e e e e for e e e e e sh e e e e e e e e e e e e e e e e e e e e e e e [Music] here all you H this is 228211 7 the Commonwealth versus Karen Reed can I have Council identify themselves for the record signning with the commonweal Adam L for the Comm good morning your honor good morning Mr L morning your honor laa mlin for the Comm good morning m mlin Jackson on behalf of Miss Reed good morning good morning Mr Jackson Elizabeth little also on behalf of Miss re good morning Miss little morning Judge David jetti for Karen Reid morning Mr jetti good morning Miss Reed good morning jurors so I have to ask you those same three questions were you all able to follow the instructions and refrain from discussing this case with anyone everyone said yes and Ed affirmatively were you also able to follow the instructions and refrain from doing any inde dependent research or investigation into this case yes everyone said yes and moded affirmatively did anyone happen to see hear or read anything about this case since we left here on Tuesday everyone said no wor should their hands so um jurus from time to time I will give you instructions I talk to you for a few minutes about um how you evaluate evidence so I just want to take a couple of minutes today it's part of my job where my job is to teach the jury about the law so in considering the testimony of any witness please remember the questions are not evidence only the answers which are in fact the only part of the exchange between the lawyer and the witness that had given under oath are evidence so if a witness is asked isn't it true that after you learn that your uncle left you money and his will you poisoned him and the witness answers no based solely on that question and that answer there's no evidence that the witness has an uncle that the uncle had a will that the uncle left the witness money that the witness knew that he did or that the witness poisoned him so going forward I want you to consider the evidence in that regard also there were videos shown to you and I expect that throughout the course of this trial there'll be many more videos shown to you these videos are evidence and there's audio on these so what the video shows is for you folks to decide not me not any of the lawyers what an audio recording says is for you to decide not me not any of the lawyers because you find the facts that's your job we all have different jobs but finding the facts in the case is your job okay so with that please get your commonwealths witness back on the stand Mr famat Jim just War minut again please thank you just watch [Music] you raise your one more time you the EV you give the court and jury the case down here she the truth the whole truth and nothing the so all right Mr L whenever you're ready before I begin I sure [Music] good morning sir good morning from when we had left off uh the other day uh you had arrived in the area of 34 fa road that correct correct and when you arrive there uh what if anything did you do on your run so on arrival um positioning the apparatus is going to be our most important thing trying to figure out where our patient is and parking our apparatus close enough especially at night time that we can light up the scene as well as we can try and figure out how to approach a scene because if we have to track equipment farther distances it can slow our response down so we try and make sure our arrival and positioning is as best as we can put it and as far as positioning in reference to when you first are sort of pulling up on the scene where are you in the ambulance again so I would have been the passenger of the ambulance um usually the tech that's leading into the call will sit on the passenger side to try and mentally get ready for or what's going on whether it's reviewing protocols or just trying to assess the information coming across the radio so you can update your treatment plan as much as you can before you even see the victim and when the ambulance comes to a stop or Park your positions where is what if anything do you see sort of as far as the scene is concerned so we have our fire apparatus that are helping light up the scene but uh we also have two female parties going by to the victim on the side of the road going back and forth between that that person and the side of the road and uh from the position when you first arrive are you able to see the person on the side of you can see a shape of a person so we know that's where the patient is because we reported that there was a party on the side of the road so seeing a body shape that glued us that that was where we were headed in addition to the ambulance that you're in how many other vehicles are on C you get when I get there I believe it is engine three and car five and Beyond sort of the vehicles from your department what if any other vehicles see you get if I remember correctly it was a just a personal vehicle I don't remember if there's any police cars on scene at that time and from your orientation when you pull up um where is is the body positioned to your left to your right or something to my left and so after the ambulance is positioned what do you do so then it's going to be bringing all the equipment over to the patient side um to be able to extricate them from that situation whether it's a house or a street or a road we assess where they are and then the best tools to get them out into the ambulance to be able to work effectively on the patient when you proceed over to um now again at some point uh subsequent later on are you be able toidentify person on the ground is yes um we will try and get a general idea of the age of the patient the positioning of the patient how they were found and then when we get them into the ambulance we can start identifying ways to register that patient in the emergency room so identifiers whether it's a license or Witnesses or we try and figure out who they are so they can get registered at the hospital at some point were you able to identify who this person was that's correct uh his wallet was in his pocket and we were able to grab his license and who were you able to identify that was John O'Keefe and so with reference to Mr o'keef when you first obser him on the ground how far away from the street or the roadway is say approximately 10 feet away from the road and how is he positioned as far as how is his body positioned I'd have to R but I believe he was a supine on his back um just in general terms uh uh when you're responding to a call of this nature what are some of the protocols of that you speaking about what is it that you're seeking to do or assess when you first arrive so we're trying to determine if it's a cardiac arrest that whether it's a viable um transport or workable arrest we have certain protocols within the Massachusetts protocols for whether we work the patient or we leave the patient on scene if it's a police matter if there's injuries not sustainable with life so we're trying to make that assessment before we make any decisions um let me stop you there just for one second use a term as far as Cardiac Arrest based on your training experience what do you want say that so Cardiac Arrest to to best of my knowledge is just the cation of electrical and mechanical activity in the cardiac muscle so the cardiac muscle pumps blood throughout the body and when that stops all life stops after that now um in particular reference to the conditions the weather conditions that you find yourself in what if anything else is sort of on uh the scale of spectrum in regard to diagnosis so Cardiac Arrest depending on where they're found um we try and figure out what led them to be at that point so we're looking at weather conditions as well um that can also affect viability of resuscitation so due to the extreme weather extreme cold um will attempt resuscitation on that patient due to the fact that it'll prolong viability of the arrest or ability to recover from Cardiac Arrest afterwards so weather is definitely a key factor and where they are found and you're familiar with the term based on your training experience called hypothermia correct and so what if any sort of relationship with Cardiac Arrest has let me ask you this first what what is your understanding of the term hyp the exposure to extreme cold that lowers your core and extremity temperatures down to a below 95° usually and what if any interplay is there between hypothermia and cardiac so like I said before it'll prolong how long um it'll preserve the body after a rest so if somebody's found in like a cold water situation there's been multiple reports of patients recovering after being drowned in cold water for up to an hour so viability is definitely improved by the cold weather and as far as viability is concerned you talk about your assessment what what are sort of the steps that go into your assessment so we're looking at um obvious signs of death uh so we're looking at exposure of brain matter we're looking at traumatic injuries decapitation things that would basically be non-life sustainable U we're looking at signs of lividity and rigor to basically show us how long the patient has been down for and uh the age of a particular patient what if any relationship does that have to your access so it'll show the extent of Frailty a patient has if somebody's an elderly patient severe cancer patient their ability to sustain a cardiac event like that is less so somebody that's younger middleaged will have a much better chance of recovery afterwards but that would really be the only key that we're looking at and what if any observations uh did you make of of this Kei during your assessment of him initially just said he was a middle-aged male and that was all we had and as far as uh the other things that you've talking about as far as viability ofation what if anything did You observe with reference to the Strat in regard to that so with viability we were looking at um any rigidity or rigor in the body or lividity or separation of blood you would have a pooling of blood or bruising it would look like at the lower parts of the body depending on how the person positioned basically if they're supine you'd have positioning or pooling underneath the body and then you would have stiffness of the arms legs jaw neck to be able to move the body we're looking to if they don't have those things present it's another check mark of saying this is viable we can work this and specifically as it applies to your assessment of Mr what if anything you recall in regard to that initial assessment as far as viability so his limbs were able to be moved jaw was able to be moved the posterior of his body was red so not the indicative of lividity that we're looking for um so we dermed it to be a viable arrest and continue to work you mentioned as far as sort of gathering your equipment bringing it over to Mr what if any equipment so equipment initially is going to be our scoop stretcher to be able to pick the patient up break apart put it underneath them we have a first in bag an airway bag cardiac monitor we'll bring all that over to the patient side to be able to do as much as we can in that situation but due to the weather we wanted to get him out of the weather because that was one of the things that was hurting him at that point is getting him into the warmer ambulance and warm beginning the warming process so getting into an area where we can assess the patient thoroughly with good lighting and um to be able to expose the patient begin the warming process and when you go over to where Mr o' is uh about 10 feet off the roadway who if anyone from your department goes along with so I have Matt Kelly with me and Tim nut I also have Frank Walsh Katie mlin and Greg wood uh Woodbury and uh Captain robbery and as far as this sort of initial assessment uh on the ground with Mr O what if anything we sort of each of those respective people doing with regard to this I'd have to review specific interventions um as far as who did what when but um that's why we document things immediately afterwards so it's all fresh so CPR was initiated by me and ALS assessment as well so I can go over individual interventions if you'd like but it's really and for the record sir you're looking at exhibit number 160 what page is that are you looking at it says two five of my EMS report but there's also the ERS report on the top as well so initially when you go over to Mr O how many other people have sort of in that area so in the area we have the First Responders and then we have the two female parties on scene where were the two females in in relation to so as we're approaching the scene they were kind of in between us and the patient so we try to gather as much information as we could from them as we could once you make that uh determination as far as viability of of recitative efforts uh sort of specifically what what are you and and the other fire is doing u in regard to those efforts with so we're beginning CPR we're trying to establish good quality CPR get the patient onto our stretcher begin an IO start medication start ventilating the patient all this the um all of the conditions that the body has we're trying to remedy through intervention so we're trying to breathe for the patient we're starting to press on his chest to do CPR to cause his cardiac muscle compressed spread blood through the heart cardiac muscle cerebral brain and we're trying to reverse what's happening in the body now as far as when mrke you observe him on the ground what if any snow did You observe on or around to the ne so snow was probably up to the mid- axillary point so we're looking at probably halfway up his rib Point top of his body was clear and uh you know about how much snow was covering his body up to the mid a I'd say probably about four inches four to six inches now as far as your observations Mr o'keef when he's on the grounds what if any observations did you make as far as how he address for the exposure I'd say he was pretty underdressed um long sleeve t-shirt jeans nothing really substantial to be out in that type of weather and at this point or any subsequent Point what if any observ did you make of M foot uh by the time we so our first priority is obviously going to be treating the patient um his clothes do matter but it's on the list of priorities not huge so by the time we figured out he was missing one of his shoes we were already at the hospital at that point and um do you recall which of his shoes missing I don't and as far as uh that missing shoot uh was that something that you or any of the other firefighters paramedics would have needed to have removed on scene to any sort of treatment uh nothing would have been done through the feet it would have been just exposure of the patient to see possibly the extent of frostbite if it had started affecting extremities fingers nose that type of thing hypothermic reaction there would that be something that would have been removed by one of one of you or one of the other firefighters while he was on ground if it would have been removed both of them would have been REM removed um to assess that it wouldn't do much much good to just remove one and leave it there on scene now as far as the two females uh that you observed um did they sort of remain in the same position you initially reserve them they move around or something kind of cleared a little bit away from the scene they I would say they moved off to the right um of the apparatus so we could work on the patient at that time and what if any conversation or what if anything did you ask either of those so how the patient was found and what brought them to that situation is critical so we're trying to figure out as much information past medical history that we can of the patient so we're trying to find somebody who has knowledge of the event so as we approach the scene begin to talk to one of the females um what is going on why are they there what's going just what happened and um you say you're speaking to one of the two Fales is that correct that's correct you see any of those females in the Portland today that's correct M Reed just identify as to where or an article right okay now with regard um to one of the two females that you were talking to was that Miss Reed or was that somebody else that was Miss Reed and um why if at all U were you talking to her versus some of one of the other females if she seemed to be the one that was most personally affected by it so figured she'd had the most information about why the person was there and what if any observations did you make of her in regard to um your conclusion that was the one seems the most personally she was the most distressed on scene um obviously upset so personally related to or had a relationship with the person before we get to um conversations what if anything did um You observe Miss Reed or any of the females doing reference to mr's body when you first started to come up to so I I would characterize it as an attempted resuscitation they were attempting to she was attempting to do CPR but due to the erratic Behavior she was running back and forth between the other female on scene and the body back and forth trying to press on his chest wake him up talk to him um just to no avail and as far as your conversation with M re what have any questions asked in regard to demographics or anything so do you have any information of who this is how are they here tried to um get any type of information we could from her at that time but with no luck when you say with no luck what if anything what if any response did you receive Miss Reed in regards to your question so the only response that we I was personally given was just I hit him I hit him oh my God I hit him and when she's saying I hit him I hit him oh my God I how loudly she so she was within two feet of me but very loud um any type of followup questioning did you hit him with your hand did you kick him what happened she just repeated the phrase over and over again I hit him I hit him and just to be clear where does this conversation occur this was as we're bringing equipment over to the patient um the interventions are going to be started basically by whoever gets over to the scene first I'm trying to gather information as a lead paramedic to try and coordinate interventions and therapy to kind of holistically be the team leader in that situation and treat and transport the patient so it was on approach to the patient probably halfway between the ambulance and the patient and with regard to that treatment of Mr um you reference it earlier being in your report U what were sort of those uh steps or or what if anything to do and the other fire firefighter do with before you answer that may I request May the witness just refer TOS report as yes if need be thank you um so we try and document through our flowchart of all of the interventions that we're doing so CPR is obviously going to be our first priority CPR is initiated unchanged but successful in the actual intervention itself no complications we do our ALS assessment that we talked about of any further indications of this is not a viable arrest we determined it was a viable arrest and we move on then we're going to start we refer to it as a bag valve m mask at 15 L per minute on oxygen to the patient's not breathing on their own so we're trying to assist ventilating that with high flow oxygen as well and EAS iio which is a a needle we put into the bone of the tibia of the patient that was on that right tibia was the first one we put in we're going to be putting in warm fluid uh we have a warmer in the back to be able to bring up the core temperature uh then we start with epinephrine one milligram through that IO I could just one when you say as far as IO put it into the leg how is that sort of inserted so we have a two different methods we can do uh we have a a drill a power drill that drills through the out outer layer of the bone to into the capillary area of the bone the soft spongy material um so we drill through that or we can do it by hand if that fails and um when it comes to the epinephrine what what is sort of the purpose of that medication what are you trying to do with that so that medication will improve um it's a vasil constrictor it'll cause the vasculature to constrict so it'll improve the quality or Effectiveness on the cardiac muscle cardiac vascular chair and the cerebral um area as far as the administration of epinephrine is concerned is that something that's done once more than once there a protocol for that so it's going to be serial um every 3 to five minutes during the cardiac arrest to try and bring them over to the hospital so it continues that entire time unless there's a rhythm change or that can change our algorithm of how we approach the patient if there's a rhythm regain or return of spontaneous circulation so how many times or or what times was the epinephrine administer via the io so I have epinephrine at 620 625 630 635 640 645 and when was that first administered would that have been at some point when he was outside of the ambulance on the ground or in the ambulance something um it be dependent on transport time so our first we're at patient side at 615 transport 627 so best estimation would have been inside of the ambulance at that point I'm sorry I interrupted you before but after sort of the introduction of the what do the other after the first round yeah so first round of epinephrine after that we would drop in what's called an Opa that would be to push the tongue out of the way open up the airway to improve our bag valve Mass so it has an open air way to get the oxygen into the lungs We Begin uh external warming stripping the patient um getting the heat turned up in the back of the ambulance we would then switch over from manual CPR done by hand to a mechanical CPR device um to ensure adequate consistent CPR compressions of the chest it was a Lucas device put that on the patient and then we continue with another round of Epi patient starting to warm up this time so we would do suction at that point to try and suction fluid out of the airway to improve ventilation efforts another round of fep is done have another suction this time through a deep suction via the endot tral tube sorry at 622 after warming we uh were we intubated the patient uh we have a seven and a half tube to past at 27 CM then verified through various means through chest rise off consultation waveform and title CO2 so we had complications listed as patient vomiting aspirating suction was then done with a rigid tip rigid tip uh suction device after successful intubation we then suctioned via French tube through the airway established jump back up to 631 another IO line was established on the opposite tibia on the left side and then another three rounds of EPI and then arrival at the hospital was the arrival time at the hospital at destination was 645 what hospital was that again good samarit Medical Center a term that you use in your reports I'll probably this but as is that correct yeah assistly is going to be a cardiac Rhythm um where there's no electrical activity in the heart and is referred to as Flatline what any observations that you makeing your treatment diagnosis in regards to as far as exist so that was the Rhythm he was found in um yeah from initial Rhythm I have on the EKG at 632 is a Cy so we' basically observe that for any changes whether it's increase of electrical activity regain of adequate pulses all of that can kind of be hinted at with the cardiac Rhythm and then we would change our algorithm based on whether we go down the Ros protocol or we continue down the cardiac arrest protocol and whether it's on scene or it's in the ambulance is there sort of a division of of task division of different skill that's being employed in patient care so patient care will have to do with level of training and also proximity on the patient um where you get into the ambulance is just logistically if you have the training it's not a huge open ER it's a small environment so we try and not have people jump over each other as best as we can and if you recall who was sort of doing what in relation to treatment of this patient so in the back of the ambulance specifically yes okay in the back of the ambulance Tim Nal was managed in the airway um I was the team lead that was kind of coordinating all of the interventions Matt Kelly was assisting in gathering equipment doing CPR before the mechanical device was placed on um basically they asked act as an assistant to hand equipment um place things in strategic areas around so we can actually work without having to go get those physical things ourselves now as far as um you indicated removal of Mr clothing once in the ambulance cor yes what was it about sort of the condition of clothing that led to uh REM that so removal of clothing is actually pretty standard for any Cardiac Arrest um any traumatic injuries we're basically trying to get further Clues because this is all happening very quickly um so we're trying to get more evidence of why are they here we're looking for extremity injuries Crush injuries bruising anything that would that we could document that we could pass on to the emergency room staff and doctors um so we we would strip most most patients and as far as were you involved personally as far as sort of The Cutting of the clothing patient yes and upon removal of the clothing what if anything did You observe as to sort of the condition of the clothing or texture of the clothing condition seems pretty well intact but just wet and cold and what if any relationship with the wet and cold clothing have to any of the diagnosis that you were running through it would really just be the exposure to the weather would be our biggest trigger off of that or if you had protruding injuries through the clothing compound fractures things like that um the clothing was intact but we knew it was wet it was cold so as we strip things off of him we can see underneath basically if there are any sub not every fracture breaks through the skin not everything causes obvious things obvious signs so as we strip the patient we can begin to further assess take back just for a second to outside of the ambulance um what if anything specifically were you able to observe with reference to any injuries um injuries are pretty tough to see outside of the ambulance just due to the weather due to the lighting um we have seen Lighting on the ambulance as well but um let me ask you as far as what was what any difference did you know between Lighting in fact ambulance versus so he was still out in the weather at that point so bleeding wasn't really obvious at that point as soon as we get him into the back of the ambulance then we start noticing Hemorrhage from different areas of his body and when you say Hemorrhage from different areas which are um so mostly from his mouth his eyes nose yeah [Music] and just be clear for the record when you use the term Hemorrhage based on your training experience what do you you understand that bleeding external bleeding now you mentioned that there was some suctioning of Mr Airway is that correct correct and what specifically was suction from suctioning from the air W is mostly blood um blood sputum and uh as far as how much what if any what if anything you have to sort of measure how much blood suction so we have a can a canister that has marks of milliliters so we can determine as we're suctioning how much um is in that container at different times and about how much based on that was suction from this so the initial suctioning with the rigid tip was about 150 millit and subsequently so that would have been above the airway in the mouth in that type of area we establish the intubation and then deep suctioning with that soft tip through the intubation tube would have been another 50 milliliters of fluid now with reference to you mentioned to some observations to Mr O correct what's up sorry you mentioned some observations you made earlier in reference to m back yes and what were those again so that would have been redness of the skin and the posterior of the body what if any significance that have to do as far as your observation so redness from the skin um if it's General across the body can mean certain things if it's just a particular area and due to the fact that it was cold outside that would have been the initial stages of frostbite or exposure to cold and as far as the remainder of Mr O's body what any other observations did you make which areas you make those observations to in regard to the initial state so for as far as the cold exposure yeah cold exposure we're looking at the most exterior Parts um extreme cold exposure can lead to frost snip and frost bite in different areas the first affected areas are going to be your fingers your ears your nose your toes that type of so that was a cold waxy um pale stark white substance basically or um condition of his skin and on each of those areas that you just described yes now sort of up in the area of Mr O you mentioned some bleeding from the eyes yes and beyond that one if any observations any other injuries to his head or so his eyes were pretty well swollen we were trying to clear areas of blood to figure out if there are any contusions around the head I believe there was a contusion on his forehead also had some markings on his extremities as well and just as far as your understanding based on your training experience when you use the word contusion what do you understand that bruising and before we get to the extrem what if any observations you make as far as abdom abdomen we noted as significant uh as distension or swelling of the belly and what if any significance do that have to you in regard to it's another of our detailed assessments we go through the body in a more detailed way um to try and find more clues that we can pass on for the assessment uh distension in the belly could be due to trauma or bloating it could be are usually our biggest triggers for distension now you mentioned as far as the extremities concerned what if anything You observe as far as in so we're looking at so we had the cold rigid fingers hands feet and we had multiple dry blood uh lacerations to the right arm recall specifically where On's right arm would have been his upper upper arm and you mentioned Drive is that correct yes so these were not actively bleeding at the time that you observed them no now as far as being dried blood versus actively bleeding what if anything does that indicate to you as as far as sort of time so we had active bleeding from other areas in the body so the fact that it had already stopped and clotted I would assume that would have been several hours before the the incident that led him to be there but I would guess earlier in the evening now as far as uh the history is concerned um your attempts on scene and then what if any attempts were made subsequent when you were in the ambulance to obtain any sort of history of how much be there or or what have been causing injuries You observe um once we get the patient into the ambulance there was no family no bystanders in the back of the ambulance so then it's going to be solely based on fiscal assessment and within sort of a team of of firefighters that you had with anyone did you direct to um try and obtain that information volum so that would have been Katie mlin and what did you ask M mlin so Katie was one of our uh senior paramedics at the time so we had enough skilled hands working on the patient at that time so to direct her I wasn't able to get as much information and still had a skill to do or still had a task to do to run the the cardiac arrest so I pushed I didn't push I I directed Miss Reed over to Katie to try and gather more information um as to why they were there if you could get any more information about who he was events leading to the injury how long he was down for any type of information and then moved on to the patient at that point and so the block when was having this conversation outside of the ambulance is that correct that's correct this is going on while you're inside of the ambulance actively treating this R it was very quick process so I start the conversation wasn't productive wasn't moving forward moved her over to uh fighter fighter mlin continued on to the patient and then start a treatment mov the patient in and then Katie came into the back of the ambulance to help so it was a very quick process now as far as um Mr oi's eyes were concerned what if any observations further did you make as far as Mr O's eyes so both eyes were swollen um and bleeding what if any observations were you able to make of of the pupils I'm sorry what pupils pupils so I have documented as four millimeters and non-reactive what what if any significance of those observations as far as so we're looking for equality between the two so signs of bleeding can be demonstrated by unequal pupils or if they were restricted could lead us to believe it was as a result of an opioid um interaction but we're looking at whether they react to light as well um if there's brain activity if there's still something causing the body to react you'll have some type of pupilary response so we shine light there was no response so was fixed and at 4 millimeters now at some point uh you leave the scene in rout to Good Samaritan is that correct that's correct and who is continuing treatment of this the back of ambulance so back of the ambulance and transport would have been firefighter Kelly firefighter nle and myself and so if anyone was driving the ambulance so that'll be determined by um basically just positioning on the engine so the step driver for that position would then drive as the detailed person over to the ambulance that was firefighter mlin now during the transport from Fair View to Good Samaritan um what if anything are you and the other five parties in the back of the ambulance doing as far as continuing treatment so we started transport at 627 so between 627 and 6:45 treatments included epinephrine additional suctioning managing of the airway placing another Inus line and then three additional rounds of epinephrine while the mechanical CPR is continuing CPR and during the course of the transport what if any changes uh in Mr O's status as far as the cardiac AR breathing occurs during trans no changes now that time that it took to get from Fairview to Good Samaritan is that um sort of a typical transport time not normally uh due to the weather it was pretty slow driving even though the ambulance was a smaller vehicle than the engine um slow transport compared to normal and during the course of the transport what if any communication are you having with good Maring in regard to Mr and his eventual arrival every medical that goes on um we try to give the hospital staff a heads up basically of what's coming in we'll have different alerts that we would give them whether it's a cardiac arrest a stroke a stemi to have the certain appropriate teams come in and be ready whether it's a trauma alert there's different Specialties within the hospital that'll treat those different particular cases so we call them five to 10 minutes prior to give that team time to get down into the emergency room to get ready to work when you arrive at Good Samaritan um with anyone who you're met by and and sort of what happened with regard to so we're continuing interventions um from the ambulance through the bay into their cold room we're then met by registration a registered nurse and the doctor that took care of the patient as well as a team of other assistants and CNAs and where do you sort of you physically go with M or how does that work y so that's referred to as a transfer of care so there's different people like I said it's a team base where different people are in charge of different things we'll have the nurse in charge that's in charge of documenta documenting our interventions that have been done so far time of down the patient was down and then she starts documenting all the din different interventions that were done by the hospital staff as well you also give a report to the Doctor Who's then taking over as lead for the cardiac arrest they're going to start issuing orders for the patient in treatment and then you have registration that will get the information to register the patient that they can tie all of it interventions too and during that sort of process of exchange of information things of that nature what if anything did you learn in regard to core body temperature of so to add that assessment I believe it was a core body temperature of 80 degrees what if any significance does that have in regard to the typical core body temperature typical core body temperature is going to be in the high 90s um where body temperature being in the at 80 with a rectal temp of core temp is going to be extreme hypothermia now here I could SM in for a certain amount of time correct before you clear and at that point in time while you were at good Mar in uh that initial time what if anything be learned as far as status or what it happen so as we talked about before with the hypothermia and the extreme cold they're going to work that for an extended period of time um most cardiac arrests I will try and hang out by the patient or in the area um as new staff come through different things are found the doctors and nurses might have follow-up questions so I try to stay available as an asset that they can bounce those questions off at least for 10 or 15 minutes afterwards to make sure the whole process is completely transferred from all the interested parties and during that course of time what if anything you learn as eventual status of M we didn't learn anything um at while we were at the hospital uh we then cleared the hospital returned back quarters to Decon the ambulance and to replenish all the equipment that we had used get back in service and move on with the shift at some point during the course of the shift did you have occasion to go back to good me personally no it would have been for an additional medical call if there was any calls for service afterwards did you recall whether or not you went back you could Samar for any additional medical calls or anything of that nature I don't recall [Music] if I could uh direct your attention to the screen just over there m Gilman if I could please have exhibit number nine so directec your attention of what's been previously marked as exhibit number n up on the screen you recognize what's in that photograph the house is that the house that you responded to is that correct Miss if I could have exhibit number this if I could have exibit number 14 again so what's up on screen recognize what that is I see blood snow general area not and last if I could have number 18 and again fire do you recognize what's pied up on screen as exh number eight yes [Music] yes Sor I'm GNA hand the pointer so fire form within this Photograph up on the screen is exhibit 18 uh do you see the area in which you observed Mr O's on the ground first yes and using that laser pointer could you direct the jury's attention to where in this Photograph Ober initially AR initially arrived would have been in this area one moment yes T you thank you uh nothing further for this witness at this time all right cross examination thank [Music] you good morning good morning um I'd like to start sort of at the beginning when you first arrived yes at the location you indicated that you could in fact see the body from your perspective correct I could see a body yes and you I think you indicated the shape of a body yeah couldn't tell if it was female or male no but obviously looked like a human figure yes okay that Drew your attention to the left side of the ambulance as you were approaching correct yes and you're sitting on the right side which means you're sort of the furthest away from from that figure from the perspective of the ambulance and ambulance yes and you had no problem making out that figure in the snow so figure in the snow uh we had a good distance between the ambulance and the engine so yes okay and you indicated that the figure in the snow was on top of the snow if you will with some snow accumulating up the body of the of the individual yes but he was not covered in snow no he wasn't there wasn't like a mound of snow over this figure there were mounds of snow in the area but not over the patient due to this the wind there were snow drifts in the and his clothes were dark as compared to the white snow yes I want to ask you a couple of quick questions about some of the last conversation you had with Mr L about the injuries you did note a that Mr O had a laceration over his right eye correct over his right eye over his right eye there a contusion over the eye okay and your definition of a contusion is bruising was it also swollen there was swelling around the eyes and a little bit of contusion and bruising around did you see an actively bleeding laceration over his right eye I don't recall you don't remember that um what about his left eye both eyes were pretty well swollen shot what about not from the nostrils but on the skin on the nose did you know the laceration or multiple lacerations on the nose so due to the bleeding that was coming from the ores trying to clean the area and find exactly where it's from is sometimes difficult so we can just say it was bleeding in that area okay so you can't define as you sit here you don't remember if it was bleeding from the nostril or from a laceration on the nose I believe it was the nostrils okay are you are you saying that there was no laceration on the skin of the nose or you just don't recall it on the top of the nose no I don't know I'm sorry on the top of the nose I don't recall you don't recall okay with regard to his abdomen you indicated that it was distended medical term for swollen yeah um you said that that could be from trauma or it could be just bloating correct correct did you notice any contusions on his abom no any skin that was abided no cut no so there's no bruising no contusion but there was a disension correct yes so there was no visible trauma to the abdomen visible trauma doesn't really matter to internal trauma um it's not always indicative one way or the other so my question was did you see any visible trauma on his abdomen no okay but you did not it that it was bloated that it was descended yeah okay I want to talk to you for a second about uh if I could shift gears about the conversation that you indicated to Mr La that you had with Miss Reed um you were also asked about that conversation at the Grand Jury when you testified correct correct you testified that the as the lead May paramedic you were specifically trying to get as much information from my client Miss Reed as you possibly could concerning the victim and how the victim ended up being there correct correct you indicated in no particular order uh that you ask questions like how do you know him correct correct how did he get here correct what happened correct um is there any additional information you can give me about what happened to this person correct okay so that was a conversation that you were personally engaged in with my client in order to gather as much data if you will about what you were dealing with correct correct but your focus was when you first arrived your focus is I need need to attend to the patient correct correct like conversations not withstanding I need to deal with what's in front of me which is a an unconscious man in the snow correct dressed inappropriately correct and possibly freezing to death correct but you did say that you had enough of a conversation with Miss Reed that she answered you and said something to the effect of I hit him oh my God I hit him correct so then you followed up on that conversation correct as much as I could yes matter of fact you said that you asked her additional elaborating questions correct did you hit him in the face or did you kick him did you hit him with your hand okay so that's a conversation that you're having with Miss Miss with Miss Reed face to face cor um you're talking to her you're looking her in the eyes she's looking you in the eyes you're standing still and you're attempting as best you can to converse with this woman so that you can gather as much information as you possibly can as you attend to the victim correct you indicated that that conversation lasted long enough that you the conversation was frustrated by the fact that you weren't getting information that was helpful to you so you turned that conversation over to Katie mclin objection sustain ask it a different way sure did you have uh did was your conversation in some way in your mind and when I use the fr the word frustrated I mean I mean it was just you weren't getting the information that you were seeking correct it wasn't productive okay better way to put it I'll use your word that conversation was unproductive enough that you then moved the conversation over to miss mclin correct correct firefighter mclin and once firefighter mcclaflin engaged Miss Reed you then began to attend to the patient again so the patient was already being treated by the other Personnel on scene okay um I started the conversation realized it wasn't going anywhere I had other respons abilities regardless of how they ended there they still needed treatment and transport so that began my priority and moved her over to try and get as much information while treatment was being done what part of the treatment were you responsible for all of it sorry that was a that's a great answer to a very vague question what physically were you doing with Mr O'Keefe uh in which particular moment uh when you first arrived and attended to him and physically touched him in other words were you the airway person were you the cardiac person uh were you doing chest compressions were you squeezing the the bag I would have been doing chest compressions initially until I could delegate that task to somebody else okay and chest compressions I'm G to butcher this because I've never been trained other than my little toddler uh they look a little like what I'm doing now correct correct and I indicated Palm over the one Palm over my hand arms extended and you can see my shoulders moving up and down in a rhythmic fashion correct so if I think answer correct yes I'll wait to what were you wearing what was I wearing uh my uniform didn't expect that one did you that was a different one uh heavy winter coat okay uniform does the do paramedics wear sometimes yellow bright yellow for safety yes were you wearing a bright yellow heavy winter coat I don't recall I have a few different coats got it got it do you remember what Miss mlin was wearing I don't okay [Music] um that conversation that you had with Miss Reed at the scene um that had to have lasted I'm not guessing it was very long but it had to have lasted a minute at most yeah at most once you finished your conversation with Miss Reed uh did you then start attending specifically to the chest compressions and the high level CPR that we've heard so much about your colleague yes as you're doing the CPR on the scene that high level CPR high quality CPR uh was Mr o'keef then moved to the scoop which would then facilitate getting him on a g correct that g was then moved between couple of patrol cars Cruisers and into the ambulance correct correct once you were in the ambulance the first priority is to get this person warm is that right first priority is always going to be CPR um the secondary would be getting them warmed up okay um so obviously when you got into the ambulance you would shut the doors there's a heater on in the ambulance yes you never came back out of that ambulance after you got Mr o'keef into the ambulance did you no okay and you were in there with firefighter nutal at the time nutal and Kelly and firefighter mlin was outside the ambulance doing whatever she was doing correct okay initially and then she came in afterwards to yeah and did I hear you correctly when when firefighter thein got in the ambul she took over the driving responsibilities so there's two different compartments they're not connected there's a little window between the two areas um so she assisted with interv I in the back and then after we had established everything we needed to on scene to begin transport she then got out and then started driving got I'd like to play first I'd like to have marked uh I think it's already been marked exhibit 379 it's a a video a snippet of a video it's probably three minutes long it's not that long I'd like to play that portion of the video for you and when it's done firefighter nuttle firefighter nle sorry I'm looking at the wrong notes firefighter fromat which is not that easy to say um did a great job I'm going to ask you to show me exactly where on the video if you can that you have this conversation with the laser pointer my client I'll yes you can use the laser pointer as you wish this is just to orient you if I may your honor uh the top this see if I can do this here we go the top is a Das cam from one Cruiser so I'm going to see I'm going to see council at Side by for a second please e for this uh until we pause it I'm going to ask you to Focus your attention on the top dash cam video go ahead and play that can you pause it actually I need to see s council at sidebar again e e folks we'll we'll take a 15minute recess please t e e e you are muted yes I'd like to see it [Music] [Music] s for [Music] for [Music] for e that's the extent of the approximately the extent of the length of the video the clip that I was going to play okay all right so we'll take a 10-minute recess thank you for e e e e for e e e e e e e e e e e for e e e e e e e e e e e e e e e e e e e e why does council come to sa the jurors are coming in for e e e just sure okay thank you your honor um fire flatti I want to draw your attention to the top video uh and I will I may pause it and ask you a couple of questions [Music] this did you see a person run into the screen yes run into the frame rather from screen left yes who's that I don't recall okay uh let's go and pause I want to draw your attention to the left side of the top video did you see somebody wearing a bright yellow jacket if you could rewind it I'd look at that area why I play it forward okay and see if you see that [Music] yes pause and do you recognize that person I see a yellow jacket I can't tell you who it is okay based on your memory have you seen this before by the way no based on your memory is that the approximate position you see person enter from screen left you you so ask the question if you don't see it you don't see it on the video I I couldn't tell you if that was myself or not was there somebody else doing CPR multiple people rotate through CPR so yes who was responsible for doing the chest compression whoever is closest to that area we're all trained for that skill okay I'm asking in this particular case yes I know everybody's trained did you testify earlier that you were the one doing the chest compressions I said I was one of them okay does that appear to be you doing the chest compressions it could be I'm not sure let's go stop it do you see the person basically in the middle of the screen there yes is that appear to be my client tell I tell [Music] you see individuals entering from screen right yes does that appear to be in the yellow jacket that build would have been uh probably it could have been firefighter Kelly or could have been mclin who's the person trailing the gney I I can't tell [Music] okay the person in the hood just obscured that figure did you see that figure standing on the other side of the person no [Music] POS the activity that's going on just to the sort of left side of the SUV in the frame can you describe to the jurors what that activity is so that would be lowering the stretcher to get ready to load the patient [Music] on it now this person now appears to be facing the camera do you now recognize that person I don't [Music] pause can you focus your attention on that individual in the Yellow Jacket yes what does that person seem to be doing CPR uh which part of the CPR chest compressions sorry I didn't mean to talk it's okay justs I want to make sure that Nancy could get down what we're both saying so which part of the CPR just compressions thank you is that you I don't know okay at this point you have no idea whether or not you don't remember whether you were the one doing chest compressions when he was moved from the ground to the gurnie I don't recall but you did earlier testify you were doing chest compressions I I did at some point during this call yes okay in the entire length of this video you see anybody else trade off from that person doing chest compressions from the time the person was on the ground to the G is that the same person it could be the same person I'm not sure did you say that's probably Jack sustained jur disregard that [Music] direct your attention to this person that appears to be a fighter firefighter in the middle do you see that person yes may the objection sustained I'll see council at Side by e May yes take a look at the person or the yellow in the middle of the screen do you recognize that as a fire jacket but and build I would guess it was either firefighter Kelly or so we don't want you to guess I would my best estimation would be firefighter mlo firefighter M yes [Music] okay recognize the person in the Yellow Jacket to the right of who you just described as firefighter M no is that what is that person doing a my guess would be I'm sorry guess uh not even an estimate do you know I don't know next [Music] question a at that point did you join your colleagues in placing Mr the ambulance yes okay based on that did that appear to be you following the gurnie in the yellow jacket over to the yes okay and who is the the lead fir five when I say lead I mean the one to the right leading the gurnie on the front side of the gurny I'm not sure okay uh one of your colleagues though yes what did you do once you left the frame where did you go that would have been into the ambulance and as you earlier indicated shut the doors correct correct okay and you never came back out no okay uh I'd like to draw your attention to the lower video okay and we're just going to let that play for a couple minutes and see if you recognize anything I'll ask you to pause it in just a second [Music] [Music] [Music] I'm I'm G to ask you to look up to the top video uh you see what appears to be a person wearing yellow to the right yes recognize who that is no [Music] [Music] [Music] looking at the lower video do you see what appears to be a vehicle in the middle of the screen yes what is that that is an ambulance that appeared to be the ambulance that you arrived in yes and that's ambulance that you took the Stef to yes doors are closed yes are you in the ambulance this point I'm not sure well this was let me just ask it a different way this was running continuously no pauses you've already taken Mr o'keef to the ambulance would you have gotten in the ambulance I don't recall well I mean you're not standing outside the so if you know the answer I don't know next question you have no idea whether you're in the ambulance or not at this point at this point no would you have gone any place else when you left the frame could have been to gather equipment but for certain I don't know where would Mr o'keef have been been in the ambulance again don't know for certain could have been or was in the ambulance at this time I don't know okay let go [Music] stop okay taking a look at both screens you see the group of people including the individual with the yellow jacket at the bottom screen yes that appear to be the same from a different angle same group of people including the person with the yellow jacket on the top screen yes who is the person that was U directed to um get the medical history from my client mlin you believe that's Miss mlin no you don't think that's her I'd have to rewind to know where she went well let me ask you a couple of other questions in the bottom screen see police officer yes you see woman with long hair standing next to the police officer yes that appear to be my client yes there's an individual with a fire jacket on right yes and she was Miss mcclaflin was directed to get medical history and interview my client correct yes that appear to be what she's doing right there Jack sustained at this point where do you believe you were now I don't remember think you might have been in the ambulance I don't remember you testified earlier and this has been a continuously running video on the top testified earlier that when you left the screen with that gurnie got in the ambulance correct we headed that way yes so firefighter flatti it's not a trick question where did you go when you left the screen it would have been to either gather equipment or to put the patient in the ambulance okay when did the what what equipment did you need to gather it would have been anything that was left by the patient side whether it was a first end bag Airway bag any other equipment basically you were doing chest compressions I didn't state that you didn't say that I said I did chest compressions at some point I didn't say I did them continuously throughout the call so you just put John O in the back of the ambulance and went to look for some equipment not what I said um so chess compressions were done continually throughout whether they were done by me or by another provider I can't tell you specifically so when you left the screen and joh O was on the jurny you're engaged in vital life-saving a a vital life-saving Endeavor correct yes that that had to have been your focus correct that was at the time yes and you wanted to get them out of the the the cold the weather yes because it was inclement it was freezing out correct yes so you wanted to put them in the ambulance right and you wanted to continue CPR because in your words you testified on direct examination you believe that there might be some viability left yes so CPR and and life-saving measures were absolutely vital at that point yes you didn't go find equipment you got in the ambulance didn't you yes so at this point you're in the ambulance correct at this point I don't know you indicated you never got back out of the ambulance after you got in correct I don't believe so no [Music] did you see any place in that video where you had any sort of detailed conversation with my client no did you see any place in that video where you engaged my client and said how'd you get here what happened she said I hit him and you said how' you hit him all the the stuff that you testified earlier to I didn't see that in the video know you indicated in a police report during an interview that you had with um Yuri bunik on February 8th that my client said I hit him correct correct you remember having that conversation with Sergeant pnck I don't recall the conversation but I'm trusting that your records are accurate is it true that during that conversation you indicated to Sergeant bunik that quote Katie spoke with Karen Reed Katie is Katie who M Katie spoke with Karen Reed collecting medical history for the victim and was also told by Karen the last time saw the victim was 1:00 a.m. that morning that is when Anthony who's Anthony would have been myself that is when Anthony heard Karen say I hit him I hit him is that what you told Sergeant Buck I don't recall does it appear that this is the time firefighter for that haenlin is getting a medical history from my client or attempting to I can't tell from the video H we do know however that during this time you're in an ambulance probably 30 or 40 feet away with the doors closed I don't know Well you certainly don't see yourself in that frame do you doesn't appear to be good if we're done with the videos can we take it down please of course yes I think we are finished thank you you were the lead firefighter on that team that night correct uh lead paramedic lead I'm sorry lead paramedic thank you uh you understood obviously the gravity of hearing a statement like I hit him some sort of of explanation about what may have happened to the victim correct corre that statement could potentially have direct relationship to or a direct relational U impact on how life-saving measures are done by the medical personnel that you turn the victim over to right you testified at the Grand Jury that you wanted once you got to the hospital you wanted to be as quote unquote helpful as possible when you hand it over the patient correct corre you said said you actually stayed at Good Samaritan for additional 10 to 20 minutes which is your Habit in cases like this because you wanted to be quote unquote an asset to the medical intervention team correct that team includes the doctors and nurses that were trying to provide life-saving services to the F correct but you never relayed to a single doctor or a single nurse a single word about a woman who said I hit him did you documentation for us ends at transfer of patient care as far as my memory I do remember relaying that information to the doctors and nurses you do yes have you ever testified about that ever this never been asked about that oh nobody ever asked you so you didn't tell anybody in the court setting no testified in front of a grand jury didn't you yes L asked you bunch of questions during the course of that conversation that was under oath did you ever disclose that you told the doctors and the nurses you heard a woman say I hit him I recall telling the doctors and nurses that there's a question of that the patient was hit by a vehicle or we don't know is what I directly said to the doctors and nurses you directly told the doctors and nurses that there was a question about whether or not he was hit by a vehicle right have you ever said that in any context either to the police or in a grand jury before today I don't recall you were asked a bunch of questions yesterday the day before yesterday and this morning by Mr L yes did you say it on your direct examination I wasn't asked that question ah so since Mr Al didn't ask you you just left it out that you told the the doctors the medical professionals that in fact you described that this patient was likely hit by a car objection wrong sustained you a report as well correct yes we talked a little bit about that report there's an area in the report for a narrative yes about your observations your experiences with this patient correct cor your job as a lead paramedic as detailed as possible correct corre you want to provide and impart the most detail you possibly can about an incident to assist in medical intervention correct correct take a look at page three of five of your report yes you see that narrative area I do and you point to that P portion of your report where you indicate that my client it said the words I hit him it doesn't say that and you point to your report the portion of your report where you indicate that you told the doctors and nurses that she said I hit him doesn't say that can you point to that portion of your report where you indicate that your concern for the patient was that he had been hit by a car doesn't say that you indicated on direct examination that you were quote unquote looking for anything that we could pass on to the emergency room that would assist I think it might have been an assistance to the emergency room Personnel to indicate that you believe this person been hit by a car jaction sustained do you believe believe that it that would have been an important piece of information to pass on to the emergency room assistance objection I'll let him have that thanks it would have been important yes and it's nowhere in your reports correct it's not in the reports no you didn't tell that to the police when you were interviewed eight days later I was not asked about how or what I was my question is did you tell the police eight days later or nine days later when you were interviewed and you didn't tell the grand jury that correct no and you didn't mention that on direct examination in front of these jurors did [Music] you I have a moment y yes that's all I have hey Mr L far apart from you had been asked some questions about the observation you made of Mr O's ad [Music] being and absent any external observation of injuries that could be from an internal injury cause is that correct correct now the conversation that you were talking about in which the defendant indicated you repeatedly that hit or I um that occurred on your sort of way to the bot correct correct now turning back to sort of when you're coming to the scene and arriving at the scene you've got a call uh or dispatch in regard to an unresponsive male in snow correct corre you know that going there correct corre and where you sort of bring the ambulance to the stop there are other vehicles already in that area where Mr O is correct correct and it's from that vantage point that you're able to then see Mr O's body off the side of the road about 10 feet or so into the law correct now when it comes to chest compressions uh your department any Department as far as uh sort of the medical field the jine is there any sort of policy or protocol for how long one person should be doing those at a time so recommendation is always two minutes but it's usually based on the fatigue of the provider um but really the most important thing is just quality of CPR and making sure that they have the best CPR throughout regardless of fatigue it's not recommended that one person do continuous chest compressions for 15 or 20 minutes bre it's actually recommended not and so that would be sort of when you have that many sort of assets we you want to see uh would it be typical for somebody to continue on with chest compressions for that long period of Time videos that you were showing up on the screen have you ever seen either of those videos no you have no idea as far as the times whether they're accurate correct no clue and whether the videos are synchronous you have no idea about that either [Music] no the conversation in which you heard the defendant say I hid him and the conversation that firefighter mclin had in which the defendant told her I those are two separate conversations correct correct happen at two different times two different locations and you weren't even present for Miss ml State correct correct we did when you were interviewed by The Troop and when you testified before the grand EUR you indicated in both instances that the defendant said to you I hit repeated correct correct now when you were asked questions uh about what you relate to the hospital staff that what you're testifying to that's your memory of what you told the hospital correct correct and you indicated in that that you had said something uh to the effect of there question about whether or not Mr O'Keefe had been hit by a car correct correct and so from your conversations with the defendants um and the sort of expounding questions if you would ask for clarification uh why was it that you related motor vehicle sort specifically as a as a question to the to the hospital staff so it was due to the proximity of the patient to the roadway um and the vagueness of the statement so proximity to the roadway and the fact that she stated I hit him the red flag of him being underdressed and not people don't just lie down in the snow um in a blizzard so how he got there we're not sure so we're trying to figure out what happened but due to the proximity of the roadway that was our first inclination I not all right you may may I a couple of [Music] questions you indicated that um it's not recommended that someone do chest comp for 15 or 20 minutes correct uh you saw the video screen that video was about three minutes yes did it appear that the same person that was doing chest compressions at the beginning of the video continued doing chest compressions all the way through I don't know we just watched the video um I don't I can't tell you for certain which Personnel we all have yellow coats so I can't tell you if somebody swapped I don't know did it appeared to you and watching that video that the person that started on the the chest compressions on the left side of the screen continued all the way through up to the scoop up to the gurnie and off screen doing chest compersion jaction sustained you indicated that when you heard this phrase I hit him that your response was did you hit him with your hand right yes did you kick him yes did you punch him yes that's what you previously testified to correct yes nowhere in that nowhere in that conversation did you ever suggest did you hit him with your car I don't recall if I asked her specifically about that so now you don't recall about that either jackon your Jed and for the first time in any Forum you're telling this jury that you then thought based on that conversation it was attendant to the video that we just watched you believed that Mr O'Keefe had been hit by a car and that she said she did it I did not say that so what am I allowed to respond yes so I left it open-ended to the staff of the hospital that these are both possibilities of what happened to the patient and of course if you had said that to the staff of the hospital what staff of the hospital would certainly put it in some of the Medicals correct they don't have to it's it's really up to them and you're aware that none of those have that statement I'm not aware all set all right you are all set firefighter flatti or paramedic flatti thank you who is your next witness Mr L yes you're on the call to call Mr Matthew Kelly okay you I may approach just to retrieve the exhibit I think St [Music] step the court and jury the case he the truth the whole truth the truth help you I do morning so you can sit or stand however you're comfortable just bring perfect thank you all right Mr L whenever you're ready thank you good morning sir good morning you uh please state your name and spell your last name for the record sure Matthew Kelly k l l y and what is it that you do for work I'm a firefighter paramedic for Canton Fire and how long have you been a firefighter paramedic with cant uh approximately two and a half years and uh prior to um working for the Canon fire department uh what if any other employment did you have within that sort of field I worked for a private ambulance BR ambulance for approximately 5 months and sort of geographically where was that located uh Boston area now prior to you uh working as an EMT or paramedic you worked as an EMT before being working as a paramedic correct okay and so prior to working as either an EMT or paramedic um did you have any sort of training or did you receive any sort of certification in regards to being an EMT paramedic um yes so I had to do a a six-month EMT course and then I had to do a uh practical and written exam for the course and then for the state to get my EMT and then for paramedic school it was about a uh 10 to 12 month didactic portion and then I did a uh believe it was 200 hours clinical in the hospitals and then I did a 300 hours ride time and then I had to do a uh a practical and written exam for the course and also for uh the state and now with Canton Fire I'm getting uh preset as a paric and uh when you use that term as far as precepted what what exactly does that term mean within your um it just means that you get trained by um an experienced paramedic for an extended period of time until they say that you you can do the job on your own and uh with regard to being a EMT and a paramedic to receive a certification in regard to working within that deal you say that again with regard to being an EMT and a paramedic to receive some sort of certification either from the state or some other body in regards to working in that yes you have certification in regard to V yes and is that certification up to dat yes it is uh sir if I could turn your attention to January 28th uh the evening of that into January 29th 2022 were you working with the can fire department that day yes I was you recall what kind of shi you working on that uh um 24-hour shift on the ambulance and um which Station House were you assigned to on that station one and that's located where within the town of Camp uh 99 Riv Street and you were assigned to the ambulance is that correct correct and who if anyone else from your department was assigned to the ambulance along with uh paramedic Anthony fatti and on that morning of January 29th do you recall about what time that you woke up on that day um believe it was about 4:45 a.m. when you woke up what if anything is it that you did with regard your duties and responsibilities around so we woke up a little bit early to uh shovel off the apron shovel off the parking lot and just prepare for uh the new shift coming in and just briefly sir like so when you go outside to shovel what if anything you recall about sort of the weather conditions and what they were at that point um there was snow on the ground it was snowing high winds low visibility still dark o and you recall being dispatched to a call shortly after 6: a.m. yes I do and so what was that call or what was that dispatch in regards to and where specifically were you dispatching it was uh unresponsive mail in the snow on a Fairview Road and that area Fair viiew Road uh through your work with can fire department are you familiar with that specific area yes and you respond in the ambulance is that correct correct or if anyone goes along in the ambulance please uh flatti was in the passenger seat and then uh paramedic Tim n was in the back and who was driving I was driving and in addition to the ambulance uh ambulance one that you were in uh what if any other sort of vehicles or apparatus responded from your station to Fairview uh we also had an engine and a um our shift Commander SUV if you recall who was the shift commander in the SUV shift Commander was uh Captain W Roby at the time um and Captain Roby is now the chief of cfire is that correct correct and as far as the engine was concerned who offend assigned to the engine and responded call it was Lieutenant uh Greg Woodbury firefighter paramedic Katy mcgoffin and Fir fighter paramedic Frank Walsh and as you're driving from the Station House to Fairview what if anything you recall about weather conditions visibility anything like that along with way um just uh heavy snow wind uh real low visibility um good amount of snow on the ground so I was just trying to take it slow so we didn't spin out or or drift or anything like that and can you describe for the jury sort of the route that you took from the station on Rivier Street to uh Fairview Road that yep we took a right onto Rivier Street left on to uh Sherman Street right onto Chapman Street and then a left on to uh Fairview and as you're driving down Fairview what if anything uh can you tell the jury about sort of the the elevation of that roadway as you go from Chapman down to where you st um it was a pretty pretty steep long road uh downhill it was probably the uh downhill for half of the way through fear few um and because of that I was just trying to go real slow so we didn't uh drift down the hill and one last question about driving but as you're driving along what if anything else that you observe as far as sort of other vehicular traffic on the roadway any other cars trucks anything like that uh nothing until I saw the police cruiser at the scene and so as you're approaching the scene and you're driving towards what if anything sort of first draws your attention to to where you're going and and where you sto um so it was just real low visibility but we could see uh blue lights at the time so just kept going towards the blue lights and knew that it would be in that area now do you where do you stop in relation to the creu um we I believe they were facing towards us so we would be in front of them and uh at some point uh you're you're being dispatched for an unresponsive mail part correct cor right and so when you're pulling up to the scene you see the cruiser are you able to also see any sort of unresponsive mail party uh not when I'm in the truck I had to get out of the truck to see and when when was it and how far away from it were you at the first time that you observed the unresponsive um once I got out the truck it was I was probably had to be about like five feet away until I could see uh victim and at this time when you're arriving sometimes shortly after 6 AM is light out dark out or something it's dark and just we can stop saying unresponsive Ma at some point you identified who the patient was that you eventually treated and transported and who did you identify uh Mr o'keef the John o'keef is that correct correct um so you get out of the vehicle um you all get out at the same time is that correct um relatively yeah and where is it that you firefighter fromti and firefighter nuttle go um so we we first go to pick up some of the uh bags and stuff that we would need to conduct a arrest and then we just go straight over to uh the body and um some people that were around there and with regard to the bags that you retrieved what what kind of bags we talk uh we take uh like a first in bag that has uh miscellaneous stuff uh we' take an airway bag and we would take a cardiac Monitor and when you indicate as far as where Mr o'keef was who if anyone else or what if any other people were we're in that same are can you say that one more time when you first go over to where Mr o'keef is if anyone or how many other people are are in that general area sure I remember seeing a police officer and um two women and um as far as where Mr o'keef was first of all how was he positioned in relation to the uh he was on his back probably about around a fire hydrant probably about five or so feet from what I saw would be the street you believe about five or so feet in from the road correct cor um now with regard to um Mr o'keef when you first come over uh what if anything did You observe as far as um snow on him or around him or in the area where he uh I I don't really recall you recall how Mr o'keef was dressed when you first get over there believe he was wearing a hoodie like a sweatshirt and jeans and remember he had one shoe on but forget which shoe it was I don't recall which shoe it was but there was one shoe on his s at that point correct and when you first arrive um at this patient at Mr o' what is it that you and the other firefighters uh are doing in regard to to treatment EV um so the other fight firefighters were checking for a pulse um and then after that we while I was getting some of the supplies and then we would uh start compressions and start moving them into the ambulance so we could get a better look at them and and uh what we were doing you say St compressions uh what what kind of compressions are you referring to oh CPR ch and based on your training experience is there um some sort of protocol as to how long one individual should be doing chest compressions um so we want early and continuous chest compressions uh for as long as the person is pulseless we will take breaks in order to uh check for a pulse and check for uh Rhythm any R uh Rhythm changes and so when when brakes are taken is that one person that's doing those same compressions the entire time or is it switched off or something else uh we try to switch off every few minutes now when you first approach where Mr o'keef is on the ground uh what if any sort of injuries if at all Did You observe on Mr o'keef that time um on the ground I didn't observe any injuries that or recall seeing any any injuries at the time it wasn't until got him in the ambo and said I saw some injuries and so from that sort of initial assessment and initial sort of treatment at the Patients uh what exactly does that sort of assessment and treatment consist of when Mr O is on the um basically just checking for uh Brea breathing and if he has a pulse um it was pretty dark and very low Vis visibility so um we wanted to get them out of the conditions and into the ambulance to kind of further assess them and from your sort of initial assessment did he have a polic was he no and so want to get him out of the conditions and how how is that accomplish uh I believe we used a uh scoop board or scoop stretcher it's just a uh backboard that breaks into two pieces that can slide underneath the victim or the patient um we used that and then we um had picked them up and put them onto our actual EMS stretcher and then just put the stretcher into the and where was the stretcher sort of placed in regard to where or in relation to where Mr o'keef was 5T off thead uh I don't recall um now once you get to the ambulance what if any difference did you notice between sort of the lighting and the ambulance versus the lighting outside on the W um so there was very low visibility outside there was great visibility inside with the lighting all around the back of the ambulance and so once you're in the back of the ambulance what if anything did You observe or note at that point in regard to any injuries you observed in this um he had a uh like a swollen black and blue right eye and he had some blood uh around his mouth now as far as as Mr o'keef was concerned uh during treatment you're obviously you're touching or making contact with Mr O's SP correct correct and during the course of that what if any observations or what if anything not in regard to sort of tactile observations of Mr uh he was very cold to touch very stiff almost Frozen like um yeah now at some point um during the course of your treatment in the back of the ambulance are close remove uh yes is that why is uh it's just so we can try to uh examine his full body for any uh other injuries and there's some concern for cardiac reps correct correct can you explain are you familiar with that sir yes can you explain to the jury what your understanding based on your training experience is as what is card uh sure it would be when a um a person has a lethal cardiac rhythm where they no longer have a pulse now once um the clothes as far as being removed how are they physically sort of how are they I believe they were probably cut off with trauma shears and um once the Clos are removed promise what if any additional observations you make of injuries to uh there was some lacerations on his uh right upper extremity now the chest compressions uh that you were talking about was that continuous sort of throughout the the patient care with respect to Mr O yes and um in addition to um that what if anything was done with respect to body temperature from is ke once in the back um so we did some rewarming so we did Heat Blankets and uh warm fluids and as the chest compressions continue in the back of the ambulance what have anything did You observe with regard to Mr O's nose or mouth um I remember that there was some kind of some blood or vomit or bile coming out of his uh coming out of his mouth now turn your attention to back outside of the ambulance taking you back there for a moment um you indicated in your testimony that when you arrive there there two females in the area where Mr was is that correct correct um can you describe anything as far as what they look like or anything about those two females you saw um I just remember they white looked to be between 35 and 45 years old I would say and uh average Building height what if any sort of distinguishing characteristics Did You observe between one of the other I remember one had some red stuff around her mouth I I was thinking it could be blood and that individual That You observe with red stuff that you talk to be blood around her mouth uh what if any observation did you make of her as far as her demeanor or anything like that um she was just acting kind of erratic and uh kind of running around screaming different things and as far as the the different things that she was screaming what if anything do you recall specifically hearing her screaming when she was running around uh it was it was just something like he's dead he's dead is that something that she said once or more than once or something at least twice as far as that sort of phraseology was that consistent throughout I would say so yes now when you enter uh the ambulance does to the patient care continue obviously with Mr O yes and if you recall who was sort of involved in that patient care in the back of um me nut all fatti um Woodberry um Walsh and mofin came in a little bit later I'm not sure if she if she did did any patient care or not the majority of the people from your department that responded the scene at one point or another were involved in patient care with regard correct now you drove the ambulance to Fairview is that correct and so for the transport from um Fairview what hospital did you go to uh Good Samaritan so transport from fair viiew to Good Samaritan uh who drove the ambulance that uh Molin and so firefight M Driving where are you located within I was in the back with a nut all in flatti do you recall sort of specifically what if anything you were doing with Brad to Patient Care during the transport phase um um so I was just helping them the transport phase we I was doing compressions before but we had uh switched them over to a um automatic uh compression device um so I was just uh involved in helping uh ventilate and suction and was there any who if anyone else in the back of the ambulance was also sort of working on Airway for um we've uh not all and I for I forget who else now during the course of Transport from see when you arrive to Good Samaritan what if any change did you note in reference to Mr o' um as far as heart activity respiratory anything of what uh no changes um Miss kilman if I could uh ask for divot number nine please part Kelly I'm just directing your attention to the screen and what's been marked as exhibit number n do you recognize that yes and what do you recognize that to uh the location of the scene for the house that you responded to on January 29th is that correct correct and uh M gim if I could also have exhibit number 18 and again so just directing your attention to the screen you recognize the photograph that's up on the screen yes what's depicted in that photograph uh the location of the scene again sort of a different view of the same home is that correct correct I approach [Music] yes hi far Kelly with using that uh lasor pointer that you have now before you if you could uh please direct the jury's attention on the screen to whereabouts uh you located mrke in that position when first it was about uh this area right here thanks I have nothing further this with all right Cress examination yes may we approach for a minute jur remember you can stand up and stretch anytime we go good morning sir Mr Kelly you and I have never met before correct correct we've never had a conversation correct in or out of court correct now with regard to the clothing that John o'keef was wearing when you came upon him I believe you remembered that he had on a pair of jeans so my the best of my recollection yes and you remember that he had a hoodie sweatshirt yes and what also stuck out in your mind is that he had only one shoe on correct correct uh from your memory you're not sure if it was the left or the right shoe but it was one of those correct correct and you did not see another shoe or the matching shoe in the area anywhere around where he was L correct correct and to your memory you you never saw that other shoe correct correct now with regard to the removal of the clothing I believe you testified before this jury on direct examination that trauma shears would have been used um is that accurate yes and what what do those look like how big are they and if you could describe them um they're about this big so say six in and they have like a usually like a plastic or metal handle and then just kind of two curved blades that are used to cut and are they are they essentially a large pair of scissors uh yes and are they sharp in terms of the blades yes and they need to be somewhat uh you know heavy duty because you don't know what type of clothing you're going to have to cut fruit correct correct where was it that the trauma shears were used in order to start to remove John O'Keefe's clothing that morning uh I don't recall do you recall if it was before he was put into the ambulance during the ambulance ride or after he was at the hospital I believe it would I don't recall but I believe it would be in the ambulance I'm I'm sorry there's a little bit of noise could you repeat that sure I I don't recall but I believe it would be in the ambulance in the ambulance and you wouldn't have waited until you got to the hospital because there was a reason why you were taking the cloth correct correct and what was that reason to look for any other injuries that uh the patient might have and that was a priority as you were treating him correct okay you don't think that you cut off his clothes before you put him in the UL it's correct correct and you don't think that and when I say you I mean your your team right you don't think your team uh cut off the clothes after he was out of the ends correct correct so it was sometime during the ride correct do you recall who it was that actually used the trauma shears along that ride no do you recall at what point during the ride would it have been sort of the beginning of ride or would it have been toward the end uh toward the beginning now with regard to the clothing that was cut uh do you recall if it was the sweatshirt the jeans or both I don't recall do you think or is your memory that the hoodie sweatshirt was left on him without being cut I don't recall where did that clothing go after it was cut by the trauma shears during that ride uh some some of it would be stay right on the stretcher but I don't recall on all of it okay and some of it could have been on the floor of the ambulance as well potentially and then once the uh ambulance arrives at the hospital what is the protocol regarding the clothing that have been cut um it gets transferred over to the RN in charge of the patient and usually stays in their room usually they'll put it in some sort of bag okay and is the clothing put in the bag does somebody meet you out at the ambulance in order to collect the clothing or do you bring the clothing into the hospital in order to transfer it to an RN we bring bring it in and do you recall who it was that brought in that clothing uh no who was with you at that time going into the hospital from the inance not all in flat so it had to be one of the three of you that delivered that clothing to an RN correct correct do you know if all the clothing was delivered to an RN or if some stayed in the ambulance I don't recall and once you give the clothing to the RN do you see where she takes it I don't recall did you go into the treatment room wherever John O'Keefe was brought once he was at the hospital yes and you would previously testify that you believe the clothing would have been brought in with him correct correct do you have a memory of seeing that clothing within that treatment room at the hospital I don't recall do you recall seeing the clothing on the floor I don't recall okay now let's get back to when when you were first arrived on scene and actually but before I get to that um I I did want to ask you a couple of questions about where you were at in terms of your uh career on January 28th 29th um you were uh a fairly new firefighter correct uh uh and you were conscious you had been trained not long before January 29th right it was within several months uh two months yeah within two months okay uh and your priority as a new firefighter was to follow your training correct correct it was fresh in Your Mind Correct you wanted to do things the the right way correct correct and particularly at the beginning of your career you don't want to develop any bad habits correct correct and you were following protocol once you got to the scene as best you could correct correct I believe you testified on direct examination that when you got when the ambulance got to 34th Fair viiew as soon as it was parked you and Anthony flatti went straight to the body correct I I don't recall saying saying that I I wasn't sure um who went straight to the body I said some of us got some supplies okay I I I thought your testimony correct me if I'm wrong but I thought your testimony was that that you may have gotten some supplies but then you and flamma went straight to the body uh yes so we we did uh me and nut uh got supplies me and nut went went to the body all right where was but we didn't go straight there we got supplies first and then went to the body or I got supplies first and then went to the body okay uh how long did it take you to get supplies um probably within a minute I would say okay and where was flati when you were getting supplies uh I don't recall once you got to the body who assisted you with regard to treating John O um I believe it would be the people who are on scene with me um who who would that have been fatti nut Walsh mofin Woodberry and Ry okay so is it your testimony that your memory is that five six however many people were there with you all were hovered over John O'Keefe doing treatment on him uh not treatment but getting supplies uh getting the stretcher um we're all work working together but we weren't all involved in the treatment portion sure and and the treatment was essentially CPR correct correct chest compressions yes uh and dealing with his Airway as well correct uh which of your co-workers Andor you were directly involved with the CPR the chest compressions and the airway issues um I recall that I was doing compressions and uh helping suction and ventilate in the ambulance but I do not recall who else was uh partaking in that okay so let's talk about when he John O'Keefe was put on the scoop stretcher and then ultimately taken to the ambulance who was with you when that was occurring um so would have been me nut flatti and robbery I believe were uh trying to get them on the scoop and then I believe the engine guys were uh trying to get the stretcher who are the engine guys um that would be Walsh it must have been Walsh Woodberry or and mlin but I don't recall who exactly was all right so your memory is that yourself not all and flatti were loading John O'Keefe onto the scoop wait so yeah and then from the scoop he's put on a stretcher okay and then who would it have been that wielded the stretcher to the ambulance um I don't recall who it was you I don't recall so you have no memory of who would have taken John O'Keefe on that stretcher into the back of the ambulance um I don't recall who actually did it but it would just be whoever's in the best location at the time to move the stretcher all right do you have a memory of Jon o Keef going into the back of the ambulance uh not a clear memory now who went into the ambulance with him um me nut offat uh Walsh Woodburry okay and by the way on once he's on the scoop and then put on the stretcher the priority is to get him into that ambulance correct and part of the reason for that is he was cold correct yes sir and your priority was you wanted to warm him up correct correct and the best place to do that would have been the inside of that ambulance correct correct so it wasn't that he was put on the stretcher and then there was was some detour in terms of where he was taken you made a or whoever took him made a beline for the back of that ambulance in order to get him warm correct correct and once he's in the ambulance the priority at that point would be to close the doors of the ambulance correct correct because if you leave the doors open there's a blizzard outside correct jackon sustained let's go ahead Mr Keep mve It Forward please and so the doors were closed to the ambulance correct uh at some point yes all right and inside the doors of that ambulance as you testified was at least not naming everybody but at least you and nut all and flani correct correct and once those doors were closed to the ambulance none of you left the ambulance correct none of us meaning you I'm talking specifically about you and nut all and flatti I don't believe so no um you would have remained in the ambulance all the way to the hospital and that's the point in which the doors will be open correct correct all right now I'd like to ask you some questions about the the scene That You Came Upon in terms of the people who were there when you arrived uh sir uh you had previously testified that you saw I believe you testified that you saw two women and a law enforcement officer already on seene correct correct one of those women appeared to have blood around her mouth correct correct um it was some something red but you assumed that it was blood correct corre and that led you to also believe that uh she had rendered or tried to render CPR correct jaction is that what you thought yes okay and while you were on scene it was the woman who had the blood around her mouth who appeared to be most upset correct correct um she was really upset correct yes would you go so far as to say she was distraught yes hysterical yes frantic yes and you you heard her say um he's dead he's dead something like that correct CH and she didn't say it in the tone of voice that I just said it correct correct she was screaming when she said that correct correct it was uh very easy for you to discern that her words were he's dead he's from dead correct correct and and she repeated it more than once correct correct and it's fair to say that at no point in time did you ever hear her say I hit him I hit him I hit him correct right and you would agree with me sir that you have been extremely consistent in terms of your memory of what she said correct cor correct uh you've been asked these questions not for the first time by Mr L or me in court today there have been other occasions where people have asked you what what did the woman with the blood on her mouth say when she was on scene correct correct you were asked that by Trooper Proctor on February 9th of 2022 correct uh I don't recall um you know it's probably unfair me to say the date but you do recall speaking to a State Trooper not long after these incidents correct correct um and to that state trooper uh you told him that what she said was he's dead he's dead correct I I don't recall you don't recall saying anything differently than that do you uh I remember saying a lot differently but I might have also said that I just don't recall well you don't let me rephrase that you don't recall changing her words at all you recall you always said he's dead he's dead correct correct that was not only to the state police on February 9th but then in April of 2022 you were in a grand jury setting correct correct um there was no defense attorney there on that day correct uh I don't believe so you don't remember seeing me there no I didn't okay uh Mr L was asking the questions correct and there you also said that what he what my well I'm sorry what the woman with the blood on her mouth said was he's dead he's dead correct correct and you've testified to that today yes sir you've never changed that story correct correct and that is because the truth does not change correct correct all right at this point I'd like to play a 15c portion of a video which I would offer as the next exhibit your honor okay so we'll watch it and then you offer with no narration right never and before you start um I'm I'm not as interested in the video sir I'm interested in the audio so if you could listen as best you can sure [Music] he [Music] problem H would you agree with me sir that you we heard what what you heard that night which is he's dead he's dead it was kind of hard for me to hear I heard about does he do drugs I couldn't really hear the the background moment okay may we approach okay e Mr Kelly I got permission to play it one more time I'll try my best um so I again and and by the way before it's queued up I I would direct your attention more toward the beginning of that 15 seconds as here there are things that happen I think that you heard at the end but you tell us what if you can hear what you can hear [Music] [Music] okay that's what did you hear uh I heard someone say dead thank you sir any redirect just briefly on Mr Kelly from that video that was just up on the screen uh you indicated that when you got to the scene you saw the cruiser and park sort of behind the Cru correct uh around the cruiser yeah um so from that video you didn't see the ambulance that you were driving anywhere in correct correct you have no idea whether or not you were even on scene at that time but any of those statements that were made in that video were made correct correct now as far as patient care was concerned we're sort of all of you being yourself firefighter flatti firefighter nuttle firefighter mlin firefighter Walsh firefighter Woodberry were you all together all the time or were you doing separate things in separate places during the course of of your time on uh separate things separate places yeah so fair to say that everything that you heard may not be everything that someone else that was there from your department that day heard correct correct and conversely something that someone else heard may not be necessarily something that you were in a position to hear that day correct correct you also asked some questions about sort of using the shears and cutting off Mr O's clothing during the ride is it your testimony that that was in the back of the an correct correct was that dur during the transport or was that prior would you be utilizing shears on a patient cutting off clothing while the ambulance is in transit uh no so if it was in the back of the ambulance that would have been fire to the ambulance leaving scene and going to correct correct nothing you want the only thing I would offer is the video that I played um I have it all right so we will do that M Mr clerk I it's already been preed right do you not have it Nancy okay thank you thank you all right so we're all set thank you okay thank you you're all set thank you your next witness yes H the call call Mr Francis Walsh to this stand okay Tori what do you have for [Music] today you the evence the court and jury the case down hearing truth hold nothing but the truth okay whenever you're ready Mr L thank you uh good afternoon sir good afternoon could you uh please state your name and spell your last name uh Francis Walsh wsh and what do you do for us I'm a lieutenant paramedic with the Canton Fire Department and uh how long have you been a uh firefighter param with can fir uh just shy of 10 years and uh you indicated that you have the lieutenant is that correct that's correct how long have you been a lieutenant C uh since September of last year now with regards um to you have certifications both as an EMT and a power correct that's correct and and uh with regard to those certifications um when was it first that you sort of received those um I received my paramedic certification in June of 2014 it's when I was officially certified and is that uh something that you've been subject to sort of continuing educational components and recertification since then yes yeah every two years we have to recertify and take continuing education classes is your certification up to certification up to speed at this point yeah it's current I just recertified last month actually now if I could turn your attention to uh the evening of January 28th into January 29th 2022 you recall that day I do and were you working that day with I was and what kind of shift were you working on that occas uh 24 hour shift which is standard and is that 8 am. to 8 am. that's correct that correct me if I'm wrong that would be 8 a on the 28th until 8 am on the 29th that's correct and so where were you assigned to on that on that particular B I was assigned to a headquarters which is on uh 99 Rivier Street and my position was engine driver so fair to say people within your department get different sort of assignments on different apparatus based on the different shift that there was that's correct and your assignment that day was the D driver of the engine correct yes uh engine three now Beyond uh sort of your assignment as the the engine driver in that particular ship um what if any sort of specialized assignment do you have or did you have at that time in regard to uh snow removal yeah so on that particular shift I was also um the snowplow driver um we have an in-house truck and a snow plow for the for the fire department and that was my responsibility on that shift how how many people within your department have that sort of responsibility when it comes to uh it kind of depends uh group to group so um some working groups will just kind of rotate and have a different person do it each time um at that time the group that I was on I kind of had the most experience plowing so I was I was always the go-to person to to be in the plow truck when it snowed and so with respect to that Duty about what time did you sort of get up on on that morning of the 20 I believe it was around 4 a.m. and and why was it that you got up at that it was it was snowing pretty heavily I mean we knew the forecast called for a lot of snow um so I got up early and and hopped in the plow truck and so and just briefly in addition to the snow what if anything else you observe as far as the weather conditions when you're out in the the uh it was very windy um yeah just windy in really heavy snow now at some point uh shortly after 6: am does your department get dispatch to yes and uh where was the dispatch to and what was it in regards to um so I didn't hear the actual dispatch because I was I was in the plow truck um I was in the the rear of headqu is in the plow truck um but my captain captain robbery came out and told me that we had a call for 3 few 34 Fairview Road for an unresponsive mail party and he told me you know to hop in the engine and head to that call and when you hop in the engine who if anyone else from your department was assigned to same engine as you on that so I had Lieutenant Woodburry to my right in the passenger seat and firefighter mlin um in the rear and Beyond the engine uh that you were driving what if any sort of other apparatus uh from your department disat call so that would have been ambulance one and then also uh car five went as well um that's kind of like an optional thing but with a call of that severity the captain will will go as well and who was was in car on that uh Captain robbery and um you drove the engine is that correct that's correct if you could describe for the jury sort of what you observed as far as the road conditions visibility things that like in route from the station very yeah so it was um it was really really poor driving conditions and visibility um I I can't recall ever driving to a call of that nature and that severity that slowly um the visibility was so poor that we were just driving extremely slow [Music] um okay and from if you could describe to the jury sort of the route of travel that you took from station one to Fair sure so uh out of uh out of station one take a right onto Riv Street and then a left onto Sherman Street um a right onto Chapman Street and then a left onto Fairview now if you recall U what was sort of the order you're all sort of dispatching you're all sort of responding around the same time being car five the ambulance and Eng correct correct and if you recall what was sort of the order of the vehicles in response so engine 3 we were the last uh vehicle for the fire department to arrive on scene so when we arrived on scene ambulance one and car five were already on scene and if I could ask just sort of um as you're turning on to Fairview Road you travel down um what if anything do you know about sort of the the elevation of the roadway as we driving down uh it's a downhill grade yeah it gets it gets a little bit steep at one point and the residents that you eventually stopped at or responded to where was that in location in reference to when you first turn on turn on a Fairview about how far down how far down is the residence that you eventually uh pretty far down it's I I believe it's one of the last houses on Fairview and the residents that were talking about it from your perspective when you're driving down there is that on your left or right or something left and as we approaching the scene what is it sort of that you see before you as you know how do you know where to stop and and where you're going uh yeah so I mean we like I said visibility was really poor um but there was ambulance one car five um at least a coule a couple of police cruisers on scene before us so it's kind of hard to miss that um so that's how we knew where to stop now in regard to um you're responding to an unresponsive me correct correct and just be clear at some point you were able to identify or you were told what the identity was of that unresponsible correct that's correct what was uh John O'Keefe and so with respect to Mr O'Keefe uh as you're approaching um when was the first time that you were able to sort of see where Mr o'keef was on SE when arrive uh it wasn't until a little bit after we actually arrived on scene that I could see the patient um because as we pulled up uh the ambulance was blocking our line of sight to where the patient was um so I couldn't see him right away and what was sort of the the I know you talked about visibility but as far as had the sun come up yet no it was it was Pitch Black and so when you arrive on scene um what is it that you and sort of the other people on your engine are are doing in relation to Patient treatment um so at that point uh I got out of the engine and I started walking towards where the ambulance true was um but at that point firefighter mlin was coming around to the rear of the ambulance to get the stretcher out so I went directly to that to give her a hand with that and we proceeded to bring that around the front of the ambulance where um firefighter nut all flatti and Kelly and I believe Captain robery were were working on the patient now in reference to where patient Mr o' was uh where was he could you see sort of how reference to the ground um I could see they had the other firefighters and Captain that I just mentioned had just put him on the backboard at the at the first time that I saw him um I'd say that was like roughly 10 feet in from the road and to that point how how we were able to say that it was approximately 10t in from the road um just a just an estimate let ask you as far as the stretcher was concerned that you and firefighter ml treat where did you place that in relation to where Mr was when you first brought so we placed that we decided to leave it on the street and get it as close to the to the grass or snow as possible um it was unspoken but we knew that we didn't want to put the stretcher onto the snow because it would be too unstable so we put it right up against the curb so right at the edge of the street where the street meets the the yard and so you put the stretcher basically right up against the curve and M was that's correct and with respect to positioning the stretcher was that parallel with the curve or perpendicular to it or how was it parallel and mentioned that obviously Mr Keith is on scene and there are number of different firefighters for your department correct that's correct there was at least a police cruiser did you see any officers sort of around the scene uh yes I remember officer sarif and uh Sergeant good and with respect uh to civilians what have any civilians Did You observe around the scas I observed uh two female civilians and where were they in relation to where you were or in relation to where um I mean they were pretty worked up so they were moving around quite a bit um but I'd say they were somewhere in between my myself and the stretcher and where Mr o'keef was and did you yourself have any conversation with either of the the two females as yourself I did not directly no and you just testified a little bit before that they were upset is this so both of them were yes yes and what if anything leads you to that sort of conclusion as far as their demeanor what if anything did you specifically observe um I mean I I observed one of them um like screaming and crying and um they were both just frantically like moving around a lot as far as the one that you observed screaming or crying do you recall specifically what if anything that person said um all I recall her saying was is he [Music] alive now with respect to uh Mr o' as far as uh his clothes what if any observations did you make of his clo uh the notable observation that I made was that he was missing one shoe uh his right [Music] shoe and where was Mr O when you made that observation of Miss um it was when we when we put the stretcher into the ambulance the stretcher lifts up so it's kind of right at my face and that's when I noticed it so at the time you was being placed in the ambulance you only had one shoe based on what you saw that's correct now once Mr o'keith is in the back of the ambulance where did you so I stayed down at the feet um I was positioned right by his right leg and what if any difference did you know between sort of the lighting conditions outside on the lawn versus the lighting conditions in the back uh in the back of the ambulance it was dramatically better so once in the back of the ambulance what if anything did you note or observe as far as um I noticed the hematoma on his right eye and I noticed some blood coming from his nose and just to be clear for the record so when you say hematoma based on your training experience can you explain what your understand of that term is to the jury uh swelling and bruising now at some points with respect to uh the clothing that Mr o'keef was wearing what if anything did you or other firefighters or paramedics from your department do with reference Mr O we removed all all of his clothing and um let me first ask how was that removal sort of accomplished can you repeat that when you removed his clothing how was that how did you do that oh uh with a trauma shears basically scissors that that cut clothing and um once uh sort of was that pursuing to some sort of protocol or was the clothing yeah on any on any uh any trauma call it's protocol to expose the patient so you can see all injuries and you don't miss any injuries and once close remove was removed with the with trauma shears what if any additional injuries or anything that you observe uh I noticed some um some scratches and lacerations on his right arm now in reference to treatment in the back of the ambulance with regards to Mr o' what if any sort of um role in that Did you sort of assume or were you sort of assigned by the Le paret yeah so I was responsible for the the io drill and access um it's a intra Aus access can you explain to the jury sort of what that is and how that's yeah so uh you do that instead of um instead of IV access so when somebody's in Cardiac Arrest it's really hard to get an IV so what you do is you actually drill into into a bone and uh you can administer medication and fluids like into the bone marrow space and so pursuant to uh so Mr o'keef was undergoing um Cardiac Arrest correct correct can you explain your understanding of that term based on your training experience jury what is card um his no cardiac function his heart isn't pumping blood anymore and so what if any sort of Protocols are there as far as um medication administration is is there in reference to a cardiac yeah so the Frontline medication for that is epinephrine um that's what we gave through the io access what is the purpose of the epine epinephrine I mean basically in layman's terms it it gets the heart pumping again if that's a viable option and in addition to the EP what if any other medication was administered to the io um I believe that was it as far as when I was on scene it was it was just EP and Efron you recall anything about sing oh yeah saline as well but you know it's not a medication but yeah we also administered saline what is what is the purpose of the uh saline is um just to increase blood volume now as far as um as far as the transport uh Mr O has then taken from s Hospital correct correct did you go along with the ambulance on the transport thepit I did not so you remained on scene at least for some period of time correct very briefly but yes and uh you referenced some officers from the can police department that were on scene when you were on scene correct correct and without reference to anything said which of them if any did you have any conversation with fire uh Sergeant good and uh just as far as what you told Sergeant could what if anything did you relay to him before you left I relayed to him that there were signs of trauma on the patient and did you give it any sort of further explanation as to the signs of trauma That You observe yes I believe I told him what I told you about the hematoma on the eye and the the blood in the nose and the scratches and lacerations on the arm so you told Sergeant what youve just testified to this jury that you have that's I believe so mman uh if I could ask for uh exhibit number 18 FR Walsh what's up on the screen is exhibit 18 do you recognize that yes uh 34 Fair View Road is that fair you know minus whatever the weather conditions are fair and accurate portrayal what you observed that day 34 Fair yes [Music] yes [Music] okay and so far W I ask using that laser pointer if you could direct the jury's attention to uh where within this photographic you see uh That You observe body when you first arrived right in that general area than may I have one moment yes no further questions for this witness all right cross examination yes good afternoon sir good afternoon I just want to ask you about the uh woman that you saw on scene who appeared to be screaming and crying would you agree with me that uh she stood out to you because she appeared to be the most upset yes I would agree with that yes and the loudest yes um she appeared to be crying more than others yes and she was screaming right yes and what you heard her say I understand your testimony was that she just said is he alive correct that's what I recall correct in a loud voice yes in a distraught voice yes while she was crying correct have nothing f there's nothing Mr L right no all right you are all set sir thank you thank you who is your next witness uh Miss Katie mclin [Music] you raise your right hand you the EV give the court and jury in the case now in hearing should be the truth the whole truth and nothing but the truth so help we God thank you you can have I just need you to speak into that microphone nice and Loud okay whenever you're ready Mr L thank uh good afternoon could you uh please state your name and your last name it's Katie mlin m c l a u g h l i n and what do you do for um I'm a firefighter paramedic for the town of Canon and how long have you been a firefighter param um probably about 7 years at this point and uh prior to working for the can fire department what if any other work did you do sort of within that that General field um I worked as a excuse me um an EMT basic for rooster ambulance um went to paramedic school I event became a paramedic for Brewster ambulance um and I worked there for a few years before getting on the the fire department and just briefly but uh prior to becoming a paramedic or working as a paramedic um what was sort of what if any sort of training did you receive in regard or Certification did you receive in regard um so it's a a two-year schooling um where you have about a year of um dactic uh there's a lecture portion for about a year and then after that there's about a year to a year and a half of uh clinical training that's done in an ER and then done in an ambulance um so that's that whole period is around two years and uh prior to working um prior to working with fire department you received certification from the state or some other sources being corre yes it's um through the state and through a National Registry and both those certifications to the state and the National Registry are those um granted sort of forever or is there like a continu continuing educational component and a recertification process um so you recertify every two years uh you have to take continuing education classes uh in that two-year period uh and that's just on a a two-year cycle you recertify and your certification is up to date at this point is that correct yes if I could turn your attention to um the dates of January 28th 2022 into January 29 2022 do you recall those dates yes and were you're working with the can fire department on those States yes you recall what kind of shift you were working from the 28 to um it was just my regular 24-hour shift and 24hour shift to can fire is essentially 8 AM to 8 AM is that correct correct and where were you sort of assigned within the town of fire department on that uh so I was on the engine for that shift uh so I was the third person on the engine there's uh a engine driver there's officer and then there's a a third person who's in the back and so your sort of role with respect to the engine is there sort of like name for that position um PE some people call it like the back step yeah and which station house where you assign on that uh the station one which is 99 Rivier Street and in addition to yourself who if anyone else was assigned to the other sort of roles on the Eng Frank Frank Walsh was the engine driver that day and um Greg Woodbury was the lieutenant on the engine that day now turn your attention to um that morning of the 29th do you recall about what time you you got up or what time you went outside that um I think we were up maybe a little a little before 6 because it was snowing and uh we had to like shovel the the front apron uh so we were up maybe 5 5 a so when you were up around that time around 5 a and outside you were outside shoving is that correct yep intermittently sorry intermittently yeah um so during the times that you were outside shoveling what if anything You observe as far as weather conditions that uh it was snowing pretty heavily uh it had been snowing uh we were shoveling and was pretty pretty cold and and windy and if you know around that time that you initially sort of went out were shoving about how much snow had been had accumulated at that point uh I don't know how much I mean enough enough for us to to shovel that front apron but I don't know how much yeah sometime shortly after 6: a.m. were you and other members of your department dispatched call yes and um where were you dispatch to and what was that dispatching uh so the call came in as e a man down in the snow or a a man unresponsive in the snow uh and the call was 434 Fair viiew Road and about how long uh was it from the time that you sort of received that dispatch and and go sort of on the engine to Res how long yes um we're on the truck in going within probably within a few minutes uh at most and so in addition to yourself and the and firefighter Walsh ande Woodbury um what if any other sort of apparatus from your station was dispatched called uh the ambulance was dispatched as well and I believe uh the command car car five uh also was dispatched to the call and as far as car five if you recall who was in car five um at the time Captain robbery and with respect to the ambulance uh if you know who if anyone was was assigned to the ambulance and went uh firefighter Kelly and firefighter flatti were on on that ambulance and I believe Tim nutall was also there he came in uh early and so he jumped on the ambulance as well and um with respect to when you get to Fairview room um do you recall what sort of order the vehicles were in as far as car five ambulance and fire engine uh I'm I think car five was maybe first and then uh the ambulance was in front of us and then we pulled up behind the ambulance and so when you sort of arrive on scene pull up behind the ambulance other than vehicles from your department what if any other sort of vehicles Did You observe on uh I noticed there were uh multiple police vehicles um and a at least one civilian vehicle now obviously you're responding to a report of a nonresponsive mail correct yes and when you're sort of first arriving on scene or or just in reference to when you arrived on when was the first time that you were able to see that unresponsible uh so when I got out of the engine I uh went right back to the ambulance to get the stretcher um because I knew that from wherever they were they they seemed to be kind of uh in off of the road uh so I went got the stretcher with uh firefighter Walsh I believe and then we brought the stretcher uh as close as we could to the patient that was about that was like parallel to the curb uh and that would be the first time that I observed them working on on a patient and so if I could just ask you just with regard to sort of those duties as the back step person so what is sort of the duties and responsibilities of the backstep person on the engine to this kind of medical um so the role of the person in the back of the engine is it it kind of is dependent upon what that what that lead paramedic needs you to do um you're there to assist the ambulance in any way that they need so that could be uh assisting with extrication of a patient it could be obtaining information about a patient or bystanders um it could be assisting with patient care if they need you in the back of the ambulance um it really depends on what they need you to do for that particular call turning back to your testimony moment ago said over rendering sort of patient care is that correct yes who do you mean by um I noted Tim I noted Tony um and there were there was there were a lot of people that seemed to be around that area so I'm not I'm not sure exactly who else was there but I did note uh Tony and Tim were were in that area as far as sort of the other people in that area where Tony and timble um so people sort of beond people from your department um what if any other sort of people did you notice around um I I don't know specifically what do you mean like as far as outside of the uh right so outside of Fire Department Personnel in that area what any observations you make of those people who were those people um well at that point I couldn't really make out uh like the identities of like other people I just I noted Tim and Tony but I I didn't really pick up on who anyone else was at that point they were still uh like in off of the road at that point and so from where they positioned with regard to uh the patient just for clarity purposes you were subsequently learn the identity of the patient correct yes who did you learn uh John o'keef and um where you uh in firefighter walls were with the stretcher how far away from where you were uh was Mr o'keef and and the other um they were I don't know that I could give a great a number um several feet away they were like uh I remember kind of seeing a fire hydrant uh but I don't know exactly uh number-wise that how that would what that would be and from your observation of where mrke was could you tell uh how his body was positioned uh he was supine so he was lying on his back or face up and um what if anything by the time that you arrived with firefighter walls from the stretcher what if anything could you see that firefighter is fat and or n or anyone else was doing with reference M uh they by that point it seemed like they had uh they had already got him pretty much secured on a on a backboard uh and they were ready to to move him to the stretcher and once Mr o'keef is then move with the backboard from where he was where you are what happened um so I remember Tony was uh kind of at the head of the stretcher um I was standing on the side there was um a woman next to me uh and Tony said to me can you try to figure out what what happened any kind of motion to this woman that was next to me and this so fire lead paramedic directs you to asking questions of this people correct yes and fair to say this woman that was next to you you didn't know her you never met her before no um from your conversations with her that day you see that woman in the cour today yes just direct where she seated or an article of clothing she record identification okay now with respect uh to this woman um she's standing next to you when you're at the side of the structure correct yes and um what if any observations Did you sort of initially make as far as her demeanor or how was she sort of acting when you first started to Eng she seemed uh very upset very upset and when you say she seemed very upset what what about her Did You observe that made made you say that uh just her facial expression she was just visibly uh distraught and so as far as your questions what what type of questions are you asking or what type of information are youing from this person um so just basic demographic info uh who the patient is his name his date of birth um and then as far as any more questioning it's you're trying to gather information that would uh basically help explain how this person ended up in the scenario that they're in uh so did he have any medical problems um does he take any medications daily does he have any allergies to medications um so I was asking those questions um and as you're asking those questions what if anything is the defendant this doing while you're asking those questions uh she she answered uh who the patient was his birthday I think she answered the uh maybe some of those initial medical questions that I asked she was but as I said she was she's very distraught she she was kind of moving around uh the scene a little bit so I was uh like just kind of following her and then we came to a stop at at one point and uh I continued to ask a or I asked one more question what was that one more question uh so at that point I asked her if uh there had been any significant trauma that happened before this what she said so she said I hit him she repeated it um there was a woman standing across from her who I believe at that point said uh you're hysterical you need to calm down you're hysterical she repeated I HIIT him and there was a police officer who was in that vicinity kind of with us who replied you what she repeated it one more time um and that officer then signal to somebody get goody down here which I'm assuming would be the the [Music] sergeant so when you have this conversation if you um mentioned that the the other person who was across from you was just was that somebody from your department or an officer civilian or who was that um so it was I was standing I I the uh Karen Reed was to my right there was another woman to the left of me kind of across from her and then there was a a police officer kind of uh not directly across from me but uh within like uh within the same kind of area that was more closer to Karen I would say you know who that officer was I don't you know who the female or civilian person that was across from you know what that person's name is no and with respect to When Miss Reed said this repeatedly I hit it uh you describe for the jury sort of the the tonality of that like how did she um she seemed she was very very upset she seemed hysterical I would even say um just just very upset but once you receive that information did you follow up with any other questions to M Reed at that point at that point I I did not um I have to drive the ambulance so it's a time sensitive situation so I knew I I had to drive the ambulance um it was said in the presence of the police officer so I felt like that was the appropriate uh that that information was appropriately transferred and um I I just felt based by based on her demeanor I don't think it would have been productive for me to continue to ask her questions at that point and uh so after asking and receiving that answer if I hit him did you go uh so I went to the ambulance and reference to the ambulance did you go to the back of the ambulance front of the ambulance where so I went to the back of the ambulance where uh the patient care was was uh happening and as far as the information that you had received uh from defendant did you relay that information to any of the other firefighters from the Department in the back of the I did and uh you recall who was there in the back of the ambulance when you Rel that uh Tony was there Tim um I think maybe uh firefighter Kelly firefighter Walsh maybe might have been in there at that point now as far as when you get to the back of the inance what if anything did you do with reference to assist or help as far as patient care with regard to uh I I didn't assist or uh partake in any patient care now prior to putting Mr o'keef into the back of the ambulance and prior to your conversation with defend what if any observations had you made during the brief time that you on the side of the stretcher of Mr o'keef and then inj uh I noted he had injuries to his face uh I noticed some blood from his nose from his mouth and most notably he had some swelling uh to his eyes mostly the right eye and a laceration uh above the right eye and same as far as when you went to the back of the ambulance to relay the information that you have been asked to to obain um what if any injuries Did You observe oh I'm sorry that I observed those injuries in the back of the ambulance I I didn't observe those injuries while he was uh out on the stretcher I didn't get a good look at him you really had got a good look until right right now as far as you indicated you drove the ambulance from Fairview where did you go um Good Samaritan Hospital and as you were driving that ambulance along the roads from to what have anything you know as far as visibility road conditions uh it was there was poor visibility the roads weren't uh plowed yet so it was a it was a took a probably longer than usual based on the conditions and I apologize but if I can take you just a step back further for a moment just in reference to when you're at the back of ambulance indicated the injuries if your Ober what if any OB make as as I noted that he was wearing jeans um I noticed a lighter like a black zipup jacket or a sweatshirt it was like a lighter jacket um I noticed he had one one sneaker on and that that was it you recall which foot the sneaker was on I don't all right could I see Council for a second please e was trying to figure out some logistical things because we're going to go on a View tomorrow we're going to finish with the testimony first and we'll go on The View after we [Music] finish so but a couple of things about the view please dress comfortably I really appreciate everybody's dressing respectfully for court but wear comfortable shoes at least for tomorrow so um those three cautions please do not discuss this case with anyone don't do any independent research or investigation into the case if you happen to see hear or read anything about the case please disregard it and let us know and for the view I'll give you some preliminary instructions on that just than so we'll see you tomorrow and tomorrow's a full day all right for the please go e e e e e e e e e e for