Thursday, April 19, 2007

Understanding Levicy

At the Liestoppers forum, SANE nurse Kethra posted a long and highly informative item critiquing the performance of SANE nurse-in-training Tara Levicy. Below are quotes from the relevant sections of Kethra's post.
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Tara Levicy was acting as a SANE under the specific direction of Dr. Julie Manly, a fourth-year resident. Both Dr. Manly and Tara Levicy performed a “general physical” examination and documented the results with Dr. Manly doing the vaginal exam and collection portion of the forensic collection. Both found no trauma. The statement Ms. Levicy gave to Sgt. Gottlieb on March 21, 2006 runs contrary to all physical findings:

“I asked her if the exam was consistent with blunt force trauma, and she replied, ‘Yes,’" Sergeant Gottlieb wrote in the notes of his March 21 interview with the nurse. “She stated the victim had edema and tenderness to palpitation both anally and especially vaginally. She stated it was so painful for the victim to have the speculum inserted vaginally that it took an extended period of time to insert same to conduct an examination. I asked her if the blunt force trauma was consistent with the sexual assault that was alleged by the victim. She stated the trauma was consistent with the victim’s allegation.” (Gottlieb’s notes).

The first inherent problem with this statement is that it is given in the first person. That means it looks like Ms. Levicy is speaking as if she did the exam rather than simply watch which we now know is exactly what occurred. However, Ms. Levicy did not disabuse the police of that notion. The second was Ms. Levicy’s inaccurate portrayal of the “extended” vaginal exam. We shall revisit that shortly. The third was the outright lie of blunt force trauma as the record will indicate.

The ONLY part of the SANE that Ms. Levicy was directly responsible for was the clothing collection (done wrong) and the oral swabs as well as the head to toe visual examination. (SANE document) Everything else was performed by Dr. Manly. Yet Ms. Levicy puts herself forth as the person who did the exams. Instead of saying something like “in observing Dr. Manly’s exam, I noted,” she instead makes statements that leave her appearing to be the examiner. This, as any RN will tell you, is very unprofessional and is in fact professional misrepresentation.

Dr. Manly met with the defense in October of 2006. She stated to the defense that NO ONE from the District Attorney’s office OR the DPD had spoken to her as of yet. This is no surprise given Ms. Levicy’s representation to the police of her being the examiner (and Nifong’s incompetence). It is in this interview we find out from Dr. Manly that she had seen a white exudate vaginally and just “assumes” its semen (she forgets to document this small fact however). It is also in that series of interviews she comes up with the alternative explanation from “semen” to a “yeast infection.” The facts are this, a yeast infection is incredibly common, VERY easy to diagnose (even a nurse can figure it out ) and for a Physician who supposedly has done “hundreds” of pelvic exams to mistake a vaginal discharge from yeast as semen is just stunning. The two substances look nothing alike, they smell nothing alike and if Dr. Manly was unsure, then she should have done the fast test for yeast which was not done nor did she employ a wood’s lamp which would have fluoresced semen but not yeast. At the very LEAST a woods lamp should have been employed (semen, fibers, urine and other substances fluoresces under a woods lamp) Needless to say, the slides Dr. Manly produced would have shown nothing but yeast had this gone to trial . . .

Dr. Manly also remembered that the “patient was screaming and resisting the vaginal exam in such an extreme fashion that the vaginal portion took an hour to complete.” This behavior by Crystal Mangum was in direct contradiction to the level of non-injury found. She put on a good show for the examiners needless to say.

Dr. Manly goes on to state, “Mangum was different in several ways. Most rape victims are withdrawn and quiet but cooperative. Mangum, on the other hand, called attention to herself by screaming; Manly had never seen that behavior before, she told defense lawyer Doug Kingsbery in October. Amazingly, Dr. Manly makes no note of the out of character behavior or her observations of that behavior in the formal record as far as I can tell at this time. I would wholly agree with Dr. Manly’s assessment of the normal demeanor of rape victims with one caveat, I have seen screaming behavior but that is from a truly badly injured victim (vaginal/anal tearing) and ONLY before pain meds are offered. None of the findings from the exam support this behavior.

The important part of the above is that Dr. Manly alone is responsible for the vaginal exam and Dr. Manly made ONE notation on the SANE paperwork that being “diffuse edema of the vaginal walls.” Dr. Manly did not make a note as to patient demeanor nor to the extended amount of time the vaginal exam too OR to the finding of a “white exudate.” Dr. Manly did sign the SANE as having participated but Tara Levicy signed the SANE as the examiner. In interviews with the DPD she took credit for Dr. Manly’s examination and in interviews with the DPD did nothing to disabuse them of the notion she was wholly responsible for the exam. These statements were rightfully attributed to Ms. Levicy by the DPD based on what she was quoted as saying, when in fact it was the Physician’s note and examination that she was claiming as her own work.

Ms. Levicy committed on the worst acts an RN and a SANE can commit—that of injecting her opinions and beliefs onto the patient and into the case. Ms. Levicy stepped out of her required role as an impassionate forensic examiner and into the role of a feminist with an agenda. She made stated conclusions not based on an evidence based practice, but instead based on her own personal agenda and skewed world view. No where in the SANE exam or the medical examinations that occurred was there any evidence to support Ms. Levicy’s statements of “Signs consistent with sexual assault during her test.”

There was no evidence to support her statements to Gottlieb on March 21, “I asked her if the exam was consistent with blunt force trauma, and she replied, ‘Yes.’” “She stated the victim had edema and tenderness to palpitation both anally and especially vaginally. She stated it was so painful for the victim to have the speculum inserted vaginally that it took an extended period of time to insert same to conduct an examination. I asked her if the blunt force trauma was consistent with the sexual assault that was alleged by the victim. She stated the trauma was consistent with the victim’s allegation.”

Nor did the evidence support her statements made on January 10, 2007: “Ms. Levicy stated she asked if condoms were used and Ms. Mangum said ‘no’ but wasn’t really sure. Ms. Levicy stated that it was her opinion as a [sexual assault nurse examiner] that ‘victims can never be sure if condoms are used because if they can’t see them how would they know for sure. You can’t feel them so you have to realize there is always a possibility that a condom could have been used.’” Even her own documentation denied this claim.

Instead ALL physical examination documented, directly contradicts these ongoing claims made by Ms. Levicy. Incredibly enough, Ms. Levicy herself notes in the systems examination portion of the SANE “Head, back neck, chest, breasts, nose, throat, abdomen and upper and lower extremities were all “normal” and in the Pelvic Examination portion of the SANE Ms. Levicy writes “Diffuse edema of the vaginal walls” (echoing the actual Physicians findings since she did NOT do the vaginal exam) and recorded “nothing notable” in the subsection for the anal exam.

In DIRECT contradiction to not only her own notes, but those of Dr. Manly and other Physicians and nurses that examined Crystal Mangum, she begins telling her “she was raped” conclusion to DPD. She not only was inaccurate as a forensic examiner but she was untruthful. There is no documentation that supports her claims of “the victim had edema and tenderness to palpitation both anally and especially vaginally” (Gottlieb notes) other than Crystal Magnums’ hour long display of hysterics for the Physician which interestingly is NOT noted in Levicy’s documentation. It is somewhat beyond me that a patient could present like this and the SANE documentation indicate “nothing notable” . . .

Ms. Levicy continues this interjection of personal beliefs into the case as late as January 10 of this year when she is interviewed by Mr. Wilson. In this interview she changes her story, negating her very own documentation “Ms. Levicy stated she asked if condoms were used and Ms. Mangum said ‘no’ but wasn’t really sure (the SANE does not reflect a “wasn’t sure” statement by Ms. Mangum. Ms. Mangum states NO). Ms. Levicy stated that it was her opinion as a [sexual assault nurse examiner] that ‘victims can never be sure if condoms are used because if they can’t see them how would they know for sure. You can’t feel them so you have to realize there is always a possibility that a condom could have been used” She also tows the feminist line of “I wasn’t surprised when I heard no DNA was found because rape is not about passion or ejaculation but about power.” While this statement is true about finding semen and it is true about what rape is, it is not true about DNA. This shows Ms. Levicy’s glaring ignorance of forensics and the most basic of science facts. To add to her own presentation of just how ignorant of basics she is, she calls Mr. Wilson back a few days later and states “A few days later, Levicy called Wilson with second thoughts. She wanted to clarify her statement about rape and power. “Ms. Levicy stated that there are numerous reason [sic] why semen is not found in a victim and include: 1) condoms were used; 2) No ejaculation; 3) It didn’t happen.”

Someone with a modicum of intelligence must have spoken to Ms. Levicy and basically told her the basic facts that she apparently slept through in Nursing 101.

Ms. Levicy, in her zeal to be a big bad forensic nurse, misrepresented to lay persons the true facts in this case. The police depend on us as forensic nurses to give them accurate information with impassionate observation. If you, in a haze of egotistical stupidity, misrepresent the facts and observations to the police, the police believe you. They have to believe us, we are their experts, and we are their teachers and most of all we are their translators. We as SANE nurses translate the medical gobbledygook into plain understandable English. These men and women are NOT medical professionals and depend on us WHOLLY to give the facts and just the facts, ma’am, to them. If we lie, misrepresent, embroider, expand or expound we mislead them and they go down the primrose lane blindfolded.

In Closing:

Ms. Levicy’s actions were unconscionable, unprofessional and the inherent sign of an incredibly biased person and nurse. She alone, is responsible for the start of this witch hunt in my opinion. By not telling the actual facts, by misrepresenting to the police the signs and symptoms of a rape victim, by “embroidering “the true patient findings and historical story, by her sheer ignorance of appropriate forensic evidence collection technique, her sheer ignorance of basic pathophysiology, her sheer ignorance of general medical conditions and the identification of those conditions and by her glaring egotistical need to portray herself as an expert, she sent the police down the trail of deception. Combine that with a rogue prosecutor and shoddy police work (didn’t they read the stupid medical reports for themselves?) she almost put 3 innocent men in jail.

I have no doubt now that she made those statements to the police and as irritated as I am with Sgt. Gottlieb, I have no doubt she made those statements as well given her continued performance as late as January 10, 2007. This nurse needs to turn in her license and stop “helping” sexual assault victims. Until she can learn compassionate investigation, dispassionate factual statements and the difference between right and wrong, she should have no part in nursing. I am guessing she missed the required ethics portion of Nursing School.

220 comments:

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Anonymous said...

If you have a complaint about a registered nurse in the state of North Carolina go here and do that.

http://www.ncbon.com/Complaint.asp

This is the complaint process of the NC Board of Nursing

http://www.ncbon.com/Complaint.asp

Anonymous said...

Try this link too

http://www.ncbon.com/Contact.asp

Anonymous said...

http://www.ncbon.com/Discipline.asp

Active Investigations/actions

Anonymous said...

If you believe it is a good thing (while posing as a licensed nurse) to publish here anonymous criticism of a licensed professional nurse based on the word of Linwood Wilson
Ask yourself:
1. Will my anonymous attacks increase the body of knowledge on the subject?
2. Will the public favorably weigh my statements as an anonymous critic?
3. Will my statements improve patient care?
4. Are my arguments presented in a professional manner?
5. Does it feel good to attack someone from the cover of anonymity?

Quick review: How do we know Kethra is a registered nurse? Kethra said so. How do you know Universe Nurse is a registered nurse? Because I said so.

I submit to you, as an anonymous licensed professional nurse, that the anonymous critic cannot answer affirmatively to any question but 5.

5 is where all of the anonymous critics are coming from - including UNIVERSE NURSE, of course.

We belong in the comments gallery not in the spot light spewing from where position itself can bestow a shade of legitimacy to the uninformed.

Anonymous said...

Goggled Wilderness Emergency Medical Technician - Levicy name comes up with certification. In my view this kills the opinion that she was a newbie nurse overtaken by events and ego. I think we have all seen the EMTs in action. This is no small achievement. As far as the unprofessional attacks made on this nurse by Ketha and Kathleen - Well - what goes around does often come around. An apology is not enough.

Anonymous said...

To 12:25
If Levicy was not, in fact, inexperienced, then there is no excuse for her misleading, mischeif-making hallway conversations with the cops.
One really cannot have it both ways.

Anonymous said...

Those cops were Gottlieb and later Wilson. Both of whom have LIED about everything else. You can't have it both ways either.

Anonymous said...

Don't forget to complain about Doc Manly to the Doctor Board. She did make that diagnosis of vaginal swelling and messed up the yeast infection diagnosis.

Anonymous said...

To 1:38
Did Levicy have misleading and mischief-making conversations in the hallway with cops? I was not there; neither were you. However, her comments in Jan. 07 suggests that she was still taking a position in favor of the bogus victim(CGM) here.
Were the cop-sources of this story lie-ing altogether? It is hard to know for sure sitting as I am at my computer screen at a great distance away in terms of time and space.
The actual trials - aimed at the real perps - do seem to be imminent and might drag a lot of the main truths into the light.

Anonymous said...

We belong is the comments gallery not in the spotlight spewing from where position itself can bestow a shade of legimitacy to the uninformed. BEARS REPEATING

Anonymous said...

No, I was not there: however, everything I have read about Gottlieb and Wilson indicates they are liars. Is this different from what you understand of them?

Anonymous said...

Perhaps Levicy could produce her own version of Vagina Monologues starring Crystal Mangum:

Crystal Mangum's VAGINA MONOLOGUES:

Secrets are not safe inside these walls

I am any man's and every man's port in the storm

Garage open 24/7; Parking: $800/hr

Live sperm tell no tales

CGM DNA FBI CIA

My vagina can live for me, it can breathe for me, it can LIE for me

JUST (can't) SAY NO

If it was rape, I couldn’t tell

My vagina is my tool of empowerment, not my brain

My vagina has a voice; did you hear it?

Free speech for my free vagina

Anonymous said...

"I DISAGREE WITH EVERY WORD YOU HAVE SAID, BUT WILL DEFEND TO THE DEATH YOUR RIGHT TO SAY IT"? Beware of those who want to silence free speach

Anonymous said...

1:00pm

And we don't want to silence free "speech" either.

Anonymous said...

Oh dear. Another typo, which of course is what is really important in the post.

Anonymous said...

Cash wrrites on TL that it was the Durham authories and Nifongs statements that made this look like a rape - incensed the community.

M. Simon said...

gp Apr 19, 2007 2:02:00 PM,

Who is in the torturable class? It never changes. Here is what Graham Greene has to say about it in his novel of the cold war "Our Man In Havana":

"The poor in my own country, in any Latin American country. The poor of Central Europe and the Orient. Of course in your welfare states you have no poor, so you are untorturable. In Cuba the police can deal as harshly as they like with emigres from Latin America and the Baltic States, but not with visitors from your country or Scandinavia. It is an instinctive matter on both sides. Catholics are more torturable than Protestants, just as they are more criminal.

The Biggest Cover Up Of All

M. Simon said...

"There is a difference between possibly using poor judgement, or even having a bias and failing to follow procedures or being legally liable for some kind of damages."

===================

Generally: Failing to follow procedures makes one legally liable if the procedures would have resulted in a different outcome.

If I send up an untested piece of software or hardware on a commercial aircraft and there are requirements for tests (there are) then I'm liable.

The really good engineers will try to figure out tests that will test the system in ways not normally done in the usual course of testing. Like data inputs well outside the range of possibility.

Not only that but according to the rules if I'm not authorized to sign off on a test I can't. Even if I conducted the test personally.

M. Simon said...

Georgia Girl said...

Physically "getting it up" is not nearly as important as "pretending to get it up" for the sake of the brotherhood. Surely, you must know that!

I believe you are a woman and an orgasm faker.

However, being of the male persusion myself, I can tell you that erections are hard to fake.

OTOH we men do have our bag limit.

Some men will do it with a woman who requires one bag to cover their ugliness. Some two. A few three.

However, there is a four bag limit.

CGM is a five bagger even without personality considerations.

Attraction (erections - even faked erections) to four baggers will lose a man a lot of status. In a man's world getting it up for some skank (barring a romantic connection) is considered very uncool.

May I suggest you spend some time with real men (who will tell you the truth rather than parrot PC tripe to keep in your good graces) rather than letting your PC fantasies run wild?

My mate and I have an excellent relationship re: this subject. She is frequently amazed (less so these days) that what she thinks and what I report are so far off.

M. Simon said...

My take on the yeast dischage.

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