Exhibit 5 Part III — Case 1:04-cv-10981-PBS (Document 1636-13)

Summary

Document 1636-13 in Case 1:04-cv-10981-PBS, filed 01/23/09, is Exhibit 5 Part III: pages 618 to 673 and 686 to 689 of a deposition in which Ms. Schultz questions an expert witness, addressed as Doctor, as Mr. Fromson objects. The questions concern the witness's opinion on the suicide of Susan Bulger and the risk factors the report listed. The witness testifies that being on Gabapentin for a protracted period of time was the significant contributing factor. Counsel presses on Susan Bulger buying cocaine six months before her suicide, word that she was back on the drugs, methadone withdrawal, Ron Bulger's physical abuse, five months without contact with her sister Linda Landry, and chronic pain. The witness says these were considered, that there was no specific evidence she was using at the time of her suicide, and reaches no opinion on withdrawal.

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Case 1:04-cv-10981-PBS Document 1636-13 Filed 01/23/09 Page 1 of 14

EXHIBIT 5 PART III
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1 my overall thinking and assessment that form | 1 MR. FROMSON: Objection.
2 the basis of my conclusions. 2 Asked and answered.
3 So that when I concluded that 3 THE WITNESS: Yes.
4 this patient had been on Neurontin for a 4 BY MS. SCHULTZ:
5 long period of time, that that increased her 5 Q. And so when I ask you if you included
6 GABA levels in her brain, that increased 6 aspecific portion of a record in your
7 GABA levels in short or long periods of time | 7 appendix, all I need is a yes or no answer.
8 can increase the likelihood of suicide, 8 A. And I've answered that, and I'll be
9 that, in a reflection of all of the risk 9 happy to repeat my answer.
10 factors and all of the protective factors 10 Q. I don't want you to repeat your
11 that this woman demonstrated, that, in my 11 answer. I'm going to ask you the next
12 opinion, based upon my conclusion as 12 question. | just want you to be clear with
13 referenced by all the facts and all the 13 the question I'm asking you. I'm not asking
14 information that I've had to examine, that 14 you what you considered with all of the
15 that was the significant contributing 15 documents you reviewed. I am asking you, is
16 factor, being on Gabapentin for a protracted {16 it one of the facts that you pulled out and
17 period of time, and acutely on the day that 17 placed in your appendix? That's all I'm
18 she committed suicide. 18 asking you on these questions. Okay?
19 MS. SCHULTZ: Object and move 19 A. AndasI said very simply, I did not
20 to strike the entire answer. 20 inscribe that in my report. I included
21 BY MS. SCHULTZ: 21 that --
22 Q. My questions are very simple, and I 22 Q. That's fine. That's all I want to
23 understand you don't want to answer them. 23 know. Yes or no.
24 But Im asking you -- you've attached a list 24 A. Its nota yes—
25 of exhibits to your report, correct, Doctor? 25 Q. Did you include it in the appendix?
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1 MR. FROMSON: Hold on, 1 MR. FROMSON: Why don't we
2 Doctor. 2 wait for the next question.
3 Objection to the colloquy. 3 MS. SCHULTZ: It is a yes or
4 It's argumentative. 4 no answer.
5 BY MS. SCHULTZ: 5 MR. FROMSON: Is that a
6 Q. You've attached a list of exhibits to 6 question?
7 your report, correct? 7 BY MS. SCHULTZ:
8 <A. Yes, that's correct. 8 Q. Are you aware, Doctor, that Ron Bulger
9 Q. And in that list of exhibits, and the 9 interfered with Susan Bulger's attempts at -
10 list is what, some-twenty pages long, 10 detoxification?
11 approximately? 11 MR. FROMSON: Objection as to
12 A. I think we said Page 13 to 27. 12 form.
13 Q. Okay. And in that list, you cite 13 THE WITNESS: Yes.
14 portions of deposition testimony, correct? 14 BY MS. SCHULTZ:
15 A. That is correct. 15 Q. Did you cite any facts in any of the
16 Q. And you cite portions of medical 16 exhibits attached to your report that
17 records, correct? 17 reflect that Ron Bulger interfered with
18 <A. That's correct. 18 Susan Bulger's attempts at detoxification?
19 Q. And you cite portions of prescription 19 A. Ido not believe that I did.
20 records, correct? 20 Q. Are you aware that Susan Bulger left
21 A. Yes. 21 AMA, against medical advice, in July of 1997
22 Q. And you testified that you included 22 and was convinced to leave by her husband
23 the facts as exhibits to your report that 23 and refused to allow any follow-up
24 you felt were important to your opinion, 24 intervention?
25 correct? 25 A. Jam aware of that, yes.

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622
Q. Do you agree that you did not place
that fact in the exhibits to your report?
A. That is not in my report.
Q. Are you aware that she left Somerville
Hospital on October 16th, 1997, and left on
the third day of her treatment on a
nonscheduled discharge?
A. Tam aware of that.
Q. Did you include that fact in the
exhibits to your report?
A. That fact is not in my report.
Q. Are you aware that she entered Salem

Hospital in November 1997 and was discharged
for noncompliance and failure to attend
sessions?

A. Idid mention earlier about her Salem
hospitalization. And, therefore, I am aware
of it.

Q. How did you rule out Susan Bulger's
failed attempts at detoxification and
rehabilitation in forming your opinion in
this case?

A. I considered them all, and I ruled it
out because of her failed treatments --
failed attempts at treatment and her

624

A. He did say that as well.

Q. So James Gibbons gave no testimony as
to whether she used illegal substances
between 1998 and August 4, 2004, did he?
A. He said, the best I'm paraphrasing it,

he believed that that was the end of her
substance abuse in 1997 and 1998.

Q. Because that was the last time he saw
her, correct?

A. I'm not sure he put it in those words,
but we can look at the evidence if you would
like.

Q. Sois it your opinion that she

recovered from substance abuse in 1998 based
on that statement of James Gibbons?

A. No, that is not. My opinion is that

she probably had relapsive and recidivistic
substance abuse behavior up until the end of
her life.

Q. So you believe she would have relapsed
on illicit drugs up until the day she killed
herself?

A. Ijust don't know.

Q. Soshe could have relapsed the day
before she killed herself, correct?

623

recidivistic and relapsive behavior and her
drug use was consistent with every known --
it was consistent with the usual and
customary behavior of someone who is
addicted to substances.

As such, I reflected that on my
report that she had a significant risk
factor for substance abuse and all of the
behaviors subsumed under substance abuse
that I listed in my conclusions by using
that as two'words, substance abuse, and as
well included the protective factors that
I've talked about previously.
Q. You listed as a protective factor at
the time of her death, recovery from
substance abuse, correct?
A. Yes.
Q. When did she recover from substance
abuse?
A. Her brother, James Gibbons, says that
she did not use substances after 1997 or
1998.
Q. Well, doesn't James Gibbons actually
say that she stopped in 1998, and then he
didn't see her after that?

any

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A. She could have. —
Q. She could have relapsed the day she
killed herself, correct?
A. Correct.
Q. So how did you rule that out as a
cause for her suicide, Doctor?
A. We don't have any evidence to rule it
in, specifically. The toxicology reports,
as you know, which were not comprehensive in
this case, only have her with a body fluid
positive for benzodiazepines.

We have her history of
treatment, failed treatment, substance
abuse, lack of substance abuse. We don't
have any specific information available at
the time of her death that she was actively
abusing substances.
Q. Well, the tox report wouldn't have
shown whether or not she had any illegal
substances in her at the time of her death,
would it?
A. Actually, let me check that. Jt may
be Exhibit E. I'm trying to find what the
forensic toxicology tested for and did not
test for. I've already stated that it did

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Q. But it could account or explain her
decision to commit suicide, correct?

MR. FROMSON: Objection.
Asked and answered.

THE WITNESS: It could, if
that evidence were available.
BY MS. SCHULTZ:
Q. Are you aware that Susan Bulger was
caught buying cocaine off the streets six
months before her suicide?

MR. FROMSON: Objection as to
form.

THE WITNESS: I do not recall
that.
BY MS. SCHULTZ:

Q. Wouldn't that be an important factor
to consider in determining there was no
onset of reutilization of illicit
substances?
A. That would not explain the cause of
her death, and it was not at the time of her
death, as you had just reported.

As I have stated earlier, my
assumption in my overall conclusions in this

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of the cocaine metabolites.

632

BY MS. SCHULTZ:

Q. Well, if you have a drug addict that
has been clean for a-long period of time,
and then starts using drugs six months
before their suicide, are you telling me
that that has no significance to a suicide
that occurred six months later?

MR. FROMSON: Objection as to
form. Lack of foundation. And improper
hypothetical.

THE WITNESS: Obviously, I'm
saying what -- I'll reiterate what I've
already said. I believe that
Susan Bulger, with the limited
information we have about her substance
use and abuse throughout her lifetime,
was likely abusing substances right up to
the time that she committed suicide. We
don't have any specific evidence that she
was using at the time of her suicide to
explain in my retrospective analysis that
that was a specific cause of her death.
That, indeed, it was a risk factor, I

25 __ case is that she was -- had relapsive and 25 have no argument with.
631 633
1 recidivistic behavior to substances of 1 BY MS. SCHULTZ:
2 choice, which I previously described as 2 Q. And I'm making a distinction here
3 cocaine, opiates, and alcohol. 3 between her being on cocaine at the time of
4 Q. So you place no significance on the 4 her suicide and the cocaine she's on
5 fact that Susan Bulger was caught buying 5 actually causing that suicide, okay --
6 cocaine off the streets six months before 6 A. Okay.
7 her suicide? 7 Q —to having a drug addict who has
8 MR. FROMSON: Objection as to 8 been trying to stay clean but then relapses
9 form. Asked and answered. ; 9 and starts using cocaine again.
10 THE WITNESS: I believe I've 10 A. Yes.
11 answered that. I do not see that as a -- 11 Q. So tell me your opinion. If
12 let me start again. 12 Susan Bulger had gone clean for a while, and
13 I believe that any relapsive 13 then relapsed six months before her suicide
14 behavior on drugs and alcohol is an 14 oncocaine, and used cocaine up until the
15 increased -- increases your risk factor 15 day before her death, are you saying that
16 for suicide. That relapsive behavior, as 16 could not be a precipitating factor to her
17 you've just testified to me, occurred six 17 suicide the next day?
18 months before her death. I do not have 18 MR. FROMSON: Objection as to
19 any evidence that she was actively 19 form.
20 abusing cocaine on the day of her death 20 THE WITNESS: I'm not
21 or the day before her death. It was not 21 saying -- before I respond to that, I'm
22 tested for. And a history of using 22 going to ask you to read that back to me,
23 cocaine six months prior would no longer 23 if you would.
24 bea significant contributing factor 24 (The record was read as
25 _ because of the very, very short half-life 25 requested.)

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1 THE WITNESS: I'm saying 1 form. Lack of foundation. Assumes facts
2 that, like any person who abuses 2 not in the record.
3 substances, including Susan Bulger, that 3 THE WITNESS: My response
4 the relapsive and recidivistic behaviors 4 would be the same. It's still six months
5 associated with substance abuse are 5 out in my overall assessment of risk
6 chronic risk factors. 6 factors, risk factor is always when
7 The separate issue is the use 7 someone relapses on substance abuse or
8 of cocaine six months before her death. 8 alcohol.
9 Jdo not believe that that was a risk 9 ' However, in my determination
10 factor. I do not believe that was a 10 of what was etiologically related to her
11 significant contributing factor to 11 decision to commit suicide and my
12 explain her decision to submit suicide. 12 explanation and my conclusions, I did not
13. It is hypothetical because I 13 believe that that was a significant
14 have no evidence that she was abusing 14 contributing factor, because there was
15 cocaine immediately before her death to 15 furthermore no evidence that she was
16 help explain her cause of death. 16 using cocaine at the time of her suicide.
17 BY MS. SCHULTZ: 17 BY MS. SCHULTZ:
18 Q. Howsoon prior to her death would she [18 Q. Well, you didn't even consider her use
19 have had to use cocaine for itto accountor {19 of cocaine six months before in your
20 explain her decision to commit suicide? 20 conclusions because you didn't know about
21 MR. FROMSON: Objection as to 21. it?
22 form. 22 MR. FROMSON: Objection as to
23 THE WITNESS: Can you repeat 23 form. Lack of foundation. Assumes facts
24 that? 24 not in the record.
25 BY MS. SCHULTZ: 25 MS. SCHULTZ: Right?
635 637
1 Q. How soon prior to her suicide would 1 THE WITNESS: No. As I've
2 she have had to use cocaine in order for it 2 said today, I don't remember the specific
3 to account or explain her decision to commit | 3 episode that you're talking about from
4 suicide? 4 the records. What I did say, however, is
5 A. I don't have a specific timeframe. 5 that I assumed that she likely had
6 Again, the cocaine and it's metabolites are 6 recidivistic and relapsive behavior on
7 very short lived. So that's probably the 7 her substances of choice which were
8 best response that I have. 8 cocaine, opioids, and alcohol throughout
9 Q. Well, can't the fact, just the fact 9 her history, and that was elevated --
10 that someone has relapsed be a risk factor 10 that elevated her risk factor for
11 for suicide? 11 suicide.
12 A. It absolutely is, as I've already 12 BY MS. SCHULTZ:
13 stated. 13 Q. Do you agree that you did not rule out
14 Q. And can't just the fact that someone 14 her cocaine use six months prior to her
15 relapsed account for or explain a suicide 15 suicide as a cause for her suicide?
16 even if there's no drug left in the 16 MR. FROMSON: Objection as to
17 individual's system at the time they commit |17 form. Lack of foundation.
18 suicide? 18 THE WITNESS: I believe I've
19 A. Yes. 19 answered that already.
20 Q. So why isn't Susan Bulger's relapseto (20 BY MS. SCHULTZ:
21 using cocaine six months prior to her death [21 Q. Well, you couldn't have ruled it out
22 considered a recent reutilization of elicit 22 if you weren't aware of it, correct?
23 ‘substances that accounts or explains forher (23 A. As I've I said -- I've already said
24 precipitous decision to commit suicide? 24 it.
25 MR. FROMSON: Objection as to 25 Q. Were you aware of the fact that
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638

Susan Bulger was caught buying cocaine off
of the street six months before her suicide?
Yes or no?

MR. FROMSON: Objection.
Asked and answered. Lack of foundation.
Assumes facts not in the record.

Go ahead and answer again.

THE WITNESS: As I said, I
did not specifically remember that until
you reintroduced it into this
conversation. That does not mean that I
did not consider it, because I actively
considered, as reflected in my specific
causality report, that she was using
substances of choice, which included
cocaine, opioids, and alcohol.
BY MS. SCHULTZ: ;
Q. Did you include that fact anywhere in
the facts you set out in your appendix to

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said to Linda Landry at the funeral about
Susan Bulger's drug use?

A. As [just said, I do not recall that

as I sit here today. So if you can tell me
exactly what was said, I'll tell you how I
considered it and what I did with the
information.

Q. Well, you can't tell me how you
considered it if you were never aware of it,
correct?

A. No. Isaid I recollect that I read

about it. As I sit here today, I cannot
specifically tell you what was said.

Because the records, again, were voluminous,
there's no possible way for me to do that.

If you want to me speculate about my
consideration, please show me the evidence
in the medical record, and I'll be happy to
tell you how I considered the information.

20 your report; the fact that she was caught 20 Q. And ail I'm asking you is: What was
21 buying cocaine off the street six months 21 it that you did consider? You don't know?
22 before her suicide? 22 A. Howcould I possibly answer what I did
23 A. Idid not include that in my 23 or didn't consider if] don't remember the
24 appendices. 24 — specifics as I sit here today?
25 Q. Did Susan Bulger enter any 25 Q. Just tell me, generally, if you
639 641
1 detoxification center at any time from the 1 remember what was said at the funeral.
2 point that she was buying cocaine off the 2 A. Idon't recall what was said at the
3 street six months prior to her suicide and 3 funeral. So if you want for me to describe
4 the date of her suicide, to your knowledge? 4 and opine on what was said and how I
5 MR. FROMSON: Objection as to 5 considered it in my overall assessment of
6 form. Lack of foundation. 6 this case, I'll be happy to do that. Just,
7 THE WITNESS: Not to my 7 please, show me the evidence.
8 knowledge. 8 Q. Yes. I'll tell you the deposition
9 BY MS. SCHULTZ: 9 testimony. But what has been transpirinig
10 Q. Did you consider the testimony of 10 throughout this deposition is you say that.
11 Linda Landry concerning the statements made [11 Then I show you the deposition testimony,
12 by Ron Bulger's family at Susan Bulger's 12 and you say, "Oh, yes. I considered that.
13 funeral regarding her drug use? 13 Ofcourse, it's not in my report, but I
14 A. Iremember reading it and, therefore, 14 considered it and ruled it out."
15 Iconsidered it, yes. 15 So I'm trying to ask you what it
16 Q. And what was it that you read? 16 was that you ruled out. That's my question.
17 A. Idon't remember the specifics as I 17 And I guess you can't answer that, correct?
18 sit here. [remember there was discussion 18 MR. FROMSON: Objection to
139 of people who attended her funeral. 19 the colloquy. Objection to the form of
20 Q. Well, did you consider what was told _ 20 question.
21 to Linda Landry at the funeral about 21 THE WITNESS: There's
22 Susan Bulger's drug use, in your opinion, 22 thousands of pages of documents in this
23 that withdrawal did not cause her suicide? 23 case. If you show me what it is, as I've
24 A. Ido not remember that I did that. 24 already stated, I considered all of the
25 Q._ Well, do you recall anything that was 25 information that I reviewed in this case.

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There is no possibility that I can
remember specific elements and tell you
what happened and how I considered that.

If you show me the evidence,

I'll be happy to tell you what it is I
remember about the consideration.

BY MS. SCHULTZ:

Q. Let me ask you about this deposition
testimony in Linda Landry's deposition.

"QUESTION: Let me just get
back on the -- you mentioned a
second ago that the family told
you at the funeral that she was
back on the drugs?

"ANSWER: Yes, that she had.

a relapse.

"QUESTION: Who told you
that?

"ANSWER: The mother. And
my son was there outside. He can
testify to that. Migr
was sitting right there."

Did you rule out that testimony

concerning the fact that she was on drugs at
the time of her death in reaching your

‘been a year before her death. This could

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BY MS. SCHULTZ:

Q. So ifRon Bulger's family is telling
Linda Landry at Susan Bulger's funeral that
Susan Bulger was quote, Back on the drugs,
unquote, that has no significance to you?

A. Do you have another page that I didn't
read just now? I have Page 22. I'm sorry.

I did read that. That was, again, this does
not specifically say when she relapsed and
when she was back on the drugs. That could
have been specifically that she had abused
cocaine and what we've already described in
the scenario six months before her death.

Q. So you're saying that statement to
Linda Landry at the funeral that

Susan Bulger was back on the drugs is not
significant because you're not sure if they
meant at the time she died, correct?

A. That's exactly right. This could have

have been six months before her death. This
was a family that did not stay in touch. As
we've already said, James Gibbons had not
seen her for a long time. Linda Landry had
long periods of time —

643

opinion that she had not relapsed on drugs?

MR. FROMSON: Objection as to
form.

THE WITNESS: Can I see the
exhibit, please?

MS. SCHULTZ: Yes. Let's go
ahead and mark it.

(Document was marked as
Exhibit 14 for the purposes of
identification.)

THE WITNESS: Yes. [can
tell you exactly now that I've reviewed
this why I didn't consider it an
important factor.

There's no mention here in
this report of Mr. Chaffin asking
questions to Linda Landry about when that
relapse occurred. In my estimation, and
what I've already said over the last two
days, is that relapses and recidivistic
behavior occur chronically in people who
abuse substances.

This does not give me any
more information to have reported this
specifically.

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Q. Doctor, the mother is the one that
made the statement to Linda Landry. Do you
see that in the deposition testimony?

A. Yes, I do.

Q. And the mother testified that she had
just talked to Susan Bulger the week of her
suicide, correct?

A. Let's read this back into the record.

Q. No. I'masking you, did you read

Pat Bulger's deposition testimony?

A. Yes.

Q. So you're aware that Pat Bulger
testified that she spoke to Susan Bulger the
week before her death, correct?

A. Yes.

Q. And you're aware, aren't you, that
Ron Bulger identified Pat Bulger, the
mother, as one of the people closest to
Susan Bulger, right?

A. Yes.

Q. In fact, he only listed three

people -- Ron Bulger, Ron Bulger, Jr., and
Pat Bulger, the mother, correct?

A. In terms of what?

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1 consistent with what I've been stating, 1 withdrawal effects when she ran out of her
2 that we have evidence from the records, 2 OxyContin early and, therefore, stopped
3 and as we've just described from family 3 taking it?
4 members, that Susan Bulger had 4 A. Idon't remember that specific
5 recidivistic and relapsive behavior. 5 citation.
6 We do not have any objective 6 Q. Did you consider whether Susan Bulger
7 evidence that she was consuming any 7 may have run out of her OxyContin medication
8 illicit drugs at the time of her death. 8 prior to committing suicide?
9 BY MS. SCHULTZ: 9 A. Ididn't have enough information to
10 Q. Doctor, did you consider possible 10 know whether or not she had been taking her
11 withdrawal from any of medication 11 OxyContin and methadone or not taking her
12 Susan Bulger was taking as a potential cause |12 OxyContin and methadone. And, therefore,
13 for her suicide? 13 the speculation that she was in withdrawal
14 A. Yes. We've already discussed that I 14 from not having it or not taking it was too
15 did. 15 far removed from the actual information that
16 Q. And that's because you list substance 16 used to form my opinions.
17 abuse under the risk factors you considered, |17 Q. Ifshe was taking the medication and
18 right? 18 ran out of the medication prior to her
19 A. You were asking me just now about 19 suicide, then she would be in a withdrawal
20 withdrawal from any substances? 20 state, correct?
21 Q. Yes. 21 A. That's correct.
22 A. So there could be withdrawal from 22 Q. Ifshe was not taking the medication
23 substance abuse. And there could be 23 and selling it instead, no withdrawal
24 withdrawal from serotonin reuptake 24 effect, correct?
25 inhibitors and neuro adrenergic serotonin 25 A. Correct.
651 653
1 reuptake inhibitors if she were not taking 1 Q. And we know from -- all we know from
2 the Effexor which we talked about earlier. 2 the police report is that Ron Bulger did not
3 So I considered all of those. 3 tell the police that Susan Bulger was taking
4 Q. And did you determine that she was not 4 OxyContin, correct?
5 ina state of withdrawal at the time of her 5 A. That's correct.
6 suicide? 6 Q. Did you consider the fact that
7 <A. Idid not determine that she was not 7 Susan Bulger ran out of methadone prior to
8 ina state of withdrawal or in a state of 8 her suicide?
9 withdrawal. 9 A. Asl've already testified, I
10 Q. You didn't rule that in or out one way 10 considered both her possible use of both
11. or the other, correct? 11 opioids, her possible nonuse of both
12 A. That's correct. 12 opioids, her vacillating use of opioids, and
13 Q. You will agree, however, that 13 the possibility of withdrawal from opioids.
14 withdrawal can be the precipitating factor 14 Q. Well, you're aware that at her
15 fora suicide, correct? 15 June 14th appointment, she had a discussion
16 A. Ido believe that, yes. 16 with Dr. Goldman about her use of
17 Q. And are you aware of the effect that 17 methadone -- Methadose, right?
18 running out of OxyContin reportedly hadon |18 A. Idon't recall as I sit here, but
19 Susan Bulger when that occurred? 19 entirely possible.
20 A. Can Iask you to re-ask that? I can 20 Q. But the month before, Dr. Goldman had
21 reframe it. Are you asking me, is there 21 temporarily increased her methadone,
22 evidence from the medical records that she 22 correct?
23 suffered withdrawal from previous nonuse of |23 A. From fourteen to fifteen tablets a
24 OxyContin or other opioids? 24 day, yes.
25 Q. Is there evidence that she suffered 25 Q. And at the June 14 appointment, he

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1 kept that methadone dose the same, correct? | 1 to respond to your hypothetical.
2 A. Yes. 2 Q. But what evidence is there that she
3 Q. Butat the June 14th appointment, she 3 was taking some but not all of the
4 told Dr. Goldman that she was running out 4 methadone, or taking it variably, as you
5 early of her methadone, correct? 5 said?
6 A. Yes, she did. 6 A. Asl've said, I'm trying to cover all
7 Q. And at her July appointment, 7 of the possible bases. She was either
8 Dr. Goldman reduced her methadone from 8 taking all of her medicine or none of her
9 fifteen to fourteen tablets a day, correct? 9 medicine or anything in between at variable
10 A. That's correct. 10 times, and we don't know what happened to
11 Q. And then on July 30, four days before {11 that medicine.
12 her suicide, she he called Dr. Goldman and [12 Q. Well, we know on the day of her
13 asked if she could increase her dosage, 13 suicide that either she had run out of her
14 correct? 14 medicine or she had sold her medicine, or
15 A. Ibelieve that's accurate, yes. 15 Ron Bulger had sold her medicine, or
16 Q. And we know that there was no 16 Ron Bulger just didn't give it to the police
17 methadone provided by Ron Bulger to the 17 because he wanted to keep it, right?
18 police, correct? — 18 MR. FROMSON: Objection.
19 MR. FROMSON: Objection. 19 Form.
20 Asked and answered. 20 THE WITNESS: Yes.
21 THE WITNESS: Yes, we know 21 BY MS. SCHULTZ:
22 that. 22 Q. Soon the day of, those are the three
23 BY MS. SCHULTZ: 23 alternatives, correct?
24 Q. So it would be reasonable to conclude (24 MR. FROMSON: Objection to
25 that Susan Bulger had run out of her 25 form.
655 657
1 methadone as of August 4th, 2004, correct? 1 THE WITNESS: Yes.
2 MR. FROMSON: Objection. 2 BY MS. SCHULTZ:
3 THE WITNESS: Well, that's 3 Q. And alternative one, that she had run
4 not necessarily a correct assumption 4 out, would mean that she was in withdrawal,
5 based upon what we've been discussing in 5 correct?
6 the last few minutes. 6 A. Jt could mean that, yes.
7 BY MS. SCHULTZ: 7 Q. And alternatives two and three require
8 Q. The only other assumption would be 8 an assumption that Ron Bulger was lying,
9 that Ron Bulger lied, correct? 9 correct? —
10 A. Well, the assumptions are: That she, 10 MR. FROMSON: Objection to
11 one, ran out of the medication, as you just 11 form.
12 indicated; that she was taking some of the 12 THE WITNESS: They require
13 medication, but not all of it; and that she 13 more assumptions, that she was not in
14 was taking it variably at different times; 14 withdrawal because either she was not
15 or that there was medicine left over, and 15 taking all of her medicine, or it had
16 Ron Bulger was not giving that medicine to [16 already been diverted and she was using
17 the police; or that there was no medicine . [17 less medicine and, therefore, not in
18 and that she had not been taking a 18 significant withdrawal or not in any
19 significant amount of medicine because the [19 withdrawal.
20 medicine had already been sold, or had been [20 BY MS. SCHULTZ:
21 diverted in some other way. 21 Q. Well, no. Ifthere's no medicine in
22 Q. Well, there's nothing to base a 22 the house that day, either she has run out
23 statement that she was taking some but not {23 of it or Ron has sold it, correct?
24 all of the methadone, is there? 24 MR. FROMSON: Objection to
25 A. _I'mjust giving you the hypotheticals 25 form. Lack of foundation.

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1 THE WITNESS: That's not 1 along period of time. She had, as you've
2 correct. 2 described, great love of her child, 99m»
3 BY MS. SCHULTZ: 3 great love of B a variable
4 Q. Well, where would it be? 4 relationship with her husband, a
5 A. Itcould certainly be in the house and 5 relationship that's not well quantified for
6 Mr. Bulger just didn't turn it over to the 6 me with Pat Bulger, and off again/on again
7 police. 7 relationship with Linda Landry and a
8 Q. But my question was, if there's no 8 previous relationship with James Gibbons.
9 methadone in the house that day, then either | 9 And she also had the support,
10 she had run out of it, or Ron Bulger had 10 which we've talked about, of CAB and
11 sold it, correct? 11 outpatient counseling and whatnot.
12 MR. FROMSON: Objection as to 12 Q. Well, she didn't have any support of
13 form. 13 CAB and outpatient counseling at the time of
14 THE WITNESS: Yes. 14 her death, correct?
15 BY MS. SCHULTZ: 15 A. Shedid not.
16 Q. The only other option would be that 16 Q. In fact, that was what we talked about
17 there was methadone in the house and 17 before as being a potential risk factor not
18 Ron Bulger did not provide it to the police, 18 having the mental health counseling,
19 correct? 19 correct?
20 MR. FROMSON: Objection to 20 A. That's correct.
21 form. Lack of foundation. 21 Q. Now, were you aware that she had no
22 THE WITNESS: Yes. 22 friends, none at all, at the time of her
23 BY MS. SCHULTZ: 23 death?
24 Q. But did you reach a determination, 24 A. Iwas aware that she had virtually no
25 Doctor, that Susan Bulger was not in 25 friends.
659 661
1 withdrawal from methadone on the day ofher | 1 Q. Are you aware that she did not have
2 suicide? 2 the support of a father or mother?
3 MR. FROMSON: Objection. 3 A. Tam aware of that.
4 Asked and answered. 4 Q. Are you aware that she had no support
5 THE WITNESS: My same 5 from her siblings at the time of her death?
6 response. I did not reach an opinion 6 A. I'mnot aware of that because
7 that she was or was not in withdrawal 7 Linda Landry had testified that she was
8 because there was not adequate evidence 8 planning to move in with Linda and move away
9 to suggest either. 9 from Ron Bulger, Sr., that the children were
10 BY MS. SCHULTZ: 10 the love of her life, and she could not wait
11 Q. Did you include on your list of issues 11 to move on, particularly with Regina, and
12 that increased Mrs. Bulger's risk of suicide 12 out of the confines of Mr. Bulger.
13 a lack or loss of social support at the time 13 Q. In fact, you list forward future
14 ofher death? I'm looking, again, at 14 outlook and supportive sister as a
15 Page 12 of your list of issues that increase 15 protective factor at the time of her
16 her risk of suicide. It's not there, 16 suicide, right?
17 correct? 17 A. Yes.
18 A. It's not there, correct. 18 Q. Doctor, are you aware that Ron Bulger
19 Q. Loss ofa social support network is a 19 did not allow Susan Bulger to speak with her
20 risk factor for suicide, correct? 20 sister for the five-month period prior to
21 A. Itis, yes. 21 her death?
22 Q. Did you rule out that risk factor as 22 MR. FROMSON: Objection as to
23 being a cause for Susan Bulger's death? 23 form.
24 A. Idid, and did not include it because 24 THE WITNESS: I am aware, and
25 she had a variable social support system for 25 [have already spoken about that, that
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1 that relationship was variable. 1 MR. FROMSON: Objection as to
2 Ron Bulger -- I didn't testify to this 2 form.
3 before -- but it's adequately reflected 3 THE WITNESS: J am aware of
4 in the records, that he stood between 4 that. I'malso aware of the fact, as
5 Linda Landry and Mrs. Bulger. 5 I've reflected in my report, that
6 However, it was also the 6 Linda Landry believed that Susan would
7 testimony of Linda Landry that 7 absolutely not hang herself and not
8 Mrs. Bulger intended to move out with her 8 commit suicide because she was going to
9 and they were planning for a future. 9 move in with her.
10 BY MS. SCHULTZ: 10 BY MS. SCHULTZ:
11 Q. Butare you aware that that forward 11 Q. But Doctor, are you still considering
12 future outlook that you're describing had 12 that Susan Bulger had a forward future
13 actually tumed into a -- had actually 13 outlook of moving in with Linda Landry, her
14 failed as of the time of Susan Bulger's 14 sister, when she had not spoken to her for
15 death? 15 the five months prior to her death?
16 MR. FROMSON: Objection as to 16 A. Yes. There's no reason to believe
17 form. 17 otherwise.
18 THE WITNESS: There's no 18 Q. Other than the fact that the plan
19 evidence that it failed. 19 didn't carry through as Susan and Linda had
20 BY MS. SCHULTZ: 20 planned?
21 Q. Did you read Linda Landry's 21 A. Like any plans, some of them do not
22 deposition, Doctor? 22 carry through at a specific point in time.
23 A. Yes. 23 But that does not eliminate the plan for
24 Q. Are you aware that she testified that 24 future consideration. And it was certainly
25 __she hada plan that Susan Bulger was going [25 in Linda Landry's assessment in her
663 665
1 to leave Ron Bulger and move in with her, 1 deposition that she expected that
2 correct? 2 Susan Bulger would eventually move in with
3 A. That's correct. 3 her.
4 Q. And they were going to do this when 4 Q. No. Didn't Linda Landry actually
5 she went into the hospital, correct? 5 testify that the reason the plan foiled was
6 A. I don't remember the specific 6 because Ron Bulger was standing behind
7 circumstances, but ~ 7 Susan Bulger the last time they talked about .
8 Q. Because she was going to come stay at 8 the plan and overheard it? Wasn't that her
9 Linda Landry's house, correct? 9 testimony?
10 A. Yes. 10 A. She did testify, and that's why the
11 Q. Are you aware that when Linda Landry {11 plan failed at that point in time.
12 went into the hospital, she kept trying to 12 Q. And that's why, in Linda Landry's
13 call Susan Bulger's house and Ron Bulger 13 opinion, the plan failed from that point
14 wouldn't let her speak to Susan? 14 forward, correct?
15 A. Tamaware of that. 15 A. That's not correct, to my knowledge.
16 Q. So are you aware that that plan never 16 Q. Now, you list in your list of issues
17 carried through? 17 that increased Mrs. Bulger's risk of suicide
18 A. Iam aware that the plan did not carry 18 marital problems?
19 through at that point. There's no evidence 19 A. Yes.
20 that that plan was then terminated for the 20 Q. And I take it you are going to tell me
21 future. 21 that included in marital problems is
22 Q. Well, Doctor, there was zero 22 physical and mental abuse by a spouse?
23 discussion from that point on for the next 23 A. Yes.
24 five months between Linda Landry and 24 Q. Istherea difference in a risk factor
25 Susan Bulger. Are you aware of that factor? |25 for suicide if someone is having marital

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1 problems versus someone that is physically 1 would lose custody of iia Ron, Jr.?
2 and mentally abused by their husband? Is 2 A. Idon't remember that being
3 one situation a higher risk factor than the 3 specifically cited. It would be something
4 other? 4 that I would suppose and suggest was likely
5 A. Depends how you define marital 5 because she had already lost Ron Bulger once
6 problems. If you subsume under marital 6 previously and would be fearful of losing
7 problems that there's any domestic conflict 7 custody of what's described as the love of
8 ofany kind, including physical, emotional, 8 her life, Regina.
9 or sexual abuse, as I do, then it is 9 Q. Well, Ron Bulger told her that, didn't
10 subsumed and they are the same. 10 he? Didn't Ron Bulger tell her if she left
11 Q. And you will agree that Ron Bulger was {11 that she would never get custody of the kids
12 physically abusive to Susan Bulger, correct? [12 because of her past drug abuse?
13 A. ITagree that there is evidence in the 13 A. Yes, he did.
14 record to support that he was physically 14 MS. SCHULTZ: We need to
15 abusive. 15 change the tape. We-have to take a
16 Q. Well,-you'll agree that close to the 16 break. —
17 time of her death he told her she was 17 THE VIDEOGRAPHER: We're
18 nothing but a mental maniac like her mother [18 going off the record. The time is
19 and the rest of her family, correct? 19 3:47p.m. This is end of tape Number 6.
20 A. Yes. 20 (A brief recess was taken at
21 Q. And you'll agree that Susan Bulger 21 this time.)
22 told her treating physicians that he had 22 THE VIDEOGRAPHER: We are on
23 beat her up on multiple occasions, correct? 23 therecord. The time is 3:55 p.m. This
24 A. Yes. 24 is the beginning of tape Number 7.
25 Q. But you still can say that you think 25 -BY MS. SCHULTZ:
667 669
1 there's conflicting evidence as to whether 1 Q. Doctor, Im going to run through a few
2 there was a physical abuse by Ron Bulger to 2 more risk factors as quickly as possible.
3 Susan Bulger? 3 Okay?
4 A. Isaid there's conflicting evidence 4 A. Yes.
5 about her use of substances and her 5 Q. Hopelessness is a risk factor for
6 substance abuse treatment. I do not believe 6 suicide, correct?
7 that I used the word conflicting evidence 7 A. Yes.
8 about the abusive nature of her relationship 8 Q. And will you agree that you did not
9 to Ron Bulger. I do believe that that was 9 list hopelessness in your report as one of
10 an abusive relationship at times. Jt was 10 the issues that increased Mrs. Bulger's risk
11 also a relationship in which she left the 11 of suicide?
12 house and came back to him and stayed with j12 A. Jagree that I did not list it
13 him for a long period of time and decidedto [13 separately.
14 have another child after her first one from 14 Q. Well, did you list it in combination
15 1987, another one in 1999. 15 with another risk factor?
16 Q. Well, that's not unusual that a woman 16 A. No.
17 that's being physically abused may return 17 Q. Are tragic events in one's life a risk
18 home, correct? 18 factor for suicide?
19 A. That's correct. 19 A. Yes,
20 Q. And you would agree that Susan Bulger (20 Q. Did you list tragic events that had
21 didn't think she had much of any place else 21 occurred in Mrs. Bulger's adult life as one
22 to go, correct? 22 ofthe issues that increased Mrs. Bulger's
23 A. Idon't know what she was thinking. 23 risk of suicide?
24 Q. Do you agree that Susan Bulger worried |24 A. Only inasmuch as it would be subsumed
25 that ifshe did leave Ron Bulger that she 25 under my shorthand version of marital

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670

problems, for example.

Q. So, for example, her mother dying in a
house fire, that's not subsumed under
marital problems, correct?

A. That's correct.

Q. Orher brother being murdered. That's
not subsumed under marital problems, is it?
A. I considered that but, again, I did

not believe that that was a significant
contributing factor to explain her death at
the time that it occurred.

Q. Unemployment is a risk factor for

672

factors for her suicide.

Q. Now, I want to run briefly through the
risk factors that you list here in your
report as issues that increased

Mrs. Bulger's risk of suicide. Okay?

A. Okay.

Q. First you have emotional trauma as a
youngster?

A. Yes.

Q. But you ruled out that as the
precipitating factor for her suicide,
correct?

13 suicide, correct? 13 A. That's correct.
14 A. Yes. 14 Q. You list placement of son in foster
15 Q. And you'll agree that Susan Bulger had [15 care asa risk factor, correct?
16 no gainful employment or potential for 16 A. Yes.
17 future gainful employment, correct? 17 Q. But you ruled that out, correct?
18 A. I don't think I opined or concluded 18 A. [ruled it in, but did not consider it
19 about future employment. I was aware, 19 asignificant contributing factor for her
20 however, that she was on disability and had {20 suicide at the time that it occurred.
21 been on disability for several years; and 21 Q. Okay. Depression -- let me go in your
22 that her rheumatoid arthritis was advancing 22 order. I'm sorry.
23 which made her an unlikely candidate to 23 Absent or negative parenting and
24 assume future employment. 24 foster care. You determined that those were
25 Q. Did you list unemployment as an issue |25 not precipitating causes to her suicide,
671 673
1 that increased Mrs. Bulger's risk of suicide 1 correct?
2 on Page 12 of your report? 2 A. Yes.
3 A. Idid not. 3 Q. Substance abuse, you determined that
4 Q. Is aggression a risk factor for 4 was not the precipitating cause of her
5 suicide? 5 suicide, correct?
6 A. Yes, it is. 6 A. That's correct.
7 Q. Did you list aggression as an issue 7 Q. With respect to the risk factors we've
8 that increased Mrs. Bulger's risk of 8 already discussed that you determined were
9 suicide? 9 not the precipitating factors to her
10 A. Idid not separately list that. 10 suicide, are there any other reasons for
11 Q. Well, did you list it in combination 11 that opinion that we've not already
12 somehow with one of these other factors? 12 discussed today or yesterday in your
13. A. Only so much as it's subsumed in the 13 deposition?
14 symptomatic complaints of depression and [14 THE WITNESS: Let me hear
15 posttraumatic stress. 15 that question again.
16 Q. Subsumed in the systematic (sic) 16 MR. FROMSON: Note my
17 complaints? What do you mean by that? 17 objection as to the form of the question.
18 A. There are many signs and symptoms 18 Overbroad.
19 associated with her multiple psychiatric 19 (The record was read as
20 diagnoses. I did not separately list any of 20 requested.)
21 the specifically emotional signs and 21 MS. SCHULTZ: Let me just ask
22 symptoms, but I did list her extensive 22 it quickly this way instead.
23 psychiatric history, and I tried to give a 23 BY MS. SCHULTZ:
24 shorthand version of the three diagnoses 24 Q. Have we already discussed the reasons
25 __ that I thought were most relevant as risk 25 why you would have ruled out emotional

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1 Jreferred to. It was not only picking up 1 chronic pain is that in and of itself,
2 anonymous men at bars, but also being 2 regardless of the duration, and as long as
3 physically abused by them. 3 it's not intractable pain, for the most
4 Q. Did she have any prior suicide 4 part, that when that gives rise to
5 attempts? 5 hopelessness and a sense of desperation and
6 A. Idon't think I know the answer to 6 depression, that that becomes a very
7 that. 7 significant risk factor.
8 Q. Was she abused as a child? 8 Q. Do you agree that Susan Bulger
9 A. Ido not know. 9 suffered from chronic pain?
10 Q. Did she abuse prescription drugs? 10 A. Ido.
11 A. No. 11 Q. And are you aware that she told her
12 Q._ Did she abuse illicit drugs? 12 physicians, "I'm always depressed because
13 A. No. 13 this disease has taken the life right out of
14 Q. Was she in chronic pain? 14 me. Before I got arthritis, I was very
15 A. No. 15 active. Now I just exist. I feel I have no
16 Q. Did she suffer from marital discord? 16 desire whatsoever"?
17 A. She was single. 17 MR. FROMSON: Objection as to
|18 Q. Did she have financial problems? 18 form.
19 A. Yes. 19 THE WITNESS: Yes.
20 Q. Did she suffer from depression? 20 BY MS. SCHULTZ:
21 A. Yes. 21 Q. Are you aware that she told her
22 Q. And anxiety? 22 physicians that she is pretty down, that she
23 A. Yes. 23 is never without pain?
24 Q. Did she have posttraumatic stress 24 A. Yes.
25 disorder? 25 Q. How did you go about ruling out
687 689
1 A. Not that I recall. 1 chronic pain as the precipitating event for
2 Q. Let me ask you about the risk factor 2 her suicide?
3 of chronic pain. I think I skipped over 3 A. Because I considered it and because I
4 that. So hold on one moment. 4 was aware that she had lived with chronic
5 Doctor, you agree that chronic 5 pain successfully. And I use the word
6 pain is a risk factor for suicide, correct? 6 "successfully" because she had not, to my
7 A. AsIsaid yesterday, I agreed that _7 knowledge, tried to hurt herself because of
8 when chronic or intractable pain leads to 8 the chronic pain. And, therefore, it was
9 depression and hopelessness, that becomes a | 9 nota significant contributing factor when
10 significant risk factor for suicide. 10 she did commit suicide, all factors
11 Q. And you listed chronic pain as an 11 considered.
12 issue that increased Mrs. Bulger's risk of 12 Q. Well, does chronic pain as a risk
13 suicide, correct? 13 factor, does the importance of that risk
14 A. Yes. 14 factor increase over time? In other words,
15 Q. Does the severity of pain contribute 15 is someone that has chronic pain for six
16 to whether it's chronic pain? Orischronic |16 months less likely to commit suicide than
17 pain an issue of duration? Or both? 17 someone who has been living in chronic pain
18 A. Say that again. I'm sorry. 18 for twenty-five years?
19 Q. Is it the severity of the pain that 19 A. I believe so.
20 would cause you to classify something as 20 Q. Doesa person in chronic pain ever get
21 chronic pain? Or would it be the duration 21 tothe point, once they've been in chronic
22 of the pain that would cause you to classify (22 pain for a long period of time, where they
23 it as chronic pain? 23 simple say, I can't live with this anymore?
24 A. I believe that both factors can be 24 A. Ibelieve they can get to that point,
25 responsible. Again, my overall response to |25 yes.

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