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Toxicology Focus of First Defense Witness In ALS Murder Trial

A defense witness testified Tuesday that Heidi Good did not have a toxic level of drugs in her system when the Solvang ALS patient died in 2013, and blamed the detected alcohol in her system on a fermentation process that occurred after her gastric contents were sent to the lab.

Judy Stewart, a senior forensic toxicologist with Forensic Analytical Sciences in Hayward, took the witness stand in the Santa Barbara County Superior Court trial Marjorie Good, 89, and Wanda Nelson, 63, in Santa Maria.

The elderly mother and caregiver of Heidi Good are charged with conspiring to murder the ALS patient in 2013 by giving her a heavy dose of medication and tampering with her ventilator.

However, Stewart spent most of Tuesday morning answering questions about a report showing levels of medication in Heidi’s blood and gastric contents. 

Heidi’s level of diphenhydramine, an antihistamine, was above therapeutic levels. 

“I don’t feel the diphenhydramine, although it is present at above therapeutic (levels), I don’t feel that it’s present at anywhere near a lethal dose,” Stewart said.

Defense attorney David Bixby, who represents Good, noted that a prosecution expert had testified Heidi had toxic levels of some medications in here system, asking Stewart whether he disagreed with the label.

“I do,” she responded.

“And that it would be reasonably expected that it would be promptly fatal?” Bixby asked.

“I do disagree with that,” Stewart added.

Lethal doses of the medication range from 8,000 to 34,000 nanogram per milliliter, much more than Heidi had her system, Stewart said. 

Defense attorneys have claimed Hawley’s determination that Heidi had a toxic level of medication in her system led to a conclusion the paralyzed patient's death was either suicide or homicide, and sparked the case against the women. 

A long-term patient with the neurodegenerative disease called amyotrophic lateral sclerosis, Heidi had been on the medication for some time and likely built up a tolerance, Stewart said.

Another medication found in Heidi’s system, quinidine, affected the absorption of the dextromorphan, Stewart added. 

“You have to look at these things in the totality of their environment,” Stewart said. “Is the drug present with another drug that’s going to suppress metabolism or is it present with a drug that’s going to increase metabolism? In this case it is going to decrease the metabolism of the dextromethorphan and allow that concentration realized.”

Other testimony Tuesday focused on test results that claimed Heidi had alcohol in her system, which a prosecution witness said was too high to be exogenous fermentation, or occurring outside the body.

Under questioning from attorney Lori Pedego, who represents Nelson, the defense witness expressed doubts about the alcohol found in Heidi’s system in tests conducted within months after her death.

“The issue for me is I'm not sure that that’s a real number or a phantom number,” Stewart said. “In my opinion, because of the lag of time in testing the blood sample, and then having the gastric sit around for four to five months and then testing the gastric sample, there may have been alcohol production within that vial.” 

Exogenous fermentation can occur with proper situations including sugar, bacteria, time and proper temperature.

“The gastric content has everything available within it that would allow for fermentation,” she added.

Leading to uncertainty about whether the alcohol level is real or phantom is the fact blood tests did not detect alcohol, Steward added. 

Defense witnesses are expected to testify for the rest of the week in the trial that began with jury selection in mid-November. 

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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