Automatism and the Ambien Defense

Friday, August 12, 2011
posted by Douglas Keene

We’re betting you know what the ‘Ambien Defense’ would be—but that maybe the definition for automatism has escaped you. Generally it refers to a robot, specifically to an autonomous robot—which is a pretty scary thing when you think about it. And in this case, scary things happened. Here’s the story, courtesy of the Fayetteville Observer.

Robert Stewart is charged with shooting and killing eight people with a shotgun at the Pinelake Health and Rehabilitation Center in Carthage, North Carolina. He had taken Ambien the night before but the shootings occurred the next morning. His attorneys have said:

“Stewart was not in control of his actions because of a combination of alcohol and three prescription drugs he was taking, including Ambien. As such, they say, he should not be held legally responsible.”

In essence, the defense has given strong hints they will be pursuing the automaton defense—that Stewart was not in true control of his actions due to the impact of his prescription medications mixed with alcohol. This defense is a bit different than the insanity defense although the attorneys say they also may file insanity and diminished capacity defenses.

We’ve seen similar strategies before with defenses for sexsomnia, and other ‘my brain made me do it’ defenses like this one or this one. We still think it’s a long shot.

You are not supposed to drink alcohol with Ambien (or probably with any of the other drugs he was taking). Mr. Stewart says he did. That’s a point for Mr. Stewart’s irresponsibility with his medications, and in most jurisdictions it creates problems for using it as a defense.

Mr. Stewart had pre-existing “emotional issues” and had visited a doctor 48 hours before the shootings for depression and anxiety. Jurors may think his pre-existing mental health issues are more at fault here than the use of Ambien.

His ex-wife says he had “violent tendencies” and that he would “get mad because of things that didn’t go his way. He never really hurt me, but he would get mad and blow up.”

An early news report stated Mr. Stewart’s current wife (from whom he was separated) worked at the Pinelake facility and speculated that is why he targeted that location.

Most of the cases of odd behavior on Ambien are described as occurring a few hours after you take Ambien (people who drive, mow their lawns, or sleepwalk/sleepeat) but the Pinelake shootings occurred the morning after.

It’s one thing to believe Ambien will result in sleepwalking or even sleep-driving. But killing eight people [seven elderly patients and their nurse] and wounding two others?

It’s a long road to convince jurors of the idea that Mr. Stewart was simply robotically obeying the influence of the Ambien when he had preexisting conditions, a history of rage, his estranged wife worked at the Pinelake facility and he acknowledges he had consumed alcohol. But stranger things have happened. We’ll keep an eye on this one.

And for those of you who are involved in Ambien liability litigation, we don’t mean to be taking sides on the merits of these disputes.  This case caught our eye because of the seriousness of the conduct, and some evident problems related to Mr. Stewart’s history.  We have worked on many pharmaceutical cases and diminished capacity cases, and understand that they can be brought about by myriad influences.  And perhaps most importantly, we got these reports from the media.  As we learned from the Casey Anthony trial, that may not be the whole picture…

September 6, 2011:

See an update on how the jury deliberated and decided in this case.

Praveen Kambam, MD, & Phillip Resnick, MD (2010). Ineffective Counsel and Mental Health Expert Witness Testimony in an Insanity Defense. Journal of the American Academy of Psychiatry and the Law, 38 (4)

Measuring knowledge of the insanity defense: Scale construction and validation. Tarika Daftary-Kapur Ph.D., Jennifer L. Groscup Ph.D.†, Maureen O’Connor Ph.D.‡, Frank Coffaro M.A.§, Michele Galietta Ph.D. Behavioral Sciences & the Law, Volume 29, Issue 1, pages 40–63, January/February 2011

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4 Responses to “Automatism and the Ambien Defense”

  1. @DaytonDUI says:

    AUTOMATISM AND THE AMBIEN DEFENSE http://t.co/9S2WlAl

  2. @Melistomato says:

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  3. @steigerlaw says:

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  4. @ASTCNow says:

    ASTC Consultant Doug Keene: Automatism and the Ambien Defense http://bit.ly/oT4duH

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