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Case 2:O2—cv—O2252-JAT Document 278-2 FiIed10/26/2005 Page10f3
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‘ ` RODERIC GOTTULA MD -
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October 23, 2004
James Bnmhouse r U
` Renaud, Cook, Drury and Mesaros, PA
Phelps Dodge Tuwcr
· _ One North Central, Suite 900
Phoenix, AZ 85004 2
Supplement to my opinions on Mikkelsen v CHR
Dear Mr. Bamhousrc, V ;
This is a supplement to my previous stated opinion. It is based on the ihllowing factual information being supported by _ g
evidence.
- . As I stated in my previous opinion, it is my belief, that had Mr. Mikkelsen taken 46 Valium as Hrst reported by his with at ·
6:30 am on Oct. l 1, 2001, hc would have been incapacitated within at couple of hours and in a deep sleep- T.l‘|E!'Cli)'!'C, it is more E
likely than not, that he did not ingest the quantity ofpilla that he stated to his wife that morning.
When Mr. Mikkclsen was presented to Ofal Diaz, he was sluggish but coherent. She was led to believe that he had taken two . ·
·m tluuc Valiwrr prior to retunring to the jail. His behuviur at that time was consistent with his ingesting this qutmtityofhlalium
and his vit-al signs are normal (again consistent with Mr. Mikkelsetfs statement that he took 2-3 Valium). Assuming that she
instructed the oflieer at that time to take Mr. Milckelsen to the unit and be cheeked by the nurse who she believed to be there,
site met the Standard of Care tor a nursing assistant. i ‘ ` _
` When Mr. Mlkkelsen was taken to the red unit, Nurse Bragen who was passing medications was not informed that she needed
to see Mr. Mikkelsen. Although she saw him at a distance and mentioned later, that he appeared Enebniated, the Standard of
Care would not dictate that she interview him, if the routine procedure ofthe jail would be tier this evaluation to be performed
· by thenurse on for the evening, who was Nurse Kinsley. Had Nurse Bragen been asked to see Mr. Mikkelscn and ln fact done L
so, Ibelieve that she would have recommended immediate transport to the hospital after her evaluation. Therefore, I do11't
believe any of hluxse Bragen’s actions fell below the Standard of Care. _ ‘
Nurse Kinsley was waiting to see if Mr. Miklceisen returned iiorn his day pass. In anticipation ofhis remrn, she had his
medical record with her on the unit wherehe had been housed, expecting him to return to that unit. luaddition, it is her _j
testimony, that she expected custody to contact her when Mr-. Miklcelsen returned “as they usually do", She had no way of
knowing that Mr. Mikkelsen had returned because she was not contacted and once she did discover that he had returned tothe i
jail, immediately went to his cell to check on him. Unfortunately, by that time, he was deceased. Her actions did not fall ,
below the Standard of Care. . y {
New infomation has been brought to my attention, that the individual and his son, who drove Mr. Mhckelsen from the auto -
dealership back to the jail. observed Mr. Mikkelsen taking a large quant-ity ofpi-lla (20 to 35) which have been identiiierl as 2
. Valium and Darvou just prior to arrival at the jail. Assuming this information is accurate, it is consistent with Mr. Mikltelserfs
_ behavior upon arrival to the jail and his subsequent death: ingesting such a quantity ofpotonlially lethal medication, indicates
to me that Mr. Milcltelsen was intent on committing suicide and not exhibiting a suicide gesture, especially when he told
custody and health care staffshortly alterward, that he had taken only 2-3 Valium. _
An ingomiorr ofsurli a qtrantity of medication would begin to show its effects in about 30 minutes, but not reach its peak thr j
_ several hours, Therefore, shortly alter the ingestion, he would begin to get sluggish and sleepy, but I would expect his vital ;
r n Case 2:02-cv-02252-JAT Document 278-2 Filed 10/26/2005 Page 2 of 3 s
09/23/2004 THU 17:11 [TI/RX N0 9168] @001
signs be normal. lt would only be after some time had passed, tl1at he would be unable to be aroused. I mn led to believe,
that there are internal investigation reports that state bythe time Mr. Mikltelseu was placed into his cell, that he no longer was
able lo talk. If this infbrmation proven acmtmte, than it is consistent with the history of ingestion given bythe driver and his
son. At that point, it would be the duty of thc ctllcer, to notify medical immediately so that they could come an evaluate Mr. ·
Mikketsen. Had it done so, I believe that Nurse Kinsley would have sent Mr. Mikkelsen immediately to the hospital. Failure
ofthe olilicer to notify Nurse- Klnsley of Mr. Miklcelserfs deterioration in my opinion, exhibited deliberate indifference to the
serious health care needs of Mr, Mikkelscn. I see nothing at this time that makes me believe that CHR steffcxhiblted
deliberate indifference toward Mr. Mikl
I reserve the right to change or revise my opinion timed on the receipt ofncw information on this case and verification ofthe
iufortuetiou I have been given.
Res , `
f
Roderic Gotmla MD .
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