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Nicolas Guaman Case: One Set of Medical Records, Two Interpretations

Nicolas Guaman, the Ecuadorian man who is charged in the death of motorcyclist Matthew Denice, sought treatment in 2005 for a head injury. Two doctors testifying as to Guaman's competency had differing interpretations of his injury.

Nicolas Guaman, an Ecuadorian laborer who is facing multiple charges in the death of Milford resident Matthew Denice, fell two stories from a roof in 2005, sustaining a head injury.

Has this injury had a lasting impact? in a competency hearing to determine if Guaman should be tried in the case, drew different conclusions from the same medical records.

The medical records are not a public record. But the testimony of the doctors and questioning by attorneys were made in Worcester Superior Court, making public for the first time some of the details of Guaman's injury, and whether the two doctors assigned to evaluate his competency think it is relevant.

Guaman, now 35, according to the testimony, sought treatment in August 2005 at The Miriam Hospital in Providence.

He had fallen two stories while working on a construction site, according to the doctors. He was admitted to the hospital, and released the following day. He did not seek followup treatment.

Since the fall, Guaman told both doctors, he has had difficulty hearing out of his right ear. He told the state-appointed psychologist, Hanya Bluestone, that he has had anxiety since that fall going up on ladders. According to Bluestone, he said this had impacted his ability to work and the family for several years before his arrest relied on the income his wife earned as a restaurant worker.

Bluestone said she examined his medical records. EMTs who found him reported he was sitting upright, against a wall, and conscious and alert. At the hospital, a CAT scan was performed, and the findings were normal, she said. A test that determines injury from a concussion was performed, and came back normal. He was kept overnight for observation, and released the following day.

When asked if the fall had any significance relating to his competency, Bluestone restated that all of the tests were normal. "There was no indication from the medical records that there were any significant issues that would affect his capacity."

Bluestone reported that Guaman was not able to specifically name the charges he faces, but he was aware that he was in the Worcester County jail, and he knew he was before the Superior Court "because of an accident."

He knew there had been a death, Bluestone said, because his attorney had reported that to him. "He was aware that the charges he faced were serious."

When he was asked about the records, defense-appointed neuropsychologist Paul Spiers said Guaman reported he has suffered memory loss, headaches and blurred vision at times, which Spiers said could have resulted from the fall.

Under cross-examination by the prosecutor, Spiers said Guaman has an absence of any memory of the crash involving Denice, or of the consequences.

"Yes, so he said to me," Spiers said.

Although the tests conducted at Miriam Hospital to determine if Guaman had suffered a traumatic brain injury were "all normal," Spiers reported, he said a head injury resulting in loss of consciousness "no matter how brief" could lead to a seizure disorder, including a form of epilepsy. 

Spiers testified that he believes Guaman is not competent to stand trial. "He has a fixed, neuropsychological deficit. His ability to keep track of verbal information we were giving him was not good."

Superior Judge Janet Kenton-Walker has taken the competency testimony and reports under advisement, and is expected to issue a decision in the coming weeks.

unclkebuck January 31, 2013 at 07:08 PM
So what! He needs to pay for the crime he committed.
Babs01757 January 31, 2013 at 09:36 PM
Give me a break!!! He fell 7 or 8 years ago, the head CT scan was normal, the doctors at the hospital discharged him, he had no follow up care and he has been working and taking care of his child all this time. I would have anxiety too if I fell off a ladder along with being in a country illegally and driving around illegally. He conveniently can not remember the accident where he killed someone while drunk. Duh!!!! Two other things cause memory loss drinking too much alcohol and selective memory. I will put my money on one of those two.
Mark Cain January 31, 2013 at 09:36 PM
Who wouldn't be a little timid climbing up a ladder after falling on his head two stories. (guess who paid that doctor bill). OK, now let the trial of the murdering freeloader begin! A shame that wasn't a five story fall and Matt would still be here today! Just pray that Matthew and his family get justice.
Dustin Ciccarelli January 31, 2013 at 11:40 PM
R u kidding me only in Massachusetts
Eleanor February 01, 2013 at 04:08 AM
He shouldn't be drinking and driving if he has such problems. Actually, he shouldn't be driving at all if he can't see well. If you do the crime, you do the time-and there is more then one crime here. This is infuriating to me.
Danu February 01, 2013 at 10:11 AM
The legal system is so easily duped. We knew this was going to happen though.
Anonymous February 01, 2013 at 01:58 PM
Absence of memory could be because he was wasted!!!!! LOCK THIS ANIMAL UP FOREVER!!!!
Michelle April 10, 2013 at 06:24 PM
Disgusting!!!

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