New information on what killed Ethan Stacy

Posted at 9:38 AM, Mar 29, 2013

UPDATE 8:46 p.m.: Outside of court, Nathan Sloop's defense attorneys said that while they dispute some of the facts about Ethan Stacy's death, they did not dispute what happened after his death.

"The dysfunction that occurred afterwards is undeniable," defense lawyer Scott Williams said. "We stipulated to it at the start of the preliminary hearings."

Asked if there was still a chance for a plea deal, Williams told FOX 13 they remain open to the idea.

"We believe a resolution in the case is always a possibility. This is just a step that is necessary, maybe toward such an end," he said.

UPDATE 4:57 p.m.: Supporters of Ethan Stacy and his family left the courthouse, somber after hearing three days of gruesome testimony in the case.

Anissa Martinez of the group "Ethan's Army," said she had been in contact with Ethan's father, Joe Stacy, in Virginia. She said he has been following some accounts of the preliminary hearing but it has been difficult for him.

"Very hard. Very hard. He's seen some of the media, but not all of it. His wife Becky kind of gives him the highlights so that… it's hard. It's really hard on him," she told FOX 13.

UPDATE 3:47 p.m.: Prosecutors asked a few more questions of Dr. David Andrenyak, the toxicologist who analyzed the Ethan Stacy case.

Andrenyak said he did not believe Benadryl should be used to help a child who had a serious injury, such as Ethan's burns.

"Stephanie Sloop bought cherry Benadryl on May 5, 2010," deputy Davis County Attorney David Cole said. "(Defense) counsel was concerned that had been recalled… is there a children's Benadryl that had been recalled? Does the product number match the product number that was recalled?"

"No it does not," Andrenyak said.

"So the council's concern that it was recalled is unfounded," Cole said, finishing his questioning.

Prosecutors said they would return on April 19 for further witness testimony.

UPDATE 2:51 p.m.: Dr. David Andrenyak, the assistant director of the Center of Human Toxicology at the University of Utah, is on the witness stand.

Deputy Davis County Attorney David Cole asked about alcohol being found in Ethan Stacy's body. It can happen because of fermentation with the body as it decomposes, Andrenyak testified.

Other drugs were found in Ethan's body, including children's pain reliever and Xanax. Stephanie Sloop did not have a prescription for Xanax, Andrenyak testified. It is also not supported for use in children under the age 18.

"It has a calming effect, it reduces anxiety. If people take higher amounts of it, it could create a depression of central nervous system functions," Andrenyak told the court.

"In higher does it depress respiration?" Cole asked.

"In very high doses it probably depresses respiration," he replied.

Asked how much Xanax was found in Ethan Stacy, Andrenyak said it was a normal, adult sized dose.

"I don't think it's a safe amount for a child," he said. "It may be that children are more sensitive to these drugs. But I can't say for sure that concentration would make a person have a severe reaction to these types of drugs."

Ethan Stacy also had a lot of antihistamines in his system, the toxicologist testified, specifically diphenhydramine (Benadryl).

"It does produce drowsiness and a depression of the central nervous system," Andrenyak told the court.

The concentrations of drugs found in Ethan's body were higher than what an adult would take, he said.

"Would any one of these medications at the level you saw have killed Ethan?" Cole asked.

"There was no one single drug detected in the blood samples where the concentration was high enough to say it was a clear-cut drug overdose," Andrenyak said.

The toxicologist testified the fact that children can be more sensitive to drugs, and the fact that he had been burned and had blunt force trauma injury, and was not eating, it can combine to make the drugs contribute to his serious medical condition.

"Perhaps the combination of the drugs," he said. "But there's also some serious medical problems with Ethan and these drugs could have contributed to his death."

Under cross-examination, Nathan Sloop's defense attorney Richard Mauro asked about the drugs Nathan was on and if they would impair his ability to answer questions.

"It would perhaps affect maybe a person's ability in terms of putting together some information and integrating their thoughts," he said.

Asked about the 4,146 pills Nathan Sloop had been prescribed in the 11-month period leading up to Ethan Stacy's death, Andrenyak said:

"I would say that person definitely has a lot of medications. A LOT of medications," he said, later adding: "You wonder how a person is functioning under these medications."

Andrenyak suggested the physicians were likely doing what they could to mitigate pain.

Mauro turned to the drugs in Ethan's system, asking a number of detailed questions about their safety and effects. He asked about medications that would help someone with allergies, or whether they could exacerbate things.

UPDATE 11:25 a.m.: Defense attorney Scott Williams continued his cross-examination of deputy chief medical examiner Dr. Edward Leis.

Williams asked about the levels of drugs in Ethan's system -- various forms of cold and pain-relief medicine. Williams noted that some of the drugs given to Ethan Stacy were recalled a month after he died because there was no proper dosage recommendations.

"I'm not aware of that," Leis said.

Affects of the medicine could be dehydration, Williams said.

"Their side-effects could exacerbate other conditions that are going on," Leis said.

Williams wondered if the drugs administered to help the child could have harmed him.

Williams then asked about Xanax being found in Ethan's system.

"Of course you don't have any idea how that got into the blood stream of Ethan Stacy, other than it got ingested somehow," Williams said.

"Correct," Leis said.

Williams asked if he could say how much of the dosage was given. The medical examiner could not say.

Williams wrapped up his line of questioning by asking why Ethan Stacy's death was declared a "homicide." Leis said it was for statistical purposes.

"So homicide for you is a medical term not a legal term?" Williams asked.

"Yes," Leis said.

Wrapping up his questioning, Williams said ultimately, there was a child who died from being sick and the drugs he was given contributed to his death.

Dr. Leis was excused.

UPDATE 10:46 a.m.: Dr. Edward Leis, the deputy chief medical examiner, is testifying about the autopsy he performed on Ethan Stacy.

"I certified the combined effects drug toxicity, scalding injuries and aspiration pneumonia," Leis said of the official cause of death.

He ruled Ethan's death a "homicide," and noted the damage to Ethan's face from a hammer.

Autopsy photos were shown to the judge after Ethan was removed from the plastic bag.

Deputy Davis County Attorney David Cole asked about how Ethan got the burns on his leg.

"The location would be consistent with exposure to hot water," Leis said, noting that there is no scalding on the knees -- suggesting his knees were drawn up higher than the water.

Leis said the injuries suggest the child did not step into a tub of hot water.

"If he stepped in there, I wouldn't suspect the soles of his feet would be so badly injured," Leis said.

Leis also testified that it doesn't support the water suddenly turning hot.

"They were all second and third-degree burns," he said.

Leis testified that Ethan Stacy was dehydrated from body fluid loss as a result of the scalding burns.

"Is it your views these scalding injuries contributed to Ethan's death?" Cole asked.

"Yes," the doctor replied.

Any medications Ethan may have been given were elevated by the dehydration from the burns, Leis testified.

The medical examiner spoke about bruises on Ethan's head before he died, a loose tooth, a hemorrhage in his right eye, long bruises on his thighs and injuries to the boy's genitals.

All of these occurred before Ethan died, Leis testified.

"What kinds of effects would these injuries have on Ethan why he were alive?" Cole asked.

"Depending on how they're inflicted, they could be a stressful situation. Response to that stress could increase his heart rate, anxiety around the situation, people in that," Leis said.

Leis testified about the injuries inflicted on Ethan after he died, including lacerations on his face that may have come from repeated blows from a hammer.

"The skull was fractured in multiple locations," Leis said.

Leis testified there were chemical burns on Ethan's face, which had the strong smell of ammonia.

Cole asked about "aspiration pneumonia," which Leis said came from choking or vomiting and inhaling stomach contents into the lungs.

"How about if the child is fed feces?" Cole asked.

"That would do it as well," Leis replied.

Leis testified that Ethan could have contracted pneumonia at least 24-72 hours before his death, and said the drugs the boy was given could have contributed.

The autopsy revealed no food in his stomach, the medical examiner testified. Cole asked how long it had been since Ethan last ate.

"I'd say at least hours before he ate anything solid," Leis said.

Challenging defense claims that Ethan may have had allergies, Cole asked the medical examiner if he suffered from anything. Leis said he saw nothing that would suggest the boy had an allergic reaction to anything.

Leis testified that the over-the-counter medications contributed to his death.

On cross-examination, Scott Williams began by asking what did not cause the death of Ethan Stacy. Williams noted that Leis initially reported to police the death as "suspicious," but insisted upon waiting for toxicology before saying anything more.

Williams asked if the head injuries to Ethan could have come from other objects than a hammer.

"Could it also be the head came in contact with another object, in other words it was dropped and hit a rock?" Williams asked.

"Potentially," Leis said.

Williams called up the photograph of Nathan and Ethan sitting on the couch, playing a video game. On the image, the boy's face appears bruised.

Leis noted that they did not find any bruises on Ethan's body like what appeared on the image.

Williams asked about the bruises they found on the boy's head. Leis said under careful examination, they found them.

"Would it be consistent with what you'd see with a child at play?" Williams asked.

"Definitely," Leis replied.

Williams asked about Ethan's discolored tooth. The doctor conceded it is possible the boy could have just started losing his teeth.

Ethan's eye injury, Williams asked, could have come from a lot of scratching or rubbing his eye.

"It seems not quite severe enough but anything's possible," Leis said.

Williams asked about the bruising on Ethan's thighs, noting it is difficult to know when they were inflicted.

"How close are they to the pelvic area?" Williams asked. "Minor bruising? Certainly something consistent with a child at play?"

"Potentially, yes," Leis replied.

Asked about an injury to Ethan's genitals, he asked if it was a zipper injury. Leis said he could not rule that out.

Williams asked about the scalding burns Ethan suffered.

"They would be obviously painful, correct?" Williams asked.

"Yes," Leis said.

Williams asked about treatment, which included giving medication to a four-year-old. Leis said it could be used, but it would be insufficient. He recommended getting a child medical attention.

Leis also told Williams dehydration would be a significant factor in his death.

"It's going to put additional stress and concentrate medications and those are the two biggies," he said.

Williams asked about "aspiration pneumonia," and inquired if it could come from other sources. He asked if a burp could cause it.

"Potentially, but unlikely," Leis told him.

UPDATE 9:15 a.m.:  Nathan Sloop entered the courtroom for the start of the third day of his preliminary hearing appearing more animated. He chatted with his legal team and took notes on his case.

Layton Police Sgt. Jeff Roderick returned to the witness stand, and Davis County Attorney Troy Rawlings asked about medications prescribed to Nathan Sloop.

"Did any of those medications end up in Ethan Stacy?" Rawlings asked.

"Yes," Roderick replied.

Rawlings asked about efforts to clean the apartment. Roderick testified cleaning supplies were purchased and walls washed in the apartment. A bottle of ammonia was found in the gravesite. Sloop allegedly told police it was to "erase DNA."

Prosecutors insisted there was no evidence that Ethan Stacy was taken to any medical professional for treatment.

"Why didn't they take Ethan to the E.R.?" Rawlings asked Roderick.

"He said he was afraid of going to prison," he replied.

Rawlings asked about subpoenas served to Dr. Rob Pramann to bring his medical records concerning Stephanie Sloop and Ethan Sloop. The family therapist was subpoenaed to testify at a hearing on it.

Both the defense and prosecution then made a stipulation before the court. Rawlings said they have served multiple subpoenas to Dr. Pramann for medical records concerning Ethan Stacy and the Sloops.

They have been denied.

"This has not been forgotten about," Rawlings told the judge. "We've tried to get evidence and records."

Nathan Sloop's attorney, Scott Williams, stood and told the judge that the defense provided prosecutors with some records Dr. Pramann handed over to them. He countered a claim that Dr. Pramann's attorney told police that Nathan Sloop was never a patient.

Williams said Sloop was a patient of Dr. Pramann's for nearly a decade.

"The attorney's claims were flatly false," Williams told the judge.

Rawlings alleged Ethan Stacy may have been taken to the family therapist, but the doctor refuses to provide information.

"Dr. Pramann has maintained that portions of the file are privileged as to Stephanie Sloop," he said.