A forensic pathologist testified Friday that the totality of the circumstances led him to conclude that ALS patient Heidi Good of Solvang was the victim of a homicide rather than an accident, suicide or natural causes.
But defense attorneys in the murder trial of Marjorie Good and Wanda Nelson questioned why Dr. Dean Hawley had labeled the death as either homicide or suicide as soon as April 2013, and cited the allegedly toxic level of medication a month after the the woman’s death.
Hawley wrapped up three days of testimony Friday afternoon in the Santa Barbara County Superior Court trial of Good, 89, and Nelson, 63, for the alleged murder of Heidi Good on March 25, 2013.
Marjorie Good is Heidi’s mother; Nelson was the caregiver for the patient, who had amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig’s disease.
The prosecution team contends the women conspired to kill Heidi by giving her a toxic amount of medication and tampering with the ventilator she required to stay alive.
Defense attorneys counter that the level of medication was not fatal for Heidi, and blamed a ventilator malfunction for her death.
Under questioning from Senior Deputy District Attorney Cynthia Gresser, Hawley said he relied on a combination of factors, including autopsy findings, toxicology reports, microscopic slides and more in concluding the manner of death was homicide.
“It’s a package,” Hawley said, adding it would be premature to rely on toxicology tests alone.
Many defense questions focused on Hawley’s April 23, 2013, email to the Santa Barbara County District Attorney’s Office in which he cited the toxicology report.
“And you told her, ‘the tox by itself, even for a young healthy person, is reasonably expected to be promptly fatal. Disease or not, this kills,’” attorney Lori Pedego, who represents Nelson, read from the email.
Hawley confirmed his opinion.
Defense attorney David Bixby noted that the doctor earlier told the jury the cause of death was not the medication. But Hawley told the Santa Barbara County Grand Jury a different opinion and cited the medications, the defense attorney said.
“In my opinion, within reasonable medical certainty, Heidi died of asphyxiation. It is a combination of respiratory depressing drugs and being disconnected from the mechanical ventilator,” Bixby read from the grand jury proceeding transcripts of Hawley’s testimony.
Hawley, under questioning from the prosecutor, said his opinion has not changed.
“The medical evidence in this case, the autopsy, the circumstantial evidence regarding the inquiry of the ventilator, the combination of toxicologies that are available now, including the gastric results, show that Heidi Good was respiratory distressed by drugs when she died, and she died because the ventilator stopped delivering air,” Hawley said. “But for the ventilator, she would still be alive. That’s the cause of death.”
Under questioning from the prosecutor, Hawley said the fact the ventilator alarm sounded for 30 minutes is the reason he did not rule Heidi’s death accidental.
“For the conditions of this death, someone has a duty to provide attendance to that alarm,” Hawley said. “This is an individual who by natural disease is dependent on others for that care.”
Hawley said the toxicology is corroborating evidence in that it showed someone had tended to the patient around the time of the ventilator’s disconnection.
The defense and prosecution disagree on what caused the ventilator to become disconnected, with Bixby asking the doctor whether the tubes can become detached even in hospital settings.
“I’m just saying that accidents, whatever you want to call it, act of God, I’m not sure what you would call it, a malfunction of machinery, something occurs and the tube pops off?” Bixby asked.
“I like the idea of malfunction of the equipment,” Hawley said.
“Because machines break down, machines do things that they’re not supposed to do sometimes?” Bixby asked.
“That happens,” Hawley said.
At the time the alarm was sounding, the caregiver was running an errand to pick up prescription medication. The elderly mother was home, but is hard of hearing and reportedly was outside for some time.
Prosecutors say the women gave different stories to investigators in the weeks after the death.
Hawley is a professor at the Indiana University School of Medicine, and said he also teaches at law schools including in South Carolina. He estimated he testifies approximately 156 times a year, primarily for the prosecution, and denied a defense suggestion he is a professional witness.
“Is it possible that you improperly analyzed the evidence in this case and the conclusions you have drawn are incorrect?” Pedego asked at one point.
“Anything’s possible,” Hawley answered.
Testimony in the case will resume Tuesday morning in Judge Rogelio Flores’s courtroom where separate juries will consider the fates of the two women.
— Noozhawk North County editor Janene Scully can be reached at jscully@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.