SPRINGFIELD, Mo.– The second day of the trial of a woman accused of causing a car crash and subsequently slamming her car into the other driver in Springfield in November 2018 ended with the prosecution resting, with a continuation of the trial to be held tomorrow, June 8.

Elizabeth McKeown is being charged with first-degree murder and armed criminal action. During the second day of the trial, the defendant McKeown’s daughter, 22-year-old Brianna Shane McKeown, Greene County Medical Examiner Deiter Duff and Leigh Anne Nelson, an associate professor at the University of Missouri-Kansas City School of Pharmacy all testified.

From each testimony the courtroom learned of the injuries suffered by Barbara Foster which led to her death, the strange behavior of McKeown the day of the crash and how McKeown could potentially have suffered from an unintentional psychosis during the crash.

Here’s what was uncovered from each testimony:

The medical examiner’s testimony

Examiner Duff’s testimony confirmed injuries suffered by Foster which are believed to have caused her death are consistent with injuries that would have been caused by being struck by a car. This testimony, Duff said, was based on photos of the victim that were taken on-scene by a responding officer, as well as an autopsy of Foster.

The manor of Foster’s death the examiner reported was homicide.

This is consistent with the initial probable cause statement after the crash, which reported that McKeown had backed up into Foster and Foster’s car, and ran over her after she was knocked down.

The testimony of McKeown’s daughter

McKeown’s daughter said during her testimony that her mother had one bottle of cough medicine, but that she never saw her mother drinking the medicine.

On the day of the crash, Brianna McKeown said she had seen her mother before leaving acting strangely.

“She kept saying the words ‘red tomato’ and then laughing,” McKeown said.

While Elizabeth McKeown is a former alcoholic, Brianna McKeown said her mother had checked with a pharmacist before purchasing cough medicine for a cough she had to ensure there was no alcohol in it.

The pharmacy expert’s testimony

The third testimony heard on Wednesday from Nelson focused on the effects the cough medicine McKeown had taken that day could have affected her and potentially delivered her into psychosis. The cough medicine McKeown is assumed to have taken contains dextromethorphan, which according to Nelson cannot be metabolized by the liver of about 6 percent of caucasian people.

Nelson said the erratic behavior she had been shown from McKeown was potentially contributed to by toxicity experienced from her body’s inability to metabolize dextromethorphan the same as somebody without the condition would.

“If you are a normal metabolizer, your levels should be 2 nanograms per mL, and toxicity is expected to occur at 100 times that dose or that level, so that would put you at 200 nanograms per mL,” Nelson said. “Her level was 350 nanograms per mL, so I am confident that she, based on that level and the descriptions of her behavior and her speech, that she was experiencing toxicity related to dextromethorphan.”

Nelson went on to say that if McKeown had consumed the entire bottle of cough medicine her levels would likely be significantly higher than what was recorded, and she does not believe McKeown had consumed an entire bottle of cough medicine. As well, tests returned on McKeown’s liver enzymes indicated that her liver was functioning as normal.

“If she took a dose of cough medicine and is a poor metabolizer of that, her level would expect to be about 100 times higher than what you would see in a normal person, but that’s just an estimate,” Nelson said. “It would be extremely rare for a normal metabolizer to experience what was described in court.”

Nelson also said she recommended further testing be done on McKeown’s liver to determine if she is a poor metabolizer, as well as testing for her overall health.


The trial will be continuing on Thursday, with the majority of that time spent hearing witnesses called by the defense.