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IN THE UNITED STATES DISTRICT COURT FOR

THE NORTHERN DISTRICT OF ALABAMA

DOYLE LEE HAMM, ) Civil Action No. ) 2:17-cv-02083-KOB

Plaintiff, ) v. )

) JEFFERSON S. DUNN, Commissioner, ) Alabama Department of Corrections, et al., )

) Defendants. )

NOTICE OF SUBMISSION OF EXPERT REPORT OF DR. MARK HEATH RE. EXAMINATION OF

PETITIONER DOYLE HAMM ON FEBRUARY 25, 2018

Bernard E. Harcourt Bar Number: ASB-4316-A31B Attorney for Doyle Lee Hamm Columbia Law School 435 West 116th Street New York, New York 10027 Telephone: (212) 854-1997 Fax: (212) 854-7946

Dated: March 5, 2018

FILED 2018 Mar-05 PM 12:10U.S. DISTRICT COURT

N.D. OF ALABAMA

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NOTICE OF SUBMISSION OF EXPERT REPORT OF DR. MARK HEATH RE. EXAMINATION OF

PETITIONER DOYLE HAMM ON FEBRUARY 25, 2018

Pursuant to the Order of the Court issued on February 23, 2018 (Doc. 78),

modified orally during the conference on February 23, 2018, counsel for Plaintiff Doyle

Lee Hamm hereby respectfully submits, as Appendix A, the preliminary report of Dr.

Mark Heath regarding his physical examination of Doyle Hamm conducted on Sunday,

February 25, 2018, at Holman Correctional Facility.

Should the Court need further information, Dr. Mark Heath is ready and willing to

provide such information through a supplemental report and/or personal appearance

before the Court.

Respectfully submitted,

Bernard E. Harcourt Bar Number: ASB-4316-A31B Attorney for Plaintiff Doyle Hamm Columbia Law School 435 West 116th Street New York, New York 10027 Telephone: (212) 854-1997 Fax: (212) 854-7946 Email: beh2139@columbia.edu

Dated: March 5, 2018

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CERTIFICATE OF SERVICE

I hereby certify that on March 5, 2018, I served a copy of the attached pleading by

electronic mail to opposing counsel, Assistant Attorneys General Thomas Govan and Beth

Jackson Hughes at tgovan@ago.state.al.us and bhughes@ago.state.al.us, as well as to the

Docket Clerk of the Capital Litigation Division of the Office of the Alabama Attorney

General, Courtney Cramer at ccramer@ago.state.al.us.

BERNARD E. HARCOURT Counsel of Record

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Appendix A

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PreliminaryreportofDoyleHammexaminationMarch5,2018

Mark.J.S.Heath,M.D.MynameisMarkJ.S.Heath.Iamamedicaldoctorwithanactive,licensed,full-timemedicalpracticeinNewYorkState.Iamboardcertifiedinanesthesiology.IpracticedailyattheNewYork-Presbyterian/ColumbiaHospitalinNewYorkCity,whereIprovideanesthesiaforopen-heartsurgeries.IexaminedDoyleHammonSundaymorning,February25th,2018,inaconferenceroomadjacenttotheWarden’sofficeinHolmanCorrectionalFacility.Mr.Hammwasunshackledandseatedinachair.Somepartsoftheexamwereconductedwithhimlyingonasheetontheconferencetableasnoexaminingtablewasavailable.Mr.Hammwascooperative.IexplainedthatthemainpurposeoftheexaminationwastoassesstheextentofanyinjuriescausedbytheattemptedexecutiononthenightofFebruary22nd.Iexplainedthattheexaminationwasvoluntary,thathecouldenditatanytime,andthathecoulddeclineanypartofitatanytime.Heunderstoodandconsentedtotheexamination.Iexplainedthattheresultsoftheexaminationcould,andlikelywould,beusedinlitigationthatcould,andlikelywould,bepublic.Heunderstoodandconsented.Irequestedpermissiontocreateaphotographicandvideorecordoftheexam,heconsentedtothisalso.AlsopresentintheroomwereMr.Hamm’scounselBernardHarcourt,hislawassociatesPhoebeWolfeandNicolaCohen,andanofficerfromtheADOC.TheWardenopenedthedoorseveraltimestocheckifanythingwasneeded.History:Obtainingthehistoryrelatedtotheexecutionattemptwasinterleavedwiththeconductoftheexamination.Mr.Hammstatedthat:HisstandingdoseofNorcohadbeenswitchedtoTylenolNo.3whenhearrivedatHolman.OnthedayoftheexecutionhewasgivenT#3at2:30AMand10:00AM,buttheroutine6:00PMdosewaswithheld.HestatedthattheT#3waslesseffectiveatcontrollinghispainthantheNorco.Hewastakenfromtheholdingcelltotheexecutionchamberandstrappedtothegurney.Hisarmswereextendedstraightoutoneachside.Therewereapproximatelynineotherpeopleintheroom,noneofthemwerewearingsurgicalmasksorhaircovers.Theroomwasbrightlylitandthereweremultiplebrightlightsintheceilingabovethegurney.

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TwomenattemptedIVaccessonhislowerextremities,workingsimultaneously,oneoneachside.Themenwerewearinghospitalscrubsandgloves,butnosurgicalmasksorhaircovers.Tourniquetswereappliedbelowtheknees.Theyfirstattemptedaccessinhisankles,thenmoveduptohiscalves.Mr.Hammstatedthateachattemptinvolvedoneskinpenetrationbutthenmultipleprobingadvancesandwithdrawalsoftheneedle.Thecontinuedprobingwaspainful.Oneoftheprobingneedleadvanceswasextremelypainfulandhefeltthatthe“shinbone”inhisrightcalfwasreachedbyaneedle.Heestimatesthattheprobinginhisrightcalfpersistedforabout10minutesandstatesthathecouldfeelthem“rollingandmashing”thetissueinhisleg.Overallheestimatesthatthetwomenspentabout30minutesattemptingIVaccessinhislowerextremities.AtnopointdidMr.HammseethemattachIVlinesorhearthemdiscussingattachingIVlinestotestwhetheracatheterhadbeensuccessfullyinserted.Afterapproximatelyfiveattemptsinhislowerextremitiestheexecutionteammembersstatedthattheycouldnotgainaccess.Afewminuteslateramaninasuitenteredtheroom,accompaniedbyawomanwithanultrasounddevice.Mr.Hammisoftheunderstandingthatthemanisadoctor.Thedoctorwaswearingasuitbutnotie,heputonglovesbutdidnotwearagownorsurgicalmaskorhaircover.Hedidnotremovethesuitjacket.Theultrasounddevicewaspluggedin,Mr.Hammcouldnotseethescreen.EKGstickerswereplacedandleadsattached.ThemanstoodbyMr.Hamm’srightgroin,thewomanstoodbyhisleftgroinandreachedoverhispelvistoplaceandholdtheultrasoundprobeonhisrightgroin.Hecouldhearthemachinemakingaswishingnoise.Themanwashedtherightgroinwithcoldliquid,adrapewasplaced,andthewomanbeganapplyingtheprobetotherightgroin.ColdjellywasusedbetweentheprobeandMr.Hamm’sskin.Theyweresaying“artery”and“vein”whilemanipulatingtheprobeandtheymarkedhisgroinwithamarker.ThedoctoradvancedaneedleintoMr.Hamm’sgroin.Mr.Hammfeltmultipleneedleinsertions,andwitheachinsertionhefeltmultipleprobingadvance-withdrawalmovements.Itisnotclearwhetherlocalanestheticwasadministered.Mr.Hammfelttheneedlepenetratingdeepintohisgroinandpelvis.Mr.Hammstatedthatthisprobingwasextremelypainful.Twiceduringneedleadvancementheexperiencedsuddensharpdeepretropubicpain.Thedoctorrequestedanewneedleseveraltimes.DuringthistimeMr.HammbegantohopethatthedoctorwouldsucceedinobtainingIVaccesssothatMr.Hammcould“getitoverwith”becausehepreferredtodieratherthantocontinuetoexperiencetheongoingseverepain.Hewasshiveringandtremblingfromacombinationoffearandthefactthattheroomwasverycold.HestatesthattheroomwasthecoldestroomhehadeverexperiencedineitherDonaldsonorHolmanprison.AtonepointalargeamountofbloodbegantoaccumulateintheregionofMr.Hamm’sgroin.Thebloodsoakedapadordrape,andanotheronewasapplied.Amanwhohadbeenwatchingfromthefootofthegurneyandtalkingonacellphone

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beganfrowning.Thismanlefttheroomseveraltimes,eachtimereturningafterafewminutes.Thefinaltimethismanenteredtheroomhestatedthattheexecutionwasover.Thedoctorstatedthathewantedtokeepattemptingcentralaccess,andthemanre-statedthattheexecutionwasover.Thedoctorappliedabandagetothegroinbutdidnotapplypressureordirectanybodytoapplypressure.ThedoctorthenmovedtoMr.Hamm’sfeetandbeganexaminingthemandpalpatingthem,statingthathehadnothadanopportunitytoattemptaccessinthefeet.Themanthentoldthedoctorto“getout”.Thedoctorandthewomanwhohadbeenperformingtheultrasoundguidancewereescortedfromtheroom.Thedoctordidnotapplypressuretothegroinorprovidewoundcareinstructionsbeforeleavingtheroom.Mr.Hammwasunstrappedandliftedoffthegurneybyseveralcorrectionalofficers.Hewasnotabletosupporthisownweightandalmostcollapsed,butwasheldoffthefloorbytheofficers.Hewasescortedbacktotheholdingcellwithofficerssupportinghimbyhisarmsbecausehewasintoomuchpaintowalkandsupporthimself.Atsomepointhewastakentotheinfirmarywhereabodychartwascompletedandbandaidswereappliedtohislegs.ApproximatelyonehourafterhereturnedtotheholdingcellMr.Hammurinatedandhadgrosshematuria.Hedescribedtheurineasbeingbrightred.Hedidnotnoticeanyclots.Hehasneverpreviouslynoticedgrosshematuria,includingonthedaypriortotheexecution.Hehadnotingestedanyfoodorliquidthatwasredcolored,includingbeets.Hehaddeclineda“finalmeal”thatevening,andhadonlyeatenpotatochipsearlierthatday.Overthefollowingday,thenexttimehevoidedtheurinewasbrown-yellow,thenexttimeitwaspalebrown-yellow,andthenexttime(andsubsequently)itwasanormalyellowcolor.AlsoapproximatelyonehouraftertheexecutionMr.Hammdevelopedapersistentirritatingcough.Thecoughwasinresponsetoanirritationhefeltinhisupperchest,notinhisthroat.Hecouldoccasionallyproduceasmallamountofwhite-yellowsputum.Hedeniesanyhemoptysis,fever,orchills.Hedidnotexperienceanychestpainorshortnessofbreathduringtheexecution.Mr.Hamm’srecollectionwasgood,althoughIwasmindfulthathewasrecountingalong,complex,andstressfulsequenceofeventsheexperienced.IspokewithMr.Hammthreetimesbyphoneaftertheexamination.Hehasdevelopeda“knot”inhisrightaxillathathedescribesasbeingthesizeofagrapeandagolfball.Themassistenderandheexperiencesa“stretchingpain”inhisupperrightarmwhenheraisesit.On3/2/2018hewasseenintheprisonclinicandtoldthathehadinfectedlymphnodesinhisrightgroinandrightaxilla.Anoralantibioticwasprescribed.

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Focusedphysicalexamination:Oraltemperature:98.1HR:65seatedBP:121/77(leftarm,seated)O2saturation:~95-98%(4extremities)Comfortablewhileseatedbutevincingpainwhenchangingpositionsorclimbingon/offthetable.Spontaneouscoughingmultipletimesduringtheexam.Walkingslowly,stiffly,andwithanasymmetricgaitfrompain.Lowerextremitypuncturewounds(photo1):2Leftmedialmalleolus(photo2)2Rightleg,medialaspect,uppercalf(photo3)1Rightmedialmalleolus(photo4)Rightinguinalpuncturewounds(photo5):Thereisalargetenderhematoma/ecchymosisintherightinguinalregion,withdiffusesubcutaneousdiscolorationborderingthemargins.Theupperthighandlowerabdomenaretender.Thereareapproximately6puncturewoundsapproximately2cminferiortotheinguinalligament.Thereispartialoverlapofsomeofthepuncturewoundsmakingitdifficulttodeterminepreciselythenumberofseparateneedlepenetrationevents.Thefemoralarteryispulsatile,withnoappreciableenlargement.Totalof11lowerextremitiesandrightinguinalpuncturewounds(photo6)Mentalstatus:hestatesthatheisstressedandisexperiencingintrusiveflashbackstotheexecution.Heisalsoexperiencingnightmares.Hissleephasbeenverypoor,andisalsodisturbedbycoughing.Theflashbacksoccurwhenheisalone,andinvolveimaginghimselfstrappedtothegurney.Hecanfeelhisheartracingduringtheflashbacks.Heisappreciativeofthesupportofotherdeathrowprisonerswhoareaskingwhattheycandotohelphimrecover.Assessment:1–largerightinguinalhematomafrommultiplefailedfemoralveinaccessattempts.Thisistypicalofpost-arterialpuncturehemorrhage,butcouldpossiblybecausedbyanunusuallylargeleakfromthefemoralvein.Thesuddenbleedingthatoccurredduringtheprocedureismoreconsistentwitharterialpuncture.2–grosshematuriaisfrompenetrationofaureter,thebladder,theprostategland,ortheurethra.Bladderpenetrationisararebutreportedcomplicationoffemoralcannulation.Theextentofthelowerabdominalpainmayberelatedtobladderorothervisceralinjury.

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3–newonsetcough,etiologyunclear.4–newonsettenderaxillaryandinguinaladenopathy,attributedtoinfection.Itispossiblethatthecoughandadenopathyarecausedbybacterialdisseminationduringorafterthefailedfemoralcannulation.Bacteriamayhavebeenintroducedintothecirculatorysystemfromtheskin,fromurogenitalpenetration,orfromcolonperforation.5–atriskforPTSD.Note:whenIspokewithMr.HarcourtshortlyaftertheexecutionIaskedhimtoaskthestafftopreserveandprovidetheexecutionlogandanynotestakenduringtheprocedure,theneedleandsharpsdisposalcontainers,andtheusedcathetersandcentrallinekits.Ialsoaskedtoviewthesheets,padding,andclotheswornbyMr.Hammtohelpgaugetheamountofbloodloss.TheWardensaidthatallpreserveditemshadbeentakentoanotherlocationandwerenotavailable.ThisreportrepresentsmypreliminaryfindingsresultingfrommyexaminationofMr.HammonFebruary25,2018.Ireservetherighttoamendthisreportinlightofanyadditionalinformation.______________________________MarkJ.S.Heath,M.D.March5,2018

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Photo1:Lowerextremitypuncturewounds

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Photo2:Leftmedialmalleoluspuncturewounds

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Photo3:Rightleg,medialaspect,uppercalfpuncturewounds

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Photo4:Rightmedialmalleoluspuncturewound

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Photo5:Rightinguinalpuncturewounds

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Photo6:lowerextremitiesandrightinguinalpuncturewounds

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