5.Keith Nette — Direct
138 linesMS. BUCKINGHAM: Thank you. The Commonwealth will call Keith Nette as its next witness, please.
MR. REDDINGTON: Same objection, your Honor.
KEITH NETTE: Good morning.
THE COURT: Stop right there. Would you mind answering the questions, please?
COURT CLERK: Good morning. Do you solemnly swear that the testimony and the evidence you shall give to the court and the jury in the matter now pending between the Commonwealth and the defendant at the bar shall be the truth, the whole truth, and nothing but the truth, so help you God?
KEITH NETTE: I do.
COURT CLERK: Thank you, sir. You may have a seat.
THE COURT: Watch your step, please. Hi. Good morning, sir.
KEITH NETTE: Good morning.
THE COURT: All right. Counsel?
MS. BUCKINGHAM: Thank you. Good morning.
KEITH NETTE: Good morning.
MS. BUCKINGHAM: Could you please tell the jurors your first and last name, please?
KEITH NETTE: First name is Keith. Last name is Nette, N-E-T-T-E.
MS. BUCKINGHAM: And where do you work, sir?
KEITH NETTE: I work for the Duxbury Fire Department.
MS. BUCKINGHAM: How long have you been with the Duxbury Fire Department?
KEITH NETTE: About 17 years.
MS. BUCKINGHAM: And currently working for the Duxbury Fire Department, what is your role? What do you do there?
KEITH NETTE: Right now I'm a captain and shift commander.
MS. BUCKINGHAM: Okay. And are you a firefighter as well as a trained paramedic?
KEITH NETTE: Yes.
MS. BUCKINGHAM: At Duxbury Fire, you all work 24-hour shifts?
KEITH NETTE: Correct.
MS. BUCKINGHAM: If I draw your attention to January 24th, 2023, do you recall working a 24-hour shift that day?
KEITH NETTE: I was at home.
MS. BUCKINGHAM: Okay. And so what was the shift that you were working that week, if you remember?
KEITH NETTE: I believe I worked maybe two days prior. I don't really remember.
MS. BUCKINGHAM: Okay. So you were on a day off?
KEITH NETTE: Yes. Correct.
MS. BUCKINGHAM: And how was it that you ended up being involved in the call at 47 Summer Street on January 24th?
KEITH NETTE: We were recalled from, via a pager and text message that there was an incident going on, and that we were to respond.
MS. BUCKINGHAM: So can you explain to us how that works?
KEITH NETTE: So a tone goes off through dispatch that sends off a pager at our houses that alerts us. Then we also get text messages about the incident, and then respond either to the station or to the scene, whichever they request.
MS. BUCKINGHAM: As a Duxbury firefighter, are part of your responsibilities to respond to these, these recalls?
KEITH NETTE: Yes.
MS. BUCKINGHAM: Is it a voluntary thing?
KEITH NETTE: Yes.
MS. BUCKINGHAM: So if you were indisposed or unavailable when a call went out, a tone went out, would you be expected to respond to the scene?
KEITH NETTE: No.
MS. BUCKINGHAM: But in this case, on January 24th, just after 6:00 PM, you heard that call go out, correct?
KEITH NETTE: Correct.
MS. BUCKINGHAM: And so then what did you do when you heard the call?
KEITH NETTE: I drove to the scene in my personal truck.
MS. BUCKINGHAM: When you got to the scene, what did you see?
KEITH NETTE: I saw police and fire vehicles, and then I walked up the driveway and walked into the back of the ambulance.
MS. BUCKINGHAM: Now, when you arrived and saw police, so that was Duxbury police?
KEITH NETTE: Correct.
MS. BUCKINGHAM: And the fire personnel that was on scene, who was on scene, if you remember?
KEITH NETTE: I only saw two people on scene initially. That was Kevin Heath and Sergeant Homestead.
MS. BUCKINGHAM: Okay. And Sergeant Homestead is a Duxbury officer?
KEITH NETTE: Correct.
MS. BUCKINGHAM: Now, was there a Duxbury ambulance in the driveway when you pulled up?
KEITH NETTE: Yes.
MS. BUCKINGHAM: And before even getting past that ambulance, were you asked to assist?
KEITH NETTE: Yes.
MS. BUCKINGHAM: What did you see when you came to the back of that ambulance?
KEITH NETTE: I saw an officer, Sergeant Homestead, and Kevin Heath doing CPR on a child.
MS. BUCKINGHAM: Had you seen how the child ended up in the ambulance, or did you come after?
KEITH NETTE: I came after.
MS. BUCKINGHAM: Okay. Did you then help take over with treating that child in the back of the ambulance?
KEITH NETTE: Yes.
MS. BUCKINGHAM: What was your initial observation of the patient? What did he look like?
KEITH NETTE: Blue, white, non-responsive, not breathing, no pulse.
MS. BUCKINGHAM: And this particular patient, did you come to learn him to be the child named Dawson Clancy?
KEITH NETTE: Yes.
MS. BUCKINGHAM: And he was approximately three years old?
KEITH NETTE: Yes.
MS. BUCKINGHAM: What kind of treatment did you and the paramedic, Heath, offer to Dawson in the back of the ambulance? What did you do?
KEITH NETTE: We tried to start an IV, but then we also started an IO, which is kinda like an IV. Tried intubation, which is a advanced airway. Medications and continued CPR.
MS. BUCKINGHAM: So an IV, that's just putting a needle into somebody and trying to pump fluids and medicine, correct?
KEITH NETTE: Correct.
MS. BUCKINGHAM: Tell us what an IO is.
KEITH NETTE: An IO is intraosseous, which is basically into the bone marrow on the lower leg.
MS. BUCKINGHAM: So what do you do to try to enter an IO?
KEITH NETTE: Usually we have a drill. But we had a manual one instead.
MS. BUCKINGHAM: So what do you do with the manual drill to enter the IO?
KEITH NETTE: You just twist, and then it goes into the bone.
MS. BUCKINGHAM: And where—what bone do you attempt to do this in? And were you able to enter that IO into Dawson?
KEITH NETTE: Yes.
MS. BUCKINGHAM: What is the purpose of the IO versus the IV?
KEITH NETTE: If the patient has difficult access, which pediatrics do.
MS. BUCKINGHAM: And in this circumstance, what kinds of medication were you trying to deliver through the IO to Dawson?
KEITH NETTE: Epinephrine.
MS. BUCKINGHAM: What's the purpose of epinephrine?
KEITH NETTE: Basically kind of just kind of helps to restart the heart.
MS. BUCKINGHAM: And at this point, he had no heart activity?
KEITH NETTE: Correct.
MS. BUCKINGHAM: You also mentioned attempts to intubate. Can you tell us what that means?
KEITH NETTE: So intubation is an advanced airway where you put a tube into the airway to secure it to deliver high-flow oxygen.
MS. BUCKINGHAM: Were you able to intubate Dawson?
KEITH NETTE: Yes. Kevin Heath did.
MS. BUCKINGHAM: And what do you do when you enter the tool to intubate?
KEITH NETTE: You go into the mouth, and you do a motion of pulling up to see the vocal cords so you can pass a tube through.
MS. BUCKINGHAM: And what do you attach to the tube to try to increase the breath?
KEITH NETTE: Oxygen and a BVM, which is a—basically you're squeezing a bag.
MS. BUCKINGHAM: So BVM would stand for bag valve mask?
KEITH NETTE: Correct.
MS. BUCKINGHAM: Okay. While you were treating Dawson and doing the airway, intubating him, giving him the medicines, were you able to observe anything about the area of his neck?
KEITH NETTE: Yes.
MS. BUCKINGHAM: What did you observe about his neck?
KEITH NETTE: Dark red marks around his neck.
MS. BUCKINGHAM: Now, all of this is happening while you are in the back of the ambulance with Firefighter Heath, correct?
KEITH NETTE: Correct.
MS. BUCKINGHAM: And do you recall another Duxbury officer being present, Dan Dougherty?
KEITH NETTE: Yes.
MS. BUCKINGHAM: Eventually was that ambulance then sent to the local hospital?
KEITH NETTE: Yes.
MS. BUCKINGHAM: Which hospital did you guys go to?
KEITH NETTE: BI Plymouth.
MS. BUCKINGHAM: On the ride to the hospital, did you ever get a pulse for Dawson?
KEITH NETTE: No.
MS. BUCKINGHAM: Were you ever able to resume breathing using that method with the bag valve mask?
KEITH NETTE: No.
MS. BUCKINGHAM: The efforts to give him the medication, the epinephrine, did it ever do anything to start his heart?
KEITH NETTE: No.
MS. BUCKINGHAM: When you arrived at the Beth Israel Hospital Emergency Department, tell us how you transferred the care of the patient.
KEITH NETTE: We wheeled the stretcher in, and we went into the first room, which is trauma one and trauma two. We moved the patient over to their bed, and then transferred care.
MS. BUCKINGHAM: While you were at the Emergency Department at Beth Israel, did you see another child from that same home come in?
KEITH NETTE: I did.
MS. BUCKINGHAM: And what department brought them in? What fire department?
KEITH NETTE: Marshfield.
MS. BUCKINGHAM: Did you do anything to assist Marshfield when they came through the Emergency Department?
KEITH NETTE: I assisted in compressions when they were getting the child out of the ambulance.
MS. BUCKINGHAM: And is that something that is ongoing during transport when you're trying to transfer care to the emergency staff?
KEITH NETTE: Yes.
MS. BUCKINGHAM: Do you remember seeing the father of the children at the Emergency Department that evening when you were there?
KEITH NETTE: I did.
KEITH NETTE: Upset, and, yeah, just basically visually upset.
MS. BUCKINGHAM: Did you do anything yourself to assist him when he was there?
KEITH NETTE: I assisted to get a chair in case he needed to sit down.
MS. BUCKINGHAM: And was that before or after the children had passed, had been declared?
KEITH NETTE: I believe it was after.
MS. BUCKINGHAM: Thank you.
THE COURT: All right. Attorney Reddington?
MR. REDDINGTON: I have no questions. Thank you, sir.
THE COURT: All right. All right. Thank you, sir. You may step down. Thank you.
KEITH NETTE: Thank you.