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Inquiry into Pediatric Forensic Pathology in Ontario
December 6, 2007
Cross-examination of Dr. Michael Pollanen, Chief Forensic Pathologist for the Province of Ontario, by Suzan Fraser, counsel for Defence for Children International-Canada.
The following is an excerpt from the transcript of the Inquiry into Pediatric Forensic Pathology in Ontario. For the official transcript, or for more information about the Inquiry, visit the Inquiry web site: http://www.goudgeinquiry.ca.
[Page 1]
1
2
3 THE INQUIRY INTO PEDIATRIC FORENSIC
4 PATHOLOGY IN ONTARIO
5
6
7
8 ********************
9
10
11 BEFORE: THE HONOURABLE JUSTICE STEPHEN GOUDGE,
12 COMMISSIONER
13
14
15
16 Held at:
17 Offices of the Inquiry
18 180 Dundas Street West, 22nd Floor
19 Toronto, Ontario
20
21
22 ********************
23
24 December 6th 2007
25
. . . . .
[Page 203]
25 CONTINUED CROSS-EXAMINATION BY MS. SUZAN FRASER:
[Page 204]
1 MS. SUZAN FRASER: Thank you, Mr.
2 Commissioner.
3 Dr. Pollanen, you'll recall I'm Sue Fraser
4 and I'm here on behalf of Defence for Children
5 International, which is a children's rights organization.
6 And I'm glad that Ms. Greene confirmed that
7 pathologists are people. Having heard your presentation
8 and your analysis, I was beginning to think that
9 pathologists were Vulcans.
10 Now, on the question I -- I think there's
11 just a delayed reaction to my attempted humour, so -- I
12 had raised when -- when Professor Milroy -- Milroy, Dr.
13 Crane, and Dr. Butt were here, the two (2) sort of ends of
14 the spectrum as I saw it as sudden un -- unexpected death
15 in infancy.
16 And on the one (1) side of that extreme
17 being the child dying in infancy where there are no
18 apparent signs of trauma and the question is whether this
19 is SIDS or whether some caregiver or other individual had
20 a hand in that death by smothering. That was sort of on
21 the one (1) extreme.
22 And on the other extreme I put where there
23 were obvious signs of child abuse, and the question for
24 the pathologist was whether the abuse had a role in
25 causing the death of the infant.
[Page 205]
1 And would you agree with me that the -- the
2 challenges facing the pathologist in those sort of two (2)
3 extremes are -- are both very different?
4 DR. MICHAEL POLLANEN: Yes.
5 MS. SUZAN FRASER: All right. And on the
6 case of the extreme where there is a clear indication of
7 abuse, what -- the expert panel seemed to agree with me
8 that -- that on the one (1) hand, the pathologist might
9 not be able to say that the injuries or the abuse apparent
10 on autopsy or examination caused the death, but the
11 question might be whether that the pathologist's opinion
12 could sustain another type of charge.
13 And you'll agree with me, I take it, that
14 while an autopsy might not allow you to form an opinion
15 about whether there's culpable homicide, there might be
16 room for the pathologist's evidence to sustain a lesser
17 charge.
18 Is that fair?
19 DR. MICHAEL POLLANEN: Yes.
20 MS. SUZAN FRASER: All right. And that
21 would be appropriate in your view?
22 DR. MICHAEL POLLANEN: Certainly that's --
23 that's the way the Court sometimes use the medical
24 evidence.
25 MS. SUZAN FRASER: All right. And I take
[Page 206]
1 it in both of those extremes, both the SIDS or, you know,
2 that sudden unexpected death that's not easily explained,
3 or the case of the extremes, those are the kinds of cases
4 that pull our society to its emotional extremes, because
5 on the one (1) hand, we can't understand why there's no
6 explanation for a child's death, and in the case of abuse,
7 we can't understand while -- how this could have happened
8 to an innocent child?
9 Would you agree with me that there's an --
10 an emotional pull attached to both of those scenarios?
11 DR. MICHAEL POLLANEN: Yes.
12 MS. SUZAN FRASER: And it would seem to me
13 that as a pathologist -- coming back to pathologists are
14 people, too -- that there is an emotional pull that must
15 come in those cases from the Courts, from the families,
16 from all players in the justice system.
17 Is that -- is that a pull that you've
18 experienced?
19 DR. MICHAEL POLLANEN: Well, as I said, we
20 are people, not Vulcans, and we also are doctors --
21 MS. SUZAN FRASER: Yes.
22 DR. MICHAEL POLLANEN: -- and so we've
23 worked, we've had clinical training --
24 MS. SUZAN FRASER: Yes.
25 DR. MICHAEL POLLANEN: -- we've cared for
[Page 207]
1 patients, patients have died while we've cared for them,
2 so yeah, we're in tune with those issues.
3 MS. SUZAN FRASER: All right. And you're
4 also in tune that in terms of the more high profile cases
5 there is a push, people look to the medical profession to
6 provide answers where they might not otherwise be found.
7 DR. MICHAEL POLLANEN: Yes.
8 MS. SUZAN FRASER: And that -- and that
9 sometimes as a profession you're not capable of giving
10 those answers?
11 DR. MICHAEL POLLANEN: Correct.
12 MS. SUZAN FRASER: And so in terms of on a
13 systemic level the issues that you have put forward in
14 terms of the cultural change, that training, is that part
15 of what you do is to -- how do you resist, as a
16 pathologist, the emotional pull? Is -- that come through
17 the cultural change that you've talked about?
18
19 (BRIEF PAUSE)
20
21 DR. MICHAEL POLLANEN: I think it's --
22 it's part -- it's probably part of your evolution as a
23 doctor, I would think and it starts in the -- in the early
24 part of your medical training and evolves over time. And
25 it probably involves being sort of self reflective on
[Page 208]
1 issues.
2 It involves identifying people who are
3 trusted colleagues that you can discuss these issues with.
4 It involves having some facility with some of the ethical
5 issues that -- that emerge. It involves having some
6 sensitivity to being compassionate to others. For example
7 something that happens to forensic pathologists
8 occasionally is seeing the next of kin in court --
9 MS. SUZAN FRASER: Yes.
10 DR. MICHAEL POLLANEN: -- as you're
11 testifying in a murder trial. You have to keep your mind
12 open to those -- those issues because we -- we exist in a
13 greater context --
14 MS. SUZAN FRASER: Yes.
15 DR. MICHAEL POLLANEN: -- we're not --
16 we're not -- we're just not in autopsy rooms. We -- we go
17 to court. We go out in the community.
18 So, yes, I think -- I think most forensic
19 pathologists reflect on those issues.
20 MS. SUZAN FRASER: All right. And is it
21 fair to say you've talked about the need to build a
22 culture and build colleagues? We've also heard the
23 importance of a multi-disciplinary approach to the review
24 of a child's death. You've talked about that both in
25 terms of the death investigation team and the death review
[Page 209]
1 process.
2 Those are -- that's important?
3 DR. MICHAEL POLLANEN: Yes.
4 MS. SUZAN FRASER: And I raised with Dr.
5 Cairns, although I don't think he necessarily agreed with
6 me that this wasn't already happening, but the need for
7 there to be also different perspectives; that it's
8 important not just to have sort of a prosecution-type
9 perspective, but it's important to have a range of
10 perspectives if we're to sort of stay on issue or on the
11 evidence-based model, to keep you sort of going back to
12 the real issues.
13 DR. MICHAEL POLLANEN: Well, I think
14 that's what we try to do in -- in for example the -- the
15 teamwork approach to death investigation and also in the
16 context of the multi-disciplinary committees; for example,
17 the Paediatric Death Review Committee.
18 I think that's -- that's the sort of issue
19 that -- that our organization is trying to get at there,
20 the type of values that we're trying to -- to put in the
21 system.
22 MS. SUZAN FRASER: All right. And I'm
23 going to leave -- I don't want to get into the Paediatric
24 Death Review Committee although it's very important from
25 my client's perspective.
[Page 210]
1 But in -- in terms of these difficult
2 deaths an issue was raised by -- in the Office of the
3 Chief Coroner's questioning of the expert panel about the
4 use of a sort of standard protocol in investigating sudden
5 unexpected deaths in infancy, and reference was made to
6 the Coroner's protocol.
7 And Dr. Milroy made reference to a protocol
8 that they sort of based their investigations on -- that's
9 what I understood it to be -- called "CESDI"?
10 DR. MICHAEL POLLANEN: Yes.
11 MS. SUZAN FRASER: Are you familiar with
12 that protocol?
13 DR. MICHAEL POLLANEN: I am, yes.
14 MS. SUZAN FRASER: All right. And he
15 reference it as a seventy (70) page protocol. I've
16 included it in your binder, Volume XIII.
17 COMMISSIONER STEPHEN GOUDGE: Tab 13?
18 MS. SUZAN FRASER: Tab -- Tab 13. No,,
19 Volume XIII, Tab 24, Mr. Commissioner.
20 COMMISSIONER STEPHEN GOUDGE: I don't --
21 MS. SUZAN FRASER: Oh, okay. Well, then,
22 it -- I understood from the index that -- Ms. Hogan --
23 that it was at Tab 24. Maybe it's --
24 MR. MARK SANDLER: Tab 24 is -- just no
25 volume --
[Page 211]
1 MS. SUZAN FRASER: All right. I see,
2 okay.
3
4 (BRIEF PAUSE)
5
6 DR. MICHAEL POLLANEN: Yes, thank you.
7
8 CONTINUED BY MS. SUZAN FRASER:
9 MS. SUZAN FRASER: Now, this I -- I make
10 no promises about this because I've done my own research
11 about this, Mr. Commissioner, and I'm hoping that Dr.
12 Whitwell might help me fill in the gaps, but I wanted to
13 sort of take this to its conclusion.
14 And so in terms what -- Dr. Milroy said you
15 can get -- you can download it off the internet. This is
16 the only questionnaire that I could see and the -- the
17 name of it being the CESDI, which is the Confidential
18 Enquiry into Sudden Unexpected Deaths in Infancy.
19 And what I understand about -- are you
20 familiar with that process before I give you an
21 understanding of what I think it's to be and hope to
22 confirm that with the expert?
23 DR. MICHAEL POLLANEN: I'm generally
24 familiar with it, yes.
25 MS. SUZAN FRASER: Okay. So this is what
[Page 212]
1 I understand it to be -- and you can confirm if I'm right
2 -- that this was established in the early 1990s to improve
3 the understanding of risks and causes in death in late
4 fetal infancy in England, Wales, and Ireland.
5 And that there are two (2) elements of it:
6 that they survey all deaths of gestational age twenty-two
7 (22) weeks to one (1) year after their birth, whether
8 they're born dead or alive.
9 And the second that there's a confidential
10 inquiry into a subgroup of those, which is an assessment
11 of anonymized clinical records by multi-disciplinary
12 independent assessors.
13 And I'm hoping that Dr. Whitwell can
14 confirm my understanding of that, Mr. Commissioner, but is
15 that --
16 COMMISSIONER STEPHEN GOUDGE: Do you know
17 enough about it to respond?
18 DR. MICHAEL POLLANEN: Not really, no.
19
20 CONTINUED BY MS. SUZAN FRASER:
21 MS. SUZAN FRASER: Okay. Did you have a
22 chance to look at the protocol?
23 DR. MICHAEL POLLANEN: Yes.
24 MS. SUZAN FRASER: All right. And my
25 question then for you is putting aside, Mr. Commissioner,
[Page 213]
1 that it's a very detailed questionnaire and -- and how
2 that would be -- that information would be taken is -- is
3 another issue.
4 Is this type of standardized detailed
5 protocol something that would first be of assistance in
6 the investigative stage?
7 DR. MICHAEL POLLANEN: Yes.
8 MS. SUZAN FRASER: Yes. And would there
9 be benefits to developing such a detailed protocol for
10 these types of death?
11 DR. MICHAEL POLLANEN: We have.
12 MS. SUZAN FRASER: All right. And the one
13 (1) that you have that we have seen, in terms of the
14 coroner's protocol, is a much shorter form? Do you agree
15 with me?
16 DR. MICHAEL POLLANEN: It's smaller font.
17 MS. SUZAN FRASER: All right. All right.
18 But in your view -- in your view, it encompasses the same
19 types of issues in this? All right.
20 DR. MICHAEL POLLANEN: Yes.
21 MS. SUZAN FRASER: Now, I understand the
22 second part of this is that -- that this type of
23 questionnaire is done in every case and represents almost
24 all of the births, and then is that information is then
25 used for research?
[Page 214]
1 DR. MICHAEL POLLANEN: Yes.
2 MS. SUZAN FRASER: Do we have that
3 component of it in Ontario?
4 DR. MICHAEL POLLANEN: No.
5 MS. SUZAN FRASER: All right. And would
6 that be useful?
7 DR. MICHAEL POLLANEN: Yes.
8 MS. SUZAN FRASER: All right.
9 DR. MICHAEL POLLANEN: If I could just say
10 what I know about the -- the CESDI study --
11 MS. SUZAN FRASER: Yes.
12 DR. MICHAEL POLLANEN: -- is that it's a
13 multi-disciplinary epidemiological population based
14 analysis.
15 MS. SUZAN FRASER: Yes.
16 DR. MICHAEL POLLANEN: This is not meant
17 to be an investigative tool. What -- what we have is --
18 COMMISSIONER STEPHEN GOUDGE: This is
19 epidemiology?
20 DR. MICHAEL POLLANEN: Yes.
21 COMMISSIONER STEPHEN GOUDGE: Under whose
22 auspices, do you know?
23 DR. MICHAEL POLLANEN: I don't.
24 COMMISSIONER STEPHEN GOUDGE: Okay. We'll
25 ask Professor Whitwell, I'm sure she'll know.
[Page 215]
1 DR. MICHAEL POLLANEN: And the point here
2 being that we have this -- this tool --
3 MS. SUZAN FRASER: Yes.
4 DR. MICHAEL POLLANEN: -- similar to this
5 for investigations of deaths for -- that come under the
6 coroner's jurisdiction.
7
8 CONTINUED BY MS. SUZAN FRASER:
9 MS. SUZAN FRASER: Right. And just in
10 terms of that tool, is it your expectation as a
11 pathologist that the coroner uses that tool from the
12 outset in terms of forming his or her initial observations
13 at the scene, or is that something that takes place as the
14 investigation evolves?
15 DR. MICHAEL POLLANEN: It's -- it's meant
16 to start at the scene.
17 MS. SUZAN FRASER: All right.
18 DR. MICHAEL POLLANEN: And -- and that's,
19 in fact, what happens.
20 MS. SUZAN FRASER: All right. So your
21 experience is that as a pathologist doing a suddent --
22 sudden unexpected death in infancy, that as part of the
23 materials you receive early on would be the coroner's
24 protocol for sudden and unexpected deaths?
25 DR. MICHAEL POLLANEN: Well, that's a
[Page 216]
1 separate issue. The -- the coroner may -- the coroner
2 usually does fill that document out as part of their
3 investigation. How -- whether the -- the information is
4 always transmitted to the pathologist at the time of the
5 post-mortem examination is a separate matter.
6 But at the time that the case comes to the
7 Death Under -- now -- Five Committee, that information
8 with the police report, the post-mortem report, radiology,
9 et cetera, all comes to the Committee and is analysed.
10 MS. SUZAN FRASER: All right. And I -- I
11 take it --
12 COMMISSIONER STEPHEN GOUDGE: Sorry, does
13 it go to the pathologist?
14 DR. MICHAEL POLLANEN: Variably.
15 Sometimes it does, sometimes it doesn't.
16 COMMISSIONER STEPHEN GOUDGE: What does
17 that turn on?
18 DR. MICHAEL POLLANEN: Well, it turns on
19 if -- if it's actually sent, if the coroner sends it, and
20 whether or not it's done. But in my --
21 COMMISSIONER STEPHEN GOUDGE: So it isn't
22 done in every --
23 DR. MICHAEL POLLANEN: It's supposed to be
24 done in every case, yes.
25 COMMISSIONER STEPHEN GOUDGE: Right,
[Page 217]
1 that's what I thought. Okay. So where it's done and sent
2 to your office, then it would get to the pathologist doing
3 the autopsy?
4 DR. MICHAEL POLLANEN: Not necessarily my
5 office.
6 COMMISSIONER STEPHEN GOUDGE: Yes, but --
7 DR. MICHAEL POLLANEN: The pathologists
8 wherever they are, right.
9 COMMISSIONER STEPHEN GOUDGE: Right.
10 Okay, thanks.
11
12 CONTINUED BY MS. SUZAN FRASER:
13 MS. SUZAN FRASER: So in terms of your
14 protocol, your guidelines to your pathologists, should you
15 be saying to your pathologists that, You should expect and
16 demand that this protocol be received prior to doing your
17 autopsy?
18 DR. MICHAEL POLLANEN: Well, the -- the
19 point here is effective communication.
20 MS. SUZAN FRASER: Right.
21 DR. MICHAEL POLLANEN: And this is
22 certainly one (1) of the ways to accomplish effective
23 communication. Sometimes the -- the better way of doing
24 it is through personal communication --
25 MS. SUZAN FRASER: Yes.
[Page 218]
1 DR. MICHAEL POLLANEN: -- with the
2 coroner.
3 MS. SUZAN FRASER: All right.
4 DR. MICHAEL POLLANEN: So, in -- in the
5 ideal world, we would actually have both. So we would
6 have the coroner's warrant sent to us, we would have this
7 form sent to us, and we would talk to the coroner.
8 MS. SUZAN FRASER: All right. But is it
9 anywhere spelled out to your pathologists that this is
10 something that they should receive? Because I'm just --
11 on the one (1) hand pathologists are familiar with their
12 procedures. They might not be familiar with the coroner's
13 procedures.
14 So is that something that should form part
15 of your instructions generally to your pathologists?
16 DR. MICHAEL POLLANEN: For example, when I
17 -- when I'm thinking now about our autopsy guidelines, I
18 do not believe we have that in the guidelines.
19 MS. SUZAN FRASER: All right. Would that
20 be a good idea?
21 DR. MICHAEL POLLANEN: Yes.
22 MS. SUZAN FRASER: Okay.
23
24 (BRIEF PAUSE)
25
[Page 219]
1 MS. SUZAN FRASER: And just then on the
2 research side of that.
3 We've talked about evidence-based medicine,
4 and I've heard you use that -- sort of having two (2)
5 components, that you draw your conclusions based on the
6 literature that -- that's based on evidence and study.
7 And that the second part of it, that you
8 draw from the evidence that's at the scene, and using
9 those sort of -- the research, and what's apparent to you
10 from the investigation, that's how you draw your
11 conclusions. Is that fair?
12 DR. MICHAEL POLLANEN: Yes.
13 MS. SUZAN FRASER: All right. So the
14 second part of that is, is that you -- and what I put to
15 the expert panel was that it's important to have the
16 actual evidence to -- to do the research.
17 That -- the CESDI the -- for -- for
18 instance, if we wanted to study sudden and -- Sudden
19 Unexpected Death in Infancy in England, we would be much
20 better off because we have years of this data being
21 collected. Is that fair?
22 DR. MICHAEL POLLANEN: Yes.
23 MS. SUZAN FRASER: All right. And that
24 our knowledge in this area can only grow as we standardize
25 the way that the data is collected.
[Page 220]
1 DR. MICHAEL POLLANEN: Correct, yes.
2 MS. SUZAN FRASER: Okay. Thank you, Mr.
3 Commissioner. Those are my questions.
4 COMMISSIONER STEPHEN GOUDGE: Thanks.
5 Before we leave this, there is a question
6 that I have been meaning to ask you. It is a general
7 question, Dr. Pollanen.
8 The evidence-based approach that you have
9 eloquently put forward really has, as its goal, think
10 truth, if I can put it that way, as opposed to "think
11 dirty".
12 Is that a fair juxtaposition?
13 DR. MICHAEL POLLANEN: Yes.
14 COMMISSIONER STEPHEN GOUDGE: Where does a
15 heightened index of suspicion fit into that, if at all?
16 Do you equate that with "think dirty", or
17 is it somewhere in between, or --
18
19 (BRIEF PAUSE)
20
21 DR. MICHAEL POLLANEN: "Think dirty" is an
22 unfortunate turn of phrase.
23 COMMISSIONER STEPHEN GOUDGE: Yeah. Yeah.
24 DR. MICHAEL POLLANEN: I think -- my
25 understanding of "think dirty" is that it was intended to
[Page 221]
1 tell the members of the Death Investigation Team and the
2 pathologist to consider child abuse, and in other
3 circumstances, homicide.
4 I think it has grown to mean something more
5 than it was ever intended to mean. And I think the best
6 way to say this in -- now -- where we -- where we sit now
7 relative to "think dirty", is that if we think truth, if
8 we think objectively, then there is no need to give
9 specific advice about "thinking dirty", for example, or
10 having high -- a high index of suspicion.
11 Because if -- if you're -- if you're
12 allowing the facts to guide your thinking, they will guide
13 you in the correct direction.
14 There needs to be no a priori set up for
15 it. Because if you are engaging the issues in a
16 evidenced-based manner, you will get there.
17 But if it were so simple. The -- the other
18 competing variable is that we have, purely on an operation
19 basis, and out of necessity, have identified a group of
20 cases which are criminally suspicious and homicidal.
21 For the -- for the nature -- because we
22 need to do -- to develop protocols and procedures to deal
23 with those cases. Because it's a -- it's an
24 epidemiological situation that when you have
25 undifferentiated cases -- this large number of
[Page 222]
1 undifferentiated cases, at some point in time before the
2 pathologist gets involved, there has to be some type of
3 streaming.
4 So the streaming happens essentially by the
5 police, with some input by the coroner into this criminal
6 -- this sort of amorphous category of criminally
7 suspicious.
8 And that to some extent is "think dirty",
9 unless you are making that decision, or those decisions
10 are purely being made on the basis of evidence and fact.
11 So there's a lot of -- there's a lot of
12 corollaries that come out of this discussion, but I think
13 the best -- the best framework, or the best model to use
14 to understand the methodology or the desirable process is
15 the framework of an evidence based approach using as an a
16 priori principle: think truth, think objectively, search
17 for the truth.
18 I think that's the best platform because if
19 you do that you don't need to think benign or malignant,
20 the evidence will guide you.
21 COMMISSIONER STEPHEN GOUDGE: Okay. A
22 couple of implications, I am sure more than a couple, have
23 been read into the heightened index of suspicion notion.
24 One is the implication of presumption which you've spoken
25 about; the other is an implication of more thorough
[Page 223]
1 investigation than one would have in a simple case.
2 Is that a fair kind of assertion of two (2)
3 implications that might flow out of the notion of
4 heightened index of suspicion?
5 DR. MICHAEL POLLANEN: You could think of
6 it that way and I'll -- I'll give a concrete example. In
7 the -- if you look at the protocol that -- the analysis
8 that led to the '95 memo, six thirty-one (631) I think it
9 was --
10 COMMISSIONER STEPHEN GOUDGE: Yes.
11 DR. MICHAEL POLLANEN: -- you'll notice
12 that there was an analysis of how frequently x-rays were
13 being done --
14 COMMISSIONER STEPHEN GOUDGE: Right.
15 DR. MICHAEL POLLANEN: -- on infants. And
16 what this -- what they found when they did that analysis,
17 which was a very good analysis, was that x-rays were not
18 being done frequently, or as frequently as would be
19 desirable.
20 COMMISSIONER STEPHEN GOUDGE: Right.
21 DR. MICHAEL POLLANEN: And the reason
22 that's significant is that we -- we know that one of the
23 patterns of child abuse are, for example, multiple
24 fractures.
25 COMMISSIONER STEPHEN GOUDGE: Fractures,
[Page 224]
1 yes.
2 DR. MICHAEL POLLANEN: So the -- the
3 evidence base, to use that term, the -- the conclusion
4 that came from the analysis in the document was "do x-
5 rays". It did not support the conclusion "think dirty".
6 COMMISSIONER STEPHEN GOUDGE: So if
7 heightened index of suspicion means gather all the
8 evidence you possibly can and follow it wherever it leads,
9 you would say that's fine?
10 DR. MICHAEL POLLANEN: Correct. It -- it
11 can include -- it necessarily includes that.
12 COMMISSIONER STEPHEN GOUDGE: Okay. If it
13 was to mean start with an a priori presumption, you would
14 say that's not fine?
15 DR. MICHAEL POLLANEN: Correct. And let
16 me enlarge that one (1) other way and say, we've talked
17 about petechia; well, if we see petechia in someone's eyes
18 at autopsy then that is an indication that the neck will
19 need to be dissected in a special way to determine if they
20 have been strangled.
21 Well, are the petechia telling us to "think
22 dirty"? No.
23 The petechia have within their differential
24 diagnosis, manual strangulation, and because of that we
25 need to apply a technique to detect it if it's there.
[Page 225]
1 So in a way both are achieving the same
2 outcome, except one (1) has as its value a search for the
3 truth platform.
4 COMMISSIONER STEPHEN GOUDGE: Right.
5 Okay, that is a helpful exchange. Thank you.
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