HomeMy WebLinkAbout04-21-10
NDEX TO WITNESSES
FOR PETITIONERS
EXAMINATION
Dr. Charles E. Cladel, Jr. (Telephonic) 3
Lillie Binder
Dr. Eric Binder
Elise Rachel Binder
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2
August 31, 2009
2 Carlisle, Pennsylvania
3 (The following proceedings were held at 1:37 p.m.)
4 THE COURT: This is the time and place for a
5 hearing in the matter of Elise Rachel Binder at No. 21-09-0496.
6 We will let the record indicate that the
7 Petitioners are present in court with their counsel. I am not
8 sure whether the allegedly incapacitated person is present.
g MS. MULLAUGH: She is, Your Honor.
10 THE COURT: She is, all right, go ahead.
11 MS. MULLAUGH: Thank you, Your Honor. I would like
12 to call first Dr. Cladel, our medical expert, telephonically.
13 THE COURT: All right.
14
15 DR. CHARLES EDWARD CLADEL, JR.,
16 having been duly sworn,
17 testified as follows telephonically:
18 EXAMINATION
19 BY MS. MULLAUGH:
20 Q Dr. Cladel, this is Elizabeth Mullaugh calling from
21 Carlisle in the courtroom in front of Judge Oler to take your
22 testimony so I am going to let the Court swear you in.
23 (Witness sworn.)
24 BY MS. MULLAUGH:
25 Q Could you please state your name, address, and
3
occupation for the Court?
2 A My full name is Charles Edward Cladel, Jr., and my
3 occupation is a physician in the practice of psychiatry with a
4 specialty in child and adolescent psychiatry.
5 Q Could you describe your educational background
6 including the schools that you have attended and the degrees
7 you received?
g A Well, I attended the University of Rochester in
9 Rochester, New York, and graduated with a degree in mechanical
10 engineering in June of 1961.
11 Partway through that program I decided that I was
12 going to pursue the medical field, so I went to Cornell
13 University to take pre-medical courses. I was enrolled as an
14 English major, but I was accepted in medical school after one
15 year there, so I accepted that and went to the Upstate Medical
16 Center in Syracuse, New York, obtained my MD degree in 1966.
1~ I then went to Indiana Medical Center for one year
18 of internship and was accepted in their psychiatry residency
19 program, I completed one year there; but then I served in the
2G United States Air Force, I had a one-year deferment, I didn't
21 get the full four-year deferment. So I worked as a captain in
22 the Air Force in Anchorage, Alaska, in the emergency room at
23 the Elmendorf Air Force base for 2 years, after which I
24 transferred to University of Michigan Medical Center in Ann
25 Arbor to complete my child and adolescent psychiatry program
4
which was an additional three years there.
2 I completed the fellowship in child psychiatry,
3 which was my final two years there, in 1973; and then accepted
4 a position as assistant professor of Psychatry at the Penn
5 State University Medical Center in Hershey, and I was on the
6 staff there for three years; and then went into private
7 practice of child and adolescent psychiatry as a specialty in
8 this area, and I remained here ever since, address being in
9 Hummelstown, Pennsylvania.
10 I have been in private practice since then but I
11 also am on the staff at Holy Spirit Hospital part time, 30
12 hours a week, and have been on the staff there for almost 30
13 years.
14 I currently serve as the chief of psychiatry in the
15 Department of Psychiatry there, I am immediate past president
16 of the medical staff. I consult, in addition, my job at Holy
17 Spirit Hospital, I consult to the West Shore School District,
18 and the Lower Dauphin School District as a psychiatric
19 consultant.
20 I am the medical director of the Partial
21 Hospitalization Program at Paradise School in Abbottstown,
22 Pennsylvania, which is a facility for adjudicated delinquents.
23 I consult to the Mechanicsburg Children 's Home and
24 to the Keystone Service Program.
25 Q Could you describe your professional licensure and
5
current board certifications?
2 A My professional licensure, I have my medical
3 license in the Commonwealth of Pennsylvania and also in the
4 State of New York simply because I graduated from Syracuse and
5 have a medical license there.
6 I am a diplomat of the American Board of
7 Psychiatry/Neurology, having passed the boards in 1976 and then
8 went on to become Board certified in child and adolescent
9 physiatry in 1979.
10 I am a member of several organizations, including
11 the American Psychiatric Association, the American Academy of
12 Child Adolescent Psychiatry, Central Pennsylvania Psychiatric
13 Society, the PA Medical Society, the Dauphin County Medical
14 Society of which I am a board member, and I guess that about
15 rounds that out.
16 Q Have you ever testified as a witness in a
17 determination of incapacity matter?
18 A No, I haven't done that before.
19 MS. MULLAUGH: I would ask the Court if there are
20 any more questions, or if not, to recognize Dr. Cladel as an
21 expert in psychiatry.
22 THE COURT: All right. He will be permitted to
23 testify as an expert in the area of psychiatry.
24 MS. MULLAUGH: Thank you, Your Honor.
25 BY MS. MULLAUGH:
6
Q Dr. Cladel, how have you come to know Elise Binder?
2 A Oh, I have known her for several years. Near the
3 end of 1998 I received a call from her father outlining some of
4 the problems they had been having and some of the evaluations
5 that Elise had received and they were interested in my
6 following her.
~ She was being followed at the time by Dr. Todd
8 Behrens (phonetic), a neurologist at the Hershey Medical
9 Center, and she was on medication. I gradually took over
10 following her for the medications that seemed to be required to
11 help her function as appropriately as possible.
12 Q Can you describe your general medical impressions
13 of Elise and then also your psychiatric impressions?
14 A Well, Elise is a rather complicated situation. She
15 has been diagnosed and I concur with the diagnosis of autism.
16 She had a difficult start in life with her mother's pregnancy.
17 She was a twin, and in the first trimester mother miscarried
18 Elise's twin and mother had problems during pregnancy. She was
19 quite sick and vomited rather severely, and there was an ABO
20 blood incompatibility.
21 When Elise was born it was soon discovered that she
22 had a rather significant delay developmentally; and as she got
23 a little older, not just physically, but primarily socially and
24 emotionally, seemed to retain these difficulties as she matured
25 chronologically through her years up to now and that there
7
seems to have been some arrest which has been maintained, this
2 arrest in her social and emotional development.
3 She required much help early on, especially with
4 educational needs. She required speech and language therapy
5 beginning at an early age; and throughout her school career has
6 required the assistance of specialized classes to help her with
7 her rather severe learning needs and emotional needs.
g Physically, she has been developing as a normal
9 child. She has had problems with -- in the area as I
10 mentioned, social sphere, she has had problems with impulse
11 control, she has had trouble sustaining attention and
12 concentration. She is extremely impulsive.
13 Socially, she is quite immature. She comes across
14 as a much younger child when one talks to her. She tends to --
15 she is, can be very pleasant and delightful, but she has
16 problems when she is met with any frustration. She can have
17 and has had through the years several, many actually, many
18 severe meltdowns, as we describe them, with crying and yelling
19 spells up to at least 45 minutes, depending on the day.
20 Some days she functions much better than others,
21 some days she can handle frustrations better than others; but
22 because of her delays in development, she is not able to
23 perform the way her age mates are expected to perform at the
24 chronological age.
25 The thing about Elise is that she recognizes this
8
and she has had problems with mood and she has felt depressed
2 and she -- at times she has said that she wishes that she
3 wasn't alive.
4 She has never been directly suicidal or attempted
5 anything of that nature, but she has made the comment that --
6 and she knows her diagnosis, she says, I wish I wasn't
7 autistic, she knows that she is different, and she is unable to
8 do anything about it. She can sometimes tell you what she
9 needs to do, but she can't carry it out, she can't sustain it.
10 Certainly on her own, she would certainly flounder.
11 Q Doctor, could you speak directly to Elise's ability
12 to receive, evaluate and communicate information, for example,
13 with regard to her day to day living needs and maybe more
14 specifically to any medical needs she might have?
15 A Well, she can't do this on her own. She needs to
16 have someone controlling, for instance, just her medication.
17 She knows -- she is very, very positive about her medication
18 and she can tell me in her own idiosyncratic way how much they
19 help her, that she needs them, but she wouldn't remember to
20 take them on her own.
21 She has much difficulty sustaining any sequential
22 kind of request. She gets easily confused. She needs someone
23 to kind of guide her along to follow through with things. She
24 will tell me and she knows this, that she says that -- she
25 tells me her mind feels topsy-turvey when she has to do
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something, even simple things she says like tieing my shoes.
2 She knows that that could be a problem for her.
3 She is able to do it at times, but she can be very upset. If
4 she hasn't done it and she is requested to do so, she might
5 throw a tantrum at that.
6 While she knows that she does this, she is unable
7 to apply that knowledge. She is very good verbally, she has a
8 good vocabulary, but that is as far as it goes as far as being
9 able to utilize it in a way that will help her sustain
10 independent activity.
11 She could not be trusted alone with medication.
i2 First of all, she probably wouldn't take it or she wouldn't
13 know where she put it. If you asked her did she take it, she
14 might say, no, when she had or, yes, when she didn't.
15 This is a problem through the years of school,
16 there was not too long ago some incident where people thought
17 maybe she had lied about her homework, her teacher was upset
18 with her. It turns out that Elise was very confused actually
19 even if she had the homework in the first place. She didn't
20 remember where she put it. She thought it was in the locker,
21 then she didn't know if she put it in the locker and because
22 she didn't know that, she didn't know if she had even done it.
23 So she would not be able to, definitely would not
24 be able to sustain independent living of any kind. It wouldn't
25 work. She would be putting herself in danger, great danger.
10
She even knows that.
2 There have been instances where you worry about,
3 she can be extremely friendly and she doesn't regard personal
4 space in the way that other people do. She might get up real
5 close while she is talking, talks rather loud in a sink-song
6 voice, can be friendly, waive to strangers.
~ There was an incident where she waived to some man
8 unknown to her and she knew, she was warned about that and she
9 said maybe, you know, maybe there should be consequences, like
10 I should be given a three minute timeout. No matter what one
11 would do, she would repeat that knowing afterward that she
12 shouldn't have done that.
13 She might follow somebody's advice, I think there
14 is one instance where she was told by some kids to eat birdseed
15 and she did that and then that was processed with her, I think
16 they discussed that in school. She is able to say what she
17 should have done but I am afraid that she could do that again.
18 So, I mean, she is not able to really safeguard her own
19 interests.
20 Q Dr. Cladel, you mentioned that Elise was on some
21 medications, could you tell us what they are?
22 A I have her on three medications, one is the
23 Concerta, which is a long-acting Ritalin based, methylphenidate
24 based medication for attention deficient/hyperactivity
25 disorder, that is to help her focus more, stay on one subject
11
appropriately for longer periods of time. It is also to help
2 physical hyperactivity.
3 As I say, she is very positive about her medication
4 and with the Concerta, if she didn't do that, she might lean
5 over the kitchen counter and pretend she is surfing, that is
6 her idiosyncratic way of saying that she could be very hyper.
~ She is taking an antidepressant which also has
8 anti-obsessive compulsive features and anti-anxiety features
9 known as Zoloft, that helps her some with OCD problems. She
10 tends to get focused on one thing and sometimes she has a hard
11 time switching to something else. She can become preoccupiea
12 with minuta, things that really she shouldn't be worried about
13 such as virus particles. Having something happen to her,
14 somebody shooting her in the spine, she used to worry about
15 that.
16 She used to touch things to prevent a blizzard from
17 happening, and this is to help reduce that kind of anxiety and
18 the tendency to be obsessive.
19 She is on a mood stabilizer which also has benefit
20 for anger management called Abilify, it is in the same class as
21 the much older Thorazine but it is much newer and is supposed
22 to have fewer side effects and she has responded very well to
23 that. Again, she is very positive about her medication and she
24 said that it really helps her ups and her downs and she says
25 she still has -- it is like a roller coaster the way she
12
described it, she has downs and fewer ups to this roller coater
2 ride that she feels she is on but very positive.
3 She is on those three medications and has been on
4 them for awhile.
5 Q In your medical opinion, is Elise's condition
6 likely to improve over time?
~ A No, it is actually quite static and it has remained
8 pretty much the same. As she gets older, she is already 18, so
9 it is already very, very obvious that she is much younger in
10 the way she functions and that is not going to change, it will
11 just become more of a gap. She will stay the way she is, you
12 know, as far as that is concerned, she is not deteriorating,
13 but she is quite arrested I think in her development and that
14 will remain the same.
15 Q In your medical opinion, do you believe that Elise
16 is in need of permanent guardianship services?
l~ A I certainly do.
lg Q Do you believe there are less restrictive
19 alternatives to plenary guardianship services?
20 A No, I don't think so, I can't imagine that. She is
21 going to need very direct one-to-one for everything, even just
22 daily living, food preparation, getting dressed, being careful
23 where she goes, when she goes and who she is with. It would
24 just be a constant concern if she didn't have this kind of
25 guardianship.
13
Q Dr. Cladel, are you acquainted with Elise's
2 parents?
3 A Yes, I am.
4 Q Do you have an opinion as to the appropriateness of
5 appointing them as her plenary guardians?
6 A I think that would be wonderful. They are
7 certainly excellent parents. I worked with them through the
8 years with Elise. I know her father professionally, as a
g physician, and they have been super parents and they understand
10 her needs, they understand her wish to be independent.
11 They try to allow her flexibility, but they have to
12 keep the leash fairly short. They would be willing to lengthen
13 it in whatever way that Elise would indicate that that would be
14 a good thing. But they understand her needs very well and they
15 are very sensitive and attuned to her, obviously, through all
16 these years. I can't imagine a better situation for her than
,17 to have them remain as they are now as her guardians now as
18 parents.
19 MS. MULLAUGH: Okay, thank you. I will ask the
20 Court, if his honor has any questions.
21 BY THE COURT:
22 Q Doctor, if I might ask you more directly your
23 opinion using the language of the statute: Do you have an
24 opinion to a reasonable degree of psychiatric certainty as to
25 whether Ms. Binder's ability to receive and evaluate
14
information effectively and communicate decisions is impaired
2 to such a significant extent that she is totally unable to
3 manage her financial resources and totally unable to meet
4 essential requirements for her physical health and safety;
5 first, do you have an opinion, and, second, if you do, what is
6 that opinion?
~ A Well, yes, certainly, financially, she isn't able
8 to handle finances. They have tried to do planning things with
9 her in school and I don't think she fully understands currency
10 and the value of currency.
11 I remember she had given some high monetary value
12 to some rather small item and she definitely -- she can't do
13 simple math. Math is not her strong -- math is very, very
14 difficult for her, she needs to count on her fingers. Reading
15 is better but she doesn't always understand exactly what she is
16 reading but she has a good vocabulary.
1~ As far as taking care of herself, you can ask her
18 about food preparation and she says that she can -- I think she
19 told me once she can make bread butter. I said, what do you
20 mean? She said, I can spread butter. She would not know, she
21 would not be able to exist actually without somebody's help.
22 She wouldn't be able to prepare food, she wouldn't
23 know how to do that. It would be a diaster in my opinion if
24 she would be -- she is very, very dependent in all the areas of
25 her needs.
15
Q So, do I understand your answer is, yes, to that
2 question?
3 A Well, I'm sorry, but, yes, to the question that she
4 is dependent on other people, yes, to that. Sorry, I might
5 have missed the gist.
6 Q Let me ask the question again: Do you have an
7 opinion to a reasonable degree of psychiatric certainty as to
8 whether Ms. Binder's ability to receive and evaluate
9 information effectively and communicate decisions is impaired
10 to such a significant extent that she is totally unable to
11 manage her financial resources and totally unable to meet
12 essential requirements for her physical health and safety?
13 A Yes, I do have an opinion on that.
14 Q Your opinion is?
15 A That she would be totally unable to manage her
16 affairs, financially or otherwise.
I~ Q All right. Did Ms. Binder graduate from high
18 school?
19 A Well, she did graduate but she is eligible to
20 receive, because of her special need status, she is eligible to
21 receive education input until age 21 I believe.
22 Q Does she live at home?
23 A She lives at home, yes.
24 THE COURT: Well, I appreciate very much your
25 taking your time, doctor. You are excused.
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THE WITNESS: Thank you very much.
MS. MULLAUGH: Thank you, doctor.
You Honor, I would like to call Elise's mother,
Lillie Binder, to the stand.
THE COURT: Okay.
LILLIE A. BINDER,
having been duly sworn, testified as follows:
EXAMINATION
BY MS. MULLAUGH:
Q Good afternoon. Would you please state your name
and address for the Court as well as your relationship to
Elise?
14 A My name is Lillie A. Binder, I live at 5264
15 Strathmore Drive, Mechanicsburg, PA 17050. I am Elise Binder's
16 mother.
17 Q Please describe your educational background and
18 your current occupation?
19 A I have my J.D. from Columbia University in New
20 York; I have a Master's Degree in theatre history from
21 Northwestern in Evanston, Illinois; and my undergraduate degree
22 is also in theatre history from University of California,
23 Berkley.
24 My present occupation, I am fortunate enough to
25 have part-time work that lets me meet the bus. I work for the
17
Commonwealth of Pennsylvania for the Department of Community
2 and Economic Development. I work processing loans basically.
3 Q What led you to seek appointment of yourself and
4 your husband as Elise's guardians?
5 A Elise turned 18 and although that gives her
6 majority status, she still is in need of everything that she
7 would need as if she were not 18.
g Q Dr. Cladel has given us a fairly significant mental
9 history for Elise, if you can elaborate on that if you would
10 from your point of view as a parent?
11 A We started seeing delays in Elise when she was very
12 little. We told the pediatrician and he said it was us and
13 that we were fancy and we expected our kid to be born from
~4 Harvard clutched in our hand and it was our fault and we should
15 just enjoy our kid and every kid is different. We had only one
16 child and didn't know.
l~ Then it became more and more apparent and we took
18 her to places and they said she had receptive and expressive
19 language delays and OCD and ADHD and sensory processing
20 dysfunctions and all sorts of things; until finally down at
21 Hopkins when she was about eight they put it all together and
22 said, no, she is autism plainly, and then it all sort of made
23 sense.
24 They told us wait until she is in early teens to
25 see how far she will go because in the very early teen years
18
some kids make this huge spurt and some things all gel for
2 them. So we just figured that everything would come together.
3 In fact, Elise's vocabulary has become fantastic; but as Dr.
4 Cladel said, she is really very concrete in her understanding
5 of language, and she does not understand social relationships
6 at all.
~ You can watch Wheel of Fortune on TV; but even Andy
8 of Mayberry has social relationships that are too complex for
9 Elise to understand. Every social relationship is too complex.
10 We have to keep things very simple for Elise or she gets very
11 upset.
12 So things are kept simple. She can't be home alone
13 ever. She knows she is never supposed to answer the door ever.
14 When the door bell rings, she will call me and she will be very
15 concerned; or if I give her an instruction like if there is a
16 pie in the oven and I turned the timer bell on and I say call
17 me when the bell rings, I am going to go to the computer, call
18 me when the bell rings. I came back from the computer and the
19 smell of burning pie was in there and I said, why didn't you
20 call me? Well, I didn't know what bell you meant.
21 As Dr. Cladel said, Elise interprets things
22 differently and has to be with an adult and have an adult
23 within earshot all the time, just all the time.
24 Q As Dr. Cladel testified, Elise resides at home with
25 you and your husband?
19
the lid on the mayonnaise. These are things Elise can't do for
2 herself.
3 Q You described Elise's income to some extent, does
4 she have finances beyond that?
5 A No, she does not.
6 Q Can you describe Elise's ability to manage her
7 financial assets?
g A She does not understand money. Dr. Cladel
9 explained that she doesn't understand -- her lack of
10 understanding numbers is very profound and hard to explain the
11 depth of it. For years she cried when it got dark in the
12 winter because she thought she would have to go to bed. She
13 doesn't really get that time is not elastic. Similarly, she
14 doesn't get that money has real fixed amounts that they go with
15 things, it is hard to explain how much she doesn't understand
16 money.
1~ She first was estimating that a can of soup would
18 cost $10. If you told her that a can of soup costs a hundred
19 dollars, she would have said okay. She would never say that
20 can't be right, a can of soup can't be a hundred dollars.
21 Q Do you have any fear that she might, without some
22 supervision or guardianship services, she might become the
23 victim of designing persons?
24 A This is a constant fear and we have asked them to
25 work with her at school. So now because they have been working
21
with her, when a TV commercial comes on she will say, that must
2 be a scam, that must be a scam. Because they are practicing at
3 school, the TV commercial must be a scam.
4 Not every commercial is a scam, some are offering
5 services, and I try to differentiate what TV commercial might
6 not be a scam. But it is very hard because now that she knows
7 that a TV commercial might be a scam, things are very concrete
8 for Elise and now she will not be able to differentiate.
g She doesn't know that if somebody was nice and
10 said, Elise, we all sign here and get a stuffed animal, she
11 would sign.
12 If somebody said, oh, I have a neat shampoo, give
13 me your lunch money and I will buy it for you and then they
14 came back and said, $20 and I will get it for you, of course,
15 she will give it to them, she doesn't know. She doesn't know
16 what should be $20 or a hundred or a thousand, she has no idea.
l~ Q Can you describe Elise's ability to manage her
18 physical well being, any medical needs she might have?
19 A She has a very hard time with that. We work very
20 hard with that. If she has an itch, for example, or a rash,
21 she feels like when she has put on the cream once, it should be
22 healed. Usually, when you have to put cream on a rash, you
23 have to put it on at least twice a day for a period of a week
24 or so.
25 But if I ask Elise did you put the cream on, if the
22
Wheel of Fortune is on TV, she will tell me, yes, I put the
2 cream on because she doesn't want to get up and put it on
3 because the Wheel of Fortune is on. Even with me helping, it
4 is hard to manage Elise's health, but without me helping, it is
5 impossible because she can't differentiate.
6 She had this huge mole that I happened to see, I
7 wouldn't normally see it because it is underneath the area
8 covered by pants, but we were trying something on, and she used
9 to have a little mole there and it had grown to more than an
10 inch.
11 We took her to the doctor and it turned out there
12 is like this staging thing and like four stages and the last
13 one is skin cancer. It wasn't skin cancer, but it was the last
14 stage before skin cancer.
15 Now a normal child would know if your mole had
16 gotten really big and hairy, irregular and lumpy, that they
17 would want to take it off. Elise didn't catch that.
lg Now she will need regular skin checks, but now she
19 is frightened and showing me these tiny little beauty marks
20 that are not a concern. She doesn't know the difference, so I
21 have to help her manage her anxiety about the things that are
22 not of concern. Just like all TV commercials are a scam, all
23 beauty marks are something to be afraid of.
24 It is extremely difficult to help Elise have
25 caution but not be terrified, that is a lot of work.
23
Q Do you believe that Elise is impaired to such an
2 extent that she is totally unable to care for her physical well
3 being, manage her financial resources, take care of her medical
4 needs?
5 A Yes.
6 Q Did you serve Elise personally with the petition
7 order and citation for this hearing?
g A Yes, I sat down with her and explained what we
9 were -- we looked at it together. I explained what we were
10 going to be doing, she knows what guardianship is and what it
11 would mean. We went over what it said, yes.
12 Q Are you prepared to permanently manage Elise's care
13 to serve as her guardian and to make personal and financial
14 decisions for her benefit?
15 A As long as I am alive.
16 Q Are you familiar with the duties of a guardian and
17 those sorts of requirements?
18 A I reviewed copies of those documents, yes.
19 Q So you are aware that each year annually you will
20 be required to file both a report of Elise's person and of her
21 estate?
22 A Yes, I have copies of both of those reports
23 downloaded into my computer.
24 MS. MULLAUGH: I have nothing further for Ms.
25 Binder.
24
BY THE COURT:
2 Q Ms. Binder did graduate from high school, was she
3 in a regular class?
4 A No, Elise is in an autism support classroom and she
5 continues in that. She will be in that until she is 21. Two
6 afternoons a week she goes to the Center for Industrial
7 Training where she learns prevocational skills.
g It is our hope that after she turns 21, she will go
9 there maybe 30 hours a week or so, so that I -- she will work
10 semi-full-time there and I will work. That will be supportive
11 if she gets waivers from Mental Health Mental Retardation, she
12 would have to get funding from them to be able to go there
13 after she graduates. Right now the school pays for it.
14 But other than those two afternoons a week, she
15 is -- and she takes a regular science class, she is out in
16 regular science. They adapted for her with an aid, an aid goes
17 with her to regular science and they adapted that for her. But
18 other than that, she is in the autism support classroom.
19 Q Has she gotten treatment other than through the
20 school?
21 A Yes, she sees Dr. Cladel. When she was younger, we
22 took her for special therapy and we took her for occupational
23 therapy, sensory integration. They would put her on a swing
24 and put her hand in rice, and she would feel objects and the
25 goal was to help make her more aware of her surroundings.
25
The speech therapy at that time was helping with
2 things like she couldn't drink through a straw, she couldn't
3 figure out how to make her mouth work very well. We would
4 take -- I took her there once a week and I took her to speech
5 therapy once a week and occupational therapy once a week over
6 the hospital that is closed now, Uptown Harrisburg.
~ Then when she started in school, the school had
8 speech therapist and occupational therapists and were providing
9 those services.
10 But Dr. Cladel, at that time we had -- Dr. Barron
11 (phonetic) was seeing her, and we took her briefly to a
12 psychiatrist who was supposed to be an ADHD expert but he was
13 giving her a drug that was making her feel suicidal and we told
14 him and he said give her more of it. We said no, discontinued
15 that and starting seeing Dr. Barron and found Dr. Cladel, who I
16 think you got a feel for how well he understands Elise, he has
17 been very good.
lg We see him usually I would say about as often as
19 once a month when needed, sometimes farther apart than that
20 when she is doing well.
21 THE COURT: Okay. You may step down, thank you.
22 MS. MULLAUGH: I would call Elise's father, Dr.
23 Eric Binder to the stand.
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25
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DR. ERIC BINDER,
2 having been duly sworn, testified as follows:
3 EXAMINATION
4 BY MS. MULLAUGH:
5 Q Good afternoon, Dr. Binder, can you state your full
6 name and address for the Court?
7 A Eric J. Binder, MD, 5264 Strathmore Drive,
8 Mechanicsburg, PA, 17050. I live with Lillie and Elise.
g Q Obviously, you are Elise's father?
10 A Yes, I am.
11 Q Can you describe your educational background and
12 current occupation?
13 A I am an internist with Susquehanna General Medicine
14 Associates. I am boarded and re-certified in the practice of
15 internal medicine.
16 I got my Bachelor of Science, University of
17 Wisconsin of Medicine; I graduated from the University of
18 Guadalajara Medical School. I finished my internal medicine
19 residency at Harrisburg Hospital.
20 Q Would you like to add anything to your wife's
21 testimony about Elise's abilities and deficits?
22 A No, I have nothing to add.
23 Q I know that you help Elise with certain things,
24 certain daily activities, would you describe what those are?
25 A I help -- give Elise her medicine first thing in
27
the morning, get the breakfast going; and then usually when I
2 come home, we have to set the table. So I have to remind Elise
3 to do certain things which she may have forgotten such as put
4 cups on the table or filing water glasses. At the end of the
5 day, giving her evening medicines and supervising how she
6 brushes her teeth.
~ Q Do you believe that Elise is impaired to such an
8 extent that she is totally unable to manage her financial
9 affairs, her physical well being and her medical needs?
10 A Yes, Elise is impaired and does need guardianship.
11 Q So you believe that she is in need of plenary,
12 meaning total guardianship services?
13 A Yes, I do.
14 Q You are not testifying as a medical expert, but do
15 you believe there are less restrictive alternatives to a legal
16 guardianship for Elise?
1~ A No, I think Elise needs total guardianship.
lg Q Are you prepared to permanently manage Elise's care
19 and make personal and financial decisions for her benefit?
20 A I am prepared to take care of Elise totally.
21 MS. MULLAUGH: Thank you. Your Honor.
22 BY THE COURT:
23 Q Are all of the facts in your petition true and
24 correct?
25 A Yes, they are, Your Honor.
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Q Is there any possibility that her medicine is
2 affecting her adversely instead of helping her?
3 A Your Honor, I had trouble hearing the question.
4 Could you please restate that.
5 Q Is there any possibility that her medicine is
6 affecting her adversely instead of helping her?
~ A Honestly, no. I think her medicines are
8 appropriate. We are monitoring her for side effects or
9 something that can cause or has been linked with diabetes. She
10 has recently had fasting blood work done, her cholesterol, her
11 liver functions, glucose, cholesterol are all within normal
12 limits. No, I think her medications are appropriate, they are
13 appropriate.
14 THE COURT: Okay, you may step down, thank you.
15 MS. MULLAUGH: Your Honor, I don't know if you
16 would like to ask Elise any questions.
l~ THE COURT: Yes, I think it would be appropriate if
18 Elise would testify.
19
20 ELISE RACHEL BINDER,
21 having been duly sworn, testified as follows:
22 EXAMINATION
23 BY MS. MULLAUGH:
24 Q Hi, Elise.
25 A Hi.
29
Q How are you?
2 A Good.
3 Q Where would you be today if you weren't here?
4 A I don't know.
5 Q Maybe would you be in school?
6 A Yeah.
~ Q What do you in school?
g A We do stuff like CBI which is a community based
9 instruction. We do stuff like reading, science, all the basic
10 stuff. I am currently in a very cool anatomy class that I
11 really like. Reading, we are doing things like we are reading
12 a library book. Ms. Heartdale (phonetic), my teacher, is
13 reading to me and Doreen. We are allowed a book, a fancy book
14 we both agree on it, it is called the Warrior Heir. We do
15 stuff like science, earth science, stuff like that.
16 Q You live at home with your parents, correct?
l~ A Yeah.
lg Q I understand you have a new addition to the family,
19 right?
20 A You mean pets? Yes, Leo.
21 Q Tell me about Leo?
22 A He a collie who is -- we adopted him. He is really
23 cute. He has an attitude of ice cream, he is really sweet. He
24 likes to lick. If you sit on the floor, he will sit on your
25 lap and he is really sweet.
30
Q Do you help take care of him?
2 A Yes, I think.
3 Q What do you do to take care of him?
A I throw the toys and stuff. I like to, you know,
4
5 stuff like that. For Abby, what I do is take acorns and put
6 them in a bag and two bags equals a pack of Pokeman cards and
7 there is like -- because if Abby eats them, she will get sick,
8 so it helps mommy and daddy financially and for the dogs.
g Q So Abby is another dog?
10 A Yes.
11 Q So if you didn't pick up the acorns, she would go
12 around the yard and eat the acorns?
13 A Yeah, and sometimes mommy has to scoop them out
14 with her hand.
15 Q What else do you like to do at home?
16 A Play my Nintendo DS, play Wii. Watch TV and read
17 and draw and stuff.
18 Q Do you go to work sometimes?
19 A Yeah, VIP.
20 Q What do you do there?
21 A We put like coupons that might say $2 off a can of
22 Lysol and put them on the lid, the spray part. There might be
23 six in a box, so we put them in there and then we put like a
24 sticker on the box and then we take the box over and put it on
25 there and then it goes over to this person who is like a
31
checker to see if they are all in good condition. Then they
2 put it through the tape machine and we put it on a skid.
3 Q Do you get paid?
4 A Uh-huh.
5 Q Do you know how much you get paid?
5 A There is a formula that depends on how many boxes
7 we do. I don't think it deals on the time, it deals on how
8 many you do. I don't really know exactly but I know that as
9 much as I told you because people told me.
10 Q Your mother said that she discussed this hearing
11 with you, this guardianship hearing. Do you understand what
12 guardianship --
13 A Yeah, uh-huh.
14 Q Would you tell me in your own words?
15 A It means that somebody will be there when I am a
16 grownup to help me which I fully appreciate.
l~ Q Do you want to live alone?
lg A No, not really because it would be lonely and also
19 if somebody would come along and say -- if you sign here, you
20 will get like a couple of stuffed animals and if it was a scam,
21 I wouldn't know. I am really grateful for that, for that
22 guardianship.
23 MS. MULLAUGH: Your Honor, would you like to ask
24 any questions?
25 BY THE COURT:
32
Q You understand you would lose certain rights, you
2 wouldn't be able to vote?
3 A I understand.
4 Q You understand?
5 A Yeah, and I appreciate that because I don't
6 understand.
~ Q You make a very good impression. Anything else you
8 wanted to say?
g A No, not really.
10 THE COURT: Okay, you may step down, thank you.
11 THE WITNESS: Okay, you are welcome.
12 MS. MULLAUGH: Your Honor, I have nothing further
13 but we would ask that Elise Binder be declared totally
14 incapacitated; and that her parents, Lillie Binder and Eric
15 Binder, be appointed as plenary guardians of both her estate
16 and her person.
1~ THE COURT: This is a little bit troubling. I
18 don't doubt at all that you have Elise's best interest at heart
19 and I know that you see things that I don't, obviously, but she
20 makes just a wonderful impression.
21 Her handicap to the extent that she has one is
22 rather -- it is not obvious; but I will go along with the
23 order, but I think I will put a time period on it so that we
24 review the case in six months.
25 Maybe there will be some advances in treatment of
33
autism during that period. It can always be reversed and you
2 can always change it and that may be what happens.
3 I will ask counsel to contact my secretary so that
4 we can put it on the list again for another sort of update
5 hearing. I am certainly not going to require a bond in this
6 case.
~ We will enter the order that was proposed, I won't
8 read it verbatim, but I am going to take out any requirement
9 that there be a bond and I will add to the order that this will
10 be reviewed in six months. You will need to contact my
11 secretary because I wouldn't remember. I have a worse memory
12 than Ms. Binder does I assure you.
13 MS. MULLAUGH: I will put it on my calender, but
14 you would like 6 months as opposed to maybe a longer period of
15 time?
16 THE COURT: Well, I will make it 9 months if you
17 want, but I would like to see Elise again, see how she is
18 doing. Court is adjourned.
19 You are excused.
20
21
22
23
24
25
34
ERTIFICATION
I hereby certify that the proceedings are contained
fully and accurately in the notes taken by me on the above
cause and that this is a correct transcript of same.
~~ '`mac "~ f' ~ G` ~ ~ ~ C2 ~ ~ ~- .
` f ~ ~_ . ~
Patricia C. Barrett
Official Stenographer
The foregoing record of the proceedings on the
hearing of the within matter is hereby approved and directed to
be filed.
~,z, ~.Zi~16
Dat
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