October 2, 2009
Dr. George Kaysen, MD was hired by plaintiff's attorney as a medical expert. Kaysen teaches at UC Davis; his expertise is in nephrologist, specializing in kidney disease, including electrolite abnormalities.
He said that hyponatremia "happens quite commonly," especially with patients on diuretics. He spent a lot of time educationg the jury as to the technical meaning of hyponatremia; it came down to the dilution of the level of salt in the bloodstream balances with the level of salt in the cells, and that when the salt fell below a certain level, it would cause cell swelling, and brain swelling. Kaysen also said that no matter how much water a person drinks, the kidney can only process about one pint an hour; so anything ingested above that amount would not be urinated out, but would have to be absorbed by the body. He also said that the smaller the person, the greater the dilution. Jennifer was petite. Lucy Davidson, who won the contest, was much larger physically.
Kaysen said a medical "water challenge" would involve drinking one quart of water, then waiting an hour and a half to urinate. He said that amount of water drinking would have been safe for a contest, but that any doctor or nurse would have known not to exceed that amount. He cited two studies, one with 15 women in a hospital setting, who had died from water intoxication. He also testified that such loss of salt would cause impaired mental status and impaired judgment similar to alcohol intoxication. He said it was not possible to determine exactly when contestants would have felt impairment from the water.
When asked about some other contestants experience of headaches, lightheadedness, and nausea, he said that was to be expected with acute hyponatremia. Dreyer played the audio clip of Jennifer saying her head hurt, how she didn't feel well, and her belly distended, and Kaysen said those were classic symptoms of water intoxication. He said that Jennifer's judgment had been impaired, that she should not have driven herself home, and that, had she had medical attention when she left KDND at 9:40 AM, her life would have been saved.
Entercom Defense attorney Don Carlson established that water intoxication and alcohol intoxication had different effects. He aslo established that the Chico case was different from the Strange case in that the Matthew Carrington had been force fed water, whereas Strange had voluntarily drunk water. Kaysen admitted that while he has treated 200 cases of chronic hyponatremia, he had never treated an acute case. He also said he had never before seen anyone die from a water drinking contest. Carlson: "When I took your deposition in August of 2009, you were not aware of anyone dying from acute hyponatremia other than marathon runners or those who were severely psychiatric damaged; are you aware of anyone dying from voluntarily drinking too much water?" Kaysen: People don't generally volunteer to drink this kind of water." Carlson presses him for yes or no answer; Kaysen said no.
Carlson asked about the study of the fifteen women, and confirmed that they had all been alert and talking until ten minutes before they had seizures. When asked about Kevin Williams, who had testified that he felt he could no longer go on with the contest, then urinated, and felt fine, Kaysen said that every person is different, and that women react worse to hyponatremia than men, and that men are generally larger.
Carlson pointed out a picture of contestants Gina Sherrod and Lucy Davidson, and pointed out that Kayson had met with both contestants in Plaintiff attorney Dreyer's office. He asked whether Kaysen had been told that Jennifer made several cell phone calls throughout the course of the contest, and that her close friend Worcester thought Jennifer sounded fine; Kaysen had not. When asked if she was too impaired to drive, Kaysen thought that she was.
On redirect, Dreyer asked Kaysen whether the circumstances surrounding that study of the fifteen women was anyway near the circumstances the radio station had set up; Kaysen said it was not. He asked why he had never published a paper on hyponatremia, and Kaysen said it was unnecessary as it was "standard medical practice." Dreyer: "If someone approached you that this is what we're going to do, that 100% would suffer symptoms? Yes, with the exception of very large men."
For video of the Jennifer Strange story, go to www.broadcastblues.tv .
For earlier coverage of the trial and other media commentary, see the September archives .