A Poplar Bluff woman will stand trial for second degree murder and second degree elder abuse stemming from the December 2016 death of her mother, 87-year-old Theresa Smothers. Associate Circuit Judge Thomas Swindle made the ruling Monday following a preliminary hearing for Judy Ann Smothers, 66, in the Butler County Courthouse.
Three witnesses presented by Butler County Prosecutor Kevin Barbour offered enough probable cause for the case to be bound over for trial. Smothers and her attorney, John Scott, will then appear before Circuit Judge Michael Pritchett Sept. 19 for her arraignment.
Smothers was arrested Dec. 29 after police found her mother malnourished and lying in a bed soaked with fecal matter and urine.
The elder Smothers was found in what police described as extremely serious condition. Though conscious, she was naked and unaware of her surroundings. She weighed only 71 pounds, having lost more than half her body weight in a three month period, according to reports.
Poplar Bluff Police Det. Andrew Cleaveland's probable cause statement said the victim suffered from extreme malnutrition, dehydration, and numerous open bed sores. He said she never regained the cognitive ability to speak with police officers and spent her last two days at Westwood Hills Health and Rehabilitation Center, where she died at 4:50 a.m. Dec. 31.
An autopsy was performed on Jan. 3 by forensic pathologist Dr. Russell Deidiker in Farmington, Mo., who determined the cause of death was from complications resulting from neglect.
Barbour first called Deidiker to the stand. He said the elder Smothers was undernourished, extremely underweight, extremely dehydrated, and had multiple pressure sores on the body, including on the back and the right knee. Deidiker said internal findings showed signs of pneumonia and renal failure.
In Smothers' defense, Scott asked the pathologist if he had reviewed the victim's medical records prior to his examination. Deidiker said he had not.
Scott then asked if he was aware the elder Smothers had been diagnosed with Alzheimer's Disease "a number of years ago, prior to her death." Deidiker said he was not aware. Scott asked the pathologist to confirm symptoms of the advanced stages of Alzheimer's Disease, which include refusal to eat or drink and to sometimes regurgitate food, which he did.
When Scott pressed Deidiker for specifics on how fast the visible symptoms he described progressed, Deidiker could not specify a time frame, saying it could be anywhere from "several days to a week."
Scott verified the options for patients with advanced Alzheimer's Disease, which include admission to a hospital setting, using feeding tubes to "force feed them" or simply sending them home. Scott said Judy Ann Smothers attempted to contact hospice prior to her mother's death. He asked Deidiker if it is true Alzheimer's patients may stop responding to care and Deidiker agreed.
Scott asked Deidiker if he had knowledge of suspected foul play prior to the autopsy and if he did, asked if he considered the information during the procedure.
"I view every case as a potential homicide," Deidiker said. "I do take into account what I've heard."
"Do you think it's important to know someone's health history prior to performing an autopsy," Scott asked.
"If I had known prior to the autopsy she had Alzheimer's, that still would have been my cause of death," Deidiker said.
Karen Romine of Legacy Hospice testified after Deidiker. Romine, who described herself as a social worker for Legacy Hospice, had been present the day the elder Smothers' severe condition was discovered. Barbour asked Romine about her experience in the Smothers' home on Dec. 28, which was her first visit to the property.
"I sat at a table with the daughter to complete paperwork prior to seeing the patient," explained Romine, adding the scent was "unbearable." Completion of the paperwork was necessary before Legacy Hospice could see the patient, Romine said.
Barbour asked Romine to describe the conditions of the room where the victim was being kept.
"The room was cluttered, dirty," she said. "(Theresa) was lying in a bed soiled with urine and feces. The patient had a straw up her nose. The odor was unbearable. It was filth."
Romine told Barbour the victim was "very bony" with sores, open wounds and was unable to speak. She described a "slimy" substance around the victim's face and referenced her "frail little body," lying in the bed.
Romine said when the nurse performing the initial assessment on behalf of Legacy Hospice would touch the victim, she would moan. Romine said after accessing the patient, it was determined removing her from the home was imminent. She said the victim's daughter was reluctant to let her mother go, but eventually agreed. The elder Smothers was then transported by Butler County EMS to Westwood Hills and put on respite care.
"That was the last contact I had with the patient," Romine said.
During Scott's cross examination, he asked Romine to confirm the first date of contact between Legacy Hospice and Judy Smothers. Romine said it was on Dec. 27, but added the nurse did not see the victim during the initial home visit. Romine said the victim's daughter claimed she had to check with her attorney before she could authorize the use of funds regarding her mother's health care. Romine said she felt the response to be odd, but went to the residence herself the next day to complete the paperwork.
Scott asked if Romine was aware the daughter had guardianship over her mother and that all funds spent from her mother's account were monitored? Romine agreed this information made Smothers' original claims make more sense.
Romine told Scott she called a nurse, who had no prior contact with the victim or her daughter, to perform the elder Smothers' assessment.
Scott asked why, if the victim was in such a critical condition, was she not taken to the emergency room? Romine said because she had been placed into hospice care. Scott asked when. Romine said on Dec. 28, the same day.
"We were not looking to heal her, just to make her more comfortable" Romine said.
Upon Smothers' arrival at Westwood Hills, Romine said Dr. Matthew Riffle examined her on the evening of Dec. 28.
Romine said in many cases, if the home had been cleaned, the patient could potentially return. She said she was not speaking about this case in particular.
It was also determined through Scott's cross-examination, Romine had been employed with Legacy Hospice for four months at the time after transitioning from a long-time career in a different field and was unable to provide the last name of the organization's owner.
For its third witness, the state called police detective Cleaveland
Cleaveland told Barbour on Dec. 29 he was contacted by Legacy Hospice and given a report in reference to elder abuse to follow up on. He said he first went to Westwood Hills Health and Rehabilitation Center where he made contact with the victim.
"The victim was in extremely poor health," he said. "She had multiple injuries, some were extremely infected."
Barbour asked Cleaveland to confirm what he listed in his probable cause statement, including bed sores, discolored skin and oozing tissue. Cleaveland confirmed.
"She was like a Holocaust victim," he told the prosecutor.
Cleaveland said when he arrived at the Smothers' residence on Dec. 29, he found a mattress "soaked with blood, urine, and fecal matter," as well as "living lice on the bed." He said the bed clothes had been removed and it looked as if the daughter had attempted to clean her mother's room.
"They attempted to treat (Theresa's) head twice with lice shampoo, and eventually ended up cutting her hair," Cleaveland said.
When it was his turn to question Cleaveland, Scott verified the timeline of his involvement and asked Cleaveland if he had any contact with the victim prior to his visit at Westwood Hills or any knowledge of the victim's medical history. Cleaveland said no.
Scott asked Cleaveland to verify other conditions of the home, such as a full refrigerator, electricity, water, heat and the absence of exposed elements. Cleaveland agreed all elements were present in the home.
When Scott asked Cleaveland if the defendant was compliant, he said "for the most part."
Cleaveland confirmed police were contacted on Dec. 28, but said his first contact with Legacy Hospice was on Dec. 29. He said he went to see the victim the same day and got a search warrant the same day. He said he executed the search warrant, taking photographs of the scene, but removed nothing from the home.