A judge is expected to rule Monday on whether a doctor and nurse at the Las Colinas jail in Santee will go to trial on involuntary manslaughter charges in connection with a woman's 2019 in-custody death.
Testimony wrapped up Friday in the week-long preliminary hearing for Dr. Friederike Von Lintig, 58, and nurse Danalee Pascua, 38, regarding the death of 24-year-old Elisa Serna on Nov. 11, 2019, five days after Serna was booked into the jail.
The defendants face up to four years in state prison if convicted. El Cajon Superior Court Judge Selena Epley will hear arguments from attorneys Monday morning before ruling on whether the case will proceed to trial.
The prosecutions come as San Diego County continues to face scrutiny for the number of in-custody deaths at its jail facilities. Eight people have died in local custody this year, including two in the last week.
Serna was pronounced dead shortly after she collapsed in her cell in the jail's medical observation unit.
Von Lintig was the physician on duty the day Serna died and Pascua witnessed the fall.
Testimony indicated that upon Serna's booking into the jail, she reported that she was withdrawing from drugs and alcohol and was about five weeks pregnant.
Dr. Shaun Carstairs, an emergency physician at Scripps Chula Vista and Rady Children's Hospital, testified that Serna's self-reported drug history should have put jail medical staff on notice to look out for withdrawal symptoms. Carstairs said that after reviewing Serna's time at the jail, she exhibited signs of confusion and "multiple episodes where she appeared to be suffering generalized seizure activity," which he said were signs of withdrawal.
Evidence presented during the hearing highlighted three instances in which medical staff was alerted to Serna's condition on Nov. 11.
The first time occurred early in the afternoon when Serna was being moved out of the medical observation unit in a wheelchair and her limbs began stiffening.
She was taken back into her cell and multiple staff members, including Von Lintig, responded and examined her.
During that examination, Von Lintig took a measurement of Serna's oxygen saturation level, which shows how much oxygen is in a person's bloodstream. Serna's oxygen saturation was measured at 87%, which Carstairs described as "quite abnormal" and she should have been closely monitored afterward, he said.
Von Lintig later told an investigator that she believed it was a "false reading" because Serna appeared awake and alert and was resistant when nurses tried to place an oxygen mask on her, according to testimony.
About two hours later, nurses witnessed Serna lying across the seat of the toilet in her cell. A nurse requested that Von Lintig return to Serna's cell, but she never did.
A few hours later, Serna fell in her cell as Pascua was attempting to check her vital signs.
Video played in court earlier this week showed Serna standing at her cell door, then collapsing.
After the fall, Serna lay on the floor with her head slumped forward and propped up against the wall while the rest of her body was prone.
Pascua and a deputy entered the cell, but later left without moving Serna from that position. Pascua and other deputies re-entered the cell nearly an hour later and Serna was pronounced dead shortly afterwards.
Carstairs testified that Serna's positioning with her head bent forward likely obstructed her airway.
Serina Rognlien-Hood, the sheriff's department director of nursing, testified on Friday that the position was not necessarily life-threatening, but Serna should have been moved into a more comfortable position.
She also testified that 911 should have been called after Serna fell.
Serna's death is also the subject of a federal wrongful death lawsuit filed against the county by her family, which alleges jail medical staff failed to provide proper care despite knowing her substance abuse history. Von Lintig, Pascua and several others are also named as defendants in the ongoing lawsuit.
