A doctor and nurse at the Las Colinas jail in Santee "failed" a woman who died while in custody, a prosecutor said Friday, while defense attorneys argued that their clients had only treated the woman during a limited window of time and were not ultimately responsible for her death.
Opening statements and the first witness testimony were delivered Friday in the trial of Friederike Von Lintig, 59, and Danalee Pascua, 38, who are charged with involuntary manslaughter in the Nov. 11, 2019, death of Elisa Serna.
Serna, 24, died five days after she was booked into the jail. A county medical examiner determined that Serna died of complications of chronic polysubstance abuse with a contributing factor of early intrauterine pregnancy.
She was pronounced dead shortly after she collapsed in her cell in the jail's medical observation unit.
Deputy District Attorney Samira Seidu said Serna, who was pregnant and suffering from symptoms of withdrawal from alcohol and drugs, was "abandoned, ignored, and accused of faking" her symptoms by those charged with caring for her. Those symptoms included frequent vomiting and around a dozen seizures in the final 24 hours of her life.
The prosecutor said Von Lintig, the physician on duty the day Serna died, should have had Serna transferred to a hospital amid these episodes of seizurelike activity. Instead, Seidu said, Von Lintig ignored the severity of Serna's condition. At one point, nurses summoned Von Lintig after one of Serna's seizures, but the doctor "refused" to see her and implied Serna was faking her ailment, Seidu said.
Von Lintig's attorney, Dana Grimes, told jurors that her client only saw Serna on the final day of her life and was operating on information provided to her by other medical professionals.
Those doctors and nurses told Von Lintig that Serna had been faking fainting spells and self-inducing her vomiting, according to Grimes. The defense attorney also said Von Lintig never personally witnessed any of Serna's seizures and never accused Serna of faking symptoms.
At the end of her shift, Von Lintig left the jail about three hours before Serna collapsed in her cell. Grimes said the doctor ended her day "without understanding the gravity of the situation because it was never communicated to her."
Pascua began her shift a few hours later and during that time attempted to take Serna's vital signs.
But Serna collapsed, struck her head against the wall and began experiencing yet another seizure.
Pascua and a deputy entered the cell and, according to Seidu, Pascua briefly examined Serna without taking her vital signs.
Seidu said Pascua later told investigators that she attempted to get Serna's vitals, but Serna was "resisting." The prosecutor said Pascua "dismissed" Serna's seizurelike movements as "resisting."
Pascua and the deputy then left Serna, who was laying on the floor with her head slumped forward and propped up against the wall. She remained there for the next hour, during which time she urinated herself. Pascua later noticed Serna was pale and didn't appear to be breathing, at which point emergency medical personnel were summoned, but "by that point, it was too late," Seidu said.
Pascua's defense attorney, Alicia Freeze, said her client's actions were being scrutinized with "the benefit of hindsight."
Freeze alleged Pascua did not actually see Serna fall because the nurse was on the other side of the cell door. The defense attorney also said medical experts would testify that the position Serna was left in was not a contributing factor in her death.
"Ms. Serna's death was not caused by Nurse Pascua in the four minutes that she saw her," Freeze told jurors.
Von Lintig's medical license has been suspended, but the Medical Board of California has also filed a civil petition known as an accusation, which could lead to a revocation of her license.
The state Medical Board filed an accusation last year against another jail doctor, Carol Gilmore, who also treated Serna in the days leading up to her death. The accusation alleges Gilmore didn't "appropriately medically manage a pregnant patient in active withdrawal" and didn't "perform an appropriate physical exam, work-up, and plan of treatment for a patient with an undiagnosed acute medical condition." Gilmore has not been criminally charged.
A trial brief filed by the prosecution states that several of the witnesses expected to testify during the trial were also responsible for Serna's care, but their testimony won't open them up to criminal liability.
According to the brief, "the most serious applicable charge in regard to Ms. Serna's death is involuntary manslaughter ... a crime for which the statute of limitations has expired."
Serna's death is also the subject of a federal wrongful death lawsuit filed against the county by her family, which charges that jail medical staff failed to provide proper care despite knowing her substance abuse history. Von Lintig, Pascua and several others are listed as defendants in the ongoing lawsuit.
