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PSYCHIATRIC SECURITY REVIEW BOARD
AT: WHITING FORENSIC INSTITUTE
DIVISION OF THE CONNECTICUT VALLEY HOSPITAL
MIDDLETOWN, CONNECTICUT
DATE: NOVEMBER 4, 2011
IN RE: KENNETH RUGGLES - Mandatory Review
(CGS, Section 17a-585)
AND
Temporary Leave
Filed by CVH
(CGS, Section 17a-587)
PSYCHIATRIC SECURITY REVIEW BOARD:
Mark Kirschner, Ph.D., Acting Chairman
Ellen Lachance, Executive Director
FOR DMHAS, DIVISION OF FORENSIC SERVICES:
Dr. Maya Prabhu
FOR CONNECTICUT VALLEY HOSPITAL:
Dr. Michael Lah
FOR GILEAD REHABILITATION CENTER:
Patricia Burke
FOR THE STATE:
Deborah Mabbett, ASA
FOR KENNETH RUGGLES:
Monte P. Radler, PD
ALSO IN ATTENDANCE:
Kenneth Ruggles
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Michael Daubart
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
. . .Verbatim proceedings of a hearing
before the Connecticut Psychiatric Security Review Board,
In Re: Kenneth Ruggles, held on November 4, 2011, at 10:36
a.m., at the Whiting Forensic Institute, Middletown,
Connecticut . . .
ACTING CHAIRMAN DR. MARK KIRSCHNER: Id
like to call to order the hearing on Kenneth Ruggles.
Would all persons who are going to testify, please rise
and raise their right hand to be sworn.
MS. ELLEN LACHANCE: You may stand.
(Whereupon, Dr. Maya Prabhu, Dr. Michael
Lah, Patricia Burke, and all potential witnesses were duly
sworn in.)
COURT REPORTER: Thank you.
ACTING CHAIRMAN KIRSCHNER: Miss Lachance,
the background information please.
MS. LACHANCE: The purpose of todays
hearing is a Mandatory Review of the Status of Kenneth
Ruggles, pursuant to Connecticut General Statute, Section
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
17a-585; and Temporary Leave filed by Connecticut Valley
Hospital, pursuant to Connecticut General Statute, Section
17a-587.
I have a three-page document marked PSRB
Exhibit 1 with todays date, which lists all the materials
that will be considered as evidence for todays
proceeding.
ACTING CHAIRMAN KIRSCHNER: Id like to
bring to the attention of counsel the missing seats up
here on the Board, that were missing five members
currently. It will become necessary for members of the
Board to read the transcript of the hearing so they can
participate in the deliberations. Are there any
objections?
MS. DEBORAH MABBETT: No.
MR. MONTE P. RADLER: No objection.
ACTING CHAIRMAN KIRSCHNER: Thank you.
The first witness please.
DR. MAYA PRABHU: Good morning. My name
is Maya Prabhu. Im a consulting forensic psychiatrist
attached to the Office of the Commission for Mental Health
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
and Addiction Services in the State of Connecticut and I
act as a consulting forensic psychiatrist for CVH in the
case of Mr. Kenneth Ruggles.
In preparation for todays hearing, I
spoke with Mr. Ruggles on November 1st and 3rd. I also
spoke to members of his clinical team, which include Dr.
Shahil Battell (phonetic), his attending psychiatrist, who
is present, Dr. Justin Winkel, his individual therapist,
who may yet join us, and various members of his team,
including his nursing staff, his group supervisors, his
rehab supervisors, and his prospective TL supervisor. I
will be describing Mr. Ruggles source in the hospital
since his last hearing before the Board in March of 2010
and then review the application for TL.
Mr. Ruggles has been maintained on Dutcher
3 South, an enhanced security community reintegration unit
since his hearing in March 2010. There has been no change
to his psychiatric diagnosis. On Axis I of the DSM-IV he
is diagnosed as having schizophrenia, chronic, paranoid
type, and alcohol abuse. He does not have a diagnosis on
Axis II. He has been on the antipsychotic medication
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
Olanzapine (Zyprexa) at a dosage of 30 milligrams daily.
He is compliant with his medications, including those for
his medical illnesses, which I will describe in a moment.
You may recall that prior to your last
hearing with Mr. Ruggles there had been some changes to
his medications and some changes in Mr. Ruggles behavior.
However, since then, Mr. Ruggles has been absolutely
clinically stable, there have been no violent incidences,
no episodes of aggression, no threats made to other
people, and his behavior has been socially appropriate.
He has not written any letters to any government or
judicial officials or filed any legal petitions in this
time. He has shown no reoccurrence of the delusions from
which he had suffered previously, and there has been no
evidence of persecutory or grandiose thinking.
He has a number of medical problems to
which Ill return in one moment, but Ill note that his
random urines for drugs and alcohol have been negative,
and his blood serum levels for Olanzapine, his
antipsychotic medication, are -- are -- are where they are
to be slightly above perhaps the target high level of 80
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
nanograms per milliliter. His dose is at 89 -- his serum
levels are 89.6, but he has none of the side effects that
hes previously reported on higher doses.
Since June of 2009, Mr. Ruggles has had a
full Level 4 pass, which allows him to have unsupervised
access to certain areas of the hospital for five to six
areas daily -- sorry -- for five to six hours daily. And
with the current privilege level, he participates in a
number of staff supervised community trips and multiple
grounds passes in his own custody. He attends a range of
psychotherapy groups. He attends supportive psychotherapy
with -- which is one-to-one therapy with Dr. Winkel, which
has been increased to 30 minutes weekly. He is in a group
therapy called the Forensics Group, which is 45 minutes
weekly. And Dr. Winkel, who is also the therapist for
that group, notes that Mr. Ruggles has made progress in
linking his depression, his alcohol use, and his paranoia
at the time of the crime and to think about how theyve
contributed to the crime. Mr. Ruggles goes to a substance
group called Sobriety Skills in which he has also
discussed the role that alcohol played in his lifestyle
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
prior to the crime. And he attends a number of
recreational groups, including band, computer skills, has
been in walking and bowling groups. And I note that the
walking and recreational groups are also part of the
integrated treatment plan to manage some of his medical
illnesses, which Ill talk about as I said in one moment.
He works in the greenhouse twice a week
and he attends a self-esteem group at River Valley
Services, which is one of the community treatment options
that are being recommended as part of his TL. And he --
once a month he attends the Gilead Social Group.
Mr. Ruggles is uniformly described as
behaving appropriately, as engaging in the groups and the
activities, and making good use of his passes. He is
described by -- has been described by most members of his
team as a model patient.
I mentioned that he had a number of
medical illnesses. These are unchanged since the last
time that you saw him, but I note that he has
hypothyroidism, for which hes being treated with
Synthroid; hypertension and hyperlipidemia, for which hes
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
being treated with Zocor, Avalide, Metoprolol, Vasotec,
and is on a low salt diet. He is -- hes seen by a
cardiologist once a year and his medical conditions are
stable.
On a formal exam, I found Mr. Ruggles to
be pleasant and cooperative, with appropriate eye contact.
His speech was quiet, of normal rate and normal tonal
variations. He told me that his mood was good and I
didnt see any signs of depression or elation. He told me
his appetite was fine and that between the walking group
and the attention that hes trying to pay to his diet,
that hes lost a little bit of weight over the course of
the year, which was in fact a medical goal. His sleep was
adequate. I did not find any evidence that he suffered
from any abnormal beliefs or that he had any overvalued
persecutory ideas. I didnt find any evidence of
delusions, and in particular I didnt find that he had
worked for the U.S. Government as a government agent. He
denied any visual or auditory hallucinations, and I didnt
see him responding to internal stimuli. I didnt find any
signs that he suffered from suicidal or homicidal
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
ideation. His formal cognitive exam was unremarkable but
for some slight difficulty interpreting abstract proverbs.
With regard to his insight, so as has been
noted on previous PSRB hearings, Mr. Ruggles insight
around his mental illness and his need for medication
remain a focus of his treatment. He acknowledges that he
was paranoid at the time of the crime and that he felt at
the time that there were certain groups of individuals who
were out to harm him, including the government and the
police. He described himself as having been frightened
and paranoid. However, he refuses to believe that he has
a mental illness. Indeed in some of his writings he notes
that he does not believe that mental illness exists at
all. And he told me that it was not the antipsychotic
medication that hes on, but rather his spiritual beliefs
that have been -- and time which have been most helpful in
contributing to his clinical progress.
Having said that in describing his lack of
insight, Mr. Ruggles is willing to take medication as long
as the clinical team recommends it and as long as it is
part of the PSRBs recommendations for him. He stated
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
that he intends to follow the PSRBs recommendations and
noted spontaneously that he would never let such an event
happen again as he would not carry weapons again and that
he has no desire to drink and has not had cravings in the
time that hes been at CVH.
I asked him whether he thought that the
crime was part of his being -- was part of him being part
of a conspiracy or whether he was the target of a
conspiracy, and he told me that he didnt like thinking
about that period in his life and that it had been a
particularly difficult time for him.
So in my opinion, I think that the best
risk management of Mr. Ruggles requires both the continued
treatment of his schizophrenia and his history of alcohol
abuse, it requires continual monitoring by mental health
staff of his mental state, and the provision of an
appropriately structured environment. And Mr. Ruggles has
acknowledged that the PSRBs recommendations in this are
key to his compliance.
As his case is currently being managed and
as he is currently presenting, I do not think that Mr.
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
Ruggles represents a danger to himself or other people.
And its the basis of that clinical stability that, as you
know, there has been a proposed temporary leave
application submitted to the PSRB.
The purpose of the temporary leave
application is to provide for treatment in the community
at two facilities, River Valley Services and Gilead
Rehabilitation Center in Middletown. Those are two
facilities where hes already currently receiving
treatment. The application provides for treatment in
these two facilities for up to four days a week and up to
six hours a day. His TL supervisor, Wendy Blakely is not
here to day. In her place, as we mentioned, we have
Patricia Burke from Gilead, who is the program director
there, and we have a representative from River Valley
Services, Colleen Milt (phonetic) -- is she -- Im sorry,
I dont think that shes here --
A VOICE: (Indiscernible) -- no, Im here
--
DR. PRABHU: Sorry. Hello. The groups
recommended for Mr. Ruggles at River Valley Services
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
include Symptom Management group and continuation of his
self-esteem group. He will also be attending other
recovery groups as its deemed clinically appropriate as
his attendance there and his engagement there is observed.
He will walk himself unescorted to the facility which is
located on CVHs campus. At the second facility, Gilead
Community Services, he will be transported by a Gilead
van, which is staff supervised, and he will be attending
an outpatient group, a therapeutic group, and then
engaging in the clubhouses daily activities, which
include a community meeting, tasks for the day, lunch and
cleanup. Both facilities are supervised and Mr. Ruggles
will be required to check in with unit staff over the
course of the day. I will note that he will remain on his
overnights at Dutcher. He will have his medications
administered by CVH staff and he will remain in one-to-one
therapy with Dr. Winkel.
Part 2 of the plan will involve -- has
involved Mr. Ruggles being placed on the waiting list for
the Gilead Apartment Housing Program, which is a 24-hour
supervised boarding type house where six other clients
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
would be present. There is a staff office present in the
same building. He would attend the Gilead Clubhouse for
programming or at River Valley Services. And specific
clinical services will be considered as Mr. Ruggles
progresses through Part 1 of the TL if it is approved by
the Board.
So in conclusion, as Ive noted, Mr.
Ruggles has not experienced any psychotic decompensation
or clinical deterioration since his last PSRB hearing.
Hes remained on the same antipsychotic medication. He
continues to be in therapy and groups. He is reported to
be and the staff notes him to be compliant with his
medications, and this is confirmed by his serum blood
levels. His insight about his illness remains partial,
but he has been consistent in expressing a willingness to
comply with the clinical teams and the PSRBs
recommendations for him. Thank you.
ACTING CHAIRMAN KIRSCHNER: Any other
testimony or just questions and answers? Attorney Radler.
MR. RADLER: I have no questions.
MS. MABBETT: I have a few, thank you.
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
Youve indicated with Mr. Ruggles that theres been no
further motions that have been filed that youre aware of
with the courts or any type of government facility?
DR. PRABHU: Yes.
MS. MABBETT: Okay. And the last motion
that youre aware of that has been filed, when was that?
DR. PRABHU: That was in January of 2010.
MS. MABBETT: Okay. And there was an
issue I believe that was brought to the Board at that
time, correct?
DR. PRABHU: Yes.
MS. MABBETT: Okay. And -- now Mr.
Ruggles was very good about keeping a journal. Do you
know if he still keeps any type of journal?
DR. PRABHU: I did not ask Mr. Ruggles
specifically about whether he had a journal. Im not sure
if any other members of his clinical team are aware of
whether he had one and continues to keep one. Im sorry,
I dont know the answer to that, but I can find out and
let the Board know.
MS. MABBETT: Okay. And the other thing
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
is my understanding is that he has computer access. Can
you tell me is it monitored in any way whatsoever
DR. PRABHU: You mean currently or in the
proposed TL?
MS. MABBETT: Currently and in the
proposed.
DR. PRABHU: So he -- as part of his
computer club he does have computer access. It is
supervised in the sense that Mr. Ruggles cannot get on to
the computers and roam the internet freely without staff
supervision. There are the usual CVH blocks which limit
websites to which hes accessed. And printouts are picked
up and seen by the staff that are there. He doesnt have
one-to-one supervision during the computer club, but
theres always staff present in the room when people are
in use of the computers is my understanding.
MS. MABBETT: Okay. So if theres any
sites that are out there that are sites that violates or
sites that deal with any type of weapons or guns or
anything like that, would CVH be made aware of that or is
that one of the blocks?
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
DR. PRABHU: I -- my understanding is that
there are blocks built around dangerous sites as well as
sites of a sexual nature and content. I cant speak
specifically to the sites that are listed. My
understanding is that IT would be able to -- would always
have access to sites that are being reviewed, although I
dont know if in the same time -- in real time whether
theyd be able to provide feedback as to what any specific
person on any computer site is looking at. I may have to
defer to Dr. Lah or one of the other members of the
clinical team about that.
DR. MICHAEL LAH: Michael Lah, Supervising
Forensics Psychologist on the Whiting Forensic Division.
The blocks that the hospital has on our
computers do prevent patients from accessing sexually
oriented sites, which are easier to kind of identify. I
think depending on what the site was, things regarding
weapons and violence and stuff might be blocked, but it
also is possible that he could access some things that
might have -- you know, sort of regular retail things
about weapons or something. But staff do supervise.
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
Theyre always in the area. So depending on what the site
was, it might be possible for him to have some kind of
access. But I dont think anything like groups that
propose, you know, violence or anti-government kinds of
things, I dont think hed be able to access things like
that.
And in the community setting, staff are --
or my understanding is that staff are always in the room
when the computers are being used and -- they may not
constantly be looking at what hes doing, but are always
there and able to kind of check now and then and see what
hes doing, how the computer was being used.
The hospital computers, we do have the
ability to print out a history of where -- the activity
where people went. So if there was a question about him
accessing something, the computer technology folks would
be able to access and print that out, the history, and be
able to tell what he was doing on the computer.
MS. MABBETT: And is that information --
if the PSRB Board asked for that information, for the
computer printouts of an individual, would you be -- I
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
mean I dont know -- is it something that you would
provide to them?
DR. LAH: We -- whatever the Board
requests, wed provide if were able to.
MS. MABBETT: Okay. And then the
computers access at the other facilities are certainly --
do they do have any type of blocks or something like that?
MS. PATRICIA BURKE: This is Patty Burke
from Gilead Community Services, the rehab center where Mr.
Ruggles will be attending.
We do have blocks on our computer systems,
again its sexual in nature. There are not specific
blocks related to guns or any kind of violent websites.
However, having said that, we do routinely print out for
ourselves a review of internet sites that have been
accessed and we are available in the room when people are
on the computers.
MS. MABBETT: Okay. And again, with you,
if the PSRB asked for that information from your agency,
is that something that the PSRB Board would be able to
access without any type of court orders?
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
MS. BURKE: I can ask our IT department to
put a -- set up a program on the computers that will give
the PSRB, if they required it, access to websites that
have been accessed.
MS. MABBETT: Thank you. When you were
talking about the Level 4 and the access that Mr. Ruggles
has out there on the grounds, has there been any type of
violations or times that he has not gone from one place to
the other?
DR. PRABHU: No. The clinical team has
reported that he has -- there have been no instances and
no violations with regard to his use of the passes.
MS. MABBETT: Okay. And the passes are he
would go from one facility to the next?
DR. PRABHU: So hed be able to walk
unescorted say to Merritt Hall or to the pavilion for
special events or to, for example, the greenhouse where he
might have -- where he -- where he works twice a week. And
he currently attends one group once a week already at
River Valley Services that hes able to escort himself
there and back.
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
MS. MABBETT: Okay. And what type of time
frame are we looking at there? How long does it take him
to get to and from these? Fifteen minutes --
DR. PRABHU: Oh --
MS. MABBETT: -- an hour? I dont know
--
DR. PRABHU: Oh, less than that. I mean a
couple of minutes, five minutes.
MS. MABBETT: Okay. And then I know that
he started the services, the community visits to River
Valley -- to River Valley and out there into the
community. Could you tell us a little bit about this? I
mean hours per day, the places that he goes to, and what
type of activities take place?
DR. PRABHU: Im sorry, currently?
MS. MABBETT: Yes.
DR. PRABHU: So currently with regard to
River Valley Services, which is on, as I said, the campus
at CVH, he attends one weekly self-esteem group. He walks
himself there. He participates in the group. Apparently,
hes been invited to remain to socialize and to engage
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
with the group a bit more, but hes always expressed an
anxiety and interest in getting back to the unit.
He attends events or recreational
activities at Gilead Clubhouse once a month, and those
activities have been, as I understand it, sort of whatever
the club has been doing on that particular day. You can
tell -- Ill let Gileads representative describe it in a
little bit more detail, but the activities that he
currently engages in which take him into the community are
always staff supervised. So he attends a weekly walk,
which is staff supervised, which may take him into say a
bookstore downtown, but again this is staff supervised,
and were talking a couple of -- a matter of hours, not
for the entire day, and certainly not unattended
currently. So in the proposed TL, he would be attending
Gilead two days a week for a maximum of six hours. He
would be picked up approximately around 9:00 am and would
return again by Gilead van by 3:00 p.m. And during that
time he would be present at the Gilead Clubhouse doing
activities with staff and with other clients and under
staff supervision.
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
At River Valley Services he would again be
attending twice a day and be participating in structured
groups, again approximately leaving around 9:00 a.m. or in
time for the first group, and then returning no later than
3:00.
MS. MABBETT: Okay. And -- and when I was
reading the temporary leave, it indicated that for some of
the community service leaves he could bicycle, he could
walk. Are you just talking about those activities on CVH
grounds, because I was with the impression that he could
do this getting to the Gilead House?
DR. PRABHU: Well the plan as it is
currently -- the current plan is that in fact he will be
picked up by a Gilead van, sorry, which is staff driven,
and that the van will drop him off again. That is the
plan as it is currently formulated.
MS. BURKE: And he will remain with us at
the clubhouse.
DR. LAH: Michael Lah again. I think the
other factors -- there are two phases to the temporary
leave. And so during the first phase, which is just day
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
treatment, he will be transported as Dr. Prabhu mentioned
and supervised by staff. During the second phase he will
have limited ability -- by bicycle and stuff to get from
his apartment, maybe to come to River Valley to attend
treatment activities. So he would have some ability to
kind of transport himself in that regard.
MS. MABBETT: So that down the road then
when he would have a bicycle --
DR. LAH: In the second phase when we
start the overnights in his apartment, supervised
apartment.
MS. MABBETT: Okay. Which we -- is that
-- because the one I was looking at was talking about
three months -- this plan is in place for three months.
Are you talking about perhaps he might be in his own
apartment after a three-month time span?
DR. LAH: The first phase is three months.
And then the day treatment, we would do that at least
three months depending on his clinical progress. Then we
would progress to the second phase, assuming that the
Board had approved that. And then the second phase is
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
also estimated to at least be like a three-month period.
It could go longer and definitely depending on his
progress and our assessment of him.
MS. LACHANCE: Just for clarity, there is
no application for overnights at this time. This is only
an application for day. At the point that the hospital
should they come forward and ask for overnights, that
would be -- would require another hearing.
MS. MABBETT: Okay, thank you. That was
my concern.
DR. LAH: So --
DR. PRABHU: Yes, if I could just note the
understanding of the team is that Part 1, the piece before
the Board right now will be at least three months. And --
and the planning for Part 2 would be obviously dependent
on his clinical progress and his clinical experience, and
with further discussions with the team and the community
providers.
MS. MABBETT: Okay. And one of the other
questions Ive got is if in fact he should violate any of
these rules or he should be late, is somebody going to
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
keep track of this, so that -- I believe that the Board
has that right to know when theres any violation, no
matter how minor -- are they going to be made aware of it,
or are we just going to say, oh, it was just a minor, he
was five minutes late?
DR. PRABHU: Well, I think it depends a
little bit on the form of the violation if there is one.
And in both cases both Gilead and River Valley Services
have indicated that they would both let the ward and the
sorry -- Dutcher, as well as his TL supervisor know. So
both will be keeping track in various ways. I assume on
the ward there will be a note written. And in the case of
the TL supervisor, we can ask her to keep a separate
record if that would be useful to the Board of any
violations or deviations from the plan.
MS. MABBETT: And that would be something
all kept in one or two different places so that we
wouldnt have to go to several different areas to try to
locate it?
DR. PRABHU: Yes, I would think that would
be --
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
MS. MABBETT: Like a log --
DR. PRABHU: -- simple to record in a log
if needed.
MS. MABBETT: And you also indicated in
the temporary leave that he could go pretty much anyplace
in the State of Connecticut as long as it was supervised
by staff?
DR. PRABHU: There is a clear caveat hes
not able to return to the Town of Bethel or the location
of the crime. And the -- any -- any trips outside of the
community treatment centers would be staff supervised.
MS. MABBETT: But -- and youre aware that
the location of the crime wasnt necessarily where it took
place, it was where the police officer actually pulled him
over?
DR. PRABHU: Yes.
MS. MABBETT: The crime was ongoing with
his delusional state. I mean it was -- it could have been
any police officer, it could have been any area, it could
have been any government facility that this could have
taken -- it could have taken place. So why are you just
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
limiting it to that one place, Mansfield Street in Bethel,
Connecticut? Shouldnt it also include government
buildings, the Governors mansion, because the Governor
was at stake at some point in time, and any other
government facilities thats out there?
DR. PRABHU: Well this has been the
restriction on Mr. Ruggles up until this point, and of
course he has been present in residing at CVH. If the
Board thinks that it would be appropriate to limit -- to
further limit the areas in which -- to which he might be
able to travel, then certainly Im sure that the team and
Mr. Ruggles would comply with that.
Mr. Ruggles -- the community -- the types
of community trips that Im aware of that Gilead and/or
CVH and/or River Valley Services provide are largely
recreational, to bookstores, to parks. They dont involve
trips to government facilities, trips to courts. So, I --
my understanding of the nature of the trips that theyve
conducted so far, I dont think would put him at risk of
visiting the types of facilities that you might have
concerns about. Nor might I add has Mr. Ruggles
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
expressed any desire to visit any of the types of the
facilities that you are expressing concerns about.
MS. MABBETT: And also concerning police
officers, when hes on any of these community trips at all
has he come in contact with any police officers? And if
so, what has been his state?
DR. PRABHU: I have not seen any mention
in the records of Mr. Ruggles coming into any contact with
police officers. Im not sure if anybody else has any
further information about that.
I will note that there are of course
police officers and security on the grounds of CVH whose
presence Mr. Ruggles has noted and who are certainly
present there when he is walking on grounds. And I have
not heard Mr. Ruggles report any difficulties with them
and Ive not seen any reports in any of his records of any
altercations with them.
DR. LAH: As Dr. Prabhu mentioned there
are police officers on grounds that Mr. Ruggles has
interacted with and theres never been any problem.
Its hospital policy whenever -- if he was
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
on a community trip and a police officer asked him his
name or any kind of contact like that, its our policy to
inform the Board. Whenever any acquittee has any
interaction with police officers. So regardless of the
reason, you know, if he was in the van and somebody else
rear-ended the van and a police officer asked him his
name, we would inform the Board that a police officer was
there for the accident and asked him his name and
interviewed him. So any contact that acquittees have with
the Board we inform -- or with the police, we inform the
Board.
MS. MABBETT: But isnt that pretty
important considering the fact that it was police officers
that were in danger here, it was just a matter of which
police officer he was going to end up shooting, and
unfortunately he shot --
DR. LAH: Yes --
MS. MABBETT: -- Michael Daubart --
DR. LAH: -- Im aware of that. But to
prevent him having access to that, means he would not be
able to go anywhere in the state because there are police
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
officers everywhere in the state, in every town, in every
--
MS. MABBETT: But what Im saying is have
we watched his interaction with any police officers thats
been assertive with him at all and watched what he has
done because thats -- thats part of --
DR. LAH: Theres --
MS. MABBETT: -- his delusions?
DR. LAH: There have been no problems at
all with his interaction with the officers on grounds and
hes had no interaction with community police officers.
MS. MABBETT: Okay, thank you. And the
medication that hes required to take, will he take that
medication prior to the day leaves or when he returns?
When -- when exactly is that medication --
DR. PRABHU: Actually, he currently takes
it at night. And hell remain taking it at night.
MS. MABBETT: Okay. And if Mr. Ruggles on
one of these walks should disappear or not show up on
time, when exactly do you notify the authorities? I know
that you indicated in the temporary leave that you would
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
notify CVH. But when are they required to notify the
authorities or what steps are taken after or if that
should happen?
DR. LAH: We have clear procedures for --
even with hospital staff supervised trips with patients if
a patient -- or an acquittee left the area. The first
call is to the police. They call 911 and inform the
police. The second call is to the hospital to the
hospital police. The third call is to the Dutcher nurse
supervisor, who would inform the treatment team. So 911
is the first call that staff would make immediately if he
walked away.
MS. MABBETT: What time frame are we
talking about?
DR. LAH: Minutes.
MS. MABBETT: So if he was to be at a
certain location within minutes and he wasnt there, then
that 911 call would take place?
DR. LAH: Oh. If he was supposed to leave
Dutcher and walked to the building on grounds to go to an
activity at River Valley Services, if he wasnt there
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
within 10 minutes, theyre supposed to call the unit. We
would immediately notify our police, then staff. We would
search the grounds. And then after a period of time, the
procedure is our police if they couldnt find him, would
then do the teletype communication with statewide, with
all state and local police. So the response is pretty
quickly. Our policy is if somebody doesnt come back from
a grounds pass within five or ten minutes, we initiate the
escape procedure.
MS. MABBETT: Okay. In one of the -- we
had sent a letter back when -- and Im sure its in your
file someplace -- that there are certain individuals that
needed to be notified if Mr. Ruggles should disappear,
such as the police officers that were involved --
DR. LAH: Yes --
MS. MABBETT: -- the Governor --
DR. LAH: Yes --
MS. MABBETT: -- and all those people that
we felt could potentially be threatened as a result of
what he -- the shooting that had occurred --
DR. LAH: Right. Part of our procedure is
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
also to immediately notify the Executive Director of the
Board. And then it would be the Boards responsibility to
inform the victims.
MS. MABBETT: And when you talk about
victims, would that be in compliance with the letter that
the State had previously sent to your facility? And --
and you may not have that --
DR. LAH: It would be in compliance with
the victims of his crime that the Board has on record.
MS. MABBETT: Okay.
DR. LAH: So if you had listed the
Governor, the Governor is not considered a victim of his
crime --
MS. MABBETT: No, hes not --
DR. LAH: -- so we -- they wouldnt -- I
wouldnt -- Ellen Lachance could answer that, but --
MS. MABBETT: Alright. And I would be
concerned about perhaps security at the Governors
facility or any government facility that might be -- in
Hartford or in the area to be notified.
MS. LACHANCE: You can rest assure that we
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
will take no chances in terms of notifying as many people
as we think is appropriate in each individual case.
MS. MABBETT: Okay, thank you. And my
question to you --
MS. BURKE: Mmm-hmm --
MS. MABBETT: -- is what exactly will
happen at your facility?
MS. BURKE: Were a working clubhouse,
which means that individuals who attend our programming,
theres an expectation that they contribute to the working
of the clubhouse, whether that is working in the culinary
unit, which Mr. Ruggles has expressed an interest in,
writing a newsletter potentially, maintenance of the
building and the grounds, potentially career services when
thats deemed appropriate. So its relatively structured.
People can decline to participate obviously, but generally
we have about a 90 to 95 percent participation rate on a
daily basis.
MS. MABBETT: Okay. And then this
information of his participation is relayed back to CVH
then and documented?
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
MS. BURKE: It can be, absolutely. Its
documented in our electronic medical record on a daily
basis.
MS. MABBETT: Okay. And then thats
something again too that the Board could have access to --
MS. BURKE: Absolutely --
MS. MABBETT: -- if need be?
MS. BURKE: Yeah.
MS. MABBETT: Okay. Okay, thank you.
Thank you.
ACTING CHAIRMAN KIRSCHNER: I just have
one question. I dont know who can answer it, but he
continues to deny that he has any type of mental illness
or need for psychiatric treatment, medication, or therapy,
but yet hes engaged in therapy. What is he working on in
therapy and whats he talking about?
DR. PRABHU: Dr. Winkel, who is both his
individual therapist and the, sorry, group therapist for
the Forensics Group, reports that he has -- much of the
discussion are about the events of the prior week, the
activities, his interactions with staff and/or other
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
patients on the unit. But hes also volunteered
information about the crime, about his state of mind at
the crime, his understanding of how his depression and his
alcohol use and his paranoia, which is his term, had
contributed to the crime at the time. And hes also
spoken about how alcohol was a part of his lifestyle prior
to the crime and how he felt that -- hes described it in
terms of wishing to emulate other men in his peer group
and his regrets about how those things contributed to the
crime. He has spoken about having strong commitments to
maintaining sobriety. Hes indicated that he has no
desire to ever drink again, that hes not had cravings.
So these are the sorts of things that have come up in
individual as well as group therapy over the last two
years.
ACTING CHAIRMAN KIRSCHNER: So does he
attribute his paranoia and his depression to his alcohol
use?
DR. PRABHU: My understanding is that he
attributes it both more to his -- as he would describe it
to his spiritual problems, which is his understanding of
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
his mental illness, and that his -- he was -- he had
difficulties with his faith and his spirituality, and
those were the reasons for his being unwell. He has been
consistent in, you know, not acknowledging that he has a
mental illness and attributing the paranoia for example to
the mental illness.
ACTING CHAIRMAN KIRSCHNER: So he can
acknowledge paranoia and depression, but doesnt classify
that as any type of mental illness?
DR. PRABHU: He attributes it to spiritual
problems rather than to a mental illness, yes.
ACTING CHAIRMAN KIRSCHNER: So to what
does he attribute his spiritual growth or change over the
course of his hospital stay in terms of how his
spirituality got corrected?
DR. PRABHU: In fact, we did discuss this
this week. He attributes it to time, to learning, and to
renewed commitment to his spiritual beliefs.
ACTING CHAIRMAN KIRSCHNER: Is he engaged
in any type of religious activities, spiritual --
DR. PRABHU: Its actually not listed as
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
part of any of his activities. Im not aware that -- any
detail about some of the religious events that he may
partake in on campus or around holidays.
I would also note that he -- there was a
significant change in his participation in treatment
around 2001. You may recall that prior to 2001, he wasnt
engaged in therapy at all and he wasnt even attending the
PSRB hearings. However since then, he has been coming to
hearings and his engagement in therapy has increased from
what was my understanding a fairly cursory 15 minutes to a
now weekly 30 minutes. So although Mr. Ruggles has not --
continues to state that he does not think that he needs
therapy, he does come to the meetings, he has increased
his involvement, and I think that probably reflects his
growing comfort with his therapists and the treatment team
even if he doesnt recognize the mental illness for what
it is.
ACTING CHAIRMAN KIRSCHNER: Is there any
concern that this spirituality aspect is almost a form of
another delusional belief system as opposed to an actual
spiritual type of faith?
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
DR. PRABHU: Right. So in the past when
he has psychiatrically decompensated, he has been more
grandiose and more overtly religious, or one might
actually use the term religiosity to describe the nature
and the flavor of his speech and his thought or his
organization. That has not been the case in the last two
years. There has been no evidence of religiosity or
grandiosity or of the kinds of disorganization that hes
seen in the past -- that weve seen in the past.
ACTING CHAIRMAN KIRSCHNER: Okay, thank
you. Miss Lachance.
MS. LACHANCE: Dr. Prabhu, two years ago
at his last Mandatory Review hearing, Dr. Buchanan had
testified about the mental status exam that he had
performed and he asked similar questions as you had
described you were asking. And at that point Dr. Buchanan
was testifying and he said that when he asked Mr. Ruggles
if he thought that there was a conspiracy against him and
if he currently believed the conspiracy theory that he had
believed at the time of the crime, and Mr. Ruggles stated
that he didnt know if it was a conspiracy, but thought it
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
remained a possibility. So that was two years ago. And I
note that in your mental status exam you asked a very
similar question. And I recall that you said something
about -- or akin to his saying he doesnt like to dwell on
that. Did you push him on that question?
DR. PRABHU: I did, in particular because
I was familiar with Dr. Buchanans questions about it.
And Mr. Ruggles was more conclusive. He didnt leave open
the possibility that there might have been a conspiracy
against him. He simply said no and that he recognized
that he was troubled at the time and that there were other
things going on at the time. So he didnt even refer as
hes had in the past, however even though weakly to
believing that he was part of a conspiracy or a government
agent.
MS. LACHANCE: Is there anyone who can
give us information about how Mr. Ruggles has participated
or been engaged in the activities that hes participated
in at River Valley or Gilead up to this point? I know
its once a month, but can anyone characterize how he has
-- how his involvement has been?
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
DR. PRABHU: Again, hes uniformly
described as polite, cooperative, he does what he needs to
do, he does what hes asked to do, he volunteers for jobs,
and he performs jobs also around the unit. He cannot be
described as the most expressive or voluble of the
patients in the groups, but he does engage the other
patients and has volunteered observations about their
treatment and has absorbed feedback from other patients
about his own engagement for example in Forensics group
without any difficulty.
MS. LACHANCE: In 2006 Dr. Zeman conducted
an evaluation at the request of Attorney Mabbett. And in
part that evaluation noted the importance of monitoring
Mr. Ruggles mental state, particularly in light of his
refusal to believe he has a psychiatric illness and also
because he maintains a -- maintained then at least a
belief that he did not require psychiatric medication.
For the record does he still believe, do you know, that he
doesnt require psychiatric medication?
DR. PRABHU: That is his belief, yes.
MS. LACHANCE: And -- so in light of his
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
decompensation in June of 2009 and the comments that Dr.
Zeman made about the importance of monitoring his mental
status, is that something that you would concur would be
important as well as he transitions?
DR. PRABHU: Yes, I would. And in fact, I
note that in addition to the new activities that he will
be doing, he will maintain his relationship and his
therapeutic therapy with Dr. Winkel, whos had a long time
observing the patient, he will still be having his
overnights -- hell still be returning to the unit every
night. So again, hell be working with people who have
observed him for a long period of time. And both the
staff at Gilead and River Valley Services have described
themselves as being another set of eyes on the patient.
And -- so hes never going to have an extended period of
time where he is not being supervised. So there will be
both structure and eyes on the patient at all times.
MS. LACHANCE: In the community who will
be the primary responsible party for monitoring his mental
status?
DR. PRABHU: So -- you mean does he --
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
will he be having a separate supervisor --
MS. LACHANCE: No, I meant --
DR. PRABHU: A clinician?
MS. LACHANCE: Yes. I dont mean
necessarily to conduct mental status exams in the formal
way that you do. What I meant is there one party in
particular whose responsibility is maybe more so than
others in terms of monitoring his mental state or checking
with other people who he has interaction with while in the
community? Is there one person whos responsible for
that?
DR. PRABHU: His TL supervisor, Wendy
Blakely has described her role to me as realizing that her
job is to keep an eye on him and to elicit feedback from
other people who have interactions with him about his
mental status.
MS. LACHANCE: And what is her clinical
background?
COURT REPORTER: One moment please.
(pause - tape change)
DR. PRABHU: Im sorry. May I go ahead?
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
Thank you. She is a mental health worker -- Ive just
been informed by Patty Burke that she has almost completed
her Masters Degree in social work. Yes, I knew that she
was a social worker. And shes had about 12 years of
experience in -- at least 12 years of experience in
working with mentally ill clients in the community.
MS. LACHANCE: From a previous hearing we
heard testimony that River Valley Services at that time,
which is probably going back two years ago, did not have a
forensic team or a forensic psychiatrist on their team. Do
you know if thats still accurate?
DR. PRABHU: I dont, but I --
A VOICE: That is accurate.
DR. PRABHU: It is accurate according to
Colleen who is here from River Valley.
MS. LACHANCE: Thank you.
ACTING CHAIRMAN KIRSCHNER: Thank you. Do
we have a statement from --
MR. MICHAEL DAUBART: How do you do,
Board. My name is Michael Daubart. Im one of the
victims of this crime as you know. I strongly oppose any
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
reducing or reduction in Mr. Ruggles level.
I just want to go back and remind the
Board of what happened here. And as I sit here throughout
the years listening to the different hearings, we kind of
forget what actually went on and what the mental state of
this person was and what he said back then and what hes
saying today. So if I can just take a moment and remind
us what happened.
Mr. Ruggles was -- planned this assault
and assassination of me for over three months. He had
followed me and kept a very detailed journal of all of the
activities that went on in our town. Mr. Ruggles did not
have a drinking problem at that time. We had run into Mr.
Ruggles numerous times. I started out as a 21-year-old
rookie police officer. I asked Mr. Ruggles one day to
stop handing out literature from the front of the post
office in violation of post office regulations. He felt
he could run for governor and that the government was now
being run by communist agents and he must take over. I
did a simple act and just asked him to remove himself from
those stairs. That put me on his hit list as the No. 1
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
person.
Mr. Ruggles followed me around,
unbeknownst to me, and I was a pretty sharp police
officer, I thought. He sat outside my house in the woods.
He noted what room I was in. He noted what time I came
and went. He knew what car I drove. Again, we go back to
his journal. He wrote detailed entries into that journal.
How did this Board not review his journal at this day is
beyond me. He still does that. In those journal entries
he writes how he had put a bomb in my car, how he walked
up behind me as I stood in line at a grocery store and put
a 45 caliber gun in my back, and if I had turned around,
he had to disable me and cripple me before he shot me in
the head. He wrote about other officers, David
Bruckinthal (phonetic), Charles Hubb (phonetic). There
was a group of officers that had stopped him at minor
times just asking him to remove himself from sidewalks
that he was handing out -- or on motor vehicles stops.
They became on his hit list. He had a large hit list.
As he progressed down the scale and became
more and more paranoid, all of these things started to
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
come to head. He planned like I said for three months
when he was going to assassinate me, how he was going to
tap the back of my police car, causing me to chase him.
He was not going to stop. He was going to finally pull
over in front of a day care center so that when he got out
of the vehicle, I was looking at 60 kids in the front of a
day care center as I drew my weapon. If I missed, I was
probably going to hit one of the little kids. If he
missed, he had set it up very meticulously that behind my
backdrop was a sand bank, a sand bank. So his misfire
would hit a sand bank and mine would hit a group of kids.
His car was booby trapped. So not only was he going to
take my life, but any of the officers that came afterwards
if he was killed or not, were also going to be maimed.
You talk about location. He marked his location. We had
spent months where he followed us around and set that up.
And his interaction with police officers, it could have
been any of us. He wrote in his journal how officers had
-- if the officer attempted to stop him, he must get out
and shoot that officer.
I need this Board to be able to say these
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
things are corrected, this gentleman will not do that
again. He still feels that his actions are okay. He
doesnt accept what he has done. One of the critical
elements we have in parole is that he accepts his crime. I
dont hear that coming from him. You talk about alcohol
was a problem. It wasnt when his crime was committed.
You talk about medication. He refuses to take medications
most of the time if you were not here. You have to
guarantee us that when hes in the community, hes going
to take it. Hes already telling you hes not going to do
that. You mention about not having any control or review
of a journal entry. Ive already gone over that. The
journals are critical to know what he is really thinking
in his mind.
His computer access, it appalls me that
you dont have detailed knowledge of where this man is
going. He spent hours in the library researching bombs
and weapons and mass destruction and how to set all of
these things up, hours upon hours. And you dont have one
list of where hes gone in the last six months. And
youre telling me that it might be time to reduce him?
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
I find that hes still a very -- a very
large threat to society, that releasing him into society
without these precautions in place is almost guaranteeing
that he is going to slip back and run into the same
problems. And this time hes going to kill somebody.
He stood above me with a shotgun. He shot
me the first time, disabling my arm. He wrote in his
journal how he had to do that. That I had a bad habit of
unzipping my vest as I was pulling into a dinner break.
And he knew that. He used that against me to disable my
arm. He shot me the second time square in the chest,
knocking me back. He shot me a third time, to ensure I
was going to die. He put the gun to my head for the
fourth time. And by the grace of God another officer
showed up and he had to take it off of my head and shoot
at that officer. I dont know how I survived that day.
But I ask the Board if you can guarantee thats not going
to happen, then you can release him. But if you cant
guarantee that that is not going to happen again, it is
your duty to keep him under strict supervision and locked
up. Thats all.
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
MS. LACHANCE: Thank you.
ACTING CHAIRMAN KIRSCHNER: Thank you.
MR. DAUBART: Thank you.
ACTING CHAIRMAN KIRSCHNER: If there are
no further questions or matters to be brought before the
Board, then this hearing is closed.
(Whereupon, the hearing adjourned at 11:25
a.m.)
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HEARING RE: KENNETH RUGGLES
NOVEMBER 4, 2011
INDEX OF WITNESSES
PAGE
DR. MAYA PRABHU
Direct Testimony 3
Examination by Ms. Mabbett 12
Examination by Acting Chairman Kirschner 31
Examination by Ms. Lachance 35
DR. MICHAEL LAH
Examination by Ms. Mabbett 15
PATRICIA BURKE
Examination by Ms. Mabbett 16
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