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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 APPEARANCES: GRADY NELSON, vs. STATE OF FLORIDA,

IN THE CIRCUIT COURT OF THE 11TH JUDICIAL CIRCUIT, IN AND FOR MIAMI-DADE COUNTY, FLORIDA CASE NO. F05-00846

Plaintiff, REDACTED TESTIMONY DEBORAH MASH, PhD

Defendant. ------------------------------------/ Gerstein Justice Building Miami, Florida November 29, 2010

The above-entitled case came on for hearing before the Honorable JACQUELINE HOGAN-SCOLA, as Judge of the Circuit Court, in court pursuant to notice.

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OFFICE OF THE STATE ATTORNEY KATHERINE FERNANDEZ-RUNDLE BY: ABBE RIFKIN, ASA -AND- HILLAH MENDEZ, ASA -AND- JOEL ROSENBLATT, ASA FOR THE DEFENDANT: TERENCE LENAMON, ESQUIRE -AND-DAVID MARKUS, ESQUIRE

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MONDAY, NOVEMBER 29, 2010, 10:14 A.M. (The following proceedings are a redacted version of the testimony of Deborah Mash, PhD, omitting objections, rulings and sidebars at the request of the ordering party). DEBORAH MASH, PhD., called as a witness on behalf of the Defense having been duly sworn by the Cler , was examined and testified as follows: THE WITNESS: I do so help me God. DIRECT EXAMINATION BY MR. LENAMON: Q Doctor, would you introduce yourself to the

members of the jury? A M-A-S-H. Ladies and gentlemen, I am Dr. Deborah Mash,

I am a professor of neurology and molecular and

cellular pharmacology at the University of Miami, Miller School of Medicine. It's down the street over there by Jac son.

Q A

What do you do there, Doctor? I am a member of the faculty, a tenured full

professor in the Department of Neurology. I have a laboratory there, and I do research, medical research full-time.

Dr. Mash, where do you wor ?

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I'm also involved in medical education of doctors, residents and interns. I wor with a team of 15 employees in various capacities in my laboratory to study the brain and all aspects of the brain with regards to both abused drugs, li e cocaine and alcohol and opiates, and I also study serious mental illness, and I also study neurodegenerative diseases, things that can damage the brain and how we can treat brain based illnesses and how we can come up with medications. So, everything from new tools to discovery of the illness in the brain as well as ways to treat it. Q And are you particularly involved with any

particular medications that are being created?

attempting to develop a medication for the treatment of drug abuse.

addiction, but I'm now expanding it for not only cocaine, but for opiates and alcohol and also loo ing as medication for the treatment, a non-addicting substitute for strong opiates for the treatment of pain. Q In the course of doing that, were you involved in

the creation of a company that is doing that? A Yes. Unfortunately because it's very expensive,

as you may now, to ta e a drug through the FDA, you have to

I specifically began this wor

Yes. I have been wor ing for the past 18 years on

targeting to cocaine

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raise money to do that. And I try to do it for many years unsuccessfully, but more recently in the past year, I have been able to launch the idea.

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Florida State University. I was wor ing in the area of psychology and biology or bac then what was called psychobiology. I then stayed in Tallahassee at the time, my father had

Master's degree in pharmacology there under the direction of the chair of that program. I then went on to do my Doctoral training and I came down to Miami with my then husband at the time to wor at the University of Miami and do my training in the Department of Pharmacology at the Miller School of Medicine, finished my degree there, left and went to Boston and did my fellowship in neurology at Beth Israel Hospital at Harvard Medical School under the direction of Dr. Marcel Meslem (phonetic) wor ing primarily then at that time in the area of degenerative diseases and Alzheimer's disease, which was just becoming an important area of research. I was invited to join the faculty shortly thereafter in

the Department of Neurology, moved bac

home to join my

died, and I went over to Florida A&M University and I too

bac ground. Where did your education begin? A I started out educated in the State of Florida at

Doctor, let's tal about your education and

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husband in Miami who had a law practice, and I've been there ever since. I was the first woman hired on the tenure trac in my

associate professor, and the first woman to be promoted to on the ran of full professor. I hold an endowed chair in the Jean Seely Professor of Neurology.

publications?

you don't. And I have published over 200 articles and monographs dealing with the topics that I've described for you today in peer-reviewed scientific journals. I have held federal grants from the Public Health Service National Institutes of Health uninterrupted since I joined the faculty in 1987. I receive funding specifically for an area that's very important, which deals with the effects of cocaine on the brain and that grant is in year 17 of funding. Q A What is your particular area of expertise, Doctor? I have several different areas that I publish on

that I am recognized as an expert in the field, but one area, which is relevant to this matter today, is specifically the effects of cocaine on the brain and behavior.

They li e to say publish or perish in academia, if

Doctor, have you published boo s and other

department. I was the first woman promoted to the ran

of

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Also the effects of cocaine on the brain, how it damages the brain, how it affects people with underlying brain damage, how it affects people with underlying psychiatric damage. I'm considered an expert in the area of cocaine excited nerves. (Omission). Q A What have you testified about and who for? I have testified about the effects of cocaine on

the brain and behavior; on the effects of cocaine in a psychiatric patient; on the effects of cocaine in the brain-damaged patient. I have also testified on the effects of excited delirium, and I am considered to be one of the leaders in that area. Q Have you ever testified on behalf of the State of

Florida for the prosecutor's office? A In the past, I have on the effects of cocaine on

the brain and the ability of an individual to be able to identify individuals. So, the effects of cocaine on the brain and behavior and what are the intoxicating effects of cocaine. Q Why are you employed at the medical school in the

Department of Neurology? A I'm employed in the medical school in the

Department of Neurology as opposed to a basic science

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because I do what is called translation neuroscience.

also study the brain after death. So, we do everything from womb to tomb, literally, loo ing at the development of the brain, and then when

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corroborate their findings during life. And that involves everything from loo ing at pathology

at the university to really localize brain damage, and then also to loo at something more subtle which is the underlying neurochemistry of the brain.

how the chemistry of the brain changes and how that interplays with structural damage in the brain. Q A What is it neuroscience, Doctor? Neuroscience is a very broad area, but it's

basically the study of everything above the nec . Everything from the anatomy of the human brain, the physiology of the human brain, the chemistry of the human brain, the pharmacology of the human brain, leading right up on to behavior and what we understand to be mind brain connection. Q And you mentioned that you are on the faculty.

This is where the pharmacology comes in, is to loo

in the brain, wor ing with -- I wor

with neuropathologists

an individual passes away, to help wor

I study the human brain. I wor

department li e pharmacology or immunology or biochemistry

with patients, and I

with doctors to

at

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What is your primary role as a faculty member? A My primary role I am involved, of course, in

medical education and lecturing and publishing, as we have already heard, but my main area is research. My main area is I use taxpayer dollars. I'm funded my taxpayer dollars to conduct research on the brain to try to come up with better ways to treat -- and that's my mission as a faculty member.

to this case and the effects of drugs on Grady Nelson, were you not? A Q Nelson? A Q A Q A Q Yes, I did. On how many occasions did you interview him? I interviewed Mr. Nelson one time. Were you provided material to review in this case? Yes, I was. Can you describe what the material was that you I was. Did you have an opportunity to interview Grady

reviewed in this case? A I reviewed the following, and this is attempting

to be succinct: His school records; his military records; the discharge from the military doctor; his Jac son Health System records; the records from his substance abuse

Now, you were as ed to review material pertaining

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treatment at The Village; the guilt phase proceedings. I mentioned his Army records already. His complaint and the scene descriptions and witness statements; his sworn statement and the videotape; his Department of VA records; His Miami-Dade employment records; the affidavits of Dr. Thatcher; the neuropsychology reports of Dr. Ouaou; Dr. Gluc 's report; materials from the Frye hearing, and various depositions and testimony. Also the deposition of subject SP, and I believe that is a summary of what I reviewed.

is crac cocaine? A

So probably everyone here lives in Dade County

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cocaine hydrochloride which is so-called powder which is the hydrochloride salt. It's something that's soluble in water. And it is something that is usually snorted, snorted, powder cocaine. Crac cocaine hit the streets of Dade County right around when I got here in the mid-'80s. And what that is, is that it converts it because if you try to burn the hydrochloride, the temperature has to be very high. But if you convert it to the freebase, which is what

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ba ing soda and ammonia, and you get rid of hydrochloride

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crac

cocaine is, you mix it -- there's a procedure with

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nows what crac cocaine. So crac cocaine, there is

O ay. Doctor, would you explain to the jury what

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itself, which is the freebase, then you can pyrolize that, and that's why it's smo ed. Q A Now, what is cocoa ethylene? Cocoa ethylene. Co e ethylene is something that

demonstration of cocoa ethylene. Why it's relevant is that when someone is using both substances together, you get a third drug onboard and that is a drug, an actual drug. And it's why people co-abuse cocaine, it prolongs the high and it also has adverse effects in and of itself on the brain. Q What was Grady Nelson's drug of choice?

(Omission). Q Based on your conversation with Grady Nelson, did

he indicate to you what drugs he used? (Omission).

of drugs he used? A Mr. Nelson completed a structured interview with

me and tal ed about his original use of marijuana, which was uninterrupted throughout, from late teenage years, but his primary drug was cocaine. Some occasions cocaine in

Doctor, what did Grady Nelson tell you what

combination, and my laboratory did that original wor

is formed in the body when you drin

and use cocaine in on the

salt, the hydrochloride goes away and you get the al aloid

ind

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combination with alcohol.

cocoa ethylene? A Q problem? A Yes, he did. He received treatment, by my review Yes. Did he receive treatment for his drug abuse

of the records, three times. There's a note, first of all regarding corroborative evidence about the treatment and vis-a-vis the military. He was -(Omission). Q Doctor, did you review a number of records that

you considered in your ultimate opinion in this case? A Q I did. And did you review those records and formulate

ultimately your final conclusion in this case? A Q Yes. What were the records that you relied on and what

did they say? A This is specifically now for the -- pertaining to

the question about the drugs. There was evidence in the records of marijuana use in the military. He was treated at the VA, the Veteran's Administration, in the '80s in reference to this for cocaine abuse. In 1990

That's what you were tal ing about before, the

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drugs. There is testimony in the transcript regarding the assault on the minor girl that he had a drug problem. And then in 2004, he tests positive for cocaine and marijuana, and that goes with the personality changes at wor . That's in his records of his employment by Miami-Dade. And then from there, he's referred from the employee assistance program to The Village, which is a substance abuse treatment program. And their information suggests that he has a polysubstance abuse problem, but the primary drug is cocaine. Q Based on your records, review of those records and

your conversation with Mr. Nelson and your study of all the information that was provided, did you confirm that he had indeed a problem with drugs? (Omission). THE WITNESS: Yes. I should mention also that in addition, The Village he tested positive, they did a urinalysis, which is objective evidence for cocaine and marijuana and he was positive for that in his urine. So, it is my opinion that there's more than three decades of evidence of drug-related problems for Grady Nelson.

he is again treated at St. Lu e's for detoxification from

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where it worsens, where his behavior spirals down, is my opinion. Q Now, was he able to maintain any sobriety during

these periods, and how do you account for that? A Yes, he did. He did maintain sobriety and when

he's able to maintain sobriety, he was able to hold his behavior and to stay employed and there are even some very good employment records that go with this. So, we now that addiction, what we now now from the sciences, is that addiction is a chronic relapsing disorder. So it's li e -(Omission). Q A Go ahead, Doctor. -- sobriety. So how can it be if somebody is

addicted that they can maintain sobriety. That was the question I'm trying to answer. We now from the science that this is a chronic relapsing disease, just li e diabetes. If you can treat it, you can hold sobriety. But if you don't treat it, there are triggers to relapse and you then

you go bac

into the downward spiral of drug and alcohol.

Doctor, are you familiar with the frontal lobes? MR. LENAMON: May she step down? THE COURT: Sure.

And if you loo

at the timeline of this, they show

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THE WITNESS: The question is am I familiar with the frontal lobes. I apologize that I can't seem to figure

The question was am I familiar with the front frontal lobes, yes, I am. This is the front lobes here in the front of the brain. THE COURT: Doctor, be sure that everybody can see. If her body is bloc ing, let us now. BY MR. LENAMON: Q What is the function of the frontal lobes, Doctor?

(Omission). THE WITNESS: I can. I have a lot of frontal lobes in my lab. It's not ma ing a jo e about -- so the frontal lobes. MS. RIFKIN: Judge, I'm a little confused. Are we using both? THE WITNESS: I was as ed to do that because my body was bloc ing. THE COURT: Luis, can you loo in my des to see if you can find the pointer? Maybe this would be a good time to use it. We are using both. People over here can see that one and people over here can use this one. Louis, call the tech? BY MR. LENAMON: Q Doctor, why don't you let me hold up your

out how to bend this bac

for you.

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computer.

THE COURT: Can everybody see?

orchestra. The frontal lobes are the executive function. He would be the conductor. He tal s to all the other parts of the brain. And what's important about the frontal lobes is that it's problem solving, it's inhibition, it's bra es. It stops you from -- you have to ma e a judgment. If I do something I'm going to get hurt; inhibition; planning; complex planning; decision-ma ing; language; judgment; motivation; spontaneity. Interestingly, when you have damage to that, this is a plastic thing where if somebody had a spi e go through the frontal part of the brain. Pain stage. Abnormal sexual activity. Damage to the frontal lobe is with sexual behavior and then reactive aggression and that goes bac with hitting the bra es. BY MR. LENAMON: Q Doctor, did you have an opportunity to review a

number of different items that suggested to that you Mr. Nelson had frontal lobe damage? (Omission).

THE WITNESS: If you thin

If you thin the brain as an --

of the brain as an

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BY MR. LENAMON: Q Did you have an opportunity to review a number of

other documents that indicated whether you believe that Mr. Nelson had frontal lobe damage? (Omission). THE WITNESS: Two documents that I reviewed. One was the neuropsych assessment of Dr. Ouaou and the other was Dr. Gluc 's use of the technology to demonstrate frontal lobe damage. (Omission).

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neurological diagnosis of brain scores in your research? A Q Yes. Can you explain that to the jury what that is?

comes into evaluation in my laboratory as part of research

THE COURT: Did you say brain ban ? THE WITNESS: Brain ban . THE COURT: O ay. THE WITNESS: Brain endowment ban . I am the director at the University of Miami Brain Endowment Ban . So, these are people that have pledged to donate

or as part of my brain ban

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too into consideration in this case. Do you use

(Omission). THE WITNESS: So for every case we study, that

We were tal ing about some of the things that you

program, they have --

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organ, but in this case they're donating the brain for research. And sometimes the family members will elect to donate a brain of a loved one who have died suddenly. These are usually younger people who may have died from the effects of drugs or alcohol or even natural causes. In the course of that, we have to get every bit of available medical information, all the neurology, all the reports of the neurologists, all the neuropsych evaluations. We also do neuropsych testing in my laboratory by a psychologist that we review as part of our ongoing prospective wor to trac cognition in the elderly.

depression in patients. (Omission). Q Doctor, in this particular case did you use the

information and the raw data and the information that was

Thatcher?

accept -(Omission). Q Did you review material provided by these doctors

without getting into the specifics of it?

I did not loo at the raw data but what I did

provided to you by these doctors, Ouaou and Gluc

or

We also use psychological testing to trac

their brain after death, li e an organ, you would donate an

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A Q A Q

Yes, I did. Did you ta e that into consideration? Yes, I did. Now, you were tal ing about the frontal lobe and

the function of the frontal lobe. How does cocaine abuse affect the function of the frontal lobe, and can you explain that to the jury? A So in order to do that, what I want to do is to,

Your Honor, show this diagram, and I apologize to the jurors. Q Can you go ahead and set this one up, too, as

Bear with me for a minute. I'm not used to this one. Q We are going to focus on one because apparently we

are not meant to use this today. We are going to push it away.

better -- I apologize. THE COURT: Doctor, we need to do one of two things, either go bac to the microphone or eep your voice really up. (Omission). THE WITNESS: So a brain-damaged individual of the frontal lobes who ta es cocaine is made much worse. Cocaine

Just to be on the safe side, I thin

I'm going to ta e a minute to set this one up.

it would be

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itself damages the functionality of the frontal lobe. So if you have got a person, for example, with serious mental illness li e schizophrenia and they use cocaine on top of it, they are worse. If somebody had head trauma and had damage to the brain or if something happened in utero and the brain was damaged and then they go and start using cocaine, it ma es it much worse. (Omission). THE WITNESS: So cocaine itself can damage the brain. BY MR. LENAMON: Q Doctor, would you necessarily see this on a PET

Scan or a CT Scan or other imaging technique of the brain? A No, you may not. And the issue here is that you about an x-ray or you thin about the new technologies

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that provide a window on the brain, if there's overt damage, big damage li e a stro e or a bleed, you can see that. But if there's underlying problems with wires of the brain or the chemistry of the brain, you may not see it at all. It doesn't mean it's not there. It's there, but we

opportunity to view the videotape of Mr. Nelson, ta e into consideration his statement and the statements of other

don't

now how to image it yet. Now, in this particular case did you have an

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thin

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witnesses that testified at the guilt phase? (Omission). Q You indicated that you reviewed all the guilt

phase material, the first part of trial material. What material was that, that you reviewed? A The witness statements, the information that was

gathered which was in evidence, the facts surrounding it. Q And in this case did Grady Nelson indicate to you

that he used cocaine? (Omission). Q What did Grady Nelson tell you he did the day of

the homicide? (Omission). Q A Go ahead, Doctor. Mr. Nelson told me that in the hours before that

he had used cocaine and that he had also dran a pint of Hennessey.

would that have on Grady Nelson's brain at the time of the murder? (Omission). Q A Q A Go ahead, Doctor. It's my opinion that that would be very bad. And can you explain that, Doctor? The frontal lobes tal s to a part of the brain

And based on that information, what

ind of effect

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called amygdala. THE REPORTER: Can you spell that? THE WITNESS: Yes. It's A-M-Y-G-D-A-L-A. And why this is important is as follows. And I apologize. The amygdala is here in the temporal lobe. Here is the frontal lobe and here is the amygdala.

When a person is drug addicted or a person uses drugs or alcohol, especially cocaine, this system becomes the primary. This is flight or fight. This is the part of the brain that goes off. This is the part of the brain that the frontal lobe inhibits. This is the inhibitory loop from the frontal lobe. That's what I'm trying to show. This little almond shape is the amygdala. Cocaine activates this pathway.

cocaine and over and over again despite the consequences of their behavior. It's the primordial brain. It's the old brain. It's the reptilian brain. People go out and use over and over again in this crazy compulsive pattern of behavior because the frontal lobes don't wor . When you go into sobriety, the point is to engage the frontal lobe, to ma e the right decision, don't use

That's part of the reason people go out and see

These two parts of the brain tal

to each other.

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drugs. If somebody is in a cocaine state of paranoia, of hallucinations, thin ing somebody is out to get me, that's the amygdala. Now, you want to perceive that nobody is really getting me, that's just the drug. That's the frontal lobe saying slow down, that's the drug. Somebody is out to get me and all that, that's the amygdala. So, what happens here is you have a dysfunctional frontal lobe and you lose the ability to silence the amygdala. So the amygdala ta es over and all of a sudden you are in that hyperexcitable state of the amygdala. That's what cocaine does. It heats up this part of the brain. Now, for most cocaine abusers it doesn't go all the way because the frontal lobe still has an effect. My opinion in this matter is that that was defective. (Omission). Q Doctor, can you specifically state within medical

certainty what your opinion was of Grady Nelson's brain based on your bac ground, your experience and the information that you reviewed in this case at the time of the homicide? (Omission). Q A Go ahead, Doctor. It is my opinion that clearly there was evidence

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of trauma, damage and functional impairment provided by the experts that -(Omission). Q A Go ahead, Doctor. Neuropsych evidence on two very important

diagnostic tests. (Omission). Q What is your opinion based on all the information

you were provided at the time that Grady Nelson was committing the stabbing of his wife, Angelina, at that moment, within a reasonable degree of certainty is your medical opinion? (Omission). Q What is your opinion of the status of Mr. Nelson's

brain at the time of this homicide? (Omission). Q A Go ahead, Doctor. It's my opinion that he was in a hyperresponsive

amygdaloid state. Q A Can you explain that to the jury? Yes. The evidence that I reviewed suggested that

he was paranoid. (Omission). Q means. Describe what you believe -- explain what that

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Just say what does this mean, the amygdaloid

hyperresponsive state. Q A Yes. When people in this state, in this neurologic

state, which is described in the textboo s and described in the medical literature, they attac , they go into destructive rage. They are angry. Not just anger, I get angry at you, you get angry at me, this is over the top anger. They are agitated, intense, hostile, aggressive and unpredictable. Q What is the significance of him burning the tape?

(Omission).

consideration when you formulated your opinion? (Omission). Q How is that significant to your opinion?

(Omission). Q A Go ahead, Doctor. Cocaine-induced paranoia. Classic.

(Omission). MR. LENAMON: I have no further questions at this time, judge. (Subsequent proceedings were reported but are herein omitted at the request of the ordering party).

Did you ta e the burning of the tapes into

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CERTIFICATE OF COURT REPORTER

STATE OF FLORIDA COUNTY OF MIAMI-DADE

I, BRYNN DOCKSTADER, Court Reporter for the Circuit Court of the Eleventh Judicial Circuit of the State of Florida, in and for Dade County, DO HEREBY CERTIFY, that I was authorized to, and did, report in shorthand the proceedings and evidence in the above-styled cause, as stated in the caption hereto, and that the foregoing pages constitute a true, accurate and correct computerized transcription of my report of said proceedings and evidence. IN WITNESS WHEREOF, I have hereunto set my hand in the City of Miami, Dade County, Florida, this 13th day of February, 2011.

________________________ Brynn Doc stader, RMR