The man convicted in the Capital Gazette murders fell off the radar of the psychiatrist at the Anne Arundel County jail, who was convinced the gunman didn’t need mental health care, the doctor said in court Thursday.
Prosecutors and defense attorneys argued Thursday about the weight Dr. Andrea Adiaconetei’s observations about the man who fatally shot Gerald Fischman, Rob Hiaasen, John McNamara, Rebecca Smith and Wendi Winters should carry when the gunman stands trial in June. It was the first of two court hearings remaining before the sanity trial is slated to begin with jury selection June 23.
In the process, the lawyers revealed new details about Jarrod Ramos’ almost three years in custody and foreshadowed how each side will interpret information about his time behind bars. The debate cut to the heart of what remains to be decided in his case: Whether he was sane at the time of the attack and will spend the rest of his life in prison or whether he was insane during the mass shooting and is committed indefinitely to a state psychiatric facility.
Ramos, 41, has pleaded guilty to the murders but maintains he was not criminally responsible by reason of insanity. He asked for a jury to decide his fate. At the trial in June, it’ll be up to his lawyers to prove by a preponderance of the evidence — a lower standard of proof than a guilt-innocence trial — that, because of a mental condition, he couldn’t understand his actions were illegal or could not prevent himself from breaking the law.
Almost three years ago, he arrived at the Jennifer Road Detention Center in the early hours of June 29, 2018, the morning after he blasted into the Annapolis office with a shotgun and shocked the close-knit community. According to Adiaconetei’s testimony, Ramos underwent some intake evaluations, including one about his mental health, and was immediately put on suicide prevention — a precaution for anyone charged with a horrific crime, she said.
Ramos has spent much of his incarceration in a special, isolated unit that features only seven cells. Inside, detainees awaiting trial are under lockdown for 23 hours a day. Adiaconetei testified he also spent time on her unit, the mental health ward, as a precaution.
Another doctor performed the intake evaluation. Adiaconetei, the lone psychiatrist employed at the detention center and the person in charge of overseeing the facility’s mental health unit, said she saw Ramos a handful of times between July and December of 2019. She said he answered her questions promptly but wasn’t talkative.
“I’m OK. I don’t need you,” Adiaconetei recalled Ramos saying. “If I need you, I will call.”
Her team of nurses and correctional officers with mental health training would continue to monitor him for a few months. The staff looks for the inmate’s ability to conduct daily activities, Adiaconetei said, and she was impressed by the way he kept his cell clean and that he was reading materials available to him. She took notes during their meetings and read reports from her staff but ultimately determined he didn’t need treatment or medication.
Then, she said, he fell off her radar.
“To be honest,” Adiaconetei testified Thursday, “I didn’t even know he was still with us.”
Prosecutors argued that statement was key evidence refuting Ramos’ insanity defense. They contend that Adiaconetei’s observations and her interpretation of them should serve as part of the foundation for the testimony and opinion of Dr. Gregory Saathoff, the forensic psychiatrist prosecutors hired to investigate Ramos’ mental health. Saathoff believes Ramos was sane when he attacked the Capital Gazette, which is part of Baltimore Sun Media.
How could someone be so mentally ill and not alarm the jail’s mental health staff, State’s Attorney Anne Colt Leitess argued. Adiaconetei testified that she had observed no signs Ramos had Autism Spectrum Disorder, the key diagnosis from the psychiatrist Ramos’ attorneys hired to evaluate an insanity defense, Dr. Dorothy Otnow Lewis. Leitess acknowledged Lewis had cited additional diagnoses in coming to her conclusion that Ramos is insane.
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Ramos’ lawyers looked at Adiaconetei’s statement in a different light. They said it showed how little time the doctor had actually spent with their client, that she lacked the necessary data to render a medical opinion about him and that the prosecution’s expert, Saathoff, shouldn’t be able to cite her psychiatric opinions — only the things she noted in her few interactions with Ramos.
Public Defender Elizabeth Palan noted that Adiaconetei, who also evaluates children for the state’s Department of Juvenile Services and is a licensed child psychiatrist, explained that diagnosing somebody with some form of autism requires spending a lot of time with them and how they interacted with others. If Adiaconetei didn’t even know Ramos was there for the last year, how could she be so sure he didn’t have autism or a mental health disorder, Palan argued.
Palan also pushed back on Adiaconetei’s assessment of Ramos’ intake report, which the doctor had described as “very mild.” Palan read excerpts from the report prepared by the intake doctor, who noted that Ramos was “very blank during intake,” “incredibly suspicious” and “cooperative to a certain degree, but very deliberate” about what he disclosed.
Someone who doesn’t want treatment or medication could be suffering from a mental condition, Palan said. She also pointed to Adiaconetei’s notes from a meeting with Ramos where the doctor wrote he was suspicious and paranoid.
Circuit Judge Michael Wachs ruled Adiaconetei couldn’t testify as an expert witness about psychiatry and that Saathoff couldn’t rely on her expertise, only her observations. Wachs acknowledged that most of the information that would come through her testimony as an expert was likely to make its way to the jury in different forms, like the medical reports from jail and nurses status notes.
Saathoff is expected to appear in court Friday during a hearing where the defense attorneys will try to limit further his testimony at the forthcoming trial.