to the outpatient facilitythat is certified by the department and that is located onCorning Place.
Q. Uh-huh. What did you do there?A. I pulled some personnel files, client files, and the
next day, I conducted interviews with some staff.Q. Okay. Were these face-to-face interviews?A. Yes.Q. Were any of them other than face to face?A. I conducted one telephone interview.Q. Okay. How did you know you had reached the right
person when you did a telephone interview?A. I was informed that the staff member had moved and
was working at a different facility. And when I called, Iasked for the person by name.
Q. Uh-huh. And when you called, did they answer in away that indicated you had reached the proper facility oranything like that?
A. I don't recall.Q. All right. So do you recall the people you
interviewed?
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A. Yes. I interviewed Andrea Powell.Q. Uh-huh.A. And I interviewed her actually at a different
location. I interviewed her at the facility located onWinchester Drive, I believe.
Q. Okay.A. She was working there --Q. Uh-huh.A. -- at the time.Q. Go ahead.A. And that was A Better Tomorrow location as well. And
then I interviewed Josie Gann and Jim Fent, and I interviewedboth of them at the outpatient facility on Corning.
Q. Now, you say "outpatient facility." So you said aresidential place. What's the difference between aresidential -- 24-hour residential facility and an outpatientfacility?
A. So a 24-hour residential would be someplace wherepeople live and sleep at, and an outpatient operates more onbusiness hours. People will come between 8:00 to 5:00 and dogroups and one-on-ones and then leave.
Q. Okay. And was the Corning Place -- Corning Avenueresidence an outpatient facility?
A. Yes.Q. Who ran it there? Who's the entity that ran that
outpatient facility?A. A Better Tomorrow.Q. And was it the same A Better Tomorrow that operated
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Iron Gate?A. Yes.Q. Is this considered all part of one entity?A. I believe they had three different legal entities at
the time, but I would say they were all under the sameumbrella.
Q. What do you mean by that?A. So they had three different legal entity corporations
involved with them, but they all worked in conjunction. Soeven if one house was licensed under ABTTC, Inc., and anotherhouse was licensed under Forterus Health Care or justForterus, they all funneled in and worked through the CorningPlace, where services were provided, so all clients cametogether.
Q. At Corning?A. Yeah -- yes.Q. And you said ABTTC, Inc., and Forterus, and Forterus
what?A. Health Care, Inc.Q. And did the same people answer questions, if you had
questions about these different facilities, for the differentcorporate entities? Like if you had a question for any ofthese three that you mentioned, ABTTC, Inc., Forterus, andForterus Health Care, would you go to the same people to getthe answers?
A. Yes.Q. And they were the people at Corning?A. Yes.
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Q. Who were those people, if you recall?A. Jim Fent, Josie Gann, and Jerrod Menz.Q. All right. Now, are you trained in how to do
interviews with people about these incidents that you'reinvestigating?
A. Yes.Q. And just describe that training for us.A. So we go through a training program and then we are
also trained by other staff, such as staff that have been --when you initially come on, you are trained by veteran staffin different interviewing techniques.
Q. Okay. Are you trained on how to write reports afteryou've done an interview?
A. Yes.Q. What's included in that training?A. So it would be similar. We do take a report writing
course and then also train by veteran staff.Q. Okay. And the report writing course, what does it
stress, if you recall, if anything?A. Accuracy.Q. Okay. And was this your first death investigation,
this one in July of 2010?A. I don't recall if it --Q. Could it have been?A. It could be, but I might have done one other one
before that.Q. All right. So did anyone assist you in this
investigation?
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A. Not -- no, not while I was out in the field, no.Q. Okay. Did you have a supervisor?A. Yes, back at the office.Q. All right. So was it an individual or a
collaborative process?A. I would say collaborative. So I would write the
reports and then discuss the information with my supervisor,and my supervisor reviews all our reports prior to signingthem and sending them out.
Q. Okay. And these reports are held by, at that time,the Department of Alcohol and Drug Programs. If you did onenow, who would it be through?
A. Department of Health Care Services.Q. So these aren't reports that just get thrown away or
anything, are they?A. No.Q. How are they maintained?A. They are maintained in a locked file -- in a locked
room in a file cabinet.Q. Okay. So you did an investigation and you spoke to
Kris McCausland, Andrea Powell, Josie Gann, and Jim Fent. Howdid you become aware of Jerrod Menz?
A. I believe I was made aware of who Jerrod Menz waswhen talking with Jim Fent, and he had informed me that JerrodMenz was the CEO of the program.
Q. Did you ever ask him questions about A BetterTomorrow?
A. Jerrod?
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Q. Yes. In this investigation.A. I don't recall.Q. Have you ever spoken with Jerrod Menz?A. I have.Q. Was it with regard to this circumstance?A. I don't recall.Q. Okay. Now, I want to go through your interviews to
the extent you recall them. I want to start with KrisMcCausland. All right?
A. Okay.Q. You don't have any paperwork open on the desk and I'd
ask you to keep it that way. I'll ask questions and you tellme what you remember as best you can from your investigation.
Now, was Kris McCausland a face-to-face interview?A. No. That was over the phone.Q. And is that the only contact you had with him?A. Yes.Q. Did you ever meet him face to face?A. No.Q. Okay. And did you take any steps to identify him,
with particularity, ask him anything that he would know?A. I interviewed him about the death and he -- just
himself and Andrea were the only ones present in the facility,so the questions were very specific to the incidents thatnight. So I believe that was indicative of who it was.
Q. Okay. When you say they were the only ones in thefacility, Andrea and Kris, were there any other people there,to your knowledge?
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A. I'm sorry. For clarification, they were the only twostaff.
Q. Okay. Thank you. All right. So starting from thebeginning. What do you remember that stands out aboutMr. McCausland, what he told you regarding that night?
A. What really stood out was the fact that a detoxprotocol was initiated on this client and the client had notmet with a doctor yet, so they did not have medicationsprescribed to him. Mr. McCausland explained that the detoxprotocol is there and there were medications available in thehouse. And if a client came in and they were unable to meetwith the doctor and there was a specific drug that they weredetoxing from, he would follow the protocol and just give themedications to the client.
Q. Okay. You said quite a bit there. I'd like to rollthat back and go through it.
Did Kris McCausland tell you when Gary Benefieldarrived at the house?
A. I don't remember the specific time.Q. Okay. And did he tell you -- what did he tell you
about whether or not Gary Benefield had seen a doctor?A. I believe he had confirmed that he had not seen a
doctor yet.Q. And did he tell you anything about Gary Benefield's
condition, in his opinion, when he arrived?A. I remember that he indicated that he had his oxygen
tank and --Q. He who?
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A. Mr. Benefield.Q. Okay.A. And that he was smoking and that he had Chantix with
him, but he had informed him he can't have both -- "You can'thave both Chantix and the cigarettes."
Q. Okay. Who informed who?A. Mr. McCausland informed Mr. Benefield, "You can't
have both."Q. Now, what do you know about Chantix?A. I'm not real familiar except basic knowledge that
it's a nicotine substitute.Q. All right. Do you know whether or not it's a
prescription medication?A. I believe it is.Q. Did it cause you any concern that Kris McCausland was
telling Gary Benefield he couldn't have a medication that hadbeen prescribed to him?
A. The concern is just that the clients have rights tochoose or deny any medication that is prescribed to them.That is their medication, so they have their own rights totheir medication.
Q. All right. What about the house managers? Did theyhave any rights with regard to medication, by yourunderstanding?
A. To my understanding, no.Q. All right. So you mentioned that Kris McCausland
told you that Gary Benefield had an 02 tank or else you saidoxygen. Did he tell you anything particularly about this
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tank, Kristofer McCausland?A. From what I recall, he indicated that it was empty.
It wasn't full.Q. All right. Did Mr. McCausland indicate any knowledge
of why there was an 02 tank?A. I believe Mr. Benefield had informed him that he had
some health issues and one of them being COPD. I can'tremember the name of it right now, but -- and that was why heneeded the oxygen.
Q. Did McCausland indicate when he became aware thatGary Benefield had COPD and needed oxygen? Was it upon GaryBenefield's arrival, prior to that time? Did he tell youthat?
A. I believe it was at arrival. And when he was doingthe intake paperwork for him, he was -- is when Mr. Benefieldindicated some of his health history.
Q. Now, do you remember Mr. McCausland telling youanything about how Gary presented to him -- Gary Benefieldpresented to him?
A. I remember that he indicated that he had seen himsmoking, walking around. And then when -- in the evening,late evening, I want to say like around 11:30, 11:45 thatevening, he saw him walking in the hallway, I believe to therestroom, and he had just boxers -- boxer shorts on --
Q. Uh-huh.A. -- and Mr. McCausland informed him that he needed to
put clothes on and that he couldn't walk around like thatbecause it was a co-ed facility.
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Q. All right. Do you remember Kris McCausland tell youthat during his interaction with Gary Benefield, GaryBenefield seemed fine?
A. Yes. And I remember that Mr. McCausland had statedthat when he told him that, he made kind of a comment back tohim, which he indicated it was a smart aleck comment, in thosewords, what he stated to me. So that's what indicated to himthat he thought he was fine.
Q. This is when he saw him without a shirt?A. Yes.Q. What about earlier? Did he say anything about how
Gary Benefield seemed earlier upon intake?A. I don't remember when he --Q. Would it refresh your recollection to refer to your
report?A. Yes.Q. Do you have a copy of your report there?A. I do.Q. May I see it? Is this your entire report?A. Yes.
MR. SAMUELS: I'm going to -- I think it might be toothick to have it stapled, but if I could have it paper clippedand have this marked.
Q. BY MR. SAMUELS: Now, what I'm going to ask you to dois to refer to your report and see if it refreshes yourrecollection. Refreshing your recollection is when you have apresent memory in your own mind of the events we're inquiringabout. Please don't read from your report. Just see if you
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bring back a memory by referring to it. So look at the reportand if it brings back a memory, you can look up at me and letme know whether or not it does.
(Pause in proceedings.)THE WITNESS: Can you repeat your question?MR. SAMUELS: May I have the reporter read back the
last question.GRAND JURY FOREPERSON: Yes, Counsel.
(Record read by the court reporter.)THE WITNESS: To my knowledge, in what I'm
remembering is just that he had indicated initially that heseemed fine.
Q. BY MR. SAMUELS: Okay. Can you close that report andturn it over, please. All right. So you said that -- if I'mremembering correctly, you said that Gary Benefield wassupplied with drugs that were on the premises without seeing adoctor?
A. Yes.Q. Did you ask about that?A. Yes.Q. And what was -- what did Kris McCausland tell you in
that regard?A. What told me was that there were always medications
onsite at the facility, what we call sample medications orbulk medications, because they are not directly prescribed toa client. So they're just medications that are available.They could have belonged to a client who left and themedication -- they left their medications. We don't know, but
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the department -- we call them sample or bulk medications. SoMr. McCausland had indicated that there were always -- alwayssample medications at the facility. He didn't know how theygot there. He had never been present when medicationsarrived, just that there were always medications available.
Q. Did he say how they were stored at the facility?A. I believe he stated that they were stored in the same
room where all the other medications are and that wasgenerally in the bedroom closet of one of the house managersand at that time it was Andrea Powell.
Q. All right. Did he say how they were packaged?A. He had indicated that they were in what we call
bubble packets, so each pill is in its own bubble and you popthem -- we say pop them out, you press each one out.
Q. Okay. Did he say anything about any meds beingstored in bottles?
A. I don't recall.Q. You mean you don't recall if he said that or you
don't recall in general?A. I don't recall in general.Q. Would it refresh your recollection if you referred to
your report?A. Yes.Q. Then please do so.
Yes, ma'am?A. I don't recall him indicating bottles.Q. Okay. Flip your report back over so it's not face
up.
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A. Oh, sure.Q. Did you discuss Gary Benefield's oxygen tank with
Kris McCausland in any detail?A. Yes.Q. What was that discussion like?A. I asked him in regards to the oxygen being empty or
full, he indicated it was empty and any attempts to get itfilled for him.
Q. What do you mean by "any attempts to get it filled"?A. Were the staff making any attempts to get his oxygen
tank filled for him.Q. And what was said in that regard?A. I believe Mr. McCausland indicated that it wasn't
urgent because the client had indicated that he didn't need itbecause he had his inhaler.
Q. Okay. So that's what Kris McCausland told that youGary Benefield told him?
A. Yes.Q. Did you ask McCausland if he had ever had any
patients with oxygen before?A. I don't recall if I asked him that.Q. Would it refresh your recollection if you referred to
your report?A. Yes.Q. You may do so.
Do you remember now?A. Yes. So I remember he had indicated that it was the
first client that he had worked with that required oxygen.
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Q. Okay. Now, are there any best practices orguidelines regarding monitoring in a residential detoxfacility?
A. I don't understand your question.Q. Well, you said that there are certain things that
differentiated a social detox facility from a medical model.And so I'm asking, I guess, is there any kind of guidelines orprograms at ADP, the Alcohol and Drug Programs, you would givefolks about, you know, you're a social model, you're supposedto monitor; you're a medical model, you're supposed to hookthem up to machines that monitor. Any sort of best practicesor directions you know about in that regard?
Well, let me just step back. What does monitoring adetox patient mean to you?
A. So in our programs, that monitoring would be visualchecks of the clients to ensure that they're okay.
Q. Okay. And do you know -- understand that there areany guidelines or directions on how often a client in a detoxfacility was supposed to be visually checked?
A. In a licensed facility, there are no regulatoryrequirements for time frame, so what the department willfollow and hold a program accountable for is their ownpolicies and procedures.
Q. So did you review policies and procedures for ABetter Tomorrow regarding visual checks on clients to makesure they were okay?
A. Yes.Q. And your review of A Better Tomorrow's policies and
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procedures, do you remember what it told you about monitoring?A. Yes. From what I recall, there were -- it was a
little confusing because there were some indicators that itwas every four hours that clients need to be checked on, andthen I also found other indicators that their policy was to dotwo-hour checks on clients.
Q. Okay. And were those policies all for A BetterTomorrow?
A. Yes.Q. Did you talk with Kris McCausland about monitoring in
general?A. Yes.Q. Do you remember what he told you?A. He indicated that he is -- was supposed to do regular
checks for any detoxing clients, and specificallyMr. Benefield, he was supposed to do, I believe, four-hourchecks on him.
Q. And did he say anything about whether or not he haddone a four-hour check?
A. He indicated he had not.Q. And so did he give you a time -- the last time he saw
Gary Benefield alive?A. I believe it was around 12:15 a.m.Q. And when did he see him the next time he saw him?A. At 8:00 a.m. when he had found him deceased.Q. But that's not a rule of the State or anything,
that's the policies and procedure of A Better Tomorrow?A. The checks?
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Q. Yes.A. Correct.Q. Okay. I want to go back to the oxygen for just a
moment. Did Kris McCausland tell you that Gary Benefield madeany requests to him about oxygen?
A. I don't recall.Q. Would you -- okay. I'll leave it at that for a
moment.If you wrote in your report that Kris McCausland told
that you Gary Benefield never made any requests for oxygen,would that be -- and you had never in quotes, why would neverbe in quotes?
A. If it is in quotes, then that would be -- I wouldhave put it in quotes because that's the exact word thatMr. McCausland used while I was interviewing.
Q. Okay. Would you look at your report on page -- I'msorry, I had it. On page 9 of 24, there's a big middleparagraph, and I'm going to show you where I'm referring to.I want you to say whether those are the words McCausland toldyou, so start right here.
A. Yes. So --Q. Okay. Would you read that sentence starting from
where I pointed out. It says, "That" --A. "That it was okay and could be filled the next day."Q. And read the next sentence, please.A. "Mr. McCausland stated that Client 1 never asked for
his oxygen tank to be filled. And from what he was told,Client 1 was already asked and if he needed it to be filled
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and he declined to them as well."Q. All right. And some portions of that are in quotes,
are they not?A. Yes.Q. And so that would have been because it's exactly what
Kris McCausland told you?A. Yes.Q. All right. Now, it's my understanding we're going to
break at a quarter 'til. So I want you to turn back to thevery first page of your report. And if I may, I'm going toproject this up on the screen. And may I get the laserpointer from you? And because we have had difficulties withour projection equipment, you may not be able to read this onthe screen, but I'll give you the form back, if necessary.Remember on the other program investigative report or PIR youread the number up here?
A. Yes.Q. Okay. Can you read that number?A. 330071CP.Q. Is that the same number and alphabetic designations
in the other report?A. No.Q. What's different?A. The A and the C.Q. Indicating what?A. That it's a different location.Q. And this location is?A. The Iron Gate Lane.
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Q. Okay. And in the middle of the top of the -- oops,wrong button. The middle of the top of the PIR right herewhere I'm circling, what's that?
A. That is the name of the facility.Q. And what's it say on this?A. Forterus Health Care, Inc.Q. Did you fill in this form yourself?A. Yes.Q. Where would you have gotten that information?A. From a licensing document.Q. All right. Housed where?A. In the licensing file or in our database. We had a
licensing database.Q. Okay. And here I'm circling. What's that?A. That is the name of the legal entity, the
corporation.Q. And what's it say?A. A Better Tomorrow, ABTTC, Inc.Q. So tell me what's the relationship between the
program facility name and the program facility legal name, ifyou can?
A. So the legal entity is generally the corporation thatowns the company and the facility name, the Forterus, is thename of the actual facility.
Q. Okay. So Forterus was the name of the actualfacility at 42368 Iron Gate when you did this report?
A. Yes.Q. Okay. Let me just get a date of when you did this
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report. Is it -- is the report dated there?A. Yes.Q. Where?A. At the bottom.Q. Okay. I'm going to give you back the laser pointer.
Please show us where it's dated. Right there. What's it say?A. That is March 8th, 2011.Q. And there's a signature to the left of that. Whose
signature is that, if you recognize it?A. Mine.Q. Janelle Ito-Orille?A. Yes.Q. So did your investigation take from August, I believe
you said you started, until March of 2011 to complete?A. Yes.Q. And do you know whether or not during that time the
program facility name was changed in any way?A. The only knowledge I have is that the program closed
down. That was the change.Q. All right. Did you talk to people who represented
that they were in charge of the facility during the time thedeath occurred there?
A. Yes.Q. And they're the people you've discussed in your
testimony earlier?A. Yes.Q. Okay. And so if I'm understanding, their corporation
was known as A Better Tomorrow, ABTTC, Inc., and the facility
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at Iron Gate had a formal name in your database as ForterusHealth Care?
A. Yes.Q. Okay. Thank you. Now, it is a little past a quarter
'til.MR. SAMUELS: Mr. Foreman, what I would ask is this
witness be excused to remain present in the -- at our beck andcall, so to speak, and that the witness who has a limited timeto testify be called at 1:00 so his testimony can be included,and then Ms. Ito-Orille's testimony can be completed and/orconcluded. Is that appropriate?
GRAND JURY FOREPERSON: Yes, Counsel.MR. SAMUELS: And I intend to finish at or before
4:30 today.GRAND JURY FOREPERSON: Okay. Ms. Ito, you are
admonished not to reveal to any person, except as directed tothe Court, what questions were asked or what responses weregiven, or any other matters concerning the nature or thesubject of the grand jury, unless and until such time as thetranscript of this grand jury proceeding is made public.Violation of this admonition is punishable as contempt ofcourt.
THE WITNESS: Okay.GRAND JURY FOREPERSON: You are excused.MR. SAMUELS: The jury will take a recess and should
promptly be back by 1:00 p.m. Thank you.(Lunch recess.)
GRAND JURY FOREPERSON: The grand jury will now come
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to order.Will the secretary please take roll again.GRAND JURY SECRETARY: Juror No. 1.GRAND JUROR NO. 1: Here.GRAND JURY SECRETARY: Juror No. 2.GRAND JUROR NO. 2: Here.GRAND JURY SECRETARY: Juror No. 3.GRAND JUROR NO. 3: Here.GRAND JURY SECRETARY: Juror No. 4.Juror No. 5.GRAND JUROR NO. 5: Here.GRAND JURY SECRETARY: Juror No. 6.GRAND JUROR NO. 6: Here.GRAND JURY SECRETARY: Juror No. 7.GRAND JUROR NO. 7: Here.GRAND JURY SECRETARY: Juror No. 8.GRAND JUROR NO. 8: Here.GRAND JURY SECRETARY: Juror No. 9.GRAND JUROR NO. 9: Here.GRAND JURY SECRETARY: Juror No. 10.GRAND JUROR NO. 10: Here.GRAND JURY SECRETARY: Juror No. 11.GRAND JUROR NO. 11: Right here.GRAND JURY SECRETARY: Juror No. 12, here.Juror No. 13.GRAND JUROR NO. 13: Here.GRAND JURY SECRETARY: Juror No. 14.GRAND JUROR NO. 14: Here.
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GRAND JURY SECRETARY: Juror No. 15.GRAND JURY FOREPERSON: Here.GRAND JURY SECRETARY: Juror No. 16.GRAND JUROR NO. 16: Here.GRAND JURY SECRETARY: Juror No. 17.GRAND JUROR NO. 17: Here.GRAND JURY SECRETARY: Juror No. 18.And Juror No. 19.GRAND JUROR NO. 19: Here.GRAND JURY FOREPERSON: The record will reflect all
17 jurors are present.Counsel, good afternoon.MR. SAMUELS: Good afternoon. In preparation for
this witness' testimony, could I have the photos from thehouse?
Are we ready for the witness?GRAND JURY FOREPERSON: Yes.Reminder to everyone, please turn off your electronic
devices or silence them. Thank you.Please remain standing and raise your right hand,
please. You do solemnly swear that the evidence you shallgive in this investigation now pending before this grand juryshall be the truth, the whole truth, and nothing but thetruth, so help you God?
THE WITNESS: I do.GRAND JURY FOREPERSON: Please be seated.THE WITNESS: Thank you.GRAND JURY FOREPERSON: I have a statement
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acknowledging a secrecy order that I would like you to read.THE WITNESS: Okay.GRAND JURY FOREPERSON: Sign and print your name at
the bottom.THE WITNESS: Okay. Great.GRAND JURY FOREPERSON: Thank you.THE WITNESS: Would you like me to read out loud or
to myself?GRAND JURY FOREPERSON: To yourself.MR. SAMUELS: To yourself.THE WITNESS: Okay.
(Pause in proceedings.)GRAND JURY FOREPERSON: Please state and spell your
full name for the record.THE WITNESS: Sure. My name is Joseph I. Cohen,
first name is J-o-s-e-p-h, middle initial I., last nameC-o-h-e-n.
GRAND JURY FOREPERSON: Thank you.THE WITNESS: You're welcome.GRAND JURY FOREPERSON: Counsel, you may proceed.MR. SAMUELS: Thank you.
JOSEPH I. COHEN,called as a witness by the People, was sworn and testified asfollows:
DIRECT EXAMINATIONBY MR. SAMUELS:
Q. Good morning -- good afternoon, excuse me.A. Good afternoon.
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Q. And how are you employed, if at all?A. I am a forensic pathologist, a full-time practicing
forensic pathologist in Northern California through mycompany, United Forensic Services.
Q. Now, is a pathologist a particular profession?A. Yes.Q. What's that?A. Well, a forensic pathologist is a very specialized
type of physician that generally deals with coroner cases ormedical examiner cases. These are deaths that occur and are,by law, reportable to the coroner or medical examiner. Sothat would include homicides, suicides, accidents, anyunnatural death, any sudden unexpected death, unattendeddeaths of children, deaths involving law enforcement, deathsthat may be a public health issue, such as an outbreak ofdisease, and so forth. These would be all reportable. And sowhat a forensic pathologist does, this is a physician whogenerally performs autopsies for the purpose of determiningthe cause of death, that is, why the person died, as well asthe manner of death, which is just a box that's checked on thedeath certificate, whether the death is a natural death,accident, suicide, homicide, or undetermined.
Q. All right. And I'm handing you what's been markedfor identification as Exhibit 90.
A. Okay.Q. Do you recognize this document? It's a multipage
paper-clipped document.A. Yes.
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Q. What is it?A. This is my curriculum vitae, my CV.Q. Is that like a resumé for lay people?A. Yes.Q. And briefly could you describe your educational
background?A. Sure. Well, I was raised in Arizona. I attended
high school there and college. I received my Bachelor ofScience in Biology at the University of Arizona in Tucson.
I went on to medical school in Milwaukee, Wisconsin,Marquette University Medical School, which is now known as theMedical College of Wisconsin. So I received my medicaltraining and my medical degree from there.
After that, I returned to my hometown of Phoenix,Arizona, and I spent one year of training in general surgery.That was my internship the year following medical school.
After that, I switched to pathology, generalpathology, and I spent four years training at UC Irvine,University of California, Irvine program, based in Orange --Orange, California. This was my general pathology training,which includes both anatomic and clinical pathology, mostlyhospital-based pathology with only maybe one month of forensictraining in those four years.
After that, I relocated to New York City to Manhattanand I spent one year training in forensic pathology. This wasmy first exposure to performing autopsies in a medicalexaminer setting on a regular basis. So I performed about 300forensic autopsies in that year, 1994, '95, in Manhattan at
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the Office of Chief Medical Examiner under the supervision ofmy boss, Dr. Charles Hirsch.
Following that year, I remained on the staff as afull-time medical examiner in New York City performingautopsies on a day-to-day basis. So I was in New York Cityfor five years almost to the day.
For the last four years of that, I was stationedprimarily in the Bronx but also performed autopsies inManhattan and Brooklyn.
Following -- that takes us to June and July of 1999where I was offered the position of Chief Forensic Pathologistfor the county we're in today, Riverside County. And Iaccepted that position at a time that the lay coroner wasbeing transitioned to a sheriff coroner system. So I washired by the Board of Supervisors under the administrativeguidance of the Sheriff, where I spent 11 years, again almostto the day, as the Chief Forensic Pathologist for RiversideCounty.
Q. Let me stop you there.A. Yep.Q. Chief Forensic Pathologist, that means you were the
boss, the head of the forensic pathology department for theCounty?
A. Yes. Yes. I would manage five or six other full-and part-time forensic pathologists that performed autopsiesin Riverside County between our two offices, one in Perris andthe other in Indio. About a third of our cases were done inIndio in the Indio facility. But I would supervise those
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Sonja A. Hudson, CSR1247
other doctors from 1999 to 2010, ones that were either alreadyperforming autopsies when I arrived, plus the ones that Ihired, which were several.
Q. So were you the boss of Riverside County Sheriff'sForensic Pathology Department in July of 2010?
A. That was my last month.Q. Okay.A. I believe my last day was July 26th of 2010.Q. All right. And are you still --A. Maybe August 5th. I stand corrected.Q. Okay. Are you still working as a forensic
pathologist?A. Yes.Q. And have you been continuously licensed since you
first got your license back in 1986, was it?A. Yes. In three states, California, Arizona, and
New York.Q. And there's, unfortunately, pages -- the copy I have
of your CV, the pages are not numbered, but can you tell usafter the second page what's contained on your CV, what kindsof entries, just a general characterization.
A. Well, the resumé basically has some identifying data,some biographical information, where I'm from, my experiencethat I've discussed already, short of my current position,which is the Chief Forensic Pathologist of Marin County andNapa County, both in Northern California, through my company.So I incorporated in 2010 at or about the time that I tookearly retirement from Riverside County.
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The resumé has a list of numerous lectures andpresentations and other activities, professional activitiesthat I was involved with, agencies and organizations that Iwas either a member or a participant. Most of this is a listof the various topics that I provided training for manydifferent agencies. That would include district attorneys,locally and for the State, for defense attorneys and numerousother agencies, Child Protective Services, and others.
Q. Okay. Now, were you presented with materialsregarding a death that occurred in Riverside County inMurrieta in July of 2010?
A. Yes, I was.Q. Could you tell us what materials you were provided to
review?A. Yes. Well, I received, I believe on -- as multiple
PDF files, I think that I received them through the Dropboxprocess over the Internet. And there were some 30 or 35different files. The -- I think the ones that are mostpertinent to my involvement would be the autopsy report ofGary Benefield, which is listed under File No. 2010-05812.And that's an autopsy report that is authored by one of mypathologists at the time, Dr. Marc Fajardo.
Q. When you say "at the time," what do you mean?A. Well, the autopsy was performed on July 27th of 2010.
My departure was August 5th, so it was just about a week afterthat. However, the case was not certified and signed byDr. Fajardo until September 20th, 2010, which was alreadyquite some time after I had departed.
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Q. Okay. We'll get back to what certified and signedmeans, but let's stick to what materials you reviewed.
A. Sure. So the autopsy report, which lists the causeof death and other significant conditions, drug testingreports by Bio-Tox Laboratories, Bio-Tox, B-i-o, dash, T-o-x.They're based in Riverside. The coroner investigator's reportfrom the coroner division of the Riverside County Sheriff's.
Q. And do you know who authored that?A. That was Steve Albert, I believe. Yes, Deputy
Coroner Steve Albert.Q. Go on, please.A. And then the rest were numerous medical records,
doctors' visits, hospital stays pertaining to Mr. Benefielddating back to, I think, 2006 or '7.
Q. Did those records include records from Dr. SimranjitGalhotra? Do you recall?
A. I could check. I don't recall the name. And itdepends on -- I'm not sure. It's possible. I don't recallthe name.
Q. All right. What's the easiest way for you to recallwhich records you reviewed?
A. Well, the easiest way is, you know, this is the --these are the PDFs. So I have a single page, which doesn'treally say much. These are labeled by numbers. So there aresome 35 or so, approximately, PDF files. Most of these arefairly short, in the five- to seven-page range. Several arelonger, such as the autopsy report and the coronerinvestigator's report and the Murrieta Police Department
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report, which I believe was 35 pages. So that was there and Ireviewed that.
The other records were -- pertain to doctor visitsand at least one recent hospital stay that was, I believe,July 13th through the 17th or 18th. There's a little bit ofquestion on the -- on the date of discharge, but that wasabout a week before the death of Mr. Benefield. There wasabout a one week hospital stay where he was admitted withpneumonia.
Q. Do you remember where that was?A. That was -- let's see, that was at -- it was White
Mountain Regional Medical Center in Springerville, Arizona.Q. Okay. All right. So you reviewed those materials --A. Yeah.Q. -- including the police report that you've already
indicated regarding the death of Gary Benefield?A. I did, yes.Q. And you reviewed Dr. Fajardo's autopsy?A. I did, yes.Q. And did you obtain and review pictures of the
decedent as he was found?A. I sure did, yes.Q. And did you get any records regarding any medications
or prescription drugs the decedent was provided on July 25th,this evening -- his last evening?
A. Yes.Q. All right. Now, what did -- in your examination of
this patient, was there anything about him physically that was
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remarkable in your opinion?A. By way of the clinical history or by way of the
autopsy findings?Q. I want to talk about his clinical history.A. Yes.Q. If you were to see this patient's medical records --A. Yes.Q. -- and not know he was dead, was there anything in
those medical records that you would have said that standsout?
A. Absolutely, yes. He was quite ill. Even though hewas not that advanced in age, I think 52 or 53 years of age,he had a long-standing history of severe emphysema, chronicobstructive pulmonary disease, and he was requiring 24/7oxygen to supplement to keep him alive. He also had a historyof congestive heart failure and some atrial arrhythmias, suchas atrial fibrillation and atrial flutter, I believe. So hisheart was not in great shape from hypertension, from highblood pressure over time.
He also had pneumonia, which I mentioned earlier.That's all directly related to heart and lung disease, thedevelopment of pneumonia, including up to a week before hisdeath. What else?
Q. What about bad habits, if any?A. Yeah, he did. And I was going to mention that as an
aside. He was a smoker of many, many years and he was adrinker of alcohol. So he was an alcoholic and that was a bigproblem for him as well.
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Q. All right. Now, do you know -- you said he wasrequired to have oxygen at all times as a supplement to keephim alive. Do you know how much oxygen he was using?
A. It was many liters per minute by the nasal prongs ornasal cannula. So I don't know if was eight to ten or morethan ten liters per minute.
Q. All right. Do you have an impression that it wasless than that on a regular basis?
A. No.Q. This is two pages out of an exhibit that's been
labeled as Exhibit 40, which were the records of EileenFurman, a family nurse practitioner who treated Gary Benefieldin July of 2010. And this is her record of July 20th, 2010.It's a two-page document.
A. Okay. Thank you.Q. Could I offer it for your quick review?
(Pause in proceedings.)THE WITNESS: Okay.
Q. BY MR. SAMUELS: Now, that record from NursePractitioner Furman, did it note, from your reading andreview, how much supplemental oxygen Gary Benefield wasreceiving on July 20th?
A. Yes.Q. How much?A. It was 4 liters by nasal cannula, and then it says 2
liters at 86 percent. So that was insufficient to maintainoxygen saturation.
Q. What do you mean by that? Why is 86 percent
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insufficient?A. If that's what that means. I think that's what that
means. The normal oxygen saturation should be close to100 percent. It should be 97, 98 percent, in that area. Andthat's a measurement of the amount of oxygen that's beingbound to the red blood cells in your body. So if the redblood cells are only 86 percent saturated, then about14 percent of the oxygen that you should have beingdistributed to the tissues, 14 percent less is actually makingit to the brain and to the heart and vital organs.
Q. Including that record and all the other records youreviewed, can you characterize your conclusions about to whatdegree Gary Benefield was dependent on supplemental oxygen?
A. Very, very high degree. I would say -- I mean, howdo you express that in words? I mean, if on a 1 to 10, 1being very little dependency and 10 being that oxygen -- yourlife depends on your oxygen supplementation, I mean, it's gotto be at least an 8 to a 10, in my opinion.
This is a gentleman that had severe emphysema that iswell-documented back to 2007, at least that far back. Soit's -- he was dependent upon oxygen, no question about that,very much so.
Q. When you say dependent on oxygen. Aren't we all?A. We are. Unfortunately, his lungs were damaged to an
extent that they themselves were unable to exchange oxygen andcarbon dioxide with the environment sufficiently.
Q. You mean "they," his lungs?A. His lungs, yes.
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Q. Okay. Now, did you review -- did the records youreviewed include any medications that were provided to GaryBenefield on July 25th, 2010?
A. Yes.Q. And what did you learn about the medications?A. Well, the two that he was provided with on that day
were trazodone and Serax. Serax is also known as oxazepam andthat's an antianxiety agent and also used for -- to treatalcohol withdrawal. And trazodone, the other drug, is anantidepressant but also used as a sleep aid, and some otherthings as well.
Q. Now, do you know if these drugs fall in any class ofprescription drugs?
A. Yes, they do.Q. And what's that?A. Serax falls under the class of benzodiazepines,
B-e-n-z-o-d-i-a-z-e-p-i-n-i-s or e-s, I guess. I'm glad it'snot a spelling bee today. So oxazepam is a benzodiazepine,which is the general antianxiety class. And trazodone is anantidepressant. I believe it's a serotonin reuptakeinhibitor, along with some other mechanisms, but it's anantidepressant.
Q. And, to your knowledge, are these prescription drugs?A. Absolutely, yes.Q. And you're a physician; right?A. Yes.Q. So what can you tell me about prescription drugs that
are available out there?
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A. Well, unfortunately, they are too available manytimes, you know, through my experience. You know, drugs areactually categorized as being highly addictive or not so much.And so the rules and regulations for each of the drugs aredifferent depending on the type of drug in terms of who canprescribe and what for and so forth. So in my experience, I'ma pathologist, so I don't regularly prescribe, you know,prescription medication. On occasion I do, but I generally dofor family and friends when they need antibiotics. I wouldnever prescribe an opiate drug like methadone even for familymembers. And I know that, you know, some doctors do and Ithink that's crossing a line. But these are drugs that shouldbe prescribed by physicians who are seasoned at andexperienced at using them and prescribing them.
Q. All right. So these are drugs that should beprescribed by a physician?
A. Absolutely.Q. Would it be inappropriate for these drugs to be
handed out by a nonphysician?A. Absolutely.Q. All right. Now, if Gary Benefield were deprived of
his supplemental oxygen, what would this effect on him be, inyour medical opinion?
A. Well, the effect of not having his supplement in theway of oxygen is that he is going to feel air hunger. He'sgoing to feel like he's just not getting enough air. And thatis a noxious stimulus, meaning it's -- if anybody has, youknow, had the experience of either inhaling something that's a
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noxious gas or, you know, a near drowning accident orsomething like that, the feeling of not having adequate oxygensupply is quite scary. So he would experience air hunger,shortness of breath. His body would naturally try to breathefaster to get more air and oxygen in to compensate for that.His heart rate would increase to try to get the blood to thetissues and what -- what oxygen remains to the tissues in theabsence of his supplemental oxygen.
So there are bodily physiological functions that takeeffect, either consciously or subconsciously, in the presenceof low oxygen saturation in the blood. So that's what theeffect on his body would be.
Q. Now, do these things occur all at once?A. They occur together in time fairly much. I mean, I
think that, you know, the increase in breathing rate and theincrease in heart rate would occur at or about the same time.I'm not an exercised physiologist, but I can say that, forexample, both of those functions would increase to try and getmore oxygen to the brain and the heart.
Q. Okay. Well, let's turn to your area of expertise.A. Okay.Q. And in the records you reviewed, did you notice a
time when death was pronounced on Gary Benefield --A. Yes.Q. -- by a qualified person?A. It was 8:09 in the morning on the 26th of July, 2010.Q. And did you see any indication of when there was a
last sighting of Gary Benefield by anybody when he was alive?
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A. It was some eight hours earlier, maybe just aftermidnight, 12:30, I think. 12:30 in the morning.
Q. Now, were you able to determine from your review ofthe records what time Gary Benefield stopped usingsupplemental oxygen on the 25th?
A. Approximately, yes.Q. Can you give me that approximate time?A. On the 25th, that would have been his trip from
Phoenix to San Diego arriving at -- well, he had the oxygentank at the airport in Phoenix. Reportedly that tank wasemptied at the airport. So whatever time he departed Phoenix,I know he checked in at about 5:30 p.m.
Q. Checked in where?A. Checked into A Better Tomorrow.Q. All right. So let's work back from 5:30 and I'm
going to ask you to take some things as facts because Ibelieve there's been testimony to these timelines.
A. Okay.Q. If he checked in and did intake at A Better Tomorrow
at 5:30, and he was driven there and it took 45 minutes to anhour from another facility, and he had gone to that facilityfrom the airport where it took awhile to find him and get himto the facility, about 45 minutes, I believe, so we're back anhour and a half. And the flight took about an hour fromPhoenix, so we're about an hour and a half, plus another hourfrom 5:30, now we're back to about 3:00.
A. Correct.Q. So let's say between the hour of 2:00 and 3:00, just
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for the sake of putting a bracket around it, Gary Benefieldstopped using supplemental oxygen.
A. Okay.Q. And I want you to further presume that at around
4:30, Gary Benefield was provided with two 15 milligrams pillsof Serax.
A. Okay.Q. And that at about 2100 hours or 9:00 on the evening
of 25th, he was given two more 15 milligrams Serax, as well asthree 50 milligram trazodone, as well as two number 3, if thathas a meaning to you, Tylenol with codeine?
A. Yes.Q. Now --A. At 9:00?Q. Yes.A. Okay.Q. You have all of those written down --A. Yeah.Q. -- or in your mind?A. Yes.Q. Now, before you go to that, in general, what would
the effect of Serax be? You said it was benzodiazepine thatwas an antianxiety drug.
A. Yes. It's a central nervous system depressant, so itwill slow the breathing.
Q. What about trazodone? You said it's a sleep aid.A. Same thing.Q. And what about Tylenol with codeine?
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A. Definitely codeine, same thing, depressesrespiration.
Q. And what class is codeine?A. Codeine is an opioid or opiate drug. It's a narcotic
drug.Q. Okay. Now, in a patient or person who has
compromised lungs because of COPD, to the extent that you'veseen in your review of the medical records -- you've seenDr. -- I'm sorry, Nurse Practitioner Furman's notes from justa few days before -- do you have an impression of what effectthese drugs and the lack of oxygen would do to Gary Benefield?
A. They -- they would do no good. This would -- wouldput him over the edge potentially, and did.
Q. And what do you mean by "put him over the edge"?A. Well, I mean that he's already in pretty bad shape
even with the oxygen. Without it, it's a ticking time bomb.Without his oxygen, especially for that long, if it was from3:00 in the afternoon until -- let's just assume for thepurpose of discussion that he died shortly after he was lastseen, say, at 12:30 or 1:00 in the morning, if that was thecase, it would be still at least about ten hours of being, youknow, without his oxygen. And if he had expired closer to8:09 in the morning, then that adds that many more hours toit, although the autopsy evidence does not -- or the scenephotographs and the scene investigation does not point to thedeath occurring closer to 8:00, it points at death occurringin the early morning hours.
Q. So you've reviewed your report from the deputy
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coroner on the scene, Travis -- I'm sorry, not Travis -- whatwas his name, please? Steve Albert.
A. Yes.Q. And did you review the pictures?A. I sure did, yes.Q. Okay. I've got Exhibit 43, which has a number of
pictures that Deputy Albert testified to earlier today.A. Okay.Q. And I'm going to show them to you for your comment
regarding what you just said about what they indicate as tothe possible time of death.
A. Okay.Q. So this is out of the exhibit. This is page marked
000167 that shows where Gary Benefield was when the deputycoroner observed him. Now, what can you say about thispicture, Doctor?
A. Well, this picture, it's -- the resolution, at leaston the screen, is not the best, but it does tell us quite abit of information.
Q. There was a laser pointer.A. I think this may be it here.Q. Okay. Great. Red button.A. Make sure I hit the right button and not something
that's going to set off anything.Q. Right up in the top in the middle there's a red
button.A. There we go. Okay. So Mr. Benefield is in a
facedown sort of a crouched position. To me -- well, I mean,
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the first thing that stands out is the appearance here is thatof a sudden -- fairly sudden collapse. He's not laying in acomfortable, you know, sleeping position. It looks like hejust collapsed and died right here.
The next thing that stands out is this deep redpurply discoloration that you can see on the upper back,shoulders, and all extremities. It's very deep, purply redcolor, and that's livor mortis or livor mortis. That'spooling of blood after death in the dependent portions of thebody closest to gravity. So the blood pools and, hence, theareas that are closest to the ground become red.
And this is very, very vivid. And you can see thatthe back doesn't have any down by the buttocks, the lowerback, and the midback, so that's because that's the upper partaway from gravity and the blood is pooling downward.
This is a very intense livor mortis. This does nothappen in seconds or minutes. Something like this takes hoursto develop like this. This is one of the most intense livormortis patterns you'll see. So this puts -- one may ask howmany hours? I would say that from the time this picture wastaken, going backwards, I mean, it could be 6 or 12 hours, Imean, if I didn't know anything else about the case. It'squite prominent.
Q. Okay. Now, I'm going to show you another --A. It could be longer, I mean, with -- depending on
environmental factors.Q. Okay. I'm going to tell you that there's testimony
that the room was cool, somewhere between 70 and 78 degrees.
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A. Okay.Q. This is page 000168 from this exhibit and this is the
decedent, Gary Benefield. Now, does this add to your analysisfrom that last photo?
A. It does. It does add another attribute. This -- notonly can we see the livor mortis more easily since it's --we're facing it, but the appearance here is that the jointsare stiff, that the knees are -- the legs are flexed, and theupper extremities are flexed. This is rigor mortis, or thestiffening of the muscles after death that occurs. And thisdoesn't occur in seconds to minutes, this would take severalhours or longer depending on the environmental conditions.
Now, if it's cool in the room, it takes longer todevelop these processes. So a cooler environment means ittakes longer to develop these livor and rigor mortis patterns.So that adds a little bit more time, relatively speaking, ifit was a cool environment. So depending on what exactly thetime was that these photographs were taken, we can estimatebackwards the approximate time of death.
Now, I want to point out very clearly that unlikesome of the television shows that, you know, putting a time ofdeath based on any postmortem change, whether it's the gastricdigestion process, livor mortis, rigor mortis, it's verydangerous and very difficult because there's so many factors,body weight, the type of flooring, the humidity, air currents,if there's a lot of clothing, a lot of factors. So -- but,generally speaking, the fact that it takes a number of hoursdoesn't change my opinion here.
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Q. All right. Now, rigor mortis, what you justdiscussed, the stiffening of the joints --
A. Yes.Q. -- does it get -- is it progressive?A. It is progressive. It then peaks and then it
dissipates. In other words, when a person dies, they have norigor mortis. In 24 hours or 36 hours, it may peak to be thevery tense rigor mortis, where it takes a lot of work to evenbreak the rigor mortis, and then it dissipates over time.That continuum can come and go as quickly as six hours in ahot environment in the desert or it can take many days to acouple of weeks or longer in a cold environment.
Q. All right. You've used the terms hot and cool andcold --
A. Yes.Q. -- can you put any temperature ranges on those?A. Yes. I put 70 to 75 degrees Fahrenheit as average.Q. Is that hot or cool or cold?A. It's in the middle.Q. Okay. Cool/hot? I don't want to put words into your
mouth.A. Comfortable.Q. Comfortable. Thank you.A. Baseline.Q. All right. So it's neither hot nor cold, so it would
be kind of the average progression of rigor mortis in theaverage dead person.
A. For temperature --
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Q. Okay.A. -- yes.Q. Okay.A. Not average if you're considering my parents because
they're on completely opposite ends of the spectrum.Q. Okay. We'll leave them out of this.
Now, in your review, did you review -- you said, Ibelieve, that you reviewed toxicology results from Bio-ToxLabs.
A. I did, yes.Q. Did they include a benzodiazepine confirmation panel?A. They did, yes.Q. And did they include a confirmation panel for
trazodone?A. Yes.Q. Okay. What can you tell us about any findings of
trazodone or any findings of trazodone or benzodiazepine inthe toxicology of Gary Benefield?
A. Okay. Both were present in a blood sample.Trazodone was present in the concentration of 0.89 milligramsper liter; and oxazepam, which is Serax, S-e-r-a-x, is thetradename, returned 0.12 milligrams per liter.
Q. All right. Are you familiar with the termtherapeutic dose?
A. Yes.Q. And how would you relate that to what you see in
these toxicology results?A. I would say that the trazodone is pretty close to the
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middle of steady state therapeutic; and oxazepam is not veryhigh, it's fairly low. It may be subtherapeutic.
Q. Okay. Now, for a layperson, can you give us a laydefinition of therapeutic?
A. Yes. So a therapeutic level of a drug would bethe -- well, a therapeutic dose would be the amount of drug aperson needs to take to achieve blood levels that are going totreat the problem without having adverse side effects.
Q. Okay. So when you say without having adverse sideeffects, is that in a normal stable person or does thataccount for every person with every medical condition on theface of the earth?
A. Everybody's different.Q. Everybody is different.A. Everybody is different. So a person with severe
heart and lung disease would achieve -- generally speaking,with certain drugs, would achieve toxicity adverse effectsmore easily even with therapeutic concentrations perhaps.There's a lot of variability.
Q. All right. So, in other words, it's really difficultto say what therapeutic is without knowing what the underlyingphysical and health conditions are of the individual patient.
A. That's fair.Q. That's fair?A. Yes.Q. Okay. All right. So I want to talk about your
practice as a forensic pathologist.A. Okay.
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Q. When you are asked to reach some sort of medicalopinion about the cause of death --
A. Right.Q. -- for a patient, what kinds of things are important
for you to know as specifically as possible to reach a goodconclusion?
A. That -- the answer to that is really the basis ofwhat we do. And so to -- the essence of forensic deathinvestigation is certifying the death fairly and accurately,and that requires -- it's fairly simple as long as asystematic approach is taken. And that approach is to performa technically adequate autopsy examination, document thefindings, review the medical history, any health history, thescene, and the circumstances of the death and then put it alltogether. Part of this involves the autopsy, which is todetermine whether there's any injury that contributed to thedeath, the injury -- physical injury or drug or poison thatcaused or contributed to the death either by their presence orby their absence.
Q. Let me stop you. Just in case anyone is not aware ofwhat an autopsy is, can you define what an autopsy is?
A. Yes. An autopsy is an examination of a body afterdeath. We do an external examination, looking at the bodysurfaces and documenting tattoos and scars, body height andweight, and other identifying features, and then we makeincisions on the body to remove and examine the organs one byone all for the purpose of determining the extent of naturaldisease, the presence of any physical injury, and then through
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drug testing, whether there are any contributing factors fromdrugs or alcohol.
Q. Now, when you were the chief of the Riverside Countyforensic pathology department, did you have any policy thatyou personally implemented to achieve this kind ofput-it-all-together approach to an examination of someone'sdeath?
A. I sure did, yes.Q. Can you describe those policies?A. Yeah. I remember them vividly. I arrived in July of
1999. I was -- I was requested by the Sheriff to put policiesand procedures in place, not to embarrass the Sheriff, and toprovide fair and accurate death certification for the citizensof the County. And so I did that through numerous forms and,I mean -- and people weren't happy about that, including mydoctors sometimes. But I actually had a form that -- I don'tknow if it's still in use. I still use it and New York Citystill uses it. That's where I got it. And it's called aWorksheet and Inventory Form. And that is just a single-pageform that you can check what specimens were retained from theautopsy, what, if any, records were reviewed for the case,what samples were taken, any evidence that was taken. It's avery straightforward and fairly complete, nice form that onejust needs to make some checks and fill in some blanks andthen it's there for the record.
Q. Now, was it a policy that you implemented during yourtime as a chief pathologist that the pathologist in youremployee -- in the employ of the Riverside County Forensic
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Pathology Department used such a checklist?A. They were supposed to use that checklist, yes.Q. They were supposed to?A. Absolutely.Q. And would it be a document that would be attached to
a copy of an autopsy?A. It wouldn't be part of the text portion of the
autopsy, but it would be available to attorneys on subpoena.Q. All right. And did you receive the entire autopsy
file in the materials you reviewed for this case?A. I did. I received what's called the packet. The
packet is three things. It's the toxicology testing, theautopsy report, and the coroner investigator's report, thattriad or that packet, those three things.
Q. Okay. I'm handing you what's been marked asExhibit 91. It's a multiple-page stapled document. Could youreview that and tell me if you recognize it?
A. Yes. Yes, I do.Q. What is it?A. This is an autopsy report pertaining to Gary
Benefield authored by Dr. Marc Fajardo.Q. Do you know Dr. Fajardo?A. I sure do, yes.Q. And how long have you known him?A. I've known him since August of 1999, I believe,
August or September. It would have been right after I arrivedin Riverside County.
Q. And what -- in what context did you know him?
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A. I hired him.Q. As?A. As a full-time forensic pathologist.Q. Did you do any of his training?A. Not formal training. He was trained elsewhere, but I
was his supervisor.Q. For how long were you his supervisor?A. I was his supervisor for the entire time that I was
here through my departure of August 6th or August 5th of 2010,11 years.
Q. So in July of 2010, you were Mark Fajardo'ssupervisor?
A. Yes.Q. And have you seen this autopsy protocol before?A. I sure have, yes.Q. And have you reviewed it as part of your review of
this case?A. I sure have.Q. Is there anything that you see in here -- well, first
of all, let me just start out this way. Is there a cause ofdeath assigned by this autopsy protocol?
A. There is, yes.Q. And what is it?A. The cause of death is hypertensive cardiovascular
disease.Q. And is there another significant condition specified?A. Yes.Q. What's that?
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A. Chronic obstructive pulmonary disease.Q. Now, just to start with, you mentioned that an
autopsy includes an external and internal examination. Arethey reflected in this report?
A. They are, yes.Q. And what other things are reflected in this report?A. In this report? Well, this report has again a
description of the external examination of Mr. Benefield aswell as the description of the organs one by one.
Q. Okay. Does that include the heart?A. Sure does, yes.Q. Does it include the lungs?A. Sure does, yes.Q. Now, on the very last page of the report, do you see
a signature?A. Yes.Q. And do you recognize that signature?A. Yes.Q. Whose is it?A. Marc Fajardo, M.D.Q. And just above that, are there a couple of lines of
entries?A. Yes.Q. Do you see one that's labeled specimens for
toxicology?A. Yes.Q. And do you see what's written there?A. I do, yes.
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Q. What are those?A. Those are the specimens that were recovered from
Mr. Benefield's body at -- during the autopsy examination,peripheral blood, which a blood sample, vitreous,v-i-t-r-e-o-u-s, is the fluid from the eye that we typicallydraw on most or every case, gastric contents, liver tissue,bile from the gall bladder, and urine.
Q. And do you associate, in your medical knowledge, anyof these specimens with the toxicology reports you reviewed?
A. Yes.Q. Which one?A. Peripheral blood.Q. Okay. Now, I want to turn to -- first, were you
present for this autopsy protocol?A. I don't have an independent recollection. Typically,
we would specify in the beginning of the report who waspresent, and I don't see that mentioned here. So I don't havean independent recollection of being present for this case. Ican't exclude it, but I don't remember.
Q. Okay. But if you were present, it should have beenplaced somewhere on the first page.
A. It should have been, yes.Q. Okay. So is there a section that is entitled
cardiovascular system?A. Yes.Q. Are all these sections, are they boilerplate? Do you
review all these sections in every autopsy that comes in?A. Pretty much. They are boilerplate but we add or
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subtract as appropriate.Q. And what makes something appropriate?A. Well, if there's disease, we specify what the disease
is. If something is not normal, as is in the template, thenwe would add that.
Q. Okay. Now, you see Dr. Fajardo's review of thecardiovascular system.
A. Yes.Q. What's included there? What kind of information?A. The heart weight, 550 grams, the fact that it's
enlarged, the description of the heart muscle, the measurementof the thickness of the left and right ventricles, the pumpingchambers of the heart, left ventricle being 1.6 centimeters,the right being 1.3 centimeters, and then the rest is fairlytemplate.
The coronary arteries of the heart, these are thearteries that supply blood to the heart, the ones that arebypassed by surgeons if they get blocked. They did showslight to moderate blockages, so up to 50 percent narrowing ofthe three major coronary arteries of the heart. So there wasdisease there. And those were the significant findings.
Q. Let me ask you this. Have you done autopsy protocolsyourself where someone died to a traumatic condition of theheart?
A. A traumatic?Q. Such as a vessel blowing out.A. Oh, many times, yeah. Last week.Q. Okay. And this description of the heart, is there
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any evidence of a vessel blowing out?A. There is no -- we would call that a Class 1 finding.
A Class 1 finding is something that we see that clearlyexplains the death and without it, the death would not haveoccurred.
Q. Is there any Class 1 finding with regard to the heartin this autopsy --
A. No.Q. -- protocol?A. No.Q. Now, are you familiar with an important blood vessel
such as an artery getting clogged with plaque or some materialcausing injury to the heart?
A. Yes.Q. Was there any evidence of that in this autopsy
protocol?A. That's a thrombus. On top of a plaque, no.Q. Was there any evidence that the heart stopped for a
dramatic reason related to any of the veinous structures orarterial structures?
A. Not related to those structure, definitely not.Q. Okay. So what in the examination of the heart is
related to the diagnosis of cardiovas- -- what was it,hypertensive cardiovascular disease?
A. Correct.Q. Can you explain that?A. Yes. A normal heart weighs between 300 and
400 grams. Mr. Benefield's heart weighed 550 grams, so it's
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about one and one half times normal size. That occurs throughlongstanding high blood pressure that your heart has to pumpover -- pump blood through high pressures and so ithypertrophies. It gets bigger. And once a person reaches500 grams or bigger, we consider that pretty severelyenlarged. Now, they get up to 1,000 grams on rare occasionsor more. But this is a heart that is clearly in the dangerzone even if he were to have nothing else going on in hisbody. So it's a significantly enlarged heart. And we callthat hypertensive heart disease.
So hypertensive cardiovascular disease includes thedamage that high blood pressure does to the vasculature orblood vessels, which is seen in the kidneys. We haven'tdiscussed that, but there's some changes in the kidneys thatare consistent with high blood pressure over time.
So I agree with the conclusion, but I would add -- ontop of hypertensive cardiovascular disease, I would addatherosclerotic -- I can spell that. It will be challenging,but I think I can do it -- a-t-h-e-r-o-s-c-l-e-r-o-t-i-c. Andthat's just hardening of the arteries. So with respect to hisheart and blood vessels, his disease would be best classifiedas hypertensive and atherosclerotic cardiovascular disease.So that's it for the heart.
Q. Okay.A. The other -- the other findings, excuse me, is the
thickness of the ventricles. So the normal thickness of theleft ventricle should be less than 1.5 centimeters. Hiswas -- Gary Benefield was 1.6 on the left, a little bit big.
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That's because again it's hypertrophied from working over timeextra hard.
And on top of that, the right ventricle is1.3 centimeters, very hypertrophied for the right ventricle.Normal should be 0.5 or 0.7 maybe at the most. The reason forthis is because of the lung disease. So the right ventricleis pumping blood into the lungs and when the resistance toflow increases because of lung disease, then the heart suffersfrom that. So there was 1.3 centimeters on the rightventricle. And we call that left and right ventricularhypertrophy.
Q. Okay. Now, is there a section for respiratorysystems?
A. Yes.Q. What was written there that's of note?A. It's fairly easy. It's a short paragraph, but it is
actually, in my opinion, is the biggest problem thatMr. Benefield had was his lung disease, even worse than hisheart disease, which was pretty bad.
So it lists the weights. The right lung is660 grams, the left lung is 570 grams. There's a descriptionof the lungs. There's some pigment accumulation whichDr. Fajardo describes as anthracotic mottling. It'sa-n-t-h-r-a-c-o-t-i-c, anthracotic mottling, m-o-t-t-l-i-n-g.That's just smoker's pigment, the black spots that aredeposited over time in the lungs.
In addition, Dr. Fajardo describes the lung tissue asbeing spongy and hyper crepitant, h-y-p-e-r,
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c-r-e-p-i-t-a-n-t. That means if you picture a normal lungbeing like a sponge, well, an abnormal lung with emphysemawould be a sponge with the holes. The spaces are much bigger.So there's more -- they're more airy because of the damage tothe walls to the tissue from smoking over time. So that'scalled hyper crepitant. That's a very specific description ofemphysema.
He does describe the emphysematous change or thechanges of emphysema to be moderate, which is his subjectiveopinion. I find it interesting that it wasn't more severe,given this state of his clinical condition with his breathing.
Q. So what do you mean by that, that everything else youread in your review would indicate a different state of hislungs?
A. I mean, everything that I've read through medicalrecords and hospital stays and his breathing tests that weredone in the past dating back to 2007, the description of himhaving severe emphysema, I would have expected severe and notmoderate. So that becomes subjective and, you know, that'sokay. I mean, we have that disparity sometimes.
Q. Subjective means an individual opinion?A. Correct.Q. Now, would you expect to see anything -- any
condition in his lungs related to his recent pneumonia?A. You could. And so the answer to that is we sometimes
look at tissues microscopically. We take samples and so wecan evaluate the status of the lungs more carefully throughmicroscopic examination. That was not done here, but that
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would pick that up. In other words, we can look at diseaselike pneumonia that's been there for three days versus threeweeks versus three months and say it looks like it's recent,it looks like it's older, it looks like it's very old. Thatwasn't done here.
The other way we can assess for pneumonia is just bythe appearance and the texture of the lungs. So when thelungs are very heavy and solidified, very solid and notspongy, we think then there's something going on, eitherpneumonia, congestion, or edema, or a combination.
Q. So is there anything at all in this autopsy protocolthat indicate that Dr. Fajardo was aware of Gary Benefield'srecent hospitalization for pneumonia?
A. No.Q. All right. Is there anything else under the
respiratory system that's of note?A. That covers it.Q. Before I forget, I wanted to ask you about an entry
that's on page -- I guess it's the first page, where it says"Final Diagnosis."
A. Okay.Q. There appears to be four points there. Could you
just read through them each and identify them?A. "Final Diagnoses, I, decedent status post apparent
sudden death event while at a drug rehabilitation center,recently positive for THC." That's marijuana.
Q. All right.A. "II, please refer to formal toxicology report."
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That's what's stated for II."III, hypertensive cardiovascular disease. Under
that is A, cardiomegaly" -- that's an enlarged heart -- "withconcomitant left ventricular hypertrophy." That's increasedthickening of the left ventricular wall.
Then under III as well is "B, nephrosclerosis," andthat's kidney damage from high blood pressure.
"IV is chronic obstructive pulmonary disease withmoderate emphysematous change."
Q. Okay. Let's go to III B, the nephrosclerosis.A. Okay.Q. What is that about?A. That simply means that over time a person with high
blood pressure tends to get a granularity to the surface ofthe kidneys or we call it pitting, p-i-t-t-i-n-g. And that'sscarring on the surface of the kidney due to high bloodpressure. That's the effect of high blood pressure on thekidneys.
Q. All right. So if you were Dr. Fajardo --A. Okay.Q. -- I don't mean -- I'm not asking you to criticize
Dr. Fajardo necessarily. I want you to put an unknownpathologist in this position.
A. Okay.Q. He's presented with a decedent who has this much
information.A. Okay.Q. Let's assume that this autopsy protocol was done
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appropriately and you knew nothing else.A. Okay.Q. Just what's on the page. You knew nothing about his
prior medical condition other than decedent's status postapparent sudden death while at a drug rehabilitation centerrecently positive for THC and the rest of it. What conclusionwould you be able to reach with these findings that areincapsulated in this report?
A. Without any clinical history?Q. Right.A. Okay. And opinions with respect to cause of death?Q. Yes.A. And manner of death?Q. Yes.A. Well, with the prime- -- I would place the lung
disease at the top under the cause of death. Now, seeing whatI see in Dr. Fajardo's report, maybe not. I mean, if he'ssaying moderate lung disease and the heart is 550 grams, Idon't think I can argue with the way he did it here, butthat's not including the clinical history of being on oxygenand having severe emphysema dating back to 2007. And he hadknown heart issues, but not to the extent that his lung wasfailing.
Q. All right.A. So I would have probably kept it somewhat similar to
what Dr. Fajardo says.Another way to do it would be to specifically say a
fatal cardiac arrhythmia due to hypertensive and
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atherosclerotic cardiovascular disease because it looks like asudden collapse. The heart is big enough to explain thesudden death. I would add in the atherosclerotic that was notmentioned in Dr. Fajardo's final diagnosis. So I would saythe cause of death would be fatal cardiac arrhythmia, whichwould occur over seconds due to hypertensive andatherosclerotic cardiovascular disease which occurred overyears. And then as another significant contributing factor, Iwould put chronic obstructive pulmonary disease.
Now, knowing what I know about the clinical history,that's not how I would have done it.
Q. Okay. So do you believe, as a forensic pathologistand someone who ran a department of forensic pathologists,that in order to have an accurate analysis and reach anaccurate and scientifically valid cause of death, that youneed to review more than just what's done in the autopsyprotocol?
A. Absolutely. I mean, this is a big problem in ourbusiness that, you know, people drop dead on a day-to-daybasis and there are families that want answers and there's alot that rides on these cases. There's a lot of emotion andat times, there's a lot of money involved.
And in -- and they did a great job, I've got to say,in Riverside County when I was here in getting records for us.But whether they were reviewed routinely to the extent thatthey should have been on some cases, it's hard to say.
Currently, I'm the only guy in my shop in MarinCounty and Napa County. So I play by my own rules pretty
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much, and I've trained the Sheriff's Department to get memedical records on every case. And I get PDF files on a dailybasis, hundreds of pages, so I can review them and includethat in my assessment.
Q. All right. While you were the chief of the forensicpathology department here in Riverside County, did youencourage or direct -- well, did you direct the pathologiststhat worked under your control and direction to obtain theserecords?
A. The records were obtained. And, yes, I did directthe pathologists to review records to the extent that isnecessary. If somebody is shot dead, shot in the head anddrops dead there, the medical records don't usually make a lotof difference. But if somebody dies three weeks after havingsurgery from a complication of surgery or something that wasplaced in the body, it becomes very important. So it depends.Yes, they were directed.
Q. Okay. Is there anything you saw in the packet -- youcalled it the packet -- that you received regarding theautopsy of Gary Benefield that was done by Mark Fajardo andsigned by Mark Fajardo, and includes the toxicology and thereport of Steve Albert. Did you see anything about GaryBenefield's records, his clinical history?
A. I don't recall seeing anything.Q. All right. Now, I want to show you some sworn
statements that Dr. Fajardo made.A. Okay.Q. And we'll go through them and I'd like you to comment
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on whether you reached the same conclusions. These arestatements in two exhibits, one marked 92 and one marked 93.The first one runs marked pages 15 through 27. The second onemarks -- covers some of the same pages and it's 20 through 23.
A. Okay.Q. So I'll direct you to certain portions of this.
Okay. On page 15, Dr. Fajardo was asked if hisconclusion, his determination as to the cause of GaryBenefield's death was hypertensive cardiovascular disease andhe said correct. Do you see where I'm referring?
A. Yes.Q. Now, as you stand -- sit here today, excuse me, do
you agree with that conclusion?A. No.Q. All right. What do you believe the cause of Gary
Benefield's death was?A. So I -- my opinion is that this is a collapse due to
acute respiratory failure due to chronic obstructive pulmonarydisease with the heart disease mentioned as a contributingfactor, not the primary factor.
Q. Is that your opinion to a medical certainty based onyour training and experience?
A. Sure is, yes.Q. Okay. Now, I would like you to turn to page 18.A. Okay.Q. And I'm looking at -- the page has lines on the left
side of it. Do you see those?A. Yes.
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Q. Lines 18 through 22.A. Okay.Q. I'm going to read them out loud and ask you if agree
with this --A. Okay.Q. -- okay?
"Question: Okay. Now, is this hypertensivecardiovascular disease, is this somethingthat occurs over many, many years or --"Answer: Yes, absolutely. It takes a number ofyears to develop."Do you agree with that?
A. Yes.Q. All right. Does that change your opinion in any way
about the cause of death?A. No.Q. Turning to page 19, looking at lines 19 through 25 on
that page --A. Okay.Q. -- and going down the entire next page and the entire
next one, two, three, three and a half pages. So I'm going tobreak it up into sections.
A. Okay.Q. The first section at page 19 -- and just as an aside,
this has been marked as an exhibit."Was the autopsy protocol, was that draftedbefore you sent these specimens off to toxicology?I guess what I'm asking you is when you wrote the
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autopsy report, did you have the results of thetoxicology?"At the time of the autopsy, we get our notesmy notes are in the back of the protocol, andfrom these notes we have a dictated report that ismade on that day before we walk out the door"So clearly you didn't have the toxicology report,the results at that time?"Exactly."Is that normal procedure?
A. I want to make sure before I answer that I'm -- I'mnot missing something outside of these excerpts.
Q. I believe this is talking about the blood sample thatwas sent for toxicology.
A. Yeah, this is -- this is correct.Q. Okay. And it goes on and talks about when the
autopsy report was signed. And then at the bottom of page 20,Dr. Fajardo was asked:
"Walk me through what this means and thesignificance of the findings in referenceto the toxicology report."Dr. Fajardo responded:"He, Gary Benefield, has a multitude of medicines,prescription medications in his system. He hascodeine, a very common cough suppressant that'sused in cough syrup but is also given as apainkiller, he has low in the therapeutic range.He has a very, very small amount of morphine. It's
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possible and it's probable that that representsbiotransformation, a byproduct of the codeineitself, and he wasn't given morphine directly."Do you agree with that?
A. Yes.Q. "He also has hydrocodone. Again, it's possible
that it's directly a metabolite of codeine, butactually that's a little unlikely. More thanlikely it's not he was given hydrocodone byitself" --I'm sorry."More likely than not, he was given hydrocodoneby itself -- Vicodin is its common name -- also inthe therapeutic range."Do you agree with that?
A. Yes.Q. "He's got Tylenol, again therapeutic.
He has trazodone, another pain medication in thetherapeutic range. He does have the presence ofcannabinoids, which is marijuana?"Do you agree with that?
A. Yes.Q. Do you agree with the statement that trazodone is
another pain medication?A. I -- no, that's not correct.Q. Okay. And then, finally:
"He has a class of drugs known as benzodiazepines.Valium would be the most common recognizable
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medication. He has what's called oxazepam,similar to Valium, in a very small amount inhis bloodstream?"
A. Yes.Q. Do you agree with that?A. Yes.Q. And did you discuss that in your comments about the
toxicology report?A. Yes.Q. And then the next thing Dr. Fajardo says is:
"So everything in the therapeutic range orsubtherapeutic?"Do you agree with that?
A. Yes.Q. Then he's asked: "What does that mean when you say
everything is in the therapeutic range? What isthe significance of that?"Answer: It has nothing to do with his death.We're concerned about overdoses obviously. It's avery common cause of death and that's one of thethings we do when you look at the toxicologyresults, is to exclude that possibility. In thiscase, all of his levels are in keeping andwould not contribute to his cause of death."Do you agree with that statement?
A. I stand corrected on my last answer, I'm thinkingabout still. I apologize. The last question, I think I erredbefore this one.
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Q. What was that question, to your memory?A. I know what it is. It's the -- whether the --
everything is in a therapeutic or subtherapeutic range. Oneof the drugs -- hydrocodone, which I don't think we've talkedabout before, is getting up in concentration. It's on thevery, very low end of potential toxicity or overdose accordingto some reports.
Q. Okay. And hydrocodone, you may have mentioned it,but in case you didn't, how would that affect -- how wouldthat relate to his COPD and his breathing difficulties?
A. It's a central nervous system depressant. It slowsor depresses respiration. It is not helpful to a person withCOPD.
Q. And are these drugs, you know, additive or do theyinteract to form even bigger bang for the buck? We're talkingabout the drugs hydrocodone, Serax, and trazodone.
A. They're additive or what we call synergistic.Q. So can you explain what you mean by that?A. Yes. It means that the combination of two or three
drugs may be even more active than each of the drugs alone.If you were to take the three individually, add them up, whenyou -- you think that you'll get a certain effect but, ineffect, what happens is you get an increased effect. That'scalled synergism.
Q. Okay. Is it sometimes called a drug interaction?A. It's another way of saying it more generically, yes.Q. So you believe that the hydrocodone was at the high
level, maybe the low level of bad, the high level of
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therapeutic; is that what you're saying?A. It was very, very low level of toxicity in some case.Q. And what's the word toxicity mean to you?A. Toxicity is getting into a concentration where the
effects are not good. They're -- they're -- they're harmful.Q. Okay. Now, the question that I believe was posed to
you, back to that question, was regarding his, Dr. Fajardo's,statement. I'll just sum it up with his last sentence.
"In this case, all of his levels are in keeping andwould not contribute to his cause of death?"
Do you agree with that?A. No.Q. And why not?A. Well, I mean, it's pretty clear to me that
Dr. Fajardo is not considering this to be a drug toxicitycase. And I would say that I am very concerned that drugtoxicity, while not the primary issue, may very well be acontributing factor to his death.
Q. All right. When you say "a contributing factor,"what does that mean?
A. Well, it means that if I have to list what I think isthe most important factor in causing Mr. Benefield's death,one, two, three, four, five, I would put lung disease, number1, heart disease, and then I would consider drug toxicity.
I'm also not sure, because he was taking some otherdrugs to help his COPD, other drugs that open up the airways.And I'm not sure -- we haven't even discussed that, nor do Ieven really know if those were given to help him in that way.
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Q. Uh-huh.A. So it's not always the effect of drugs being present
but sometimes the absence of giving a drug that's needed canbe harmful. So I have -- I do have concerns. And again, mycertainty level is, you know, based on, you know, a highdegree of medical certainty. There's some issues with drugtoxicity which did not help him and would have contributed tothe physiologic derangement, the problems that ultimately madehis heart stop.
The lung is the primary culprit in causing the heartto stop, but I can't sit here and say the drug toxicity didn'tcontribute to the breathing problem that led to his collapseand the heart stopping.
Q. Okay. You said what you can't say. But, in essence,what you are saying is that drug toxicity, to a high degree ofmedical certainty, is a contributing factor?
A. It's a contributing factor.Q. Okay.A. Albeit small to medium. It's hard to argue that
these respiratory depressant drugs, several of them, is notgoing to place a stress on his already difficult breathingsituation from not having oxygen.
Q. All right. Now, you talked about the presence orabsence of drugs. What about the absence of supplementaloxygen?
A. That's the biggest. That's the biggest factor here.Q. And is there anything in this autopsy protocol that
indicates that Dr. Fajardo was aware of Gary Benefield's use
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of supplemental oxygen?A. I didn't see anything, no.Q. And is there anything that indicates Dr. Fajardo was
aware of the degree to which Gary Benefield was dependent onsupplemental oxygen?
A. Definitely not.Q. All right. I want to return to this sworn statement.
Dr. Fajardo was asked:"Are you familiar with that drug Serax?"Answer: I am not. I don't know what Serax is."Do you see that?
A. I do see that.Q. Do you think that that's -- what do you think about
that in terms of reaching full evaluation about the cause ofGary Benefield's death?
A. Well, I mean, I think it's a bit short-sided in thatI -- it's obvious to me he knows what Serax is, he just didn'tknow that Serax was oxazepam. And I think that brushingthrough this very quickly just, again, is minimizing thepotential effect of these respiratory depressant drugs.
Q. All right. And then he's asked at the bottom ofpage 23:
"But it's your conclusion that the presence oftrazodone was not a -- did not cause or contributeto his death; is that correct?"And the answer is, "Correct."Now, would you, in your analysis, break things up
that way and consider each drug singly?
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A. You know, that's one way to do it, but really thebody doesn't look at it that way. The body looks at it as,you know, what do I have in my body that's causing mybreathing to become impaired.
Q. Okay.A. And that's really what it comes down to is not
breaking things down one by one necessarily, but saying, youknow, three or four drugs have this similar effect of slowingbreathing. That is not good in a person that is alreadyvulnerable from a breathing standpoint.
Q. Now, on page 27, Dr. Fajardo was asked:"Okay. Based upon your medical experience andtraining and your expertise, would you -- wasit your conclusion that Mr. Gary Benefield diedof natural causes?"Answer: Absolutely."Do you agree with that?
A. Well, that -- unfortunately, I hate to say this butthere's -- this is the big question and it's one that I cansummarize in one or two minutes. I promise it will be fairlyquick. But what this -- so Dr. Fajardo is saying that this isa natural death. And you recall earlier, one of our jobs isto determine what the manner of death is. The manner of deathwe also call the classification of death. That's just a boxwe check. It's natural, accident, suicide, homicide, orundetermined. It's on the death certificate. That's themanner of death. And so Dr. Fajardo would call it a naturaldeath. The coroner's office would call it a natural death.
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And I suspect the death certificate says natural death on itas well.
Q. Did you review the death certificate?A. I don't remember.Q. Okay.A. I don't have it today and I don't -- I'm not even
sure if I received it.Q. Okay.A. However, now the difference between a natural and
unnatural death is that for a death to be natural, there canbe no contribution, however small -- even if it's a five orten percent contribution -- cannot be a contribution byphysical injury or drug or alcohol toxicity. Okay. So ifthere's any alcohol or drug toxicity or any physical injurythat is contributory to the death, it takes it out of thenatural category, and so we have to choose either accident,suicide, or homicide.
So then it becomes an issue because if there'sneglect, we have the option of calling it a homicide if thedeath occurred not from like an act of commission but saymedical neglect, we have the option of ruling those homicides.
Now, so what's the difference? Well, there is nodifference in why the person died, but there is a differencein how a grand jury or a judge or a jury is going to perceiveit. If we call it a homicide, it has a little extra fluff toit, which may be inappropriate, maybe not.
So without giving examples of those -- I could, butthe bottom line here is that the simplistic approach to this
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is that it's a natural death.But looking at this case in more detail, that we're
dealing with a person that is under the care of an operationthat is supposed to do their best to make him better, thequestion becomes is there some element of neglect, whetherit's conscious or subconscious. So that is an option for uson our ruling.
And we can call these undetermined and let thelayperson, let the public decide, but the fact of the matteris, what we call it doesn't change what happened. And whathappened to Mr. Benefield is that he -- he collapsed, probablydue to a respiratory arrest, inability to breathe, collapsedand his heart stopped after, and that was due to the extent ofhis lung disease, number one, his heart disease, number two,the potential contribution by drug toxicity next, and the factthat there is no supplemental oxygen being given in somebodywhose wife the day before clearly made it -- informed staff --and it's all over the records -- that he has this oxygen 24/7to carry him along. So to not have that oxygen for even30 minutes or 60 minutes is deleterious, it's problematic tome, let alone just letting it go. Checking him in and notdoing anything, that, to me, is harmful.
Q. Okay. So given the entire scope of the records youreviewed, including the police report, including the medicalrecords, including the autopsy protocol, including thetoxicology, including the first responder's note -- the firstresponder coroner's -- deputy coroner's note, what do you say,in your professional opinion, given your training and
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experience, was the major cause of Gary Benefield's death onor about July 26th, 2010?
A. Okay. So the cause of death would be acuterespiratory arrest or acute respiratory failure. He'sbasically having a respiratory arrest due to chronicobstructive pulmonary disease or emphysema. That is theprimarily cause of death. The contributing conditions wouldbe hypertensive and atherosclerotic cardiovascular disease.It would also include the respiratory depressant effects ofmedications. And I would also -- I mean, really to make thisright, I would include interruption or cessation insupplemental oxygen administration.
Q. And where would you put that?A. You could put it right -- tack it in anyplace you
want. We have the luxury of writing it where we want.Everything other than the lung disease would come under that,would come as a contributing factor.
Q. So it would be acute respiratory failure due to COPD,interruption of supplemental oxygen, and then the hypertensiveatherosclerotic issues?
A. Negative. It's going to go like this. We have twolines for the cause of death --
Q. Uh-huh.A. -- the primary cause of death and then other
significant contributing factors.Q. Okay.A. So everything has to go under those two categories
for cause of death. The primary cause of death is acute
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respiratory failure due to chronic obstructive pulmonarydisease. The contributing factors are hypertensive andatherosclerotic cardiovascular disease, the respiratorydepressant effects of medication -- medications plural, andcessation or interruption of oxygen supplementation, somethingto that effect.
Q. Okay.A. Now, the other option -- in all fairness, now there's
a lot of freedom because it's the pathologist that has thefreedom to write what they want.
Now, the other option is, you know, to not be aswordy on the death certificate but still include the clinicalinformation on the final diagnosis. So I would have includeddefinitely, instead of having those four Roman numerals underfinal diagnosis, I would add several others. That wouldinclude the fact that he wasn't getting his oxygen, it wouldinclude the drug toxicity probability, and whatever else. SoI would make sure it's highlighted on the report and I mayalso include it on the death certificate.
But keep in mind, to place that kind of wording onthe death certificate, then we've got to start thinking about,you know, is this going to take it out of a natural death intoan accidental or a homicide.
So, you know, there are different variations anddifferent levels of homicide. There's, you know, weakhomicides and there are accidents that are bordering onmedical malpractice.
So the perception is important. But don't let the
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words and the forms and the death certificate throw youbecause what really counts is physiologically what's happeningin the body, why this person ceased to exist. What were thefactors and what is the priority?
Q. Okay. Now, when you were the chief of pathology,forensic pathology, did you train your pathologists as to aparticular meaning for homicide?
A. That -- that was a discussion that came up regularlynot just amongst the pathologists, but amongst the sheriff'sofficials and others. It was something we always had toexplain to juries and to judges.
So the answer is yes, but it's -- that is notsomething that is my decision. It -- it is -- it would be mydecision in a medical examiner setting like New York City,Chicago, LA, San Diego, but in a Sheriff Coroner, like SanBernardino now, Riverside, Orange County, Marin County, NapaCounty, most counties in California, nearly 50 out of 58counties, are Sheriff Coroner systems. The Sheriff or his orher designee controls the manner of death solely.
Now, since they're cops and don't really know usuallymuch about death certification, who do they come running tofor help? They come running to the pathologists. So keepthat in mind. In a medical examiner setting, the forensicpathologist controls the whole death certificate. In aSheriff Coroner situation -- the pathologist is not called amedical examiner, he's call a forensic pathologist -- controlsthe cause of death but not the manner of death on the deathcertificate.
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So that -- that -- what that means is that, to answeryour question, this made for a lot of not only discussion butdebate. It was specifically in relation to police shootingsand police confrontations, whether deaths are accidents,naturals, or homicides, as can you imagine. So we finally,after many months, thanks to the Sheriff and thanks to theunderstanding on the part of the District Attorney and thanksto the pathologists coming together and having anunderstanding, we did develop a -- an approach to this so weweren't going to be arbitrary and capricious from case tocase. And that's the same way that every county should do it.Even if there are differences in opinion, they should beconsistent within their county.
Q. Okay. So you spoke about a death certificate. I'mshowing you a two-page exhibit marked as Exhibit 94. Do yourecognize that?
A. Yeah.Q. And what is it, if you recognize it?A. Well, there are two death certificates with Gary
Benefield's name on both. And the first one is the first onethat was generated that says pending. So it was pendinginitially, pending for drug testing and whatnot. That was --that was certified on July 28th, which was one -- it was thenext day after the autopsy or two days after death. Sopending goes out right away.
And then on September 28th, 2010, which is just afterDr. Fajardo provided his autopsy report, the Sheriff Coronerthen amended the death certificate to read natural, what I
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mentioned from Dr. Fajardo's report, hypertensivecardiovascular disease as the primary and chronic obstructivepulmonary disease as the contributing.
Q. Okay. Now, if you had done this case -- and I'masking this hypothetically and I'm going to give you the factsI want you to pay attention to.
A. Okay.Q. If you had been the examining forensic pathologist
and you knew that Gary Benefield had a history of severeoxygen dependency going back to 2007, and you knew that he hadbeen hospitalized for pneumonia from the 13th to the 17th ofJuly, 2010, and you knew that he and his wife had said that itwas essential that he have oxygen 24/7, and then he flew onJuly 26th, and because of airline regulations, he had todisable his portable supplemental oxygen --
A. He flew on the 25th, no?Q. Yes. Thank you.A. Okay.Q. I appreciate that.
And he was given two Serax around 4:00,30 milligrams, and then around -- I'm sorry, around 4:30,let's say. And around 9:00, he was given two more Serax,30 milligrams total, three trazodone, and I don't have thetoxicology in front of me, but as we've discussed earlier, andthe Tylenol with codeine as we discussed earlier, and then waslast seen alive at 12:30, and was found dead and pronounceddead at 8:09 the next morning, and had the physicalcharacteristics that you've seen in the pictures that were
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taken at or around 9:30 that morning of the 26th, and you'dhad to prepare -- and autopsy results consistent with thosenoted by Dr. Fajardo, the physical characteristics --
A. Okay.Q. -- are consistent, what conclusion would you have
reached when you had to do that check the box to be the causeof death, the nature of his death?
A. The manner of death.Q. The manner of death.A. Yeah, I was afraid you were going to ask me that. I
was expecting it. And that's okay. It's good because that'simportant.
And I -- you know, I would have ruled it either -- Imean, I could articulate natural, accident, or homicide eitherof the ways. I could, in other words. So what would I do? Iwould do what I think is the most fair approach and one that Ithink that I could explain to a court, but it would depend onthe law enforcement investigation, on Murrieta PoliceDepartment's investigation.
And so with that investigation, which clearly pointsto, you know, doctors not being available, you know,medications being given without prescription, not beingmonitored properly or at all during certain times, you know, Imean, I could explain a homicide. I just -- now, if I were todo that, the Sheriff may, before he certifies the amendeddeath certificate, he may not buy in on it. So, again, thisis not my call. But in a case like this, the Sheriff will --would come to me for a roundtable to have a discussion.
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I would -- if there was frank neglect, if it's -- ifit is a conscious -- in other words, a care facility thatconsciously neglected a patient, I would call that a homicide.If it was a facility or one or more individuals that forgot ordidn't understand or they're ignorant or don't care, you couldcall it either a homicide or an accident.
Now, what makes it an accident is the fact that thedrugs play in drug toxicity. What makes it a homicide is notmonitoring, not -- not -- giving, you know, inappropriatemedications, not giving the oxygen -- getting the oxygen inthat first hour to take care of that patient who needs it24/7. It could be a homicide. But again, it doesn't changewhat happened in terms of what box we check.
If it is -- just to give you an example, which Ithink is one that I recall in this County that we ruled ahomicide, was a 16-year-old diabetic --
Q. I want to stop you.A. -- that didn't get her insulin.Q. Yeah, I don't want to go there --A. Yeah.Q. -- because I don't want --A. So they're different gradations or different levels
of homicide.Q. All right.A. There's, you know, voluntary, involuntarily, and
whatnot, which --Q. Let's not discuss other cases --A. Okay.
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Q. -- or legal characterizations.What I do want to clarify, though, is the
determination by the pathologist and the Sheriff that it's ahomicide or a natural death, that's a characterization; isthat a fair way to put it?
A. Yes.Q. It doesn't change what medically -- the medical
opinions that contribute to that characterization, does it?A. That is exactly the point, that's correct.Q. All right. So I'm asking you as a doctor of
30 years, 29 years?A. Yeah. It's getting up there. It's somewhere in that
area.Q. All right. And you've been a pathologist, I believe
you said, since '96?A. Correct.Q. So we're going on 20 years there too.A. Since '94, so --Q. '94, so more than 20 years ago. So given your
training and experience as a forensic pathologist, puttingaside the check the box, is it your -- you said -- you'vedescribed what you believe the cause of death was.
A. Yes.Q. And you said that that was -- I want to use the
correct term of art -- to a high degree of medical certainty.A. Yes.Q. And the absence of oxygen, the failure to supply
oxygen, is that also a cause of death in the same high degree
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of medical certainty?A. Yes.Q. Greater or lower than the supplying the drugs?A. Greater. Definitely greater. And I would place
that -- I would prioritize that. Instead of putting it laston that second line, I would put it at the beginning. Notthat it makes a difference, but I would highlight it.
Q. Okay. In your autopsy.A. Yes, in my report.Q. Okay. And as you sit here today, do you agree or
disagree with the conclusions of Dr. Fajardo's autopsy or isthere more nuance response you want to make?
A. Well, based on what he -- what I believe Dr. Fajardoknew at the time that he certified it, I can't argue with it.But based on what really the totality of the information thatwe have, I disagree with it.
Q. And do you believe that he fell short in some fashionin not getting more information to base his opinion?
A. I do. I feel he fell short. And he's a very, verysmart pathologist, but I do feel that he fell short on this.And in the transcripts that you've provided, I feel that nothaving reviewed the medical history and the clinicalinformation, he fell short on that.
Q. Okay. Just one moment, please.Now, do you believe that Gary Benefield, that he --
that it was just his time, you know, he just died as a matterof his ongoing medical condition that night?
A. No.
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Q. Do you believe that the things we've discussed hadthe contrib- -- that they were such strong contributingfactors that it's fair to say that they are integrally relatedto the timing of his death?
A. Yes.Q. You said in a sworn statement, "Mr. Benefield died of
acute respiratory failure primarily due to his COPD, and to astrong degree of medical certainty, he would not have diedwhen he did if he had received external oxygen support aspromised by ABT and as prescribed."
A. Correct.Q. Do you agree with that statement still?A. Yes.Q. Thank you.
MR. SAMUELS: I'm going to ask if the grand jurorshave any questions for you.
GRAND JURY FOREPERSON: Yes, Counsel.Q. BY MR. SAMUELS: Question from Grand Juror No. 17.
I'll try to clarify this but it may be a little difficult.Given Gary's entire medical history, can you clarify
if the Serax or trazodone was within therapeutic levels and ifhis medical condition would affect those therapeutic levels?And can you tell how long ago the Serax and trazodone wouldhave been given to him by their levels?
A. I wish I was a toxicologist, to answer that question.And I can answer part of the question. The levels were withintherapeutic. I believe their levels are consistent withhaving received them at the time noted earlier in the
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testimony, but I can't be certain because I -- I'm not able tobreak down these drugs like a toxicologist with respect totheir half lives and the timing of metabolism and the effectsof heart and lung disease on those levels.
Q. All right. This is a question from Juror No. 10. Inyour opinion, would Gary Benefield be alive if he had hadconstant supplemental oxygen?
A. Absolutely.Q. This is a question from Juror No. 3. And I'm going
to decline to ask it as being outside the scope of histestimony for this witness.
A. Okay.Q. So another question from Juror No. 3. In your
professional opinion, would you, as a practitioner, as adoctor, ever prescribe Serax, trazodone, Tylenol with codeineand it says hydrocodone for one person to take in theseamounts?
A. I don't think so, but I don't know because, again, Ihaven't prescribed any of these types of medications since1987 when I was in my general surgery. So I'm not a clinicaldoctor, I'm a pathologist. So it sounds like a lot and thatis my concern here, and the presence of those drugs incombination definitely had a physiologic effect onrespiration.
Q. Would a different -- a doctor who had a differentspecialty practice be able to comment on that kind of issue?
A. Yes.Q. What specialty?
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A. It would be a toxicologist or a pharmacologist,perhaps an intensive care doctor or an internal medicinedoctor.
Q. What about a pulmonologist?A. Sure. Any practicing physician with experience with
those types of medications --Q. And --A. -- should be able to address that --Q. Would it --A. -- question.Q. I'm sorry, I didn't mean to interrupt.A. That's okay.Q. Would it be important for the physician who gave that
opinion to know the severity of Gary Benefield's underlyingcondition?
A. Absolutely.Q. The question from Grand Juror No. 2, was a time of
death determined by your review of the records?A. Well, the time of death is -- officially on the death
certificate is when the death was pronounced, it's not whenthe death occurred. So the time of death on the deathcertificate is definitely different than the actual time ofdeath.
The actual time of death -- and we touched on thisearlier -- is closer to 12:30 or 1:00 in the morning than itis closer to 7:00 or 8:00 in the morning for sure. So whetherit was 1:00 or 2:30, I don't know. It could have been 12:35in the morning, it could have been 2:00 or 2:30 or 1:30, but
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not 4:00, 5:00, 6:00, or 7:00 most likely, definitely not onthe closer to the 8:00 side.
Q. You said 2:30 and you said not 4:00. What aboutbetween 2:30 and 4:00?
A. You're pressing me. I'm not that good. And that'sthe point is that to place a specific time on it is, in myopinion, unless there's a witness to the death, isinappropriate when a body is found in this condition. I cantell you that it is a very high probability it was between --if it's accurate that 12:30 was the last time that Gary wasseen and he was found -- and found at, what, 8:00 -- I thinkthere was a mixup in the times on one of the reports, but Ithink 8:09 he was pronounced, so a little bit before that,they called 911.
The other factor is when were the photographs taken?So if the photographs were taken at 8:15 as opposed to 3:00 inthe afternoon, that makes a difference. So I'm a littleuncertain as to when they were taken. Usually they're takenwithin a couple hours of the death. But still, even if thatwere the case, I would pin it on the early morning hours, not6:00 or 7:00 or 8:00.
Q. When you say the early morning hours, you mean a.m.hours, not --
A. Early a.m. between 12:30 and 2:00 or 3:00.Q. And just to round things out, have you ever seen
television programs or movies where a forensic pathologist isable to determine within a very tight window, such as a halfhour, when a death occurred according to that program or
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movie?A. Mr. Samuels, that is not a problem seen only on TV,
that is a problem we see in real practice. And I've seen thatand it's -- it's not the way it is in real life. But thereare pathologists that will come in and try to pin it down to aspecific half hour. I know they're out there.
Q. In your experience, is that something you believethat a pathologist can do to a medical certainty?
A. Only give a range.MR. SAMUELS: Okay. Are there any more questions for
this witness?Q. BY MR. SAMUELS: Just one moment, Doctor. I see one
coming. The question from Grand Juror No. 7.A. I know which one Grand Juror No. 7 is. I didn't know
who the other ones were, but I know who this one is.Q. Would alcohol have played a role in Gary Benefield's
death if alcohol were found to have been in his body at thetime all these events took place?
A. Yes. Alcohol is also a respiratory depressant and soit would act in additive way or synergistic way with the otherones.
Q. If at 5:30, when he checked into the house, he had analcohol -- a blood alcohol level read by a breath device at.059 percent, would that be remarkable to you?
A. Only so much that it tells us he was drinkingrecently and probably earlier that day. With respect to hisdeath, probably not. Because a .059 is the equivalent ofabout two or three drinks -- about three drinks, plus or
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minus, in the body at the time of the test. And if that wasat what time?
Q. 5:30.A. 5:30 p.m.? Then all of that alcohol, assuming he
didn't take any more, that he didn't imbibe in any morealcohol, all of that .059 would be gone within several hours.
Q. Would it be gone by 12:30 at night?A. Yes. Before then.Q. I appreciate this question. It's from Juror No. 11,
but --A. Do I have to answer it?Q. I'm going to decline to ask it because I believe it
was meant in good spirits --GRAND JUROR NO. 11: Yes.
Q. BY MR. SAMUELS: -- but it's not relevant.GRAND JUROR NO. 11: Okay.THE WITNESS: I don't mind.
Q. BY MR. SAMUELS: The question is do you have a hightech machine like in the movies?
A. Oh, a high tech machine.Q. And I'm going to strike that question.A. Okay.Q. I'm going to not ask you. I'll ask you to disregard
that in terms of the technical nature.A. I was going to say asked and answered, but I guess
that wouldn't be right either.MR. SAMUELS: All right. Are there any more
questions for this witness?
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May he be excused?GRAND JURY FOREPERSON: Doctor, before you leave, I
have an admonition to read to you.THE WITNESS: Yes. I figured that.GRAND JURY FOREPERSON: You're admonished not to
discuss, at any time outside of this jury room, the questionsthat have been asked of you in regard to this matter, or youranswers, until authorized by this grand jury or the Court, oruntil such time as these grand jury proceedings become amatter of public record. You will understand that a violationof this instructions on your part may be the basis for acharge against you of contempt of court.
This admonition, of course, does not preclude youfrom discussing your legal rights with any legally employedattorney representing you, should you feel that your personalrights are in any way in jeopardy.
Do you understand, Doctor?THE WITNESS: I do, yes.GRAND JURY FOREPERSON: Thank you. You're excused.THE WITNESS: Thank you so much.MR. SAMUELS: Would the grand jury like to take a
break at this time?GRAND JURY FOREPERSON: The grand jury will take a
ten-minute break and return at 3:20.Thank you, Counsel.
(Brief recess.)GRAND JURY FOREPERSON: The grand jury will now come
to order.
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MR. SAMUELS: Mr. Foreman, a couple things before Isummon the next witness. In this envelope that I'd like tohave marked as an exhibit, are what are known as returns onsubpoenas issued under the authority of this grand jury. Asubpoena is a lawful order for a person to attend court orthis grand jury or to provide documents or materials to thisgrand jury. And the returns indicate the manner of servicethat this -- you know, on the person who's summoned. And theyare a record that goes with this grand jury, although theydon't necessarily come back to this grand jury other than inthis fashion. And they'll be in an envelope together andmarked for the record and your inspection, if necessary. Andthat is Exhibit No. --
GRAND JURY SECRETARY: 94.GRAND JURY FOREPERSON: Exhibit 94.GRAND JUROR NO. 8: I already have a 94.GRAND JURY FOREPERSON: No, Exhibit 95. Sorry.MR. SAMUELS: You may find names of people who are
subpoenaed who you don't hear testimony from.GRAND JURY FOREPERSON: Uh-huh.MR. SAMUELS: And that shouldn't lead you to
speculate about what these people may or may not have had toadd to the record. It just means that they were served with asubpoena but were not required to testify.
The other thing is I just want to make it clear, it'sall right in a long proceeding such as this to have a laughand I'm not discouraging that. I do -- when I say -- ask youto strike something and not consider it in your deliberations,
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I think it was clear that that last question was meant to befrivolous and fun and wasn't serious, and so I hope you don'ttake any offense when I ask you to exclude it. But you shouldmaintain a serious demeanor and attitude towards seriousissues. All right? That's all I'm saying on the record.
(Pause in proceedings.)MR. SAMUELS: All right. This is a question from
Juror No. 2, and I believe it has been answered now. It iswas a cause of death determined? And it was to be directedtoward the deputy coroner this morning who did not determinethe cause of death. But I believe the testimony and theevidence that came in through Dr. Cohen does address thatissue, so I'm going to return that question to you asanswered.
Did the coroner's office -- this is a question fromGrand Juror No. 7. Did the coroner's office do an autopsy onGary Benefield? I believe that question has now been answeredas well.
This is a question from Grand Juror No. 3. It wastoward Dr. Cohen and I don't know why. Oh, this is the onethat I said I would decline to answer because it's involvingpatients other than Gary Benefield. And that wasn't thesubject of Dr. Cohen's testimony, and for that reason, Ideclined to ask it.
This is from Grand Juror No. 11, and it's a questionabout -- it's a question I'm still going to decline to answer,but I believe will be an issue that becomes clear as thetestimony develops. And I would like the foreman to hold onto
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Sonja A. Hudson, CSR1312
it.GRAND JURY FOREPERSON: Okay.MR. SAMUELS: All right?GRAND JURY FOREPERSON: Yes. Thank you.MR. SAMUELS: May I get the witness now?GRAND JURY FOREPERSON: Yes, please.MR. SAMUELS: Now, this clock says it's 3:27. And I
think this witness is likely to take less than a full hour butprobably not -- somewhat less. I won't estimate. If we endearly, it's not looking like we can fit another witness in, Iwill leave it up to you whether you want to start anotherwitness and go right to 4:30 or whether you'd like to endearlier today and start each witness fresh. And I'll leavethat to your --
GRAND JURY FOREPERSON: Thank you.MR. SAMUELS: -- discretion.GRAND JURY FOREPERSON: Good afternoon, Janelle. You
may resume the stand. I would admonish you you are under thesame oath as previously given, okay? Thank you.
Counsel, you may begin.MR. SAMUELS: Thank you.
JANELLE ITO-ORILLE,having been previously sworn, resumed the stand and testifiedfurther as follows:
DIRECT EXAMINATION RESUMEDBY MR. SAMUELS:
Q. Just to reset the stage since we've had anotherwitness in between, we were talking about your investigation
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of a death at the A Better Tomorrow facility on Iron Gate inMurrieta, California, in July of 2010. And in yourinvestigation, you interviewed certain employees who wereassociated with the A Better Tomorrow facility. Do youremember that?
A. Yes.Q. Okay. And I believe when we -- when we stopped for
our break, you were talking about your interview with KrisMcCausland.
A. Yes.Q. Okay. And if I ask you a question that you believe
was asked prior to the break and you answered it already,please let me know, all right, if you can. I don't want tocover ground we've covered again. All right?
A. Okay.Q. Did you ask -- or in your conversation with Kris
McCausland, did Kris McCausland tell you whether he had anymedical training or not?
A. I don't recall him telling me that.Q. You don't recall the subject coming up or you don't
recall him telling you?A. I don't recall him telling me that.Q. Okay. Did he talk about anything with regard to what
he believed was the cause of Gary Benefield's death? Did hetalk about what he believed the cause of death to be?
A. He did not talk about what he believed the cause tobe.
Q. Did he talk about things he did not believe caused
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Sonja A. Hudson, CSR1314
Gary Benefield's death?A. He did state to me that he did not believe the
medications were the cause of his death.Q. And did he tell you the basis for his opinion, Kris
McCausland's opinion?A. He was of the opinion that if the medications were to
have had an adverse effect on him, then it would have happenedsooner than the last time he saw them, which was 12:30 a.m.
Q. And did he tell you -- did he describe his trainingand experience on which he based that opinion?
A. No, not of what he based that opinion on, no.Q. Do you remember if you asked him any questions about
how he reached that conclusion?A. I don't recall asking him questions about that.Q. Okay. Now, were there -- did you, in your analysis
of the death of Gary Benefield, find any -- anything in whatwas described to you by Mr. McCausland that you believed wasat odds with regulations as you understood them for the socialmodel detox facility?
A. What was of concern or a violation of our regulationswas the administration of the medications to Mr. Benefieldwithout a prescription.
Q. Okay. What about the fact that they had themedications at the house? Was that a concern?
A. Yes.Q. Why?A. Because our facility -- per regulations, our
facilities don't allow medications that are not prescribed to
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Sonja A. Hudson, CSR1315
a person.Q. Okay. And if he hadn't seen a doctor before these
medications arrived, what conclusion did you reach? I'msorry, I misphrased that.
If I recall your testimony, Kris McCausland told youthat Gary Benefield had not seen a doctor and that they gavehim medication that was in the house meds. Was that aconcern?
A. Yes.Q. Why?A. Because they're administering medications that
they're unaware if the client can take those medications basedoff of their health history. So it's a concern thatprescription medications are just being given to a clientwithout any type of medical assessment --
Q. All right.A. -- or being prescribed by an appropriate person.Q. Such as?A. A doctor.Q. Okay. And is this one of the things you focus on in
your investigation, these kinds of concerns?A. Yes.Q. All right. But you don't decide yourself whether
there's been a violation of a regulation or law, do you? Byyourself.
A. I will take the information and analyze it anddetermine if there is a violation of our regulations.
Q. All right. But you do that in a vacuum by yourself?
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Sonja A. Hudson, CSR1316
A. No. All of -- I will make a determination or anassessment and then a supervisor will review.
Q. All right. And so there's a process beyond what youthink before someone suffers any penalty or anything likethat. That's all I'm getting at. Is that what you believe?
A. Yes. And if there's anything that is an action thatwe feel is severe enough, it will also go through our legalcounsel as well.
Q. Okay. So what I want you to limit yourself to inyour testimony is just things that you believe presented aconcern for an investigator such as yourself. All right?
A. Okay.Q. And have we been successful in limiting your
testimony in that way up to this point?A. Yes.Q. Okay. So who else did you speak with again? I
believe you said you spoke to Kris McCausland, Jim Fent, andAndrea Powell.
A. And Josie Gann.Q. Okay. I want to turn to Jim Fent.A. Okay.Q. Do you remember where you spoke with him?A. In his office at Corning Place.Q. And do you remember when this was in relationship to
your going to the facility at Iron Gate and finding it empty?A. The next day.Q. And do you remember the date?A. August 10th, 2010.
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Sonja A. Hudson, CSR1317
Q. Okay. Anybody accompany you?A. No.Q. And do you remember what you talked about with
Mr. Fent very well?A. Yes. I had spoke with him about the policies and
procedures of A Better Tomorrow and then I spoke with himspecifically about the client.
Q. All right. And did he tell you when he -- when hefirst became aware of Gary Benefield?
A. He stated that he was made aware of the client theevening that he came into the program.
Q. All right. So would that have been -- what datewould that have been, if you recall?
A. I believe that was July 25th, 2010.Q. All right. But did he say how he became aware of it
that evening?A. Ms. Powell, who was on duty at the time, called him
and asked for some direction in regards to medications.Q. And did he explain to you what the question was
about?A. I believe that Ms. Powell stated that Mr. --Q. No, I'm asking what Mr. Fent told you, not what
Ms. Powell told you. I know that may be hard to keepstraight, but just what Mr. Fent told you at the time.
A. What Mr. Fent told me was that Ms. Powell hadcontacted him and stated that Mr. Benefield was also detoxingfrom opiates and was inquiring about what medications to givethe client.
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Sonja A. Hudson, CSR1318
Q. And did he tell you what he told Ms. Powell?A. He stated that to continue -- for Mr. Benefield to
continue taking the medications that he arrived at thefacility with.
Q. Did Mr. Fent say anything about the detox protocolthat Kris McCausland told you about?
A. He had informed me that the protocols wereDr. Bumby's orders and that they were not policies of A BetterTomorrow.
Q. Okay. I'm sorry, I misphrased the question. WhatI'm asking for is did Jim Fent tell you about the protocoldrugs in that phone call that he got from Andrea Powell?
A. I'm not sure I understand your question.Q. All right. I'll try to make it clearer.
You said you talked to Jim Fent and he was made awareof Gary Benefield on the evening of July 25th, 2010, by a callfrom Andrea Powell. And in that call, Andrea Powell asked himabout the medications Gary Benefield could take given that hewas detoxing, and you said detoxing from opiates in yourtestimony. So did Mr. Fent mention -- and you said Mr. Fenttold you that he told Powell that he could take the drugs hehad come with.
But my question is, did he say anything about detoxdrugs? Did he tell Powell that Gary Benefield could have thedrugs he came with and the detox drugs, the detox drugs andsome of the drug he came with? Did he say anything about thedetox drugs at all?
A. I don't recall him saying anything about them.
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Sonja A. Hudson, CSR1319
Q. Okay. But was Kris McCausland clear that he gave thedetox drugs?
A. Yes.Q. And that they were per protocol?A. Yes.Q. Even though a doctor had not been seen by this
client?A. Yes.Q. And did you speak separately with Andrea Powell about
the detox drugs?A. Yes.Q. What did she say in regard to that?A. I don't recall.
MR. SAMUELS: Do you have the marked exhibit of thereport?
Q. BY MR. SAMUELS: Just a moment, please. Okay. I'mgoing to give you Exhibit 89, and I'm going to direct you topage 4 and 5 of the 24 page -- 24 pages of the reportcontained in the exhibit. I'm going to ask you to look atthose and see if they refresh your recollection, as you sithere today, about your interview with Ms. Powell. All right?
A. Okay.Q. So take your time. And what I'm asking for, in case
you don't remember, a refreshed recollection is yourindependent memory sitting here today because something inthat report jogs your memory, not because you're reading fromthe report. Please don't read from the report.
A. Okay.
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Sonja A. Hudson, CSR1320
Q. All right. You're looking up at me. Is yourrecollection refreshed?
A. Yes.Q. Do you remember it now as you sit here?A. Can you rephrase the question?
MR. SAMUELS: Let me ask the court reporter, if Imay, to read back the last question.
(Record read by the court reporter.)Q. BY MR. SAMUELS: Okay. Do you remember now?A. Yes.Q. Okay. I'm going to ask you just to flip the report
over --A. Yes.Q. -- and tell me what you remember about what Andrea
Powell told you.A. So Andrea Powell confirmed to me that they do have
what is called an alcohol detox protocol, and in that protocolthey administer the medications Serax and trazodone.
Q. Did she say if they had those at the house on IronGate?
A. Yes. She stated that there was an extra supply ofmedications at the house.
Q. Did she describe how they came to have an extrasupply of these medications at the house?
A. No.Q. And did she say whether they were provided these
medications, the medications for the alcohol detox protocol,whether they were provided to Gary Benefield?
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Sonja A. Hudson, CSR1321
A. Yes. She stated that the house manager,Mr. McCausland, had started providing the medications toMr. Benefield.
Q. Did she talk about a phone call with Jim Fent?A. No. I'm sorry, not that I recall. I would need to
refresh if she mentioned that.Q. Okay. Would it refresh your recollection if you
referred to your report?A. Yes.Q. All right. Please do so.
(Pause in proceedings.)Q. BY MR. SAMUELS: So do you remember the question?A. Yes.Q. And what's your answer?A. No, she did not mention that she talked to Mr. Fent.Q. Now, do you remember, sitting here today, whether you
spoke to Andrea Powell first or Jim Fent first or do youremember the order in which you spoke to these folks?
A. I interviewed them in order. So Andrea Powell firstand then Josie Gann and Jim Fent and then Mr. McCausland viatelephone a few days later.
Q. Okay. But the first three, Powell, Fent, and Gannwere in person?
A. Yes.Q. Now, did you ask Fent about the medications in the
home, the alcohol detox protocol medications?A. Yes.Q. Did you ask him what he knew about them?
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Sonja A. Hudson, CSR1322
A. Yes.Q. Do you remember what he told you that he knew about
them, what the scope of his knowledge was?A. He stated that the protocols, the detox protocols
were Dr. Bumby's orders --Q. Uh-huh.A. -- and that they weren't the policy of A Better
Tomorrow.Q. Now, did Mr. Fent tell you whether or not he believed
Gary Benefield had seen Dr. Bumby?A. Mr. Fent said he had reviewed his chart and confirmed
that he had not met with Dr. Bumby.Q. He being Gary Benefield?A. Yes.Q. So did he have any knowledge of where -- did he tell
you about any knowledge that he had about where these drugswere coming from?
A. No. He was not sure where the medications came from.Q. Did he express any concern on this issue?A. He stated that the night of the death, he had seen
some medication concerns and addressed it with staff.Q. Did he describe how he addressed it with staff?A. No, he didn't go into the specifics.Q. Okay. Now, did Mr. Fent tell you anything about his
knowledge of Gary Benefield's health condition when he arrivedat A Better Tomorrow?
A. He stated that he wasn't aware that Mr. Benefield wasin need of an oxygen tank.
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Q. Did he tell you when he became aware of GaryBenefield's need for an oxygen -- supplemental oxygen?
A. After his death.Q. When you spoke to Ms. Gann, did she have any personal
knowledge about Gary Benefield's coming to A Better Tomorrow,his arrival at A Better Tomorrow before his death? What I'masking is before his death, did Ms. Gann -- did Ms. Gann tellyou that she knew about Gary Benefield before she was informedof his death?
A. I don't --Q. Did that make sense? I'm sorry.A. It did, and I would have to look at my report.Q. Okay. Would it refresh your recollection?A. Yes.Q. All right. You may do so.
(Pause in proceedings.)Q. BY MR. SAMUELS: Yes. I'm sorry, what's your answer?A. She was not made aware of the death of Mr. Benefield
until after he had -- or the condition of Mr. Benefield untilafter he passed.
Q. Okay. What about Kris McCausland? Did he say he hadany prior knowledge about Gary Benefield's medical conditionbefore Gary Benefield arrived at the Iron Gate facility?
A. No, he did not have any prior knowledge.Q. You said he said he did not have any prior knowledge?A. Correct.Q. What about Andrea Powell? Did she say she had any
prior knowledge about Gary Benefield's medical condition?
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A. I don't recall asking her that question.Q. Okay. So did you ask Jim Fent about the intake
process for new clients?A. Yes.Q. Do you remember what Mr. Fent told you in that
regard?A. He had informed me that there are some initial phone
screenings that are done with clients and that when theyarrive, they should have a medical assessment done.
Q. Did he say when those medical assessments were done?A. I don't recall if he gave a specific time.Q. Okay. Do you recall if he spoke about the assessment
process?A. I would have to look at my report.Q. All right. I'm going to direct you to page 7. I
believe there may be something there to refresh yourrecollection.
(Pause in proceedings.)Q. BY MR. SAMUELS: Let me ask it you this way. Did you
prepare this report shortly after you had this interview withMr. Fent?
A. Yes.Q. And what did you base your report on?A. Based off of my notes that I took while doing my
interviews.Q. And how long would you say lapsed between the time
you spoke to Jim Fent and the time you wrote this report?A. Maybe a month.
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Q. All right. So in that amount of time, do you believethat your memory and your notes allowed you to create anaccurate and a full report of what occurred in yourconversations with Jim Fent?
A. Yes.Q. And was that way of preparing this report consistent
with your -- with the Department of Alcohol and Drug Programs'policy for creating investigative reports?
A. Yes.Q. And was this report prepared in the course and scope
of your duties as an investigator?A. Yes.Q. All right. I'm going to ask you to read two
sentences or three sentences from your report and I'llindicate which ones to you. Starting here, "Mr. Fent," andgoing down through the word "process" there. Do you see whereI'm indicating?
A. Right here.Q. Okay. Would you read that?A. "Mr. Fent stated that a phone call is used initially
to screen potential new clients and will bring the clients infor a full assessment and discuss any concerns. Mr. Fentstated that if there is a medical concern, then the clientswill be taken to the urgent care. The intake office is openfrom 8:00 a.m. to 5:00 p.m. Monday through Saturday. Theintakes are done at the individual residential homes by thehouse managers on the days and times that the office isn'topen. Mr. Fent stated that Dr. Bumby has a standing order for
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clients that are going through the detox process."Q. Now, there was a time for when the office was open on
there; right?A. Yes.Q. And there was a mention of urgent care.A. Yes.Q. Did Mr. Fent tell you what happened with patients who
came in for A Better Tomorrow services and it wasn't duringthe office hours and if they, for whatever reason, were nottaken to urgent care? Did he address that? I'm not askingyou to look at your report, I'm asking you if you rememberthat.
A. I don't recall.Q. And did you ever hear anyone admit that a patient or
a client was supposed to see a doctor before any detoxprotocol was started?
A. I recall Mr. McCausland stating to me that if aclient had any medical issues, they were to be taken to urgentcare immediately. And generally he would take them straightfrom the airport where he would pick them up to an urgent carebefore bringing them to the facility.
Q. All right. And did he say whether or not GaryBenefield was taken to urgent care?
A. He stated he was not.Q. Did he say whether or not Gary Benefield was taken to
a doctor?A. He confirmed that he was not.Q. And did he say whether or not he believed Gary
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Benefield had a medical condition that required him to see adoctor, him, Gary Benefield?
A. I don't believe he stated that.Q. Did he state anything in that regard?A. Mr. McCausland stated that he didn't feel that the
client shouldn't be at the program.Q. All right. Didn't feel that Mr. Benefield shouldn't
be at the program. In other words, he felt that it was okayfor him to be there.
A. Yes.Q. What about Andrea Powell? Did she say anything in
that regard about whether or not Gary Benefield was physicallyable, healthy enough to be at the program?
A. Ms. Powell did not feel the client should be at theprogram.
Q. Really. What did she say in that regard?A. She felt that he needed a higher level of medical
care.Q. Okay. Thank you.
MR. SAMUELS: Are there any questions from themembers of the grand jury for this witness?
GRAND JURY FOREPERSON: Yes, Counsel.Q. BY MR. SAMUELS: This is a question from Grand Juror
No. 11. Are the standards of your application for licensingset in such a way as to ensure that a detox business is runwith the protection of clients' rights in mind? Do youunderstand that question?
A. Can you repeat it one more time?
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Q. The licensing process and the application forlicensing that's part of that process, is part of the goal toensure that the clients at the detox facilities, that theirrights, the rights of these clients are protected?
A. Yes, that's the purpose of our regulations there.There is a section in our regulations that fall -- or arecalled personal rights, and that is to ensure the health andsafety of our clients.
Q. This is a question from Grand Juror No. 15, who asks,Can you please explain your report, which I believe is infront of you, signed on March 8th, '11 -- 2011, but the reportdate itself is January 24th, 2011?
A. So the report date that states January 24th, thatwould be the date that I initially submitted it to -- for --to my supervisor for -- at that point when I would consider itto be completed, but then there might be some revisions thatgo back and forth, which would then be the discrepancy andhave a March 8th signature date. The March 8th date indicatesthe day that it actually will leave the department and be sentout to the licensee.
Q. Okay. So it's kind of a review process?A. Yes.Q. I'm going to adopt some different language to this
other question on this form. Does it cause you, as aninvestigator of Alcohol and Drug Programs, any concern aboutwhen a client in a social model detox facility arrives with anoxygen tank?
A. Yes. That would be a concern that we -- that we
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would feel that that client needs a higher level of medicalcare.
Q. All right.A. And maybe needs to be in a medically managed detox
program.Q. All right. You said a concern and maybe. So it
wouldn't lead you to a conclusion by itself, would it?A. No.Q. Okay. So meaning no, it would not lead you to a
conclusion, the fact that someone had an oxygen tank?A. Not alone, as we would want to assess and analyze the
whole situation.Q. All right. In a licensed outpatient facility, would
it be appropriate for a doctor to have an office in the samebuilding as the licensed outpatient facility?
A. I'm sorry, could you repeat that question?Q. Sure. This a question from Grand Juror No. 3. In an
outpatient -- in a licensed outpatient facility, would it beappropriate for a doctor to have their office in the samebuilding as the licensed outpatient facility? When I say thesame building, I mean in the same offices as the licensedoutpatient facility.
A. I would say that it's -- yes. Yes.Q. Yes. Okay.
It's a question from Grand Juror No. 11.A. Can I just clarify? I would say that it's
acceptable. I don't know about appropriate.Q. Okay. Acceptable though?
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A. Yes.Q. Within guidelines?A. Yes. That would not be a violation. And just for
clarification --Q. All right.A. -- an outpatient program that's certified, not
licensed.Q. Thank you. I appreciate that. Do you do spot checks
without notice to licensed facilities?A. When we receive -- all complaint investigations are
done unannounced and then licensing will do biannual reviewsfor renewal for a licensure renewal, but that is a scheduledvisit.
Q. Any there any unscheduled visits when there's noactive investigation?
A. There could be. Licensing may go out and do acompliance review.
Q. Well, if licensing goes out to do a compliancereview, do they do an assessment of a facility or business'sinfrastructure in terms of how that business is complying withregulations and providing for the safety of their clients?
A. Yes.Q. This is a question from Grand Juror No. 7. And I
believe it's been asked. It has to do with spot checks and ithas been asked.
I've got a question. This question is from GrandJuror No. 11. After a license has been granted, someoneapplies for a license and it's granted, to your knowledge,
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does the licensing -- did the licensing authorities of ADPever go out to do spot checks to make sure that what has beenstated in the license application is consistent with theactual practice at the facility?
A. Not to my knowledge were any spot checks done afterthe initial licensure.
Q. There's another question I'm going to decline to askbecause it requests your personal opinion rather than factualmaterial.
This is a question from Grand Juror No. 17. Would astaff member in a licensed house be required or be trained inreporting any concerns they might have at their facility toADP, reporting their concerns to ADP?
A. Did the question ask trained and/or required?Q. Yeah, I guess that's two questions. So I would say
was there a requirement that staff members be trained aboutreporting their concerns?
A. No, there are no requirements for them to be trained.Q. Do you know if there were any requirements that a
staff member report concerns to ADP directly?A. There are regulatory requirements that for staff --
for the licensee to report any deaths, any injuries to clientsif they need to go to the hospital, there's other adminrequirements, if there's a change in organizational structure,things like that. Those are all regulatory requirements to bereported to the department.
Q. So such as the death report you got regardingMr. Benefield?
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A. Correct.Q. This is a question from Grand Juror No. 15. I'm
going to decline to ask the first part because that's an issuefor the grand jurors themselves, as well as the second part.
Given your familiarity with A Better Tomorrow and itsother corporate entities, do you know if after the Iron Gatefacility was closed, if the corporate -- if the corporationopened any other detoxification houses?
A. Yes.Q. Do you know how many or can you approximate -- well,
let me put it this way, do you know how many?A. I believe they currently are operating with seven
homes and the Corning Place outpatient is still operating.Q. All right. Do you know if those -- you said
currently. But I'm asking about A Better Tomorrow, Forterus,and Forterus Health Care Services. Let's restrict it to thatfor a moment.
A. I believe that the current homes are under Forterus.Q. Okay. And I'm going to decline to ask the last
portion of this question as not relevant to the grand jury'sinquiry.
If the Department of Alcohol and Drug Programsreceived an anonymous report that a facility -- a licensedfacility were violating regulations, how would that be handledand would it -- well, how would it be handled, first of all?
A. We would open up a complaint.Q. And did you inspect the files regarding the Iron Gate
facility of A Better Tomorrow?
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A. The licensing files?Q. Yes. In preparation for your testimony here today.A. No.Q. What about in complying with any subpoena from the
grand jury?A. No.Q. All right. So in your work with the investigation
you performed with A Better Tomorrow, did you come across anyother investigations that were opened up because of anonymousreports to Alcohol and Drug Programs?
A. I don't recall them being anonymous or reviewinganything that was an anonymous complaint.
Q. Okay. Now, are you sure that every anonymouscomplaint would have a file opened? Were anonymous complaintsalways given that kind of weight where an investigation filewould be opened?
A. Yes. So any complaint that comes into ourdepartment, regardless if it's anonymous or by staff or afamily member, we open up a complaint on it. If we havejurisdiction over the allegation, we would open up acomplaint.
Q. So any complaint you say?A. That is within the department's jurisdiction.Q. All right. Question from Grand Juror No. 8. Without
specifically speaking about A Better Tomorrow or the facilityat Iron Gate -- that's strictly in a generic sense without anyconnection to any known facility -- if a facility was found tohave deficiencies, what kinds of repercussions could it face?
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A. Depending on severity of the deficiencies, thedepartment could revoke a license, suspend a license, and/orissue a temporary suspension.
Q. Question from Grand Juror No. 3. If a client weresent to a hospital from a detox facility, would thatnecessarily trigger an investigation by your department?
A. No.Q. Why not?A. If during the course of a client coming in and
needing medical attention and the program appropriately takesthe client, then it doesn't necessarily or automaticallytrigger a complaint.
Q. And, in fact, even though you're informed of deathsat detox facilities, is there anything necessarily wrong abouta death at a detox facility?
A. Not always.Q. Do people just happen to die in detox facilities
sometimes?A. Sometimes.Q. And have you had investigations where that was your
opinion after the investigation?A. Yes.Q. This is a question from Grand Juror No. 12. And I'm
pausing because it's a difficult legal issue for me to askthis question as written now. I need to think it through fora moment, so if you'll give me a moment.
Because I believe this question is not likely toresult in what is called material evidence to this inquiry,
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I'm going to decline to ask it because it's also potentiallymore prejudicial than it is what we call probative, meaningit's not going to reveal information about this inquest. It'slikely it will reveal information about other things that areoutside the scope of this inquiry.
MR. SAMUELS: Are there any other questions for thiswitness?
GRAND JURY FOREPERSON: No more questions, Counsel.MR. SAMUELS: All right. May she be excused?GRAND JURY FOREPERSON: Yes.Before you leave, I have an admonition to read to
you.You are admonished not to discuss, at any time
outside of this jury room, the questions that have been askedof you in this regard to this matter, or your answers, untilauthorized by this grand jury or the Court, or until such timeas these grand jury proceedings become a matter of publicrecord. You will understand that a violation of theseinstructions on your part may be the basis for a chargeagainst you of contempt of court.
This admonition, of course, does not preclude youfrom discussing your legal rights with any legally employedattorney representing you, should you feel that your personalrights are in any way in jeopardy.
Do you understand, ma'am?THE WITNESS: Yes.GRAND JURY FOREPERSON: Thank you. You are excused.MR. SAMUELS: Mr. Foreman, it is now 14 after 4:00.
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I don't have another witness who would fit into the 16 minutesremaining, so I'll leave it up to you whether you want to hearvery short, partial testimony or whether you'd like to breakat this time.
GRAND JURY FOREPERSON: The grand jury will be inrecess and return tomorrow at 8:00 a.m.
MR. SAMUELS: Thank you, sir.GRAND JURY FOREPERSON: Thank you, Counsel.
(Proceedings adjourned.)