Stanwood Elkus was enraged over a 21-year-old unsuccessful surgery when he drove to urologist Ronald Gilbert's Newport Beach office and fatally shot him, an Orange County prosecutor alleged Thursday.
Prosecutor Matt Murphy told jurors during opening statements in Orange County Superior Court that Elkus, 79, of Lake Elsinore was fixated on the 1992 procedure, which Elkus alleges left him incontinent and suffering from erectile dysfunction.
Elkus, a retired barber, is facing a special-circumstances murder charge with a possible sentencing enhancement over use of a firearm. He has pleaded not guilty by reason of insanity, according to court records.
In 1992, Gilbert was a young medical resident working at the Veterans Affairs hospital in Long Beach. He worked with a team of other doctors to diagnose Elkus with a urethral stricture — a narrowing of the urethra — after he complained of frequent urination, Murphy said.
Two other doctors at the VA performed surgery — without Gilbert — to widen Elkus' urethra, but Elkus continued to hold a grudge against Gilbert, Murphy said.
"Mr. Elkus began to blame all of his problems on this procedure," Murphy said. "Whatever went wrong in his life he'd blame on the procedure. He obsessed over this."
He became even more forlorn and angry when other doctors in the years following told him he had been initially misdiagnosed and hadn't needed the surgery at all, according to Elkus' attorney Colleen O'Hara.
"It was further confirmation that his suffering was for naught," she said. "He became more and more upset and focused on it."
Murphy alleges that in 2010, Elkus started to make plans for revenge.
He created a living trust for his sister to assume control of all of his assets and property in the event of his death or incarceration and printed out MapQuest directions to Gilbert's Newport Beach office. In December 2012, he bought a Glock 21, a .45-caliber handgun, and practiced shooting about 150 rounds with it, Murphy told jurors.
On Jan. 20, 2013, Eklus made the roughly 55-mile drive from his home in Lake Elsinore to Gilbert's office off Superior Avenue and made an appointment under a fake name to return to the office eight days later.
Murphy alleges that Elkus began putting his affairs in order in the week leading to the fatal shooting. He left copies of his trust, instructions for his rental properties and a reminder to pay the gardener on a cabinet in his house. He packed a bag with his medication, loaded his gun and drove to Newport Beach.
Murphy's version of events paints Elkus as clear-headed and diligent in his plan to harm Gilbert.
"The evidence shows very clearly that Mr. Elkus left his home on Jan. 28 without any illusion that he'd be coming back," Murphy said.
Based on witness accounts, Murphy described to jurors how the shooting unfolded, starting with a receptionist asking Elkus — who was using the name Allen Gold — for identification.
He told her he'd left it in the car, Murphy said.
Eventually, a nurse led Elkus to an examination room. When Gilbert entered the room, he was shot 10 times in the chest, neck and side. All but one bullet went though his body, leaving holes in the wall.
Elkus opened the door holding a handgun and told a nurse, "I'm insane, call the police," Murphy said.
Gilbert, who lived in Huntington Harbour, died on the floor in the hallway outside the exam room, despite his colleagues' attempt to save him. Elkus handed over the pistol and waited for police to arrive, Murphy said.
Gilbert's family passed tissues and wiped tears in the courtroom as Murphy described the killing Thursday.
Elkus, who was wearing a headset to assist with his hearing, sat in a wheelchair, listening intently to the opening statements. He smiled at the mention of his now-deceased dog, Toby.
In contrast to Murphy's version of events, O'Hara told jurors that Elkus was not in a coherent state the day of the shooting.
O'Hara said Elkus had not intended to harm Gilbert when he made the appointment with him but that an anti-depressant he had begun taking in the days afterward weakened his inhibitions and led to the deadly shooting.
Elkus, she said, suffers from dementia and has severe brain damage that affects his inhibitions, impulse control and ability to feel empathy.
In the decades after the 1992 surgery, Elkus sank into a deep depression that appeared to worsen each year, which O'Hara argued contributed to his diminished brain function.
Images of Elkus' brain displayed for jurors showed low levels of brain activity.
The trial is expected to continue next week.