Stroke victim's mistaken symptoms turn into DUI nightmare

In the first glimpse you get of Doug Scott that Friday night in July, he is taking an extra-wide turn on to Eagle Road. The footage isn't grainy—it's digital, from Idaho State Police Trooper Jesse Avery's dashboard cam—but makes most movements seem almost ghost-like.

Avery has been hunting Scott's dark work van since an officer from another agency saw Scott driving erratically. Once he finds Scott, Avery slips his cruiser behind the van.

As he tails Scott, dispatch crackles in.

"If you're unable to find PC, we'll give him a call back and he'll meet up with ya." The female voice is friendly, a little bored.

PC, in this case, is "probable cause." If Avery doesn't find a good reason to detain Scott, the first officer who saw Scott weaving through traffic will come to provide cause.

But Avery watched Scott turn wide, running the van's right tires nearly off the road.

"Copy, I've got PC," Avery says. He gives his location as northbound on Eagle, "in front of St. Luke's" and hits his lights.

In the video, the cruiser's lights cast multi-hued glares. Scott puts his right blinker on almost immediately, but then drives through a green light. After about eight seconds, Avery turns on his siren, and Scott pulls over.

The van's right tires hit the curb, sending small clouds of dirt or dust up from the road.

As the video's digital time stamp rolls into the future, Avery walks to Scott's window. After a couple of minutes, Scott hands his keys to Avery, who sets them on the van's bumper.

Seconds metastasize into minutes, and the events that will happen tonight begin to pass. Scott will remember little of what is to come, and the others who were there will not be available to talk about the next nine hours.

This much is clear: Avery will walk Scott through the sobriety tests that comedian Bill Hicks once described as "an audition for your freedom." Scott will fail them miserably. But once in the Ada County Jail, Scott will be given two breath tests for alcohol. Both will come back flat zeros—0.0 twice.

These facts are indisputable. Their veracity rests on this video. It rests on state documents. It rests on the things we see happen and the things that happen as witnessed by people we trust. Scott is pulled over for suspected DUI, performs so badly on the field tests that it's frightening to watch, and is taken to jail where he is bonded out in the morning.

This fact, though, is also indisputable: At the time he was pulled over that night, Scott was suffering from multiple strokes—technically an acute left thalamic infract, as well as a tiny left cerebellar hemispheric acute infarct—that rendered him unable to drive safely, confused to the point of incomprehensibility.

That Scott sat in county jail until his wife Laura, a nurse, bailed him out points to this: From the time he was stopped on Eagle Road to the time he was given a semi-medical exam in jail to the time he was released, no one noticed Scott was suffering strokes.

After nine hours in police custody, Scott was driven to the St. Alphonsus Regional Medical Center emergency room. He was released three days later.

On Nov. 12, 2008, the Scotts filed a lawsuit alleging that the permanent brain damage that Doug Scott suffered from the stroke was a result of both the ISP's and Ada County Sheriff's Office's "negligence, gross negligence, willful, wanton and indifferent treatment."

Two months after the Scotts filed their lawsuit, Ada County dropped the criminal DUI charges.

At the end of the video, just before it goes dark, Trooper Avery punches a button and the camera points the other direction. Captured in its frame, Scott sits in the back seat, breathing heavily, looking straight ahead.

You are watching a man suffering two strokes, one on the base of his brain stem. Scott seems almost resigned, tired. His eyes rarely leave that middle distance in those few minutes, just before the video goes black.

The Aftermath

On a Tuesday morning in February, Doug and Laura Scott sit in a Nampa McDonald's, sipping coffee and soda. When Scott was arrested, they lived in Boise. But the costs associated with the arrest—bail, impound fees, lawyer, medical expenses compounded by Scott's inability to return to work—forced them to move into a small apartment in Nampa.

"This has been a real disaster," said Laura.

After six months, Scott received his first Social Security disability payment. It was garnished by one of the Scotts' creditors. He is looking for work against medical advice, and Laura is picking up all the extra shifts she can at St. Al's. The lawsuit, asking for more than $1 million in damages, crawls along.

The Scotts' lawyer, Joseph Ellsworth, released a written statement. It's lawyerly, but worth repeating in part.

"While the matter is under investigation with regard to a pending civil claim, and it would be unfair to draw conclusions in the press, there is no doubt that law enforcement officers are often the first responders in a wide variety of medical emergencies. One would expect some basic training in the recognition of stroke. Mr. Scott underwent extensive interviewing, drug recognition testing, his blood pressure was checked, and the paramedics came and went after drawing his blood for evidence to be used against him in court. And still nothing was done."

Scott said his memory of the traffic stop, his arrest and subsequent night in jail is "pretty good." But in talking to him, it's apparent that his memory is spotty at best. Both he and Laura have seen the video from Avery's cruiser and listened to an audio recording of the drug recognition exam Scott was given in jail.

"He was obviously a senior person having a medical moment," said Laura.

That night Laura was working the late shift at St. Al's. It took Scott several hours to remember his correct phone number. At first, he gave Avery an address and phone number from his childhood in California. When he did remember his current phone number, Scott reached his son at home. The son called Laura.

Laura, who'd never bailed anyone out, drove to the first bond agency she saw, walked in the door and asked, "What do I do?"

After the bondswoman interviewed Scott, she came back and described his condition. "Boy, your husband's really drunk."

But Laura had another thought: "Those are the signs of a stroke." When she told the bondswoman this, "she just laughed her head off," said Laura.

It seemed no one realized what Laura did: Scott was having a medical emergency.

After she bailed him out, Laura took Scott to St. Al's, where doctors found he was having problems with motor skills, the word-finding portion of speech, comprehension and confusion. When asked where he was, Scott repeatedly answered "Highlands," a hospital in his hometown of Oakland, Calif. Deprived of oxygen, his brain was scrambling old memories with reality. When his daughter came to see him, Scott didn't recognize her.

After Scott was discharged, he underwent extensive rehabilitative therapy. Three court appearances later, the criminal charges against him remained. The Idaho Transportation Department was still going after his driver's license.

"[The police] are so eager beaver to prove drugs and alcohol that they're blind to everything else," said Laura. "They disregard medical symptoms. He was pulled over right in front of a hospital, and they could have taken him there. Anybody with a first-aid course would know the signs of a stroke."

It's hard to discount Laura's outrage, even though Scott has retained the good natured-ness that he's known for. In her mind, his untreated stroke and subsequent brain damage are the fault of careless officers who over-aggressively pursued explanations for Scott's behavior that focused on alcohol and/or drugs.

During the Drug Recognition Expert exam in jail, Scott's blood pressure, respiration and pulse were abnormally high. His breath tests came back negative, proof that he hadn't been drinking that night.

In fact, Scott doesn't drink. He quit more than 20 years ago.

There, on the side of Eagle Road, Scott displays the ataxia that he was still suffering from when he was admitted to St. Al's—gross lack of muscle coordination.

Problems with word finding, comprehension, confusion: All of these are evident in the video and the recording of the DRE exam, the same behavior Scott exhibited at the hospital.

When he blew zeros in jail, why wasn't another explanation for his behavior sought? Why did the drug recognition officer keep, as Laura said, "coming up with random stuff" that might have caused his impairment?

Sitting in jail that night, surrounded by the parade of drunks and meth heads and regular Friday-night, two-beers-too-many DUIs, Scott was a cipher—a blank screen on which one could project any possible type of story. The question is, why this story, one in which Scott plays the villain rather than victim?

Misleading Impressions

Perhaps the greatest irony is that Scott was stopped in front of St. Luke's Regional Medical Center in Meridian. This much is clear from the video: The driver of the dark van appeared to be hammered as all shit.

According to the arrest report, Avery asked Scott if he had any alcohol to drink. Even though he doesn't drink, Scott said that he'd had a couple of beers.

Scott also had a number of prescription drugs with him: Ambien, acetaminophen with codeine and dextroamphetamine. When Avery asked Scott if he took any medication, Scott replied that he had taken a Percodan that night. Percodan, a powerful painkiller, contains oxycodone. It's also a Schedule II controlled substance and if taken with alcohol, can cause severe impairment.

Why Scott told Avery he'd taken a drug that wasn't even in his possession is unclear.

click to enlarge Doug Scott stands where the drama started when he was arrested for DUI, while suffering multiple strokes. - LAURIE PEARMAN
  • Laurie Pearman
  • Doug Scott stands where the drama started when he was arrested for DUI, while suffering multiple strokes.

Along with the initial report of erratic driving and Scott's admission to drinking, now Avery had Scott telling him that he'd taken a painkiller. During field tests, Scott fails the heel-toe walk and one-leg stand but doesn't show any nystagmus—involuntary shaking of the eyeball while tracking an object—that is usually a sign of alcohol or drug impairment.

"Clearly there were signs of something going on," said Lt. Brian Zimmerman of the ISP. "And typically we put that to impairment of some sort."

Zimmerman is an amiable 27-year ISP veteran. And he does what you'd expect any commanding officer to do in his situation: backs up his officer.

"When you see this," he said, referring to Scott's erratic driving, "and then you get a little bit of admission ... you're immediately thinking 'impairment.' You're not thinking anything else is a possibility.

"In reviewing that file and watching the video—I'm at 27 years," Zimmerman said, "and I probably would have done the same thing and not recognized any medical issues."

A Typical Night

In the early hours of March 1—a Saturday night—the sally port of Ada County Jail has gone from hopping with DUIs to nearly dead.

The only person in here at 3 a.m. is Lynn (not her real name), whom Officer Sam Ketchum arrested a little more than 30 minutes ago after her blue Ford truck crossed the center line. She's sitting in handcuffs looking as at peace as is humanly possible.

On the other side of the door just to her left, things are busy. This is the jail intake desk, last stop before the holding cell, and the officers are in the weeds, much like a short-staffed waitress. It is a libation-loving slice of humanity, from the Army sergeant too drunk to talk, to the grinning, tattooed fellow whom officers surely wish would just shut the hell up.

Ketchum is part of the ISP DUI strike force that only works nights. He has spent a good portion of this night in the jail, performing DRE evaluations on Lynn and, a little earlier, a 22-year-old woman high on meth.

Ketchum, like all Idaho law enforcement officers, received eight hours of first-aid training, during which he was taught the signs and symptoms of a stroke. During ISP academy training, all troopers receive 25 hours of refresher training on first aid, 24 hours of DUI training and eight hours of drug and impaired driving training. ISP officers are taught to look for basic medical reasons that could lead to impairment, such as head injuries and diabetic incidents. It is training focused on recognition of general medical situations in which paramedics are needed, not necessarily specific issues.

Not that officers can't recognize issues when they see them. In a two-month span, ISP troopers responded to three drivers going into insulin shock. Ketchum personally responded to one that he had to force off Eagle Road.

After cuffing the driver and putting him in the back of his car, Ketchum smelled something fruity coming off of the driver.

"You can smell that odor," he said, "and we could tell what was going on."

Ketchum uncuffed the man and called for paramedics. In all three incidents, officers recognized the emergency and got medical help. But training only goes so far.

"We're not doctors, not EMS personnel," said Ketchum. "It's a very basic first aid."

Unusual Symptoms

Two things complicate Scott's arrest and jailing. The fact that Scott told Avery—wrongly—that he'd been drinking is one of the likely reasons Avery searched for chemical rather than medical explanations. The second complicating factor was the type of Scott's stroke.

Avery noted on the arrest report that Scott didn't slur his speech. While his motor skills were severely impaired, Scott didn't exhibit any partial paralysis. At the end of the video, Scott's lips don't droop, nor does one side of his face go slack with the facial paralysis commonly associated with stroke victims.

Scott is suffering a stroke at the base of his brain stem, not in a hemisphere. It is a dangerous, debilitating stroke, one that could have easily killed him. But it doesn't produce the telltale signs of partial paralysis.

Dr. Jeffrey Hartford, Scott's physician of 16 years, said that while it's out of the ordinary for a stroke victim not to have drooping lips or facial paralysis, Scott's stroke wouldn't have necessarily had those indicators.

"[These types of strokes] are just so debilitating in a different way," Hartford said. "They affect your balance. They make you dizzy. They affect your coordination and thinking, but [they] don't take your speech away. It doesn't make half your body paralyzed."

Scott's blood clot was striking at his brain's thalamus, the "translator" which processes and relays information to the cerebral cortex.

"And his way of coping with things," Hartford said, "is he unconsciously tried to cover up what defects he has. So if he doesn't know the answer, he makes an answer up."

This behavior could have started with the onset of the strokes, making Scott suggestible to Avery's questions and at the same time unable to understand and answer them in any meaningful way, Hartford said.

"It could be the officer asked leading questions," he said. "Doug, even right after the stroke, would try to give an answer that he thought the person asking wanted to hear."

Even if Scott hadn't been drinking, if he somehow sensed Avery wanted to hear a particular answer, he might have been likely to give it to him. Or he may have been calling up memories from a distant past.

"Just like when he gave his address from California," Hartford said. "He could be calling up memories from when he did drink. Maybe he got stopped when he was a teenager and he had been drinking beer, and that popped up as the answer to the question."

In fact, before Scott quit drinking in 1984, he was arrested for DUI in California, an event that spurred his sobriety.

Mixed Messages

After Scott's breath tests came back negative, a sheriff's deputy identified as Walls begins a DRE examination. It is 11:46 p.m., a little over one hour since Avery stopped Scott.

To call a DRE evaluation a medical test is a stretch. It's given by a law-enforcement officer who has gone through drug-recognition training. The evaluation is a combination of the same sobriety tests used in the field; clinical tests such as blood pressure and heart rate; and a urine or blood toxicology test.

That the DRE evaluation is administered by an officer, usually in a jail, is indicative of its purpose. While there are medical aspects to it, the evaluation is not meant to gauge its subject's health; it's meant to reveal the source of its subject's intoxication. The report of Scott's evaluation reads like something from Kafka.

Scott tells Walls he's not seeing any doctors and not on any medications. In almost the next breath, Scott says he's taking two to three tablets of Tenuate daily for headaches so "he wouldn't mess up." Walls asks how often he sees a doctor. Scott says he sees a doctor about two or three times a day but can't remember who the doctor is or where he's located.

During the evaluation, Walls tells Scott repeatedly that he thinks Scott is lying. Becoming frustrated with Scott's nonsensical responses, he brings up the possibility that Scott may need medical attention no less than three times. But Walls never acts on this possibility.

Walls also finds that Scott's pulse and blood pressure are above normal limits, and here is a chance for someone to notice something. Scott's confusion, his inability to answer simple questions, his raised pulse and blood pressure are all indicators of a stroke.

But Scott's symptoms were also consistent with someone under the influence of a stimulant. And that was Walls' diagnosis.

"It is my opinion as a certified Drug Recognition Expert," wrote Walls in the report, "that Douglas Scott is under the influence of Central Nervous System Stimulant [sic] and is not able to operate a vehicle safely."

"The blood pressure and heart rate are all indicators of a stimulant," said Zimmerman, a DRE instructor. "So they're just going to point you down that road: 'That's what he had, this is what he's got in his possession, this is what I'm seeing.' You're just connecting the dots."

Scott had told Walls he was taking Tenuate, a medicine used to treat obesity. It's also a stimulant similar to amphetamine.

"You've got the verbal admission," said Zimmerman. "Why would you think anything else?"

But Scott's lack of any nystagmus­—an indicator that someone is under the influence of a stimulant­—may have been one reason that Walls might have questioned himself that night.

That might have led Walls to question his opinion, even though it was based on Scott's clinical indications and admissions. But Walls didn't, and Scott was booked into jail.

Lingering Questions

What remains of that night are a $1 million-plus lawsuit, a husband and father with stroke-induced brain damage and questions.

Police point to the number of people they take off the road who might injure or kill themselves and others while driving under the influence. Zimmerman said his officers in region three, covering 10 counties in Southwest Idaho, made 608 DUI arrests last year.

"When we talk about lives being saved, it's hard to put a measure on that," he said. "Our only gratification is that out of those 600 drunks, is that somebody would have died had we not done our jobs."

click to enlarge Doug and Laura Scott's lives have been changed forever following Doug's stroke. - LAURIE PEARMAN
  • Laurie Pearman
  • Doug and Laura Scott's lives have been changed forever following Doug's stroke.

Scott's case, though, highlights just how far and wide police cast their net. Why was a 60-year-old man allowed to sit in police custody for nine hours while suffering multiple strokes? And who, if anyone, is at fault?

"Officer Walls took it upon himself to conduct a medical examination of Scott, without any appropriate medical training," the claim argues. "Although Walls discovered that Scott's blood pressure was high and his pulse rapid, Walls failed to request medical intervention or seek treatment for Scott."

This raises a pressing question. Do we really want law enforcement officers venturing into the realm of medicine, diagnosing chemical impairment? Police have been doing this since the early 1970s when the Los Angels Police Department developed the DRE program.

Doctors are motivated by concerns for a patient's health or safety. And while police DREs share these concerns, their motivations are clearly different.

"They were searching for something," said Laura about her husband's DRE evaluation, "but they didn't know what it was. They're not doctors, and they shouldn't have the prerogative to rule out medical cause."

The reasons the county pursued criminal charges in a case where it was evident that Scott suffered a stroke are unclear. Ada County dropped its charges a little more than a week before Scott was to go to trial. A spokesperson from the Ada County District Attorney's Office declined to talk about Scott's case because of the lawsuit.

And while at first glance, it's almost impossible to believe that someone didn't recognize Scott was having a medical emergency, the closer one looks, the more mitigating factors one finds. Scott was swept up by a well-oiled machine designed to take impaired drivers off the street, find cause to book them and get officers back out on the streets to do it again.

Lost among the virtual circus of drunks in Ada County Jail that night, Scott might have seemed just another involuntary guest who couldn't walk a straight line. Never mind he was suffering in ways he couldn't describe.

Hartford can't say whether Scott's hours in jail contributed to his brain damage or permanent effects of his stroke. That will be argued in court, if the lawsuit goes to trial.

"For a lot of people, that stroke would have progressed to the point where they would have just died from it," said Hartford. "So it could have been something that got to a certain point and didn't go any further, and he was left with this damage. It could have been that there wasn't a window when they could have reversed any of it."

The question of blame floats around. In essence, it boils down to this: Did someone make an honest yet terrible mistake?

"It was just a horrible, unfortunate thing," said Hartford. "I kind of appreciate that the police protected the public because he was certainly impaired that night from driving. It was a sad, tragic thing that he was kept in jail overnight, and I don't know whether it would have made a difference if they had just taken him to the hospital.

"I don't know if anybody missed anything. It's just a bad place to get a stroke. I wouldn't point my finger at anybody," he said.

Shades of Gray

The very beginning of the video is silent. The camera's audio doesn't activate until Avery hits his emergency lights. In this gray quiet, the chain-link fence of the ISP office in Meridian pulls back, and Avery shoots onto the street, in pursuit of Scott.

For the first few minutes, the car moves through a strange half-world and actions seem divorced from meaning or agency. Even at the beginning of the video, there will be just one resolution to all of this, though each time viewers find themselves hoping for something different.

Something other than the words that pass between Avery and Scott. Something other than Scott's blank countenance in the back seat. Something other than the next nine hours.

This particular story, though, begins and ends the same way, again and again and again.

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