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Elizabeth Holmes- Case Archive
personpersonAudra ZachmanAudra ZachmanNurse practitioner who provided prenatal care to Brittany Gould.← All People
Expert witness

Audra Zachman

Nurse practitioner who provided prenatal care to Brittany Gould.

AppearedFederal Criminal Trial
315 lines·7 proceedings·4 mentions

About

Audra Zachman testified for the government about evaluating Theranos for a Phoenix-area obstetrics practice and interpreting HCG results used in pregnancy care. The court permitted her to offer expert opinions on the clinical interpretation of those results and instructed jurors that they could accept, reject, or assign weight to her opinions.

Zachman reviewed Brittany Gould's serial laboratory reports and explained that a reported decline from 12,558 to 125.58 suggested a possible pregnancy loss, leading her to say the pregnancy appeared nonviable. Results from another laboratory later rose in a pattern that she considered consistent with viability. Theranos corrected the 125.58 result to 12,558 and attributed the original report to human entry error, but Zachman said the correction did not restore her confidence because identical values two days apart remained clinically unusual. She testified that she stopped referring patients to Theranos for HCG testing.

Cross-examination established that Zachman's expertise was limited to clinical interpretation rather than immunoassay mechanics, variability among assays, or technical report language. She explained that HCG trends must be considered alongside pregnancy timing, symptoms, ultrasound findings, and repeat testing. She also acknowledged Theranos's apology, stated corrective measures, offers of assistance, a comparative study, continued patient-submitted Theranos results, and a government-requested chart review that found few apparent issues. She denied that prosecutors expected her to identify additional problems.

The court struck Zachman's initial answer that she had never encountered a similar discrepancy because additional foundation was required. After further questioning, she described her estimate of testing volume as approximate and said cautiously that another comparable event likely would have stood out. On redirect, she maintained that the comparative study did not restore her confidence and did not recall resuming referrals to Theranos.

Trial Record (7)

FederalFederal Criminal TrialAug 31, 2021 – Jan 3, 2022Called by prosecution

Audra Zachman testified about how conflicting serial HCG reports affected a pregnancy assessment and why Theranos's correction and follow-up study did not restore her confidence. Cross-examination narrowed her expertise to clinical interpretation and examined the limited number of other questionable results found in her chart review.

Day 9

ProceduralEvidentiary HearingMentioned

Summary

The court set an initial protocol for displaying selected Holmes-Balwani messages, confirmed limits on customer-impact testimony, and addressed corrected test reports without deciding all message-specific objections.

Mentioned in this proceeding.

DirectAudra Zachman — DirectAudra ZachmanJohn C. Bostic6highlights193lines spoken

Summary

Audra Zachman testified that conflicting Theranos HCG results led her to warn Brittany Gould of a likely pregnancy loss, while later Quest results and a successful pregnancy caused her to doubt Theranos and stop HCG referrals.

Highlights (6)

Quote“WELL, IF YOU RECEIVE A LAB RESULT AND YOU HAVE TO WONDER OR YOU'RE NOT SURE IF IT'S ACCURATE OR NOT, THEN ANY CLINICAL DECISIONS THAT YOU ARE GOING TO BASE OFF OF THAT RESULT ARE NULL AND VOID.”— Audra ZachmanZachman explained why laboratory accuracy was the most important consideration for patient-care decisions.Open in transcript →
rulingWithout defense objection, the court permitted Zachman to give expert testimony on interpreting HCG results and instructed the jury on weighing expert opinions.Open in transcript →
testimony highlightZachman explained that the sharp Theranos-reported decline indicated a possible pregnancy loss, causing her to tell Gould the pregnancy appeared nonviable; later Sonora Quest results instead rose consistently with a viable pregnancy, leading Zachman to doubt both Theranos results.Open in transcript →
Quote“I REMEMBER COMMUNICATING TO BRITTANY THAT IT WAS LOOKING AS THOUGH THIS WAS A NONVIABLE PREGNANCY, WHICH WOULD MAKE IT HER FOURTH LOSS, AND I WAS WANTING TO REACH OUT TO HER TO SEE IF SHE HAD ALREADY EXPERIENCED EVIDENCE OF A LOSS OF PREGNANCY.”— Audra ZachmanThe testimony identified the direct clinical communication prompted by the Theranos-reported HCG decline.Open in transcript →
Show all 6 highlights
Quote“I FELT VERY UNCERTAIN OF THE VALIDITY OF THE RESULTS AND FELT UNCOMFORTABLE AS A PROVIDER CONTINUING TO HAVE MY PATIENTS DRAWN THERE.”— Audra ZachmanZachman described how the conflicting results changed her confidence in Theranos and her referral decisions.Open in transcript →
objectionThe defense challenged Zachman's claim that she had never encountered a similar accuracy issue, and the court struck her last answer while allowing the government to lay additional foundation.Open in transcript →
CrossAudra Zachman — CrossAudra ZachmanKatherine Trefz4highlights97lines spoken

Summary

Zachman limited her expertise to clinical interpretation, acknowledged Theranos's corrective response and a later comparative study, and confirmed that her broader chart review found few apparent anomalies while maintaining that Gould's result was unusually out of place.

Highlights (4)

testimony highlightDefense counsel established that Zachman interpreted HCG values clinically but lacked detailed knowledge of immunoassay mechanics, assay variability, and technical language in Exhibit 3305.Open in transcript →
Quote“I WOULD SAY THAT I INTERPRET VALUES MORE THAN THE SCIENCE BEHIND IT.”— Audra ZachmanZachman expressly limited her expertise to clinical interpretation rather than the underlying assay science.Open in transcript →
impeachmentZachman confirmed that a government-requested chart review produced little that seemed out of place and no other questioned quantitative result with a different clinical outcome, while maintaining that Gould's result was markedly anomalous and rejecting the suggestion that prosecutors wanted additional problems found.Open in transcript →
Quote“NO. I THINK THAT THEY JUST WANTED ME TO TAKE MY TIME TO LOOK THROUGH ANYTHING THAT MIGHT HAVE BEEN OVERLOOKED AT THE TIME.”— Audra ZachmanZachman rejected the defense suggestion that prosecutors wanted her to find additional Theranos-related problems.Open in transcript →
RedirectAudra Zachman — RedirectAudra ZachmanJohn C. Bostic2highlights25lines spoken

Summary

Zachman said a follow-up study did not restore her confidence and reaffirmed that both the original and corrected Theranos HCG patterns raised serious clinical concerns that did not match Gould's pregnancy outcome.

Highlights (2)

testimony highlightZachman said her brief review of the roughly 30-sample HCG study did not restore her confidence because Gould's care and the earlier values remained impactful to her.Open in transcript →
Quote“MY CARE OF BRITTANY, AND THE VALUES THAT I RECEIVED AT THAT TIME WERE VERY IMPACTFUL TO ME AS A PROVIDER AND PERHAPS EMPHASIZING TO HER AS A WOMAN, AND SO THERE WASN'T MUCH THAT COULD HAVE RESTORED MY FAITH AT THAT TIME.”— Audra ZachmanZachman explained why the later study did not overcome the effect of Gould's earlier HCG results on her confidence in Theranos.Open in transcript →

Day 47