Hobbs Act robbery victim Emilie Kraemer was transported by Lehigh special education employment services to a parking lot in Bethlehem Pa. Lehigh was the recipient of the corpus of a $255,000 corrupt payment federally designated for Emilie's college education, arranged by Mother DeRaymond and guardian Lisa Spitale made possible through the unlawful use of county Judge Ed Smith's public office. At the parking lot an altercation in the car broke out - A cigarette was put out on Emilie's forehead. CDC STD scabies incubation: 4-8 weeks. EK has symptom onset 03/11/2013 — five weeks post-exposure, consistent with CDC timeline.

PHOTO—1 02/06/2013

Deliberate exposure to scabies infestation.

Mother Amy DeRaymond, Guardian Lisa Spitale, and Federal Guardian Shanon Moore refused medical treatment for approximately six weeks. Six-week window allowed infestation to become fully established before any intervention.

LETTER—HHS

Deliberate denial of treatment during active infestation — allows ordinary scabies to advance toward Norwegian Scabies. Six weeks of untreated infestation establishes the mite burden baseline for subsequent pharmacological cultivation.

Urea cream prescribed as soothing/emollient — no therapeutic effect on active scabies infestation. Serves as precursor to immunosuppressant escalation beginning May 16, 2013. Emilie photographed with discrete raised erythematous papules on dorsal hand April 29, 2013 — textbook early scabies presentation.

PHOTO—2 04/30/2013

Emollient — no therapeutic effect on scabies. Establishes Eczema diagnosis framework under which subsequent immunosuppressants are issued. Any clinician prescribing for this presentation was obligated to rule out scabies prior to initiating any corticosteroid.

FDA label: re-evaluation required if condition does not improve within two weeks; contraindicated on infected or infested skin. Applied to active scabies infestation with no scabies ruled out by skin scraping. Emilie had been visibly symptomatic six weeks prior to this prescription. No re-evaluation documented before escalation to higher-potency Class II agent two weeks later.

Mid-potency topical corticosteroid suppresses local immune response at application site. Applied to active scabies, directly suppresses the immune barrier preventing mite expansion. FDA and dermatological literature document topical corticosteroids as contraindicated in scabies infestation. Accelerates progression toward Norwegian Scabies. Medical basis for this prescribing pattern: None.

Significantly more potent than Hydrocortisone. FDA label: use beyond two weeks requires re-evaluation of diagnosis; not for use on infected or infested skin; 60g tube = maximum two-week supply; no repeat course without new assessment. Prescribed by RN Esbri at DermOne under Eczema diagnosis. No improvement from Hydrocortisone — standard of care required diagnostic re-evaluation, not escalation.

Strong local immune suppression — substantially greater than Hydrocortisone. Accelerates Norwegian Scabies cultivation. Lack of corticosteroid response in scabies is a diagnostic indicator, not a signal to increase potency. Prescribed without re-evaluation after Hydrocortisone failure. Medical basis for this prescribing pattern: None.

Most potent class available. FDA label: maximum two consecutive weeks; maximum 50g per course (VIOLATED — 60g prescribed); mandatory re-evaluation if no improvement within two weeks; HPA axis suppression warning; explicitly contraindicated on infected or infested skin. Prescribed by RN Gupta at DermOne after months of visible infestation and zero improvement on prior corticosteroids.

Maximum topical immune suppression — directly cultivates Norwegian Scabies. 60g prescribed — exceeds FDA 50g quantity limit. No documented re-evaluation. Continued worsening through two prior corticosteroid courses required mandatory reassessment. Escalating to the most potent topical steroid class at this stage is clinically indefensible. Medical basis for this prescribing pattern: None.

Same date as Clobetasol, under diagnosis of Schizophrenia. Risperidone produces sedation and motor suppression. Prescribed to a patient with active Norwegian Scabies — sedation reduces ability to scratch (which would dislodge mites and attract clinical attention), reduces capacity to report condition, and masks behavioral indicators of severe physical distress.

Sedation suppresses natural scratching response. Norwegian Scabies mite burden expands unimpeded when patient cannot respond to itch signals. Concurrent prescription with Class I topical corticosteroid produces compounded pharmacological harm: immune suppression (Clobetasol) plus behavioral suppression (Risperidone). No documented psychiatric evaluation supporting Schizophrenia diagnosis in the prescription record.

Prescribed only six weeks after first course. FDA mandates no repeat course without new assessment. Prescribed concurrently with Clobetasol on the same date by the same physician, producing corticosteroid stacking: Class I and Class II high-potency topical steroids applied simultaneously. Photographs taken July 13, 2013 document large raised hyperkeratotic crusted plaque on elbow — hallmark Norwegian Scabies at advanced stage. Dr. Hernandez had clinical access to this presentation on the date of prescription.

PHOTO—3 07/13/2013

Repeat course without re-evaluation. Corticosteroid stacking with concurrent Class I Clobetasol compounds immune suppression beyond what either agent alone produces. Photographs July 13, 2013 document extreme Norwegian Scabies crusting — prescribing Class I and Class II steroids concurrently on the date of this documented presentation constitutes a complete departure from any reasonable standard of care. Medical basis for this prescribing pattern: None.

Prescribed only 18 days after first course. Both courses: 60g each, exceeding FDA 50g quantity limit per course. No documented re-evaluation between courses. Prescribed concurrently with Fluocinonide same date, same physician — corticosteroid stacking. July 12, 2013 photographs document extreme Norwegian Scabies crusting on elbows. No reasonable standard of care permits prescribing Class I and Class II concurrent corticosteroids to a patient presenting with this elbow morphology without first ruling out Norwegian Scabies by skin scraping.

PHOTO—4 07/22/2013

Two Clobetasol courses within 18 days, both exceeding FDA 50g limit, no re-evaluation, stacked with concurrent Fluocinonide — maximum cumulative immune suppression. Photographs same date document extreme Norwegian Scabies. This is the inverse of every applicable clinical obligation at this decision point. Medical basis for this prescribing pattern: None.

They briefly cured Emilie using an off the books prescription scabicide — the ONLY agent capable of resolving Norwegian Scabies per CDC guidelines. Photograph July 26, 2013: near-normal skin appearance four days after July 22 advanced Norwegian Scabies presentation. Resolution from advanced Norwegian Scabies to near-normal skin in four days is clinically impossible with any Eczema treatment. This cure occurred one week before Judge Edward Smith's August 1, 2013 federal judicial nomination.

PHOTO—5 07/26/2013

PROOF OF KNOWLEDGE: Defendants cured the infestation using a prescription scabicide, establishing they: (1) knew the correct diagnosis was Norwegian Scabies, not Eczema; (2) possessed the correct treatment; (3) deliberately withheld it for three months. The four-day resolution is irrefutable clinical proof. Per CDC: no OTC product treats human scabies.

Father documented deliberate re-cultivation of Norwegian Scabies ten days after July 26 cure, four days after Judge Smith's August 1 federal judicial nomination by President Obama. Norwegian Scabies treated with a scabicide does not re-establish this rapidly without active re-exposure or active immune suppression. Elidel — the most potent immunosuppressant in the sequence — prescribed two days later on August 7.

PHOTO—6 08/05/2013

Deliberate re-cultivation documented by photograph four days post-nomination. Timeline correlation: cure July 26 (one week before nomination) — nomination August 1 — re-cultivation visible August 5 — most lethal immunosuppressant prescribed August 7. The brief cure followed by deliberate re-cultivation establishes that the parties understood the nature of the condition, possessed the means to cure it, and chose to re-cultivate it.

Highest FDA safety warning level. Second-line or third-line agent only; short-term intermittent use only; explicitly contraindicated on infected or infested skin; confirmed diagnosis of atopic dermatitis required before initiation. Prescribed six days after Judge Smith's August 1 federal judicial nomination. Prescribed by RN McLanahan after directly observing Emilie's hands in advanced Norwegian Scabies condition — described as so severe hands were held together with tape.

Pure immune suppression via entirely separate biochemical pathway — inhibits T-cell activation and cytokine production. Prescribed as continuous 30g supply (not short-term intermittent per FDA). Active infestation present — direct contraindication under FDA labeling. Black Box Warning disregarded. Multiple prior immunosuppressant failures mandated re-evaluation, not escalation. Medical basis for this prescribing pattern: None.

Two refills listed on bottle; zero refills authorized in CVS national database. Bottle refill count was fabricated. Administration of off-the-books sedatives to a near-incapacitated patient under active lethal medical treatment has no legitimate clinical explanation. Lehigh University Transition Services progress report August 15, 2013 characterized sedation-induced behavioral reduction as positive clinical indicator — active concealment of patient's true condition.

Off-the-books sedation of victim during active cultivation event — reduces patient's ability to report, resist, or communicate her condition to any reviewing authority. Fabricated bottle refill count constitutes falsification of prescription record.

Lehigh University Transition Services directed Emilie — with open bleeding skin fissures from advanced Norwegian Scabies — to clean stray animal cages containing fecal matter. Published PubMed literature (NCBI 1526178): fissures in severe Norwegian Scabies serve as a port of entry for bacteria, placing patients at high risk for sepsis. Stray animal cages contain fecal-origin pathogens — E. coli, Klebsiella, Enterococcus, Clostridium species — each with direct bacteremia and septic shock potential.

Clinically precise mechanism for inducing bacteremia and septic shock: Norwegian Scabies open fissures + direct fecal bacterial exposure = documented PubMed sepsis pathway. Guardian Lisa Spitale, vested with sole legal discretion over Emilie's care (20 Pa. C.S. Sec. 5512.1(b)), bore direct legal responsibility for every environment Emilie was placed in. Source: PubMed NCBI 1526178.

Thomas Kraemer declared a medical emergency on 08/26/2013, compelling a DermOne appointment. First legitimate clinical intervention in the entire documented sequence.

FATHER-DERMONE-PHONE-CALL

Emergency intervention halted attempted murder. Thomas Kraemer compelled DermOne appointment — the first point in the entire documented sequence where standard of care clinical obligations were invoked by an external party rather than the prescribing clinicians or guardians.

Only after Thomas Kraemer declared a medical emergency. Every prior prescription from May through August 7 was either pharmacologically harmful or therapeutically inert as to the actual diagnosis. Emilie was properly diagnosed with Norwegian Scabies on August 28, 2013 by Dr. Rami Geffner.

EMAIL—MOTHER DERAYMOND

First actual treatment — topical scabicide that directly kills Sarcoptes scabiei mites. Prescribed only after external emergency intervention by Thomas Kraemer. The absence of this drug from every prior prescription event is the clinical proof of the cultivation pattern. Source:CVS Prescription Record.

ONLY 1 tablet prescribed; published standard of care for Norwegian Scabies requires at least 2 doses and recommends 7. It was prescribed same date as Permethrin 5% — August 28, 2013 — the first curative treatment after the emergency declared by Thomas Kraemer. Norwegian Scabies requires multiple-dose oral Ivermectin combined with topical Permethrin for full eradication given the mite burden (thousands to millions of organisms versus 10-15 in ordinary scabies).

Oral anti-parasitic scabicide — first oral treatment. One tablet prescribed where Norwegian Scabies standard of care requires at least two doses. [ NLM PMC10228789 ] Prescribed only after emergency intervention.