‘Covered in blood’: Doctor testifies during third day of the Nakamoto attempted murder trial

The trial of Aaron Nakamoto, who allegedly severely injured two women, on Wednesday included testimony of the doctor who treated all three people involved in the Oct. 12, 2014, incident.

Although there is no dispute that Nakamoto and the women fought that night, the extent of the injuries and who is responsible remain questions before the court.

Dr. Tracey Banks-Greczanik was the on-duty emergency room doctor that night at North Hawaii Community Hospital.

The first group to come in was Hanna Luepkes, Carly Ann Sugimoto and Lansen Paolo. Paolo had driven the two women to the hospital.

They were “covered in blood,” Banks-Greczanik said, some of which had already clotted.

She determined only the women had been cut and began to survey their injuries.

“There definitely was a life-threatening emergency,” she said, and she directed an increase to trauma level one.

This activation brought the on-call surgeon to the hospital, in case surgery was needed.

The most concerning injury was the cut on the front and right of Luepke’s neck, Banks-Greczanik said, due to the body systems in the area.

That cut threatened the carotid artery that takes blood away from the heart, the jugular vein that brings blood to the heart and the trachea, which is the primary air supply to the lungs, Banks-Greczanik said.

“The carotid artery is the artery that provides most of the blood to the brain,” she said. If it is injured, “you can bleed to death very quickly,” she said.

Leupkes’ other major injury began beside her right eye, ran along the side of her head and struck her upper ear.

Banks-Greczanik said the injury continued bleeding during the exam. She said the smooth edge of the cut meant it was made with a “very sharp edge,” such as a knife or a piece of glass.

Sugimoto also had severe injuries, one that threatened her life, the doctor reported. A puncture-type wound to her chest, also by a sharp implement, struck Sugimoto’s sternum. That is also known as the breastbone.

“The majority of the trauma was spared by the fact it was on the sternum,” the doctor said.

If the injury had not struck the bone, Banks-Greczanik said, it would have struck a major blood vessel and Sugimoto would have “died in seconds.”

The deep cut on Sugimoto’s left arm required three layers of stitches — one to relink the muscle and two for layers of the skin, she said.

Banks-Greczanik treated Nakamoto after he was later brought to the hospital by ambulance.

There was an injury on his outer right leg, she said, which combined the depth of a puncture wound with the breadth of a laceration. She was concerned about damage to an artery, but no such injury occurred. The treatment include stitching, she said.

Both of the bones in his nose were fractured, which cannot be treated in such a situation, she said.

During cross-examination, defense attorney Robert Kim established that Banks-Greczanik had listed all of the major injuries at the “substantial” level instead of any at the more critical “serious” level in her instructions to other physicians.

While Leupkes was in the hospital, testing showed amphetamines in her system. She did not have a prescription for the drug, often sold as Adderall.

On Wednesday she testified she had taken the pill the previous day. Kim pointed out that there was no way to verify that.

Paolo, her live-in boyfriend, said in his testimony that the medication did not noticeably change her personality or mood.

“In fact, she’s more to herself while on the drug,” he said.

She took the pill as an aid to her work, he said, since it allowed her to focus better with a large number of people.

She was fairly infrequent in use, he said, taking it at most twice a week.

Today is the last day for the prosecution’s presentation, beginning with the doctor who operated on Luepkes. The defense will then begin its case.