Dr. Avram Mack resigned from Nemours Children's Health the same day he finished a combative cross-examination in the trial of a Massachusetts mother charged with strangling her three children, and no one will say why.
Mack, 54, took the stand on August 21 as the prosecution's key psychiatric witness against Lindsay Clancy, 36, who faces three counts of first-degree murder in the January 2023 deaths of her children Cora, 5, Dawson, 3, and Callan, 8 months. He returned the following Monday, August 24, for cross-examination conducted via Zoom. By the end of that day, he had clashed repeatedly with defense attorney Kevin Reddington, drawn a rebuke from the trial judge, and walked away from his job at a Delaware children's hospital.
A spokesperson for Nemours Children's Health confirmed the departure to the Daily Mail: "Dr. Avram Mack is no longer employed by Nemours Children's Health. He resigned on Monday, August 24." The hospital offered no further explanation, and Mack did not return calls or emails seeking comment.
Clancy does not deny killing her children. She has pleaded not guilty by reason of insanity, arguing that postpartum psychosis drove her to strangle all three with exercise bands at her Massachusetts home. If the jury accepts that defense, she could be committed to a mental health facility rather than sentenced to life in prison.
Mack's testimony cut directly against that claim. He told jurors that Clancy said "Go to God" to each child as she strangled them, a detail that, in his assessment, showed organized, goal-directed behavior rather than psychotic detachment. As we previously reported, that moment was among the most consequential of the five-week trial.
"The deaths were done one by one in a way that was organized and tended to achieve a particular goal."
Mack also pointed to Clancy's alleged suicide attempt, which failed and left her paralyzed, as further evidence of deliberate planning rather than a psychotic break.
"Her attempt at suicide was also organized in that it included as many methods as possible."
He cited another detail to argue Clancy was thinking clearly: before the killings, she asked to change her healthcare proxy from her then-husband Patrick Clancy to her parents. That kind of decision-making, Mack testified, reflected awareness and intent. He and another unnamed doctor had interviewed Clancy at Tewksbury Hospital in Massachusetts, where she has been held since her arrest, after being hired by the prosecution.
Reddington went after Mack hard during cross-examination. He challenged the psychiatrist's experience treating women, questioned whether Mack suffered from confirmatory bias, and pressed him on how much he earned as an expert witness, though no dollar figure appeared in testimony.
At one point, Reddington zeroed in on Mack's professional background and asked bluntly: "Your area of interest is in adolescents who like to smoke weed and drink, isn't it?" Mack answered with a single word: "No." Reddington shot back: "What, are you making this up?"
The exchange grew heated enough that Judge William Sullivan, who had already navigated a mistrial motion earlier in the proceedings, stepped in to correct Mack's conduct on the stand.
"Doctor, hold on. Here's the way this works. You don't really ask a lot of questions, you answer the questions."
Sullivan added: "I told you before, if you can't answer a question the way it is framed, just let me know and I'll tell counsel to frame it in a different way."
Reddington also challenged Mack on postpartum psychosis itself. When Mack referred to the condition as a "proposed" symptom or disease, language that suggested he questioned its standing in the DSM-5, the standard diagnostic manual used in psychiatry, Reddington pressed: "Are you telling me you don't believe or buy postpartum psychosis?" Mack responded, "I'm not saying that at all."
The clash over whether postpartum psychosis is an established diagnosis or something more ambiguous sits at the center of the entire case. The defense has argued Clancy was misdiagnosed and overmedicated by her doctors. Prosecutors contend she acted with premeditation. Newsmax reported that prosecutor Jennifer Sprague told jurors in closing arguments: "She left them discarded on the basement floor, like broken toys, because she was done playing the game."
The defense attorney's closing argument framed the killings as the result of institutional failure, bad medicine and worse care, rather than criminal intent. During his summation, Reddington told the jury: "How does this turn into this? Because of the d*** medicine and the lousy medical care that she got."
That framing, a system that failed a vulnerable mother, is the emotional engine of Clancy's defense. And Mack's combative performance on cross-examination, followed immediately by his unexplained resignation, handed Reddington's side an unintended gift. A prosecution expert who quits his job the same day he finishes testifying raises questions no spokesperson statement can answer.
The trial itself has been marked by disruptions, including a paused session after the judge barred a TikTok witness and cited an "unforeseen circumstance." Mack's resignation added one more strange footnote to a case already heavy with them.
The jury, nine women and three men, began deliberating Thursday and worked through Friday without reaching a decision. The New York Post reported that jurors logged 10 hours across those two days. Their only request so far: to see the knife Clancy used in her suicide attempt and her prescription pill bottles.
Judge Sullivan sent the panel home for the weekend with a clear instruction: "Don't talk about this case. Don't talk about deliberations. Don't listen to anything. Don't read anything and just put this out of your mind as best as you can." Deliberations are set to resume Monday morning. Our latest reporting covers the jury's return.
The five-week trial spanned 21 days of testimony and featured 85 witnesses, 72 called by the prosecution, along with roughly 290 pieces of evidence. The jury has five possible verdicts: first-degree murder, second-degree murder, manslaughter, not guilty, or not guilty by reason of insanity.
Reddington told reporters outside court that he had "no idea" what the jury would do and said he is "never confident." He described Clancy's emotional state during deliberations as "nervous, scared, beat down as usual." Asked whether Clancy was aware of the public support shown for her at the courthouse, Reddington told Fox News, "I hope so."
Legal analyst Sam Mirejovsky warned that the intense public and media attention surrounding the trial could create problems down the road. He told Just The News that "regardless of if there's a guilty verdict here, some of that pressure will be cited, no doubt, by the defense team in their appellate brief looking to have this verdict overturned."
That warning underscores a reality the court system will have to face no matter what the jury decides. If Clancy is convicted, her defense team has a growing list of trial-day irregularities, from the mistrial motion to the barred witness to a prosecution expert who resigned hours after his testimony, to build an appellate argument around.
And if she is acquitted by reason of insanity, the public debate over whether postpartum psychosis can excuse the killing of three children will only intensify. The case of a Massachusetts mental health advocate found dead after a domestic tragedy earlier this year already showed how raw these questions remain.
Three children are dead. Their mother does not deny killing them. The question before twelve jurors is whether the system that was supposed to help her bears more responsibility than she does, and whether the law allows that distinction to matter. Whatever they decide, the adults in charge owe those children more than excuses.
