Forensic Nursing and Elder Abuse Cases

Excerpted from:
http://www.bedfordbulletin.com/articles/2005/10/05/news/news01.txt

Following some three hours of testimony that described in graphic detail what rescue and medical personnel found at a Bedford caregiver’s home in June, General District Court Judge Harold Black found probable cause to certify elder abuse and malicious wounding charges against that caregiver, Dorothy Thompson Leonard, to the grand jury.

In presenting evidence at the preliminary hearing, Krantz used emergency responders from the Bedford Lifesaving Crew, emergency room personnel and doctors from Bedford Memorial Hospital, law enforcement officers and a neighbor to convince Black to certify the charges.

Krantz had also hoped to have Leonard’s husband, Alvin, testify. But he chose to invoke spousal privilege.

“The Commonwealth was willing to give Mr. Leonard the benefit of the doubt,” Krantz said. “He had indicated he wanted to be cooperative; he wanted the truth to come out.”

In fact, Krantz said Alvin Leonard had indicated just minutes before Monday’s hearing that he would testify, but changed his mind. That, Krantz said, will force the Commonwealth to evaluate whether Alvin Leonard has any culpability as a codefendant or co-conspirator in the case.

Krantz said exceptions to the spousal privilege include incidents when the victim is a child.

“My feeling in this case is that these women were certainly child-like and were being cared for by Mrs. Leonard in her household. I dare say Mr. Leonard was at least assisting with that care,” he said. “I can’t force Mr. Leonard to testify. It’s frustrating when you have a potential eye witness to the criminal act who has the knowledge that in an analogous situation could have been required to testify.”

The initial 911 call that came from the Leonards’ home at 750 Peaks St. on June 15 of this year was played early during Monday’s hearing. In that call Dorothy Leonard said that a woman had fallen and she was not able to get her up. “I can’t get a pulse,” Leonard states during the call. When asked by the 911 dispatcher if the woman was breathing she replied, “I don’t think so.”

Jeff Johnson of the Bedford Lifesaving Crew testified that the crew responding found Minnie Thompson lying on the floor at about 11 p.m., adding that she was not responsive or breathing. He said he noticed, while performing emergency procedures, that Minnie Thompson had dried blood on her nose, which also displayed deformity, and bruising on parts of her body.

Another Lifesaving Crew member, Janet Blankenship, testified she noticed bruising on Minnie Thompson’s chest, face and abdominal area. She also said another woman, who would later be identified as Nellie Thompson, was laying still on a bed in the room, covered up to her neck with a blanket.

Freda Easterly, another crew member who responded to the scene, said the home was dark when they arrived at the scene. “It was very hot in there,” she said of the room where the two sisters were found. “The room was very dirty. There was a strong smell of urine. It hit me in the face as soon as I walked in.”

She added that she noticed bruising on Minnie Thompson, of varying colors. “I noticed more bruising in the ambulance when there was more light,” she added. “I noticed she was very, very dirty.”

She said Nellie Thompson, whom the crew later went back to see following the transport of her sister, had severe bruising all over her body, including a significant bruise on the side of her face. She testified the diaper Nellie Thompson was wearing “looked like she had been wearing it for days.”

“It appeared to have been old. It appeared to have been soiled multiple times.”

She also said Nellie Thompson had dark, brown stains on her hands, that looked and smelled like feces. “She was very dirty, very pitiful,” Easterly testified.

Theresa Kern, a registered nurse at Bedford Memorial Hospital who also was accepted as an expert witness for the hearing in forensic nursing, was on duty at the emergency room when Minnie Thompson was brought in to the hospital.

Kern testified she photographed Minnie Thompson’s condition and saw bruises that had resulted from trauma that had occurred over various time periods – some recent, others not.

She testified to various stages of bruising under Minnie Thompson’s chin, on her chest, face, rib area, abdomen, umbilical area, arms and legs, and back. She testified there appeared to be feces on her feet. When asked if the bruising could be explained by just falls, she testified it wouldn’t be consistent with that claim.

She testified to a linear bruise on Minnie’s back, which she said would be inconsistent with a fall.

Kern also said there was skin breakdown on Minnie’s back, along with the evidence of dried feces. In addition, she said there was a laceration to the back of Minnie Thompson’s head, bruises on the outside of her hand and arms that she said would be consistent with defensive wounds.

She presented similar testimony on the state of Nellie Thompson, pointing out by photographs bruising and abrasions over much of Thompson’s body

She testified that Minnie and Nellie Thompson had received inadequate care, in her opinion.

Leonard’s attorney, William Quillian, questioned Kern on the manner the bruising may have occurred and whether the elderly bruise easier. “You noted a lot of bruising on the ladies. You have no idea where the bruises came from do you?” he asked.

“Correct,” Kern replied.

Two doctors, Dr. Bruce Bradfield, a family physician, and Dr. William Weddle, who was working in the emergency room at BMH June 15, also testified.

Bradfield said Nellie Thompson had both of her forearms in splints when he visited with her later that evening in her room at BMH. He said both her forearms had been fractured just above the wrists. He also said he noted signs of dehydration.

When asked if Nellie Thompson was receiving adequate care prior to being brought to the hospital, he responded: “It’s hard to believe that she was.”

A neighbor of the Leonards, Michael Nicholas who lives at 748 Peaks St., also testified, stating that he had witnessed an incident occur between Nellie Thompson and Dorothy Leonard. In that incident he said he heard Leonard yelling at Nellie Thompson as she struggled to take the trash outside.

“What the hell are you doing? You know where that goes,” he testified he heard Leonard yell at Nellie Thompson as she took out the trash. He testified Leonard was standing in the doorway to the house and that when Nellie Thompson came to the door Leonard struck her in the head, pushing Thompson’s head into the door jam.

He also testified that, on numerous occasions, he heard Leonard cussing at the Thompsons and also heard “a couple of thumps and thuds” on one occasion.

“It kind of made the hair stand up on me,” he said. “I called my wife and let her know.”

On cross, Quillian was asked why he hadn’t called the authorities.

He later testified that he had told Alvin Leonard that if what he was hearing didn’t stop, he was going to have to take action. He said he never heard anything after that.

Dr. Weddle, who was working in the emergency room on the night of June 15, testified that Minnie Thompson, when she was admitted, was covered in bruises of varying ages over her body. “I do not believe the injuries she had could be explained by repetitive falls,” he testified.

But when he saw Nellie Thompson, he said her appearance was even “more shocking.”

“She was alive but she was severely battered,” he testified.

Investigator Eddie Harmony of the Bedford Police Department testified Leonard told her that the Thompsons would fall repeatedly, but that she didn’t seek medic
al attention because “she didn’t trust any of the doctors around here.”

He said she later admitted in the interview that she “would tap them lightly” because they wouldn’t listen to what she would say. She later admitted to him she would use a fly swatter, ruler or paint stick to strike the women, he said.

Harmony testified Leonard said in her interview that she never struck the Thompsons in anger. “She tapped them because she loved them,” he testified Leonard had told him.

Leonard remains free on bond. Nellie Thompson is currently living in a long-term care unit of Bedford Memorial Hospital.

Questions:

1. If you were called to present expert testimony for this case as a forensic nurse; how would you prepare?

2. What sorts of evidence would you personally review as an expert witness?

3. In your opinion, is there anything that local law enforcement could have done to prevent the deaths of this victim?

Does this sort of case interest you? It may be time to sign up for online forensic nursing certification.

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