Deadly Errors (2 page)

“… T
HE NEEDLE, SPONGE and cottonoid counts were correct. The estimated blood loss was 350 ccs with no blood or blood product replacement. This has been dictated by Tyler Mathews.”

Neurosurgeon Tyler Mathews finished dictating his operative report, returned the beige dictation telephone to its cradle and leaned his weary body against the acoustical tile wall of the small dictation booth. The sweat-dampened scrub shirt chilled his back but he was too exhausted to move to a more comfortable position. For an uncharacteristic moment he savored the professional satisfaction and pride his work gave him. The benign brain tumor, a meningioma, had been a particularly nasty one involving a fifty–year-old woman’s nerves for sight and eye movement. He’d spent the past six hours peering through a surgical microscope, picking bit by bit at the knobby, cream colored, grape-sized hunk of tough fibrous tissue until every visible nubbin was removed. A total removal was one thing. But the real trick—and the thing that made this case so satisfying—was getting out of there with the surrounding nerves functioning perfectly.

It was meticulous, demanding work. He loved the challenge.

With a deep breath he palm-wiped his face.

Ignoring the familiar fatigue created by six hours of continuous mental exertion, he pushed off the bar-height stool and headed for the recovery room to once again check his patient’s progress recovering from anesthesia.

“D
OCTOR MATHEWS, THERE’S a man wants to see you.” Matilda, the ever-smiling unit clerk nodded toward the automatic doors leading to the rest of the hospital. The man appeared to be close to Tyler’s 38 years and perhaps two inches shorter, maybe 5’9”. He wore a summer weight dark gray suit, white shirt and abstract black and white tie.

Tyler thought,
FBI
, without knowing exactly why.

“What does he want?” By now the man was approaching with a self-assured strut Tyler recognized as characteristic of law enforcement or military types.

“Doctor Mathews?”

“Yes?” The questioning stares of nurses and anesthesiologists tingled Tyler’s back, their interest already sharpened by a stranger in street clothes in a restricted area.

The stranger glanced around. “Not here. Let’s move this out into the hall.” His tone carried an irritating edge of authority.

Tyler didn’t move. “Not until you tell me what this is about. I’m wrapping up a case. Who are you?”

The man pointedly surveyed the room again. “I think it’s better we continue this discussion in the hall.”

Tyler told the clerk, “I’ll be back in a minute,” as his gut tightened into a square knot.

Out in the hall the automatic doors slid shut at their backs. The man studied Tyler a moment before his hand appeared holding a wallet. “Agent Dillon, DEA.” The wallet dropped open exposing official looking identification.

The square knot in Tyler’s gut began to send sharp stabbing pains up through his diaphragm. “Yes?” He’d wondered about reprisals from his chairman and how they might come. Was this the beginning?

“Mind if I have a look-see in your locker?”

Tyler’s heart started galloping. “Why would you want to look in my locker?”

Legs spread in military at ease, Agent Dillon hooked both thumbs over his belt, throwing open his suit coat just enough to flash a shoulder holstered firearm. “And why would this be a problem, Doctor?”

Tyler spread his legs too, folded both arms across his chest. “The problem’s your attitude. It sucks. I want to know what you’re looking for and why.”

Dillon laughed. “Hey, not my problem. And I
will
look in your locker… . One way or another.”

Tyler shook his head. “There’s nothing in my locker that would interest the DEA. Period.”

“Hey, have it your way. But, we can do this one or two ways. Either you open it for me, or I’ll have security do it.” As he spoke, his right hand replaced the ID wallet with a folded paper from his inside breast pocket. “This is a signed order to search your locker.” A shrug. “Your call, Doc.”

Seeing no other option, Tyler marched toward the dressing room, anger constricting his chest. “What’s the deal, you guys don’t have enough to do in The War on Drugs? You have to get your jollies now by bullying doctors?”

As they rounded the corner to the narrow passageway between rows of identical gray metal lockers Tyler came face to face with two security guards, one leaning against his locker, the other one blocking the aisle, telling a joke. Their conversation stopped abruptly when Tyler appeared.

Tyler turned to Agent Dillon. “What are they here for?”

Dillon flashed irritation. “Just open the fucking locker.”

Tyler glanced at the guard leaning against his door. “Mind?” The guard moved away with an embarrassed grin.

Tyler’s mind started racing as he reached for the combination lock. What if someone placed something in there? How long ago had he opened the locker to change into scrub clothes? He checked his watch. Six hours. A long time. Long enough for anything to have happened.

“Well? You going to open it?”

Tyler spun the dial and missed the third number. He started over and missed again. By the third time his fingers, trembling from anger, hit the combination and the lock dropped open. He stood aside. “Go ahead, knock yourself out,” and drilled the closest security guard a questioning look. The guard glanced away.

Agent Dillon snapped on a latex glove, stepped up, opened the door and stood there a moment before reaching up to the single shelf above Tyler’s hanging clothes. “My oh my, what have we here?”

“What the hell—” Tyler reached out but the DEA agent slapped his hand away.

“Don’t touch a thing.” Dillon pulled down a vial from the shelf. The label read Morphine Sulfate. He turned to one of the security guards. “Open one of those plastic bags for me, will you? And neither one of you to is touch anything before I drop it in a bag. Understood?”

A
TTORNEY, MARY MCGUIRE’S richly appointed office occupied the southwest corner of the fifteenth floor, and commanded a magnificent view of San Francisco’s industrial district. The morning sky was so dark with late October fog and drizzle that cars snaking along the streets below had headlights on at nine o’clock in the morning. It would rain soon. Tyler was sure of this.

“You have a choice. You can accept their offer, which by the way, I think is extremely generous under the circumstances, or you can take your chances in court. I shouldn’t have to reiterate the consequences should you lose the case, but just for the record, I will. In this state, as is the case in most states, a felony conviction would mean loss of your professional license. Bottom line, you lose the case and you will never practice medicine again. Ever.”

“Goddamit,” Tyler said, his frustration and fury building. He continued to stare out the window, fists shoved deeply into his pockets, shoulders hunched as if protecting his body from the chilly, foggy, autumn gusts outside. “Say we got to trial, what do you estimate my chances of winning?”

His lawyer sighed. They’d been over this how many times this morning? “If you hadn’t come up with a positive urine test, well, I would’ve said pretty good. But, considering that particular bit of ammunition …”

“Goddamnit, just give me the odds.”

“They haven’t changed from the last time we went over this,” she said testily. “My guess, you have about a ninety percent chance of losing.”

Typical. He’d asked for his chances of winning. She’d given his risk of losing. He grunted sarcastically and continued staring at the street below.

“Just so I understand this completely … so I have an informed consent …” His jaw muscles were aching again, producing tight throbbing across his forehead. He paused to work out the tension. “Tell me again exactly what the
deal
is.” He glanced over his shoulder at her.

Peering back at him over the tops of her half-height reading glasses, sending him her stern-faced lawyer expression, she said, “First, you must complete a drug rehab program here in San Francisco. One that is certified by the California Medical Society’s impaired physician program. Only after being fully discharged from such a program can you practice again. Second, when you
do
practice again, it must be outside the State of California.”

“This is the part that baffles me. Can they really do that? Dictate which state I practice in?”

“Under the circumstances of this particular deal they can, yes.”

“Final question. How long do I have to consider this?” He turned to fully face her.

She reached up, took off her reading glasses, her face deadly serious now. “What’s to consider? It’s a no brainer, so far as I see. But, to answer your question, no time at all. They expect an answer from you today.”

He knew what he had to do. He thought of Nancy, how he still had her in spite of losing everything else that mattered in his life. He drew in a deep breath, and gave his answer.

T
HE MOMENT TYLER opened the front door to their one-bedroom apartment, a bolt of intuition warned of something wrong. He hesitated, hand still on the doorknob, then shrugged it off as residual paranoia from a very bad day.

He turned into the living room and saw Nancy push up from the couch, fists clenched, cheeks streaked black from mascara. Confused, Tyler stopped. Two pieces of luggage stood neatly aligned to each other a few feet from the couch. She moved to them.

His heart stumbled, a knot of fear encasing it. “Something happen to your mother?”

Fresh tears trickled down her cheeks. “No, Tyler, she’s fine but I’m not. I’m moving out. I’ve contacted a lawyer. I’m filing for divorce.”

He placed a hand on the wall for support as his legs weakened. “I—”

She shook her head. “It’s not debatable, Tyler. I’ve made up my mind.”

“Not debatable? Who said anything about a debate?” He found himself unable to think clearly.

“I know how you are, that’s all. I just don’t want to discuss this.”

“Jesus, I come home from a very bad day and you tell me we can’t even discuss this … that you’re leaving me? Why?” He pointed at the suitcases. “Christ, we’ve always been able to talk things out … that’s been one of the really special things about our relationship … being able to communicate.”

“Well, not this time, Tyler. I just don’t want to be pressured out of my decision.”

He straightened his legs back up. “As I remember, the vows went something like, ‘for better or worse.’ Were we both on the same page that day?”

Before she could react, he held up a hand. “Hold it. I take that back. Let me start over again.” He inhaled deeply. “Isn’t there something we can do to work this out? I mean, why are you doing this?”

“It’s the drug thing, Tyler. I just can’t handle it. I believed in you. I really did. I was willing to stand by you if it went to a trial because I believe that innocent people win.”

“But I
am
innocent. I’ve been framed.”

“Then what are these?” She held up an amber prescription bottle.

“I have no idea. Here, let me see.”

She handed it to him. “I know what they are, Tyler. They’re oxycontin.”

“But—”

“I found them in the back of your nightstand. I … I just can’t deal with the fact that you lied to me.” New tears began flowing down her cheeks, making glistening new trails. “I’m not going to live with a drug addict.”

She grabbed the bags and walked to the door. “Don’t try to contact me. My lawyer will contact you.”

“I
S THIS HOW you found him?” Robin Beck, the doctor on call, asked the paramedic as she quickly ran the back of her fingers over Tyrell Washington’s skin. Warm, dry. No fever, no clamminess. Black male. Age estimated in the mid-sixties. Half open eyes going no where. Findings that immediately funneled the diagnosis into the neurologic bin.

“Exactly as is. Unresponsive, pupils mid position and roving, normal sinus rhythm. Vital signs within normal limits. They’re charted on the intake sheet.” Breathing hard, the paramedic pulled the white plastic fracture board from under the patient, unofficially consummating the transfer of medical responsibility from Medic One to Maynard Medical Center’s Emergency Department.

“History?” Beck glanced at the heart monitor as the nurse pasted the last pad to the man’s chest. Heart rate a bit too fast. Was his coma cardiac in origin?

A respiratory therapist poked his head through the door. “You call for respiratory therapy?”

She held up a “hold-on” palm to the paramedic, and told the RT, “We’re going to have to intubate this man. Hang in here with me ’til anesthesia gets here.”

The tech nodded. “You called them yet?”

“Haven’t had time. It’s your job now.” Without waiting for an answer she rose up on tip toes and called over the paramedic’s head to a second nurse plugging a fresh line into a plastic IV bag, “Glenda, get on the horn to imaging and tell them we need a STAT CT scan.”
Better order it now
. The scan’s status would be the first question out of the neurologist’s mouth when asked to see the patient. Nervously fingering the bell of her stethoscope, she turned to the paramedic. “I need some history. What have you got?”