First Posted: 1/6/2014
WILKES-BARRE — Former state Sen. Raphael Musto will likely die if his trial on public corruption offenses is held, a medical doctor proclaimed, while a psychiatrist testified Monday Musto is not competent to challenge his accusers.
Musto’s state of mind and ability to concentrate and recall facts are being hampered by rising levels of ammonia in his brain caused by non-alcoholic cirrhosis of the liver, Dr. Cataldo Doria and Dr. Susan Rushing testified before U.S. District Court Judge A. Richard Caputo.
The hearing Monday was held to determine if Musto is competent to stand trial that is scheduled to begin with jury selection next week.
After attorneys completed their closing testimony at about 5:07 p.m., Caputo said he wanted to “reflect a little bit” on the evidence presented and would have a decision by the end of the day today.
A federal grand jury in November 2011 charged Musto with accepting $25,000 from a construction contractor who developed various properties in Luzerne and Lackawanna counties in a scheme to secure Musto’s continued support for other construction projects.
Musto’s attorneys, John E. Riley and William J. Murray, identified the contractor as Robert Mericle.
The indictment also alleges Musto accepted thousands of dollars in cash from another unnamed individual affiliated with Northeastern Pennsylvania municipal authorities. Musto allegedly accepted those cash payments in the 1990s as a reward for having helped the municipal authorities obtain loans and grants.
Rushing, a psychiatrist at the University of Pennsylvania, Perelman School of Medicine, said Musto is not competent to assist his lawyers in preparation for trial, nor is he competent to stand trial.
Rushing, who was court appointed to evaluate Musto’s mental status, said the former state senator from Pittston Township couldn’t finish drawing a clock showing 10:50 and finish a simple test of matching letters with numbers, such as A=1, B=2, C=3.
“It’s easy to engage in a conversation with him, but it may not be the conversation you want,” Rushing said.
She said she diagnosed Musto as having mild cognizant ability, which is one stage short of dementia.
Musto’s diminished mental capacity was blamed on his liver disease that has caused toxins, such as ammonia, to build up in his body including in his brain, said Doria, chief of organ transplant surgery at Thomas Jefferson Hospital in Philadelphia.
Doria said Musto’s liver disease has contributed to other ailments, such as rapid weight loss, fluid retention, extreme fatigue and dermatitis or constant itching of the skin. Doria said Musto has an inoperable thoracic aneurysm that could rupture if Musto’s blood pressure rises, which he predicted it will from the stress of a trial.
“Mr. Musto has so many medical problems that is affecting his cognitive ability. I don’t think it is reversible,” Doria testified.
Doria said that if Musto’s blood pressure rises and causes the aneurysm to rupture, “Mr. Musto will die. He is not a candidate for surgery, for any kind of surgery.”
Musto, dressed in a dark blue suit that hung from his body, sat quietly with his hands folded across his upper chest and his chin resting on his fingers. During a break in the hearing, he took tiny steps to the rest room while being assisted by his family.
When he returned to the courtroom, he dropped into his chair.
It appeared Musto had dozed off a few times during the all-day hearing. He turned around to look at the clock hanging on the wall behind him.
While Rushing and Doria offered their opinions, Dr. K. Rajender Reddy said he found Musto has the ability to stand trial.
Reddy, professor of medicine and director of hepatology specializing in liver transplants at the University of Pennsylvania, Perelman School of Medicine, said Musto did not display certain medical ailments he would expect from a person suffering liver cirrhosis, despite high levels of ammonia in the brain. Musto’s fluid retention is being handled by medication, Reddy said.
Reddy said he expects Musto has a 90 percent chance of living two more years.
“I see no good reason for someone not to be able to go to trial,” Reddy told U.S. assistant attorneys Michael Consiglio and Gordon Zubrod.