EFTA00726525.pdf

Aug 18 09 11:17a Richard C. Hall, 407-322-8169 p.2 V. Jeffrey Epstein AFFIDAVIT OF RYAN C.W. 11.M. STATE OF FLORIDA COUNTY OF SEMINOLE ed authority, Ryan C.W. On this day personally appeared before me, the undersign and says: a M.D., who, being by me first duly sworn under oath deposes 1. My name is Ryan C.W. M.D. I am over the age of majority, and make knowledge of the this affidavit and declaration upon the basis of personal factual matters contained herein. forensic psychiatry 2. I have maintained a private practice in psychiatry and since 2008. Department of 3. I, also, currently serve as an Affiliate Instructor of the of South Florida, Psychiatry and Behavioral Medicine at the University in the Department of Tampa, Florida, and Assistant Professor of Psychiatry da College of Medicine. Medical Education at the University of Central Flori ins University and 4. I received my undergraduate degree from Johns Hopk medical degree from Georgetown University. legal proceeding. 5. No opinion of mine has ever been disqualified in a 1 Is 6 EFTA00726525 Aug 18 09 11:17a Richard C. IIII, 407-322-8169 p.3 hiatry and the 6. I was a Rappeport Fellow of the American Academy of Psyc Law in 2007. in Forensic Psychiatry 7. I completed an additional year of training fellowship at Case Western Reserve in 2007-2008. d of Psychiatry and 8. I am Board Certified in Psychiatry by the American Boar hiatry. Neurology, with additional qualifications in Forensic Psyc 9. The amended complaint filed by against Jeffrey Epstein makes a minor and seek sensitive allegations of sexual assault and abuse upon damages in excess of $75,000. has filed a 31-count complaint in which liation, embarrassment, she alleges confusion, loss of innocence, shame, humi further alleged that she and severe psychological and emotional injuries. It is and permanent traumatic suffered, and will continue to suffer, severe damages. injuries, including mental, psychological, and emotional distress and that Mr. 1.0. She alleges the intentional infliction of emotional ss, severe mental anguish Epstein's conduct caused severe emotional distre and pain. y including mental, 11. She further alleges that she has suffered personal injur psychological and emotional damage. ble and disturbed home. 12. Police records show thatMlicame from an unsta 2 EFTA00726526 Aug 18 09 11:18a Richard C. II ■ 407-322-8169 p.4 t from school, In 2001, prior to meeting Mr. Epstein, she was noted to be truan was described by was on probation for an incident of domestic violence, and subject to her mother as being completely out of control. She had been sexually active previous physical abuse, was fearful, isolated, and had been her history and prior to meeting Mr. Epstein. For further elaboration of n and access to all background, a thorough psychiatric interview/examinatio ct of any of available records is crucial if one is to fully understand the impa n the impact of these events on her subsequent behavior and proportio ion. specific events, if any, or her current and future level of funct nt assessment of 13. It is critical for an IME examiner to be able to make a coge mic, psychological any Plaintiff and to understand their medical, social, acade ed victimization. and psychiatric condition/state prior to any act of alleg the effects of such There are a number of variables that combine to determine of the alleged assault, alleged victimization, including the type and character ological reactions at and key victim variables such as demographics, psych or psychological history, the time of the trauma, previous psychiatric cal difficulties, previous victimization history, current or previous psychologi well as sociocultural and general personality dynamics and coping style, as ity and/or inadequate factors such as drug use/abuse; poverty; social inequ 3 EFTA00726527 Aug 18 09 11:18a Richard C. ■, Ill 407-322-8169 p.5 de the family; social support; any previous history of abuse within or outsi or family whether individuals were abused by strangers, acquaintances behavior that members; and whether there was any history of indiscriminate know if there had may have placed them at increased risk. It is important to or welfare agencies, been previous sexual conduct, contact with police contraceptive use, alcohol or drug use/abuse, voluntary sexual activity, abuse. genital infections, or apparent indifference to previous emotional support, 14. It is also essential to understand the Plaintiff's level of whether they were whether any significant psychiatric illnesses were present, ), whether there had taking any medications (prescribed or non-prescribed been previous suicide attempts, thoughts, plans, etc. and familial factors, 15. Knowledge of Plaintiff's relationships to her family to toxic substances such including social disadvantage, intrauterine exposure ionship, and parental as cocaine, family instability, impaired parent/child relat adjustment difficulties is also critical. iner has available to 16. It is, therefore, crucial that the independent medical exam ious legal, social, him a full and complete record that includes medical, prev ta; psychological criminal, academic, psychological and psychiatric records/da ds and that they tests; laboratory tests; and clinical, hospital, physician recor 4 EFTA00726528 Aug 18 09 11:18a Richard Cal,• 407-322-8169 p.6 Examination. have time to conduct a full and complete Independent Medical full medical and 17. The Independent Medical Examination will cover Plaintiff's of present illness, psychiatric history, including: chief complaint, history ry, past psychiatric specific complaints of symptoms or injury, medical histo hood history, school history, family history, abuse history, birth history, child history, relationship history, occupational history, violence history, legal ms, activities of history, substance use history, sexual history, review of syste using DSM-IV axes, and daily living, mental status examination, diagnoses discussion of case findings and opinions. n Scale, Zung Anxiety 18. Psychological tests and questionnaires: Zung Depressio I-III, MMPI -2 with forensic Scale, Mini Mental State Examination, MCM sic Questionnaire. implications, Life History Questionnaire, and Foren been put at issue, the 19. Because Plaintiffs emotional and mental states have physical, emotional undersigned must ask question of Plaintiff regarding her nt, in order to form an and mental problems, in the past and in the prese hours with the Plaintiff. expert opinion. Such examination will require seven the examiner. Other The IME requires the presence of only the Plaintiff and individuals present will invalidate the process. er and have been asked to 20. I have been retained as an expert in this matt 5 EFTA00726529 Aug 18 09 11:18a Richard C.. ■ 407-322-8169 perform an independent medical evaluation of Plaintiff videographer, court 21. I strenuously object to allowing the presence of a examination of reporter and/or attorney being present in the room during my Plaintiff r attorney in the 22. The presence of a videographer, court reporter and/o endent medical examination room during my performance of an indep distractions, and would examination would create an artificial environment, n. A video camera in compromise the integrity of my psychiatric examinatio de the room would be the room connected to a monitor by cable outsi acceptable. court reporter and/or 23. Furthermore, enabling the presence of a videographer, ce of an independent attorney in the examination room during my performan al standards imposed medical examination is a clear departure from the norm within the psychiatric field for such an examination. examination, I require 24. As part of the performance of an independent medical and a "Forensic that examinees complete a "Patient Questionnaire" about the examinee, Questionnaire" designed to elicit historical information ination and gives the which assists in my performance of the clinical exam 6 EFTA00726530 Aug 18 09 11:18a Richard C. ■,. 407-322-8169 p.8 obtain appropriate examinee opportunity to review records obtained and data prior to the examination. aire seeking the 25. Requiring that a patient/examinee complete a questionn col of the clinical provision of historical information is a standard proto examination. independent medical 26. My ability to provide a complete and thorough of the historical examination is compromised without the provision aire" and "Forensic information sought in my "Patient Questionn Questionnaire." ination consists of a 27. Additionally, part of the independent medical exam ry and background consultation with the examinee, in which histo us written standardized information is obtained, and administration of vario and scales goes to the tests and scales. The administration of such tests essence of such examinations. ination of Plaintiff 28. I have been asked to perform a psychiatric exam independent pursuant to a request in the above-styled cause for an medical examination. ested to videotape the 29. I understand that Plaintiff's counsel has requ both present in the room examination and have counsel, a court reporter, or 7 EFTA00726531 Aug 18 09 11:19a Richard C. IN 407-322-8169 p.9 during the examination. 30. The presence of third-party observers, meaning persons other than the examiner and examinee, in the examining room is inconsistent with standardized administration of the tests and changes the testing environment considerably by introducing extraneous variables that may distract the examinee and alter the results of the IME. 31. A psychiatric examination, which consists of, but is not limited to, interview, mental status examination, and tests of intelligence, memory, attention, concentration, problem solving, sensory-perceptual functioning, motor functioning, psychomotor problem solving ability, is properly conducted in the absence of third parties from the examination site (i.e., court reporter, attorney, videographer). The presence of third parties often affects the examinee's responses to examination items and may alter or distract their stream of thought. 32. For the above reasons, I oppose having third parties present in the examination room during an examination. I may choose not to perform the standofd examination in the presence of third parties (court reporter, attorney, videographer) except under Court order and with the caveat that the test results may be invalid. 8 EFTA00726532 Aug 18 09 11:19a Richard C.111,11 407-322-8169 p.10 the ethical 33. The examination of Plaintiff will be conducted in compliance with hiatrist. Plaintiff principles and code to which I am bound as a licensed psyc drink, and visit will be allowed to take breaks, as she may need, to relax, eat the restroom. an attorney present, but 34. In the event that I must conduct an examination with interruption in the outside the examination room, I request that there be no the examination examination. Interruptions will distract the Plaintiff, disrupt the attorney should not and skew the validity of the examination- If present, g breaks or otherwise. coach the examinee during the examination or durin will be necessary for 35. It is not possible to predict the exact amount of time that an appropriate psychiatric examination of Plaintiff III. of information that will be because of unknown variables such as the amount at which Plaintiff will covered in the consultation segment and the pace perform the standardized tests. Such examinations generally take any break time), with approximately six to seven hours (excluding to-face consultation approximately four to six hours used for the face- the testing segment. segment and approximately two to three hours used for take ppproximately However, in this case, I anticipate the !ME of Plaintiff to Additional time may be between five and eight hours, excluding break time. 9 EFTA00726533 Aug 18 09 11:19a Richard C. III II 407-322-8169 p.11 necessary for Ms. alla to complete testing on her own, which most OM has not patients complete in 30 minutes to one hour. If Ms. Questionnaire" completed the "Patient Questionnaire" and the "Forensic ney prior to the before the examination, which was provided to her attor pertinent historical examination, additional time will be needed to obtain information. Respectfully submitted, Ryan C. W.I. MD vioral Medicine, University of Affiliate Instructor, Department of Psychiatry and Beha South Florida Education, University of Central Assistant Professor of Psychiatry, Department of Medical Florida College of Medicine STATE OF FLORIDA COUNTY OF SEMINOLE RYAN BEFORE ME, the undersigned authority, personally appeared M.D., who i0.41-personally known to me or ( ) who has produced says that the attached Affidavit is as identification, and who did take an oath, deposes and f. true and correct to the best of his knowledge and belie 10 EFTA00726534 Aug 18 09 11:19a Richard C. 407-3224169 p.12 SWORN TO AND SUBSCRIBED before me on this titt ‘ day of Ph xjaJr 2009. Nota>yy Public Printed Name: tta:S ntrrNenvic4O My Commission Expires s ninone fats JAN' 0:r.r-1C30561004 # 1% te: 10 4 061 2010 FCfisi :Wary Asen.. ine Pte »».»«..«».«...M 'W,..µ......... 11 EFTA00726535