kristin rossum v. deborah patrick - Ninth Circuit Court of Appeals

17402 ROSSUM v. PATRICK
son commented to one of the toxicologists at the OME that he
had looked at a sample of de Villers’s stomach contents.
That same day, November 8, Russ Lowe—the veteran
OME employee who served as acting laboratory manager
before Robertson supplanted him—called the police to report
Rossum’s and Robertson’s affair. Lowe’s call was a turning
point in the investigation, focusing the police’s attention on
the possibility of foul play.
Toxicology tests showed that de Villers’s autopsy specimens
contained extraordinarily high concentrations of fentanyl,
as well as a smaller amount of clonazepam and a trace
level of oxycodone. Dr. Blackbourne characterized the concentration
of clonazepam found in de Villers’s blood as a high
therapeutic level, but not at the level of an overdose and “not
fatal.” He conceded, however, that sometimes postmortem
testing reveals a lower concentration of a drug than had previously
been present in the body. The jury also heard testimony
that oxycodone, which is an opiate, and clonazepam, a benzodiazepine,
can have a “synergistic” effect on each other,
meaning that each drug is made more powerful when taken
with the other.
The discovery of fentanyl in de Villers’s samples was
unexpected; the OME did not ordinarily test for it; Pacific
Toxicology, the outside laboratory to which the samples were
first sent, did so regularly. After receiving the test results, Dr.
Blackbourne concluded that de Villers died of acute fentanyl
intoxication.
Prior to Rossum’s trial, de Villers’s samples were also sent
to two other laboratories for testing: the Alberta Office of the
Chief Medical Examiner in Canada and Associated Pathologist
Laboratories in Las Vegas, Nevada. As the following
chart demonstrates, the concentration levels of fentanyl measured
by the different laboratories varied: