Code 15 (15 page)

Even before the tech slid the needle into Morgan’s vein, she cringed with anticipation.

“Your jaw muscles are tighter than a banjo string,” Ackerman said. “If I had known it was going to be this traumatic for you, I would have volunteered myself.”

Before Morgan could answer, she felt the hot pinch of the needle penetrating her skin.

“We’re almost done, Dr. Connolly,” the tech said, exchanging an amused look with Ackerman. As soon as he had filled the red-top tube with ten cc’s of Morgan’s blood, he handed it to Ackerman.

“I’ll get started on this. As soon as you’ve recovered from your little ordeal, you can join me over there by that little blue ACT machine.”

By the time the tech had made sure there was no bleeding from the puncture site and had placed a Band-Aid on Morgan’s arm, Ackerman was already adding the heparin to the tube of Morgan’s blood. He flipped the tube over several times to make sure the drug was well mixed. He then removed a small amount and introduced it into the ACT machine. It took only about thirty seconds for the result to appear on the digital display. It read six hundred fifty.

“Okay,” he said to Morgan. “The normal ACT should be about a hundred so we’ve successfully anticoagulated your blood. You wouldn’t be able to make a clot now if your life depended on it.”

Next, Ackerman reached for the IV bag containing the nitroglycerine drip. Using a small needle and syringe he removed five cc’s of the solution and injected it into the tube that contained Morgan’s blood and the heparin. Once he had thoroughly mixed the contents, he held it up in the air and tapped the tube several times.

“What are you looking for?” she asked.

He gave a light shrug. “I don’t know, but in every old doctor movie I’ve ever seen on TV, the brilliant pathologist always holds the tube up, studies it intently, and then taps it a few times.”

Morgan rolled her eyes but said nothing. She watched as Ackerman withdrew a small amount of blood from the tube and introduced it into the ACT machine. Morgan stood with her arms crossed staring at the blank digital display.

When the number ninety flashed up, her eyes remained locked on the display. Finally, she looked over at him. He was now stone-faced.

“No doubt about it,” he said. “There has to be protamine in the nitroglycerine drip.”

“The question is, how did it get there?” Morgan asked in just above a whisper. “John,” she began slowly, “I’m not sure what I’m going to do with this information yet, but it’s absolutely imperative that you don’t discuss this with anybody. I’m sure I don’t have to tell you that is an extremely delicate matter.”

“I understand,” he said in a manner that left no doubt in her mind that he would respect her wishes.

“Can you find someplace safe for that tube of blood?”

“I know just where to put it,” he assured her. Morgan could feel his eyes probing her. “If you need me, just let me know.”

“Thanks, John.”

As she started away, he said. “Your father and I were good friends, Morgan. He was an exceptional physician and an extremely insightful man. If he were here, I’m sure he’d tell you to proceed with extreme caution.”

Ben had just finished teaching a one-hour introductory course in instrument flying when his secretary, Lisa, motioned for him to pick up the phone.

“Who is it?” he asked from across the large classroom he had recently added to his school. Lisa had worked for Ben since the day he opened his medical practice and had come with him when he changed careers. She was indispensable, but not one to embrace a strict professional office environment.

With a saccharine smile, she wagged her finger at him and in a singsong voice said, “It’s Dr. Connolly. You’d better hurry.”

Ben pointed at her and then feigned slitting her throat. She covered her face and pretended to shudder in fear.

He picked up the phone. “Hi.”

“I just met with John Ackerman. We analyzed the nitroglycerine drip used in the Tony Wallace case. Somebody put a massive dose of protamine in it. I suspect it was intentional.”

Ben sat down in one of the folding canvas-backed chairs in the front row. “Slow down a sec. What makes you so sure it wasn’t accidental?”

“The only person who makes up the drip is the anesthesiologist, and that was Mike Quintana. I’ve spoken to Mike on three separate occasions about the case. He’s positive every med he gave and every drip he prepared was fine.”

“Mike’s a meticulous physician, but he’s also a human being . . . and, if my memory serves me correctly, you’re the one who’s always saying human beings make mistakes. I just don’t see how you can categorically reject the possibility that Mike made an error.”

“Because for each open-heart case the pharmacy sends the anesthesiologist two vials of protamine. I’ve examined both of them. They were untouched as the day they were shipped from the factory.”

“I assume Mike made this drip the morning of surgery.”

“Uh-huh.”

“Then explain one thing to me. How would anybody, in the middle of a busy open-heart operating room, be able to add protamine to a drip without being seen?”

“They wouldn’t. But if somebody had snuck into the OR a few hours before the operation . . . say three in the morning when the suite was closed, he could have drained the nitroglycerine bottle and substituted protamine. That way when Mike made up the drip, he would have thought he was adding nitroglycerine to the IV solution when he was really adding protamine.”

“That sounds a little far-fetched, Morgan.”

“But it’s possible,” she insisted. “Weren’t you the one who told me to open my mind and treat this investigation as if it were an aviation inquiry?”

“But why would somebody do that? What would be their motive?”

It was a question Morgan expected him to ask. “I don’t know,” she told him. “Not yet, anyway.”

“Aren’t you suppose to meet with Bob Allenby today?”

“I’m on my way now.”

“Are you also going to tell him what you just told me?”

“Bob’s looking for answers. It’s my job to provide them.”

“I’m sure Bob’s looking for answers, but I think he’s looking for medical explanations. Once you tell him you suspect that we’ve had two Code Fifteens caused by criminal acts . . . well, that’s going to be a tough bell to un-ring. We talked about the fire, aim, ready approach to things.”

“I appreciate your concern but I don’t see what choice I have. I’m obligated to tell him.”

“I’ll remember you said that.” Ben stopped for a few moments. He then said, “Listen, I’m flying up to Vero Beach late this afternoon to pick up some parts for one of my planes. Why don’t you come with me? We can talk about your meeting with Bob. “

“I’ll go if I can fly.”

“One way,” he told her firmly.

“What time?”

“Meet me on the flight line at four.”

“I’ll be there.”

Ben came to his feet slowly and walked over to a small table. He tapped the power button on his laptop. Waiting for it to boot up, his mind became preoccupied with Morgan and her meeting Bob Allenby. If he concluded that Morgan was a grief-stricken, stressed-out physician who wasn’t thinking rationally, things could go south for her pretty fast. Ben was sure the first thing Bob would do after Morgan left his office would be to call John Ackerman to confirm her story. But what hadn’t occurred to Morgan was that Bob might assume it was Morgan who had tampered with the drip to give credibility to her conspiracy theories.

Morgan stepped off the elevator on the eighth floor and strolled down a long hallway until she reached the corporate offices of Constahealth, Dade Presbyterian’s parent organization.

She was just about to walk into Bob Allenby’s outer office when her cell phone rang. She checked the caller ID. When she saw it was Kevin, she cringed. She doubted whether he was calling simply to say hello but after listening to the phone ring a couple of more times, she decided to take his call.

“Hello.”

“I got your check and just wanted to call and say thanks.”

Knowing Kevin rarely thanked her for anything, she said, “If you’re calling to ask me for more money, you can just—”

“Take it easy, Morgan. I’m not calling about money. I told you. In a few months I’ll be swimming in the stuff. And don’t think for a second I’m not going to give you your fair share. We’re still married and the law says everything’s fifty-fifty.”

Fully understanding his cryptic message, Morgan shook her head.

“It’s nice to see you’ve become so conversant in Florida divorce law. Look, Kevin, I’m running late for a meeting, so unless there’s something else . . .”

“Did I remember to mention to you before I left that I’m a couple of months behind on my Mercedes payment?”

“C’mon, Kevin. I can’t believe you didn’t—”

“Relax, Morgan. If they call you, just tell them we’re separated and that you don’t know where I am.”

“That’s a great idea except for one minor detail. The lease is in both of our names.”

“Just put them off until I get back.”

“And ruin my credit? I don’t think so. I pay my bills. Have a great trip.”

“Don’tbe somelodramatic,Morgan.Trytobea littlesupport ive for a change. Maybe we’d still be living together if I hadn’t become exhausted trying to live up to your expectations.”

All too familiar with Kevin’s canned speeches and lame explanations, Morgan flipped her phone closed. Determined not to let his financial irresponsibility ruin her day, she put her phone back in her purse.

She continued down the hall and pushed open the large glass door leading to Bob Allenby’s office. Julia, his secretary, was one of the few people in his employ who didn’t quake at the mere mention of his name.

“Go ahead in. He’s waiting for you,” she told Morgan with a quick wave.

“What kind of mood is he in?”

She looked up from her desk. “Well, it’s still pretty early, but I haven’t heard any screaming or the sound of shattering glass coming from his office.”

“That’s something,” she said, with a quick laugh.

Morgan knocked on the door, waited a few seconds, and then stepped into Allenby’s dark wood-paneled office. She saw him on the other side of the room, gazing out of his window.

“Come over here and share this incredible view of Port Everglades with me.”

Morgan crossed the room, taking up a position beside him. Bob was a square-jawed man with brick-like shoulders that he oftentimes joked were necessary to support the weight of the hospital. The chronic puffiness under his closely spaced eyes made him appear older than his fifty-one years.

She gazed out the huge window. It was a clear day and the deep-water harbor with its massive concrete docks loaded high with cargo bins and tumultuous activity was, as Bob so aptly put it, an incredible sight.

“How’ve you been?” he asked.

“Fine. I should have called and thanked you for coming to the funeral.”

“Your dad and I were very good friends. We accomplished a lot of great things for Presby together.” He looked over at her. “Have the police come up with anything?”

“Not really.”

“Let’s have a seat,” he suggested, gesturing toward a small mahogany conference table with four leather chairs around it. Morgan waited to see where he was going to sit and then took the chair across from him. The pressure of being the chief executive officer of Dade Presbyterian for the last fifteen years had taken its toll on him in the form of two stomach ulcers and a blood pressure that would have already given most people a stroke. “I wanted to talk to you about these two unfortunate cases from the Cardiac Care Center. The buzz in the hospital is that you figured out what happened.”

“The buzz?”

“It’s a hospital,” he said with a casual shrug. “Word gets around—even to the CEO’s office.”

Morgan wasn’t surprised that Bob knew something was up. She had been as discreet and diplomatic as possible regarding her inquiries, but as he just implied, hospitals are notorious for their rumor networks.

After an inward sigh, she said, “I believe I know what happened, but I don’t think you’re going to like it.”

He regarded her politely. “I appreciate your cautious approach, but I’m running out of time. We have two unexplained and rather serious Code Fifteens. If we don’t come up with some answers pretty soon, we’ll have every inspector from the Agency for Health Care Administration down here with pitchforks and lanterns. If you think you know what happened, I’d like to hear about it.”

Running out of wiggle room, Morgan said, “As bizarre as this may sound, it looks like Alison Greene died of a cardiac arrest caused by a magnetized cross.”

Allenby cupped his chin and then stroked his thick mustache. “I’m not a doctor, so I’m unaware of how a magnetized cross could harm anybody.”

“Magnets can affect pacemakers in many ways. They can even cause a fatal heart arrhythmia. I checked with Mira Ramos and she agrees.”

“And Mr. Wallace?”

“He received a medication that made the pump clot off.”

“You can’t be serious.”

Morgan took her time to explain what had occurred to Tony Wallace in layman’s terms. When she finished, Bob rubbed his chin and asked, “How could we have made such a colossal series of mistakes?”

“That’s what I’m trying to tell you, Bob. I’m not sure we can assume these two deaths were unintentional patient errors.”

Bob’s gaze intensified. Finally and in an unexpectedly calm tone, he said, “What are you trying to say, Morgan?”

“I think there’s a strong possibility that somebody intentionally tampered with the nitroglycerine bottle and that Miss Greene’s visitor intentionally placed a magnetized cross around her neck knowing it would cause a problem.”