4.Rebecca Jollotta — Cross/Redirect/Recross Attempt (Part 2)
988 linesBAILIFF: This court is back in session. You may be seated.
THE COURT: All right, are we ready for the jury?
BAILIFF: Court, all rise. Jurors enter.
BAILIFF: This court's now in session. Please be seated.
COURT CLERK: Your Honor, for the purpose of the record, we return back to the trial, Commonwealth versus Lindsay Clancy. All parties are present, including the 18 jurors.
THE COURT: All right. Thank you, Ma'am Clerk. Mr. Reddington?
MR. REDDINGTON: Thank you, Judge. Good afternoon.
REBECCA JOLLOTTA: Good afternoon.
MR. REDDINGTON: Your Honor, just a couple of housekeeping matters. I have the medical records from Women and Infants Hospital. I thought I offered that as an exhibit, but it's only marked for ID, so can I offer that now?
THE COURT: Commonwealth, any objection?
MS. BUCKINGHAM: I have that we did mark it as exhibit 220.
MR. REDDINGTON: Yeah, I don't… This just says Exhibit F, though. That's why I just… I usually mess up on those things when I do that.
MS. BUCKINGHAM: There was another, smaller packet that's not in a binder that counsel offered yesterday that's been marked as Exhibit 220.
THE COURT: All right, why don't we keep that marked for identification. If for some reason there's something different between Exhibit 220 and the identification, we could enter it. Okay.
MR. REDDINGTON: I think I only came up with this.
THE COURT: All right. If you need to—
MR. REDDINGTON: Yep.
THE COURT: … offer anything additional, just let me know.
MR. REDDINGTON: Great. Thank you. Thank you, Judge.
MR. REDDINGTON: The other thing, Your Honor, that what I would ask is that there has been a lot of reference to the Diagnostic Statistical Manual 5TR, especially as it relates to bipolar and related disorders. There's an awful… Not an awful lot, but there's, like, probably 15 pages of single-spaced typing, and it's really hard for people to absorb it. I'd like to offer that section of the DSM just as an exhibit, so if somebody wanted to re-f- look at it, they could.
MS. BUCKINGHAM: I would object. We have witnesses to testify about that.
THE COURT: All right. All right. Why don't we—just why don't we mark that for identification? I guess the—
MR. REDDINGTON: That's my book, though. I need it.
THE COURT: Oh. Oh, I don't want to take away your book.
MR. REDDINGTON: That's all right.
THE COURT: Why don't, why don't we… We can re-address that—
MR. REDDINGTON: Okay. Sure.
THE COURT: … in regards to that. And if we're gonna do it, it would just be portions of the DSM—
MR. REDDINGTON: Yeah.
THE COURT: … file.
MR. REDDINGTON: So we'd only do that one section, like you said.
THE COURT: And, but we'll see. Well, I'll give the Commonwealth the opportunity to be heard.
MR. REDDINGTON: Okay. Thank you. So you, in the course of your employment at the South Shore Health, is it?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: How many times did Lindsay meet with you?
REBECCA JOLLOTTA: Meet with me was three.
MR. REDDINGTON: And how many times did she meet with... Does that include tele-medical?
REBECCA JOLLOTTA: Yes. I saw her twice telehealth, once in person.
MR. REDDINGTON: And do you know how many times that... You knew that she had a psychiatrist that had been treating her since end of September, early October, right?
REBECCA JOLLOTTA: I knew that she had a psychiatrist that treated her in September.
MR. REDDINGTON: And who was that?
REBECCA JOLLOTTA: Dr. Tufts.
MR. REDDINGTON: And did you know that she continued to see Dr. Tufts through October, November, December, the same time that she was reaching out to you guys for help, too?
REBECCA JOLLOTTA: I was aware she took the Zoloft in October. I was not aware she was still seeing Dr. Tufts in November, and I knew she called her in December.
MR. REDDINGTON: You would agree with me that young woman came to you people for help, right?
REBECCA JOLLOTTA: Mm-hmm. Yes.
MR. REDDINGTON: Okay. And she was very, very forthright. In other words, if you wanted her to sign a HIPAA form, she'd sign it, right?
REBECCA JOLLOTTA: Right.
MR. REDDINGTON: And she would answer your questions, to your perspective, in an honest fashion.
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: She didn't really hide anything.
REBECCA JOLLOTTA: Nope.
MR. REDDINGTON: She told you all about the medications that she had been on and her fears and concerns about the medications, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: She described for you, as district attorney brought out, what she felt her symptomology was, including suicidal ideation, worrying about suicide, feeling heavy, lethargic, can't get out of bed, all of that stuff, right? Correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And one of the things that you had left us with towards the end of your testimony is the fact that you were very willing, if you will, to work in tandem with other providers. In other words, you were concerned about being able to get information from other providers that had been dealing with her, treating her, right?
REBECCA JOLLOTTA: I'm not sure I understand the question.
MR. REDDINGTON: Did you talk to Tufts?
MR. REDDINGTON: Did you ever get access to Tufts' medical records?
MR. REDDINGTON: Do you know how many times she saw Dr. Tufts?
REBECCA JOLLOTTA: I do not.
MR. REDDINGTON: Would it surprise you if I told you that she saw Dr. Tufts 14 times in the timeframe of October, or the end of September, October, November, December, and then January? Four months.
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And that's 14 times plus the three that she saw you. Is that right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So that's 17 times that this young lady had access to healthcare providers for her mental health issues, correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And that would be within a compressed period of time. I know it's the last week, I believe, in September, but October, November, December, and then January, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And during that period of time, you're aware that she was provided many, many, many prescriptions for antipsychotics, selective serotonin reuptake inhibitors, benzodiazepines, all of that, right?
REBECCA JOLLOTTA: I'm aware she was prescribed other medications.
MR. REDDINGTON: She was what?
REBECCA JOLLOTTA: Prescribed other medications.
MR. REDDINGTON: Did you ask what other medications they were?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And did she tell you?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Did she tell you who prescribed them?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: It's pretty easy to get a list from CVS, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And did you have any difficulty determining who was providing the prescriptions for all of these medications?
MR. REDDINGTON: And did you know that, in fact, it was Jennifer Tufts that prescribed the...
MR. REDDINGTON: Excuse me for a minute.
MR. REDDINGTON: Sertraline, September 15th of 2022, 30 count, 25 milligrams, was Jennifer Tufts. You knew that?
REBECCA JOLLOTTA: I did.
MR. REDDINGTON: You know that Jennifer Tufts, on October 21st, a seven count of Lorazepam.
MR. REDDINGTON: You know that?
REBECCA JOLLOTTA: I did.
MR. REDDINGTON: And five days later, Jennifer Tufts prescribed, on October 26th, hydroxyzine, 25 milligrams with a 30 count. Did you know that?
REBECCA JOLLOTTA: I did not know that.
MR. REDDINGTON: Did you know that on the same day, Tufts prescribed 30 count of Lorazepam? Did you know that?
REBECCA JOLLOTTA: I would've known that, yes.
MR. REDDINGTON: I would've known.
REBECCA JOLLOTTA: Checking the PMP for controlled substances, yes.
MR. REDDINGTON: So you do recall that you checked with it?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: When you download... Do you download that information and kind of put it in a file, save in a file?
MR. REDDINGTON: So is this your memory that you believe that you checked with PMP?
REBECCA JOLLOTTA: I do routinely check the PMP.
MR. REDDINGTON: You might routinely check, but did you check—
REBECCA JOLLOTTA: Yes. Yes, I did.
MR. REDDINGTON: ... You don't download it. You don't keep it with the medical records, right?
REBECCA JOLLOTTA: It's a box you can click in the medical record, and you can check that you reviewed it.
MR. REDDINGTON: Okay. Is it in your medical record that you reviewed it?
REBECCA JOLLOTTA: I'm not sure how it would have gotten printed out. It doesn't, like, go into my note, but it is a box that I would've re- checked it.
MR. REDDINGTON: Checked a box in the computer?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Okay. October 26th, buspirone, five milligrams, 30 count, same day, by Tufts. You knew that?
REBECCA JOLLOTTA: Buspirone?
MR. REDDINGTON: Yeah.
REBECCA JOLLOTTA: I had- I was not sure that it was Dr. Tufts that had recommended the buspirone.
MR. REDDINGTON: Okay. So if I suggest to you that the prescriptions that we have in evidence on the chart indicates that on October 26th, Dr. Tufts prescribed a 30 count of buspirone, would that either refresh your memory, or would you accept that as being a medical history?
REBECCA JOLLOTTA: I would accept that.
MR. REDDINGTON: Okay. And what is buspirone?
REBECCA JOLLOTTA: It is a medication used to treat anxiety.
MR. REDDINGTON: Okay. And Lorazepam, what is that?
REBECCA JOLLOTTA: Benzodiazepine.
MR. REDDINGTON: And hydroxyzine, what is that?
REBECCA JOLLOTTA: It is an antihistamine medication.
MR. REDDINGTON: And lorazepam, again, prescribed on October 21st, as well as 26th, by Tufts. That's the same thing you've just told us what lorazepam is, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Sertraline, of course, is Prozac. Is that right?
REBECCA JOLLOTTA: Zoloft.
MR. REDDINGTON: Zoloft, Prozac.
REBECCA JOLLOTTA: Yeah.
MR. REDDINGTON: They're both SSRIs, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So from October 21st up through November 9th, she was prescribed all of this group of drugs, until she saw a Kayvon Izadpanah. I-Z-A-D-P-A-N-A-H. Do you know who that person is?
REBECCA JOLLOTTA: They work in the emergency department at South Shore Health.
MR. REDDINGTON: All right. And that would've been on November 16th when she went into the emergency department, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Prescribed trazodone, 50 milligrams, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And then...
MR. REDDINGTON: She started to consult with your clinic around the 25th of November. That would be around Thanksgiving or so, correct?
MR. REDDINGTON: November 25th?
REBECCA JOLLOTTA: I believe her first visit with Julie was November 21st.
MR. REDDINGTON: Okay.
MR. REDDINGTON: So what I'm saying is that it was around that time in November that she started to consult with your clinic, correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: You know that she was referred to your clinic by her mother-in-law, Pat's mother, who was a labor and delivery nurse?
REBECCA JOLLOTTA: Yes, I am aware.
MR. REDDINGTON: Referred her to Julie Paul, who kind of stepped in for a very short period of time to try to help out, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And then Julie left, went to New Hampshire to continue her work, and you picked up on November 30th of '22. Is that right?
REBECCA JOLLOTTA: November 29th.
MR. REDDINGTON: On November 30th of '22, you wrote a script for quetiapine, 30 count. Is that right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And what is quetiapine?
REBECCA JOLLOTTA: Seroquel.
MR. REDDINGTON: You also, a week later, wrote a script for diazepam, five milli—five milligrams. Is that correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And then the next day, you wrote a script for... I'm sorry, December 6th, you wrote a script for diazepam, five milligrams, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: December 7th, you wrote a script for diazepam, five milligrams, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: December 7th, again, you wrote a script for quetiapine, 30 count, right?
REBECCA JOLLOTTA: I would need to check my records.
MR. REDDINGTON: You can look at anything you want.
REBECCA JOLLOTTA: Okay.
MR. REDDINGTON: If you have, you have your records, feel free, please.
REBECCA JOLLOTTA: Okay. You said December something?
MR. REDDINGTON: Yeah, it was December 7th. And I'm looking at quetiapine, 30 count of 100 milligrams.
REBECCA JOLLOTTA: I don't believe it was a 30 count of 100 milligrams.
MR. REDDINGTON: Do you remember writing quetiapine script for 100 milligrams?
REBECCA JOLLOTTA: I do. I believe the quantity was 22.
MR. REDDINGTON: 22, okay. So on December 7th of '22, you wrote a script for quetiapine... And forgive me, I'm sorry, what is that again?
REBECCA JOLLOTTA: Seroquel.
MR. REDDINGTON: Seroquel. For 100 milligrams, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And why did you write the script on November 30th for quetiapine 25 milligrams, and then about a week later increase it to 100 milligrams?
REBECCA JOLLOTTA: On November 30th, I had anticipated utilizing it over a four-week course of treatment for sleep and anxiety. But her clinical symptoms, presentations changed, and I... we opted to use it for mood stabilization.
MR. REDDINGTON: And who's we?
MR. REDDINGTON: Okay. And were you working with anybody else, any psychiatrists or anybody?
MR. REDDINGTON: So when a person comes to your clinic as a woman who has recently had a baby or is within that postpartum range of time, and presents with the symptomology that she presented, is that something that would give you cause for concern?
MR. REDDINGTON: Suicidal ideation?
REBECCA JOLLOTTA: I in no way want to minimize what Lindsay experienced, but it's common for us to treat—
MR. REDDINGTON: It's common to treat women in that fashion that are postpartum?
REBECCA JOLLOTTA: That are postpartum who may have suicide.
MS. BUCKINGHAM: She keeps cutting off the witness before she gives an answer. May she complete her answer?
THE COURT: Sure. As I've said before, let's only talk one at a time. You finish your answer, and then we'll go to the question.
MR. REDDINGTON: Go ahead.
REBECCA JOLLOTTA: Her symptoms were serious, and it's not uncommon for me to treat women with serious symptoms in the postpartum period.
MR. REDDINGTON: Okay. Two days later, you prescribed a count five milligrams of diazepam. Is that right?
REBECCA JOLLOTTA: Two days from December 7th?
MR. REDDINGTON: Yeah, it was December 9th.
REBECCA JOLLOTTA: December 9th. Yes.
MR. REDDINGTON: Four days later, you prescribed more diazepam. Is that correct? December 13th.
REBECCA JOLLOTTA: Correct. That would have been two milligrams.
MR. REDDINGTON: Yes.
REBECCA JOLLOTTA: Okay.
MR. REDDINGTON: And then jumping ahead to December 19th, you prescribed 14 count, two milligrams of diazepam. Is that correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And then December 19th, you prescribed 300 milligrams of quetiapine, 30 count, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And that was on December 19th. Three days later on December 21st, you prescribed additional quetiapine, 100 milligrams, 14 count, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And then one day later, you prescribed more quetiapine, 25 milligrams of 14 count, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: As far as your prescriptions continued on, if we can jump ahead, you continued to treat her, and on January 13th, you prescribed two milligrams of diazepam, seven count, right? That would be on January 13th.
REBECCA JOLLOTTA: I did not prescribe that on January 13th.
MR. REDDINGTON: All right. If I suggest to you that Rebecca Jollotta has a script for January 13th of diazepam, that doesn't refresh your memory?
REBECCA JOLLOTTA: Would it have been a script that I had sent previously that hadn't been filled at the original date?
MR. REDDINGTON: Well, I believe the records would indicate that... We'll make a note of it, January 13th, diazepam. How about January 16th? Do you recall prescribing diazepam to her, two milligrams, three count?
MR. REDDINGTON: Diazepam on the 19th of January, two milligrams, 14 count.
MR. REDDINGTON: Okay. No? So are you... You're not able to prescribe medications, or somebody else can't use your name, right?
REBECCA JOLLOTTA: Right.
MR. REDDINGTON: Okay. And you have the DEA license to prescribe medications, correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: Now, one of the things that you went through was a lot of, obviously, it's a little confusing with the names of the various drugs, and the district attorney said to you blithely, she said, "Well, she's a nurse, so she knows what those drug names mean." Do you recall that question?
REBECCA JOLLOTTA: I do.
MR. REDDINGTON: Yeah. And you just said yeah, right?
REBECCA JOLLOTTA: Mm-hmm.
MR. REDDINGTON: So you're assuming that a woman who gets her RN at the age of 24 in a one-year program, and then works for seven years as a labor and delivery nurse, is familiar with these names and what they are, what drugs they are?
REBECCA JOLLOTTA: She seemed to be familiar with them. Yes, she understood.
MR. REDDINGTON: But did you know that she was googling 60, 70, 100 times a night what benzodiazepines are, what Seroquel is, what all of these medications are?
REBECCA JOLLOTTA: I did not know that.
MR. REDDINGTON: Did you ever ask her where she acquired what appeared to be, apparently to you, her ability to know what these medications are?
REBECCA JOLLOTTA: I'm sorry. I don't understand the question.
MR. REDDINGTON: Well, you wouldn't know the medications that a labor and delivery nurse uses when they're helping a woman who's giving birth, would you?
REBECCA JOLLOTTA: Not necessarily.
MR. REDDINGTON: Okay. In any event, one of the things that you left us with is the fact that you were very, I think the word was invested in Lindsay Clancy, and were concerned about her treatment, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: You knew that she had gone to the Rhode Island Program for Women and Infants Center Behavioral Health Day Program in Providence, Rhode Island. You knew that, right?
REBECCA JOLLOTTA: I did.
MR. REDDINGTON: And you basically gave her the referral. You didn't make the referral. I think it was Latiesha Dukes that might have done that?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: So you were aware of the fact that a recommendation was made to Lindsay that she reach out to someone else for help, right?
REBECCA JOLLOTTA: Lindsay made me aware of that, yes.
MR. REDDINGTON: And she needed help, didn't she?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And she went to Women's and Infants Hospital on December 20th, right?
REBECCA JOLLOTTA: She did.
MR. REDDINGTON: And was she treated at Women and Infants?
REBECCA JOLLOTTA: I don't believe so.
MR. REDDINGTON: Why not?
REBECCA JOLLOTTA: I wouldn't want to speculate. I... Or assume, but it seemed to be her intake appointment.
MR. REDDINGTON: Her what?
REBECCA JOLLOTTA: Her intake appointment.
MR. REDDINGTON: Okay. So without assuming or speculating... you referred her to-
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: ... this provider, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So you have this woman who you know has been seeing Dr. Tufts, a psychiatrist, right?
REBECCA JOLLOTTA: Right.
MR. REDDINGTON: You knew that.
REBECCA JOLLOTTA: Mm-hmm.
MR. REDDINGTON: You didn't get access to Tufts' records. You didn't know what Tufts was doing, but you knew that for a period of time before she saw you, she was dealing with a psychiatrist, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: You knew that she was a woman who had just given birth, like, five months ago, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: You knew that she was obviously in trouble. She was sick, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: You told us that she was suffering from, and your words were, "a mental health illness that was very real," and you told her that, "This will get better," and that was in December of 2022.
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So when you referred her, needing help, to this Women's and Infants program in Rhode Island, and she went because that's what she was told to do, what happened at Women and Infants program?
REBECCA JOLLOTTA: I can't speak to what happened at Women and Infants.
MR. REDDINGTON: Why not?
REBECCA JOLLOTTA: Because I was not a part of that assessment.
MR. REDDINGTON: What does that mean?
REBECCA JOLLOTTA: I did not see the assessment, and I did not speak with Dr. Diaz.
MR. REDDINGTON: Why?
REBECCA JOLLOTTA: Lindsay had informed me that she was going to be at the program for two weeks.
MR. REDDINGTON: She was hoping to be at the program for two weeks, right?
REBECCA JOLLOTTA: She told me she was gonna be at the program for two weeks.
MR. REDDINGTON: But she was turned away after about eight hours of sitting there, in an assessment and sitting in a group session, and she was turned away because of their concern that she was suffering from... Well, let me ask you, what was their diagnosis?
REBECCA JOLLOTTA: I'm not sure.
MR. REDDINGTON: Did you ever find out?
REBECCA JOLLOTTA: I have not.
MR. REDDINGTON: Does it matter to you as a treating person that, I think your words were, is invested in Lindsay Clancy's care at that time? Did it matter to you why she didn't get accepted into the program?
REBECCA JOLLOTTA: It did.
MR. REDDINGTON: Why was it?
REBECCA JOLLOTTA: I do not know their diagnosis.
MR. REDDINGTON: Did you know that she had been diagnosed? You have different diagnoses, right? Like general anxiety disorder or general anxiety, GAD, and then you have, is it a differential? Is that what it's called?
REBECCA JOLLOTTA: Mm-hmm.
MR. REDDINGTON: What does that mean?
REBECCA JOLLOTTA: Yes. It means a differential in medicine could be patient comes in with a cough. What are your differentials? Differential might be bronchitis, pneumonia, strep throat. So it's different things, different diagnoses you consider.
MR. REDDINGTON: Did you know that, in fact, they wouldn't accept her into the postpartum program because of their concern that she had been overmedicated by drugs, and they wanted to find out?
REBECCA JOLLOTTA: I can't speak to that.
MR. REDDINGTON: Did you know that she was diagnosed as diagnosis depression due to adverse drug effects?
REBECCA JOLLOTTA: I cannot speak to that.
MR. REDDINGTON: Do you know, invested as you were, that on December... Strike that. On
MR. REDDINGTON: December 20th, the very same day that she had finished being evaluated, woman you were invested in, had been evaluated by Dr. Diaz, that you recommended or you mentioned, that in fact, looking at the exhibit, that they recommended tapering Seroquel, starting 200 milligrams tonight, follow up with outpatient provider. Of note, we attempted to reach current outpatient provider, Rebecca Jollotta, but did not receive a call back.
REBECCA JOLLOTTA: I never received a call from Women and Infants.
MR. REDDINGTON: So this medical record from Women and Infants saying that they called Rebecca Jollotta and never got a call back, your memory is that they never called you?
REBECCA JOLLOTTA: They never called me. I absolutely would have called them back.
MR. REDDINGTON: Uh-huh, okay. Well, regardless, you never talked to anybody from Women and Infants, did you? Whether they called you or whether you reached out to them, being invested.
REBECCA JOLLOTTA: I did not. I know our program re-referred her a few days later.
MR. REDDINGTON: I'm gonna offer this now, Your Honor. I think just to—
MS. BUCKINGHAM: It's already in evidence.
MR. REDDINGTON: Yeah, I know. I was just...
THE COURT: Yeah, we, well, I'll allow. We'll keep it as an exhibit for identification. You can double-check, make sure the pages that have been referred here are contained within, is it Exhibit 220?
MR. REDDINGTON: Yep.
THE COURT: And if not, then we can admit the second.
MR. REDDINGTON: Okay. Thank you. One of the things that you, as a takeaway from your treatment of Lindsay, is that she was, I think your words were that she was scared, and thought that starting these drugs, this, the drugs, it was scary. Were her words, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And at no time did it occur to you that Lindsay was doctor shopping or trying to get drugs. She was trying to basically get off drugs, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: One of the things that you had mentioned is that the Good Moms Have Scary Thoughts book is something that you guys would give out to women when they would come into your program?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And hopefully it would give a good source of them to read things and maybe get some comfort from it, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: This is not, in your opinion, something that is indicative of, like, being the smoking gun?
MR. REDDINGTON: So what sees it in the search warrant is—
MR. REDDINGTON: ... This is something you guys provide people to just help 'em out, right?
REBECCA JOLLOTTA: Yes. Yeah.
MR. REDDINGTON: And just a couple of things.
MR. REDDINGTON: So on November 17th, she had an office visit with you, is that correct?
REBECCA JOLLOTTA: Not on November 17th.
MR. REDDINGTON: Okay. And the US South Shore Medical Center, right?
REBECCA JOLLOTTA: Yes. That may have been her PCP.
MR. REDDINGTON: Okay. Her... Is that, is that her PCP? Is that a person that would be under the umbrella of the South Shore Medical Center?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Would that be Kimberly Tocchio?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Okay. So you must have read Kimberly Tocchio's records, I would imagine, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And you know that she was seen... The record indicates that she was seen by a psychiatrist, and this would be November 17th note. Started Zoloft 25, which was then increased to 50 milligrams, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And she took the Zoloft, 50 milligrams, for one night, and was unable to sleep, and was discontinued because of the effect that it had on her, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Now, one of the things that you had mentioned is that it's important to determine, and you did have thoughts of possibility that she was bipolar. Is that correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And one of the things that is contraindicated to someone who does suffer from bipolar, whether it's I or bipolar II, is that you do not place them on a selective serotonin reuptake inhibitor drug, such as Prozac or Zoloft, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: Because it can have an effect on them. Isn't that right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And what's the effect it can have on them?
REBECCA JOLLOTTA: It can cause what we consider rapid cycling, meaning you can swing from mania symptoms to depression symptoms relatively rapidly.
MR. REDDINGTON: On November 21st, did she have a meeting with you all? If you recall, looking at the records, did she meet with Julie Paul, if you know?
REBECCA JOLLOTTA: Yeah. Yes.
MR. REDDINGTON: Okay. And she gave Julie a history of what she had been going through. Is that correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And in that history, and in her talks with Julie, she had disclosed the fact that one of the things that she did in November was took a marijuana gummy, one gummy to try to sleep, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And again, her medical tests, blood tests, urine tests, everything showed that she had no alcohol, no THC, nothing on board, but she still disclosed the fact that to try to get some sleep, she took one gummy in November, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So again, she's reporting, you know, what, trying to be honest with you people as a provider, correct?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And the scales that counsel asked you about, you were talking about the depression scale. You were talking about the Edinburgh scale. And I think we all know that the—now that the Edinburgh scale is geared for an evaluation of a person, of a woman who is in that postpartum period, and you evaluate whether or not they are, as a result of being postpartum, severely depressed, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And you indicated that at some point her Edinburgh scale was initially, what was it, 15, 17? If you know.
REBECCA JOLLOTTA: Initially at my visit, my first initial with her?
MR. REDDINGTON: Yeah. What was her Edinburgh scale the first time you saw her?
MR. REDDINGTON: Okay. And that would be moderate?
REBECCA JOLLOTTA: Moderate.
MR. REDDINGTON: Okay. And then she had another Edinburgh scale after that, correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And when was that, if you know?
REBECCA JOLLOTTA: December 6th.
MR. REDDINGTON: And what is EPDS? What does that mean?
REBECCA JOLLOTTA: Edinburgh Postpartum Depression Scale.
MR. REDDINGTON: All right. So would you look at November 21st, please, which would be... So November 21st, she was administered a Edinburgh test, right?
REBECCA JOLLOTTA: On the 21st. That would have been at Julie's appointment. I don't have that in front of me.
MR. REDDINGTON: If I told you that, well...
MR. REDDINGTON: On November 21st, it's a short period of time after November 17th. Did they, whether it's Julie or somebody else, administer a Edinburgh test to her?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And what was the result?
MR. REDDINGTON: That's severely depressed, isn't it?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So in, like, six days she decompensated from Edinburgh scale 17 to Edinburgh scale 23, right?
REBECCA JOLLOTTA: So she was 23 on November 21st—
MR. REDDINGTON: Right.
REBECCA JOLLOTTA: ... and 17 on November 29th.
MR. REDDINGTON: Okay. So when you see a patient that's come to you and has an Edinburgh scale of 23, and an Edinburgh scale a couple of days later that would be, what was it?
MR. REDDINGTON: And what was it when you first saw it, you referenced it before, 17?
MR. REDDINGTON: Yeah. That's still pretty high, isn't it?
REBECCA JOLLOTTA: It's high, yes.
MR. REDDINGTON: Would that give you pause in conjunction with the symptomology that she's referring to and self-reporting what she's feeling?
MR. REDDINGTON: I mean, the fact that she has a 23 on the Edinburgh scale, which is very high, and then followed up a couple of days later by a 17, taken in conjunction with what she was saying her symptoms were. That's of a concern, isn't it?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So on November 20th, which would be the day before that Edinburgh scale of 23, and the jury will have access to all these records, she was reporting struggling with postpartum anxiety, right?
REBECCA JOLLOTTA: I can't speak to that.
MR. REDDINGTON: Okay. That's fair enough. We'll go to when you treated her.
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Did you have a chance to review Julie's notes at all?
REBECCA JOLLOTTA: I did.
MR. REDDINGTON: Okay.
REBECCA JOLLOTTA: Yeah.
MR. REDDINGTON: And when was the first time that you actually met with Lindsay?
REBECCA JOLLOTTA: November 29th.
MR. REDDINGTON: Okay. Which would have been after Thanksgiving, obviously, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And you would have reviewed the records up to that point, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So one of the things that you would have reviewed was what she had indicated or reported to Nicole Harden Francis. Do you know her?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And who is Nicole Harden Francis?
REBECCA JOLLOTTA: She's the nurse at our program.
MR. REDDINGTON: All right. And this would be on November 28th that she was speaking with Nicole, the nurse. You read the report before you met with Lindsay on the 29th, right?
REBECCA JOLLOTTA: Right.
MR. REDDINGTON: So you knew that she had been reporting panic symptoms, that she was disoriented, that she was forgetful, that she was not connected to her body. This is what she told her, right?
REBECCA JOLLOTTA: I would have to review that just to—
MR. REDDINGTON: Sure.
REBECCA JOLLOTTA: ... be accurate.
MR. REDDINGTON: Great. And this was at...
REBECCA JOLLOTTA: That's correct.
MR. REDDINGTON: Okay.
MR. REDDINGTON: And would you agree with me that symptomology of mania, especially when incurred or encountered by a woman within the postpartum period, that's one of the symptoms, is being disoriented, right?
REBECCA JOLLOTTA: Not necessarily.
MR. REDDINGTON: How about maybe a little bit?
REBECCA JOLLOTTA: Could be confused if you're manic.
MR. REDDINGTON: Yeah. How about forgetful? That's an issue, isn't it?
REBECCA JOLLOTTA: Not necessarily a symptom of mania.
MR. REDDINGTON: Okay. How about not connected to her body? What does that mean?
REBECCA JOLLOTTA: I'm not sure what that means.
MR. REDDINGTON: So if you have a patient who's coming to see you, who's indicated the day before that she has the panic symptoms, disoriented, forgetful, not connected to her body, wouldn't you ask her what she meant by that?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Okay. So when you saw her on November 29th, you diagnosed that she had postpartum anxiety, right?
REBECCA JOLLOTTA: Mm-hmm.
MR. REDDINGTON: Adjustment insomnia, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And when you met with her, you noted that over the last two weeks you asked her about how she had been feeling, and she said she was feeling nervous, anxious, and on edge, and she said nearly every day, right?
MR. REDDINGTON: That's November 29th. That would be under screenings.
REBECCA JOLLOTTA: Yes, she was.
MR. REDDINGTON: I would give you a page number, but they don't give us page numbers. She told you, and you can pull it up if you have it there, that she was not able to stop or control worrying, and that had been for several days at least, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And she was worrying and stressing about things, worrying about different things every day, right?
REBECCA JOLLOTTA: Nearly every day, yes.
MR. REDDINGTON: Couldn't relax nearly every day. This is a questionnaire form that you have, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Being so restless, nearly every day, correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: Asked if she was annoyed or irritable, and she said, "Not at all." Sure, like she doesn't think- She didn't believe that she was a person that would be irritable or angry with people, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And then feeling afraid as if something awful might happen, and she got that GAD-7 score of 14, is that correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: So what does a GAD score of 14 tell you on November 29th?
REBECCA JOLLOTTA: Moderate anxiety.
MR. REDDINGTON: And then you ask about in the last seven days, trying to get a history, she denied, definitely not so much now, that she was able to laugh or see the funny side of things, right?
REBECCA JOLLOTTA: Right.
MR. REDDINGTON: And that she was asked, is she looking forward with enjoyment to things, and she responded, "Hardly at all," right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Blaming herself when things go wrong, she says, "Yeah, some of the time." Yep?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Anxious and worried for no good reason, yes, correct?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Scared and panicky for no good reason. Yes, correct?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Then they asked if she felt sad or miserable, if she was a miserable person, and she said, "No, not at all," right?
REBECCA JOLLOTTA: Right.
MR. REDDINGTON: Did she indicate that on that date, you gave her the EPDS, Edinburgh test, and she had an Edinburgh score, as we said, of 17, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: All right. And then the medications that you prescribed to her, we've already got in evidence. The jury will be able to look at the actual scripts in the exhibit without going through every single day. The next time you saw her was November 30th, is that right?
REBECCA JOLLOTTA: I messaged with her on November 30th, yes.
MR. REDDINGTON: Okay. And you indicated that if you're not sleeping well with Valium, no need to continue it. I'll prescribe a short taper. And you went on about tapering and five milligrams of Valium to 2.5 milligrams and no benzos and…
REBECCA JOLLOTTA: That was not on November 30th.
MR. REDDINGTON: Okay. Does it say on the record? Are you looking where it says patient message in the Perinatal Behavioral Health Program of South Shore Health, November 30, 2022?
REBECCA JOLLOTTA: Yes, I'm looking at the messages.
MR. REDDINGTON: Okay. So is it a different date that you sent that message? It says November 30th on it, right? I just don't know internally if you guys have different—
REBECCA JOLLOTTA: Oh, I understand. Oh, at the top it says November 30th.
MR. REDDINGTON: Okay.
REBECCA JOLLOTTA: More specific, it'll say—
MR. REDDINGTON: Okay.
REBECCA JOLLOTTA: …the dates, but the header will say November 30th. I understand.
MR. REDDINGTON: Okay. And basically you indicated that you were gonna send along information about bipolar I or bipolar II, which actually would be what's known as a bipolar spectrum disorder. Is that correct?
REBECCA JOLLOTTA: Yes. That was on December 7th.
MR. REDDINGTON: Okay. But it's underneath November 30th, so forgive me for looking at it that way.
REBECCA JOLLOTTA: Yeah. I don't know why I printed that.
MR. REDDINGTON: That's all right. No problem. So one of the things with the mania that you refer to and that you talk about is excessive activity. Is that it? Excessive cleaning sometimes, right?
REBECCA JOLLOTTA: Sometimes.
MR. REDDINGTON: Excessive exercise.
REBECCA JOLLOTTA: Sometimes.
MR. REDDINGTON: Did you know that after she had Callan, that within a matter of a couple of weeks, that she ran a 5K?
REBECCA JOLLOTTA: No, I did not know that.
MR. REDDINGTON: And that nobody wanted her to, including Pat, but she just had to get out there and run, and did.
MS. BUCKINGHAM: Objection.
THE COURT: Overruled.
MR. REDDINGTON: You know that?
REBECCA JOLLOTTA: I did not.
MR. REDDINGTON: Is that something that would be important to know? I mean, as far as whether or not a person is in that manic stage where it's post-delivery, and that's a significant artifact, if you will, of exercising, right?
REBECCA JOLLOTTA: It would've been something I would've considered.
MR. REDDINGTON: Okay. And as I said, you were the, pretty much the only one that actually considered bipolar spectrum disorder of all the doctors that she had seen. You know that, right? Are you aware of that?
MR. REDDINGTON: All right. Never mind. That's all right. She's gonna object. That's okay.
REBECCA JOLLOTTA: Okay.
MR. REDDINGTON: So the symptoms that you noted were a mania. It says, "Mania characterized by exaggerated excitement, hyperactivity, and racing scattered thoughts," right?
REBECCA JOLLOTTA: Yeah. Um—
MR. REDDINGTON: So what is... Go ahead.
REBECCA JOLLOTTA: Was that from my note?
MR. REDDINGTON: I'm looking at the same thing that we've been looking at, which is—
REBECCA JOLLOTTA: Oh, the information I sent her on bipolar. Yes.
MR. REDDINGTON: Yeah. It says, "Hi, Lindsay," and then your note, right?
REBECCA JOLLOTTA: Mm-hmm.
MS. BUCKINGHAM: Your Honor, if I may suggest maybe showing the witness what he's referring to so she knows what he's—
MR. REDDINGTON: She has it in front of her.
REBECCA JOLLOTTA: I think I understand what he's referencing. But thank you.
THE COURT: So if the witness has a problem in regards to that, and you need to look at something, just let me know, okay?
REBECCA JOLLOTTA: Okay.
THE COURT: All right.
REBECCA JOLLOTTA: Thank you.
MR. REDDINGTON: Thank you.
MR. REDDINGTON: She... If you move ahead to, I think the message portal or whatever it's called, on November 30th, it's captioned, "Stopping Remeron."
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And it st— Okay, you're with me. And it says, "No, the w—" This would go to the fact that she was still not sleeping. It was a huge problem for her, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And she told you in her message thing, "No, the weird thing is I don't feel tired at all."
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And that's one of the things that you had told us earlier is a symptom, correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: A person that is not getting sleep but doesn't feel tired.
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: What is a symptom of?
REBECCA JOLLOTTA: It's... It could... It's a symptom of mania that we look for.
MR. REDDINGTON: Okay. And when we looked for that mania, did you notice that, and did you factor that into your diagnoses?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Okay. How many times, if you recall, did Pat come with his wife to meet with you? Was it three?
REBECCA JOLLOTTA: He came to a visit once. I believe I spoke with him and Lindsay on the phone twice.
MR. REDDINGTON: Would you agree with me that, as counsel asked, did he get permission to be there, and you indicated no, that you—would welcome the third party contact, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And did it appear to you that he was very, very invested in her care, and was very scared and worried?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And he was complaining about the fact that he believed, or they believed, that she was being overmedicated, right?
REBECCA JOLLOTTA: I believe he was concerned about her symptoms. He felt that they started once she started being medicated initially.
MR. REDDINGTON: Right, because she indicated that when she first started taking the SSRI back in s- October, I believe, that she ended up having it increased—
REBECCA JOLLOTTA: Mm-hmm.
MR. REDDINGTON: ...and then had a period of almost two days where there was no sleep whatsoever. That was one of the instances, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: She also, and counsel had asked you, and you did not recall her saying horrible intrusive thoughts. So if you would just look at November 30th patient message. It says, "Hi Rebecca." And then it begins, "I don't expect you to answer this until Monday."
REBECCA JOLLOTTA: I see that.
MR. REDDINGTON: Okay. And then she says how she basically only slept for about four hours at the beginning of the night, 9:30, and then dozed off for 45 minutes, and said, "Today, all day, I had horrible intrusive thoughts, and deeply depressed," right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So when was the next time that you saw her after she sent that message on November 30th?
REBECCA JOLLOTTA: I would've seen her on December sixth. She had sent this message, I believe, on December 3rd, and I saw her on the 6th.
MR. REDDINGTON: So on December 3rd, and again, it would be the way that they print this thing out, it has a date of November 30th, but then underneath it, it would be a different date of December 3rd. Is that right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Okay. And when you as a, you know, an invested nurse practitioner, receive a message from a woman who is postpartum, who has been through what she's been through and the symptomology that she explained, and the doctors that she's seen, not to very good results, you'd be concerned when you see a person saying, "I have horrible intrusive thoughts," right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: All right. So as a result of seeing on December 3rd that Lindsay Clancy, with her history, had been telling you that she had horrible intrusive thoughts, what did you do? Did you call her?
REBECCA JOLLOTTA: She had told me that she took the Ativan and now the thoughts were gone, and she had felt good.
REBECCA JOLLOTTA: But I did speak to her about it—
MR. REDDINGTON: Yeah, but she told you that in the—
REBECCA JOLLOTTA: …at her next appointment.
MR. REDDINGTON: …she told you that in her message.
REBECCA JOLLOTTA: Right.
MR. REDDINGTON: That she had, "Today, all day, I had horrible intrusive thoughts, deeply depressed. I finally took 0.5 of Ativan," that Ativan, "at 6:00 PM—"
REBECCA JOLLOTTA: Mm-hmm.
MR. REDDINGTON: …"and the thoughts are gone." Is what she told you, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Did you ever bother to ask, I don't know. I mean, would you ask the patient what the horrible intrusive thoughts were?
REBECCA JOLLOTTA: I would have. Yes.
MR. REDDINGTON: Did you?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: What did she say?
REBECCA JOLLOTTA: She described them as thoughts of not wanting to be here.
MR. REDDINGTON: How about, did she ever describe to you that she was hearing voices?
MR. REDDINGTON: How many people have you treated for postpartum psychosis?
REBECCA JOLLOTTA: Five.
MR. REDDINGTON: And of those five people, did they hear voices?
REBECCA JOLLOTTA: Not all of them.
MR. REDDINGTON: How about some of them?
REBECCA JOLLOTTA: Some of them.
MR. REDDINGTON: And that's a real thing, isn't it?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And visual hallucinations, likewise?
REBECCA JOLLOTTA: Not all.
MR. REDDINGTON: So with the voices, that would be an auditory hallucination.
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Visual hallucination, not all, but some.
REBECCA JOLLOTTA: Mm-hmm. Yes.
MR. REDDINGTON: And that's a real thing.
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So when she had horrible intrusive thoughts, did she say where these happened? Like, was she in the yard? Was she in her car? Was she... Did she... Did you ask her where and what?
REBECCA JOLLOTTA: She-
MR. REDDINGTON: Or was it just that she just didn't wanna be here anymore?
REBECCA JOLLOTTA: It was more that she didn't wanna be here anymore.
MR. REDDINGTON: Okay. Did you ask her what that meant?
REBECCA JOLLOTTA: I did ask her if she had any plans or intent for suicide.
MR. REDDINGTON: Okay.
REBECCA JOLLOTTA: Which changed at different times during our treatment.
MR. REDDINGTON: So on December 2nd, you have received a... I'm sorry. You sent a note to Lindsay and said, “It,” meaning what she was telling you in a prior communication. “It sounds more like depression than side effects.” That would be of drugs, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: “It is not uncommon for me to hear,” and then you quote, “I have never felt anything like this before,” end quote. Or quote, “I just don't feel like myself. All of this sounds like postpartum depression.” Is that correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: All right. So she was expressing all of the symptomology of depression, what you believe would've been side effects, and you indicated that at this point, while you're working through it, this sounds like postpartum depression, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And what would the symptomology of po- what does postpartum depression mean, and what is its effect on a patient?
REBECCA JOLLOTTA: Postpartum depression is like depression at any time during a patient's life. However, there are some unique considerations. It's... typically occurs in the first three months after a person has a baby, but it can happen at any point in the first year. The considerations that are a little bit different than regular major depressive disorder are that there are significant hormone fluctuations that a person undergoes when they deliver a baby. Sometimes they breastfeed, and they wean from breastfeeding, and that can set off additional hormone shifts. And it tends to be a very anxious presentation. And obsessive thoughts can occur with greater regularity in postpartum depression than they would with major depression outside of the postpartum period.
MR. REDDINGTON: So as a result of this information, you prescribed medication to her?
REBECCA JOLLOTTA: After I sent her the information on the postpartum... Would this still be December 2nd?
MR. REDDINGTON: Looking at the form that you have, it would be, yes. But I don't know if it's another date that there's a message underneath it. So let's look at the record where it says that on December 7th.
REBECCA JOLLOTTA: 7th.
MR. REDDINGTON: Yes.
REBECCA JOLLOTTA: Okay.
MR. REDDINGTON: Okay? And that's where you talked about bipolar spectrum disorder, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And that's where you talked about how people would have these, these feelings of goal-directed activity, overly talkative, racing thoughts, need for sleep, things of that nature, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: What was the end result of that? Did you prescribe medication for her?
REBECCA JOLLOTTA: I did.
MR. REDDINGTON: And what was it?
REBECCA JOLLOTTA: Seroquel.
MR. REDDINGTON: One of the things that you had mentioned is that you provided a mood chart, I think. Is that what you said, a mood chart? Is this it? Is that an indication, just so the jurors know that it's in the records?
MR. REDDINGTON: It's a horrible picture.
REBECCA JOLLOTTA: That looks accurate, yes.
MR. REDDINGTON: Yeah. I don't know why this... Yeah, there it is. Right there. See on the very top it says mood chart? To the left.
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: All right. And right on the top it says daily mood chart. And then you also provided another chart on that date. What is that? That's another variation of it?
REBECCA JOLLOTTA: It's the weekly mood chart.
MR. REDDINGTON: Okay. So did you tell her to fill this out?
REBECCA JOLLOTTA: I suggested that she fill it out so we could keep track of her symptoms.
MR. REDDINGTON: Okay. Do you remember if she filled it out when she spoke to you?
REBECCA JOLLOTTA: She did not speak to me about filling it out. After that, she did say she printed it out.
MR. REDDINGTON: Okay. Did you ever ask to see it?
REBECCA JOLLOTTA: I don't recall.
MR. REDDINGTON: Okay. On December 1st, you met with her, is that right? Oh, no, wait a minute. Christine Zappi. Who's Christine Zappi?
REBECCA JOLLOTTA: I believe she's also someone that works at South Shore Medical Center.
MR. REDDINGTON: All right. Do you know that she saw Christine Zappi on December 1st? Christina, I'm sorry. It says Christina.
REBECCA JOLLOTTA: I'm not sure if she saw her for a visit that day.
MR. REDDINGTON: Okay. Have you seen in the pool of records that you have that she did see this individual and noted that she had been dealing with the problems, the insomnia symptomology, for over a month and a half, and medications keep changing, and it doesn't seem like much is helping? Did you ever see that?
REBECCA JOLLOTTA: That does sound familiar.
MR. REDDINGTON: Okay. So she was somewhat in... This is almost hand in glove with saying, "I'm not being heard," right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: That idea? Did you see her on December 2nd, the next day?
REBECCA JOLLOTTA: I spoke to her on December 2nd.
MR. REDDINGTON: Okay. And again, the district attorney kept asking you about, you know, she had the opportunity to come in and see you if she wanted to and things of that nature, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And would you agree with me that it's sometimes better to have a face-to-face actual meeting with a patient rather than just on the computer?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Did you ever, if you recall, with all of the symptomology and deterioration going by week after week, say to her, "You know, I really think that we should get together in person"?
REBECCA JOLLOTTA: Yes. So we met in person on the 16th, and our plan had been to meet in person on the 13th.
MR. REDDINGTON: Okay. So that would be December 6th, correct?
REBECCA JOLLOTTA: Mm-hmm. Yes.
MR. REDDINGTON: Now, December 2nd, you had a conversation with her on the phone, is that right?
REBECCA JOLLOTTA: I believe it was just My Chart messages.
MR. REDDINGTON: Okay. So you see on where it says, again, it's got the big black letters December 2nd, '22, and then underneath it, it says behavioral health history. Can you find that on your records?
MR. REDDINGTON: If you don't, that's fine. That would be the time that she indicated that she had been to the ER for anxiety symptoms as well as insomnia and heart palpitations. Do you remember that?
REBECCA JOLLOTTA: I don't see that.
MR. REDDINGTON: Okay. Well, then let's get it. Do you have... You have access to other staff notes and records, right?
REBECCA JOLLOTTA: I do. I only brought my own with me. Yeah.
MR. REDDINGTON: Okay. All right. That answers that. So if I approach you—
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: Sir, can I see what you're showing her first? Sorry.
MR. REDDINGTON: Sure. Latiesha Dukes. Let's look at this.
MS. BUCKINGHAM: So this is from two doctors.
MR. REDDINGTON: Yeah. Latiesha Dukes. Who's Latiesha Dukes?
REBECCA JOLLOTTA: Latiesha Dukes was a clinician at our program at the time.
MR. REDDINGTON: All right. So am I looking at Latiesha Dukes, MSW? What does that mean?
REBECCA JOLLOTTA: Master of social work.
MR. REDDINGTON: All right. And does that indicate a date that Ms. Dukes saw Lindsay?
REBECCA JOLLOTTA: December 2nd.
MR. REDDINGTON: All right. And on December 2nd, again, she was complaining of symptomology. She, meaning Lindsay, having heart palpitations, right? Yeah.
REBECCA JOLLOTTA: She's describing that she had heart palpitations, and she went to the ER for anxiety symptoms.
MR. REDDINGTON: Okay, so the answer is yes.
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Okay, so—
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: ... Okay. And then she then went to the ER, and per patient's report, she has an addiction to Ativan, and that's why she can't sleep. And she also noted had weight loss, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And panic attacks, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: So she's got a fear that she's on the benzodiazepines by a script that she didn't wanna be on, and she couldn't sleep, and she was losing weight, and all the other symptomology that we talked about, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And that's in December?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: December 5, Nicole Hadn Francis had a chance to speak with Lindsay.
MR. REDDINGTON: And at that point, there was a recommendation that she might wanna try inpatie- in- INPT LOC. What does that mean?
REBECCA JOLLOTTA: Inpatient level of care.
MR. REDDINGTON: Okay. And that would be Nicole Hadn Francis, who's a nurse, was telling her that on December 5?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Now, on... And again, I know you don't have the records from Latiesha Dukes. So if I may approach.
THE COURT: You may.
MR. REDDINGTON: December 5. On December 5, and you correct me if I'm reading this wrong, this would be Latiesha Dukes, December 5, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: Okay. And on that occasion, Latiesha Dukes notes that she called Aspire Crisis Support. She meaning Lindsay, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: What is Aspire Crisis Support?
REBECCA JOLLOTTA: Aspire is the community mental health program that operates the local twenty-four-hour emergency services program for psychiatric emergency services.
MR. REDDINGTON: Okay. So when you—when I say you, collectively, I mean psychiatrists, nurse practitioners, RNs from, in the psychiatric world—tell patients that are in crisis that if you feel that you're gonna have suicidal ideation or anything, that you should call these numbers, is what you people will give them, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: All right. She called Aspire Crisis Report—Support—not once, but twice, right? If you know.
REBECCA JOLLOTTA: I'm aware of the one time she called.
MR. REDDINGTON: Okay. But she was not given any help at all by Aspire, whoever they are, right?
REBECCA JOLLOTTA: I'm not aware of that.
MR. REDDINGTON: Well, it says right in the records from Latiesha that she met with an Aspire clinician, virtually, and was told that she did not meet the criteria for inpatient treatment due to not having an SI plan. What does that mean? They just told her, "You're not, you, you're not laying on the ground with your throat cut, so we're not gonna be able to help you"?
REBECCA JOLLOTTA: Can't speak to what they told her.
MR. REDDINGTON: So Aspire then recommended that she start or go to a day program. Is that correct?
REBECCA JOLLOTTA: That's correct.
MR. REDDINGTON: And the clinician said that he, from Aspire, would be sending the patient resources, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: But they never did, did they? If you know.
REBECCA JOLLOTTA: I don't know.
MR. REDDINGTON: Further, Latiesha notes that they review the sleep hygiene with the patient. Clinician provided patient suggestions for meditation, grounding, self-soothing techniques. What's a self-soothing technique? You know.
REBECCA JOLLOTTA: It might just be simple strategies to soothe yourself using any of your five senses.
MR. REDDINGTON: And she notes, and again, this is on December 5th, that Pat, patient's husband, joined the visit, reporting that her anxiety had become significantly worse since starting the psychiatric medications. Does that say that? Anybody?
REBECCA JOLLOTTA: That is what that says.
MR. REDDINGTON: Okay. And in fact, when you spoke to Pat, he had told you that, in his quotation, his words would be, "It was ten thousand times worse since she started this medication," right? If you know.
REBECCA JOLLOTTA: He... I don't recall him using that phrase.
MR. REDDINGTON: But he was upset about the medication, wasn't he?
REBECCA JOLLOTTA: I would say he was concerned.
MR. REDDINGTON: Do you recall that he said that you're turning her into a zombie?
REBECCA JOLLOTTA: I do not recall that he said that.
MR. REDDINGTON: So would you say to jury that he was concerned or he was pissed off about the medication and what it was doing to his wife?
MS. BUCKINGHAM: Objection. Asked and answered.
THE COURT: No, overruled.
REBECCA JOLLOTTA: I would say he was concerned.
MR. REDDINGTON: Concerned? Okay. Did anybody address his concerns?
REBECCA JOLLOTTA: That day—
MR. REDDINGTON: Any day.
REBECCA JOLLOTTA: … I would say that day I collaborated with them to take her off certain medications.
MR. REDDINGTON: Okay. December 6th, you had a meeting with her. Is that correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: Again, she's diagnosed postpartum anxiety, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: Her EPDS score, as a result of being administered the Edinburgh Test, was at that time a twenty-one, right? That would be underneath office visit and perinatal behavioral health, above assessment and recommendations.
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And twenty-one, how would you grade that?
REBECCA JOLLOTTA: Severe.
MR. REDDINGTON: Severe what?
REBECCA JOLLOTTA: Severe signs of postpartum depression.
MR. REDDINGTON: Do you know that she had lost over fifteen pounds by that point?
REBECCA JOLLOTTA: I was aware she had lost some weight. I was not aware that it was fifteen pounds.
MR. REDDINGTON: Okay. So then, there was another patient message on December 7th, where she again was expressing concern about the drugs, and you indicated, “Either way, I continue to recommend the Valium taper,” right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: There was a period of time that she indicated that she wanted to get off the medication and get off the drugs, and you indicated, as you told us, that you were on vacation that week, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: You basically told her to tough it out and, “Just hit me up when I come back from vacation,” right?
MR. REDDINGTON: No. Did you tell her to call you when you came back from vacation?
REBECCA JOLLOTTA: No, I asked that she try to hold off and wait for me to come back from vacation for the taper. She had wanted to taper it sooner.
MR. REDDINGTON: All right. Do you have somebody that covers for you if you're on vacation?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Does somebody cover?
REBECCA JOLLOTTA: She said that she was going to follow up with her other psychiatrist for the taper, but she did reach out to our program while I was on vacation.
MR. REDDINGTON: Sorry, I couldn't understand you. What—
REBECCA JOLLOTTA: I'm sorry. I know that she said that she had an appointment with her psychiatrist who would work on the taper with her. And I do know that she was in contact with other providers at our program, including Latiesha Dukes, while I was on vacation.
MR. REDDINGTON: And Latiesha Dukes is a social worker, is that right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Okay. December 9th, there was another telephone encounter, it's called, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: And yet again, her husband, Pat, was involved with this call, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: So does this put Patrick up to around four times, maybe five times, that he had been involved either in person with your business or on the telephone or on the telemetry or whatever it is, computer?
REBECCA JOLLOTTA: I spoke with him on the phone twice. He was in one of our visits on December 6th, and it appears he was in the visit with Latiesha as well.
MR. REDDINGTON: So this would be a Rebecca Jollotta telephone—
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: …encounter on December 9th, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And on that occasion, Lindsay, and it says, “and her husband,” called this writer, that'd be you, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: Regarding the plan to taper, correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And they both agreed that Lindsay's symptoms remained too acute. What does that mean? What's acute mean?
REBECCA JOLLOTTA: Severe.
MR. REDDINGTON: Did they say that she's sleeping but waking up with... Let me back up. Was he telling you all this while she sat there? She wasn't saying much in that call, conversation, was she?
REBECCA JOLLOTTA: I don't recall who was saying more than the other person.
MR. REDDINGTON: Do you recall that she indicated that she wanted her husband to be involved to speak for her because she was really decompensating, right? She wasn't self-reporting and self-advocating too well for herself at that point, was she?
REBECCA JOLLOTTA: I just know she did have her husband on the call, and he did speak on the call.
MR. REDDINGTON: They indicated that she was waking up with panic symptoms, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: But what panic symptoms? What does that mean?
REBECCA JOLLOTTA: Panic symptoms can be this sudden rush of intense—
MR. REDDINGTON: That's not what can be. What did she tell you, or what did her husband tell you? Her panic symptoms were—
REBECCA JOLLOTTA: Panic symptoms.
MR. REDDINGTON: What were they?
REBECCA JOLLOTTA: Panic symptoms are racing heart, intense fear. Those are panic symptoms. Sudden rushes of intense anxiety that seem to come out of nowhere.
MR. REDDINGTON: Okay. Is that something that you learn in school, or is that in a book? Is it in the DSM or what? We all have our own opinion as to what panic symptoms might be, but from a medical standpoint.
REBECCA JOLLOTTA: Those are panic, what panic symptoms are.
MR. REDDINGTON: Would you agree that Patrick, in this conversation, also indicated that she was having intrusive thoughts yet again, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: What were the intrusive thoughts that she was having when she wakes up with panic symptoms?
REBECCA JOLLOTTA: I don't recall the specific intrusive thoughts. I recall asking about safety, and that she did identify having thoughts of suicide.
MR. REDDINGTON: Well, Patrick told you that she has thoughts of suicide, right?
REBECCA JOLLOTTA: Lindsay as well.
MR. REDDINGTON: Okay. So I'm asking you what you, as an invested healthcare provider, told this woman to advise her what your investigation revealed. If you have a patient tell you, "I'm having intrusive thoughts," what were they?
REBECCA JOLLOTTA: I recall that they were intrusive, suicidal thoughts.
MR. REDDINGTON: And is this a frequent theme that you noted?
REBECCA JOLLOTTA: I don't know if it was a frequent theme that I noted, but I know that it was documented several times throughout her course of treatment with providers in my program.
MR. REDDINGTON: So at this point, with all the providers of your program and her indications as well as her husband's about the number of times that she had suicidal ideation, did you prescribe more drugs for her?
REBECCA JOLLOTTA: At this occasion, I prescribed Valium.
MR. REDDINGTON: You bumped her up to Seroquel to 400 milligrams, didn't you?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Did that help? How'd that work out?
REBECCA JOLLOTTA: At 200 milligrams she was able to sleep. So I felt that the mixed, the manic symptoms in her mixed presentation were alleviated at 200.
MR. REDDINGTON: So on December 12th, she sent you one of those messages. Thank you, Rebecca. December 12th. She says, "So the last three nights I've taken 2.5 milligrams of Valium and 200 of Seroquel. I have to say, I do like the way it makes me sleep deeply and soundly for about seven or eight hours. I don't like the way I feel in the morning." You read that to the jury for the DA, right?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: But then the rest of the sentence is, "Incredibly depressed and unmotivated to do anything at all." Do you remember her saying that?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Now, you'd agree with me that that's one of the observations that you make or symptomology of a person that's in—suffering significantly from postpartum anxiety, depression. She's incredibly depressed and unmotivated to do anything, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: What does that mean? What does she mean by that?
REBECCA JOLLOTTA: I'm not sure I understand the question. What it-
MR. REDDINGTON: When she says that she's unmotivated and is incredibly depressed, was she able to go shopping? Could she get in a car and drive? Did you know that she stopped driving?
REBECCA JOLLOTTA: I was not aware of that.
MR. REDDINGTON: On December 12th…
MR. REDDINGTON: She saw Latiesha Dukes. Patient's reporting thoughts of SI, suicidal ideation, but no plan. She contacted crisis over the weekend and will be starting a PHP in Norwell. What does that mean?
REBECCA JOLLOTTA: Partial hospitalization program.
MR. REDDINGTON: Okay. And that's because, yet again, she's reporting the suicidal ideation, correct?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: And there's a difference between suicidal ideation and having thoughts of suicide, right?
MR. REDDINGTON: Under the DSM, is there?
REBECCA JOLLOTTA: There's a suicidal ideation can be a spectrum.
MR. REDDINGTON: Okay. On December 13th, telemedicine in the perinatal behavioral unit. Again, there was a concern about suicidal ideation. And her—look underneath—Edinburgh Postnatal Depression Scale, if you have it, was now 20. It's still severe, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: So what did you do on that date, if you know, December 13th?
REBECCA JOLLOTTA: I recommended that she continue Seroquel 200 milligrams and Valium 2 milligrams.
MR. REDDINGTON: December 19th, telemedicine with Latiesha Dukes. And this is when she indicated that she was gonna contact Women and Infants, and Latiesha helped her out to do that. So she went to Women and Infants on the 20th, right?
REBECCA JOLLOTTA: Correct.
MR. REDDINGTON: Okay. So as time went on and she had gone to Women and Infants and was unable to be treated on December 20th and went home, or picked up by her husband, what was her course of treatment after that?
MR. REDDINGTON: You didn't talk to anybody at Women and Infants, right?
REBECCA JOLLOTTA: At that time, I did not talk to anybody at Women and Infants, but I do know that we re-referred her in a few days.
MR. REDDINGTON: I know. You already told us you re-referred her. My question is real simple, and I don't mean to be evolving. I just wanna ask you.
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Did you talk to anyone at Women and Infants?
MR. REDDINGTON: So as I read the record, which is an exhibit, Women and Infants, December 20th, differential diagnosis, concern about medications, reaches out to Rebecca Jollotta. No return call from Jollotta. You don't recall that. You don't know what happened to her after that, do you, other than going to McLean?
REBECCA JOLLOTTA: I know that she went to McLean.
MR. REDDINGTON: Right. Do you know when she went into McLean?
REBECCA JOLLOTTA: At the end of December, early January.
MR. REDDINGTON: Okay. Did you review the McLean records? 'Cause you have access to them, right?
REBECCA JOLLOTTA: I do not have access to them.
MR. REDDINGTON: You don't?
REBECCA JOLLOTTA: I don't.
MR. REDDINGTON: So if you're treating a person for all of the stuff that we've talked about and it's now apparent that things have decompensated so bad that they have voluntarily admitted her to a locked ward in a mental institution, is it important to Rebecca Jollotta to find out what the diagnosis and treatment was of their patient?
REBECCA JOLLOTTA: Yes.
MR. REDDINGTON: Did you find out?
REBECCA JOLLOTTA: I did not.
MR. REDDINGTON: And any time you called in an ROI, any time you needed a release of information such as a HIPAA release, she would have signed it, right?
MS. BUCKINGHAM: Objection.
THE COURT: Overruled.
REBECCA JOLLOTTA: She would have.
MR. REDDINGTON: You have no reason—
MS. BUCKINGHAM: Speculation.
MR. REDDINGTON: I'm not Hadley.
THE COURT: All right, I'm gonna allow that. The jury can weigh that. You can explore that on a cross-examination. Redirect, I'm sorry.
MR. REDDINGTON: From your treat... Thanks, Judge. From your treatment of Lindsay and her efforts to be a good patient and tell you all what her symptoms were, and third-party contacts, and everything. She, to your opinion, she would've signed a release for you to get access to pretty much anything you wanted, right?
REBECCA JOLLOTTA: I'm not sure if she signed a release for McLean to be able to speak with us.
MR. REDDINGTON: Did anybody ask her? Did you ever ask her to sign a release?
REBECCA JOLLOTTA: I did not.
MR. REDDINGTON: That's all I got, Your Honor.
THE COURT: All right, Attorney Buckingham.
MS. BUCKINGHAM: Ms. Jollotta, Lindsay Clancy was only a patient at South Shore Perinatal Behavioral Health Clinic between November 20th and December 13th. Fair to say? Meaning November 20th is the first contact she had with Julie Paul, right?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And December 13th is the last time that you met with her.
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And she came to that clinic not from a referral from somebody, like Jennifer Tufts, correct?
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: And so your information about her contact with that psychiatrist is limited to what she shared with you.
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: And she never offered to you that maybe you should talk to her. Did she?
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: Now, you've also been asked about providing all the different medications.
MS. BUCKINGHAM: And if I may approach with exhibit one, please.
THE COURT: You may. Yes, you may.
MS. BUCKINGHAM: I'm gonna show you the second page there. I know it's kind of small, but take your time to take a look at it.
MS. BUCKINGHAM: Do you ever see on there that you prescribed any medications to Lindsay Clancy in January of 2023?
REBECCA JOLLOTTA: None.
MS. BUCKINGHAM: And in fact, January 12th of 2023 is Jennifer Tufts, correct?
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: January 5th of 2023, Alia Goodheart, correct?
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: January 16th, Jennifer Tufts.
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: Jennifer Tufts for diazepam. Jennifer Tufts for diazepam. So your last prescription filled was December 22nd, 2022.
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: So when counsel asked you about this chart he was reading from—
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: ...you would agree with me if this record from CVS is what you would generally see when you pull a patient's prescription list?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And as far as the going back through some of the medications, and you were read by counsel about on December 6th and seventh, prescribing the same medication, is it common that you would change prescriptions to adjust for dosage?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And when you start some new medications, do you give somebody an automatic 30-day supply if you're not sure if that's gonna be the course of medication?
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: So sometimes you're prescribing things at kind of odd dosages, right? Or odd number of pills.
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: So on December sixth, for the diazepam, you actually prescribed one pill.
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And then December seventh, two pills.
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And then December ninth, a different... a five milligram dose, eight pills.
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And then on December thirtieth, I think it is, two milligram dose, seven pills.
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And then the Seroquel as well. On December, or November 30th, when you first prescribed that at that low 25 milligram dose for insomnia, she was given 30 pills.
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And then when you changed the plan as of December seventh, you had to give her a new prescription for a higher dose, didn't you?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: So that's the 100 milligrams at 22 pills.
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: Now, when you adjust the dosages or adjust the number of pills, do you give specific instructions on how to take the medication going forward?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: Do you expect the patient to follow those instructions and disregard the previous prescriptions?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: Now, at several points, you've indicated and counsel asked you about referrals or recommendations that Ms. Clancy go to a partial hospitalization program. Right? Do you recall that line of questioning?
REBECCA JOLLOTTA: I do.
MS. BUCKINGHAM: And does South Shore Perinatal Behavioral Health have a partial hospitalization program?
REBECCA JOLLOTTA: Not at this time.
MS. BUCKINGHAM: And so oftentimes you have to pair or recommend places outside in other communities, correct?
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: And you've talked about Women & Infants, and that's one of the places that you've referred, and that you did in fact refer this patient, correct?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: You don't have an affiliation with Women and Infants, do you?
MS. BUCKINGHAM: So any information that you receive would have to come from the patient or at the patient's request. Is that fair to say?
REBECCA JOLLOTTA: That's fair to say.
MS. BUCKINGHAM: In regards to her visit to Women and Infants in December, December 20th, you had contact with Lindsay Clancy the next day, didn't you?
REBECCA JOLLOTTA: I did.
MS. BUCKINGHAM: And that was through the MyChart messaging?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And she explained to you what happened at Women and Infants?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: She gave you details about what they told her, that she wasn't gonna benefit from the groups, and that when she told them about her medication history or medication issues, that they believed that she should come off Seroquel?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: So while you don't have the records of the diagnosis, you had a report from the patient about what they were recommending, didn't you?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And as a result of that, you started a conversation with her about tapering Seroquel, didn't you?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: Counsel bounced around a little bit with the dates, but as far as some of the communications and contact with her, in December or November 30th into December 1st, were you talking to her about postpartum depression?
REBECCA JOLLOTTA: Let me double check, please.
MS. BUCKINGHAM: Mm-hmm.
REBECCA JOLLOTTA: I was.
MS. BUCKINGHAM: So that's when you sent the information and the mood chart, right?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: So that's November 30th, December 1st, and now by the time you get to December 7th, after having pretty significant back-and-forth communication with her, now you're talking with her and giving her some information about bipolar, correct?
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: So upon her presentation at the clinic, in her initial focus of treatment, it was for postpartum depression and anxiety, was it not?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And as you began to have more contact with her, as you began to trial different medication regimens, is that when your differential diagnosis started to emerge?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And you responded to that appropriately with the medication you recommended, right?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: That's why the titrating of Seroquel became a conversation. Is that fair to say?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And when you, after the Women and Infants program on December 20th, you didn't see Lindsay Clancy again in the clinic, did you? Either telehealth or in person.
MS. BUCKINGHAM: And the only contact you had with her was through the messages about the plan for tapering, correct?
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: And—
MS. BUCKINGHAM: While you were going to be away and not available to her, you still gave her a plan and a prescription to assist with tapering, didn't you?
REBECCA JOLLOTTA: I did.
MS. BUCKINGHAM: Was your clinic or your colleagues still available for her if she needed it?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: Did she reach out?
REBECCA JOLLOTTA: I believe that either she or Patrick did reach out on December 30th.
MS. BUCKINGHAM: And that was for a higher level of care recommendations, right?
REBECCA JOLLOTTA: Correct.
MS. BUCKINGHAM: But as far as issues with the taper, did she reach out to you or your colleagues about issues with the taper?
MS. BUCKINGHAM: Now, counsel went through with you a call in which Patrick and Lindsay or Lindsay indicated to you that she was having panic symptoms and intrusive thoughts. Do you recall that?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: In that call, did you contract for safety?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: What does that mean?
REBECCA JOLLOTTA: It means assessing immediate safety. For example, not to speak in hypothetical, but if somebody was saying, "I have a plan to kill myself. I have a knife," I am calling nine one one. I am sectioning that person. If somebody's saying, "I'm having thoughts of suicide." "Okay, what are they? Do you have a plan? Do you have intent?" What I recall from Lindsay, she was having thoughts of suicide. She did not disclose a plan, no intent, and her husband was aware of this as well. He was on the call.
MS. BUCKINGHAM: And in fact, in any of the times that you met with or had messages with Lindsay Clancy, and she talked about intrusive thoughts or suicidal thoughts, did she ever articulate that she ever had a plan?
MS. BUCKINGHAM: Or that she ever actually had any intent of completing the act?
MS. BUCKINGHAM: And you're aware that she did have support in the way of her husband and her family, didn't you?
REBECCA JOLLOTTA: I was aware of that.
MS. BUCKINGHAM: And again, intrusive thoughts, when a person tells you, a postpartum mom tells you they're having intrusive thoughts, in your training experience, in the times that you've treated moms with postpartum depression or anxiety or even psychosis, that's a fairly common complaint, right?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And again, depressed and unmotivated. Fairly common to hear those from new moms?
REBECCA JOLLOTTA: Yes.
MS. BUCKINGHAM: And in your experience in treating individuals with postpartum psychosis, whether they hear voices or not, did you ever have any concerns, based on your contact with Lindsay Clancy, that she was suffering from postpartum psychosis?
REBECCA JOLLOTTA: I did not.
MS. BUCKINGHAM: I have nothing further.
MR. REDDINGTON: Well, it appears as though she was, doesn't it?
MS. BUCKINGHAM: Objection.
THE COURT: Hold, hold on. Why don't we do this? Once you get over there, Mr. Reddington, if you can, go ahead. Let me ask you a question.
MR. REDDINGTON: I'll withdraw.
THE COURT: All right. All right. Anything further? All right. You may—you can step down. Thank you.
REBECCA JOLLOTTA: Thank you.
THE COURT: All right. Anything else? Could I see you over at sidebar?
THE COURT: Looks like I finally got one prediction about how the day was gonna go pretty close. So, we're gonna break for the day at this point. And so what I'm gonna ask you to do is come back tomorrow at nine o'clock. The hope would be kind of a similar schedule that we could follow tomorrow as well. And then I'm told that we are well on schedule and perhaps somewhat ahead of schedule. So just for purposes, I don't wanna jinx us, but that's kinda where we are. So I'm gonna excuse you till tomorrow. Remember those instructions. Don't read anything about this case or any similar cases. Don't do any research. Don't talk about anything. Don't take any field trips. Don't, don't happen to be driving by any certain places. And put this out of your head till tomorrow. All right? It's been a long day. I appreciate it. So I hope you have a nice evening, and come back here tomorrow morning. We'll pretty much follow the same type schedule. So again, my thanks. I hope you have a great evening, and we'll see you tomorrow.
BAILIFF: The court, all rise. Jurors, close your notebooks, please.
BAILIFF: Jurors have exited the courtroom. This court's in session.
THE COURT: All right. Counsel, anything we need to address before we recess till tomorrow?
MR. REDDINGTON: No, thank you.
THE COURT: All right. So this court will be in recess on this case till tomorrow, nine o'clock. Thank you.
BAILIFF: Court, all rise.