The Blogs: The Court of Public Opinion: Ellen Greenberg vs Nancy Grace

“Adverse reaction” is the rather euphemistic term for a wide range of unintended side effects of taking medications; it turns out that term can also be accurately applied to certain responses to blog posts about controversial deaths. Beginning less than 24 hours after my first post about the Ellen Greenberg case, and continuing throughout the entire week since, waves of reaction washed over me from several directions. Split fairly evenly, three camps emerged: those who enthusiastically agreed with my argument that Ellen killed herself in a psychotic episode; those whose reaction was a rather emotionless acknowledgement that I’d raised points they hadn’t previously considered; and finally, as most criminal defense attorneys have experienced a time or two, a group of people found colorfully expressive ways to let me know that they think I, and my theory of the case, are both “unacceptable” to them in every way.

The essential mystery of this case is tragically simple to frame: was Ellen murdered, or did she kill herself? The controversy has been set up by the clash of two sets of facts, kind of like the irresistible force meets the immovable object: On one side, there are the mechanics of how she died, which are definitely unusual for typical suicides. On the other side, there is overwhelmingly strong evidence that Ellen was alone in her apartment when she was stabbed, enough to make it a physical impossibility that anyone else could be responsible except her. How can these be reconciled?

In summary, Ellen suffered 20 stab wounds, 10 of which were to the back of her neck. She also had a series of bruises around her body, in various levels of severity. She was stabbed in her chest several times, all of which were through her clothing, and she left no suicide note. The people who are convinced that Ellen was the victim of murder are centering their argument around these facts.

However, multiple independent agencies investigated the scene, and the key facts upon which they agree include that there were only two doors to the apartment: the front, which was manually bolted from the inside, and a sliding glass door to the balcony, which was on the 6th floor, and was covered in undisturbed, fresh snow. There was nobody else’s blood, fingerprints, or DNA on the single knife that was used in the killing, which was still lodged in Ellen’s chest when police arrived. Ellen had no defensive wounds on her hands or arms; none of the stab wounds are slashes – most are very shallow, except for two that were deep. The apartment had no signs of any struggle – it was entirely clean and ordered. The blood stains proved that the entire act of violence occurred in one small area of the kitchen, meaning Ellen stood in place; there was no chase, no fight, nothing knocked down or askew. The neighbors heard nothing in the way of fighting or shouting, and Ellen herself never called for any help.

Legally speaking, there are only five options for medical examiners to use in their findings to determine a manner of death: natural, accident, suicide, homicide, or undetermined. In this case, various experts have concluded each of the last three, and at least one has changed his mind. The fact that such a conflict exists means there is some evidence to support each of those conclusions. How is that conflict possible?

In a trial in US criminal court, the issue is what conclusion is proven beyond a reasonable doubt. Ultimately, although the burden of proof is legally imposed upon the prosecution in criminal cases, and defendants are supposed to be protected by the presumption of innocence, the reality is the opposite: if police and prosecutors are making a serious enough accusation against someone to charge that person and put him in jeopardy of going to prison, people tend to believe the authorities. In reality, the defense has to come up with a damn good explanation. Rare are the instances when the defense finds an issue that everyone else has missed, but they do occur. Ellen’s case is a perfect example.

Among the many responses I received after writing about this case the first time, two in particular advanced my knowledge of both the case itself and of its profile, so I’m writing this follow-up to address them. First, someone sent me 24 pages of official case documents, including the following:

An Investigation Report from the Office of the Medical Examiner (OME), by Investigator Stephen Olszewski (4 pages, with no opinions or findings expressed);
An OME Report of Examination by Assistant Medical Examiner Dr. Marlon Osbourne (6 pages, with no opinions expressed, but describing detailed findings of the post-mortem examination of Ellen’s body);
The OME’s Findings and Opinions, also by Assistant Medical Examiner Dr. Marlon Osbourne, ruling the case a suicide (1 page);
An OME Toxicology Report by Toxicologist Lisa Mundy stating that preliminary colorimetric testing was negative for alcohol, but gas chromatograph/mass selective detector tests were positive for both Zolpidem and Clonazepam (1 page);
An opinion letter from Dr. Cyril Wecht to Ellen’s father Dr. Joshua Greenberg stating that the “manner of death…is strongly suspicious of homicide” (5 pages);
Another letter of opinion from Dr. Wayne Ross to a “consultant” named Thomas Brennan, Jr., stating that “…scene findings were indicative of a homicide”, although reserving the right to amend that opinion pending further information (1 page);
Another opinion letter to the same consultant from The Henry C. Lee Institute of Forensic Science at the University of New Haven, signed by Dr. Lee (PhD) and an attorney named Elaine Pagliaro, stating that “The number and type of wounds and bloodstain patterns observed are consistent with a homicide scene” (3 pages);
And finally, a 2-paragraph email from Joe Grace “@attorneygeneral.gov” to Stephanie Farr “@phillynews.com” with 2 attached pages purporting to show the results of the AG office’s investigation of internet searches that had been performed on Ellen’s personal computer “in the weeks before her death” which concludes that the “evidence supports Suicide as the manner of death.”

The second response of significant interest was a link to a story in People magazine about an imminent book release by noted American legal commentator and former prosecutor Nancy Grace, in which she claims to “know” that Ellen didn’t kill herself. Although Ms. Grace accuses nobody in particular of murder, she goes to great lengths to express strong support for Ellen’s parents, who have always believed their daughter was murdered. https://people.com/ellen-greenberg-death-nancy-grace-new-book-exclusive-11714118?utm_campaign=people&utm_content=likeshop&utm_medium=social&utm_source=instagram

Trials in actual court are much more structured and formal than trials that occur in The Court of Public Opinion, but here you don’t have to pass voir dire to sit on the jury. To the extent that Ms. Grace (or anyone) is inclined to make an accusation of murder in this case, I stand ready to vigorously defend.

To begin, my previous post about this case cited a source to suggest that Ellen had combined Ambien with wine, but that may not be the case. Her post-mortem toxicology report was negative for alcohol, although that finding is only based on a preliminary test that is known to be unreliable because it relies on color interpretation by the naked eye (see a 2024 study by the doi Foundation https://advanced.onlinelibrary.wiley.com/doi/full/10.1002/adma.202409297). However, we now know as a matter of medical certainty that at the time of her death, Ellen Greenberg was on Clonazepam (brand name Klonopin) and Zolpidem (brand name Ambien), to treat “severe anxiety,” and that combination might be much worse.

Before I get into this too deeply, this seems like the right moment for some humanity. In all the years I spent in the largest and busiest criminal defense office in the world – The Cook County (Chicago) Public Defender’s Office – I read tens of thousands of reports related to violent crimes, including innumerable toxicology and post-mortem examination reports. Meeting someone is personal; legally examining the details of their bodies and their darkest secrets is far more intimate. When I see pictures of dead people, I am acutely aware that I am seeing a person at their most vulnerable, in a state they never got to see for themselves. When I read the accompanying medical reports, which go into excruciating detail about the shape, size, color, texture, and condition of their internal organs, or the aspects of their mental condition that they may have hidden from their family and friends…”intrusive” doesn’t seem like a strong enough word. On this point, I think prosecutors (including Ms. Grace) and I agree: the obligation to get justice for victims of violence by getting to the truth is as holy a duty to which a person can accede. And although it’s not the same as violent crime, I know what it feels like to experience searing, seemingly inexplicable grief: I lost my wife to pancreatic cancer when she was only 43 years old, and our kids were 13 and 11. For what it’s worth, to the Greenbergs and anyone else who needs to hear it: I am so very deeply sorry for your loss. May her memory be a blessing to you always.

In that same exact vein of mercy, we must acknowledge that Ellen was being treated for a mental health issue when she died. When the investigator from the Philadelphia Medical Examiner’s Office (Olszewski) interviewed Ellen’s parents shortly after her death, they said she had been “battling issues with anxiety since the end of [the previous year]. Mom states she was ‘struggling with something,’ for which she urged her to seek help. She was seeing a psychiatrist, Ellen Berman, in Merion Station. The decedent was described as anxious, insecure, not sure of herself and not liking how she felt, characteristics that were not the norm her entire life.” (OME Investigation Report, page 3). Per the same page of the same report, psychiatrist Ellen Berman was interviewed, and the report details what she said:

“…the decedent presented initially as severe anxiety for 2 months. During her brief sessions it was believed that she was doing well but the school district changed some regulations. She also had issues with difficult students. She didn’t know whether to quit or work through it.

Berman was in the process of developing a treatment plan and was in contact with the decedent’s mother who called expressing concerns for her daughter. There was never any feeling of suicidal thoughts. When asked about her fiancée, the decedent had nothing but good things to say about him, mentioned they were getting married, and he was wonderful. Berman even noted a smile when she spoke of him. Berman recalls asking about abuse, the decedent denied any verbal or physical confrontations.

The decedent was initially prescribed medication, although she expressed the uneasiness of taking medication. She tried Zoloft first, and then switched to a low dose of Xanax. After no success, Berman prescribed her ambient [sic] and clonopin [sic] to help her get sleep. There was never any indication of abusive behavior.”

The problem with all the reports and analyses are that none of them address the drugs Ellen had inside her at the time of her death. Specifically, what could be the behavioral effects of taking Zolpidem and Clonazepam independently, or, as in this case, in combination with each other?

Which brings us back to adverse reactions. Clonazepam (Klonopin) is a benzodiazepine medication used to prevent and treat anxiety disorders, seizures, bipolar mania, agitation associated with psychosis, obsessive–compulsive disorder, and akathisia – which is a neuropsychiatric syndrome of “psychomotor restlessness,” meaning the inability to remain physically still. According to The National Alliance on Mental Illness (NAMI), Clonazepam users can experience “rare and serious side effects, including…various behaviors while they were asleep/not fully awake, such as sleep driving, making phone calls, and preparing or eating food. The individuals have no memory of the events when they awaken.” https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/clonazepam-klonopin/

As described in my first post about this case, Ambien also carries the risk of adverse side effects, including “unusual complex behavior” and “neuropsychiatric reactions such as visual hallucinations/sensory distortion, delirium, amnesia, sleepwalking/somnambulism, and nocturnal eating.” https://pmc.ncbi.nlm.nih.gov/articles/PMC3067983/ The American Addiction Center notes that “The side effects of Ambien may range from mild symptoms such as drowsiness to more severe symptoms that should be discussed with your doctor, including complex sleep behaviors, suicidal thoughts, and significant next-day impairment.” https://americanaddictioncenters.org/ambien-treatment/side-effects The world-famous Cleveland Clinic warns: “After taking this medication, you may get up out of bed and do an activity that you do not know you are doing. The next morning, you may have no memory of this. Activities include driving a car, (“sleep-driving”), making and eating food, talking on the phone, sexual activity, and sleepwalking. Serious injuries have occurred. Stop the medication and call your care team right away if you find out you have done any of these activities. Do not take this medication if you have used alcohol that evening. Do not take it if you have taken another medication for sleep. The risk of doing these sleep-related activities is higher.” https://my.clevelandclinic.org/health/drugs/20871-zolpidem-tablets

Further, the warnings for each drug specifically caution against combining them with each other, because mixing them increases the risk of adverse side effects. Several sources can be found with detailed warnings, such as this one from the US government: “Clonazepam may increase the risk of serious or life-threatening breathing problems, sedation, or coma if used along with certain medications. Call your doctor or get emergency medical treatment if you experience any of the following symptoms: unusual movements; ringing in your ears; anxiety; memory problems; difficulty concentrating; sleep problems; seizures; shaking; muscle twitching; changes in mental health; depression; burning or prickling feeling in your hands, arms, legs or feet; seeing or hearing things that others do not see or hear; thoughts of harming or killing yourself or others; overexcitement; or losing touch with reality.” https://medlineplus.gov/druginfo/meds/a682279.html

Ellen’s mother and her psychiatrist both denied that Ellen had any suicidal thoughts, right? Well, that’s where the Attorney General investigation comes in: during the weeks immediately before her death, while she was being treated for severe anxiety, the AG’s office found that her personal computer was used to search for the following terms: suicide methods, quick suicide, painless suicide, several queries about unusual deaths, and many inquiries about prescription drugs.

What about the medical consultants who concluded that her manner of death was consistent with homicide based on the absence of a suicide note, the number of stab wounds, and the fact that she was stabbed through her clothing? None of the consulting experts were asked to opine about unintentional suicide via a psychotic episode that was caused by an adverse reaction to a combination of Ambien and Klonopin. All of the facts they relied on to suspect homicide are, in fact, entirely consistent with a violent, psychotic episode that occurred while the victim was effectively sleep-walking. Ellen had some suicidal thoughts as a result of her severe anxiety, but was not likely to act of them until she combined Ambien and Klonopin, which combined with her unique biochemistry and mental state to produce deadly results. This is the only scenario that truly fits all the facts.

I’m sure Nancy Grace is trying to find answers for Ellen’s parents, and in that endeavor, we entirely agree. But it has to be pointed out that Ms. Grace has been famously wrong. A lot. Maybe she feels the need to stir up controversy to sell books or drive up ratings for her television appearances, I don’t know. But her Wikipedia page lists many instances where she has driven speculation that has turned out to be tragically wrong in famous cases, including the cases of the Duke Lacrosse team; Elizabeth Smart’s kidnapping; the kidnap and murder of Danielle van Dam; the Caylee Anthony acquittal; Whitney Houston’s accidental death; the death of wrestler The Ultimate Warrior; and Amanda Knox’s tragedy in Italy. Grace’s accusations have been loud, public, and at times cruel enough to be directly linked to two known suicides of people she targeted: Melinda Duckett, and Toni Medrano. https://en.wikipedia.org/wiki/Nancy_Grace

Sam Goldberg doesn’t deserve to be accused of murdering Ellen Greenberg, even indirectly. Just as strongly as Ms. Grace says she “knows” Ellen didn’t kill herself, I know she did, because that is the only scenario that is consistent with all the evidence. Again, I hope her family can take some solace from knowing that in the scenario I believe to be true, Ellen did not specifically intend to do what she did. This case is truly a tragedy, and I worry it’s about to be compounded by the release of a deeply misguided book.