Medical Board Hearing Transcript

0001
1 LICENSE NO. L-3154
2 IN THE MATTER OF ( BEFORE THE DISCIPLINARY
3 THE LICENSE OF ( PANEL OF THE
4 RICK SZUMLAS, M.D. ( TEXAS MEDICAL BOARD
6 TEMPORARY SUSPENSION
7 WITH NOTICE
8 WEDNESDAY, APRIL 20, 2011
10 BE IT REMEMBERED that on this the 20th day of April,
11 2011, between 10:00 a.m. and 4:21 p.m., the above-entitled
12 matter came for hearing before the Disciplinary Panel of
13 the Texas Medical Board, 333 Guadalupe, Tower 3, 7th
14 Floor, Austin, Texas, and the following proceedings were
15 reported by Renea Seggern, Certified Shorthand Reporter.
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0002
1 APPEARANCES
3 DISCIPLINARY PANEL MEMBERS:
4 Mr. David Baucom, Chair
Patrick Crocker, D.O.
5 Ms. Paulette Southard (Appeared via telephone)
6 Ms. Nancy Leshikar, Counsel for the Panel
8 FOR THE TEXAS MEDICAL BOARD:
9 TEXAS MEDICAL BOARD

Mr. Christopher Palazola
10 Ms. Claudia Kirk
333 Guadalupe Street
11 Tower 3, Suite 610
Austin, Texas 78701
12 (512) 305-7071
13
FOR THE RESPONDENT:
14
LEICHTER LAW FIRM
15 Mr. Louis Leichter
Mr. Dan Lype
16 1602 East 7th Street
Austin, Texas 78702
17 (512) 495-9995
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0003
1 WITNESS INDEX
2 Appearances.............................................2
3 WITNESSES FOR THE BOARD:
4 DETECTIVE SERGEANT JAMES MAZY (Via Telephone)
Direct Examination by Mr. Palazola.................19
5 Voir Dire Examination by Mr. Leichter..............33
Continued Direct Examination by Mr. Palazola.......35
6 Cross-Examination by Mr. Leichter..................41
Redirect Examination by Mr. Palazola...............47
7 Recross-Examination by Mr. Leichter................48
Examination by Dr. Crocker.........................49
8 Further Recross-Examination by Mr. Leichter........51
Further Redirect Examination by Mr. Palazola.......52
MARK MESSER, D.O. (Via Telephone)

10 Direct Examination by Ms. Kirk.....................54
Cross-Examination by Mr. Leichter..................61
11 Redirect Examination by Ms. Kirk...................78
Recross-Examination by Mr. Leichter................80
12 Examination by Dr. Crocker.........................83
Further Recross-Examination by Mr. Leichter........85
13
KIMBERLY SMITH (Via Telephone)
14 Direct Examination by Mr. Palazola.................89
Cross-Examination by Mr. Leichter..................96
15 Redirect Examination by Mr. Palazola...............99
Recross-Examination by Mr. Leichter...............100
16 Further Redirect Examination by Mr. Palazola......101
17 BRANDI RUSSELL (Via Telephone)
Direct Examination by Mr. Palazola................104
18 Cross-Examination by Mr. Leichter.................114
19 WITNESSES FOR THE RESPONDENT:
20 GEORGE GLASS, M.D.
Direct Examination by Mr. Leichter................124
21 Cross-Examination by Mr. Palazola.................145

Examination by Dr. Crocker........................155
22 Examination by Mr. Baucom.........................159
Further Examination by Dr. Crocker................160
23 Examination by Ms. Leshikar.......................160
Further Examination by Mr. Baucom.................161
24 Examination by Ms. Southard.......................163
Continued Cross-Examination by Mr. Palazola.......167
25 Redirect Examination by Mr. Leichter..............175
0004
1 GEORGE GLASS, M.D. (Continued)
Further Examination by Ms. Leshikar...............178
RICK SZUMLAS, M.D.
3 Direct Examination by Mr. Leichter................181
Cross-Examination by Ms. Kirk.....................196
4 Redirect Examination by Mr. Leichter..............206
Recross-Examination by Ms. Kirk...................211
5 Further Redirect Examination by Mr. Leichter......212
Examination by Mr. Baucom.........................212

6 Examination by Dr. Crocker........................214
Examination by Ms. Southard.......................216
Reporter's Certificate................................240
EXHIBIT INDEX
9 FOR THE BOARD
NO. DESCRIPTION PAGE
10
1 Notice of Hearing 17
11
2 Application for Temporary Suspension or
12 Restriction of License With Notice 17
13 3 Public Physician Verification 17
14 4 Complaint Documents 17
15 5 Correspondence, Complainant (Under Seal) 17
16 6 Correspondence, Board Staff (Under Seal) 17
17 7 Correspondence, Board Staff (Under Seal) 17
18 8 Terrell State Hospital, Medical Records for
Respondent (Under Seal) 17

19
9 Order Granting Temporary Suspension Without
20 Notice, March 18, 2011 (Under Seal) 17
21 10 Transcript from Temporary Suspension Without
Notice, March 18, 2011 (Under Seal) 17
22
13 Lakes Regional Medical Records (Under Seal) 17
23
14 Color Photos 38
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0005
1 EXHIBIT INDEX
FOR THE RESPONDENT
2 NO. DESCRIPTION PAGE
3 1 Psychiatric Evaluation of Dr. Szumlas by
Dr. George Glass 144
2 Resume for George S. Glass, M.D., P.A. 129

5
3 Letter of Reference from Dr. Shafiq 124
4 Letter of Reference from Dr. Prakash 124
5 Letter of Reference from Dr. Thurmond 124
6 Letter of Reference from Dr. Petrakian 124
7 Letter of Reference from Dr. O'Neal 124
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8 Continuing Medical Education Certificate 124
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9 Continuing Medical Education Certificate 124
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10 Letter from Lynda Sessa 124
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11 Letter from Helen Gootinag 124
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12 Certificate from the Institute for Cardiovascular

15 CC Certification 124
16 13 Certificate from the Society of Cardiovascular
Computed Tomography 124
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14 Continuing Medical Education Credit Form 124
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15 Continuing Medical Education Registration 124
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16 Certificate from the University of Virginia
20 Health System 124
21 17 Continuing Medical Education Certificate from
22 SNM 124
23 18 Certificate from the American College of
Cardiology Foundation 124
24
19 Continuing Medical Education Tracker from January
25 2010 until December 2010 124
0006
1 PROCEEDINGS
2 MR. BAUCOM: I call this meeting of the
3 Disciplinary Panel of the Texas Medical Board to order at
4 10:00 a.m. on the 20th day of April 2011.
5 My name is David Baucom. I've been
6 appointed to be Chair of this Disciplinary Panel. The
7 other Panel members are Patrick Crocker, D.O., and
8 Paulette Southard. Nancy Leshikar, general counsel, will
9 serve as hearings counsel for the Panel in today's
10 proceedings.
11 The hearings counsel will call the roll.
12 MS. LESHIKAR: David Baucom?
13 MR. BAUCOM: Here.
14 MS. LESHIKAR: Dr. Crocker?
15 DR. CROCKER: Here.
16 MS. LESHIKAR: Ms. Southard?
17 MS. SOUTHARD: Present.
18 MS. LESHIKAR: Mr. Chair, all members of the
19 Disciplinary Panel are present.
20 MR. BAUCOM: I call the case of the Matter
21 of the Texas Medical License of Rick Szumlas, M.D. The

22 Panel is here to consider the Application for the
23 Temporary Suspension With Notice filed with Board staff
24 under the authority of Section 164.059, Texas Occupations
25 Code, and Board Rule, Chapter 187, Subchapter F.
0007
1 I remind this Disciplinary Panel members
2 that each of us have a duty to be fair and impartial in
3 our decision in this matter. Board Rule 187.42(b) sets
4 forth the standards for recusal. If there is any request
5 for recusal, please make that request now.
6 MS. SOUTHARD: No.
7 MR. BAUCOM: The record will reflect there
8 is no request for recusal.
9 I now request that the parties and attorneys
10 in this hearing identify themselves for the record.
11 MR. LEICHTER: Louis Leichter,
12 L-e-i-c-h-t-e-r, first name L-o-u-i-s, for Respondent,
13 Rick Szumlas, M.D.
14 MR. PALAZOLA: Chris Palazola for Board

15 staff.
16 MS. KIRK: Claudia Kirk for Board staff.
17 MR. BAUCOM: All right. We also need your
18 mailing address. I'm sorry, Mr. Leichter.
19 MR. LEICHTER: That's fine. 1602 East 7th
20 Street, Austin, Texas 78702, Leichter Law Firm.
21 MS. LESHIKAR: Also the Respondent's. We
22 need the Respondent's address as well.
23 MR. BAUCOM: And your address?
24 THE RESPONDENT: 225 South Collegiate Street,
25 Apartment Number 254, Paris, Texas 75460.
0008
1 MR. BAUCOM: Okay. We will begin with the
2 Board staff attorney. I would like to set a fair,
3 reasonable and appropriate time limit for today's
4 hearings. I would ask that each party announce the number
5 of witnesses that you anticipate calling to testify and
6 estimate the time you require for direct examination of
7 any witnesses you may call.
8 MS. KIRK: We will be calling between two

9 and four witnesses, and we will need approximately three
10 hours.
11 MR. LEICHTER: We will be calling between
12 two and four witnesses. We also need approximately two to
13 four hours.
14 There is a procedural note that I would like
15 to bring up on the record at some point before we begin
16 the evidentiary matter and when the Panel decides it's
17 appropriate to take it up.
18 MR. BAUCOM: Would this be a good time?
19 MS. LESHIKAR: Yes.
20 MR. LEICHTER: We realize that the Rule
21 requires or allows for the provision the -- the Rule
22 requires or provides for Ms. Southard to appear by
23 telephone. However, because this is a Temporary
24 Suspension Hearing With Notice, it is an evidentiary
25 hearing, we acknowledge Ms. Southard's presence. We would
0009
1 ask that appearances that regard credibility, which is the

2 appearance of a witness, their demeanor, their gestures,
3 their body language, their credibility largely be deferred
4 to these Panel members with decision and input being made
5 to Ms. Southard because she's not here to judge the
6 demeanor and character and credibility of these witnesses.
7 And this is a very important matter and
8 these witnesses, including Dr. Szumlas, who will testify
9 either called by staff or called by us, is very important
10 and goes to the nature of the facts in issue of this case.
11 We want to preserve that for the record.
12 Thank you.
13 MS. LESHIKAR: Noted.
14 MR. BAUCOM: Do you have any comment on
15 that?
16 MS. LESHIKAR: No.
17 MR. BAUCOM: Each side will be allowed 15
18 minutes to make an opening statement. Board staff has the
19 burden of proof and will be allowed to make the first
20 opening statement. The Respondent may make an opening
21 statement after Board staff's opening statement or may

22 reserve opening statement until after Board staff rests.
23 Each side will be allowed a maximum of four
24 hours to present their case. This will include direct
25 examination of any witnesses called by the party and
0010
1 cross-examination of any witness called by the other
2 party.
3 Each side will be allowed 15 minutes for a
4 closing argument. Board staff will make the first closing
5 argument and may reserve up to one half of its time for
6 rebuttal.
7 The Board staff attorney may now make an
8 opening statement.
9 MS. KIRK: At this time, the Board staff
10 would request that the Panel invoke the Rule.
11 MS. LESHIKAR: All right. Panel, impose the
12 Rule.
13 MR. LEICHTER: We only have one witness who
14 is here with us who would not appear, which is Dr. Glass.

15 And because he's an expert, we ask that he be exempted
16 from the Rule because his very testimony goes to the
17 nature of these proceedings. We feel that him listening
18 to the testimony, because he's already interviewed the
19 Respondent in this matter, would be helpful to the Panel
20 in deliberation. Under the rules and case law in Texas,
21 he should be exempted from the Rule.
22 MS. KIRK: He's not a party to these
23 proceedings, and the Rule is really for necessary parties.
24 So we would ask that he be excused.
25 MS. LESHIKAR: Panel, under the Rule,
0011
1 everybody that's going to be a fact witness is excused
2 except for --
3 MS. SOUTHARD: I'm not able to hear what is
4 being said.
5 MS. LESHIKAR: Under the Rule, when you
6 invoke the Rule, what you are asking is that all witnesses
7 that are going to testify in the hearing be excused from
8 the testimony. And so now what Mr. Leichter has argued is

9 he has an expert witness and as such the expert witness
10 should be excluded from the invocation from the Rule.
11 It is up to you-all to determine if you
12 believe that is appropriate or not. It is my opinion that
13 he should not be allowed in the room. Simply because he's
14 an expert witness does not, in fact, excuse him from the
15 Rule. But it is up to you to make that decision.
16 MR. BAUCOM: I would follow your
17 recommendation, then.
18 MS. SOUTHARD: As do I.
19 MS. LESHIKAR: He will be subject to the
20 Rule as well.
21 MR. LEICHTER: Can someone escort him down
22 to the sixth floor.
23 MR. BAUCOM: Board staff attorney may now
24 offer documentary evidence.
25 MS. LESHIKAR: They haven't made their
0012
1 opening statement yet.

2 MS. KIRK: Can you excuse Mr. Bernardo as
3 well? He may be a potential witness.
4 MS. LESHIKAR: Mr. Bernardo.
5 MS. KIRK: Thank you. A physician who is a
6 threat to the general health and welfare to the public due
7 to an impairment cannot be allowed to practice with a
8 completely unrestricted license. Allowing an impaired
9 physician to practice in that condition would go against
10 this Board's mission, which is to protect the people and
11 the state of Texas.
12 Approximately six months ago, Dr. Szumlas,
13 the Respondent, who lives alone in an apartment, started
14 to believe that satellites were beaming radioactive waves
15 into his apartment. He also heard voices that conversed
16 and provided running commentary as to what he was doing
17 and what was going on around him. He believes the Food
18 and Drug Administration or the military or other
19 government agencies is doing this to him.
20 You will see and hear evidence today that he
21 made several calls to the police using the 911 emergency

22 system to report the harassment and satellite activity.
23 His apartment has sophisticated electronic equipment set
24 up; that he slept with reflective equipment to deflect the
25 beams that were supposedly being transmitted to his head;
0013
1 and that he purchased a semiautomatic pistol and had a
2 large knife for protection.
3 We will also present evidence that due to
4 his impaired mental state, Respondent had to be
5 involuntarily committed to a psychiatric hospital. You
6 will hear from his doctor who will testify that Respondent
7 suffers from a psychotic disorder and had to be treated
8 with anti-psychotic medication.
9 You will also see that even at discharge,
10 not too long ago, while on medication, he still had
11 symptoms of psychosis. We will also present evidence that
12 this type of disorder has a high relapse rate and requires
13 compliance with the prescribed medication.
14 Once you hear all our evidence, we think you

15 will see that Respondent is impaired due to mental illness
16 and that he presents a continuing threat or a real danger
17 to the health of his patients, potential patients or the
18 public in general.
19 We also believe that you will find that
20 based on his state of mind and actions, terminating his
21 suspension today and allowing him to practice freely and
22 treat patients would pose a threat to the public safety
23 and welfare.
24 Thank you.
25 MR. BAUCOM: Does the Respondent prefer to
0014
1 proceed with an opening statement now or reserve the
2 opening statement until after Board staff reserves?
3 MR. LEICHTER: We will reserve.
5 offer documentary evidence.
6 MS. KIRK: At this time, we would like to
7 offer into evidence Exhibits Number 1 through 10. And we
8 would also like to add to Exhibit Number 7, the last part

9 of the chain of the e-mail that's missing. And we would
10 like to add an Exhibit 13, which is the Lakes Regional
11 medical records that just came in today.
12 MR. BAUCOM: If I understood you, Items 1
13 through 10 and adding the last part of the e-mail on 7
14 that was missing; is that correct?
15 MS. KIRK: Yes.
16 MR. BAUCOM: And then on 13?
17 MS. KIRK: Adding a new 13, which I will
18 give you a copy.
19 MR. LEICHTER: I don't have any of that
20 stuff. I would appreciate paper copies of 1 through 10
21 also if you have them.
22 MS. KIRK: That was on a disk.
23 MR. LEICHTER: I know. We prefer paper
24 copies.
25 MS. KIRK: I will see if Tam can get you
0015
1 some.
2 MR. PALAZOLA: Are you offering any of these
3 under seal?
4 MS. KIRK: Yes, I am offering Exhibits 5
5 through 10 under seal, and 13 to be admitted under seal as
6 well.
7 MR. BAUCOM: What did you say about 13?
8 MS. KIRK: To be admitted under seal.
9 MR. BAUCOM: Okay.
10 MR. LEICHTER: 13 is the Lakes Regional
11 Medical Center?
12 MS. KIRK: Yes.
13 MR. LEICHTER: We object due to timely
14 notice. We have no objection to the e-mail. What was the
15 other exhibit?
16 MS. KIRK: That was it.
17 MR. BAUCOM: Does the Panel have a response
18 to the tender of Exhibit 13?
19 MR. PALAZOLA: Exhibit 13 was just received.
20 We had to subpoena the records. Respondent instructed
21 Lake Regional Medical Center MHMR not to provide them to

22 us, is our understanding. So we had to issue a subpoena
23 for those records. That came in after 5:00 yesterday.
24 We just basically had a chance to look at
25 them this morning. These are the Respondent's medical
0016
1 records. We have reason to believe he's asked for his own
2 copy, so he should not have any surprise as a result of
3 these records.
4 Also I didn't hear a specific citation to
5 any section of the Board rules or Administrator Practice
6 Act concerning Mr. Leichter's specific objection, so I'm
7 not sure exactly what the basis of the objection is other
8 than just unfair surprise since these are the Respondent's
9 records.
10 MS. LESHIKAR: Panel, it's up to you. I
11 would suggest that it is somewhat disingenuous for the
12 Respondent to have directed the hospital not to provide
13 the records and require us to subpoena them and then to
14 argue that they did not have adequate notice of receipt of

15 the records.
16 MR. LEICHTER: Excuse me. There is
17 absolutely no proof of that. We don't know where that
18 came from. That is not factually accurate, and I'd like
19 to hear if you do call the witness for them to make
20 evidence -- provide evidence to that point. That is
21 absolutely untrue. There is no documented evidence to
22 substantiate that.
23 MS. LESHIKAR: Mr. Palazola, do you have
24 any --
25 MR. PALAZOLA: What we could do, if the
0017
1 Panel is concerned about that, we could tender them for
2 admission at this time; and if necessary call the
3 necessary witness or attempt to lay the foundation for
4 those records as we proceed through the hearing today.
5 MS. LESHIKAR: That would be fine.
6 DR. CROCKER: I think they are important.
7 MR. LEICHTER: I was just apprised that Dr.
8 Glass, our expert, reviewed these records. So as such, we

9 think they fall into some kind of admissible category that
10 way, so we will withdraw our objection at this time.
11 MR. BAUCOM: Okay. Exhibits 1 through 10,
12 then, are admitted. The last part of the e-mail for
13 Exhibit 7 is in addition, and 13 is also admitted as
14 agreed.
15 (Board's Exhibit Numbers 1 through 10 and 13
16 admitted.)
18 call witnesses.
19 MR. PALAZOLA: Board staff would call
20 Detective Sergeant Mazy of the Paris Police Department.
21 We will have to reach him by phone.
22 (Phone call initiated.)
23 MR. LEICHTER: We invoke that he be asked
24 whether or not he's in a room by himself and whether or
25 not anyone else is listening to him, watching him testify
0018
1 and whether or not any other witness who might be

2 testifying in this proceeding be removed.
3 MR. PALAZOLA: Detective Mazy, I think you
4 are going to be given some instructions and sworn in by
5 hearings counsel. We are in the room right now.
6 THE WITNESS: Okay.
7 MS. LESHIKAR: Detective, this is Nancy
8 Leshikar. I'm the hearings counsel with the Medical
9 Board. I'm going to ask you whether you are, in fact, in
10 a room by yourself?
11 THE WITNESS: Yes, I am.
12 MS. LESHIKAR: All right. And I would
13 instruct that you remain in that room by yourself and not
14 allow anyone else to enter that room while you are giving
15 your testimony. Is that clear?
16 THE WITNESS: Yes.
17 MS. LESHIKAR: Thank you.
18 Mr. Leichter, will that satisfy you?
19 MR. LEICHTER: Yes, and no one else is
20 listening to the phone conversation, right?
21 MS. LESHIKAR: Detective, is anyone else

22 listening on the phone conversation?
23 THE WITNESS: No.
24 MS. LESHIKAR: All right. I think we've got
25 that clear. He is by himself alone in a room with no one
0019
1 listening. Okay. All right.
2 Detective, I'm going to swear you in now.
3 (Witness sworn.)
4 MS. LESHIKAR: You are now under oath and
5 everything to be testified to will be the truth and
6 nothing but the truth, all right?
7 THE WITNESS: Yes.
8 DETECTIVE SERGEANT JAMES MAZY,
9 having been first duly sworn, testified as follows:
10 DIRECT EXAMINATION
11 BY MR. PALAZOLA:
12 Q Detective Mazy, would you please go ahead and
13 introduce yourself to the Panel.
14 A I'm Detective Sergeant Jay Mazy with the Paris,

15 Texas, Police Department. I've been employed here almost
16 20 years.
17 Q In your capacity as a detective sergeant for the
18 Paris Police Department, are you familiar with the
19 procedures regarding emergency detentions?
20 A Yes.
21 Q Could you tell us briefly what an emergency
22 detention is and what role you play in that type of
23 detention?
24 A Emergency detention is basically a -- in this
25 particular case, as in most cases, it's either an on-view
0020
1 type of offense to where an officer believes that someone
2 is mentally unstable, mentally handicapped at the moment,
3 to the point that they are a danger to theirself or
4 others, and they require some type of hospitalization to
5 intervene.
6 Q And, Detective, are you familiar with a
7 Dr. Szumlas?
8 A Yes.
9 Q How are you familiar with Dr. Szumlas?
10 A I was asked by my supervisor to do some follow-up
11 investigation on 911 calls that he was placing to our
12 agency.
13 Q And you talked about 911 calls that were being
14 placed to your agency. Let me ask you a few questions
15 about those calls, Detective. Does the Paris Police
16 Department keep a record of 911 calls that are received by
17 the police department?
18 A Yes, they do.
19 Q And are you familiar with that practice as to how
20 those are recorded?
21 A Not 100 percent. I know that there are audio
22 recordings that are maintained for a certain amount of
23 time and then there are written or recorded messages that
24 are typed in by the dispatchers when the call comes in or
25 goes out.
0021
1 Q If there is a particular individual that calls

2 the 911 system a number of times, are you able to access
3 those logs and review them?
4 A Yes, for the most part, yes.
5 Q At some point did you have an opportunity to
6 review the 911 calls that were made by Dr. Szumlas?
7 A Yes, I did.
8 Q And do you have a copy of those logs in front of
9 you now?
10 A Yes, if we are talking about the same thing, I
11 do.
12 Q Let me tell you what I'm looking at and we can
13 make sure we are talking about the same thing, we are all
14 on the same page. These would have been part of the
15 materials that were submitted to the Medical Board as part
16 of your complaint. I am looking at a log of 911 calls.
17 These are dated -- they've got a date on the top.
18 MR. LEICHTER: Excuse me. I would have to
19 object. We don't have a notice of these logs. We don't
20 have these logs in front of us. This is obviously going
21 to be a hearsay; it's not comment. We don't necessarily

22 object, but we would at least like to see what we are
23 referring to.
24 MR. PALAZOLA: These logs are part of the
25 exhibits that have already been admitted into evidence.
0022
1 MR. LEICHTER: As what number?
2 MR. PALAZOLA: These are part of the
3 complaint, which is Tab 4. These are for everyone to kind
4 of follow along. This is going to be Tab 4, Pages 2, 3, 4
5 and 5. And we can take a minute for Mr. Leichter to get a
6 hold of these.
7 MS. LESHIKAR: For the record, when was Mr.
8 Leichter provided with a CD of this Application?
9 MS. KIRK: He was provided with the CD
10 within the ten days' notice period. I believe it was back
11 on the -- I have to look at the --
12 MR. LEICHTER: For some reason, the disk we
13 have didn't work -- doesn't work. It did work. We copied
14 whatever we have, and I have paper copies of a large part

15 of the file. I'm not finding the 911 log. Give me a
16 minute.
17 MR. PALAZOLA: They look like this, Mr.
18 Leichter.
19 MS. LESHIKAR: Would you mind taking that
20 actual document over to Mr. Leichter to where he can see
21 it.
22 MR. PALAZOLA: Sure.
23 Is the objection withdrawn?
24 MR. LEICHTER: I don't have a copy of that
25 in the material we printed out. For some reason, it
0023
1 didn't make it. It is referenced in here, but it is not
2 in the printout.
3 MS. LESHIKAR: Is it on the CD that you
4 have?
5 MR. LEICHTER: The CD that I have doesn't
6 work.
7 MS. LESHIKAR: Did you inform staff that it
8 did not work?

9 MR. LEICHTER: It worked in my office. I
10 printed it out because I don't like electronic copies.
11 And for some reason, I don't have the paper copy, so my
12 fault.
13 MS. KIRK: I was uninformed of any issues.
14 MR. LEICHTER: There were no issues. The CD
15 worked. I don't know whether we printed out everything
16 that I believe was on the CD.
17 MS. LESHIKAR: Are we now making copies?
18 MS. KIRK: Cynthia is making copies of
19 everything for Mr. Leichter.
20 MS. LESHIKAR: Let's go off the record for
21 just a moment while the copies are being made.
22 (Off the record.)
23 MS. LESHIKAR: Let's go back on the record.
24 Q (BY MR. PALAZOLA) All right, Detective. You are
25 looking at the same thing we are all now looking at. You
0024
1 are looking at the 911 logs. And at the top of the page,
2 it's got a date. I think these were printed on February
3 7th, 2011. And they have a Paris Police Department name
4 on them. Are you able to look at those right now?
5 A Yes.
6 Q And if I thumb through these, it looks like the
7 dates of individual log entries began on November 12th,
8 2010 and go through February 6th, 2011. Is that what you
9 are looking at as well?
10 A Yes, 11/12 of '10 and the last one was 2/6 of
11 '11.
12 Q This isn't the first time you have seen these,
13 today, is it?
14 A No.
15 Q Can you summarize for us what these logs reflect?
16 A Basically this is what the dispatcher types into
17 the call screen and -- of what the person is stating, and
18 I'm sure it is paraphrased.
19 Q And the nature of these concerns, who is the
20 person calling 911 in these logs?
21 A This is coming from Dr. Szumlas' residence.

22 Q What's the nature of his complaint to the 911
23 emergency system?
24 A Basically that he's being harassed by electronic
25 or radio beams and that they are coming into his
0025
1 apartment.
2 Q And did officers respond as a result of these 911
3 calls?
4 A Yes. I'm not 100 percent sure about this very
5 first one, but I know the other ones that they did.
6 Q And have you had an opportunity to discuss with
7 those officers their interactions with Dr. Szumlas?
8 A I did speak to one or two of them. Sometimes it
9 might be the same officer that went out; sometimes it was
10 different officers.
11 Q And I am not, at this point at least, going to
12 ask you to relay the details of those conversations; but
13 to summarize, you had a record of these 911 calls that
14 were being made; you talked to the officers. At some

15 point, did you also receive a copy of a -- it looks like a
16 typed written document that had Dr. Szumlas's name on it?
17 A Yes, I did. That was given to me by our
18 supervisor or assistant chief of police.
19 Q When you reviewed that note -- do you have a copy
20 of that in front of you right now?
21 A I am looking at it, yes.
22 MR. PALAZOLA: For everyone's benefit, this
23 is going to be part of the complaint documents again.
24 This is going to be, I believe, Page 5 of Tab 4.
25 Q (BY MR. PALAZOLA) You don't need to read this
0026
1 letter to us. Everybody has a copy of this letter here.
2 But if you could just summarize briefly for us --
3 actually, let me ask you a different question, Detective
4 Mazy.
5 Is the information in this letter consistent
6 with the records and the 911 logs and your conversations
7 with the officers who responded to Dr. Szumlas's
8 apartment?
9 A Yes, they both contain the same complaints and
10 details.
11 Q At some point, Detective, you filed a complaint
12 with the Texas Medical Board; is that right?
13 A I did.
14 Q And why did you file that complaint?
15 A Basically that I felt that he was -- Dr. Szumlas
16 could be a threat to his patients or -- by including the
17 public if this type of behavior was not checked or
18 evaluated by a professional medical facility or something.
19 Q Were you aware at that point in time that Dr.
20 Szumlas had obtained any weapons?
21 A One of the officers did make a notation in the
22 report that he had saw some type of gun inside the
23 apartment on one of these calls.
24 Q Detective, did you -- at what -- we talked a
25 little while ago about the emergency detention and what
0027
1 that process entails. At some point did you decide to

2 pursue an emergency detention of Dr. Szumlas?
3 A Basically in agreement with the chief deputy of
4 the sheriff's office, we came to the agreement that that's
5 what needed to be done.
6 Q Were you present at the time that Dr. Szumlas was
7 taken into custody as a result of that emergency
8 detention?
9 A Yes, I was.
10 Q Did you have an opportunity to observe Dr.
11 Szumlas while you were there?
12 A Yes.
13 Q Did you have an opportunity to observe his
14 apartment while you were there?
15 A Yes.
16 Q Detective, you actually took photographs of
17 Dr. Szumlas's apartment?
18 A Yes, I did.
19 Q And you made an auto recording of the event as
20 well, correct?
21 A Correct.
22 Q Do you have a copy of your photographs in front
23 of you?
24 A Actually, I don't believe I do.
25 Q Are they somewhere where you can access them on
0028
1 your computer where you are sitting right now?
2 A I can go outside the door and look at them.
3 Q If you could obtain a copy, I'm going to show a
4 copy of these to opposing counsel, and you'll have a
5 minute to do that.
6 A Okay.
7 Q Thank you.
8 A All right. Hold on.
9 MS. LESHIKAR: Are these in the record?
10 MR. PALAZOLA: Not yet.
11 MR. LEICHTER: Are these for me?
12 MR. PALAZOLA: These aren't extra copies.
13 MR. LEICHTER: I'll object until I get
14 copies for myself.

15 MS. LESHIKAR: We are going to go off the
16 record for a minute. We are going to be off the record
17 for a moment.
18 (Off the record from 10:29 a.m. to 10:39
19 a.m.)
21 MR. LEICHTER: We were apparently sent two
22 disks with the same name, same information, Tab 1 through
23 whatever. Apparently, one tab was supplemented on one of
24 the disks and one tab wasn't supplemented on one of the
25 disks.
0029
1 When we loaded them, our computer said it
2 was the same thing. We apparently loaded one after the
3 other and it erased the other copies of the disk and
4 obviously printed out this. So that appears to be what
5 occurred.
6 MS. KIRK: We did update with the medical
7 records. There were two disks sent, but they all had all
8 the information on both.

9 MS. LESHIKAR: You have the diskette and you
10 have the documents now, is that correct, Mr. Leichter?
11 MR. LEICHTER: I'm checking to see if it's
12 accurate. Apparently, Ms. Southard had the first disk
13 too.
14 MS. LESHIKAR: Ms. Southard has everything
15 as well. All right. We are back on the record.
16 Detective, are you still with us?
18 MS. LESHIKAR: Good for you. You are going
19 to talk about photographs; is that correct?
20 Q (BY MR. PALAZOLA) Before all this recess, the
21 question I asked you is, did you have an opportunity to
22 take photographs of Dr. Szumlas's apartment?
23 A Yes, I did.
24 Q Do you now have a copy of those photographs in
25 front of you?
0030
1 A I do.
2 Q What I would like you to do, first of all, just
3 give us a general description of what you observed as you
4 walked into Dr. Szumlas's apartment.
5 A Basically the interior of the apartment was, I
6 guess, somewhat unkept. It looked like maybe someone had
7 -- it was like someone had moved in recently or it was a
8 lot of boxes and stuff maybe packed or unpacked. There
9 wasn't really any type of organization to anywhere inside
10 the apartment.
11 Q And did you see specific things in the apartment
12 that you thought would be a good idea to document with
13 photographs?
14 A Yes. The area that he described as his bedroom,
15 when I entered that was where I saw the large butcher or
16 kitchen knife. It was stuck into a wooden nightstand.
17 And this is where three -- I'm sorry, two of the radio
18 transmitters or deflectors, I'm not exactly sure what they
19 are, but this is where they were found.
20 Q And did you take pictures of the knife that you
21 just talked about and the radio deflectors or equipment?

22 A Yes, I did.
23 Q And I think this is a little bit confusing
24 because you are over the phone and we are both looking at
25 pictures, but they are not going to be in the same order.
0031
1 How many photographs do you have in your stack there?
2 A I have eight photographs.
3 Q Okay. That's going to correspond to what I have
4 as well, I believe. I think the easiest way to do this --
5 MR. PALAZOLA: Unless you want to lay the
6 foundation for all of them at once or do you want to go
7 through them one at a time?
8 MR. LEICHTER: I would like to take the
9 witness on voir dire.
10 MS. LESHIKAR: Detective Mazy, the defense
11 counsel is going to take you on voir dire at the moment
12 for the purpose of?
13 MR. LEICHTER: Establishing these
14 photographs were taken a good bit ago. He had them in his

15 possession. If they were going to introduce them into
16 evidence, he should have provided them to staff and we
17 should have been given copies of them quite some time ago
18 so they could have at least been given to our expert.
19 This is unfair surprise outside the
20 requirement that notice be given ten days in advance with
21 the exhibits. I think we can establish that he delayed in
22 waiting to forward these to staff; that he had them in his
23 possession and he should have given them to staff a long
24 time ago.
25 MR. PALAZOLA: If I can respond, and if we
0032
1 need to hit mute, we can do this out of the presence of
2 the witness.
3 MS. LESHIKAR: Hit mute.
4 MR. PALAZOLA: There was a lot of
5 information there but, to me, a lot of these questions are
6 not really questions for Detective Mazy. A lot of these
7 are to be addressed by the rules of the Administrative
8 Procedures Act and the Board rules and are not necessarily
9 going to be within his realm as a witness to testify
10 about.
11 What is appropriate to voir dire the witness
12 about is whether or not these picture are a fair and
13 accurate representation of what he witnessed in Dr.
14 Szumlas's apartment. Once that foundation is laid, I will
15 offer them as exhibits into evidence. And at that time,
16 Mr. Leichter can make all of those objections he has, and
17 we can discuss that at that point. But I would recommend
18 that we go ahead and lay the foundation for these
19 photographs with Detective Mazy so we can proceed that
20 way.
21 MS. LESHIKAR: Mr. Leichter, I will let you
22 voir dire the witness solely as to the dates he took them,
23 whether he took them, whether they were a fair
24 representation of what he saw at the time. Those are the
25 only purposes for voir dire. Anything else that relates
0033
1 to the delay on the part of the staff to provide you with

2 anything is not going to be relevant to the voir dire or
3 the purpose of laying the foundation for those particular
4 paragraphs.
5 MR. LEICHTER: He did file the complaint
6 with the Medical Board. He admitted that, so I do think
7 that's relevant. Not to argue with you, but it is a
8 relevant factor in terms of his providing information to
9 staff.
10 MS. LESHIKAR: You can ask an additional
11 question when he provided it to staff. But in terms of
12 providing the basic fundamental foundation for admitting
13 photographs into the record, that is going to be the
14 extent of what you can do. We are not going to be going
15 into any other discussion about to the appropriateness of
16 when you did or did not get those exhibits.
17 All right. Unmute.
18 MR. LEICHTER: Thank you.
19 VOIR DIRE EXAMINATION
20 BY MR. LEICHTER:
21 Q Detective?
22 A Yes.
23 Q This is Louis Leichter. I represent Dr. Szumlas.
24 When did you take these photographs?
25 A They should have been taken on the day he was
0034
1 taken into custody, which was on the 16th, I believe.
2 Yes, March 16th.
3 Q And that March 16th date is so indicated in the
4 right-hand corner in yellow print, is it not?
5 A It is.
6 Q And I take it these photographs were taken with a
7 digital instrument, digital camera?
8 A Yes.
9 Q And that means they were processed and available
10 for review right away; were they not?
11 A Yes.
12 MS. LESHIKAR: That's beyond the question.
13 You can say when he filed -- ask when he filed them with
14 the Board.
15 Q (BY MR. LEICHTER) At what point did you provide
16 these documents to staff?
17 A Yesterday.
18 Q Did you provide these documents to anyone else,
19 such as the individuals in conjunction with the commitment
20 paperwork that was provided to the District Court?
21 A No.
22 MR. LEICHTER: That does it.
23 MS. LESHIKAR: Detective -- does that
24 complete your voir dire?
25 MR. LEICHTER: It does.
0035
1 MS. LESHIKAR: Are there any other
2 questions?
3 MR. PALAZOLA: Yes.
4 CONTINUED DIRECT EXAMINATION
5 BY MR. PALAZOLA:
6 Q Detective, I'm going to go through these
7 photographs with you. We have eight of them. What I
8 would like you to do, because we are doing this by phone,

9 we can't look at them -- see exactly what we are all
10 looking at. We are going to briefly describe them and be
11 as concise as we can.
12 I have eight photographs. I have one of
13 what looks like a pillow with something that's been either
14 -- it was pulled out of the pillow. It looks like some
15 sort of foil. Are you looking at that picture?
16 A Yes, I am.
17 MR. LEICHTER: We will stipulate that the
18 photos are authentic and accurate representations of what
19 occurred. We object -- so we don't have to go through
20 this whole predicate foundation crap -- we object on the
21 notion that he was given lack of notice.
22 They were available 30 days ago. He didn't
23 provide them to staff until staff apparently probably
24 asked him about them. And it's unfair surprise. It could
25 have been reviewed by our expert. It's a complete waste
0036
1 of time and it's in violation of his rights under the

2 Medical Practice Act, Texas and United States
3 Constitution. Preserving the record.
4 MS. LESHIKAR: So you are going to stipulate
5 that those photographs are an accurate representation of
6 the subjects of which they purport to show; is that
7 correct?
8 MR. LEICHTER: Correct. We object on the
9 basis -- for the reasons I just layed.
10 MS. LESHIKAR: All right. Now, would you
11 like to respond to his objection?
12 MR. PALAZOLA: The response to that would be
13 that first and foremost these are photographs of the
14 inside of Dr. Szumlas's apartment. Again, as to any
15 unfair surprise to the Respondent, these are documenting
16 what Detective Mazy is able to testify to, and these will
17 assist him in explaining what he saw in Dr. Szumlas's
18 apartment.
19 These are photographs. There is no
20 objection to the authenticity of the photographs. We just
21 heard that from Mr. Leichter. I believe they will help

22 Detective Mazy explain what he saw inside the apartment.
23 I think they will help the Panel.
24 As to any unfair surprise, we didn't know
25 they existed before yesterday. We couldn't make them
0037
1 available before then. If they are going to need a short
2 recess for their expert to review these photographs before
3 he testifies, Board staff would have no objection to that,
4 to have him review these at that point in time.
5 Other than that, I don't see how there's
6 undue prejudice to the Respondent for introducing
7 photographs of his own apartment.
8 MS. LESHIKAR: Panel, I would recommend that
9 Mr. Leichter's objection be overruled.
10 MR. BAUCOM: Fine. Ms. Southard, did you
11 hear that okay?
12 MS. SOUTHARD: I second.
13 MS. LESHIKAR: She said she seconded.
14 MR. BAUCOM: Do you concur?

15 MS. SOUTHARD: Yes, I do.
16 MS. LESHIKAR: Mr. Leichter, your objection
17 is overruled.
18 And now you do not have to go through the
19 entirety of proving those up. Perhaps you would like to
20 admit them and have the Panel be able to look at them.
21 MR. PALAZOLA: Yes, at this time, Board
22 staff would ask that the eight photographs taken by Dr.
23 Mazy [sic] be offered into evidence as Exhibit 14 -- Tab
24 14.
25 MS. LESHIKAR: Okay.
0038
1 (Board's Exhibit Number 14 admitted.)
2 MS. LESHIKAR: Do we have an extra copy for
3 me by any chance?
4 MR. PALAZOLA: Yes, we do.
5 Q (BY MR. PALAZOLA) Detective, rather than having
6 you go through each of these photographs, I think you
7 described earlier that you that you had witnessed some
8 electronic devices. And I have some photographs with some

9 objects that look like they are hard plastic with antennas
10 in them. Those are the electronic devices that you are
11 referring to?
12 A Yes, it is.
13 Q And then I see there's -- you have taken a
14 photograph of a -- what looks like a large kitchen knife?
15 A Yes.
16 Q Where did you find that knife when you entered
17 Dr. Szumlas's apartment?
18 A That particular knife was stuck down into the
19 wooden nightstand in his bedroom, the same place where the
20 pillow is located.
21 Q I see a picture of a box that says it's for a
22 Ruger LCP. Is that a box for a handgun?
23 A Yes, it is.
24 Q Did you find a handgun in Dr. Szumlas's
25 apartment?
0039
1 A Yes, inside the apartment in the kitchen area.

2 Q What was inside -- you have a picture of what
3 looks like the inside of that box. What did you find
4 inside the box?
5 A The box was two -- inside the white box you see
6 there is two boxes of ammunition somewhat. There's 50
7 rounds per box. The locking mechanism that goes to the
8 handgun, and I guess that's some type of stopwatch or
9 something that was in there.
10 Q I think I was asking you before we had an
11 objection about what was in Dr. Szumlas' pillow. Could
12 you -- and I do see a photograph of that. Can you
13 describe what you found in Dr. Szumlas' pillow?
14 A That basically is the same type of product that
15 you see people putting in the windshield of their cars to
16 reflect the sun's rays to the interior of the car. And
17 that's the same item you see behind the headboard there,
18 blue in color.
19 Q And in addition to taking photographs and
20 observing the apartment, did you -- were you present
21 during Dr. Szumlas' conversation with you and the other

22 officers?
23 A Yes.
24 Q And what was Dr. Szumlas' response when you
25 arrived at the scene?
0040
1 A Basically he was kind of cordial and kind of glad
2 to see us, that his request for something to be done about
3 the situation he has been alleging. He thought that's
4 what we were there for, to take care of the problems with
5 the ultrasound or radio waves.
6 Q At some point did you advise him or did one of
7 the officers on the scene advise him that he was actually
8 under a warrant to be taken in for treatment?
9 A Yes.
10 Q What was his response to that?
11 A I don't recall verbatim, but he basically didn't
12 -- wasn't sure that that was legal to be done to him or
13 against him. But after that, he was very cordial and said
14 he understood. So there was no -- not any argument or

15 anything verbal or physical in his response.
16 Q Did he indicate to you -- did he make statements
17 at that time that were consistent with the statements in
18 the 911 calls and the letter that was received regarding
19 the satellites and the advanced electronics?
20 A Yes, he was basically just kind of reiterating
21 about the radio waves and that they were actually in an
22 area of the house, where we were at was the worst part for
23 him to be getting those signals.
24 Q Did what you observed in Dr. Szumlas' apartment
25 on the date of his detention reinforce your position that
0041
1 an emergency detention was required?
2 A Yes.
3 Q Why?
4 A Well, in addition to him writing the letters, I
5 mean, he was personally telling us the same thing that we
6 had been receiving either by phone or in writing by the
7 letter; that this had been ongoing since February of last
8 year and it was still consistent with what was happening

9 on that particular day; that he was still seeing or
10 hearing or feeling some type of objects that apparently
11 were not there.
12 MR. PALAZOLA: We pass the witness.
13 MS. LESHIKAR: Mr. Leichter.
14 CROSS-EXAMINATION
15 BY MR. LEICHTER:
16 Q Officer, it's fair to say you wrote a report
17 regarding these incidents; did you not?
18 A Yes.
19 Q And that report is probably true and accurate in
20 every respect, isn't it?
21 A Yes.
22 Q And it's complete; is it not?
23 A Yes.
24 Q It's fair to say you didn't leave out any
25 pertinent details, true?
0042
1 A I'm sorry. Could you repeat that.

2 Q It's fair to say you didn't leave out any
3 pertinent details; would you agree?
4 A Not that I'm aware of.
5 Q Because that's what good, trained police officer
6 activity involves, correct?
7 A Correct.
8 Q It's fair to say these photographs are complete
9 in every regard; are they not?
10 A Yes.
11 Q You didn't leave out any pertinent illustrative
12 depictions of relative evidence; would you agree?
13 A Yes.
14 Q So you don't have photographs of material taped
15 to Dr. Szumlas's window, do you?
16 A No.
17 Q These phone calls started in January of 2011; is
18 that accurate?
19 A They started November 2010.
20 Q So your testimony just now that it started in
21 February of last year is not true?

22 MR. PALAZOLA: Objection, misstates the
23 evidence. His testimony was consistent with the 911 logs.
24 MR. LEICHTER: I think he can answer it. He
25 just testified. I heard him say that it was consistent
0043
1 with Dr. Szumlas's position that this had been occurring
2 since February of 2010; February of last year is what he
3 testified to. That's not what this record indicates. He
4 can answer questions about it.
5 MS. LESHIKAR: Detective, we will have Mr.
6 Leichter restate the question.
7 Q (BY MR. LEICHTER) When does your log of 911
8 calls begin?
9 A November 12, 2010.
10 Q When does it end?
11 A It ends on February 6th of 2011.
12 Q And there's been no calls since Dr. Szumlas's
13 discharge from the Terrell State Hospital, has there?
14 A Not that I'm aware.

15 Q These calls didn't begin in February of 2010, did
16 they?
17 A No.
18 Q So you testified Dr. Szumlas was cordal?
19 A Yes.
20 Q And was cooperative?
21 A Yes.
22 Q Are you aware that Dr. Szumlas admitted to having
23 a psychotic break?
24 A No.
25 Q Are you also aware that Dr. Szumlas admits and
0044
1 acknowledges that what he experienced at that time wasn't
2 real?
3 A No.
4 Q So it's fair to say that you haven't received any
5 information since Dr. Szumlas's discharge from the Terrell
6 Hospital that indicates he's an ongoing threat to the
7 citizens of Paris, Texas; is there?
8 A No.
9 Q In fact, you haven't heard any information on Dr.
10 Szumlas since his discharge from the Terrell State
11 Hospital, have you?
12 A I have none to my knowledge.
13 Q And was that gun loaded, Detective?
14 A Yes, it was.
15 Q It's not illegal to own a weapon in the state of
16 Texas, is it, Detective?
17 A No.
18 Q In fact, you didn't arrest Dr. Szumlas for having
19 an illegal weapon, did you?
20 A No, I did not.
21 Q Dr. Szumlas, you ran his criminal history, did
22 you not?
23 A I don't believe I did. I do not recall, and I do
24 not have it here in front of me. I don't think I ever ran
25 a criminal history.
0045
1 Q So it's fair to say that you have had no

2 interaction with Dr. Szumlas since you took him into
3 custody on a mental health commitment; is that accurate?
4 A I have not.
5 Q So you really have no way of knowing whether he's
6 an ongoing danger at this point in time at all, do you?
7 A I do not.
8 Q Is it fair to say, Detective, that there is no
9 record of any communication between Dr. Szumlas and your
10 department since March 18, 2011?
11 A None that I'm aware of.
12 Q Is it fair to say also that had there been
13 communication, you would probably be aware of it?
14 A Probably so. I would probably get some type of
15 notification from somebody if they knew that I was
16 involved in the case.
17 Q Detective, you indicated that Dr. Szumlas seemed
18 somewhat surprised or irritated that you were taking him
19 into custody; did you not?
20 A Yes.
21 Q That's pretty normal though, isn't it?

22 A I would agree.
23 Q And once you apprised Dr. Szumlas of the reasons
24 for your taking him into custody, he acquiesced; did he
25 not?
0046
1 A Yes.
2 Q In fact, when you took him into custody, you were
3 in no way afraid for your safety, were you?
4 A Well, not at that -- not at the great amount, I
5 don't guess. We believed we had the apartment secured and
6 had him secured.
7 Q In fact, Dr. Szumlas displayed no violent
8 tendencies toward you or anyone else during this whole
9 affair; isn't that true?
10 A True.
11 Q Are you aware that Dr. Szumlas was getting ready
12 to move out of that apartment?
13 A No.
14 Q There were a bunch of boxes there and items being

15 packed. Would that be a fair description of the scene you
16 saw?
17 A That would be a description of what I saw, yes.
18 Q When is the last time you talked to staff with
19 the Texas Medical Board regarding your testimony today?
20 A Yesterday.
21 Q Is that when you apprised them of the pictures
22 you took?
23 A Yes.
24 MR. LEICHTER: Pass the witness.
25 MS. LESHIKAR: Is there any redirect?
0047
1 REDIRECT EXAMINATION
2 BY MR. PALAZOLA:
3 Q Detective Mazy, I have a couple of follow-up
4 questions. When Dr. Szumlas -- you were just asked if he
5 was surprised and irritated and if that was unusual. Did
6 Dr. Szumlas offer any of his own opinions regarding
7 whether or not he felt he needed treatment, if you recall?
8 A I apologize. Could you repeat that, please.

9 Q At the time that you discussed with Dr. Szumlas
10 that you had a warrant to take him into custody for
11 treatment, did he -- what was his response regarding his
12 needing treatment?
13 A Once again, I don't recall exactly word for word
14 what he said. But he kind of -- he was surprised that we
15 were there, and as to why we were there, that there was
16 any type of -- he did not believe there was any type of
17 problem, you know, going on with him, that he knew of.
18 Q You were asked just a second ago, at the time you
19 took him into custody if you felt threatened. Did you
20 have any reason before, as you were approaching the
21 apartment, to feel concern for your safety?
22 A Yes, the other officers, like I said, have made
23 reference to that was some type of -- actually, that there
24 was a long gun. I don't know if it was a rifle or
25 shotgun, that he had seen on previous calls, leaned up
0048
1 inside the apartment.

2 MR. PALAZOLA: And, Detective, I don't have
3 anything further for you. I am going to pass the witness.
5 RECROSS-EXAMINATION
6 BY MR. LEICHTER:
7 Q Detective, you did search an inventory of the
8 apartment; did you not?
9 A We did a search. We did not do any type of
10 written inventory other than the gun that was taken in.
11 Q You didn't find a long gun such as a rifle or a
12 shotgun which you just described; did you?
13 A We did not see one, no.
14 Q In fact, you found no record that Dr. Szumlas had
15 ever owned such a gun; did you?
16 A I did not do any type of gun search on his name.
17 Q So essentially you found no record that Dr.
18 Szumlas had ever owned such a type of gun?
19 A No.
20 MR. LEICHTER: Thank you. Pass the witness.
21 MR. PALAZOLA: Nothing further.

22 MS. LESHIKAR: Detective, you are now
23 excused from your testimony. I'm sorry. The Panel has
24 some questions.
25 EXAMINATION
0049
1 BY DR. CROCKER:
2 Q Hi, this is Dr. Crocker. I just have a couple of
3 questions to clarify his demeanor. At no time did he
4 brandish the gun at anybody?
5 A No.
6 Q And when he was asked to give it up, he gave it
7 up without any fuss?
8 A Yes, we actually found the box first and couldn't
9 find the gun, and he really didn't recall where he put it.
10 He said he thought it was in the kitchen, and that's where
11 we found it.
12 Q And the picture of the knife, did he ever
13 brandish the knife?
14 A No.
15 Q Was it just laying on his kitchen counter?
16 A When we found it, it was -- the picture of it was
17 taken laying down on a counter. It was actually stuck
18 down into a wooden table.
19 Q Like a knife holder or?
20 A I'm sorry?
21 Q Like a knife holder?
22 A No, just stuck like you would just stick it into
23 maybe a chopping block or knife holder. It was stuck into
24 the wood, pointing down.
25 Q Okay. And those electronic devices, there's one
0050
1 that has six antennas that's hooked up to a speaker and
2 one that's just four antennas and a little blue box. Have
3 you ever seen any electronics like that?
4 A No, I have not.
5 Q So you don't have any idea what they are for?
6 A We asked him and he -- I don't remember exactly
7 what he said. They were either a receptive device or
8 deflective device. I'm not exact sure what his

9 explanation was for those.
10 Q When you looked through his apartment, you didn't
11 find any drugs?
12 A No.
13 Q Was there any alcohol bottles?
14 A No. None that I noticed. I did not -- there
15 were three of us there. I didn't do -- I may not have
16 searched someplace someone else did or looked.
17 DR. CROCKER: That's all I have.
18 MS. LESHIKAR: Mr. Baucom, do you have any
19 questions?
20 MR. BAUCOM: No.
21 MS. LESHIKAR: Ms. Southard, do you have any
22 questions?
23 MS. SOUTHARD: No, ma'am. Thank you.
24 MR. LEICHTER: I should be entitled to ask
25 questions, I believe, now in response to that.
0051
1 MS. LESHIKAR: Limited solely to what was

2 brought up.
3 MR. LEICHTER: Of course.
4 FURTHER RECROSS-EXAMINATION
5 BY MR. LEICHTER:
6 Q Officer, remember I asked you if you provided a
7 fair and comprehensive, complete report?
8 A Yes.
9 Q And you admitted it was fair to say you didn't
10 leave anything relevant out of that report?
11 A Not that I'm aware of.
12 Q And drugs, alcohol, weaponry, violence would be
13 relevant things, correct?
14 A I would think so, yes.
15 Q It's fair to say the absence of those things
16 indicate they weren't an issue?
17 A It merely states the fact I didn't see them or
18 didn't photograph them if they were there.
19 Q It's fair to say, isn't it, that if drugs,
20 alcohol or something else was an issue it would have been
21 brought up in the report?

22 A I would think so.
23 Q And violence, officer threat for safety, et
24 cetera, if it was an issue would have been brought up in
25 the report, correct?
0052
1 A Yes.
2 Q And Dr. Szumlas was cooperative?
3 A Yes.
5 MR. PALAZOLA: I may have to have one
6 further question too.
7 FURTHER REDIRECT EXAMINATION
8 BY MR. PALAZOLA:
9 Q Detective, if you recall, what did Dr. Szumlas --
10 did Dr. Szumlas tell you what the purpose of having the
11 knife in his nightstand was?
12 A The purpose was for his protection in case he was
13 somewhere in one room and his gun was in another room.
14 MR. PALAZOLA: That's all I have.

15 MS. LESHIKAR: Mr. Leichter?
16 MR. LEICHTER: No.
17 MS. LESHIKAR: Detective, you are now
18 excused from your testimony. We thank you very much for
19 your time.
20 THE WITNESS: Thank you.
21 MS. KIRK: At this time, the Board would
22 like to call Dr. Messer.
24 MS. KIRK: This is Claudia Kirk at the
25 Medical Board. You understand you are testifying at a
0053
1 temporary suspension hearing?
2 THE WITNESS: Right.
3 MS. KIRK: Now, the hearings counsel is
4 going to instruct you and swear you in.
6 MS. LESHIKAR: Dr. Messer, this is Nancy
7 Leshikar. I'm the general counsel of the Medical Board.
8 At this time, you are going to be preparing to provide

9 your testimony. Is there anyone in the room with you?
10 THE WITNESS: No.
11 MS. LESHIKAR: Is there anyone listening to
12 this phone call?
13 THE WITNESS: No, ma'am.
14 MS. LESHIKAR: You are instructed that no
15 one is to come into the room while you are testifying nor
16 are they to overhear this particular phone call, because
17 we have invoked the Rule which means that others may not
18 be present while you are testifying.
20 MS. LESHIKAR: I'm going to swear you in.
21 (Witness sworn.)
22 MS. LESHIKAR: Thank you. You are now sworn
23 and you are under oath.
24 MARK MESSER, M.D.
0054
2 BY MS. KIRK:
3 Q Could you please introduce yourself for the
4 record?
5 A My name is Dr. Mark Messer.
6 Q And what is your profession?
7 A Psychiatry.
8 Q And can you describe your training.
9 A Well, I completed medical school in Fort Worth
10 and then did a four-year psychiatry residency afterwards.
11 Q And how many years have you practiced in that
12 area?
13 A Approximately 13.
14 Q And have you worked with patients who have
15 psychosis or schizophrenic-type illness?
16 A Yes.
17 Q Approximately how many patients have you seen
18 with these type of conditions?
19 A Throughout the 13 years?
20 Q Well, how many do you see on average a week, to
21 give us an idea.
22 A 20.
23 Q Are you licensed to practice medicine in the
24 state of Texas?
25 A Yes.
0055
1 Q Since what year?
2 A Until what year?
3 Q Since what year? When were you licensed?
4 A 2006, I believe.
5 Q Could you describe your current practice.
6 A I work on an acute care unit, acute care male
7 unit. And we have approximately 25, 28 patients on the
8 ward at any time, with a majority being schizophrenic.
9 Q And is that where you first encountered Dr.
10 Szumlas?
11 A Yes.
12 Q Let's discuss his admission to the Terrell State
13 Hospital. How was he admitted -- how did the admission
14 come about?
15 A Well, my understanding, he had called the police
16 department and they brought him -- I'm not sure if it was
17 directly to Terrell State Hospital. That's my
18 understanding, though, that he was brought directly here.
19 Usually they go to a prior hospital for several days. And
20 that he was brought here and admitted to the acute care
21 ward.
22 Q And at that time, were you his main psychiatrist
23 during that whole stay?
24 A Yes.
25 Q Can you describe his symptoms on admission?
0056
1 A He was suffering from auditory hallucinations and
2 paranoid delusions.
3 Q And approximately how long did he have these
4 symptoms?
5 A Prior to admission?
6 Q Yes.
7 A Well, the admission evaluation recorded it as
8 five months.
9 Q And when he came in, his first admission, would
10 you describe those symptoms as mild, moderate, severe?
11 How would you describe that? Please explain.
12 A I would say moderate to severe.
13 Q And based on those symptoms, did you make a
14 diagnosis?
15 A No, not yet. Not until discharge.
16 Q At discharge, what was he diagnosed with?
17 A Psychotic disorder not otherwise specified.
18 Q And what was your treatment starting from
19 admission based on his symptoms?
20 A We started him on the anti-psychotic Risperdal.
21 Q What dosage?
22 A We titrated up to three milligrams per day.
23 Q And is that a high dose, a medium dose? How
24 would you describe that?
25 A Medium.
0057
1 Q How long was he hospitalized?

2 A 12 days.
3 Q Let's talk about his discharge. You were the
4 discharging physician, correct?
5 A Yes.
6 Q Describe his symptoms and demeanor at that time.
7 A Well, he was much improved. He appeared to have
8 clear, lucid, organized thought processes. He denied
9 having the thoughts or worries about the paranoid themes,
10 and stated that his auditory hallucinations had largely
11 resolved and that he was doing much better.
12 Q When you say they were largely resolved, meaning
13 that he may have still had some or not?
14 A It's possible that he may have had them at a much
15 reduced frequency and intensity.
16 Q Would you say he was stabilized or cured at this
17 point?
18 A Stabilized.
19 Q And as far as you know, he was living alone? He
20 was going home to live alone when you discharged him?
21 A To my knowledge, yes.
22 Q Did he talk about having any friends or family
23 that lived nearby?
24 A No.
25 Q Did you send him home with any discharge
0058
1 instructions?
2 A Well, the emphasis was placed on compliance with
3 his medicine and outpatient clinic follow up.
4 Q And did he tell you how he was going to go about
5 getting those medications, and how he was going to follow
6 up?
7 A Yes.
8 Q Where was he going to go?
9 A I think he was going to Lakes Regional, which is
10 a mental health care center in Dallas.
11 Q Now, with this disease in general, the psychosis,
12 is it possible that even with medication you can still
13 exhibit some symptoms?
14 A Yes.
15 Q Is it possible that it may take months to
16 actually find the right dosage to control the symptoms
17 adequately?
18 A No, it shouldn't take months to find the
19 appropriate dosage, no.
20 Q How long would it take to actually know whether
21 he's going to be stabilized on that medication?
22 A That's difficult to say. It could be as short as
23 five days or as long as several weeks.
24 Q So months? Okay. And what would happen if he
25 stopped taking the medication?
0059
1 A Well, there's a likelihood or possibility that
2 his symptoms would return.
3 Q And at the time he was admitted and he had these
4 symptoms, was he aware that he was ill?
5 A Well --
6 Q Other than what the police told him? I mean, did
7 he understand that he was psychotic?
8 A My impression was if he did, it was in a minimal,

9 mild way. Not a full understanding, no.
10 Q So if for some reason he stopped taking the
11 medication and he did revert back to these symptoms, it
12 would be likely that he would not understand he's ill once
13 again; is that a true statement?
14 A I would believe so, yes.
15 Q You said when he had minimal issues once he was
16 discharged. I'm going to read to you a statement that he
17 made after discharge. I would like you to tell me if
18 that's consistent with what he was hospitalized with.
19 The aliens were invading my head while I was
20 in my apartment and I went outside and sat in my car with
21 tinfoil on my head to block the rays, which is a total
22 fabrication and suggests to me possible guilt and
23 involvement on their part.
24 And he's referring to the sheriff's
25 department that reported this to the Board. Does that say
0060
1 anything to you?
2 A This was a written statement after discharge?
3 Q Yes.
4 A Well, could you read the first sentence over
5 again, please.
6 Q Sure. Actually, I'll read the whole thing. I
7 just received -- I just received confirmation letter from
8 the Board regarding my temporary suspension and in it the
9 sheriff's department told the Board that I had called and
10 said, quote, the aliens were invading my head while I was
11 in my apartment and that I went outside and sat in my car
12 with tinfoil over my head to block the rays, unquote,
13 which is a total fabrication and suggests to me possibly
14 some guilt or involvement, question mark, on their part,
15 question mark, dot, dot, dot, Rick.
16 A Well, everything seemed clear until the last part
17 of the suggestion that they may play a role, with might
18 possibly point to still being paranoid. That's my
19 impression.
20 Q Did you have a chance to review the Lake Regional
21 records from his discharge?

22 A Yes, I did.
23 Q Give me one minute to sort through my junk.
24 A Sure.
25 Q If you look on Page 27 on the progress note. It
0061
1 is dated 3/31/2011. It says, quote, unquote, Rick states
2 it is a fact, unquote, that radioactive waves are beaming
3 into his apartment and at times, quote, hears voices from
4 the radio. What does that say to you?
5 A Well, if he's meaning it -- that that was
6 happening at the time he made the statement, which was
7 approximately two, three days after discharge, then
8 obviously he wasn't stabilized completely.
9 Q And as far as his discharge, did he notify you of
10 a psychiatrist that he was going to see or a primary care
11 physician?
12 A Yes.
13 Q And did he give you a name?
14 A Not to my recollection, no. I mean, he might

15 have. I don't remember the name, if he did.
16 MS. KIRK: Pass the witness.
19 BY MR. LEICHTER:
20 Q Doctor, I take it you graduated from TCOM; is
21 that correct?
22 A Yes.
23 Q Did you do residency at the JPS?
24 A Residency in the University of Tennessee in
25 Memphis.
0062
1 Q Are you Board certified?
2 A D.O.
3 Q Are you Board certified in psychiatry?
4 A No.
5 Q Is that because you didn't take the examination
6 or didn't pass the examination?
7 A I haven't taken it.
8 Q And you are a full-time employee at the Terrell

9 State Hospital?
10 A I am.
11 Q Doctor, it not unlikely for individuals who
12 experience psychosis who, when they experience the
13 psychosis, think the events are real; isn't that true?
14 A Yes.
15 Q It's only after treatment that they are able to
16 ascertain truth from the false; would you agree?
17 A I would.
18 Q Now, you did not diagnose Dr. Szumlas with a
19 schizophrenic-type disorder, did you?
20 A No.
21 Q And no other mood-related disorder as well,
22 correct?
23 A I'm sorry?
24 Q No other mood-related disorder as well, correct?
25 A No, no mood component.
0063
1 Q You would expect, Doctor, that the symptoms upon

2 initiation of treatment with Risperdal would take some
3 time to resolve, at least a few days; isn't that true?
4 A Yes.
5 Q And they, in fact, did resolve while he was at
6 the Terrell State Hospital, didn't they?
7 A That was my impression, yes.
8 Q Because you, in fact, wrote a discharge summary
9 that was signed by you, Mark Messer, D.O., and it looks
10 like it was typed on 4/6/11 and dated 4/6/11; isn't that
11 true?
12 A Yes.
13 Q Do you have that discharge summary in front of
14 you?
15 A No.
16 Q Can you grab it?
17 A I have it on computer.
18 Q Let me ask: Do you need time to find it?
19 A Yes, please.
20 Q You can notify us when you have found it.
21 A All right.
22 Q Thank you.
23 MS. LESHIKAR: Mr. Leichter, are you
24 referring to an exhibit in the packet?
25 MR. LEICHTER: It was State's Exhibit -- I
0064
1 believe the medical records was 13; is that right? And in
2 our package, it's reverse chronological order. It was
3 about Page 4 of the record. It's entitled, Physician
4 Discharge Order Inquiry, and it's a typewritten note.
5 It's three pages long.
6 MS. LESHIKAR: Did you say Exhibit 13? It
7 was staff's exhibit. What number did you admit it as?
8 MS. KIRK: It's all together from Terrell.
9 It is Number 8. The whole exhibit is Number 8.
10 MS. LESHIKAR: Thank you. I thought, just
11 to clarify, 13 is only from Lake.
12 MS. KIRK: Lakes Regional.
13 MR. LEICHTER: Sorry.
14 MS. LESHIKAR: All right. So we are on the

15 same document; is that correct?
16 THE WITNESS: Okay. I have it now. Sorry
17 for the delay.
18 Q (BY MR. LEICHTER) That's okay. We are probably
19 going to come back to it.
20 The treatment at the Terrell State Hospital
21 involves a multidisciplinary approach to help stabilize
22 and treat the patient; does it not?
23 A That's correct.
24 Q And you have nurses, other support staff, other
25 therapy providers who all integrate and report to you in
0065
1 order to provide you with appropriate information to make
2 diagnosis, treatment recommendations and discharge
3 planning, correct?
4 A Yes.
5 Q And all that is taken into account in your
6 discharge summary; would you agree with that?
7 A Yes.
8 Q So isn't it fair to say, Doctor, that there is no

9 mention of aliens or alien intrusion in any of the
10 discharge paperwork or medical records; that that wasn't
11 one of Dr. Szumlas's hallucinations?
12 A No, I don't recall anything about aliens.
13 Q Now, the statement that Ms. Kirk read to you
14 referenced aliens; did it not?
15 A I don't remember, to be honest.
16 Q Well, she just read it to you to try and get you
17 to admit that Dr. Szumlas was insisting that he continued
18 to have hallucination, and the statement contained aliens.
19 Let me find it and read it to you.
20 It said, who told the Board and I had called
21 and said, quote, the aliens were invading my head while I
22 was in my apartment and I went outside and sat in my car
23 with tinfoil over my head to block the rays, which is a
24 total fabrication. That's what she read to you; did she
25 not?
0066
1 A That's true.
2 Q It's also fair to say that nowhere in any of the
3 records or any of the information provided to you in the
4 treatment of Dr. Szumlas was there a complaint regarding
5 aliens ever brought forward by anybody, correct?
6 A No.
7 Q So you don't know if Dr. Szumlas was objecting to
8 the fact that they were talking about aliens when that was
9 not what he had complained of; you don't know that, do
10 you?
11 A Right.
12 Q Would that change your opinion if that was the
13 fact, that he was just saying, hey, factually, that's not
14 accurate. I think you should have an accurate
15 understanding of what these facts are. Does that change
16 things?
17 A No.
18 Q Why not?
19 A Does it change that he offered the opinion on
20 aliens?
21 Q No, the fact that -- isn't it possible, based on

22 that, that he was saying, no, that wasn't the presenting
23 question upon admission. The presenting question on
24 admission had to do with my thoughts that I was being
25 followed by government surveillance. It had nothing to do
0067
1 with aliens?
2 A Right.
3 Q You don't know what that statement means, do you,
4 Doctor?
5 A Well, like I said, he didn't say anything about
6 aliens during his stay here on presentation or discharge.
7 I'm not sure what to make of the alien statement
8 afterwards.
9 Q So you don't know whether he was contesting that
10 those allegations were not part of the initial admission
11 criteria, correct?
12 A Yes.
13 Q Doctor, you would expect someone like Dr. Szumlas
14 to have symptoms such as those that he had prior to

15 admission, with a discharge diagnosis of psychotic
16 disorder NOS, correct?
17 A Yes.
18 Q Was it the treatment team's recommendation or
19 your recommendation to start him on the Risperdal?
20 A It was mine.
21 Q And you did note, at least the medical records so
22 indicate, that he started to stabilize after just a few
23 days, correct?
24 A That is correct.
25 Q And you hospitalized him a total of 12 days,
0068
1 accurate?
2 A Yes.
3 Q And it's fair to say also that he was probably
4 stable before discharge, but you kept him a couple extra
5 days in order to ensure that he was safe to go home,
6 correct?
8 Q You said that he was much improved?

9 A I felt so.
10 Q And you also testified that Dr. Szumlas had no
11 thought or worries upon discharge, correct?
12 A That he had what?
13 Q He didn't exhibit any thoughts or worries about
14 being discharged; that the actual surveillance was real,
15 correct?
16 A He know -- to my opinion, he no longer felt that
17 that was an issue, yes.
18 Q You knew he was a cardiologist; that's clear from
19 your discharge summary, correct?
20 A Yes.
21 Q You didn't make any recommendation in there about
22 him returning or not returning to work, did you?
23 A Did I make a recommendation?
24 Q The report does not have a recommendation with
25 regards to him returning to work, does it?
0069
1 A I did not make any recommendation.

2 Q In fact, you specifically didn't say, don't
3 return to work, did you?
4 A That's right.
5 Q In fact, you testified previously that Dr.
6 Szumlas had stabilized while in the care and under
7 treatment at Terrell State Hospital, correct?
8 A Yes.
9 Q Let me ask you: Dr. Szumlas was a very complaint
10 patient; was he not?
11 A That's right.
12 Q And he was very cooperative with you, correct?
13 A Yes.
14 Q He was nonviolent?
15 A Yes.
16 Q In fact, a lot of the other patients who are
17 admitted into the facility were violent offenders; were
18 they not?
19 A That's true.
20 Q And Dr. Szumlas remained free and clear of any of
21 those kind of interactions with those individuals; didn't

22 he?
23 A That's right.
24 Q No difficulty from him whatsoever?
25 A That's right.
0070
1 Q Did you consider him to be a pleasant man?
2 A Sure.
3 Q And let me ask you this because this is
4 important: Was he cooperative with you regarding his
5 treatment planning?
6 A Yes.
7 Q Did he give any indication that he wouldn't take
8 his medicine?
9 A No, he gave no indication of that.
10 Q In fact, didn't he acknowledge throughout
11 treatment that the medication was helping him?
12 A Yes.
13 Q Wasn't he grateful to you and your team for
14 assisting him and helping him improve the quality of his

15 overall health?
16 A I don't know. I don't know what his feelings
17 were in that regard.
18 Q Let me ask you, Ms. Kirk also read to you about a
19 note previously from Lakes Regional Medical Center wherein
20 she makes a quote that Dr. Szumlas purportedly made on
21 March 31, 2011, okay?
22 A Yes.
23 Q You don't know the context of that quote, do you?
24 A I have read it.
25 Q It states, it is a fact that radio waves are
0071
1 beaming into his apartment and at times hears voices from
2 the radio. You don't know whether Dr. Szumlas was saying
3 this was the nature of the reason I was admitted or that
4 he was still having those hallucinations?
5 A That's right.
6 Q Okay.
7 A It's one way or the other.
8 Q And it's unclear from that document, wouldn't you

9 agree, or at least as far as what you have personal
10 knowledge of, what he was thinking at the time?
11 A It is unclear.
12 Q Thank you. You can't say to a reasonable degree
13 of medical probability that Dr. Szumlas is unfit today,
14 can you, Doctor?
15 A I can't offer any opinion on that.
16 Q You can only offer a reasonable opinion of where
17 Dr. Szumlas was upon discharge; wouldn't you agree?
18 A Yes.
19 Q When you discharged Dr. Szumlas, he had a gap of
20 low assessment functioning score on your Axis V of 70;
21 isn't that correct?
22 A Yes.
23 Q And that's as much improved from his initial
24 hospitalization score of 40; isn't that true?
25 A Yes.
0072
1 Q Now, as I read through your discharge summary,

2 Doctor, there is no referral here to a treating
3 psychiatrist, is there?
4 A No. There's a referral to a mental health
5 clinic, yes.
6 Q It would be helpful if Dr. Szumlas was to follow
7 up with a psychiatrist; don't you agree?
8 A Yes.
9 Q That recommendation really wasn't in here. Is
10 there any reason why?
11 A Every patient that we discharge, it's a hospital
12 rule, has to have an outpatient follow-up appointment at a
13 mental health clinic; and because of that, no, it is not
14 listed.
15 Q Okay. And does your -- so you are of the
16 opinion, at least according to the discharge summary, that
17 Dr. Szumlas improved and should continue to improve; is
18 that fair to say?
19 A That he would continue to improve?
20 Q Correct. So essentially what you are saying now
21 is he really had no room for improvement, that he was

22 better when you discharged him?
23 A There is no doubt he was better.
24 Q He wasn't having the hallucinations anymore,
25 correct?
0073
1 A That was my impression.
2 Q And did he acknowledge to you that the
3 hallucinations, although they seemed real at the time, he
4 acknowledged they weren't real?
5 A Yes.
6 Q And that's all you could really expect; isn't
7 that fair to say?
8 A That's right.
9 Q Okay. I notice under Axis I, there is no other
10 diagnosis other than a psychotic disorder not otherwise
11 specified, correct?
13 Q So the only co-morbidities that exist here are
14 under Axis 3; would you agree?

15 A Yes.
16 Q And doesn't that mean that his prognosis or
17 prospects for recovery are greatly enhanced because of no
18 Axis I or Axis II diagnosis?
19 A No, I can't say that.
20 Q Isn't it true, Doctor, that a person who also
21 suffers from an underlying Axis I diagnosis such as a mood
22 disorder, generalized depression or other kind of anxiety
23 disorder stands a less likelihood of a continued recovery
24 due to the co-morbidities associated with his illness?
25 A Well, for the illness schizophrenia, ironically
0074
1 has a better prognosis if there is a mood -- a co-morbid
2 mood disorder.
3 Q You didn't diagnosis Dr. Szumlas as being
4 schizophrenic, did you?
5 A No.
6 Q You have no reason to think that Dr. Szumlas
7 isn't taking his medication, do you?
8 A That he didn't take?

9 Q That he's not continuing to take it, do you?
10 A I have no idea whether he's taking it.
11 Q You have no reason to think he's not; would that
12 be true?
13 A Right.
14 Q In fact, would you be notified by Lakes Regional
15 if he wasn't compliant with his treatment recommendations?
16 A No.
17 Q You did not file a report against Dr. Szumlas
18 with the Texas Medical Board, did you?
19 A No.
20 Q And you didn't do so because you didn't think,
21 upon discharge, he was an ongoing danger to the public?
22 A At the time of discharge, I did not think he was
23 a danger to the public, no.
24 Q And you didn't impose any discharge
25 recommendations that he not go back to practice, did you?
0075
1 A That's right.
2 Q Doctor, it's fair to say that anyone who doesn't
3 take medication as prescribed runs a risk of relapse
4 whether it be for cardiovascular disease, high blood
5 pressure or mental illness; isn't that true?
6 A Yes.
7 Q You would expect to see statements from a
8 compliant patient with mental illness that would indicate
9 if symptoms return, I'm going to call my doctor. Isn't
10 that what you, as a psychiatrist, would like to see?
11 A Sure.
12 Q In fact, that's all you can expect to see; isn't
13 it?
14 A Yes.
15 Q But all your patients don't do that, do they?
16 A No.
17 Q Did you get the notion that because Dr. Szumlas
18 was a physician he understood the importance of following
19 your treatment recommendations?
20 A Yes.
21 Q And that gives him an even greater chance of

22 successful continued stability, doesn't it?
23 A I would think so, yes.
24 Q Just a couple more questions, Doctor. And I
25 appreciate your patience. I'm sorry if I seem like I'm
0076
1 screaming. I'm sitting across the room from you.
2 A Okay.
3 Q Can you rule out any kind of other drug or
4 alcohol-related underlying cause for the psychosis?
5 A Yes, those are ruled out.
6 Q Did you rule out any other underlying maybe
7 medical cause that might have caused the psychosis?
8 A From his --
9 Q Such as a head injury, a head lesion, a tumor,
10 any other kind of medical co-morbidity that might be
11 causing the delusions, did you try to rule that out?
12 A Yes, there was no evidence or history given of
13 anything like that.
14 Q Let me ask you, Doctor: How much time did you

15 spend with Dr. Szumlas?
16 A I saw him approximately two to three times in the
17 treatment team meetings. Each meeting was approximately
18 anywhere from 15 to 20, 30 minutes.
19 Q I'll grant you, you would agree with me, wouldn't
20 you, it's kind of unusual for a man who is -- actually,
21 your discharge summary has him at 45; I think he's 48 or
22 49 -- to have a break such as this with no other episodes
23 in his entire life. You would agree with that, correct?
24 A I wasn't aware of any other episodes.
25 Q Right. And that's kind of rare and unusual for
0077
1 an individual in his late 40s to all of a sudden
2 experience an event like this; isn't that true?
3 A That's a fact.
4 Q Okay. Did you look for the underlying root cause
5 of what may have brought this on?
6 A Well, in regard to his history, I didn't see any
7 significant stresser or trigger.
8 Q Let me ask you this: It's fair to say that your

9 job at the Terrell State Hospital is to admit, treat --
10 admit, diagnosis, treat, stabilize, discharge with
11 planning; and then the ongoing therapy, maybe we can get
12 to the root cause analysis and try to get to that and
13 continue with that. That's also accurate, isn't it?
14 A Yes.
15 Q Wouldn't you think that Dr. Szumlas's chances for
16 increased -- enhanced long-term stabilization continue if
17 he sought such therapy and counseling?
18 A I'm sorry?
19 Q That was a convoluted question. I apologize.
20 Wouldn't it be true that Dr. Szumlas'
21 chances for continued stabilization and wellness are
22 increased if Dr. Szumlas is able to, with a psychiatrist,
23 get to the root cause problems or issues that caused this
24 episode?
25 A If he maintains compliance with a psychiatrist
0078
1 and his meds, there is still no guarantee that the root

2 cause would ever be discovered.
3 Q But it is fair to say that if he maintains
4 treatment with a psychiatrist in compliance with his meds,
5 that to a reasonable degree of medical probability he will
6 be safe to practice medicine; wouldn't you agree?
7 A That's a difficult question. I don't know if I
8 could offer an opinion on that.
9 Q And that's because you haven't seen him in a
10 month, correct?
11 A Well, it's tough to say his prognosis. I mean,
12 certainly if he maintains compliance with meds and
13 appointments, the likelihood of relapse is less. That, I
14 could say.
15 Q Okay. So it's fair to say you don't know?
16 A That's right.
17 MR. LEICHTER: Pass the witness.
18 MS. LESHIKAR: Any redirect?
19 MS. KIRK: I do.
21 BY MS. KIRK:
22 Q In your discharge summary, you wrote that his
23 auditory hallucinations were at a minimum. Not absent,
24 but at a minimum; is that correct?
25 A Yes.
0079
1 Q So there was room for improvement, which is kind
2 of counter to what you had said before; is that correct?
3 A How do you mean?
4 Q I mean, they weren't absent, so there is room for
5 improvement as far as he was still having some symptoms?
6 A Well, to answer that I have to take what he says
7 into account. I also said that his treatment was being
8 transferred to an outpatient basis, meaning it wasn't the
9 end of his treatment. My impression was that he may still
10 be having them occasionally. It's an insidious onset and
11 it's probably the same in resolution. They don't just
12 come on abruptly or end abruptly, if that answers your
13 question.
14 Q Yes, thank you. And as far as relapse, opposing

15 counsel talked about patients who don't take their
16 medications such as hypertensive patients, diabetes -- I
17 don't know exactly the list he said. But those people
18 generally, when they stop taking their medications, don't
19 go out and buy a semiautomatic weapon or large knife, do
20 they?
21 A When they stop their meds?
22 Q Yeah. And relapse?
23 A No, I don't think they go buy weapons.
24 Q And as far as you wrote another report on the
25 24th of March and it said that during this interview,
0080
1 however, he elects to minimize and divert attention away
2 from these delusions. He is not quite focused -- he is
3 quite focused on discharge from the hospital. What did
4 you mean by that?
5 A Well, Dr. Szumlas is an intelligent man, and I
6 think he was motivated to be discharged and that's
7 understandable. There is a possibility that he was
8 underreporting or minimizing his symptoms to gain

9 discharge. That's a possibility. I can't say that for
10 certain, but that was my impression.
11 Q And in that same report, on the next page, you
12 write that you really talked to him and placed a strong
13 emphasis on the fact that that he would be vulnerable to
14 relapse; is that right?
15 A Should he be noncompliant, yes, he would be
16 vulnerable.
17 MS. KIRK: Pass the witness.
19 BY MR. LEICHTER:
20 Q Doctor, I'm just going to refer to your discharge
21 summary. Dr. Szumlas did not report to you that he was
22 having anymore hallucinations or delusions upon discharge,
23 did he?
24 A Right.
25 Q In fact, it said in your report, quote, during
0081
1 the latter part of his stay he no longer volunteered any

2 of the paranoid delusions. And when asked of his progress
3 in that area, he stated that he no longer felt that he was
4 being persecuted and that his auditory hallucinations were
5 at a minimum. That was at the latter part of his stay,
6 wasn't it? There is no particular date on that, is there?
7 A Right.
8 Q So it's your opinion, I guess, that based upon
9 your statements here, when he was discharged the auditory
10 hallucinations had left him, correct?
11 A That is right.
12 Q And you agree, Doctor, that you can't opine to a
13 reasonable degree of -- excuse me. Yes. You were
14 testifying that it was a possibility that he was telling
15 you what you wanted to hear but you testified that you
16 can't opine to some reasonable degree of probability that
17 that was the case, correct, about him telling you things
18 to get discharged?
19 A You are asking -- I'm sorry. Help me again.
20 Q Ms. Kirk just asked you questions about wasn't it
21 possible he was telling you what you wanted to hear in

22 order to be discharged?
23 A That's possible.
24 Q And you said you can't say with any certainly, at
25 least a degree of medical probability, that that was the
0082
1 case; isn't that true?
2 A I have to go by what he's saying.
3 Q And you had no reason to disbelieve him, did you?
4 A That's right.
5 Q In fact, everyone who's met Dr. Szumlas describes
6 him as a very gentle, kind, cooperative man; would you
7 agree that's how you would characterize him?
8 A Sure.
9 Q Okay. And there is no reason to think he was
10 noncompliant with anything you said or asked of him,
11 correct?
12 A Right.
13 Q And there is no reason for you to think he
14 wouldn't be compliant with you or honest with you, true?

15 A That is right.
16 Q And you never noticed one instance of him being
17 dishonest with you throughout the whole treatment stay,
18 right?
19 A I never saw any dishonesty, no.
20 Q With you or the staff, correct?
21 A No. That's correct.
22 MR. LEICHTER: Pass.
23 MS. KIRK: No further questions.
24 MS. LESHIKAR: Panel?
25 EXAMINATION
0083
1 BY DR. CROCKER:
2 Q This is Dr. Crocker. I just have a couple
3 questions about the workup of the patient.
4 You said you ruled out drugs or alcohol. I
5 believe you said that to Mr. Leichter; is that correct?
6 A Yes.
7 Q When I went through the medical records, and
8 maybe I just missed it, I didn't see a urine drug screen

9 anywhere.
10 A Normally those are done before they present to
11 our hospital.
12 Q It wasn't in either the medical records I looked
13 at. Do you recall seeing one?
14 A No, I don't.
15 Q Have you -- I think we all, or at least the
16 physicians, agree that new psychosis at 49 years old
17 without prior illness is pretty unusual. Have you seen
18 people have psychotic breaks like this with amphetamines,
19 cocaine abuse later in life?
20 A Sure.
21 Q Any idea why that wasn't tested for?
22 A I'm going to say that it was overlooked.
23 Q The other thing that I noted and I'm curious your
24 thoughts on, in his lab done at the first hospital, his
25 MCV was 103. His GGTP was normal. And I'm wondering
0084
1 about the possibility of CNS pernicious anemia symptoms.

2 Did that occur to anybody, or do you think that's
3 reasonable?
4 A Yes, it is reasonable. But, no, that wasn't
5 given attention.
6 Q When you write a discharge order, do you
7 typically write specific instructions on return to work or
8 do not return to work?
9 A No.
10 Q Well, from your recollection, was it your opinion
11 that at the time of discharge while he was certainly okay
12 to go home to his own recognizance and care, was he also
13 ready to go back to a cardiology practice?
14 A That's hard for me to say. Cognitively, he
15 seemed intact. But it's hard for me to say whether he was
16 ready to return to work as a cardiologist.
17 Q How long, in your experience, would it take you,
18 if you were providing the ongoing psychiatric care, to
19 make that kind of decision?
20 A It's a subjective response. I could say anywhere
21 from four to eight weeks approximately.

22 Q Even for a complex, high-functioning job like a
23 cardiologist?
24 A Yes.
25 DR. CROCKER: That's all I have.
0085
1 THE WITNESS: I don't think there's an exact
2 answer to that.
4 questions?
5 MS. SOUTHARD: No, ma'am.
6 MS. KIRK: Nothing further.
7 FURTHER RECROSS-EXAMINATION
8 BY MR. LEICHTER:
9 Q Doctor, isn't it true that upon admission --
10 before Dr. Szumlas presented to you at the Terrell State
11 Hospital, he was admitted to the Paris Regional Hospital,
12 correct?
13 A I don't remember, to be honest.
14 Q Isn't that the normal protocol? You even

15 testified to it before. Generally a person is admitted
16 somewhere else after taken into custody by the mental
17 health deputies and then brought to you?
18 A That's right.
19 Q Okay. And the urine toxicology screens and other
20 kind of workups would have been done at the Paris Regional
21 Hospital, correct?
22 A That's right.
23 Q Okay. And if there was a positive finding there,
24 it would have been reported to you; wouldn't it have?
25 A Sure.
0086
1 Q Isn't that the normal routine course of business?
2 A That's the norm.
3 Q I'm sure you would be glad to know -- withdraw.
5 MS. LESHIKAR: Staff?
7 MS. LESHIKAR: All right. Doctor, you are
8 excused from your testimony. We appreciate your

9 attendance and your testimony today. Thank you.
10 THE WITNESS: Yes, ma'am. Thank you.
11 MS. KIRK: May we have a five-minute break
12 to confer with co-counsel?
13 MS. LESHIKAR: We have about a five-minute
14 break to confer.
15 (Off the record from 11:51 a.m. to 12:00
16 p.m.)
18 Staff counsel.
19 MR. PALAZOLA: We are ready to attempt to
20 contact our next witness.
21 MS. LESHIKAR: And that is going to be?
22 MR. PALAZOLA: Kimberly Smith.
24 MR. PALAZOLA: This is Chris Palazola. I'm
25 an attorney with the Texas Medical Board. We are calling
0087
1 you from a temporary suspension hearing in Austin, Texas.

2 I'm going to have the hearings counsel give you some
3 instructions, okay?
4 THE WITNESS: Okay. Hold on. Let me put
5 you on speaker. Okay. Can you hear me?
6 MS. LESHIKAR: Yes, we can. Ms. Smith, this
7 is Nancy Leshikar. I'm the general counsel of the Medical
8 Board. First, I'm going the ask you, are you in a room by
9 yourself?
10 THE WITNESS: I'm in a room with the
11 other --
12 THE REPORTER: Hold on just a second. Ask
13 her to speak up and repeat what she said.
14 MS. LESHIKAR: Ms. Smith, first, we are
15 going to have to ask you to repeat what you just said and
16 to speak up so that the court reporter can hear you.
17 Now, my question was, are you there with
18 anyone else in the room?
19 THE WITNESS: Brandi Russell is in the room
20 with me. She's the other crisis worker that Ms. Mershon
21 asked to be here.
22 MS. LESHIKAR: Is there anyone listening on
23 the phone?
24 THE WITNESS: No, it is just us two in here.
0088
1 MR. LEICHTER: We object and ask that that
2 person be removed. I think the Rule requires you to
3 instruct that.
4 MS. LESHIKAR: Yes. Ms. Smith, we are going
5 to have to ask Ms. Russell to vacate the room, because we
6 are operating under the Rule, which is a procedural rule
7 for trial, and other possible witnesses cannot hear the
8 testimony of those who are testifying.
10 MS. LESHIKAR: So if Ms. Russell will leave
11 the room and if you tell us when she's left the room, I
12 will appreciate it.
14 MR. PALAZOLA: If she can be instructed to

15 remain available, Ms. Russell.
16 MS. LESHIKAR: Ms. Russell, please remain
17 available.
18 THE WITNESS: She will be out in the
19 hallway. She's left the room.
20 MS. LESHIKAR: All right. Thank you, Ms.
21 Smith.
22 (Witness sworn.)
23 MS. LESHIKAR: All right. Thank you, ma'am.
24 You are now sworn and your testimony will be given under
25 oath.
0089
2 KIMBERLY SMITH,
5 BY MR. PALAZOLA:
6 Q Ms. Smith, as I just said, my name is Chris
7 Palazola. I'm the staff attorney for the Medical Board.
8 I would ask you initially, could you please introduce

9 yourself. We have a Panel sitting here. If you would
10 just introduce yourself to the Panel for the record.
11 A Okay. I'm Kimberly Smith. I'm a crisis intake
12 screening worker for Lakes Regional MHMR Center in Paris,
13 Texas.
14 Q And if you could give us a very brief summary of
15 what your job duties for MHMR would be.
16 A Okay. My job duties are to do crisis screenings
17 for people who have expressed suicidal ideations, and also
18 I do intakes to other people in services, and I have a
19 caseload of routine case management for people who don't
20 qualify for regular services but are in transitional
21 services.
22 Q Is it typical in your position to receive
23 referrals from the Terrell State Hospital?
24 A Yes.
25 Q And when you get a referral from the Terrell
0090
1 State Hospital, what do you -- what is the process for

2 you? Does the patient contact you; do you contact the
3 patient; how does that work?
4 A The hospital liaison calls our office to schedule
5 an aftercare appointment for someone who is being
6 discharged from Terrell State Hospital. In the aftercare
7 appointment, we offer whatever services they are eligible
8 for and open the clients into those services.
9 Q These individuals, when they are referred to you,
10 is one of those individuals a Dr. Rick Szumlas?
11 A Yes.
12 Q And how did you first become familiar with Dr.
13 Szumlas?
14 A I screened him at the Paris Regional Medical
15 Center. I did a crisis screening when he was in the ICU
16 there.
17 Q You did a screening for him at the ICU in the
18 Paris Regional Medical Center?
19 A Yes, sir.
20 Q And that was prior to his admission at Terrell
21 State Hospital?
22 A Yes, I recommended admission to Terrell State
23 Hospital.
24 Q Why did you recommend admission to Terrell State
25 Hospital?
0091
1 A Due to delusional thoughts.
2 Q Okay. And upon his release from Terrell State
3 Hospital, was he referred back to your MHMR location?
4 A Yes, sir.
5 Q And did you have an opportunity to meet with Dr.
6 Szumlas again at that time?
7 A Brandi Russell did the aftercare and intake
8 appointment, and I met with him again for a follow-up
9 appointment after that.
10 Q And do you have -- you generated several case --
11 it looks like case management notes regarding your
12 contacts with Dr. Szumlas; does that sound right?
13 A Yes, sir. There should be two notes, I believe,
14 from me.
15 Q And do you have those notes in front of you right
16 now?
17 A No, I do not.
18 Q Are they where you can get them quickly?
19 A Yes.
20 Q Okay. If you would go ahead and get those up on
21 your computer or pull them out of your file, however you
22 do that, and let us know when you get them, please.
23 A Okay.
24 MS. LESHIKAR: Counsel, what pages are these
25 going to be?
0092
1 MR. PALAZOLA: They were pulled out of the
2 documents for me.
3 They are Pages 24 and 25.
4 MS. LESHIKAR: Are they Bates stamped?
5 MR. PALAZOLA: They are not Bates stamped.
6 These are faxed numbered pages.
7 MS. LESHIKAR: Are these out of Exhibit 13?
8 MR. PALAZOLA: Yes, they are.

9 MS. LESHIKAR: Could you tell me what pages
10 they are in Exhibit 13.
11 MR. PALAZOLA: I will. Somebody will pull
12 that up for you.
13 MS. KIRK: It should be Page Number 24.
14 MR. PALAZOLA: 24 and 25.
15 THE WITNESS: Sorry. This is taking me a
16 moment. Okay. I have them in front of me.
17 Q (BY MR. PALAZOLA) Okay. If you would take just
18 a moment to read over what your notes are there so that
19 you will be familiar with what's in there when I ask you
20 about it.
21 A Okay.
22 Q Are these -- just to clarify for the record, are
23 these dated April 8th, 2011 and April 13th, 2011?
24 A Yes, sir.
25 Q And once you have had a minute to look them over,
0093
1 you can let us know, please.

2 A Okay.
3 MS. LESHIKAR: Counsel, has Mr. Southard had
4 this exhibit put in her box?
5 MS. KIRK: I don't think so.
7 Q (BY MR. PALAZOLA) And, Ms. Smith, is part of
8 your services at MHMR, do you provide referrals for
9 individuals for psychiatric care or psychological care and
10 treatment?
11 A We provide referrals for whatever services that
12 individual needs.
13 Q Do you have the ability to help a patient receive
14 prescription medications?
15 A If they don't qualify for regular services in
16 transitional services, I do not. I can just refer them to
17 someone else. Does that make sense?
18 Q Did you receive a copy of the discharge summary
19 from Terrell State Hospital?
20 A I'm sorry?
21 Q Do you recall whether or not you received a copy

22 of the discharge summary from Terrell State Hospital
23 referring Dr. Szumlas to your facility?
24 A I did not receive the referral from them. It
25 would be discharge paperwork. Whoever did his aftercare
0094
1 appointment, which was Brandi Russell, would have seen
2 that paperwork.
3 Q That might be a better question for her, then?
4 A Yes, sir.
5 Q On the two notes you have completed for us, in
6 looking over them, did you -- did Dr. Szumlas indicate he
7 wanted assistance locating a psychiatrist or psychologist?
8 A No, what he indicated was he wanted me to assist
9 him with locating community mental health facilities or
10 mental health clinics in the Tampa, Florida, area.
11 Q Did he utilize your services to help find a
12 psychiatrist or psychologist to provide him treatment
13 while he was still in Texas?
14 A To my knowledge, he said that he was going to go

15 to the Agape Clinic or to his primary care physician to
16 obtain his prescriptions.
17 Q Can you tell us what the Agape Clinic is?
18 A It's a free medical clinic available here in
19 Lamar County the third Saturday of each month. And they
20 do provide both medications for psychiatric and mental
21 health conditions.
22 Q And Dr. Szumlas also indicated he was going to
23 seek his own appointment with a private psychiatrist?
24 A He said with his primary care physician, is what
25 he told me.
0095
1 Q Did he indicate who that primary care physician
2 was?
3 A No, sir.
4 Q Has he received any psychiatric or psychological
5 treatment in your facility, to the best of your knowledge?
6 A Not at our facility. We are just doing
7 transitional services with him.
8 Q Has he received any medications from your

9 facility, to your knowledge?
10 A No.
11 Q Did you discuss how frequently Dr. Szumlas should
12 report to your facility for care and treatment?
13 A We maintain contact weekly either by telephone or
14 in person. The requirement is once every 30 days. But
15 here we do either weekly visits or weekly telephone
16 contacts.
17 Q And did you recommend weekly contact to Dr.
18 Szumlas?
19 A Yes.
20 Q What was his reaction to that?
21 A He thought he -- he said he could come in every
22 two weeks, but we could make contact weekly on the weeks
23 that he didn't come in for a visit.
24 Q I am looking at your note dated April 8, 2011.
25 A Yes.
0096
1 Q What I have, written in your note is, Rick

2 refused stating he only needs appointments every two
3 weeks. Is that consistent with your understanding of that
4 interaction with Dr. Szumlas?
5 A Yes, because I offered to schedule him an
6 appointment the following week from when I saw him.
7 Either -- he refused the face-to-face appointment but
8 agreed to a telephone contact.
9 MR. PALAZOLA: Pass the witness.
11 BY MR. LEICHTER:
12 Q Ms. Smith, hi. My name is Louis Leichter. I'm
13 just going to ask you a couple of questions. I represent
14 Dr. Szumlas. Okay?
15 A Yes, sir. I couldn't hear your name.
16 Q It is Louis Leichter.
17 A Okay.
18 Q Do you hold any type of counseling degree?
19 A No, sir, I do not.
20 Q So that means you don't have any type of
21 professional certifications?
22 A No, I don't.
23 Q It's fair to say that your facility really
24 provides screening to make sure that a person remains, you
25 know, reasonably status quo; is that a fair statement?
0097
1 A Depending on the services the individual
2 qualifies for, we also have a psychiatrist and licensed
3 professional counselors. However, my duties are crisis
4 screening and intake.
5 Q And in the case of Dr. Szumlas, the duty -- the
6 reason for the weekly contact is just to make sure that
7 Dr. Szumlas maintains the status quo; would you agree with
8 me?
9 A Yes, make sure he continues to be stable.
10 Q And in your estimation, at least based on your
11 notes, he's continued to not only be stable but improve
12 since his discharge. Don't your notes reflect that?
13 A Yes, he appears to have improved in the few
14 visits that I have had with him.

15 Q In fact, on April 8, 2011 you don't know the
16 reason why he was hesitant to come in. It could have been
17 because he had to come to my office and travel to Austin;
18 isn't that true?
19 A Yes, I don't know why he refused to come in that
20 week.
21 Q And you will agree that the issues surrounding
22 his medical license and the temporary suspension thereof
23 are quite personal; wouldn't you agree?
24 A Yes.
25 Q Okay. And are you aware that Dr. Szumlas has
0098
1 been spent quite a deal of -- a good deal of time in the
2 last ten days travelling around the state of Texas seeing
3 various medical doctors, meeting with me a couple of times
4 and gathering documents?
5 A No, sir.
6 Q That would explain his inability to -- or his
7 lack of desire to want to come meet with you but rather do
8 the assessment by phone, wouldn't it?

9 A Yes.
10 Q You have no reason to think that Dr. Szumlas
11 wouldn't be compliant with all treatment recommendations
12 based on your interactions with him, would you?
13 A No.
14 Q In fact, based on all of your interactions with
15 Dr. Szumlas you felt no need to make any further
16 recommendations or referrals; isn't that true?
17 A I asked him about his medications, and he's told
18 me he's got that under control; that he's been able to
19 obtain those. And that's my only concern for him.
20 Q And you had no reason not to believe that was the
21 case, right?
22 A No.
23 Q You had no reason not to believe that he had been
24 compliant with his medication therapy, true?
25 A I have no reason to think that, no.
0099
1 Q In fact, it appears as though he was compliant

2 with his medication therapy, didn't it?
3 A I'm sorry?
4 Q It did appear he was compliant with his
5 medication therapy, true?
6 A Yes, he reported he was taking his medication as
7 prescribed.
8 Q Had he ever been unavailable to you?
9 A I'm sorry?
10 Q He hadn't put up roadblocks or been unavailable
11 to you in your efforts to contact him?
12 A No, sir.
13 Q And he was always timely and punctual; was he
14 not?
15 A In the time I saw him face-to-face on the 8th and
16 when I spoke to him on the phone, yes, he was functional.
19 BY MR. PALAZOLA:
20 Q Ms. Smith, let me ask you a couple more
21 questions.
22 A Okay.
23 Q Does your facility perform urine drug screens?
24 A No, sir.
25 Q So your knowledge as to whether or not Dr.
0100
1 Szumlas is complaint with his medication regimen is based
2 on his statements to you?
3 A His statements to me and his appearance when he
4 came in.
5 Q And that was when you saw him two times?
6 A I saw him one time. I saw him on the 8th of
7 April and I spoke to him on the 13th.
8 Q And do you have any idea who his treating
9 psychiatrist is?
11 Q Any idea who his primary care physician is?
13 Q Any idea if he's receiving psychological
14 counseling at all?
15 A No, I don't know.
19 BY MR. LEICHTER:
20 Q Did you refer Dr. Szumlas for therapy?
21 A No, I did not.
22 Q Why not? I guess you didn't feel he needed it
23 then; is that correct?
24 A My referrals are regarding medications, not
25 therapy. I don't know what else was -- he was referred
0101
1 for.
2 Q Okay. So I guess essentially as far as you are
3 concerned, Dr. Szumlas did what you asked of him?
4 A He has done what I asked him to, yes.
7 BY MR. PALAZOLA:
8 Q And your opinion would certainly be that Dr.

9 Szumlas does need to comply with his medication regimen?
10 MR. LEICHTER: Object. She has no basis to
11 make that. She testified she doesn't have a degree and
12 she's not licensed.
13 MR. PALAZOLA: Just following up on the
14 questioning that Mr. Leichter asked her.
15 MR. LEICHTER: She's not qualified to offer
16 that opinion.
17 MS. LESHIKAR: You opened it up, so he gets
18 to ask the question.
19 Q (BY MR. PALAZOLA) Is it part of your job -- is
20 it your belief and your opinion, based on your
21 observations of Dr. Szumlas at the Paris Regional Medical
22 Center, that he needed medication at that time?
23 A Yes.
24 Q And would that still be your opinion today, or do
25 you have enough information to make that determination one
0102
1 way or another?
2 MR. LEICHTER: I'm going to object. She's
3 not a medical doctor. She's not qualified to render an
4 opinion such as that. She's not a licensed counselor.
5 She doesn't have a social worker degree. She's not
6 licensed by anybody. She's a layperson. She can't render
7 an expert person on whether or not he --
8 THE WITNESS: I'm a qualified mental health
9 professional, even though I am not licensed.
10 MR. LEICHTER: I just want my objection in
11 the record.
12 MS. LESHIKAR: Your objection is noted and
13 overruled.
14 Q (BY MR. PALAZOLA) You can answer the question,
15 Ms. Smith, if you know.
16 A Based on the symptoms that I saw he had when he
17 was at Paris Regional Medical Center and his diagnosis,
18 yes, I believe he does need medication.
19 Q And you are not doing urine drug screens, so you
20 have no way of knowing whether or not Dr. Szumlas is
21 taking medication or whether or not medication has even

22 been prescribed to him by anyone?
23 A Not past his prescription from Terrell State
24 Hospital, which would have been a two-week supply upon
25 discharge.
0103
1 MR. PALAZOLA: I pass the witness.
2 MR. LEICHTER: Nothing further.
3 MS. LESHIKAR: Panel members? Ms. Southard,
4 do you have any questions?
5 MS. SOUTHARD: No, I do not. Thank you.
6 MS. LESHIKAR: Thank you, Ms. Smith. You
7 are excused from your testimony. We appreciate your time
8 and attention.
9 MR. PALAZOLA: If you could put Ms. Russell
10 on the phone.
11 THE WITNESS: I'm sorry. I couldn't hear
12 you.
13 MR. PALAZOLA: If Ms. Russell is outside in
14 the hall, could she use this same phone?

15 THE WITNESS: Yes. One moment, I'll go get
16 her.
17 MS. LESHIKAR: Panel, while we are switching
18 witnesses, let me urge you, you need to recall and
19 remember when Mr. Leichter asks questions of which there
20 are questions such as, we don't have any reason to believe
21 that he was not spending time all over the state spending
22 a lot of time with me on his blah, blah, blah. That is
23 just questions. That is not evidence of where he's
24 actually spending his time.
25 (Off the record.)
0104
1 THE WITNESS: This is Brandi Russell.
2 MR. PALAZOLA: Hi, Ms. Russell. I'm Chris
3 Palazola. I'm a staff attorney with the Texas Medical
4 Board. And we are calling you from a hearing regarding a
5 Dr. Rick Szumlas. I'm going to -- the hearing counsel is
6 going to give you some instructions.
8 MS. LESHIKAR: Ms. Russell, this is Nancy

9 Leshikar. I'm the hearings counsel. Are you now in a
10 room by yourself?
12 MS. LESHIKAR: Is there anyone listening on
13 the phone?
14 THE WITNESS: No.
15 MS. LESHIKAR: We are going to instruct you
16 and make sure you remain in the room by yourself and that
17 your testimony is unobserved or not overheard by anyone
18 there.
19 I am now going to swear you in.
20 BRANDI RUSSELL,
23 BY MR. PALAZOLA:
24 Q Good afternoon, or it is afternoon now, Ms.
25 Russell. Would you please introduce yourself to the Panel
0105
1 for the record.

2 A Yes, my name is Brandi Russell. I'm a crisis
3 worker here at Lakes Regional MHMR.
4 Q As a crisis worker at MHMR, have you had the
5 opportunity to interact in any way with a Dr. Rick
6 Szumlas?
7 A I met with him face-to-face for his hospital
8 aftercare.
9 Q And when was that?
10 A On March 31st.
11 Q And have you made -- have you had other contacts
12 with him since that time?
13 A Only by phone, not face-to-face.
14 Q And each time that you have a discussion with Dr.
15 Szumlas, do you create a note in the MHMR database
16 regarding that interaction?
17 A Yes, we document a progress note each time.
18 Q And I have a document in front of me dated April
19 18th of 2011 that I believe has your name on it. Do you
20 have access to that note or can you get access to it very
21 quickly?
22 A Yes, I do. I'm viewing it right now.
23 Q And is this a record of a phone interaction with
24 Dr. Szumlas?
25 A Yes, it is.
0106
1 Q And it is dated the 18th of April which is two
2 days ago; is that correct?
3 A Yes.
4 Q And is this your own record that you generated?
5 A Yes.
6 Q I'm going to ask you about what's in this report.
7 First of all, is this a report that you have -- is this a
8 report that's kept in the ordinary course of business of
9 Lamar County MHMR?
10 A I'm sorry, repeat that.
11 Q I know these are -- this document has not been
12 introduced into evidence yet, so I'm going to have to ask
13 you a few questions about the document before I can ask
14 you.
15 A Okay.
16 Q So I want to know, first of all, is this a record
17 that you made at our near the time that you had the
18 interaction with Dr. Szumlas?
19 A Yes, this is a note stating it was an attempt to
20 contact by phone.
21 Q Has this record been a altered in any way, shape
22 or form since you input it into the computer system?
23 A No, it has not.
24 Q Has it been in the custody and control of Lamar
25 County Mental Health and MHMR the entire time since it's
0107
1 been created?
2 A Yes.
3 Q And as part of the ordinary business practice of
4 your business, Lamar County MHMR, to keep these treatment
5 notes?
6 A Yes.
7 MR. PALAZOLA: Board staff would offer as
8 Exhibit 15 [sic] a note from Terrell -- Lamar County

9 Mental Health dated April 18, 2011, completed by Brandi
10 Russell.
11 MR. LEICHTER: I would like an opportunity
12 to review it since I'm now just receiving it, for the
13 record.
14 MR. PALAZOLA: Lake Regional.
15 MS. LESHIKAR: Could counsel and the staff
16 please have -- do Panel members have a copy?
17 MS. KIRK: It's on the last page of the
18 copies you were just given.
19 MR. BAUCOM: The last page of this recent
20 package?
21 MR. PALAZOLA: Bates Stamp 30.
22 MS. LESHIKAR: Is this, what we were just
23 given, is this Exhibit 13?
24 MS. KIRK: This is Exhibit 13. The last
25 page we did not have until very recently and that is Bates
0108
1 Stamp 30.
2 MR. PALAZOLA: I guess I would offer Page 30
3 from these records to be added to Exhibit 13, Pages 1
4 through 29.
5 MR. BAUCOM: Do I need to admit that?
6 MS. LESHIKAR: We are waiting to see if
7 there is an objection.
8 MR. LEICHTER: I'm trying to figure out what
9 it is. No objection.
10 MS. LESHIKAR: Admit -- we will admit Page
11 30 as an addendum to Exhibit 13.
12 MR. BAUCOM: Ms. Southard, we are admitting
13 Page 30, which is an addendum to Exhibit 13, to the record
14 submit.
15 MS. LESHIKAR: Ms. Southard, do you have
16 Exhibit 13?
17 MS. SOUTHARD: I would like you to go ahead
18 and fax it to me.
19 MS. LESHIKAR: If you would look in your
20 LaserFische box, supposedly 13 is in your box along with
21 this Page 30. Would you mind checking to see if you have
22 it.
23 MS. SOUTHARD: I need to refresh, then?
24 MS. LESHIKAR: Yes, ma'am.
25 Go ahead.
0109
1 Q (BY MR. PALAZOLA) Ms. Russell, I think everyone
2 has had an opportunity to look over the note dated April
3 18th. What I would like to ask you is, at some point were
4 you asked to provide copies of medical records from Dr.
5 Szumlas to the Texas Medical Board?
6 A I was personally not asked by Doctor to present
7 that to the Medical Board, no.
8 Q Had you received a request from the Medical Board
9 for these records?
10 A I have not personally, no.
11 Q Well, I'm looking at your note dated April 18th,
12 and I see in your note that you have got QMHP who -- what
13 does that stand for?
14 A QMHP stands for qualified mental health

15 professional.
16 Q And the qualified mental health professional
17 asked Rick if he wanted the clinic to fax his records to
18 the Texas Medical Board. And then I'm skipping a little
19 bit. Rick declined the offer, stating he would give the
20 paperwork to whom he needed.
21 A Right. The Medical Board requested a prior date
22 to our --
23 MR. LEICHTER: I want to object. She
24 testified she didn't know. Objection, nonresponsive. She
25 testified that she didn't know if the Medical Board had
0110
1 requested the records. Now she is testifying that the
2 Medical Board did request the records. That's a
3 nonresponsive answer. It lacks foundation.
4 MR. PALAZOLA: I can clean it up.
5 MS. LESHIKAR: The objection is going to be
6 granted. You may rephrase the question.
7 Q (BY MR. PALAZOLA) Ms. Russell, let me back up
8 just a little bit here. Did you -- we have already

9 covered that you created this note; is that correct?
11 Q Okay. And at the time you wrote this note the --
12 you have had a chance to review it prior to your testimony
13 today as well?
14 A Yes.
15 Q At the time you wrote this note, do you believe
16 what was in it was accurate?
17 A Yes.
18 Q And when I asked you a couple of minutes ago if
19 you had had any awareness to the Medical Board asking for
20 Dr. Szumlas' records, you indicated that you didn't
21 recall, or I think your actual testimony was it not you
22 personally?
23 A Correct, I was not personally requested. Our
24 office, yes, but not me.
25 MR. LEICHTER: Objection, nonresponsive. We
0111
1 have no indication that there's been a request. There is

2 no request in evidence. There is nobody testifying to
3 this evidence. That is hearsay.
4 What are they trying to get at? Number one,
5 it's irrelevant. I don't see how that's relevant to
6 whether he's an ongoing or imminent threat to the public
7 health and safety. This is, frankly, a waste of time.
8 MR. PALAZOLA: May I respond?
9 MR. LEICHTER: He picked up his records. He
10 can testify about it. And that's the end of it. He went
11 and got his medical records under my direction. He's
12 entitled to do that.
13 MS. LESHIKAR: Your objection is granted.
14 You may try one more time to get whatever you are trying
15 to get in. You need to be -- his point is well taken.
16 MR. PALAZOLA: Right.
17 Q (BY MR. PALAZOLA) Ms. Russell, have you had any
18 conversations with Tamara Mershon, from the Medical Board?
19 MR. LEICHTER: Object, hearsay.
20 Q (BY MR. PALAZOLA) I'm asking her if she's had
21 any conversations --
22 MS. LESHIKAR: Overruled.
23 Q -- with Ms. Mershon of the Texas Medical Board.
24 A I have had a conversation, yes.
25 Q Did she -- at that point, did she ask you for
0112
1 records of Dr. Szumlas' treatment at the MHMR facility?
2 A Not directly. She stated that they were --
3 MR. LEICHTER: Object, hearsay.
4 MS. LESHIKAR: Overruled.
5 MS. LESHIKAR: Let's do this. Whenever you
6 ask a question and he objects, then let me rule. And
7 then, Ms. Russell, if you will hold your question [sic]
8 until there is further -- a ruling by me.
10 MS. LESHIKAR: I may not get it out really
11 quickly, but I'm going to get it out.
12 Now, would you like to start your question
13 again, which was, I believe, have you received a call from
14 Ms. Mershon; and the answer was yes.

15 Q (BY MR. PALAZOLA) At any time in your
16 conversations with Ms. Mershon, did the topic of Dr.
17 Szumlas consenting to his medical records being provided
18 to the Medical Board come up?
19 A Yes.
20 Q And I'm referring to your note here dated April
21 18th. At some point, did you communicate that request to
22 Dr. Szumlas?
23 A Yes.
24 Q And what was his response?
25 A I asked Dr. Szumlas on April 18th if he would
0113
1 like for me to fax his records to the Texas Medical Board
2 regarding his court case. And he stated, no, that he
3 would give the paperwork to whom he needed whether it be
4 the lawyer or the person representing him. He did not
5 feel at that time that the -- he needed for us to fax that
6 information. So he declined that offer.
7 Q Following that conversation with Dr. Szumlas, did
8 you communicate that to Ms. Mershon at the Medical Board?

9 A No, I did not.
10 Q Following that, did you receive a subpoena from
11 Ms. Mershon of the Texas Medical Board?
12 A I also received a subpoena dated yesterday. I
13 was out of the office.
14 Q And do you have any personal knowledge as to
15 whether or not -- how the documents were eventually
16 provided to the Medical Board?
17 A No, my understanding is they were faxed yesterday
18 with the exception of the very last note, the one that is
19 dated 4/18, the last document which was faxed this
20 morning.
21 Q And the report -- do you have any anything in
22 your April 18th, 2011 report that you feel needs to be
23 corrected at this time?
24 A No, I do not.
0114
1 CROSS-EXAMINATION
2 BY MR. LEICHTER:
3 Q Ms. Russell, you made this note this morning, is
4 that correct, at 7:58 a.m.?
5 A That was the time that my signature was put in
6 and it was final and approved. I was out of the office
7 sick yesterday. So, yes, I final approved that note this
8 morning when I received the information that it would need
9 to be turned in due to the subpoena.
10 Q When did you type in the progress note, this
11 morning?
12 A It was typed in on April 18th, but it was final
13 approved this morning.
14 Q The note doesn't indicate that you asked Dr.
15 Szumlas to sign a consent to release information, does it?
16 A I'm sorry. Could you repeat that. I can't hear
17 you very well.
18 Q The note does not indicate you asked Dr. Szumlas
19 to sign a consent to release information, does it?
20 A This note does not state that, no.
21 Q Okay. In fact, Dr. Szumlas received the records

22 and it was clear he was going to give them to my office;
23 isn't that pretty apparent from his conversation with you?
24 A Yes.
25 Q To your knowledge, Dr. Szumlas --
0115
2 MR. PALAZOLA: Nothing further.
3 MS. LESHIKAR: Panel members, do you have
4 any questions?
5 MR. BAUCOM: No.
7 questions?
8 MS. SOUTHARD: No, I do not. Thank you.
9 MS. LESHIKAR: All right. Ms. Russell,
10 thank you. You are excused from your testimony. We
11 appreciate your time and effort.
12 THE WITNESS: Thank you.
13 MR. PALAZOLA: Board staff has no further
14 witnesses and we would rest at this time.

15 MS. LESHIKAR: All right. Mr. Leichter.
16 MR. LEICHTER: I would ask for a directed
17 verdict. Staff presented no evidence he poses an ongoing
18 threat or imminent risk to the public safety through the
19 continuation of his practice of medicine. Their own
20 witness couldn't even testify to some reasonable degree of
21 medical certainty that his continuation of practice would
22 pose that ongoing risk and as such, we ask this Panel for
23 a directed verdict in his favor.
24 MS. LESHIKAR: We are going to -- do you
25 have a motion to go into executive session to discuss his
0116
1 motion?
2 MR. PALAZOLA: Would the Board staff have an
3 opportunity to respond to that prior to?
4 MS. LESHIKAR: Yes. Go ahead.
5 MR. PALAZOLA: Obviously, the Panel is aware
6 that the evidence presented is not limited to the verbal
7 oral testimony that we have heard today, but also the
8 documentary evidence here. We did hear testimony from Dr.

9 Messer that there is a probability or a likelihood of
10 relapse should he become noncompliant in his care.
11 At this point, the evidence is either -- at
12 least some indication that he may not be compliant. We
13 have no indication where he's getting his medications,
14 whether he's getting his medications, whether he's taking
15 his medications, whether he's receiving any psychological
16 treatment that would account for any of that. So his
17 likelihood for relapse at this point is unclear.
18 If they can present evidence in their case
19 in chief to answer that, then that would be the
20 appropriate time for the Panel to make a determination on
21 the evidence today.
22 The likelihood of relapse that's talked
23 about is the concern that the Board staff has, and we
24 think there is ample evidence to show there is a risk of
25 that happening, and we need to at least take the time to
0117
1 hear some evidence from them on that topic before we make

2 a resolution today.
3 There is a risk to the health of the public
4 health and welfare from relapse. And there is also
5 evidence in the written documents, in particular, that Dr.
6 Szumlas may still be suffering from psychotic symptoms
7 after his discharge from the State Hospital, e-mails that
8 are in evidence and have been accepted into evidence and
9 documents and at least one of the treatment records from
10 the MHMR facility where he indicated that he did have a
11 factually-documented audio assault that was after his date
12 of discharge. And I think that's ample evidence to at
13 least make a prima facie case at this point.
14 MS. LESHIKAR: We are going to -- would
15 either of you like to -- or, Ms. Southard, would you like
16 to go into executive session and have a brief discussion?
17 MR. BAUCOM: Yes.
18 DR. CROCKER: Yes.
19 MS. SOUTHARD: I would like that.
20 MS. LESHIKAR: Can I have a motion to go to
21 executive session.
22 DR. CROCKER: I move that we go into
23 executive session to discuss the motion.
25 MR. BAUCOM: Is there a second to the
0118
1 motion?
2 MS. SOUTHARD: Second.
3 MR. BAUCOM: We have a motion and a second.
4 All in favor say aye.
5 MS. SOUTHARD: Aye.
6 DR. CROCKER: Aye.
7 MR. BAUCOM: All opposed, no. We are going
8 into executive session at 12:41 p.m.
9 (Off the record from 12:40 p.m. to 12:48
10 p.m.)
11 MS. LESHIKAR: We are going to go back on
12 the record.
13 At the time that we just broke, Dr. Crocker
14 had moved this meeting be closed to the public and be

15 continued in executive session for deliberations
16 concerning a motion from Mr. Leichter and for private
17 consultation and advice of counsel.
18 The motion was seconded by Ms. Southard and
19 it was granted. And it carried and the motion was
20 granted. Mr. Baucom.
21 MR. BAUCOM: This meeting of the
22 Disciplinary Panel was closed to the public at 12:42 on
23 April 20, 2011 for deliberations concerning disciplinary
24 action under the authority of the Medical Practice Act,
25 Section 152.009, Occupations Code, and for private
0119
1 consultation and advice of counsel concerning pending and
2 contemplated litigation, settlement offers and/or legal
3 matters subject to the attorney/client privilege under the
4 authority of the Open Meetings Act, Section 551.071,
5 Government Code.
6 While in executive session, the Disciplinary
7 Panel did not take any action, make any decision or vote
8 with regard to any matter that may have been considered or

9 discussed.
10 A certified agenda of the executive session
11 was made.
12 The executive session has been concluded.
13 The Disciplinary Panel has returned to open session at
14 12:48 on April 20th, 2011. While in executive session, no
15 vote was taken and no decision was made in regard to the
16 Application for Temporary Suspension.
17 A certified agenda was made.
18 MS. LESHIKAR: All right. Panel members,
19 you have before you a motion by the Respondent for a
20 directed verdict, if you will. And you have the option of
21 granting that motion or denying that motion and continuing
22 with the hearing and require the presentation of evidence
23 by the Respondent. Which would you like to do?
24 MR. BAUCOM: Is there a motion?
25 DR. CROCKER: I move that we deny the
0120
1 motion.
2 MR. BAUCOM: Is there a second?
3 MS. SOUTHARD: I would second that.
4 MR. BAUCOM: There's a motion and a second
5 to deny the directed verdict. All in favor indicate by
6 saying aye.
7 DR. CROCKER: Aye.
9 MR. BAUCOM: Opposed, no. The motion
10 carries.
11 MS. LESHIKAR: Your directed verdict motion
12 is overruled, Mr. Leichter. Are you now ready to make
13 your opening statement and present your witnesses?
14 MR. LEICHTER: I am.
15 Briefly, on opening the standard here --
16 this is not a disciplinary case. So although staff urges
17 that Dr. Szumlas needs intervention against his medical
18 license, that is not the issue before you today.
19 The issue before you today is simply this:
20 Does Dr. Szumlas' continued practice in medicine pose an
21 imminent risk to the public health and safety? That's the

22 only question for you that you can reasonably answer. And
23 the likelihood, maybe, possibility is not sufficient under
24 the case law or under the statute.
25 I believe you will hear evidence today from
0121
1 the testimony of Dr. Glass as well as from Dr. Szumlas
2 that the auditory hallucinations subsided and left. He is
3 compliant with all treatment recommendations. And in the
4 opinion of a Board certified expert, he's competent and
5 safe to return to the practice of medicine.
6 Although -- we would like to call our first
7 witness. We call George Glass, M.D.
8 (Witness sworn.)
9 MR. LEICHTER: At this point in time, I
10 would offer Dr. Szumlas' Exhibits 3 through 19. They
11 consist of letters of reference from other cardiologists,
12 continuing medical education and certificates that he's
13 received regarding cardiology practice.
14 MR. PALAZOLA: Board staff is going to have

15 to have some time to -- I understand that Dr. Glass is
16 scheduled, but this is the first, after several objections
17 regarding unfair surprise from Mr. Leichter, this is the
18 first time we have seen virtually all this evidence. And
19 it has been previously requested by us from him, including
20 just this morning when I asked for a copy of Dr. Glass'
21 report.
22 And whether or not we have valid objections
23 or not, I can't say without taking at least some time to
24 review these records.
25 MR. LEICHTER: I didn't move to admit Dr.
0122
1 Glass' report.
2 MR. PALAZOLA: The same would apply to the
3 other documents on here, whether or not they contain
4 admissible evidence or not.
5 MR. LEICHTER: We can take this up after Dr.
6 Glass is finished. He can review them while the testimony
7 is proceeding.
8 Would that be fair, Ms. Leshikar?

9 MS. LESHIKAR: No. We are going to take
10 about five minutes and let you look at these exhibits and
11 you can make a motion on these.
12 From my brief cursory look, it doesn't look
13 like there is a report that's going to be admitted; is
14 that correct?
15 MR. LEICHTER: There will be. It's Exhibit
16 1. I didn't move to admit it just yet. I'm going to
17 authenticate it through Dr. Glass. Exhibit 1 and 2 which
18 is his resume and evaluation.
19 MS. LESHIKAR: Well, it doesn't take me too
20 long to look at a resume, but the actual psychiatric
21 evaluation is something that the staff is entitled to have
22 time to review and to at least be able to get an idea
23 about what it says before they are forced to do
24 cross-examination on it, Mr. Leichter.
25 MR. LEICHTER: Okay.
0123
1 MS. LESHIKAR: I think what's good for the

2 goose is good for the gander. Since we have allowed you
3 some time to look at documents in preparation for cross,
4 we are going to do the same things with regard to the
5 staff.
6 I'm going allow the staff approximately --
7 I'm going to say ten minutes. And you may look at that
8 and then be prepared to respond to it and cross-examine on
9 it.
10 Off the record for ten minutes to allow the
11 staff to look at this evaluation.
12 (Off the record from 12:54 p.m. to 1:08
13 p.m.)
14 MS. LESHIKAR: We are now on the record.
15 MR. LEICHTER: We would offer Respondent's 3
16 through 19.
17 MR. PALAZOLA: No objection.
18 MS. LESHIKAR: Having heard no objections,
19 these should be admitted.
20 MR. BAUCOM: They are accepted.
21 MS. LESHIKAR: Just indicate that

22 Respondent's Exhibits 3 through?
23 MR. BAUCOM: Three through what, Mr.
24 Leichter?
25 MR. LEICHTER: 3 through 19.
0124
1 MR. BAUCOM: 3 through 19 are accepted.
2 (Respondent's Exhibit Numbers 3 through 19
3 admitted.)
4 MR. LEICHTER: They are appropriately marked
5 with stickers on each exhibit.
6 GEORGE GLASS, M.D.,
9 BY MR. LEICHTER:
10 Q Dr. Glass, can you please introduce yourself to
11 the Panel.
12 A Sure. My name is George Glass. I'm a medical
13 doctor and psychiatrist. Do you want me to run through
14 it?
15 Q I'll ask you some questions, but you can lead
16 quickly to that.
17 A I live in Houston. I hate to admit it, I was
18 born in 1941. I went to Swarthmore College where I
19 graduated in 1963 with a BA in psychology. I went to
20 Northwestern University Medical School, graduated with a
21 medical doctorate degree in '67.
22 I was a medical -- straight medical intern
23 in Kings County Downstate Medical Center in New York '67,
24 '68. I did my psychiatry at Yale University Department of
25 Psychiatry from '68 to '71.
0125
1 Got drafted. I spent two years as a
2 lieutenant commander in Bethesda Naval Hospital. Set up
3 the Navy's alcohol/drug program. I have travelled around
4 the east coast setting up programs. Spent a year in
5 London as a senior registrar at St. George's Hospital.
6 Came to Houston in 1974 where I was an assistant professor
7 of psychiatry in the UT Medical School.
8 I went into practice in 1977 and I've been

9 in practice in Houston ever since. I am Board certified
10 as a psychiatrist by the American Board of Psychiatry and
11 Neurology. I am Board certified by -- in addiction
12 medicine by the American Medical Society on Addiction
13 Medicine.
14 I have 30-plus peer review papers. I'm a
15 clinical associate professor of psychiatry at Baylor,
16 UT, Cornell. I am a distinguished life fellow of the
17 American Psychiatric Association.
18 Probably relevant here, among other things,
19 is I was on the Harris County Medical Society Impaired
20 Physician Committee for seven years. I was the head of it
21 for three. One of the few doctors in the country who do
22 independent evaluations for the FAA, the Airline Pilots
23 Association, a bunch of different airlines and airline
24 unions. I have done reviews for the Board. I have done
25 reviews for the Bar and the Bar's grievance committee.
0126
1 I have five kids. And that's about -- first

2 time I've ever been at the Board, although I've been
3 around here a lot one way or another.
4 Anything else?
5 Q (BY MR. BAUCOM) I would like to talk a little
6 bit about your work with pilots. Do you work largely for
7 the Defense Bar, for the airline, for the Federal Aviation
8 Administration? Who hires your services?
9 A Actually, I'm hired -- I'm an independent guy.
10 And I am hired, and I always tell people I have two hats.
11 On the one hand, I have one hat that I'm paid to do an
12 evaluation and do a report for the airline or whatever.
13 The other hat is, I try to give a
14 consciences competent evaluation and tell somebody what I
15 thought they ought to do regardless of whether they have
16 to go into monitoring or not.
17 The pilots in particular have a very
18 rigorous program in which before a pilot either turns
19 himself or herself in or they are stopped -- I got a call
20 today. Somebody got a random check after they got off a
21 plane and their blood alcohol level was just below the
22 arrest level. They get sent to treatment. They are
23 terminated. They then are put through rigorous aftercare
24 program. And then they are monitored. They have to see
25 me and they see a psychologist who does their neuropsych
0127
1 testing.
2 They see me. I evaluate their recovery or
3 psychiatric state because some of them are psychiatric;
4 some of them are people who have had been on psychotropic
5 drugs and now they are allowed to apply on
6 antidepressants. And I monitor them every year. They
7 come back and see me. I follow their monitoring progress
8 and do a report that goes to the FAA, goes to the company,
9 et cetera.
10 So in a way, it's as if I am a independent
11 person hired by the court, so it's not a defense or
12 whatever to have the option of going to a second person if
13 they don't like my opinion. But usually -- I've been
14 doing it enough so that usually doesn't happen. If they

15 do it, my opinion usually gets followed through.
16 Q Did you have an opportunity to -- I requested
17 that you evaluate Dr. Szumlas for this case; did I not?
18 A Yes, you did.
19 Q In conjunction or prior to that evaluation -- or
20 in conjunction with that evaluation, did you review any
21 material?
22 A Yes, I did.
23 Q And what was it that you reviewed?
24 A I reviewed, I believe, what Board has which is
25 essentially recommendations or comments and CMEs from
0128
1 physicians and people he's worked with, number one.
2 Q And that is what's been admitted into evidence as
3 Respondent's Exhibit 3 through 19; is that correct?
5 Number two, I have Board Notice of Hearing
6 paperwork with attachments, et cetera. You can see I have
7 kind of an obsessive doctrine. I have all these
8 underlinings and yellow stick-ums and stuff on it.

9 Number three, I have the medical records
10 from Terrell State Hospital which is what this is.
11 And number four, I have the follow-up
12 records from the mental health clinic where he was sent
13 for follow up on his discharge from Terrell State
14 Hospital. So that's what I reviewed before I saw him.
15 Q And in preparation for his interview with you, we
16 had requested asked that he obtain all these records as
17 quickly as he could.
19 Q Was he compliant with that request?
20 A Yes, he was.
21 Q How long did you interview Dr. Szumlas for?
22 A I saw him three-and-a-half hours. Three,
23 three-and-a-half hours.
24 Q And this was in your office?
25 A In my office, Saturday afternoon.
0129
1 Q In Houston?
2 A In Houston from 1:30 to 5 o'clock.
3 Q Was Dr. Szumlas on time for his appointment?
4 A Yes, he was. He was sitting in the lobby when I
5 got there.
6 Q I'm going to pause at Respondent 2, which is your
7 resume. You provided this resume; did you not?
8 A Yes, I did.
9 Q And this resume was created by you?
10 A That's correct.
11 Q Just recently?
12 A 2010, sometime a year-plus ago. I think there
13 are probably a couple more papers and some other stuff but
14 basically it's up to date.
15 MR. LEICHTER: We would offer Respondent's
16 2.
17 MS. LESHIKAR: Any objection?
19 MS. LESHIKAR: It should be admitted.
20 (Respondent's Exhibit Number 2 admitted.)
21 Q (BY MR. LEICHTER) What was the presenting

22 problem, as you understood it, when Dr. Szumlas came to
23 your office?
24 A The question was -- he had a psychotic episode.
25 Was he together -- was he over it and was he capable, in
0130
1 my opinion, of going back to work as a physician. That
2 was the gist of the question.
3 Q And that was the question that I posed to you in
4 conjunction with the evaluation; is that right?
5 A That's true. Correct.
6 Q Tell me a little bit how the evaluation
7 proceeded.
8 A I asked him, you know, what happened. And, you
9 know, we talked about kind of what happened. And we
10 talked a little bit about his history. Talked about his
11 family. Talked about had he had any other issues before.
12 Tried to get background information on both psychiatric,
13 medical, et cetera. Tried to get background information
14 on the episode.
15 And then I tried to poke and prod about what
16 was the reason for this. Here is a 49-year-old man who
17 had no psychiatric history, no previous anything. All of
18 a sudden, something happens. How come?
19 I was poking around for the other reasons
20 that are possible like drug use, alcohol use, medical
21 problems. That was basically -- or a long-standing
22 pattern of dysfunction that had created problems for him,
23 to work out essentially a differential diagnosis of was
24 there something that was missed or was there a reason for
25 it.
0131
1 Q Did you conclude that he, in fact, had had a
2 psychotic episode or a psychosis-related episode back in
3 March of 2011?
4 A Yes.
5 Q And when he presented to you in your office, in
6 your opinion, had that episode resolved?
7 A With treatment, yes, medication, it had resolved.
8 Q In your review of the medical records from

9 Terrell State Hospital, do you have an on opinion whether
10 or not he was treated appropriately for the episode at
11 that facility?
12 A Yes.
13 Q What is that opinion?
14 A He -- I reviewed the records. And if I could --
15 he was committed to the State Hospital on the third time
16 because he had called the -- have you gone over this or
17 should I do it?
18 Q Go ahead.
19 A He called the police to say he thought people
20 were bombarding his house with audio waves or electronics,
21 or that there were people outside his house who were
22 swearing and saying nasty things, for want of a better way
23 to put it.
24 This is the third call the police had in
25 several months. They had already called the Medical Board
0132
1 once, I believe, in February to say there was something

2 strange. They asked him, in essence -- they took him to
3 the hospital, the local med/surg hospital where
4 psychiatrists evaluated him, filled out commitment papers.
5 He was taken to Terrell State Hospital,
6 where in the course of ten days or thereabouts, he was
7 given a set of blood tests and usual medical screening
8 stuff. He was given a CAT scan.
9 All the tests came back essentially normal
10 other than he's got a history of high cholesterol, history
11 of hypertension, history of mild diabetes. There were no
12 significant physical findings. The only thing that wasn't
13 done was a testosterone, and that's not what you would
14 usually do anyway.
15 They put him on anti-psychotic medication,
16 and he responded, and they let him go in ten days. What I
17 found interesting, for want of a better way to put it,
18 most people who are committed, particularly physicians or
19 lawyers, tend to be boisterous or threatening or something
20 when they are committed and locked up in a hospital.
21 There were no notes about anything other

22 than his just being compliant, going along, goes to group,
23 tells people what happened. There is no sense that he's
24 outraged, mad, combative. That to me was the only thing I
25 noticed that was, other than the response to treatment,
0133
1 which was what happens usually in kind of involutional
2 psychosis.
3 Q Do you think the medication choice from the
4 treating physician at the Terrell State Hospital was
5 appropriate?
6 A Yes. He was tried on a different anti-psychotic
7 and then they switched him.
8 Q In your experience, is that -- so that is an
9 appropriate choice of medication?
10 A Appropriate choice of medication. The dosage is
11 obviously working. And he's in agreement to take it.
12 Q When he presented to you in your office, in your
13 opinion, was he experiencing delusion or psychosis or
14 hallucinations, auditory hallucinations, at that time?

15 A No.
16 Q Did he express his thoughts and opinions to you
17 about what those events were?
18 A Can you be clearer about?
19 Q Did he indicate to you that he understood those
20 hallucinations weren't real when he presented to you?
21 A Yes.
22 Q So he understood that they were imagined at the
23 time?
24 A At the time that I saw him, which was on the
25 medication, he acknowledged that he had had an episode and
0134
1 they were not real, and he had been overconscientious in
2 pursuing and reporting them.
3 Q Did you have any reason to think, Dr. Glass, that
4 he hadn't been compliant with his medication therapy?
5 A No.
6 Q Did you write him a renewed prescription for the
7 Risperdal?
8 A Yes, I did.
9 Q We will get to this in a minute. Let's talk
10 about any violent tendencies of Dr. Szumlas. Did you
11 notice any violent tendencies that Dr. Szumlas may have or
12 proclivities?
13 A No. That's something I pushed around for you.
14 He bought a gun. There was some concern in the record
15 about that was part of why they went through the
16 commitment because he had bought a gun. He's never used
17 the gun. He's not been in a fight since maybe high
18 school. And if anything in reviewing the record and
19 reviewing the history -- can I mention this?
20 Q Yes, please.
21 A He is a guy who -- he's a boarded cardiologist.
22 He's a boarded internist. I went to medical school in
23 Northwestern. Only the people who were the smart people
24 went to the Mayo Clinic from my class. He went to medical
25 school in Chicago. That's a good place to have gone.
0135
1 So what I wondered is, why is a guy who is

2 well-trained, et cetera -- he's had a number of different
3 jobs. Well, I asked him. And he had been in a number of
4 group settings for two years or four years or more locums,
5 why? What happened? Why didn't you settle?
6 Well, he got into groups and it lasted for a
7 period of time. And then they would have him, you know,
8 for a set amount of time. He's a noninvasive
9 cardiologist. He doesn't do anything invasive. That's --
10 compared to psychiatrists, that's a high-dollar thing.
11 But compared to most other guys who do procedures, that's
12 not a high-dollar thing.
13 So the question is, he's not an aggressive
14 guy. I asked him about that. I said, aren't you mad that
15 you worked for this group for four years and then they
16 just say, gee, we are sorry; there is no room for you, et
17 cetera. He was nice. It's just a business thing. And I
18 understand that.
19 That's what I was poking for is that most
20 people I know they would get mad; they would get a lawyer
21 to go do -- he wasn't that kind of guy. I just said, do

22 you ever get angry? What do you do? He goes and hits
23 golf balls. He doesn't even play golf most of the time.
24 And he lifts weights.
25 Well, why don't you get angry, did you ever
0136
1 get in a fight besides a couple times in high school? He
2 has two older twin brothers who fought all the time. So
3 he was the peacemaker. So somehow or another, that's just
4 his style. And so I was not concerned about violence.
6 I asked about the gun. He never shot a gun.
7 I don't know that he would know how to shoot a gun. He
8 was going to have somebody teach him. But he got it
9 because of the noises outside. That's --
10 Q Is it your opinion that Dr. Szumlas is not a
11 violent man?
12 A Yes.
13 Q Is it your opinion to a reasonable degree of
14 medical probability that Dr. Szumlas does not pose a

15 threat to society due to violent tendencies?
16 A Absolutely. This guy probably should have been a
17 priest. He's got an aunt who is a priest -- a nun. He's
18 got an uncle who's a Father. He's had this stuff where
19 he's been in different parishes, if you will. Four years
20 here, two years there.
21 He doesn't mind moving. He doesn't really
22 make connections to people much, from what I can tell,
23 other than his daughter. He just happens to be a
24 cardiologist instead of a minister.
25 Q So why the gun, then, Doctor, in your opinion?
0137
1 A I think that he heard the noises. He didn't know
2 what it was. And he's living up in Texas where everybody
3 has guns. He's from Illinois. I think he got nervous and
4 worried and that was it.
5 Q Without drawing attention or going into detail
6 about the delusions, are those kind of delusions that
7 abnormal and unusual in your line of work, or can it be
8 expected?
9 A That's one of those, do you still beat your wife?
10 I'm a psychiatrist. People don't come to me because
11 everything is wonderful and happy. They come because
12 something is not right. It is not the first or second
13 time or the 15th time I have heard about delusions or
14 imaginations.
15 You know, what I said in my report is back
16 in the late '60s and '70s, we used to talk about
17 involutional melancholy and involutional depression, but
18 it was about women. They get to be 50-ish, hormone
19 problems. They are not involved, whatever. They are kind
20 of isolated. And they start to imagine stuff which, in a
21 way, is sort of stuff that puts them in the center of
22 attention, if you will.
23 I think that's really what happened to Dr.
24 Szumlas. I mean, he's up there in Paris, Texas. He
25 doesn't really -- he's not involved with the doctors that
0138
1 he worked with. He doesn't barely see them. He's not

2 been working since June, because he's been studying for
3 two boards. So his schedule is he gets up; he studies.
4 goes -- hits some golf balls, comes back and studies. The
5 high point of the week is he goes to the movies or he goes
6 to a cafeteria to get something to eat. He doesn't talk
7 to people other than to say hi; give me my change; is that
8 a good movie.
9 He's got no interpersonal stuff except for
10 his 20-year-old daughter and his ex-wife who he still
11 communicates with and a couple of siblings and his
12 85-year-old mother. And that's it.
13 I think he got up there and he was isolated.
14 And he went from being an important guy as a cardiologist
15 that people call and patients all know him to being just
16 somebody with nothing going on and got depressed.
17 Q Couple more questions. Prior to him coming to
18 see you, Dr. Szumlas coming to see you, had he reached out
19 within recent days to the physician health program, to
20 your knowledge?
21 A That, I don't know. What I know is when he was

22 discharged from the psychiatric -- from Terrell State
23 Hospital, they gave him medication. They sent him to an
24 outreach clinic. And he saw a couple of social workers.
25 He said, you know, that surprised me. I'd think they
0139
1 would at least send me to a doctor or something. They
2 told me to go see my L and D to go get prescriptions and
3 go talk to these people once in a while rather than
4 anything else.
5 Q I would like to talk to you about Dr. Szumlas'
6 treatment compliance. In your opinion, to a reasonable
7 degree of reasonable medical probability, has he been
8 compliant with his treatment?
9 A Yes.
10 Q And that means with his medication therapy?
11 A With his medication therapy. And he's gone to
12 see these people they told him to go see, although they
13 essentially are not even medication checks because they
14 are not nurse practitioners who can prescribe. They are

15 just social workers essentially who -- case managers who
16 document that he comes in.
17 Q How did Dr. Szumlas strike you with respect to
18 self-care and following physician orders? Do you have an
19 opinion as to whether or not he can do that?
20 A I think he's a very compliant guy in everything
21 in his life. He was before this happened, and I think he
22 is now.
23 Q Did Dr. Szumlas indicate to you what he would do
24 if he started to hear the voices again?
25 A Yes.
0140
1 Q What was that?
2 A He'd call the doctor he's seeing and say, hey,
3 I'm concerned.
4 Q In your opinion, to a reasonable degree of
5 medical probability, do you have an opinion as to whether
6 or not Dr. Szumlas is aware that what happened to him
7 wasn't real?
8 A Yes.
10 A That he knows that it was an episode, psychotic
11 episode. It was not real.
12 Q Do you have a medical opinion as to whether or
13 not his continued treatment of Risperdal, three milligrams
14 QD, would be effective?
15 A Yes, I think it would. I think he should be
16 monitored by a doctor because at some point it may take
17 less or more. It ought to be followed, but, yeah.
18 Q In your opinion, Doctor, is that a low or high
19 dose of Risperdal?
20 A It's a relatively low dose.
21 Q And why would that be? Do you have any reasoning
22 or explanation for that?
23 A Why it's a low dose?
24 Q No, why would he respond to a low dose
25 therapeutically? Who knows?
0141
1 A Because I think it was a small episode, whatever.

2 He's not a process guy. From what I can tell, he's not
3 somebody whose been having inner demons for 25 years and
4 they suddenly lift out.
5 Q Do you think that if Dr. Szumlas continues to
6 take his medication he's at risk for -- a high risk for
7 relapse?
8 A No.
9 Q What risk is there of relapse for Dr. Szumlas?
10 Can you opine? Is it low?
11 A I think it's low. I don't think it's -- I think
12 if he takes medication and he's followed by somebody, I
13 think it's relatively low. And even if he had a relapse,
14 I don't think he's going to hurt -- do any damage. He
15 will go to somebody and say, hey, you know -- I mean --
16 Q Let me ask you this: As a cardiologist, did Dr.
17 Szumlas describe his medical duties?
18 A I didn't go into that in detail. I have a rough
19 idea what noninvasive cardiologists do.
20 Q Were he to continue in the practice of medicine
21 under the same medication regimen, in your opinion would

22 he pose a risk to his patients?
23 A I don't believe so.
24 Q And can you assert that opinion to a reasonable
25 degree of medical probability?
0142
1 A Yes. I mean, what's the worst he's going to do,
2 misread an EKG? I mean, if worse came to worst and he
3 thought he was hearing stuff, what's the worst that's
4 going to happen? He's going to misread an EKG or order a
5 second one. I don't think it's a problem. There is no
6 record that he has any performance problems. He's never
7 had a complaint, from what I can tell.
8 Q Let me ask you this, Doctor: If Dr. Szumlas
9 continues his medication therapy and to follow all
10 treatment recommendations, is there any reason why his
11 underlying previous episode should cause any performance
12 issues in his practice?
13 A No.
14 Q What are your ongoing recommendations for Dr.

15 Szumlas?
16 A My ongoing recommendations are, number one, he
17 continue on medication. Number two, he see a psychiatrist
18 to deal with therapy, somebody who is not a medication
19 check 15 minutes, once every two months, but who will talk
20 to him about issues in his life.
21 He's a sad, lonely guy. He's a bright,
22 successful guy in one arena, but he's a sad, lonely
23 isolated person. And to have somebody help him sort out
24 how to do that. He's 49 years old. There's no reason he
25 couldn't have a fuller life.
0143
1 Q Are you working with him to find clinicians in
2 his area with whom he can coordinate care?
3 A Yes.
4 Q Was he willing to follow all your treatment
5 recommendations?
6 A He's willing to do all that. In fact, he asked
7 me. He said, if I move, will you help me find somebody?
8 If I go to Florida where my daughter is, because I want to

9 work there or if I go to Iowa, where he's got positions
10 offered in both places, from what I understand.
11 Q How did you rule out any drug or alcohol
12 disorder?
13 A He denied it. There was no reference to it in
14 the charts, in the medical records from Terrell in any
15 way. His lab tests didn't fit with drug or alcohol
16 problems.
17 Q And other than the low testosterone, you ruled
18 out any kind of medical problem due to the CT scan being
19 negative and the other blood work being okay?
20 A Yeah, within range. I don't even know that he
21 has low testosterone. That was just one thing that was
22 blatant. He's a 49-year-old guy who has not a lot of
23 interest in stuff, if you will, at this point in his life.
24 Q Did you prepare the report that's -- that is
25 authored by you, signed by you and marked as Respondent's
0144
1 Exhibit 1?
2 A Yes, I did.
3 Q It's dated April 18th and, I guess, signed yours
4 truly, George Glass, which is a seven-page document?
5 A Yes, I did.
6 MR. LEICHTER: We would offer Respondent's
7 1.
9 MS. LESHIKAR: To be admitted.
10 (Respondent's Exhibit Number 1 admitted.)
11 Q (BY MR. LEICHTER) Doctor, in your opinion, to a
12 reasonable degree of medical probability, what is your
13 opinion with respect to whether or not Dr. Szumlas poses a
14 threat to the public interest and public health and safety
15 if he were to return to the practice of medicine?
16 A I don't think he poses a threat to the public. I
17 don't think he poses a threat to himself as long as he
18 stays on his medication and stays involved with treatment.
19 Q Staff has suggested that it was possible that it
20 could relapse -- that he would relapse. Would you say
21 this is likely given what you know about Dr. Szumlas, all
22 the paperwork you reviewed and in your interview with him?
23 A It's possible that he could relapse. But if he
24 takes his medication, the odds are very low.
25 If he's being monitored by somebody over
0145
1 time, it's also unlikely. And if he relapses, the doctor
2 will increase the medicine or respond differently, number
3 two.
4 Number three, I recommend, and I do this
5 with physicians, I do it with attorneys, that when they go
6 somewhere and they go back to work that they have a
7 monitor for a period of time, somebody who kind of checks
8 on them or signs off on them once in a while to make sure
9 things are going okay. And I would recommend that for Dr.
10 Szumlas and he agreed. He said that was fine.
11 Q Was there anything that Dr. Szumlas objected to
12 that would give you cause for alarm or concern?
13 A No.

15 MS. LESHIKAR: Staff.
17 BY MR. PALAZOLA:
18 Q Good afternoon, Doctor. I wanted to ask you
19 initially. We have a copy of your resume in evidence and
20 it seems like the bulk of your work over your career has
21 been with substance abuse drugs and alcohol. Would you
22 agree with that assessment?
23 A It's both. I am boarded as a psychiatrist.
24 Q I understand that.
25 A And, you know, I do both things. I happen to be
0146
1 one of the few guys around that does substance abuse. I
2 see people with both kinds of problems, have for a long
3 time.
4 Q And when asked to describe yourself, you
5 mentioned your work with pilots an the FAA; is that right?
6 A That's one part of my practice.
7 Q That was the part you chose to talk about today?
8 A I thought that was relevant because that's

9 essentially a one-time evaluation where I have to make a
10 judgment about somebody and make a recommendation, fill
11 out a report. And then decisions get made on the basis of
12 that. That's different than -- what I tell people when I
13 get asked this, 60 percent of my practice, 50, 60 percent
14 of my practice is I have a day job and I'm a psychiatrist.
15 MR. PALAZOLA: Objection to the
16 nonresponsive portion to that.
17 MS. LESHIKAR: Sustained.
18 Q (BY MR. PALAZOLA) I am going to try to do a good
19 job of asking questions that have a brief response.
20 A Okay.
21 Q Keep your answers to what I ask you.
22 MS. LESHIKAR: We also want to keep in mind
23 the time constraint, and I believe the Panel is going to
24 want to ask some questions too.
25 THE WITNESS: Sure. Okay.
0147
1 Q (BY MR. PALAZOLA) My question regarding the FAA,

2 Doctor, was that the example you gave today was of a pilot
3 who had failed a blood screen for alcohol, correct?
4 A Correct.
5 Q And that's what you have got at the very top of
6 your resume, is that you do substance abuse work and
7 rehabilitation of alcoholism and drug work as well as
8 chronic pain and post traumatic stress.
9 A That's true.
10 Q Did you know Dr. Szumlas prior to the date of
11 your evaluation?
12 A No.
13 Q How many times -- you mentioned you examined him
14 on, I believe, last Saturday?
16 Q Is that this past Saturday?
17 A This past Saturday.
18 Q Is that the only time you have met with Dr.
19 Szumlas?
20 A That is correct, other than out in the waiting
21 room.
22 Q Have you had any opportunity to speak with him by
23 telephone?
24 A Yes, he called me to tell me he had got a
25 prescription filled and when was his next appointment with
0148
1 me.
2 Q Have you entered into a treatment relationship
3 with Dr. Szumlas?
4 A No, other than I prescribed the medication for
5 him. He was running out of medication. And I said, after
6 the Board hearing, we will decide whether I'm going to see
7 you or whether I will find somebody close to where you
8 are, because it's a six-hour drive to Houston from where
9 he is.
10 Q What percentage of your practice is spent
11 treating patients versus testifying?
12 A 15 to 20 percent of my time is spent doing
13 forensic work, which is not usually testifying. It is
14 usually evaluating or doing reports. As I said, probably

15 50 or 60 percent of my time is -- I'm a country
16 psychiatrist, in which I do treatment of folks like us,
17 period.
18 Q And how much -- you also evaluated the records.
19 You went over the records. How much time did you spend
20 evaluating the records in this case?
21 A Probably couple hours.
22 Q Two hours?
23 A Two hours.
24 Q Two, three hours?
25 A Yeah.
0149
1 Q So the three-and-a-half hours you spent with him
2 on Saturday, the two to three hours you spent reviewing
3 the records, and then you had a brief phone conversation
4 with him. Was that the extent of your time spent on this
5 case?
6 A I've been here a while.
7 Q Did you have an opportunity to meet with Mr.
8 Leichter regarding your testimony today?

9 A When I came in this morning, yes.
10 Q Had you talked with him on the phone prior to
11 that?
12 A I called him after I saw Dr. Szumlas. And I
13 said, this is what I think. And I said, I'll do a report,
14 if that's okay, and went from there.
15 Q Are you being paid for your testimony today?
16 A I'm not being paid for my testimony. I am being
17 paid to do an evaluation and give my opinion.
18 Q How much do you charge for your time spent
19 reviewing records? Do you have an hourly rate?
20 A I have an hourly rate. In this case, I did a
21 flat rate for the whole thing.
22 Q What was the flat rate?
23 A Flat rate was $5,000. My usual rate is $400 an
24 hour to review, 2,500 bucks -- $500 for court time or
25 deposition time, including travel.
0150
1 Q And you would agree that Terrell State Hospital

2 admitted Dr. Szumlas for 12 days?
3 A I believe that is correct.
4 Q And that was for 24-hour-a-day care?
6 Q They had the opportunity to observe Dr. Szumlas
7 for 24 hours a day for 12 days. You would agree with
8 that?
9 A Yes.
10 Q And over the course of that time period, he was
11 evaluated by several providers at Terrell State Hospital
12 over those 12 days?
13 A Oh, yes.
14 Q Would you agree that Terrell State Hospital has
15 more data available reaching their opinions and
16 conclusions in their reports?
17 A Yes. They saw him through the course of when he
18 came in and was psychotic. And when they discharged him,
19 they thought he was okay to be discharged.
20 Q And your opinion in this case is based upon your
21 evaluation last Saturday and the review of the records

22 provided to you by Mr. Leichter?
23 A And my 40 years of experience as a Board
24 certified eligibly-certified psychiatrist, yes.
25 Q Doctor, you indicated briefly what records you
0151
1 had reviewed prior to coming in today. And you wrote a
2 report following your review of that record; is that
3 correct?
4 A Yes.
5 Q And you had your three-and-a-half hour assessment
6 of Dr. Szumlas, correct?
7 A Correct.
8 Q And your report is now in evidence. I would like
9 to ask you a couple of questions about that.
10 A Sure.
11 Q On Page 2 of the report -- of your report under
12 current problem under Dr. Szumlas, you indicate he left
13 his -- one of the reasons he didn't make a career move in
14 July of 2010 is because there was some sort of government

15 activity around him surrounding Medicare legislation?
16 A Yes. Whatever it was, the whole shift in the
17 Obama care passed, what was going to happen.
18 Q And when you started to get into what his problem
19 was from November of 2010, was his characterization to you
20 that he heard people outside his house using swear words?
21 A Derogatory comments, swear words, threatening
22 types of things.
23 Q Is that consistent with the intake admission that
24 was done at the Paris Regional Medical Center in the
25 emergency room there?
0152
1 A I'm not sure what you mean. He was having
2 hallucinations and delusions, which is what essentially
3 they said.
4 Q Well, let's be precise so we can get that exactly
5 right. You did have an opportunity to review the records
6 from the Paris Regional Medical Center?
7 A Yes.
8 Q And the Paris Regional Medical Center, do you

9 recall reviewing the assessment that they completed for
10 their referral to Terrell State Hospital?
11 A Let me take a look at what you have. I have seen
12 it but I'm not sure.
13 Q This is Bates stamped Page 81 through 83, I
14 believe. I'll hand you my copy there. If you can take a
15 minute to look that over.
16 A Yeah, I have seen this.
17 Q And some of the portions that are highlighted
18 there on your copy indicate that Dr. Szumlas -- this is in
19 the history -- this is in the history section or this is
20 in the report written for the assessment for Terrell State
21 Hospital, correct?
22 A Correct.
23 Q And we have got -- in quotation marks -- it's
24 fair to say that this is what -- this provider is
25 indicating Dr. Szumlas has indicated to them. That he
0153
1 says that he's talking about being stalked by satellites.

2 And in quotations he says, they focused their beams so bad
3 it hurts my body sometimes. And he says, he bought a gun
4 because, quote, man, they are stalking you.
5 Rick reported to me someone is stalking me
6 for five months. It is not just a person. It's a few
7 military people using inappropriate satellite equipment.
8 Can you tell me where in your report you documented that?
9 A I said that he had delusions and hallucinations.
10 I did not do a verbatim -- had I had the time and had I
11 thought it relevant, I would have parsed out paragraphs.
12 I didn't think it relevant. The fact is, he
13 was delusional. He was psychotic. What the -- I'm trying
14 to think. What the content of the hallucinations and
15 delusions were not important to me specifically, other
16 than that he was not having command hallucinations that
17 said, go out and kill somebody or jump off a tower.
18 Q Doctor, let me stop. I think you have answered
19 that question. Let me go on and --
20 MS. LESHIKAR: Excuse me. Mr. Leichter, how
21 much later than 2 o'clock is -- I mean, we are now there.

22 And the Panel has some question that we want to make sure
23 the Panel gets answered. Is there any room to go beyond 2
24 o'clock?
25 MR. LEICHTER: I have to ask Dr. Szumlas.
0154
1 THE WITNESS: I have a 5:45 plane out of
2 Houston Intercontinental. I assumed it was about a
3 three-plus-hour thing. I have to at least walk through
4 with my bag. I'll stick around for five or ten minutes.
5 We've already been through it. I'm not trying to jam
6 everybody. I'm just --
7 MR. LEICHTER: We can always call him on the
8 phone.
9 THE WITNESS: When he called me he said, you
10 will be out of here by noontime. I said, look, I have to
11 give a workshop, so I apologize. You know, I did not --
12 had I known that it would have been an all-day thing, I
13 would have said, I'm sorry, I can't do it.
14 MS. LESHIKAR: How much more do you have,

15 Counsel?
16 MR. PALAZOLA: I have some questions about
17 the report and some of the medical records where there are
18 inconsistencies that I think need to be brought about.
19 It's going to be at least ten or 15 more minutes.
20 I'm happy to talk to him on his cell phone
21 while he's driving if we have to do that to get this done
22 or whatever the Panel wants us to do.
23 MS. LESHIKAR: Let's -- Dr. Crocker, you
24 have some questions?
25 DR. CROCKER: Yes.
0155
1 MS. LESHIKAR: Let's interrupt you for right
2 now to make sure we get Dr. Crocker's concerns addressed.
3 And, Mr. Leichter, by noon, really?
4 MR. LEICHTER: I didn't think you were going
5 to have any witnesses. I thought they were going to put
6 on the documentary evidence and that was that.
7 MS. LESHIKAR: All right. Dr. Crocker.
8 EXAMINATION
9 BY DR. CROCKER:
10 Q Couple of questions. In your experience, a
11 single, new psychotic break with no prior psychiatric
12 illness at 49, pretty unusual?
13 A It's relatively unusual, yes.
14 Q And when you see that sort of thing, you
15 mentioned trying to focus down on what might have brought
16 it on. What kind of things do you usually find when you
17 find something?
18 A Sometimes it's a metabolic thing. Sometimes it's
19 a brain tumor. You know, you may see it with an alcohol
20 or drug issue. You can see it with a circulatory problem,
21 somebody has a bleed or something like that. Those are
22 the primary ones I think about.
23 The other psychiatric ones other than drugs,
24 et cetera, are that you have somebody who has been slowly
25 developing something over time, and it suddenly shows up.
0156
1 And after that, they either get better or they don't on

2 medication.
3 You go back and look at the history and you
4 find there's been a long history of by bazaar behavior
5 problems somewhere. And that was something I questioned
6 because he has moved. I thought, you know, well, he's
7 lived here for four years; he's lived there for two years;
8 did he leave because there were complaints. That was the
9 question that I had. I didn't hear that. And I asked him
10 specifically, were there ever -- have you ever had a
11 complaint? Have you ever been turned in to a Board? Have
12 you ever been sued? None of those things. So that's --
13 it's a relatively unusual event but it's not totally out
14 there.
15 Q What do you think about the -- what seems to me
16 very prompt response to Risperdal? Here is a guy who is
17 got significant delusional psychosis and after four days,
18 five days of Seroquil and Risperdal, he's almost back to
19 normal enough to the point that they discharge him without
20 restricting or recommending that he not go back to
21 practice even?
22 A It sounds to me like it was a brief episode. The
23 other possibility is, he's a terribly compliant guy who is
24 really as crazy as you can be and he's playing a game and
25 pretending. I don't believe that's true because he's been
0157
1 such a compliant person. I mean, he's that sort of
2 person. I think it was a minor deal. As much as
3 anything, he probably got a lot of attention in the
4 hospital after being isolated for six months.
5 Q You saw his history of sleep deprivation. He was
6 only getting two hours of sleep for a couple of months.
7 Do you think that contributed to this?
8 A Absolutely.
9 Q And I mean that in terms of as opposed to
10 progressive psychosis and sleeplessness because of
11 abnormal thought content, the vice versa, being
12 overstimulated by his thyroid and getting two hours' sleep
13 and getting psychotic because he isn't sleeping?
14 A That could be part of it.

15 Q Did you see his free T4 level?
16 A It was high, as I remember. And he was taking --
17 as I remember, I think he was taking thyroid at one point.
18 Q Yeah, he was taking thyroid. But his free T4
19 level is 50 percent above the maximum. I'm concerned that
20 nobody has investigated this for this doctor.
21 If they are going by his TSH, which was
22 extremely suppressed, as it usually is, and looking at
23 just his T4 and saying, that's normal and ignoring his
24 free T4, I wonder if this isn't even psychiatric illness;
25 that it's a medical illness with a psychotic break because
0158
1 he wasn't sleeping?
2 A Could be.
3 Q What about his MCV of 103 and a normal GTP?
4 Could he have issues with B12 and CNS?
5 A He could, but you are asking me essentially
6 internist questions that I don't know. What I talked to
7 him about was, you need to go get a good medical workup.
8 And he said if he hadn't had the Board hearing, he was

9 going to go somewhere and he had an internist that he was
10 going to go see.
11 Q Okay. And in the last six months, he's passed
12 two major board examinations; is that correct?
13 A That's what I was told, yes.
14 Q And how many psychotic people function at that
15 high a level, have you ever encountered?
16 A That's unusual to me. I don't know what
17 happened. But he's been a functional guy. I don't know
18 what happened that triggered it off. But -- and his
19 problem is, if I had to pick an issue as a psychiatric
20 issue is, he's a compliant guy. So why isn't he -- he
21 goes in the hospital and hadn't complained. He ought to
22 go find a medical center internist somewhere and get
23 checked out. He ought to get the whole deal done, instead
24 of being this kind of thing. I agree with you.
25 DR. CROCKER: I don't have any other
0159
1 questions.
2 EXAMINATION
3 BY MR. BAUCOM:
4 Q I had a question and you got into it and got an
5 answer for most of it.
6 But your earlier remarks, you settled on you
7 were trying to decide what happened to him, why this
8 situation. And you said he got off -- he was up in Paris
9 and he didn't have a lot of friends. He wasn't involved
10 in things and such as that. And then he just got
11 depressed. I thought, well, if that's the only reason,
12 there's got to be more than you came up with, but not that
13 you are withholding anything --
14 A I am not withholding anything.
15 Q No, I know that. Depression is very common; is
16 it not?
17 A Yes.
18 Q So we are sitting here trying to say how much
19 chance is this happening again. And we are hearing you
20 say very low possibility. I'm trying to weigh all these
21 things and get some kind of a balance.

22 A I understand. If he were -- if he weren't six
23 hours away, I would say, I want you to go get a full
24 medical workup. I want you to go get a neurologist to
25 check all that stuff out. I'd go get psychological
0160
1 testing by somebody that I use to find out what's going on
2 and then treat him accordingly. That's --
3 FURTHER EXAMINATION
4 BY DR. CROCKER:
5 Q And in the meantime, while that's going on and
6 you needed a cardiac echo and Dr. Szumlas showed up, would
7 you let him do the cardiac echo?
8 A Absolutely. I think he's probably better
9 qualified than a lot of people to do it.
10 EXAMINATION
11 BY MS. LESHIKAR:
12 Q But, Doctor, we don't know for sure what prompted
13 this. We can speculate that it was --
14 A Sure.
15 Q -- a variety of things. We don't know exactly
16 whether -- we can't predict in the future whether it's
17 going to happen again --
18 A Sure.
19 Q -- since we can't identify what caused it in the
20 first place. But all we know so far is that he was very
21 responsive once he got Risperdal?
22 A Correct.
23 Q That's about all we know for sure?
24 A He responded quickly, correct, and didn't argue,
25 fight or whatever about getting help.
0161
1 MR. BAUCOM: I had one other question.
2 FURTHER EXAMINATION
3 BY MR. BAUCOM:
4 Q You did characterize his experience with some
5 term, and I can't remember exactly how you said it. But
6 you used a term which made it sound as if it had been a
7 mild experience; is that correct?
8 A He had a psychotic experience. It was a

9 relatively --
10 Q It was nonviolent, we understand that.
11 A Yeah. And didn't really hurt anybody or himself
12 other than he called because he was concerned about what
13 was going on in the community.
14 Q I'm a public member of the Board and you have to
15 understand that when I ask questions, I'm thinking, how
16 does the public view this kind of activity, this behavior?
17 Would they be confident with this man as a physician
18 practicing medicine in Texas? That's -- I'm asking a
19 medical doctor to --
20 A I understand it completely. I come from a family
21 of doctors. I understand. My father was -- whatever. So
22 I am concerned about how people view doctors as well. I
23 am concerned about being here. I wouldn't be here -- he
24 didn't ask me the question, but I don't do stuff if I
25 don't believe in it.
0162
1 I'm far enough along in my life that it's

2 not worth it to me for any reason. He's a well-trained,
3 well-qualified guy. And as the doctor said, he's probably
4 better at reading stuff, cardiographs and cardiac stuff,
5 than probably 80 percent of the people that we are all
6 going to go see. I believe that.
7 I think just from his background and
8 training, even if he becomes delusional again, which I
9 don't think will happen on medication, he's learned not to
10 tell anybody that. But in terms of, you know, we all see
11 physicians who have lots of issues. You are here
12 primarily for practice issues, not this kind of thing.
13 I don't think it's a problem. If you said
14 to me, should he be flying an airplane with 380 people on
15 it as the chief pilot from here to over the ocean, I would
16 say, I do all the tests we talked about and I would follow
17 him for six months, every month, to see what he's like.
18 They won't let pilots do it on medication,
19 but that's -- but what he does is essentially intellectual
20 observation, intellectual type of medicine. In a way,
21 it's even safer than a psychiatrist. If you see a

22 psychiatrist who's out there, that's -- he starts telling
23 you how to live your life, that's a problem.
24 I don't know that that totally answers your
25 question.
0163
1 Q It helps. Why do you think he didn't go to
2 professional help to begin with when he realized he was
3 having these very difficult problems?
4 A I don't think that he knew it was a delusion.
5 What he told me was, a couple times he put earplugs in and
6 the noise went down, so he thought there really were
7 people out there in the beginning. And that's sort of
8 what started it. I mean, I think if he thought this is
9 out there, he would have gone.
11 questions?
12 MS. SOUTHARD: I didn't understand his last
13 comment. If he thought they were out there, what?
14 MS. LESHIKAR: He would have gone to -- he

15 really thought that people were out there. If he had
16 thought that they were a delusion, he probably would have
17 sought help.
18 THE WITNESS: That's what I meant. Had he
19 known it was delusional or a hallucination, I believe he
20 would have gone to somebody and said, this isn't right.
21 I'm having a problem.
22 EXAMINATION
23 BY MS. SOUTHARD:
24 Q Yet he believed they were there?
25 A Yes.
0164
1 Q And you believe that he just needs a complete
2 health checkup and needs some psychological testing, and
3 you think that's going to take care of that?
4 A I think he should stay on the medication, that's
5 what I really think. I think it would be worth having a
6 full medical checkup and the testing, if that would be
7 indicated -- you know, testing. I don't know that it will
8 show anything at this point.

9 Q You said he was too young to have these symptoms.
10 Again, that indicates some serious problems; don't you
11 agree?
12 A I missed the question. I'm sorry. He was having
13 what?
14 Q To quote you, you said, he was too young to have
15 these symptoms. Don't you agree that indicates some
16 serious issues?
17 A I don't believe I said that.
18 Q I believe that's exactly what I wrote down. You
19 said he moved frequently and he's a terribly compliant
20 guy.
21 MS. LESHIKAR: I think what Dr. Glass said,
22 Ms. Southard, was that it was unusual for someone this
23 young with no prior history to have these kind of breaks.
24 MS. SOUTHARD: That's pretty much what I
25 thought I was saying.
0165
1 THE WITNESS: That's what I said. It is

2 unusual but it's not unique. It happens.
3 Q (By MS. SOUTHARD) We are concerned about it
4 happening to a doctor that takes care of citizens in
5 Texas.
6 A I am too.
7 MS. LESHIKAR: Panel, any other questions?
8 MR. BAUCOM: No.
9 MS. LESHIKAR: Mr. Leichter, here is the
10 deal. The staff is essentially, for a variety of reasons,
11 effectively cut off from continuing what they are entitled
12 to, which is a full opportunity to cross Dr. Glass. So I
13 understand he needs to be at the -- he needs to catch an
14 airplane.
15 Are you flying to Houston and then --
16 THE WITNESS: No, I'm driving to Houston.
17 That's the problem.
18 MS. LESHIKAR: I think what we are going to
19 have to do is we are going to have to have him on the
20 phone to allow the staff to cross-examine him to the
21 extent that they are entitled to. And so I don't know how
22 you are going to arrange this, but that is what needs to
23 be done.
24 MR. LEICHTER: Can they call you?
25 THE WITNESS: I am glad to call you or you
0166
1 can call me in ten minutes. I will be in my car. I have
2 a phone jack, a car jack and earphones.
4 MS. SOUTHARD: Do you need to have lunch?
5 MS. LESHIKAR: I have given up on lunch. I
6 think what we are going to do is we are going to recess
7 for about 20 minutes. We are going to have Dr. Glass -- I
8 want you to get a number from Mr. Freshour or someone to
9 call in so that we will be able to talk with you and
10 continue the cross-examination that the Panel is entitled
11 to.
12 And certainly to the extent that none of the
13 Panel gets to see his demeanor, et cetera, et cetera, we
14 will note that as well, Mr. Leichter. Since you were so

15 careful to note the fact the Panel wouldn't get to see the
16 demeanor of the staff witnesses, we will have to note that
17 the Panel will not get to see the demeanor of the expert
18 on the rest of his testimony.
19 So if you will get a number to call in, sir,
20 we will then continue your cross-examination. You will
21 obviously still be under oath. And we will proceed from
22 there.
23 MR. PALAZOLA: Can we make available to him
24 some of the exhibits that have been admitted today that
25 were not part of the original record?
0167
1 MS. LESHIKAR: Certainly.
2 MR. PALAZOLA: We will get to those to you
3 just as quickly as we can.
4 MS. LESHIKAR: Yes, before he leaves.
5 MR. BAUCOM: You are not going to have him
6 driving down the highway.
7 THE WITNESS: Show them to me.
8 MR. PALAZOLA: I have six of the eight.

9 MR. LEICHTER: Do you want the photographs?
10 MS. KIRK: Yes.
11 MR. PALAZOLA: I will give you those. And
12 there was one e-mail. You can have that copy, if you
13 want. We can get another copy for Mr. Leichter.
14 MS. LESHIKAR: All right. We are going to
15 go off the record for 20 minutes. We will resume at about
16 2:35.
17 (Off the record from 2:07 p.m. to 2:36 p.m.)
18 MS. LESHIKAR: The witness is still sworn
19 and now you can actually finish your cross.
20 CONTINUED CROSS-EXAMINATION
21 BY MR. PALAZOLA:
22 Q Doctor, can you hear me okay?
23 A Fine. Sure. Can you hear me?
24 Q Yes. Doctor, your report is dated April 18th,
25 2011; is that right?
0168
1 A Yes.
2 Q And it was based on the information you had as of
3 that date that you wrote the report, correct?
4 A That is correct. Well, that's when I did it. I
5 finalized it on the 19th. That's the date that's on it,
6 correct.
7 Q And as a treating psychiatrist, if you receive
8 new information, that can always mean your opinion can
9 change; is that true?
10 A Absolutely.
11 Q Now, I was starting to ask you about your report
12 and some of the details in your report before we had to
13 take a break. Let me get back to my notes here.
14 Now, in your report, and I'm looking at the
15 page. I'm going to have to read it to you because
16 obviously you are now driving down the road.
17 A I'm not reading well at the moment, yes.
18 Q I'm going to be on -- I'm on Page 3 of your
19 report, which is going to be --
20 MR. PALAZOLA: I'm not sure where it is in
21 your LaserFische file. This is Dr. Glass' report.

22 Q (BY MR. PALAZOLA) I'm assuming you are getting
23 this information from Dr. Szumlas. If that assumption is
24 wrong, I'm sure you will correct me. But this appears to
25 be based on your examination of him.
0169
1 It says, the report from the police
2 department said he had covered the house with aluminum
3 foil and thought there were aliens in his head, but he now
4 denies this was the case and felt the police had
5 embellished that in their report. Do you recall that
6 being a part of your report?
7 A Yes, I do.
8 Q And do you recall Dr. Szumlas denying that he had
9 these things in his apartment?
10 A No, he said that he had shielding. He said the
11 whole place wasn't covered. And he wasn't wearing an
12 aluminum hat.
13 Q Had you had an opportunity to review the photos
14 of Dr. Szumlas's apartment at the time you wrote this

15 report?
16 A No, I had not.
17 Q You would agree that there was a foil-like, I
18 guess that's the best way to describe it, substance in the
19 photos that you were provided today?
20 A Yes.
21 Q And do you remember in the pictures where that
22 foil was?
23 A One of them was by his pillow, I think. And one
24 of them looked like it was on the stairs or something. I
25 couldn't tell what that was.
0170
1 Q Was it possible this was the headboard of a bed?
2 A Could be. Yeah, that's possible certainly, yes.
3 Q And you were shown other pictures of different
4 radio-type devices with multiple antennas?
5 A Correct. Yeah, I saw those. One of them was on
6 an ironing board.
7 Q And I believe your testimony earlier this morning
8 was that when Mr. Leichter asked you if his condition had
9 resolved, his psychotic episode had resolved, and you
10 said, yes, with medication; is that an accurate statement
11 of your testimony?
12 A Yes, it is.
13 Q If I were to represent to you that Dr. Szumlas
14 has sent e-mails to the Medical Board indicating that
15 among other -- indicating -- I'll be specific here, that
16 given the police reports in this case that you might be
17 led to believe that they were in on it. Is that a
18 statement of somebody who may possibly still be having a
19 psychotic episode, Doctor?
20 A It depends when the report came. I mean, if you
21 go in his pocket and he has a radar device like the one
22 you showed me, I would say, hey, he's not fully treated at
23 this time, and I would increase the medication. If the
24 letter -- what's the date on the letter that says the
25 Board is in on it with the police or vice versa? Before
0171
1 he got out of the hospital or after?

2 Q I should have told you that before. It was April
3 1st, 2011, after his discharge.
4 A By how many days?
5 Q By two days.
6 A You know, I don't know. I think that --
7 Q Doctor, let me ask you this: Did you have an
8 opportunity to review the records, the MHMR records, from
9 Lake County?
10 A Yes, I did.
11 Q Do you recall reviewing a note in there where Dr.
12 Szumlas indicated that it was a fact that he had been
13 assaulted with audio weaponry?
14 A He told that to the people there, yes.
15 Q And that was also after he was discharged from
16 the State Hospital?
17 A That's true, yes. But they also say in there
18 that he's doing well. He's compliant. And all four or
19 five of them, I don't have them in front of me, but all
20 four of five of them basically he's compliant, he's doing
21 what he should be doing.

22 Q And, Doctor, your testimony is also that he's
23 compliant, correct?
24 A Yes.
25 Q Who provided his latest prescription for
0172
1 Risperdal?
2 A I did.
3 Q Do you know who Dr. Szumlas' treating physician
4 is?
5 A At this time?
6 Q Yes.
7 A I believe he was discharged from the hospital and
8 was told to go to his family physician. No, I do not
9 know. I don't know that he has a family physician in
10 Paris, Texas.
11 Q But you do know that he came to you to prescribe
12 him Risperdal?
13 A He didn't come to me for that purpose. He came
14 to me for the evaluation. And he said, I'm almost out.

15 Will you fill this prescription for me while I'm here; it
16 will save me from going to somebody else. And I said,
17 yes, sure.
18 Q And you are recommending in your report that he
19 receive psychiatric treatment on a weekly, perhaps twice
20 weekly basis; is that accurate?
21 A Weekly or every other weekly. Biweekly, I
22 thought, meant every other week, I think is what I said.
23 Again, I apologize. I don't have it in front of me. I
24 don't think he needs to go twice a week. But I think
25 going once a week or every couple of weeks would be
0173
1 helpful.
2 Q Did you review the reports of Dr. Messer from the
3 Terrell State Hospital?
4 A Yes, I believe so. It's all part of that
5 hospital record, yes.
6 Q Dr. Messer's note indicated that Dr. Szumlas was
7 suffering from persecutorial hallucinations. What does
8 that term mean to you?

9 A Paranoid, suspicious, delusional stuff. People
10 are after him or persecuting him. That's what it says.
11 That's what he said. People were -- the waves, the voices
12 all were talking about swear words. I saw the part about
13 kill them or bad stuff messed up your life. All that's in
14 there. That's what you had me read earlier.
15 Q And you would agree that he was characterized in
16 those records as being committed to his delusions?
17 A At the time, yes. That's why they committed. He
18 believed his delusions, that's what committed to delusions
19 means. That's why he was committed to the hospital also,
20 because he believed the delusions. That's why Dr. Holmes
21 originally filled out the commitment papers on him. Sure.
22 I'm in agreement with that, yes.
23 Q And you would agree that he was the subject of an
24 emergency detention order? In other words, he did not
25 seek treatment on his own; he was brought to treatment so
0174
1 to speak?
2 A Yes, true. But you know, he went along with it.
3 I have seen numerous instances where --
4 MR. PALAZOLA: I would object to the
5 nonresponsive portion.
6 Q (BY MR. PALAZOLA) I think we have answered the
7 question that I asked you, Doctor.
8 MS. LESHIKAR: Sustained.
9 Q (BY MR. PALAZOLA) And your recommendations for
10 treatment would be that his medication regimen be
11 monitored and that he receive regular psychiatric
12 treatment or psychological treatment; is that accurate?
13 A That's accurate. That is correct.
14 Q I think your words were that he needs to be --
15 his treatment should be monitored?
16 A There are two pieces to it. He should be seeing
17 somebody for therapy and medication. That's true. But
18 monitoring, it's not as if he's a predator who needs to be
19 monitored by somebody or else he gets thrown back in the
20 slammer. That was not at all what I intended. The idea
21 he's on medication and to continue is one piece.

22 The other piece was I said when he goes back
23 to practice, I think it would be helpful to have someone
24 monitor or mentor him. That's the monitoring piece that I
25 intended to -- that's how I meant it.
0175
1 Q One minute to review any notes here, Doctor.
2 MR. PALAZOLA: I'll pass the witness at this
3 time.
4 MS. LESHIKAR: Any redirect, Mr. Leichter?
6 BY MR. LEICHTER:
7 Q Dr. Glass, do you have an opinion as to whether
8 or not Dr. Szumlas would continue to seek psychiatric
9 treatment and continue to take his medication if he
10 weren't ordered to do so?
11 A Yes.
13 A I think he would continue to do it. He's
14 uncomfortable. People who are -- who have those kinds of

15 delusions and hallucinations, it's frightening. That's
16 why he didn't argue when they put him in there. That's
17 why he's glad he had the medication. It's a relief for
18 him not to have that stuff going on.
19 Q And do you have that opinion to a reasonable
21 A Yes.
22 Q One thing, Dr. Glass. Dr. Szumlas never reported
23 alien activity to you or any of the records at Terrell
24 Hospital so indicate that; is that accurate?
25 A Can you re-ask the question again, please.
0176
1 Q Yes. The questions posed to you by the staff's
2 attorney are related to a statement that Dr. Szumlas made.
3 Are you aware of that?
4 A About aliens in his head, yes. That they did the
5 commitment the next day, correct.
6 Q If you were to be told that Dr. Szumlas wasn't
7 stating that he had delusions, just that the delusions
8 didn't involve aliens, would that change your opinion

9 about what the basis or reasoning for his statement was?
10 A No. Whether there were pink people, purple
11 people or college kids who didn't like folks from Chicago
12 and were swearing outside his house, they are all
13 delusions. They are all paranoid auditory hallucinations,
14 delusions.
15 I don't think it really matters what the
16 content are as much as they are not command delusions or
17 hallucinations that tell him, hey, go do this; or, hey, go
18 do that, which would be something much more upsetting.
19 And he's never had those.
20 Q I guess what I was getting at is Dr. Szumlas has
21 tried to direct his treaters as to what the delusions
22 were. And that statement is just an effort by him to help
23 people who are reading the material understand that that
24 wasn't one of the delusions. It didn't involve aliens.
25 It just involved what he thought was surveillance
0177
1 equipment. Does that make sense to you?

2 A Yes. I mean, you know, sure.
3 Q Let me get back to this question. In your
4 opinion, does Dr. Szumlas, if he were return to the
5 practice of medicine, pose a threat to the public
6 interest?
7 A No. I think the fact that something happened,
8 and it's weird sounding, is upsetting to the nonmedical
9 people on the Board. Here is a guy that is having these
10 wild crazy things, so we let him lose. Obviously, the
11 State Hospital wasn't concerned because they let him
12 loose. They put him on medicine; they let him loose.
13 The question is, can he practice medicine,
14 doing his specialty without them? The answer is yes.
15 Were you to ask me a different question which is, could he
16 practice medicine even with them? I would say, probably
17 for what he does, yeah; it wouldn't interfere. If he can
18 pass two board tests. You know, from the Board status, he
19 probably could read cardiograms and make reasonably good
20 medical decisions. That's a conflict free area of his
21 life, from what I can tell and from what everybody else --
22 everything I have looked at can tell.
23 Is he any different from the guys I see at
24 the criminal courthouse in Houston that walk around in
25 cowboy outfits like they are Buffalo Bill or Wild Bill
0178
1 Hickok, and they are criminal attorneys? That's a little
2 bizarre in 2011 for a guy from New Jersey. But they ain't
3 being picked up and stopped. So everybody is a little
4 eccentric.
5 Q Is it your opinion that if he continued to take
6 that medication, he should stay delusion free?
7 A Yes.
8 Q Can you assert that opinion to a reasonable
10 A Yes, I do.
12 MR. PALAZOLA: I have no further questions.
13 MS. LESHIKAR: Do you have any questions,
14 Panel?
15 MR. BAUCOM: No.
17 questions?
18 MS. SOUTHARD: I believe I have covered them
19 all before. Thank you.
20 MS. LESHIKAR: I have one question, Dr.
21 Glass.
22 EXAMINATION
23 BY MS. LESHIKAR:
24 Q Dr. Glass, is Nancy Leshikar. I wanted to ask
25 you: Is it not possible for people to compartmentalize
0179
1 such that when you are having a psychotic break, you are
2 having it in sort of one area of your existence, but you
3 do not necessarily have it in others, and that
4 periodically sometimes that compartmentalization breaks
5 down to where the psychotic break extends into other areas
6 of your life?
7 A Yes, sure that can happen. It does happen.
8 MS. LESHIKAR: Okay. Thank you very much.

9 All right. Dr. Glass, you are now --
10 THE WITNESS: But I would say that there was
11 no evidence, from what I could see, that he has been
12 psychotic in the past and it has broken into a different
13 area. From what I could tell, there was no evidence that
14 he had been a long-term person with psychotic who
15 compartmentalized in one area but was able to function
16 professionally in another.
17 Q (BY MS. LESHIKAR) However, Dr. Glass, if the
18 evidence is correct that he indicated that he had had this
19 psychotic break that had extended for about five months,
20 is there anything that in your experience that's going to
21 tell you that it's either not going to happen in the
22 future or it could happen in the future or anything else?
23 I mean, he's had it for five months. Is just the fact
24 that he's had it for five months indicative of anything?
25 A Well, I would reframe the question. You know, I
0180
1 don't believe that he was having it everyday for five

2 months because, number one, he wouldn't study.
3 Number two, he only called three times in
4 five months. So therefore -- there clearly were periods
5 of time when, for whatever reason, he was sleeping better;
6 he was focusing on studies, maybe spent time on the phone
7 with his daughter. I don't know that that didn't happen.
8 It's like it did occur on those three times we know of and
9 perhaps days around that. That's really all I can find
10 out.
11 MS. LESHIKAR: Thank you, Dr. Glass. You
12 are now excused from your testimony. We appreciate your
13 time and your effort.
14 THE WITNESS: Again, I appreciate y'all
15 working with me. I'm very sorry. I didn't mean to give
16 Mr. Leichter difficulty or anybody else. I am doing the
17 best I can to -- after having five kids, juggling three
18 balls in the air at all times is not unusual for me.
19 Thank you.
21 MR. LEICHTER: We call Dr. Szumlas.

22 MS. LESHIKAR: Dr. Szumlas.
23 RICK SZUMLAS, M.D.,
0181
1 BY MR. LEICHTER:
2 Q Hi, Dr. Szumlas.
3 A Hi.
4 Q Could you introduce yourself to the court
5 reporter and the Panel by name, please.
6 A I'm Rick Szumlas. I'm a cardiologist that
7 recently has finished his practice in Paris, Texas.
8 Q And it's okay to be nervous today. Are you
9 nervous today?
10 A Yes, I have never been through this.
11 Q You are the star of the show, and I imagine they
12 want to hear you from. I'll try to answer all the
13 questions they have on direct examination with you, okay?
14 A Okay.
15 Q Do you understand why we are here today?
16 A Yes, I do.
17 Q And what's the purpose for our being here today?
18 A To evaluate if the suspension should continue or
19 if we can terminate it and allow me to practice
20 cardiology.
21 Q And you understand that you were committed to the
22 State Hospital?
23 A Yes, I do.
24 Q And why were you committed to the State Hospital?
25 A For psychiatric evaluation for possible illness.
0182
1 Q Do you think you have that illness?
2 A Yes, I had a psychotic disorder diagnosed.
3 Q And when did you come to the understanding that
4 you had had a psychotic episode?
5 A After treatment.
6 Q Was it during treatment or after the continuation
7 -- when you were discharged from the State Hospital?
8 A Pretty much after -- during the stay basically,

9 yeah.
10 Q And what did that awareness consist of? Can you
11 describe that for me.
12 A Well, not actually hearing any disturbances or
13 noises and actually feeling much more myself, I guess is a
14 good way to put it. I felt more clear minded at that
15 time.
16 Q Do you feel better?
17 A Yes, I do, yes.
18 Q About how long into the stay at the Terrell State
19 Hospital did you start to feel better?
20 A Probably after two to three days.
21 Q Did you continue to start to feel better
22 throughout the stay?
23 A Yes, I did.
24 Q You heard Dr. Glass' testimony; did you not?
25 A Yes, I did.
0183
1 Q Did it hurt your feelings?

2 A No, it didn't. I think his diagnosis was also
3 very similar to Dr. Messer's diagnosis. He had a little
4 bit more insight as far as what areas of my life that I
5 might try to improve.
6 Q Dr. Messer, you heard him testify as well; did
7 you not?
8 A Yes, I did.
9 Q I believe he said he's spent a couple of hours
10 with you in total; is that accurate?
11 A Yes, it was.
12 Q Did you spend more time with Dr. Glass or Dr.
13 Messer, in total?
14 A Probably Dr. Glass, I would think, yes.
15 Q At the time you were experiencing the delusions,
16 Doctor, did they seem real to you?
17 A I believe so. They did, yes.
18 Q Can you tell the Panel what the delusions were.
19 A Well, basically after I had heard a noise, I did
20 a little bit of researching on the Internet and I began to
21 explore the idea that it possibly was a cause from

22 possibly satellite harassment.
23 Q And do you understand that -- do you still
24 believe that to be the case today?
25 A No, I don't. I think I overindulged in that
0184
1 area.
2 Q Are you embarrassed about what happened or
3 ashamed about what happened?
4 A A little bit, but I'm glad that I actually got
5 help.
6 Q I am going to hand you -- I believe some other
7 witness characterized your house as being covered with
8 tinfoil; is that true?
9 A Not exaggerating. I don't need to exaggerate
10 anything.
11 Q I'm going to hand you these photos which were
12 marked as State's Exhibit something and entered into
13 evidence. There is four photos there.
14 MS. LESHIKAR: Here is another one I just

15 found.
16 Q (BY MR. LEICHTER) State's Exhibit 14, which was
17 admitted. There's eight photographs in there.
18 Dr. Szumlas, in those photographs, are any
19 of those photographs depicting your house covered with
20 tinfoil?
21 A No, they are not.
22 Q In fact, is there any tinfoil in any of those
23 photos?
24 A No, there is not.
25 Q What is in the photos?
0185
1 A Some electronic equipment that I had basically
2 read about on the Internet that would basically -- it's
3 there. It's advertised to protect against electronic
4 interference and surveillance.
5 Q And you realize -- in retrospect, what do you
6 think about this equipment now?
7 A I don't need it.
8 Q Have you put it away or thrown it out, or what

9 have you done with it?
10 A Pretty much, yeah. Just packed it away.
11 Q No tinfoil here?
12 A No.
13 Q There is on your pillow or it looks like --
14 A Shielding. Another recommendation that I
15 basically got through Internet pursuit.
16 Q Have you destroyed that?
17 A No, I haven't destroyed it. I guess it's just
18 like foam padding shielding with a silver coating to it.
19 Q Did you put it away? You no longer use it?
20 A It's packed away like my other things. I was in
21 the midst of moving.
22 Q Do you think you ever may need that equipment
23 again?
24 A I hope not. I hope not.
25 Q Are you compliant with your medication therapy,
0186
1 Doctor?
2 A Yes, I am.
3 Q When you say you hope not, I take it that's
4 because you hope that the delusions never return?
5 A Yes, I hope they don't, yes.
6 Q What were those delusions like for you, Doctor?
7 Was it painful, if you remember?
8 A As far as painful, at times it did appear to be
9 painful. A headache would be a good explanation for that.
10 Emotionally, I think that living with myself, I guess, in
11 the area probably contributed to it as Dr. Glass pointed
12 that out to me.
13 Q When you came to my office, we suggested you get
14 a whole bunch of medical records to help us and you in
15 your continuing care; is that correct?
16 A Yes.
17 Q We had you drive all over the place?
18 A Yes, you did.
19 Q Were you able to obtain all the records?
20 A Just about, yes.
21 Q And you know those are going to be used to give

22 to your subsequent treating providers, right?
23 A Yes.
24 Q Prior to your obtaining the prescription for
25 Risperdal from Dr. Glass, you had not run out of your
0187
1 refill, had you?
2 A No.
3 Q And you had plans to go see somebody else to get
4 that medication refilled?
5 A I didn't initially have an appointment to see Dr.
6 Glass, but we had already made plans for me to at least
7 get refill medications at the Agape Clinic until we could
8 decide which follow-up doctor that I was going to see.
9 There was plans to see another internist or a family
10 doctor and also a psychiatrist.
11 Q Are you embarrassed or ashamed to take this
12 medication?
13 A No, not really.
14 Q Have you had any side effects to the medication,

15 to your knowledge?
16 A No, not too bad. No, actually, I mean, noticing
17 some mild things but nothing that needs to be
18 discontinued.
19 Q If you did have side effects, would you stop
20 taking the medication?
21 A I would talk to the doctor ahead of time and talk
22 to them about that.
23 Q Would you discontinue the medication unilaterally
24 without talking to anybody?
25 A No, no, no.
0188
1 Q You are a physician. How important is it that
2 your patients follow your orders?
3 A Compliance is the best thing they can do.
4 Q Are you a complaint patient?
5 A Yes, I am. I am very compliant.
6 Q Why is that important, Doctor?
7 A For my safety, for my own health that I be
8 compliant, for other's health.

9 Q Let me ask you this: There was some testimony
10 that during this time from March of last year on, you had
11 been studying for two board examines; is that accurate?
12 A Yes.
13 Q What were the board exams you were studying for?
14 A Nuclear cardiology and also certification for
15 cardiac computed tomography.
16 Q And approximately how long did you study for each
17 of those respective examinations?
18 A For the -- basically at least for the entire
19 latter part of the six months. Pretty much equal between
20 the two.
21 Q Did you take the examinations?
22 A Yes, I did.
23 Q And how did you do?
24 A Did well. I got the certification and then I got
25 the -- passed the board exam.
0189
1 Q Doctor, there's been some issue made about some

2 statements that you made about aliens. Can you clarify
3 those for the Panel members?
4 A Never said anything about aliens. It was more of
5 delusional comments on military satellite surveillance,
6 nothing on aliens.
7 Q So were you causing the fact that aliens were
8 present, or were you saying, hey, you got your facts
9 wrong?
10 A Basically I was just trying to correct the
11 information. I can understand sometimes how silly stories
12 actually can get distorted sometimes but it never got that
13 distorted.
14 Q So you weren't causing the effect; you weren't
15 disputing that you had delusions, were you?
16 A No.
17 Q You were just saying, those weren't delusions I
18 had?
19 A No, I was just trying to make the record as
20 accurate as possible.
21 Q Did you ever sit in the car with tinfoil around

22 your head?
23 A No.
24 Q If no one orders you to go to treatment; no one
25 orders you to continue care with this psychiatrist, are
0190
1 you going to continue to go?
2 A Yes, because it actually -- it's already been
3 recommended to me and I felt very comfortable doing that.
4 I would probably seek Dr. Glass' recommendations and
5 follow up.
6 I feel very comfortable with the people that
7 I have identified with at Lakes Regional Medical Center,
8 and basically they are already in pursuit for finding me
9 referrals in case I relocate.
10 Q Doctor, have you ever had a patient complaint
11 filed against you at the Medical Board?
12 A No.
13 Q In Texas?
14 A No.
15 Q How about in Florida?
16 A No.
17 Q How about in Illinois?
18 A No.
19 Q You do have Illinois medical license, don't you?
20 A Yeah.
21 Q And you do have a Florida medical license?
22 A Yes, I do.
23 Q Have you practiced in all three states?
24 A Yes, sort of. More Florida, I think, than
25 Illinois.
0191
1 Q Have you been sued for a malpractice case?
2 A No.
3 Q Describe your practice to me, would you, Dr.
4 Szumlas. In general, what your goals are as far as being
5 a cardiologist?
6 A Yeah, I'm a noninvasive cardiologist. Basically
7 we do in-office consultations, talk to patients about
8 their heart disease, whether or not they have chest pain

9 or shortness of breath. And basically we do a lot of
10 testing, which a lot of people have become familiar with
11 treadmill exercise stress testing and echo ultrasounds.
12 And nowadays it's gotten to the point where it's
13 accelerated to nuclear cardiology and computed tomography.
14 Q Is that why you took the subspecialty board
15 certification exams?
16 A Yes, it is.
17 Q Have you ever had any experience like the
18 delusions that you have experienced from November on,
19 happen to you before?
20 A No, no. Not that I'm aware of, no. Not at all.
21 And I haven't had anybody complain about that at all. No.
22 Q Have you had any since you have discharged from
23 Terrell State Hospital?
24 A No, no.
25 Q Do you feel generally better?
0192
1 A Yes, I do.
2 Q You have heard some testimony today about your
3 general medical health and some of your abnormal lab
4 results or what are perceived as abnormal lab results.
5 Can you comment on some of those for the Panel's benefit.
6 A They are borderline, and it is certainly
7 something I am going to keep in mind. I did not see the
8 folate or B12 there, but I definitely will seek that as
9 far as looking to make sure that I'm not deficient in
10 folate or B12.
11 As far as the other one, the MCV, I don't
12 have any -- if my thyroid might have had relationship to
13 that at one point or possibly my total protein level is a
14 little bit on the low side at 6.2, I noted. So maybe that
15 might have some influence on the free T4 index. I'm not
16 an expert in the endocrine field, so I might in the future
17 actually get a little bit of input as far as that's
18 concerned.
19 Q Are you, based on all the evidence that you heard
20 today, are you going to seek an internal medicine
21 evaluation even if ordered to or not?

22 A I think I will. I think I will probably
23 investigate maybe a little bit more on the -- like I said,
24 on those particular laboratory issues that appear to be on
25 the borderline side of possibly could be maybe a sign that
0193
1 something needs to be changed.
2 Q Do you feel as though there is anything medically
3 wrong with you at this point in time other than the
4 auditory hallucinations you experienced?
5 A Yeah, I had a psychotic disorder and that's
6 basically why we are here, along with my other medical
7 diagnoses that are listed.
8 Q Have you been compliant with the other medication
9 therapies for the other Axis III illnesses that you have?
10 A Yes, I have. And they have done pretty well.
11 Q And those would include the hypothyroidism,
12 hypertension, hyperlipidemia, and Type 2 diabetes?
13 A Correct. I check my sugars just about daily and
14 they have been doing quite well.

15 Q Doctor, talk to me about the gun.
16 A You know, at the time when I started indulging in
17 these delusions of mine that basically I had some sort of
18 rational that said, I don't know what's going on so maybe
19 I needed to think about my personal safety. And so I
20 decided that that would be something that I would purchase
21 at that time just for home safety. And that's basically
22 the only reason it was purchased.
23 Q Did you even know how to fire a gun when you
24 purchased it?
25 A Yes, I know how to fire a gun. When I was
0194
1 younger, my dad took me hunting and we were able to fire
2 at least shotguns before. And I have had time to spend
3 with one of my friends a few years back and he taught me
4 actually how to shoot a pistol. I don't use guns myself
5 as far as a part of entertainment purpose, so.
6 Q The report from Dr. Glass and your discussions
7 with me indicated you may wish to relocate to Florida; is
8 that true?
9 A Yes, I have had a couple job duties. The job
10 market, like I said before, was actually slow last summer
11 and that's why I took advantage of the time to study for
12 the board examinations. And I have had a couple of job
13 openings or possibilities in the last couple weeks. There
14 may be some temporary spots that I might be able to fill
15 in the Tampa region. There is a temporary spot possibly
16 in Iowa, and right now those are the two that I'm looking
17 at.
18 Q And you realize this report that was with you for
19 temporary suspension hearing went to the national
20 partitioner data bank? You saw that report?
21 A Yes, I did.
22 Q And you also saw a letter from the Florida
23 Medical Board; did you not?
24 A Yes, I did.
25 Q And we were planning on discussing these issues
0195
1 with the Medical Board by correspondence from my office at

2 the end of today's hearing; were we not?
3 A Absolutely, just to make sure they know we are
4 trying to comply with their boards as much as we are
5 trying to comply here.
6 Q Did you try to contact the Physician Health
7 Program in the last several days after you contacted my
8 office?
9 A I did at one point, yes, I did.
10 Q And when was that, within the last week or so?
11 A Week or two weeks ago.
12 Q Who did you call?
13 A Lisa James, I believe was her name.
14 Q And what were you told by the Physician Health
15 Program?
16 A They didn't want to schedule me at this time.
17 Q Were you told you weren't eligible at that point
18 in time?
19 A Yeah, they needed to check for authorization.
20 Q From who?
21 A Mr. Jackson, I believe might have been his name,

22 the director.
23 Q And you haven't received a call back to date,
24 have you?
25 A No, I haven't.
0196
1 Q Doctor, if you started to, is there any reason
2 why you would discontinue your medication unilaterally?
3 A No.
4 Q If you started to hear a voice or have a
5 delusion, what would you do?
6 A I would make sure that I notified my physician.
7 Q Anything else?
8 A And seek his consultation as to what to do.
10 MS. LESHIKAR: All right. Before -- let me
11 give this to you to complete my set you borrowed from me.
12 MR. LEICHTER: Would you like it back?
13 MS. LESHIKAR: No, I'll get it later.
14 MR. LEICHTER: I'm going to give it back to

15 Ms. Leshikar. She can do as she will.
16 MS. LESHIKAR: All right. Who is going to
17 do the cross?
18 MS. KIRK: I will.
20 BY MS. KIRK:
21 Q My name is Claudia Kirk. As you understand, I
22 represent the Board.
23 A Yes.
24 Q Can you explain what this is I'm looking at,
25 Exhibit Number 14?
0197
1 A That's a personal radio device that basically is
2 advertised to block for any interference.
3 Q And how many of these did you have?
4 A That's the other one in the picture right there.
5 Q So you had two?
6 A Two.
7 Q Where was this located? It's hard to tell from
8 this picture.
9 A I think it's just charging, I think right there
10 on the counter.
11 Q It's not the same as this one?
12 A No, that's the other one.
13 Q So you actually had three?
14 A There's three there.
15 Q And you got those off the Internet?
16 A Yes, they sell them off the Internet.
17 Q And were they pretty expensive?
18 A Yeah, relatively, I guess, as far as electronic
19 equipment is concerned.
20 Q And you say you don't need them anymore?
21 A Correct.
22 Q But you only packed them away; you didn't
23 actually throw them away; is that correct?
24 A No, I didn't throw them away.
25 Q Did you also buy this knife during that time?
0198
1 A No, that's just -- I'm in the midst of packing

2 and relocating. And I packed most of my stuff to the
3 point of even almost silverware and I have only a few
4 things that are available to me to actually use.
5 Q But this is your knife?
6 A Yes.
7 Q And when the police came in, they found it on
8 your nightstand?
9 A Yes, they found it on my nightstand.
10 Q Did you purchase this or was this something you
11 had already from your kitchen?
12 A No, it was already in my kitchen.
13 Q But you did purchase this pistol?
14 A Yes, I did.
15 Q And it was loaded, according to the police?
16 A I take their word for it, that it was loaded.
17 Q And your psychiatrist -- well, not your
18 psychiatrist but the psychiatrist that was the expert for
19 your attorney, your case, seems to think that you don't
20 know how to shoot. But he would have only gotten that
21 information from you?

22 A I guess I can't really feel a good answer to that
23 question. I never told him I was a bad shot, I guess. I
24 never told him I was a good shot actually. So I don't
25 think we really indulged in the expertise of gun use.
0199
1 Q But you do know how to shoot, right? You just
2 said?
3 A Yes, I do know how to shoot; and, yes, I have
4 shot a pistol in the past.
5 Q What was this? Can you describe?
6 A Phone shielding. Basically that's another
7 recommendation, more stories that actually listening on
8 the Internet and -- not listening, but actually reading
9 off the Internet for people with these types of complaints
10 that's basically what they recommend, shielding.
11 Q Was this was kept in your pillowcase of your
12 head?
13 A Yeah, it's just a foam shield.
14 Q And this was tied to your headboard; is that

15 correct?
16 A Yes, it is.
17 Q And can we presume that you rolled it over your
18 head?
19 A Just rolled it down along the wall.
20 Q To protect your head?
21 A Yeah.
22 Q Since being discharged you were sent to get all
23 your records. Did you get your primary care physician
24 records?
25 A I actually called the office, and they actually
0200
1 are sending me my laboratory results. I also had some
2 laboratory results there, so I'm expecting to have those.
3 And I'm expecting to get some -- also some additional
4 refill medications within the next couple of days.
5 Q When did you see that? What's your doctor's
6 name?
7 A Alam Safdar. It's not an easy one. I have to
8 constantly look at his card. Alam Safdar, S-a-f-d-a-r,

9 Alam, A-l-a-m. He was -- basically, I had seen him after
10 good advise from my brother, who I had seen probably two
11 months ago now.
12 Q You saw the doctor two months ago?
13 A Yeah.
14 Q Have you seen him since you were discharged?
15 A No, I haven't been back. He's in South Carolina.
16 Q Your doctor is in South Carolina?
17 A Yes, he is.
18 Q Your primary care physician?
19 A That's where I actually was on the initial --
20 when I initially saw him, I was actually at my brother's
21 house.
22 Q And your primary care physician examined you.
23 You had all these delusions and he didn't tell you to do
24 anything?
25 A No. Basically, I did not alarm him with that
0201
1 concern at this time. I was basically seeing him for the

2 hypothyroidism and the diabetes and the blood pressure and
3 cholesterol.
4 Q And you didn't discuss any of these voices, this
5 pain that you were feeling, these --
6 A At that time, I did not feel comfortable, I
7 guess, enough to speak with him.
8 Q And when you went to the MHMR after discharge,
9 you told them that you were going to follow up with your
10 primary care physician to obtain prescriptions, and that
11 was on the 8th. Were you talking about Dr. Hassad
12 (phonetic), Hassan (phonetic)?
13 A I was contemplating actually using another doctor
14 that had seen me at the Paris Regional Medical Center.
15 He's an internist. And I understand he's actually pretty
16 good. So I was contemplating using him locally, the
17 internist that had seen me while I was at Paris Regional
18 Medical Center, or just calling Dr. Alam Safdar and
19 actually asking him for refill medications and give him an
20 update on my condition.
21 Q But you didn't see any of them since you were

22 discharged?
23 A No, we have been kind of pressured for time.
24 Like I said before, on this -- well, like other people
25 have mentioned before, on the 16th I was scheduled to go
0202
1 to the Agape Clinic for refill on the medications. And it
2 just so happened that that was the time that I was able to
3 go see Dr. Glass. So I ended up seeing Dr. Glass and he
4 prescribed the Risperdal. But I don't think that that's
5 going to be a problem for me to see an internist and
6 get -- continue with my follow-up care.
7 Q Going back. Before you went to South Carolina,
8 you weren't seeing any primary care physician, right? You
9 were not going to South Carolina every few months, were
10 you?
11 A No, actually no. Actually, I had not,
12 unfortunately, because my position had been terminated
13 already here in Paris, that I had not had the time to be
14 fortunate enough to actually have a primary care

15 physician.
16 Q So looking at your Terrell State Hospital
17 continuing of care record, it says you have hypertension;
18 you have diabetes, Type 2?
19 A Yes.
20 Q To follow up with your doctor and they had
21 prescribed medication. So were you treating that
22 yourself?
23 A I had at times. I admit that I refilled my
24 medications because I had not had the resources. But that
25 was only for the diabetes and the hypothyroidism and the
0203
1 hypertension.
2 Q And you were also provided a community -- it says
3 when you went to the MHMR -- I am looking at Page 23 of
4 Exhibit 13, with the addendum -- that you were provided a
5 community resource list for medication assistance. Was
6 that Agape?
7 A Yes, yes, that's the Agape referral that we were
8 planning on going to, and still do possibly. But as far

9 as the psychiatrist is concerned, I asked him about that.
10 They said at that time, Kim and Brandi basically said at
11 that time they did not have a psychiatrist referral. And
12 then after talking with my lawyer, basically we decided it
13 was a good idea to actually have another opinion and
14 psychiatrist involved with long-term care.
15 Q And what date was that conversation?
16 A Oh, I think -- I couldn't actually recall how
17 long I've been talking with Mr. Leichter, but it's been
18 for couple weeks now.
19 Q So it was really Mr. Leichter who put you in
20 contact with the psychiatrist?
21 A No, I basically would have had to pursue a
22 psychiatrist eventually. I was surprised, as Brandi and
23 Kim stated previously, I had asked and requested to
24 actually see a psychiatrist. And they said they could not
25 provide one for me at that clinic. So I basically knew
0204
1 that I would need to do that in the future for myself in

2 order to continue the medications.
3 Q And up to that point, you just had not contacted
4 anybody?
5 A I realized at that point that I needed -- that I
6 was going to need to contact someone. And I contemplated
7 actually even calling Dr. Messer back up and seeing if he
8 possibly would be able to provide me with referrals.
9 After speaking with Mr. Leichter, that he had plenty of
10 referrals for me, so I felt that was a good
11 recommendation.
12 Q And after your discharge, you found out the Board
13 had taken action against your license and you e-mailed
14 somebody at the Board and eventually that communication
15 came to me; is that correct?
16 A I believe, yes. I believe so. I believe I was
17 notified, yes.
18 Q And in one of those e-mails you say that you said
19 you were recommended by Lee Hopper, and you explained the
20 situation. And you say that you were a victim of audio
21 harassment in my home that led to a diagnosis of psychotic

22 disorder; is that correct?
23 A I was trying to attempt to summarize for them,
24 yes, why I had not been able to promptly -- as I was in
25 the hospital, I did not have communication with my e-mail
0205
1 or my phone messages.
2 And when I was released, I felt actually a
3 little bit guilty myself personally that I had not been
4 able to respond in time. That way I was summarizing --
5 attempting to summarize what had occurred.
6 Q And you also say, I'm continuing treatment at
7 Lakes Regional Medical Center. But there really was no
8 treatment; it was just a referral service?
9 A We had stayed on the same treatment plan and they
10 were monitoring my treatment plan. I didn't understand
11 exactly how that was actually going to be completed at
12 that time.
13 Q And then you also send me an e-mail the next day,
14 on April 1st, where you had read part of the sheriff's

15 department report. And you say in your e-mail, and I
16 quote, the sheriff's department told the Board that I had
17 called and said the aliens were invading my head while I
18 was in my apartment and I went outside and sat in my car
19 with tinfoil over me head to block the rays, quote,
20 unquote, which is a total fabrication and suggests to me
21 possibly some guilt or involvement, question mark, on
22 their part, question mark. That sounds like you think the
23 police is involved; is that correct?
24 A No, actually that comment basically is just my
25 attempt to tell you that it was inaccurate. It was
0206
1 definitely an inaccurate statement. I never mentioned
2 anything about aliens or tinfoil.
3 Q I understand that from the first part of the
4 e-mail. But what about the second part, possibly some
5 guilt or involvement, question mark, on their part?
6 A Well, maybe the question mark said that I really
7 didn't know. I had no idea.
8 Q But can you agree with me that's consistent with

9 some of your earlier remarks about the military, the FDA,
10 the other government agencies?
11 A I can see --
12 Q What you said to the police?
13 A I can see that you are feeling that maybe this is
14 a partial or a leak of possibly a delusion. Maybe it's
15 not a complete cure at this point, I guess, is maybe what
16 you are.
17 Q But can we agree it sounds consistent with those
18 previous statements?
19 A It sounds like I don't know. It really sounds
20 like I don't know.
22 THE WITNESS: When I sent it.
24 BY MR. LEICHTER:
25 Q Doctor, you discharged from the hospital on the
0207
1 31st; is that correct?

2 A Yes.
3 Q You contacted my office within a week of that; is
4 that correct?
5 A Just about, I believe.
6 Q And then you drove to Austin, six-and-a-half
7 hours to my office?
8 A Yes, I did.
9 Q And at that point in time, we discussed your care
10 and your continuing to go see another psychiatrist who
11 would evaluate you and help with treatment options; is
12 that right?
13 A Yes, I did.
14 Q And you hadn't run out of medication by that
15 time, had you?
16 A No.
17 Q Had you run out of any of your other medications,
18 your diabetes medications, your cholesterol medications?
19 A No.
20 Q So was there any pressing need for you to go see
21 your internist?
22 A Not right away, no.
23 Q But your medical license had been suspended?
24 A Yes.
25 Q Was that a pressing need?
0208
1 A Yes, that was very pressing, yes.
2 Q And through that process you sought medical care;
3 is that correct?
4 A Yes, I did with Dr. Glass, yes, and also follow
5 up.
6 Q And through that process, you refilled your
7 medication?
8 A Yes, I did.
9 Q You just testified that you discovered that Lakes
10 Regional Medical Center wasn't providing medical services
11 to you; is that correct?
12 A They -- upon the initial interview, they
13 explained exactly what they were to provide. And they
14 explained to me what was lacking and at least a start in

15 the right direction as far as seeking further referrals,
16 the Agape Clinic for an internist in town and possibly
17 that I would have to entertain a psychiatrist on my own.
18 Q Generally, Doctor, do you have a physical at
19 least once a year?
20 A Yes, actually it's usually provided with the
21 people that I work with. When I start a new job,
22 basically they usually offer and require a full physical
23 and they do the blood work and screening, blood tests.
24 Q And you have labs drawn at least once a year?
25 A Probably, yes.
0209
1 Q Doctor, did you continue to have delusions upon
2 your discharge from Terrell State Hospital?
3 A No, I don't think so. I think that my initial
4 incident and understanding has really dramatically
5 improved.
6 Q How do you distinguish the truth from the false
7 today?
8 A The absence of the noises that I have heard and

9 the understanding, with the help of the psychiatrist, how
10 basically delusions actually get formed.
11 Q Did you ever have these delusions while you were
12 at work?
13 A No, I guess with the help of Dr. Glass, he kind
14 of mentioned to me that the more activity and active that
15 I'm in, that basically that prevents me from indulging in
16 possibly things that are of the imagination or other
17 sorts, or other delusions.
18 Q Do you think if you were to return to work
19 tomorrow as a cardiologist, that you would pose a threat
20 to your patients?
21 A No, I don't.
22 Q Do you feel as though your clinical skills are up
23 to snuff, up to par?
24 A Yes, I do.
25 Q An that's indicated by the recent passing of the
0210
1 two exams, I guess, as well?

2 A More than that. There are a lot of things that I
3 entertain when that subject actually comes to view. Even
4 when it comes to supervision that basically I'm never
5 working alone. I'm always working with other physicians,
6 and I'm always getting their opinions as well as my own.
7 So I'm never really working by myself. I never have and
8 probably never will.
9 Q Elaborate on that for me. When you say you don't
10 work alone, you don't use your independent medical
11 judgment or you confer with your colleagues or how does
12 that work?
13 A Yes, I don't have an independent practice or a
14 private practice, and I never will. I will always be
15 working in a group setting where there is plenty of
16 support group and there is plenty of supervision.
17 Q Is that by choice?
18 A Sort of. It's a financial burden, I think, to be
19 able to have your own private practice.
20 Q And do you like discussing medicine with your
21 colleagues?
22 A Yes, I do. I enjoy it very much.
24 MS. LESHIKAR: Any recross?
25 MS. KIRK: I do.
0211
2 BY MS. KIRK:
3 Q You stated in your earlier testimony that you
4 hadn't worked since June of 2010 in a clinical setting; is
5 that correct?
6 A Correct.
7 Q And your symptoms started in November of 2010?
8 A Yes.
9 Q So you don't know if you had delusions at work,
10 right, because you haven't been at work?
11 A Well, I didn't have those thoughts.
12 Q And as far as when you were having the delusions,
13 you didn't know because you had them for six months and
14 you didn't know to call a doctor at that time or you

15 didn't call a doctor?
16 A No, I didn't call a doctor. I asked for help,
17 but I didn't particularly call a doctor on that.
18 Q You even went to a doctor at that time and you
19 didn't tell him at that time even?
20 A I was hesitant. That was true, I guess.
21 Q So there is no -- you could have one again and
22 there is no -- like you couldn't know that you would know
23 to call a doctor if it happens?
24 A No, I think since I have identified what the
25 problem, that I feel comfortable actually talking about
0212
1 it. That's the difference and that's where it helped.
2 Q But in a delusional state, can we agree you may
3 not know to feel comfortable to talk about it?
4 A No, I think the delusional state will come up in
5 my follow up with my doctor in my continuing participating
6 care; that we talk about different things and different
7 thoughts. And that, actually that's part of their job. I
8 think they know how to evaluate that and actually ask the
9 right questions in evaluations. Just like I'm a
10 cardiologist. When someone walks in and they ask me to
11 evaluate their heart, I know what to look for and I know
12 the questions to ask to actually pull out that disease.
15 BY MR. LEICHTER:
16 Q Doctor, you didn't know you were sick, did you,
17 when you were those having delusions? Did you understand
18 it was a psychiatric illness at that point in time?
19 A No, if I did, I would have sought treatment
20 earlier.
23 MS. LESHIKAR: Penal members?
24 EXAMINATION
25 BY MR. BAUCOM:
0213
1 Q You haven't worked since 2010?

2 A Yes.
3 Q Tell us what would you like to do. Would you
4 like to move back to Florida and practice medicine down
5 there? Is that your best plan?
6 A Yeah. You know, my daughter lives down in
7 Florida with my ex-wife. We have a wonderful
8 relationship. There is no -- any kind of relationship
9 issues to worry about there.
10 But it's a very competitive market as far as
11 cardiology is concerned. And I always, when I get the
12 chance to seek new job employment, I always check the
13 Tampa market to see if there is something available so I
14 can be a little bit closer to her. So that's usually my
15 first choice with regards to finding a cardiology
16 practice.
17 Q And you actually have a lead right now about
18 possible employment?
19 A Yeah, there's temporary jobs been opening up in
20 Tampa. And hopefully I'm going to find one. There's
21 definitely one in Florida that's open that they'd like for

22 me to entertain at this time. But it's really not in
23 Tampa. I'm going the try to get a little bit closer to
24 family.
25 Q I understand.
0214
1 MR. BAUCOM: That's all I had.
2 EXAMINATION
3 BY DR. CROCKER:
4 Q Which medications are you taking today for --
5 that are psychoactive?
6 A The Risperdal, the three milligrams.
7 Q No more Seroquil?
8 A No.
9 Q Are you taking any herbals?
10 A No.
11 Q Supplements of any kind?
12 A No. In fact, I have avoided those after being
13 discharged. I used to -- when I was active in working
14 out, pumping weights at the gym, which I haven't done in

15 the last year or so -- I might entertain doing something
16 like that, but.
17 Q Were you taking DHEA?
18 A Yes, that's a supplement that I've been using,
19 yes. That's the supplement that I use maybe for improved
20 blood sugar control.
21 Q You know it's been linked to psychotic thinking?
22 A No, I have not.
23 Q I would throw that away.
24 A Okay.
25 DR. CROCKER: Side comment.
0215
1 Q (BY DR. CROCKER) When you were occupied studying
2 for the two board examines that you passed and the
3 certification that you obtained, while you were involved
4 in doing what you needed to do to study, were you ever
5 bothered by intrusive delusions?
6 A Can you please repeat the question.
7 Q When you were occupied --
8 A Yes.
9 Q -- studying for the board exams and the
10 certification?
11 A I was usually doing pretty good, yes.
12 Q And how are you sleeping now?
13 A Very good now. Very good now.
14 Q And when you mentioned -- I think Mr. Leichter
15 asked you something about follow up and you said you
16 weren't an expert on T4, but you were going to investigate
17 that, what do you mean by that?
18 A Bring it up to my internist or family doctor and
19 say, hey, what do you think about this? It's elevated but
20 it's not really a total. Does it really have a lot of
21 clinical significance for you? When you told me about it,
22 it doesn't have a lot of clinical significance to me at
23 this point with regards to --
24 Q Free T4 is the preferred method of measuring
25 active thyroid now. And particularly in people who have a
0216
1 low or a high serum protein level, it is the only measure

2 that is not affected by serum protein.
3 So pick something good or see an
4 endocrinologist. I would be very surprised if that didn't
5 contribute to part of your problem. Your free T4 is 150
6 percent of the highest level that's acceptable. You are
7 probably getting too much thyroid. But don't mess with
8 anything until you see an endocrinologist.
9 A Dr. Messer didn't mention that abnormality to me,
10 so I didn't really know what to make of it, and I haven't
11 seen my laboratory evaluation until you mentioned it
12 actually here, only because the time restraint because of
13 the -- we have been trying to collect all the information
14 and give copies to everyone. So I definitely will seek
15 that. Thank you.
16 DR. CROCKER: I have no other questions.
18 questions?
19 EXAMINATION
20 BY MS. SOUTHARD:
21 Q I'm a public member. But I do -- your

22 psychiatrist or psychologist that we interviewed earlier,
23 he said that you were isolated up to six months. Explain
24 what he meant, or why -- were you isolated and how are you
25 creating that isolation, if you were?
0217
1 A I think he emphasized how that studying for the
2 board examinations and actually being up in a rural area
3 tended to enhance my isolation. I think I've been up in
4 the Paris area probably the longest as far as a rural area
5 without having any family members that are close by. And
6 the population is probably a little bit less dense, I
7 think, than most other areas that I have practiced in
8 before.
9 Q You had no doctors that you interacted with, no
10 guys playing golf, nothing like that?
11 A I keep myself active as much as possible. But
12 after talking with him, he kind of pointed out to me that
13 my activity level and my interaction level is probably on
14 the low side in comparison to other people.

15 Q Since your primary care doctor was in South
16 Carolina, how was he continuing to treat you and write
17 prescriptions for you if you were not able to see him
18 frequently?
19 A I haven't gone that far yet. I had seen him but
20 I have not discussed that with him. Again, right now if I
21 do relocate, I will also seek help from -- not only for
22 the psychiatric but actually for the medicine follow up as
23 well. I'll need to do that just as well and not just for
24 the psychiatric evaluation.
25 Q That will be difficult, will it not, if you move
0218
1 to Florida?
2 A No, not really. I don't think so. I've been
3 pretty used to getting referrals from a lot of other
4 physicians. I don't think it will be difficult at all to
5 get an internist referral.
6 MS. SOUTHARD: Thank you.
7 MS. LESHIKAR: Is there anything else?
8 MR. LEICHTER: No.

9 MS. LESHIKAR: Doctor, you are excused.
10 Thank you very much.
11 MR. LEICHTER: We rest.
12 MS. LESHIKAR: All right. The Respondent
13 has rested. Staff has rested. We are ready for closing
14 arguments.
15 And if you will recall, Mr. Leichter
16 reserved his opening for his closing so.
17 MR. LEICHTER: I did a brief opening, I
18 think I remember.
19 MS. LESHIKAR: That's right. It was very
20 brief. It was unlike you, I forgot.
21 MR. LEICHTER: I'm grateful for your
22 comments.
23 MS. LESHIKAR: Thank you. So it's time for
24 the staff to make your closing statement.
25 MR. PALAZOLA: I will be making the closing
0219
1 statement. And I would like to reserve three minutes.

3 MR. PALAZOLA: Panel, Dr. Szumlas is not
4 here because he violated boundaries with any patients or
5 because he has a drug or alcohol problem that's surfaced
6 anywhere in these records, and Board staff is not asking
7 that Dr. Szumlas be punished in any way. But we all need
8 to be mindful of the mission of this Board which is to
9 protect the public. And the primary consideration here is
10 whether there's a continuing threat to the public.
11 I think what we have heard from opposing
12 counsel is that, you know, while this is all hunky-dory
13 now, that's been the evidence we have heard from the other
14 side, that Dr. Glass' report which is now in evidence,
15 which we just got this afternoon says, well, he may have
16 heard some people swearing at him outside his apartment;
17 you know, the police may have exaggerated some of this.
18 And, you know, I think in testimony Dr. Glass referred to
19 this as just some eccentricities. This is all just a
20 bunch of ado about nothing.
21 But the Board staff would ask that the Panel

22 consider all the evidence in the packet and believes that
23 all of it is relevant, because there is evidence and
24 testimony that there is a possibility of relapse in this
25 case. We are talking about a few options here. That is
0220
1 keeping him suspended until we get an ISC and get him
2 under an order, if that's what that Panel decides to do
3 and the Board decides to do; or cutting him lose entirely
4 and dismissing this; or trying to fashion some sort of
5 restriction.
6 As we do that, we need to be mindful of what
7 the condition was that might relapse. And let's start
8 with the 911 logs from the Paris Police Department which,
9 you know, to hear Dr. Glass talk about it, this was a
10 brief episode. But these 911 calls go back to November of
11 2010.
12 The medical records talk about going back to
13 a playoff game with the Rangers, which would have been
14 likely October, close to November 2010 as well.

15 And these are not eccentricities. Nobody
16 could characterize them that honestly. This was an
17 individual who was calling 911 and making complaints that
18 he was being attacked by satellites, that the Food and
19 Drug Administration or the military or somebody else was
20 out trying to stalk him. He was fearful that he was going
21 to be attacked. This is all well documented in the
22 medical records, records that Dr. Glass pretty much just
23 glosses right on over in his report.
24 At some point in February, this was followed
25 up in a letter that really spelled out for us everything
0221
1 that Dr. Szumlas was feeling at that point in time, and
2 that letter is in evidence. I'm not going to take the
3 time to read it to you-all now, but it talks about being
4 assaulted with ultrasonic weaponry. It talks about the
5 military being involved in things like child pornography.
6 It talks about perverted criminals. That is part of the
7 complaint, which is I think Tab 4, and that would probably
8 be in the pages there.

9 To classify that as eccentricities, I don't
10 know if Dr. Glass didn't have enough time to review all of
11 this evidence or what the problem was, but that really is
12 an understatement in this case.
13 And the problem with the relapse issue is
14 that there are indicacies of noncompliance sprinkled all
15 over the evidence. Dr. Szumlas keeps telling everybody
16 what he's going to do. He's going to follow up with a
17 primary care physician. But the primary care physician
18 that he saw once several months ago happens to be in South
19 Carolina.
20 He's going to discuss a treatment regimen
21 for psychiatric care. And yet he's relying on the
22 psychiatrist that his attorney located and paid to write a
23 prescription for him. He says, I'm going to go to Agape
24 and get my medications. Well, he didn't do that.
25 He says, you know, I'm going to -- now he
0222
1 says, if these are physical problems, these are related to

2 physical medicine as been suggested possibly, he's been
3 self-treating several of his conditions, was the
4 testimony, diabetes and hypertension and the thyroid
5 issue. And it's, well, I'm going to go ahead and get that
6 followed up on too.
7 He's had time to drive all these hours to go
8 meet with his attorney, to go meet with Dr. Glass, but he
9 hasn't taken the time to make sure that his condition is
10 being properly treated.
11 We hear testimony that he's taking his
12 medication, but we really have no way to document that.
13 And that is the heart of the problem that is before this
14 Panel today. Because to cut him lose means there will be
15 no monitoring until there is an ISC.
16 Now, this is not about punitive. It is not
17 about punishing Dr. Szumlas. Perhaps Dr. Szumlas would be
18 better served by staying suspended until we can get him
19 under an order in which the Panel can make recommendations
20 to monitor.
21 And I would point out to the Panel, even his

22 own psychiatrist, Dr. Glass, says he needs weekly or
23 biweekly and he needs someone monitoring his medication
24 treatment. Well, Dr. Glass is not an expert on Medical
25 Board rules and Medical Practice Act. We are going to
0223
1 have to get an ISC to get to that point.
2 And to just cut him lose, we don't know what
3 the Panel is going to recommend at the ISC. We don't
4 whether Dr. Szumlas is going to accept it; whether it's
5 going to have to go to SOAH. We are just throwing this
6 out there in the black hole. I think there is a real
7 concern here as to whether that's even what's in the
8 Respondent's best interest, much less the best interest of
9 the public that we are charged with protecting.
10 Dr. Messer's reports are in evidence. I'm
11 obviously not going to read those either. But the March
12 24th, 2011 report is one that I would draw everybody's
13 attention to where Dr. Messer says, you know, this is an
14 individual who is very focused on discharge from this

15 hospital, who is minimizing his symptoms, who is trying to
16 give us an indication that these delusions are gone.
17 But -- and I would point out that's
18 consistent with what we see in Dr. Glass' summary. When
19 Dr. Glass meets with Dr. Szumlas, Dr. Szumlas tells him,
20 these are just folks standing outside my door saying swear
21 words at me. There is an effort again to minimize the
22 symptoms to get to where Dr. Szumlas wants us to go. But
23 there is no documentation of what Dr. Szumlas is doing to
24 make sure that he's getting treatment.
25 What there is in the evidence is
0224
1 indications, more indications, of noncompliance as well as
2 indications that perhaps there is still some problem here
3 and that he's writing letters, e-mails, to the Board in
4 which he's saying, I was a victim of audio harassment.
5 That was added to, I believe, Tab 7 in the correspondence
6 section.
7 He is still expressing on April 1st, two
8 days after discharge, after he's convinced Dr. Messer that

9 this is all over, that he is still having a problem, or
10 that he still believes he was the victim of audio
11 harassment.
12 He had a hard time, I think, my opinion,
13 explaining that he had done away with these -- this stuff
14 we see in the photos, the electronic equipment, the
15 padding. I think there is an indication that there still
16 could be an ongoing problem on top of the fact that there
17 is risk of a relapse going forward too.
18 Keep focussing on the fact he says, I'm
19 going to do this with my psychiatrist; I'm going to do
20 this; I'm going to do that. He hasn't done it. He's been
21 out of the hospital three weeks. Nothing is more
22 important, I would imagine, to a doctor who has been
23 suspended, than trying to get unsuspended.
24 But his focus has not been on finding a new
25 primary care physician, finding a treating psychiatrist,
0225
1 finding a reliable source for medication. The focus has

2 been on, how do I fight this. And I think that gives some
3 alarm as well.
4 Perhaps most concerning, these are described
5 as persecutorial hallucinations. Dr. Szumlas, in the
6 delusions, is convinced that certain elements are out to
7 get him, the FDA, the military. We don't need to talk
8 about aliens. It doesn't matter whether aliens come up in
9 this or not. We are talking about allegations that the
10 FDA, the military might be stalking him and attacking him.
11 And he has taken concrete actions. And I
12 would point out that the Board Rule 187.5(c) which says in
13 part, a threat to patients that is not merely abstract but
14 actual actions or inactions of physician. This is a
15 physician who did take actual actions. He went out and
16 purchased a firearm. He had it loaded. He had a knife on
17 his nightstand.
18 He has no history of violence. He may have
19 no intention of committing violence on anybody. But if
20 there is a risk of relapse and mental illness, there has
21 to be a concern of a threat. What if he were to mistake a

22 patient as an agent of one of these elements that's out to
23 get him. There are issues that are necessary to provide
24 protection.
25 In summary, the Board staff does believe
0226
1 that there is an ongoing and continuing threat. There is
2 ample evidence in the records of that.
3 And other than reserving my remaining time,
4 I would pass.
6 MR. LEICHTER: Thank you. The statute is
7 clear. The issue before this Panel today is whether or
8 not his continuation in practice represents an ongoing
9 threat to the public interest.
10 MS. SOUTHARD: Can you please speak up.
11 MR. LEICHTER: Sure. The statute is clear.
12 The only issue before this Panel today is whether or not
13 Dr. Szumlas's continuation of practice poses as threat to
14 the public interest, a threat to the health, safety and

15 welfare of the citizens of state of Texas.
16 Whether he should be on an order, what the
17 terms of that order should be is not before this Panel
18 today. The sole question, statutorily-mandated question,
19 that the Panel is forced to answer is the question before
20 it in 164.059. Does this doctor, if he was to return to
21 practice, constitute a continuing threat to the public
22 welfare. And that's it.
23 Whether or not he should be under an order,
24 have drug tests to make sure the Risperdal is in his
25 system, all those other factors are not before you. It is
0227
1 whether or not he's compliant. If he's to go out and
2 practice tomorrow, if he poses a threat to the public
3 interest.
4 With that, I would just like to comment a
5 little bit on the evidence. The whole evidentiary record
6 is chocked full of references and inferences that Dr.
7 Szumlas is nothing but a complying individual. Both of
8 the witnesses who spoke from Lakes Regional, I think it

9 was Ms. Smith and the other witness from that facility,
10 Walker, indicated that he had done what was asked of him,
11 that he had followed through, had been available, made
12 himself available for appointments and been available for
13 phone consults.
14 Dr. Glass testified he was a compliant
15 patient through his review of medical records and his
16 discussions with Dr. Szumlas. More important, Dr. Messer
17 indicated that his whole stay at the Terrell State
18 Hospital indicated that he was compliant with the nursing
19 staff, with the administrative staff, with the other
20 patients, with Dr. Messer, with all treatment
21 recommendations.
22 There is nothing in this record to indicate
23 Dr. Szumlas would be anything but compliant for the rest
24 of his life with respect to medication therapy, whatever
25 else he does. And that's who he is. He's a complaint
0228
1 person. I believe the record speaks to that.

2 You know, there is suggestions made by staff
3 that Dr. Szumlas hasn't done what was necessary in order
4 to take care of himself, to give him adequate self-care
5 since his discharge. He got out of the discharge on the
6 31st to find himself temporarily suspended. He lives
7 six-and-a-half hours from Austin. In that time, he's
8 driven here twice and he's driven to Houston, Texas, once.
9 He's driven to Terrell to get his medical records and
10 driven around the other areas to get his medical records,
11 only have to wait, come back, get releases filed, get the
12 medical records and have them returned to us.
13 He testified that he was going to go to the
14 Agape Clinic to get the medication refilled, but Dr. Glass
15 gave it to him instead. I don't know what a person is
16 supposed to do in the midst of all this ongoing events in
17 his life in 18 days, when they are required to sleep, when
18 they are required to give himself good self-care, which
19 means eating, resting, sleeping right and taking care of
20 himself, which is what he's indicated to do.
21 He has not minimized the episodes that

22 occurred in his life. He sat here and told you, I had a
23 psychotic break. I was delusional. What happened, I
24 realize now, wasn't real. I didn't seek treatment or call
25 somebody because I didn't know it wasn't real. I thought
0229
1 it was real. What's a person to do?
2 Now, armed with the knowledge that what
3 happened to him was a psychotic break, a little mental
4 illness, he knows what to do. He's testified he takes his
5 medication. He's going to continue to take his
6 medication. He's going to alert a primary care. He is
7 going to go seek an endocrinologist's advice regarding the
8 T4 levels as well as the testosterone suggestion of Dr.
9 Glass, and he's going to follow up with this.
10 He, as a physician, understands the nature
11 of compliance. He testified to that. And he said he's
12 going to do what's necessary.
13 Moreover, in that time, the 18 days since
14 he's been discharged, he's contacted the PHP, asked to be

15 involved. What else can he do? He's been under the care
16 of a psychiatrist, after he met with Dr. Glass and he
17 said, I will follow through with any other recommendations
18 you have.
19 I understand this Panel may think an order
20 is appropriate. That is not the question before you
21 today. The question is, does he pose an ongoing and
22 imminent threat to the public, is really the question this
23 Panel has to ask. And if this Panel goes on to
24 deliberating to impose some kind of effort to temporarily
25 suspend him when the records suggest otherwise, that's
0230
1 going beyond the scope of what this statute authorizes you
2 to do in this instance.
3 Dr. Messer testified that Respondent, Dr.
4 Szumlas, was -- had stopped having the auditory
5 hallucinations and that he thought he did not pose a risk
6 to himself or a risk to the public upon discharge.
7 He also didn't make a note in the medical
8 record that he shouldn't continue to return to the

9 practice of medicine. He also, when he testified, said
10 that Dr. Szumlas continues to improve if he takes his
11 medication and he should follow through with a
12 psychiatrist, which is what he did.
13 Within two weeks of discharge, he saw Dr.
14 Glass. Paid him $5,000, yes, to testify here but also to
15 seek good recommendations and referrals and follow through
16 with it.
17 Dr. Szumlas is a man who wants to comply
18 with the statute, with the rules, with everything that
19 surrounds his practice of medicine and provide good safe
20 patient care. That's why he got the certifications in
21 both the computerized tomography and the nuclear medicine.
22 You know, again, Dr. Szumlas was very frank.
23 Yes, I had a psychotic break; but, no, I didn't wrap
24 tinfoil around my apartment. And I think the evidence
25 shows there was no tinfoil around the apartment. And,
0231
1 yes, he acknowledged the severity of that. But he said

2 factually that was inaccurate. I want you to understand
3 this is what I did.
4 And I believe the State's own evidence
5 indicates that what he did was put shielding around his
6 pillow, put shielding over his bed. And he admits to
7 that. He's not proud of what happened. He understands
8 that what he was experiencing at the time wasn't real.
9 He's made very clear statements to you that if he starts
10 to have those feelings against, he will contact his
11 doctor, contact primary care doctor, contact somebody to
12 make sure he gets the appropriate care that he needs.
13 You know, staff suggests that there is a
14 possibility of relapse. We indicate to you that a
15 possibility of relapse is not enough to continue the
16 suspension under the statute.
17 Anybody who takes medication is prone to
18 risk of a relapse if they cease the continuation of that
19 medication. Someone with high blood pressure, if they
20 stop their high blood pressure medicine, can spike their
21 blood pressure again. That's what happens when you stop

22 taking the medication.
23 No record, no evidentiary piece of documents
24 in the evidence, in the evidentiary record indicate Dr.
25 Szumlas is going to stop taking the medication.
0232
1 The possibility of relapse is not enough
2 under this statute to continue the suspension.
3 The last medical doctor who interviewed Dr.
4 Szumlas was Dr. Messer, and he wrote that discharge
5 summary which, I believe, was signed and dated sometime in
6 early April. That own statement, on it's very face,
7 indicates Dr. Szumlas did not pose a threat to the public
8 interest, and as such was fit for release from that
9 institution. I ask that you look at that discharge record
10 carefully in making your decision.
11 In essence, our position is that staff has
12 failed to meet its burden and present this Panel with
13 sufficient probative evidence demonstrative of the fact
14 that Dr. Szumlas' continued suspension is required under

15 the statute. As such, we ask that this Panel enter an
16 order denying continuation of that suspension.
17 Thank you.
18 MR. PALAZOLA: Let's focus on the continuing
19 threat aspect of this, because that is the standard.
20 Let's just talk about postdischarge for a minute. Let's
21 talk about what we have seen in the evidence
22 postdischarge.
23 I think we see evidence that Dr. Szumlas has
24 a poor insight into his condition and minimizes his
25 symptoms. And we see this in a report that just came out
0233
1 of an evaluation that happened last Saturday, where this
2 is described very differently to Dr. Glass versus how it
3 was described to the providers on his intake and
4 admission, which is in the evidence for Terrell State
5 Hospital. What he tells Dr. Glass is minimized.
6 Let's talk about the accusations that he
7 made against the police since discharge. First of all,
8 the accusation in the e-mail to Board staff. Second of

9 all, in the report that Dr. Glass wrote where he -- on
10 Page 3 of the report Dr. Glass writes, he is denying some
11 of the things that the police did. And he says, perhaps
12 the police embellished things in their report.
13 Also postdischarge, the lack of follow up,
14 as I have talked about extensively and I'm not going to go
15 back again. He says, I'm going to; I'm going to; I'm
16 going to. But he hasn't done it. He hasn't followed up.
17 These minimizations are consistent with Dr.
18 Messer's report from March 24th.
19 Finally, we have to look at Dr. Glass' own
20 recommendations in this case. Is there a continuing
21 threat? Dr. Glass says, well, no, provided that -- you
22 know, he says, my recommendation is that he continue to
23 take his medications, see a psychiatrist weekly or
24 biweekly and have some medication management. In that
25 case, he should be okay. That's not an option today,
0234
1 unfortunately.
2 And Mr. Leichter is right. That's not an
3 option. But the way he says it, well, that means there's
4 no continuing threat. I see it differently. I see it,
5 there is a continuing threat.
6 Even his own psychiatrist, who just
7 evaluated him on Saturday, says he needs these things.
8 The logical deduction from that is, if you don't do these
9 things, he could pose a continuing threat to the public
10 health and welfare. With that, Board staff believes there
11 is evidence that there a continuing threat to the health
12 and welfare.
13 We are not asking you to punch his ticket.
14 We are saying there is enough evidence to warrant keeping
15 him suspended at this time. Hopefully, he's going to get
16 better and go back to practicing medicine. At this point
17 in time, the evidence, the Board staff believes, is there
18 to warrant a continued suspension.
19 MS. LESHIKAR: Mr. Baucom, I think you are
20 at Section 15.
21 MR. BAUCOM: 15?

22 MS. LESHIKAR: Uh-huh.
23 MR. BAUCOM: Both sides have now closed and
24 it is time for the Panel to deliberate its decision. Is
25 there any discussion by the Panel members?
0235
1 DR. CROCKER: No.
2 MS. SOUTHARD: I move that we go into
3 executive session today.
4 MR. BAUCOM: We don't have to go in
5 executive session.
6 MS. SOUTHARD: We don't?
7 MS. LESHIKAR: Yes, you have to go into
8 executive session for you to determine if you want to
9 discuss the issue.
10 MR. BAUCOM: All right. There is a motion.
11 Is there a second?
12 DR. CROCKER: Second.
13 MR. BAUCOM: There is a motion and second.

15 DR. CROCKER: Aye.
17 MR. BAUCOM: No? Motion passes. This
18 meeting of the Disciplinary Panel is now closed to the
19 public at 4:04 p.m. on April 20, 2011 for deliberations
20 concerning disciplinary action under the authority of the
21 Medical Practice Act, Section 152.009, Occupations Code,
22 and for private consultation and advice of counsel
23 concerning pending or contemplated litigation, settlement
24 offers and/or legal matters subject to the attorney/client
25 privilege under the authority of Open Meetings Act,
0236
1 Section 551.071, Government Code.
2 While in executive session, the Disciplinary
3 Panel will not take any action, make any decision or vote
4 with regard to any matter that may be considered or
5 discussed. A certified agenda of the executive session
6 will be made.
8 (Off the record from 4:03 p.m. to 4:16 p.m.)

9 MR. BAUCOM: The executive session has been
10 concluded. The Disciplinary Panel has returned to open
11 session at 4:18 p.m. on April 20, 2011. While in the
12 executive session, no vote was taken and no decision was
13 made in regard to the Application for Temporary
14 Suspension. A certified agenda was made.
15 Is there any further discussion by the
16 Panel?
17 DR. CROCKER: No.
18 MR. BAUCOM: Do I hear a motion?
19 DR. CROCKER: I move that this Disciplinary
20 Panel determine that the Application for Temporary
21 Suspension of the Texas Medical License of Rick Szumlas,
22 M.D. be granted. Rick Szumlas, M.D., Respondent, is a
23 continuing threat to the public welfare.
24 The Order of Temporary Suspension as
25 presented by the Board staff including all findings of
0237
1 fact and conclusions of law be adopted and entered by the

2 Chair. An imminent peril to the public health, safety or
3 welfare requires immediate effect of this decision.
4 The Order of Temporary Suspension With
5 Notice is final and effective on the date rendered. The
6 Order of Temporary Suspension With Notice shall remain in
7 effect until superceded by a subsequent order of the
8 Board.
9 An informal settlement conference shall be
10 held as soon as practicable but no earlier than May 12th,
11 2011.
12 MR. BAUCOM: Is there a second?
13 MS. SOUTHARD: Second.
14 MS. LESHIKAR: Is there a second, Ms.
15 Southard?
16 MS. SOUTHARD: Yes, I did.
17 MS. LESHIKAR: Ms. Southard seconded.
18 MR. BAUCOM: You have heard the motion and
19 second. All those in favor would indicate by saying aye.

22 MR. BAUCOM: All opposed, no. There are
23 none. Motion carries. The Application for Temporary
24 Suspension With Notice is granted. The Respondent's
25 license is suspended effective immediately.
0238
1 Dr. Crocker would like to make some
2 comments.
3 DR. CROCKER: Prior to the ISC, because we
4 would like to get a decision and get things going for you
5 as soon as possible and make this as short as practicable,
6 if it can be made short, it will be extremely helpful if
7 we have a Board psychiatrist evaluation. We think there
8 is still some questions and that we don't have an
9 absolutely clear picture, and that will help us as an
10 independent opinion.
11 I think it will also be extremely helpful if
12 you can get the full medical examination by an internist
13 or endocrinology or both specifically addressing the
14 questions of the elevated free T4, your elevated MCV and

15 for reasons that the Terrell State Hospital physician
16 couldn't elucidate or explain, we need a urine drug screen
17 too.
18 MR. BAUCOM: Okay. Is there a motion to
19 adjourn?
20 MS. SOUTHARD: I make a motion to adjourn.
21 DR. CROCKER: Second.
22 MR. BAUCOM: We have a motion and second.
0239
1 MR. BAUCOM: Opposed, no. The motion
2 carries. This meeting of Disciplinary Panel of the Texas
3 Medical Board is hereby adjourned at 4:21 p.m. on April
4 20th, 2011.
5 (Proceeding concluded.)
8
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0240
1 CERTIFICATE
2
3 STATE OF TEXAS )
4 COUNTY OF TRAVIS )
I, Renea Seggern, CSR, in and for the State of Texas,
6 do hereby certify that the above-captioned matter came to
hearing before the Disciplinary Panel of the Texas Medical
7 Board on the 20th day of April, 2011, as hereinbefore set
out.
I FURTHER CERTIFY that the proceedings of said
9 hearing were reported to me, accurately reduced to
typewriting under my supervision and control and that the
10 foregoing pages are a full, true, and correct
transcription of said proceedings.
11
I FURTHER CERTIFY that I am neither attorney or
12 counsel for, related to, nor employed by any parties to
the action of these proceedings and, further, I am not a
13 relative or employee of any counsel employed by the

parties hereto or financially interested in the action.
14
SUBSCRIBED AND SWORN to under my hand and seal of
15 office on this the ________ day of ________________, 2011.
16
17
18 ______________________________
Renea Seggern, CSR #7262
19 Certificate Expires 12-31-2012
Ken Owen & Associates, Cert #115
20 801 West Avenue
Austin, Texas 78701
21 (512) 472-0880
22
23
24
25

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0001

1 LICENSE NO. L-3154

2 IN THE MATTER OF ( BEFORE THE DISCIPLINARY

3 THE LICENSE OF ( PANEL OF THE

4 RICK SZUMLAS, M.D. ( TEXAS MEDICAL BOARD

8 WEDNESDAY, APRIL 20, 2011

10 BE IT REMEMBERED that on this the 20th day of April,

11 2011, between 10:00 a.m. and 4:21 p.m., the above-entitled

12 matter came for hearing before the Disciplinary Panel of

13 the Texas Medical Board, 333 Guadalupe, Tower 3, 7th

14 Floor, Austin, Texas, and the following proceedings were

15 reported by Renea Seggern, Certified Shorthand Reporter.

3 DISCIPLINARY PANEL MEMBERS:

4 Mr. David Baucom, Chair

Patrick Crocker, D.O.

5 Ms. Paulette Southard (Appeared via telephone)

6 Ms. Nancy Leshikar, Counsel for the Panel

8 FOR THE TEXAS MEDICAL BOARD:

9 TEXAS MEDICAL BOARD

10 Ms. Claudia Kirk

333 Guadalupe Street

11 Tower 3, Suite 610

Austin, Texas 78701

FOR THE RESPONDENT:

LEICHTER LAW FIRM

15 Mr. Louis Leichter

Mr. Dan Lype

16 1602 East 7th Street

Austin, Texas 78702

3 WITNESSES FOR THE BOARD:

4 DETECTIVE SERGEANT JAMES MAZY (Via Telephone)

Direct Examination by Mr. Palazola.................19

5 Voir Dire Examination by Mr. Leichter..............33

Continued Direct Examination by Mr. Palazola.......35

6 Cross-Examination by Mr. Leichter..................41

Redirect Examination by Mr. Palazola...............47

7 Recross-Examination by Mr. Leichter................48

Examination by Dr. Crocker.........................49

8 Further Recross-Examination by Mr. Leichter........51

Further Redirect Examination by Mr. Palazola.......52

MARK MESSER, D.O. (Via Telephone)

Cross-Examination by Mr. Leichter..................61

11 Redirect Examination by Ms. Kirk...................78

Recross-Examination by Mr. Leichter................80

12 Examination by Dr. Crocker.........................83

Further Recross-Examination by Mr. Leichter........85

KIMBERLY SMITH (Via Telephone)

14 Direct Examination by Mr. Palazola.................89

Cross-Examination by Mr. Leichter..................96

15 Redirect Examination by Mr. Palazola...............99

Recross-Examination by Mr. Leichter...............100

16 Further Redirect Examination by Mr. Palazola......101

17 BRANDI RUSSELL (Via Telephone)

Direct Examination by Mr. Palazola................104

18 Cross-Examination by Mr. Leichter.................114

19 WITNESSES FOR THE RESPONDENT:

20 GEORGE GLASS, M.D.

Direct Examination by Mr. Leichter................124

21 Cross-Examination by Mr. Palazola.................145

22 Examination by Mr. Baucom.........................159

Further Examination by Dr. Crocker................160

23 Examination by Ms. Leshikar.......................160

Further Examination by Mr. Baucom.................161

24 Examination by Ms. Southard.......................163