UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF MICHIGAN

DAFINKA STOJCEVSKI, as Personal 

Representative of the Estate of DAVID 

STOJCEVSKI, Deceased,

Plaintiff,

v.

COUNTY OF MACOMB, et al.,

Defendants.

Case No. 15-cv-11019

Hon. Linda V. Parker

Mag. Judge David R. Grand

IHRIE O’BRIEN

Robert D. Ihrie (P26451)

Harold A. Perakis (P35921)

Attorneys for Plaintiff

24055 Jefferson Avenue, Suite 2000

St. Clair Shores, MI 48080

(586) 778-7778

ihrieobrien@aol.com

hperakis@ihrieobrienlaw.com

MACOMB COUNTY 

CORPORATION COUNSEL

John A. Schapka (P36731)

Robert S. Gazall (P41350)

Attorneys for Macomb County 

Defendants

One S. Main Street, 8th Floor

Mount Clemens, MI 48043

(586) 469-6346

john.schapka@macombgov.org

robert.gazall@macombgov.org

Cara.Swindlehurst@wilsonelser.com

John.Eads@wilsonelser.com

(313) 327-3100

Livonia, MI 48152

17197 N. Laurel Park Dr., Suite 201

Defendants

Co-Counsel for Macomb County

Cara M. Swindlehurst (P79953)

John T. Eads, III (P43815)

Dicker, LLP

Wilson Elser Moskowitz Edelman &

myoung@chapmanlawgroup.com

rchapman@chapmanlawgroup.com

(248) 644-6326

Troy, MI 48098

1441 West Long Lake Rd., Suite 310

Defendants

Attorneys for Correct Care Solutions

Madeline Young (P82140)

LL.M. (P37603)

Ronald W. Chapman Sr., M.P.A.,

CHAPMAN LAW GROUP

Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7641 Filed 01/19/21 Page 1 of 39
DEFENDANTS CORRECT CARE SOLUTIONS, L.L.C.; MONICA 

CUENY; CHANTALLE BROCK; MICAL BEY-SHELLY; VICKY 

BERTRAM; AND LAWRENCE SHERMAN, M.D.’S MOTION TO 

PRECLUDE PLAINTIFF FROM ELICITING EXPERT TESTIMONY 

FROM PLAINTIFF’S EXPERT ROBERT GREIFINGER, M.D.

EXHIBIT B Deposition Transcript of Robert B. Greifinger, M.D. dated 

April 4, 2018

Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7642 Filed 01/19/21 Page 2 of 39
Page 1

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF MICHIGAN

------------------------------------------------x

DAFINKA STOJCEVSKI, Individually, and as Personal

Representative of the Estate of DAVID STOJCEVSKI,

Deceased,

· · · · · · · · · Plaintiffs,

· · · · · · -againstCOUNTY OF MACOMB, et al.,

· · · · · · · · · Defendants.

------------------------------------------------x

· · · · · · · · · · · · · ·90 Broad Street

· · · · · · · · · · · · · ·New York, New York

· · · · · · · · · · · · · ·April 4, 2018

· · · · · · · · · · · · · ·9:00· A.M.

· · · · · · · · EXAMINATION BEFORE TRIAL, of the

Expert Witness, ROBERT GREIFINGER, M.D., held at the

above time and place, pursuant to Order, taken

before Shea Sorensen, a Court Reporter and Notary

Public of the State of New York.

Page 2

APPEARANCES:

· · · · · · IHRIE O'BRIEN

· · · · · · Attorneys for Plaintiff.

· · · · · · 24055 Jefferson Avenue - Suite 2000

· · · · · · St. Clair Shores, MI 48080

· · · · · · BY:· HAROLD A. PERAKIS, ESQ.

· · · · · · Hperakis@ihrieobrienlaw.com

· · · · · · LAW OFFICE OF ROBERT S. GAZALL

· · · · · · Attorneys for Defendants, Macomb County

· · · · · · Corporation Counsel, Macomb County.

· · · · · · One S. Main Street - 8th Floor

· · · · · · Mount Clemens, MI 48043

· · · · · · BY:· ROBERT GAZALL, ESQ.

· · · · · · Robert.gazall@macombgov.org

· · · · · · CHAPMAN LAW GROUP

· · · · · · Attorneys for Defendant, Correct Care

· · · · · · Solutions.

· · · · · · 1441 West Long Lake Rd., Ste. 310

· · · · · · Troy, Michigan 48098

· · · · · · BY: RONALD W. CHAPMAN, SR., M.P.A.

· · · · · · · · LL.M.

· · · · · · RChapman@ChapmanLawGroup.com

· · · · · · WILSON ELSER MOSKOWITZ EDELMAN &

· · · · · · DICKER, LLP

· · · · · · Co-Counsel for Defendants County of

· · · · · · Macomb, Sheriff Wickersham and Michelle

· · · · · · Sanborn.

· · · · · · 17197 N. Laurel Park Dr., Suite 201

· · · · · · Livonia, MI 48152

· · · · · · BY: CARA M. SWINDLEHURST, ESQ.

Page 3

· · · ROBERT GREIFINGER, M.D., the expert witness, having

been first duly sworn in by a Notary Public of the

State of New York, was examined and testified as

follows:

EXAMINATION BY

MR. CHAPMAN.

· · · Q· · ·Would you please state your name for

the record?

· · · A· · ·Dr. Robert Greifinger.

· · · Q· · ·What is your present address?

· · · A· · ·380 Riverside Drive, New York, New York

10025.

· · · · · · · · · MR. CHAPMAN: Dr. Greifinger,

· · · · · · before we get going, let the record

· · · · · · reflect I am handing you a check for

· · · · · · $4,000.00.

· · · · · · · · · THE WITNESS: Thank you very much.

· · · · · · · · · MR. CHAPMAN: Thank you for

· · · · · · letting me bring it.

· · · · · · · · · Dr. Greifinger, My name is, Ron

· · · · · · Chapman, and I represent all of the

· · · · · · medical mental health defendants in this

· · · · · · case.

· · · · · · · · · I do not represent any of the

· · · · · · deputies of Macomb County.· Those are

Page 4

represented by other counsel, that are

here, okay.

· · · I am going to be asking a series

of questions.· You have given your

deposition, I don't know how many times

before.

· · · If you don't understand the

question that I ask, stop me and ask me

to repeat the question.· If you don't

answer, later on when the transcript is

read or looked at, I will assume the

ordinary meaning of my question and the

ordinary meaning of your answer, fair

enough?

· · · THE WITNESS: Yes.

· · · MR. CHAPMAN: I am not a doctor.

· · · If I misstate a medical term or

something, please clarify me on that.

If I use a medical term that doesn't

make any sense for the question, call me

on it and we will try to correct the

question, fair enough?

· · · THE WITNESS: Yes.

· · · MR. CHAPMAN: I don't think you

are actively practicing, so you don't

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

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Phone:· 888.644.8080

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 1–4

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7643 Filed 01/19/21 Page 3 of 39
Page 5

have the problem of other doctors do,

answering the phone and taking messages

and things?

· · · THE WITNESS: Correct.

· · · MR. CHAPMAN: If you need to take

a break for any reason, go to the

bathroom, phone a friend talk to

anybody, you may do that.· My only

requirement is you have to answer the

question that is on the table, then we

can take a break and move on.

· · · Sometimes, I would like a little

bit of forewarning, because I might have

a line of question; 2, or 3 questions.

Since, you don't have counsel here, and

there is no attorney client privilege to

anything, if you do talk to anybody, I

will ask you, more likely than not, when

you come back, who did you talk to, what

did you talk to.· I don't care about

friends and relatives.· I actually care

about talking to Mr. Perakis, and I want

to know what you and he talked about and

then you are obligated to answer those

questions.

Page 6

· · · · · · · · · One other ground rule, that I

· · · · · · would like, not obligatory, but if the

· · · · · · question calls for a yes, no, I would

· · · · · · prefer a yes or no then an explanation,

· · · · · · if you need it.

· · · · · · · · · If you can't answer a question

· · · · · · yes or no, just say I can't answer, yes,

· · · · · · no and we will move on, and do what we

· · · · · · have to do.

· · · Q· · ·Is it true you have not performed hands

on medical treatment to any adult patient, since

1985?

· · · A· · ·Yes.

· · · Q· · ·You were first licensed to practice

medicine in 1972, if I read your CV correctly,

right after you graduated from medical school?

· · · A· · ·Yes, soon after I graduated in '71.

· · · Q· · ·What states were you, I guess initially

licensed in?

· · · · · · I know your CV says New York, and I

believe Pennsylvania?

· · · A· · ·I was initially licensed in New York

and I have been licensed initially in New York.· My

Pennsylvania license is inactive.

· · · Q· · ·But you were licensed there at one

Page 7

time?

· · · A· · ·I was licensed there, yes.

· · · · · · When I was engaged by the Pennsylvania

Department of Corrections, as a consultant it

required me to have a license.

· · · Q· · ·Were you, did you apply for a license

in any other areas any other states, other than

those two states?

· · · A· · ·I have been licensed in Illinois, 1972

to 1974.· Sometime, in that time.

· · · Q· · ·That is inactive as well?

· · · A· · ·That is not.

· · · Q· · ·Just don't have it?

· · · A· · ·Just don't have it anymore.· I was

licensed in Connecticut for a brief time, in the

'19 in the early 1980's.

· · · Q· · ·Have you ever applied for a state

license and were denied?

· · · A· · ·No.

· · · Q· · ·To the best of your knowledge, have you

ever been investigated, by a licensing board?

· · · A· · ·Not, to my knowledge.

· · · Q· · ·So I assume the next question is no,

correct you have never been disciplined?

· · · A· · ·Correct.

Page 8

· · · Q· · ·Which would be represented by a letter

of consent anything of that nature?

· · · A· · ·Correct.

· · · Q· · ·Did you complete medical school in

1971?

· · · A· · ·Yes.

· · · Q· · ·Shortly after that, you entered a

pediatric residency program?

· · · A· · ·Pediatrics and social medicine,

combined residency.

· · · Q· · ·How do you define, pediatric?

· · · A· · ·It is a medical care for children and

adolescence.

· · · Q· · ·Is there an age a typical age perimeter

that children's easy to whatever, what about

adolescent, how do you define that?

· · · A· · ·It is prepped up over the years.

· · · · · · It was roughly 20, 21, back in the days

I was practicing.

· · · Q· · ·So you would treat people from 0 to 21?

· · · A· · ·Generally, yes.

· · · Q· · ·Were the majority of your patients

though in pediatrics, children 8, 9 school age

coming in for physicals and colds and flus, and

broken bones and what ever else kids have?

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 5–8

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7644 Filed 01/19/21 Page 4 of 39
Page 9

· · · A· · ·Yes.

· · · Q· · ·Completed your residency program in

1976?

· · · A· · ·Yes.

· · · Q· · ·You would say you were also in social

medicine, I tried to find a definition of social

medicine.· I couldn't find one.

· · · · · · Is that a recognized subspecialty, by

the American Board of Subspecialities?

· · · A· · ·No, it is, I have been looking for a

definition too, since 1970.

· · · · · · It is a county health, public health,

epidemiology population based health care, it is

all those things and in some places, it is called

community health.· Other places, public health.· It

is a little variant on those.

· · · Q· · ·Were you board certified in social

medicine?

· · · A· · ·There is no board.

· · · Q· · ·There is a board for example

epidemiology.

· · · A· · ·No, that is not correct.

· · · Q· · ·You completed your residency in 1976.

Did you become board certified at some time after

your residency?

Page 10

· · · A· · ·Yes.

· · · Q· · ·When did you become board certified?

· · · A· · ·As soon as I was eligible.· That is on

my resume, if I can refer to it.

· · · Q· · ·Do you have a copy of your report, your

resume is attached to your report?

· · · · · · · · · MR. PERAKIS:· I don't have his

· · · · · · resume.

· · · A· · ·As soon as I was eligible.

· · · Q· · ·You remained, board certified in

pediatrics until when?

· · · A· · ·Forever.

· · · Q· · ·That is because you were grandfathered

in, you are not required to take any retesting?

· · · A· · ·That is correct.

· · · Q· · ·When is the last time you actually

treated a pediatric patient?

· · · A· · ·1985.

· · · Q· · ·Even though you are board certified

today in pediatrics, 15, 23 years later, you

probably wouldn't venture to hold yourself out as a

pediatrician treating pediatrics would you?

· · · A· · ·Not, without some reeducation.

· · · Q· · ·During your pediatric residency, did

you treat pediatric patients that were experiencing

Page 11

substance abuse withdrawal issues such as

benzodiazepine or cocaine withdrawal?

· · · A· · ·I did during my residency.· I had

several rotations, at the Spofford Juvenile

Detention Center, and the adolescent unit on Rikers

Island.

· · · Q· · ·The rotation is for how long?

· · · A· · ·There were month long rotations.

· · · Q· · ·How many rotations, did you have

through either Rikers Island or the other?

· · · A· · ·Approximately, three.

· · · Q· · ·You would have spent approximately

three months combined in those rotations in those

institutions?

· · · A· · ·Yes.

· · · Q· · ·During that three month period, how

many pediatric patients did you treat that were

going through withdrawals of benzodiazepine or

cocaine, if you recall?

· · · A· · ·I have no idea.

· · · Q· · ·Since only there for three months, you

would agree with me it is a finite number?

· · · A· · ·Always a finite numbers.

· · · Q· · ·Agree with me be very small finite

number?

Page 12

· · · A· · ·Likely, yes.

· · · · · · · · · MR. CHAPMAN:· ·Do you recall, and

· · · · · · I don't want you to guess, and that is

· · · · · · one of the admonitions I probably would

· · · · · · have given to you.

· · · · · · · · · The only thing I am interested

· · · · · · today is what you know, because you read

· · · · · · it, you saw it you touched it you smelt

· · · · · · it, somebody told it to you; I don't

· · · · · · want you to speculate onto anything.

· · · · · · If you don't know the easiest way to

· · · · · · answer a question say I don't know, I

· · · · · · don't recall, and move on.

· · · Q· · ·So can you specifically in your mind

recall treating anybody that was going through

cocaine withdrawal, during that time period?

· · · A· · ·No.

· · · Q· · ·Can you specifically recall treating

anybody that was going through benzodiazepine

withdrawal, during that time period?

· · · A· · ·No.

· · · Q· · ·How about alcohol withdrawal during

that time period?

· · · A· · ·No.

· · · Q· · ·During your pediatric residency, or

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 9–12

MIdeps@uslegalsupport.com

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U. S. LEGAL SUPPORT

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7645 Filed 01/19/21 Page 5 of 39
Page 13

after your residency during a period that you were

board certified in pediatrics, did you diagnose or

treat any pediatric patient who suffered from

catatonia?

· · · A· · ·No, I did not.

· · · Q· · ·Your work in pediatrics from 1976 until

1985, is it detailed in your resume, in your CV?

· · · A· · ·Yes.

· · · Q· · ·Did you ever apply for or attend a

neurological residency program?

· · · A· · ·No.

· · · Q· · ·Did you ever apply for or attend a

psychiatry residency program?

· · · A· · ·No.

· · · Q· · ·Ever apply for or attend an internal

residency program?

· · · A· · ·No.

· · · Q· · ·From 1977 through 1980 your resume

seems to indicate you practiced clinical pediatrics

at a community HMO, at Community Health Plan of

Suffolk?

· · · A· · ·Yes.

· · · Q· · ·What is that clinic?

· · · A· · ·It was a multi-speciality group

practice, established under the HMO act of 1973, to

Page 14

create prepaid group practices.

· · · Q· · ·So when you say HMO, actually was a

health maintenance organization?

· · · A· · ·Yes, licensed as an HMO.

· · · Q· · ·You were the one of the pediatricians

in that group?

· · · A· · ·Yes, I was also the medical director.

· · · Q· · ·Now the medical director, that would

have been an administrative position?

· · · A· · ·It is not hands-on practice but it has

to do with recruitment and retention of clinical

staff and quality management in general.

· · · Q· · ·But you as a medical director didn't

give you the ability to practice neurology in the

group, did it?

· · · A· · ·No, it didn't.

· · · Q· · ·Didn't give you the ability to practice

psychiatry in the group did it?

· · · A· · ·Correct.

· · · Q· · ·You still practiced pediatrics as your

medical specialty but you were involved in the

management of the organization; hiring, firings,

recruiting, setting up standards those types of

things?

· · · A· · ·Yes.

Page 15

· · · Q· · ·Watching the budget, I would assume

economic?

· · · A· · ·Yes.

· · · Q· · ·Didn't, what I am trying to get to,

sometimes I can beat a dead horse really good.

· · · · · · Even though, you were the medical

director it did not change the structure of the

practice of medicine that you performed.

· · · · · · You still practiced pediatrics?

· · · A· · ·Correct.

· · · Q· · ·From 1980 to 1985 your resume says you

worked as chief medical officer COO, of an HMO in

White Plains, New York.

· · · · · · Was the COO an administrative title, I

am assuming that means chief operating officer?

· · · A· · ·I don't recall that.

· · · Q· · ·Let me show you a copy of your resume.

Was in Westchester Community Health Plan?

· · · A· · ·Yes, I worked at Westchester Community

Health Plan as chief medical officer.· I don't

remember.

· · · Q· · ·I am going to show Dr. Greifinger, at

least a CD portion of expert report and I would

refer you to the first line under where it says,

vice-president and medical director.

Page 16

· · · A· · ·I guess so.· That is what I had.· That

was my title.

· · · Q· · ·COO means, chief operating officer?

· · · A· · ·Yes.

· · · Q· · ·That is an administrative position, I

assume?

· · · A· · ·Yes.

· · · Q· · ·Chief medical office again or medical

director again, is an administrative position?

· · · A· · ·Yes.

· · · Q· · ·You still practiced pediatrics here,

correct?

· · · A· · ·Yes.

· · · Q· · ·What percent of your time was spent

doing administrative duties under the chief medical

officer as chief operational officer assuming a

hundred percent work, what percent was

administrative verses non-administrative.

· · · A· · ·It was at least half administrative.

· · · Q· · ·From 1980 so from 1980 to 1985, even

though you were still practicing pediatrics, your

work time in pediatrics was basically cut in half,

because the other time was spent doing

administrative duties?

· · · A· · ·Yes.· May I explain?

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 13–16

MIdeps@uslegalsupport.com

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U. S. LEGAL SUPPORT

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7646 Filed 01/19/21 Page 6 of 39
Page 17

· · · Q· · ·Any time.

· · · A· · ·I don't like passive voice.· You said,

my work time was cut off.· I cut my pediatric time

in order to be medical director of the group.

· · · Q· · ·I am not sure of the distinction. I

wasn't implying somebody else cut it.· There is so

much work.

· · · A· · ·Wanted to clarify that.

· · · Q· · ·That is fine. From 1985 to 1989, says

you were employed at the probably mispronounced

this:· Montefiore Medical Center in the Bronx?

· · · A· · ·Yes.

· · · Q· · ·What did you do there?

· · · A· · ·Excuse me, it is the Bronx.

· · · · · · I had several roles.· When I left, I

was a vice-president and I was operationally in

charge of a variety of non-inpatient programs

including among others, management of the contract

that Montefiore had with the City of New York to

provide the medical care for the inmates on Rikers

Island which is New York City's Jail.

· · · Q· · ·Was your functions between 1985 and

1989, administrative?

· · · A· · ·Yes.

· · · Q· · ·So, this was the first position that

Page 18

you took or now your function was one hundred

percent administrative?

· · · A· · ·Correct.

· · · Q· · ·Your functions have remained one

hundred percent administrative, since then?

· · · A· · ·No, I haven't administered anything

other than my own life since I left the New York

State Department of Corrections in 1995.

· · · Q· · ·So, from 1985 to 1995, your

professional life was one hundred percent

administrative duties?

· · · A· · ·Correct.

· · · Q· · ·From 1995 till now, your no longer

administrating any businesses or functions or

philanthropic organizations or anything, you do

consulting work, now?

· · · A· · ·I do consulting work.· I have a sole

proprietorship and, so there are no employees and

nobody to administer.

· · · Q· · ·You don't have a hundred employees or 8

thousand employees or two hundred or anybody that

reports to you since 1985, other than maybe a part

time secretary or a clerical person?

· · · A· · ·I did have a few colleagues who work

with me where technically they report to me.· They

Page 19

are independent contractors.· Not with me, they are

independent contractors with the agency who I

consult with.

· · · Q· · ·From 1989 to 1995 says that you were,

Deputy Commissioner Chief Medical Officer of the

New York State Correctional Services?

· · · A· · ·Yes.

· · · Q· · ·I assume your duties there were

administrative?

· · · A· · ·Yes.

· · · Q· · ·From, 1995 through the present time,

you were involved according to your CV, consulting

in the area of design management operations,

quality improvement and utilization management for

correctional health care systems, correct?

· · · A· · ·Yes.

· · · Q· · ·No time has been spent in the active

clinical assessment or treatment of adult patients,

correct?

· · · A· · ·Correct.

· · · Q· · ·No time is spent in the active clinical

assessment of neurology patients, correct?

· · · A· · ·No time is spent in the assessment or

treatment of patients with neurological disease.

· · · Q· · ·No time is spent in the clinical

Page 20

assessment or treatment of psychiatric patients,

correct?

· · · A· · ·No.

· · · Q· · ·No time is spent in the clinical

assessment and treatment of patients suffering from

withdrawal, correct?

· · · A· · ·Correct, though I do evaluate and

monitor, jail detoxification withdrawal programs

particularly in Miami, New Orleans and Albuquerque.

· · · Q· · ·You would monitor those programs not

involved in the assessment or treatment of those

patients, correct?

· · · A· · ·Correct, I evaluate the assessment and

treatment of those patients.

· · · Q· · ·I understand as an administrator you

might evaluate what somebody does.

· · · · · · You are not the one that is doing it,

correct?

· · · A· · ·No, I am not an administrator.

· · · Q· · ·I want to say you do not do hands on

assessment and treatment of people suffering from

withdrawal, correct?

· · · A· · ·That is correct.

· · · Q· · ·Do you have a copy of your report with

you?

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 17–20

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7647 Filed 01/19/21 Page 7 of 39
Page 21

· · · A· · ·Yes.

· · · Q· · ·Now, your deposition notice here today

was a deposition notice taken for you to bring all

of the records with you.

· · · · · · Did you do that?

· · · A· · ·Yes.

· · · Q· · ·I see you have a flash drive, correct?

· · · A· · ·Yes.

· · · Q· · ·In your report, I think it is page two

or so, you list some documents that you were given.

· · · · · · Are those the documents that are on

that flash drive?

· · · A· · ·Yes, but there are other documents that

I didn't put down in my report, in part because

just didn't, and other part because I didn't know

at the time if I was allowed to list documents, FBI

documents, and then by the time I found out it was

okay, I forgot to put them down.

· · · · · · I have a list for you, if you would

like it.

· · · Q· · ·Let's go back to the flash drive that

you have there.

· · · · · · That is all the documents that you have

looked at, in relation to this case?

· · · A· · ·I believe so, yes.

Page 22

· · · Q· · ·You believe so or you know so, I only

get one time to ask you questions.

· · · A· · ·I can't recall any questions that I

reviewed, that are not there.

· · · Q· · ·Can I see the flash drive?

· · · A· · ·Yes, I don't work with paper and so

this if it came electronically I likely saved it.

· · · · · · · · · MR. CHAPMAN: Mr. Perakis, do you

· · · · · · have a problem if I plug this into my

· · · · · · computer, and see what is on it?

· · · · · · · · · MR. PERAKIS:· No problem.

· · · · · · · · · In January, several months before

· · · · · · we sent those documents for review, we

· · · · · · sent some of the FBI stuff we received

· · · · · · from subpoena, and I brought this

· · · · · · letter, so you know.

· · · · · · · · · MR. CHAPMAN: Here is what my

· · · · · · demand was.

· · · · · · · · · I have copies in front of me, of

· · · · · · everything you have looked at.· You have

· · · · · · represented to me this flash drive has

· · · · · · everything.· Are you now saying Dr.,

· · · · · · other documents you have looked at are

· · · · · · not on the flash drive?

· · · A· · ·No, I am saying, I did not list the

Page 23

documents that are listed here on the January 9,

2017 letter, from Mr. Perakis.

· · · Q· · ·They are on this flash drive?

· · · A· · ·They should be, yes.

· · · Q· · ·The way I understand this flash drive

contains documents that weren't listed on the list,

because you forgot or but it does contain all the

documents you looked at?

· · · A· · ·Yes, to the best of my knowledge.

· · · Q· · ·There are a lot of documents here.

· · · · · · Did you look at every single page of

every single document that is on this flash drive?

· · · A· · ·Yes.· I didn't necessarily read every

single page very carefully, but I scanned through

every page.

· · · Q· · ·Okay. You have billing records?

· · · A· · ·Yes, they are on the flash drive.

· · · Q· · ·Here is what I have on this flash, do I

have all that showed up, it is Perakis/Stojcevski

documents, Perakis/Stojcevski invoices.· According

to this, you don't have a copy to look at, looks

like you sent two invoices or 4 invoices.

· · · · · · One says 1/17, 6/17, 2/18, and 4/18.

· · · · · · Those are the numbers on the invoices?

· · · A· · ·Yes, that is a secret code that

Page 24

corresponds to the month and the year.

· · · Q· · ·Secret code that everybody knows the

4/8/18 invoice, I sent by e-mail last night and

gave it physically to Mr. Perakis, this morning.

According to the first invoice, 1/17 you spent 3.5

hours in reviewing documents, I assume that is the

invoice that you received, this flash drive, prior

to, to look at.

· · · · · · It is that correct?

· · · A· · ·I don't recall.

· · · Q· · ·So that is 3.5 hours.

· · · · · · Are your invoices accurate when you

billed them, I assume you are saying they are

accurate, correct?

· · · A· · ·Generally, I don't always bill for all

the hours for all the time, I put in.

· · · · · · Generally they are accurate.

· · · Q· · ·Then the next invoice which is in June.

· · · · · · It is 1.25 hours for reviewing

documents, and then three hours for drafting your

report and then, February 18, you sent another

invoice, give you the benefit of the doubt here, it

says document review in conference, 2.5 hours and

then you just sent one you said -- and that was for

prep including travel for today that had nothing to

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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U. S. LEGAL SUPPORT

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 21–24

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7648 Filed 01/19/21 Page 8 of 39
Page 25

do with anything other than reviewing documents

maybe to prep you for this dep.

· · · · · · Nothing, to do with preparing you for

this report?

· · · A· · ·Correct.

· · · Q· · ·Your report was drafted, and signed on

June 7, 2017, so I am going to assume, that since

you drafted your report in June of 2017, the only

two invoices that apply to any work that went into

these reports, were the January 17, and the June

17, because the other one were in '18, well after

you drafted your report?

· · · A· · ·Correct.

· · · Q· · ·And, in that, all of these documents on

this flash drive, you spent 4.75 hours to review?

· · · A· · ·You have to understand, I was familiar

with a lot of the documents from other work that I

had done, for another client, prior, regarding this

case.

· · · Q· · ·You did other work for another client

regarding this case; there is only one plaintiff in

this case, Mr. Stojcevski, it would be the personal

representative who is the other person in this

case, you would have done work for?

· · · A· · ·When I say, case, I mean the

Page 26

circumstances around Mr. Stojcevski' medical care,

that was the US attorney's office.

· · · Q· · ·I asked for all the documents you have

looked at.

· · · A· · ·I have a very strict confidentiality

agreement, also I understand I am unable to discuss

anything about what they told me, what I told them,

or what they sent me.· Unless, it otherwise comes

up. It was my understanding, that I could not share

any of those documents with you.

· · · Q· · ·Let me explore that a bit.

· · · · · · It is your belief that you have a

contingency agreement that prohibits you from

discussing or disclosing anything that you guys

talked about; you gave to them or you learned,

during that investigation?

· · · · · · · · · MR. PERAKIS: Note for the record.

· · · · · · · · · MR. CHAPMAN: Make an objection

· · · · · · nothing for the record.

· · · · · · · · · MR. PERAKIS: All I am asking you

· · · · · · is to be clear.

· · · · · · · · · When you say they or them, those

· · · · · · guys, who are you talking about?

· · · · · · · · · MR. CHAPMAN: We were talking

· · · · · · about the FBI, make an objection form

Page 27

· · · · · · and foundation.

· · · · · · · · · Want to make the question clear.

· · · A· · ·I am certain that I am not authorized

to respond to questions about what the US

attorney's office or the FBI told me, or what I

told them.· It is my understanding that I am not

allowed to share the set of documents, that I

received from them, but I did on my list of

documents say that I had reviewed the video

recording of the last whatever it was 7 days of Mr.

Stojcevski's life.

· · · Q· · ·Bare with me, this is important for me

to explore.· I am sure will be become the subject

of a motion.

· · · A· · ·Okay.

· · · Q· · ·Let me just explore it.

· · · · · · I want to give you an opportunity to

identify everything.

· · · · · · What I hear you saying is, you spent

time looking at this case at the request of the US

government?

· · · A· · ·Yes.

· · · Q· · ·And you spent time looking at documents

that they gave you to look at, correct?

· · · A· · ·Correct.

Page 28

· · · Q· · ·That they obtained through subpoenas, I

know I responded and gave them a bunch of documents

they got through subpoenas?

· · · A· · ·Correct.

· · · Q· · ·You spent time talking to

investigators, FBI agents, US attorneys, whatever

in discussions about this case, correct?

· · · · · · Don't tell me what you said, that you

talked to people about the case?

· · · A· · ·Yes.

· · · Q· · ·They provided, did they provide

additional opinions to you that maybe they got from

other sources?

· · · · · · · · · MR. PERAKIS:· Objection, he said

· · · · · · he can't talk about opinions, that they

· · · · · · talked about.

· · · · · · · · · MR. CHAPMAN: Form and foundation.

· · · · · · Did you, and if you can't talk about

· · · · · · it, you say you can't disclose that.

· · · · · · Move on.

· · · · · · · · · MR. PERAKIS:· I am telling you,

· · · · · · you can't.

· · · · · · · · · MR. CHAPMAN: Form and foundation.

· · · · · · Let me question this person on my own.

· · · · · · · · · MR. PERAKIS:· He already

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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04/04/2018 Pages 25–28

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7649 Filed 01/19/21 Page 9 of 39
Page 29

· · · · · · explained to you he can't do it, and you

· · · · · · need to respect that.

· · · · · · · · · MR. CHAPMAN: I don't need to

· · · · · · respect that at all, until he tells me

· · · · · · he can't answer the question, your not

· · · · · · his attorney let's not do that.

· · · · · · · · · MR. PERAKIS:· He already told

· · · · · · you.

· · · · · · · · · MR. CHAPMAN: No, he hasn't.

· · · · · · · · · Be quiet and let him answer the

· · · · · · questions.

· · · A· · ·My understanding, I can't disclose

that.

· · · Q· · ·What you are telling me is, you have a

body of knowledge, that you have learned through

your work with the FBI and US government in this

case, that you applied to your opinions and things

in this case, but I am prohibited from questioning

you on those because of your disclosure agreement

with the government?

· · · A· · ·No, all of my opinions are based on

materials that I received from Mr. Perakis.· I did

not, I was just familiar for example, with the

clinical guidelines and the lesson plans not only

from work on this case, because I worked with CCS

Page 30

on other venues.

· · · Q· · ·Here is the thing that bothers me.

· · · · · · You said, I said and I am somewhat

shocked, but you could have gone to the Evelyn

speed reading course and been their stellar

performer for years, and you spent 4.75 hours

reading several pages of documents.· Your response

was, you have to understand, I am already familiar

with that material.

· · · · · · Did you gain your familiarity, while

working for the government?

· · · A· · ·In part, yes.

· · · Q· · ·But you are telling me because of your

non-disclosure, I cannot question you about what

you looked at during your employment, who you

talked to, what information they gave you to you,

what dialogue you had with investigators?

· · · A· · ·That is my understanding.

· · · · · · · · · MR. CHAPMAN: Well, I think we

· · · · · · have a problem.· I am going to take a

· · · · · · break, Bob.

· · · · · · There is a serious problem here.

· · · · · · · · · MR. GAZALL: Call me on my phone.

· · · · · · · · · (Break taken at 9:46 a.m.)

· · · · · · · · · (Back on the record at 9:58 a.m.)

Page 31

· · · · · · · · · MR. CHAPMAN: Let's go back on the

· · · · · · record, Dr.

· · · Q· · ·The work that at least the work that

you billed Mr. Perakis for, is contained in your 4

invoices, correct?

· · · A· · ·No, it is not correct.

· · · · · · Mr. Perakis just reminded me that he

had sent me a 5,000.00 retainer which would have

paid for at least ten hours of work, that may not

be reflected on those invoices.

· · · · · · I looked up -- my, I did approximately,

twenty hours work.

· · · Q· · ·So you are saying total, you did

approximately twenty hours work?

· · · A· · ·For Mr. Perakis.

· · · Q· · ·Twenty hours including your $5,000.00,

and whatever?

· · · A· · ·Yes, yes.

· · · Q· · ·Let's, look at this, and see what we

have.

· · · · · · We have, and that is not counting my

prep yesterday.

· · · · · · That would be the bill you sent him for

418?

· · · A· · ·Yes.

Page 32

· · · Q· · ·Well sir, I I didn't add it up with a

calculator, so I might not be accurate.

· · · · · · Comes to 21.33 hours for your three

invoices.· Looks like all your time is accounted

for.

· · · A· · ·Then, it is all there, okay.

· · · Q· · ·Now, I see a copy of your report on

here.

· · · · · · One in word form as well as one in PDF

form.

· · · A· · ·I should have just put the PDF on

there.

· · · Q· · ·Now, for example on this list of

documents, you have here you have a number of

expert records from the defendants, your report was

drafted before those expert reports were ever

produced.

· · · · · · Your report was drafted quite a while

before those were ever produced?

· · · A· · ·That is correct.

· · · Q· · ·Those expert reports did nothing to

aide you in formulating opinions in your report,

correct?

· · · A· · ·That is correct.

· · · Q· · ·You would agree with me on I guess on a

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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04/04/2018 Pages 29–32

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7650 Filed 01/19/21 Page 10 of 39
Page 33

hypothesis that any documents or any testimony

created after you formulated your report, could not

have been used by you in formulating your report,

correct?

· · · A· · ·Yes.

· · · Q· · ·Do you stand by your report as being

accurate and fairly reflecting all of your opinions

in this case?

· · · A· · ·Yes, I did review the.

· · · · · · · · · MR. CHAPMAN: Mr. Perakis, the

· · · · · · doctor answered yes, and then you signal

· · · · · · to him, then he wants to amend his

· · · · · · answer.· You have got to stop that

· · · · · · stuff.

· · · · · · You can't counsel, correct, educate, or

· · · · · · assist or help the witness testify.

· · · · · · · · · MR. PERAKIS:· That is fine.

· · · Q· · ·Looking at your report, Dr., is that

your signature at the end of the report?

· · · A· · ·Yes.

· · · Q· · ·Did you draft the report?

· · · A· · ·Yes.

· · · Q· · ·Were there other drafts of this report,

or was it just that particular draft?

· · · A· · ·I draft my reports dynamically, that is

Page 34

I begin with an A template, which has my backround

on it, and as I review materials, I add findings

which are pretty much historical and then I

complete the report with opinions.

· · · Q· · ·So you don't just sit down, if I hear

what you are saying, you don't just sit down and 4

hours later there is a report.

· · · · · · It is a process that doesn't begin and

end in one sitting?

· · · A· · ·Typically, that is correct.

· · · Q· · ·And, and then that is your signature,

at the end, correct?

· · · A· · ·Yes.

· · · Q· · ·Is your CV reasonably accurate?

· · · A· · ·Reasonably, so.

· · · Q· · ·Have you had any publications that

aren't in your CV that relate directly to the

psychiatric treatment of patients in a county jail?

· · · A· · ·I co-authored a chapter in the textbook

that I edited on treatment planning for mentally

ill inmates.

· · · Q· · ·Did you do that after you prepared your

CV?

· · · A· · ·No, it is on my CV.

· · · Q· · ·Listen to my question.

Page 35

· · · · · · I understand your CV.

· · · · · · You said it is fairly accurate.

· · · · · · My question is that, have you published

any publications relating to the treatment of

psychiatric patients in a county jail that is not

reflected in your CV; in other words, something you

might have done yesterday, a day before, a month

ago, a week before, or something?

· · · A· · ·No.

· · · Q· · ·Have you published anything relating to

the detoxification of people suffering from a

variety of addictions, that relate to

detoxification in a county jail that is not

reflected in your resume?

· · · A· · ·I am co-author of a paper that was

recently published, regarding opiate substitution

therapy.· I am not sure if that is reflected on the

version of my resume that you got; I believe it is

but -- just to say for the the record that, that is

a fact.

· · · Q· · ·Have you ever published anything

relating to catatonia?

· · · A· · ·No.

· · · Q· · ·Have you ever been involved in any

research projects that relate specifically to the

Page 36

diagnosis or treatment of catatonia?

· · · A· · ·No.

· · · Q· · ·Have you written or been involved in

any research projects that deal with forensic

pathology as a science in determining the cause of

death?

· · · A· · ·No.

· · · Q· · ·As to the cause of death of Mr.

Stojcevski in this case, am I correct in assuming

that you rely on the opinions of pathology experts

in this case; in other words, you defer to people

more learned than yourself in the science of

pathology?

· · · A· · ·Yes.

· · · Q· · ·With respect to the diagnosis and

treatment of neurological conditions, am I correct

that you defer to people that are board certified

and more highly trained in the science of neurology

than yourself?

· · · A· · ·Yes.

· · · Q· · ·With respect to the opinions relating

to psychiatric conditions Dsm-5 applications,

treatment of psychiatric conditions, you would rely

on people that are more learned in medicine than

yourself, to make those determinations and

GREIFINGER, M.D., ROBERT

04/04/2018

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04/04/2018 Pages 33–36

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7651 Filed 01/19/21 Page 11 of 39
Page 37

opinions?

· · · A· · ·Yes.

· · · Q· · ·I am assuming that this report that you

drafted June 7, 2017, at least completed on that

date, this is not your one and only expert report,

that you have ever drafted, not meaning this case,

other cases you have drafted the other reports?

· · · A· · ·Yes.

· · · Q· · ·And I say that, because you are

familiar with the requirements of expert reports in

federal litigation, correct?

· · · A· · ·Yes.

· · · Q· · ·Is it important to be truthful in

drafting a report an expert report that is

submitted to the federal court in support of

opinions you might have?

· · · A· · ·Yes.

· · · Q· · ·There is a section in your report, if

you can turn to it that is called, materials

reviewed.

· · · · · · Do you see that, I think it is, you got

ten items listed here.· We have already had the

discussion.

· · · · · · There are other items that are on this

flash drive.

Page 38

· · · · · · Other than the items listed on this

flash drive and the one item that is listed here,

item number 16, which isn't on the flash drive.

· · · A· · ·Yes, it should be.

· · · Q· · ·The only thing you reviewed for this

case, that is on the flash drive other than all the

things you reviewed for the government?

· · · A· · ·Yes, that is correct, to the best of my

recollection.

· · · Q· · ·Now item number 14 says, video

recordings, relevant to Mr. Stojcevski's, period of

confinement.

· · · · · · What do you mean by, relevant?

· · · A· · ·I mean, I reviewed the video

recordings, to the extent they existed.

· · · · · · Let me say it a different way.

· · · · · · I reviewed the video recordings that I

got, from the Department of Justice.

· · · Q· · ·Okay. Now to the best of my knowledge

and Mr. Perakis will correct me here if I am wrong,

there are about 240 hours of video, if he was in a

video cell from June 11th, not June 11th, June 17th

at about 1350 hours, until June 27th, that is about

ten days.

· · · · · · Those hours, did you review all 250 so

Page 39

or hours that would be ten days of sitting in front

of a video machine?

· · · A· · ·I don't know, if I am allowed to

discuss that.

· · · Q· · ·That is because that might have been

something you did with the DOJ?

· · · A· · ·Yes.

· · · Q· · ·Not, to beat something up.

· · · · · · You don't know if you are allowed to

discuss it, you signed some kind of confidentiality

agreement, you think might be problematic, for

discussing it?

· · · A· · ·Yes, I am not trying to be difficult.

I am just trying to keep out of trouble with the

FBI.

· · · Q· · ·If you think you can't talk about, just

say you can't talk about.

· · · · · · I am not going to press.· I will deal

with it later, if I think I need to deal with it.

· · · A· · ·Okay.

· · · Q· · ·These hours of tape, can you tell me

how many hours you reviewed, or you think that is

something you can't talk about?

· · · A· · ·I think, that is something I can't talk

about.

Page 40

· · · Q· · ·Can you tell me if you looked at these

tapes in fast forward; three times, 4 times, 5

times fast forward?

· · · A· · ·I can tell you I am very familiar with

fast forward.

· · · Q· · ·When you say, you are very familiar,

that means you probably used it in this case; if

you can't tell me, say you can't tell me.

· · · A· · ·I don't think, I can tell you that.

· · · Q· · ·Okay, look at item number 15, it says,

meal in hydration summary.

· · · · · · This is something that would be on this

drive?

· · · A· · ·Yes.

· · · Q· · ·Now is this some document that

Mr. Perakis prepared or someone from his office?

· · · A· · ·Yes, someone either he prepared it or

someone from his office did.

· · · · · · · · · MR. CHAPMAN: Could you let me

· · · · · · turn this over here.

· · · · · · · · · Can you maybe step up and find

· · · · · · the document, maybe Mr. Perakis is used

· · · · · · to or more familiar with what is there.

· · · · · · · · · (Attorney and witness looking at,

· · · · · · computer screen.)

GREIFINGER, M.D., ROBERT

04/04/2018

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 37–40

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7652 Filed 01/19/21 Page 12 of 39
Page 41

· · · Q· · ·Mr. Perakis identified a PDF folder

that is called, meals and hydrations.

· · · · · · Show you on the screen looks something

like that.

· · · · · · Is that what you are familiar with?

· · · A· · ·Yes.

· · · Q· · ·Did you prepare that or somebody

prepared that for you?

· · · A· · ·I did not prepare that.

· · · Q· · ·Do you know who prepared it?

· · · A· · ·No.

· · · Q· · ·Do you believe it was prepared by,

somebody from Mr. Perakis's office or Mr. Perakis?

· · · A· · ·Yes.

· · · Q· · ·How do you know it is accurate?

· · · A· · ·I don't.

· · · Q· · ·Is it typical for somebody on your

position to rely on information that they don't

know, if it is accurate or not accurate and it is

prepared in this case by somebody who has an

invested interest in this particular case.

· · · · · · It is not like an independent third

party coming in to prepare a document like maybe an

expert?

· · · · · · How do you know it is accurate?

Page 42

· · · A· · ·I just list it as documents, they

reviewed.

· · · Q· · ·Do you agree that a human can go 21

days without any food whatsoever, and substantially

longer if they have a modicum of food?

· · · · · · · · · MR. PERAKIS:· Objection to form

· · · · · · and foundation.

· · · Q· · ·If you don't know, say you don't know.

· · · A· · ·Can go before they die?

· · · Q· · ·Before they die.

· · · A· · ·To the extent someone is maintaining

some degree of hydration, they could go.

· · · Q· · ·I am not talking about hydration.· I am

talking about food.

· · · A· · ·I am qualifying my answer to the extent

they maintain some form of hydration, they can go

for without food for approximately three weeks,

without dying of starvation.

· · · Q· · ·We actually know from, and I don't want

to bring it up, we know from concentration camps

and other things, people can go substantially

longer than 21 days if they have some food.

· · · · · · · · · MR. PERAKIS:· Objection to form

· · · · · · and foundation.

· · · · · · · · · MR. CHAPMAN: Good objection.

Page 43

· · · A· · ·Yes.· Your question was without food?

· · · Q· · ·Do you agree with no food, 21 days, but

they can go substantially longer, if they have some

food, periodically?

· · · A· · ·That is correct.

· · · Q· · ·Have you been trained in how to analyze

the body of a deceased person to determine whether

starvation was a cause of death?

· · · A· · ·No.

· · · Q· · ·Do you agree that a human can go one

week without any water and substantially longer if

they have some water?

· · · · · · · · · MR. PERAKIS:· Objection to form.

· · · · · · · · · We are not talking about any

· · · · · · human.

· · · · · · · · · We are talking about one human.

· · · · · · · · · MR. CHAPMAN: Form and foundation.

· · · · · · · · · MR. PERAKIS:· And foundation.· Is

· · · · · · whether he is --

· · · · · · · · · MR. CHAPMAN: No speaking

· · · · · · objections.

· · · · · · · · · Go ahead and answer the question.

· · · Q· · ·Do you agree a human can go one week

without any water and substantially longer with

some water?

Page 44

· · · A· · ·Some people can go, up to a week

without water, and most people could go

substantially longer, if they have some water.

· · · Q· · ·Were you aware that there is a working

faucet, in Mr. Stojcevski's cell during his entire

stay?

· · · A· · ·I don't recall.

· · · Q· · ·If you watched the videos, you might

have seen multiple times him actually getting up

and getting a drink of water from the faucet.

· · · · · · Did you see that?

· · · A· · ·I watched the videos.

· · · Q· · ·Did you see that?

· · · A· · ·I don't recall.

· · · Q· · ·Again, if you can't answer a question

because of this agreement you have with the

government, tell me and I will move on okay, fair

enough?

· · · A· · ·Yes.

· · · Q· · ·Did you watch him drink water?

· · · A· · ·I don't recall.

· · · Q· · ·Did you watch on the video, guards and

nurses periodically giving him water to drink?

· · · A· · ·Yes.

· · · Q· · ·Did you read any of the material where

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 41–44

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7653 Filed 01/19/21 Page 13 of 39
Page 45

nurses and guards, reminded him that you know, you

should drink water?

· · · A· · ·Yes.

· · · Q· · ·Item number 16, says that you looked at

an article from Dean Reager, that talks about the

difference between, malpractice and deliberate

indifference.

· · · · · · Can you please tell me what relevance

that has to do with anything we are talking about

today?

· · · A· · ·None, whatsoever.

· · · Q· · ·Why did you read it?

· · · A· · ·Because, I saw it and he was the chief

medical officer of CCS at the time, and this is a

case in federal court that from a legal point of

view has to do with deliberate indifference.

· · · Q· · ·But you understand or you agree don't

you, that that particular article was a

non-scientific, non-scholarly article that was

published that basically was about, let's just say

lacked depth, in talking about the difference

between malpractice and deliberate indifference.

· · · A· · ·You are asking me for my judgment about

that.

· · · Q· · ·Sure, you read it.

Page 46

· · · A· · ·Yes, I would agree with you.

· · · Q· · ·There is no basis in your opinion?

· · · A· · ·Absolutely not.

· · · Q· · ·Could you list for me or not for me,

for the record, any of your medical training in the

field of psychiatry, after you completed medical

school in 1971; formal training, not things you

might have read.· Formal training.

· · · A· · ·I had formal training during my

residency.

· · · Q· · ·After your residency then?

· · · A· · ·No formal training.

· · · Q· · ·In your formal training during your

pediatric residency, would that be in pediatric

psychiatry?

· · · A· · ·No, it was general psychiatry.

· · · Q· · ·Again, that would be, where you spent a

rotation in a psychiatric area?

· · · A· · ·No, the social medicine program had a

full time psychiatrist on the faculty and so we had

lots of lectures and workshops and seminars on

psychiatric issues.

· · · Q· · ·And this was a program you completed in

1976, correct?

· · · A· · ·Correct.

Page 47

· · · Q· · ·41 years ago?

· · · A· · ·Whatever, I am an old man.

· · · · · · · · · MR. CHAPMAN: For the record, you

· · · · · · are not that old.

· · · Q· · ·Could you list all the medical training

you have received in the field of neurology, let's

say outside of or after your residency program that

you completed in 1976?

· · · A· · ·No, no formal training since that time.

· · · Q· · ·Can you list all your formal training

that you had in the field of forensic pathology

since your medical school training that ended in,

1971?

· · · A· · ·No, formal training since that time.

· · · Q· · ·Could you list all of your medical

training you received in the field of nursing?

· · · A· · ·No formal training, since that time.

· · · Q· · ·Please list all of your medical

training that you have received in the field of

addiction management and treatment since completing

your medical training in 1971?

· · · A· · ·No, formal training since that time.

· · · Q· · ·Are you, do you hold or have you ever

held --

· · · A· · ·I am sorry.· Since the end of my

Page 48

residency, I did have formal training, during my

residency, as I testified earlier.

· · · Q· · ·Sure.

· · · · · · Have you ever held the New York State

Certification of Certified Addiction Professional?

· · · A· · ·No.

· · · Q· · ·Could you please state the title and if

you need to look at your resume, we can get that to

you; the title of the last scholarly article that

you reviewed, that specifically dealt with,

withdrawal symptoms related to benzodiazepine, or

if you haven't looked at one in the last 5 years

say you haven't.

· · · A· · ·Oh, I have.· I just can't recall

specifically, I can't recall the specific article.

· · · Q· · ·Could you state the last scholarly

article that you reviewed that specifically dealt

with the diagnosis and treatment of catatonia?

· · · A· · ·No.

· · · Q· · ·Please state the title of the last

scholarly article that you reviewed that

specifically dealt with the treatment or death, as

a result of starvation?

· · · A· · ·I don't recall.

· · · Q· · ·Please state the title of the last

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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04/04/2018 Pages 45–48

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7654 Filed 01/19/21 Page 14 of 39
Page 49

scholarly article you reviewed that specifically

dealt with death, as a result of dehydration?

· · · A· · ·I don't recall.

· · · Q· · ·Could you list for me, the names and

the titles of individuals, that you believe

approximately caused the death of Mr. Stojcevski,

because of their actions or inactions; and be

specific.

· · · · · · I want the name and the title, after

the person.

· · · A· · ·Okay. I am going to refer to my report.

· · · Q· · ·You can refer to your report, sure.

· · · A· · ·For this purpose, Correct Care

Solutions, if that corporation counts as a person.

Dr. Sherman, who is the medical director at the

Macomb County Jail, excuse me, did you talk about

health care people or all people, clarify that.

· · · Q· · ·My question relates to health care,

don't know if you want me to explain it to

everybody.

· · · · · · Give me the name and title.

· · · A· · ·Correctional Officer Harrison, Mental

Health Director Natalie Pacito, David Arft who was

the health service administrator.· Ms. Cueny, who

is the registered nurse, and nursing director.· LPN

Page 50

Tiffany Deluca.· Nurses Heather Erlich, Teresa

Williams, Correctional Officer Likavoli.

Correctional Officer Campo, Mental Health

Professional Daniel Nelson, who was known at the

time as Daniel Covins.· LPN Breen.· LPN Lisa

Bingham.· Mental Health Professional Brock.· Mental

Health Professional, Kelly Mann.· Correctional

Officers, Oxly· Cueny, Gallos, McGilly, Avery,

Venio, Glout, Ray, White and Polasky.· LPN Bey

Shelly, LPN Breen, LPN Williams, LPN Parkin, MPN

Barber, LPN Havy.

· · · · · · I am not sure if I have the right title

for Kelly Mann.· It is a mental health

professional, that is all I can identify, at this

time.

· · · Q· · ·Let's start with first Deena Pavey.

· · · · · · Can you please give me the date of any

action or inaction, that she did that in your

professional opinion approximately caused the death

of Mr. Stojcevski; meaning if she hadn't done it,

or did it, Mr. Stojcevski would not have died?

· · · A· · ·I don't recall.

· · · Q· · ·In you are the expert.· You just said

that these individuals proximately caused the

death.

Page 51

· · · · · · I want to know the date and the act or

action that Ms. Pavey did, that which proximately

caused Mr. Stojcevski's death.· I got all day.

· · · · · · Look at anything you want.

· · · A· · ·I can state specifically, that all of

these people were aware of Mr. Stojcevski's

addiction, his condition, his tremors, his

unresponsiveness, his seizures, his lying naked on

the on the floor.· And, on a systematic basis,

persistently, not one of all these individuals, who

I mentioned, took any action to try to save his

life.

· · · Q· · ·I am going to go back and ask my

question again.

· · · · · · Liability in 1983, and you have been

around the block a long time, is not based on the

corrective action or inaction of groups of people,

individual acts.· What individual act or failure to

act, did Ms. Pavey do and give me the date she gave

it that approximately caused Mr. Stojcevski's

death.

· · · · · · If you don't know, or you can't tell me

because you learned about this through the DOJ,

tell me that.

· · · A· · ·No, I don't recall.

Page 52

· · · Q· · ·I will be here all day till you recall.

· · · · · · If you don't know say you don't know.

If you don't recall, read whatever you want.

· · · · · · · · · MR. PERAKIS:· He has no

· · · · · · obligation to read the entire file.· If

· · · · · · you have questions about particular

· · · · · · documents, ask him.· He is not going to

· · · · · · sit here and go through 4000 pages.

· · · · · · · · · It is your job to do that.

· · · · · · · · · MR. CHAPMAN: Sure, he can do

· · · · · · that.

· · · · · · · · · MR. PERAKIS: It is your job to do

· · · · · · that.· We disagree what your job is.

· · · · · · · · · MR. CHAPMAN: Object to form and

· · · · · · foundation.· Irrelevant to this

· · · · · · deposition.

· · · Q· · ·Sir, answer the question.

· · · A· · ·I can't answer it at this time.· I am

unable to do so.· I did not chronicle the

individual actions in that manner.· So, I don't

have easy access to that.

· · · Q· · ·What did Ms. Pavey do, what was her

involvement?

· · · A· · ·It is what she didn't do.

· · · Q· · ·What was her job?

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 49–52

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7655 Filed 01/19/21 Page 15 of 39
Page 53

· · · A· · ·Her job was to try to take care of her

patient to make sure her patient doesn't suffer

harm from being abandoned.

· · · Q· · ·Why did you believe that Mr. Stojcevski

was Ms. Pavey's patient what was Ms. Pavey's title;

what did she do, what was her function?

· · · A· · ·I don't recall.

· · · Q· · ·How can you make a conclusion she

failed to do something when you don't know what she

did?

· · · A· · ·My conclusion was based on the

aggregate as I mentioned before that nobody took

any action to save the life of a patient, who was

deteriorating and dying.

· · · Q· · ·Tell me specifically what Ms. Parton

did or did not do specifically to proximately cause

the death of this individual?

· · · A· · ·I have the same answer.

· · · Q· · ·Which is you don't know?

· · · A· · ·No, the answer is I didn't put my

report together in that manner so I didn't

chronicle each of those.

· · · Q· · ·You understand sir, I only get to

depose you once you can't point by saying well I

didn't put my report that way, because I will wait

Page 54

all day.

· · · A· · ·Sure, I didn't do my work in that

manner in a manner I can answer that question.

· · · Q· · ·You understand that is the critical

question that somebody can only be responsible if

they proximately cause the death of somebody?

· · · A· · ·If that is your testimony, that is not

-- that would be putting words in my mouth.

· · · Q· · ·Let me ask you this.· I am going to go

through all of these.· It your opinion with all of

the individuals on the medical side, if I ask you

the question to tell me specifically what they did

or did not do.· Give me the date and time that they

did not do something to proximately cause you're

your answer would be, I didn't look at the file, I

don't have the information.

· · · A· · ·I may be able to answer that for you.

· · · Q· · ·For which ones?

· · · A· · ·For Dr. Sherman and mental health

professionals.

· · · Q· · ·For all the other nursing professionals

your answer would be you don't have that

information?

· · · · · · · · · MR. PERAKIS:· Form and

· · · · · · foundation.

Page 55

· · · A· · ·You didn't let me finish my September

and for Nurse Cueny, Monica Cueny.

· · · Q· · ·For all of the other nursing

professionals your answer would be you don't have

that information?

· · · · · · · · · MR. PERAKIS:· That is not what he

· · · · · · has testified to, he said I don't recall

· · · · · · that is your job if you actually want

· · · · · · his opinion.

· · · Q· · ·Doesn't give speaking opinions, shut

up?

· · · · · · · · · MR. PERAKIS:· If you truly want

· · · · · · his opinion ask him questions like you

· · · · · · are interested in his answers.

· · · · · · · · · MR. CHAPMAN:· I am very

· · · · · · interested in his answers.

· · · · · · · · · MR. PERAKIS:· Apparently you are

· · · · · · not.

· · · · · · · · · MR. CHAPMAN: Don't give

· · · · · · objections that are allowed under the

· · · · · · court rules.

· · · · · · · · · Let's do that please.

· · · · · · · · · MR. PERAKIS:· I will do what I

· · · · · · feel is appropriate under the

· · · · · · circumstances, and this is appropriate.

Page 56

· · · · · · You are not prepared for this

· · · · · · deposition, it is clear, because you

· · · · · · don't know what records he reviewed you

· · · · · · are not willing to go through the

· · · · · · records that he reviewed.· If you were,

· · · · · · you would get answers.

· · · Q· · ·Dr., tell me specifically what Ms.

Pacito did that proximately caused the death of

Mr. Stojcevski?

· · · A· · ·Ms. Pacito failed to train and

supervise the mental health professionals who

worked for her and if there is something further

then I will look at my report.· Natalie Pacito was

apparently told by Lisa Bingham, on June 20, that

Mr. Stojcevski behavior was bizarre, and she didn't

take any action, as a matter of fact he was on

suicide watch for reasons I could never understand

because there was no indication or documentation in

the medical record that he should have been

classified as such but she certainly didn't take

any action to try to get at what the source of this

bizarre behavior was.

· · · Q· · ·Since those individuals gave those

depositions after your report, how would you know

that?

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 53–56

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7656 Filed 01/19/21 Page 16 of 39
Page 57

· · · A· · ·This is in my report.

· · · Q· · ·It is in your report, they gave your

deposition after your report.

· · · · · · How would you know that; did you learn

that through the DOJ?

· · · A· · ·No.

· · · Q· · ·How would you know it?

· · · A· · ·Because it was in the medical records.

· · · · · · · · · MR. CHAPMAN: Here is a copy of

· · · · · · the medical records.· Find me the

· · · · · · medical records where it is in.

· · · · · · · · · MR. PERAKIS:· For the record, it

· · · · · · is not in the medical records.

· · · · · · · · · MR. CHAPMAN: Do not testify for

· · · · · · him.

· · · · · · · · · MR. PERAKIS:· I am going to

· · · · · · testify about what you are doing, you

· · · · · · know what the facts are.· They are in

· · · · · · the complaint.

· · · · · · · · · MR. CHAPMAN: The complaint has

· · · · · · nothing do with the facts.

· · · · · · · · · MR. PERAKIS:· The complaint has

· · · · · · everything to do with the facts.

· · · · · · · · · Mr. CHAPMAN: You are losing your

· · · · · · case and trying to direct your witness.

Page 58

This is absolutely bizarre.· You cannot

do this.

· · · MR. PERAKIS: I can do what I feel

is appropriate.

· · · You are not asking the questions

based on the records that he looked at.

You prefer to have these

generalizations, without getting any

answers.· You know what the answers are

going to be.· They are not going to

benefit you, that is not the purpose of

the deposition.· The purpose of the

deposition is get to the facts and your

not doing it.· If you don't want to know

the facts, fine why even do the

deposition.

· · · MR. CHAPMAN: You know, sir.· I am

fed up with your diatribes, and trying

to coach your witnesses.· It is beyond

professionalism, as an attorney.

· · · MR. PERAKIS:· I disagree with

you.

· · · MR. CHAPMAN: Take a break for a

second, Bob.

· · · We will call you in a minute.

Page 59

· · · · · · · · · (A break was taken at 10:42 a.m.)

· · · · · · · · · (The deposition resumed at 10:50

· · · · · · a.m.)

· · · Q· · ·What were you looking at, first?

· · · A· · ·I was looking at the fact chronology.

· · · Q· · ·Dr., could you please explain to me

what action or inactions Mr. Arft did that

proximately caused the death of Mr. Stojcevski and

the date of those actions or in actions?

· · · A· · ·He failed to train and supervise the

staff who reported to him, which included among

others Monica Cueny and the licensed practical

nurses.

· · · · · · His failure to do that prior to the

incarceration of Mr. Stojcevski, was an proximate

cause of his abandoning this patient, watching the

deteriorating, unresponsive patient die before

their eyes.

· · · Q· · ·What specific training did they fail to

do?

· · · A· · ·He failed to assure that they were

trained in the clinical guidelines for, withdrawal.

They failed to, effectively convey the lesson plan

on detoxification and withdrawal, failed to, follow

the CCS policy of, I don't remember his specific

Page 60

words, but to protect, to provide timely care in an

appropriate level for the patients in their charge,

so this was in one of the policies that I reviewed.

He also failed to assure that they knew what to do

to monitor a patient who is unresponsive.· I have

to monitor them with vital signs and with intake

and output measurements and to try to determine the

reason for physical and mental deterioration.

· · · Q· · ·What clinical guidelines did he

specifically not train somebody on?

· · · A· · ·The clinical guideline on

detoxification and withdrawal.

· · · Q· · ·What specific part did he not train

somebody on?

· · · A· · ·Let's go find the policy and look at

it.

· · · Q· · ·I asked you to bring everything that

you looked at.· Here is the flash drive.

· · · A· · ·Now you are playing games.

· · · · · · · · · MR. PERAKIS:· You said.

· · · Q· · ·I am here to depose you with all of the

documents.

· · · A· · ·It is right here.

· · · Q· · ·No, if you need a computer to look at

this -- did you bring a computer to look at these

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 57–60

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7657 Filed 01/19/21 Page 17 of 39
Page 61

documents; you knew I was going to depose you on

those.

· · · A· · ·I did not bring a computer.

· · · Q· · ·Why would you not bring the document

when I asked you; I subpoenaed, I filed a subpoena

duces tecum.

· · · · · · Why did you not bring sufficient means

to go through the documents so I could question

you?

· · · A· · ·It is my understanding that counsel

informed you that I was going to bring a flash

drive and a copy of my report, that there were no

objections to that, on your part.

· · · · · · · · · MR. PERAKIS:· That is accurate.

· · · Q· · ·What did you need to look at my

computer, to find something?

· · · · · · I am not leaving the question until you

tell me specific what part of a guideline did

Mr. Arft, have to train somebody on?

· · · A· · ·Okay let's look at your computer,

another one.

· · · Q· · ·Ms. Deluca, would you please tell me

the dates of any action or inactions that

proximately caused the death of Mr. Stojcevski?

· · · A· · ·I don't recall.

Page 62

· · · Q· · ·Heather Ehrlich, can you tell me the

date of any act or inaction that proximately called

the death of Mr. Stojcevski?

· · · A· · ·I don't recall.

· · · Q· · ·Ms. Williams, Ms. Teresa Williams.

· · · · · · Any act or inaction that she performed

or did, the date that proximately caused the death

of Mr. Stojcevski?

· · · A· · ·I don't recall.

· · · Q· · ·Ms. Nelson, could you please tell me

the date of any act or inaction that proximately

caused the death of Mr. Stojcevski?

· · · A· · ·I don't recall.

· · · Q· · ·Ms. Bertram, can you please tell me the

date and act or inaction that proximately cause the

death of Mr. Stojcevski?

· · · A· · ·I don't recall.

· · · Q· · ·Ms. Breen, can you please tell me the

date of the act or inaction that proximately caused

the death of Mr. Stojcevski?

· · · A· · ·I don't recall.

· · · Q· · ·Should say proximately caused.

· · · A· · ·The same with Ms. Bingham.

· · · · · · Can you please tell me the date of the

act or inaction that proximately caused the death

Page 63

of Mr. Stojcevski.

· · · · · · · · · MR. PERAKIS:· Bob, for the record

· · · · · · you are aware that Ms. Bingham, was

· · · · · · dismissed out of the case, right?

· · · · · · · · · MR. GAZALL: I am.

· · · Q· · ·He listed somebody who is liable.· I am

going through, I understand it was dismissed to go

ahead, and answer the question, sir.

· · · A· · ·I don't recall.

· · · Q· · ·Dr., let's continue.

· · · · · · Can you please tell me the date of the

act or inaction, of Michael Bey-Shelly, that

proximately caused the death of Mr. Stojcevski?

· · · A· · ·I don't recall.

· · · Q· · ·Can you please tell me the act or

inactions of Ms. Breen that proximately caused the

death of Mr. Stojcevski?

· · · A· · ·I don't recall.

· · · Q· · ·Now, I think I asked you on these so

can you clarify.

· · · · · · Can you please tell me the date of the

action or inactions of Ms. Pavey, that proximately

caused the death of Mr. Stojcevski?

· · · A· · ·What is the name?

· · · Q· · ·Ms. Pavey.

Page 64

· · · A· · ·I don't recall.

· · · Q· · ·Can you please tell me the date or the

date of act or inactions, of Ms. Barber, that

proximately caused the death of Mr. Stojcevski?

· · · A· · ·I don't recall.

· · · Q· · ·Before we go down that list.· We were

talking about Mr. Arft.· You said Mr. Arft trained

staff on the typical guidelines.

· · · · · · What clinical guidelines, are you

referring to?

· · · A· · ·I have already testified the clinical

guidelines.

· · · Q· · ·What specifically did he fail to train

them on, and I have your file up here, as well.

· · · · · · Could you identify the document in the

record here?

· · · · · · Don't help him find documents.

· · · · · · · · · MR. PERAKIS:· He can't see it.

· · · · · · · · · MR. CHAPMAN:· No, you can't see

· · · · · · it and identify for him.

· · · · · · · · · MR. PERAKIS:· Ask him questions

· · · · · · about your policies and procedures.· You

· · · · · · have copies of them.· It is your client.

· · · · · · If you want answers, you ask questions.

· · · · · · · · · MR. CHAPMAN:· I am waiting for

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 61–64

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7658 Filed 01/19/21 Page 18 of 39
Page 65

the answer right now.

· · · MR. PERAKIS:· This is how he is

testifying at this point.· You have his

report.· You have full ability to look

at the report and make the

determinations how he based his opinion.

If you don't want to do it, that is fine

by me.

· · · MR. CHAPMAN: Please don't help

him find documents.

· · · MR. PERAKIS:· I can do what I

want.

· · · MR. CHAPMAN: You cannot direct

him to find documents.

· · · Let the record reflect, that

Mr. Perakis is looking at the document

trying to get him to answer questions.

· · · MR. PERAKIS:· Let the record

reflect, they are in his report the

specific notification to you of the

specific policy, and why it was

violated.· You don't want to talk about

his report, and that is okay.· If you

don't want more information about his

report, go for it, then finish the dep

Page 66

· · · · · · and be done with this.

· · · · · · · · · He is giving you the report.

· · · · · · Look at it.

· · · A· · ·I don't know how to find it. Well, they

are in here some way.· I don't know how to find it.

· · · Q· · ·I am waiting for you to find it, sir?

· · · A· · ·I know, you are.

· · · Q· · ·This flash drive that you have in the

computer, the court reporter is kind enough to loan

us, is the way you received the files from

Mr. Perakis, correct?

· · · A· · ·That is correct.

· · · Q· · ·Those are the ways, you would have

looked at it.· I opened every file.· Now, you can

continue to find them.

· · · · · · · · · MR. PERAKIS:· What is the point

· · · · · · here if he referenced your policies,

· · · · · · that you are well aware of, in his

· · · · · · report, that is sufficient for you to

· · · · · · question him about.· If you are claiming

· · · · · · that somehow he doesn't have the

· · · · · · documents, I don't know what to tell you

· · · · · · except he had them.· If they are not in

· · · · · · here, that doesn't do anything for you.

· · · · · · · · · Take a break.

Page 67

· · · MR. CHAPMAN: There is a question,

on the table.

· · · MR. PERAKIS:· Take a break.

· · · MR. CHAPMAN: Continue to the

documents.

· · · THE WITNESS: I can't find the

documents right now.· I have cited the

bates numbers and those should be

available through, either parties.

· · · MR. CHAPMAN: I appreciate that,

sir.· I would like you to find it on the

documents you have.

Those are the only documents you looked

at.· If you continue to do it, if you

are refusing to look through your file

to find a document then say you refused

it; otherwise, I have the time.· It is

my deposition.· Look for them.

· · · MR. PERAKIS:· For the record, he

has already told you he tried looking

for them.· He can't find that.· He

already said that.· If you want more,

you are not going to get it.· If you

want to know the truth about his report,

ask him about the report.· If you want

Page 68

· · · · · · to talk bull, do it.· If you want to

· · · · · · bring up some technicality that you

· · · · · · think is important, go for it.

· · · · · · · · · MR. CHAPMAN: You are being

· · · · · · unprofessional, Mr. Perakis.

· · · · · · Pejorative. Let me just ask the

· · · · · · questions.

· · · · · · · · · MR. PERAKIS:· You are being

· · · · · · pejorative.

· · · Q· · ·Dr., I prefer you to look through.

· · · · · · If you have exhausted every file in

that folder and you say it is not there, then tell

me it is not there.

· · · A· · ·I have cited the page.· I have not

looked through every single folder.

· · · Q· · ·Could you please look through that

folder?

· · · A· · ·There are thousands of pages here.

· · · Q· · ·Look through them, Dr.· I am ready to

wait.

· · · · · · · · · MR. PERAKIS:· This will be the

· · · · · · full deposition then won't it.

· · · · · · · · · If he doesn't want to ask you

· · · · · · questions about your report.· That is

· · · · · · fine.

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 65–68

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7659 Filed 01/19/21 Page 19 of 39
Page 69

· · · · · · · · · THE WITNESS: Okay, I would like

· · · · · · to take the flash drive out of this and

· · · · · · put it on the Mac, that would be easier

· · · · · · so.

· · · · · · · · · (A break was taken at 11:24 a.m.)

· · · · · · · · · (The deposition resumed at 11:35

· · · · · · a.m.)

· · · Q· · ·Dr., we have been or you have been

looking at the computer screen for about ten

minutes or so, trying to find these clinical

guidelines and you are -- am I correct, unable to

locate them on your floor drive at least with the

amount of time you have looked at them?

· · · A· · ·That is correct.

· · · Q· · ·You haven't looked through everything,

you couldn't find them in the ten minutes or so

looking through it?

· · · A· · ·That is correct.

· · · Q· · ·You had mentioned clinical guidelines.

· · · · · · What do you been mean by clinical

guidelines?

· · · A· · ·Clinical guidelines is a term of art, I

guess, that are generally accepted guidelines based

in large part in science, as to how to handle

certain situations.· They are used for physicians

Page 70

and health care staff.

· · · Q· · ·And you agree that guidelines are not,

they don't make the standard of care or they don't

determine what is deliberately, indifferent,

correct; if you don't know the case law, say you

don't know.

· · · A· · ·They don't determine deliberate

indifference, that is correct.· They are the CCS,

clinical guidelines for in 2014 were excellent,

they were based on standard of care.

· · · Q· · ·A facility, could a facility, any

facility we could deal specifically with jails and

prisons, if that is what you are more familiar

with, but a facility could create policy or

clinical guidelines far superior to the standard of

care, correct?

· · · A· · ·I don't know what the word, superior

means in terms of standard of care.

· · · · · · · · · MR. PERAKIS:· Let him finish his

· · · · · · question.

· · · Q· · ·For example, if the standard of care

says, that you should give somebody access to the

phone every 30 minutes, and your guidelines states,

you know what we are going to give somebody access

to the phone every 15 minutes, you could do that,

Page 71

write a policy for your staff that says this is

about what we are going to do, correct?

· · · A· · ·Yes, but the access to the phone

wouldn't be clinical standard of care.

· · · Q· · ·My hypothetical, the phone is sitting

there.· I am using as an example for you, the

standard of care, you check somebody's blood

pressure every 4 hours.· I want to run a superior

organization so we are going to check this person's

blood pressure every two hours.

· · · · · · I could do that, correct?

· · · A· · ·Yes.

· · · Q· · ·That would be superior to the standard

of care that everybody else is doing, if that truly

was the standard of care, every four hours.

· · · A· · ·If waking people up every two hours,

instead of every four hours, that would be below

the standard of care.

· · · Q· · ·You are going way beyond and adding.

· · · · · · Don't add to my questions.

· · · · · · · · · MR. PERAKIS:· Let him finish your

· · · · · · question.

· · · A· · ·I understand what you are saying, but I

just can't think of examples, giving people more

medication would not necessarily be better.· Giving

Page 72

people more observation, might not be better.

· · · · · · Clinical guidelines are based on, the

best information that people have at that point in

time, based on evidence, usually clinical trials,

or other scholarly work as to what works best.

· · · Q· · ·In your opinion CCS clinical

guidelines, or what was the term you used?

· · · A· · ·More than adequate.· They were good.

They are good.

· · · Q· · ·Now, you said that you believed that

Mr. Arft's action of not training people on the

clinical guidelines proximately caused the death of

Mr. Stojcevski.

· · · · · · What evidence do you have that he

didn't personally train people?

· · · A· · ·I didn't exactly say that.· He didn't

insure that training and supervision happened.

· · · · · · What evidence is that they, every

single health care professional, who was involved

in this case, acted in a manner contrary to the

clinical guidelines, so he couldn't have

successfully trained them and had them supervised

or had them trained and supervised.

· · · Q· · ·I had gone through everybody you

listed, all the health care people, and asked you

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 69–72

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7660 Filed 01/19/21 Page 20 of 39
Page 73

to tell me what this action or inaction they did,

that was contrary to clinical guidelines.

· · · · · · Be specific.· You said, you couldn't do

that.

· · · A· · ·I answered that generally for all of

them.

· · · · · · Specifically, for all of them I

couldn't give you the dates and times.

· · · Q· · ·Or specific actions?

· · · A· · ·Well, it was inactions.· It was their

inactions, this is a tragedy with inaction.

· · · Q· · ·Let he give you an example here, sir.

· · · · · · Ms. DeLuca was involved in the intake

on June 11th, and never again was involved in

anything to do with Mr. Stojcevski who died 16 days

later.

· · · · · · How could anything she have done,

proximately cause his death?

· · · A· · ·She didn't verify his medication.

· · · Q· · ·What did that have to do with causing

his death?

· · · A· · ·Had they verified his medication, he

would have been perhaps treated differently.

· · · Q· · ·Perhaps you don't know, that he would

have.

Page 74

· · · A· · ·If they were doing a good job they

would have treated him differently.

· · · Q· · ·He came in and said that he took

Methadone, what he said on his intake, correct?

· · · A· · ·Yes.

· · · Q· · ·He was asked what medications did he

take, he chose to lie and not say he was taking

Xanax and, Klonopin and heroine and cocaine, and

all the other stuff he was taking, is that correct?

· · · · · · · · · MR. PERAKIS:· Objection.· No

· · · · · · basis.

· · · A· · ·All I can say, he did not reveal that

information at the time.· I wouldn't say that he

chose to lie.

· · · Q· · ·What do you call it when you don't tell

a health care provider who says, give me all the

medication you are on?

· · · A· · ·People might not have the presence of

mind to mention it, or they don't want to mention

it, at that time.

· · · · · · He did reveal that information later.

· · · Q· · ·Methadone, when you are on methadone

generally, according to the CCS policies would

require the implementation COWS protocol, correct?

· · · · · · Methadone is an opiate.· COWS protocol

Page 75

is protocol for opiates.

· · · · · · Did they do that?

· · · A· · ·I don't know, because there was a page

missing.

· · · · · · Page one of the COWS protocol was

missing.

· · · Q· · ·You don't know, whether the COWS

protocol was implemented?

· · · A· · ·I know part of it was, page two and

beyond.· I don't know about page one, that wasn't

produced in discovery to me.

· · · Q· · ·Did Ms. DeLuca, start the COWS

protocol?

· · · A· · ·I don't recall.

· · · Q· · ·Let's assume hypothetically that she

started the COWS protocol, isn't that the treatment

you get when you are on methadone?

· · · A· · ·COWS protocol is not a treatment, it is

a monitoring.· It is a tracking.

· · · Q· · ·I am confused as to why you said it

does call for certain things including some

medications to be given, doesn't it?

· · · A· · ·Only by a physician's order it is

monitoring signs and symptoms and vital signs.

· · · Q· · ·So what treatment --

Page 76

· · · A· · ·COWS protocol, again passive voice,

protocols can't call for anything, but there is the

COWS protocol is a scoring system and has certain

scoring points, the physician should be notified,

and the physician or other practitioner might order

medication.

· · · Q· · ·If I give you some medical records,

turn to page 7, 8 and 9.· I think, you might see

Nurse DeLuca started the COWS protocol and

performed her intake.

· · · · · · I know you are not a nurse, but tell me

specifically what she did wrong there?

· · · A· · ·What page?

· · · Q· · ·7, 8, 9.

· · · · · · · · · MR. PERAKIS:· To the extent he is

· · · · · · not a nurse, you made it clear, he

· · · · · · doesn't have certain training.· There

· · · · · · are other experts that will handle that

· · · · · · aspect of it.

· · · · · · · · · But, if you wish him to opine in

· · · · · · an area you are an expert in, go ahead.

· · · Q· · ·You are opining Nurse DeLuca, did

something wrong?

· · · A· · ·I already answered your question that

was in regard to not having medications verified or

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 73–76

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7661 Filed 01/19/21 Page 21 of 39
Page 77

not making sure his reported medication were

verified.

· · · Q· · ·I am saying to you, how did not

verifying that he in fact was taking methadone, on

June 11th, proximately cause his death on June

27th?

· · · A· · ·Because, had they verified his

methadone they would have found the prescriptions

that he had for the benzodiazepine medications;

Xanax and Klonopin.

· · · Q· · ·Who was prescribing the methadone, to

him?

· · · · · · Where did he get the Methadone from?

· · · A· · ·I don't know.

· · · Q· · ·How do you know they would have found

out he was on benzodiazepine and Klonopin?

· · · A· · ·Because it, the --

· · · Q· · ·You are guessing?

· · · A· · ·I know how it works in New York and

Massachusetts.· I assume it works the same in

Michigan.

· · · Q· · ·You are guessing?

· · · A· · ·I am not guessing.· I am making an

educated assumption.

· · · · · · There is a medication profile, whoever

Page 78

was prescribed the methadone and whoever was

administering the methadone would have a record of

all the other active prescriptions that he was on.

· · · Q· · ·Let's follow your rational basis, had

she done that, would have presented something that

have occurred 16 days later, but 6 days later, the

17th, and 18th, he said he was taking Klonopin and

Xanax, right?

· · · A· · ·Yes.

· · · Q· · ·He got the things on 16th, and 17th or

17th and 18th?

· · · A· · ·They did.

· · · Q· · ·How did whatever she did on the 11th,

cause this gentleman's death?

· · · A· · ·It was an example of inaction of

ignoring a potential medical need, which put him at

serious risk at harm.

· · · · · · This is not a malpractice issue.· This

is a, risk of harm, is a very serious thing.· It is

very serious condition, and her inaction as well as

all the other health care staff inaction, together,

it describes a systematic inattention to this

patient's serious medical needs.

· · · Q· · ·I am not asking about all the others.

· · · · · · I am focusing on Ms. DeLuca, now.

Page 79

· · · · · · The only information Ms. Deluca had is,

he was taking methadone, she didn't have any other

information he was on any other drug.

· · · · · · What you are saying is, what she should

assume that he was taking all kinds of other drugs?

· · · A· · ·No, I answered that question, already.

· · · Q· · ·Since the only drug he said he was

taking was methadone and methadone is never

prescribed in a jail?

· · · A· · ·No.

· · · Q· · ·Not in Macomb County Jail?

· · · A· · ·Is that your testimony?

· · · Q· · ·Macomb County Jail doesn't prescribe

it?

· · · A· · ·Thank you for your testimony.

· · · Q· · ·He would have been put on COWS protocol

and he was.

· · · · · · You see 7, 8 and 9, he was by Ms.

DeLuca.

· · · · · · How could anything she had done

conceivably led to this gentleman's death?

· · · · · · · · · MR. PERAKIS:· How many times.

· · · · · · Have you answered that question?

· · · · · · · · · THE WITNESS:· I have answered

· · · · · · that question.

Page 80

· · · · · · · · · MR. PERAKIS: He is not answering,

· · · · · · it anymore.

· · · · · · · · · He answered it three times.· Move

· · · · · · on.

· · · Q· · ·Now, Mr. Perakis made a statement

earlier you are not a nurse, you are not giving

testimony as to whether nurses did anything against

the standard of care deliberately?

· · · · · · · · · MR. PERAKIS: You have answered

· · · · · · the question and he answered it, as to

· · · · · · the nurses.· As to each nurse.

· · · · · · · · · You are the one that asked the

· · · · · · questions.

· · · · · · · · · MR. CHAPMAN: Will you shut up.

· · · · · · Say form and foundation.

· · · · · · · · · Read the court rules.

· · · · · · · · · MR. PERAKIS:· Listen, let me tell

· · · · · · you something.· I can say whatever you

· · · · · · want, if what you are doing on the one

· · · · · · hand asking him questions about people

· · · · · · where he is not an expert.

· · · · · · · · · On the other hand, you are saying

· · · · · · he can't testify to it.

· · · · · · · · · MR. CHAPMAN: I never said he

· · · · · · can't testify.

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 77–80

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7662 Filed 01/19/21 Page 22 of 39
Page 81

· · · · · · · · · Simply ask him the question.

· · · · · · I am asking questions not directing

· · · · · · anything.

· · · · · · · · · MR. PERAKIS: He is smarter than I

· · · · · · am.

· · · · · · · · · I don't know, what you are

· · · · · · talking about.

· · · · · · · · · MR. CHAPMAN: Answer the question

· · · · · · please, Dr.

· · · · · · · · · MR. PERAKIS: You already answered

· · · · · · it, haven't you?

· · · · · · · · · THE WITNESS: Yes.

· · · Q· · ·Yes to what?

· · · A· · ·I answered the question about

medication, about how her failure to verify

medications contributed to my conclusion, about

systemic failures to reduce risk of harm that lead

to the death of this patient.

· · · Q· · ·Continue to explore this about Ms.

DeLuca.

· · · · · · What was the serious medical need that

you are aware of at the time, that she failed to

act on?

· · · A· · ·She failed to?

· · · Q· · ·What was the serious medical need?

Page 82

· · · A· · ·The serious medical need, potential

from withdrawal from benzodiazepine.

· · · Q· · ·That is not a need she was aware of.

· · · A· · ·She would have become aware of it, if

she done her job.

· · · Q· · ·She was not aware of it, on the 11th.

He didn't tell her, correct?

· · · A· · ·He didn't tell her she would have been

aware of it, had she done her job.

· · · Q· · ·My question to you is: What is the

serious medical need she was aware of; not the

potential future need she might have been aware of,

if she had done something.

· · · · · · What is the serious medical need she

was aware on July 11th, other than he was on

methadone and needed to be placed on the COWS

protocol?

· · · A· · ·That is it.

· · · Q· · ·Now, you said with respect to Mr. Arft,

he didn't you said something relating to intake and

output documentation.· Where is there any

requirement to do intake and output documentation

of somebody in high observation?

· · · A· · ·It would be required for someone who is

not eating or drinking, or not eating or drinking

Page 83

very much, in that would be in this CCS, is hunger

strike policy.

· · · Q· · ·It is the hunger strike policy unless

made aware that somebody was on a hunger strike,

right?

· · · A· · ·Oh, these nurses that saw him enough

times to know he was lying on the floor naked with

tremors, and being unresponsive.· It was derelict

in their duty to care for their patient not to

inquire, whether he was eating or drinking and how

much he was eating or drinking.

· · · · · · This is acceptable accept for the last

three days, when they totally abandoned him as they

were dying.

· · · · · · They saw him almost every day, the

nurses and as did the mental health workers.

· · · Q· · ·Do you know how many people lie on the

floor naked, in high observation?

· · · A· · ·Two.

· · · Q· · ·Two?

· · · A· · ·No, you are asking how many.

· · · · · · What do you mean how many?

· · · Q· · ·Is it a common thing, does it happen

all the time, is it infrequent?

· · · A· · ·No, it is not common.· It happens

Page 84

sometimes.

· · · Q· · ·Have you read the deposition of all the

corrections officers who say it is pretty darn

common, it is not an unusual thing?

· · · · · · · · · MR. PERAKIS:· For the record,

· · · · · · they not uncommon.· They didn't say it

· · · · · · was common, that it happens a lot.

· · · · · · · · · MR. CHAPMAN:· ·Don't testify.

· · · · · · · · · MR. PERAKIS: You are testifying.

· · · · · · · · · MR. CHAPMAN: He can tell me if he

· · · · · · believes I am wrong.· He has read the

· · · · · · transcript, I assume.· Answer the

· · · · · · question.

· · · A· · ·I read the depositions, and I have also

been in approximately three hundred correctional

facilities in the course of my career.

· · · Q· · ·You haven't been in Macomb County?

· · · A· · ·No, sorry, I missed that.· It happens,

but it is not -- when that happens, it is people

with very, very serious medical needs, whether it

is mental illness, or physical illness that is

causing that.· It is not a healthy state, it is not

a healthy state to be lying on the floor naked with

tremors.

· · · Q· · ·With what?

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

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Phone:· 888.644.8080

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 81–84

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7663 Filed 01/19/21 Page 23 of 39
Page 85

· · · A· · ·Tremors and babbling.· It is a clear

sign of serious acute, serious medical need.

· · · Q· · ·Do you know that whenever the nurses

saw him, his vital signs were normal?

· · · A· · ·No, I don't think his vital signs were

being taken after the first few days.

· · · Q· · ·You looked at the jail logs have you?

· · · A· · ·I may have.· I don't recall.

· · · Q· · ·4 times in the jail logs, that the

nurses were in, and vital signs were done?

· · · A· · ·I would have to go back and look.

· · · Q· · ·You are not here giving testimony as to

whether or not the nurses violated some sort of

standards, correct?

· · · A· · ·I would like to.

· · · Q· · ·You are not a nurse, are you?

· · · A· · ·I am not a nurse.

· · · Q· · ·You never trained nurses, did you?

· · · A· · ·But I oversee medical care for three

federal judges in three large jails in the United

States.· I have managed nursing care in a state

correctional system, what at the time was the

largest jail in the United States.

· · · Q· · ·Ancient history 30 years ago.

· · · A· · ·Not the New York State Prison System.

Page 86

That was twenty something years.

· · · · · · I don't think that kind of nursing care

has changed as much over the decades.· Other things

have changed.

· · · Q· · ·Look at your report paragraph 25,

please.

· · · · · · If I am reading that correctly, one of

your criticism is the 14 day, health assessment and

screening wasn't completed.

· · · · · · So arguably, it was two days later?

· · · A· · ·It wasn't done at all.

· · · Q· · ·I understand he died on the 16th day.

It was two days late, so is it really your

testimony that being two days late somehow was

deliberate, and caused this person's death?

· · · A· · ·Yes, because had they done the 14 day

assessment they would have begun to evaluate the

cause of his physical and mental status and

discovered that he was not well, and that he needed

hospital care.

· · · Q· · ·What is the 14 day assessment, that was

done on June 15?

· · · · · · · · · MR. PERAKIS: Objection it not

· · · · · · part of the evidence in the record.

· · · · · · Nothing in that.

Page 87

· · · · · · · · · MR. CHAPMAN:· Form and

· · · · · · foundation.

· · · · · · · · · Counselor, go back to law school.

· · · · · · · · · Can you answer my question, sir?

· · · A· · ·This is just another example of the

health care staff not following sound correctional

health care policies.

· · · Q· · ·Could you answer my question, you are

given hypothetical that had they had done this they

would have found this.

· · · · · · What if assessment was done on the June

15?

· · · · · · · · · MR. PERAKIS:· It was

· · · · · · hypothetical.

· · · · · · · · · MR. CHAPMAN: You are so abusive

· · · · · · in violating the ethical rules of taking

· · · · · · the deposition.

· · · · · · Answer the question, Dr., please.

· · · A· · ·If it was done on the 15th, they might

have missed it.

· · · Q· · ·He was in the COWS protocol, until the

evening of the 15th, the morning of the 16th,

correct?

· · · A· · ·Don't recall.

· · · Q· · ·His assessments were done everyday

Page 88

taking vitals every so many hours, correct?

· · · A· · ·There were vital signs, taken the first

few days, of incarceration?

· · · Q· · ·He had a complete assessment within,

almost daily by the nurses, one could argue that?

· · · A· · ·That would be your testimony following

the COWS protocol, is not a complete assessment, a

physical assessment by an LPN; it is not an

adequate assessment.

· · · · · · Just taking vital signs and asking

about selected focused symptoms, is not a

comprehensive health assessment in the sense that

that term is used, by the National Commission on

Correctional Health Care or the American

Correctional Association or the American Jail

Association.

· · · Q· · ·Dr., doing an assessment and even

having the policy that everybody gets assessed in

the 14 days, is really to protect those people that

have no contact with medical at all, and that they

are seen by somebody within 14 days, isn't that

really if you look at the underlying notes, if we

are going to talk about the NCC, as to why that

policy is there?

· · · A· · ·That is part of it.

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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U. S. LEGAL SUPPORT

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Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 85–88

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7664 Filed 01/19/21 Page 24 of 39
Page 89

· · · · · · It is also to pick up things that might

have been missed during the initial assessment,

where the whole story doesn't always get told for a

variety of reasons, during the initial assessment,

so it is to give it a little bit of time and sit

down when people are sober and feeling a little

better, than the day they get arrested and detained

say, okay let's go over again, let's go over your

medical history and drug use history, let's do a

physical examination and a physical examination,

include the mental status exam including a

neurological screen, it includes listening to heart

and lungs and feeling the belly.

· · · · · · Had that been done anywhere around his

so called 14 day, they would have determined that

he was really, really not well.

· · · · · · · · · MR. PERAKIS:· Take a break.

· · · · · · · · · (A break was taken at 11:50 a.m.)

· · · · · · · · · (The deposition resumed at 11:52

· · · · · · a.m.)

· · · Q· · ·36 to 41, has the specification.

· · · · · · One thing I am looking at on June 17th

at 1750 hours, Michael Bey-Shelley responded to the

call performed an assessment, brought the inmate

down to be seen by the doctor?

Page 90

· · · · · · 36 to 41, has a whole bunch of

allegations regarding Michael Bey-Shelley talking

about the June 17, 715 hours.

· · · · · · What more are you saying she should

have done?

· · · A· · ·I am sorry, 36 I don't see.

· · · Q· · ·Talking here about him being brought

down to Dr. Sherman.

· · · · · · You know that Michael Bey-Shelley is

the one who saw him and brought him down to see Dr.

Shelly, are you aware of that?

· · · A· · ·Yes.

· · · Q· · ·There is not much more the nurse can do

than go up do an assessment if she feels the person

needs a doctor bring him down to see the doctor,

right?

· · · A· · ·In that case, yes, in that case, yes.

· · · Q· · ·Michael Bey-Shelley saw him again on

the 18th with Ms. Cueny and on the later on the

17th, with another nurse where he said he was

taking Xanax.· Both the Xanax and Klonopin was

reported to Dr. Sherman on the 18th by Ms. Cueny,

correct, along with her assessment of the 18th?

· · · · · · · · · MR. PERAKIS:· Is that your

· · · · · · testimony?

Page 91

· · · · · · · · · MR. CHAPMAN: I said, is that

· · · · · · correct; listen please.

· · · · · · · · · MR. PERAKIS:· I am listening.

· · · A· · ·It is not clear to me that Dr. Sherman

saw Mr. Stojcevski on the 17th.· He was brought

down by the nurse that I saw documentation of that,

but it is my recollection there was no progress

note or records of that encounter, and then there

was an entry of June 24th, which might have

referred back to June 17th or to June 23rd.

· · · Q· · ·Why don't you turn to page 16, of the

medical record, while you are doing that, if you

can answer a question.

· · · · · · You are aware that there was only one

medical doctor at the jail that is Dr. Sherman, one

physician?

· · · A· · ·Right.

· · · Q· · ·Do you see where Michael Bey-Shelley in

her note says, physician into access and speak with

patient, for the 17th?

· · · A· · ·Could you just let me read it?

· · · Q· · ·Sure.

· · · A· · ·There is no clinical note by Dr.

Sherman.

· · · Q· · ·That is not my issue.· She writes her

Page 92

note, she says the physician is in to see him,

physician into access.

· · · A· · ·I don't know, what that means.

· · · Q· · ·You did, you read her transcript?

· · · A· · ·I did.

· · · Q· · ·What did she say about that?

· · · A· · ·She said, Dr. Sherman saw him, the

patient.

· · · Q· · ·Do you have any evidence to suggest

that Michael Bey-Shelley, is not telling the truth?

· · · A· · ·No.

· · · Q· · ·Now, later on the 17th, he is seen

again?

· · · A· · ·Who we don't know what Dr. Sherman did,

if he did see this patient, did he look, did he

evaluate, did he examine, did he get a history.

· · · · · · · · · MR. CHAPMAN:· Move that, that be

· · · · · · stricken.

· · · · · · · · · ·My question isn't about what Dr.

· · · · · · Sherman did.· What did Michael

· · · · · · Bey-Shelley, she brought the patient

· · · · · · down, put him in an observation room and

· · · · · · testified the doctor was in to see him.

· · · Q· · ·That is about all you can expect an LPN

to do, isn't it?

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 89–92

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7665 Filed 01/19/21 Page 25 of 39
Page 93

· · · A· · ·Yes.

· · · Q· · ·Later on that night and the next

morning, later on that night, she went to see him

and the next morning, she went to see him with Ms.

Cueny, he said he had taken Xanax and taken

Klonopin and she was with the director of nursing,

correct?

· · · A· · ·Yes.

· · · Q· · ·It would be reasonable for an LPN to

assume that the director of nursing would follow-up

with a phone call to the doctor and what needed to

be taken care of, right?

· · · A· · ·Yes, except for the verification which

would have been done by the, LPN?

· · · Q· · ·The verification of what?

· · · A· · ·Xanax and Klonopin.

· · · Q· · ·You are assuming in some kind of a

policy that says it was Michael Bey-Shelley to do

something?

· · · A· · ·There is a policy that when --

· · · Q· · ·Don't give me a general policy.

· · · · · · Tell me a specific policy, you might

know that applies to Macomb County Jail CCS.

· · · · · · If you don't know say you don't know,

but don't give me a generalized one that you have

Page 94

learned over the years of doing this.

· · · A· · ·Okay, I don't know the specific policy

of the Macomb County Jail.

· · · Q· · ·We do know that those are the three

times Ms. Michael Bey-Shelley had involvement with

the patient, correct?

· · · A· · ·Yes.

· · · Q· · ·You would agree with me she did what

she was supposed to do?

· · · A· · ·In those cases, yes.

· · · Q· · ·Ms. Cueny saw the patient one time on

the 18th, correct?

· · · A· · ·Yes.

· · · Q· · ·You can look if you want on page 20, I

believe.· If you want the medical records, page 20,

sir.

· · · A· · ·I do see paragraph 28.

· · · · · · This CCS policy, medication services

that talks about verifying prescriptions to assure

continuity of care, so that is in my report, I will

give the page cite.

· · · Q· · ·A generalized policy to verify, but you

were saying that somehow it was the LPN's job.

· · · · · · There is no policy that says in this

context, it was Michael Bey-Shelley's job.

Page 95

· · · · · · If you do, cite it to me, that is not

what that policy says?

· · · A· · ·I don't recall, whether that is

specified in the policy.

· · · Q· · ·We do know the director of nursing was

in seeing the patient and wrote an extensive note?

· · · A· · ·The director of nursing wrote a note,

yes.

· · · Q· · ·Look at the note.· Seems to be

extensive.

· · · · · · Have you looked at a few notes in your

time?

· · · A· · ·Perhaps.

· · · · · · · · · MR. PERAKIS:· Page twenty.

· · · Q· · ·Have you read that note, before?

· · · A· · ·Yes.

· · · Q· · ·You would agree that that is a pretty

extensive note isn't it?

· · · A· · ·That is a note, yes.

· · · Q· · ·Did you read her deposition?

· · · A· · ·I did.

· · · Q· · ·Did she say that she relayed that

information together with that fact that she

learned that he also was taking Xanax, to Dr.

Sherman?

Page 96

· · · A· · ·Yes.

· · · Q· · ·Isn't that what a director of nursing

or any nurse really should be, examine a patient,

write a note if they believe it is necessary, call

the doctor, accurately relay the information to the

doctor?

· · · A· · ·That is one of the things they should

do.

· · · · · · They are independently licensed and

they have an independent duty to let me -- let me

read the language for you. In the -- this has to do

with the initial health assessment.

· · · · · · "It is the goal of CCS to prevent

deterioration of the inmates health during

incarceration and to improve vital functions with

whenever possible."

· · · · · · I think, talking with Dr. Sherman was

the right thing to do, but I don't think that her

duty ended there, because.

· · · Q· · ·Sir, I am not asking you to comment on

that.

· · · · · · You are not a nurse.· You can't comment

on what her duty was writing a note and calling the

doctor.

· · · · · · What you would expect the nurse to do,

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 93–96

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7666 Filed 01/19/21 Page 26 of 39
Page 97

right?

· · · A· · ·Yes.

· · · Q· · ·Dr. Sherman responded to her, that is

in his transcript, also in her transcript, also in

a note, right?

· · · A· · ·Yes.

· · · Q· · ·And he made no further orders, correct?

· · · A· · ·Yes, correct.

· · · Q· · ·In other words, to get to the point, he

did not place him, being Mr. Stojcevski, on

benzodiazepine, CW protocol, correct?

· · · A· · ·Correct.

· · · Q· · ·Now, starting on the 18th, the mental

health workers, Ms. Brock, B-R-O-C-K, based on the

referral by Officer Campo, I believe, when up to

assess whether or not, he could be removed from

suicide watch.

· · · · · · Do you understand that?

· · · A· · ·Okay.· Could you say it again?

· · · Q· · ·Did you read the testimony of Ms.

Brock?

· · · A· · ·Yes.

· · · Q· · ·Is it your understanding that she

believed her function was to communicate or to

assess the patient to determine the patient could

Page 98

be removed from suicide watch.

· · · · · · Is that what she testified was her job?

· · · A· · ·Yes.

· · · Q· · ·And you agree with me for the most

part, she was the mental health worker that went up

there the most, correct?

· · · A· · ·I would have to look back through my

notes.· That is possible.

· · · Q· · ·Assume for me, I think there were two

other visits by two other people.· She was there

the majority of the time.· Each time she went up

there, she stated that he refused to talk to her,

correct, or refused to cooperate with mental health

providers, that is your exact words, correct?

· · · A· · ·That is what she said.

· · · Q· · ·That is what is in your report?

· · · A· · ·That is what she wrote, yes.

· · · Q· · ·Do you know what Websters definition

of, refused, is?

· · · A· · ·Not offhand.

· · · Q· · ·Paragraph 65 of your report you accuse

Kelly Mann and Chantelle Brock of fabricating, that

he refused; paragraph, 65.

· · · · · · Ask you a question.

· · · A· · ·I have it.

Page 99

· · · Q· · ·Any time I ask you to refer to a

paragraph or document, take all the time to read

it, tell me when you are done.

· · · A· · ·Okay, I have read it.

· · · Q· · ·For two definitions in, Websters

Intercollegiate Dictionary, for refused.

· · · · · · Quote, to express oneself as unwilling

to accept, end quote or two quote to decline.

· · · · · · Do you agree in a fair determination

that Mr. Stojcevski declined to talk to her?

· · · A· · ·No.

· · · Q· · ·Did he talk to her?

· · · · · · Answer my question.

· · · · · · Did he talk to her?

· · · A· · ·No, but I disagree strongly.

· · · Q· · ·I don't care whether you disagree

strongly or not.· I am the one asking the

questions.

· · · · · · He did not talk to her on the 18th,

19th, or 20th, correct?

· · · A· · ·That is correct because he was

unresponsive, he was unable to.

· · · Q· · ·That is your determination, I am

asking.

· · · A· · ·That is my opinion.

Page 100

· · · Q· · ·I don't want your opinion.· I am asking

you facts.· The facts are, he did not talk to her

on the 18th, 19th and 20th, correct?

· · · A· · ·That is correct.

· · · Q· · ·On the 21st, he did talk to her,

correct?

· · · A· · ·I don't recall.

· · · Q· · ·Why don't you turn to page 29.

· · · · · · · · · MR. PERAKIS:· Just for the

· · · · · · record, Ron, the pages you are

· · · · · · referencing are paginated and they just

· · · · · · say MCJ Medical.

· · · · · · · · · D. Stojcevski, and then they have

· · · · · · the page number.

· · · Q· · ·I have no idea if you could turn to

page 29, should be the only page number on there?

· · · · · · · · · MR. PERAKIS:· There is also pages

· · · · · · two of two.

· · · · · · · · · MR. CHAPMAN: Those are the

· · · · · · internal pages of the document. You know

· · · · · · what I am referring to. The doctor,

· · · · · · knows what I am referring to.

· · · Q· · ·Are you on page 9, Dr?

· · · A· · ·Yes.

· · · Q· · ·Here the note says, "MH staff received

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

Lansing | Mt. Clemens | Saginaw | TroyYVer1f

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04/04/2018 Pages 97–100

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7667 Filed 01/19/21 Page 27 of 39
Page 101

collateral information that patient fully engaged

with nursing staff prior to inmates visit."

· · · · · · Can you see that?· MH staff received

collateral information that patient fully engaged

with nursing staff, prior to inmates visit.

· · · · · · Do you see that, Dr?

· · · A· · ·Yes.

· · · Q· · ·So, he was able to talk, correct?

· · · A· · ·I didn't see that on the video.

· · · Q· · ·Oh, now did you watch all the video

because before you told me you couldn't tell he

about that?

· · · A· · ·I said, I watched the video.

· · · Q· · ·I was questioning you on, you have a

gag order from the government and you can't talk to

me about it?

· · · · · · Which is it, can you or can't you?

· · · A· · ·I don't know the answer to that.

· · · Q· · ·Well, you have to give me the answer

now.

· · · · · · Which is the answer, you want to go

with?

· · · A· · ·Okay, my question to your question is,

I can't verify that collateral information.

· · · Q· · ·Here it says, "The nurse or the nurse

Page 102

mental health worker Brock said that she received

collateral information that he fully engaged with

nursing staff."

· · · · · · That is what she wrote there, correct?

· · · A· · ·That is correct.

· · · Q· · ·That is information she had and she

testified that he was talking to nurses, correct?

· · · A· · ·That she heard that.

· · · Q· · ·Isn't that a natural conclusion for

somebody to make, if somebody has the ability to

talk to other people and he won't talk to me, and

he has declined to talk to me?

· · · A· · ·No, you have no --

· · · Q· · ·That is not a reasonable thing to

conclude.

· · · A· · ·Not reasonable, you have no sense of

how these neurological conditions are.· There are

people who are unresponsive one minute and perhaps

responsive another minute.

· · · Q· · ·That is your opinion. You are not a

psychiatrist, a neurologist, you have no training

in regards to that so let's not go down that route.

· · · · · · · · · MR. PERAKIS:· He is answering

· · · · · · questions.· Listen, he is not finished

· · · · · · answering your question.· You asked him

Page 103

· · · · · · a question he is answering it.

· · · · · · · · · Let him finish the question.· You

· · · · · · don't let him finish the question.· He

· · · · · · will stop answering your questions.

· · · · · · · · · MR. CHAPMAN:· Don't threaten me?

· · · · · · · · · MR. PERAKIS:· What was your

· · · · · · answer, Dr.

· · · A· · ·My answer is, just because he had been

in a conversation, doesn't mean he was faking.

Withdrawal includes changes in cognition among

other things, that vary overtime.· Things become

clear, then they become foggy.· They become

responsive and unresponsive.

· · · · · · It is not simplistic the way you are

describing.

· · · · · · · · · MR. CHAPMAN:· Move to strike as

· · · · · · having your statement stricken.

· · · · · · Clearly, outside your expertise.

· · · Q· · ·He did talk to her on the 21st, didn't

he?

· · · A· · ·Yes.

· · · Q· · ·He said, where is my medication, right?

· · · A· · ·Yes.

· · · Q· · ·He could talk to her and chose to talk

to her on the 21st, right?

Page 104

· · · A· · ·That doesn't mean he was able to.

· · · Q· · ·I am not asking you what it means.

· · · · · · Acknowledge the fact that he did.

· · · A· · ·I acknowledge that, but I don't

acknowledge the, could.

· · · · · · I don't acknowledge.· You asked me if

he thereby could and I said no to that.

· · · Q· · ·He opened his mouth and words came out,

that means he had the anatomical ability to speak,

right, words came out?

· · · A· · ·He had the anatomical ability.

· · · Q· · ·That is all, I asked you Dr.

· · · · · · I am not asking your opinion on that.

You don't have the expertise, to give your opinion.

· · · · · · · · · MR. PERAKIS:· Off the record.

· · · · · · · · · (A discussion was held off the

· · · · · · record.)

· · · A· · ·May I add an exact to an answer, I gave

a little bit earlier, in your, we were talking

about the documentation of Ms. Cueny's visit, with

Mr. Stojcevksi.

· · · · · · She wrote that note on June 24th, which

was approximately one week after the encounter.

· · · Q· · ·What fact do you base that on?

· · · A· · ·It was a late entry that is marked on

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 101–104

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7668 Filed 01/19/21 Page 28 of 39
Page 105

the record.

· · · Q· · ·Did you read her transcript?

· · · · · · · · · MR. PERAKIS:· Ha, ha, ha, ha.

· · · · · · · · · MR. CHAPMAN: Mr. Perakis, you

· · · · · · laugh and carry on, be quiet.· Be quiet.

· · · Q· · ·Did you read it?

· · · A· · ·I did, I don't recall, what it says.

· · · Q· · ·Do you know that it says she put it in

on the 18th, didn't hit submit and the computer

system at that time had a problem and he hung up

and they would not be posted until they were

submitted.

· · · · · · Did you follow that?

· · · A· · ·Blaming the computer is like blaming

the victim.

· · · Q· · ·Did you read that?

· · · A· · ·I read it.

· · · Q· · ·Did you read it, when Mr. Arft said the

same thing with the computer system, most of the

nurses said the same thing.

· · · · · · Did you read that?

· · · A· · ·I am reporting what is documented on

page twenty of this set of medical records.

· · · Q· · ·I am asking you if you read that in

your transcript to know their explanation for that?

Page 106

· · · A· · ·I already answered, yes.

· · · Q· · ·Did you also see, as an attachment the

computer printout that said it was in fact posted

on the 18th, it was put on the 18th, wasn't posted

until the 24th.

· · · · · · Did you see that?

· · · A· · ·I don't recall that.

· · · Q· · ·When is the last time if ever that you

prescribed Xanax or Klonopin, to a patient?

· · · A· · ·I never did.

· · · Q· · ·Do you know the difference between

Xanax and Klonopin, as far as clearing through the

body?

· · · · · · Don't guess, I want to know.

· · · A· · ·They, I know that they are different.

· · · Q· · ·Do you know the difference?

· · · A· · ·I don't know.

· · · Q· · ·Do you know the difference half-life of

the two drugs?

· · · A· · ·No.

· · · Q· · ·Do you know if half-life means anything

with respect to whether or not someone would begin

withdrawal or go through withdrawal, or how long

withdrawal might last; don't guess.

· · · A· · ·I know, that it is sometimes a

Page 107

consideration, but I also know with benzodiazepine

withdrawal signs and symptoms can occur weeks after

the last dose.

· · · · · · Well, beyond the half-life of whatever

drug it was.

· · · Q· · ·Are you aware of the currently

identifiable stages of benzodiazepine withdrawal.

· · · · · · Do you know them?

· · · A· · ·Yes.

· · · Q· · ·What are they?

· · · A· · ·They are autonomic reactions,

elevations of pulse, blood pressure, of

respiration.

· · · Q· · ·What you are giving me is the symptoms

of someone going through withdrawal.

· · · · · · That is not my question to you?

· · · · · · Do you know the identifiable stages of

benzodiazepine withdrawal, not the symptoms

somebody might have?

· · · A· · ·I am not sure what you mean by that.

· · · Q· · ·Are you aware that there are specific

stages of withdrawal that benzodiazepine, they are

very specific things may or may not happen?

· · · A· · ·I don't know what you mean by, stages.

· · · Q· · ·That is fair, if you don't know you

Page 108

don't know.

· · · · · · Are you aware that people that suffer

from catatonia, do not have pain?

· · · A· · ·No.

· · · Q· · ·Do you know anywhere in the record or

did you see from anything, did Mr. Stojcevksi ever

tell anyone, he was in pain?

· · · A· · ·No.

· · · · · · · · · MR. CHAPMAN: Turn to your

· · · · · · paragraph 61, please.

· · · · · · If you want to read your paragraph

· · · · · · first, go ahead and do that, then we

· · · · · · will have a question for you.

· · · · · · Ready.

· · · Q· · ·If you look down about, a little more

than halfway over on the 5th line you use the

phrase, "each of them made choices to ignore?"

· · · · · · Do you see that phrase?

· · · A· · ·Yes.

· · · Q· · ·I have very specific questions to ask

you.

· · · · · · I am going to ask you 4 of them if you

can tell me.

· · · · · · I want to know:· Specifically what

choice, who made it, when they made it, and how it

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 105–108

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7669 Filed 01/19/21 Page 29 of 39
Page 109

caused the death of Mr. Stojcevksi, specifically.

· · · · · · Not generalized.· They made choices.

· · · · · · I want to know the specific choice, who

made it, when they made it, and how it caused his

death.

· · · · · · Or, if you can't do that because you

are talking more systemic and it is more general

say that?

· · · A· · ·Yes, I am talking systemic, generally.

· · · Q· · ·Look at page 63.· Not page 63,

paragraph 63.· I will leave that.

· · · · · · Go to paragraph 66.· Please read that.

· · · A· · ·Out loud?

· · · Q· · ·No, no.

· · · · · · Read it to yourself.· Counsel, has

stated that you need time to look at it, and you

should.

· · · A· · ·Okay.

· · · Q· · ·Dr. Sherman testified that he only saw

the patient once on the 17th, that is his

testimony, correct?

· · · · · · Do you agree?

· · · A· · ·Yes, but to contradict that, he wrote.

· · · Q· · ·That is not my question.

· · · · · · I don't have a question posed to you.

Page 110

I want to know, is that his testimony?

· · · A· · ·I didn't finish my sentence.

· · · Q· · ·I said yes or no, he said yes or no, so

you finished it.

· · · · · · · · · MR. PERAKIS:· If he needs to

· · · · · · explain his answer, yes or no, he needs

· · · · · · to explain it and you are willing to

· · · · · · allow him to do it an hour and a half

· · · · · · ago.

· · · Q· · ·I don't want to drag that out.

· · · · · · Say whatever you want to say.

· · · A· · ·On June 24th, he wrote that the visit

occurred on June 23rd.

· · · Q· · ·Correct, he testified differently,

correct?

· · · A· · ·That is correct.

· · · Q· · ·And Michael Bey-Shelley testified on

the 17th, the doctor saw him, correct?

· · · A· · ·That is correct.

· · · Q· · ·So referring to page 66, what proof is

there that Dr. Sherman made a choice to ignore

Mr. Stojcevski, altered consciousness.

· · · · · · Please state the date and the

circumstances that Dr. Sherman made the choice to

ignore altered consciousness.

Page 111

· · · · · · So first identify when did he have

altered consciousness, that Dr. Sherman ignored?

· · · A· · ·I need to go back to the medical

records.

· · · Q· · ·Feel free.

· · · · · · On the 17th, there is a documentation

in the medical record that he was hallucinating and

there is a note by LPN Bertram that patient was

vaguely responsive, that he had all of his organs

but ten percent of his heart had been removed and

his arms had shredded a couple of days ago.· All

that was documented in the medical record, by the

time that Dr. Sherman saw the patient.· Also

documented by, Nurse Cueny that he had fluttering

eyelids, etcetera. So, he failed to do a physical

examination and neurologic examination or a mental

status examination, in the face of the patient who

had, clear changes in mental status?

· · · Q· · ·I am confused, Dr.

· · · · · · If you read the records, I am sure that

you did on June 17th, he did do an examination of

the patient.

· · · · · · He testified to an examination in the

observation room.

· · · · · · My question is, not that these things

Page 112

were reported what is your evidence he ignored

them. He testified he examined the patient.

· · · A· · ·He didn't testify as to the nature of

his examination.

· · · · · · He did to.

· · · · · · Did you read his transcript?

· · · A· · ·I did.

· · · Q· · ·He didn't say what he did?

· · · A· · ·He didn't do the kind of evaluation,

that I would have expected him to do under the

circumstances.

· · · Q· · ·You are a practicing physician you

haven't evaluated anybody since 1985?

· · · A· · ·That is also correct.· A physical

examination hasn't changed in more than a hundred

years.

· · · Q· · ·I don't know whether it has or hasn't.

Not only have you not done one, you haven't been

employed as an educator educating or training

physicians on how to do examinations at least since

1985, correct?

· · · A· · ·That is correct.

· · · Q· · ·My question to you is, not that these

things happen.

· · · · · · My question to you is on the 17th he

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 109–112

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7670 Filed 01/19/21 Page 30 of 39
Page 113

did do an examination.

· · · · · · What proof do you have that he ignored

them, he came to a conclusion, you might not agree

with them.

· · · · · · What proof do you have that he ignored

them?

· · · A· · ·That is my opinion.

· · · Q· · ·And the same question would be, what

proof is there that Dr. Sherman made a choice to

ignore Mr. Stojcevski's disturbed cognition.

· · · · · · Is it your same opinion that you don't

think he did an adequate enough exam?

· · · A· · ·That is correct.

· · · Q· · ·The same would be with respect to what

proof is there that Dr. Sherman chose to ignore

Mr. Stojcevski temors.

· · · · · · Is it again your opinion that on the

17th, he didn't do a good enough exam?

· · · A· · ·Well, either that or he just ignored

the tremors, that he saw.

· · · Q· · ·He testified that he did in fact

examine those tremors, and did in fact talk to the

patient and came to the conclusion, he thought the

patient was fading, right?

· · · A· · ·That is correct.

Page 114

· · · Q· · ·So he considered them, he came to a

different conclusion then you might want him to

come to, but he considered them and came to a

conclusion, right?

· · · A· · ·Correct.

· · · Q· · ·Now, the next one is what proof is

there that Dr. Sherman made a choice to ignore

Mr. Stojcevski's history of benzodiazepine

medication?

· · · A· · ·He didn't treat him in the face of a

history, and physical and signs, and symptoms of

benzodiazepine withdrawal.

· · · Q· · ·I assume, you are speaking of the 18th

now, when Ms. Cueny called him?

· · · A· · ·Yes.

· · · Q· · ·That would have been the only time he

learned about this?

· · · A· · ·That is correct.

· · · Q· · ·You would agree with me that Ms. Cueny

called him, relayed her information to him, which

included the Xanax and Klonopin, the other

information about the things in the records about

his organs and those kind of things.

· · · · · · What evidence is there that Dr. Sherman

ignored them; I know he made a conscious medical

Page 115

decision, and included in his transcript talking

about it, that he did not believe that I should put

him on benzodiazepine protocol, for benzodiazepine

withdrawal, because sufficient time had lapsed and

he wasn't in withdrawal.

· · · · · · That is a conscious choice he made

though right, Dr. Sherman?

· · · A· · ·He made that in the face of clear,

either delusion or delirium, with the statements

about the arms and the heart.

· · · Q· · ·That is your opinion.

· · · · · · My question is not your opinion as a

physician, because frankly, I am not very

interested in that opinion.

· · · · · · I don't think you are qualified to give

that opinion.

· · · · · · But, in this particular case, the only

thing I am trying to say to you, is you say he

deliberately ignored him.

· · · · · · He took the information in.

· · · · · · He didn't do with it, what you thought

should have done, didn't ignore it.· Took it in and

chose to use it or not use it, he considered it, in

fact his deposition says he considered it?

· · · A· · ·That is my opinion.

Page 116

· · · Q· · ·Do you agree that in his deposition he

said he considered it and decided that he didn't

believe he should be on benzodiazepine withdrawal?

· · · A· · ·Yes.

· · · Q· · ·So what evidence do you have? You said

that you read Dr. Sherman's deposition, where is it

that you have the evidence that he precisely

intended to not do a mental status examination,

when he said that he did one?

· · · A· · ·In order to answer that question, I

would have to look at the deposition.· If you could

direct me, I would be happy to do that.

· · · · · · · · · MR. CHAPMAN: Let the record

· · · · · · reflect that Mr. Perakis is helping the

· · · · · · doctor.· I don't believe, he can.· It is

· · · · · · inappropriate in a deposition for him to

· · · · · · be directing him and helping him.

· · · · · · · · · MR. PERAKIS:· Looking for a

· · · · · · deposition transcript.

· · · · · · · · · MR. CHAPMAN: I don't know what

· · · · · · you are doing.

· · · · · · · · · You have been guiding him and

· · · · · · trying to get him to testify your way

· · · · · · all along.

· · · · · · · · · I don't think you should be able

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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04/04/2018 Pages 113–116

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7671 Filed 01/19/21 Page 31 of 39
Page 117

· · · · · · to help him or guide him, he knows how

· · · · · · to use a Mac that is what he said, he

· · · · · · can find it.

· · · · · · · · · (A break was taken at 12:35 p.m.)

· · · · · · · · · (The deposition resumed at 12:46

· · · · · · p.m.)

· · · Q· · ·Sir, referring to specifically to

paragraph 71, of the report. I want to ask you a

couple of questions.

· · · · · · If you want to look at it, feel free to

and tell me when you have looked at it.

· · · A· · ·Okay.

· · · Q· · ·I assume you read all or at least some

of the health care defendant's transcripts?

· · · A· · ·Yes.

· · · Q· · ·Every one of the health care persons

that testified said that they were aware of the

guidelines for withdrawal, correct?

· · · · · · You were questioned by Mr. Perakis?

· · · A· · ·I recall, that they testified they were

aware of the risks of withdrawal.· I just don't

recall one way or the other about their awareness

of the guidelines.

· · · Q· · ·What about the hunger strike CCS,

hunger strike policy.

Page 118

· · · · · · Can you testify they were aware of

that?

· · · A· · ·I just don't recall.

· · · Q· · ·What about the mental health care, the

mental health staff testified that they were aware

of this duty with respect to suicide watch,

correct?

· · · A· · ·I don't recall.

· · · Q· · ·Well, I need to explore, 75.

· · · · · · You say here, that CCS failed to train

and supervise, so all of the CCS employees said

that they were aware of these policies, they were

trained on them.

· · · · · · They knew the policies.

· · · · · · Where was it that you had information

that CCS failed to train and supervise, that is

different, somebody didn't follow a policy?

· · · A· · ·Well, they didn't, if CCS handled,

failed to train and supervise, then that would say

that this behavior by all these people was

intentional, and but I am not testifying to that

but that would be the only other logical

conclusion.

· · · Q· · ·Well -- let's explore that.

· · · · · · Let's take for example let's take for

Page 119

example, Ms. Brock.

· · · · · · She was aware of the mental health

policies, correct, you testified she was, nobody

questioned her and she said I wasn't aware of

whatever it was, I was questioned on, right?

· · · A· · ·She testified to that.

· · · Q· · ·She testified that she was not a

medical doctor, and she didn't make medical

decisions, right?

· · · A· · ·Yes.

· · · Q· · ·If she felt that if somebody needed

medical determination, refer that to medical?

· · · A· · ·Yes.

· · · Q· · ·On the 18th she referred it to Monica

Cueny.· She personally asked if Monica, could see

the patient, correct?

· · · A· · ·Yes.

· · · Q· · ·She said that her job was to determine

whether or not Mr. Stojcevski needed to remain on

suicide watch, or not that was her primary job,

right she testified to?

· · · A· · ·That was her understanding, but I mean

that was her understanding, but that is the face of

no information that suggests he was ever suicidal.

· · · Q· · ·He was put on suicide watch by Officer

Page 120

Campo, correct?

· · · A· · ·I don't recall who put her on suicide

watch.

· · · Q· · ·Let's assume he was placed on suicide

watch, you have worked enough in jails, I believe

once somebody takes the step to place somebody on

suicide watch, you now can't just arbitrarily

remove the person from suicide watch, somebody has

to.· The mental health or physician or a nurse,

some learned person in the health care arena, has

to make the determination this person is no longer

suicidal?

· · · A· · ·That is correct.

· · · Q· · ·If they don't, they are going to open

themselves up for tremendous liability if 24 hours

later somebody hangs themselves?

· · · A· · ·Right.

· · · Q· · ·A guard can't take somebody off suicide

watch they put them on?

· · · A· · ·They shouldn't be able to take them

off.

· · · Q· · ·Let's assume that the policies in

Macomb County there is no allegation here, that

anybody has taken somebody off suicide watch.

· · · · · · So once somebody with an abundance of

GREIFINGER, M.D., ROBERT

04/04/2018

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 117–120

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7672 Filed 01/19/21 Page 32 of 39
Page 121

caution puts somebody on suicide watch, you need a

mental health person now, to attempt to evaluate

that person, to see if they can come off suicide

watch, right?

· · · A· · ·Correct.

· · · Q· · ·Ms. Brock said she saw that as her

primary job, right?

· · · A· · ·Yes, she did.

· · · Q· · ·She went up there every day which was

the policy to go see the person once a day, right?

Right?

· · · A· · ·Yes.

· · · Q· · ·She went up there once a day, and she

would try and communicate.

· · · · · · She said, she would knock on the door,

beat on the door, to get the person's attention,

try to get the person to communicate.

· · · · · · She was unable to do that, right?

· · · A· · ·Yes.

· · · Q· · ·She did that on repeatedly, on the

21st.

· · · · · · She would talk to her?

· · · A· · ·Yes.

· · · Q· · ·He didn't talk to her on the 22nd. I

don't know if she was there on the 22nd, but the

Page 122

rest of the day she was there, he wouldn't talk to

her, or didn't talk to her or failed to communicate

whatever word you want to use.

· · · A· · ·I don't believe she was there, all the

rest of those days.

· · · Q· · ·I am not assuming she was.

· · · · · · She was there some of them, I don't

know the exact days.· She was there some of the

days between the 21st and 27th, right?

· · · A· · ·Certainly not the last three days.

· · · Q· · ·Ms. Brock, I am talking about?

· · · A· · ·I don't recall her being there the last

three days.

· · · Q· · ·I believe, you are mistaken but that is

not germane to my question.

· · · · · · She was actually the one there on June

27th, and made another call for a psychiatrist?

· · · A· · ·I have been mistaken.

· · · Q· · ·That is not my issue and that is not

germane to my question.

· · · · · · For all the times she was there, she

would come up, try to communicate with him and for

whatever term you want to put on it, communication

didn't occur, and in her mind she said I am unable

to clear him from being on suicide watch, right?

Page 123

· · · A· · ·Yes.

· · · Q· · ·Let he give you a hypothetical.

· · · · · · Let's assume on the 20th, she said you

know what, she doesn't talk to me, he looks like a

fine young man, I don't think he has any problems

take him off suicide watch.

· · · · · · The 21st he hangs himself.

· · · · · · Do you think Ms. Brock would be in hot

water?

· · · · · · · · · MR. PERAKIS:· Hypothetical.

· · · A· · ·Yes.

· · · Q· · ·So, she has to get some information to

determine whether he was is or isn't suicidal,

right; she can't take him off without information?

· · · A· · ·Yes, but that is not her only role.

· · · Q· · ·That is what she says her role is.

· · · · · · Do you have any information that her

role is different from what she says and what

Natalie Pacito says her role was?

· · · A· · ·Yes.

· · · Q· · ·What I am looking for is not general,

interpretations, working in Pennsylvania, Illinois,

and New York and all these other fine places.

· · · · · · I want to know from policies or

procedures of Macomb County, CCS in particular, is

Page 124

there something you can point me to that says her

role was definitely different than what she said

her role was?

· · · A· · ·I am talking about her duty as a mental

health professional, when she can't intervene

constructively, it is her duty to consult a hire

level authority, which in her case would be a

psychiatrist.

· · · · · · · · · MR. CHAPMAN: I am not asking for

· · · · · · your opinion.· I am going move to have

· · · · · · that stricken on what the standard of

· · · · · · care is or standard of care is for a

· · · · · · mental health person. That is not my

· · · · · · inquiry.

· · · Q· · ·My inquiry is:· She has to get some

information before she can clear him from suicide

watch, correct?

· · · A· · ·Yes.

· · · Q· · ·Do you know in Macomb County, what are

the mechanisms an inmate can utilize in order to

obtain medical care?

· · · A· · ·Yes.

· · · Q· · ·One of them is they could fly a kite?

· · · A· · ·Yes.

· · · Q· · ·One of them is they could ask a guard,

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04/04/2018

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 121–124

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7673 Filed 01/19/21 Page 33 of 39
Page 125

I need to see medical, correct?

· · · A· · ·Yes, I know what the term kite means.

· · · · · · I didn't know, it was used in Macomb

County.

· · · Q· · ·You understood the word kite, basically

means it is a slip of paper you can say what your

condition ailment whatever it is, you give it to a

guard, put it in a slot and the guard takes care of

it?

· · · A· · ·In modern day historically, it is a

rolling paper, for cigarettes.

· · · Q· · ·I have seen the transcripts of the

various depositions.· The word kite has been used

quite a bit.

· · · A· · ·Now, that you mention it, I recall.

· · · Q· · ·You can access medical care by a kite.

· · · A· · ·Yes.

· · · Q· · ·Did you see that every inmate that come

in the facility is given a handbook, and in the

handbook it tells them how to access health care,

do you see that?

· · · A· · ·Yes.

· · · Q· · ·That is pretty good.· Most jails do?

· · · A· · ·They do.· That works for inmates who

are not illiterate, or functionally illiterate,

Page 126

which is about half of the inmates.

· · · Q· · ·You are making generalizations.

· · · · · · You don't know the percentage of

illiterate inmates in Macomb County, do you?

· · · A· · ·No, that is true much more.

· · · Q· · ·I don't want you to make just

generalized statements of the nature of things of

New York and apply them to Macomb County.

· · · · · · They could be more, better or worse. We

don't know.· I want to know facts, that you know

about this case.

· · · · · · So you could do a kite, you can ask a

guard or you could be perceived by a guard that

says there is a problem and the guard could call

medical, right, or a fellow inmate can call

medical, for you, or yell and say this person needs

medical?

· · · A· · ·Or a medical health professional or a

nurse or doctor?

· · · Q· · ·Or somebody that walks by or sees you,

or can render medical care, correct?

· · · A· · ·Correct.

· · · Q· · ·You agree a number of times where the

guards said, you know nurse you are here on

med-pass, I think you should look in on

Page 127

Mr. Stojcevski, right?

· · · A· · ·Yes.

· · · Q· · ·And each time those nurses that were

there on med-pass, look on him basically take his

vitals.

· · · · · · Is that your testimony in the record?

· · · A· · ·I don't recall, if it was each time.

· · · · · · His last vitals were done on as I

recall on July 21st.

· · · Q· · ·Understand my premises to you though,

the only time that the nurses after he gets placed

in high observation see him, is when basically the

guards or Ms. Brock called medical or saw them on

med-pass, says you need to see this person or I

would like you to see this person, right?

· · · A· · ·Right, that is because there is no

individualized care plan for him.

· · · Q· · ·My question is: That is how he got seen

by people from basically the 18th to the 27th,

correct?

· · · A· · ·Well, he wasn't seen by nurses for the

last days.

· · · Q· · ·I know, you keep focusing on that.

· · · · · · From the 18th to the 27th, that was the

method he received medical care.· Basically, either

Page 128

a health care, mental health worker or a guard

would call medical, or see medical and look at

Mr. Stojcevski?

· · · A· · ·He didn't receive any medical care.

· · · Q· · ·You are trying to be pejorative with

me.

· · · · · · I am asking you the process.

· · · A· · ·I am answering the question.

· · · · · · You asked me a question that included a

phrase that said he received medical care.

· · · · · · That is a distortion of the facts.

That is his testimony that I am supposed to be

giving, and I will tell you he did not receive

medical care.

· · · Q· · ·That is not my question, sir, you are

being argumentative.

· · · · · · The process by which he would get

medical care would be if the guards, or a mental

health person would see or believe he needed some

care and call and get somebody, correct?

· · · A· · ·No.

· · · Q· · ·I have another method by which he

received medical care.

· · · A· · ·He didn't receive medical care.· You

are not listening to me.

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 125–128

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7674 Filed 01/19/21 Page 34 of 39
Page 129

· · · Q· · ·No, no.

· · · A· · ·I would like to finish my sentence.

· · · Q· · ·When a nurse goes up and sees him, that

is not medical care?

· · · A· · ·Correct.

· · · Q· · ·So, you define medical care to me.

· · · A· · ·Medical care includes, active and

constructive attention to, evaluation, and

treatment and includes treatment plan.

· · · · · · This poor guy, was deteriorating under

their eyes and they watched him deteriorating, and

they looked at him, but that is not medical care.

· · · · · · They didn't get him evaluated, they

didn't get him hydrated. They didn't check his

weight.· They didn't address his mentation.

· · · · · · They didn't deal with his delirium or

delusions.

· · · · · · They ignored him.· That is not medical

care.

· · · Q· · ·I am sure you have read multiple

medical opinions you engage, Ipsum Dickson.

· · · · · · Basically, you make statements which

say they are true, because I say they are true.

· · · · · · You have read those court opinions like

the Duke's opinions and other opinions from federal

Page 130

courts that have excluded your testimony?

· · · A· · ·Yes.

· · · Q· · ·I don't want you to do that here.

· · · · · · I am asking you and saying to you, you

disagree with me or not,· but if a nurse gives you

a pill because it is med-pass.

· · · · · · That is a form of medical care,

correct?

· · · A· · ·Yes.

· · · Q· · ·If a nurse takes your vital signs, that

is a form of medical care, correct?

· · · A· · ·No.

· · · Q· · ·Taking vital signs is not a form of

medical care?

· · · A· · ·It is a part of medical care.

· · · Q· · ·Don't be argumentative with me.

· · · A· · ·I am saying it is a part.

· · · Q· · ·Is talking to a patient saying, "Hey

John I see you are a little down what is going on

today, is there something I can do, have a drink of

water."

· · · · · · That is part of delivering medical

care, isn't it?

· · · A· · ·It is part of.

· · · Q· · ·Yes or no, is it part of delivering

Page 131

medical care?

· · · A· · ·Yes.

· · · Q· · ·So, when the nurses were on the floor,

and the guards on a number of times all throughout

their log they would say, hey nurse, could you go

look at Mr. Stojcevksi.· And the nurse would go in

there. Sometimes give them some water, sometimes

talk to them, take his vital signs.· That is

medical care; may not be the quality you want it to

be.

· · · · · · That is a form of medical care, isn't

it?

· · · A· · ·It is not the medical care he needed.

· · · Q· · ·I am not asking you that question.

· · · · · · It is a form of medical care, correct?

· · · A· · ·If you are really.

· · · Q· · ·Yes or no?

· · · A· · ·I can't answer that as a yes or no.

· · · Q· · ·I just want to make the record clear.

· · · · · · I want to make the record clear.

· · · · · · You are saying when a guard says "Nurse

Chapman, can you go see Mr. Stojcevski," I would

say, "No problem, Joe."· I walk in there, and I

take his vital signs.· Vital signs are normal,

everything is good.· You are trying to tell me it

Page 132

is not a form of medical care?

· · · A· · ·Not, the form of medical care for him.

· · · Q· · ·Is it a form of medical care, yes or

no?

· · · A· · ·I can't answer that as a yes or no.

· · · Q· · ·If you can't answer it, how in the heck

do you expect a guard to ask a nurse, to see a

patient; answer it.

· · · A· · ·Is that a rhetorical question, I don't

know.

· · · Q· · ·Now, you tell me.

· · · A· · ·I don't understand your question.

· · · Q· · ·It is very basic.

· · · · · · A guard says to a nurse, "please see

this patient."

· · · · · · The nurse sees the patient, says his

vital signs are normal.

· · · · · · How is a guard not to assume that is

delivering some form of medical care?

· · · A· · ·I can't speak to the mind of a guard.

· · · · · · · · · MR. CHAPMAN: God bless you.

· · · · · · I have no further questions.

EXAMINATION BY

MS. SWINDLEHURST:

· · · · · · · · · · MS. SWINDLEHURST: We met

GREIFINGER, M.D., ROBERT

04/04/2018

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 129–132

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7675 Filed 01/19/21 Page 35 of 39
Page 133

· · · · · · previously. My name is Cara Swindlehurst

· · · · · · and I represent the Macomb County

· · · · · · defendants in this matter.

· · · · · · · · · I am going to start briefly on

· · · · · · qualifications as it relates to the

· · · · · · corrections field.· Mr. Chapman has done

· · · · · · a fine job as it relates to all the

· · · · · · medical care and opinions with regard to

· · · · · · that.

· · · Q· · ·Are you certified by the State of

Michigan, to be a corrections officer or certified

in any state to be a corrections officer?

· · · A· · ·No.

· · · Q· · ·Have you ever completed any courses in

the Michigan Sheriffs Training Counsel?

· · · A· · ·No.

· · · Q· · ·Have you ever authored any correctional

law policy that has been adopted by the Michigan

Sheriff's Training Counsel?

· · · A· · ·No.

· · · Q· · ·Have you ever authored any policy that

has been adopted by Michigan Commission on Law

Enforcement Standards?

· · · A· · ·No.

· · · Q· · ·Have you ever served as faculty at any

Page 134

colleges in the State of Michigan?

· · · A· · ·No.

· · · Q· · ·Have you actually reviewed the training

records of the various officers in this case?

· · · A· · ·No.

· · · Q· · ·Is it, that you haven't reviewed any of

their training records?

· · · A· · ·No, I don't recall reviewing them.

· · · Q· · ·Has any state court in Michigan ever

recognized you as an expert in the field of police

procedures?

· · · A· · ·State court?

· · · Q· · ·Correct Michigan State Court.

· · · A· · ·No.

· · · Q· · ·Has any state court in Michigan ever

recognized you as as expert as it relates to

correctional operations outside the scope of

health?

· · · A· · ·No.

· · · Q· · ·Has any federal court in the State of

Michigan ever recognized you as an expert in the

field of police procedures?

· · · A· · ·No.

· · · Q· · ·Has any federal court in the state of

Michigan ever recognized you as an expert as it

Page 135

relates to correctional operations, ever outside

the scope of health?

· · · A· · ·No.

· · · Q· · ·Today, are you offering an opinion on

the correctional policies in this case?

· · · A· · ·No.

· · · Q· · ·Are you aware of any deaths in Macomb

County Jail that allegedly rose out of acute

withdrawal for current benzo-methadone and opiate

medications?

· · · A· · ·No.

· · · Q· · ·I know you can't discuss what you did

do for the DOJ.

· · · · · · Did you, were you ever asked to look at

the actions of the correctional officer within

that?

· · · A· · ·No.

· · · Q· · ·Do you have an individual opinion, you

stated earlier there are particular CO's that you

believe did specific actions, incorrect, correct?

· · · A· · ·Correct.

· · · Q· · ·Now, for those specific CO's, and we

will go through each one of them.

· · · · · · Can you explain to me exactly what this

officer, either the act or omission that occurred

Page 136

which you think means they were· a proximate cause

of Mr. Stojcevski's death?

· · · A· · ·Yes, could you ask that again?

· · · Q· · ·Absolutely.

· · · · · · Are you able to point to any individual

CO's their individual specific acts or omissions

that led to the proximate cause of Mr. Stojcevski's

death?

· · · A· · ·No, I could just talk to them in the

aggregate, excuse me.· I can speak to that in the

aggregate.

· · · Q· · ·That speaks to just the systemic

generalized action of the whole?

· · · A· · ·Yes, while they recognized that to some

extent that he needed help, they did not track his

meals and his fluid intake.· They did not initiate

a hunger strike policy, which would have been

appropriate.· They did not notify their command

staff that he was not eating or drinking much and

while one officer did encourage him to drink, it

clearly wasn't effective. So, they should have

notified command staff who would hopefully then

would have worked with health care staff, to get

him hospitalized.

· · · Q· · ·Okay, have you reviewed the Macomb

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 133–136

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7676 Filed 01/19/21 Page 36 of 39
Page 137

County Jail policies and procedures?

· · · A· · ·No.

· · · Q· · ·You have no opinion on those policies

and procedures?

· · · A· · ·Correct.

· · · Q· · ·You did mention the hunger strike

policy, previously.

· · · · · · Were you referring to the Macomb County

Sheriff, hunger strike policy or CCF hunger strike

policy?

· · · A· · ·I believe, I did review the Macomb

County Jail hunger strike policy.· I was referring

to that.

· · · Q· · ·As it relates to the Macomb County Jail

hundred strike policy, did you have any opinions on

the policy itself?

· · · A· · ·No.

· · · Q· · ·Did you have any problems with the

policy, itself?

· · · A· · ·Not, that I recall.

· · · Q· · ·Now, you stated that as a whole you

feel that the officers, it was a systemic issue,

correct?

· · · A· · ·Yes.

· · · Q· · ·Now, did you ever review the deposition

Page 138

transcript of all the officers?

· · · A· · ·I know, I read at least one.

· · · Q· · ·Would that be I believe in your report,

number 72 it states that you relied on the

testimony of CO Harrison?

· · · A· · ·Yes.

· · · Q· · ·Did you rely on any other testimony in

arriving at your conclusions, as it relates to the

CO officer any other CO testimony?

· · · A· · ·No.

· · · Q· · ·Okay, so to the extent that the

deposition transcript, of those other CO officers,

included statements where the officer contacted

medical with concerns, you wouldn't have any reason

to dispute that?

· · · A· · ·Correct.

· · · Q· · ·And earlier you started to speak on

this a little bit, to the extent that those

officers did contact medical, would that be a

sufficient step for Mr. Stojcevski's well being?

· · · A· · ·Of that, those were good steps, but not

sufficient.

· · · Q· · ·Okay. Have you testified regarding this

type of, whether it was sufficient enough to call

medical, in the past?

Page 139

· · · A· · ·Yes.

· · · Q· · ·Okay do you happen to recall a case

that was Clemmons vs. Corrections Corporations of

America back in 2013.

· · · · · · A woman's fetus had died in uterus?

· · · A· · ·Yes.

· · · Q· · ·And now, in that deposition do you

recall whether you stated that was sufficient for

the corrections staff to contact medical, that more

could have been done but that was a sufficient step

for the corrections officer to have taken?

· · · A· · ·I don't recall, but I don't doubt what

you are, that that might be correct.

· · · Q· · ·So if it was a sufficient step, for the

corrections officer in that case to contact

medical, was it also a sufficient step here?

· · · A· · ·No, I don't think so because this

gentleman was morbid.

· · · Q· · ·He was what?

· · · A· · ·He was dying.

· · · Q· · ·Wasn't the fetus also dying?

· · · A· · ·The fetus was dying but -- -- the

problem there, as I recall was the transportation,

problem, that is my recollection.

· · · Q· · ·Okay, and let me try to refresh your

Page 140

recollection on this case a little bit more, and

you can correct me if I am wrong.

· · · · · · On this particular case, there were

instances where Ms. Clemmons was seen bleeding and

the corrections officer asked one of the nurses to

look at it and the nurse in fact ignored that

request, and that went on for a couple of hours,

and then there was a transportation issue you are

discussing.

· · · · · · Does that refresh your recollection a

little bit more?

· · · A· · ·Yes.

· · · Q· · ·And so in that particular case, the

corrections officer had notified the nurse and the

nurse made a conscious decision not to take any

steps, okay?

· · · A· · ·Yes.

· · · Q· · ·And you had stated that perhaps the

corrections officer could have gone up the ladder;

but their steps were in fact sufficient merely

reporting it to medical?

· · · A· · ·Yes, and what is different about this

case from that case in Tennessee, was that this

went on for day after day after day, and then I

think would have, should have resulted in

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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U. S. LEGAL SUPPORT

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 137–140

MIdeps@uslegalsupport.com

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7677 Filed 01/19/21 Page 37 of 39
Page 141

notification of command staff, to take a look and

do something about it with the health care staff

who of course are accountable to the county.

· · · Q· · ·You have stated that you in fact only

reviewed Sgt. Harrison's deposition transcripts.

· · · · · · Do you have any knowledge, whether or

not command was notified by any of the other

officers, if they testified to that in their

deposition?

· · · A· · ·I don't know.

· · · Q· · ·Okay.

· · · · · · As we have already discussed we

actually can't point to any action, within each

individual officer that someone did something

incorrect?

· · · A· · ·That is correct.

· · · Q· · ·Okay.

· · · · · · · · · MR. PERAKIS: Form and foundation.

· · · · · · · · · MR. CHAPMAN:· Do not testify for

· · · · · · the witness; form and foundation.

· · · Q· · ·You stated earlier when you read the

names you did not in fact make an opinion as to

Sheriff Wickersham.

· · · · · · Is that to mean Sheriff Wickersham, you

do not have an opinion?

Page 142

· · · A· · ·I was asked about the correction

officer, not asked about the Sheriff.

· · · Q· · ·Is there anyone on the corrections side

of it other than the correctional officers you have

mentioned previously, that you think had a specific

actions or omissions had a proximate cause on Mr.

Stojcevski's death?

· · · A· · ·If you are counting the sheriff, I

don't count the Sheriff as the corrections side.

· · · · · · I count the sheriff as the boss, but if

the sheriff is definitely accountable for the

medical care in the facility and for oversight of

the medical care to assure that the providers of

care, the health service administrator, the

director of nursing physician, follow the policies

and procedures that are approved by the sheriff.

In that sense, I would hold the sheriff

accountable.

· · · Q· · ·Just to clarify.· I picture anything I

think corrections is anyone that works for Macomb

County Sheriff's Department?

· · · A· · ·Including contracted contractors.

· · · Q· · ·No, that is a separate contract.

· · · · · · I am saying specifically their employer

is the Macomb County Sheriff's Department.

Page 143

· · · A· · ·That is a semantic, but yes, the

sheriff is accountable in my opinion.

· · · Q· · ·Anyone else who you think is

accountable for Mr. Stojcevski's death?

· · · A· · ·The jail administrator.

· · · Q· · ·Do you have any knowledge or

information that Sheriff Wickersham had any

individual involvement with David Stojcevski?

· · · A· · ·I do not.

· · · Q· · ·Do you have any knowledge or

information that the jail administrator Michelle

Sanborn, had any individual knowledge or

interactions with Mr. Stojcevski?

· · · A· · ·If she didn't she should have but the

answer is no.

· · · Q· · ·Have you reviewed Sheriff Wickersham's

deposition testimony?

· · · A· · ·I don't recall.

· · · Q· · ·Do you know if you reviewed --

actually, Michelle Sanborn hasn't been taken yet,

so.

· · · · · · As it relates to David Stojcevski's

alleged weight loss while he was in jail.

· · · · · · What records are you relying on for

this opinion?

Page 144

· · · A· · ·The intake weight that was recorded and

the weight recorded by the medical examiner.

· · · Q· · ·Do you have any knowledge, or

information that that intake weight was in fact

accurate or that a scale was ever used?

· · · A· · ·I recall, someone saying or telling me

or reading that they didn't even have a scale, but

so the answer is no I have no idea if it was

accurate but it was clear to me that he was losing

weight, as time went on.

· · · Q· · ·How is it clear to you?

· · · A· · ·From the video.

· · · Q· · ·That you can't talk about?

· · · A· · ·I can't talk about what I told the FBI,

and I can't talk about what the FBI told me, or

asked me.

· · · Q· · ·But you didn't specifically review the

video for this case, is that correct?

· · · A· · ·I don't how to answer it.

· · · · · · I reviewed the video of the events

surrounding the medical care and the death of this

individual.

· · · Q· · ·After you were retained by Mr. Perakis'

firm, did you ever review the video again?

· · · A· · ·No.

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

Ann Arbor | Detroit | Flint | Jackson

U. S. LEGAL SUPPORT

Bingham Farms/Southfield | Grand Rapids

Phone:· 888.644.8080

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 141–144

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7678 Filed 01/19/21 Page 38 of 39
Page 145

· · · Q· · ·You relied on your prior knowledge, is

that correct?

· · · A· · ·Yes.

· · · · · · · · · MS. SWINDLEHURST: I don't have

· · · · · · anything further.

· · · · · · · · · MR. CHAPMAN: Mr. Perakis, do you

· · · · · · have a follow-up or two?

· · · · · · · · · MR. PERAKIS:· No.

FURTHER EXAMINATION BY

MR. CHAPMAN:

· · · · · · · · · MR. CHAPMAN: I have a follow up

· · · · · · question or two.

· · · Q· · ·I tried to question you regarding this

video including what speed you watched, how much

you watched.· You told me you were unable to talk

about it.

· · · · · · That is still your testimony, correct?

· · · A· · ·Yes.

· · · · · · · · · MR. CHAPMAN: I would like to mark

· · · · · · David Stojcevski's CCS medical records

· · · · · · pages, 1 through 51, as exhibit 1, and

· · · · · · then we have a flash drive that Dr.

· · · · · · Greifinger has testified, these are the

· · · · · · records he has reviewed for Mr. Perakis.

· · · · · · We can mark this as exhibit two, and

Page 146

then I think Mr. Perakis, has kindly

agreed to make three flash drives, exact

copies of this, and send one to Mr.

Gazall, one to Cara, and one to myself.

· · · MR. PERAKIS:· Thank you.

· · · (Marked for Identification,

Stojcevski's Exhibit 1, CCS Medical

Records, pages 1 to 51, dated April 4,

2018.)

· · · (Marked for Identification,

Stojcevski's Exhibit 2, Flash Drive,

dated April 4, 2018.)

·(Time noted: 1:30· p.m.)

· · · · · · _________________________

· · · · · · · DR. ROBERT GREIFINGER

Page 147

· · · · · · · · · · · I N D E X

·WITNESS· · · · · · · · · · · EXAMINATION BY· · · · ·PAGE

Robert Greifinger, M.D· · · · Mr. Chapman· · · · · · 3, 145

· · · · · · · · · · · · · · · Ms. Swindlehurst· · · ·132

· · · · · · · · · · · E X H I B I T S

·Stojcevski· · · · · DESCRIPTION· · · · · · · ·PAGE

·1· · · · · · · CCS Medical Records.· · · · · · 146

· · · · · · · · Pages 1 -51

·2· · · · · · · Flash Drive.· · · · · · · · · · 146

· · · · · (Exhibit 2 retained by counsel.)

· · R E Q U E S T E D· · ·I N F O R M A T I O N

·DESCRIPTION· · · · · · · · · · · · · · · · · PAGE

· · · · · · · · · · R U L I N G S

· · · · · · · · · · · · ·PAGE

Page 148

· · · · · · · ·C E R T I F I C A T E

STATE OF NEW YORK)

· · · · · · · · ·) ss.:

COUNTY OF NEW YORK )

· · · I, SHEA SORENSEN, a Notary Public in and

for the County of New York, State of New York, do

hereby certify that the foregoing examination of

DR. ROBERT GREIFINGER, was taken on the 4th day of

April 2018 pursuant to Order and recorded

stenographically by me; and that the foregoing

examination is a correct and accurate transcript

of my stenographic notes.

· · · ·I further certify that the witness was

duly sworn by me, prior to testifying, to tell

the truth, the whole truth, and nothing but the

truth.

· · · ·I further certify that I am not an

attorney or counsel for any parties or any of the

attorneys in this action, and that I am not

financially interested in this action.

· · · IN WITNESS WHEREOF, I have hereunto set

my hand this 4th day of April, 2018.

· · · · · · · · · · ·_______________________

· · · · · · · · · · · ·SHEA SORENSEN

GREIFINGER, M.D., ROBERT

04/04/2018

MIdeps@uslegalsupport.com

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GREIFINGER, M.D., ROBERT

04/04/2018 Pages 145–148

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Case 4:15-cv-11019-LVP-DRG ECF No. 209-2, PageID.7679 Filed 01/19/21 Page 39 of 39