Dr. John Lipinski interview

Sunday, February 9 – 11:23 a.m.

Dr. John Lipinski was Diane Coates's primary care physician.

Detectives Armstrong and Murphy spoke with him at his medical office on Belk Boulevard.

Participants:

• Detective T. Armstrong
• Detective S. Murphy
• John Lipinski, M.D.

Detective Murphy: Good morning, Dr. Lipinski. Thanks for speaking with us.

Dr. Lipinski: Sure. It's a sad thing that happened.

Detective Murphy: Yes, sir. To get us started, would you tell us your name and address for the record?

Dr. Lipinski: I'm Dr. John Lipinski. I live at 210 Old Taylor Road here in Oxford.

Detective Murphy: Thank you. Now, it's our understanding that Diane Coates experienced a significant health issue within the last year. Is that correct?

Dr. Lipinski: Yes, that's right.

Detective Murphy: When did this happen?

Dr. Lipinski: Let me check her chart here. It was around midnight on July 21. She was treated at Baptist Memorial Hospital in the early morning hours.

Detective Murphy: Were you present when she was being treated that night?

Dr. Lipinski: No. I received a phone call at home from the emergency room after she was brought in. I spoke with the attending physician about her condition. He said it looked like a TIA, a transient ischemic attack. She was given warfarin that evening, and I ordered an MRI. She went home that night, and I told her to come to my office first thing the next morning.

Detective Armstrong: So this warfarin, it was given in pill form?

Dr. Lipinski: No, I believe they give an injection for a loading dose. I gave her a prescription for 5mg tablets the next day at the office.

Detective Armstrong: So she did come in, as you requested. How did she seem to you at that time?

Dr. Lipinski: She was a little shaky but otherwise okay. All her vital signs were normal. I informed her that she would have to come in every other day for blood levels of the warfarin.

Detective Armstrong: Did she do that?

Dr. Lipinski: She was kind of a complainer, but she did do as I requested. We adjusted her warfarin dose according to her blood levels. I saw her in the office once a week as well. Once her levels were becoming steady, she started complaining of mouth pain.

Detective Armstrong: When did she start having this mouth pain?

Dr. Lipinski: Well, let me see. According to her chart, it was one month after she started taking the warfarin.

Detective Murphy: Is that a common side effect of warfarin?

Dr. Lipinski: Well, she was only my second patient to experience it, but mouth pain is known to be a possible side effect. But Diane didn't seem to handle it as well as my other patient. She was adamant about getting off of it. She wouldn't take no for an answer, so I took her off warfarin and prescribed 300mg of aspirin every day instead. She was thoroughly relieved.

Detective Armstrong: What exact day did you take her off the warfarin?

Dr. Lipinski: Uh, it was August 16.

Detective Armstrong: What happened to the prescription for warfarin?

Dr. Lipinski: Nothing. I assume it expires after a while. But if she took two a day from the day after her stroke until I took her off the warfarin, that'd be July 22 to August 16, so she would have taken, uh … 30 days have September, April, May—

Detective Armstrong: 50 pills.

Dr. Lipinski: Well, 50 tablets. Pills are an entirely different dosage form and really don't exist in today's medicine.

Detective Armstrong: Okay, assuming she took 50 tablets, how many would be left?

Dr. Lipinski: Well, I gave her enough for a three-month supply, so 30 times 2 times…

Detective Armstrong: 130 pill— uh, tablets left.

Dr. Lipinski: Yes, 130 tablets. I did authorize one refill for another three-month supply, but since she stopped taking them only one month after beginning therapy, she wouldn't have needed the refill.

Detective Murphy: Could she have refilled the prescription even if she didn't need them?

Dr. Lipinski: Well, sure. One refill was authorized, but you would have to check with the pharmacist if she did or not. I can't see why she would have.

Detective Murphy: Was Mrs. Coates on any other medication from August until her death?

Dr. Lipinski: Except for the aspirin, no. That's not counting, of course, any over-the-counter medication she may have taken on her own, but she hadn't mentioned anything to me. I had stressed to her that she must call me before she took anything, and I feel confident that she would have. She took this very seriously.

Detective Murphy: When did you last see Mrs. Coates in your office?

Dr. Lipinski: That would be just a few weeks ago, January 24.

Detective Armstrong: How did she seem to you?

Dr. Lipinski: She seemed in much better spirits than the prior few visits. I asked her if she was still taking the aspirin and if she was having any problems with that. She said, "300mg a day every morning with my oatmeal, Doc!"

Detective Armstrong: She didn't mention anything about the warfarin or getting the refill?

Dr. Lipinski: No, in fact, she said something quite the contrary, like, "Boy! I'm glad I'm off that warfarin stuff. I would hate to give up kissing!" Then she gave me a little wink.

Detective Murphy: Well, thanks, Dr. Lipinski. We appreciate your time. Please let us know if you think of any other information that might be useful to us.

Dr. Lipinski: I'll do that. Yes, a terrible thing.

Interview ended – 11:51 a.m.