ER doctor takes stand in malpractice suit

Weeklong trial wraps up Friday

Testifying for two-and-a-half hours Wednesday, Dr. Mark Turpen, a Southwest Memorial Hospital emergency room physician, denied that he was negligent in the suicide death of Ted Villelli on June, 10, 2010.

“I remember that night very well,” Turpen said. “I remember the events vividly.”

Turpen stuck to themed replies, avoiding a single gotcha moment from a torrent of questions by plaintiff’s attorney Mike McLachlan.

Making direct eye contact with jurors, Turpen said, “My first obligation as a doctor is to the patient. I have to represent the patient sitting in front of me.”

Turpen’s central message, which he repeated numerous times, was the patient was “competent, rational and sober.” He added that after Villelli indicated he was not a danger to himself or others, he was discharged.

“Mr. Villelli did not show any clinical signs that he was unable to make a rational decision,” said Turpen.

Requested by law enforcement on behalf of concerned family members, Villelli’s mental health evaluation by Turpen lasted a total of 10 minutes. He committed suicide less than six hours later.

“Do you have an obligation to verify information provided by patients?” McLachlan asked.

“I take patients at their word,” replied Turpen.

“Was believing Ted Villelli a mistake?” a frustrated McLachlan demanded.

“No,” said an unflinching Turpen. “I thought he was being honest.”

“Did you care about Mr. Villelli?” McLachlan fired back.

After an objection by defense attorney John Mullen, Chief District Court Judge Doug Walker admonished McLachlan to cool his tone. A medical malpractice and insurance attorney, Mullen is a senior partner in a Colorado Springs law firm. Representing Villelli’s wife, Renee, McLachlan is also a Democratic member of the Colorado House of Representatives from Durango.

Wearing a dark gray suit and black cowboy boots, Turpen was also drilled on why he never opted to examine Villelli’s past medical history on file at Southwest Memorial. Medical records reveal the patient had a history of chronic depression dating to childhood; had been prescribed anti-depressants, pain medication and sleeping pills; and had attempted suicide by drug overdose twice in late 2008.

“Were you the captain of the ship?” McLachlan asked.

“We don’t have a ship,” replied Turpen. “I am the doctor. I make decisions as the emergency room physician for medical treatment.”

“Did you have access to the medical history records?” McLachlan demanded.

“If we had needed them, then we could have gotten them,” said Turpen. “We didn’t need them.”

An independent contractor with the hospital, Turpen was working a 24-hour shift, one of six he’s obligated to cover each month. Turpen said he had been on duty for 16 consecutive hours without sleep when Villelli entered the emergency room four years ago.

“Did you fulfill your professional obligation?” asked McLachlan.

“Mr. Villelli made choices,” Turpen responded. “After he left Southwest Memorial Hospital, he made a bad choice.”

On cross-examination, Turpen again reiterated that Villelli was “competent, rational and sober” and even “jovial” on the night in question.

“There were no overt signs that he was depressed,” Turpen said.

Other witnesses

Also on Wednesday, Walker ruled the jury would not be privy to information that former emergency room nurse Marsha Casey or Southwest Memorial Hospital were both initially named as defendants in the lawsuit. Walker said that detail would create confusion among jurors.

“It (would) open up a can of worms that we don’t need to get in to,” Walker said.

Made aware that Villelli had expressed suicidal thoughts to a relative on the day in question, Casey was the emergency room nurse on duty that night. She said the hospital did not provide mental health training to staff, but using her near four decades of experience as a registered nurse, Villelli did not appear depressed or sad.

“He denied he was suicidal,” Casey said. “He denied he had a gun.”

“We made a judgment that he was safe,” she said.

Psychologist Tom Seymor, one of Villelli’s former mental health counselors, also testified Wednesday. He described his former patient as “vulnerable,” stating Villelli could be happy one moment and depressed the next – generous and then selfish.

“He was almost always suicidal,” Seymor said.

Seymor last treated Villelli in November 2008, days after his second suicide attempt. He concluded, stating all emergency room staff should be on high alert anytime when caring for a known suicidal patient.

Day 2: Tuesday

On Tuesday, law enforcement officials, who escorted and monitored Villelli during his ER visit, testified they were shocked that the mental health evaluation lasted mere minutes rather than the normal hour or more.

“Damn, that was quick,” one deputy recalled.

Discharged from the hospital, the patient was transported to his residence on County Road 27 by Montezuma County Deputy Sgt. Jason Spruell.

“I told (Villelli) to shake my hand and tell me he wasn’t going to hurt yourself,” Spruell said. “He shook my hand.”

Also on Tuesday, Renee Villelli, said she discovered her husband’s body in the backyard of their home. She added her husband had removed all the couple’s photos from the home before his death.

Renee Villelli said that in the last few months of her husband’s life, she went into protective mode, and removed both her and the couple’s children from the residence. She wanted to safeguard her kids from her husband’s verbal attacks and threats of physical abuse.

“I stood up as tall as I could,” she testified. “Life was hard.”

Walker also ruled on Tuesday that jurors would not be privy to Villelli’s final note found at the scene.

Day 1: Monday

On Monday, McLachlan said in his 40-minute opening statement a preponderance of the evidence, that which was likely true, would show that Turpen was negligent and could have prevented the suicide.

“They didn’t want to bother with Ted Vernelli,” McLachlan told jurors.

During his seven-minute opening statement, Mullen asked the jurors to rely on testimony and evidence presented at trial, rather than argumentative statements made by opposing counsel.

“What happened after Mr. Villelli left the hospital is a tragedy,” Mullen told jurors, “but we can’t judge this case with hindsight.”

A total of 55 potential jurors appeared in court Monday morning for jury duty. After hours of voir dire, seven jurors, composed of six women and one man, were impaneled. Made up of a business manager, the wife of a police officer, an artist and a retired teacher, the jury was expected to deliberate on Friday.

Throughout the trial, Walker has repeatedly asked jurors to refrain from discussing the case with anyone, reading any media reports, conducting any Internet research or forming any opinions until all evidence was presented.

“Keep an open mind during the trial,” Walker told jurors.

On Thursday, day four, several expert witnesses were expected to testify.