Ereck Plancher trial: Medical examiner defends finding Plancher died from trait

Crime, Law and JusticeJustice SystemMedical ResearchHealthSecurityDiseases and IllnessesGeorge O'Leary

UCF Athletics Association attorneys aimed to discredit the medical examiner who testified complications from sickle cell trait contributed to Ereck Plancher's death.

Medical examiner Joshua Stephany told the jury Plancher's death was caused by complications from sickle cell trait. He said it is a genetic disorder that can cause red blood cells to break down organs when the body is under extreme stress.

He told the jury Plancher's sickle cell trait caused sickling, or malformation, of red blood cells. Stephany said the cells become flattened and are shaped like sickles. He said the cells become sticky and do not move easily through capillaries. Stephany said "sickle cell trait can become very harmful."

UCFAA attorneys have argued Stephany's conclusion was incorrect, and Plancher's death was caused by an undiagnosed heart condition. They contend the jury should find no one was negligent for the 19-year-old's death following an offseason UCF football workout.

Stephany said he considered whether Plancher's death was caused by a heart problem, but the medical examiner said Plancher died an hour after he first showed signs of distress and had a weak pulse for much of that time. Stephany said that would not be consistent with a "sudden instantaneous cardiac event."

UCF coach George O'Leary was scheduled to testify Wednesday in the Plancher wrongful death trial, but the Plancher family attorneys told the judge after a lunch break they did not think they could call him to the stand until Thursday.

UCFAA attorney Kevin Taylor told Circuit Judge Robert M. Evans O'Leary had a scheduling conflict and would only be available Thursday morning.

Plancher family attorney Steve Yerrid said he would do his best to call O'Leary at 8:30 a.m. Thursday and question him, but he did not want to compromise the presentation of his case. Yerrid said he understood O'Leary's coaching clinic scheduled for Thursday and Friday was important, but his clients had been waiting three years for the trial and deserved a fair chance to present their case.

After the medical examiner's testimony ran longer than expected, Yerrid told the judge there was no way he could call O'Leary in the morning. He said needed to play video highlights of athletic trainer Mary Vander Heiden before calling O'Leary.

Despite Taylor's objections, the judge ruled O'Leary may be called later on Thursday.

"I can't let his schedule dictate this trial," Evans said. "He cannot do it. We moved [the trial] from football season because football is an issue. Everyone has a busy schedule. Everyone. "

O'Leary supervised Plancher's final workout on March 18, 2008. Plancher collapsed and died after offseason conditioning drills.

UCFAA attorney Dan Shapiro cross examined the medical examiner, questioning whether he did a thorough review of Plancher's body before reaching his conclusion about the cause of Plancher's death.

Stephany said he had no experience sickle cell trait before Plancher's death. He also confirmed Plancher was the first person out of more than 1,000 autopsies whose death he determined was related to sickle cell trait.

Shapiro broke down each portion of Stephany's finding Plancher's death was caused by "dysrhythmia due to acute exertional rhabdomyolysis with sickle cell trait."

Shapiro asked Stephany about the way he studied Plancher's body to prove acute exertional rhabdomyolysis, which is muscle breakdown.

The medical examiner said there are a number of ways to determine whether muscle breakdown occurred. He said he studied myoglobin in a sample of Plancher's blood, which indicated there was muscle breakdown. Myoglobin is protein found in muscle tissue.

Stephany agreed that myoglobin in the blood increases after death. He also agreed there was no way to prove whether the myoglobin levels used to prove muscle breakdown happened before Plancher died.

Stephany said he did not use any other laboratory tests to prove the muscle breakdown, but he did use supplementary information.

During redirect by Plancher family attorneys, Stephany was asked whether sickling he found in key body systems were more than would typically occur in the body naturally after death. He agreed that his findings were based on a greater amount of abnormal red blood cells than would naturally occur after death.

Shapiro asked Stephany at length why he didn't do a serial examination of the cardiac conduction system, which UCFAA attorneys said would prove their suggestion Plancher's death was caused by a heart condition.

The medical examiner said he was aware Dr. Saroja Bharati, a cardiologist the Orange County medical examiners often consulted, recommended further study of Plancher's cardiac conduction system.

Bharati said she had never seen studies related to the cardiac conduction system and sickle cell trait, so she had interest in seeing what the conduction system showed in someone with sickle cell trait.

During Plancher family attorney's redirect questioning, Stephany said he viewed Bharati's comments as a recommendation for research purposes rather than something that needed to be reviewed to determine cause of death.

Stephany said it was a last case resort for medical examiners who cannot find a cause of death. He said he did not believe it was necessary to complete Plancher's autopsy report.

Dr. Randy Eichner, who previously worked as the team doctor at the University of Oklahoma and has since retired, has done extensive research of sickle cell trait causing sudden death in athletes. Eichner corresponded with Stephany about sickle cell trait before the medical examiner completed his autopsy report, but Stephany said it had no impact on his findings.

Eichner contacted Stephany immediately after Plancher's death and corresponded him regularly about proving sickle cell trait caused Plancher's death. Eichner was eventually hired by the Plancher family in July 2008, about four months after he first began communicating with Stephany, to serve as an expert witness on sickle cell trait.

Shapiro asked Stephany to read through the emails for the jury, noting when it appeared Eichner and Stephany collaborated to prove Plancher's death was caused by sickle cell trait. Stephany said there are times when outside experts contact the medical examiner's office, but it does not happen often.

When he was asked whether he consulted Eichner more than any other person while determining Plancher's cause of death, Stephany said he recalled speaking more with his colleagues in the medical examiner's office than Eichner. However, he agreed there was no written record of those conversations.Stephany agreed when he was asked whether Eichner's emails were "remarkably similar to what you found on your death certificate."

During redirect questioning by Plancher family attorneys, asked why Stephany referenced Eichner's articles on sickle cell trait as footnotes in the autopsy report released to the public.

Stephany responded, "I thought they were fairly easy to read for anyone requesting the autopsy report. There's not a lot of clinical terms."

The attorneys continued to clash, prompting the judge to warn them throughout the day about following court rules.

The attorneys agreed to interrupt the Stephany's testimony Wednesday morning to question Plancher family computer forensic expert Andy Swenson because he had a scheduling conflict and would not be available later in the trial.

Swenson testified he had more than 30 years experience with computer security and information technology. He stated he did a thorough search of Plancher's laptop for any references to the terms sickle, sickle cell, sickle cell anemia, sickle trait, anemia and names of UCF football coaches. Swenson said there was no record of any of those terms on Plancher's laptop besides definitions of some of the terms automatically loaded with Microsoft Word's spell check dictionary.

When he was cross examined, Swenson said he did not recall the specific dates the laptop was used but he thought it may not have been used in early 2007.

UCFAA contends Plancher first tested positive for sickle cell trait in January 2007 and was informed of his condition. Plancher family attorneys argue he did not know he had the trait.

Swenson was also asked if he researched any other computers on in labs on the UCF campus and he responded he did not.

Plancher family attorneys played video highlights of UCF wide receivers coach David Kelly's deposition for the jury.

Kelly testified Plancher was "a fantastic kid."

"He was a very private, reserved, not good-natured but great-natured human being who only cared about -- who cared about others and their well-being much more than himself," Kelly said. "I mean, he truly characterized what we stand for not only in the UCF football family, but more specifically in our wide receiver football family, the term of family, caring for one another more than oneself."

Kelly, who was Plancher's position coach, said he did not learn Plancher tested positive for sickle cell trait until after the player's death. Kelly said he did recall the UCF football coaches ever meeting with athletic trainers to discuss sickle cell trait.

"We respect each other and whatever our area of expertise is, we trust that each other's going to do their jobs," Kelly said.

He testified he never saw Plancher fall during the workout, but added it was possible Plancher fell in an area he was not watching.

The jury was released at about 5 p.m., but the judge and attorneys stayed in the courtroom to review objections to video highlights of Vander Heiden's testimony that will be played for the jury Thursday morning.

Before the jury entered the courtroom Wednesday morning, both sets of attorneys read objections into the court record.

UCFAA attorney Anne Sullivan's list included an objection to Plancher family witnesses referencing other athletes whose deaths have been tied to sickle cell trait. UCFAA protested it was not allowed to reference other athletes at UCF who had the trait but did not suffer any problems during workouts.

Evans said UCFAA withheld information about those athletes despite repeated requests from the Planchers.

UCFAA provided the number of people on the football team who sickle cell trait at the time of Plancher's death, but they stated federal privacy laws prevented them from releasing the names of those athletes.

Evans previously ruled if they did not release the players' names, UCFAA could not use them as part of their defense.

Evans asked Sullivan to sit down and instructed the attorneys to move on to the next topic.

While Plancher family attorney Steve Yerrid began speaking, Sullivan stated, "Judge, we never withheld information."

Evans admonished Sullivan for interrupting Yerrid and disobeying his order.

"I'm tired of that," Evans said to Sullivan. " I said I'm tired of that. After this is all done, you're going to stay here I'm going to have a contempt proceeding on you. You may want to consider getting counsel for that."

Shapiro and Yerrid are the lead attorneys and have interrupted the opposing side the most during the first eight days of the trial.

Taylor asked the judge to understand that the team of attorneys were simply trying to aggressively defend their client and did not mean to disrespect the judge. Sullivan was upset and briefly left the courtroom. Taylor said she was an appellate specialist who simply was trying to make sure the record accurately reflected objections for any future appeals.

Evans told the attorneys the cameras in the courtroom seemed to have an impact on the their demeanor, prompting them to continue aggressively arguing points after the judge has ruled. Evans said Sullivan may have been in the wrong place at the wrong time. He backed off his plan to start contempt proceedings against her.

"It's not my intent to upset you, it's my intent to reign in everyone," Evans said to Sullivan when she returned to the courtroom.

She responded, "I'm not upset. I apologize."

Evans also urged the attorneys to use their time wisely. He said both sides agreed to a three-week trial and promised the jurors they would stick to that timeline.

"When you run out of time, you run out of time for anything other than to sit and watch," Evans said.

The judge told the attorneys after releasing the jury Wednesday that the Plancher side has 15 hours and 10 minutes remaining for questioning of witnesses, objections and closing arguments. He said UCFAA has 19 hours and 44 minutes. Evans said he would be willing to work late and during the weekend if the attorneys made a compelling case that they would not receive due process and be able to complete their case in time.

Check back for live updates throughout the day. ilimon@tribune.com or 407-650-6353. Read Iliana Limón's blog at OrlandoSentinel.com/knightsnotepad.

Copyright © 2014, Los Angeles Times
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Crime, Law and JusticeJustice SystemMedical ResearchHealthSecurityDiseases and IllnessesGeorge O'Leary
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