Groves Trial Day 1 - Stacey Riffitt - Maternity Ward Nurse

back on the record state of Ohio versus Daniel groves in state of Ohio versus Jessica groves the counseled parties and the jury are back in the courtroom mr. teaming firm in session so you may call your next witness thank you your honor the state of Ohio we call Stacey rip it [Music] please raise your right hand for me please you solemnly swear the testimony you're about to give will be the truth the whole truth nothing but the truth so help you God please have a seat a man there are media in the courtroom do you have any objection to your image being film or photograph during your testimony sturdy man Ewbank wire man would you state your name for the record Stacey rip it and could you spell your first and last name for the record sta Cey RI FF I tt thank you ma'am where you from I'm from Franklin furnace and that's here inside Ada County for those that might not know how long have you lived inside accounting my whole life 46 years we received any education yes I have an associate degree in nursing from Shawnee State and then a Bachelors of Nursing from Ohio University would that make you a registered nurse yes registered nurse is there any additional training or protocols that you had to go through besides your formal education well when I became a nurse at a Southern High Medical Center we had an orientation time that was kind of like on-the-job training that gave us better skills in the maternity Department when did you start working for southern Ohio Medical Center in 1992 in that time what positions did you hold at southern Ohio Medical Center my hope rear has been in maternity and for 25 years I was a staff nurse and then I became the assistant assistant nurse manager of the nursery two years ago this past October alright so if I do my math and I'm a lawyer that would mean 2017 you became okay yes the assistant nurse manager yes okay what does it mean to be a nursery nursery staff nurse well a nursery staff nurse we are there to take care of the babies when that delivery we had 10 deliveries and like a maternity nurse we're all maternity nurses but an ldrp nurse would take care of the mother and then at a delivery the nursery comes in as soon as the baby is born then we assumed the care and we would help the mother do skin-to-skin by placing the baby on her chest helping her with breast feeding assessing the baby's needs if the baby is in distress then we would take the baby to the nursery area on our floor and provide extra care now what are your duties as the MS an assistant manager or the manager of the nursing staff I am responsible for doing like the schedules for the staff making sure that our protocols and policies are up-to-date current I do research to make sure that we're providing the best practice of care and then I help develop like order sets at the physicians decide on and make sure all that is correct now in your role as a manager of the nursing staff do you also take turns or take shifts where you're actually staffing the nursery it's a week I'm actually a staff nurse so I will work my eight-hour shift at alongside the regular staff staffing in the nursery now I'd like to direct your attention to January 10th of 2019 do you recall that date I do were you working that day yes I came on at 7 o'clock that morning and what was your shift do you recall 7 to 3:30 afternoon and just for clarification where we working the nursery that day were you familiar with a baby that was born earlier that morning by the name of Dylan groves were you also familiar with his parents Daniel and Jessica yes yes at the time I knew the dad I had not met the mother yet was there did you subsequently meet the meet the mother yes later I did are they in the courtroom here today yes could you identify him for the your points on please sitting over there [Music] the record reflect my hand was previously marked the states into the for the title of the SOC medical records Mamo hand these to you if you need to refer to them this is a a mic under here so if you lay it down on there be very gentle okay that doesn't pick up too much those are the medical records of Dylan gross yes it is okay did you play a role in this care of baby Dylan and the interaction with his parents yes what was your role when I came on seven the baby was in our intermediate care nursery meaning that he was laying on a radiant warmer receiving oxygen and so I came in and received an oncoming report from Tori how what kind of information is in that oncoming report well they tell us what time the baby was born the date and time of birth if there was any risk factors if the mother how her prenatal care was as she was posted for drugs or not so any history how the baby's assessment is what if since this baby is not on oxygen tell me the amount of oxygen if any medication have been given to the baby or the mother and just the condition of the baby this report does it come in the form of verbal communication or written communication or both it's mostly verbal but we have the chart have the written chart excuse me the paper chart and then the computer charting so what's this protocol or procedure done with baby Dylan yes were you aware of any substance abuse reported with the mother at the time I knew that she did that yes she was positive for amphetamines okay and how does that affect your treatment of a child born in that situation well we have certain orders that the pediatricians have collectively come together and decided that we would do further care on these newborns we would get a urine drug screen initially from the first gern we would send off a piece of the cord to be tested and then we would involve social service in their care no I'd like to back up a moment was there a diagnosis made with regard to baby Dylan do you mean concerning the care that we are providing concerning the substance abuse issue with the mother it's called neonatal abstinence syndrome and that is when a baby has been exposed to a drug a substance mostly the the opiate which role these babies will start experiencing some withdrawals so this diagnosis goes and leads us to do an assessment every four hours called a Finnegan assessment what is the Finnegan assessment we perform it on the babies we look at them for a 30-minute time frame and there is a set it's a tool that we use and it is broken down into three different categories we would look at the central nervous the neurologic then we look at the three different ones and symptoms that we can see that the baby is experiencing this was developed by a doctor after a research and it's a tool that we have come up to give us a score on these babies each of the symptom is has a number that we assign to and then you add all those together and if the score is at the time if it was eight or higher than we would see that the baby was exhibiting signs of withdrawal from an opiate use okay and I want to clarify this withdrawing from opioid abuse what does that mean it would be different symptoms that we would experience or the baby would be showing maybe the baby is very irritable not sleeping well having tremors where the baby is being disturbed meaning that we've done wrap the baby's blankets or touch the baby causing them to tremor or if the baby is wrapped up and just laying in the bed shaking all over sneezing is that also one of the then it would be there's there's several that they could have they could have sneezing they could have loose stools not sleeping well modeling of the skin several different signs of the drop so the first statement that some of these signs are normal they are normal things but the way we explain it to parents is if you see one or two of those any baby could have that but when you have several of them together then it that makes the score go higher because it's a sneezing is one point and tremors is two points but together that makes three and the higher the score then the the more symptoms the baby is exhibiting one way to describe it would be if there's a storm coming and you know it's been predicted that there's a storm so dark clouds will be coming in the sky the Sun is hidden behind the cloud the wind starts blowing maybe it gets a different smell then you know those are signs that a storm is coming but if you're just outside in the winds blowing or that gets a little cloudy you don't know there's been a storm but when you have all of those symptoms together it shows that the end result is going to be a storm so that's how this Finnigan goes if you have you know up to the eight points of the symptoms then that shows a baby is exhibiting these signs with regard to the finnegan do you recall the scores or assessments that were made with baby Dylan I would have to refer back if that's good is it a fair statement that typically when you're looking at those they're on a computer screen and it might be easier to access them yes this in the paper is one symptom or two symptoms first thing and on the computer and we have them all together so I'm sorry looks like the first one that he had was around twelve o'clock eleven thirty twelve o'clock the day of birth and he got a four it's like a four for tremors and disturbed tremors and disturbed tremors I don't get it what is the difference on tremors and that would be if he was laying wrapped up in the bed and no one is bothering him and he was tremoring that would be an undisturbed tremor and they can be mild or normal or moderate and mildest when just the upper part of their limbs are shaking or the bottom and moderate would be all over and then that's a disturbed and undisturbed is when you would go I'm sorry I said that backwards and then disturb is when you're not bothering the baby and you see the tremors a disturbed is when you would uncover them or touch them and cause them to tremor okay thank you were there other Finnegan stores later as the withdrawals progressed yes he had tremor excuse me he had Finnegan scores every four hours until he was ready to be dismissed why do they continue to measure Finnegan scores well as the baby develops his own system then they may start exhibiting other signs because with the mother being positive also on a mission the baby was receiving as the mother took in the substance the baby must have being exposed to that because it the baby swallows it and then excretes it out and then all of that amniotic fluid has all the substance in there and so day after day of being exposed the baby's swallowing it excreting it swallowing excreting it so when the baby is delivered and then it's away from that substance then it starts to start missing it and so it starts withdrawing from that okay there were some terms that were associated with with babies experience in this could you explain disorganized infant uh what am I trying to say here was it either my defendants or nice sucking or just this disorganized care are being able to control itself babies every baby cries but a baby should be able to cry for a short time without getting assistance and then gather itself back to where it can calm down just because a baby cries doesn't mean that it's hungry or it needs a diaper change sometimes babies cry because that's just the sound that she they make but they should be able to calm themselves down and then just lay there quietly but Dylan was not able to do that he needed some assistance to try to bring himself back to the center so we had to comfort him wrap him in a blanket maybe put a positioning tool so that he felt safe so he wasn't able to gather himself back together and acute it's a pain due to substance abuse pain yes just as an adult in all of the evidence that we have done adults go through discomfort and pain from withdrawing babies due to and they that's a way that they exhibit the signs where they cry they cannot settle they shake because of the pain of needing the substance that they had in utero in addition to the the observations and assessment you did through Finnegan scoring were there any medical tests perform that confirm Dylan had been exposed to drugs in utero yes we did a urine test on the baby and his urine came back positive for the amphetamines and then also we sent the youth the double cord off and it came back for multiple positive why do you utilize the umbilical cord to test for substances bambo the cord will show every substance the mother used from 20 weeks gestation on and a lot of times if a mother is using something it's on us it's on everyday use it may not show because it's a there's a certain level but mothers that use different drugs and they may be just used what they can get a hold of it has peaks and valleys and the cord allows us to see everything that she might have taken during her pregnancy from 20 weeks thank you other than the diagnosis from being exposed to drugs and withdrawal symptoms did Dylan have any other complications or concerning health conditions he was on some oxygen which is very common that a baby until they stabilized themselves from just the trauma of delivery they may need some oxygen but I weaned him off of oxygen within an hour and a half after he was born so he was doing really well I was able to bathe him and he was very healthy were there any physical injuries as a result of the birth no during the course of your duties in the nursery did you have an opportunity to interact with the parents of baby Dylan I did tell us about those interactions well in the beginning when I got there the father came in soon after and he was standing by the side of the bed and I was able to talk with him at length and I after I introduced myself I asked him if he could tell me why they his wife did not go to the doctor why she did not receive prenatal care and he told me because she was taking heroin and she had found out late later that she was pregnant but that she was taking heroin enough to keep the withdrawal symptoms did you learn anything about Ms groves training or education she was a nurse now at this point in time what was mr. groves demeanor he was quiet he only spoke if we if I spoke to him he kept his eyes kind of low he had a hat on but he kept his eyes kind of low and wanted to touch the baby too if he would like reach up to touch him some but he's kind of wrung his hands a little bit like this and just seemed a little withdrawn did he make any statements with regard to any substance abuse by himself he did not now at this point early on this period that you're talking the father wouldn't when did this occur do you recall I was it was early on my shifts and the baby was still on oxygen at that time so it must have been you know I came on at 7 o'clock so that was early on and he was still in office until about 8:00 8:30 8 or 8:30 and then he left okay so if the baby was born at 5:50 4 a.m. approximately an hour later he came in yes to your knowledge did the father ever discuss any drug usage with hospital staff yes he told me later in the afternoon it probably three o'clock before I left that he had I asked how the mother was and he said she was doing okay and he told me he had just talked with a physician and ask if meth could be found in heroin now you'd had this initial conversation and apparently he came back later to the nursery was there any change in his behavior demeanor in this second time you saw him yeah there was a big difference his eyes looked a little more glassy he would not make eye contact with me his speech was slow he's not slurred but it was definitely slower it's like he had to concentrate before he said anything and he he definitely just looked down and was quiet you believe you testified you've worked approximately 27 years something have worked 28 years in SMC one year as a nurse tech in 27 as registered nurse in that time have you experienced or observed individuals under the influence of various substances has that been able to make you identify or recognize symptoms yes and from those did you have an opinion as to the father's intoxication at that point expert please the court for this type of flow yes I believe that he had used something heinous understand for Vincent did you smell any alcohol did you smell marijuana not to my knowledge okay very familiar with the smell of marijuana unfortunately yes okay we have patients that are visitors that usually tell us that they are using so yes okay did you explain to the jury the discharge process for a linking back up how long was baby Dylan at the hospital it's their five days I believe is that a usual amount of time for a baby born under these conditions we usually like to keep them about 72 hours because a mom that any baby that we're suspecting opiate which is the heroin used then for 72 hours these babies could their symptoms could come out more and their Finnegan scores could go higher so the P attrition likes to watch them for 72 hours a baby that's been kept longer probably was showing these signs at 72 hours and they just wanted to keep and watch just to make sure if they're going to kind of tip the scale the score is going to go higher and maybe need to be treated what was the pattern with regard to Dylan's Finnegan scores have to look and see what the scores were them together sorry there's a lot of paper here I understood [Music] okay looks like the scores went from a three all the way up to a nineteen what's the high and for Finnegan score it can go any of the lowest score can be a zero but when we start to think they're having withdrawal symptoms it's an eight an eight or higher and at that time if we get a score of eight or higher then we have a second or income and do a assessment with us so we can verify the score okay does that explain the length of your time at the hospital yes as the scores got higher at 72 hours looks like was having a 14-1 time so they kept a baby another day and then the scores did go back down but not enough that they felt that he was without the symptoms that we thought you'd mentioned earlier protocol with regard to a child born under the influence of drugs or withdrawing from drugs you'd mentioned contacting I believe social services could you explain what social services yes we have social service department in our Hospital and when we have a child that has been exposed then we have them come in and they are licensed social workers then they go and speak with the mother and try to get the story of her risk factors or why she didn't receive care or why she was using this substance and then if they feel that further care or assistance is needed then they are the ones that call Children's Services and on the case okay and was to your knowledge with Children Services called in this matter yes we have the social services workers coming in to discuss that part so I'm going to skip ahead here is there a discharge process for an infant at Esalen see yes let me back up one second was this infant discharged with his parents yeah who was he discharged with do you know um he went he went to foster care so he was under the authority of Children's Services that they discharged him to foster care okay thank you so again was the discharge process for an infant before that infant can leave the hospital well the baby has to be eating well they don't always gain weight because they may lose some weight in the beginning able to a normal baby would not have a Finnegan assessment but on Naas or neonatal abstinence syndrome infant the scores have to be less than eight and they have to have been avoiding and having you know diapers and making sure that their bilirubin is good and that they're able to heat was a little early 36 weeks so the baby had to have passed the carseat test to be able to go home okay what's the car seat car seat tests entail a car seat test and we do on babies that are what we call a late preterm and that means less than 37 weeks gestation and they have to be able to be fitted in the car seat with the straps you know buckled in and be able to sit for an hour and their heart rate respiration and option saturation level has to we have guidelines that we follow what they have to be able to pass at this point on this charge did Dillon meet all the criteria from the hospital on the day of discharge is that what you're speaking how to do you have discharge have to go back and look but I believe everything once we got the carseat test completed that yes okay thank you ma'am for a question shot good morning with surfing a couple questions about the Finnegan scores you mentioned earlier that he had a Finnegan score of what to what what was his Finnegan scores his pattern looks like the spores were threes any range anywhere from a three well I said nineteen but I could be mistaken there sir I just saw that was a date not so I apologize for that so let me look at another part of the chart it's like I said this chart is similar and it's very hard to read [Applause] there was a serene I'm sorry I'm just saying that the story I'm trying to find the very last one because they just range 7 server yes so I apologize so with 8 being the score that we watched for before we treat them that is why he was kept the extra days in the hospital and you want to give medication to babies who have a thin against poor above a crowd I'm sorry you know at what point do you give medication when the scores are eight or higher baby would have three eights in a row then we would give the medication and no medication was given to baby Diller yes sir okay at any time did you have it any interaction with Jessica groves I did ok what were your observations of her well I really only had one observation with her and when I took the baby out she never asked to hold him never asked what condition he did come off of his oxygen because it was right after the bath and she only kept him for 15 minutes okay no observations after that no okay were you familiar with some of her complications after delivery yes what were those complications um I believe she had a postpartum hemorrhage okay I mean she had increased bleeding after her delivery okay and because of that complication what what had to be done I know she had to be transferred to another unit for tear that's not provided on our floor okay and would that make it more difficult and to get to the nursery to visit the baby yeah okay do you take the baby off the floor down the other floors we do if the mother requests to see the baby we have taken we have security come with us to escort us down okay no further questions I believe that you've indicated in your testimony on direct examination that you did meet the father pretty quickly after you came on shift is that correct yes and you did come on shift around 7:00 a.m. on the day of Dylan's birth is that correct yes and you said that he Dylan was on oxygen for approximately an hour and a half of the for the first hour and a half of his birth is that after Zwerg correct so that took that up to about 8:30 correct yes okay answer just make it a record I know it's it's it's terrible but we got to insist on a outloud answer and you did meet with the father while the baby was still actually on oxygen correct correct okay so he was there at some point time before 8:30 in the morning correct yes okay and then you talked to him a little bit about mrs. groves pre no prenatal care correct yes and did he indicate to you when he actually found out that she was pregnant how far along he didn't have her pregnancy he did not say how far along but he just said it she just found out not too long ago or recently okay so she delivered him and what you all determined to be around 36 weeks correct yes we determined that by a gestational age assessment it's a sort of our tool and he indicated to you that she just recently found out that she was pregnant correct correct and so he obviously then just found out that she was pregnant fairly recently correct correct okay so he may not based on that conversation with him had known she was pregnant for very long correct right okay you also described mr Groves as being very quiet and he spoke to you when you spoke to him correct okay yes okay and that he never admitted to you that he actually consumed any substances he did a little list of substances correct the hospital perform a drug screen on mr. gross no I know he's not listed as a patient but I did not know if that was something that you performed that's not a routine thing that we did okay and you at some point in time were became aware that Children's Services became involved with this family correct correct were you aware that Children's Services a representative from Children's Services performed a drug screen on mr. groves the evening of Dylan's birth I did not know that okay and whether you did or you did and I did not know if you knew that or not so if you did not know that then you did not know that it was a negative drug screen correct straight okay and Daniel grows appeared as if he was trying to be attentive to the baby by trying to touch the baby's hand I believe that you described initially yes okay and that did he kind of appear like he was scared to touch maybe what appeared to be a fragile baby I would say that okay is that a typical with parents who have babies that appear to be medically fragile yes it is okay it is a very typical reaction yes so that behavior of him would not be out of the ordinary No okay thank you and the the second time that you met him do you recall if it was your next shift within that same she does that same day okay and you that's just later in that shift that's the incident that you're describing him as appearing to have glassy eyes speaking slower and what's much more quieter d'hubert yes okay do you recall what time the day that was it's probably around three o'clock in the afternoon because I leave at 3:30 okay I might have to go back and look in my the chart to see what I charted but I know it was near the end of my shift okay so around 3:00 p.m. is when this incident happened or this interaction happened that you're describing as behavior that you are suspicious that he have may have consumed some type of drug yes okay did you see him consume any type of drug no did you see if he even left the hospital between that first interaction in that second interaction with him I just know he left the nursery just left the nursery but you did not see him go anywhere okay and I do know and I and I appreciate the fact that you have many many many years of experience and medical training but your assumption is just that correct it is an assumption it's an assumption based on just my years of experience sure it is speculation correct yes you do not have any definitive or direct proof that he consumed anything that he should not have consumed correct correct okay and if he had passed a drug screen later that on that evening around 8:00 p.m. for Childress's would that potentially negate the fact in your mind that he was on something not necessarily because it just depends on the substance that the person is using some of it has a short-acting half-life means but it's extruded quickly so within just a few hours yes okay okay but there's no reason to believe you you would have no idea what may have caused him to act like that other than your assumption correct he could have been crying in another room could he have been crying and upset zooming okay he have just be reeling from the facts that he just had a newborn baby that he had learned about recently and the baby was born 30 at 36 weeks and was struggling could be upset about that I'm assuming okay [Applause] [Applause] based on your interactions with mr. groves in your observation of him did he seem to have a genuine concern about his infant yes I think he did okay thank you ma'am I talked about as an analogy symptoms of a storm in your in your direct testimony so let's think about that a minute for your observations with regard to his behavior and that subsequent discussion you had with him all those observations you had in and of themselves what did they lead you to the opinion that he was doing at that point I believe he had taken a substance that would alter his behavior did you think he was crying in another room no did you think he was upset over something that happened on SportsCenter or something like that your your conclusion was based on 27 years of observations and experience in the medical care and the daily observations that your maternity ward sees is that correct yes that's correct now she Scott asked you about a drug test you weren't aware of a drug test I think it was basically your answer yes and then you wouldn't be aware of any questionable practices with regard to that drug test would you yeah you wouldn't be aware of any possible people providing urine for the father with that drug test would you I would not do parents visit with children that are on oxygen in the nursery yes quite often yes quite often and this postpartum hemorrhage do you recollect approximately when that occurred in this groves care I know it did not happen right away because she delivered rather early before I got there and this did not happen until I know after the bath and the bath was around ten o'clock in the morning so I know it happened because the baby came back to the nursery before this all before the hemorrhage occurred so there was plenty of opportunity from his groves to go to the nursery or to call the child to where she was at yes mothers can request infants to come out anytime and when I did take the baby she didn't ask I just took the baby out and she kept in for 15 minutes what was her interaction with the baby at that point she didn't home to him she didn't ask how his condition was she just said him there on the wall there further questions here across the sky you were asked by mr. teaming to follow up with your observations and your belief that my client had taken some type of illicit substance and that his appearance to you was not based on any other behaviors such as crying or being upset correct yes okay so and you were also asked in regards to not being aware of a drug test or how the drug test was performed correct okay so were you aware of anybody else such as their older child Daniel jr. was present at the hospital with the parents he was there at some time yes Durer was it that day yes I did meet him later that day okay do you recall when that was it wasn't the first meeting okay father later that afternoon so was then in the teenage trial with with him at that time yes at that time okay so let me ask you about this you gave me an answer and follow basically up with mr. teaming that you still believe that my client was under the influence of some type of illicit substance and we're going to get into who performed the drug screen when they performed the drug screen and under what procedure and protocol they performed that drug screen but let's just take it as of right now and my hypothetical question that he passed his drug screen it was given properly and it was under appropriate protocol and it was not faked in any way for lack of better words we looked at it a suspect or things like a jacket at this point beyond normal speculation your honor my mr. teaming asked miss riff 't if she was aware of a drug screen being given if she was aware of it what the test would be and what the practice and protocol of it was if it was given under questionable circumstances okay thank your honor okay let me just go ahead and ask you this then what drugs would have a half-life or whatever words you indicated between 3:00 p.m. and 8:00 p.m. if this drug screen was given properly um excuse me I know that if a person had taken some form of amphetamine or a speed excuse me is the term that has a short half-life and I know we have tested mothers that have admitted to just taking or smoking marijuana and it not show a positive I don't have the evidence in front of me so I can't say that a hundred percent but I'm just speaking from my practice of what we have done in the past on my floor so some form of speed which is a form of methamphetamine or some type of NF Etta mean correct yes and marijuana yes and you already stated that my client did not smell as if he had been consuming marijuana didn't smell it I wasn't super close sure however did he appear to have the same clothing on at the 3:00 p.m. meeting as he did in the meeting earlier in the day I didn't pay attention to his clothing so I can't say okay Your Honor if I can have just a moment thank you Miss Scott does either side have any additional questions for this witness [Applause] Stratton she excused and you're free to go thank you very much for your time here today just came back available ladies and gentlemen it's gonna be a good time to take our noon recess now yesterday I I kept you here pretty long and it give you much for lunch I'm gonna try to be better to you here the next to the rest of the week we won't always stop right at noon on the water today that I'm going to give you an hour for lunch here today remember our earlier admonition to you did not discuss this case amongst yourselves do not permit anyone to discuss it with you or in your presence it is your duty not to form or express an opinion on this case until it's finally submitted to you leave your notes on your chairs the bailiffs will secure those they make sure they're not disturbed during the recess I want to ask that you be back in the jury room by 10 minutes after 1:00 I give you a full hour and B my intention to be back here in the courtroom as soon as you're ready no later than 115 or is recess

Channel: Law&Crime Network

Views: 286,842

Keywords: Dylan Groves, Groves Trial, Jessica and Daniel Groves Trial

Id: C_PsrXRF0Wk

Length: 52min 27sec (3147 seconds)

Published: Tue Jan 07 2020