3.Gregory Saathoff — Redirect/Recross (Part 4)
260 linesTHE COURT: Attorney Sprague.
MS. SPRAGUE: Thank you, Your Honor.
MS. SPRAGUE: Sir, you were asked during cross-examination about your work as a forensic psychiatrist for the Bureau of Prisons and for the prisons in Virginia. What ex- and about that work and kind of minimizing what your experience was there. What was your work there? What is—what did that entail?
GREGORY SAATHOFF: Well, I continued to work there, and I continued to teach students in that system.
GREGORY SAATHOFF: Seeing patients who are inmates in a number of different facilities, men's and women's facilities over the years. And doing assessments, evaluations, making determinations about treatment, and the like, gathering information. So really, treating these inmate patients as patients who have significant mental illness and really require the best treatment that we can provide in the system.
MS. SPRAGUE: And during the course of your many, many years working in that system and treating these patients, have you treated patients with psychosis?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And does that include treating women with psychosis?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And how often have you done that?
MR. REDDINGTON: I'm going to object. I didn't ask about who- he said two already. He's already said twice.
THE COURT: Overruled. She may have that. Go ahead.
GREGORY SAATHOFF: Since 1992?
MS. SPRAGUE: Yes.
GREGORY SAATHOFF: So thirty-four years.
MS. SPRAGUE: How many patients have you treated in the prison system, women patients dealing with psychosis, approximately?
GREGORY SAATHOFF: Several hundred.
MS. SPRAGUE: And are there certain common signs or symptoms that these women display who have psychosis?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And what are those?
GREGORY SAATHOFF: Well, some have delusions, fixed false beliefs about certain things. So they can present as being psychotic that way. Also they can present with hallucinations, what we call perceptual disturbances. And generally, they are, in most cases, auditory hallucinations, auditory verbal hallucinations. And they also can present with disorganized thinking, having words, making up words that have special meaning, really having a great difficulty communicating.
MS. SPRAGUE: And you also mentioned that you worked for a state hospital for, I think you said fifteen years. Is that correct?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: And did you treat patients with psychosis during those fifteen years?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And did those include women with psychosis?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And in terms of your treatment of women with psychosis, were you responsible for diagnosing them with their underlying mental condition?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Diagnosing psychosis as being one of their symptoms?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: And then treating the underlying condition and the symptom of psychosis for those women?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And you did that for approximately fifteen years, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And you mentioned two specific patients, females that you dealt with with postpartum depression or postpartum psychosis. Do you recall that?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And what did you learn from treating those two patients?
GREGORY SAATHOFF: So those are the two patients that are mentioned in the case reports.
MS. SPRAGUE: Which case reports?
GREGORY SAATHOFF: The case report about postpartum psychosis that was written.
MS. SPRAGUE: On the medication interaction?
GREGORY SAATHOFF: Yes. Are you asking how those patients presented?
MS. SPRAGUE: Yes.
GREGORY SAATHOFF: Okay. There were, as I recall—it's been a while, it's been a while since I've looked at the paper. But one was an eighteen-year-old woman who had delivered her child and had decided not to take, or that she did not want to breastfeed. And so in those days, this medication, bromocriptine, also called Parlodel, was given. And we found that within, I think, just a couple of days of the time that she was given this medication, she became...
GREGORY SAATHOFF: Convinced that she had to kill her child. And I believe that she was experiencing auditory hallucinations. And she was so distressed about that, that she wanted to kill herself and was suicidal. And that was what... how she was brought to our attention. In evaluating her, we removed the Parlodel, the bromocriptine, and she responded and resolved her symptoms, her psychotic symptoms, and we were able to discharge her back to her family.
GREGORY SAATHOFF: The other case, I believe, was somewhat someone, another female, a bit older, maybe mid-twenties, and she was also given this medication and also became psychotic. For her, it was more a manifestation of mania. She was hypersexual with her husband. She, I think, was quite hyper-religious, and she was—
MS. SPRAGUE: And Doctor—
GREGORY SAATHOFF: Sorry.
MS. SPRAGUE: In terms of her delusions, those were more of religious delusions?
GREGORY SAATHOFF: Pardon me?
MS. SPRAGUE: Her delusions regarding her child were religious delusions?
GREGORY SAATHOFF: Yes, I believe so.
MS. SPRAGUE: Okay. And once that medication was removed from that woman, did her symptoms subside?
GREGORY SAATHOFF: Yes. I think in that case, she was also given... She was so disruptive on the ward, taking her clothes off, et cetera, et cetera, that she was also given antipsychotic medication for a period of time, and her symptoms resolved.
MS. SPRAGUE: And going back to the first patient that you described, you said that she had voices instructing her to harm her child. And was it as a result of her feelings of guilt for those, about those thoughts and voices that she was suicidal?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Okay. So she wanted to kill herself instead of killing her children, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Now, you were asked by Attorney Reddington about your curriculum vitae and focusing in on terrorism, and is that your sole focus, and you said no. What has been your focus over your career?
GREGORY SAATHOFF: Well, from the time that I finished my residency, I've been very interested in public psychiatry. And so upon realizing the seriousness of mental illness within the prison system and the value of teaching psychiatry to students within the system, I began doing that while I was also doing work with the state hospital, seeing patients, whatever. I would say that of all the things that I do, and consider myself the th— what is most important to me is working with patients. And it's the value of also being with students and having them learn from these patients is gonna make them better doctors, even if they don't choose to go into psychiatry. So I see my identity actually as a clinician, and I have patients I'm scheduled to see. I was supposed to see some yesterday, and also I'm gonna see patients on Friday.
MS. SPRAGUE: And Doctor, you... Defense counsel asked you about the onset of postpartum depression and postpartum psychosis, and you had said that the DSM5 lists postpartum onset within four weeks, correct?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: And he asked you about other organizations going up to approximately a year, correct?
GREGORY SAATHOFF: That's right.
MS. SPRAGUE: Are you aware that the World Health Organization has a clinical descriptions and diagnostic requirements for behavioral and neurodevelopmental disorders that has a section on mental and behavioral disorders associated with pregnancy, childbirth, or the puerperium, P-U-E-R-P-E-R-I-M? Which, does that mean during or after birth?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And that in that section by the World Health Organization, they state that mental and be-
MR. REDDINGTON: Objection. She's not gonna read that to him, and then he's gonna agree with that. She can ask him if he's read it.
THE COURT: Well, let's hear the question first.
MR. REDDINGTON: Yeah.
THE COURT: And then-
MR. REDDINGTON: I've done already.
THE COURT: ... I'll assume there'll be an objection.
MS. SPRAGUE: Are you aware that in that section it states that, "Mental and behavioral disorders associated with pregnancy, childbirth, or the puerperium are syndromes associated with pregnancy or the puerperium commencing within about six weeks after delivery"?
MR. REDDINGTON: Objection.
THE COURT: Overruled. Overruled. I'll allow that if you know that, Doctor.
GREGORY SAATHOFF: Yes.
THE COURT: Okay.
MS. SPRAGUE: And are you also aware that there's a section talking about mental and behavioral disorders associated with pregnancy, childbirth, or the puerperium with psychotic symptoms that says, "Onset of a syndrome involving significant mental and behavioral features occurring during pregnancy or the puerperium, i.e., up to about six weeks following delivery, is required for diagnosis"?
GREGORY SAATHOFF: That's my understanding.
MS. SPRAGUE: And that's from the World Health Organization, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Now, you were asked about whether blood testing would be appropriate for a patient, and you said that it would depend on the history of the patient, the symptoms, the medication. Do you recall that?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Okay. Did you see anything in the records about Lindsay Clancy that would have required blood testing?
MS. SPRAGUE: You were also asked about thyroid function and how sometimes you might wanna test thyroid function in a postpartum woman. Do you recall that?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Are you aware that, reading from Exhibit 222, I believe, that Ms. Clancy's thyroid levels were checked when she visited the South Shore Hospital Emergency Room on November 16th, 2022, and her levels were within normal limits?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: I just move to submit this page from Exhibit 222 showing the thyroid levels.
THE COURT: All right. So that's in. It's just a follow-up of a sheet that's in. I'll allow that.
COURT REPORTER: 296.
MS. SPRAGUE: And Doctor, just for the jury to know, in that page that's just been marked in as exhibit, the thyroid levels would be marked by TSH, correct?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: You were asked about Lamictal and the serious rash that could occur. You said that the serious rash is rare. How rare is it?
GREGORY SAATHOFF: Approximately 1 in 1,000.
MS. SPRAGUE: And you mentioned that millions of people take Lamictal with no problem at all, correct?
GREGORY SAATHOFF: That's right.
MS. SPRAGUE: And is there anything that providers do to be aware of the potential for the rash and to explain that to patients and to try to just basically keep an eye out to see if the patient's developing that symptom?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And what is that?
GREGORY SAATHOFF: It's a medication that needs to be started at a low dose, 25 milligrams, and only gradually moving up, finally after a number of weeks to a dose as much as 200 milligrams, perhaps even more. When the medication is given in a what we call titrated, slow process, the potential for this serious rash is greatly, greatly decreased. So it really is a medication that requires a slow titration. So the patient needs to be patient with that process. But it's now one of the most used mood stabilizers for bipolar disorder, that it really is a very, very important and valuable medicine for bipolar disorder.
MS. SPRAGUE: And you said that it's important to start at a low dose. Did you say 25 milligrams?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: And do you recall what dose Dr. Tufts wrote the prescription for, for Ms. Clancy?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And what was that?
GREGORY SAATHOFF: 25 milligrams.
MS. SPRAGUE: And do you recall from the records whether the plan was if she were to take it to titrate in the manner you described?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: And putting aside whether or not someone chooses to take the medication because of a rash, is there any significance to the person, to a patient, being prescribed a medication and then not telling that provider that they chose not to take it?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And what is that?
GREGORY SAATHOFF: Well, it really limits the provider in making other decisions. If a decision is made that a patient's not going to take a certain category of medication, it's helpful to let that provider know and say, "I've decided against it. What are some other alternatives?"
MS. SPRAGUE: Doctor, you were asked about lack of sleep causing, potentially causing psychosis, correct?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: And sleep was definitely an issue for Ms. Clancy in the fall leading into December of 2022, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And looking back to the McLean records, would it be accurate to state that her sleep got progressively better while at McLean?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And then, directing your memory to the text messages that Ms. Clancy had with her mother from January 7th through January 22nd of 2023, would it be accurate to state that she told her mother she was sleeping better during that time?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Defense counsel asked you if by all the evidence and witnesses that the defendant was a happy wife, mother, daughter, all of that, and you said no. What were you referring to when you said no?
GREGORY SAATHOFF: Well, I was thinking about the paper that she filled out on September 12th of 2022 in which she expressed some of the concerns that she had significant anxiety. But also, as I recall, insomnia was a concern of hers. And she... It was followed up with Jennifer McAllister, who worked with Dr. Tufts. And I think in Ms. McAllister's note, Ms. Clancy mentioned that she had waning, waning confidence in being able to take care of her children as they were growing up. And that, I think in a note of Dr. Tufts, Dr. Tufts noted that she said that she found that Callan needed more attention, and that as the kids were growing older, that she was finding them more challenging.
MS. SPRAGUE: Did Ms. Clancy give any information about why it was more challenging as the kids got older?
MR. REDDINGTON: I'm gonna object. You know, this is pretty far afield from—
THE COURT: Yeah. Sustained. It goes beyond cross.
MS. SPRAGUE: So doctor, defense counsel asked you about Dr. Tufts and her treatment of the defendant, and mentioned repeatedly how she'd only been in the practice on her own for a few months. Do you remember that?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: In reviewing Dr. Tufts' treatment of the defendant and the medications she's prescribed and the methods she used in prescribing those medications, did you see... Did you have any issues or concerns about the approach she took or what she prescribed?
MS. SPRAGUE: And what were your thoughts about her approach to treating this defendant?
GREGORY SAATHOFF: Well, possibly because Dr. Tufts was new and had just come into practice, she was more available. And so I think she was able to see Ms. Clancy over video 14 times. And for example, when Ms. Clancy was discharged from McLean, the request from McLean was that she needed immediate outpatient follow-up, and so Dr. Tufts arranged it the following day. And so there were some weeks where Dr. Tufts saw Ms. Clancy more than once a week. And I will also say that when Ms. Clancy decided to go to Nurse Practitioner Paul and then saw Nurse Zelata, I think early December, it might have been December 1st, she then went to Dr. Tufts. And Dr. Tufts wrote a note saying that she felt uncomfortable making prescriptions while Ms. Clancy was going to another provider. But in that note suggested that Lamictal could be helpful. So Dr. Tufts was very responsive to concerns of Ms.
GREGORY SAATHOFF: Clancy in terms of seeing her, was seeing her weekly, and saw her on the 23rd of January, and then had another appointment the next week, and had talked about future treatments, possible treatments, esketamine, as well as TMS. So—
GREGORY SAATHOFF: Perhaps the fact that she had just left her residency meant that she could be more responsive to seeing patients quickly, and she did that.
MS. SPRAGUE: And speaking specifically to the prescribing, you know, prescribing, which medications she's prescribed, which doses, what different options she tried. Did you have an opinion based on your training and experience of Dr. Tufts' method with prescriptions?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And what was that?
GREGORY SAATHOFF: I felt that the prescribing was very reasonable.
MS. SPRAGUE: How so?
GREGORY SAATHOFF: Well, back in 2013, 2014, Ms. Clancy had taken Prozac, an SSRI, and it was helpful. She also took Wellbutrin and propranolol. After Dawson was born, Ms. Clancy had some significant anxiety and actually went to a doctor and was prescribed Zoloft. So this would have been in 2019. But then decided—2019, early 2020—but then decided not to take the Zoloft. Her anxiety symptoms resolved. It was a difficult time, particularly as she got older because of COVID. But she decided that even though she had the prescription of Zoloft, she decided not to take it. The anxiety that she experienced after Callan's birth was more significant and lasted longer. And so she went to Dr. Tufts, who got a history of Ms. Clancy having taken the Prozac and done well on it. Having seriously considered Zoloft to the extent that she got a prescription for it, decided not to take it. That Zoloft at twenty-five milligrams, which is the lowest dose, starting at, would be a reasonable choice. Really perhaps the most reasonable choice of an antidepressant, given Ms. Clancy's history up to that point. I believe that there were only seven pills taken. Ms. Clancy was directed to take twenty-five milligrams for a week, and then increase to fifty milligrams, two, two tablets. But had, I think maybe after five days, taken that increase and increased from twenty-five to fifty milligrams, and then had the adverse reaction of insomnia, very significant insomnia.
MS. SPRAGUE: And in terms of after seeing the effects from the Zoloft and stopping that prescription, the various prescriptions that Dr. Tufts tried with the defendant, did you have an opinion based on your training experience about whether that trial and error process and what she prescribed and what she tried with the defendant, whether that was reasonable?
MR. REDDINGTON: Objection.
THE COURT: Overruled.
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And was it reasonable?
GREGORY SAATHOFF: Was it reasonable?
MS. SPRAGUE: Yes.
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And how so?
GREGORY SAATHOFF: Well, Ms. Clancy, after having the insomnia, was very upset and concerned, as anyone would be. I think that was around October 21st. And so, Dr. Tufts assessed her and told her to stop the Zoloft, and started her on Ativan, I understand, and Benadryl. And that medication was helpful for a while. But Ms. Clancy was concerned about Ativan, benzodiazepines being addictive and concerned about getting hooked on these types of medications, and that is a concern over the long term. And so part of the process was to see if she could be treated effectively by decreasing the benzodiazepines or maybe giving her a longer-acting benzodiazepine. The medication Buspar, buspirone, was prescribed by Dr. Tufts. But Ms. Clancy, in a note—
MR. REDDINGTON: Excuse me, doctor. I apologize. Can I have a standing objection to the rambling answers? This is redirect. I object.
THE COURT: Okay. We can see counsel sort of put something on the record. Counsel.
MS. SPRAGUE: And so, Doctor, if you could continue your answer, as—
THE COURT: Just, just for a second. I just wanna... So members of the jury, we're gonna go a little past the one o'clock, the usual time of the break here, for certain scheduling reasons. Okay?
MS. SPRAGUE: So if you could just summarize briefly, what... You said that you thought her, that Dr. Tufts' approach was reasonable. If you could just summarize briefly why you thought her approach was reasonable.
GREGORY SAATHOFF: According to the notes and also the emails, communications with, between Dr. Tufts and Ms. Clancy, I found Dr. Tufts to be very responsive to Ms. Clancy's symptoms and concerns, in really trying to make adjustments according to how Ms. Clancy was doing.
MS. SPRAGUE: Thank you. And you were asked by defense counsel about her visit to Women and Infants Hospital, and about the defendant. I believe what defense counsel asked you was that every time a doctor told the defendant to do something, she was on it immediately. Do you remember being asked that?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And do you recall that in the Women and Infants records that they offered her three programs, an in-patient hospitalization, a partial hospitalization program, and an out-patient program, and the defendant said that she would talk to her provider for guidance about those programs?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And do you recall reading in the notes and records of Jenni—Dr. Tufts, Doc—Nurse Practitioner Jollotta, that she never discussed those three programs with her doctor or her nurse practitioner, correct?
GREGORY SAATHOFF: That's my recollection.
MS. SPRAGUE: Now, in terms of the calls to Aspire, to the hotline for the suicide hotline, you were asked about where in the records you saw that. And I would just like to approach, also from Exhibit 222, the note from December 8th, 2022 of Latiesha Dukes. And if you could just review this note here, and then look up when you're finished.
GREGORY SAATHOFF: Yeah.
MS. SPRAGUE: Doctor, is this the record that you were referring to that gave you the information about the defendant's call to the suicide hotline?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: In reading from this page from the exhibit, page 45, it states that patient contacted Aspire Crisis Support. She met with an Inspire, Aspire clinician virtually and was told that she did not meet the criteria for in-patient treatment due to not having an SI plan. That's a suicidal ideation plan, correct?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: And then reading again, “Aspire clinician recommended that the patient attend a day program. The clinician said he would be sending the patient resources. Clinician informed the patient that it would be beneficial to attend an IOP or a PHP to help the patient build coping skills and build community.” What's an IOP and a PHP, do you know?
GREGORY SAATHOFF: Part, PHP is partial hospitalization program, and IOP is, I believe, an in-patient program.
MS. SPRAGUE: And so when the defendant called the suicide hotline, she told them she was having suicidal thoughts, correct?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: But she told them she did not have a plan, correct?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: And they didn't just hang up on her. They sent her resources and recommended a day program and a partial hospitalization program or an in-patient program, correct?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: Move to submit this, these two pages, 45 and 46, as the next exhibit. They're a apart from Exhibit 222.
THE COURT: All right. Subject to the same objection, I'm gonna... That may be admitted.
COURT REPORTER: 197.
MS. SPRAGUE: You were asked a lot of questions about hormone changes after pregnancy and if that can affe- and stopping breastfeeding and if that could affect someone's mental health. Do you remember that?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And you said something about the timing matters. Why does the timing matter?
GREGORY SAATHOFF: Well, after lactation and a postpartum period, and it may be, the decision for a woman to stop lactation can occur at various times, not just during a circumscribed one-month period. But stopping lactation causes a decrease in prolactin levels, an increase in estrogen and progesterone. And it really depends on when someone decides to stop breastfeeding. Those significant hormonal changes that are tied to breastfeeding or lactation. And so that's why timing and the time is important to see at what point did breastfeeding stop, and at what point are we seeing symptoms.
MS. SPRAGUE: And Doctor, with the defendant, the breastfeeding stopped sometime in October. Is that correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And then looking ahead to January, January 24th, 2023, would you still be expecting to see hormonal problems from stopping breastfeeding in October, in January that many months later?
MS. SPRAGUE: Now, you were asked about the statements Patrick made regarding his interaction with the defendant when he found her outside in the snow, and is it correct that he told you he found her and said, “What did you do?” And she said, “I tried to kill myself”?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And did she then say—did he then say, “Where are the kids?” And she said, “They are in the basement”?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Did he then tell you that he then called 911?
GREGORY SAATHOFF: I don't recall exactly when he told me that he called 911. What I recall is his statement about what she said to him.
MS. SPRAGUE: And that was his—her statements to him when he immediately found her on the ground?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: Okay. And you're aware that at some point he made a 911 call, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And during that 911 call that you listened to, you didn't hear the defendant saying any words at that point, correct?
GREGORY SAATHOFF: I did not.
MS. SPRAGUE: And as a physician, are you aware that someone who's been injured can deteriorate over time?
GREGORY SAATHOFF: Yes, particularly after an overdose.
MS. SPRAGUE: And can they be speaking in one moment and then unable to speak moments later?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Now, you were also asked about the crushed up pills and whether there was any residue on the nightstand or anywhere in the house that the police saw, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And there was no residue in the photos, correct?
GREGORY SAATHOFF: Not that I saw.
MS. SPRAGUE: But you don't know when she crushed up the pills, do you?
GREGORY SAATHOFF: I don't.
MS. SPRAGUE: If she had crushed them up earlier in the day, there wouldn't necessarily be residue, correct?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: If she had crushed them up days before and put the empty bottles in a drawer, there wouldn't necessarily be residue, correct?
THE COURT: Sustained.
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: There were many texts between the defendant and her mother in January, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And from January 7th until January 22nd, when Ms. Clancy's mother and father visited her at her home, the text messages clearly indicated that they were in two separate locations, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And in those text messages, the defendant repeatedly told her mother that she was doing a little bit better, a little bit better, sleeping's a little bit better, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: You were asked about Dr. Resnick, and how many articles and how many books he's written, and how he's well-known in this area, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And are you familiar with Dr. Resnick's teachings about malingering and about psychosis?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And is it fair to say that Dr. Resnick teaches others that one of the red flags to look for in malingering—
MR. REDDINGTON: You can ask him what he's read. Not tell him what she wants him to say.
THE COURT: No. Hold on. Let me hear the question first.
MS. SPRAGUE: Are you aware that one of the red flags that Dr. Resnick teaches to look for in malingering, in faking hearing voices, is that someone automatically obeys a command?
GREGORY SAATHOFF: Yes.
THE COURT: It's stricken it this time. Can I see counsel?
THE COURT: So members of the jury, that last answer, I think as I said, was stricken. Okay? Yeah, Commonwealth.
MS. SPRAGUE: Thank you, Your Honor. Now, you were asked about trying to do collateral interviews with the defendant's family, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: And you had requested of our office to make arrangements to interview the defendant's parents and her sister, correct?
GREGORY SAATHOFF: Yes.
MS. SPRAGUE: Were you aware that an email was sent to—I'm sorry. Were you aware that a phone message was left for Paula Musgrove, asking if she and her husband would be willing to meet with you on June 11th, 2026, and that they did not return the call?
GREGORY SAATHOFF: That's my understanding.
MS. SPRAGUE: And are you aware that an email was sent to Allison Ozga, the defendant's sister, requesting that she meet with you? And her response to that email was, "I am awaiting a response from Kevin advising me on participating in Dr. Saathoff's assessment. I will respond once I speak to him." Were you aware of that?
GREGORY SAATHOFF: That was my understanding.
MS. SPRAGUE: And were you aware that she did not respond after that?
GREGORY SAATHOFF: Correct.
MS. SPRAGUE: I have nothing further. Thank you.
MR. REDDINGTON: You weren't aware that Kevin was on a month-long federal trial during that period of time either, were you? That'd be me.
GREGORY SAATHOFF: Is that a question?
MR. REDDINGTON: Yeah.
GREGORY SAATHOFF: Can you repeat it?
MR. REDDINGTON: You weren't aware—
THE COURT: You could say, maybe get a little closer to the mic for it. I had problems.
MR. REDDINGTON: You weren't aware, sir, that during the time that Ozga, her sister, said she's waiting to hear from Kevin, and I'm the Kevin, that I was on trial on a month-long federal case out of my office. You didn't know that, did you?
GREGORY SAATHOFF: I did not know that.
MR. REDDINGTON: Did you ever think to call me directly, or at my secretary, my office manager, to ask about me reaching out to these people?
MR. REDDINGTON: That's all I have, Judge. Thank you.
THE COURT: All right. Anything else?
MS. SPRAGUE: No.
THE COURT: All right. Thank you, Doctor. You may step down.
GREGORY SAATHOFF: Thank you.