FULL TESTIMONY — B&W's Hospital's Dr. Eitan Negri testifies at Lindsay Clancy's murder trial

[00:00:00] Speaker 1: Good morning, sir. Good morning. Could you please tell the jurors your first and [00:00:03] Speaker 2: last name? My first name is Eitan, last name is Negri. Can you spell your first name for the record? E-I-T-A-N. And your last name? N-E-G-R-I. And what do you do for work? I'm a physician associate, physician assistant. And did you go to school for [00:00:19] Speaker 1: that? Yes. Can you tell us about your educational background? I did my [00:00:23] Speaker 2: undergraduate at City College in New York and I did a post-bac at Brooklyn College followed by a PA program at Torrey University in Manhattan. And do you [00:00:33] Speaker 1: currently work as a physician's assistant? Yes. And do you work, currently work in the state of Massachusetts? No, ma'am. Are you licensed in the state of Massachusetts? Yes, ma'am. Are you licensed in any other states? New York State. I'm gonna go back to January of 2023. Were you working in Massachusetts then? Yes. And where where were you working? Brigham and Women's Hospital. And were you in that same role as a physician's assistant? Yes. And what were you doing? What were your general duties in [00:01:02] Speaker 2: that role working at Brigham and Women's? Generally, you assess a patient, you diagnose, you formulate a plan with an attending physician and you execute that plan throughout the day. It encompasses various things. Were you working in any [00:01:17] Speaker 1: particular department at Brigham and Women's back in January of 2023? Trauma, burn surgical ICU. Now I'm gonna draw your attention to a particular patient that came into the Brigham and Women's Hospital on January 24th of 2023. That patient was Lindsay Clancy. Do you recall encountering this patient on January 25th of 2023? Yes. And what did you do as it pertained to the care and treatment of this patient? I received the [00:01:48] Speaker 2: information from the shift before me, formulated a plan, examined her, assessed her, staffed that plan with the attending physician and executed that plan throughout [00:01:57] Speaker 1: the day. And fair to say this particular patient had injuries that you were directed to observe, review, form that plan on. Correct. What were the injuries? She had [00:02:09] Speaker 2: multiple injuries. The most acute were injuries that were requiring consultation with other services and the ones that I directly managed were the lacerations to her wrists and her, just her wrists actually. And as far as when you say she had [00:02:23] Speaker 1: other acute injuries, you were not involved in the care of her for those, correct? I was [00:02:28] Speaker 2: involved in the care that involved consulting other services to manage those [00:02:33] Speaker 1: things, yes. Okay. And as far as any sort of repair work that you were doing as a physician's assistant working with the trauma surgeons, what repair work were you assigned to do? Laceration repair. And on this particular patient, where were the injuries or lacerations that you were going to repair? She had multiple [00:02:56] Speaker 2: lacerations on both of her wrists. She had superficial on her neck, which I did not [00:03:00] Speaker 1: repair. Okay. And as it pertained to the wrists, did you go through that process of observing, reviewing, coming up with a plan and then repairing those injuries? Yes. And were you directed to do that by any particular doctor? Not necessarily directed. A lot of [00:03:20] Speaker 2: those things fall within my scope. And since they were less acute, they kind of [00:03:24] Speaker 1: fell down the chain to me. Okay. And you're aware that she was being seen and treated by a host of other doctors, nurses, an entire team? Yes. As it pertains to the wrist injuries, what did you do to examine those areas? [00:03:43] Speaker 2: The first thing I do is assess the location. Then I assess the severity, whether it requires intervention by someone other than myself. In this instance, it did not. So then I proceed with just kind of protocol laceration repair. [00:04:01] Speaker 1: When would it be a situation where you'd need somebody else to intervene? [00:04:06] Speaker 2: If it required surgical intervention or suturing repair beyond my skill set. In this [00:04:14] Speaker 1: instance, it did not. Okay. And so referring to these particular injuries, when you observe them, did you observe any areas of active bleeding? No. And fair to say they had been treated by nurses and other staff prior to you encountering these injuries, correct? Yes. They were dressed and covered before I got there. Now when you assessed them, you noted that they were bilateral, correct? Yes. What does that [00:04:38] Speaker 2: mean? It means on both sides of the body. So both wrists. Okay. And so referring to the [00:04:45] Speaker 1: right wrist, what were your observations of the injuries to the right wrist? The [00:04:52] Speaker 2: right wrist, as far as my reference to the note, is that she had a few lacerations, one [00:04:58] Speaker 1: of which was severe and deep enough to require repair. And fair to say that, that right wrist injury was, the one that you repaired, was three centimeters deep? Approximately, [00:05:16] Speaker 2: if that's what my note says, then that's, that's what it was. Okay. And on a wrist, or this area [00:05:21] Speaker 1: of the wrist where you observed the injuries, that depth of three centimeters, did that, that, did that require further surgical intervention, or were you able [00:05:30] Speaker 2: to suture that area? I was able to suture that area. As far as what happened subsequent to that, I wasn't there, so I'm not sure. Okay. And how many sutures did [00:05:40] Speaker 1: you use to repair that injury? I believe three. And in relation to any other cuts or lacerations that were on that right wrist, did any other of those lacerations require suturing? No. How did you treat those other injuries? Just irrigation, meaning [00:05:55] Speaker 2: cleaning them out, and then using the type of tape to close them shut. And that's [00:06:00] Speaker 1: generally referred to as a steristrip, correct? Correct. Okay. May I approach the witness? Me. I'm showing you two photographs. Do those photographs depict the repairs or the sutures that you did on the right wrist of Lindsay Clancy? Yes. I would move to admit these as the next two exhibits. All right. Those may be admitted. I'm just going to show on the screen what's now been marked as exhibit 201, and you should be able to see it, sir, on the screen in front of you. Can you see that? Yes. Okay. And so this is the right wrist, correct? Correct. And those black lines in the middle of the photograph are those the sutures that you did? Correct. And I'm just showing you 202, exhibit 202. These white strips that are all around the injury, are those the steristrips? Correct. Now on the left wrist, do you recall what you observed to be the injuries on that wrist? I believe there is a similar laceration, just shorter in length, just shorter in length that required fewer sutures. Okay. And then there is a similar laceration, just shorter in length that required fewer sutures. Okay. And then I think that there was a similar laceration, just shorter in length that required fewer sutures. Okay. And then there was a similar laceration, just shorter in length that required fewer sutures. Okay. And then there was a similar laceration, just shorter in length that required fewer sutures. Okay. And then there was a similar laceration, just shorter in length that required fewer sutures. Okay. And then there was a similar laceration. There was a similar laceration, just shorter in length that required fewer sutures. Okay. And then there was a similar laceration, just shorter in length that required fewer sutures. Okay. And then there was a similar laceration, just shorter in length that required fewer sutures. Okay. And then there was a similar laceration, just shorter in length that required fewer sutures. Okay. And then there was a similar laceration, just shorter in length that required fewer sutures. Okay. And then there was a similar laceration. [00:07:26] Speaker 2: believe there was a similar laceration just shorter in length that required [00:07:31] Speaker 1: fewer sutures. And fair to say if your notes reflect that the left wrist had a one had one meaning just a singular two centimeter deep linear cut that that would have been what your observations were of the injury that you repaired? Correct. And how many sutures did that injury require? One suture. And were there other areas that you observed that had some sort of laceration? I believe [00:07:59] Speaker 2: similarly just superficial ones that needed hysteria strips. And again in [00:08:05] Speaker 1: treating this particular injury when you came upon it was there active bleeding or any concern that you needed more intervention other than a suture? At that time no. Are those familiar to you? Yes. And are those the the suture that you did on the left wrist of Lindsay Quincy? Yes ma'am. [00:08:35] Speaker 3: Do I move to admit these? All right. That may be admitted? Or they may be admitted? And now again just showing what's been marked as exhibit Q03 and you see the injury there and on the wrist near the ruler. in the photograph? Yes. And exhibit 204 which is just a closer upshot of that. Is that in the [00:08:55] Speaker ?: graph? Yes. And again you see the white strips. Those are also [00:09:02] Speaker 1: seri-strips that were applied? Correct. Now in relation to any of these wounds on the right or the left wrist, did you observe that there was a lacerations to go any deeper than the subcutaneous tissue? On my observation no. Okay. So you see the lacerations to go any deeper than the subcutaneous tissue? On my observation no. Yes. So you see the lacerations to go any deeper than the subcutaneous tissue? On my observation no. And when we talk subcutaneous tissue we talk about that fatty tissue on your underneath your skin correct? Correct. And did you have to return at any point to your knowledge to readdress these issues or do any further laceration repair as it pertained to this patient? On that shift no. Do you recall if you did on any other shift? No. [00:10:00] Speaker ?: Okay. [00:10:05] Speaker 1: I have no further questions. Thank you. Mr. Redington. [00:10:09] Speaker 4: Is it Mr. Negri? Agri, yes, sir. And you're not a doctor, you're a physician assistant, is that what it is? That's correct, yes. Okay. And how long had you worked for Brigham and Women's prior to seeing Lindsay Clancy that on January 24 or 23? [00:10:29] Speaker 2: I believe I was in my second year of employment with Brigham and Women's. [00:10:32] Speaker 4: Okay. And you've got to keep your voice up because people back here have to be able to hear you too, okay? [00:10:36] Speaker 2: I believe I was in my second year of employment at Brigham and Women's. [00:10:41] Speaker 4: You're not suggesting for one minute that after you did your butterfly stitches, Lindsay could have got up and walked out the door of the hospital, right? No, sir. And would you agree with me that in fact she was critically ill when you saw her, right? Yes, sir. And she certainly wasn't critically ill from COVID or a flu or something like that, right? No, not to my knowledge. You know that there are notes that are prepared for the records from the hospital. For example, on January 24, 2023, hospital admission form is filled out. Do you know a doctor, Jeffrey Andrew Anderson? Yes. And he was, what was his position that night? [00:11:28] Speaker 2: He was one of the trauma surgeons and also one of the intensivists, the attending physicians in the ICU. All right. [00:11:35] Speaker 4: And you've had a chance to review a number of records and photographs with the DAs, I imagine, right? [00:11:42] Speaker 2: I've reviewed my own procedure note. [00:11:45] Speaker 4: Okay. So what does that mean? [00:11:48] Speaker 2: It means I reviewed the note that I wrote myself regarding the laceration repairs. [00:11:52] Speaker 4: Okay. Is that the note that indicates that it appears as though, for example, on the right upper extremity, there's a three and a half centimeter deep laceration on the volar aspect of the wrist? [00:12:05] Speaker 2: I don't believe that I commented saying volar specifically, so I don't know if that's in regards to my note, but I believe my note did say about three centimeters deep, yes. [00:12:13] Speaker 4: Okay. So do you recall indicating in your note that it was superficial laceration or did you indicate that it was a deep laceration? [00:12:22] Speaker 2: I indicated that some of them were superficial and the one that I repaired in particular was three centimeters deep. [00:12:28] Speaker 4: And you've had occasion to speak to the prosecutors on this case and they've asked you about the superficial, superficial, superficial injury to a wrist, right? [00:12:38] Speaker 2: Correct. [00:12:39] Speaker 4: In addition to the, as indicated on page 75 of the Brigham and Women's Hospital record that I have, and we can fix that with other records if it doesn't coincide, there's a note from Dr. Anderson that the right upper extremity 3.5 centimeter deep laceration volar aspect of the wrist, left upper extremity 2 centimeter deep laceration on the volar aspect of the wrist. Do you agree with that assessment? Yes, sir. All right. And then you were able to, as you say, clean it up with saline or whatever and then you stitched up what you had to stitch up, right? Yes, sir. Did you have anything to do with the massive transfusion that she had? No, sir. Do you have anything to do with the treatment of the transected spine that she had, the shattered spine? No, sir. Do you have anything whatsoever to do with the insertion of tubes on both sides of her body and the draining of the blood that had pulled in her middle cavity? Just the management of those tubes after, but not the placement. [00:13:37] Speaker 2: Okay. So you were there while that was done? I was there managing once they had been placed, but I was not there for the placement. Okay. [00:13:45] Speaker 4: But you knew that they were in there, that they were draining the blood. Correct. Okay. And do you know where the blood came from? It was in her middle extremity? I don't know specifically. [00:13:55] Speaker 2: I'd have to refer back to the imaging reports. [00:13:58] Speaker 4: Okay. In any event, you know that shortly thereafter she coded, right? Yes. Were you there for that? No, sir. And basically that means that the patient has in effect died from cardiac arrest, right? Not necessarily died, but their heart has stopped beating for that. And then there's crash teams and everybody hopefully revives the person, right? Correct. And you guys did that, or they did, and they were successful reviving her, correct? Yes. So without going through everything, you'd agree with me, sir, that your observations would be of the wrist, the repair, and taking care of the tubes after they were inserted into both sides of her chest? [00:14:37] Speaker 2: That's correct. [00:14:38] Speaker 4: And that was your involvement extended, correct? You're all done after that? [00:14:41] Speaker 2: I was involved in the ongoing management of her care throughout the day, but just as you stated, not the things that you asked me about. Okay, thank you, sir. [00:14:49] Speaker ?: Sure. [00:14:49] Speaker 2: They're part of the record. [00:14:50] Speaker 4: They're part of the record. [00:14:51] Speaker ?: I would object if we could approach. [00:14:51] Speaker 4: I don't want to have a jury go through 10. [00:14:52] Speaker ?: I know that. [00:14:53] Speaker 4: Listen, mark them for identification, and then we can address that. [00:15:07] Speaker 3: Thank you, sir. [00:15:08] Speaker ?: Okay. [00:15:09] Speaker 3: May I just put a few questions? [00:15:10] Speaker ?: Sure. Thank you. [00:15:12] Speaker 1: Mr. Negri, I'm just going to approach and show you the file. We'll go on a second. [00:15:15] Speaker ?: Is that my? [00:15:16] Speaker 1: Okay, thank you. All right, thank you. [00:15:18] Speaker 3: I'll just show you the page from the records. That's labeled Brigham and Women's, page 76. [00:15:20] Speaker 1: Can you just, you can hold it in. [00:15:21] Speaker 3: Specifically the file reader? [00:15:22] Speaker 1: Yeah, I would direct your attention to the bottom paragraph where it says exam. That's not your note from the record, correct? Correct. And when it's noted that the right upper extremity, left upper extremity has three and a half centimeter deep lacerations, two centimeter deep lacerations, deep in the medical notes is not an adjective of it, correct? It's more of a directionality of the injury. [00:16:10] Speaker 2: It's a description of, yeah, basically an objective unit of measure. Okay. [00:16:15] Speaker 1: But when we say deep, it means that it goes down into the skin as opposed to across the skin. [00:16:20] Speaker 4: It doesn't matter what we say. It's what the records say. [00:16:22] Speaker 3: All right. I understand. Go ahead. [00:16:25] Speaker 1: Just, you could ask that question again. As far as your assessment of injuries, deep goes down in the skin as opposed to across the skin. Correct. Okay. And as far as Dr. Anderson goes, you knew that him to be one of the attendings and a trauma surgeon in this case. Were you aware that on January 24th, he had examined these injuries and indicated they did not require repair at that time? I don't recall specifically. [00:16:50] Speaker 2: I'm sorry. [00:16:51] Speaker 1: But you came in to repair these on January 25th? Yes. Okay. [00:16:58] Speaker 3: Thank you. Anything on that? All right. Thank you, sir. Thank you. [00:17:03] Speaker ?: You're welcome.