1 NO. 90-CI-6033            JEFFERSON CIRCUIT COURT
                                    DIVISION ONE (1)
 2 
   
 3 
   JOYCE FENTRESS, ET AL.                 PLAINTIFFS
 4 
   
 5 VS.
                DEPOSITION FOR PLAINTIFFS
 6 
   
 7 SHEA COMMUNICATIONS, ET AL.            DEFENDANTS
   
 8                 * * * * * * * * * *
   
 9 
   
10 DEPONENT:    DR. LEE A. COLEMAN
   
11 
   DATE:        SEPTEMBER 9, 1993
12 
   
13 
                   * * * * * * * * * *
14 
   
15 
   
16 REPORTER:     KATHY NOLD
   
17 
   
18                KENTUCKIANA REPORTERS
                        SUITE 260
19                730 WEST MAIN STREET
               LOUISVILLE, KENTUCKY  40202
20                   (502) 589-2273

                                                 Page 1

 1 
                   * * * * * * * * * *
 2 
   
 3            UNITED STATES DISTRICT COURT
              SOUTHERN DISTRICT OF INDIANA
 4                INDIANAPOLIS DIVISION
   
 5 IN RE ELI LILLY AND COMPANY  )
     Prozac Products Liability  )  MDL Docket No. 907
 6   Litigation                 )
   
 7                 * * * * * * * * * *
   
 8                   NO. 91-02496-A
   
 9 JACKIE LYNN BIFFLE, ET AL  )  IN THE DISTRICT
                              )  COURT OF
10 V.                         )  DALLAS COUNTY, TEXAS
                              )
11 ELI LILLY & COMPANY AND    )  14TH JUDICIAL
   DISTA PRODUCTS COMPANY     )  DISTRICT
12 
                   * * * * * * * * * *
13 
                     NO. 92-14775-E
14 
   RICHARD HAROLD CROSSETT, JR.,       ) IN THE
15 CHAD H. CROSSETT, AMY MICHELLE      ) DISTRICT
   CROSSETT AND KRISTEN ANN CROSSETT,  ) COURT OF
16 INDIVIDUALLY AND AS SURVIVORS OF    )
   AND ON BEHALF OF THE ESTATE OF      )
17 JOCQUETTA ANN CROSSETT, DECEASED    )
                                       )
18 V.                                  ) DALLAS COUNTY,
                                       ) TEXAS
19 ELI LILLY & COMPANY, DISTA          )
   PRODUCTS COMPANY, TEXAS             )
20 PSYCHIATRIC COMPANY, INC.           )
   D/B/A/ HCA WILLOW PARK              ) 101ST JUDICIAL
21 HOSPITAL, JAMES K. WITSCHY, M.D.,   ) DISTRICT
   AND DOUG BELLAMY, ED.D.             )

                                                 Page 2

 1 
                   * * * * * * * * * *
 2 
                     NO. A-921,405-C
 3 
   MARIA GUADALUPE REVES               ) IN THE
 4 INDIVIDUALLY AND AS NEXT            ) DISTRICT COURT
   FRIEND OF GRANT JULIAN REVES        ) OF
 5 A MINOR CHILD, AND ON BEHALF        )
   OF THE ESTATE OF CHRISTIAN          )
 6 MARIE REVES, DECEASED               )
                                       ) ORANGE COUNTY,
 7 V.                                  ) TEXAS
                                       )
 8 ELI LILLY & COMPANY, DISTA          )
   PRODUCTS COMPANY, RAVIKUMAR         )
 9 KANNEGANTI, M.D., HOSPITAL          )
   CORPORATION OF AMERICA, A           )
10 TENNESSEE CORPORATION, HEALTH       )
   SERVICES ACQUISITION CORP.,         )
11 A DELAWARE CORPORATION,             )
   HCA PSYCHIATRIC COMPANY, A          )
12 DELAWARE CORPORATION, TEXAS         )
   PSYCHIATRIC CO., INC.. A/K/A        )
13 AND/OR D/B/A HCA BEAUMONT           )
   NEUROLOGICAL HOSPITAL, AND HCA      )
14 HEALTH SERVICES OF TEXAS, INC.      ) 128TH JUDICIAL
   A/K/A AND/OR BEAUMONT               ) DISTRICT
15 NEUROLOGICAL HOSPITAL               )
   
16                 * * * * * * * * * *

                                                 Page 3

 1 
           IN THE UNITED STATES DISTRICT COURT
 2          FOR THE WESTERN DISTRICT OF TEXAS
                  SAN ANTONIO DIVISION
 3 
   ELIZABETH T. SANCHEZ,          )
 4 INDIVIDUALLY AND AS THE        )
   SURVIVING SPOUSE, MARGARET R.  )
 5 SANCHEZ, INDIVIDUALLY AND NEXT )
   OF FRIEND OF DEBRA JEAN        )
 6 SANCHEZ, VERONICA MARIE        )
   SANCHEZ, EDWARDO ESTEBAN       )
 7 SANCHEZ, AND MICHAEL ANTHONY   )
   SANCHEZ, CHILDREN; AND ALL ON  )
 8 BEHALF OF THE ESTATE OF        )
   EDWARDO SANCHEZ                )
 9                                )
   V.                             ) CIVIL ACTION NO.
10                                ) SA93CA367
   ELI LILLY AND COMPANY AND      )
11 DISTA PRODUCTS COMPANY         )
   
12                 * * * * * * * * * *
   
13         IN THE UNITED STATES DISTRICT COURT
           FOR THE SOUTHERN DISTRICT OF TEXAS
14                  HOUSTON DIVISION
   
15 MARIA SANCHEZ, INDIVIDUALLY    )
   AND AS NEXT FRIEND OF DEBORAH  )
16 SANCHEZ, VERONICA SANCHEZ,     )
   EDDIE SANCHEZ, AND MICHAEL     )
17 SANCHEZ, AND ON BEHALF OF THE  )
   ESTATE OF EDUARDO SANCHEZ      )
18                                )
   V.                             ) CIVIL ACTION NO.
19                                ) H-93-1469
   ELI LILLY AND COMPANY AND      )
20 DISTA PRODUCTS COMPANY, A      )
   DIVISION OF ELI LILLY AND      )
21 COMPANY                        )

                                                 Page 4

 1 
                   * * * * * * * * * *
 2 
   STATE OF NEW YORK
 3 
   SUPREME COURT        COUNTY OF JEFFERSON
 4 _____________________________________________
   
 5 STEPHANIE CAPONE, AS EXECUTOR OF THE
   ESTATE OF JOSEPH J. CAPONE, JR., AND
 6 STEPHANIE CAPONE, INDIVIDUALL,
                                     NOTICE TO TAKE
 7                   PLAINTIFF,      DEPOSITION UPON
                                     ORAL EXAMINATION
 8 
           VS.                       INDEX NO. 93-251
 9 
   ELI LILLY AND COMPANY, DISTA PRODUCTS
10 COMPANY, A DIVISION OF ELI LILLY AND
   COMPANY, FLOYD BAJJALY, M.D,
11 
                    DEFENDANTS.
12 _____________________________________________
   
13                 * * * * * * * * * *
   
14 SUPREME COURT OF TEH STATE OF NEW YORK
   COUNTY OF ORANGE
15 --------------------------------------X
   BRUCE R. MALEN AS EXECUTOR OF THE     : INDEX NO.
16 ESTATE OF BARBARA E. MALEN, AND OF    : 4119/92
   BRUCE R. MALEN, INDIVIDUALLY,         :
17                                       : HON. PETER
       PLAINTIFF                         : PATSALOS,
18                                       : J.S.C.
               -against-                 :
19                                       :
   ELI LILLY & COMPANY, DISTA PRODUCTS   :
20 COMPANY, A DIVISION OF ELI LILLY &    :
   COMPANY, BARRY SINGER AND UNITED      :
21 HOSPITAL,                             :
                                         :
22     DEFENDANTS.                       :
   --------------------------------------X
23 
                   * * * * * * * * * *

                                                 Page 5

 1 
   ---------------------------------X
 2 VALARIE J. FRIEDMAN AND DAVID    : SUPERIOR COURT
   FRIEDMAN, HER HUSBAND,           : OF NEW JERSEY
 3                                  : LAW DIVISION:
           PLAINTIFF,               : MIDDLESEX COUNTY
 4                                  : DOCKET NO.
                                    : L-3191-91
 5 VS.                              :
                                    :
 6 ELI LILLY & COMPANY; DISTA       :
   PRODUCTS INC, A DIVISION OF      :
 7 ELI LILLY & COMPANY; LISS        :
   PHARMACY; MADISON PHARMACY AND   :
 8 JOHN DOES NOS. 1-25 (UNKNOWN     :
   ENTITIES),                       :
 9                                  :
           DEFENDANTS.              :
10 ---------------------------------X
   
11                 * * * * * * * * * *
   
12 SUPREME COURT OF THE STAET OF NEW YORK
   COUNTY OF SUFFOLK
13 -------------------------------------x
   
14 RHOMDA L. HALA and JOSEPH L. HALA,   :
   
15                 Plaintiffs,          : Index No.
                                          14869/90
16  - against -                         :
   
17 ELI LILLY & COMPANY and DISTA        :
   PRODUCTS COMPANY, a DIVISION OF
18 ELI LILLY & COMPANY                  :
   
19                 Defendants.          :
   -------------------------------------x
20 
   
21                 * * * * * * * * * *

                                                 Page 6

 1 
      IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
 2           COUNTY DEPARTMENT, LAW DIVISION
   
 3 PATRICIA BRACH,                    )
                                      )
 4                  Plaintiff         )
                                      )
 5       v.                           )No. 92 L 13369
                                      )
 6 ELI LILLY AND COMPANY, a foreign   )
   corporation; ALAN N. MILLER, M.D., )
 7 WILLIAM BRUINSMA, Psy.D., and      )
   CONDELL MEMORIAL HOSPITAL,         )
 8                                    )
                    Defendants.       )
 9 
                   * * * * * * * * * *
10 
      IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
11          COUNTY DEPARTMENT - LAW DIVISION
   
12 RENATO DI SILVESTRO, Individually  )
   and as Special Administrator of    )
13 the Estate of JOHN DI SILVESTRO,   )
   Deceased,                          )
14                                    )
                    Plaintiff,        )
15                                    )
        v.                            ) No. 91 L 7881
16                                    )
   ROBERT L. NELSON, et al.,          )
17                                    )
                    Defendants,       )
18                                    )
   GEORGE MELNICK, M.D. and PETER     )
19 FINK, M.D.                         )
                                      )
20           Respondents in Discovery.)
   
21                 * * * * * * * * * *

                                                 Page 7

 1    IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
             COUNTY DEPARTMENT, LAW DIVISION
 2 
   JOAN M. GRYER,                     )
 3                                    )
                      Plaintiff,      )
 4                                    )
        v.                            ) No. 92 L 7387
 5                                    )
   ELI LILLY AND COMPANY, et al.,     )
 6                                    )
                     Defendants.      )
 7 
   
 8                 * * * * * * * * * *
   
 9    IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
             COUNTY DEPARTMENT, LAW DIVISION
10 
   JENNIFER HAMMERLI, as Plenary      )
11 Guardian of the Estate of RAY B.   )
   HAMMERLI, a disabled person,       )
12                                    )
                      Plaintiff,      )
13                                    )
        v.                            ) No. 92 L 2365
14                                    )
   ELI LILLY AND COMPANY, THE         )
15 UPJOHN COMPANY, DICKIE KAY, M.D.,  )
   (former Respondent in Discovery),  )
16 and RICHARD CZECHOWICZ (former     )
   Respondent in Discovery),          )
17                                    )
                      Defendants.     )
18 
                   * * * * * * * * * *

                                                 Page 8

 1 
   IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT
 2             CHAMPAIGN COUNTY, ILLINOIS
   
 3 LINDA GARDNER, Individually and    )
   as Special Administrator of        )
 4 the Estate of SHANE GARDNER,       )
   deceased,                          )
 5                                    )
                       Plaintiff,     )
 6                                    )
        v.                            ) No. 91 L 1066
 7                                    )
   ELI LILLY AND COMPANY, a foreign   )
 8 corporation,                       )
                                      )
 9                     Defendant.     )
   
10 
                   * * * * * * * * * *
11 
        IN THE NINETEENTH JUDICIAL CIRCUIT COURT
12                LAKE COUNTY, ILLINOIS
   
13 JAMES E. SHEPPARD, Special         )
   Administrator of the Estate of     )
14 KENNETH K. SHEPPARD, Deceased,     )
                                      )
15                    Plaintiff       )
                                      )
16      v.                            ) No. 93 L 124
                                      )
17 GOOD SHEPHERD HOSPITAL, a          )
   corporation, DR. STEWART SEGAL,    )
18 DR. SANFORD SHERMAN, DR. BRUCE     )
   CARLSON, DR. R. BERGLUND, and ELI  )
19 LILLY & COMPANY, a corporation,    )
                                      )
20                    Defendants.     )
   
21                 * * * * * * * * * *

                                                 Page 9

 1 
        SUPERIOR COURT OF THE STATE OF CALIFORNIA
 2 
              FOR THE COUNTY OF LOS ANGELES
 3 
   DR. MARIUS SAINES, etc., et al.,    ) Case No:
 4                                     ) SC 008331
                       Plaintiffs,     )
 5                                     )
        vs.                            )
 6                                     )
   ELI LILLY & COMPANY, a corporation; )
 7 DISTA PRODUCTS COMPANY, a division  )
   of Eli Lilly & Company; and DOBS 1- )
 8 100, inclusive,                     )
                                       )
 9                     Defendants.     )
   ____________________________________)
10 
   
11                 * * * * * * * * * *

                                                 Page 10

 1       THE DEPOSITION OF DR. LEE A.  COLEMAN, TAKEN
 2  AT THE OFFICE OF OGDEN, NEWELL & WELCH, 1200 ONE
 3  RIVERFRONT PLAZA, LOUISVILLE, KENTUCKY, 40202, ON
 4  SEPTEMBER 9, 1993; SAID DEPOSITION TAKEN PURSUANT
 5  TO NOTICE IN ACCORDANCE WITH THE RULES OF CIVIL
 6  PROCEDURE.
 7                 * * * * * * * * * *
 8                A P P E A R A N C E S
 9 
   
10      NANCY ZETTLER
        COUNSEL FOR GROUP A PLAINTIFFS
11      LEONARD M. RING AND ASSOCIATES, P.C.
        111 WEST WASHINGTON AVENUE, SUITE 1333
12      CHICAGO, ILLINOIS  60602
   
13      LAWRENCE J. MYERS
        COUNSEL FOR ELI LILLY AND COMPANY
14      FREEMAN & HAWKINS
        4000 ONE PEACHTREE CENTER
15      303 PEACHTREE STREET, N.E.
        ATLANTA, GEORGIA  30308-3243
16 
        EDWARD H. STOPHER
17      COUNSEL FOR ELI LILLY AND COMPANY
        BOEHL STOPHER & GRAVES
18      SUITE 2300, CAPITAL HOLDING CENTER
        400 WEST MARKET STREET
19      LOUISVILLE, KENTUCKY  40202
   
20      GREGORY J. BUBALO
        COUNSEL FOR DR. LEE COLEMAN
21      OGDEN NEWELL & WELCH
        1200 ONE RIVERFRONT PLAZA
22      LOUISVILLE, KENTUCKY  40202

                                                 Page 11

 1      LEE ANN RISNER
        COUNSEL FOR HALL SECURITY
 2      MACKENZIE & PEDEN, P.S.C.
        650 STARKS BUILDING
 3      LOUISVILLE, KENTUCKY  40202
   
 4      MELISSA A. STEVENS
        COUNSEL FOR STANDARD GRAVURE
 5      SEGAL & SHANKS
        327 GUTHRIE GREEN
 6      LOUISVILLE, KENTUCKY  40202
   
 7      MARK R. DOBIEZ
        COUNSEL FOR PLAINTIFFS
 8      1700 WATERFRONT PLAZA
        LOUISVILLE, KENTUCKY  40202
 9 
        ALSO PRESENT:  MRS. COLEMAN
10 

                                                 Page 12

 1                      I N D E X
 2 
 3 DEPOSITION OF DR. LEE A. COLEMAN
 4 
 5 
 6     DIRECT EXAMINATION BY MS. ZETTLER:          14
 7     CROSS EXAMINATION BY MR. DOBIEZ            134
 8     REDIRECT EXAMINATION BY MS. ZETTLER        155
 9     QUESTION CERTIFIED                          88
10     QUESTION CERTIFIED                          94
11     QUESTION CERTIFIED                         179
12     CERTIFICATE                                182
13     ERRATA                                     183
14 
15                      EXHIBITS
16 
17     EXHIBIT 1                                   29
18     EXHIBITS 2 AND 3                           103
19     EXHIBIT 4                                  174
20 

                                                 Page 13

 1            COMES DR. LEE A. COLEMAN, CALLED BY THE
 2  PLAINTIFF, AND AFTER FIRST BEING DULY SWORN, WAS
 3  DEPOSED AND TESTIFIED AS FOLLOWS:
 4                 DIRECT EXAMINATION
 5 BY MS. ZETTLER:
 6            Q.      Good afternoon, Doctor.  As you
 7  know, my name is Nancy Zettler and I represent
 8  Group A plaintiffs in the Wesbecker and Fentress
 9  case.  We're here on court order by Judge Potter
10  for our continuation of your deposition.  I'm not
11  sure it's going to take the entire four hours,
12  hopefully it won't, but it may, so please bear
13  with me.
14                    I would like to start with
15  getting what your understanding is of the statute
16  known as Duty Of Qualified Mental Health
17  Professionals To Warn Intended Victim Of
18  Patient's Threat Of Violence Statute.  I'm not
19  asking you for a legal opinion or a legal review,
20  but I would like to know what your understanding
21  of that statute is.
22            MR. BUBALO:  I object to the question
23  because you're asking him for legal conclusions,
24  even his understanding is a legal conclusion and

                                                 Page 14

 1  I don't see how this is relevant or how it could
 2  lead to relevant testimony.  But with that
 3  stipulation, you can answer.
 4            A.      Well, my understanding of the
 5  statute is that if a patient relates to a
 6  psychiatrist, or not necessarily a psychiatrist
 7  but a mental health professional, a direct threat
 8  of harm to others, that the psychiatrist has a
 9  certain duty which encompasses a couple of
10  things.  One, as I understand it, to warn the
11  potential victim of a threat made, also to warn
12  police in the jurisdiction as I understand it.
13  If someone makes a threat that doesn't identify a
14  specific victim but makes a specific threat,
15  obviously there's no intended victim to notify or
16  warn, and in that case, as I understand it, the
17  duty is to at least notify the police.  Also, as
18  I understand the statute, the duty can be
19  discharged if the patient or mental health care
20  provider takes steps to hospitalize the patient.
21  That is basically my understanding of it.
22            Q.      Okay.  So if there is a
23  specific threat but not a specific victim,
24  enunciated by the patient, then the duty that you

                                                 Page 15

 1  have as a professional would be to notify the
 2  police?
 3            A.      That's my understanding.
 4            Q.      If there's not a specific
 5  victim or if there is a specific victim
 6  enunciated by the patient, then you could take
 7  steps to hospitalize that patient in lieu of
 8  notifying the intended victim or the police?
 9            A.      I'm not real clear, I've read
10  the statute and it doesn't sound real clear on
11  that as to actually what would constitute
12  discharging the duty.  I guess my assumption is
13  that you end up having to do all three but I
14  don't think the statute is real clear on that.
15            Q.      So your assumption is you would
16  have to do all three, notify the police,
17  potential victim and hospitalize the patient?
18            A.      Or try to take steps to
19  hospitalize the patient.  Now, I've read the
20  statute and it's worded that possibly your duty
21  is discharged just by hospitalizing but I'm not
22  sure I would leave it at that.
23            Q.      Do you agree it's a situational
24  type of thing and it would vary depending on the

                                                 Page 16

 1  situation presented by the patient, your duties?
 2            A.      It seems specific to me that
 3  it's specific in relation to a threat, a direct
 4  threat, I think is as it's worded.
 5            Q.      In your opinion, what would
 6  constitute a direct threat?
 7            A.      In my opinion?
 8            Q.      Yes.
 9            A.      Someone making a direct threat,
10  I'm going to kill so and so or I'm going to hurt
11  so and so or --
12            Q.      Okay.  In your opinion, what
13  would constitute a direct threat with an
14  unenunciated victim, intended victim?
15            A.      Well, I haven't thought about
16  that before but I assume if someone said I'm
17  going down to the post office and shoot up the
18  place, to me that might be not a definite victim
19  involved but a threat of hurting people or in
20  some instance like that, you know, I'm going to
21  just go out and shoot people from the top of a
22  tower or something like that.
23            Q.      Okay.  When did you first
24  become aware of the statute?

                                                 Page 17

 1            A.      Well, in our training, we --
 2  although I don't specifically ever recall being
 3  given a copy of the statute, we were kind of told
 4  about the duty to warn so I was aware that there
 5  was a statute, you know, before September of
 6  1989.
 7            Q.      Okay.  I'm sorry, I don't
 8  remember what dates you said you became licensed
 9  and started practicing, can you give me a general
10  idea of the year you started practicing?
11            A.      Practicing psychiatry, 1984.
12            Q.      And you mentioned earlier that
13  you actually have read the statute.  Do you
14  remember when you read the statute?
15            A.      The most recent time I've read
16  it?
17            Q.      Well, let's start with the
18  first time you read it.
19            A.      I probably read it completely,
20  it would be after this incident, I can't recall
21  exactly when.
22            Q.      Would it have been prior to
23  your testimony at the coroner's inquest?
24            A.      I don't recall exactly.

                                                 Page 18

 1            Q.      Okay.  When have you read it
 2  most recently?
 3            A.      Two or three days ago.
 4            Q.      Did you read it in preparation
 5  for the continuation of your deposition?
 6            A.      It was in preparation for that,
 7  I wasn't requested to read it but I thought it
 8  would be worthwhile to look at it again.
 9            Q.      Did you do anything else in
10  preparation for today?
11            A.      Read my previous depositions.
12            Q.      Did you -- when you said
13  depositions, you mean the first portion of this
14  deposition as well as the other testimony you've
15  given in the Hatfield case and the coroner's
16  inquest?
17            A.      Plus the coroner's inquest,
18  right.
19            Q.      Did you find any errors in the
20  first portion, the transcript of the first
21  portion of this deposition or anything that you
22  would like to change as far as your testimony in
23  that deposition was concerned?
24            A.      Well, I filled out a sheet of

                                                 Page 19

 1  errata -- errata sheet, I guess, which is about
 2  three pages long.
 3            Q.      I haven't gotten a copy of that
 4  yet.
 5            A.      Most of them are typographical
 6  errors.  There's a couple, as I recall it,
 7  clarification errors, I supplied it.
 8            MR. BUBALO:  I got it from the court
 9  reporter.
10            THE WITNESS:  When I got a copy of the
11  deposition, it was attached to mine.
12            MS. ZETTLER:  Greg, you don't happen to
13  have it -- it would expedite things if you have a
14  copy of the errata sheet.
15            MR. BUBALO:  Sure, you want me to get
16  it now?
17            MS. ZETTLER:  Yes.
18             (A SHORT BREAK WAS TAKEN.)
19            Q.      Doctor, I just took a quick
20  look at the errata sheets that Greg was kind
21  enough to let me take a look at, do you have any
22  corrections or any additions to any of the
23  substantive materials or anything that was
24  substantive in your first deposition?

                                                 Page 20

 1            A.      I'm not sure what you mean by
 2  substantive.
 3            Q.      Did you want to change or
 4  clarify any of your answers given other than like
 5  a word here or word there?
 6            A.      Other than what's in the
 7  errata?
 8            Q.      Right.
 9            A.      There was one in there that
10  changed somewhat on one of the clarifications,
11  but it's in here.  Other than what's in here, I
12  didn't see any other particular changes.
13            Q.      Could you take a quick look at
14  the errata sheets and show me where in the
15  deposition you believe there was a substantive
16  change?
17            A.      What I recall, it was a
18  question about when I had written the note on his
19  last visit --
20            Q.      Could you give me a page?
21            A.      Well, I have to find it here
22  first.  If you see it before I do but I
23  guess I'm the only one with a sheet, right?
24            Q.      Is it page 143, inclusion, or

                                                 Page 21

 1  exclusion to inclusion?
 2            A.      That was one but that's not the
 3  one I was referring to.  It may have been the
 4  next one which is 144, line 3, I would have to
 5  look at the deposition to see.
 6            Q.      That's page 143, right there.
 7            A.      Page 144, line 3, that's not
 8  the one I was referring to.  It was in reference
 9  to -- as I recall, the question was when I had
10  written the note from the September 11th, 1989
11  visit and the question was, so you wrote your
12  note between the time you saw him on September
13  11th, between that and the morning of September
14  14th, the day of the incident, and I may have --
15  I can't recall, something like my answer was
16  maybe, but when I went back and read it, the
17  answer should be yes, that that's during the time
18  frame.  That's what I recall it to be without
19  being able to find it specifically there, it
20  would have been probably a yes answer, that's why
21  it's difficult to find from a maybe to a yes or
22  may have to a yes or may have to a question.
23            Q.      So your testimony now is that
24  sometime between the 11th and the date of the

                                                 Page 22

 1  occurrence, you wrote the final note regarding
 2  the visit on the 11th?
 3            A.      I know it was written before
 4  the 14th because -- so it was between the 11th
 5  and the 13th, inclusive of the 13th.
 6            Q.      Okay.  But I believe your
 7  testimony from the last time was that you don't
 8  recall writing it contemporaneously with your
 9  visit with Mr. Wesbecker or shortly thereafter
10  that same day, correct?
11            A.      I don't recall exactly, I don't
12  write my chart notes contemporaneously, the
13  closest period of time is immediately after the
14  session or at the end of the day, but I don't
15  recall exactly when I wrote the notes.
16            Q.      Anything else that you
17  remember?
18            A.      Nothing that I recall right
19  now.
20            Q.      I believe the last time you
21  testified that Mr. Wesbecker had voiced
22  throughout the couple of years that you treated
23  him a great deal of anger towards his place of
24  employment and people at his place of employment.

                                                 Page 23

 1            A.      He had voiced a great deal of
 2  anger about particularly his employer, Standard
 3  Gravure, yes, that's correct.
 4            Q.      And I believe you testified
 5  that you don't recall him ever specifically
 6  talking about individuals at Standard Gravure, is
 7  that correct?
 8            A.      Well, I think as I testified
 9  before, there would be occasions that he would
10  mention names and the only name that I can recall
11  was Pat Lampton, other names I don't recall.  I
12  know on the last visit he did not mention
13  anyone's name.
14            Q.      When he reported to you the
15  sexual abuse that he remembered on the 11th, did
16  you ask him names of any individuals that may or
17  may not have been involved in that incident?
18            A.      No, I didn't ask him any
19  specific names.
20            Q.      Why not?
21            A.      Well, I was more interested
22  probably at that time in how he was doing and I
23  wasn't interrogating him about the specifics of
24  the incident but more concerned with his level of

                                                 Page 24

 1  deterioration at that time, he had reported this
 2  sex incident during this episode which could have
 3  been related to that, could not have been.  I
 4  didn't feel like it was important for me at that
 5  time to know who had done this to him or who had
 6  seen it, I didn't feel like that was particularly
 7  important at the time.
 8            Q.      Okay.  When over the two years
 9  that you treated Mr. Wesbecker and he would
10  report being angry at people at Standard Gravure,
11  what types of things would he say, how would he
12  voice that anger?
13            A.      The words he would use?
14            Q.      Generally.
15            A.      Well, he would usually talk
16  about it in the context of some situation like
17  working on the folder, you know.  He would say
18  something to the effect, and I can't remember his
19  exact words, but, you know, to paraphrase it,
20  they make me work the folder when they know I
21  don't want to, that was one particular thing.  I
22  know when he was off work, he was thinking they
23  were messing with his benefits so he would
24  usually say they, you know, were trying to

                                                 Page 25

 1  eliminate my benefits or mess with my disability.
 2  Kind of a common thing he would say is he would
 3  mention a situation and I might ask him well, how
 4  would you feel about that, and it would be common
 5  for him to say well, how would you feel about
 6  that, and when you say I guess that would make me
 7  angry and he would say you're right.  So a lot of
 8  times he would not even say that makes me angry,
 9  I would voice the words and he would agree with
10  them.  Usually he would be talking about a
11  particular situation that he was upset about or
12  felt like they were trying to make him do
13  something he didn't feel like he was able to do.
14  I recall also he would complain about -- he said
15  there was another person at work who they didn't
16  make him work the folder and he had an alcohol
17  problem and he drank on the job and be drunk
18  somewhere and yet they would make Mr. Wesbecker
19  work the folder, so more situational type things.
20            Q.      Okay.  You said that he used
21  the word they or them a lot when referring to
22  people at work, correct?
23            A.      Correct.
24            Q.      He wouldn't specify anybody, it

                                                 Page 26

 1  would be more of a generalization towards fellow
 2  employees or superiors, correct?
 3            A.      Correct.  Most of the time it
 4  was a generalization and I got the sense it was
 5  usually supervisors or people above him, not
 6  necessarily co-workers.
 7            Q.      Okay.  And when he reported
 8  this alleged sexual abuse that occurred prior to
 9  September 11, 1989, he told you that it was a
10  foreman who had forced him to perform oral sex on
11  him, correct?
12            A.      He reported it on September 11,
13  1989.
14            Q.      Okay.
15            A.      He said it was a foreman,
16  that's correct.
17            Q.      If he were to come into the
18  office on September 11, 1989, and say like your
19  scenario that you set forth earlier, I'm going to
20  go out and shoot them, would that be your
21  understanding that that would have been somebody
22  at Standard Gravure, knowing his history?
23            A.      Well, I guess it would depend
24  on the context.  If he was talking about the sex

                                                 Page 27

 1  incident that they had made me perform the sex
 2  act at work and I'm going to go shoot them, I
 3  would assume he would be talking about Standard
 4  Gravure, people at work.  If he was talking about
 5  some situation outside of work, I'm not sure I
 6  would have assumed that.
 7            Q.      If he had said something like
 8  that, would you have tried to find out who he
 9  intended to shoot?
10            A.      Give me exactly what he might
11  have said.
12            Q.      If he came in and reported to
13  you this alleged sexual abuse and then said I'm
14  going to go shoot them generally, would you have
15  tried to figure out who he intended to shoot in
16  that context?
17            A.      Hypothetically, if he had said
18  that, I might have said, well, who are you going
19  to shoot, I think I might have said that.
20            Q.      I think the last time you
21  testified that you weren't aware of any hobbies
22  that Mr. Wesbecker had, is that correct?
23            A.      I wasn't aware of any hobbies,
24  no.

                                                 Page 28

 1            Q.      You filled out at one point a
 2  form for Mr. Wesbecker to try to get disability
 3  because of his mental illness, is that correct?
 4            A.      That's correct.
 5             (PLAINTIFFS' EXHIBIT NO.  1 WAS
 6              MARKED FOR IDENTIFICATION AND
 7              RECEIVED IN EVIDENCE.)
 8            Q.      Take a look at that.
 9            A.      Just the first page?
10            Q.      Actually, I'm going to be
11  referring to, I believe, it's the third page in.
12            A.      (WITNESS EXAMINES DOCUMENT.)
13            Q.      Okay.  Have you a chance to
14  review this fourth page of Exhibit 1?
15            A.      Well, I've looked at it, I'm
16  not sure I can read all my writing but I can try.
17            Q.      The first question at the top
18  it says, "If known, provide specific examples of
19  difficulties this patient has in the areas
20  identified below."  Number 1, it says,
21  "Restriction of activities of daily living", and
22  it gives some examples, cleaning, shopping, using
23  public facilities.  Your answer appears to be
24  does little outside of home, does not have any

                                                 Page 29

 1  outside activities.
 2            A.      That's correct.
 3            Q.      How did you know that he didn't
 4  have any outside activities if you didn't ask him
 5  about hobbies?
 6            A.      Well, he never talked about
 7  having any outsides activities.  I mean there
 8  were times I would ask him what he would do with
 9  his free time.  I didn't ask him specifically, do
10  you have any hobbies, that I ever recall but I
11  would ask him what he would do with his spare
12  time, what he would do with his free time.  He
13  never, that I ever recall, said he had any
14  outside activities.  He would say, maybe, I mow
15  the yard.  So I would ask him questions that he
16  certainly had the opportunity to talk about
17  hobbies, but he never talked about any.
18            Q.      You testified the last time
19  that Mister Wesbecker was a fairly close person,
20  I believe you meant that he didn't really
21  volunteer a lot of information about himself, is
22  that correct?
23            A.      I may have said closed, kind of
24  close to the chest, correct, he wouldn't always

                                                 Page 30

 1  volunteer a lot of information about himself,
 2  that's correct.
 3            Q.      Did you find that you had to
 4  ask him more specific questions than you might
 5  normally ask a patient to obtain information from
 6  him?
 7            A.      Well, I would say my general
 8  sense is that he didn't respond very well to very
 9  open-ended questions.  You didn't have to
10  directly ask him for specifics, but they were
11  probably a little bit more closed than a general
12  initial evaluation would be.  I would say my
13  general sense of questions would be what do you
14  do with your spare time, I wouldn't feel any
15  reason to get more specific than that.
16            Q.      Did he ever offer any examples
17  of any of his activities whatsoever?
18            A.      Not that I recall, other than
19  mowing the yard.  That's why when I filled out
20  this form, I didn't know of any outside
21  activities, I didn't think he had any.
22            Q.      After Mister Wesbecker left
23  your office on September 11, 1989, what did you
24  do with regards to his case?

                                                 Page 31

 1            A.      What did I do?
 2            Q.      Yes.
 3            A.      I think I had probably another
 4  patient or two to see that day, but you're asking
 5  specifically about his case?
 6            Q.      Right.
 7            A.      Well, I could have written the
 8  note that day, as I said, I'm not exact when I
 9  wrote the note, other than that, I can't recall
10  anything else at that time, you know, on that
11  day.
12            Q.      Did you attempt to review any
13  of his hospital records from his previous
14  hospitalizations?
15            A.      Not that I recall.
16            Q.      Did you attempt to talk to any
17  of his previous treating mental health
18  professionals?
19            A.      No.
20            Q.      Did you attempt to contact
21  anybody in his family?
22            A.      No.  As I testified earlier, I
23  wanted his wife to come in with him the next
24  visit.

                                                 Page 32

 1            Q.      You expected him to come in for
 2  his next visit and I believe it was in two weeks,
 3  is that correct?
 4            A.      Correct, that's when his next
 5  appointment was.  I would have liked to have seen
 6  him sooner but there was some reason that he said
 7  his wife wasn't able to come the following week
 8  but she would be able to come the week after.
 9            Q.      You could have seen Mister
10  Wesbecker sooner without his wife being present,
11  correct?
12            A.      That's correct.
13            Q.      Why did you choose not to?
14            A.      I felt comfortable with the two
15  weeks.  As I testified earlier, he told me he
16  would call or have his ex-wife basically, but the
17  person he was living with call if there were any
18  problems in the meantime.
19            Q.      But earlier that same -- within
20  that same half hour to one hour visit, you had
21  wanted to hospitalize him, right?
22            A.      That's correct.
23            Q.      What happened during the rest
24  of that visit that convinced you that he didn't

                                                 Page 33

 1  need to be hospitalized and could be seen in two
 2  weeks as opposed to being seen sooner?
 3            A.      I'm not sure you're
 4  characterizing my impressions correctly.  At the
 5  end of the session if he had said okay, I'm
 6  willing to go in the hospital, I would have still
 7  hospitalized him.  One, he refused to go in the
 8  hospital, I didn't have any evidence of any way
 9  to involuntarily hospitalize him so we formulated
10  a plan that I felt comfortable with since I
11  couldn't hospitalize him, that was leaving an
12  avenue of communication open that he would
13  contact me if there were any problems and that
14  his wife would accompany him within two weeks and
15  I fully expected to hear from him if there were
16  any problems or if he wasn't feeling any better.
17  We had even talked in the session about when I
18  mentioned to him that you can have your wife call
19  me, he made some statement to the fact of well,
20  she's had problems doing that with previous
21  psychiatrists and I assured him that he had given
22  me his permission and if she was calling to let
23  me know how he was doing, I would be glad to talk
24  to her.  So I felt fully that he would

                                                 Page 34

 1  communicate with me if there were any problems.
 2            Q.      Isn't it true that Mister
 3  Wesbecker felt that he was getting better on the
 4  Prozac at the September 11th visit?
 5            A.      Well, as I recall, he had said
 6  he felt like the Prozac was helping him.
 7            Q.      So, it wasn't his perception
 8  that he was getting worse, correct?
 9            A.      I don't think he felt like the
10  Prozac had made him worse, he did say he was
11  having trouble sleeping as I recall and that had
12  been somewhat worse, even though that was a
13  common complaint of his, that he felt like that
14  was somewhat worse.
15            Q.      Did he tell you that he thought
16  he was out of control?
17            A.      No.
18            Q.      Did he tell you that he thought
19  he was becoming more depressed?
20            A.      No.
21            Q.      Did he tell you that he thought
22  he was becoming more anxious or irritable?
23            A.      No.
24            Q.      Did he say anything to you

                                                 Page 35

 1  verbalizing in any way that he felt that he was
 2  deteriorating in his condition?
 3            A.      Well, as I recall, he did talk
 4  about the sleep was worse.
 5            Q.      Other than the sleep?
 6            A.      He didn't say anything, I
 7  pointed out to him what I thought were signs of
 8  his deterioration and why I wanted to stop the
 9  Prozac.
10            Q.      What signs did you point out to
11  Mister Wesbecker that you felt showed that his
12  condition was deteriorating?
13            A.      I don't know my exact words, I
14  can only summarize what I -- the context of what
15  happened was that he seemed to be more anxious,
16  he certainly was not sleeping well, that he, you
17  know, agreed to -- that his emotions seemed to be
18  up and down a lot, those were the main things.
19  And I told him that I, you know, wanted to take
20  him off the Prozac because I wondered if that
21  might be part of his condition.  I think that's
22  when he said well, I think it's helped me.
23            Q.      Did you have this conversation
24  before he told you about the sexual abuse?

                                                 Page 36

 1            A.      I think, as I recall, that's
 2  what led into the sexual abuse when I asked him
 3  how has the medication helped you.  As I recall
 4  he generally went on to say well, it's helped me
 5  remember this and I can't recall his exact words,
 6  but this incident at work.
 7            Q.      Explain to me how it manifested
 8  into his anxiousness on that date.
 9            A.      Well, he was pacing for one
10  thing, his gestures were more animated and he had
11  more arm movements as I recall, those would be
12  the main things that I recall at this time.
13            Q.      Explain to me how his motions
14  were going up and down.
15            A.      Well, as you recall from the
16  previous deposition, there was a period of time
17  where he wept quickly and then quickly seemed to
18  compensate, get angry real quickly and that would
19  seem to calm down, so it wasn't that his emotions
20  were going from a high mood to a low mood, I
21  guess what I meant by that was that they were
22  fairly labile and they would come and go, strong
23  emotions and then nothing.
24            Q.      So, he demonstrated a number of

                                                 Page 37

 1  different emotions within that session?
 2            A.      Correct.
 3            Q.      And one of those emotions was
 4  anger?
 5            A.      Correct.
 6            Q.      One of them was a crying jag
 7  that he had?
 8            A.      Correct, for a short period of
 9  time.
10            Q.      Any other emotions?
11            A.      I don't recall any particular
12  other strong emotions that I recall at this
13  point.
14            Q.      Did he demonstrate any
15  happiness?
16            A.      Not that I recall.
17            Q.      Did he demonstrate a calmness?
18            A.      He would get calmer, I'm not
19  sure I would classify it as calm, I think as I
20  testified earlier, he seemed to kind of
21  recompensate a bit more toward the end of the
22  sessions, we we were talking hospitalization and
23  he was fairly calm.  For a normal person I'm not
24  sure I would call it calm.

                                                 Page 38

 1            Q.      In what context did he
 2  demonstrate anger?
 3            A.      I can't recall exactly.  I know
 4  his voice was louder, it may have been when he
 5  was talking about the sex incident.  I don't
 6  recall really at this time any specific other
 7  episodes of anger that he talked about other
 8  than, you know, there was anger with the sex
 9  episode and I guess it may have been when he was
10  talking about the lawsuit and, you know, he
11  displayed anger then, mainly by his voice being
12  louder and, you know, talking about reporting it
13  to the sex crimes division of the police, that's
14  my general recollection.
15            Q.      Okay.  I'm most interested, you
16  testified just a few minute ago that you told him
17  that you were concerned about the deterioration
18  in his condition and you wanted to hospitalize
19  him before he reported the sexual abuse to you.
20  I'm more interested in what he demonstrated prior
21  to reporting the sexual abuse that indicated to
22  you that his condition had deteriorated?
23            A.      Well, I don't think I had
24  talked with him about hospitalization until after

                                                 Page 39

 1  the sexual abuse.  As I recall, the sense of the
 2  session went, I asked him how the Prozac had been
 3  doing for him, as you will recall from my one
 4  word note in the contemporaneous notes, he seemed
 5  obviously nervous when he came in, and I had
 6  asked him about the Prozac and he had talked
 7  about sleep and then I may have said, you know,
 8  you seem -- it doesn't seem to be doing very much
 9  for you, I think I want to take you off it, and
10  as I recall, that's when he said well, it's
11  helped me remember.  I'm trying to recall a
12  session from four years ago but that's my general
13  sense of the direction and then after that I
14  would have talked about putting him in the
15  hospital as I recall.  I'm not sure I answered
16  your question.
17            Q.      Okay.  But prior to talking
18  about the alleged sexual abuse, you were
19  concerned about a deterioration in his condition,
20  correct?
21            A.      Correct.
22            Q.      I wanted to know what it was
23  specifically, as best you can remember, about his
24  condition or about his behavior prior to talking

                                                 Page 40

 1  about the Prozac and the sexual abuse that
 2  concerned you about his deterioration?
 3            A.      Well, as I recall, I probably
 4  wrote the word nervous down when he first came in
 5  because it seemed -- my sense was, I noticed that
 6  the minute he came in, and I'm not sure exactly
 7  what -- it was probably more of a non-verbal
 8  nature, either he was shaky or pacing more, I
 9  can't really recall.  But there was something
10  fairly obvious about his appearance but I can't
11  recall the exact specifics of what that was that
12  made me say, immediately say, he seems pretty
13  nervous.  I can't recall more than that exactly
14  what specifics, I mean other than what I already
15  talked about, the pacing and I think that was at
16  the first of the session but there was something
17  when he initially came in that led me to know
18  that he wasn't his normal self at the first of
19  the session.
20            Q.      How about his facial
21  expressions, do you remember anything about his
22  facial expressions when he first came in?
23            A.      Well, I would -- that would be
24  his overall picture I would guess, I don't

                                                 Page 41

 1  remember specifically.  I recall he didn't look
 2  very calm.
 3            Q.      Would you seek to hospitalize
 4  somebody because of nervousness?
 5            A.      Not nervousness alone, no.
 6            Q.      What else about Mister
 7  Wesbecker's appearance or behavior made you
 8  consider hospitalizing him?
 9            A.      Well, there were several
10  things, one, he had deterioration from the
11  previous level of functioning, that I think as I
12  testified was significant deterioration, he had
13  an increased level of anger, he was more
14  animated, his emotions were more labile.  He was
15  more nervous and he was more anxious and I wasn't
16  sure what had caused that.  As you know, I
17  questioned whether it might all have been the
18  Prozac.  But I really wasn't sure what had caused
19  that, and I felt like that I needed to have him
20  in the hospital to figure out exactly what it
21  was, whether it was the medication, whether it
22  was his condition, whether it was some other
23  medical problem.  When I'm presented with a
24  situation that worries me about somebody's

                                                 Page 42

 1  condition and I don't know what's causing it,
 2  I'll generally consider hospitalization at that
 3  time.
 4            Q.      You noted all these
 5  deteriorations in his previous level of
 6  functioning prior to discussing the Prozac with
 7  Mister Wesbecker, correct?
 8            A.      No, not necessarily.  I knew he
 9  was nervous when he first came in, but as I
10  recall I initiated the session with how he felt
11  like the Prozac had been.  So the sex abuse
12  incident came very early in the session and
13  hospitalization was discussed more toward the
14  last fifteen minutes of the session.  So I had
15  observed all of these things in the first ten or
16  fifteen minutes before we discussed
17  hospitalization is my recollection.
18            Q.      After you started discussing
19  the alleged sexual incident, describe for me how
20  he reacted after you -- he initially brought it
21  up and started crying?
22            A.      As I said, he probably heavily
23  sobbed for about fifteen seconds, and then he
24  stopped, although I wouldn't say he was calm, he

                                                 Page 43

 1  still appeared obviously shaken.  I may have
 2  asked him how he felt about it and I think that's
 3  when he went off and started talking about a
 4  lawsuit and that he had called the sex crimes
 5  division of the police to report it.  So that was
 6  the general sense of the direction he went after
 7  he talked about the sex abuse.
 8            Q.      How long did that conversation
 9  about the sex crime division and the possible
10  lawsuit last?
11            A.      I can't recall, I would guess
12  five minutes or so.
13            Q.      Did you try to elicit
14  information from Mister Wesbecker during that
15  conversation that would tell you whether or not
16  the incident was -- had happened?
17            A.      Well, I'm not sure what kind of
18  information you would be referring to.
19            Q.      Did you ask him any questions
20  about the specifics of the incident?
21            A.      I was more interested in how he
22  felt about this memory of an incident than
23  necessarily the specifics of who it was.  My
24  concern was about his psychological condition,

                                                 Page 44

 1  not about the factual condition of whether that --
 2  who it had been, when it had happened.
 3            Q.      Did he report to you when he
 4  believed that it happened?
 5            A.      I don't recall him giving me a
 6  time frame.
 7            Q.      Was it when he was obviously
 8  still working at Standard Gravure before he was
 9  on disability?
10            A.      He said, as I recall, it was to
11  get off the folder and that's when he was working
12  at Standard Gravure so I don't recall him saying
13  specifically it's when I worked at Standard
14  Gravure but he said this incident happened to get
15  him off the folder which would only have been
16  when he was working at Standard Gravure.
17            Q.      Was it important to you at all
18  whether or not the incident actually occurred?
19            A.      Sure, it would be important to
20  whether it actually occurred.  My primary concern
21  in this session was his level of deterioration,
22  how he was doing, this was part of that.  But my
23  primary concern was his deterioration, his
24  overall condition and not the facts of this

                                                 Page 45

 1  incident.  I'm not sure there would have been any
 2  way, even if I had wanted to go in that
 3  direction.  My direction to go with in the
 4  session was to try to figure out why he had
 5  deteriorated and what kind of direction to take
 6  to take steps with that, not to spend a lot of
 7  time delving into this incident which could have
 8  made him even worse.
 9            Q.      Okay.  When you first started
10  treating him approximately two years prior to the
11  the date of the accident, you treated him for
12  about two years, right?
13            A.      Correct.
14            Q.      When he first presented to you,
15  he had some fairly significant mental illnesses,
16  didn't he?
17            A.      Well he certainly had a mental
18  illness diagnosis at that time that I would
19  consider significant, yes.
20            Q.      And with varying levels of
21  functioning ability, he didn't really improve all
22  that much during the time that you treated him in
23  that two years, correct?
24            A.      I would say he did not improve

                                                 Page 46

 1  all that much, there were times he seemed to feel
 2  better but overall he did not improve that much.
 3            Q.      And in fact it was your opinion
 4  that his prognosis was fairly poor given the
 5  diagnosis you had made of schizoaffective
 6  disorder, correct?
 7            A.      Or even the original diagnosis,
 8  of atypical bipolar.  I thought his condition,
 9  the schizoaffective or atypical bipolar, that his
10  prognosis was poor for whichever condition.  I
11  considered him at that time schizoaffective, I
12  felt his prognosis was poor and part of that was
13  because of any significant lack of improvement in
14  two years.
15            Q.      Do you feel that on September
16  11th he was fairly fragile emotionally?
17            A.      Well, I would say -- it depends
18  on how you define fragile, he was certainly
19  labile emotionally, I'm not sure how you would
20  define fragile.
21            Q.      Was he fragile psychologically?
22            A.      I would think probably any
23  added stress on him could have contributed to
24  further deterioration in his condition.

                                                 Page 47

 1            Q.      Certainly if he had been forced
 2  to perform oral sex on somebody in front of a
 3  number of people would have been considerable
 4  stress, wouldn't it have?
 5            A.      You mean if it happened again
 6  after this?
 7            Q.      No, if it had happened to him
 8  at all.  That would be considerable
 9  stress on somebody to be forced to perform oral
10  sex on another person in front of a group of
11  people, right?
12            A.      Sure, although that apparently
13  had happened some significant time before.
14            Q.      Regardless of whether or not he
15  repressed it and remembered it or it happened
16  that very day, it would still have a significant
17  impact on him psychologically, wouldn't it have?
18            A.      It would have probably a
19  different degree of impact whether it had been a
20  repressed memory or it happened that day, but
21  either way I think it would have significant
22  impact, that's correct.
23            Q.      And if it hadn't happened, that
24  would be significant to at least manifesting his

                                                 Page 48

 1  deterioration in his condition, correct?
 2            A.      Whether it happened or didn't
 3  happen, Mister Wesbecker felt it happened so in
 4  his mind it had happened and so the impact of it
 5  was going to be, my guess would be, the same
 6  whether it happened or didn't happen because he
 7  felt it happened.
 8            Q.      Let me ask the question again.
 9  I'm trying to differentiate between whether it
10  actually happened, the impact it would have had
11  on him and if it did not happen the impact it
12  would have had on him.  If it had not happened,
13  that would at least have been one manifestation
14  of the deterioration of his condition, correct?
15            A.      It could have been the
16  manifestation of his deterioration, correct.
17            Q.      Would there have been a
18  difference between the way you would treat his
19  deterioration if the event had actually happened
20  as opposed to it not having happened?
21            A.      You mean if I had some factual
22  evidence at the time or when he came in that it
23  happened or had not happened?
24            Q.      Right, and I'm not talking

                                                 Page 49

 1  specifically about that day, I mean in general.
 2            A.      Then I'm not clear on your
 3  question.
 4            Q.      Well, I'll rephrase it.  Here
 5  you have a man who has a fairly significant
 6  mental illness, correct?
 7            A.      Correct.
 8            Q.      And somebody abuses him by
 9  forcing him to perform oral sex on him in front
10  of a group of people, okay?
11            A.      Hypothetically?
12            Q.      Hypothetically.  Your treatment
13  of Mister Wesbecker in that actual condition in
14  something actually happening to him would be
15  different than if Mister Wesbecker had a delusion
16  about this happening or had in effect imagined
17  that it happened, isn't that correct?
18            A.      In a longer term sense, yes, it
19  would be.  On that day I probably either way
20  would have wanted to hospitalize him, but in a
21  longer term since from then on, it would have
22  definitely been different.
23            Q.      Okay.  Did you do anything
24  after that date to try to determine whether or

                                                 Page 50

 1  not that event actually occurred?
 2            A.      Well, part of my reason to have
 3  his ex-wife come in the next time was to look at
 4  that a bit more closely.
 5            Q.      And you felt that it was okay
 6  that she could come in in two weeks to discuss
 7  that issue?
 8            A.      Well, I felt it was okay for
 9  her to come in, whether we would have discussed
10  that issue, I probably would have asked him
11  whether it was okay to do that or not before I
12  asked her about it.
13            Q.      Did you ask him whether or not
14  it would be okay for you to discuss that issue
15  with her on the 11th?
16            A.      I don't recall asking him
17  whether I could discuss that issue with her on
18  the 11th.  As I recall when I asked him about
19  having his wife in, I just said I'd like for your
20  wife to come with you next time so I could also
21  talk with her about how you're doing, but I don't
22  recall, I don't think I mentioned anything about
23  discussing this sex abuse incident.
24            Q.      Did you ask him if you could

                                                 Page 51

 1  call his wife in lieu of waiting for two weeks
 2  for her to come in and meet with you?
 3            A.      No, I didn't ask him that.
 4            Q.      Why not?
 5            A.      I felt like Mister Wesbecker,
 6  as I've testified, was a bit on the suspicious
 7  side even of me that I felt like he'd had some
 8  trust in.  And I felt like if I took it upon
 9  myself even with his permission to call his
10  ex-wife, that he would have some basis to be
11  suspicious.  A lot of times when I have, someone
12  who's somewhat suspicious, any discussions I have
13  with other people is with them present.  Now the
14  only way that person could be present, even if I
15  was in the office talking to his wife, his wife
16  was on the other end of the phone, he doesn't
17  know what she says, and I felt like it would be
18  okay for her to come in but I felt like I would
19  be aggravating his suspiciousness by calling her
20  on the phone in between sessions.
21            Q.      But you felt comfortable with
22  asking him to bring her in to talk with you?
23            A.      That's correct, that way he
24  could either say yes or no, you know.

                                                 Page 52

 1            Q.      And he said yes, he said he
 2  would bring her in?
 3            A.      He said he would bring her in,
 4  that's correct.
 5            Q.      Did you ask him, did you try to
 6  attempt to get him to bring her in sooner than
 7  two weeks?
 8            A.      Yes, as I recall, I wanted him
 9  to come back in a week but as I testified
10  earlier, for some reason he said his ex-wife
11  couldn't come in in a week.
12            Q.      And you felt comfortable with
13  not seeing Mister Wesbecker individually for that
14  two week period?
15            A.      Correct, I felt comfortable
16  with the two week time with him telling me that
17  he would call if things didn't get any better.
18            Q.      Can you explain what a mental
19  status exam is?
20            A.      A mental status exam is a -- a
21  mental status exam is a constellation of specific
22  things that a psychiatrist uses to describe a
23  patient's overall basic mental status.  It can
24  vary in degrees of how much is put in there.

                                                 Page 53

 1  There are some things that become part of what's
 2  called a formal or complete mental status exam
 3  that are separate questions.  In an overall
 4  interview of a patient I can come up with a
 5  mental status exam, I can give a mental status
 6  exam of a patient just by talking to them or
 7  taking a history, when you note their appearance,
 8  their affect, their mood.  I could give a basic
 9  mental status exam of you just by sitting here
10  talking.  So it's not necessarily just a specific
11  formal part of an evaluation, it also encompasses
12  the whole context of an interview or talking with
13  a patient.  Now there are some specific parts of
14  a mental status exam that if you want to do more
15  complete, to say let's test memory, there are
16  certain memory tests that you can give depending
17  on whether you feel like that is appropriate or
18  not.
19            Q.      Did you perform any kind of
20  mental status exam on Joseph Wesbecker on
21  September 11th?
22            A.      I didn't perform any specific
23  questions testing his memory.  As I said, I can
24  formulate a mental status exam by having sat

                                                 Page 54

 1  there with him for thirty minutes and been there
 2  that session, I can give you a, you know,
 3  somewhat of a mental status exam just by talking
 4  to him for that thirty minutes.
 5            Q.      Did you -- other than talking
 6  to him generally about how he felt on the Prozac
 7  and how he felt about the alleged sexual abuse,
 8  did you perform any other type of exam or ask him
 9  any other questions that could be considered a
10  mental status exam?
11            A.      I asked him whether he had any
12  thoughts about hurting himself, that tends to be
13  part of a mental status exam, and in a round
14  about way, I certainly gave him opportunity to
15  talk about any homicidal ideation although I
16  didn't specifically ask him that question.
17            Q.      What ways did you give him the
18  opportunities to talk about homicidal ideation?
19            A.      I asked him what he was
20  planning to do about the sex abuse.
21            Q.      Did you -- I'm sorry, go ahead.
22            A.      I feel like that would have
23  certainly given him opportunity to talk about any
24  particular plan or method of revenge or getting

                                                 Page 55

 1  back at people.
 2            Q.      At what point in time during
 3  the session did you ask him about hospitalizing
 4  him?
 5            A.      As I recall, that was more in
 6  the last half of the session when we talked about
 7  hospitalization, you know, the last ten to
 8  fifteen minutes when I would be trying to come up
 9  with what direction to go in from here, what do
10  we need to do at this point.  So it would have
11  been more toward the end of the session.
12            Q.      I believe your testimony last
13  time was that you asked him about suicidal
14  ideation after you told him you would like to
15  hospitalize him, is that correct?
16            A.      My best recollection is I
17  probably said to him well, I want to hospitalize
18  you because I don't know what's going on and then
19  as I testified, he said he didn't want to go in
20  the hospital, as I recall that's when I said are
21  you having any thoughts about hurting yourself,
22  something to that effect.
23            Q.      It's your understanding that
24  Mister Wesbecker was fairly experienced in

                                                 Page 56

 1  psychiatric hospitalizations, isn't that true?
 2            A.      I don't know what experience,
 3  he had been in the hospital several occasions but
 4  I don't know if that makes someone experienced
 5  knowing the ins and outs of psychiatric
 6  hospitalization.  He had never been hospitalized
 7  involuntarily to my knowledge.
 8            Q.      Is part of or can part of a
 9  mental status exam be geared towards examining
10  hostility levels?
11            A.      Well, as I said, you can put a
12  whole lot of things in a mental status exam.  I
13  don't think an evaluation of hostility level
14  tends to be part of any -- of most people's
15  mental status exam, I've never seen that from any
16  other psychiatrists written down.  It's certainly
17  acceptable to put that in there but I don't think
18  it would be considered part of a routine to
19  evaluate a level of hostility.  You might mention
20  that there is hostility or anger, but I've never
21  seen anybody rate that in a specific way.
22            Q.      Would you consider anger a
23  manifestation of hostility?
24            A.      It certainly can be, yes.

                                                 Page 57

 1            Q.      Do you consider Mister
 2  Wesbecker's manifestation of anger with regards
 3  to the alleged sexual abuse hostility?
 4            A.      Well, I guess it depends on how
 5  you define hostility, hostility is just general
 6  anger about something happening.  Yes, he
 7  certainly had hostility, he did not direct any
 8  threat or anger toward anybody or any place.
 9            Q.      Was he angry with the people
10  who were allegedly involved in the sexual abuse?
11            A.      I think he was angry about the
12  incident but I don't recall him specifically
13  saying I'm angry at the foreman for doing this to
14  me.
15            Q.      How did he describe the
16  incident?
17            A.      Well, as I recall, the words he
18  used was that one of the foremen made me give him
19  a blow job so I could get off the folder and
20  there were other people or other co-workers
21  around.
22            Q.      Did he say how the other
23  co-workers had reacted to his alleged oral sex?
24            A.      He didn't comment on anybody

                                                 Page 58

 1  else's reaction.
 2            Q.      Did he say how the foreman had
 3  reacted?
 4            A.      He did not say how the foreman
 5  reacted.
 6            Q.      Did he say how he reacted?
 7            A.      Other than when I asked him
 8  what he was going to do about it, he was doing
 9  this, as I said, this came up, this is what
10  initiated the sobbing episode that may have cut
11  off his conversation at that point when he was
12  sobbing and I think my follow up question at some
13  point was what are you going to do about this.
14            Q.      But he did say that my foreman
15  forced me to give him a blow job to get off the
16  folder while some of my co-workers watched?
17            A.      To paraphrase what he said,
18  those wouldn't be his exact words but that's
19  basically the context of what he said.
20            Q.      Did he use harsher language
21  than that?
22            A.      No.
23            Q.      Did he swear?
24            A.      It depends whether you consider

                                                 Page 59

 1  blow job a swear word, that was the only word in
 2  that context that he used.
 3            Q.      There was no doubt in your mind
 4  though that the incident that he allegedly
 5  remembered involved people at Standard Gravure,
 6  right?
 7            A.      There was no doubt in my mind
 8  that it was Standard Gravure, that's correct.
 9            Q.      Would you say that he exhibited
10  hostility towards those people?
11            A.      I don't recall him exhibiting
12  hostility towards those people.  As I said, this
13  was the only time he talked about it in the
14  session, he never said anything about -- other
15  than talking about the lawsuit, about wanting to
16  get back at anybody or getting back at the
17  foreman or getting back at Standard Gravure, he
18  never made any comment like that in the session.
19  He talked about reporting it to the police and
20  whether initiating a lawsuit or not.
21            MS. ZETTLER:  You want to take a short
22  break?
23             (A SHORT BREAK WAS TAKEN.)
24            Q.      Doctor, you testified earlier

                                                 Page 60

 1  that you were concerned that on September 11th
 2  that Mister Wesbecker may have been having a
 3  reaction to Prozac that he was taking, is that
 4  true?
 5            A.      That's correct.
 6            Q.      Did you do anything after he
 7  left your office to investigate how Prozac may
 8  have been causing this reaction or whether or not
 9  there were reports in any literature of similar
10  reactions?
11            A.      No, not that I recall.
12            Q.      What did you base your
13  suspicion that he was having an adverse reaction
14  to the Prozac on?
15            A.      Well, as I said, I wasn't for
16  sure but I knew that Prozac in some people could
17  cause nervousness, could cause agitation, could
18  cause sleep problems, some of the things that I
19  was seeing with him, plus I had just started him
20  on it three or four weeks before, whenever he had
21  previously been in, and now he's deteriorated.
22  When you start a new medication and something
23  different happens, you tend to suspect that it's
24  a medication that is causing it within that

                                                 Page 61

 1  period of time.  So that's what made me question,
 2  one, the constellation of symptoms that I was
 3  observing, and two, that we had just started it
 4  three or four weeks before.
 5            Q.      Do you have an understanding of
 6  what the half life of Prozac is?
 7            A.      I don't know the exact number,
 8  I know it's, compared to other medications,
 9  fairly long.
10            Q.      Do you have an understanding of
11  how long the Prozac could have an affect on a
12  person's system after they stop taking it?
13            A.      Well, I know you can probably
14  still have it in your system for at least
15  probably three weeks or so, afterwards maybe even
16  longer, obviously each day is a little less than
17  the day before.  But it's also the converse is
18  true, when you start somebody on Prozac, the
19  level goes up slowly and comes down slowly.
20            Q.      As far as other
21  anti-depressants are concerned, what's the
22  average half life, can you give me a general
23  idea?
24            A.      I would say a general sense

                                                 Page 62

 1  would probably be twelve to twenty-four hours.
 2            Q.      And Prozac can last as long as
 3  three weeks?
 4            A.      Well, but the half life -- I'm
 5  not sure exactly what it is, it may be
 6  thirty-six, forty-eight hours, I don't know
 7  exactly.
 8            Q.      Do you have a general
 9  understanding as to how long other
10  anti-depressants could stay in your system?
11            A.      Usually what I think of is most
12  of them you stop they may be there three or four
13  or five days to some level.
14            Q.      As opposed to three weeks --
15  two to three weeks with Prozac?
16            A.      Correct.
17            Q.      Was part of the reason you
18  wanted to hospitalize Mister Wesbecker was the
19  concern that he may have been having an adverse
20  reaction to Prozac?
21            A.      That was one of my concerns
22  about his deterioration -- his deterioration and
23  me being unclear as to what was causing it made
24  me want to hospitalize him.  As you know from

                                                 Page 63

 1  previous testimony, I told him to stop the Prozac
 2  on that day.  So it wasn't specifically just
 3  because this was a side effect but, you know, if
 4  this is causing it, one, I could have taken a
 5  blood level and I'm not sure that would have told
 6  me a whole lot.  But by stopping it, I would have
 7  known not real quickly but whether that was some
 8  part of it or not.  But it wasn't specifically --
 9  it was because of his deterioration, not because --
10  possibly I could attribute it to Prozac but it
11  was not necessarily just for the reason he is
12  having a reaction to Prozac that I want to put
13  you in the hospital.
14            Q.      What other possible reasons for
15  his deterioration did you consider on that day?
16            A.      One, I considered possibly this
17  was his condition that was aggravated.  As I
18  said, I wasn't real sure whether the sex abuse
19  thing was factual or not, so I didn't know
20  whether this could also be his condition that had
21  been aggravated.  Another possibility would be
22  was there something else physical going on that
23  might be causing a change in his condition, any
24  number of physical problems can certainly cause,

                                                 Page 64

 1  you know, mental problems.  So I really wasn't
 2  sure, so it ranged anywhere from his condition to
 3  medication side effects, to some other physical
 4  problems, those were the main things that I can
 5  recall thinking about.
 6            Q.      Do you have any specific
 7  recollection of what about his physical condition
 8  could have caused a deterioration other than the
 9  Prozac?
10            A.      No.  As far as I knew, his
11  physical health was okay.  My sense, my guess was --
12  at the time what I felt more strongly about was
13  that this was Prozac and that probably after
14  being off it for a few days he's going to feel
15  better.
16            Q.      Given that, why didn't you ask
17  him to come in and see you within a few days?
18            A.      Well, as I testified before, I
19  told him to call me if there was any problem and
20  I really felt like well, if it is the Prozac,
21  he's going to feel better, he won't even need to
22  call me in a few days, he'll come back in two
23  weeks and say yes, I felt better after going off
24  Prozac.

                                                 Page 65

 1            Q.      Other than reporting he was
 2  having more trouble sleeping, he didn't feel like
 3  he was getting any worse, did he?
 4            A.      He didn't feel that way, no.
 5            Q.      In fact he thought he was
 6  getting better on the Prozac, that his memory was
 7  clearing up and he was generally feeling better,
 8  correct?
 9            A.      No, he didn't say anything
10  about his memory, as I said, when I asked him
11  what he thought how the Prozac had helped him,
12  that's when he talked about it helped him
13  remember.  He didn't say my memory overall is
14  getting better, he said it helped me remember
15  this specific incident.
16            Q.      Would that indicate to you he
17  thought his memory was getting better, at least
18  with regards to that specific incident?
19            A.      No, that didn't indicate to me
20  his memory was getting better.
21            Q.      But regardless, he felt he was
22  getting better on the Prozac?
23            A.      He didn't say getting better,
24  he said he thought it was helping him.

                                                 Page 66

 1            Q.      That would generally indicate
 2  that he felt better, wouldn't it?
 3            A.      Well, he didn't say it in that
 4  regard, he said he thought it was helping him and
 5  I asked him how it helped him and he said it
 6  helped him remember this incident.
 7            Q.      What did he say to you when you
 8  told him that you thought he was becoming more
 9  anxious and that his emotions were becoming more
10  labile?
11            A.      I don't really recall him
12  saying anything other than listening and I think
13  I probably encompassed this all in one discussion
14  about hospitalization possibly, I don't recall
15  him specifically, you know, addressing either one
16  of those issues, he addressed more about going in
17  the hospital.
18            Q.      Did you approach him about
19  coming in sooner than two weeks?
20            A.      As I said, I told him I wanted
21  to see him back in a week but when I was making
22  the appointment, you know, he said his ex-wife,
23  his wife couldn't come in at that time.  As I
24  recall, I was seeing him on a Monday and a week

                                                 Page 67

 1  was another Monday and there was something about
 2  Mondays that his wife couldn't come in on,
 3  although his appointment in two weeks was on a
 4  Monday and he said she could come in at that
 5  time.
 6            Q.      Did he refuse to come in alone
 7  before that two week period?
 8            A.      I don't think I asked him to
 9  come in alone.
10            Q.      Did you ever consider calling
11  him at home to see how he was doing within that
12  two week period?
13            A.      Well, obviously in three days
14  the shooting incident occurred, I don't recall
15  thinking of that in those three days, no.
16            Q.      You asked him to stop taking
17  the Prozac, correct?
18            A.      I instructed him to stop taking
19  the Prozac, that's correct.
20            Q.      What did he say when you
21  instructed him to stop taking the Prozac?
22            A.      I don't recall exactly what he
23  said.  I think that's, you know, as I said, he
24  felt like it was helping him but I told him I

                                                 Page 68

 1  wanted for him to stop it.  I didn't write him
 2  any more prescriptions, so I felt like he was
 3  going to stop it, he didn't refuse to stop taking
 4  it.
 5            Q.      Did he agree to stop taking it?
 6            A.      As I recall, he agreed, but I
 7  don't know, I can't remember exactly what terms
 8  he agreed to it.
 9            Q.      Is it your understanding that
10  the toxicology report done by the coroner
11  indicated there were therapeutic levels of
12  Fluoxetine in his system when he died?
13            A.      I have seen the toxicology
14  report and as I recall there was a therapeutic
15  level of Prozac or Fluoxetine in the system,
16  that's correct.
17            Q.      Would that indicate to you that
18  he did not stop taking the Prozac after you
19  instructed him to?
20            A.      No.  As you asked me before
21  about the half life, that certainly wouldn't be a
22  big difference three days later, so he certainly
23  could have stopped it and it still been in the
24  therapeutic range three days later.

                                                 Page 69

 1            Q.      Assuming that the report of
 2  alleged sexual abuse was not true, would that
 3  have indicated any kind of symbolism or any kind
 4  of attempt at communication by Mister Wesbecker
 5  to you?
 6            A.      Not that I'm aware of.
 7            Q.      People frequently communicate
 8  or manifest feelings or problems through dreams
 9  or hallucinations, don't they, in the psychiatric
10  context?
11            A.      Not necessarily hallucinations,
12  they can through dreams.
13            Q.      How about delusions?
14            A.      Well, they don't necessarily --
15  delusions can sometimes take the form of
16  something they're having difficulty dealing with.
17  A lot of times they don't.
18            Q.      Mister Wesbecker had a history
19  of difficulties dealing with his work situation,
20  didn't he, before you put him on disability?
21            A.      Well, I think the term I used
22  was he was having poor interpersonal
23  relationships, which would include, I guess, his
24  co-workers as well as his supervisors at work.

                                                 Page 70

 1            Q.      But he was manifesting at
 2  various periods for various periods of time
 3  throughout your treatment of him fairly
 4  significant anger towards the workplace and
 5  people at the workplace, right?
 6            A.      He had displayed anger at the
 7  workplace.
 8            Q.      It was fairly --
 9            A.      The company.
10            Q.      It was fairly serious, his
11  anger, wasn't it?
12            A.      It depends on how you define
13  fairly serious, he never got up and punched the
14  walls.  I would not say that they were serious
15  displays of anger, I would say he had, you know,
16  certainly a moderate level of anger, but it was
17  mostly in a verbal sense.
18            Q.      Did he ever shout when he was
19  talking about work or people at work?
20            A.      He would raise his voice but I
21  don't recall him shouting.
22            Q.      Would he become agitated when
23  he talked about --
24            A.      I know the first session he

                                                 Page 71

 1  came in, he was a bit agitated and paced and
 2  certainly the last session he was agitated, those
 3  are the only two sessions that I remember him
 4  pacing and being that agitated.  His voice would
 5  get louder and, you know, I wouldn't necessarily
 6  call that agitation though.
 7            Q.      You're talking about prior to
 8  September 11th?
 9            A.      Correct.  On the initial visit
10  too, he was fairly agitated, but in between,
11  normally he would sit, he would talk about these
12  things and raise his voice and -- but he would
13  never shout or get up and pace about other than
14  those, the first and the last session.
15            Q.      He was shouting on the first
16  session?
17            A.      He didn't shout on any
18  sessions, he wouldn't get up and pace about,
19  other than the first and last sessions.
20            Q.      But he raised his voice?
21            A.      He would raise his voice,
22  that's correct.
23            Q.      Do you have an opinion as to
24  why Mister Wesbecker killed himself after

                                                 Page 72

 1  shooting the people at Standard Gravure?
 2            A.      I might have an opinion, I
 3  might not have an informed opinion.
 4            Q.      What's your opinion?
 5            A.      I was also asked that question
 6  at the coroner's inquest, I don't think he wanted
 7  to face what was going to happen afterwards.
 8            Q.      What do you base that opinion
 9  on?
10            A.      Nothing, a guess.
11            Q.      It's complete speculation on
12  your part?
13            A.      I have no basis, as I said,
14  it's not an informed opinion.
15            Q.      Given his history of suicidal
16  ideation and suicide attempts, why is it your
17  opinion that he didn't want to face the
18  repercussions as opposed to something about the
19  deterioration of his condition that caused him to
20  commit suicide?
21            A.      Well, but in none of his
22  suicide attempts had he attempted to harm anybody
23  else, to my knowledge.  If it was just strictly
24  deterioration of his condition and attempted

                                                 Page 73

 1  suicide, why would he he not have done it the way
 2  he had done it the times before?
 3            Q.      Could it have been a
 4  manifestation of his anger toward the people at
 5  work?
 6            A.      But he would probably have been
 7  angry at work when he had previous suicide
 8  attempts.
 9            Q.      That's speculation though
10  because you never treated him during that time.
11            A.      That's correct.
12            Q.      Let me pin it down.
13            A.      You asked if it was speculation
14  and I said it was speculation.
15            Q.      Okay.  Most of the sessions
16  that you had with Mister Wesbecker were really
17  centered around his anger towards the work
18  situation, isn't that true?
19            A.      Well, most of the primary
20  discussions would tend to be about medication
21  which would come up in every session.  Other
22  things outside of medication, when he was working
23  usually was about work although occasionally he
24  would bring in other things.  Now once he stopped

                                                 Page 74

 1  working that tended to diminish a lot, although
 2  there would still be an occasional time he would
 3  talk about, it wouldn't necessarily be work, it
 4  would be the lawsuits about work that I recall.
 5  But during the time he was still working, a lot
 6  of sessions he would talk about anger about work.
 7            Q.      So the answer to my question is
 8  yes?
 9            A.      No.  Most -- as I recall, your
10  question, and I'm not really sure, I think you
11  said the most common thing he talked about was
12  work.  The most common thing we talked about was
13  medication.  During the time he worked, that was
14  the second most common thing that we probably
15  talked about was work.
16            Q.      During the coroner's inquest,
17  you stated that most of the sessions seemed to
18  center on his anger at work situations, are you
19  changing that testimony now?
20            A.      No.  As I said the most common
21  thing we talked about was medication, although
22  that doesn't always entail a whole lot of a
23  session.  So during the time that he was working,
24  most of the sessions would center on work

                                                 Page 75

 1  situations, but he didn't talk about it at every
 2  situation.  We would talk about medication at
 3  every -- so if you want to prioritize, medication
 4  was at every session, work was certainly at most
 5  of the sessions, particularly while he was
 6  working, and they would tend to center around
 7  work and his anger and what he thought they were
 8  doing to him, those kinds of things.
 9            Q.      Mister Wesbecker was a fairly
10  paranoid individual, wasn't he?
11            A.      I think I testified earlier he
12  was somewhat suspicious, which has a paranoid
13  flavor to it, you know.  Paranoia can mean a lot
14  of things to a lot of different people.  He had a
15  suspicious quality to him.
16            Q.      Was he suffering from paranoia
17  when you treated him?
18            A.      Well, paranoia as a diagnosis?
19            Q.      Yes.
20            A.      No, that was not the diagnosis
21  that I carried with him.
22            Q.      I believe you testified last
23  time that at least at some point in your
24  treatment of Mister Wesbecker, you believed he

                                                 Page 76

 1  was delusional because he had thought that you
 2  had hypnotized him during a session, is that
 3  true?
 4            A.      I don't think I said I felt
 5  like he was delusional, I said that was more of a
 6  paranoid -- that I definitely knew from fact that
 7  had not happened so it was more of a paranoid
 8  thought content.  Whether that would meet, you
 9  know, exactly a delusion, those things once I
10  reassured him, he seemed to be reassured about.
11  Delusions you don't usually reassure somebody
12  about.
13            Q.      Other treaters that dealt with
14  Mister Wesbecker prior to you starting treating
15  him believed that he was suffering from paranoia,
16  didn't they?
17            A.      I don't think anybody used that
18  diagnosis.
19            Q.      Other treaters said -- thought
20  that there were paranoid elements to his illness,
21  didn't they?
22            A.      That's what I said too, some of
23  his thought patterns were somewhat paranoid.
24  There is a difference between paranoia and

                                                 Page 77

 1  paranoid thoughts.
 2            Q.      What's the difference?
 3            A.      Paranoia is a specific
 4  diagnosis which is now called delusional disorder
 5  where the primary feature is paranoid delusions.
 6  Outside of other aspects of the mental illness,
 7  you can't have a mood component to meet that
 8  diagnosis.  His primary problem was a mood
 9  problem so he doesn't meet the criteria of
10  paranoia because his primary problem was not
11  paranoid delusions with nothing else, his primary
12  problem was a mood problem.
13            Q.      If in fact nobody at Standard
14  Gravure was forcing him to work on the folder or
15  making fun of his mental illness or treating him
16  in any of the ways that Mister Wesbecker had
17  reported to you, would his reports of those
18  events be paranoid delusions?
19            A.      I guess if none of that had any
20  factual basis to it, it could have been a
21  paranoid delusion.
22            Q.      Earlier I believe you testified
23  that you didn't believe his report of the alleged
24  sexual abuse held some sort of symbolic message.

                                                 Page 78

 1  He had felt throughout the time that you treated
 2  him that he was basically being jerked around at
 3  work or screwed at work or things of that nature,
 4  that has no sort of translation to you in what he
 5  reported to you about the alleged sexual abuse?
 6            MR. BUBALO:  I'm sorry, I didn't
 7  understand the question.  Would you read it back?
 8             (THE COURT REPORTER READ BACK THE
 9              REQUESTED TESTIMONY.)
10            MR. BUBALO:  I object to the form of
11  the question.
12            THE WITNESS:  Do you want me to answer
13  it?
14            MR. BUBALO:  Sure.
15            A.      One, I don't recall him ever
16  using the expression that they're screwing me at
17  work, I know he said they're jerking me around, I
18  never considered that to be any -- symbolic of
19  anything to do with work.
20            Q.      Do you consider it a
21  communication of his manifestation of his anger
22  towards his work situation?
23            A.      I'm not real clear on your
24  question.  If you're saying that that report is

                                                 Page 79

 1  somewhat symbolic of his anger towards work, I
 2  never felt that way.  I'm not really sure what it
 3  represented at the time, I think as I testified
 4  before, I wasn't really sure.  If I had to lean
 5  one way or the other, my guess is at the time I
 6  thought it was probably factual but I wasn't
 7  really sure.
 8            Q.      Did -- how did Mister Wesbecker
 9  pay you, did he pay you through insurance or did
10  he pay you on his own?
11            A.      Well, I don't always handle the
12  finances, but as I recall, he would pay by check
13  every time he came in and handled the insurance
14  on his own.
15            Q.      To your knowledge, did he have
16  insurance through work?
17            A.      As far as I know, he did.
18            Q.      Did you ever have a problem
19  with obtaining information from Standard Gravure
20  or dealing with them in any way with regards to
21  Mister Wesbecker?
22            A.      I don't recall ever dealing
23  with them on Mister Wesbecker.
24            Q.      Did you ever ask them for any

                                                 Page 80

 1  of his employment records or any of his records
 2  through his counselor at work?
 3            A.      I never asked for any of his
 4  employment records.  As you know from the
 5  previous deposition, I had him sign a release for
 6  Pat Lampton but at some point he asked me not to
 7  get information from Pat Lampton because he
 8  didn't trust him so I didn't have any records of
 9  any of his counseling at work.
10            Q.      Did you feel it was important
11  to see Mister Wesbecker's counseling records from
12  Standard Gravure?
13            A.      I didn't feel like it was
14  particularly important.
15            Q.      Why not?
16            A.      Well, I had information from at
17  least three previous treating psychiatrists and
18  two previous psychological examinations, I didn't
19  feel like -- plus I had my own evaluation of him,
20  I didn't really feel like that I needed the
21  additional information from Mr. Lampton.
22            Q.      Was Mr. Lampton a psychiatrist
23  to your knowledge?
24            A.      I don't think he was a

                                                 Page 81

 1  psychiatrist.
 2            Q.      Do you know if he's a
 3  psychologist or --
 4            A.      I don't know, if I had to
 5  guess, I would guess he's a licensed clinical
 6  social worker but I'm not even sure of that.
 7            Q.      Would you agree that
 8  information that Mr. Lampton had, being that he
 9  was working treating or at least consulting with
10  Mister Wesbecker at the actual place of Mister
11  Wesbecker's greatest stress, would have at least
12  been interesting information to have with regards
13  to his treatment?
14            A.      It may have been interesting,
15  as I said, I didn't feel like it was at that time
16  necessary for me to have that, I had quite a bit
17  of information from other health care providers
18  that he had been under.
19            Q.      Was it significant to you in
20  any way that Mister Wesbecker did not want you to
21  see his records from Standard Gravure or that he
22  didn't trust Mr. Lampton?
23            A.      Well, that was a manifestation
24  in my mind of the mistrust that he had at work,

                                                 Page 82

 1  he felt like Mr. Lampton had broken confidence
 2  and talked to the management about him, I don't
 3  know whether that was factual or not, I certainly
 4  wasn't going to push him to do that and mistrust
 5  me because I had significant information from
 6  other health care providers.
 7            Q.      Did you ever involuntarily
 8  hospitalize any of your patients?
 9            A.      Have I?
10            Q.      Yes.
11            A.      Yes, I have.
12            Q.      On how many occasions, without
13  being specific to patients?
14            A.      Well, it can encompass two
15  ways, I can have somebody in the hospital who
16  wants to leave that I will keep them
17  involuntarily or I can have someone as an
18  outpatient that I want to hospitalize
19  involuntarily.  Do you want me to separate those
20  two?
21            Q.      I'm just interested in the
22  outpatients that you want to hospitalize
23  involuntarily.
24            A.      Well, I know of at least one

                                                 Page 83

 1  occasion I went down and took out a mental
 2  inquest warrant myself on a patient.  That's the
 3  only specific time that I can recall taking out a
 4  warrant on an outpatient.
 5            Q.      How do you go about doing that?
 6            A.      Went down to the mental inquest
 7  warrant office and swore out a mental inquest
 8  warrant.
 9            Q.      Did you have to go before a
10  judge to do that?
11            A.      No.
12            Q.      Who do you talk to if you want
13  to do that?
14            A.      The clerk in the mental inquest
15  office, she then has to get a judge to sign it.
16            Q.      Does the judge question you
17  about --
18            A.      No.
19            Q.      It is purely what is written on
20  the form that he relies on?
21            A.      Correct.
22            Q.      Without telling me who the
23  patient was, can you generally give me an idea of
24  what it was about this patient's condition that

                                                 Page 84

 1  made you want to hospitalize him?
 2            A.      This patient was --
 3            MR. BUBALO:  I don't think I'm going to
 4  let him answer that.
 5            Q.      Was the person suicidal?
 6            MR. BUBALO:  No, don't answer the
 7  question.
 8            MS. ZETTLER:  Based on what?
 9            MR. BUBALO:  Psychiatrist's privilege.
10  I think communication, specific factual
11  information and petitions of unnamed patients
12  might be covered and for that reason I'm going to
13  be on the safe side and instruct him not to
14  answer.
15            MS. ZETTLER:  Well, I'm not asking for
16  specifics, I'm asking generally.
17            MR. BUBALO:  I think you're getting
18  into specifics when you ask why did you
19  hospitalize this patient, that's specific.
20            MS. ZETTLER:  I'm not asking for
21  specifics, he has testified earlier that there's
22  certain criteria that has to be met for you to be
23  able to involuntarily hospitalize a patient, he's
24  testifying now that he has done that in the past

                                                 Page 85

 1  and I think we have a right to explore what his
 2  personal criteria are.
 3            MR. BUBALO:  Wait a minute, it's not
 4  his personal criteria, you can ask him generally
 5  what the criteria is for swearing a mental
 6  inquest warrant.
 7            MS. ZETTLER:  Then you're going to
 8  object that he's not a lawyer.
 9            MR. BUBALO:  No, you know, that's a
10  legitimate question.  I don't want him to talk
11  about specific patients, that's my objection.
12            Q.      On how many occasions have you
13  involuntarily committed a patient?
14            A.      Since I've been in private
15  practice, one.  Now when I was in my residency,
16  probably fifteen or twenty when I was on
17  emergency psychiatry.
18            Q.      Were you -- where did you do
19  your residency?
20            A.      Here at the University of
21  Louisville.
22            Q.      Were the criteria the same when
23  you were doing your residency as they were today?
24            A.      They may have changed the

                                                 Page 86

 1  wording but basically the criteria are the same
 2  to my understanding.
 3            Q.      And the criteria to your
 4  knowledge is a person has to be a threat to
 5  himself or others, correct?
 6            A.      Well, there are several
 7  criteria, there's not just one criteria.  One is
 8  that the patient is either mentally retarded or
 9  mentally ill, two that the patient presents a
10  danger.  Basically the warrant as I recall says
11  what facts support your contention that the
12  patient represents a danger to himself or others.
13  There's also a third criteria that the patient is
14  likely to benefit from hospitalization.  So you
15  have to meet all those three criteria.
16            Q.      Did you have to -- the time
17  that you did seek to hospitalize a patient when
18  you were in private practice, did you have to
19  supplement your written mental inquest warrant
20  with any specific documentation like hospital
21  records or notes or things of that nature about
22  that patient?
23            A.      I don't know if I had to, I had
24  a letter.

                                                 Page 87

 1            Q.      A letter that you had written?
 2            A.      No.
 3            Q.      A letter from another doctor?
 4            A.      A letter that the patient had
 5  written.
 6            Q.      Okay.  Was that a letter to
 7  you?
 8            MR. BUBALO:  Don't answer that, we're
 9  getting into specifics again.
10            Q.      Are you going to follow your
11  attorney's instructions and not answer my
12  question?
13            A.      Definitely.
14            MS. ZETTLER:  Certify it.
15                (QUESTION CERTIFIED)
16            Q.      Earlier you testified that
17  instead of insisting or trying to force Mister
18  Wesbecker to come back sooner than two weeks, you
19  chose to allow him to come back in a couple of
20  weeks given the plan you had set out that if he
21  suffered any relapse or felt he was getting worse
22  he would call you, right?
23            A.      Correct.  I said I was
24  comfortable with the appointment being in two

                                                 Page 88

 1  weeks with the understanding that he would call
 2  if there were any problems.
 3            Q.      And you said that you didn't
 4  want to risk ruining your relationship with
 5  Mister Wesbecker by talking to his wife over the
 6  phone as opposed to in person when Mister
 7  Wesbecker was present, correct?
 8            A.      I don't think I said risk
 9  ruining my relationship, as I recall what I said
10  was that I didn't want to enhance his
11  suspiciousness which could certainly have
12  aggravated him or to make him suspicious which
13  one component of which would be certainly
14  deterioration in the relationship but also would
15  make him suspicious.
16            Q.      What would be detrimental about
17  him become being suspicious?
18            A.      I'm sorry, I didn't hear the
19  first part.
20            Q.      What would be detrimental about
21  him becoming suspicious?
22            A.      Well, as I said, he always was
23  a bit suspicious, at times would have paranoid
24  thoughts and certainly on this last session he

                                                 Page 89

 1  was fairly agitated.  If he became more
 2  suspicious, he certainly could have become more
 3  agitated.
 4            Q.      What could have happened as a
 5  result of that agitation that concerned you?
 6            A.      Well, I don't know that I
 7  thought about specifically what might happen, one
 8  is that he would become suspicious either of me
 9  or possibly his wife, I don't know what would
10  happen with that, other than you know, damaging
11  those relationships.
12            Q.      Does there come a point where
13  you have to take the risk of damaging your
14  relationship with a patient to benefit the
15  patient?
16            A.      Well, I guess there are
17  instances where you have to do that such as when
18  you do have to involuntary hospitalize, more than
19  likely you're not going to see that person as a
20  patient anymore because you're putting them in
21  against their will.  So there is a point when
22  you, you know, if there certainly is some
23  indication of dangerousness it's probably
24  appropriate to take that action.

                                                 Page 90

 1            Q.      Did you feel that the risk of
 2  causing Mister Wesbecker to become more
 3  suspicious and possibly ruining the relationship
 4  that either you had with him or his ex-wife or
 5  wife had with him outweighed Mister Wesbecker's
 6  need for help?
 7            A.      Well, I felt I was helping him,
 8  I didn't feel like I was making a difference
 9  between those choices.
10            Q.      What did you do that was
11  helping him?
12            A.      I was continuing to treat him.
13            Q.      In what way?
14            A.      I instructed him to stop his
15  medication and to continue treatment with me by
16  coming back in two weeks or to call me in the
17  meantime if there were any problems.  I didn't
18  feel like I was sacrificing his help.  It might
19  not be my ideal, my ideal was to hospitalize him
20  but I still felt like I was helping him, I didn't
21  feel like it was worth risking him to be more
22  suspicious at that time.
23            Q.      What would the ramifications of
24  damaging the relationship between Mister

                                                 Page 91

 1  Wesbecker and his wife have been?
 2            A.      I have no idea.
 3            Q.      He had already acquiesced to
 4  you talking with her about the deterioration in
 5  his condition, right?
 6            A.      He had agreed that she would
 7  come in with him, that's correct.
 8            Q.      And even though he agreed, you
 9  felt that it was too much of a risk to ask him if
10  you could call her on the phone, correct?
11            A.      I think as I testified before,
12  I didn't feel like there was an immediate need
13  for information from his wife and that my
14  preference would be particularly with Mister
15  Wesbecker that any talking about anybody outside
16  of him was with him present, and so that's the
17  course of action I chose to take.
18            Q.      How suspicious of a man was
19  Mister Wesbecker?
20            A.      I don't know how you put
21  degrees on that.  There was one occasion where he
22  asked if I had hypnotized him, another occasion
23  where he asked if I taped him in a session.  So I
24  would say he was fairly suspicious.

                                                 Page 92

 1            Q.      And his level of suspiciousness
 2  was great enough that you thought that asking him
 3  if you could call his wife would heighten that
 4  suspicion, correct?
 5            A.      Yes, I would think it would
 6  have heightened his suspicion.
 7            Q.      Did you talk to anybody in
 8  preparation for your testimony at the coroner's
 9  inquest?
10            A.      Other than my attorney?
11            Q.      You can tell me, I won't ask
12  you what your attorney talked to you about but
13  you can tell me if you talked with your attorney.
14            A.      I talked with my attorney.
15            Q.      Did you talk with anybody else
16  in preparation for your testimony at the
17  coroner's inquest?
18            A.      I don't recall talking to
19  anybody else.
20            Q.      How soon after the shootings at
21  Standard Gravure did you hire an attorney to
22  represent you with regards to Mister Wesbecker?
23            A.      I didn't hire the attorney.
24            Q.      Who hired the attorney?

                                                 Page 93

 1            A.      My malpractice carrier.
 2            Q.      Did you call your carrier and
 3  inform him that you were the psychiatrist that
 4  was treating Mister Wesbecker?
 5            MR. BUBALO:  Don't answer that
 6  question.
 7            MS. ZETTLER:  Certify it.
 8            (QUESTION CERTIFIED.)
 9            Q.      Coroners -- how long after the
10  shootings at Standard Gravure did the coroner's
11  inquest take place?
12            A.      As I recall, the coroner's
13  inquest was in November, the day before
14  Thanksgiving, whatever day that was, so it would
15  have been two months plus.
16            Q.      Okay.  Did anybody from Eli
17  Lilly ever contact you with regards to Mister
18  Wesbecker after the shooting?
19            A.      Did anybody from Eli Lilly ever
20  contact me about Mister Wesbecker after the
21  shootings?  No.
22            Q.      Do you know what a Form 1639
23  is?
24            A.      No.

                                                 Page 94

 1            Q.      Did you ever make a report to
 2  either the FDA or Eli Lilly about your suspicions
 3  that Mister Wesbecker was suffering from an
 4  adverse reaction to Prozac on September 11, 1989?
 5            A.      No.
 6            Q.      Why not?
 7            A.      Well, one, I don't know what a
 8  Form 1639 or whatever it is, the side effects I
 9  was seeing seemed to already be encompassed in
10  what was talked about in the package insert,
11  sleep trouble, agitation, nervousness, as I
12  recall they were already in there.  What my
13  understanding of an adverse reaction is is
14  something that's unexpected.
15            Q.      Have you ever reported an
16  adverse reaction to a drug company in your years
17  of practice?
18            A.      I have never -- to a company or
19  to the FDA?
20            Q.      Start with a company, a drug
21  company.
22            A.      I've asked the drug company
23  about specific questions I might have about a
24  medication, that's not a report so I've never

                                                 Page 95

 1  made a report to a drug company.
 2            Q.      Have you ever reported an
 3  adverse reaction to a drug to the FDA?
 4            A.      No.
 5            Q.      Has there ever been an adverse
 6  reaction that you have observed in one of your
 7  patients that was not listed in the package
 8  insert?
 9            A.      Probably, but I don't recall
10  specifics.
11            Q.      You've testified earlier that
12  you have prescribed Prozac to other patients,
13  correct?
14            A.      Correct.
15            Q.      And in some of those other
16  patients you have observed side effects or
17  adverse reactions similar to those suffered by
18  Mister Wesbecker on September 11, 1989, correct?
19            A.      Well, I think as I testified
20  that I had seen other people with sleep problems
21  and with nervousness which Mister Wesbecker was
22  complaining about.  I would not say I saw exactly
23  the same constellation of symptoms that he had,
24  but those particular side effects, nervousness

                                                 Page 96

 1  and sleep trouble I certainly had seen.
 2            Q.      Have you ever taken any of your
 3  other patients off of Prozac because of their
 4  reaction to the drug?
 5            A.      Yes.
 6            Q.      On how many occasions?
 7            A.      It would just be a guess.
 8  Numberwise?
 9            Q.      Yes, if you can give me an
10  idea.
11            A.      Eight or ten.
12            Q.      Can you tell me generally
13  without being specific to a patient what it was
14  about the reactions that you felt that made you
15  feel it was necessary to take them off the drug?
16            A.      The most common reason I have
17  had to discontinue Prozac seems to be the
18  nervousness, some people it seems to make them
19  extremely nervous and they'll usually call me and
20  say I can't stand this medication, it's making me
21  very nervous.  That's probably ninety percent of
22  the people who I end up having to switch to
23  something else.  I have a few other occasions,
24  one patient I recall felt very tired on it

                                                 Page 97

 1  although we continued it for a period of time,
 2  that was the reason we stopped on that one.  I
 3  can't think of any other at this time.
 4            Q.      Okay.  Approximately how many
 5  patients have you prescribed Prozac for?
 6            A.      Total?
 7            Q.      Yes.
 8            A.      It would be a rough guess.
 9            Q.      Just give me your best
10  estimate.
11            A.      Fifty, a hundred, somewhere in
12  that range.
13            Q.      Somewhere between fifty and a
14  hundred?
15            A.      Probably.
16            Q.      Did anybody from Eli Lilly ever
17  contact you and ask you specifics about Mister
18  Wesbecker's actions on the 14th, September 14,
19  1989?
20            A.      No.
21            Q.      Have you ever talked to any
22  other, other than the detail people at Lilly,
23  have you talked to anybody at Eli Lilly?
24            A.      On occasion I have had casual

                                                 Page 98

 1  conversations in the last deposition with Mister
 2  Stopher, but that was him introducing himself.
 3  But other than that, I have not talked to anybody
 4  at Eli Lilly.
 5            Q.      Have you ever talked to any of
 6  the research physicians at Lilly?
 7            A.      No.
 8            Q.      Other than Mister Wesbecker's
 9  condition, have you ever talked to a research
10  physician at Lilly?
11            A.      No.
12            Q.      The detail people that have
13  visited you and spoke to you about Prozac, did
14  any of them ever ask you about your experiences
15  with Prozac and adverse reactions with any of
16  your patients?
17            A.      I would say as a general rule
18  that would be a question they would ask.
19            Q.      When did they start asking you
20  that type of question?
21            A.      When?
22            Q.      Yes.
23            A.      I don't have any sense that
24  they didn't and they did, my sense would be that

                                                 Page 99

 1  all along while you were using it, they would ask
 2  how -- a general question, you know, how have you
 3  found Prozac, have you had any problems with it.
 4  As you know from the last deposition, there were
 5  a couple of times I would say I've got a specific
 6  question can you relay to them and I would get
 7  something back on it.
 8            Q.      Did you ever receive a letter
 9  from Eli Lilly eliciting information on any
10  adverse reactions or adverse experiences any of
11  your patients would have had or might have had on
12  Prozac?
13            A.      I don't recall a letter
14  eliciting information on adverse reactions, no.
15            Q.      The last time you testified
16  that one of the detail people that you dealt with
17  from Lilly with regards to Prozac would ask you
18  occasionally about or talk to you occasionally
19  about the Wesbecker case, this lawsuit, do you
20  remember specifically what you would discuss with
21  that person?
22            A.      Well, I know she would
23  generally ask, you know, how's it going and I
24  don't recall really other than saying they're

                                                 Page 100

 1  doing a lot of depositions or really saying too
 2  much about it.  Of course she would ask are you
 3  still using Prozac and I would say yes and as I
 4  recall, occasionally she would mention other
 5  lawsuits that might be in progress and of course
 6  she would say that she felt there was no basis
 7  for them.  As I recall there was one here in this
 8  community and other ones.  We talked about the
 9  Church of Scientology, she would make comments
10  about that.
11            Q.      What types of things would she
12  say about the Church of Scientology?
13            A.      Well, I don't think she said
14  anything that I wasn't always aware of by
15  looking, you know, reading the media, about the
16  Citizens Commission on Human Rights' stand on
17  Prozac.
18            Q.      Anything else about the
19  Citizens Commission on Human Rights?
20            A.      I don't recall any other
21  specifics.  I know there was an article that came
22  out sometime about -- in the paper about Prozac
23  and the Church of Scientology, the connection
24  there, but I don't really recall whether the

                                                 Page 101

 1  detail person mentioned that, she may have.
 2            Q.      Did she say anything
 3  specifically about any of the other lawsuits?
 4            A.      Specifically?
 5            Q.      Uh-huh.
 6            A.      I don't remember particularly
 7  specifics, I knew a little bit about the one here
 8  in Louisville from reading the papers.
 9            A.      She might have mentioned some
10  specifics about it but I don't recall what the
11  specifics were, nothing that sticks in my memory.
12            Q.      Did you ever ask her about
13  clinical trials or clinical trials that were done
14  on Prozac and evidence of suicidal ideation and
15  hostility?
16            A.      I don't recall asking.  I know
17  there was a -- I guess the article from Teicher
18  in the American Journal of Psychiatry had come
19  out which had prompted some of the debate about
20  Prozac and there was a follow up study that she
21  may have mentioned or given me a copy that seemed
22  to come to the conclusion that that wasn't
23  actually, at least from this report, but I can't
24  remember that specific article.

                                                 Page 102

 1            Q.      Do you remember if it was a
 2  study that was done by Eli Lilly or somebody
 3  independent of Eli Lilly?
 4            A.      My recollection was it was not
 5  a study done by Eli Lilly but I'm not for
 6  certain.
 7            Q.      Do you remember, was it a
 8  perspective study or was it a reanalysis of data
 9  that had already been collected?
10            A.      From what I remember, it was a
11  study on -- it may have been a multicenter study
12  and I got the impression it had no connection
13  with Eli Lilly, where they had looked at Prozac
14  plus other antidepressants and could not
15  determine that suicidality was necessarily, you
16  know, seen more often with Prozac than any other
17  antidepressant but I can't remember the specific
18  article.
19             (PLAINTIFFS' EXHIBITS NOS.  2 and
20              3 WERE MARKED FOR IDENTIFICATION
21              AND RECEIVED IN EVIDENCE.)
22            Q.      Take a look at that, Doctor.
23            A.      Both of these are -- that one
24  looks -- is this one that I had supplied to you

                                                 Page 103

 1  all?
 2            Q.      Yes, both of those were
 3  produced by your attorney in response to our
 4  request for documents.
 5            A.      These were ones that, if both
 6  of these came from me, that I had in my office.
 7  Now I have not read them since then so at some
 8  point in the past, probably when I got them, I
 9  may have looked at them but, you know, I tried to
10  find everything that I had that had been supplied
11  to me.  So if these came from me they were ones
12  that were probably given to me by a detail
13  person.
14            Q.      From looking at them quickly,
15  do you remember if either one of those is the
16  study that you talked about, the multicenter
17  study that tended to disprove Teicher's claims
18  that Prozac caused increased suicidality?
19            A.      Without reading the specific
20  articles, I mean this summary seems to be a
21  general sense of what I remember when they
22  compared, like it says they compared tricyclic
23  anti-depressants, so it may have been this one,
24  this one I don't particularly recognize.

                                                 Page 104

 1            MR. BUBALO:  Referring to Exhibit 2.
 2            Q.      Right.
 3            A.      Yes, it would be Exhibit 2.
 4  Seems to me at some point in time, I thought I
 5  had the complete article but if that wasn't with
 6  what I gave you, I may not have kept it.  This is
 7  just a summary but this seems to kind of be the
 8  sense of what she may have presented but I can't
 9  recall exactly.
10            Q.      What was it about the article
11  or the detail person's presentation that made you
12  think the article was not written by somebody
13  connected with Lilly?
14            A.      Well, I don't recall her saying
15  that this is a study funded by us or by Eli
16  Lilly.  I mean I don't know her exact words but
17  my sense was it was a multicenter study and maybe
18  it was my incorrect assumption that that was
19  somehow not connected with Eli Lilly, but I think
20  I would have remembered if she said this was
21  funded by us.  So I don't recall her ever saying
22  that in relation to this article.
23            Q.      Did she ever give you any
24  articles that, or any information that she

                                                 Page 105

 1  admitted was funded by Lilly?
 2            A.      I don't recall ever a detail
 3  person ever saying any of the articles or studies
 4  were funded by Eli Lilly.
 5            Q.      To your knowledge, have other
 6  people besides Doctor Teicher published articles
 7  that at least they believe tended to show that
 8  people became suicidal while on Prozac?
 9            A.      I don't know other specific
10  ones other than that, I don't know if there were
11  any -- the information I gave you is that I
12  didn't review those.
13            Q.      Have you ever rechallenged any
14  of your patients that were on Prozac and had an
15  adverse reaction to it?
16            A.      I'm sorry.
17            Q.      Have you ever rechallenged --
18  do you know what rechallenging is?
19            A.      I'm not sure what you mean by
20  it.
21            Q.      What I mean by it is that
22  somebody you had on Prozac has what you suspect
23  to be an adverse reaction to the drug and you
24  take them off the drug and the reaction goes

                                                 Page 106

 1  away, you put them back on the drug to see if the
 2  reaction reoccurs.  Have you ever done that with
 3  any of your patients who have had a --
 4            A.      You mean right after you take
 5  them off it or at some point down the line?  I've
 6  never had a specific intentional rechallenge to
 7  see, well, I want to see if you have this
 8  reaction on the second dose, I can't recall ever
 9  doing that purposely.
10            Q.      In effect you did that with
11  Mister Wesbecker though, didn't you?
12            A.      It wasn't a rechallenge, I
13  didn't say okay, I want to see if you get sedated
14  again on this medication to see if that was the
15  reaction.  I did initiate another trial of Prozac
16  but it wasn't an intent to determine whether a
17  previous reaction had been caused and that was my
18  understanding of what you meant by rechallenge.
19  I have had occasion to take people off Prozac for
20  certain reasons and later on try them again on
21  it.
22            Q.      What was the reason that you
23  took them off the Prozac initially before
24  retrying it?

                                                 Page 107

 1            A.      You mean the first time it was
 2  used?
 3            Q.      Right.
 4            A.      Well, as you recall from the
 5  previous testimony, he took himself off it
 6  because he said it made him feel tired.
 7            Q.      I think maybe I misstated my
 8  question.  I think you just testified earlier
 9  that you have had occasion where you have taken
10  somebody off of Prozac and then put them back on,
11  taken them off for some reason and then put them
12  back on later on?
13            A.      But you are not talking about
14  Mister Wesbecker?
15            Q.      Not Mister Wesbecker, other
16  occasions, has that happened?
17            A.      Yes.
18            Q.      What were generally the reasons
19  that you would take these people off Prozac
20  initially?
21            A.      Well, I'm going to have to be
22  general because I'm trying to remember specific
23  patients that that might have happened to.  I
24  recall, but again we're getting into specific

                                                 Page 108

 1  patients, but one was some degree of nervousness
 2  and it -- even though the patient felt like it
 3  was somewhat effective had become a bit nervous
 4  on it and so we had tried a couple of other
 5  medications that she felt even worse on so we
 6  decided to go back and try the Prozac and that
 7  was one occasion.  Then that, and I've had other
 8  occasions where we didn't think the Prozac was
 9  working, I would try other things but felt like
10  well, hey, maybe it worked better than we thought
11  it did and went back to it.
12            Q.      Have you ever had a situation
13  where you had somebody on Prozac, took them off
14  because of nervousness, put them back on Prozac
15  and had to take them off again?
16            A.      Most of them won't go back on
17  it if I've had to take them off because of
18  nervousness.
19            Q.      Why not?
20            A.      Because they were so
21  uncomfortable on it, they don't want to try it
22  again.
23            Q.      Have you ever had a situation
24  where somebody would go back on it and became

                                                 Page 109

 1  nervous again?
 2            A.      I can't recall a single person
 3  that, one, I would even recommended it, or two,
 4  was willing to consider going back on Prozac
 5  after they got nervous enough to be taken off of
 6  it.
 7            Q.      Did you ever describe any of
 8  the nervousness suffered by your other patients
 9  on Prozac as akathisia?
10            A.      I've never thought I'd seen
11  akathisia with Prozac.
12            Q.      Have you seen cases of
13  akathisia?
14            A.      Yes.
15            Q.      On how many occasions?
16            A.      Over the course of my training,
17  I would say quite a few but mostly with the
18  neuroleptic medications.
19            Q.      Do you agree with some of the
20  literature out there that akathisia could lead to
21  suicidal ideation?
22            A.      I don't agree with that.
23            Q.      Do you agree that it can lead
24  to violent aggressive behavior?

                                                 Page 110

 1            A.      I don't agree with that.
 2            Q.      What are the consequences of
 3  akathisia?
 4            A.      The consequences?
 5            Q.      Sure, what can happen to a
 6  person if they begin suffering akathisia?
 7            A.      Well, it's -- there are varying
 8  degrees of akathisia.  I mean, I've seen some
 9  people -- I know I had one patient that was very
10  severe with it.  I guess people could feel so
11  frustrated with that condition they -- I don't
12  think it leads them to commit suicide but it can
13  sometimes aggravate their condition that they
14  might think death was better than feeling that
15  way.  There's usually things you can do to
16  alleviate akathisia, I've never seen any
17  particular consequence of it other than the
18  patient being extremely uncomfortable.
19            Q.      When you've seen that, what
20  have you done in response?
21            A.      Well, there -- if it's due to a
22  neuroleptic, you can stop the neuroleptic or you
23  can add another medication that would tend to
24  alleviate the akathisia and that one of those

                                                 Page 111

 1  usually alleviates the symptoms.
 2            Q.      Have you done any research on
 3  akathisia?
 4            A.      Any specific research?  No.
 5            Q.      Are you aware that many times
 6  the nervousness -- or akathisia can be mistaken
 7  for nervousness?
 8            A.      To me they look a lot
 9  different.  I would have difficulty -- I think if
10  a psychiatrist would ask the right questions it's
11  very easy to differentiate akathisia and
12  nervousness.  Now a lay person or someone not
13  trained in that might have more difficulty with
14  it.
15            Q.      What's the difference between
16  akathisia and nervousness?
17            A.      Well, akathisia is inner
18  restlessness and the people that I've had will
19  really describe it as that that they have a sense
20  that they have to get up and move around, they
21  can't sit still.  People who are extremely
22  nervous can still sit still but they will be
23  nervous when they're sitting still but they won't
24  have that feeling of having to get up and move

                                                 Page 112

 1  which is typical of akathisia, and they'll get up
 2  and move a lot of times, not always, but even if
 3  they don't, they'll say I feel like I've got the
 4  sense I have to get up and move around.  So if
 5  you ask the right questions, to me you can
 6  differentiate the two.
 7            Q.      Have you ever treated a patient
 8  with akathisa that hasn't voiced the feeling they
 9  have to move but had the inability to sit still?
10            A.      Well, I've had some that --
11  well, I'm not -- repeat the question to me.
12            Q.      Have you ever treated a patient
13  who you have determined was suffering from
14  akathisia who hasn't said to you, Doctor, I have
15  this feeling like I just can't sit or I have this
16  inner restlessness but can't sit still, always
17  has to constantly move?
18            A.      It won't always be their report
19  of that.  When I'm trying to figure out what it
20  is that's causing this condition, I will ask
21  several questions, you know, like do you feel
22  like you have to get up and move around or do you
23  just feel like you have to move your hands, or
24  describe it a little more in detail to me.  And I

                                                 Page 113

 1  would say in almost most cases if it's akathisia,
 2  they will give you some indication it's a sense
 3  of restlessnes and wanting to move around rather
 4  than being nervous.
 5            Q.      What's a toxic environment?
 6  You testified about that last time and I didn't
 7  quite understand it.
 8            A.      Well, I think I used that term
 9  as one of the criteria for hospitalization, if
10  someone's environment is toxic to their
11  condition, and I don't mean in a physical sense
12  but someone's in an abusive relationship, let's
13  say with a husband or parent, to me that would
14  constitute a toxic environment.  In other words,
15  their being in a situation that they're being in
16  continues to aggravate their emotional condition.
17            Q.      Would Mister Wesbecker's place
18  of employment when he was still working there
19  have been considered a toxic environment?
20            A.      Well, he considered it a toxic
21  environment both physically and emotionally.  Of
22  course, there's different degreees -- I mean, he
23  felt like he could manage it for a while, but
24  ultimately we had to put him on disability in my

                                                 Page 114

 1  mind to get him away from that environment which
 2  was -- it wasn't the cause of his condition but I
 3  think it was aggravating it.
 4            Q.      Is a toxic environment
 5  something that the patient necessarily recognizes
 6  on his or her own?
 7            A.      I would say most of them would
 8  recognize it, they would know that a particular
 9  situation is but not in a hundred percent of
10  cases but most people do recognize if a situation
11  is causing them distress.
12            Q.      Is there any period of time
13  where Mister Wesbecker's home would have been
14  considered a toxic environment?
15            A.      Not from any knowledge that I
16  had.  He had a couple of arguments with his son,
17  but as I recall they weren't living with him at
18  the time so I wouldn't consider his home
19  situation from anything he talked about or
20  relayed to me to be a toxic environment at all.
21            Q.      Does a toxic environment have
22  to be some actual place or can it be a
23  relationship like you said that he had some
24  arguments with his son, could that relationship

                                                 Page 115

 1  have been a toxic environment?
 2            A.      Well, I guess it depends on how
 3  much -- it can be a relationship but to me it
 4  would depend on how often they're exposed to that
 5  relationship.  If they see somebody once a week,
 6  to me that's not a toxic environment.  If they
 7  see somebody or have to be with somebody every
 8  day, then that can be a toxic environment in my
 9  mind.
10            Q.      At one point Mister Wesbecker
11  reported to you some hallucinations of sorts
12  seeing the floors and ceilings moving, I believe,
13  after an argument with his son, is that correct?
14            A.      Well, they weren't
15  hallucinations, I said they were illusions is
16  what I termed them.
17            Q.      Do you think that those
18  illusions were triggered by the argument with his
19  son?
20            A.      I didn't think they were.  He
21  had attributed it to the increase and then as I
22  recall, he said they had gotten worse from the
23  argument.  I didn't really attribute it to that
24  although I think as I testified earlier, I could

                                                 Page 116

 1  probably make a case where an argument might make
 2  someone more anxious which could possibly make
 3  that worse.  But as I recall from what I thought
 4  about it, I didn't think it was necessarily the
 5  argument that increased his illusions.
 6            Q.      Did you explore that, his
 7  report of illusions with him?
 8            A.      Well, I would ask him what they
 9  were and usually it was the floor and ceiling
10  moving.
11            Q.      Was that something --
12            A.      Probably the only one that I
13  remember.
14            Q.      Okay.  Was that something that
15  he reported prior to having that argument with
16  his son or reported having the argument with his
17  son?
18            A.      I would have to look at my
19  notes, I know there's an initial time I mentioned
20  in my notes.  I don't know if it was on that,
21  that he had reported an increase which means he
22  probably talked about it before and I had not
23  noted it.  Without having the note in front of
24  me, I don't know if that was -- do you want me to

                                                 Page 117

 1  refer to that?
 2            Q.      Sure.  Let me see if I can find
 3  it.
 4            A.      I've got a copy of my notes
 5  here.  If you know a date --
 6            Q.      No, I don't frankly, I remember
 7  it more from the last deposition.
 8            A.      It seems to me it was in '88
 9  sometime.
10            Q.      Try October 5th, '88.
11            A.      October 5th?
12            Q.      Right.
13            A.      Okay.  I do mention in there
14  increased delusions but that one doesn't mention
15  the argument with his son.
16            Q.      Try May 31, 1989.
17            A.      Okay.  So obviously he had
18  talked about that before May 31, 1989.
19            Q.      Okay.  Did you -- do you have
20  an independent recollection of him talking about
21  that prior to telling you about the argument with
22  his son?
23            A.      Well, I don't have a particular
24  recollection, as you know, I wrote it in my notes

                                                 Page 118

 1  earlier than that.  But I don't have a specific
 2  recollection of that date of him talking about
 3  it.
 4            Q.      Did you explore the occurrence
 5  of illusions with Mister Wesbecker other than
 6  talking to him about the argument with his son?
 7            A.      Well, in a general sense I
 8  would recall asking him what -- I would use the
 9  word illusions, not him, so he would say, you
10  know, in a general sense, I've noticed the floor
11  and ceiling moving, and as I generally recall or
12  I would ask him well, tell me a little bit about
13  it to determine whether it was a hallucination or
14  just an illusion.  It never seemed to be
15  particularly more than that or he never seemed to
16  have any indication why this would happen, it
17  didn't seem to be related to anything, any
18  particular stress or anything happening as I
19  recall which is why I felt like it was probably a
20  medication effect.  And as I said, you know, I
21  didn't really attribute any increase in it even
22  on that May 31st necessarily to his son, that's
23  just what he said.
24            Q.      Did you ever put Mister

                                                 Page 119

 1  Wesbecker through any psychiatric testing while
 2  you treated him in that two years?
 3            A.      You mean psychologic testing?
 4            Q.      Right.
 5            A.      No.
 6            Q.      Why not?
 7            A.      Well, I had two previous
 8  psychological assessments, one that had been done
 9  not too long before I had started seeing him, I
10  didn't feel there was ever a need to repeat that
11  during my treatment.
12            Q.      To your knowledge, are there
13  any psychological tests that could measure a
14  person's hostility?
15            A.      Well, I'm not a psychologist
16  and I don't know specific instruments that would
17  measure levels of hostility.
18            Q.      As a psychiatrist, are you
19  aware of any psychological testing methods?
20            A.      Well, I'm generally aware of
21  some of the tests that are used such as the MMPI,
22  the TAT, Rorschack, intelligence scales.  I mean
23  I have some knowledge of what those tests are and
24  what they can show, but I don't know a specific

                                                 Page 120

 1  instrument that measures hostility.  There may
 2  very well be one but I don't know one.
 3            Q.      If you were aware of Mister
 4  Wesbecker's history of violent aggressive
 5  ideation towards people at work that was reported
 6  in the medical records, the hospitalizations that
 7  he had, would you have asked him about any
 8  hostility or any homicidal ideation he may have
 9  had on September 11, 1989?
10            MR. BUBALO:  Would you read the
11  question?
12             (THE COURT REPORTER READ BACK THE
13              REQUESTED TESTIMONY.)
14            MR. BUBALO:  Well, I object to the form
15  of the question because it assumes the past
16  records indicate some hostile or homicidal, in
17  particular, ideations.  I don't think that's the
18  case.
19            Q.      You can answer.
20            THE WITNESS:  Do you want me to answer
21  it?
22            MR. BUBALO:  I would prefer you to show
23  him, and I think we've been over this before,
24  Nancy, but show him the specific incident in the

                                                 Page 121

 1  records.  So I'm going to tell him not to answer.
 2            MS. ZETTLER:  Based on what?
 3            MR. BUBALO:  Based on your total
 4  mischaracterization of the record.  I don't think
 5  the record is -- reflects necessarily homicidal
 6  ideations in the sense that you're talking about
 7  them.
 8            Q.      Doctor, do you agree that in
 9  one of Mister Wesbecker's previous
10  hospitalizations a nurse noted in response to a
11  question -- or Mister Wesbecker's response to a
12  questionnaire regarding harming other people that
13  he would like to harm his foreman at work?
14            A.      Well, I know in the last
15  deposition the other attorney showed me a copy of
16  that on the nursing assessments.
17            Q.      If you had read this or if you
18  had seen this nursing assessment prior to
19  September 11, 1989, would you have asked him
20  whether or not he had any homicidal thoughts
21  about anybody in particular or anybody at
22  Standard Gravure?
23            A.      If I had seen that specific
24  nursing assessment?

                                                 Page 122

 1            Q.      Right.
 2            A.      I don't know, that's a
 3  hypothetical situation.  I may have, if someone
 4  had brought that to attention to me that he --
 5  that that was in there, I may have been a bit
 6  more specific, certainly I felt like I gave him
 7  the opportunity to express that.  But as you
 8  know, from none of my records was there any
 9  indication he ever made any threats to anybody.
10  As you note from Doctor Schramm's discharge
11  summary, he doesn't even mention that in his
12  discharge summary which I did have a copy of -- I
13  don't know if that was Doctor Schramm or whoever
14  that treated him, I don't know if that was '84 or
15  '87.
16            Q.      You write discharge summaries
17  in the course of your practice for hospitalized
18  patients, don't you?
19            A.      I dictate them, yes.
20            Q.      And when you dictate them, how
21  do you go about doing it?
22            A.      Well, you have a chart in front
23  of you, usually I have a certain way of dictating
24  it or a certain method of dictating a discharge

                                                 Page 123

 1  summary of history and pertinent things that
 2  happened during a hospitalization.
 3            Q.      And what sources do you use to
 4  dictate from?
 5            A.      Well, I use the admitting
 6  history, usually by the time I dictate it which
 7  isn't too long after they leave, I've got a
 8  pretty good sense of what happened with the
 9  patient in the hospital so I don't even have to
10  usually refer to the progress notes although a
11  lot of times I do, particularly with doses of
12  medications and things.  Things that I know that
13  happened in the hospital that are significant, I
14  will put in the discharge summary, whether it
15  comes from nursing notes although I would have
16  thought if it had been significant, the Doctor
17  would have also noted that in his progress notes.
18            Q.      The Doctor being you?
19            A.      I didn't treat him at that
20  time.
21            Q.      I'm talking about your
22  practices.
23            A.      If he had been my patient at
24  that time, I might have, but you know, I'm second

                                                 Page 124

 1  guessing a doctor here which I hate to do but
 2  just from that one thing alone, I might have
 3  commented on that in my progress note.
 4            Q.      Would you have considered that
 5  significant enough to comment on in your progress
 6  note?
 7            A.      But I don't know without -- I
 8  probably would have explored that further with
 9  the patient, you know, if I had seen that in the
10  nursing assessment, I probably would have
11  explored it further.  Now depending on what
12  happened with that further explanation as to
13  whether it was a, you know, a serious threat or
14  some type of boasting remark but I certainly
15  would have follow up on it.
16            Q.      If you had seen that note,
17  would you have asked Doctor Schramm about it?
18            A.      Was that during Doctor
19  Schramm's hospitalization, do you know?
20            Q.      I believe so but let's ask it
21  this way:  If you had seen that note, would you
22  have asked the attending physician about it?
23            A.      I'm not sure how I would have --
24  I might have if somehow that note had come to my

                                                 Page 125

 1  attention.  I might have, you know, of course
 2  with the patient's permission gone back and said
 3  hey, what about this, I very well might have.
 4            Q.      Given your experience with
 5  Mister Wesbecker throughout the two years that
 6  you treated him and his verbalization of anger
 7  towards Standard Gravure and their employees,
 8  would this mention of having suicidal -- or I'm
 9  sorry, violent aggressive thoughts of possibly
10  hurting foremen at work, would that have been
11  significant to you in your treatment of Mister
12  Wesbecker?
13            MR. BUBALO:  You appeared to be reading
14  the records itself, why don't you show him the
15  record.
16            Q.      It's Exhibit Number 9, Doctor,
17  it's going to be real hard to read because my
18  copy of it is highlighted so Greg can probably
19  read it better for you.
20            MR. BUBALO:  I don't see any mention in
21  this of violent aggressive thoughts.
22            THE WITNESS:  I think that's the
23  highlighter that shows through, I think we had to
24  look at the original last time.

                                                 Page 126

 1            Q.      Would you agree, Doctor, that
 2  saying that you wanted to harm somebody was
 3  violent aggressive?
 4            A.      I'm sorry?
 5            Q.      Would you agree that wanting to
 6  harm somebody is violent aggressive type of
 7  attitude?
 8            MR. BUBALO:  I object to the question
 9  because it's not a specific hypothetical, I
10  wanted to harm people in my work, specifically
11  opposing counsel sometimes -- it wasn't in a
12  violent aggressive way.
13            MS. ZETTLER:  It wasn't me was it,
14  Greg?
15            MR. BUBALO:  No, not you.
16            MS. ZETTLER:  I didn't think so.
17            MR. BUBALO:  My point is that you need
18  to give him the context of your hypothetical.
19            Q.      What type of questionnaire is
20  this?
21            A.      I think it's from a nursing
22  assessment.  I think this is a -- and I don't
23  know whether it's still used but -- they still
24  may have a nursing assessment but it probably is

                                                 Page 127

 1  different but when a patient first comes in the
 2  hospital, a nurse will interview the patient and
 3  they have these standards questions to ask and
 4  they will go down the check list and check them
 5  off.
 6            Q.      What's the purpose of doing
 7  that?
 8            A.      Well, I guess it's the nursing
 9  assessment.
10            Q.      Why would they go through
11  exercise of doing this, for what purpose?
12            A.      Well, I guess to -- since these
13  things can be significant, to determine whether
14  somebody has had any positives with any of these
15  questions.
16            Q.      I'm going to read this as best
17  I can --
18            MS. ZETTLER:  And, Greg, if you want to
19  check it after I'm done, that's fine.
20            Q.      -- but it it says have you ever
21  felt like harming someone else and it says yes or
22  no and he's checked yes.  If yes, who, looks like
23  he says my foreman, how, anytime when at work.
24            MR. BUBALO:  It says any way.

                                                 Page 128

 1            Q.      I'm sorry, anyway, and when at
 2  work.  Knowing what you know now about Mister
 3  Wesbecker's manifestation of anger throughout the
 4  two years that you treated him up until the last
 5  time you saw him on September 11, 1989, would
 6  this answer have been significant to you in your
 7  treatment?
 8            A.      I don't think that's a fair
 9  question.  Knowing that he went in and shot
10  people at Standard Gravure, obviously that's
11  going to be -- you said knowing what I know now,
12  I know that now.
13            Q.      Limit it up to the time you saw
14  him last on September 11, 1989.  Would this have
15  been something that would have been significant
16  to you given what you know about his voicing
17  anger towards people at work at Standard Gravure?
18            A.      That depends on the context.
19  If somebody brought that to me on September 10th
20  and said hey, look I just found this in his chart
21  and he did this, you're right, it might have made
22  a difference.  If Doctor Schramm said oh, by the
23  way, he kind of jokingly said something about
24  hurting his foreman, I don't think it would have

                                                 Page 129

 1  made any difference.  A lot depends on the
 2  context, you know.  A nurse does -- this is just
 3  strictly a routine a nurse does, she doesn't
 4  comment anyway at all whether it's a serious
 5  comment a patient makes or whether they say it
 6  jokingly.  So it's real difficult to say just
 7  from that written alone without being the
 8  treating physician and being able to follow up on
 9  it what the significance of that would be.
10            Q.      Do you really think that what
11  you know about Mister Wesbecker's anger towards
12  Standard Gravure with or without the events of
13  September 14, 1989, that he was joking when he
14  answered this question?
15            A.      He may have been.  I know from
16  other nursing assessments that they will check
17  off things that are positive that I don't feel
18  like are very significant once I go back and
19  explore it, so in my sense I could have seen
20  Mister Wesbecker say oh, yes, my foreman at work
21  anytime or any way.
22            Q.      Would this have given you cause
23  to ask him on September 11, 1989, whether or not
24  he was thinking about harming anybody after his

                                                 Page 130

 1  reporting he was forced to give the foreman a
 2  blow job in front of co-workers?
 3            A.      Asking him that specific
 4  question?
 5            Q.      Asking him if he was going to
 6  harm anybody because of it.
 7            A.      That specific question?
 8            Q.      Yes.
 9            MR. BUBALO:  Well, I object, you mean
10  in what context, he never knew about that.
11            MS. ZETTLER:  I'm saying if he knew
12  about it.
13            MR. BUBALO:  Knew about it when?
14            MS. ZETTLER:  Knew about it prior to
15  September 11, 1989, I think my question is pretty
16  clear, would he have given what Mister Wesbecker
17  said to him during that last visit given the fact
18  that he had seen deterioration in his condition
19  that was bad enough for you to want to
20  hospitalize him, would you have asked him if he
21  intended on harming anybody as a result of what
22  he believed happened to him at Standard Gravure?
23            MR. BUBALO:  I still think you need to
24  be more specific in your hypotheticals.

                                                 Page 131

 1            MS. ZETTLER:  Are you going to instruct
 2  him not to answer that?
 3            MR. BUBALO:  I'm going to object to the
 4  form of the question because it doesn't have
 5  enough information for someone to speculate on
 6  what they might do in any concrete way.
 7            MS. ZETTLER:  Are you instructing him
 8  not to answer?
 9            MR. BUBALO:  No, I'm not instructing
10  him not to answer, I'm objecting to the form of
11  the question.
12             (THE COURT REPORTER READ BACK THE
13              REQUESTED TESTIMONY.)
14            Q.      If prior to September 11, 1989,
15  you had known about this answer to a nursing
16  assessment question, and given what you
17  experienced with Mister Wesbecker as far as his
18  manifestation of anger towards people at work and
19  his deterioration of his condition on September
20  11th, and what he reported to you as far as the
21  alleged sexual abuse, would you have asked him
22  whether or not he was intending on harming
23  anybody at Standard Gravure?
24            A.      Well, again I think that

                                                 Page 132

 1  depends on the context of how I knew about this
 2  from the nursing assessment.  If I had known that
 3  he had made definite threats about somebody at
 4  work, I think I might have asked him that more
 5  specifically.  Now again, it would depend on how
 6  I might have known about this or what somebody
 7  might have told me about it in what context they
 8  may have put it in, but if I had some basis to
 9  know that he had actually threatened people, I
10  might have been a bit more specific with my
11  question.
12            Q.      So, if this was a serious
13  threat that was reported by the nurse in the
14  nursing assessment, it would have given you cause
15  to ask him on September 11th after he reported to
16  you the alleged sexual abuse whether or not he
17  intended on hurting anybody in response to that,
18  correct?
19            A.      Well, not only that, if I had
20  known he had made any serious threats at all to
21  anybody, rather than generally asking him what
22  are you going to do about it, I might have been
23  more specific and said are you going to hurt
24  anybody, if I had any indication at all that he

                                                 Page 133

 1  had threatened anybody with any serious nature.
 2            MS. ZETTLER:  Can we take like ten
 3  minutes so I can go through my notes?
 4             (A SHORT RECESS WAS TAKEN.)
 5            MS. ZETTLER:  Just to expedite things
 6  while I finish going through my notes, is it okay
 7  if Mark asks questions?
 8            MR. BUBALO:  Sure.
 9                 * * * * * * * * * *
10                  CROSS EXAMINATION
11  BY MR. DOBIEZ:
12            Q.      As of September -- or on
13  September 11, 1989, the last visit, did you have
14  an understanding from Mister Wesbecker what his
15  long term disability status was?
16            A.      Well, I knew he was on
17  long-term disability, I wasn't sure more than
18  that.
19            Q.      Let me be more specific, did he
20  ever say anything to you on that date or before
21  that date about letters from Paula Warman or
22  somebody from Standard Gravure threatening to
23  remove his long-term disability, did he complain
24  about it in terms of discussing with you about

                                                 Page 134

 1  that being a threat to him and his status of
 2  having long-term disability benefits?
 3            A.      He never mentioned any letters
 4  and I don't recall him ever mentioning Paula
 5  Warman.  There were occasions he was concerned
 6  that the company was going to cut him off from
 7  his long-term disability, I don't recall ever
 8  specifics that he had that concern.
 9            Q.      Regardless of who sent it to
10  him, if you don't know that, did he ever mention
11  to you, I got a letter where they're threatening
12  to take it away from me or did he say anything
13  specific about it where there was an actual
14  threat to him or he felt there was a threat to
15  him that they were going to do that or did you
16  understand it to be a fear that they might do
17  that?
18            A.      He never made a specific
19  comment that I recall about a letter that he had
20  gotten to that effect, he expressed it more as a
21  fear that the company was going to do away with
22  his disability benefits.
23            Q.      Did he ever discuss with you
24  that he was acquiring a gun, or had guns, was

                                                 Page 135

 1  shooting guns, practicing, anything about guns?
 2            A.      No, he never talked anything
 3  about guns.
 4            Q.      You had said, I believe, let me
 5  repeat what I understood, I wrote down the three
 6  basic criteria for all patients as far as
 7  involuntarily hospitalizing them and I want to
 8  get this straight first and then I'm going to ask
 9  you some questions about it.  I understood you to
10  say that there were three basic ones, that the
11  patient had to be a threat to himself or others,
12  that he had to be mentally retarded or ill, he or
13  she, or/and that there had to be a likely benefit
14  from hospitalization.  Is that a fair statement
15  of the three main criteria of involuntarily
16  hospitalizing a patient?
17            A.      Actually I think there is also
18  a fourth one which I don't have a warrant in
19  front of me but I think there's a fourth one that
20  says hospitalization is the least restrictive
21  form of treatment.  But you're correct those
22  three.  I think there's a fourth one that says
23  hospitalization is the least restrictive form of
24  treatment.

                                                 Page 136

 1            MR. BUBALO:  I think also he testified
 2  earlier that the facts had to be listed on the
 3  form showing the danger to the patient or to
 4  others.
 5            Q.      All right.  But -- all right,
 6  that's fine.  As far as Wesbecker specifically
 7  then, are there any other criteria then or are
 8  the four that we have just discussed the ones
 9  that are necessary?
10            A.      Without having a warrant in
11  front of me, those are the four that I think that
12  are on there.
13            Q.      So, as of the time that
14  Wesbecker was in your office on the last visit on
15  September 11, 1989, is it your testimony that
16  your -- what you would be looking at as far as
17  whether you could involuntarily put him in the
18  hospital on that occasion would have been these
19  four factors with the facts to back up why you
20  were putting him in there?
21            A.      Correct, the one statement on
22  suicidal says what facts support your contention
23  that the patient is a danger to himself or
24  others, those would be the criteria that I would

                                                 Page 137

 1  have to be looking at.
 2            Q.      To make sure that I understand
 3  what you're saying and the counsel has added, you
 4  can't just put down on the form I believe he's a
 5  threat to himself or others, you have to say for
 6  the reasons that, and list some factors?
 7            A.      That's my understanding and I
 8  think the warrant specifically says what facts
 9  support your contention that the patient is a
10  danger to himself or others.
11            Q.      With regard to Joseph Wesbecker
12  specifically on that occasion, did you feel like --
13  I understand that you did feel like he would
14  benefit from hospitalization, is that correct?
15            A.      That's correct, I felt like he
16  would benefit from hospitalization.
17            Q.      You felt that he was mentally
18  ill, is that correct?
19            A.      That's correct.
20            Q.      Did you feel that
21  hospitalization would be the least restrictive
22  form of treatment?
23            A.      Well, it doesn't necessarily
24  meet that criteria because even though I would

                                                 Page 138

 1  prefer to have hospitalized him and it would have
 2  benefited him, I felt like he could continue to
 3  be treated as an outpatient.  So that wasn't my
 4  ideal or my first choice but I felt like he still
 5  could be treated as an outpatient.
 6            Q.      Well, hypothetically then on
 7  that particular occasion, you considered him
 8  mentally ill, that he was likely to benefit and
 9  you preferred that he be hospitalized, and you
10  had had some information that indicated facts to
11  you that he was a threat to himself or others.
12  The least restricted requirement would not have
13  been a factor to you in hospitalizing him?
14            A.      Well, usually when there are
15  some facts that support a patient is a danger to
16  self or others, usually hospitalization is the
17  least restrictive form of treatment at that
18  instance.  So in my mind, when you meet one
19  criteria, you also meet the other.
20            Q.      Is it fair to say then that the
21  reason that you did not go ahead and
22  involuntarily place Mister Wesbecker in a
23  hospital was because you did not find that he was
24  a threat to himself or others?

                                                 Page 139

 1            A.      No, I didn't feel like there
 2  were any facts that supported that he was a
 3  danger to himself or others at that time.
 4            Q.      When he came into your office
 5  on that occasion and when I say occasion, I'm
 6  continuing to refer to the last visit on
 7  September 11, of 1989, and he said that he --
 8  first let me start with this that Prozac helped
 9  him remember that he had been forced to perform
10  an oral sex act, all right, that's my
11  understanding of what you said, have I stated
12  that fairly?
13            A.      Correct, that's one thing,
14  probably the only thing he said that how Prozac
15  had helped him.
16            Q.      From your perspective as a
17  professional in evaluating patients, what meaning
18  did you attribute to a patient, particularly
19  Mister Wesbecker saying that a drug, Prozac,
20  helped him remember an act, is that significant?
21            A.      Well, I can't really see a
22  correlation that the Prozac would necessarily
23  have helped him remember specific acts like that.
24  I can't really correlate that those two would be

                                                 Page 140

 1  necessarily connected.
 2            Q.      Well, if I understood you, he
 3  said that the drug helped him remember or caused
 4  him to remember this act that occurred?
 5            A.      Helped him remember as I recall
 6  were his words.
 7            Q.      Isn't that unusual for a
 8  patient to say that a drug helped him remember an
 9  act?
10            A.      Sure.
11            Q.      Okay.  What was your impression
12  or thought at that time about that comment?
13            A.      Well, again the same impression
14  that I had was that, you know, he's not doing
15  very well and I don't know what's going on with
16  him.  I knew that Prozac would not likely make
17  him remember something.  If he had remembered it,
18  it might have been for some other reason and
19  again the other side of that was could possibly
20  the medication or something else, you know, could
21  this be delusional, which was another
22  consideration.
23            Q.      Why do you think that Mister
24  Wesbecker would have used the words and say to

                                                 Page 141

 1  you that Prozac helped him remember that act as
 2  opposed to I have now remembered this act?
 3            A.      I don't know.
 4            Q.      You don't have an explanation
 5  for that?
 6            A.      No.
 7            Q.      When he told you that, about
 8  the oral sex act that occurred or which he said
 9  that occurred, did you ask him how he felt about
10  that?
11            A.      As I recall, I asked him how he
12  felt about it, and I think I testified earlier
13  that's when he went on and that one occasion that
14  I felt like his thoughts were kind of tangential
15  rather than responding to the question about how
16  he felt, he started talking about lawsuits and
17  calling the sex crimes division which really
18  wasn't a response to my specific question, that's
19  when he got off on that aspect of it, either --
20  and somewhere in there, I also asked him what he
21  was going to do about it in addition to how he
22  felt about it.  Whether that was at the same time
23  or in follow up to how he felt, I can't really
24  remember the time frame but I did ask him.

                                                 Page 142

 1            Q.      Did he tell you that he was
 2  humiliated by that act?
 3            A.      No, he didn't use those words.
 4            Q.      Did you understand that that
 5  act humiliated him?
 6            A.      I assume it would humiliate
 7  him, he did not --
 8            Q.      He stated it to you in a sense
 9  that that was a harmful act to him?
10            A.      He didn't use that word, I mean
11  it was --
12            Q.      Those are my words but I'm
13  saying, I'm trying to understand what happened in
14  your office that only you know about and can tell
15  us about what happened that day.  A man who is on
16  long-term disability who has had illness, who has
17  had an ongoing problem and difficulties at work,
18  comes in and says that he's been performed --
19  forced to perform an act that I would understand
20  a person in his position would be considered to
21  be extremely humiliating --
22            MR. BUBALO:  Is this a speech or a
23  question?
24            MR. DOBIEZ:  It's a question.

                                                 Page 143

 1            MR. BUBALO:  What's the question?
 2            MR. DOBIEZ:  Would you read it back?
 3             (THE COURT REPORTER READ BACK THE
 4              REQUESTED TESTIMONY.)
 5            MR. BUBALO:  It's an objection.
 6            MR. DOBIEZ:  Let me just rephrase it.
 7            Q.      What was your impression of the
 8  effect on Mister Wesbecker of this act,
 9  regardless of whether it was real or not?
10            A.      Well, as I testified, he sobbed
11  at the time, and I would say I felt like it was a
12  pretty traumatic episode for him.
13            Q.      You may have testified to this
14  before but I want to ask you, at that point when
15  he sobbed, after that when telling you that, and
16  he became tangential and talked about other
17  things, did I understand you to say that you did
18  not ask him specifically are you going to harm
19  somebody or are you going to harm somebody at
20  Standard Gravure?
21            A.      I did not ask him that specific
22  question.
23            Q.      And at the time you tended to
24  believe that it was real as opposed to imaginary,

                                                 Page 144

 1  is that right?  The fact --
 2            A.      I wasn't really clear, you
 3  know, in the last deposition, there was about a
 4  fifty-fifty -- and, you know, if I had to guess
 5  which way I was leaning, at that time, I would
 6  have to say I tended to lean a little bit more
 7  toward it being -- had happened to him.
 8            Q.      You've testified previously
 9  that you understood Prozac, the half life of it
10  to continue on for some time and the effects to
11  continue on for some time up to three weeks or
12  so, is that a correct statement?
13            A.      Well, Prozac can be in the
14  system for three weeks, that doesn't necessarily
15  mean the effects of it are going to be there for
16  three weeks, you know.  Each day that someone is
17  off the medication, the blood level drops, so any
18  tendency, any effectiveness, or side effects is
19  going to diminish each day so it's not
20  necessarily that someone is going to have a
21  positive affect or a negative affect for three
22  weeks.
23            Q.      Did you testify earlier that
24  the level in the bloodstream rose slowly and

                                                 Page 145

 1  decreased slowly with regard to Prozac?
 2            A.      That's my understanding.
 3            Q.      You didn't take a blood test to
 4  determine what it actually was in the office?
 5            A.      No.
 6            Q.      Was it rising or falling at the
 7  time he was in your office?
 8            A.      You mean the specific thirty
 9  minutes while he was in the office or --
10            Q.      From that point to the time of
11  the shooting.
12            A.      Well, I'm not a pharmacologist
13  so I'm not sure I can give you an informed -- you
14  know, I can give you an opinion about it but not
15  being a pharmacologist -- if I had instructed him
16  and he had followed that instruction to stop it,
17  which I had instructed him to stop on the 11th, I
18  would assume his blood level would start
19  diminishing at that point.  From the time he
20  started the Prozac until the time he stopped it,
21  his blood level would have increased.  Now if he
22  had continued on the Prozac after the 11th, his
23  blood level probably would have continued to
24  increase.  It's my understanding that Prozac

                                                 Page 146

 1  doesn't reach a steady state until someone has
 2  been on it about six or eight weeks.
 3            Q.      You know what the blood level
 4  was from the autopsy?
 5            A.      I have seen it and know it was
 6  in the therapeutic range, I couldn't give you a
 7  number.
 8            Q.      Based on what it was, you have
 9  no way of knowing whether it was high or low in
10  the time he was in your office, do you?
11            A.      No.
12            Q.      Do you have an idea based on
13  what he was taking for the prescription you gave
14  him of what you would anticipate it would have
15  been if he had stopped on the day you told him
16  to?
17            A.      Well, I think, as I said
18  earlier, from the blood level that day doesn't
19  tell you whether he stopped it or whether he kept
20  taking it, the level alone doesn't give you any
21  indication of that.
22            Q.      If he had taken it as you
23  prescribed it, with the dose that you told him to
24  take as often as you told him to take it, could

                                                 Page 147

 1  you say what his blood level should have been on
 2  the day that the shooting occurred if he had
 3  stopped that day?
 4            A.      I don't think I could have
 5  predicted what his blood level would be.
 6            Q.      What assurance did you have
 7  that Mister Wesbecker's wife that came in with
 8  him was going to be in close contact with him and
 9  would watch him as far as his condition?
10            MR. BUBALO:  Well --
11            Q.      If any --
12            MR. BUBALO:  I object to the form of
13  the question.  I would just object to the form.
14            Q.      I understand and I'm just
15  saying please answer the question.
16            A.      It sounds like you're assuming
17  that he needed someone to be with him though.
18  I'm not sure you can make that assumption.
19            Q.      She came in with him, did she
20  not?
21            A.      No, she didn't.
22            Q.      Okay, that was my mistake then.
23  I had understood that you had said that either he
24  or his wife would call you if his condition got

                                                 Page 148

 1  worse, is that wrong?
 2            A.      Right, he had said that either
 3  he or his wife would -- when I talked to him
 4  about it, he said that either he or his wife
 5  would call but I had never seen his wife.
 6            Q.      Did you know at that time if he
 7  lived with anybody?
 8            A.      From what I recall at the time,
 9  he was living with actually his ex-wife, but he
10  was still living with her.
11            Q.      What assurance did you have
12  that Mister Wesbecker would not get worse the
13  next day and the day after as far as his
14  condition?
15            A.      I didn't have any assurance,
16  other than my feeling that he would probably get
17  better or that if he did get worse, he would call
18  me.  But I couldn't predict whether he would get
19  better or would get worse.
20            Q.      Are there circumstances in your
21  practice where the condition of a patient is such
22  that you cannot rely on that patient to take care
23  of themself and rely on them to report back to
24  you?

                                                 Page 149

 1            A.      I suppose if you have a
 2  demented patient they're not going to report back
 3  to you, but they normally don't live by
 4  themselves.
 5            Q.      When do you assume a
 6  responsibility to continue to monitor a patient
 7  as opposed to have them come back to you if
 8  they're having a problem?
 9            MR. BUBALO:  I object to the form as
10  it's actually a hypothetical, it's too vague to
11  answer.
12            A.      I'm not sure I can answer that.
13            Q.      Do you ever assume a
14  responsibility to contact a patient yourself or
15  have somebody from the office contact a patient
16  to make sure that they're okay?
17            A.      My normal procedure is to have
18  the patient contact me.  If I have to rely on my
19  memory to call a patient in two days, I find that
20  I may not remember it.  The patient themself is
21  more -- much more likely to remember to call me
22  in two days.  Now if I think someone doesn't have
23  the capacity to remember in two days to call me,
24  then they probably don't need to be an

                                                 Page 150

 1  outpatient.
 2            Q.      Well, what if you think that
 3  the patient should probably be hospitalized but
 4  they don't want to do it and you don't
 5  hospitalize them and they go home, when do you
 6  assume the responsibility for contacting them as
 7  opposed to them contacting you?
 8            A.      I felt like Mister Wesbecker
 9  had his capabilities still about him and he would
10  contact me, he never had any problems calling me
11  before, I did not think he would deteriorate to
12  the point that he would lose all contact with
13  reality.
14            Q.      Although he was losing some
15  contact with reality while he was in your office,
16  wasn't he?
17            A.      I can't say that, I have no
18  definite basis to say he was losing contact with
19  reality.
20            Q.      Does your note not say that he
21  was delusional?
22            A.      No, my note does not say he was
23  delusional as I recall.
24            Q.      To this day as we sit here in

                                                 Page 151

 1  this deposition, do you know or have additional
 2  information that indicates to you whether or not
 3  the oral sex act was real or not real?
 4            A.      I don't have any additional
 5  information that gives me more inclination one
 6  way or the other.
 7            Q.      If a blood test had been -- you
 8  had decided to do a blood test to determine what
 9  the level in fact was of Prozac in Mister
10  Wesbecker's bloodstream, how would you have done
11  that, would it have been in your office or sent
12  him out somewhere to a site to do that?
13            A.      I don't draw blood in my
14  office, I would have had to send him out to a
15  hospital or outpatient laboratory.
16            Q.      If on that date as you stated
17  you assumed that Prozac may have been the cause
18  of his deterioration in his condition, why did
19  you not send him up to get his blood and Prozac
20  level checked out?
21            MR. BUBALO:  I object to the question,
22  it mischaracterizes past testimony.  He said that
23  Prozac was the cause of nervousness.
24            MR. DOBIEZ:  We can scan through the

                                                 Page 152

 1  record but I think I fairly characterized it but
 2  is that an objection?
 3            MR. BUBALO:  It's an objection because
 4  you mischaracterized his past testimony.
 5            Q.      Let me ask you, Doctor, when
 6  you wrote Prozac, question mark, in your notes on
 7  that last occasion, what did that indicate?
 8            A.      That indicated the question in
 9  my mind that his deterioration might be
10  attributable to Prozac.
11            Q.      Deterioration in his general
12  condition?
13            A.      Well, from his condition of the
14  time I had seen him, the visit before, right,
15  which encompassed all the symptoms that I already
16  talked about.
17            Q.      Well, let me repeat my question
18  again.  If he was in your office on that last
19  occasion and that you suspected at that time that
20  Prozac had contributed to deterioration in his
21  general condition since the last time that you
22  saw him, why did you not send him out to get his
23  blood level checked to determine what the level
24  of Prozac was in his bloodstream?

                                                 Page 153

 1            A.      It wouldn't have told me
 2  anything.
 3            Q.      The higher the level of Prozac,
 4  the longer amount of time it would have taken to
 5  get down to a level where it wouldn't be a
 6  problem, isn't that true?
 7            A.      Well, but you have to
 8  understand that, you know, blood levels of
 9  anti-depressants are not necessarily, you know,
10  accurate.  If his blood level had been low, it
11  still could have been the Prozac that was causing
12  his problems, his blood level high still doesn't
13  tell you whether the Prozac is causing his
14  problems.  So whether his blood level -- the
15  information wouldn't have changed anything I
16  would have done, it would not have made any
17  difference so it would have been a worthless test
18  to perform.
19            Q.      When Mister Wesbecker became --
20  after reporting the oral sex act on the tangent,
21  I believe as you described it, and started
22  talking about what he was going to do as far as
23  reporting it, is that fair so far?
24            A.      That's my recollection.

                                                 Page 154

 1            Q.      Did he indicate to you what
 2  specifically he wanted, I mean by reporting to
 3  the police did he want people convicted, did he
 4  indicate what he was trying to accomplish by
 5  reporting it?
 6            A.      I don't think he specifically
 7  mentioned what he was trying to accomplish.
 8            Q.      He didn't say he wanted
 9  somebody arrested or said he wanted somebody
10  convicted, he just said I'm reporting it to the
11  police and that's it?
12            A.      Well, he said he had reported
13  to this sex crimes division of the police and was
14  considering filing a lawsuit and I'm not sure he
15  even said more than that.
16            MR. DOBIEZ:  That's all I have, thank
17  you.
18                 * * * * * * * * * *
19                REDIRECT EXAMINATION
20 BY MS. ZETTLER:
21            Q.      I just have a few more, Doctor,
22  and I'll get you out of here.  Have you ever
23  heard of distortions of perception?
24            A.      As what?

                                                 Page 155

 1            Q.      In terms, psychiatric terms?
 2            A.      I think I've heard the term
 3  before.
 4            Q.      What's your understanding of
 5  what it means?
 6            A.      Someone's perception is how
 7  they perceive things.  I would assume distortions
 8  would mean you see variations in someone's
 9  perceptions whether it be visual perceptions
10  auditory perceptions, possibly even perceptions
11  of what somebody says or feels.
12            Q.      Are hallucinations distortions
13  of perception?
14            A.      I guess they could be.  I'm not
15  really clear whether they are distortions of
16  perceptions because hallucination is when
17  something is actually not there so you can't
18  really perceive it so I'm not really sure whether
19  that would be encompassed under that.
20            Q.      How about a delusion?
21            A.      A delusion can be, somebody can
22  take a certain situation and make it something
23  more than it's not so the perception is
24  distorted.

                                                 Page 156

 1            Q.      How about paranoia, distortion,
 2  of perception?
 3            A.      Well, you have to realize
 4  paranoia can mean different things, if you're
 5  talking about the diagnosis of paranoia which
 6  would be called a delusional disorder or if
 7  you're just talking about paranoid thoughts, you
 8  have to be more clear.
 9            Q.      Well, let's start with paranoid
10  thoughts.
11            A.      Paranoid thoughts can be
12  distortions of perception.
13            Q.      If Mister Wesbecker's belief
14  that he was being persecuted at work at Standard
15  Gravure was incorrect, would that be distorted
16  perception?
17            A.      It could be distorted
18  perception if he, you know, if what was happening
19  at work was appropriate and he interpreted it as
20  harassment, that would be a distortion of
21  perception.
22            Q.      Is agitation a hyperactive
23  state?
24            A.      As I understand agitation, I

                                                 Page 157

 1  don't know if I would use the term hyperactive
 2  but it's -- can be hyperactive.
 3            Q.      Did Mister Wesbecker at any
 4  time experience diminished inhibition to your
 5  knowledge?
 6            A.      You'll have to define
 7  diminished inhibition.
 8            Q.      Have you ever heard the term
 9  diminished inhibition used in the psychiatric
10  context?
11            A.      I don't think I've heard it
12  used as a specific symptom by itself.
13            Q.      Okay.  What is your
14  understanding of what diminished inhibition means
15  in the psychiatric context?
16            A.      An inhibition would be
17  something that would inhibit somebody from doing
18  something and most inhibitions are mental
19  inhibitions.  There are some medications that can
20  diminish inhibitions, alcohol can diminish
21  inhibitions.
22            Q.      Is it your testimony that
23  Mister Wesbecker suffered from a personality
24  disorder?

                                                 Page 158

 1            A.      I did not diagnosis him with a
 2  personality disorder.
 3            Q.      Would you agree that on
 4  September 11, 1989, he was exhibiting increased
 5  hostility and anger?
 6            A.      I think, as I testified
 7  earlier, he displayed increased anger.  I don't
 8  feel like particularly on that day he was hostile
 9  toward any person or direction, he didn't make
10  any statements that implied hostility which to me
11  means in some direction.  He certainly had an
12  increased level of anger.
13            Q.      Okay.  Earlier you testified
14  that when Mark was asking you questions that you
15  tended to lean towards believing that the alleged
16  sexual abuse had actually happened.  Why is that?
17            A.      Well, I think -- what I meant
18  was at the time, I think in my last deposition,
19  pretty much I was saying I really couldn't be
20  sure so it was split about fifty-fifty and if you
21  had to lean me one percent in one direction or
22  the other at the time when he told me, I probably
23  leaned a fraction more toward that this happened
24  to be factual.

                                                 Page 159

 1            Q.      Why?
 2            A.      I would base that on his
 3  presentation of it, it was nothing else from his
 4  condition that I could definitely delineate that
 5  he was psychotic.  He was more agitated, he was
 6  more nervous, he was more angry.  But the flip
 7  side of that would be that this would be a
 8  delusion but there was nothing that told me or
 9  convinced me that this was a delusion.  He
10  recompensated a bit during the rest of the
11  session, he didn't have any other type of
12  psychotic symptoms, he didn't display any
13  hallucinations, he didn't have any specific other
14  possible delusional material.  I would guess
15  because of those things, I felt like certainly
16  this could be something that was factual.
17            Q.      How did you come about your
18  knowledge of what a therapeutic level of Prozac
19  is, of Fluoxetine?
20            A.      I don't recall other than
21  ordering it.
22            Q.      You have ordered blood levels
23  on Fluoxetine?
24            A.      Correct.

                                                 Page 160

 1            Q.      On other patients other than
 2  Mister Wesbecker?
 3            A.      Correct, I've never ordered one
 4  on Mister Wesbecker.
 5            Q.      And why did you order them on
 6  other patients?
 7            A.      Well, my philosophy is you
 8  always treat the patient and not the blood level
 9  so I don't routinely do blood levels of
10  anti-depressants.  The times that I will consider
11  doing a blood level is, let's say a person is not
12  responding to a normal dosage of medication, then
13  I will a lot of times at that point get a blood
14  level to see whether maybe just increasing the
15  dose of that medication might be beneficial, that
16  tends to be the case with Prozac as most labs
17  report what a therapeutic range of Prozac or
18  Fluoxetine is and it normally is a very wide, a
19  very wide range, but that would be the most
20  common reason I would order a blood level of an
21  anti-depressant.
22            Q.      Would you consider Mister
23  Wesbecker's discussion of possibly filing a
24  lawsuit against the foreman and fellow employees

                                                 Page 161

 1  at Standard Gravure as a result of the alleged
 2  sexual abuse, an attempt at getting back at them?
 3            MR. BUBALO:  I don't understand your
 4  question, I'm sorry.  Vague attempt at getting
 5  back at them?
 6            MS. ZETTLER:  For what they did to him.
 7            Q.      Do you understand the question,
 8  Doctor?
 9            A.      I think so, I mean Mister
10  Wesbecker's anger and recourses tend to be in the
11  nature of lawsuits, I wouldn't interpret him
12  talking about another lawsuit as any sort of
13  threat, that would just be the normal way it
14  seemed to me that his anger would take a
15  direction.
16            Q.      Would you consider that an act
17  of retribution against them or intended act of
18  retribution against them?
19            A.      Well, I guess, it may not be
20  important what I would consider it, Mister
21  Wesbecker never presented it as an act of
22  retribution, it was more of getting what he was
23  entitled to.
24            Q.      What do you think he thought he

                                                 Page 162

 1  was entitled to as a result of the alleged sex
 2  act?
 3            A.      I'm not sure what kind of
 4  lawsuit he was talking about, whether it was some
 5  type of monetary damages or -- he didn't specify
 6  lawsuitwise.
 7            Q.      To your understanding, is there
 8  a correlation between the level of Prozac and the
 9  number or severity of side effects?
10            A.      I don't know if I have read
11  anything specific about the blood level of Prozac
12  versus the severity of side effects.  So to my
13  knowledge, I don't know of anything specific that
14  would say a higher blood level necessarily means
15  more side effects.
16            Q.      How about dosages?
17            A.      Well, I think as a general
18  rule, the more medication of any you give, the
19  more likelihood you are of having particular side
20  effects, but that varies from person to person.
21            Q.      Have you read the Teicher
22  article?
23            A.      Yes, I have read it but it's
24  been some time.

                                                 Page 163

 1            Q.      If you were aware of what was
 2  reported in Doctor Teicher's article that was
 3  published in, I believe, February of 1990 back on
 4  September 11, 1989, would you have treated Mister
 5  Wesbecker any differently on that day?
 6            A.      No.
 7            Q.      If you were aware of what was
 8  reported in Doctor Teicher's article when you put
 9  Mister Wesbecker back on Prozac, in the Fall of
10  1989, would you have treated him in any different
11  way?
12            A.      No.
13            Q.      Would you have monitored him
14  more closely?
15            A.      No.
16            Q.      Why not?
17            A.      Well, I don't think Doctor
18  Teicher's article is very good for one thing.
19            Q.      Why not?
20            A.      From my estimation of reading
21  his article, one, it's just seven or eight case
22  reports as I recall, most of these patients had
23  previous suicide attempts, most of these patients
24  had previous levels of depression, I can't

                                                 Page 164

 1  correlate from his article that it definitely
 2  means that Fluoxetine or Prozac caused this in
 3  these patients, I think there's serious doubt
 4  from his case reports that he's correct.
 5            Q.      Have you read any of the other
 6  medical literature that reports similar
 7  occurrences on patients on Prozac?
 8            A.      Well, I don't know of any
 9  articles that support an increase in suicidality
10  with Fluoxetine.
11            Q.      Have you read any rechallenge
12  articles where patients that became suicidal on
13  Fluoxetine and were rechallenged and became
14  suicidal again when placed back on Fluoxetine?
15            A.      I don't recall ever reading any
16  of those, no.
17            Q.      Would that make a difference to
18  you in your opinion that Prozac doesn't cause
19  suicidality?
20            MR. BUBALO:  Assuming what the article
21  said -- I don't understand the question.
22            Q.      Do you understand the question,
23  Doctor?
24            A.      Well, I'm really not clear

                                                 Page 165

 1  other than if there was some article that said
 2  people got suicidal on Prozac and they took them
 3  off and put them back on and they got suicidal
 4  again, would that make any difference.
 5            Q.      Right.
 6            A.      In what?
 7            Q.      In your opinion that Prozac
 8  does not cause suicidality.
 9            A.      I don't think I've testified to
10  that effect.
11            Q.      What is your opinion as to
12  whether -- is it your opinion that Prozac causes
13  suicidality?
14            A.      I don't know if it does or not,
15  I have certainly never had a patient that I
16  thought that Prozac caused suicidality.  Now
17  possibly it could be a rare side effect of all
18  anti-depressants, I don't know, I have seen one
19  article that proposed that possibility.
20            Q.      Where did you get that article?
21            A.      I don't recall.
22            Q.      Is this from somebody at Lilly?
23            A.      Could have been.
24            Q.      Do you have an opinion one way

                                                 Page 166

 1  or the other as to whether or not Prozac causes
 2  violent aggressive behavior or hostility in
 3  people?
 4            A.      My opinion is that it doesn't.
 5            Q.      If there was a rechallenge
 6  article written on rechallenge of people who
 7  suffered from hostility as a result of Fluoxetine
 8  and then re-experienced the hostility when placed
 9  back on Fluoxetine, would that change your
10  opinion?
11            A.      Depending on the article and
12  how well it was written, it certainly might.
13            Q.      Is there any way to rate
14  homicidal ideation or homicidal tendencies in a
15  patient without them directly admitting
16  experiencing such ideation?
17            A.      I'm not aware of any way to
18  predict violence or rate potential for violence.
19            Q.      How about suicidal ideation, is
20  there any way to rate a person's suicidal
21  ideation without them admitting specifically that
22  they're suicidal?
23            A.      I think as I testified in the
24  last deposition, there are risk factors, but to

                                                 Page 167

 1  my knowledge there is no way either to predict
 2  suicidality.
 3            Q.      Would the same type of risk
 4  factors related to suicidality be true of
 5  homicidal ideation?
 6            A.      Not to my knowledge.
 7            Q.      I believe you testified last
 8  time that you asked Mister Wesbecker if he had
 9  any homicidal thoughts on the first visit that he
10  had with you in July of '87, I believe, is that
11  true?
12            A.      Well, I don't remember the
13  specific words I used, I do recall asking him
14  about, you know, in a general sense exactly --
15  whether I used the word homicide or not, I don't
16  know, but whether he had ever had any thoughts
17  about hurting anybody else.
18            Q.      Okay.  And I also believe that
19  you testified that after that occasion you didn't
20  feel it was necessary to ask him at any other
21  visit whether or not he had feelings of harming
22  somebody else, correct?
23            A.      I never asked him after that
24  visit about homicidal ideation in substance

                                                 Page 168

 1  because there was nothing that he ever said at
 2  any of the sessions that implied any sort of
 3  threat, any sort of revenge that would even
 4  prompt me to ask the question.
 5            Q.      Why did you ask him about it at
 6  the beginning?
 7            A.      It tends to be a part of an
 8  initial evaluation.
 9            Q.      Given the fact that he had
10  discussed great anger towards fellow employees at
11  Standard Gravure, why did you feel it wasn't
12  necessary to ever ask him if he was going to harm
13  somebody?
14            A.      Anger doesn't predict violence,
15  he never talked about his anger in any sort of
16  threat or veiled threat in any manner at all.
17            Q.      Do you ask all your patients
18  whether or not they have ever had homicidal
19  ideation or homicidal thoughts or thoughts that
20  they were going to hurt somebody?
21            MR. BUBALO:  All the patients in the
22  initial evaluation when seen?
23            A.      I try to.
24            Q.      Every single one?

                                                 Page 169

 1            A.      I try to make that part -- I
 2  guess there probably have been instances where I
 3  failed to do that but I consider that part of my
 4  initial evaluation.
 5            Q.      Regardless of their diagnosis?
 6            A.      Regardless of diagnosis.
 7            Q.      You testified earlier that you
 8  discussed the Teicher article with the detail
 9  person from Lilly, did you bring that article up
10  to her or did she bring that up to you?
11            A.      I don't think I testified that
12  I discussed the Teicher article with her, did I?
13            Q.      I think you did.
14            A.      I don't know if I recall
15  particularly discussing the Teicher article, I
16  read the Teicher article, I don't know if we
17  discussed the particulars of the article.  She
18  may have mentioned the Teicher article but I
19  don't know if we had a particular discussion
20  about it.  I don't think the detail person
21  presented to me the Teicher article.
22            Q.      Okay.  When you do your
23  discharge summaries for patients in the hospital,
24  do you routinely read through all the nurses

                                                 Page 170

 1  notes?
 2            A.      No.
 3            Q.      Do you routinely read through
 4  all the nursing questionnaires or evaluations?
 5            A.      When I'm dictating discharge
 6  summaries?
 7            Q.      Right.
 8            A.      No.
 9            Q.      Have you heard of suicide
10  contracts?
11            A.      Yes.
12            Q.      Have you ever used one in
13  treatment of a patient?
14            A.      Yes.
15            Q.      Did you contemplate using one
16  with Mister Wesbecker?
17            A.      There are different types of
18  suicide contracts, there are written suicide
19  contracts, there are verbal suicide contracts.
20  There wasn't any reason to use one with Mister
21  Wesbecker, he said he wasn't having any suicidal
22  thoughts.
23            Q.      Have you ever had an occasion
24  to treat a patient who was claiming they haven't

                                                 Page 171

 1  had any suicidal thoughts but then have exhibited
 2  suicidal tendencies or committed suicide?
 3            A.      That sounds like there were two
 4  questions there.
 5            Q.      Okay, I'll break it down.  Have
 6  you ever dealt with a patient who has claimed
 7  that they aren't suffering from suicidal ideation
 8  or suicidal thoughts and then they turn around
 9  and kill themselves?
10            A.      Yes.
11            Q.      Have you ever dealt with a
12  patient who has claimed that they did not have
13  suicidal ideation or suicidal thoughts and then
14  turned around and tried to kill themselves, be it
15  successful or unsuccessful?
16            A.      I don't know whether turned
17  around or developed, I've had patients that had
18  initially not had suicidal ideation and at some
19  point in their treatment had developed suicidal
20  ideation.
21            Q.      Within three days?
22            A.      Within three days?  I can't
23  recall any that have done it within that period
24  of time.

                                                 Page 172

 1            Q.      The last time you testified
 2  that you recall the Prozac package inserts being
 3  changed at some point, do you remember what the
 4  changes were made in the insert?
 5            A.      I don't know specifically the
 6  changes, all I know there was something added
 7  about -- my general sense is something about
 8  cautions and suicidality aspect but I'm not sure
 9  I can tell you exactly what it says.
10            Q.      Do you remember when that was
11  added, if it was before or after the shootings at
12  Standard Gravure?
13            A.      I think it was after.
14            Q.      If that warning had been on the
15  package insert or the prescribing information
16  prior to the occurrence at Standard Gravure,
17  would that have changed the way you handled
18  Mister Wesbecker while he was on Prozac?
19            MR. BUBALO:  I'm sorry, would you read
20  back the last two questions?
21             (THE COURT REPORTER READ BACK THE
22              REQUESTED TESTIMONY.)
23            A.      Well, I don't really know what
24  the warning is, you may have to read it to me to

                                                 Page 173

 1  make an informed answer.
 2            MS. ZETTLER:  Attached to the letter, I
 3  don't think we need to mark it as exhibit, but
 4  the January 8, 1992, letter from, I believe it's
 5  Doctor Beasley, Charles Beasley, is a copy of I'm
 6  assuming the most recent package insert at that
 7  time.  Is that fair enough, Greg?  Do you want me
 8  to mark it as an exhibit?
 9            MR. BUBALO:  Yes, mark it as an exhibit
10  and tell the court what you say it is.
11             (PLAINTIFFS' EXHIBIT NO. 4 WAS
12              MARKED FOR IDENTIFICATION AND
13              RECEIVED IN EVIDENCE.):
14            A.      You're not going to have me
15  read this microscopic print, are you?
16            Q.      No.  If you want, you can have
17  Greg read that one section on suicide.
18            A.      Where is it?
19            Q.      I think it's on one of the
20  first couple of pages under precautions.
21            MR. BUBALO:  Are you talking about in
22  precautions under the heading suicide?
23            MS. ZETTLER:  Right.
24            MR. BUBALO:  The possibility of a

                                                 Page 174

 1  suicide attempt is inherent in depression and may
 2  exist until significant remission occurs, close
 3  supervision of high risk patients should
 4  accompany initial drug therapy, prescriptions, or
 5  Prozac should be written for the smallest
 6  quantity of capsules consistent with good patient
 7  management in order to reduce the risk of
 8  overdose.
 9            Q.      Is that the caution that you
10  remember them putting into the package insert
11  after the shootings on November 14th?
12            A.      That's my recollection that
13  that was not in there previously.
14            Q.      Would that warning have made a
15  difference in the way you conducted your
16  treatment of Mister Wesbecker while he was on
17  Prozac prior to and including September 11, 1989?
18            A.      It wouldn't have made any
19  difference on September 11, 1989.
20            Q.      Would it have made a difference
21  on how you handled the monitoring of his
22  medication prior to that date?
23            A.      It's not a very strong warning,
24  I guess the only difference it might have made is

                                                 Page 175

 1  whether I would have used Prozac again or not.
 2            Q.      Would you have?
 3            A.      It's hard to say.
 4            Q.      When you say would have used
 5  Prozac again, you mean you would have put Mister
 6  Wesbecker back on Prozac?
 7            A.      Correct.
 8            Q.      Would you have?
 9            A.      You're asking me to go back and
10  knowing what I know now about Mister Wesbecker,
11  probably I would not have.
12            Q.      Not knowing just -- prior to
13  and not even talking about September 11, 1989, if
14  that had been in there, if that precaution had
15  been in the package insert in the Fall of 1989
16  when you reput Mister Wesbecker on Prozac, would
17  you have put him back on Prozac?
18            A.      As I said, it's not a very
19  strong warning, it doesn't say, you know, it
20  tends to -- basically says to me suicide --
21  suicidality is a side effect of depression, which
22  that's no surprise, so it really doesn't warn you
23  of anything, that specific wording, I'm not sure
24  it would have made any difference, I mean if it

                                                 Page 176

 1  was a bit more stronger, it might have made a
 2  difference.
 3            Q.      Have you ever seen that warning
 4  on any other package inserts for any other
 5  anti-depressants that you prescribe?
 6            A.      No, not that I recall.
 7            Q.      Do you know why that's in the
 8  Prozac package insert then?
 9            A.      Well, I can give you an
10  opinion, I don't know if it's correct.
11            Q.      Okay.  What is your opinion?
12            A.      Called the publicity about
13  whether Prozac might have some causality of
14  suicide, possibly from the Teicher article.
15            Q.      In your opinion, is that an
16  appropriate warning to caution people that there
17  is at least a thought out there that Prozac may
18  cause suicidal ideation?
19            A.      I don't think it says that.
20            MR. BUBALO:  I'm going to object to the
21  question because it assumes he understood the
22  intent of warning.  The form of question is not
23  appropriate.
24            MS. ZETTLER:  Would you read back the

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 1  last couple of questions?
 2             (THE COURT REPORTER READ BACK THE
 3              REQUESTED TESTIMONY.)
 4            Q.      Let me ask you this, does that
 5  warning say that Prozac could cause suicidal
 6  ideation?
 7            A.      When I was listening to Mr.
 8  Bubalo read it, I didn't think it said that.
 9            Q.      Does that warning say that
10  there have been cases reported where the reporter
11  believes that Prozac caused suicidal ideation?
12            A.      No, I don't think it said that.
13            Q.      Did you talk to the coroner
14  prior to the coroner's inquest?
15            A.      Personally?
16            Q.      Yes.
17            A.      Not that I recall.
18            Q.      To your knowledge, did anybody
19  on your behalf talk to the coroner before the
20  inquest?
21            A.      I think my attorney may have.
22            Q.      Did he talk to the coroner at
23  your request?
24            MR. BUBALO:  Don't answer the question.

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 1            MS. ZETTLER:  Certify it.
 2                (QUESTION CERTIFIED.)
 3            Q.      The last time you testified
 4  that you had certain expectations as to how
 5  Prozac would act upon a patient and what the
 6  possible side effects of Prozac were.  Would you
 7  tell us what your expectations were as to how
 8  Prozac would act upon a patient back in 1989 when
 9  you prescribed it to Mister Wesbecker?
10            A.      Well, my expectation, I guess,
11  as well as hope, is that it would alleviate a
12  certain degree of depression, tend to have
13  minimal side effects in most people, that would
14  be my expectations of its benefits.
15            Q.      What about the side effects,
16  what was your knowledge of what the possible side
17  effects were back in the fall of 1989?
18            A.      Well, in 1989, both from what I
19  read and what I observed by using Prozac, that
20  nervousness was a problem in a certain percent of
21  people, not a large percent, sleep disturbance
22  seemed to be a common side effect, sometimes
23  people got reduction in appetites,
24  gastrointestinal disturbances weren't uncommon.

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 1  Those are some of the more common side effects
 2  that I probably witnessed myself.
 3            Q.      Do you have an understanding or
 4  knowledge of what percent -- in what percentage
 5  of the population Lilly claims Prozac is related
 6  to or can be related to in nervousness or
 7  anxiety?
 8            A.      Well, I know they have
 9  percentages in the package insert, without
10  looking at it, my guess would probably be five to
11  ten percent.
12            Q.      And you testified earlier that
13  you have had eight to ten patients that you have
14  taken off Prozac because of reactions such as
15  nervousness or anxiety, correct?
16            A.      To my best recollection,
17  probably that many.
18            Q.      And you also testified that you
19  probably put between fifty and a hundred people
20  on Prozac, right?
21            A.      It would be a guess but that's
22  what I said earlier, correct.
23            Q.      So in your population, your
24  estimated population, you have as many as twenty

                                                 Page 180

 1  percent of your people that have experienced, I'm
 2  sorry, nervousness on the drug, correct?
 3            A.      Well, I'm not sure -- I guess
 4  the minimum would be eight percent, maximum would
 5  be twenty percent.
 6            Q.      Would it be fair to say --
 7  okay, between eight and twenty percent of your
 8  people?
 9            A.      From my experience, that would
10  be, although I would say it would be more towards
11  the low side of that.
12            Q.      So maybe closer to eight
13  percent?
14            A.      Or ten percent.
15            MS. ZETTLER:  That's all I have,
16  thanks.
17            MR. DOBIEZ:  No further questions.
18            MR. BUBALO:  We'll want to read it and
19  sign it.
20             (THE WITNESS WAS EXCUSED.)

                                                 Page 181

 1 
   COMMONWEALTH OF KENTUCKY        )
 2                                 :  ss
   COUNTY OF JEFFERSON             )
 3 
 4       I, MARY KATHLEEN NOLD, A NOTARY PUBLIC IN
 5  AND FOR THE STATE OF KENTUCKY AT LARGE, DO HEREBY
 6  CERTIFY THAT THE FOREGOING TESTIMONY OF
 7                LEE A. COLEMAN, M.D.
 8  WAS TAKEN BEFORE ME AT THE TIME AND PLACE AS
 9  STATED IN THE CAPTION; THAT THE WITNESS WAS FIRST
10  DULY SWORN TO TELL THE TRUTH, THE WHOLE TRUTH,
11  AND NOTHING BUT THE TRUTH; THAT THE SAID
12  PROCEEDINGS WERE TAKEN DOWN BY ME IN STENOGRAPHIC
13  NOTES AND AFTERWARDS TRANSCRIBED UNDER MY
14  DIRECTION; THAT IT IS A TRUE, COMPLETE AND
15  CORRECT TRANSCRIPT OF THE SAID PROCEEDINGS SO
16  HAD; THAT THE APPEARANCES WERE AS STATED IN THE
17  CAPTION.
18       WITNESS MY SIGNATURE THIS THE 17TH DAY OF
19  SEPTEMBER, 1993.
20       MY COMMISSION EXPIRES MARCH 10, 1994.
21 
   
22 
   
23                _________________________
                  MARY KATHLEEN NOLD
24                COURT REPORTER AND NOTARY PUBLIC
                  STATE OF KENTUCKY AT LARGE

                                                 Page 182

 1 
 2 
 3               E R R A T A   S H E E T
 4 
   
 5 COMMONWEALTH OF KENTUCKY      )
                                 : SS
 6 COUNTY OF JEFFERSON           )
   
 7 
 8            I, DR. LEE A.  COLEMAN, THE UNDERSIGNED
 9  DEPONENT, HAVE THIS DATE READ THE FOREGOING PAGES
10  OF MY DEPOSITION AND WITH THE CHANGES NOTED
11  BELOW, IF ANY, THESE PAGES CONSTITUTE A TRUE AND
12  ACCURATE TRANSCRIPTION OF MY DEPOSITION GIVEN ON
13  THE 9TH DAY OF SEPTEMBER, 1993 AT THE TIME AND
14  PLACE STATED THEREIN.
15 PAGE NO.     LINE NO.     CHANGE          REASON

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 2 PAGE NO.     LINE NO.     CHANGE          REASON
   
 3 
   
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 9 
                    _____________________________
10                  DR. LEE A. COLEMAN
   
11            SWORN TO AND SUBSCRIBED BEFORE ME THIS
12  _____ DAY OF __________, 1993.
13            _____________________________
              NOTARY PUBLIC, STATE OF
14            KENTUCKY AT LARGE

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 1     DIRECT............................................14
 2     CROSS EXAMINATION BY MR. DOBIEZ:.................134
 3     REDIRECT EXAMINATIONBY MS. ZETTLER:..............155
 4     (QUESTION CERTIFIED...............................88
 5     (QUESTION CERTIFIED...............................94
 6     (QUESTION CERTIFIED.)............................179
 7     (PLAINTIFFS' EXHIBIT NO.  1 ......................29
 8     (PLAINTIFFS' EXHIBITS NOS.  2 and             3...103
 9     (PLAINTIFFS' EXHIBIT NO. 5.......................174
10     COMMONWEALTH.....................................182
11     E R R A T A......................................183
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