Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (42 page)

She trekked through a maze of rooms on several floors. Once she stepped into what appeared to be a nursery. Blooms of black mold spread like creepers over the cheerily painted walls.

The security guard’s passkey opened most doors, but it took a battering ram to breach the Memorial and LifeCare pharmacies. A forensic scientist prepared an inventory of morphine. Agents seized pharmacy records, including the three prescriptions for large amounts of morphine dated September 1, 2005, and signed by Dr. Anna Pou.

What struck Schafer the most was the smell of death. It was everywhere in the hospital; if you’d smelled it, you could never forget it.

Some news stories had suggested the hospital had run out of food and water. It astounded Schafer to see water bottles stacked to the ceiling. There were canned goods in the kitchen and food and beverages stashed and scattered throughout the hospital. After hearing the stories of looting in New Orleans, it shocked him to see that nobody had even been desperate enough to clean out a vending machine. Those sheltering at Memorial had come supplied like good south Louisianans, with more to eat than they could possibly consume.

Search-team members traced the paths used to rescue patients. Later, putting together the pieces, they would have a hard time understanding why the staff had used the hole in the second-floor machine room wall exclusively when there seemed to be other ways to reach the parking garage, including the route over the rooftop directly from the seventh floor.

It amazed Rider to see the hospital’s main generators sitting well above flood level. She assumed they were functional. Why hadn’t the staff figured out how to bypass the submerged parts of the electrical system and drive power to important patient-care areas and equipment? She
couldn’t help thinking her self-reliant family of South Central Louisianans would have figured out a way. Some people depended too much on the government to help them.

The search team found plenty of medical records, but not the particular ones Rider had requested and not yet received from the Tenet attorneys. Schafer wondered if the company was hiding them out of fear of criminal culpability. Perhaps company officials, not only a rogue doctor, had a hand in what had happened.

While the absence of the medical records was disappointing, other evidence appeared to back up the witnesses’ stories. The agents seized boxes of morphine ampoules from the nursing station on the west side of LifeCare, a desk that sat beneath windows facing the helipad. The controlled drug was sitting out in the open instead of locked away. Elsewhere on the seventh floor, in the garbage can of Room 7305, the room Rose Savoie and Alice Hutzler had shared, they found a translucent bag like the one pharmacist Harris had described, full of syringes. Next door in what was Emmett Everett’s room, the agents seized a saline push syringe from a bedside table next to a box fan. Near it, a cafeteria meal tray still had its plate, mug, and bowl. In the second-floor lobby, multiple morphine vials and boxes sat in the open on a blue tray.

Computers and a server were removed and would go to the state’s High Technology Crimes Unit in the hopes that important records might be found. The agents documented the search with photographs and videotape.

That evening, Rider turned the seized medical items over to the state police crime laboratory to analyze for fingerprints and traces of controlled drugs. On the official request form, under the line marked “Subject,” she wrote Anna Pou’s name, birth date, and driver’s license number. She scribbled: “Suspect may have euthanised multiple patients in Memorial Medical Center (MMC) following Hurricane Katrina.”

Rider and several others returned to the hospital four days later, this time with permission from Tenet officials, accompanied by a Tenet attorney.
They went to the seventh floor and found more syringes and medical waste in the LifeCare therapy charting room, where the witnesses had described sitting and speaking with Pou about Emmett Everett. Elsewhere at Memorial they located Pou’s employment agreement, a staff roster, and a set of the hospital’s emergency policies and procedures.

In the days after the searches, Rider and Schafer interviewed family members of three of the deceased LifeCare patients. Doug Savoie was the grandson of Rose Savoie, Alice Hutzler’s roommate. Both women had been aware enough on Wednesday night to tell the infectious diseases doctor who visited LifeCare that they were not in pain or anxious. A daughter of Savoie’s,
Lou Ann Savoie Jacob, had come to New Orleans to visit her and had been with her until the storm approached. Rose was sitting up and talking, with no IVs, recovering well, it seemed to her. Learning of her death, after a difficult search, had surprised the family.

Wilda McManus’s daughter Angela, and Elaine Nelson’s daughter, Kathryn—the two who had stayed with their mothers on the LifeCare floor until Thursday, September 1—were also eager to assist the investigators.
Kathryn Nelson, who had blurted out, “I’m dying too,” when she was forced from her mother’s bedside, had waited downstairs as long as possible before leaving Memorial. When she finally climbed into a boat, a young woman behind her asked who she was and told her that her gravely ill mother, Elaine, had died.

Kathryn had, after the boat ride to dry ground, been picked up by a brother. Then, with tunnel vision, she had walked to her home in polluted, chest-high water to save her cats. She, and one of them, spent a night sleeping atop her flooded car—there was nothing dry to lie on inside her toxic-smelling home. Kathryn ended up in a Shreveport hospital with suicidal thoughts and a bout of depression. When Rider, Schafer, and another special agent interviewed her by speakerphone on October 3, her family had only recently located her mother’s body at a
massive temporary morgue set up in a town named for Saint Gabriel, the “archangel of death,” between New Orleans and Baton Rouge. A
volunteer coroner from Wisconsin had told Nelson an autopsy had been performed on her mother. Nelson asked why. The coroner said euthanasia was suspected.

“I don’t think that any circumstance justifies euthanasia,” she told Rider and Schafer, even though her mother had been close to death. Killing someone was breaking God’s law. Kathryn, her mother’s longtime caregiver, would have known more than anyone what Elaine would have wanted and whether she was suffering. Nobody had asked her opinion. Her mother was extremely strong and believed in always doing right, the kind of lady who slipped a dollar into each purse she donated to Goodwill so that whoever ended up with it would have a little something extra. Kathryn had no doubt her mother would want the truth to emerge.

She offered to write down everything she remembered from the time of the storm until she was forced to leave the seventh floor on Thursday, September 1, and provide it to the investigators. “I appreciate what you are doing,” she said. “I think this is extremely important.”

Butch Schafer sympathized with Nelson, even given her mother’s short life expectancy. Weeks earlier, looking down at his daughter’s coffin, speaking at her funeral, he’d said he would give everything that he owned, everything that he would ever have, everything that he was, for five minutes more with her right then.

He could not allow his personal grief to influence the investigation, but that grief always accompanied him, always awaited him as he filled his time and his mind with work. In Nelson’s loss, he recognized his own, and he experienced it again. This occurred each time he spoke with a bereaved family member. It was like a knife, death. Always waiting to cut.

The Wisconsin coroner Nelson had spoken with had been right about the autopsy. At first, Orleans Parish coroner Frank Minyard told Special Agent Virginia Rider it would be useless to examine the bodies from Memorial, which had decomposed in the heat for more than a week before
being recovered. There was no way to take a blood sample, for example, to check for lethal levels of drugs.

The news was upsetting. Rider and Schafer would need more than eyewitness testimony and empty morphine vials to prove a crime. But a volunteer pathologist told Rider that drugs could leave traces in other, hardier, tissues, such as liver, brain, and muscle, or in the fluid that pooled in the abdomen after death. At the attorney general’s request, overburdened coroner Minyard grudgingly agreed to ask a federal disaster mortuary team to perform autopsies and take tissue samples from all the hospital and nursing-home patients who had died in Orleans Parish after Katrina—about one hundred in total, it first appeared. The attorney general’s office had received allegations of wrongdoing at several of the facilities.

On September 22, state and federal investigators flew north with sets of tissue samples from eighteen of the Memorial Medical Center bodies and delivered them to National Medical Services, Inc., a forensic toxicology laboratory in Willow Grove, Pennsylvania.
In an acidic-smelling corner of a long, open room with scuffed walls, technicians extracted the samples into tiny, metal-capped containers shaped like medicine vials and sent them through gas chromatography/mass spectrometry machines bearing nicknames, including “Morticia” and “Gomez.”

Two weeks later, on October 6, the head of the laboratory, Dr. Robert Middleberg, called the attorney general’s office with preliminary results. Virginia Rider put him on speakerphone so prosecutor Butch Schafer and another special agent could hear. The strength of their case depended on the news the forensic toxicologist was about to deliver, the answer to whether the LifeCare patients had died with detectable levels of morphine and other sedative drugs in their bodies.

Middleberg began by qualifying his findings in the language of a careful scientist. He said the samples the laboratory had received were less than ideal because of decomposition.

“So that’s just one of the reasons why there has been a slight delay in
us getting back to you. In fact, we’re still working on these cases; we are not complete. We wanted to give you an update as to where we are.”

“OK,” Rider said.

“Thank you, Doctor,” Schafer said.

“Ah … of the eighteen cases today, nine of them are positive for morphine and a number of them, I guess about another five or six, are positive for midazolam.”

“Doctor, you’re going to have to forgive me,” Schafer interrupted. “I don’t know what that is.”

“OK, I’ll be happy to tell you. Morphine obviously you’ve heard of?”

“Yes sir.”

“Midazolam is, the brand name is Versed, V-E-R-S-E-D. And it belongs to what’s known as the class of compounds called benzo, B-E-N-Z-O diazepines, D-I-A-Z-E-P-I-N-E-S. And the one you are most familiar with in that family would be Valium, but the difference here is that midazolam is not a compound that people are routinely put on. It’s a compound generally used in operating suites or when someone is going to be intubated; someone may be given midazolam, but it’s not one of these compounds that you’ll find somebody getting a prescription for at home.”

“Yes sir,” Schafer said.

Middleberg explained that the lab had also detected a number of common medicines in the bodies, as expected, including antidepressants and drugs for gastric reflux. “Certainly the midazolam I’m finding is a little bit disconcerting,” he continued, “and I understand the difficulty, but medical records are going to be very, very important now.”

“Doctor, are these drugs such that they could have accumulated in a person?” Schafer asked.

Middleberg said midazolam shouldn’t be given on a repetitive basis. “Unless somebody is consistently being intubated and extubated or consistently going into the operating suite, there would be no reason for somebody to accumulate midazolam over periods of time.”

“Yes sir,” Schafer said.

“Morphine, certainly you can accumulate over time. But the concentrations we’re finding—and you have to understand that the specimens we have, again, were not ideal—some of the concentrations with morphine that we’re finding are, are pretty darn high.”

“If you were here,” Schafer said, “I’ll give you a kiss.”

“Ah … well, I’ll have to see you first.” Middleberg joked.

“OK,” Rider chimed in. “I would give you a kiss if you were here.”

“That would be more pleasurable,” Schafer said.

“All right,” Middleberg agreed.

“Thank you very much, Dr. Middleberg,” Rider said.

“Ah … you said, there were nine positive for morphine,” Schafer said. “Would you have the body numbers or some identifying number that we could go by and check out?”

“Yes, we can. Yes, we do. We will give you names of people, how about that?”

“Wonderful, oh great!” Schafer said.

“First one where morphine is found is a Harold Dupas, D-U-P-A-S.”

“Yes sir,” Schafer said. Dupas was one of the nine patients the LifeCare staff had believed were injected by Dr. Pou or the two Memorial nurses who came up to the seventh floor on Thursday, September 1.

“Next is a Hollis Ford [Hollis Alford]; Wilda McManus; Elaine Nelson; Emmett Everett; Alice Hutzler, H-U-T-Z-L-E-R; Rose Savoie, S-A-V-O-I-E; Ireatha, I-R-E-T-H-A
[sic]
, Watson; and George Huard, H-U-A-R-D. I apologize for the pronunciation.”

It was stunning. Of the eighteen samples tested, those positive for the two drugs coincided exactly with the names on the attorney’s list of suspicious deaths. And the laboratory hadn’t been told which names were on the list.

They said good-bye and Middleberg wished them a good afternoon. It certainly was. It was rare that everything lined up so neatly. Middleberg
had called the morphine concentrations “pretty darn high.” Rider and Schafer would remember those words.