2177 1 IN THE CIRCUIT COURT OF THE NINTH JUDICIAL CIRCUIT IN AND 2 FOR ORANGE COUNTY, FLORIDA 3 LAWRENCE M. DESTEFANO, 4 Plaintiff, 5 vs. CASE NO.: CI-00-7265 DIVISION: 32 6 ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE 7 CORPORATION; ADVENTIST HEALTH SYSTEM/SUNBELT, INC.; SUNBELT 8 HEALTH CARE CENTERS, INC.; ROLLINS BEDFORD CORPORATION, 9 d/b/a SUNBELT HEALTHCARE & SUBACUTE CENTER; SHCC 10 SERVICES, INC., and ORLANDO REGIONAL HEALTHCARE SYSTEM, 11 INC., 12 Defendants. 13 ------------------------------------------------------ 14 VOLUME XVI 15 (Pages 2177 through 2327) 16 Continued transcript of proceedings held before the 17 Honorable Renee Roche, Judge of the Circuit Court, Orange 18 County, Florida, on Wednesday, October 26, 2005, 19 beginning at 8:50 a.m., at the Orange County Courthouse, 20 Orlando, Florida, before Laura J. Landerman, R.M.R., 21 C.R.R., and Notary Public, State of Florida at Large. 22 23 24 25 2178 1 A P P E A R A N C E S: 2 WILLIAM G. OSBORNE, ESQUIRE TERRY McCULLOUGH, Legal Assistant 3 Law Offices of William G. Osborne, P.A. 538 East Washington Street 4 Orlando, Florida 32801 and 5 BRADLEY CONWAY, ESQUIRE 390 North Orange Avenue 6 Orlando, Florida 32801 7 For the Plaintiffs, 8 TRACY A. MARSHALL, ESQUIRE DYANA L. PETRO, ESQUIRE 9 Gray Robinson 301 East Pine Street -- Suite 1400 10 Orlando, Florida 32801 11 For the Defendant, Adventist Health System, 12 LARRY J. TOWNSEND, ESQUIRE 13 DAVID EVANS, ESQUIRE Mateer & Harbert 14 Landmark Center II -- Suite 600 225 East Robinson Street 15 Orlando, Florida 32801 16 For the Defendant, Orlando Regional Healthcare System, Inc., 17 18 19 20 21 22 23 24 25 2179 1 I N D E X 2 TESTIMONY OF MIEKO KOLLER 3 Direct Examination by Mr. Osborne 2180 Cross-Examination by Ms. Marshall 2192 4 TESTIMONY OF PHILLIP K. MASSEY 5 Direct Examination by Mr. Osborne 2198 6 Cross-Examination by Ms. Marshall 2201 7 TESTIMONY OF HARRY KROP, PhD (via videotaped) 8 Direct Examination by Mr. Osborne 2214 Cross-Examination by Ms. Marshall 2240 9 Cross Examination by Mr. Townsend 2312 Redirect Examination by Mr. Osborne 2315 10 PUBLISHING OF MORTALITY TABLES 2325 11 PLAINTIFF RESTS 2325 12 13 E X H I B I T S (In Evidence) 14 Plaintiff's Exhibit No. 25 Plaintiff's Exhibit No. 26 15 16 17 18 19 20 21 22 23 24 25 2180 1 (Continued from Volume XV) 2 - - - - - 3 MIEKO KOLLER 4 having been first duly sworn testified as follows: 5 DIRECT EXAMINATION 6 BY MR. OSBORNE: 7 Q State your full name for the Court and the 8 jury, please, ma'am. 9 A Mieko Koller. 10 Q And where do you live, Ms. Koller? 11 A 3000 Huntington Street, Orlando. 12 Q Who lives there with you? 13 A Mark Koller, my husband, and Alex Koller, our 14 son. 15 Q How long have you and Mark been married? 16 A Six and a half years. 17 Q And where were you born? 18 A Japan. 19 Q Do you know Larry Destefano? 20 A Yes. 21 Q How did you meet? 22 A We met in Guam. 23 Q And did you and Larry marry? 24 A Yes. 25 Q And tell the jury when you got married. 2181 1 A We got married on November 1st, 1982. 2 Q Where did you live at the time? 3 A Guam. 4 Q How long did you and Larry live in Guam? 5 A '82 through '87. 6 Q What was your lifestyle like in Guam? What 7 types of things did you do together? 8 A I was still new to the country, and Guam is 9 not exactly the United States because it's an American 10 territory, but just have fun. We always had fun. We 11 were early 20s so we have a lot of our lives, and his mom 12 was there with us, and we had a normal life. 13 Q You said his mother was there with you. She 14 lived there as well? 15 A Yes. 16 Q How often would you see Mrs. Destefano, 17 Carolina Destefano? 18 A Maybe once a week. 19 Q During that period of time, '82 to '87, what 20 was Larry's relationship with his mother, as you observed 21 it? 22 A Very good. 23 Q What happened in 1987? 24 A Larry was transferred to Japan with his 25 business. 2182 1 Q Okay. And did you go with him? 2 A Yes. 3 Q How long did you two live in Japan? 4 A '87 through '92. 5 Q And during that period of time, that five-year 6 period, where was Mrs. Carolina Destefano living? 7 A Mom lived -- stayed behind in Guam until I 8 think it was the end of 1990, and she moved to Miramar, 9 Florida, which is in Broward County. 10 Q What happened in 1992 to you and Larry? 11 What'd you do? 12 A We -- our services ended. We were -- 13 actually, Larry was working for a company who subsidized 14 military bases, and actually it ended a little before 15 that. And we were kind of thinking whether we're going 16 to remain in Japan or -- which because it's my native 17 country, so it's easy for us to decide between U.S. and 18 Japan. Whichever we decided to stay, we could do that. 19 But Mom insisted -- Larry's mom insisted that, 20 you know, come to Florida because this is nice place to 21 be. And I don't know. Somehow she put idea in our head 22 and all right. It's five years. 23 Q So you moved to Florida after five years in 24 Japan? 25 A Yes. 2183 1 Q Where were you in Japan? 2 A Hyama, which is right next to Tokyo. 3 Q And so where did you move in 1992? 4 A Miramar, Florida, to Mom's house. 5 Q Okay. 6 A We move in with her. 7 Q How long did you live with Carolina Destefano? 8 A Just about a month until we find a place. 9 Q And during that month time that you lived 10 there, how did Larry get along with his mother and what 11 was their relationship like? 12 A It was okay. The reason why I'm saying that 13 is because we had no idea about her condition, you know, 14 what stage she was in at that time. We can always look 15 back, and -- it's easier for us to look back and say, 16 yeah, that's the symptoms she's having, but she was a bit 17 difficult. 18 Q And you know now you're talking about 19 Alzheimer's? 20 A Yes. 21 Q Had you been educated in 1992 at all about 22 what Alzheimer's was? 23 A We had no idea. Even 1999 we had no idea. 24 We -- it just -- it's easy for us to think back now, yes. 25 Q At some point in time, did Carolina Destefano 2184 1 move to Arizona? 2 A I believe it was 1993 or 1994. 3 Q Did you and Larry stay in Florida? 4 A Yes. 5 Q Where did you move or where did you live in 6 Florida after Carolina went to Arizona? 7 A Well, actually, we always remained in South 8 Florida. A month after we came to Florida, July of 1992, 9 we stayed with her for a month, and then we moved to a 10 condo in Hallandale, Florida, which is like 10, 15 11 minutes away from Mom's house. And when Mom left 12 Arizona, we were still in Hollywood, Hallandale area. 13 Q So did there come a time, Mrs. Koller, where 14 you and Larry grew apart in your marriage? 15 A We separated somewhere between December '92 to 16 January '93. 17 Q Okay. Was this a friendly separation? 18 A Yes. 19 Q Tell the jury, just in your own words, what 20 happened in terms of your relationship as you would look 21 back on it. 22 A Well, we've known each other like for a total 23 of 24 -- over 24 years by now, always the same way. When 24 you're young -- we met when we were 21 and just grew up 25 together. And we're still friends because we're always 2185 1 friends from first, but as a husband and a wife in a 2 couple thing, we have different ideas, and we just grow 3 apart. And it has nothing to do with us not being 4 friends anymore. 5 And we had a period of about five years 6 between actual separation -- just mental separation, 7 physical separation, and then finally we decided, okay, 8 we're going to divorce. 9 Q So you separated in December of '92 or January 10 of '93. When did you officially get the legal document 11 saying you were divorced? 12 A It was March 25th, 1998. 13 Q Okay. How did you meet your husband Mark? 14 A I met him through Larry and then his 15 ex-girlfriend at that time, girlfriend at the time. 16 Q And you said you and Larry have remained 17 friends? 18 A Yes. 19 Q He's referred to you to this jury as his 20 sister? 21 A Yes. 22 Q Do you agree with that? 23 A Yes. 24 Q How would you describe your relationship with 25 Larry? 2186 1 A He's my family, and he's -- now he's like my 2 brother. He actually is. 3 Q Does Larry live with you from time to time? 4 A Yes. 5 Q Tell the jury how that works these days. 6 A He had a place before he left to Arizona 7 January of 1999. That was the time we got the big news 8 from one of the police officers or some officials call us 9 and let us know that Mom, she's in the hospital. And 10 Larry just dropped everything. He dropped -- literally 11 dropped everything and left. 12 And at that time, we didn't know what to 13 expect, so January he left. He did all the details and 14 came back once in, I believe, it was in March, late March 15 or early April, and he just pack up one more time to live 16 with Mom so he can care for Mom for a time. So he lost 17 his place here in Orlando because he had a house with Mom 18 in Arizona. 19 He went there, and September came around, and 20 I begged him, actually, to come back to Orlando because 21 I've been in contact with them every day at least once, 22 twice a day on the phone, and I didn't feel right about 23 them just being out there, especially Larry being a very 24 people person. He needs those connection and network 25 which he created here in Orlando, including myself. 2187 1 Mom was still in stable condition. She said, 2 okay, you know, I'm going to be there. And I ask Larry, 3 you know, sell the house and come back here so at least 4 we can be around and, you know, not only on the phone, 5 but, you know, just all the system is here, his friends 6 and family, you know, we are family here so, you know, 7 come back. 8 So September came around, and he came back 9 with Mom. And that's when he couldn't get a place right 10 away the way Mom's condition was, so we offered he can 11 stay with us from time to time when Mom -- we know Mom is 12 going to be in the hospital, in and out of some kind of a 13 medical facility, so he can stay with us. So since then, 14 he keeps our address to pick up his mail. And it doesn't 15 mean he lives with us all the time, but that's his place 16 to stay anytime he needs to stay. 17 Q Let me ask you this. In terms of as you look 18 back in the many years you've known Larry, how would you 19 describe Larry's relationship with his mother, Carolina? 20 A Very good. Since, you know, I'm the only one 21 who really knows Mom well, Mom is very professional woman 22 in and out of house. She is just a professor always to 23 us and to Larry. And very proper. It's really hard for 24 her to have a party, and we really cannot move the chair 25 around. Always we had to get permission from her kind of 2188 1 person. 2 In a way stiff but also fun and a very -- 3 sorry -- knowledgeable. And it just -- Larry and Mom 4 always had a good relationship. From outsiders, it may 5 look like a little bit stiff, but they always had like -- 6 Larry's like -- like he's my rock to me, and that was 7 like I think somebody Mom can rely on, and they always 8 have a good relationship. 9 Q Did you see Carolina Destefano in September 10 before she went in the hospital when Larry brought her 11 back to Orlando? 12 A I think I saw her a couple times. 13 Q Tell the jury what her condition was when you 14 saw her in September. 15 A I just really remember one time Larry have to 16 bring her over to our house, and I told him to just -- 17 just let her lay down on one of the beds. And she 18 wasn't -- she was out of bed. She can walk. Larry can 19 support her. She can still walk, but she doesn't 20 recognize you. 21 She cannot talk. It's just almost like she's 22 just in comatose kind of. She just sleeping all the 23 time. I laid down with her in bed. She cannot move. 24 She's just like a rock, just lay there. 25 Q Mrs. Koller, in terms of the events that 2189 1 occurred in September, from the 19th of September at the 2 various medical facilities, you don't have any personal 3 knowledge of what was going on at Florida Hospital or 4 Sunbelt or ORHS, do you? 5 A No. 6 Q The only knowledge you would have would be 7 what Larry Destefano told you about it? 8 A Yes. 9 Q After these events occurred in the hospital, 10 how was Larry acting? What was he doing in terms of your 11 communication with him? 12 A The first part of his whole thing was he was 13 picketing every day. And when we decided that this case 14 is going to go on trial or before there was a lawsuit, he 15 was always working with lawyers, and so I'm always 16 listening to his problems. 17 But as far as his personal life, it's like a 18 totally different person. And the only way I can 19 describe him how he changed is just he's so devastated, 20 and it's just not him anymore. 21 Q Let me ask you this, Mrs. Koller. What was 22 the him, Larry Destefano, before September of 1999? What 23 was he like? 24 A Like I say, he's fun-loving and very energetic 25 and athletic. He loved to jog. He loved to play tennis 2190 1 because we even belong to a tennis club when we were with 2 Mom. He was always on the move, and we always have some 3 type of get-together with people. We loved to entertain 4 and loved to be entertained, and he just always finds 5 pleasure talking to people. 6 He always finds someone from everywhere 7 that -- when we were in Japan or Guam, I stay home and 8 then often, you know, he just come home with some 9 stranger. And he just enjoyed talking to people, and he 10 loves -- he just -- we always had people, just all walks 11 of life, that's what you call it, just he likes 12 everybody. 13 And he doesn't judge you. He just like you. 14 He look at you, who you are, not by because you're 15 wearing nice suits or what become of you because you have 16 a title, because you are certain cultural -- you have a 17 certain cultural background or race or gender. It just 18 doesn't matter to him. He just love people, and that's 19 what I like with him up until '99, and then he just 20 collapsed. It just changed. 21 Q How did it change? 22 A He's very angry, and, I mean, he's too 23 disciplined because Mark and I have a son, very young 24 son, so I think he's very controlling himself in front of 25 us because the main reason why he's always around me is 2191 1 because we can talk about past, you know, fun time and 2 about Mom because I'm the only one who can share that 3 kind of memories. 4 So I know he's controlling himself, but he's 5 very angry. On some occasions we go out, and he never 6 really -- he's always strong about his belief, and he's 7 never afraid of showing or sharing his opinions with 8 other people, but he never be a confrontational person. 9 He's never trying to pick a fight with anyone, but I 10 think nowadays I think he's kind of becoming that kind of 11 people. 12 It's really, I think, for strangers to look at 13 him and just -- I can even see that look right now. He 14 really has that hard look on his face and, you know. 15 Q Let me ask you this, Mrs. Koller, in terms of 16 your son. What's your son's name? 17 A Alex. 18 Q How old is your son? 19 A Five. 20 Q And who is the guardian of Alex in the event 21 you and Mark both die? 22 A We don't have an official will or a living 23 will. 24 Q Right. 25 A We don't have that yet, but if neither of us 2192 1 can make a medical decision, that's Larry Destefano. 2 MR. OSBORNE: No further questions, Judge. 3 THE COURT: Ms. Marshall? 4 - - - - - 5 CROSS-EXAMINATION 6 BY MS. MARSHALL: 7 Q Good morning, Mrs. Koller. 8 A Good morning. 9 Q Now, you said that when Mrs. Destefano came 10 back here in September of 1999, she couldn't talk, 11 correct? 12 A I don't think she could, no, that's correct. 13 Q And you said that she was very out of it at 14 that point in time? 15 A Yes. 16 Q Now, when you and your husband or you and 17 Mr. Koller moved here from Miami, Larry came with you; is 18 that correct? You all three moved together? 19 A Yes. 20 Q And you all moved into the Cedar Cove 21 Apartments together; is that correct? 22 A No. Mark and I had an apartment together, and 23 then Larry just stayed there for a little while until he 24 finds his apartment. He never be on the lease or 25 anything like that, just stayed with us. 2193 1 Q And he continued to live off and on with you 2 in 1995; is that correct? 3 A No. Actually, he living with us on and off 4 since 1999 when this whole event occur, but before that, 5 he had his own place. 6 Q Now, have you reviewed any videos that 7 Mr. Destefano has made while he was picketing? 8 A I don't think so. His own videotape with a 9 camcorder? 10 Q Correct. 11 A I don't think so. 12 Q You have reviewed video depositions of 13 different witnesses in the case, correct? 14 A Yes. 15 Q Because he has brought them home for you to 16 watch; is that correct? 17 A From time to time, yes. 18 Q And you've listened to the audiotape of 19 Lillian Folley, correct? 20 A Yes. 21 Q And that was at Mr. Destefano's request for 22 you to listen to those? 23 A I wanted to. 24 Q Okay. And you don't know any of the nurses at 25 Sunbelt, do you? 2194 1 A No. 2 Q And you don't know any of the nurses from 3 ORMC, correct? 4 A Correct. 5 Q Or from Florida Hospital, correct? 6 A Correct. 7 Q And none of them have ever said anything to 8 you about Mr. Destefano, have they? 9 A Nurses? 10 Q Nurses, correct. 11 A Correct. 12 Q And none of the doctors have said anything to 13 you about Mr. Destefano, correct? 14 A Correct. 15 Q Everything that you've learned about this 16 whole incident you've learned from Mr. Destefano, 17 correct? 18 A Mostly. 19 Q And you certainly didn't believe any of the 20 allegations that Mr. Destefano said were being made about 21 him, correct? 22 A Correct. 23 Q And you don't believe it as you sit here 24 today, correct? 25 A Correct. 2195 1 Q And it hasn't changed the way that you look at 2 him in any way whatsoever, has it? 3 A It hasn't. 4 Q And you know most of Mr. Destefano's friends, 5 do you not? 6 A I believe so. 7 Q And, to your knowledge, none of them feel any 8 differently about him either, do they? 9 A I hope not. 10 Q And Mr. Destefano's reputation is the same now 11 as it was before among your friends; is that correct? 12 A That's correct. 13 MS. MARSHALL: I have no further questions, 14 Your Honor. 15 MR. EVANS: Your Honor, we have no questions 16 of this witness. 17 THE COURT: Redirect? 18 MR. OSBORNE: None, Your Honor. 19 THE COURT: Ladies and gentlemen, do you have 20 any questions for this witness? Please approach the 21 bench, Counsel. 22 (Bench conference.) 23 THE COURT: Two questions. How did you first 24 hear about these allegations? 25 MR. EVANS: No objection. 2196 1 MS. MARSHALL: Fine. 2 THE COURT: Did you ever encourage Larry not 3 to picket? 4 MR. OSBORNE: That's fine. 5 MR. EVANS: No objection. 6 MS. MARSHALL: (Shakes head.) 7 (Open court.) 8 THE COURT: Ms. Koller, I'm going to ask you 9 two questions. These questions are from the jury. 10 When I ask the question, if you would turn and 11 direct your response to the jury, please. 12 How did you first hear about these 13 allegations? 14 THE WITNESS: The first time, I believe that 15 was September 21st of 1999. I had a very strange 16 phone call early night of September 21st and saying, 17 you know, is Larry Destefano there, and somebody was 18 looking for him. And when I had a chance to talk to 19 Larry, that's when he explained to me what's going 20 on. I believe that was the Sunbelt nursing home. 21 THE COURT: Did you ever encourage Larry not 22 to picket? 23 THE WITNESS: No, never. 24 THE COURT: Any further questions from the 25 jury? 2197 1 (Bench conference.) 2 THE COURT: Mieko, did you ever go to the 3 nursing home to see Mrs. Destefano while she was 4 there? No objection? 5 MR. EVANS: No objection. 6 MR. OSBORNE: No objection. 7 MS. MARSHALL: No objection. 8 (Open court.) 9 THE COURT: Did you ever go to the nursing 10 home and see Mrs. Destefano while she was there? 11 THE WITNESS: At Sunbelt? 12 THE COURT: Just answer to the best of your 13 understanding. 14 THE WITNESS: I never been to Sunbelt myself. 15 THE COURT: Any other questions from the jury? 16 THE JURORS: (Shakes heads.) 17 MR. OSBORNE: No, Your Honor. 18 MS. MARSHALL: No, Your Honor. 19 MR. EVANS: No, Your Honor. 20 THE COURT: Ms. Koller, you are excused. You 21 may leave. Mr. Osborne, call your next witness. 22 MR. OSBORNE: I'm going to try Phil Massey 23 again. 24 - - - - - 25 2198 1 PHILLIP K. MASSEY 2 having been first duly sworn testified as follows: 3 DIRECT EXAMINATION 4 BY MR. OSBORNE: 5 Q State your full name for the Court and jury, 6 please. 7 A Phillip K. Massey. 8 Q Where do you live, Mr. Massey? 9 A I live in Winter Park. 10 Q What is your profession or occupation? 11 A At the moment, I'm retired. 12 Q What have you done in the past in terms of 13 your career? 14 A Well, when I was a kid, I went in the service, 15 got out of the service after four years, went to college 16 for a while. Actually, prior to that, I went back to 17 high school to qualify to go to college. 18 In 1960 I became a police officer in the city 19 of Detroit, Michigan, stayed there until 1967, moved to 20 West Palm Beach in '67 and got into sales, did sales all 21 the way to 1994. 22 Q And is that when you retired? 23 A No. I started up a business at that time with 24 my youngest son. We were in the millwork business, had 25 that business for approximately four years, then that's 2199 1 when I completely retired. 2 Q Did you meet Larry Destefano through your 3 business? 4 A Yes, sir. 5 Q And how did you meet him? 6 A He had a small antique refinishing shop at a 7 strip center like where they rent storage space off of 8 441. 9 Q And did you become friends? 10 A Yes. We became very, very, very close 11 friends. 12 Q And you knew him from 1996 to the present 13 time? 14 A That is correct, sir. 15 Q And did he do work for you at the time that 16 you had your milling business, your wood milling 17 business? 18 A Well, he did a couple of small finish projects 19 for us, yes, sir. 20 Q Tell the jury, from 1996 to 1999, how often 21 you would see Larry Destefano as a friend. 22 A Oh, sometimes I'd see him several times a week 23 and then sometimes I wouldn't see him maybe for a couple 24 weeks. It just depends what our schedules were. 25 Q Were you aware that he had to go to Arizona at 2200 1 the end of '98 or the beginning of '99? 2 A Yes, sir. 3 Q Describe for the jury, if you would, what 4 Larry Destefano was like in your friendship with him 5 before September of 1999. 6 A Well, prior to that time, he was much more 7 outgoing. You know, Larry wasn't married, and he has a 8 number of female lady friends or female friends, and he 9 just used to do things a lot different than he does 10 today. 11 Q Okay. Do you have any personal knowledge 12 yourself, Mr. Massey, of what happened in September of 13 1999 between Larry Destefano and Orlando Regional or 14 Florida Hospital or Sunbelt Nursing? 15 A No, sir. I do not have that, no, sir, that 16 knowledge. 17 Q And since 1999, September of 1999 to the 18 present, are you still good friends with Larry Destefano? 19 A Yes, sir. 20 Q Tell the jury, if you would, Mr. Massey, if 21 you have observed any changes in Mr. Destefano since 22 September of 1999 as compared to how he was before 23 September of 1999. 24 A Oh, well, his whole demeanor has changed. 25 He's so much more intense that, you know, he just 2201 1 dedicated all this time the last several years trying to 2 clear his name of all these alleged charges against him. 3 And he just is a different person than he was prior to 4 that time, Counselor. 5 Q You mention that he used to be happy-go-lucky. 6 How would you describe him now? 7 A Very, very intense. 8 MR. OSBORNE: No further questions. 9 THE COURT: Ms. Marshall? 10 - - - - - 11 CROSS-EXAMINATION 12 BY MS. MARSHALL: 13 Q Mr. Massey, is it fair to say that you have -- 14 everything that you know about this lawsuit you learned 15 through Mr. Destefano himself? 16 A That is true. 17 Q And you even visited Mr. Destefano while he 18 was picketing on a number of occasions, correct? 19 A That is correct. 20 Q And you also read his handouts that he had 21 prepared, correct? 22 A Yes, ma'am. 23 Q Now, Mr. Massey, did Mr. Destefano ever inform 24 you that his name was cleared with the Department of 25 Children and Families shortly after the allegations of or 2202 1 the incidents of September 21st? 2 A Yes, I believe I knew that, yes. 3 Q And you knew that he was cleared immediately 4 with the police, correct? 5 A Yes. I think I remember that also, yes, 6 ma'am. 7 MS. MARSHALL: I have no further questions. 8 MR. EVANS: I have no questions. 9 THE COURT: Any redirect? 10 MR. OSBORNE: No, Your Honor. 11 THE COURT: Ladies and gentlemen, do any of 12 you have a question for this witness? 13 THE JURORS: (Shakes heads.) 14 THE COURT: Mr. Massey, you're free to go. 15 THE WITNESS: Thank you. 16 MR. OSBORNE: Your Honor, next we have the 17 videotape deposition of Dr. Harry Krop, if we could 18 just have a moment to set that up. 19 THE COURT: Counsel, approach the bench. 20 (Bench conference not reported by the court reporter.) 21 (Open court.) 22 THE COURT: Ladies and gentlemen, this 23 deposition is about two and a half hours long 24 roughly, and what the lawyers have agreed to do is 25 to start that after lunch. So if you would please 2203 1 be so kind as to return and be prepared to come back 2 in at 12:30. We're not going to offer the Ninth 3 Circuit catering service today. We will ask you to 4 be on your own for about the next hour and ten 5 minutes or so and just come back in. We'll start at 6 12:30. 7 THE COURT DEPUTY: All rise for the jury. 8 (Jury exits.) 9 THE COURT: All right. I guess I would ask 10 you to reserve on your mistrial motions until the 11 close of the plaintiff's case and let's just get 12 that far, and then I'll hear whatever else you have 13 to say in that regard at that time. 14 MS. MARSHALL: Okay. Thank you, Your Honor. 15 THE COURT: All right. We'll be in recess, 16 then, until 12:30. 17 (A 70-minute lunch recess was had.) 18 THE COURT: Be seated. Counsel, why don't you 19 approach the bench. 20 (Bench conference.) 21 THE COURT: The deputies have Baker Acted your 22 client. 23 MR. TOWNSEND: Oh, my God. 24 THE COURT: So he is in custody, and subject 25 to an evaluation, when that will be concluded, I do 2204 1 not know, but I certainly don't expect he will be 2 here today. 3 MR. OSBORNE: How did that happen, Judge? Who 4 is the complaining party? 5 THE COURT: I don't know all of the details. 6 I just know that he has been Baker Acted and taken 7 into custody. 8 MR. OSBORNE: My understanding was that would 9 take somebody who would have to say that they 10 thought he was a danger to himself or others, and it 11 would have to be an attesting party to do that, and 12 that the deputies couldn't take that upon themselves 13 without a party complaining in that regard. I was 14 just wondering if you knew who that party was that 15 was the attesting party. 16 THE COURT: I don't know, Mr. Osborne. I 17 think the deputies concluded themselves, based upon 18 the testimony that was given, and so whether they 19 can take that on themselves or not, I don't -- 20 that's a legal question I don't know the answer to 21 under the Baker Act. 22 MR. OSBORNE: Okay. 23 THE COURT: I don't believe there was a 24 complaining party, per se, a witness in here, 25 certainly not anybody that I know of other than that 2205 1 the deputies made that decision. But I don't know 2 the details of that, so -- so where does that leave 3 us? 4 MR. OSBORNE: That's a good question. I need 5 to think about that. 6 THE COURT: Uh-huh. Talk to -- you can talk 7 to your clients. Unfortunately, you're not going to 8 be able to do that. You know, think about it for a 9 few minutes, and then I'll hear from you. 10 MR. OSBORNE: Yes, ma'am. Can I confer 11 with -- 12 THE COURT: Is Mr. Conway here? 13 MR. OSBORNE: He went to try to find out -- 14 THE COURT: I'm not sure he's going to be able 15 to. 16 MR. TOWNSEND: I just want to make sure who is 17 entitled to know this and not know this, and do I 18 have an obligation not to disclose what's happened 19 here, all that type of stuff. 20 THE COURT: Well -- 21 MR. TOWNSEND: It would be running rampant 22 around our office what happened, he got Baker Acted. 23 If we're not supposed to tell anybody that -- 24 MR. OSBORNE: I certainly don't want it 25 getting to the jury for darn sure. 2206 1 MR. TOWNSEND: For sure not that. I mean, 2 obviously we have to tell our clients, I think, to 3 get their opinion on what they want us to do, but do 4 we need to be silent on that or do you want to give 5 us any instruction or not? I just raise it so we 6 don't all get in a pickle. 7 MR. OSBORNE: I don't mind clients knowing, 8 but I don't think it should go beyond the litigation 9 team and clients. 10 THE COURT: I think you all would agree to 11 that, won't you? 12 MS. MARSHALL: Yes. 13 MR. TOWNSEND: Yes. That's all I was 14 concerned about. 15 THE COURT: And get passed this issue. 16 MR. OSBORNE: Let me confer for a minute. 17 THE COURT: Let me say this. I don't know -- 18 Bill, this is -- I did dependency for six years. I 19 did criminal. I've never had this happen, so I'm 20 sorry that I can't be -- 21 MR. OSBORNE: There is nothing you can do to 22 help? 23 THE COURT: I really don't know. This was not 24 at the Court's instruction. I don't know how this 25 happened except that it was told to me. I don't 2207 1 even know if Conway can find him and talk to him. 2 He must be somewhere here about to be transported. 3 My guess is he's not going to be able to find him. 4 MR. OSBORNE: They'll send him to Lakeside 5 Alternatives. 6 THE COURT: Yeah, whoever the receiving 7 facility is. I know it was Lakeside for a long 8 time, so -- 9 MR. OSBORNE: Give me about five or ten 10 minutes, Judge. 11 THE COURT: Sure, oh, sure. Dave, would you 12 tell the jury to relax. It will probably be another 13 15, 20 minutes before you can get to them. I just 14 want to advise you, I guess, that Madam Clerk tells 15 me that the receiving hospital that she has done the 16 Baker Act hearings at is Florida Hospital, so you 17 might want to just consider that, you know. I mean, 18 there's probably nothing you can do about that, but 19 that is apparently where they do the Baker Act 20 hearings. It's not a good thing in the context of 21 this case. 22 MR. OSBORNE: At Florida Hospital? 23 MR. EVANS: And South Seminole Hospital, which 24 is our facility, which is the other Baker Act 25 receiving facility. 2208 1 MR. TOWNSEND: Is that the only two? 2 THE COURT: I don't know that there is 3 anything we can do about that. I'm just telling you 4 for your -- 5 MR. OSBORNE: There is nothing the Court can 6 do to intercede in this matter? 7 THE COURT: I can't. That was a security 8 decision. I can't tell them how to do their -- make 9 their decisions. That's a completely separate 10 thing. So I'm wondering if -- you got me. I don't 11 know whether you want to make a phone call. 12 MR. OSBORNE: If you both can make phone calls 13 about expediting the process. They're your 14 facilities that he's being taken to. 15 THE COURT: That's not what I mean. I just -- 16 he made it very clear -- he made -- 17 MR. TOWNSEND: If we -- 18 THE COURT: One at a time. He made it very 19 clear his feelings about this hospital in 20 particular, and I guess, you know, I'm concerned 21 about when he gets there whether the situation is 22 going to be, you know, how that situation's going to 23 play out. Maybe Conway needs to go over there or -- 24 MR. OSBORNE: He's trying right now to track 25 him down. 2209 1 MS. MARSHALL: We can make some phone calls 2 and try and find out. 3 THE COURT: Maybe Tracy can find out just what 4 the procedure is from her contacts. 5 MR. TOWNSEND: If they haven't taken him from 6 the courthouse yet -- 7 THE COURT: Sergeant, do you know the status 8 of Mr. Destefano? 9 THE COURT DEPUTY: He's been transported now, 10 I believe, to Lakeside. I can confirm that. 11 THE COURT: Will you confirm where he's going? 12 That would help. Okay. Thank you. 13 (A 5-minute recess was had.) 14 THE COURT: It's apparently a joint receiving 15 facility, personnel from other -- all the hospitals. 16 It's on Mercy Drive. It's not -- 17 MR. OSBORNE: What's the name of the facility, 18 Judge? 19 THE COURT DEPUTY: It's the Central Receiving 20 Center is the name of it. It's a joint effort of 21 all the hospital in Orange County. 22 MR. TOWNSEND: Mrs. Pierce, our 23 representative, she's not a hundred percent sure, 24 but she thinks there's a 72-hour minimum once 25 they're -- before they're out of there. 2210 1 MR. OSBORNE: That's what I would imagine. 2 MR. TOWNSEND: Would you like us to make a 3 call? 4 THE COURT: I think it's a maximum also. 5 MR. OSBORNE: If you don't mind checking, that 6 would be great. 7 MR. TOWNSEND: Mrs. Pierce gave me the name of 8 somebody that knows a lot about that. We can call 9 down there and just ask in general terms, if you'd 10 like to. 11 THE COURT: That's always been my 12 understanding it's 72 hours. 13 MR. OSBORNE: Does it go up from the Central 14 Receiving Facility to someone else then? 15 THE COURT DEPUTY: I think they're evaluated 16 then and then they determine -- 17 MR. OSBORNE: That's on Mercy Drive? 18 THE COURT DEPUTY: Yes, sir. 19 THE COURT: They determine whether they can be 20 held -- 21 MR. TOWNSEND: Longer. 22 THE COURT: Uh-huh. 23 MR. TOWNSEND: She must have been thinking 24 about the maximum then. 25 MR. OSBORNE: All right, Judge. Mr. Conway, 2211 1 you know about this stuff, don't you? 2 MR. CONWAY: Yes, ma'am. I'm on my way over 3 there now. 4 THE COURT: You're going to the Central 5 Receiving Facility on Mercy Drive. 6 MR. TOWNSEND: What's the time frame? 7 MR. CONWAY: 72 hours. 8 THE COURT: Maximum? 9 MR. TOWNSEND: Minimum they get turned loose 10 right away. 11 MR. CONWAY: Yep, I'm working on it now. 12 MR. OSBORNE: I need to talk with Mr. Conway, 13 my co-counsel. I think we're about to come up with 14 a solution on this. 15 THE COURT DEPUTY: It's 1800 Mercy Drive. 16 (A 2-minute recess was had.) 17 MR. OSBORNE: Your Honor, may I address the 18 Court? 19 THE COURT: Yes, sir. 20 MR. OSBORNE: Judge, we've discussed this, and 21 we think what we'd like to do at this juncture is to 22 go forward with the videotaped deposition of 23 Dr. Krop, put in the rest of our -- we've got a few 24 minor exhibits to put in, rest our case. And I 25 would ask the Court not to have DV motions without 2212 1 my client being here. I think he has a 2 constitutional right to be here. Hopefully, he'll 3 be here in the morning. 4 That's all I -- I can't -- I'm renascent to 5 even do anything without him being here, but I think 6 playing the video would be fine, but I do think he's 7 entitled to be here for DV motions. 8 THE COURT: I would also -- and I'll hear from 9 the defense on this -- but I would also suggest in 10 that event that I advise the jury that as instructed 11 at the outset, that in a civil case, parties or 12 lawyers may come and go from the courtroom. They're 13 to draw no conclusions from the absence of any 14 person at counsel table for whatever reason. 15 They're not to draw any conclusions from that. 16 MR. OSBORNE: That would be fine, Judge. 17 THE COURT: Anything from you, Ms. Marshall, 18 at this time, having reserved on your motion for 19 mistrial? 20 MS. MARSHALL: I don't think so, Your Honor. 21 THE COURT: Mr. Townsend? 22 MR. TOWNSEND: That seems like about as 23 reasonable approach as we could think of at this 24 point. 25 MR. EVANS: Although I'm not sure that there 2213 1 is a constitutional right for a client to be present 2 during legal argument. 3 MR. OSBORNE: It's a trial by jury, a 4 privilege. 5 THE COURT: I'll bring the jury in, and we'll 6 press on with the videotape deposition, and we'll 7 see what happens at the conclusion of that and 8 consider further at that juncture. 9 (A 2-minute recess was had.) 10 MS. MARSHALL: What happened is in the last 11 part of his comments to the jury, Ms. Jerauld was, 12 Landerman was turning to putting her earphones on to 13 do the sidebar because we were all walking up and so 14 it's not on the transcript. 15 THE COURT: Bring in the jury. 16 (Jury enters.) 17 THE COURT: Ladies and gentlemen, we made up 18 for your shortened lunches a little bit. Thank you 19 for your patience. Mr. Osborne will be calling his 20 next witness by videotape. 21 As you all remember, I'm sure, the Court 22 instructed at the outset of the case that from time 23 to time for business reasons, personal reasons, any 24 number of things, you may see the litigants leave 25 the courtroom. This is a civil case, not like a 2214 1 criminal case. You are to draw no conclusions from 2 the absence of any person or lawyer as they come and 3 go here from counsel table. So I would remind you 4 and underscore that earlier instruction, and with 5 that, I would request that you call your next 6 witness, Mr. Osborne. 7 MR. OSBORNE: Dr. Harry Krop by video 8 deposition. 9 - - - - - 10 (Whereupon, the videotaped deposition of Harry 11 Krop, PhD, was played.) 12 BY MR. OSBORNE: 13 Q State your full name for the record and the 14 jury, please, sir. 15 A Harry Krop, K-R-O-P. 16 Q What is your profession or occupation? 17 A I'm a licensed psychologist. I'm the director 18 of Community Behavioral Services, which is a private 19 practice with offices in Gainesville and Orange Park, 20 Florida. 21 Q What is the nature of the private practice 22 that you are engaged in? 23 A The practice itself is a fairly large -- it's 24 a comprehensive practice of clinical psychology. I have 25 approximately, probably about 14 licensed mental health 2215 1 professionals, both psychologists and licensed mental 2 health counselors. And it's a wide spectrum of clinical 3 problems in children as well as adults. Specifically, my 4 practice is pretty much limited to forensic psychology, 5 which is the application of psychological principles and 6 issues to various legal issues. 7 Q Tell the jury what your formal education is 8 since high school, please. 9 A I have a bachelor's degree from Temple 10 University in Philadelphia in 1964 in psychology. I have 11 a master's degree in psychology from American University 12 in Washington, D.C., and I have a PhD in clinical 13 psychology from the University of Miami. That was 14 formally in 1971. 15 As part of the degree requirements, I did a 16 one-year clinical internship at Connecticut Valley 17 Hospital in Middletown, Connecticut, and then I came back 18 to Florida and did a one-year postdoctoral internship at 19 the VA Medical Center, and that was specifically in the 20 area of neuropsychology. 21 Q Have you held any positions in academia? 22 A I'm currently an instructor on the faculty of 23 Nova University, whose home base is Broward County, but 24 they have what's referred to as an external degree 25 program, a master's degree program, so I teach in 2216 1 different sites such as Orlando and Gainesville and Tampa 2 to individuals who are enrolled in the field of human 3 sexuality, behavior modification. And I also supervise 4 their practicum students. 5 Currently, I'm also on the faculty at the 6 department of psychiatry, University of Florida College 7 of Medicine, and I'm responsible for supervising the 8 forensic psychiatric residents, those individuals who 9 come to the university to specialize in forensic 10 psychiatry. 11 Q Have you had any past employment experience 12 with any medical centers or hospitals? 13 A I'm the -- my first job was actually or my 14 first formal PhD job was with South Florida State 15 Hospital. I was the acting director of psychology, and I 16 was -- that was probably back in the late '60s. 17 After I completed my postdoctoral internship 18 at the VA Medical Center, I remained -- I was asked to 19 stay on as a staff psychologist, and I was involved in 20 the treatment of posttraumatic stress disorder with 21 veterans returning from Vietnam, and I also worked with 22 other veterans who had both medical and sexual problems. 23 Q What licenses or certifications do you hold? 24 A I'm licensed as a psychologist in the state of 25 Florida. That's a renewable license every two years 2217 1 requiring a certain number of continuing education 2 credits. I have other certifications and other 3 diplomates. I'm a diplomate in the American Board of 4 Forensic Examiners, and I have certain certifications in 5 working with crimes against children, sexual abuse, and 6 extensive training in -- in the area of sexual abuse and 7 sexual offenders. 8 Q Tell the jury what, again, more specifically, 9 what is the practice of forensic psychology? 10 A Forensic psychology is the combined practice 11 of psychology and the law. So, for example, if it were a 12 criminal case, I would be asked either by an attorney or 13 the Court to conduct a psychological evaluation of an 14 individual who would be accused with a criminal offense. 15 There might be different issues that I would address. 16 For example, the most common issue is whether 17 the person is competent to proceed; that is, whether he 18 can assist his attorney in a legal proceeding. 19 I may also be asked to address the 20 individual's mental state at the time of the offense, 21 whether he was sane or insane at the time of the offense, 22 or I might be asked to just assist the Court in coming up 23 with a treatment plan, dispositional planning for a given 24 client. Those would be the criminal cases. 25 In civil cases, that would encompass being 2218 1 asked by the Court to do a custody evaluation, or perhaps 2 the Department of Children and Families might ask me to 3 do an evaluation to assist in coming up with a treatment 4 plan. 5 I might be asked by, in a personal injury 6 case, by either the plaintiff's attorney or the defense 7 attorney to conduct an evaluation to determine possible 8 psychological sequelae or psychological damage related to 9 a particular event in question. 10 Q Let me ask you this, Doctor. How many times 11 do you think you've been qualified as an expert in courts 12 in Florida? 13 A I keep statistics because I'm generally asked 14 that question, and I've testified in civil cases around 15 650 times and on criminal cases somewhere around 1200 16 cases. And I've always been qualified. I can't -- 17 qualified as an expert. I can't tell you exactly how 18 many times that's been in Florida. I'd say 90 percent of 19 those cases were in Florida. 20 I also testified in federal court and in the 21 court marshals, and I've testified on a number of 22 occasions in Canada as well. 23 Q Tell the jury what your experience is in 24 regarding professional publications in your field. 25 A I have approximately 30 to 40 professional 2219 1 publications. They may be in the area of 2 neuropsychology, or a lot of my publications are in the 3 field of treatment and evaluation of sex offenders and 4 treatment of sexual abuse. 5 I've done -- in addition to the publications, 6 I've done a couple of chapters and edited books in 7 different areas. And then I've presented workshops at 8 various professional conferences, probably over a hundred 9 of those. Again, those would pretty much be in the same 10 areas that I just mentioned. 11 Q What were you initially asked to do in this 12 case involving Larry Destefano? 13 A This was somewhat unusual in that, originally, 14 I was asked by Mr. Destefano's attorney, at the request 15 of another mental health professional, to just conduct 16 psychological testing; that is, diagnostic testing. 17 Another psychiatrist had done a clinical interview on 18 Mr. Destefano, and because psychiatrists typically do not 19 administer psychological tests, that psychiatrist 20 requested psychological testing. 21 So I first saw Mr. Destefano in the middle of 22 June of 2004, June 15th, and completed a comprehensive 23 battery of pretty much the traditional personality and 24 other types of psychological testing to assist in a 25 differential diagnosis. 2220 1 Q What is a differential diagnosis? 2 A A differential diagnosis is utilizing the data 3 available, either from interviews, other sources or 4 psychological testing, and determining what would be the 5 most appropriate diagnosis for a given individual and 6 trying to -- the reason it's called differential is to 7 rule out other possible diagnoses, if possible. 8 Q What is a clinical interview? 9 A A clinical interview is talking to the client, 10 or in this case the plaintiff, and eliciting a history in 11 various areas of the person's life starting from a 12 developmental history and a marital history and military 13 history, social history and so forth. 14 And in addition to getting a history of that 15 individual, it's also both from asking questions and also 16 observations, doing what's referred to as a mental status 17 examination, which is assessing the person's thought 18 processes and emotional state, both at the time of the 19 evaluation and then to extrapolate to other time periods. 20 Q Is a clinical interview something that a 21 psychologist such as yourself is trained to do? 22 A Yes. It is the basic and a necessity for 23 conducting any type of psychological evaluation. 24 Q How, then, in forming opinions does a clinical 25 interview interplay with the diagnostic testing that you 2221 1 did? 2 A Whenever a diagnosis is provided, it is 3 utilizing as much data as possible. Psychological 4 testing provides additional data to an individual to the 5 information that's obtained in a clinical interview. 6 One of the things -- one of the ways that a 7 forensic -- I made reference a little while ago what a 8 forensic evaluation was. One of the ways that a forensic 9 interview or evaluation differs from a clinical or a 10 simple diagnostic interview is that usually the person 11 being evaluated, of course, has come to the attention of 12 the court system in one way or another. And so there's 13 always the possibility, when you're dealing with an 14 individual in this capacity, that he or she may be giving 15 you information to portray him or herself in a certain 16 way, either to look bad, for example, in a criminal case, 17 an individual may want to look sicker than he or she is 18 to perhaps get off on an insanity defense. In a custody 19 case, the individual is generally trying to portray him 20 or herself in a highly favorable way to look good as a 21 parent. 22 And in a personal injury case, again, you have 23 some of the same concerns when you do the evaluation. Is 24 the person trying to exaggerate symptoms to look worse 25 than he or she may be? 2222 1 So one of the things that's important in a 2 forensic evaluation is not only to do a clinical 3 interview, do whatever appropriate psychological testing 4 is necessary, but also to review as much what we refer to 5 as corroborating evidence or collateral information. And 6 those materials could come from various sources, either 7 in terms of records, depositions, witness statements, and 8 so forth. And I try and review as much of that as 9 possible before giving any opinions in a forensic case. 10 Q What documents or records had you reviewed in 11 preparing your opinions in this case? 12 A In this case, in addition to the clinical 13 interview and the psychological testing, I reviewed a 14 number of depositions, depositions of several individuals 15 who are at the various facilities; such as Lillian -- and 16 I'm hoping I'm pronouncing these correctly -- Lillian 17 Folley, a Kelly Gregg, a Rachel Bean, a Dr. John Steely, 18 a Carol Boze. I believe her last name is Melashenko. 19 Rachel -- I'm sorry, I already said that. Mieko Koller, 20 who's actually Mr. Destefano's ex-wife. 21 I reviewed a very lengthy deposition which was 22 taken over, I believe, different time periods of 23 Mr. Destefano. Mary Thornton. I've reviewed 24 Dr. Danziger, who is a psychiatrist, who evaluated 25 Mr. Destefano. I reviewed both his report and 2223 1 deposition. A Dr. Cerra, who's a psychiatrist, who also 2 evaluated him, I reviewed his report and deposition. 3 I reviewed records from Sunbelt, from the 4 Sunbelt facility, also from the Orlando Regional Medical 5 Center. I've reviewed DCF records. I've reviewed 6 records from the Orlando Police Department. And I've 7 also reviewed a psychiatric evaluation which was 8 conducted on June 23rd, 1981, while Mr. Destefano was in 9 the military. 10 Q Did you review Florida Hospital records? 11 A Yes. 12 Q Before I get into your opinions, I want to go 13 through some of the records that you reviewed. Dr. Krop, 14 in formulating your opinions, did you have sufficient 15 information from the Sunbelt nursing records, from the 16 ORHS records, ORMC records, the Florida Hospital records, 17 from your review of those records and from your 18 diagnostic testing and from your clinical interview, to 19 formulate the opinions I'm going to ask you about today? 20 A I would believe so. In reviewing my 21 deposition, the opinions that I expressed then were based 22 on the materials that I reviewed, and as far as I can 23 tell, my opinions are identical to those. 24 Q So I would ask you in answering the questions 25 to focus your opinions on these source records that we're 2224 1 talking about, the hospital records, your clinical 2 interview, and your diagnostic testing. 3 A Fine. 4 Q I'm going to mark as Exhibit 1 -- I'm just 5 going to go through some records. These are portions of 6 records that you said you reviewed, and for the sake of 7 time, I've gone through and just made a copy of them. 8 I'm going to refer, first of all, to the 9 Sunbelt record -- excuse me, to the ORHS record. And, 10 let's see. Excuse me. This is the Sunbelt record of 11 9/19/99 to 9/21/99. I'll just represent that to you that 12 this is Mary Thornton's note, and I'm just going to 13 publish part of this on the second page. 14 I'm going to publish "Witnessed the son giving 15 his mother a passionate kiss which lasted for an extended 16 time." 17 I'm also going to publish from this same 18 document a statement by Carol Boze right below that 19 9/20/99, "Found the patient's son lying on top of patient 20 and kissing her repeatedly on patient's mouth. Patient's 21 son stopped kissing her when he saw nurse entering the 22 room." 23 And then I'm going to go to a Rachel Bean note 24 on the same document where she says "Witnessed son 25 kissing his mother intimately on the lips." Also says 2225 1 "noticed bright red blood on pad." And it also says in 2 that note, "Dr. Steely had passed on that resident's son 3 was kneeing her in the back, telling her to stand up and 4 was literally dragging her across the room telling her to 5 walk, causing the dressing to come off." 6 Also from Nurse Bean, "Called HRS abuse 7 hotline." Also from Nurse Bean, "Dr. Wilson states son 8 was inappropriate there, and he was removed from the 9 property." 10 I'm also going to publish a 9/22 -- from this 11 document, a 9/22/99 note from Carol Boze where she notes, 12 "Son on top of her, kissing her passionately on the mouth 13 for approximately two minutes." 14 And in regard next -- to the next document I'm 15 going to show you, which I'm going to mark as 16 Composite 2, this is a portion of the ORHS record. And I 17 want to publish, first of all, from the paramedic notes, 18 "Taken to ORMC for evaluation of bowel impaction where 19 the paramedic notes that nursing staff reports son did a 20 digital removal. It is believed this might be the cause 21 of trauma." 22 And then we go to a note that I'll represent 23 to you is a note by Nurse Kelly Pipkin, "Patient 24 transported from nursing home with reports of finding 25 bright red blood on sheets of bed. Paramedic reports 2226 1 that nursing home staff say, quote, Her son disimpacted 2 her Sunday. 3 There's going to be a Lillian Folley note in 4 here as well on the case management discharge planning 5 assessment: "Son inappropriate. Patient or per nursing 6 supervisor presented with rectal bleeding. Patient's son 7 was witnessed disimpacting her at Sunbelt, says Rachel 8 Bean. Has reported to abuse hotline. Patient's son was 9 witnessed lying on top of patient kissing her in a way a 10 son would not kiss his mother. Sunbelt sent patient to 11 ORMC because of rectal bleeding." That would be on the 12 following page at the same time. 13 It also states at 1830: "Son at patient's 14 bedside. Security present, asking son to leave." 15 Then there's a note on the next page from a 16 Dr. Wilson: "1700. Informed that son is with patient in 17 her room and nurse witnessed inappropriate kissing 18 between son and mother. Security and police have been 19 notified." 20 And now I'm looking at the triage form for 21 ORHS, which says: "Rectal bleeding per nursing home. 22 Has bright red blood per rectum." 23 And I have another document for you -- to talk 24 with you about, another excerpt. I'll mark that as 25 No. 3. This is from the -- I'll represent to you from 2227 1 the charting at Florida Hospital on 9/22/99. "Patient 2 admitted to ORMC. Son -- "or seen there for evaluation 3 of questionable sexual abuse between son with mother." 4 And the next page has an order, quote, 5 One-on-one sitter. Also a note 9/22/99, 9:30, "HRS 6 consult for clarification of guardian status." 7 And the next page has a diagnosis, "Protection 8 from family member, Alzheimer's." 9 Are these excerpts found in the medical 10 records you reviewed prior to forming your opinions? 11 A Yes. Yes, they are. 12 Q As it relates to Mr. Destefano's damages, that 13 type of a statement being made, what's the significance 14 of that? 15 A Well, let me say first that with the 16 presumption that these incidents did not, in fact, occur, 17 as Mr. Destefano indicates that he, of course, is in 18 denial that -- that he engaged in any inappropriate 19 conduct with his mother, a false allegation or an 20 accusation made of this proportion, particularly 21 something that's as both bizarre and deviant as this 22 allegation is, it would likely on any individual have a 23 very traumatic impact and very serious psychological 24 impact on a person who is certainly incident of such 25 allegations. 2228 1 Q Let's talk a little bit about the testing that 2 you did on Mr. Destefano. Tell the jury generally what 3 the battery of tests were that you performed. 4 A Well, without getting into each one 5 specifically, let me say that I administered seven 6 different psychological tests. Three of those tests are 7 tests that are referred to as having validity scales, 8 which means that the -- the way the test was standardized 9 and the normative data that was used, you're able to 10 determine, based on a pattern of a person's responses, as 11 well as the content of that person's responses, as to the 12 validity of that person's responses. 13 In other words, as I indicated earlier to 14 the -- to the jury, that when we do a forensic 15 evaluation, there is at times individuals who -- who may 16 try and present themselves as either more psychologically 17 disturbed than he or she is or try and portray themselves 18 in a more positive light; that is, to deny psychological 19 symptoms. There could be various reasons for this. 20 So some of these tests that I administered 21 have these validity scales that basically suggest, at 22 least to the examiner, to the particular response set 23 that the person has when he or she is completing these 24 tests. 25 Some of the other tests are fairly 2229 1 straightforward tests; that is, they have what's called 2 face validity so that the person who's taking the test 3 can pretty much manipulate the test to he or she's 4 wishes, make him or herself look like they want to 5 present themselves. In other words, it's pretty easy to 6 figure out what the test is asking for, but three of the 7 tests are not able to be manipulated that way. 8 So all of these tests are referred to as 9 self-administered tests. I give instructions to the 10 individual. He sits in an office by himself and goes 11 through the test, whether it's true, false, rating from 12 one to five, and certain different scales depending on 13 the nature of the test. 14 As long as the person has a certain degree of 15 intelligence and a certain reading level, they should be 16 able to take this test by themselves. And, of course, I 17 assured myself before I gave Mr. Destefano these tests 18 that he understood all the instructions, and he certainly 19 is capable of reading and understanding the instructions. 20 So that was the battery of tests. This is 21 pretty much a traditional battery that I would use for an 22 individual to assess psychological -- level of 23 psychological functioning. 24 Q And then you conducted your clinical interview 25 after that? 2230 1 A On a subsequent session, yes. 2 Q And the opinions you formed were based both 3 upon the diagnostic testing and the clinical evaluation? 4 A Yes, correct. 5 Q And in terms of determining any damage or 6 injury to Mr. Destefano psychologically, in this case, 7 did you rely upon these medical records from Sunbelt 8 Nursing and from ORHS and from Florida Hospital? 9 A Well, I relied on them to the extent that 10 Mr. Destefano certainly during the interview indicated 11 that his current psychological problems or many of them 12 are related to allegations that have been made against 13 him. So one of the things, of course, that I felt a need 14 to check out was what, in fact, was being said about him, 15 and so the record certainly supports, to a large degree, 16 what Mr. Destefano indicated the allegations were. So I 17 certainly relied upon them in that sense. 18 Q Doctor, let me ask you this. In terms of the 19 publications that I published in your deposition here, 20 had you reviewed those publications as a part of 21 formulating your opinions? 22 A Yes. 23 Q And in terms of whether or not these 24 statements are true or false, have you just assumed that 25 these statements are false for the purpose of formulating 2231 1 your opinions? 2 A Well, I know I'm not supposed to necessarily 3 respond to an objection, but I'm not testifying here -- 4 as I understand, that it's up to the trier of fact to 5 make a determination as to the truthfulness of the 6 statements. What I said was that the statements that 7 Mr. Destefano indicated were made against him or the 8 allegations were consistent with what I reviewed in 9 the -- in the reports. 10 Again, I'm not testifying as to the validity 11 of those statements. That's clearly up to the tryer of 12 fact. But what's most important from a psychological 13 standpoint is to know that what Mr. Destefano tells me is 14 supported by what's in the records in terms of what the 15 allegations are. And certainly, to a large degree, his 16 psychological symptoms are based on a presumption that 17 these allegations are -- do not represent his actual 18 behavior. 19 Q Let me ask you this, Doctor. Do you have an 20 opinion, based on a reasonable scientific probability, as 21 to what these publications that we've been talking about, 22 as to what the effect those publications were upon Larry 23 Destefano? 24 A Yes, I have an opinion of that. 25 Q And let me ask you, before you tell me what 2232 1 those opinions are, does the nature of these types of 2 statements being made, the content of them, to wit, being 3 sexually inappropriate with your mother, does that have 4 an impact on the psyche of Larry Destefano? 5 A Yes. 6 Q Tell me this, Dr. Krop. In terms of the -- 7 the subset of -- in any context of someone being accused 8 of being sexually inappropriate with their mother, is 9 this something that you see often in your practice? 10 A No. Number one, statistically, it's very, 11 very rare for there to be any sexual misconduct between 12 a -- a son and a parent, mother or father. It's a very 13 statistically infrequent kind of activity. So certainly 14 to be accused, and, of course, according to 15 Mr. Destefano, to be accused falsely of a sexual act in 16 and of itself would often lead to psychological problems 17 for any individual. 18 For Mr. Destefano to be accused of not only a 19 sexual -- an act of sexual misconduct, but to be accused 20 of an act this bizarre and pretty much this deviant, 21 particularly to an individual that Mr. Destefano 22 certainly would indicate that he has cared for and has a 23 very, very close bond with this person, so to -- for 24 those allegations to be made against Mr. Destefano 25 specifically, certainly there was a likelihood that there 2233 1 would be psychological damage. And certainly, from my 2 evaluation of him, that's what I determined to be, in 3 fact, so -- 4 Q And how many years have you been a practicing 5 psychologist? 6 A I've been licensed since 1971. 7 Q And how many cases do you think you've 8 investigated regarding sexual abuse? 9 A I've done over 3,000 evaluations. 10 Q Let's go back to what your opinions -- what 11 your opinions are. I had asked if you had reached 12 opinions as to the psychological effect of these 13 allegations on Mr. Destefano. You said you had. 14 What are your opinions regarding 15 Mr. Destefano's psychological conditions as a result of 16 these events that occurred in September of 1999? 17 A Well, from a diagnostic standpoint -- and I'll 18 start with what I believe with a reasonable degree of 19 psychological certainty are the diagnoses based on my 20 evaluation. The first diagnosis would be an adjustment 21 disorder with depressed mood and anxious mood. 22 What this is, is an individual responding to a 23 certain situation or certain events, which in this case, 24 were the allegations against him, and he responds in a 25 manner that causes this individual to have difficulties 2234 1 adjusting in society or in different -- different parts 2 of his life. 3 His depression, in my opinion, has been 4 moderate to severe at times. His mood has been anxious, 5 both moderate to severe. Although certainly an 6 individual who suffers with an adjustment disorder can in 7 the future become a full-blown major depression or major 8 anxiety episode. But currently, my diagnosis is an 9 adjustment disorder with mixed depression and anxiety. 10 Q What other opinions do you have as to or 11 diagnoses do you have of Larry Destefano's psychological 12 condition based upon these events that occurred in 13 September of 1999? 14 A My second diagnosis is a personality disorder, 15 NOS, which stands for not otherwise specified, with 16 obsessive features. In my -- what this is is a certain 17 personality trait which causes or contributes to an 18 individual having difficulties with certain -- certain 19 times of his life, certain areas of his life. 20 We all have personality traits. Some of those 21 traits can be constructive, but when they're to a degree 22 that causes adjustment difficulties or functioning 23 difficulties, then they can be labeled under the 24 personality disorder. 25 In my opinion, Mr. Destefano had these traits, 2235 1 these obsessive traits prior to the -- the events in 2 question at the facilities but were made worse -- but 3 were made worse, number one, by what happened. And also 4 because of those personality traits, it explained to some 5 degree why he reacted the way he did. 6 An individual with obsessive features and his 7 general personality style has been, to be a fairly rigid 8 individual, a person who tends to view things -- certain 9 things in sort of black and white, has a need to, if he 10 feels wronged, to basically pursue whatever action is 11 necessary to prove to others that he has been wronged and 12 to make things right. 13 So because of the nature of these allegations 14 and his already existing obsessive nature, I think that's 15 what certainly, in part, led to the behavior pattern that 16 Mr. Destefano or the choices that he -- he took after 17 these allegations were made. 18 Finally, I'd say that Mr. Destefano has 19 posttraumatic stress disorder features. I do not believe 20 that he has a full-blown posttraumatic stress disorder 21 which requires certain criteria and a certain nature of 22 events, but certainly he perceives -- excuse me, what 23 happened to him as very traumatic. It has had a 24 significant impact psychologically in his -- in his life, 25 and basically he has been obsessed and anxious and 2236 1 depressed about it during the last six years, I guess, 2 since this has been going on. His whole focus in his 3 life has been to become vindicated. So those would be 4 diagnostically my opinions. 5 Q Is there any way you can globally assess, you 6 know, the severity of these diagnoses? 7 A Well, there's a section in the Diagnostic and 8 Statistical Manual, which some refer to it in our system 9 as sort of the Bible. It lists all the different 10 criteria which are necessary for various diagnoses. 11 And then there is one section called the 12 Global Assessment of Functioning, which is a fairly 13 general but fairly objective list of the criteria to 14 assess how a person is functioning within the last year, 15 as well as currently. The GAF, or the global assessment 16 of functioning, is anywhere from zero to a hundred. 100 17 would be a person who is functioning in almost a perfect, 18 very optimal manner, and, of course, zero is the lowest 19 you can get. 20 I would, depending, again, on the 21 circumstances and the time period that we're talking 22 about, I indicated that Mr. Destefano would be anywhere 23 from a 60 to a 70, which is anywhere from mild to 24 moderate severity. And if you look at it with the 25 optimal functioning at a hundred, we're talking about 2237 1 functioning at a 60 to 70 percentile of efficiency or 2 psychological functioning. 3 Q Now, has Dr. Danziger done a global -- a GAF 4 for Mr. Destefano? 5 A Yes. At the time that Dr. Danziger evaluated 6 Mr. Destefano, which was in 2003, he gave him a GAF of 7 60, which, again, is a moderate level of impairment. 8 Q Okay. Let me ask you this, Doctor. In terms 9 of a notation that's in your records, I'd like to publish 10 it and ask you about it. "He freely admitted utilizing 11 this procedure at the Florida Hospital in Orlando." Do 12 you remember that note from your -- from your clinical 13 interview? 14 A Yes, yes. 15 Q What does that mean? 16 A Well, I know when I was -- in going back, it 17 certainly is consistent with the medical records that I 18 reviewed. When I was deposed, defense counsel -- I'm 19 sorry, yes, defense counsel reviewed those notes, and I 20 believe the question to me was did Mr. Destefano say 21 that. And I could only say, of course, since I wrote it 22 down, that, yes, he did say it, and in looking back at 23 the medical records. 24 Q Let me show you Exhibit 4, which is a portion 25 of the Sunbelt records. And you see the part under 2238 1 "Review of Symptoms" in the box? 2 A Yes. 3 Q Publish what that says, if you would, where it 4 says "son reports." 5 A Son -- under -- let's see. "Son reports 6 chronic" -- he's talking about his mother. "Son reports 7 chronic constipation, fecal impaction recurring requiring 8 disimpaction every five to six days." 9 And, again, in response to your question, what 10 Mr. Destefano indicated to me from reviewing my notes and 11 reviewing these records was that he indicated to me that 12 he acknowledged to the staff at Florida Hospital that, or 13 I guess it was to the next facility, that he, in fact, 14 had done this procedure previously to his mother or for 15 his mother on a -- on a regular basis at home. 16 Q Okay. So if you look at the record -- strike 17 that. 18 Is your recollection now as refreshed by the 19 charting at Sunbelt consistent with what's found in the 20 charting -- 21 A Yes. 22 Q -- at Sunbelt? 23 A Yes, it is. 24 Q Are all the opinions that you've given here 25 today regarding Larry Destefano's psychological diagnoses 2239 1 permanent as of the time you formed them? 2 A Well, let me qualify. The personality 3 disorder and the obsessive features is certainly 4 permanent. In my opinion, when I diagnose a person as an 5 adjustment disorder, by definition, that typically means 6 that within a certain -- at a certain period of time, the 7 individual will have to -- the diagnosis will have to 8 change. Either the individual no longer suffers from 9 those particular features, which I indicated were 10 depression and anxiety, or the diagnosis will have to be 11 changed to some level of depression or some level of 12 anxiety or both. 13 Given the fact that this has been six years, I 14 guess, going on, it's very, very unlikely that the 15 anxiety and the depression are going to dissipate to a 16 degree where that wouldn't be some level of permanency. 17 So I would expect that certainly the depression and the 18 anxiety are going to be permanent. Hopefully, depending 19 on what happens with Mr. Destefano over the next few 20 months or so or over the long run, hopefully there will 21 be some alleviation of those symptoms. 22 Q Will the termination of this litigation make 23 these permanent conditions go away? 24 A Not in and of itself, I'm afraid. I think 25 that certainly, as I indicated, Mr. Destefano is -- is 2240 1 quite obsessed with -- his focus for the last six years 2 has been both from his picketing and from his involvement 3 in this litigation, his goal is to get vindication. 4 That's what -- and I believe that certainly fits his 5 personality. 6 As I indicated, he will only be satisfied once 7 there is a trier of fact indicating that he was wronged 8 in this case. So depending on the outcome, I would say 9 that would certainly help if the outcome is favorable and 10 if he feels somehow that others view his situation the 11 same way he views it. So in that sense, the litigation 12 or the resolution of the litigation certainly could be 13 helpful. But this is going to be longstanding, given how 14 long he already has been experiencing these symptoms. 15 MR. OSBORNE: Thank you, Dr. Krop. I have no 16 further questions. 17 - - - - - 18 CROSS-EXAMINATION 19 BY MS. MARSHALL: 20 Q Good afternoon, Dr. Krop. 21 A Good afternoon. 22 Q You were hired by the plaintiff's attorney, 23 correct? 24 A That's correct. 25 Q And before you met with Mr. Destefano, you 2241 1 were told by his lawyer that you were evaluating him 2 because he was a plaintiff in a defamation action, 3 correct? 4 A I'm really not sure what I was told. I was 5 told that a psychiatrist had recommended psychological 6 testing for him, and certainly, I knew from reading 7 Dr. Cerra's report that he was a plaintiff in legal 8 action. 9 Q Do you have your intake sheet in front of -- 10 in front of you? 11 MS. MARSHALL: Let's do this. I'll just mark 12 this as Defendants' Exhibit 1. 13 Q Dr. Krop, if you could look at Defendants' 14 Exhibit 1, do you recognize this as your intake forms 15 that were contained in your file? 16 A Well, you have a couple of things combined 17 here. You have three things. One is my -- one of the 18 three pages is the intake form that was taken by my 19 secretary at the time. 20 Q Is that page 2? 21 A Yes. 22 Q And it says that Larry Destefano is a 23 plaintiff, correct? 24 A Yes. 25 Q And under the description, it says 2242 1 libel/slander, correct? 2 A Correct. 3 Q So you were aware when you were hired that the 4 plaintiff was seeking money damages for mental anguish as 5 a result of the alleged defamatory statements; is that 6 correct? 7 A Correct. 8 Q And you're being paid 350 dollars per hour for 9 your trial testimony, correct? 10 A Correct. 11 Q And anything that you did outside of 12 testifying here today, you were paid at 300 dollars per 13 hour; is that correct? 14 A That's correct. 15 Q And you have never given expert testimony in a 16 defamation case before, have you? 17 A Not that I can recall. 18 Q Now, Mr. Destefano made a total of two visits 19 to your office; is that correct? 20 A Yes. 21 Q And you have not seen him professionally 22 except for those two visits, right? 23 A Correct. 24 Q And let's talk about that first visit. The 25 first time he came to your office was on June 15th, 2004; 2243 1 is that correct? 2 A Yes. 3 Q And I think you testified in direct that the 4 purpose of that visit was for you to give Mr. Destefano 5 some standard psychological tests; is that correct? 6 A That is correct. 7 Q And when you do this testing, the patient is 8 normally in a room by himself or herself answering 9 written test questions; is that correct? 10 A Yes. 11 Q And you met with him for about five or ten 12 minutes that day; is that correct? 13 A I met with him for about 15 minutes initially, 14 maybe 10 minutes, to explain what he would be doing. And 15 then I met with him in terms of each time a test was 16 given to him which might not take more than one to two 17 minutes each time, and then before he was finished, he 18 asked to speak to me very briefly. 19 Q So a total of, what do you say, 30 minutes 20 amount of time -- 21 A Sure. 22 Q -- cumulative? Okay. And some of these tests 23 that you administered had to be scored, correct? 24 A Yes. 25 Q And that would have been the personality 2244 1 assessment inventory, correct? 2 A Yes. 3 Q And the MMPI-2? 4 A Correct. 5 Q And the MCMI-III? 6 A Yes. 7 Q Okay. And did you personally score these 8 tests or did you have assistance? 9 A I have an assistant. The personality 10 assessment inventory is actually -- his responses are put 11 into a computer, and I get a computer printout on the 12 personality assessment inventory. At that time, the 13 MMPI-2 and the MCMI-III were hand scored. 14 Q Okay. And who inputted the data from the 15 personality assessment inventory into the computer? 16 A My assistant. 17 Q Who is that? 18 A I don't remember at that time. It's not a 19 person who's still with me. 20 Q Okay. And who actually hand scored the two 21 other tests? 22 A Well, it may be -- they may be labeled down 23 here. Her name is Barbara Vomer. 24 Q Now, the second time that Mr. Destefano came 25 to your office, that was on August 26th, 2004; is that 2245 1 correct? 2 A I believe so, yes, yes. 3 Q And during that second visit, you personally 4 spent about an hour and a half with Mr. Destefano, 5 correct? 6 A He was -- about an hour, 30, 45 minutes, 7 correct. 8 Q And did one of your assistants, Roseann, 9 Rosanna Rutledge, also interview Mr. Destefano and take 10 down certain information for you? 11 A Yes. She is a licensed therapist. And the 12 way I conduct my forensic evaluations, she would do the 13 initial interview in which she obtains both a clinical 14 history of the individual, and in this case, she also 15 obtained from Mr. Destefano his purpose of filing the 16 lawsuit. He was very much into wanting to explain to her 17 before he got into the interview portion the basis for -- 18 Q Dr. Krop, can I just interrupt you? My 19 question was did one of your assistants interview 20 Mr. Destefano and take down certain information for you? 21 A That is correct. 22 Q Okay. And did you rely upon that information 23 that she took down? 24 A I relied upon it by going over it with him. 25 Q And so your opinions in this case were based 2246 1 on a little over an hour and a half, hour and 45 minutes 2 of face time with Mr. Destefano; is that accurate? 3 A From an interview standpoint, that's correct. 4 Q And you actually formulated your opinion in 5 this case sometime after your second interview with 6 Mr. Destefano and before you gave your second deposition 7 on September 28th, 2004, correct? 8 A My opinions were formulated before the 9 deposition, sure. It was after I completed the 10 evaluation. 11 Q And normally, in a forensic case when you're 12 asked to render an opinion as to a psychological 13 diagnosis, you would review every deposition in the case; 14 isn't that correct? 15 A I try and review as much collateral 16 information as possible. 17 Q And prior to coming to your opinion with which 18 you shared with us at your deposition on September 28th, 19 2004, you hadn't reviewed a single deposition in this 20 case, had you? 21 A I believe I told you that I -- I reviewed the 22 depositions of Dr. Danziger and Dr. Cerra. The other 23 depositions that we're referring to are depositions 24 having to do more with factual information and the 25 mother's medical history. 2247 1 So when I was asked -- I was asked to render 2 an opinion as to psychological consequences of these 3 allegations. And although certainly reviewing those 4 depositions certainly provide some useful information, 5 the depositions aren't particularly relevant to the 6 particular opinions that I'm giving here. 7 Q Okay. So the only deposition that you 8 reviewed in this case prior to forming your opinion was 9 Dr. Danziger's deposition; is that correct? 10 A I thought I had Dr. Cerra's. I'm not sure. 11 It depends on -- I don't remember what I said there when 12 I got -- 13 Q Do you want to look at page 9 of your 14 deposition? Do you have a copy of that with you? 15 A Yes. I did not indicate that in no. As I 16 indicated on page 10, that I'm expecting to be sent 17 Dr. Cerra's deposition. So I did not have it at the time 18 you deposed me. 19 Q And at the time you formed your opinion, 20 correct? 21 A That was my opinion, yes. My opinions are 22 always subject to change depending upon what -- what 23 information I receive afterwards. 24 Q Now, normally in a case when you're asked to 25 render an opinion as to a psychological diagnosis in a 2248 1 case that's in litigation, you would also want to review 2 the complaint; is that correct? 3 A That sometimes is helpful. 4 Q Well, that's your normal practice, is it not, 5 to read a copy of what the complaint is that has been 6 filed? 7 A Generally, I ask the attorney to provide me 8 with all information that is available for my review. 9 Sometimes the information is superfluous, and sometimes 10 it is helpful, and sometimes it contradicts my clinical 11 opinions. 12 Q My question was your normal practice in doing 13 a forensic case, which is one that's going to go to 14 litigation, is that you would want to review the 15 complaint prior to coming to your opinion; is that 16 correct? 17 A My normal practice is to ask for all available 18 collateral information. If that includes the complaint, 19 then certainly that would likely be helpful. So it is my 20 normal practice, most of the time, I do have that 21 available. 22 Q And in this case, prior to coming to your 23 opinion, you didn't review the complaint, did you? 24 A Not the formal complaint, no. 25 Q And, again, your normal practice, when you're 2249 1 rendering an opinion that's going to be used in a court 2 case, you would review every interrogatory; isn't that 3 correct? 4 A I would request it; and if it was available, I 5 would certainly review it. 6 Q And an interrogatory is when one party to a 7 lawsuit asks another party to respond to written 8 questions, correct? 9 A That's correct. 10 Q In this case, you didn't review any 11 interrogatories, did you? 12 A Not that I -- no, I never received any. 13 Q And you also believe it's important to 14 interview people who are familiar with the plaintiff, 15 correct? 16 A If at all possible. 17 Q And prior to coming to your opinion that you 18 shared with us at your second deposition, you hadn't 19 interviewed any people who were familiar with 20 Mr. Destefano, had you? 21 A Not -- no. I received information after the 22 deposition. 23 Q Okay. And your normal practice is that when 24 you do a forensic case, you request and review the 25 patient's medical records; isn't that true? 2250 1 A Yes, if they are available. 2 Q In this case, you didn't receive or review any 3 of Mr. Destefano's medical records prior to formulating 4 your opinion, did you? 5 A Not prior to the deposition or prior to the 6 opinions given during that deposition. 7 Q Okay. And Mr. Osborne asked you about a 8 psychiatric report dated, I believe, it was August of 9 1981; do you recall that? 10 A Yes. 11 Q From the Navy? 12 A Yes. 13 Q You didn't review that prior to coming to your 14 opinion, did you? 15 A I did not have that, no. 16 Q That was provided to you by Mr. Osborne's 17 office? 18 A Yes. 19 Q How recently ago? 20 A Probably about two months ago. 21 Q Now, we talked about -- we were talking about 22 the tests, the personality -- psychological tests that 23 you administered to Mr. Destefano, and I believe that you 24 said that there were seven of those, correct? 25 A I believe seven, yes. 2251 1 Q Have you ever heard of the phrase "garbage in, 2 garbage out"? 3 A Sure. 4 Q Would you agree that these psychological tests 5 are only useful if the test taker tells the truth? 6 A No, I wouldn't. That is what garbage in, 7 garbage out means, but that's not necessarily -- there 8 can be a lot of information that can be obtained from 9 psychological tests, even if the -- the client is not 10 providing factual information. 11 For example, an individual may give 12 information that is not consistent with facts for a 13 couple of reasons. One is he may be intentionally being 14 deceptive. But a second reason could also be the 15 person's perception may not be based on reality, but it 16 doesn't mean that the person is not trying to be honest 17 in his or her responses. So that information is 18 important. 19 But, overall, again, psychological testing is 20 only one piece of data that I use in formulating an 21 opinion. But it certainly, you know, can be a useful 22 piece of information. 23 Q Well, would you agree that if the test taker 24 is intentionally being deceptive, that that can skew the 25 results of the test? 2252 1 A Sure, especially if I don't pick that up or if 2 the tests themselves don't pick them up. 3 Q So it's definitely important for you to pick 4 up where the test taker or patient is being untruthful? 5 A If one can be, certainly. 6 Q Would it also be fair to say that the validity 7 of the test depends on how accurately it is scored by you 8 or your personnel? 9 A Generally. I mean, there certainly can be 10 some errors in scoring, which wouldn't necessarily lead 11 to a different interpretation, but certainly, overall, 12 that would be an accurate statement. 13 Q Okay. I think you testified about this on 14 direct, that some of your patients who are involved in 15 court cases, whether it's criminal or civil, may have a 16 motivation to not be entirely truthful on these tests, 17 correct? 18 A That's true. 19 Q And that you need to ferret that out, so to 20 speak? 21 A Yes. 22 Q In the personal injury cases that you do for 23 the plaintiff's side or in a case like this where you 24 have a plaintiff who's involved in a defamation action, 25 you understand that they're trying to get money for their 2253 1 psychological damage, right? 2 A Yes. 3 Q So there might be a financial motivation to be 4 less than truthful when taking these tests, correct? 5 A Sure. 6 Q Now, some of the tests you administered have a 7 validity indicator, correct? 8 A Yes. 9 Q And a validity indicator is kind of a quality 10 control system, is it not, internal within the test? 11 A Yes. 12 Q And those are built-in questions that try to 13 detect if a person isn't being straight up with you, 14 right? 15 A Correct. 16 Q But not all of your tests have these validity 17 scores, do they? 18 A No, only the -- essentially the three major 19 personality tests that I give. 20 Q So three out of the eight have validity 21 indicators? 22 A Yes. 23 Q And so for the other five tests that don't 24 have validity scores, you just sort of have to take those 25 at face value and accept what the patient is telling you; 2254 1 is that correct? 2 A You accept what the patient is telling you, 3 and then you try the best you can to compare it with 4 whatever other data you have, either from clinical 5 interview or other collateral information. 6 Q And generally, that's pretty important, isn't 7 it? You have to look at the tests against each other and 8 then compare those to what he tells you in the personal 9 evaluation to come to your overall opinion? 10 A Correct. 11 Q Let me show you what came from your file, and 12 we'll mark this as Defendants' Exhibit -- is this No. 2? 13 And I see that you brought the original with you of the 14 PAR, correct? 15 A PAI, yes. 16 Q PAI, I'm sorry. Could you take a moment and 17 just verify that what the court reporter has marked as 18 Exhibit 2 is the same thing that you have the original of 19 in your files? 20 A Well, I'm not going to go through each item, 21 but assuming they have not been altered, yes, it's 22 similar. 23 Q Well, I want you to assure -- to look through 24 it and make sure that -- that you don't believe that 25 there's been any alterations? 2255 1 A Well, from an ethical standpoint, I would not 2 believe that these that have been in your possession 3 would have been altered, and certainly because there's 4 344 questions, just spot checking and looking at them 5 random, they're pretty consistent with what I've got. 6 Q Now, out of all your tests that you give, this 7 is one of -- one of the tests that you like to use the 8 most, right? 9 A The MMPI is probably my favorite, but this is 10 the second most. 11 Q Second most commonly used by you? 12 A Yes. 13 Q And so this is a pretty important test; is 14 that correct? 15 A It is. 16 Q And you relied on this test, did you not? 17 A To a degree. 18 Q In fact, this is one of the psychological 19 tests which suggested that you should consider 20 posttraumatic stress disorder as a potential diagnosis, 21 is it not? 22 A Yes. 23 Q And your ultimate opinion that you testified 24 to was that Mr. Destefano has posttraumatic stress 25 disorder features, correct? 2256 1 A That's right. But that wasn't from the test, 2 but the test certainly supported that as a possible 3 diagnosis. 4 Q And this is a multiple-choice test, right? 5 A Yes. It's a -- basically, an individual is 6 instructed to answer each question, one of four options 7 ranging from false, not at all true, to the other extreme 8 of very true and then there's slightly true and mainly 9 true in between. 10 Q So, for example, the first question says my 11 friends are available if I need them, and the test taker 12 has to indicate whether that statement is false, slightly 13 true, mainly true or very true, correct? 14 A That's correct. 15 Q Okay. Dr. Krop, maybe it's better if you just 16 get this out of your file, but I'd like you to pull out 17 the personality assessment inventory. 18 A I have that. 19 Q And let's have the court reporter mark that as 20 Exhibit 3, please. 21 And if you turn to the end of the report, page 22 10, these are the responses of Mr. Destefano to the 23 multiple-choice test that he took that we've marked as 24 Exhibit No. 2, correct? 25 A That's correct. 2257 1 Q And those are then fed in the computer and 2 your clinical interpretive report is produced based on 3 those responses to 344 questions; is that correct? 4 A That's correct. 5 Q Now, Dr. Krop, would you please take a look at 6 Question No. 49? 7 A I see it. It's marked -- it's marked 8 incorrectly on the item response. 9 Q Well, that wasn't my question, Dr. Krop. Can 10 you -- you're looking at Question No. 49. Did you find 11 that? 12 A Right. 13 Q And are you looking at Exhibit No. 2, which is 14 Mr. Destefano's original questionnaire that he filled 15 out? 16 A Right. 17 Q Okay. And the question is, I have visions in 18 which I see myself forced to commit crimes. Do you see 19 that statement? 20 A I do. 21 Q That's No. 49? 22 A Correct. 23 Q And Mr. Destefano indicated that that was 24 false, correct? 25 A That is correct. 2258 1 Q Let's have -- this is the second copy of this. 2 Let's go ahead and have that marked as Exhibit No. 4. 3 If you will, Dr. Krop, can you put a yellow 4 highlighted X by No. 49 as that's one that was 5 incorrectly scored; is that correct? 6 A Yes. 7 Q Okay. And you're doing that on Exhibit No. 4. 8 So you would agree that the report -- that the 9 personality assessment inventory is incorrect? 10 A No. I -- 11 Q Because? 12 A I would not agree that the report is correct. 13 No. 49 is listed at -- I would say that it's entered 14 incorrectly, but the report is not incorrect. 15 Q Okay. Well, 49 says that Mr. Destefano marked 16 49 as a false statement, correct? 17 A Correct. 18 Q And what got entered into the computer under 19 No. 49 was that he said it was very true; is that right? 20 A That's what's entered into the computer, yes. 21 Q So that was entered incorrectly? 22 A Correct. 23 Q It's an error? 24 A Yes. 25 Q All right. Now, did you check her work -- 2259 1 your technician's work? 2 A There is no way I can check her work. I 3 didn't go through each item to see whether she entered 4 each one incorrectly. What I did do is look through the 5 items that will come out under the -- the critical item 6 endorsement, and one of them is I have visions -- on 7 page 9, under "Potential Malingering" which is what that 8 particular item is designed for. 9 Number 49 is in the series or one of several 10 items which have to be answered in a certain way to 11 determine whether a person may be malingering. And under 12 the critical item endorsement, the item that was endorsed 13 under potential malingering as very true is I have 14 visions in which I see myself forced to commit crimes. 15 Now, that item is totally inconsistent with 16 anything that Mr. Destefano indicated to me during the 17 evaluation or anybody else's, plus his criminal history, 18 so I certainly dismissed that. 19 I have to be totally honest and say that I 20 didn't go back to see if that was entered incorrectly. I 21 had presumed that it was basically responded wrong by 22 Mr. Destefano in terms of that's inconsistent with 23 everything else. If you recall from my deposition, one 24 of the things that I indicated is that there -- not only 25 wasn't there evidence of malingering, but to the 2260 1 contrary, that problems with his response set was that he 2 tended to be overly defensive and try and downplay mental 3 health issues. 4 So I just took this particular item and 5 dismissed it because there was absolutely no other 6 evidence of malingering. 7 Q So the answer to my question that I asked was 8 that you did not go back and check your technician's 9 work, right? 10 A No. That is correct, I did not. 11 Q Let's look at Question No. 48, and that one 12 reads: I have to be alert to the possibility that people 13 will be unfaithful. Do you see that? 14 A Yes. 15 Q Mr. Destefano said that that was very true, 16 right? 17 A That is what he said, yes. 18 Q And if you look at No. 48 on the responses 19 that were fed into the computer, that says that -- what 20 was fed into the computer was that he answered false, 21 correct? 22 A Right. She reversed those items. 23 Q So that's another error, is it not? 24 A Yes. 25 Q Let's go ahead, and where we're keeping tally 2261 1 on Exhibit No. 4, let's highlight No. 48 as being wrong 2 also. So that's another mistake; would you agree? 3 A Yes. 4 Q Now, Question No. 53 states, it's easy for me 5 to make friends. Do you see that, No. 53? 6 A Yes. 7 Q And Mr. Destefano said that that was very 8 true, correct? 9 A That is correct. 10 Q And on 53 where your technician entered it 11 into the computer, she entered false, right? 12 A That's correct. 13 Q So that's another error? 14 A That is. 15 Q Let's highlight No. 53, if you would, please. 16 Now, 56, let's look at that one. It says: 17 I'm a natural leader. Mr. Destefano marked on his test 18 that that statement was slightly true, correct? 19 A That's correct. 20 Q And if you look at what your technician 21 entered into the computer, she entered that that question 22 was answered with false? 23 A That's correct. That's incorrect again. 24 Q So we have another error, correct? 25 A Yes. 2262 1 Q Okay. Would you please highlight No. 56 on 2 Exhibit No. 4? 3 Now, Question No. 57, this one says sometimes 4 I feel terribly empty inside, correct? 5 A Yes. 6 Q And how did Mr. Destefano answer that? 7 A Very true. 8 Q And how did your technician score it? 9 A Slightly true. 10 Q So that's another error, correct? 11 A To a degree, yes. 12 Q Let's highlight 57 as well as being in error 13 so that we can keep track of these. 14 Now, 58, that one reads, I tell people off 15 when they deserve it; is that correct? 16 A Yes. 17 Q What did Mr. Destefano mark? 18 A Slightly true. 19 Q And how did your technician score that? 20 A Very true. 21 Q So that would be another error, correct? 22 A It is. 23 Q Could we mark No. 58 on there, please? 24 I want you to look at No. 59, and that 25 question reads, I want to let certain people know how 2263 1 much they've hurt me. Am I reading that correctly? 2 A Yes. 3 Q And how did Mr. Destefano answer that? 4 A Very true. 5 Q And how did your technician score that? 6 A Slightly true. 7 Q Okay. So 59 is another error, correct? 8 A Correct. 9 Q All right. Let's highlight No. 59 on Exhibit 10 No. 4. 11 Now, Question No. 60 says, I thought about 12 ways to kill myself. Do you see that? 13 A Yes. 14 Q And how did Mr. Destefano answer that? 15 A He answered it false. 16 Q And how did your technician score that? 17 A Very true. 18 Q So that would be another error, correct? 19 A I mean, it's very obvious, if I may indicate, 20 that she -- what when she did enter this, she entered it 21 in terms of probably one being wrong and then all the 22 rest of them are going to be followed wrong. 23 Q Let's just keep going, Dr. Krop. You didn't 24 check her work, so you don't know what happened, did you? 25 A No. I'm looking at, though, the pattern that 2264 1 you're giving me now and I'm looking at the particular 2 items that are listed in the scoring as important, and 3 those are the critical item endorsement. 4 Q Dr. Krop, you're just speculating about what 5 happened and how these got misentered, are you not? 6 A I can only do that. 7 Q Let's mark No. 60 on the test as being 8 incorrect as well. 9 Okay. Now, let's look at No. 63. It says, I 10 never used drugs to help me cope with the world. Do you 11 see that? 12 A Yes. 13 Q And how did Mr. Destefano answer that? 14 A Very true. 15 Q And how did your technician score that? 16 A False. 17 Q Okay. Let's mark that one as another error. 18 That was 63. 19 Now, 66 says, I have exaggerated fears. Do 20 you see that? 21 A Correct. 22 Q And how did Mr. Destefano answer that? 23 A False. 24 Q And how did your technician score that? 25 A Very true. 2265 1 Q Okay. So that would be another error, 2 correct? 3 A That's correct. 4 Q So let's circle No. 66. 5 Now, Question No. 72 says, I suffer from a lot 6 of pain, correct? 7 A Yes. 8 Q And how did Mr. Destefano answer that on his 9 questionnaire? 10 A Very true. 11 Q And how did your technician score that? 12 A False. 13 Q So that's an error? 14 A Sure. 15 Q So 72 is an error, so we can highlight that 16 one. 17 Now, 73 states, I worry so much that at times 18 I feel like I am going to faint. Do you see that? 19 A Yes, I do. 20 Q And how did Mr. Destefano answer that? 21 A False. 22 Q And how did your technician score that? 23 A Very true. 24 Q So that's another error in scoring, correct? 25 A That is correct. 2266 1 Q Now, No. 75 says that I have no trouble 2 falling asleep. Do you see that? 3 A Yes. 4 Q And how did Mr. Destefano answer that? 5 A Mostly true. 6 Q And how did your technician score that? 7 A False. 8 Q So that's another error? 9 A Yes. 10 Q So let's circle that one. 11 Now, Question No. 76 says, I get quite 12 irritated if people try to keep me from accomplishing my 13 goals. Do you see that? 14 A Yes. 15 Q And how did Mr. Destefano answer that? 16 A Slightly true. 17 Q And how did your technician score that? 18 A Mostly true. 19 Q So that would be another error? 20 A Correct. 21 Q All right. Let's go ahead and circle that 22 one. 23 Now, Question 77 says, I seem to have as much 24 luck in life as others do. Am I reading that correctly? 25 A That's correct. 2267 1 Q And how did Mr. Destefano answer that? 2 A Mostly true. 3 Q And how did your technician score that? 4 A Slightly true. 5 Q So that would be another error, correct? 6 A Yes, ma'am. 7 Q All right. Let's go ahead and highlight that 8 one. 9 Number 78 states, my thoughts get scrambled 10 sometimes. Do you see that? 11 A Yes. 12 Q How did Mr. Destefano answer it? 13 A False. 14 Q How did the technician score it? 15 A Mostly true. 16 Q So that one's wrong also, correct? 17 A That's correct. 18 Q Let's circle that one or highlight that one, 19 please. 20 Now, Question No. 80 states that sometimes I 21 get ads in the mail that I don't really want. Do you see 22 that? 23 A Yes. 24 Q And how did Mr. Destefano answer that? 25 A Very true. 2268 1 Q How did your technician score that? 2 A False. 3 Q So that's another error? 4 A It is. 5 Q All right. Number 83 says, I have had 6 numbness in parts of my body that I can't explain. Do 7 you see that one? 8 A I do. 9 Q And how did Mr. Destefano answer that? 10 A False. 11 Q How did your technician score that? 12 A Very true. 13 Q So that would be another error? 14 A Correct. 15 Q Let's circle that one. Question No. 88 says, 16 most people have good intentions. Do you see that? 17 A Correct. 18 Q And how did Mr. Destefano answer that? 19 A Very true. 20 Q How did your technician score that? 21 A Which number are we talking about? 22 Q 88. 23 A False. 24 Q Okay. So that's another error? 25 A It is. 2269 1 Q And No. 89 says that since the day I was born, 2 I was destined to be unhappy. And how did Mr. Destefano 3 answer that question? 4 A False. 5 Q And how did your technician score that 6 question? 7 A Very true. 8 Q So that would be another error, correct? 9 A That is correct. 10 Q Let's highlight that one. 11 So they are hand scored rather than fed 12 through the computer, correct? 13 A That's correct. 14 Q And you haven't checked that work either, have 15 you? 16 A No. I do rely on my assistant rather than 17 going through every single item to assess that. 18 Q But do you look at -- would you agree that 19 it's important to look at consistency among the test 20 responses? 21 A Sure. 22 Q And is it also important to compare the 23 individual's test responses with their real life 24 responses and behavior? 25 A That's correct. 2270 1 Q Now, have you looked at Mr. Destefano's 2 answers to these written questions to determine if he's 3 consistent in what he reported to you in your personal 4 interview? 5 A I can't say that I've checked every single 6 response to that. I look at the overall profile to see 7 if that's consistent with what he reports in the 8 interview. And, for example, if I may -- and I'm not 9 going to go over every item, but the ones that you chose, 10 for example, and I have to accept full responsibility for 11 this and not my technician since it's -- it's my testing 12 and my interpretation. But if you go over the items that 13 you picked out, and there may be more, I don't know 14 whether you just picked those out as samples, but in 15 every one of them, his actual responses were certainly 16 more consistent with what came across during the clinical 17 interview and consistent with the rest of the data from 18 the other evaluations as well as the rest of my 19 evaluation. 20 Q Okay. Well, let's look at that for a minute 21 and see how those consistencies play out. Now, on the 22 one that you're looking at, which is Exhibit No. 2, I 23 think that's the original. I want you to turn to page -- 24 Question 75. And the question states, I have no trouble 25 falling asleep. Do you see that? 2271 1 A Yes. 2 Q And Mr. Destefano answers that one as mainly 3 true, right? 4 A Yes, that is correct. 5 Q So that would indicate that he does not have a 6 lot of trouble falling asleep, correct? 7 A Some of the time. Most of the time he has no 8 trouble falling asleep, which would conversely indicate 9 that sometimes he does. 10 Q Okay. He says that that is a mainly true 11 statement that I have no trouble falling asleep, right? 12 A Yes, that's correct. 13 Q Now, let's look at the notes that 14 Mrs. Rutledge generated during her part of the interview 15 with Mr. Destefano. And let's go ahead and mark those as 16 the next exhibit, No. 5. 17 Now, if you will, please, Dr. Krop, please 18 turn to the last page of her notes under 19 "Sleep/Appetite." Do you see that? 20 A I'm not sure where you're at. 21 Q Last page of her notes. 22 A I may not have that in order. 23 Q Sleep/appetite. Can you read what she writes 24 about that? 25 A "Mr. Destefano described his sleep to her as 2272 1 terrible, as he said he had difficulty going to sleep, 2 but noted that once he goes to sleep, he could do so for 3 an extended period of time." 4 Q Now, would you agree with me, Dr. Krop, that 5 what Larry Destefano reported to Ms. Rutledge is 6 inconsistent with how he answered Question 75 on the 7 personality assessment inventory? 8 A Yes. 9 Q Now, let's look at the Beck's Depression 10 Inventory, if we could, please. Do you have that in 11 your -- do you have that in your file? 12 A I should. 13 Q And let's go ahead and mark that as the 14 Exhibit No. 6, please. 15 Now, Dr. Krop, could you please tell me how 16 Mr. Destefano answered Question No. 21 on the Beck's 17 Depression Inventory? 18 A Are you -- 21 is what you're asking me? 19 Q Yes, sir. 20 A That's loss of interest in sex. 21 Q "I have lost interest in sex completely," 22 correct? 23 A Correct, yes. 24 Q And now look at Mrs. Rutledge's notes under 25 "Marital/Living." And if you go to the second page of 2273 1 her notes, it says: "He describes his sexual interludes 2 with his significant others as active and gratifying. He 3 denies ever experiencing any sexual dysfunctions or other 4 sexually related problems." Do you see that? 5 A I do. I believe he was talking about past 6 history in providing the history. And, again, let me 7 clarify two things. Number one, the testing was done on 8 a different day than the history was taken. And what the 9 Beck's asks is -- the Beck Inventory asks for how one is 10 feeling during the past two weeks, including today; 11 whereas, Ms. Rutledge evaluated him on August 26, which 12 was, I believe, several months -- at least two months 13 after the psychological testing was done. And that would 14 hold true both for sleep as well as any of the other 15 depression indicants. 16 Q Dr. Krop, if you could just review the 17 instructions on the -- on the BDI-2, it does not 18 specify -- oh, I'm sorry, during the past two weeks. 19 That one does specify the two weeks. 20 Now, on the -- let's go to the MMPI-2. Do you 21 recall that test? 22 A Certainly. 23 Q Okay. Let's go ahead and pull out the -- if 24 we could go ahead and pull out the -- that MMPI-2. Do 25 you have that? 2274 1 A I do. 2 Q Let's go ahead and mark that one as the next 3 exhibit, which is No. 7. 4 Now, Dr. Krop, this was the one that you 5 refused to give us the questions to, right? 6 A I don't remember. I probably would have -- 7 Q Because -- 8 A -- refused. 9 Q -- you said that that was copyrighted and you 10 couldn't let us -- you couldn't share with us what the 11 actual questions were that were being asked; is that 12 correct? 13 A I indicated that the information is available 14 from another mental health professional. 15 Q And it's also contained in the manual for 16 administration, scoring and interpretation of the MMPI-2; 17 is that correct? 18 A It may be. 19 Q Do you recognize this as an authoritative 20 text? 21 A It's Butcher and Graham, so, yes, I would 22 accept that. 23 Q If you could please turn to where I have a 24 tab, and could you read Question No. 12 for us? 25 A "My sex life is satisfactory." 2275 1 Q And could you please tell us how Mr. Destefano 2 responded to that question on the MMPI-2, please? 3 A He indicated true. 4 Q So he indicated to you or on the MMPI that his 5 sex life was satisfactory, correct? 6 A Yes. 7 Q Okay. Now, on Question No. 166 of the MMPI, 8 could you tell us what that question is? 9 A "I am worried about sex." 10 Q And what does he answer there? 11 A False. 12 Q So he's not worried about sex, right? 13 A Not -- his choices are true and false, and he 14 indicated false. 15 Q Okay. Would you agree that the way that he 16 answered the questions in the MMPI-2, as well as what he 17 told Ms. Rutledge, is inconsistent with how he answered 18 the question on the Beck's Depression Inventory about 19 loss of interest in sex? 20 A No. I don't think they're necessarily 21 inconsistent. They're talking -- one is talking about 22 general satisfaction, again, true or false. And what 23 he's telling Ms. Rutledge, again, in describing his past 24 history of sexual relationships, they have been 25 satisfactory. He also indicated that he has never had 2276 1 any sexual dysfunction. 2 This item, which at least that he answered in 3 June, was that I have lost interest in sex completely. 4 That does not necessarily contradict some of the other 5 items with regard to his sexual history. 6 Q Okay. Mr. -- are you aware that Mr. Destefano 7 is claiming that he's become impotent as a result of 8 these allegations? 9 A He did not report that to me at the time that 10 I evaluated him a year ago. 11 Q Okay. And I believe that when you were -- 12 when we had your deposition in September, you 13 specifically said that you had requested all of his 14 depositions; is that correct? 15 A All of his depositions? 16 Q Yes. 17 A As far as I know, I did receive his 18 depositions. 19 Q And did you read them? 20 A I did. 21 Q Okay. And do you recall that he is claiming 22 that he has become sexually impotent as a result of these 23 allegations? 24 A May I have a moment -- 25 Q Sure. 2277 1 A To the question -- 2 Q Let's look at page 610 -- 609 and 610. 3 A Right, uh-huh. Was asked about various -- 4 starting with 605, he was asked about different symptoms, 5 and on 610, he indicates that he has been impotent on a 6 total basis but had not reported it to anyone. 7 Q And he did not report that to you either, did 8 he? 9 A No. 10 Q And in the MMPI-2, he reports that he's 11 completely satisfied with his sex life, right? 12 A That's correct. 13 Q Now -- 14 A Well, he didn't say he was completely 15 satisfied. He answered it true as opposed to false. It 16 doesn't have the kind of gradations that the other tests 17 have. 18 Q All right. Now, in the childhood history of 19 Ms. Rutledge, her summary of her interview, could you 20 please turn to that? 21 A I have it. 22 Q Okay. And in the third sentence from the 23 bottom under childhood history, she indicates that aside 24 from behavioral problems at school, Mr. Destefano denies 25 presenting as a management problem, noting he was 2278 1 respectful of rules and authority. Do you see that? 2 A When he was younger, yes. 3 Q And isn't that inconsistent with your 4 assessment of Mr. Destefano after having a personal 5 interview with him? 6 A I don't remember that that's inconsistent with 7 what he told me at school. He said he had behavioral 8 problems at school. What -- I'm sorry. You may need to 9 ask me an additional question. 10 Q Isn't what he told Mrs. Rutledge inconsistent 11 with what he -- what you found him to be, which was 12 rebellious, and has had conflicts with individuals who 13 tell him what to do? 14 A Well, again, we're talking, and he's referring 15 to respectful of rules and authority when he was younger. 16 Clearly, given the information that I have reviewed, and 17 his own self-report, my own assessment of him, he has 18 been rebellious and has had difficulty with authority, 19 certainly from at least teenage or young adulthood on. 20 Q So what he reported to Ms. Rutledge that he 21 was respectful of rules and authority was inconsistent 22 with what you found to be his personality; is that 23 correct? 24 A No. We're talking about as a child, he 25 reported that he was respectful of rules and authority. 2279 1 He also admitted that he had behavioral problems in 2 school. 3 What I reported is the behavior that I was 4 aware of from early adulthood on. So we're talking about 5 two different time periods in terms of his -- the way he 6 reacts to authority. So I don't see the inconsistency 7 there. 8 Q Do you have a copy of your deposition with 9 you? 10 A I do, somewhere. 11 Q Do you want me to get that? And do you want 12 to stop? Okay. We have to change tapes. 13 THE VIDEOGRAPHER: Off the record, 3:45 p.m. 14 MR. OSBORNE: Let's take a five-minute break 15 too. 16 THE VIDEOGRAPHER: On the record, 3:52 p.m. 17 BY MS. MARSHALL: 18 Q Dr. Krop, if you would turn to page 41 of your 19 deposition of September 28th, 2004. And specifically, on 20 page 40, I had asked you the question, what are the 21 traits that we are talking about specifically and which 22 ones have been exacerbated; do you see that? 23 A I do. 24 Q And you state that I think the obsessive 25 features, again, I would certainly not diagnose him, 2280 1 diagnose him as obsessive compulsive, either personality 2 or obsessive-compulsive disorder, but he certainly has 3 obsessive traits. 4 And then you go on to say, I think some of his 5 sort of rebellious -- and I'm not sure that that -- if 6 that's considered a personality trait, certainly when he 7 was younger, I think he was somewhat -- somewhat 8 rebellious. I think that there are certain conflicts 9 that he has with individuals who try to tell him what to 10 do when he, in fact, if he, in fact, does not perceive 11 that to be either correct or fair or just; do you see 12 that? 13 A Yes. 14 Q Now, is that inconsistent with his 15 self-reporting that he was respectful of rules and 16 authority? 17 A It's not necessarily inconsistent. Basically, 18 he admitted to being a behavior problem in school, which 19 is consistent with what I talked about in terms of 20 rebelliousness. But in school, he indicated that he 21 followed, when he was much younger, the rules and did not 22 necessarily conflict with authority figures. But 23 certainly at some point as he got older, he became even 24 more rebellious than he was when he was younger. So I 25 don't see where that's necessarily inconsistent or 2281 1 contradictory. 2 The other issue is he really wasn't in school 3 a lot. He was home schooled for some of that time and 4 doesn't even remember being in school on a consistent 5 basis, so he really didn't have a lot of that 6 opportunity. 7 Q Okay. Dr. Krop, on his educational background 8 that Ms. Rutledge took that we've been looking at, I 9 believe that's on the third page? 10 A Yes. 11 Q Okay. And he says, and she states, the 12 defendant states that he, quote, honestly, close quote, 13 doesn't believe he went to school, although he notes he 14 believes he remained in school during his elementary 15 years. Do you see that? 16 A Right. 17 Q Do you -- isn't that unusual for somebody of 18 Mr. Destefano's age not to remember whether he went to 19 school or not? 20 A Well, he believes that he didn't go to school. 21 I don't know -- if, in fact, he didn't go to school, then 22 he's correct in his memory. He does say that when the 23 family relocated, he attempted junior high school but 24 admits he did not consistently attend and that he felt 25 that, quote, I was disconnected and basically at some 2282 1 point ended up being home schooled. 2 Q Okay. Now, Mr. Destefano conveyed to you that 3 when he was in the military, he was busted because of 4 disrespect; isn't that true? 5 A Yes. 6 Q And that's certainly inconsistent with 7 respecting rules and regulations, right? 8 A Correct. He's not -- he's not denying that as 9 an adult. 10 Q And Dr. Krop, what we're getting at is you've 11 relied upon a lot of information that Mr. Destefano 12 conveyed to you or to Ms. Rutledge in your interviews, 13 correct? 14 A That's correct. 15 Q And you've also said that it's your job to 16 detect whether there's any inconsistencies between what 17 he self-reports and what he reports on the tests; is that 18 correct? 19 A To the best that I can, yes. 20 Q Okay. Now, let's turn your attention to 21 question 299 on the PAI test, please. It's Exhibit 22 No. 4. That question states: My anger never gets out of 23 control. Did I read that correctly? 24 A You did. 25 Q And how did Mr. Destefano answer that? 2283 1 A Very true. 2 Q Okay. So in that question, he's saying that 3 his anger doesn't get out of control, very true, right? 4 A That's his perception. 5 Q Okay. And did you review that answer for 6 consistency with his real life behavior? 7 A Well, his real life behavior, that is 8 inconsistent. I's not inconsistent, though, with his 9 perception that, that he feels that if his anger got out 10 of control, perhaps he would -- he could be potentially 11 violent, and that's not what his perception is. 12 Q Basically, his perception is different than 13 reality, is it not? 14 A With regard to his anger and how he defines 15 being out of control, perhaps, but not -- it's not 16 inconsistent with reality. 17 Q Okay. We were back on the -- we had -- I 18 think it was Exhibit No. 1 or 2 which had your intake 19 sheet. Exhibit No. 1. 20 A Yes. 21 Q Okay. And on the third sheet of Exhibit No. 1 22 are some of your handwritten notes from that very first 23 day that you saw Mr. Destefano, right? 24 A Yes. 25 Q And can you read what your notes say starting 2284 1 with the last paragraph, Larry noted? 2 A Larry noted, and this is a quote, I want to 3 explain that I'm very angry, and I want you to know that 4 if I lose my temper, it's not personal. 5 Q Now, is that -- is that quote from Larry 6 consistent or inconsistent with his statement and his 7 answer to Question 299 on the PAI that my anger never 8 gets out of control, very true? 9 A Well, he didn't lose control during the two 10 times that I saw him, so I guess it's consistent with 11 what I've seen. And again, it's consistent with his 12 perception. Again, his perception of what's out of 13 control may differ from what we may define in terms of 14 out of control. 15 Q Dr. Krop, he was warning you, a person that he 16 had never met before, that he's very angry, and he wanted 17 you to know that if he lost control, lost his temper, 18 it's not personal, right? 19 A That's correct. 20 Q Is that consistent with somebody who 21 self-reports themselves as being someone who never lets 22 their anger get out of control? 23 A Again, Counsel, I'm not denying that this man 24 could certainly have a temper. What he defines as out of 25 control is being violent and aggressive. What other 2285 1 people may define as out of control may be very different 2 than that. 3 Q Okay. Mr. Krop, or Dr. Krop, could you turn 4 to your handwritten note from the October or the August 5 26th, 2004 meeting that you had with Mr. Destefano? And 6 we'll just go ahead and mark those as the next exhibit, 7 please. And if you could read what is -- what you have 8 written in the right-hand corner on the first page of 9 your notes. 10 A These are what I refer to as my behavioral 11 observations. They're just notes as I go along during 12 the interview. 13 I indicated that he was concerned about what I 14 was saying; in other words, what I was writing in the 15 report or taking notes. He verbalized extreme rage 16 directed at the defendants. I said he had good insight 17 as to how I heard individuals come in and deny and deny, 18 which is not unusual for a forensic evaluation, and he 19 recognized that I might not accept at face value what he 20 was telling me. 21 Q Okay. And that extreme rage is something that 22 you personally observed, correct? 23 A From a content standpoint. 24 Q Okay. And on the second paragraph, you also 25 note that he's doing it out of rage, correct? 2286 1 A In terms of the -- in terms of the lawsuit, 2 yes. 3 Q The litigation -- 4 A Yes. 5 Q -- is out of rage? 6 A Yes. 7 Q And would your personal observations of 8 Mr. Destefano and his description of this rage be 9 consistent or inconsistent with somebody who self-reports 10 that my anger never gets out of control? 11 A I think it's inconsistent. Again, I think 12 it's important to -- since you've read my notes here, if 13 I can add what the following statement is. He said that 14 I can't call them out to a duel. I don't want it to 15 happen -- I didn't finish the sentence, but I don't want 16 it to happen to anybody else. 17 So he felt that by pursuing this litigation, 18 despite the amount of time and effort and perhaps 19 finances this is costing, he felt that this was the 20 appropriate and it was way to deal with his rage. 21 Q My question was whether what you observed, 22 personally observed as to his rage, was consistent or 23 inconsistent with somebody who self-reports that my anger 24 never gets out of control -- 25 A Yes. 2287 1 Q -- as a very true statement? 2 A It's consistent with his statement that he 3 does not perceive that he lets his anger get out of 4 control, that he tries to handle it in an appropriate 5 manner. 6 Q Now, another test that you gave Mr. Destefano 7 on that day was the Beck's Anxiety Indicator, correct? 8 A Beck Anxiety Inventory. 9 Q Inventory, I'm sorry. 10 A That's all right. 11 Q Did you find that one? 12 A I do. 13 MS. MARSHALL: Let's go ahead and mark that as 14 the next exhibit. 15 Q Now, this test is a test to measure or detect 16 anxiety levels, correct? 17 A During the past week. It says self-report, 18 measure of symptoms, usually associated with anxiety. 19 Q And the No. 4, can you tell us how 20 Mr. Destefano answered that one? 21 A He indicated that -- 22 Q And what is that one first? Would you read it 23 please? 24 A Unable to relax, and he said that severely 25 bothers him. 2288 1 Q Severely -- I could barely stand it, correct? 2 A Correct. 3 Q Now, on the same day he took the PAI test, 4 correct? 5 A Yes. 6 Q And if you can get that test and look at 7 No. 164 of the PAI test, please. 8 A The question -- 9 Q Did you find that one? 10 A -- yes. 11 Q It says that I am a very calm and relaxed 12 person? 13 A Yes. 14 Q Correct? And how does Mr. Destefano answer 15 that one? 16 A Very true. 17 Q Okay. And doesn't this suggest to you that 18 Mr. Destefano was not being totally truthful when he 19 answered the BAI test as being so unable to relax that he 20 could barely stand it, and then on the PAI test, he says 21 he's a very calm and relaxed person? 22 A Not necessarily inconsistent. Contentwise, 23 yes. But the BAI reflects this past week, and the PAI is 24 a more general kind of response. So it's certainly 25 possible, and again, since I don't know specifically what 2289 1 was happening the week before he came in to see me, 2 again, I did not do an interview, I can only surmise from 3 his response that that particular week was a bad week for 4 him. 5 Q Okay. He was taking the BAI and the PAI on 6 the same day, right? 7 A Yes. 8 Q You didn't instruct him that there were 9 different rules for answering the questions, did you? 10 A Well, the instructions are different. One 11 just asks more general, and the other one specifically 12 asks for including today as well as the past week. So in 13 his perception, that might be a difference. That might 14 not necessarily mean they're inconsistent or 15 contradictory. 16 Q But as of the day that he took the PAI test, 17 he reports on Question 164 that he was a very calm and 18 relaxed person, correct? 19 A Yes. 20 Q And that's very true according to 21 Mr. Destefano? 22 A Correct. 23 Q And then on his BAI, he has reported that he 24 is so unable to relax that he can barely stand it, 25 correct? 2290 1 A During the past week or the day that he was 2 taking the evaluation. 3 Q Okay. Now, one of the other tests you gave 4 him is called the Mooney Problem Checklist; is that 5 correct? 6 A Yes. 7 Q All right. Let's -- if we could go to that, 8 and if we could have that marked as the next exhibit, 9 please. This one will be marked as No. 10. 10 Now, the Mooney Problem Checklist is a list of 11 288 possible problems that a person may have, correct? 12 A Correct. 13 Q And Mr. Destefano was asked to go through 14 those problems and underline the problems that he had, 15 right? 16 A Correct. 17 Q And then he's supposed to go back and circle 18 the most serious ones, right? 19 A Yes. 20 Q And then at the end, there is an opportunity 21 or I should say it's a request in part of the directions 22 that he write in written answers to these questions, 23 correct? 24 A Yes. 25 Q And the first question is use the space below 2291 1 to indicate any additional problems that you may have. 2 And what does he write? 3 A Nothing. 4 Q Now, on the answer to No. 2, write a brief 5 summary of what you consider to be your chief problems, 6 and what does he write? 7 A Nothing. 8 Q And No. 3 asks would you like to talk to 9 somebody about your problems, and what does he indicate? 10 A Nothing. 11 Q Now, if you could go back to Ms. Rutledge's 12 typewritten notes of August 26, 2004, please, and if you 13 could go to page 6. 14 A What's the subheading on that? I don't have 15 them numbered. 16 Q Well, it's actually the -- it's in the middle 17 of another heading. And page 6 it has mental status 18 evaluation. Do you see that? 19 A Yes. 20 Q And the last sentence right above that section 21 says: Mr. Destefano has never suffered with a sexually 22 transmitted disease, correct? 23 A Correct. 24 Q And is that what he reported to Ms. Rutledge? 25 A Apparently. 2292 1 MS. MARSHALL: Okay. And let's go ahead and 2 have these marked as a composite exhibit. 3 Q Now, Dr. Krop, we talked about before that in 4 your normal practice, you would want all of the medical 5 records from a patient, correct? 6 A If they are relevant, I would prefer to have 7 them. 8 Q And you were not provided with any medical 9 records of Mr. Destefano, were you? 10 A No. 11 Q Okay. Could you turn, please, to the first 12 tabbed document that is part of No. 11. Is gonorrhea a 13 sexually transmitted disease? 14 A Yes. 15 Q Does it appear from this record of medical 16 care that Mr. Destefano was diagnosed with gonorrhea 17 while he was in the Navy? 18 A Yes. I'm not sure what the first word is, but 19 I would presume so. 20 Q Okay. So had you reviewed the medical records 21 and then reviewed what he reported to Ms. Rutledge, you 22 would see that he had been less than truthful in 23 reporting whether or not he had suffered from a sexually 24 transmitted disease, right? 25 A I would say that it was inconsistent with his 2293 1 history. I don't think that it's fair to necessarily say 2 that he was being less than truthful. There are -- there 3 are things certainly that an individual in responding 4 does not remember, and based on his overall report, he 5 certainly wasn't necessarily downplaying things in his 6 history, from what I know. But I will give you that it's 7 certainly not consistent with his medical records. 8 Q Now, under Ms. Rutledge's notes regarding 9 psychiatric/psychological, which would be on the 10 preceding page from the one you were just looking at. Do 11 you see that section? 12 A Yes. 13 Q Could you read what it says, please? 14 A Mr. Destefano reports he has never come to the 15 attention nor has he been under the care of a mental 16 health professional. 17 Q Other than the evaluations related to the 18 litigation, correct? 19 A That was my handwriting, yes. 20 Q Okay. 21 A Based on my follow-up interview with him. 22 Q So when you talked to him, he said, I've never 23 seen a psychiatrist or psychologist in my life? 24 A That's what he inferred, yes. 25 Q Okay. And you know based on the information 2294 1 that Mr. Osborne recently provided you that that's not 2 true, don't you? 3 A Correct. 4 Q So, again, this is an instance where his 5 self-reporting is not consistent with reality, correct? 6 A It's not consistent with his history. I don't 7 know if reality -- again, it may be that he did not view 8 an examination in the Navy as a psychiatric or a 9 psychological evaluation, but certainly his report is 10 inconsistent with what we know in terms of the records. 11 Q Okay. Let me reask it then. Mr. Destefano 12 did not disclose to you his psychological evaluation that 13 he had had when he was in the Navy; is that correct? 14 A That's true. 15 Q And you specifically asked him about it, did 16 you not? 17 A Yes. 18 Q Okay. Now, do you have a copy of -- well, a 19 copy of that is contained within Exhibit No. 11 of the 20 psychiatric exam? It's under the second or third tab or 21 you can pull it out of your stuff. 22 A I probably have my own. 23 Q Did you find it? 24 A Yes. 25 Q Does it appear to you, Dr. Krop, that 2295 1 Mr. Destefano was diagnosed with an adjustment disorder 2 with disturbance conduct back in June of 1981? 3 A He was. 4 Q And did he disclose that to you when you 5 examined him in August of 2004? 6 A I'm not sure he knew what his diagnosis was. 7 He told me that he got a bad conduct discharge from the 8 military and that he had been busted in the military. 9 But he did not tell me what a diagnosis was, and I'm not 10 sure he actually knew that. 11 Q Okay. And is it also true from your review of 12 that psychiatric evaluation that was in his Navy medical 13 records that he was also diagnosed with passive 14 aggressive/aggressive personality disorder? 15 A Correct. 16 Q And isn't it true that Mr. Destefano did not 17 tell you about that diagnosis either? 18 A I really doubt -- I've worked at the VA a long 19 time. 20 Q Mr. Krop, can you answer my question? 21 A Well, I'd like -- 22 MR. OSBORNE: Mr. Krop, go ahead and finish 23 your answer before you were interrupted, please. 24 A He didn't tell me, but again, I'm not sure he 25 actually knew what his diagnosis was. I doubt it very 2296 1 much. 2 Q Okay. Dr. Krop, you're not speculating about 3 what is or is not inside Mr. Destefano's mind, are you? 4 A Well, you're asking me to speculate to some 5 degree. 6 Q No. 7 A But I would say that my experience in working 8 at the Veteran's Administration and reading a lot of 9 psychiatric evaluations is that it is very rare for an 10 individual to be given feedback as to what his diagnosis 11 was. 12 Q Dr. Krop, my question was did he tell you? 13 A No. 14 Q Okay. Now, we've talked a little bit about 15 the fact that you wanted to review all of the depositions 16 in this case, correct? 17 A Yes. 18 Q And you did receive Mr. Destefano's deposition 19 and you did review it ultimately, correct? 20 A Correct. 21 Q Okay. Now, let's go to Question 181 on the 22 PAI, please. 23 A I have it. 24 Q Can you read what that says, please? 25 A I've threatened to hurt people. 2297 1 Q And how does Mr. Destefano answer that? 2 A False. 3 Q Okay. Can you turn to page 124 of 4 Mr. Destefano's deposition? 5 A I'm not sure if I have page 124. I have 6 excerpts from it in my notes. It would be easier if you 7 gave me yours. 8 Q Okay. Now, on page 124 of his deposition, 9 Mr. Destefano was asked if he told Ted Hamilton, do you 10 know what I do everyday, Ted? I look for you, Ted. I'm 11 looking for you. I go to Sam Snead's and to Houston's. 12 If I find you, I'm going to hurt you. Ted, you made a 13 mistake when you asked about my mother after she died. 14 I'm going to fucking hurt you, Ted. I'm going to fucking 15 hurt you, Ted. 16 Do you see that question being asked of 17 Mr. Destefano? 18 A Yes. 19 Q Okay. And can you tell me what his answer was 20 on line 21? 21 A He agreed or admitted that he had said that to 22 Dr. Hamilton. 23 Q Okay. And Dr. Krop, would you consider that 24 to be a threat to Mr. Hamilton? 25 A Certainly. 2298 1 Q Dr. Hamilton? 2 A Yes. 3 Q And on his test in his self-reporting, he says 4 that he has never threatened anybody, correct? 5 A That's correct. 6 Q Would you agree with me, Dr. Krop, that 7 Mr. Destefano might have been less than truthful when he 8 answered Question 181 on the PAI test? 9 A Yes. 10 Q I want to switch directions a little bit and 11 talk about the MMPI-2. And I think we've already marked 12 that as an exhibit. If you could pull that out and take 13 a look at it. 14 And we talked a little bit before about 15 validity indicators. Do you remember that discussion? 16 A Yes. 17 Q And on the MMPI-2, there are actually several 18 different types of validity scales, correct? 19 A Correct. 20 Q And actually, if you look at the -- look at 21 the test, the first eight scales are actually validity 22 indicators, correct? 23 A Of one type or another, yes. 24 Q And when scoring this test, you only 25 calculated scores for three of the eight validity 2299 1 indicators, correct? 2 A I did. 3 Q And you did not calculate or have your staff 4 calculate the TRIN indicator, correct? 5 A No. I did not feel that it was necessary 6 given the results of the other three major validity 7 scales. There was no data from those scales that the 8 testing would not be valid. 9 Q Okay. And the TRIN scale was developed to 10 identify persons who respond inconsistently to items by 11 giving a true response to questions indiscriminately, 12 right? 13 A Yes. 14 Q And you didn't believe that validity indicator 15 was necessary? 16 A I didn't, again, mainly because he did not 17 seem to me, on the basis of the F scale, did not seem to 18 be exaggerating, and that to the contrary, there was some 19 defensiveness noted, but still it was a valid profile. 20 But I did not score the other one. 21 Q And you also didn't utilize the S scale, which 22 would have been an additional validity indicator, 23 correct? 24 A Could be, yes. 25 Q And the S scale was developed to assess 2300 1 tendencies of some people to present themselves as highly 2 virtuous, responsible individuals who are free of 3 psychological problems and have few or no moral flaws; is 4 that right? 5 A It was originally designed to be a 6 supplementary defensiveness scale. If the K scale or the 7 L scale suggested that the person was highly defensive, 8 the S scale was sort of a -- tended to break down why the 9 person or what kind of items the person would be 10 defensive in. 11 Q On the MMPI-2 test, Mr. Destefano scored the 12 highest on the hypochondriasis scale and the hysteria 13 scale, correct? 14 A Yes. 15 Q And the hypochondriasis scale identifies 16 people who are preoccupied with fears of physical illness 17 and disease, right? 18 A Yes. You're murdering the pronunciation, but 19 that's okay. 20 Q That will not be the first time. You're lucky 21 you have a short name because I haven't misprounced that 22 yet. 23 A Okay. 24 Q And then hysteria scale identifies people who 25 have hysterical reactions to stress situations, right? 2301 1 A That they -- that's a general way of 2 interpreting that scale. 3 Q And he scored high on that scale, did he not? 4 A Yes. 5 Q Now, the next two scales that he scored -- the 6 next highest that he scored on the MMPI were the 7 psychopathic and the schizophrenia scales, correct? 8 A Well, they're one point over the -- they are 9 the higher, yes, but they're one point over the clinical 10 line. 11 Q Well, the clinical line is -- is 65, correct? 12 A Correct. 13 Q And on both of those, he scored a 66? 14 A Yes. 15 Q So they have clinical significance since 16 they're over the 65 level, correct? 17 A They could. And if you -- it would be more 18 appropriate to interpret, though, since there are other 19 scales that are significant in terms of their elevation, 20 that those are much more important in terms of 21 interpretation. But I do look at the -- the other items 22 that are relatively high, if I gave an overall 23 interpretation, which I did in my report. 24 Q Now, the psychopathic deviant scale identifies 25 individuals who have difficulty incorporating the values 2302 1 and standards of society, right? 2 A Yes. Again, that's a very general statement, 3 but that is accurate. 4 Q Okay. And the schizophrenia scale identifies 5 people with disturbances of thinking, mood and behavior, 6 right? 7 A If it's significantly elevated, that's a 8 general statement and description of the scale, you're 9 correct. 10 Q Okay. And people with -- who register high or 11 above the clinically significant level could be diagnosed 12 or identified as misinterpreting reality, correct? 13 A If it's significant. 14 Q Now, your actual opinions in this case, 15 Dr. Krop, is that Mr. Destefano suffers from 16 post-traumatic stress disorder features; is that correct? 17 A Yes. 18 Q And isn't it true that you have to qualify 19 your diagnosis that he has features of post-traumatic 20 stress disorder because he doesn't meet the formal 21 criteria for that diagnosis? 22 A That's correct. 23 Q Okay. And the essential feature of 24 post-traumatic stress disorder is the development of 25 symptoms following an extreme stressor that involves 2303 1 direct personal experience of an event that involves 2 actual or threatened death or serious injury, correct? 3 A That's correct. 4 Q And would you agree that under the definition 5 of this first criterion, that defamation or having a 6 defamatory statement made about one's self does not 7 qualify for a traumatic event? 8 A Not for that diagnosis, no. It doesn't 9 necessarily mean that it's not a traumatic event. It 10 just means that it would not be subsumed under that 11 particular diagnosis. 12 Q It doesn't rise to the level of what you have 13 to have in order to have a diagnosis of post-traumatic 14 stress disorder, correct? 15 A No, that's correct. 16 Q And the second criteria for post-traumatic 17 stress disorder is that the person avoids stimuli 18 associated with the event, correct? 19 A Yes. 20 Q And isn't it true that, in this case, 21 Mr. Destefano has not avoided the stimuli associated with 22 the event but rather has taken some extreme actions to 23 keep the stimuli alive? 24 A To some degree. But you're asking me 25 questions of a diagnosis that I did not give him, but 2304 1 you're welcome to go through those. 2 Q Okay. You are aware that he picketed with a 3 large sign that said he had been accused of sodomizing 4 his dying mother, correct? 5 A Yes. 6 Q And would you agree with me that's not 7 avoiding the stimuli, is it? 8 A No. It's confronting his anger and 9 resentment. 10 Q And the third criteria is persistent symptoms 11 of increased arousal not present before the trauma, 12 correct? 13 A Correct. 14 Q And I think that you identified in your 15 deposition irritability and outbursts of anger as meeting 16 this criteria, correct? 17 A As well as anxiety in general. 18 Q Dr. Krop, isn't it true that Mr. Destefano had 19 extreme episodes of irritability and outbursts of anger 20 prior to any of these events? 21 A For different reasons, but he certainly has 22 had that. That's why I gave him the other preexisting 23 diagnosis. 24 Q Actually, in the psychiatric evaluation from 25 the Navy, doesn't that indicate that he had unmanageable 2305 1 behavior which required maximum security detention? 2 A I'm sorry. Say that again. 3 Q Doesn't the psychiatric evaluation from the 4 Navy show that he demonstrated or exhibited unmanageable 5 behavior which required maximum security detention? 6 A That's what that evaluation indicated. 7 Q And it also indicated that he had short 8 frustration tolerance, correct? 9 A Yes. 10 Q And that was back in 1981 prior to any of 11 these events? 12 A It is 1981, yes, that's correct. 13 Q Okay. And it also shows that he had a strong 14 propensity for passive/aggressive behavior, correct? 15 A According to that evaluation, that's correct. 16 Q And that evaluation also showed or indicated 17 that he had a strong adherence to a philosophy of getting 18 even and winning at any cost, correct? 19 A That's what the evaluation indicated. 20 Q And that evaluation also indicated that he had 21 a very dissatisfied and angry mood, correct? 22 A I don't remember, but that's consistent with 23 the rest of the report. 24 Q Well, it's in your file. You can look. 25 A I will take you at your word for it because 2306 1 it's consistent with the rest of the report. 2 Q And finally, the psychiatric report found that 3 he had manipulative, homicidal ideation, correct? 4 A Some. 5 Q Now, you've testified on direct about 6 Mr. Destefano's response to these allegations of sexual 7 inappropriateness, correct? 8 A Yes. 9 Q And isn't it true that under his -- in his 10 psychological testing, he actually says that he doesn't 11 care what people think about him? 12 A I'm sure at this point that's correct, as long 13 as we're not talking about something such as referring to 14 him as perverted, which is what he views these 15 allegations as suggestive of. 16 Q Let's look at the MMPI-2 test, which is in the 17 book that we were looking at, and let's look at Question 18 157. Do you see that question? 19 A Yes. It says I -- I'm sorry. What others 20 think of me does not bother me. 21 Q And how did he answer that? 22 A True. 23 Q Now, Dr. Krop you said you spent about an hour 24 and a half, hour and 45 minutes talking to Mr. Destefano 25 on August 26th, 2004, correct? 2307 1 A Yes. 2 Q If you could pull out your notes, please, from 3 that interview. Now, during that interview, you 4 discussed with Mr. Destefano the fact that he was his 5 mother's total caregiver, correct? 6 A That's correct. That's what he said. 7 Q Okay. And he told you that he had to 8 disimpact his mother on a regular basis, correct? 9 A Yes. 10 Q And he told you that he would always wear 11 rubber gloves and use a lubricant, correct? 12 A Yes. 13 Q And he also told you that to maintain his 14 mother's dignity, he would role play, correct? 15 A Yes. 16 Q And he also stated to you that he didn't think 17 that she was aware of who was doing this to her, right? 18 A He would role play that it was part of a 19 medical procedure and that he was a physician doing it. 20 Q And he indicated to you that he doesn't think 21 she was aware of who he was, correct? 22 A Yes. 23 Q Okay. Did he explain why he had to role play 24 if she didn't know who he was? 25 A He wasn't sure, but he thought that if she 2308 1 felt that it was her son doing this, that she may not 2 have allowed it. And he indicated that if that were the 3 case, then he would have abided by her wishes, but that 4 he felt that it was medically necessary; and therefore, 5 pretty much manipulated the situation so that it could be 6 done. 7 Q So that he could do it every four or five 8 days? 9 A I'm not sure how often it was done. I 10 remember in the medical records it was somewhere around 11 six, seven days, something. I'm not sure. 12 Q Well, I think the very first -- no, it was 13 Exhibit No. 4 of the plaintiff's exhibits. I'm sorry. 14 That indicates every five or six days, correct? 15 A Yes. 16 Q Now, Dr. Krop, isn't it also true that 17 Mr. Destefano told you that he disimpacted his mother at 18 Florida Hospital in Orlando? 19 A No, no, that's not the case. In your 20 deposition -- in my deposition, you asked me to look at 21 those notes, and in my notes, I have he freely admitted 22 to utilizing procedures at Florida Hospital in Orlando. 23 Upon reviewing those medical records, the way I would 24 interpret that, since he's very adamant that he never did 25 that, is that he admitted to the staff at Florida 2309 1 Hospital that he had utilized those procedures of 2 disimpacting. 3 Q Dr. Krop, please read your notes word for 4 word. 5 A He freely admitted to utilizing procedures at 6 Florida Hospital in Orlando. 7 Q And prior to that note that you wrote, you 8 were talking about fecal disimpaction, were you not? 9 A Right. 10 Q And you understood that the procedure that he 11 was talking about was fecal disimpaction, correct? 12 A That's correct. 13 Q And what you wrote down you were writing down 14 contemporaneously with interviewing -- while you were 15 interviewing Mr. Destefano, correct? 16 A That's correct. 17 Q Okay. And you were asked about that in your 18 deposition of September 28th, 2004, correct? 19 A Correct. 20 Q And do you have that in front of you? 21 A I do. 22 Q And on page 53 of your deposition, we were 23 going over your notes, correct? 24 A We were. 25 Q And I said, let me stop you right there. Do 2310 1 you see that in line 16, line 16? 2 A Yes. 3 Q And then I asked: He freely admitted to 4 utilizing this procedure at Florida Hospital in Orlando, 5 question mark. And you said -- 6 A I said the disimpaction procedure. You were 7 basically asking me which procedures we were talking 8 about. 9 Q Okay. And then on page 66, if you could turn 10 to that, line 15, I asked you: Okay. And Dr. Krop, he 11 told you in your interview that he utilized this 12 disimpaction procedure at Florida Hospital in Orlando, 13 correct, question mark? And I say, it's on page 2 of 14 your note, the very first -- and what's your answer? 15 A I said that that's what I have in my notes. 16 Again, yes. I mean, that's what I wrote down. Whether 17 it was in that hospital or another facility, I'm not 18 sure. 19 Q Now, Dr. Krop, were you given the opportunity 20 to read your deposition and to note any errors in it? 21 A I reviewed it. That's not an error. When I 22 do an errata sheet, it's not necessarily -- I mean, I 23 don't disagree that I said that. I think you need to 24 look at the context. You had me look at my notes. I 25 agreed that that's what he told me. 2311 1 In reviewing his deposition, he indicated, I 2 believe it was in his deposition, that he -- and 3 certainly in the records, the medical records -- that he 4 admitted to the people at the hospital that he had used 5 these procedures. 6 Q So you're changing what you think your note 7 said based on reading Mr. Destefano's deposition? 8 A I'm changing it basically in terms of it's 9 certainly more appropriate context that he would -- he 10 has denied all along that he has done anything to his 11 mother while he was at the hospital in terms of any kind 12 of digital penetration, whether it be for medical or 13 sexual reasons. 14 In his deposition, or somewhere, I recall that 15 he denied but admitted to people at the hospital that he 16 has utilized these procedures which he indicated 17 elsewhere during my interview as certainly what he did 18 at -- this makes a whole lot of sense given what he told 19 the people in this medical record. 20 Q Dr. Krop, when you wrote -- when you had your 21 deposition taken in September of 2004, you believed that 22 Mr. Destefano had told you that -- freely admitted to you 23 that he utilized this procedure at Florida Hospital in 24 Orlando, correct? 25 A I indicated that that was in my notes. I 2312 1 could not recall the context, but I certainly didn't 2 disagree since that's all I had in my notes. 3 MS. MARSHALL: Okay. If we could take a 4 break. Are we ready to change the tape? I have no 5 further questions. 6 - - - - - 7 CROSS-EXAMINATION 8 BY MR. TOWNSEND: 9 Q Dr. Krop, my name's Larry Townsend. I 10 represent Orlando Regional, and Ms. Marshall has been 11 very thorough, so I'll be very brief. 12 And I think the only other real area I want to 13 discuss with you that hasn't been covered extensively by 14 Ms. Marshall deals with Mr. Destefano's -- I'm doing it 15 too -- Mr. Destefano's -- the only thing is I can say is 16 he said it to himself, he pronounces it three different 17 ways. It's all okay -- is the GAF. 18 Tell the jury again what a GAF is. 19 A It's a global assessment of functioning. It's 20 based on a generalized set of criteria of symptomatology 21 as to the level of psychological functioning a person is 22 doing. 23 Q And you testified earlier today that you 24 believe Mr. Destefano has a GAF of 60 to 70; is that 25 correct? 2313 1 A I think based on his self-report and what I 2 have seen in the other evaluations at various times, it's 3 been between 60 and 70. 4 Q Would you agree with me, sir, that at the time 5 of your last deposition, which was on -- 6 A September 28th. 7 Q -- September 28th, 2004, you gave him a GAF of 8 61 to 70; is that correct? 9 A Yes. I thought that's what I've been saying. 10 Q Well, in fact, there's a difference in the 11 MMPI-4 with regard to the description of the 60 and a 61, 12 correct? 13 A First of all, you're referring to the DSM, not 14 the M -- 15 Q The DSM. 16 A I understand that that's a gradated or graded 17 scale from one to a hundred. Somebody, for example, who 18 is -- who would have a 61 would really be seen as not 19 very different than somebody with a 60. 20 So if I say 61, that's just basically the 21 range and the -- sort of the artificial categories that 22 are used in the DSM, and there really wouldn't be much of 23 a difference between a 60 and a 61. 24 Q Well, then, if that's true, then, there 25 wouldn't be much difference between someone with a 70 or 2314 1 71, correct? 2 A No. And again, I'm putting the higher level 3 at 70 just as -- which, again, is a more -- I know you 4 objected when I used the word "conservative." 5 Q Well, but your testimony in your deposition 6 was it was 61 to 70, correct? 7 A I will concede that it could be 61 to 70. 8 Q And in 61 to 70, in the DSM-IV, at page 32, 9 that is one range. That doesn't overlap ranges, would 10 you agree with that? 11 A From 61 to 70 is a range, yes. 12 Q All right, sir. So read the description in 13 the DSM-IV with regard to the range of 61 to 70. 14 A It's a range from mild symptoms, such as 15 depressed mood, mild insomnia or some difficulty in 16 social, occupational or school functioning, but generally 17 functioning pretty well, has some meaningful 18 interpersonal relationships. That would be some samples 19 of some of the symptomatology that would go in that 20 range. 21 Q And that's the range you said he fell in at 22 your deposition, correct? 23 A That's correct. 24 MR. TOWNSEND: That's all I have, sir. Thank 25 you. 2315 1 MR. OSBORNE: Few follow-up questions, 2 Dr. Krop. 3 - - - - - 4 REDIRECT EXAMINATION 5 BY MR. OSBORNE: 6 Q Let me go back and recap again some of the 7 statements in the record, and I'd like you to consider 8 them in toto before I ask you the question. 9 The statement, witnessed the son giving his 10 mother a passionate kiss which lasted for an extended 11 time, Mary Thornton; Carol Boze found son on top of 12 patient kissing her repeatedly on patient's mouth; Rachel 13 Bean witnessed plaintiff kissing his mother intimately on 14 lips, noticed bright red blood on pad; Carol Boze, son on 15 top of her kissing her passionately on the mouth for 16 approximately two minutes; paramedic notes taken to ORMC 17 for evaluation of bowel impaction, nursing staff reports 18 son did a digital removal, believed this might be the 19 cause of trauma. 20 Kelly Pipkin, transported from nursing home 21 with reports of finding bright red blood on sheets of 22 bed; paramedic reports that nursing home staff said her 23 son disimpacted her Sunday; Lillian Folley, presented 24 with rectal bleeding. Per nursing supervisor, patient's 25 son was witnessed disimpacting her at Sunbelt, says 2316 1 Rachel Bean, and was reported to the abuse hotline. 2 Patient's son was witnessed lying on top of patient 3 kissing her in a way that a son would not kiss his 4 mother. 5 Taking all those together from a perception of 6 Larry Destefano, from his perception, what is your 7 opinion of the -- the effect that those statements about 8 him had upon Mr. Destefano? 9 A From a psychological standpoint, certainly if 10 you put all of those together, one would have to perceive 11 being accused of some type of sexual misconduct, both in 12 terms of the specific acts as well as the context in 13 which the allegations are made. 14 One, when a person is accused falsely of 15 sexual misconduct, in general, the person reacts with a 16 negative psychological reaction, can certainly develop 17 psychological symptoms and can feel traumatized if it 18 impacts on the person's life. 19 A person with Mr. Destefano's already-existing 20 personality traits, that person would likely even react 21 more negatively and more symptomatically and become more 22 obsessed because of the nature of the allegations. And I 23 think if you add one more factor, which I've already 24 testified to, and that is, his perception of his 25 relationship with his mother, which has always been, 2317 1 according to him, very close to the point where he was 2 willing to do some things that I'm not sure all children 3 are capable of doing for their parent, but given what he 4 thought was an appropriate, caring and concern for his 5 mother being accused as the way he perceived it would be 6 traumatic for him. 7 Q Let's talk about the -- I think you said on my 8 direct, preexistent personality disorder NOS? 9 A Yes. 10 Q What do you mean by preexistent? 11 A I'm saying that he has for quite a while had 12 certain personality traits that -- particularly the 13 obsessiveness and the need to feel that he's right if he 14 has been accused of doing something wrong, that need to 15 have other people perceive, if he is accused of something 16 wrong, particularly something that is against his 17 character as he sees it, that would be very difficult for 18 him. 19 Q Do you have an opinion one way or the other as 20 to whether or not the events that I published to you, 21 those statements, brought about an aggravation of his 22 preexistent personality disorder? 23 A I would think so. I would think that given 24 that he was functioning fairly well, as far as I know, he 25 was -- I wouldn't see him as having been in need. 2318 1 Q Is your opinions regarding the personality 2 disorder NOS, not otherwise specified, consistent with 3 the review you did of the psychiatric evaluation done in 4 1981? 5 A Yes. 6 Q In what way? 7 A It described personality traits that got him 8 into trouble in the military. So in a highly structured 9 setting, certainly he's expected to -- a person in the 10 military is expected to behave in a very specific way. 11 And if he perceives things to not be -- if he perceives 12 other people not to be abiding by the rules as well, he 13 feels that it's his obligation to report those. 14 And if people don't respond correctly, at 15 least from his perspective to him, he's going to get 16 frustrated, and he could rebell against that situation, 17 as he did in the military. 18 Q Let me ask you this. The psychiatric report 19 states that there's no frank psychiatric illness to 20 Mr. Destefano. Do you agree with that from your 21 evaluation? 22 A Yes. There was no preexisting mental illness. 23 There were personality traits which, again, he still has, 24 that caused him to react a certain way. 25 Q Another point here that's in this medical 2319 1 record in 1981 talks about a characterological defect of 2 impulsiveness and passive/aggressive nature. How is that 3 the same or different than your diagnosis of -- of 4 personality disorder not otherwise specified? 5 A Personality disorder NOS or not otherwise 6 specified is a relatively new diagnosis. It's used for 7 individuals who have certain personality traits which 8 cause difficulty but do not meet full criteria for a 9 specific personality disorder. 10 When he was evaluated in 1981, that diagnosis, 11 as far as I know, was not in existence, so he basically 12 just got a diagnosis of a personality disorder. 13 Characterological means pretty much ingrained, part of 14 the character, part of the personality. Again, 15 characterological usually implies that a person can get 16 himself into trouble because of those personality traits. 17 Q The psychiatric report, states, does it not, 18 that no psychiatric treatment was needed? 19 A Yes. 20 Q And in terms of what your evaluation was in 21 terms of needs of Mr. Destefano, do you believe that he 22 needs psychological or psychiatric treatment at this 23 time? 24 A Yes. 25 Q Why? 2320 1 A Well, he's a pretty unhappy guy. He's 2 frustrated. He's angry. He's recentful. Certainly the 3 pursuit of the litigation is an appropriate means of 4 dealing with his resentment and anger. And again, as 5 I've indicated to one of your previous questions, 6 depending on the outcome of the litigation, he may or may 7 not feel that people recognize his position. 8 But it's taken six years of his life, and he's 9 been mainly focused on this. I think when he does not 10 have this to focus on, he's also going to have to rebuild 11 his life, and I think he's going to need some 12 psychological intervention to do that. 13 Q Your notes indicated that he picketed for a 14 year? 15 A As far as I know, yes. 16 Q Tell me how that interrelates or interplays 17 with your diagnosis of his -- well, your total diagnosis. 18 How does that play into it? 19 A Well, it's consistent with how he was 20 described back in 1981. He feels a need to be vendicated 21 through various means. He felt it was important for him 22 to convey his -- what he perceived was a wrong that was 23 done to him. And he felt a need to do this publicly and 24 now through litigation. 25 So basically, for the last five and a half or 2321 1 six years, this has been the focus of his life. That's 2 those obsessive qualities I referred to. 3 Q You were asked by Ms. Marshall about him 4 picketing and having the word that she said was he was 5 accused of sodomizing his mother, and you said he was 6 confronting his anger and resentment? What do you mean 7 by that? 8 A He perceived himself -- he perceived that he 9 was being accused of being a sexual offender, of 10 perpetrating a sexual offense based on the investigations 11 that were being done and based on misstatements that were 12 being made. And this was actually, as far as I can tell 13 and what I would believe, is an appropriate way to be 14 dealing with his anger. 15 I was asked whether he feels that he has 16 control of his anger. I think Larry feels that by doing 17 things that he views as constructive and not hurting 18 anyone else, then that's controlling his anger. 19 Q You were asked about the history of gonorrhea 20 that Larry had. What year, according to those records, 21 was it that he had reported gonorrhea in the Navy? 22 A Well, I'd have to look at that. 23 Q I've got -- just look at the orange tab. 24 A Yes. 25 Q The first one, I think, or the second one will 2322 1 have a date on it as well. 2 A August of 1980. 3 Q So how old would Larry have been at that time? 4 A Well, his date of birth is 1960, so he would 5 have been about 20. 6 Q So this occurred some 24 years before your 7 evaluation? 8 A Yes. 9 Q Let's talk about one last point here, and 10 that's the -- let me find the record, in my Exhibit 4. 11 Is it your understanding that Sunbelt is a 12 Florida Hospital related facility? 13 Do you have an understanding of whether or not 14 Sunbelt Nursing Home is a Florida Hospital related 15 facility? 16 A I knew it was affiliated. I don't know 17 exactly how. 18 Q And in terms of Exhibit 4 and in terms of your 19 statement he freely admitted to utilizing the procedure, 20 was this an admission made at Florida Hospital if that 21 note was taken at a Florida Hospital facility? 22 A Yes. 23 MR. OSBORNE: No further questions. 24 (Bench conference.) 25 THE COURT: Do you have anything further? 2323 1 MR. OSBORNE: I do need to publish the 2 mortality tables and putting a document into 3 evidence. 4 THE COURT: Then I can excuse the jury for 5 today. Any objection to that? 6 MS. MARSHALL: Now that we have to put the 7 full videos in, those are going to take more time 8 than the excerpts that I had planned, so I don't 9 know if you want to start those today or not. 10 MR. OSBORNE: I am prepared to go forward with 11 the motions for directed verdict. 12 THE COURT: Okay. Publish your remaining 13 evidentiary matters to the jury, then I'm going to 14 excuse them for today. I think they've hung in here 15 long enough. We'll start in the morning, if 16 necessary, to the extent necessary, with the video, 17 if that's how you choose to do it. I don't think 18 we'll play them today. 19 MS. MARSHALL: Okay. 20 THE COURT: Mr. Osborne, call your next 21 witness. 22 MR. OSBORNE: We have no more witnesses 23 besides publishing a few documents. 24 THE COURT: I wonder if plaintiff's counsel 25 would mind moving the equipment so I can see the 2324 1 jury, please. 2 MR. OSBORNE: I'd like to move into evidence 3 what has been identified as Defendants' Exhibit J, 4 which is the punch time sheets that Mr. Sherer 5 talked about. 6 MS. MARSHALL: No objection. 7 THE COURT: It will be admitted as the 8 plaintiff's next numbered exhibit. 9 THE CLERK: 25. 10 (Plaintiff's Exhibit No. 25 was admitted.) 11 MR. OSBORNE: I'd also like to just mark for 12 identification Composite AN, which are deposition 13 designations that we can supplement to complete the 14 record about what the designations were that were 15 read to the jury. 16 MS. MARSHALL: No objection. 17 MR. TOWNSEND: No objection. 18 THE CLERK: 26. 19 MR. OSBORNE: Actually, I don't need that to 20 go to the jury. That doesn't need to go into the 21 jury. That's just for the record about what the 22 designations were, Judge. 23 THE COURT: You want it marked for 24 identification? 25 MR. OSBORNE: Correct. 2325 1 THE COURT: Just mark it next ID for the 2 plaintiff. 3 THE CLERK: Composite AN. 4 MR. OSBORNE: Lastly, I'd like to move into 5 evidence the life expectancy table regarding 6 Mr. Destefano. 7 MS. MARSHALL: Relevancy. 8 MR. OSBORNE: He was told he had a permanent 9 condition by Dr. Krop. This tells you how long he's 10 going to live with that condition. 11 THE COURT: Objection's overruled. It will be 12 admitted. 13 THE CLERK: 26. 14 (Plaintiff's Exhibit No. 26 was admitted.) 15 MR. OSBORNE: With that, I'd like just to 16 publish to the jury that Mr. Destefano is a 17 45-year-old -- this is an expectation of life by 18 race, sex and age, 1993, from the U.S. National 19 Center for Health Statistics, Vital Statistics of 20 the United States, published in 1996 for a white 21 male, age 45, whose life expectancy is 31.4 years. 22 And with that, Your Honor, the plaintiff rests. 23 THE COURT: Thank you. Ladies and Gentlemen 24 of the jury, we've reached a point in the 25 presentation of the evidence where it's appropriate 2326 1 for the Court to address some matters with the 2 lawyers outside of your presence. Because that will 3 take a significant amount of time, it could take a 4 significant amount of time, I'm going to excuse you 5 for the day and ask that you return and be prepared 6 to come into the courtroom tomorrow morning at 8:30. 7 I may be here around quarter to 9:00. If all 8 goes well, I'll get here as close to 8:30 as 9 possible, and we will begin as appropriate at that 10 time. Thank you. 11 THE COURT DEPUTY: All rise for the jury. 12 (Jury exits.) 13 THE COURT: Why don't we take five minutes or 14 so. 15 (A 6-minute recess was had.) 16 (Continued to Volume XVII) 17 18 19 20 21 22 23 24 25 2327 1 C E R T I F I C A T E 2 STATE OF FLORIDA) 3 COUNTY OF ORANGE) 4 I, LAURA J. LANDERMAN, R.M.R., C.R.R., certify that 5 I was authorized to and did stenographically report the 6 foregoing proceedings and that the transcript is a true 7 and accurate record. 8 Dated this 16th day of January, 2006. 9 10 11 ___________________________________ 12 LAURA J. LANDERMAN, R.M.R., C.R.R. 13 14 15 16 17 18 19 20 21 22 23 24 25