| Here is what I just got from Dr. Benedek's meeting with our client this morning. N Neal A. Puckett, Esq LtCol, USMC (Ret) Puckett & Faraj, PC 1800 Diagonal Rd, Suite 210 Alexandria, VA 22314 703.706.9566 The information contained in this electronic message is confidential, and is intended for the use of the individual or entity named above. If you are not the intended recipient of this message, you are hereby notified that any use, distribution, copying of disclosure of this communication is strictly prohibited. If you received this communication in error, please notify Puckett & Faraj, P.C. at 703-706-9566 or via a return the e-mail to sender. You are required to purge this E-mail immediately without reading or making any copy or distribution. Begin forwarded message: From: "David Benedek" <dbenedek@usuhs.mil> Date: September 21, 2011 1:47:52 PM EDT To: <neal@puckettfaraj.com> Subject: Re: Some info on the Burke case for the appt on Wed Neal: I have essentially completed my diagnostic assessment of your client and I believe he has no current psychiatric diagnosis. His behavior at the time of the alleged offenses is most consistant with a substance induced dilirium--a transient alteration of consciousness/disorientation/loss of reality testing--not infrequently accompanied by amnesia for the events during the episode. Alcohol played a primary role, sleep played a role in predisposing him to the effect of alchol, and it is possible that dexedrine also contributed--although in most folks, the dexedrine would have been metabolozed by the time of the effents in question. However, it is possible that he is a slow metabolizer and that its effects could have linered and been magnified by the effects of sleep deprivation and alcohol. I asked him to ask his father how he tolerated his one test-use of dexedrine. He called his dad after our meeting and he says his father told him it made him "angry and aggressive" to the point that he vowed never to take it again. If there is any genetic presdisposition to having weird side-effects from dexedrine (e.g., like father like son) or the extent to which it is common (or even uncommon) for sleep deprived otherwise intoxicarted with alcohol to experience side-effects such as dilirrium as a result of dexedrine use it would be very helpful to have a toxicologist or clinical pharmacologist answer those questions. I can speculate but better for an expert in these issues to comment. Bottom line: 1) No other psych diagnosis that would increase risk of future behaviors 2) Likely contribution of sleep deprivation and potential contribution of dexedrine to a state of dilirium that may also occur as a result of acute alcoholic intoxication (but has apparently not previously occurred in your client during periods where he has had the same amount of alcohol and but htis has not been complicated by sleep deprivation and/or dexedrine use). Whether a panel will decide that is was reasonable foreseeable that alcohol intoxication in the context of sleep derivation and relatively recent use of dexedrine could lead to the behaviors for which the accused is charged is an interesting question. I will speak with his father and his wife to corroborate my own observations and would like to talk to his supervisor if that is possible. Thx Dave David M. Benedek, M.D. COL, MC, USA Professor/Deputy Chair & Assoc. Director/Senior Scientist, Center for the Study of Traumatic Stress Dept. of Psychiatry USUHS dbenedek@usuhs.mil 301-319-4944 That may be where YOU come in.Puckett Neal 09/20/11 11:58 AM >>> Neal A. Puckett, Esq LtCol, USMC (Ret) Puckett & Faraj, PC 1800 Diagonal Rd, Suite 210 Alexandria, VA 22314 703.706.9566 www.puckettfaraj.com www.twitter.com/puckettfaraj The information contained in this electronic message is confidential, and is intended for the use of the individual or entity named above. If you are not the intended recipient of this message, you are hereby notified that any use, distribution, copying of disclosure of this communication is strictly prohibited. If you received this communication in error, please notify Puckett & Faraj, P.C. at 703-706-9566 or via a return the e-mail to sender. You are required to purge this E-mail immediately without reading or making any copy or distribution. On Sep 20, 2011, at 11:38 AM, David Benedek wrote: Right: that's my point, this long form did not detail govt vs accused's version of the offenses, past medical/psych history, family psych history, social history, legal history, current mental status, as is routinely done in the privileged long form. Dave -----Original Message----- From: Puckett Neal To: Benedek, David Cc: Ranae, Doser-Pascual Cc: Haytham, Faraj Sent: 9/20/2011 11:31:01 AM Subject: Re: Some info on the Burke case for the appt on Wed Dave, If I had copied and pasted more of the rule, you'd see that there is a limited psychotherapist privilege that applies to the process. The short form is delivered to prosecutors and simply answers the main psycho/legal questions. The long form gives all the background, patient history, testing procedures used, information about the case received from the accused (normally privileged) and puts it all in to show that nature and extent of the methodology used to reach those short form conclusions. The long form is therefore confidential, unless and until the accused raises "lack of mental responsibility" as an issue. Then the long form has to be turned over to the prosecutor, as well. Does this get at your question? Neal A. Puckett, Esq LtCol, USMC (Ret) Puckett & Faraj, PC 1800 Diagonal Rd, Suite 210 Alexandria, VA 22314 703.706.9566 www.puckettfaraj.com www.twitter.com/puckettfaraj The information contained in this electronic message is confidential, and is intended for the use of the individual or entity named above. If you are not the intended recipient of this message, you are hereby notified that any use, distribution, copying of disclosure of this communication is strictly prohibited. If you received this communication in error, please notify Puckett & Faraj, P.C. at 703-706-9566 or via a return the e-mail to sender. You are required to purge this E-mail immediately without reading or making any copy or distribution. On Sep 20, 2011, at 11:18 AM, David Benedek wrote: Neal: So where does all the discussion of "short form" or "conclusions only" for govt vs. "long form" or narrative for defense occur--is that just how its usually done but not required? Thx, Dave -----Original Message----- From: Puckett Neal To: Benedek, David Cc: Ranae, Doser-Pascual Cc: Haytham, Faraj Sent: 9/20/2011 11:08:08 AM Subject: Re: Some info on the Burke case for the appt on Wed Dave, RCM 706 does not specify anything other than the questions to be answered. The report did that. (c) Inquiry. (1) By whom conducted. When a mental examination is ordered under subsection (b) of this rule, the matter shall be referred to a board consisting of one or more persons. Each member of the board shall be either a physician or a clinical psychologist. Normally, at least one member of the board shall be either a psychiatrist or a clinical psychologist. The board shall report as to the mental capacity or mental re- sponsibility or both of the accused. (2) Matters in inquiry. When a mental examination is ordered under this rule, the order shall contain the reasons for doubting the mental capacity or mental responsibility, or both, of the accused, or other reasons for requesting the examination. In addition to other requirements, the order shall require the board to make separate and distinct findings as to each of the following questions: (A) At the time of the alleged criminal conduct, did the accused have a severe mental disease or defect? (The term “severe mental disease or defect” does not include an abnormality manifested only by repeated criminal or otherwise antisocial conduct, or minor disorders such as nonpsychotic behavior disorders and personality defects.) (B) What is the clinical psychiatric diagnosis? (C) Was the accused, at the time of the alleged criminal conduct and as a result of such severe mental disease or defect, unable to appreciate the nature and quality or wrongfulness of his or her conduct? (D) Is the accused presently suffering from a mental disease or defect rendering the accused unable to understand the nature of the proceedings against the accused or to conduct or cooperate intelligently in the defense? Neal A. Puckett, Esq LtCol, USMC (Ret) Puckett & Faraj, PC 1800 Diagonal Rd, Suite 210 Alexandria, VA 22314 703.706.9566 www.puckettfaraj.com www.twitter.com/puckettfaraj The information contained in this electronic message is confidential, and is intended for the use of the individual or entity named above. If you are not the intended recipient of this message, you are hereby notified that any use, distribution, copying of disclosure of this communication is strictly prohibited. If you received this communication in error, please notify Puckett & Faraj, P.C. at 703-706-9566 or via a return the e-mail to sender. You are required to purge this E-mail immediately without reading or making any copy or distribution. On Sep 20, 2011, at 10:46 AM, David Benedek wrote: Sounds like a plan. We can chat again after I have evaluated your client. As you suggested, although the "long form" may have reached appropriate conclusions (I don't now yet), it is most certainly not an example of an appropriately comprehensive report--and not consistent with military best practices (or perhaps even regulations)? Does MRE 706 specify a more comprehensive format for the long form? I know the Principles and Practice of Military Forensic Psychiatry (Charles C. Thomas, 1995) outlines a much more inclusive report. Dave David M. Benedek, M.D. COL, MC, USA Professor/Deputy Chair & Assoc. Director/Senior Scientist, Center for the Study of Traumatic Stress Dept. of Psychiatry USUHS dbenedek@usuhs.mil 301-319-4944 Dave,Puckett Neal 09/20/11 10:22 AM >>> You're welcome! Lt Burke and I will see you in the morning at 0930. We'll be coming up on the Metro. I'd like to make introductions, brief you on the case, and step out of the way. Cheers, Neal Neal A. Puckett, Esq LtCol, USMC (Ret) Puckett & Faraj, PC 1800 Diagonal Rd, Suite 210 Alexandria, VA 22314 703.706.9566 www.puckettfaraj.com www.twitter.com/puckettfaraj The information contained in this electronic message is confidential, and is intended for the use of the individual or entity named above. If you are not the intended recipient of this message, you are hereby notified that any use, distribution, copying of disclosure of this communication is strictly prohibited. If you received this communication in error, please notify Puckett & Faraj, P.C. at 703-706-9566 or via a return the e-mail to sender. You are required to purge this E-mail immediately without reading or making any copy or distribution. On Sep 19, 2011, at 7:28 PM, David Benedek wrote: Thanks Neal -----Original Message----- From: Puckett Neal To: Benedek, David Cc: Ranae, Doser-Pascual Cc: Haytham, Faraj Sent: 9/19/2011 7:02:03 PM Subject: Some info on the Burke case for the appt on Wed Article 32 Investigating Officer's Report. Neal A. Puckett, Esq LtCol, USMC (Ret) Puckett & Faraj, PC 1800 Diagonal Rd, Suite 210 Alexandria, VA 22314 703.706.9566 www.puckettfaraj.com www.twitter.com/puckettfaraj The information contained in this electronic message is confidential, and is intended for the use of the individual or entity named above. If you are not the intended recipient of this message, you are hereby notified that any use, distribution, copying of disclosure of this communication is strictly prohibited. If you received this communication in error, please notify Puckett & Faraj, P.C. at 703-706-9566 or via a return the e-mail to sender. 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