3.Mark Joseph Tenerowicz — Direct/Cross
90 linesMS. SPRAGUE: Commonwealth calls Dr. Mark Tenerowicz.
MR. REDDINGTON: Just for the record, Your Honor, I'm just noting. I object to this. We believe the circumstances and—
MS. SPRAGUE: Do we wanna go to sidebar?
THE COURT: Yeah, please.
THE COURT: All right. Attorney Sprague.
MS. SPRAGUE: Thank you, Your Honor.
COURT CLERK: Thank you, sir. You may have a seat.
BAILIFF: Watch your step, please.
THE COURT: Thank you. All right. Good afternoon, doctor.
MARK TENEROWICZ: Good afternoon, sir.
MS. SPRAGUE: If I may?
THE COURT: Yes, please.
MS. SPRAGUE: Thank you. Good afternoon. Could you please state and spell your name for the record?
MARK TENEROWICZ: Mark Joseph Tenerowicz. M-A-R-K J-O-S-E-P-H T-E-N-E-R-O-W-I-C-Z.
MS. SPRAGUE: And what is your date of birth, sir?
MARK TENEROWICZ: 2/28/69.
MS. SPRAGUE: What do you do for a living?
MARK TENEROWICZ: I was an emergency physician. I'm currently not acting as emergency physician.
MS. SPRAGUE: Okay. What do you currently do?
MARK TENEROWICZ: I do disability review for the State of Rhode Island.
MS. SPRAGUE: And so directing your attention back to January of 2023, were you an emergency room physician at that time?
MARK TENEROWICZ: Yes, I was.
MS. SPRAGUE: And where did you work?
MARK TENEROWICZ: Beth Israel Deaconess Plymouth.
MS. SPRAGUE: And could you briefly describe for the jurors your educational background and the training that you underwent to qualify to be an emergency room physician?
MARK TENEROWICZ: I did my undergraduate education at Trinity College. I did a one-year post-baccalaureate pre-medical program at Bryn Mawr College. I then got my medical degree from Brown University, and I did my residency in emergency medicine at UMass Memorial in Worcester.
MS. SPRAGUE: And when you finished your education and training, did you work in emergency care after that point up until you changed positions?
MARK TENEROWICZ: I worked in emergency medicine from 1997 until May of 2025.
MS. SPRAGUE: In directing your attention to January 24th, 2023, were you working in the evening hours that day?
MARK TENEROWICZ: I was.
MS. SPRAGUE: And at some point in time, did you treat a child named Dawson Clancy?
MARK TENEROWICZ: Yes.
MS. SPRAGUE: How did he arrive at the hospital?
MARK TENEROWICZ: He arrived by fire department ambulance.
MS. SPRAGUE: And when he arrived, were you given a summary of his injuries by emergency personnel?
MARK TENEROWICZ: Yes.
MS. SPRAGUE: What did you learn at that time?
MARK TENEROWICZ: I was told that he reportedly had been strangled, and he was found without a pulse and not breathing.
MS. SPRAGUE: And what observations did you make of Dawson yourself?
MARK TENEROWICZ: When he arrived, he had a breathing tube in. They had placed a device into the bone of his leg to give him intravenous fluids and medicines. CPR was in progress. He was not breathing on his own, and he had no pulse, and he was not responding.
MS. SPRAGUE: And after—well, strike that. Did you observe any trauma to his body?
MARK TENEROWICZ: I believe there were some old appearing bruises on his legs, and there was some ruptured blood vessels on his face.
MS. SPRAGUE: And did you observe anything in the area of his neck?
MARK TENEROWICZ: Not that I can recall.
MS. SPRAGUE: And what did you do to treat Dawson?
MARK TENEROWICZ: We continued CPR. We continued to give him IV fluids. We gave him doses of adrenaline to try and restart his heart. We confirmed that the breathing tube was in the right position. We eventually gave medicines to treat the presumed acid buildup in his blood. We gave him calcium to make sure that his heart would, if it started again, would beat effectively, and that's what we did.
MS. SPRAGUE: And how did you go about making sure that the breathing apparatus was in place properly?
MARK TENEROWICZ: Basically four ways. We detected carbon dioxide in the air coming out of his lungs, which usually just comes from the lungs. I listened and could hear breath sounds. I looked with a video laryngoscope to confirm that the tube was between the vocal cords going into the lungs, and we did an X-ray.
MS. SPRAGUE: And when you say you were hearing breath sounds, was that him breathing on his own or something else breathing for him?
MARK TENEROWICZ: That was someone breathing for him, squeezing the bag attached to the breathing tube.
MS. SPRAGUE: Okay. And so that, the breath sounds you heard just confirmed that whoever was squeezing the bag mask, bag valve mask, the air from that was going into the lungs and then coming—
MARK TENEROWICZ: That's correct.
MS. SPRAGUE: ... carbon dioxide was coming out?
MARK TENEROWICZ: He was not breathing spontaneously.
MS. SPRAGUE: Okay. And while all of this is happening, are you continuing to assess him and his condition?
MARK TENEROWICZ: Yes.
MS. SPRAGUE: And what were your assessments?
MARK TENEROWICZ: So we would stop periodically every several minutes to very briefly check to see if he was breathing on his own or if he had a pulse. And he was not at any point. At one point, towards the end of the resuscitation, I used an ultrasound to determine if his heart was beating effectively, and there was no evidence of that.
MS. SPRAGUE: Okay. And based on your training and experience, at some point in time, did you make a determination that your efforts weren't going to be successful?
MARK TENEROWICZ: I did. Based on the time from when resuscitative efforts started in the field by the paramedics, and the time that we put in, and the fact that despite the best resuscitative efforts we could, the fluids, the medicines, the CPR, breathing for him, it did not look like his heart would ever start again.
MS. SPRAGUE: Approximately how long did you and your team work on Dawson?
MARK TENEROWICZ: I believe we worked on Dawson about 40 minutes, in addition to what the paramedics had done previously.
MS. SPRAGUE: At any point in time, did you try to use a defibrillator?
MARK TENEROWICZ: I did not.
MS. SPRAGUE: And why is that?
MARK TENEROWICZ: He was unfortunately never in a heart rhythm that would've made defibrillation an effective treatment.
MS. SPRAGUE: So your heart has to be in a certain condition for a defibrillator to even work?
MARK TENEROWICZ: Yes. There are two heart rhythms, basically quivering of the heart, that if you use a defibrillator, you can restore a rhythm that makes the heart beat effectively. He was never in one of those rhythms.
MS. SPRAGUE: And at some point in time, did you declare Dawson deceased?
MARK TENEROWICZ: Yes.
MS. SPRAGUE: Okay. And do you recall when that was?
MARK TENEROWICZ: I believe, from my review of the records recently, it was at 19:28.
MS. SPRAGUE: And 19:28, would that be 7:28 PM?
MARK TENEROWICZ: That's correct.
MS. SPRAGUE: Thank you, doctor.
THE COURT: Mr. Reddington.
MR. REDDINGTON: Good afternoon. You indicated that you observed what appeared to be older bruises to his legs—
MARK TENEROWICZ: Yes.
MR. REDDINGTON: ... his lower leg. That, like shin area? That area?
MARK TENEROWICZ: Yes.
MR. REDDINGTON: And he also had an intraosseous device, I think, is that what you said?
MARK TENEROWICZ: Yes, he did.
MR. REDDINGTON: And that would require inserting a needle or something into the actual shin bone area?
MARK TENEROWICZ: Yes, into the tibia.
MR. REDDINGTON: Thank you, sir. That's all I have.
THE COURT: All right. Anything further?
MS. SPRAGUE: No, Your Honor.
THE COURT: All right. Thank you, doctor.
MARK TENEROWICZ: Thank you.
THE COURT: Watch your step, please.