Reasonable doubt met reasonable certainty as the standards of lawyers and doctors clashed Friday in the federal trial of a former Haysville physician and his wife.
As a criminal defense lawyer, Lawrence Williamson pursues "reasonable doubt" in the charges against a client.
As a pathologist, Jaime Oeberst reaches decisions based on a "reasonable degree of medical certainty."
Under reasonable certainty, Oeberst determined 31 people died from overdosing on mixtures of prescription drugs.
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Trying to raise reasonable doubt, Williamson spent most of Friday questioning Oeberst on a myriad of other medical conditions present when those people died.
Prosecutors are trying to tie the deaths of the patients to Stephen Schneider, a doctor whose family medical practice was managed by his wife, Linda. The couple is charged with illegally prescribing painkillers.
Many of the patients had serious heart disease, Oeberst told Williamson on cross-examination. Some abused illegal street drugs, including marijuana and methamphetamine.
One woman had no prescription drugs in her system at all. She died of a cocaine overdose.
"Can you even tell us why this case is before the jury?" Williamson asked of the cocaine overdose.
"It was one of the cases I was asked to bring," said Oeberst, who was called as a witness for the prosecution.
The defense contends that Schneider, as a doctor, shouldn't be held responsible if his patients mixed prescriptions with illegal drugs or didn't take them as directed.
Williamson repeated questions for each autopsy so often, Oeberst at times answered before the lawyer finished.
"The levels you found... "Williamson began.
"Is inconsistent with her prescribed dose," Oeberst said.
Oeberst repeatedly said the medical conditions and overdoses aren't exclusive.
If a person has a heart condition, Oeberst said, taking large doses of prescription drugs could put them in cardiac arrest. But it's a heart attack that might not have killed someone had he or she not overdosed.
Oeberst listed the drug overdoses as the primary cause of death on most people. The other conditions, such as heart disease, were contributing factors, the doctor testified.
Williamson, however, pointed out that many of the patients didn't receive prescriptions from Schneider.
Deborah Johnson, another medical examiner from Sedgwick County, testified about one man who died of "acute mixed drug intoxication."
The man had high doses of methadone and Ativan in his system, Johnson testified, and died after a relative found him passed out in his car. But Schneider didn't prescribe the methadone, Johnson said.
"To our knowledge, it wasn't prescribed by anybody," she testified of the methadone.
Johnson added that the man's wife said she suspected her husband obtained the narcotic from a friend.
Oeberst testified another man had five back surgeries and suffered from a heart condition. He received multiple prescriptions from several different doctors.
Most of the patients were also treated by, or received prescriptions from, health care providers who worked at the Schneider Medical Clinic.
All the deaths are charged against Stephen Schneider.
After asking about the details in dozens of autopsies, Williamson told Oeberst, "I think we're down to our last record."
Then Williamson looked at the jurors and smiled.
"No clapping?" he asked.