MICHIGAN DEPARTMENT OF ORIGINAL DATE: INCIDENT NO:

STATE POLICE Sat, Jun 25, 2016 062-0003129-16

ORIGINAL INCIDENT REPORT TIME RECEIVED: FILE CLASS:
2330 13002
WORK UNIT:
COUNTY:
MSP HART POST

COMPLAINANT: TELEPHONE NO:

ADDRESS: STREET AND NO: CITY: STATE: ZIP CODE:

INCIDENT STATUS:
OPEN

ASSAULT ON NURSE

SUMMARY:

I was dispatched to the Shelby Hospital for a report of an assault that had occurred. I arrived on the
scene and made contact with the suspect, and interviewed her there.
Several hours later the victim, came to the hospital for treatment. I interviewed her
at the hospital. This report will be forwarded to the prosecutor's office to review for possible charges.

DISPATCH INFORMATION:

I was dispatched to the Shelby Hospital for a report of an assault on medical personnel. Dispatch
advised the hospital had called and advised a suspect involved in an assault of medical staff was at
the hospital there. They advised the assault had occurred at the Electric Forest Festival in the
medical tent.

VENUE:

ELECTRIC FOREST, ELECTRIC FOREST MEDICAL TENT, OCEANA, ROTHBURY, MI

DATE & TIME:

06/25/2016 AT 1900

ARRIVAL ON SCENE:

I arrived at Shelby Hospital and spoke with medical staff there. They advised the victim in the assault
had not come to the hospital, but the suspect in the assault was there seeking treatment. As I spoke
with hospital staff, they did not exactly know how the medical personnel was assaulted, but had heard
the person at the hospital had assaulted medical staff with a syringe.

PAGE: INVESTIGATED BY: INVESTIGATED BY: REVIEWED BY:

1 of 4 PANKIEWICZ, TOMAS, 502, TROOPER
PRINTED: 9/15/2021 09:06
MICHIGAN DEPARTMENT OF ORIGINAL DATE: INCIDENT NO:

STATE POLICE Sat, Jun 25, 2016 062-0003129-16

ORIGINAL INCIDENT REPORT TIME RECEIVED: FILE CLASS:
2330 13002

SUSPECT:

NAM: EMP:
BIR: RAC: ETH:
NBR: DIR: SEX: DL:
STR: DOB: SSN:
SFX: HGT: SI: /
CTY: ST: WGT: FBI:
TXH: ZIP: HAI: MNU:
TXW: EYE: PR:
SMT:

INTERVIEW

I spoke with and asked her what occurred. seemed perplexed

and did not know why I was there. I asked what had happened today. stated
she had taken acid today while at the Electric Forest Festival, and had to be taken into a medical tent,
and was subsequently brought to the hospital by Electric Forest Festival medical staff.

I asked her if she had assaulted a nurse. She stated she had absolutely no recollection whatsoever
of what had happened.

CONTACT DISPATCH:

I contacted dispatch and asked if they had any calls regarding medical staff being assaulted. They
stated this was the only call they had and they had not heard from the victim.

RE-CONTACT FROM DISPATCH:

I was re-contacted by dispatch several hours later and advised the victim in the assault was now at
the hospital seeking treatment. They advised I could meet her at the hospital to speak with her.

COMPLAINANT/VICTIM:

NAM: EMP:
BIR: RAC: ETH:
NBR: DIR: SEX: DL: /
STR: DOB: SSN:
SFX: HGT: SI: /
CTY: ST: WGT: FBI:

PAGE: INVESTIGATED BY: INVESTIGATED BY: REVIEWED BY:

2 of 4 PANKIEWICZ, TOMAS, 502, TROOPER
PRINTED: 9/15/2021 09:06
MICHIGAN DEPARTMENT OF ORIGINAL DATE: INCIDENT NO:

STATE POLICE Sat, Jun 25, 2016 062-0003129-16

ORIGINAL INCIDENT REPORT TIME RECEIVED: FILE CLASS:
2330 13002
TXH: ZIP: HAI: MNU:
TXW: EYE: PR:
SMT:

CONTACT WITH

I was directed by hospital staff to one of the emergency rooms to speak with I
made contact with her there. She identified herself verbally as and advised she
had been the E.R. nurse who had been assaulted by one of the Electric Forest Festival goers.
advised she was employed as a nurse by CrowdRX, which was the medical staffing company
used for the Electric Forest Festival.

I asked what had occurred. She stated EMS had brought in a female who had been having a
bad reaction to a psychedelic drug. She stated the female had been placed onto a cot and had been
tied down onto the cot, using soft restraints, as she was swinging her arms wildly. She stated the
suspect had broken free from one of her restraints and was thrashing around wildly, screaming, and
was completely incoherent and did not appear to be coherent with her surroundings.

stated the doctor had intended to give the suspect a sedative in the arm. She stated she was
on the right side of the suspect who was lying down on the cot and several people were holding down
the suspect's arms. The doctor attempted to inject the suspect with the sedative, but had missed
while attempting to deliver the sedative. She stated the doctor repositioned the syringe towards the
upper arm of the suspect and had stuck the needle into the suspect's upper arm. She stated at this
time the suspect's left arm came free and the suspect grabbed the needle out of the doctor's hand
with her left hand and pulled the syringe out of her arm and took the syringe and had stabbed her four
times in the stomach area. showed me the four marks on her stomach where she had
received the injection marks. I observed four small red marks on the middle of her stomach.

I asked why she had not reported this immediately. stated she had some confusion of
who to report it to. She stated she was really unsure who to report it to, whether she needed to
contact the troopers at the Electric Forest Festival, or whether she had to contact Oceana County
troopers.

stated a medical screening had been done of the suspect to ensure she had not received any
communicable diseases and she advised the initial report was the suspect tested negative for those
communicable diseases which could have been transferred from the needle.

advised she did wish to pursue charges. She felt in pursuing charges, this may be an eye-
opener for the suspect and may deter her from using psychedelic drugs in the future.

INJURIES:

PAGE: INVESTIGATED BY: INVESTIGATED BY: REVIEWED BY:

3 of 4 PANKIEWICZ, TOMAS, 502, TROOPER
PRINTED: 9/15/2021 09:06
MICHIGAN DEPARTMENT OF ORIGINAL DATE: INCIDENT NO:

STATE POLICE Sat, Jun 25, 2016 062-0003129-16

ORIGINAL INCIDENT REPORT TIME RECEIVED: FILE CLASS:
2330 13002
I observed four small red marks on the middle of stomach. Those marks were
photographed and the photographs will be uploaded to the MSP crime scene repository.

CRIME VICTIM'S RIGHTS:

Crime victim's rights were issued and explained.

RE-CONTACT

I spoke with who was still at the hospital. I asked her why she had stabbed one of the
nurses at the Electric Forest Medical tent with a syringe. stated she had no recollection of
such a thing and did not believe this had even occurred. stated she had no recollection of
what occurred at the medical tent and the last thing she had remembered was taking acid and then
being at the Shelby Hospital, is where her recollection returned to her.

I advised that I did believe that an assault had occurred and my report would be forwarded
to the prosecutor's office for review. stated she understood. stated though she
had no recollection of what had occurred, she was very remorseful for what had happened. She
stated it was never her intent to hurt anyone.

CCH:

CCH will be forwarded to MISTY at the Oceana County Prosecutor's

Office on 07/11/16.

PROSECUTION REQUESTED:

This report will be forwarded to the prosecutor's office for review.

EXTERNAL DOCUMENTS:

None

STATUS:

OPEN, pending prosecutor review and supplement report done by TPR. VELDKAMP.

PAGE: INVESTIGATED BY: INVESTIGATED BY: REVIEWED BY:

4 of 4 PANKIEWICZ, TOMAS, 502, TROOPER
PRINTED: 9/15/2021 09:06
MICHIGAN DEPARTMENT OF ORIGINAL DATE: INCIDENT NO:

STATE POLICE Sat, Jun 25, 2016 062-0003129-16

SUPPLEMENTAL INCIDENT REPORT SUPPLEMENTARY DATE: FILE CLASS:
0001 Sun, Jun 26, 2016 13002
INCIDENT STATUS:
OPEN

ASSAULT ON NURSE

NO JOURNALS

SUMMARY:

Trooper Pankiewicz requested that I do some follow up regarding the initial investigation. He asked
that I interview witnesses to the original incident.

WITNESS:

NAM: DR. EMP:

BIR: RAC: ETH:
NBR: DIR: SEX: DL: /
STR: DOB: SSN:
SFX: HGT: SI: /
CTY: ST: WGT: FBI:
TXH: ZIP: HAI: MNU:
TXW: EYE: PR:
SMT:

CONTACT DR.

I spoke with DR. regarding the incident. The doctor said that the patient/suspect was
significantly under the influence of drugs. He said that he had a needle and was giving the patient a
shot in the right arm/shoulder area. He said that the patient simply reacted to the pain of the needle,
grabbed it and began flailing about, and then made contact with the nurse in the stomach with the
needle. The nurse was assisting with holding the patient down while he applied the shot. I asked
DR. if he thought that the actions were intentional. DR. stated he did not
believe the patient was specifically targeting the nurse. DR. stated the patient was in a
highly influenced state due to the narcotics she was on and was not aware of her actions, nor did it
seem like an intentional assault on the nurse.

PAGE: INVESTIGATED BY: INVESTIGATED BY: REVIEWED BY:

1 of 3 PANKIEWICZ, TOMAS, 502, TROOPER VELDKAMP, LANCE, 62, TROOPER
PRINTED: 9/15/2021 09:06
MICHIGAN DEPARTMENT OF ORIGINAL DATE: INCIDENT NO:

STATE POLICE Sat, Jun 25, 2016 062-0003129-16

SUPPLEMENTAL INCIDENT REPORT SUPPLEMENTARY DATE: FILE CLASS:
0001 Sun, Jun 26, 2016 13002
WITNESS/MEDICAL SUPERVISOR:

NAM: EMP:
BIR: RAC: ETH:
NBR: DIR: SEX: DL: /
STR: DOB: SSN:
SFX: HGT: SI: /
CTY: ST: WGT: FBI:
TXH: ZIP: HAI: MNU:
TXW: EYE: PR:
SMT:

CONTACT WITH

I spoke with regarding the incident. said he was also assisting with holding down
the patient/suspect, when the doctor was trying to give the patient a shot. said he was
dle went into the arm; the patient
reacted by grabbing the needle with her left hand. After grabbing the needle, she jerked around and
swung the needle, poking in the abdomen. When I asked if it looked intentional,
said he did not think the patient was intentionally targeting the victim. said that if
had he been standing where the victim was standing, he would have been the one that was poked.
said he thought it was a jerk reaction to the needle poke.

WITNESS/MEDIC:

NAM: EMP:
BIR: RAC: ETH:
NBR: DIR: SEX: DL:
STR: DOB: SSN:
SFX: HGT: SI: /
CTY: ST: WGT: FBI:
TXH: ZIP: HAI: MNU:
TXW: EYE: PR:
SMT:

INTERVIEW

I asked what had happened that night. tatement matched the two prior accounts.
Similarly, said the patient was given a shot in her right arm. In reaction, she grabbed the
needle with her left hand, and stabbed the victim in the abdomen. I asked if he thought it looked
intentional. He said he did not think the suspect was specifically targeting the victim. He did say that
her intent was to get free of the medical tent and get back into the festival. He said it looked as

PAGE: INVESTIGATED BY: INVESTIGATED BY: REVIEWED BY:

2 of 3 PANKIEWICZ, TOMAS, 502, TROOPER VELDKAMP, LANCE, 62, TROOPER
PRINTED: 9/15/2021 09:06
MICHIGAN DEPARTMENT OF ORIGINAL DATE: INCIDENT NO:

STATE POLICE Sat, Jun 25, 2016 062-0003129-16

SUPPLEMENTAL INCIDENT REPORT SUPPLEMENTARY DATE: FILE CLASS:
0001 Sun, Jun 26, 2016 13002
though she was trying to do anything possible to get free. He did not believe the suspect was
targeting the nurse, however, was aggressive with the intent of getting away.

STATUS:

Open pending prosecutor review.

PAGE: INVESTIGATED BY: INVESTIGATED BY: REVIEWED BY:

3 of 3 PANKIEWICZ, TOMAS, 502, TROOPER VELDKAMP, LANCE, 62, TROOPER
PRINTED: 9/15/2021 09:06
MICHIGAN DEPARTMENT OF ORIGINAL DATE: INCIDENT NO:

STATE POLICE Sat, Jun 25, 2016 062-0003129-16

SUPPLEMENTAL INCIDENT REPORT SUPPLEMENTARY DATE: FILE CLASS:
0002 Wed, Jul 20, 2016 13002
INCIDENT STATUS:
EXCEPTIONAL CLEARANCE

ASSAULT ON NURSE

JOURNAL:

07/09/16 Capling I/R and Supp #1 reviewed this date. Sent to PA for review.
07/11/16 Rios DB review- NTO- If the prosecutor authorizes a complaint you will need a SW
for the suspects medical records for her toxicology.

PROSECUTION DECLINED:

RECONTACT SUSPECT:

On 7/20/16, I spoke with

RECONTACT VICTIM:

On 7/20/16, I left a voicemail, advising her of the

authorize charges regarding this incident. I provided with my contact information and
encouraged her to call me if she had any questions.

EXTERNAL DOCUMENTS:

None.

STATUS:

EXCEPTIONAL CLEARANCE PROSECUTION DELCINED

PAGE: INVESTIGATED BY: INVESTIGATED BY: REVIEWED BY:

1 of 1 PANKIEWICZ, TOMAS, 502, TROOPER PANKIEWICZ, TOMAS, 502, TROOPER
PRINTED: 9/15/2021 09:06