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ALS Patient Heidi Good’s Doctor Testifies About Care By Women Charged With Murdering Her

Physician says patient's long survival with disease due in part to Wanda Nelson and Marjorie Good

Dr. Ronald Ungerer testified Tuesday that Heidi Good’s long survival with ALS was due in part to care by Wanda Nelson and Marjorie Good, who are accused of murdering her.
Dr. Ronald Ungerer testified Tuesday that Heidi Good’s long survival with ALS was due in part to care by Wanda Nelson and Marjorie Good, who are accused of murdering her. (Janene Scully / Noozhawk photo)

Heidi Good didn't have the health problems that normally afflict ALS patients, one of her doctors testified Tuesday, crediting the care she received in part from the two women now on trial for allegedly killing her.

Dr. Ronald Ungerer, a Santa Barbara-based pulmonologist, testified in the Santa Maria trial of Wanda Nelson, 63, one of Heidi's paid caregivers, and Marjorie Good, 89, the patient's mother.

The women are charged with conspiring to murder Heidi Good on March 25, 2013.

Prosecutors contend the women gave Heidi a large amount of medication and tampered with her ventilator, leading to her death from asphyxia.

"I thought Wanda did an extremely good job of good care," Ungerer said. "Heidi went through all those years, and only once had a bedsore one time. She only had one hospitalization for pneumonia in all those five years, which is actually quite amazing.

"She was very protective of her," Ungerer added about Nelson's treatment of Heidi. "She would call me anytime there was a problem. I was very impressed with her care."

Under questioning from Nelson's attorney, Lori Pedego, the physician said he attributed Heidi's longer-than--normal survival to the care she received.

The pulmonary physician. who had testified during the Santa Barbara County Grand Jury proceedings, contacted defense attorneys after learning the panel handed down an indictment against the two women.

"You were concerned that were a number of questions that no one asked you during the grand jury proceedings, correct?" Pedego asked.

Ungerer agreed he had concerns.

Grand jury proceedings include questions of witnesses by prosecuting attorneys only, with the defense not participating in the closed-door hearings.

The doctor said most ALS patients live three to five years after diagnosis with the progressive neurodegenerative disease called amyotrophic lateral sclerosis or Lou Gehrig's disease.

But Heidi lived eight years, and was relatively complication-free although she was on full life support, the doctor said.

He typically communicated with the caregiver or the patient about matters concerning Heidi's health, often regarding signs of a lung infection, the doctor said.

"It seemed like Wanda was always at her side anytime that I saw her," Ungerer said.

Most patients end up with some type of infection that leads to death, but Heidi's body didn't show any symptoms, an examination of her body revealed.

Approximately three years before Heidi died, Nelson had privately voiced concerns to the doctor about how Heidi's husband, Stephen Swiacki, treated his wife.

Ungerer said he asked a hospital social worker in 2010, when his patient was hospitalized, to question Heidi about any concerns regarding possible abuse.

"I didn't feel I could interview Heidi adequately," he said, noting the time it would take since Heidi couldn't speak and relied on a computer to communicate.

The caregiver also advised the doctor Heidi would deny any problem existed if anyone directly asked her about possible abuse, he said.

The doctor said Heidi never indicated to him she wanted to end her life. Likewise, the defendants never hinted that they thought it was time for Heidi to die.

Asked by the defense  to review documents from the grand jury proceedings, Ungerer also said he disagreed with the analysis of the prosecution's expert, Dr. Dean Hawley, who claimed a toxic level of medications contributed to Heidi's death.

Heidi's doctor said toxic means a bad or adverse effect.

"So to clarify, not every toxic side effect is a deathly side effect?" Pedego asked,

"That's correct," Ungerer said.

Senior Deputy District Attorney Cynthia Gresser asked the doctor about the sedating effects of medications including Benadryl, dextromethorphan and others Heidi took.

"So it is possible to overdose on dextromethorphan, is that correct?" Gresser asked, leading Good's defense attorney to object, saying the question was vague.

Judge Rogelio Flores overruled the objection and told the doctor to answer the question.

The doctor said an overdose is possible, but would require a large amount of the medication.

Other medication Heidi took also had side effects of drowsiness and respiratory suppression, he said in answering Gresser's question.

"Somebody without your training and experience may misunderstand a side effect, how that would relate to a particular patient that you're treating since they don't have your training or experience," Gresser asked.

"That's probably true," the doctor said.

Earlier Tuesday, a second representative of the ventilator manufacturer, CareFusion, testified about his role in the  investigation of ventilator-related complaints.

Noozhawk North County editor Janene Scully can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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