MA v. Lindsay Clancy Day 7

And what do you do for work, sir?

Eitan Negri (40:14):

I am a forensic toxicologist for NMS Laboratories.

Shanan Buckingham (40:18):

And where is that laboratory located?

Eitan Negri (40:19):

The laboratory is located in Horsham, Pennsylvania, just north of Philadelphia.

Shanan Buckingham (40:25):

And what does your laboratory do?

Eitan Negri (40:27):

We are a reference laboratory. We do postmortem work, clinical work, and forensic drug work. So primarily, my role is on the forensic side. I'm a forensic toxicologist.

Shanan Buckingham (40:41):

And does your lab receive specimens from all across the country?

Eitan Negri (40:46):

We do. We have clients in all 50 states. We do approximately half of the postmortem work in the United States, as well as a large number of clinical clients.

Shanan Buckingham (40:56):

And is your lab accredited across several states and across the country?

Eitan Negri (41:02):

We are, because we deal with all the states in the country, we are accredited by just about every accrediting body that I'm aware of in the clinical and forensic aspects, as well as a lot of state certifications. So a lot of states have their own requirements. The most notable one is New York State. So we're accredited by, again, every accrediting body that I'm aware of.

Shanan Buckingham (41:27):

Okay. And how long have you worked for NMS Laboratory?

Eitan Negri (41:30):

Four years as of August 1st.

Shanan Buckingham (41:32):

And what's your educational background as a forensic toxicologist?

Eitan Negri (41:36):

I have a PhD in organic chemistry.

Shanan Buckingham (41:38):

Where did you get that from?

Eitan Negri (41:40):

The University of Nevada.

Shanan Buckingham (41:42):

And do you have any other professional experience in this field prior to working for NMS?

Eitan Negri (41:47):

I do. Before joining NMS Laboratories, I was a laboratory supervisor and then forensic toxicologist for the North Carolina Office of the Chief Medical Examiner, which is a statewide system. So we did the postmortem toxicology work for all 100 counties of the state of North Carolina.

Shanan Buckingham (42:05):

And when it comes to your role in the forensic area of doing the toxicology testing, what is your role in the NMS lab when it comes to cases that come to the laboratory for forensic analysis?

Eitan Negri (42:23):

So when a case comes into NMS and is logged in and the assigned or the requested test assigned and then run and reviewed multiple times in the laboratory, when all that testing is completed, it comes to the toxicology department. And my role is to review every aspect of that case. So I'm making sure that everything on the toxicology report is complete and accurate, such as all the demographic information that we have available to us, the name of the decedent or the patient, date of birth, where it's from, the specimens that we received. And then also that everything that is reported is complete and accurate. Making sure that all the drugs that we're tested for are reported, that the reported concentrations are correct and accurate, and looking at every piece of raw data accumulated from the laboratory associated with that case.

Shanan Buckingham (43:18):

Fair to say the NMS laboratory uses a batch review workflow?

Eitan Negri (43:25):

That is correct. So we not only run the cases in batches, so we don't run one case at a time. That's not very efficient. I don't really know of any laboratory that does that anymore. So we will run cases 10, 15, 30 or 40 at a time.

Shanan Buckingham (43:44):

So as far as running a particular test and getting the raw data, that's usually done by other people in the laboratory, correct?

Eitan Negri (43:52):

That is correct.

Shanan Buckingham (43:52):

And then you come in at the end and review everything and have the ability to interpret the data?

Eitan Negri (43:58):

That is correct.

Shanan Buckingham (43:59):

Your training and experience as a forensic toxicologist, does that allow you to interpret concentration levels of particular types of drugs?

Eitan Negri (44:08):

It does.

Shanan Buckingham (44:09):

Okay. Now, as far as the testing done at NMS Laboratories, the traditional testing is kind of the drug testing, the panels for different common drugs, correct?

Eitan Negri (44:22):

Typically, we have a clients request panels to be run where we're looking for multiple drugs and classes of drugs at a time.

Shanan Buckingham (44:30):

But are there circumstances when outside laboratories or outside individuals retain your lab in order to run specific tests?

Eitan Negri (44:39):

Oh, absolutely.

Shanan Buckingham (44:43):

Now, I'm going to draw your attention to this particular case. Was your laboratory provided a blood sample from the Massachusetts State Police Crime Lab in April of 2023?

Eitan Negri (44:55):

I believe so. I'd really like to see the toxicology report so I can just confirm all of that, please.

Shanan Buckingham (45:02):

Sure.

Kevin Reddington (45:02):

I have no objection to that.

Judge William Sullivan (45:02):

Sure.

Eitan Negri (45:07):

Thank you so much.

Shanan Buckingham (45:11):

You can hang on to that.

Judge William Sullivan (45:12):

That's fine.

Eitan Negri (45:14):

Okay. Correct. We received the specimens on April 7th, 2023.

Shanan Buckingham (45:17):

Okay. And it came from the Massachusetts State Police Crime Lab?

Eitan Negri (45:23):

No. I don't know where they were initially sent from, but the client or the submitting agency is the District Attorney's Office of Plymouth.

Shanan Buckingham (45:34):

Okay. Now, as it pertains to the requested testing that was done, was it that panel that you described or was it more specific testing?

Eitan Negri (45:44):

This is what we call direct testing, where they requested just for specific drugs to be tested for.

Shanan Buckingham (45:50):

And what were the four specific tests requested?

Eitan Negri (45:53):

Lamotrigine, mirtazapine, quetiapine, and trazodone.

Shanan Buckingham (45:57):

Are you familiar with those substances or those drugs?

Eitan Negri (46:00):

Yes, ma'am.

Shanan Buckingham (46:01):

Okay. And you reviewed all of the data and information done at your lab in regards to these tests, correct?

Eitan Negri (46:09):

Yes, ma'am.

Shanan Buckingham (46:09):

Were they able to identify concentration levels in the sample that was submitted for each one of those four substances?

Eitan Negri (46:16):

Yes, ma'am.

Shanan Buckingham (46:17):

And first, can you tell us what the result was?

Eitan Negri (46:22):

Would you like me just to run down the list?

Shanan Buckingham (46:24):

Sure.

Eitan Negri (46:25):

Okay. We detected lamotrigine in a concentration of 6.1 micrograms per milliliter. Mirtazapine at a concentration of 200, I'm sorry, 200 nanograms per milliliter. Quetiapine at a concentration of 1,800 nanograms per milliliter, and trazodone at a concentration of 0.44 micrograms per milliliter. And these were all in blood.

Shanan Buckingham (46:51):

In blood. And so with each drug that you just listed, are you familiar with what the common name is for the drugs?

Eitan Negri (47:02):

I'm not always that great with common names, but I can wing it.

Shanan Buckingham (47:06):

Okay. Well, the lamotrigine, and forgive me if I botch the-

Eitan Negri (47:12):

That's okay.

Shanan Buckingham (47:13):

... pronunciation. That's also referred to commonly as Lamictal.

Eitan Negri (47:18):

It is, correct. Lamictal.

Shanan Buckingham (47:19):

What kind of drug is that?

Eitan Negri (47:21):

It's typically used as an anti-seizure medication. So if somebody has a seizure disorder, it can be prescribed to alleviate seizures, but it is also used for bipolar disorder as well.

Shanan Buckingham (47:36):

And mirtazapine, fair to say that's commonly referred to as Remeron?

Eitan Negri (47:41):

Correct.

Shanan Buckingham (47:41):

And what kind of drug is that?

Eitan Negri (47:42):

That is typically an antidepressant.

Shanan Buckingham (47:46):

And quetiapine, what's that common drug?

Eitan Negri (47:51):

Quetiapine is known as Seroquel.

Shanan Buckingham (47:54):

And fair to say that's an antipsychotic as well for bipolar?

Eitan Negri (47:57):

Yes, ma'am.

Shanan Buckingham (47:59):

Are you familiar with whether that often can be prescribed in low doses for sleep?

Eitan Negri (48:04):

It can be for insomnia.

Shanan Buckingham (48:07):

And trazodone, what's the common name for trazodone, if you know?

Eitan Negri (48:14):

I am drawing a blank on the trazodone.

Shanan Buckingham (48:17):

If I suggest trazomine, is that familiar?

Eitan Negri (48:23):

Not the one that I'm most familiar with. And I apologize. I only-

Shanan Buckingham (48:26):

That's okay. But you're familiar with trazodone?

Eitan Negri (48:27):

Correct. Yeah.

Shanan Buckingham (48:28):

And what class of drug is that?

Eitan Negri (48:30):

That's an antidepressant.

Shanan Buckingham (48:33):

Okay. Now, in your review of the levels that were detected in these four tests for each of these substances, do any of these levels appear to be outside therapeutic concentration levels?

Eitan Negri (48:46):

The only one that's a little elevated would be the quetiapine.

Shanan Buckingham (48:49):

Okay.

Judge William Sullivan (48:51):

We're going to take a very short break at this time. All right? So this will be a short break, then we'll come right back. All right?

Court Officer (49:11):

Court, all rise. [inaudible 00:49:02] please close the notebook. [inaudible 00:49:04]. This way, please.

Judge William Sullivan (49:44):

All right. We'll be right... This will be a short break just for a short recess. We'll come right back up.

Kevin Reddington (49:50):

Half hour?

Judge William Sullivan (49:52):

Hopefully not. Mr. Stan, stand up.

Court Officer (50:03):

This court is back in session. You may be seated.

Judge William Sullivan (50:06):

All right. Are we all set for the jury? [inaudible 00:50:09].

Kevin Reddington (50:06):

[inaudible 00:50:11].

Clerk (50:06):

I think if you turn this on, you can watch it too.

Judge William Sullivan (50:06):

Yeah. Thanks.

Court Officer (50:06):

Court, all rise. Jurors entering. This court's now in session. Please be seated.

Clerk (51:18):

Your Honor, for the purpose of the record, we return back to the trial of Commonwealth versus Lindsay Clancy. All parties are present, including Ms. Clancy, and including the 18 jurors.

Judge William Sullivan (51:26):

All right. All right. Counsel?

Shanan Buckingham (51:29):

Thank you. Dr. Brower, before we broke, we mentioned the term therapeutic concentration. You familiar with that term?

Eitan Negri (51:40):

Correct.

Shanan Buckingham (51:40):

What does that mean?

Eitan Negri (51:42):

It's the typical concentration that one would achieve when they're taking the medication or drug as indicated by their prescriber.

Shanan Buckingham (51:51):

And are you familiar with toxic concentrations or suicidal concentrations?

Eitan Negri (51:55):

I am.

Shanan Buckingham (51:57):

And what does that mean?

Eitan Negri (51:58):

Those are concentrations that could lead to adverse events and potentially death.

Shanan Buckingham (52:03):

Now, in relation to the four substances that were tested at the NMS Laboratory, you identified the levels for each of the four substances. Were any of those levels, excuse me, concentration levels considered within therapeutic concentration?

Eitan Negri (52:23):

It would all be in what I would say a therapeutic concentration, except maybe the quetiapine, which is slightly elevated.

Shanan Buckingham (52:29):

Okay. And in your experience as a forensic toxicologist, have you had the occasion to review cases, postmortem cases in which suicide was a mechanism of death where the person consumed medication?

Eitan Negri (52:44):

Absolutely, yes.

Shanan Buckingham (52:45):

And so that level of the-

Eitan Negri (52:48):

Quetiapine.

Shanan Buckingham (52:52):

... quetiapine at the 800 nanograms per milliliter, would that have been in that toxic or suicidal level?

Eitan Negri (52:59):

No, ma'am.

Shanan Buckingham (53:02):

Would you generally expect to see that significantly greater in a suicide case?

Eitan Negri (53:07):

Typically, quetiapines in suicide cases might be in the close to 10,000 nanograms per milliliter. Usually, people take handfuls of pills when they're trying to harm themselves and take their own life, and this is not consistent with that.

Shanan Buckingham (53:23):

Now, are you also familiar in your training and experience with the class of drugs called benzodiazepines?

Eitan Negri (53:29):

Yes, ma'am.

Shanan Buckingham (53:30):

And do you have the occasion to interpret data as it pertains to concentration levels for those?

Eitan Negri (53:34):

Every single day.

Shanan Buckingham (53:36):

And as far as the substances diazepam, nordazepam, oxazepam, temazepam, lorazepam, you're familiar with those?

Eitan Negri (53:45):

I am.

Shanan Buckingham (53:46):

And if fair to say, nordazepam, oxazepam, temazepam, those are all metabolites of diazepam?

Eitan Negri (53:55):

Typically, yes, ma'am.

Shanan Buckingham (53:56):

And what's the common name for diazepam?

Eitan Negri (53:59):

Valium.

Shanan Buckingham (54:02):

Okay. If I show you what's been marked as Exhibit 183 already... Can you see that on the screen beside you?

Eitan Negri (54:15):

I can, yes.

Shanan Buckingham (54:15):

Okay.

Eitan Negri (54:15):

Right there.

Shanan Buckingham (54:32):

Can you see the levels?

Eitan Negri (54:35):

They're all blurry.

Shanan Buckingham (54:36):

Yep. Hold on one sec. There you go.

Eitan Negri (54:36):

My eyesight's not great too, so that's perfect.

Shanan Buckingham (54:41):

Okay. So that's best I can do with the autofocus.

Eitan Negri (54:43):

Don't touch it.

Shanan Buckingham (54:46):

Anything about the levels that you observed here regarding those substances, those benzodiazepines, that tell you that they're outside therapeutic concentration levels?

Eitan Negri (54:57):

The diazepam and the nordazepam, oxazepam, and temazepam metabolites. The diazepam looks to be sub-therapeutic, meaning lower than what is typically expected from a therapeutic dose. Most therapeutic doses of diazepam, which is an anxiolytic drug or an antianxiety drug are typically 200, 250, thereabouts nanogram per milliliter. The lorazepam, depending upon the dose, could be a therapeutic concentration, if not maybe a little bit lower than expected.

Shanan Buckingham (55:35):

Okay. Thank you. Now, when you're reviewing these cases as the reporting forensic toxicologist, are there limitations on what you can say about the effects of these types of medications?

Eitan Negri (55:51):

We can speak as to the general effects that drugs can have on the general population, but we try to restrict ourselves from saying with absolute certainty that a drug will have this effect on this specific person because we just aren't there to witness their behavior.

Shanan Buckingham (56:08):

Okay. So that was kind of the follow-up.

Eitan Negri (56:11):

I'm sorry.

Shanan Buckingham (56:12):

What are the things that are the unknowns for you when you're just looking at data?

Eitan Negri (56:17):

We say that we can't do toxicology in a vacuum. You can't know everything about the case just by looking at numbers on the toxicology report and drugs on a toxicology report. You need other information to have an informed opinion. In the postmortem world, that would be the investigation itself, the history of the case, the scene findings, interviews with families and friends of the decedent, as well as autopsy findings as well. In a case like this, where it's not a decedent and the person is alive, you still need to know some facts of the case, some sort of history of the case, like what happened. So just numbers on a page. You can just make very generalized types of opinions such as that looks to be therapeutic, it looks to be high, it looks to be low. And then again, just the general effects on the drugs on people.

Shanan Buckingham (57:17):

And in this particular instance, you were not provided any further information about the case or the investigation in order to make any more opinions about effects?

Eitan Negri (57:26):

I knew nothing about this case until we spoke, I think it was probably a few weeks ago.

Shanan Buckingham (57:30):

And as far as the information available to you, you only had the data from the specimen that was tested, correct?

Eitan Negri (57:36):

That is correct. Just these four drugs that were requested to be tested for.

Shanan Buckingham (57:39):

And as far as the drugs, the four drugs that were tested by your lab, what are the general characteristics of some of those drugs?

Eitan Negri (57:47):

So these are generally antidepressants and antipsychotic medications. So if somebody had, well, the lamotrigine, if somebody has say bipolar disorder, like wild mood swings, depressive episodes or psychotic episodes, these drugs could be prescribed. They also have depressant effects, so they could make people become lethargic or sleepy.

Shanan Buckingham (58:18):

Okay. And would any of the combination of these drugs cause a person to stop breathing?

Eitan Negri (58:25):

It's possible. Especially the mirtazapine, quetiapine, the trazodone, and then the two other benzodiazepines. Those are all central nervous system depressants. So they could, in large combinations or large concentrations and in combination with each other, cause central nervous system depression, which could reduce people's respiration rates.

Shanan Buckingham (58:50):

But in the levels that you observed in the testing that your lab did, as well as what I just showed you from Exhibit 183, is there anything about those concentration levels that would give you a sense that the person could have stopped breathing as a result of these?

Eitan Negri (59:06):

Not necessarily, but if I had the information that a patient presented to an emergency department and they had labored breathing and weren't breathing adequately and I had this information, then you could probably tie all that together. But without that extra information, then generally no.

Shanan Buckingham (59:24):

Based on the levels alone, you can't give any sort of opinion?

Eitan Negri (59:26):

I would like to not.

Shanan Buckingham (59:29):

Okay. And finally, are you familiar with the drug Narcan?

Eitan Negri (59:35):

I am.

Shanan Buckingham (59:36):

And what kind of effect does the drug Narcan have on a person who has consumed these drugs, if any?

Eitan Negri (59:45):

Just these drugs that we've talked about here today?

Shanan Buckingham (59:47):

Mm-hmm. Yes.

Eitan Negri (59:47):

Absolutely nothing.

Shanan Buckingham (59:54):

Can you explain to us why it is that Narcan wouldn't have an effect?

Eitan Negri (59:59):

Narcan is an opioid overdose reversal agent. It is an opioid antagonist. So it binds to the opioid receptors. So it doesn't allow other opioids like say fentanyl or oxycodone to bind to those receptors to have to exert its effects. So it only works on opioids. None of these drugs work on the opioid receptors. So Narcan would have no effect whatsoever on these drugs.

Shanan Buckingham (01:00:27):

Okay. Thank you.

Judge William Sullivan (01:00:27):

Attorney Reddington.

Kevin Reddington (01:00:27):

Good morning.

Eitan Negri (01:00:34):

Good morning.

Kevin Reddington (01:00:36):

Dr. Brower, so one of the things that you had mentioned is that you, and I think I would quote you, "I would like not to give an opinion without, basically, the underlying facts." In other words, what you're saying is that the numbers alone do not tell the tale of what happened to a particular individual, right?

Eitan Negri (01:00:57):

Correct. They don't tell the entire story.

Kevin Reddington (01:00:59):

Right. And you're for NMS Laboratory, you were retained or working for the DA's office, these people here, right?

Eitan Negri (01:01:08):

That was the submitting agency, correct.

Kevin Reddington (01:01:10):

And they certainly were not constrained from picking up the phone and calling you and telling you that this is blood from a woman that threw herself out a window and tried to kill herself after cutting her wrists and her neck. They could have told you that, right?

Judge William Sullivan (01:01:27):

Well, overruled.

Eitan Negri (01:01:29):

It's possible that does happen in rare occasions in high profile cases.

Kevin Reddington (01:01:33):

Right. And so that would have been something, for example, the facts that you wanted to know, that you would have liked to have known to kind of round out your opinion about the actual level of the drugs and the blood that you examined, right?

Eitan Negri (01:01:45):

It's not necessary.

Kevin Reddington (01:01:46):

Well, it's not necessary, but you did indicate that you would like to not give an opinion without the facts.

Eitan Negri (01:01:54):

Correct.

Kevin Reddington (01:01:54):

Okay.

Eitan Negri (01:01:55):

Today.

Kevin Reddington (01:01:57):

From the witness stand?

Eitan Negri (01:01:58):

Correct. I don't have all the information.

Kevin Reddington (01:02:00):

Of course. And the word therapeutic, is that consistent with, in other words, the treatment level of a particular narcotic or drug in the blood?

Eitan Negri (01:02:17):

Correct. It's the concentration of the drug in the body to elicit an effect or the desired effect.

Kevin Reddington (01:02:22):

[inaudible 01:02:26].

Clerk (01:02:22):

[inaudible 01:02:32].

Kevin Reddington (01:02:32):

Yeah, I think [inaudible 01:02:33]. Thank you. [inaudible 01:02:42]. One of these that I introduced [inaudible 01:02:46]. NMS Laboratory records that I introduced that they were marked for ID.

Clerk (01:02:57):

Which one, this?

Kevin Reddington (01:02:57):

Huh?

Clerk (01:02:57):

[inaudible 01:03:02]?

Kevin Reddington (01:02:57):

Yeah.

Clerk (01:03:04):

[inaudible 01:03:04]. Which one?

Speaker X (01:03:06):

Marked yesterday.

Kevin Reddington (01:03:12):

[inaudible 01:03:11] while she's trying to find the record. As it relates to the therapeutic level, sir, is it your understanding that the lorazepam, the alprazepam, clonazepam, counsel had asked you about the benzodiazepines were within therapeutic, thank you, within therapeutic level?

Eitan Negri (01:03:35):

I'm sorry, I had trouble hearing you.

Kevin Reddington (01:03:37):

Yeah, I'm sorry. They were within therapeutic level?

Eitan Negri (01:03:40):

I'm sorry, can you repeat the entire question?

Kevin Reddington (01:03:42):

Sure. What is lamotrigine?

Eitan Negri (01:03:45):

Lamotrigine is typically used as an anti-seizure medication and could also be used for bipolar disorder.

Kevin Reddington (01:03:51):

Okay. Do you have the results for your lab in front of you?

Eitan Negri (01:03:56):

Yes, sir.

Kevin Reddington (01:03:57):

Yeah, you can read along just so you can refresh your memory if it helps. The lamotrigine, it says 6.1. What does that mean?

Eitan Negri (01:04:07):

6.1 micrograms per milliliter. So there were 6.1 micrograms of lamotrigine per milliliter of blood.

Kevin Reddington (01:04:16):

All right. Is that above therapeutic, below therapeutic, or therapeutic?

Eitan Negri (01:04:20):

It's right in the middle of the therapeutic range.

Kevin Reddington (01:04:23):

So if somebody had a prescription, for example, for that narcotic or that drug, then they were taking the drug according to the recommended dose, right?

Eitan Negri (01:04:32):

That's what it would appear to me if they were prescribed it, correct.

Kevin Reddington (01:04:35):

How about the mirtazapine?

Eitan Negri (01:04:37):

The mirtazapine also looks to be probably used appropriately as prescribed.

Kevin Reddington (01:04:43):

And you need a prescription for that, don't you?

Eitan Negri (01:04:46):

Yes. You need a prescription for all three, I'm sorry, all four of these drugs.

Kevin Reddington (01:04:50):

Okay. And is there another name for mirtazapine?

Eitan Negri (01:04:52):

Remeron.

Kevin Reddington (01:04:54):

Remeron. All right. And what is the purpose or what do you use Remeron for?

Eitan Negri (01:04:59):

It's an antidepressant.

Kevin Reddington (01:05:02):

How about the quetiapine is the number three?

Eitan Negri (01:05:05):

The quetiapine is also known as Seroquel, and that is generally used as an antipsychotic.

Kevin Reddington (01:05:13):

And what does that mean when you say an antipsychotic? What does that mean?

Eitan Negri (01:05:18):

So if somebody has psychotic episodes, say like hallucinations or just not seeing reality like, "normal" person would, they could be prescribed quetiapine as an antipsychotic to try to kind of level out their brain chemistry.

Kevin Reddington (01:05:40):

And what was the result on the quetiapine?

Eitan Negri (01:05:46):

1,800, 1,800 nanograms per milliliter.

Kevin Reddington (01:05:48):

Now is that within therapeutic? Is that below or high?

Eitan Negri (01:05:51):

It looks high to me depending upon the dosage.

Kevin Reddington (01:05:55):

Okay. And trazodone is the next one. What is that?

Eitan Negri (01:05:59):

Trazodone is also an antidepressant.

Kevin Reddington (01:06:02):

And what's the result on that?

Eitan Negri (01:06:05):

Oh, I'm sorry. 0.44 micrograms per milliliter.

Kevin Reddington (01:06:10):

Okay. And is that therapeutic, below therapeutic, or above therapeutic?

Eitan Negri (01:06:14):

I would say that's a therapeutic concentration.

Kevin Reddington (01:06:17):

Okay. So basically, with the exception of the quetiapine that was 1,800 nanograms... What is a nanogram? What does that mean? Nanograms per milliliter. What does that mean?

Eitan Negri (01:06:28):

It's a very, very small amount. It's one-millionth of a milligram.

Kevin Reddington (01:06:37):

Okay. And that's how you measure the quantity of a particular substance that would be in a person's blood, correct?

Eitan Negri (01:06:43):

In the blood, correct.

Kevin Reddington (01:06:44):

So on the quetiapine at 1,800 nanograms per milliliter, that's the only one that was not therapeutic. That was a little higher than therapeutic. Is that correct?

Eitan Negri (01:06:57):

Correct. It's approximately maybe double what you might expect. So when I say it's a little elevated, it's not in a concentration that I would consider to be necessarily toxic or lethal.

Kevin Reddington (01:07:12):

Okay. And you don't know working for NMS Labs or whether or not a person had a prescription for these drugs or when they got the prescription or who gave them the... You don't know that, right?

Eitan Negri (01:07:31):

I have none of that information, no.

Kevin Reddington (01:07:32):

You could have known that if somebody had told you that, but you don't know it from looking at the numbers that we have here, right?

Eitan Negri (01:07:37):

Correct. It's possible if they would've given us that information. We don't always need to have it though.

Kevin Reddington (01:07:41):

Sure. Your Honor, this is what I [inaudible 01:07:45].

Shanan Buckingham (01:07:49):

Can I just see it again first?

Judge William Sullivan (01:07:49):

Oh, sure.

Shanan Buckingham (01:07:49):

[inaudible 01:07:53].

Kevin Reddington (01:07:49):

Yep.

Shanan Buckingham (01:08:02):

[inaudible 01:07:54]. If we can just approach briefly on the issue.

Judge William Sullivan (01:08:22):

Yeah. All right. So we're going to introduce that exhibit at this time.

Kevin Reddington (01:08:30):

Thank you.

Speaker 1 (01:08:30):

106.

Kevin Reddington (01:08:36):

So just if I may, excuse me, approaching. Which basically is an NMS Lab report.

Eitan Negri (01:08:40):

Same as this one.

Kevin Reddington (01:08:41):

Same numbers on the top, right? Where the square is?

Eitan Negri (01:08:44):

Correct.

Kevin Reddington (01:08:44):

Same numbers. Okay.

Eitan Negri (01:08:45):

Correct.

Kevin Reddington (01:08:45):

Thank you, sir. That's all I had.

Eitan Negri (01:08:46):

All right.

Judge William Sullivan (01:08:50):

All right. Yeah. Commonwealth?

Shanan Buckingham (01:08:53):

Dr. Brower, you in fact, once got this case for review, you authored a corrected report in regards to this case, correct?

Eitan Negri (01:09:03):

Correct.

Shanan Buckingham (01:09:04):

At this point, I would move to admit the report as such.

Kevin Reddington (01:09:06):

No objection.

Judge William Sullivan (01:09:07):

All right. That may be admitted as well.

Shanan Buckingham (01:09:08):

Thank you.

Clerk (01:09:08):

Exhibit [inaudible 01:09:11].

Shanan Buckingham (01:09:08):

Nothing further.

Kevin Reddington (01:09:13):

I have nothing further. Thank you, sir.

Judge William Sullivan (01:09:16):

All right. Thank you, Doctor.

Eitan Negri (01:09:16):

Am I released?

Judge William Sullivan (01:09:17):

Who else? Thank you.

Eitan Negri (01:09:18):

Thank you.

Court Officer (01:09:19):

Watch your step.

Eitan Negri (01:09:28):

[inaudible 01:09:28].

Court Officer (01:09:28):

[inaudible 01:09:28].

Jennifer Sprague (01:09:28):

Your Honor, prior to the next witness, the Commonwealth would move to submit four stipulations the parties have entered into. The first being a stipulation regarding DNA known standard samples. The second being a stipulation regarding DNA evidence for the blue exercise band and the red-brown stain on the basement floor. The third being the stipulation regarding DNA evidence for the yellow exercise band and the black exercise band. And the fourth being a stipulation regarding DNA comparisons for the blue exercise band and the red-brown stain in the basement.

Kevin Reddington (01:10:02):

That's right. We don't need to have all...

Jennifer Sprague (01:10:00):

... and in the red brown stain in the basement.

Kevin Reddington (01:10:02):

That's right. We don't need to have all those witnesses.

Judge (01:10:05):

All right. So those stipulations may be entered as exhibits. Counsel, do you want those published or read to the jury or satisfied that they'll have those? And the parties can refer to the contents of the stipulations.

Kevin Reddington (01:10:31):

[inaudible 01:10:34] Yeah.

Jennifer Sprague (01:10:38):

The only one we would like to have to have read to the jury... I'm sorry, are you all set?

Clerk (01:10:40):

[inaudible 01:10:42].

Jennifer Sprague (01:10:42):

Take your time.

Kevin Reddington (01:10:43):

That's on me. I kind of jumped in there. I'm sorry.

Clerk (01:10:46):

Exhibits 208 through 211.

Jennifer Sprague (01:10:55):

Will be the Exhibit 211, the stipulation regarding your comparisons for the blue band and the red brown stain?

Kevin Reddington (01:11:07):

Yeah. If she wants you to read it, I don't have a problem.

Jennifer Sprague (01:11:11):

I think it was defense that wanted you to read it. I'm fine reading it.

Judge (01:11:13):

Well, you know what? I want to read it. Great. All right. So that's what we'll do. All right. So members of the jury, remember I think it was yesterday or the day before, I talked a little bit about those stipulations. So the same instructions. These are facts that I'm going to read that the parties have agreed to that you can rely on in arriving at your verdict at the end of this case. This stipulation is one of four that was just introduced. You'll have all four of them with you back in the jury room when you deliberate. So let me just read this one stipulation. This doesn't mean this stipulation is any more important than any of the other ones, but the parties would like me to just read this one here. All right. So this is a stipulation regarding the DNA comparisons for the blue exercise ban and the red-brown stain. It was marked A.

(01:12:05)
Now in the above captioned matter, the parties agree to the following facts as it pertains to the DNA comparisons for the blue exercise band and the red-brown stain A in the basement. Number one, forensic scientist Emily Oliver reviewed and interpreted the data relating to the questioned items "2-4, blue exercise ban and item 3-3, the red-brown stain A, from the basement floor." And conducted comparison analysis to the known standards in this case. Number two. The parties agreed to the following conclusions regarding comparison analysis of these items. A, item 2-4. 1.1, sample from the ends of the blue exercise band. The DNA profile was interpreted as a mixture of three contributors. There are five individuals who have a likelihood ratio that indicates an inclusion in the profile. They are Dawson Clancy, Callan Clancy, Cora Clancy, Lindsay Clancy, and Patrick Clancy.

(01:13:19)
B, item 2-4.2.1, sample from the middle of the blue exercise band. The DNA profile was interpreted as a mixture of three contributors. Callan Clancy is included as a major contributor. And C, item 3-3.1, sample of swabs from the red brown stain A on the basement floor. The DNA profile was interpreted as originating from a single contributor. Cora Clancy is included as a contributor to this DNA profile. So that's the stipulation that the parties have agreed to. All right.

Jennifer Sprague (01:14:01):

And one last stipulation to be marked as the next exhibit, the stipulation regarding the batch work done at NMS Labs. We're not asking that this be read at this time.

Judge (01:14:11):

Okay. All right.

Clerk (01:14:11):

Exhibit 212.

Jennifer Sprague (01:14:18):

The Commonwealth would call Katarina Stashyn.

Court Officer (01:14:19):

Good morning, ma'am. Can you stop right there? Raise your right hand for the clerk, please.

Clerk (01:14:41):

Good morning. Do you solemnly swear that the testimony and the evidence you shall give for the court and the jury in the [inaudible 01:14:44] now pending between the Commonwealth and the defendant shall be the truth, the whole truth, and nothing but the truth, so help you God?

Katarina Stashyn (01:14:50):

Yes.

Clerk (01:14:51):

Thank you. You may have a seat, ma'am.

Court Officer (01:14:51):

Watch your step, please.

Katarina Stashyn (01:14:51):

Thank you.

Court Officer (01:14:51):

You're welcome.

Judge (01:14:55):

And good morning.

Katarina Stashyn (01:14:56):

Morning.

Judge (01:14:58):

All right. Attorney Sprague, please.

Jennifer Sprague (01:15:01):

Thank you, Your Honor. Good morning. Can you please state and spell your name for the record?

Katarina Stashyn (01:15:05):

Good morning. My name is Katarina Stashyn. My first name is spelled K-A-T-A-R-I-N-A. Last name is spelled S-T-A-S-H-Y-N.

Jennifer Sprague (01:15:17):

And can you describe for us your educational background?

Katarina Stashyn (01:15:20):

I have a bachelor's and master's degree in biotechnology from the University of Nevada, Reno.

Jennifer Sprague (01:15:26):

And what is your occupation?

Katarina Stashyn (01:15:27):

I'm currently employed by the Washoe County Sheriff's Office Forensic Science Division, which is located in Reno, Nevada. I'm a criminalist in the biology and forensic investigation sections.

Jennifer Sprague (01:15:39):

Back in January of 2023, where were you working?

Katarina Stashyn (01:15:44):

I previously worked for the Massachusetts State Police Crime Laboratory as a forensic scientist in the DNA unit, which is functionally the same role that I currently have in the biology section.

Kevin Reddington (01:15:56):

I'm sorry. We agree to the DNA. I'm just letting you know that.

Judge (01:16:00):

Okay. All right. Attorney Sprague.

Jennifer Sprague (01:16:01):

And I'm just giving that evidence to the jury.

Judge (01:16:03):

Go ahead.

Jennifer Sprague (01:16:06):

So when did you start working for the state police?

Katarina Stashyn (01:16:09):

I worked for the Massachusetts State Police from June 2021 to February of 2025.

Jennifer Sprague (01:16:16):

And what was the nature of your work for the lab at that time?

Katarina Stashyn (01:16:23):

As a DNA analyst, I processed evidence items obtained either from a crime scene or from an individual associated with a criminal investigation. These items of evidence would be processed through the laboratory. I then would perform interpretations, comparisons as needed, write reports. I also could perform administrative reviews of other analysts work and provide expert witness testimony as needed.

Jennifer Sprague (01:16:48):

And part of your employment at the Massachusetts State Police Crime Lab, did you take competency tests and proficiency tests to guarantee that you were capable and proficient in the areas you were working?

Katarina Stashyn (01:17:01):

Yes. I took both competency tests after my training and proficiency tests throughout my career at Massachusetts and at my current role.

Jennifer Sprague (01:17:09):

And have you passed all of those tests?

Katarina Stashyn (01:17:11):

Yes, I have passed all competency and proficiency tests that I've taken so far in my career.

Jennifer Sprague (01:17:16):

Can you tell us what is DNA?

Katarina Stashyn (01:17:19):

DNA stands for deoxyribonucleic acid. And this is genetic information that is stored in our cells. This is information that makes us who we are. It determines how we develop and grow. A person's DNA is inherited approximately half from their mom and half from their dad. DNA is forensically relevant because it is expected that no two individuals will have the same forensic DNA profile.

Jennifer Sprague (01:17:43):

And is DNA the same in every single cell in a person's body?

Katarina Stashyn (01:17:48):

Yes. The DNA profile obtained from different cells, different cell types like a blood cell or from a saliva cell or cell in your saliva would have the same DNA profile barring your mutation.

Jennifer Sprague (01:18:02):

And can you explain generally the process used to analyze evidence in this case, the testing involving the defendant, Lindsay Clancy?

Katarina Stashyn (01:18:13):

The items tested in this case and in all cases will go through a four step laboratory process of extraction, quantification, amplification and detection. And then profiles developed from that laboratory process will be interpreted and compared.

Jennifer Sprague (01:18:29):

Can you just briefly explain what is extraction and how it's done?

Katarina Stashyn (01:18:33):

Extraction is the first step of that laboratory process that involves applying a variation of heat and chemicals to a sample. This breaks open cells that are present and releases the DNA and then isolates that DNA.

Jennifer Sprague (01:18:46):

And was the next step quantification?

Katarina Stashyn (01:18:50):

Yes.

Jennifer Sprague (01:18:50):

And what is that and how do you do that?

Katarina Stashyn (01:18:52):

Quantification is the second step when we determine a reliable estimate for the amount of DNA in those samples that were extracted. And those values are then used to optimize the rest of the process with the goal to obtain a quality profile for that sample.

Jennifer Sprague (01:19:08):

And the third step amplification, can you explain that?

Katarina Stashyn (01:19:11):

Amplification is when we make millions and millions of copies of certain areas of DNA to make it able to be detected and visualized.

Jennifer Sprague (01:19:21):

And then detection, what is that?

Katarina Stashyn (01:19:23):

And then the fourth step is separation or detection. This is where we separate out all those millions and millions of copies that we made to make them visual. This produces a DNA profile that an analyst is then able to review and interpret.

Jennifer Sprague (01:19:38):

And when you worked at the Massachusetts State Police Crime Lab, were there certain standardized protocols and procedures that you used at that lab?

Katarina Stashyn (01:19:46):

Yes.

Jennifer Sprague (01:19:47):

And were there controls used in your testing?

Katarina Stashyn (01:19:51):

Yes.

Jennifer Sprague (01:19:51):

What does that mean?

Katarina Stashyn (01:19:53):

So there are two different types of controls that were used in our testing. The first is a positive control. This is a sample that contains a known DNA profile and it is processed alongside evidence samples. So when that known DNA profile is obtained at the end of the process, it confirms that the process is working appropriately. The second type of control is a negative control. And this is a sample that contains no DNA that is also processed alongside evidence samples. And this is able to monitor any contamination and confirm that clean technique is used during testing.

Jennifer Sprague (01:20:26):

And does your work undergo a review process at the lab or did it?

Katarina Stashyn (01:20:30):

Yes. All work goes through two stages of review, technical review and administrative review. Technical review is when another qualified analyst reviews all of the work done in the file and in the report. They confirm that all protocols were followed and that correct conclusions were drawn. And then administrative review is when another analyst reviews that file, all of the documentation in the report for overall clerical accuracy and completeness.

Jennifer Sprague (01:20:57):

And when you worked on lab number 23-01723, evidence involved in the deaths of Cora Clancy, Dawson Clancy and Callan Clancy, did you follow the standardized protocols and procedures?

Katarina Stashyn (01:21:13):

Yes.

Jennifer Sprague (01:21:13):

Were there any issues with the controls that were present when you did this testing?

Katarina Stashyn (01:21:18):

All controls were acceptable per the laboratory protocols.

Jennifer Sprague (01:21:21):

And did your work undergo and pass that review process you just described?

Katarina Stashyn (01:21:25):

Yes. All work went through both technical and administrative review.

Jennifer Sprague (01:21:29):

And if we could talk specifically about the work that you did in this case. First, I'd like to talk or I'd like you to talk about your work done on the yellow exercise band and the black exercise band. Now, you didn't actually handle those items, correct?

Katarina Stashyn (01:21:51):

I did a portion of the laboratory work for those samples, but I did not handle the actual bands themselves. I handled swabs of those bands.

Jennifer Sprague (01:22:00):

So at some point in time in the lab, someone took swabs from those bands and then that was forwarded to the DNA unit, the swabs?

Katarina Stashyn (01:22:07):

Yes.

Jennifer Sprague (01:22:08):

Okay. And specifically there was item 2-2.1.1 swabs from the ends of the yellow exercise band and item 2-2.2.1 swabs from the middle of the yellow exercise band, correct?

Katarina Stashyn (01:22:26):

Could I refer to my report to confirm that?

Judge (01:22:28):

Any objection?

Kevin Reddington (01:22:29):

Of course not.

Jennifer Sprague (01:22:30):

Thank you.

Katarina Stashyn (01:22:38):

Yes.

Jennifer Sprague (01:22:39):

And when doing your comparison work, did you also use some DNA profiles that had been generated in the lab for Dawson Clancy, Cora Clancy, Callan Clancy, Patrick Clancy, and Lindsay Clancy?

Katarina Stashyn (01:22:54):

Yes. I utilized known standards that were developed from those individuals.

Jennifer Sprague (01:22:58):

And known standards, are those basically the DNA profiles for each of those individuals?

Katarina Stashyn (01:23:04):

Yes. Known standards are samples collected directly from a known individual for comparison purposes.

Jennifer Sprague (01:23:10):

And going to item 2-2.1.1, the swabs from the ends of the yellow exercise band, what were your findings?

Katarina Stashyn (01:23:29):

So I'm going to start with a general statement for this report as a whole. The presence of multiple first degree relatives in a mixture DNA profile can impact overall interpretation, including the determination of the number of contributors and likelihood ratios. Relatedness was considered for the following results. For item 2-2.1.1, sample from ends of yellow exercise band located in basement office 47 Summer Street. The DNA profile is a mixture including male DNA. Due to the possible relatedness of low level contributors to this profile, an alternate number of contributors was considered. First, assuming two contributors. The DNA profile is a mixture of at least two contributors, including male DNA. Contributors one and two are suitable for comparison. The DNA profile was interpreted as a mixture of two contributors. The DNA profile from this item is at least 1.7 nonillion times more likely if it originated from Dawson Clancy and an unknown individual than if it originated from two unknown unrelated individuals.

(01:24:37)
This provides support that Dawson Clancy is included as a contributor to this DNA profile. Cora Clancy, Callan Clancy, Patrick Clancy, and Lindsay Clancy are excluded from this DNA profile. Assuming three contributors. The DNA profile was interpreted as a mixture of three contributors. Contributor one is suitable for comparison. Due to limited information and possible relatedness of contributors, contributors two and three are not suitable for comparison. The DNA profile from this item is at least 920 octillion times more likely if it originated from Dawson Clancy and two unknown individuals than if it originated from three unknown unrelated individuals. This provides support that Dawson Clancy is included to this DNA profile. Cora Clancy, Callan Clancy, Patrick Clancy, and Lindsay Clancy are excluded from contributor one of this DNA profile.

Jennifer Sprague (01:25:33):

I'm going to ask you a few questions about what you've just told us. You mentioned the effect of relatedness. What does that mean?

Katarina Stashyn (01:25:42):

So as I mentioned, an individual's DNA is inherited approximately one half from their mom and one half from their dad. So this means that there's a lot of DNA shared between relatives, including between parent and children and between siblings. So this can affect the determination of the number of contributors. So when I review the profile to see how many people are in that profile, because there's so much DNA that is shared. So taking that into account, I did two different interpretations, first assuming two contributors and the second assuming three contributors. Again, just due to the complexity of relatedness and its effect on this profile, especially low level contributors.

Jennifer Sprague (01:26:27):

And would it be correct to state that when there is this level of relatedness where you have two parents and three siblings, that you can have false exclusions?

Katarina Stashyn (01:26:38):

If there is an underassignment of the number of contributors, meaning that the number of contributors is incorrectly assigned lower than it actually is, which is a possibility with relatedness because you're working with less information because that information is shared, the underassigning could lead to false exclusions of true contributors.

Jennifer Sprague (01:26:59):

Could you also miss some people to include?

Katarina Stashyn (01:27:05):

Due to the effects of relatedness, it could be difficult to determine number of contributors simply because so much information is shared. Therefore, it is more complex when assigning this number.

Jennifer Sprague (01:27:17):

And for item 2-2.1.1, the ends of the yellow exercise band, whether you considered two contributors or three contributors, both of your findings find that Dawson Clancy was a contributor? A potential contributor?

Katarina Stashyn (01:27:32):

Both propositions, either two contributors or three contributors, had high inclusionary stats for Dawson Clancy. Correct.

Jennifer Sprague (01:27:42):

Okay. What's a nonillion?

Katarina Stashyn (01:27:43):

Nonillion is a very large number.

Jennifer Sprague (01:27:49):

Do you know how many people are on earth?

Katarina Stashyn (01:27:54):

I know it's-

Kevin Reddington (01:27:55):

This is typical DNA gobbledygook at this point, Judge. I-

Jennifer Sprague (01:28:00):

I object to his objection. That's ridiculous.

Judge (01:28:02):

That's overruled, You can answer.

Kevin Reddington (01:28:03):

They're going to talk about nonillions and how many-

Judge (01:28:05):

Council can I see you over sidebar? All right. Attorney Sprague.

Jennifer Sprague (01:29:15):

Thank you, Your Honor. 1.7 nonillion. Is that more than there are people on the earth?

Katarina Stashyn (01:29:24):

That is more individuals that are on the earth, but I would like to clarify that a likelihood ratio is not a random match probability or a rarity of that profile. A likelihood ratio is a ratio that describes the probability of observing the DNA profile if a certain person is included versus the probability of observing that DNA profile if a certain person is excluded or if it is another unknown unrelated individual.

Jennifer Sprague (01:29:52):

And you said nonillion is a very high number, correct?

Katarina Stashyn (01:29:55):

Yes, that's a very large number in my opinion.

Jennifer Sprague (01:29:57):

So it's a very large probability that Dawson Clancy is a contributor to that mixture?

Katarina Stashyn (01:30:05):

It is a large likelihood ratio that provides support for the inclusion of Dawson Clancy to the profile.

Jennifer Sprague (01:30:13):

And then going to item 2-2.2.1, the swabs from the middle of the exercise band, what were your findings for that?

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