LIVE UPDATES: Psychiatric nurse returns to witness stand on day 11 of Lindsay Clancy murder trial

Lindsay Clancy’s murder trial is underway in Massachusetts. The 36-year-old woman is charged with three counts of murder for the strangling deaths of her three children, ages 5, 3, and 8 months old. Clancy is present in the courtroom, bound to a wheelchair after she was paralyzed by injuries she sustained when she jumped from her home’s second-story window in an alleged suicide attempt. Her defense lawyer claims she was insane at the time, suffering from postpartum psychosis, and could not appreciate the wrongfulness of her actions. We are posting live updates from the courtroom here. Time notes are Eastern Daylight Time. Please forgive typos.

3:42 p.m. Judge excuses jury till tomorrow at 9:00 a.m.

3:28 p.m. Redirect: Lindsay Clancy a patient at SS between NOv. 20 and Dec. 13. Dec. 13 was the last time you met with her? yes. She never offered to have you talk to her? correct. Your last prescription was Dec. 22? correct.
This record is a prescription list from CVS – yes. Is it common to change prescription when you change dosage. correct.
On Dec. 6 – you prescribed 1 pill and Dec. 7 – 2 pills. And Dec. 9 – 8 pills. yes. Dec. 30 – 7 pills? yes.
Seroquel she was given 30 pills, when you changed the plan you gave her a new prescription for a higher dose. yes.
Do you expect the patient to disregard the previous prescriptions> yes. Did SS have an inpatient program. No.
Any information from Women and Children’s would have to come from the patient or at the patient’s request? correct.
At no time when witness treated Lindsay Clancy did she exhibit signs of psychosis or did she have a plan to carry out suicide? No.

3:21 p.m. Lindsay writes on Dec 12, she likes how it makes her sleep but she’s incredibly depressed and unmotivated. She’s reporting suicidal ideation. December 13, witness recommended to stay on Seroquel and valium. Went to women’s and children’s on the 20th. Did you talk to anyone at Women’s and Infants? no. Is it important to find out what their diagnosis was? yes. Did you find out what the diagnosis was? No. From your treatment of Lindsay – she would have signed a release – did you ask her to sig a release? Did not. End of Cross.

3:17 p.m. On one of her calls with Lindsay, Lindsay indicated that she wanted her husband to speak for her – because she wasn’t advocating for herself. Witness I recalls. he was on the call with her. Her husband told her that she was having panic symptoms, racing heart, intense fear, rushes of intense anxiety. Patrick indicated that she was having intrusive thoughts again. I recall that she had thoughts of suicide. Both Patrick and Lindsay said she had thoughts of suicide.
What were they? I recall they were intrusive suicidal thoughts. Was it a frequent theme, i don’t know if it was frequent but it was documented. Prescribed valium and bumped up the Seroquel.

3:09 pm. December 5, Therapist Latiesha Dukes, notes Lindsay called Aspire Crisis Support -operates 24 hour hour emergency program. She called twice – she was not given any help at all? Aspire told her to go to a day program. Patient’s husband joined the therapy visit and shared that Lindsay’s anxiety was getting significantly worse. “It was 10k times worse since she started medication,” Patrick is quoted as saying in notes. Witness: Don’t recall him using that phrase. He was concerned. Did anybody address his concerns? That day I collaborated with them to take her off medications.

3:02 p.m. Postpartem is like regular depression. There are a few differences, it can be triggered by hormone shifts due to baby delivery. Would you agree that it would have been a good idea to meet with her considering All of her symptoms. yes. She couldn’t sleep, losing weight in December. Yes.

2:58 p.m. Lindsay writes to her on Dec 3rd and says ‘all day I have had horrible intrusive thoughts and was deeply depressed.” When you receive a woman with postpartum write such a message you’re concerned? Did you ask her about it? Witness says she has treated five women with postpartem psychosis, and that some women do experience hallucinations. You write her back and you say, “this sounds like postpartme depression.” correct.

2:55 p.m. On Nov 30 = stopping Remeron – insomnia was a huge problem. She told you she didn’t feel tired at all. It’s a symptom of mania. How many times did Pat meet with you. He came with Lindsay once, and spoke on the phone with him twice. He was invested in her care and he believed she was overmedicated. A: Patrick felt her symptoms started when she was medicated.

2:42 p.m. Lindsay was administered an Edinburgh Scale and scored 23- considered severe and scored 17 on the same scale in Nov 6 — days after the first scale assessment. Nov 28. Lindsay spoke to the nurse, you read the report before you met with her on the 29th. On Nov 29th you diagnosed her with postpartum anxiety. She said she was feeling nervous, anxious and on edge. She was worrying incessantly and feeling afraid. On Nov. 29 she had a GAD score – which represents moderate anxiety. She responded that she was hardly experience enjoyment.

2:31 p.m. Prescribed Diazepam in January on three occasions. Reddington suggests witness assumed Lindsay knew more about the drugs she was being prescribed than she actually did. Reddington notes that Lindsay went to the Women & Infants program as the witness had recommended and Lindsay was not accepted because she was ‘overmedicated,’ and the doctor at Women’s and Children recommended tapering off. Witness said she was not part of Lindsay’s assessment at Women’s and Infants and could not comment on their diagnosis.

2:18 p.m. Jollotta testifed she met with Lindsay twice (virtually) and once in person. Not aware she was seeing Dr. Tufts in November. Did you talk to Tufts? No. She saw Dr. Tufts 14 times, and 3 times with you over four months. During that period of time she was provided many prescriptions? I was aware she was prescribed other medications. Did you know Tufts prescribed Seroquel and other medications in October. Defense rattles off all the medications witness prescribed Lindsay.

2:15 p.m. Rebecca Jollotta is on cross-examination by Defense Attorney Kevin Reddington.

1:00 pm. Court is in a lunch recess until 2:00 pm.

12:56 p.m. Patrick called on December 30 about wanting a bed for Lindsay at McLean’s Psychiatric hospital. Jollotto advised him to take her to the ER of Mass General Hospital as it was a better way to get access to a bed. Witness reviewed Lindsay’s medications that were filled from her previous psychiatrist. Lindsay did not return to their clinic. Witness testified that while Lindsay was her patient at no time did she express a plan to kill herself or her children.

12:52 p.m. Lindsay shared with Jollotta that she wanted to be off the Seroquel, and told her – her psychiatrist was available for appointments in case she needed to consult with someone. Witness Jollotta asked her nurse to go over the risk of tapering off drugs with Lindsay and ask her if she really wanted to move forward.

12:44 p.m. Dec 19: Lindsay had an appt with Latiesha Dukes. She mentioned she would start partial hospitalization the next day. Witness would be on vacation – Lindsay expressed concern was that she would need a refill her script for valium. December 20th message, she reported that she was discharged from Women and Infants. She indicated that she wanted to taper the Seroquel. Next day Jollotta responded and told her she was concerned about the discharge. Reminded Lindsay that she was going on vacation and was concerned about tapering the Seroquel while she was on vacation and asked if she would be able to consult her psychiatrist.

12:42 p.m. On Dec 16 -what were her medication recommendations? Lamotrogine 25 mg., Seroquel 300 mg. and Valium 2 mg. You asked about Women and Infants? Lindsay said she missed the call from them.

12:38 p.m. December 16: Jollotta recommended 300 mg for treating bipolar depression. Advised Lindsay she could stay on the Valium if needed. Lindsay said she consulted her psychiatrist and her doctor recommended adding lamictal/lamotrogine as a mood stabilizer. Lindsay asked Jollotta to weigh in. Witness thought it was a good idea, and talked to her about the side effects. She recommended the lamictal had to be a slow titration, side effects could be a serious rash. She said the Seroquel and Lamictal could work well together.

12:33 p.m. Received phone call on Dec 15 from Patrick and Lindsay – they reported Lindsay had the worst day yet- they were ready to be assessed for a higher level of care. They reported Lindsay had persistent intrusive thoughts of suicide but no active plan to kill herself. Witness recommended they go to MGH’s ER as the best course of obtaining a bed. Did they go to the Mass General ER? Yes. Lindsay reached out to Jollotta via the My Chart portal. She decided against inpatient and opted for the partial program at Women and Infants. Asked Jollotta what she was recommended in terms of medication.

12:25 p.m. December 13: Lindsay reported improved sleep – 7 to 9 hours with 200 mg of Seroquel and 2.5 mg valium at night. However still depressed, feeling numb, and racing heartbeat. Jollotta discussed keeping 200 mg of Seroquel for full 7 days, reiterated a recommendation for partial hospitalization. Did not observe signs of mania, psychosis, suicidal ideation. She had thoughts of harming herself in previous assessments, but not at this visit. (Objection – Objection overruled.) Did not express that she had suicidal ideation, or intrusive thoughts. What did she say were the intrusive thoughts? Thoughts of wanting to die. Plan? Continue Seroquel 200 mg. and valium 2 mg.

12:15 pm. Decmber 12: By this date, if Lindsay had followed her recommendation she would have been 400 mg. Lindsay reported fluctuating heart rate. Witness explained to Lindsay that it is generally benign and goes away on its own, sometimes it necessitates dividing a dose. Lindsay spoke to a nurse about getting off of Seroquel altogether.
She recommended a partial hospitalization program. Lindsay was not reporting acute symptoms, only physical side effects.
Lindsay reports 2.5mg of valium and 200 mg of Seroquel, she said she was sleeping well, but not feeling well – incredibly depressed and unmotivated. Recommended up to 200 mg of Seroquel. Visit scheduled for Dec. 13. Lindsay asked for the 13th visit to be virtual. Witness wanted visit in person – Lindsay was communicating every day, but had significant symptoms of depression and mania. I would rather see her than not see her.

12:08 p.m. December 8 – she said she slept well on the valium and Seroquel. Lindsay requested a longer taper. Jollotta was hesitant to taper because Valium has a long half life. Lindsay was afraid to resort Ativan if she couldn’t sleep. She and husband called advocated to stay on the Valium, and taper the valium over the weekend. Still waking up with intrusive thoughts. Agreed to continue the valium until their next meeting on December 13. She recommended to titrate the Seroquel, gradually increase the dosage of the Seroquel up to 400 mg on Day 4. Jollotta recommended partial hospitalization.

11:59 a.m. Lindsay communicated via the MyChart portal the next day (Dec. 7). Lindsay reported, “Last night did not go well.” LC says she only slept 2 hours. Jollotta recommended a higher dose of Seroquel, moving from 75 mg to 100 mg. Jollotta still had suspicion about bipolar disorder, and Seroquel can address bipolar symptoms. Lindsay says she can’t sleep, doesn’t feel tired at all — potential sign of mania, according to Jollotta. LC asked if she could try a valium with Seroquel. Jollotta expressed her suspicion about underlying bipolar and suggested gradually increasing dosage of Seroquel. Jollotta says she suggested adding another medication.

11:54 a.m. Jollotta conducted a CIWA (Clinical Institute Withdrawal Assessment) of Lindsay’s dependency on Ativan – she scored low. Indicated she was anxious, but she did not exhibit physical symptoms associated with withdrawal. Jollotta recommended Valium. LC said when she took Remeron and Seroquel, she felt “weighed down” but her mind was still alert. LC expressed a preference for Prozac. Jollotta says she recommended that LC stop the Seroquel and start Prozac.

11:44 a.m. During the Dec. 6 in-person meeting, Lindsay said sleep problems did not improve. LC reported that she hadn’t slept for 48 hours and didn’t feel tired. Jollotta says she discussed with Lindsay and Patrick the possibility of an underlying bipolar disorder. LC said she had an “activating” response to Zoloft, which raised Jollotta’s suspicion of bipolar disorder. LC also had difficulty tolerating other antidepressant medications. Prosecutor: Any indicators from LC about manic episodes? Jollotta: No. Jollotta reviewed a mood disorder questionnaire that Lindsay filled out. Jollotta: I recall 3 symptoms she noted: racing thoughts, trouble concentrating, and insomnia. Screening revealed negative for mania. Prosecutor: Did she have diagnostic criteria for bipolar disorder? Jollotta: Not at that time. Jollotta recalls Patrick said, “My wife is not bipolar.” Lindsay did not say anything. During the appointment, focus was on LC’s trouble sleeping and potential for addiction to medications. Talked about concern over the benzodiazepines and came up with a plan to taper off of them.

11:34 a.m. Jollotta says Lindsay Clancy reached out to her on Dec. 5 – but she was out sick. LC changed her appointment with Latiesha Dukes to virtual and met with Jollotta in person on Dec. 6. Lindsay attended with her husband, Patrick Clancy. Assessment screens at that meeting showed: LC’s score on Edinburgh depression scale was 21 out of 30 = moderate to severe depression; GAD score was 19 out of 30 = moderate anxiety. Jollotta says she noticed nothing different about LC’s speech. Her mood and affect were anxious. Her thought process was linear and goal-directed. No indication of LC having hallucinations, delusions; no plan or intent of suicide. No signs of mania or psychosis. No sign of obsessive thoughts or behaviors.

11:26 a.m. Court is back in session.

11 a.m. Court is taking the morning recess.
10:42 a.m. Jollotta says Lindsay messaged her the next morning (Dec. 2), reporting that she had horrible intrusive thoughts and took Ativan – thoughts went away. Lindsay expressed concern that she was addicted to Ativan. Jollotta says she recommended increasing Seroquel to 50 mg. Prosecutor: Did you feel she was dependent on Ativan? Jollotta: No. I messaged her about the difference between dependence and addiction. She had been taking Ativan every day for 2.5 weeks. “… with addiction, there is a change in behavior … with dependence on benzodiazepines, there are physical withdrawal symptoms.” Jollotta says she recommend taking it (Ativan) every other night and then we won’t refill it.

10:37 a.m. On Dec. 1, Jollotta says she got a message from Lindsay that said, “I don’t like how I’m feeling when taking Remeron. I’m having intrusive thoughts, want to get back to Julie’s (previous psychiatrist Julie Paul) recommendation.” Jollotta: I responded with a detailed message about symptoms of postpartum depression – and highlighted that intrusive thoughts are common in postpartum – asked if that was was going on. Lindsay expressed fear about new medication. I responded with a detailed description of what to expect from the medications and told her about resources available to her at the clinic, including books. LC had an appointment with therapist Latiesha Dukes the next day.

10:33 a.m. Prosecutor: Did you ask specifically about suicide? Jollotta: I did. I wanted to make sure I addressed that because of the severity of Lindsay’s symptoms. LC said she’s “not at the point of suicide.” She asked for the Seroquel. Jollotta says Lindsay messaged her for a phone call, and Jollotta interacted with LC on MyChart portal, and asked her nurse to call LC. Lindsay says symptoms were feeling “hopeless.” Nurse called LC at 3:30 p.m. Lindsay agreed to the plan and said she would pick up the Seroquel.

10:28 a.m. Jollotta wanted to establish a collaborative relationship with Lindsay and suggested Prozac as an alternative, since LC had been on it in nursing school, and Jollotta recommended Seroquel to help Lindsay sleep. She recommended Remeron for another 10 days, start Prozac, and add Seroquel for insomnia. Prosecutor: Recommended that LC take the medication at the same time? Jollotta: Yes. My thought was the combination of Remeron with Prozac to address anxiety and Seroquel to help her sleep. Noticed she was attributing her condition to the medications, and asked her to keep track of how she felt when she took the medications. I wanted more data.

10:24 a.m. Jollotta says she had contact with Lindsay Clancy on Nov. 30, 2022. Lindsay asked if it would be safe to stop Remeron after five nights. On the 29th they had discussed continuing it. LC reported that the depression was much worse, and that she had only 2 hours of sleep. Jollotta says she asked Clancy what symptoms were worsening.

10:17 a.m. Prosecutor: Do you assess for suicidality? Jolotta: Yes. LC denied having thoughts of suicide and homicide. LC seemed anxious. I observed her thought process to be linear – meaning you could follow it – she was goal-directed.
Results of LC’s screens: Edinburgh scale was 17 out of 30; Generalized Depression Scale was 14 out of 21 – means moderate to severe anxiety. Telehealth visit was 30 minutes. Jollotta says the treatment plan for LC was: Continue Remeron and Ativan as needed, no new medications prescribed. Lindsay seemed receptive. Jollotta recommended therapy and physical activity. LC had some postpartum anxiety after Dawson, which seemed to resolve itself with exercise.

10:08 a.m. Jollotta says she explained to Lindsay that drugs take time to work – LC had only been taking Remeron for 4 days. Suggested taking 10 mg of Ambien. Lindsay did not want to take the Ambien; she was concerned about ‘rebound anxiety.’ Discussed hydroxyzine, which would help her sleep and address anxiety. LC not willing to try hydroxyzine. Performed a number of screenings to identify mania and signs of psychosis. Screened her for symptoms: disorganized thoughts, pressured sleep, insomnia, increased goal-directed activity, delusional thought process. Prosecutor: Did LC display psychotic symptoms? Jollotta: No.

9:58 a.m. Continued Direct of Rebecca Jollotta: Lindsay Clancy was transferred to her after Julie Paul left. First contact (virtual) with LC Nov. 29, 2022. Jollotta had access to Lindsay’s South Shore records and was aware of her medication history. What was Lindsay reporting to you on Nov 29? Lindsay said she was taking Remeron, reported difficulty staying asleep. Remeron is slightly different from an SSRI, has a calming effect and can help with sleep and appetite. Noticed LC had lost weight. What is the time frame for the drug to work? Jollotta: I tell patients it could take 4 to 6 weeks. On Nov. 28, a nurse suggested LC increase Remeron and cognitive therapy.

9:50 a.m. Commonwealth Witness No. 62: Rebecca Jollotta, Psychiatric Nurse Practitioner: Works at South Shore Perinatal Behavioral Health (since 2021). Specializes in working with postpartum women with various psychiatric issues. Has worked with women suffering from postpartum psychosis (5) and hundreds of women suffering from postpartum anxiety and depression. Highest risk period for postpartum issues is 3 months after baby is born, but South Shore program treats women for up to 2 years postpartum.

9:47 a.m. Paul has moved to New Hampshire but still works with postpartum women. Connection to Lindsay made by a colleague who worked with Patrick Clancy’s mother. Records from South Shore Hospital admitted – no further cross.

9:46 a.m. Commonwealth Witness No. 61 Julie Paul, Psychiatric Nurse Practitioner, returns to the stand. She will be on cross-examination by defense attorney Kevin Reddington.

9:42 a.m. Judge Sullivan queries the jury and tells jurors schedule will be much like yesterday’s.

9:33 a.m. Judge: Commonwealth witness says she didn’t know what the McLean staffing was on the holiday weekend that Clancy was admitted. Judge appears to agree that testimony about the staffing on that weekend is relevant. Prosecutor argues that records reflect facts about the McLean staffing and urges the judge to deny the motion.
Judge: It seems simple to me that someone at McLean can testify about the weekend staffing. Suggests a voir dire of the witness. The individual could talk about the staffing difference in holiday weekend versus a non-holiday weekend. Judge will take the motion under advisement.

9:27 a.m. Judge is reluctant to allow the defense to call Thorndike because she left a year before Lindsay was hospitalized at McLean. Defense argues the testimony would be used to counter the government’s testimony about McLean. Commonwealth of Massachusettes (prosecution) opposes the testimony, because witness is not an expert, has been following the trial, was not there and had no contact with the case. “That’s not a witness who presents facts to the jury.”

9:20 a.m. Defense wants to call Emily Thorndike as a witness who has a practice in Massachusetts. She worked at McLean Hospital as a clinical social worker for 7 years, where Clancy was hospitalized. This woman posted a video on TikTok saying she “could not stand the lies about McLean” – that it was not staffed, according to the environment described by the McLean psychiatrist.

9:19 a.m. Judge reminds gallery that there is a media order that must be followed or there will be consequences.

9:12 a.m. Court is in session. As has been the practice of Judge William F. Sullivan, he summons attorneys to sidebar before testimony begins.

8:57 a.m. Court is expected to resume shortly with cross-examination of Psychiatric Nurse Practitioner Julie Paul. Lindsay Clancy turns 36 today.