Shoot Not to Kill

by Daniel L Stephenson

  Michelle thought for a moment, then asked, “So you have not had any missing for a few months. What procedures did you change?”

  Dr. Pengill reflected for a moment, then said, “We put new locks on all the carts and put a vault inside the cart that was locked separately. The pharmacists stock the carts now, and we do inventory before each case. A pharmacist is assigned full time to surgery now that we’re running surgery crews around the clock, plus our new trauma status.”

  “What do you mean by ‘new trauma status’?” Michelle asked.

  “We were not designated as a trauma hub until a year ago. Seems we’re picking up much more trauma than in the past, and our administration determined we had gone over some threshold of numbers of cases, and we expanded coverage for surgery to the level required to be considered a level-one trauma center. Since then our call has doubled, we have suites running 24/7. That was just about the time we noticed the thefts, too,” Dr. Pengill said. “What would that have to do with your finding a vial of Acozil on someone that was shot near here?”

  “Dr. Pengill, do you have a tracking mechanism for these controlled drugs? It might be possible to verify if the Acozil vial we have at LAPD came from your sources.”

  “You’d have to take that up with pharmacy. I sign only for quantities, not lot numbers. I’m pretty sure the pharmacies have to track the lot numbers because they are tied to expiration dates. Also recalls of drugs are done with lot numbers. You would have to talk to the pharmacists on that one.”

  “What other steps have you taken in the surgery department?” Michelle asked.

  “Nothing yet. There have been no narcotics unaccounted for above the normal one or two vials a year that just never show up. We’re monitoring the numbers, but nothing else. Why?”

  “I don’t know. We’re looking at a trauma peak here. There are data that suggest more thoracic trauma victims are coming through here than in the past, and I’m trying to put that into the picture.”

  Dr. Pengill thought for a second, then said, “The number of those trauma patients is the reason we’ve been able to go up to a level-one trauma hospital. We have expanded the thoracic surgery residency, and it seems there have been some discussions across the table with the residents about getting a good exposure to gunshot wounds here. The one that is doing the most is a doctor named Stan Bishell. He’s been in on most of the cases I’ve gassed, so that would be someone to talk to.”

  Michelle wrote the name down.

  “Thanks, Dr. Pengill. You brought me over here for coffee to discuss this. Is there anything else that you felt you would like to discuss with me? Are there reasons you were uncomfortable in the clinic?”

  Dr. Pengill looked at Michelle and shrugged. “I have to trust you, you have to trust me. Michelle, there is something about the training program that I just cannot put my finger on. We work with residents in general surgery, cardiovascular surgery, and thoracic surgery. I am a residency-trained physician, and I know male egos, and I know doctors egos. This may imply that I know male doctors’ egos, but there’s just something going on that I can’t get around.

  “There is one of the physicians in the residency that is just, well, I guess mean is the word. It goes on beyond just being a jerk. Many of the doctors are just jerks, but this guy, there’s something beyond that. He’s the one we’re talking about when we talk trauma thoracic surgery. Dr. Bishell has been with this hospital now for six years, and he’s gone from a diminutive and fairly quiet surgeon that we all hoped would do well to the most domineering and snotty surgeon I have ever seen, and I’ve seen a bunch of them. I’m here because I did not want the chance that he would come in on us and catch the discussion. I am concerned enough that I’m willing to work with you any way I can.”

  “Dr. Pengill, let me be honest with you. Our data have been weak, at best, but the pattern still emerged from the research. I had no names or suspicions. All I had was a bottle of Acozil with atropine mixed in, a new data peak that appeared when someone who knows how to turn every stone did the research, and a gut feeling there could be something here. I need everything I can get on what you can’t put your finger on. How do I get in to do the research? How can I get a pattern inside the hospital?” Michelle asked.

  “I don’t know. The hospitals anymore are so touchy about data and research. They are so difficult to work with that I cannot even ask about a case I do in ER. I cannot go to the floor and follow the case because the lawyers say it will make the patient suspect something went wrong. I have to submit my work to the billing department, and they know what I’ve done from day one. That would be one avenue of research. Another would be coding and information management. I can’t get you in there, and legally I can’t get you into the hospital without someone approving it. That would require you showing your hand to someone, and I’m just not sure who that should be.”

  “That’s supposed to be my department. I’m authorized to go undercover with this investigation, but I have to bring my bosses into it to get the approval of the hospital. If I get in, I’ll need to contact you when we’re ready to move. Will you be willing to work with us?” Michelle asked.

  “Ms. Lumen, I can’t answer that now. I need to see what you got and what you are against. Thanks for the coffee,” Dr. Pengill said as Michelle picked up the bill. “There’s one more thing that I should tell you, Michelle. I’m the only gasser here that I know of that mixes atropine in the Acozil.

  “Call me Shelly, Dr. Pengill. My boss will try to get me in the hospital. If I can get in, I’ll approach you then. Thank again, Dr. Pengill, and you’re welcome for the coffee.”

  Chapter 25

  Nine Years Later

  Michelle took the call from her office. It came through the department cell phone she carried. She was in a bank with several bank employees, going over a trail of fraudulent transactions accomplished from the Internet.

  “Hello, Michelle Lumen,” she answered.

  “Michelle, Marvin the Miner. You got a minute?” came Marvin Whistler's voice.

  “My God. Yes. Can I call you back? I’m about done here. Better yet, maybe I can stop in. Must be hot if you’re calling me all these years down the road,” Michelle mused.

  “Not real hot, just some things I’ve come across. Might make interesting reading.”

  “OK, my office is close now, not that far from you. See you at say 4:00.”

  Marvin clipped, “See you then,” and hung up.

  Marvin’s office was smaller than Michelle remembered. Marvin sat in an ancient yellow chair.

  “Michelle, you’re sure going places. I knew you when. You sure look good. Do you like your work?” he asked.

  “Marvin, it is good to see you as well. I’m happy with what I’m doing, but it sure is different than I thought it would be. Went to field site analysis and somehow I ended up in fraud, now you figure out how that happened. It’s good work. Had a few years undercover. At first that was fun, but eventually it got pretty touchy. What have you been doing?” Michelle asked as she pulled up a small chair.

  “I’m still learning how to run the Diamond Miner. They came out with a new and improved model, so I’ve been getting certified all over again. I needed a project for my final certification so I did some work on Bishell. I fed a search engine that is very different than what you can use on the Internet for free and copied one file and fed it to a billion files. The program worked on all matches that could come up, and I hit something that you might be interested in. The Manitoba Medical Board issued a license to a Simons Clinker Ballows. This was several years ago, and there had been no other activity until another hit came from a disciplinary board in North Dakota. That one was a surprise, too. That was a couple years later. Bellows surfaced again with a license issued in Missouri. This was my theme for certification, trying to demonstrate the abstract analysis of Clinker’s file, and we came up with these data. I’m not sure what it means, but there was activity with the name of a guy that had the same initials for
his first and last names as did our suspect, or I should say your suspect. Listed with a middle name of Clinker, of all things. He was listed as a surgeon, trained in London. That’s all I have. Not even sure if it means anything.”

  Michelle took the sheet of paper from Marvin and studied the names and places.

  “I guess I can start calling around. I’ve got a lot on my plate right now, but I can try. Clinker, he would be the one to rub our noses in it like that. OK. Marvin, I’ll keep you in the loop here.”

  “Yeah, you recall the problem there, Michelle? The hospital he worked at had an unexpected bump in thoracic shootings, and he almost killed you. Be careful.”

  Chapter 26

  Loop Hole, Reciprocity

  It was two weeks before Michelle had time to go back to Marvin’s leads. She searched the North Dakota site and found nothing that would help. She then looked at the College of Surgeons Web site and found a listing for Simons Clinker Ballows, MD. His address was in Missouri. No hospital affiliation was provided, no contact phone numbers or information on alumnus status, training, or current position.

  Michelle called her brother-in-law. She now could dial direct.

  “May I speak to Dr. Price? Tell him it involves the amount of starch he requested in his scrubs.”

  “May I ask who is calling?” the unimpressed female voice said on the other line.

  Michelle had long since learned that discretion was needed when evoking the claim of being a police officer. “Tell him it is his sister-in-law,” she said.

  “OK, please hold.”

  “Michelle, good to hear from you. We thought maybe there had been a major earthquake in California and the whole state was now sitting next to Atlantis. Your sister is not pregnant, I’m happy to say.”

  “That’s good news, though I’m sure Sis is more excited about that news than I am. Everybody happy up there?” she asked.

  “Fine, starting to play soccer now, that’s a real sight. My new position gives me a bit more time to do the running about. What’s up?”

  “Do you recall that case I called you on a bunch of years ago? Michelle asked. “It was about someone using Acozil for crime scenes. I’d like to ask you some questions on how to look for doctors.”

  “I think I recall the case. What do you mean, look for doctors?” Henry asked.

  “I’ve got a name, and I want to see if I can track it down. It just may be the same person, and I’d like to find some information on the guy. Any ideas?”

  “Yeah, insurance companies keep a file on us all. That would be one place, but I suppose you’d need a warrant, no that was before the new rules. Then there are commercial sites on the Web that you can join and they do doctor searches for you and provide the profile on us down to the size of our shoes. You can sometimes find out if we’ve been sued, if we won or lost. It will list our schools and associations. You name it, they’ve got it; but some of it may be old or incorrect. Those companies have so far been protected from litigation for slander when they are incorrect. Then there’s the National Provider Data Bank, but that’s pretty hard to get data out of unless you pay for it, and you might need authority. That would tell you if your dude’s been sued, but unfortunately it only indicates money has changed hands or his privileges have been modified. Won’t tell you much else.”

  “That’s something to start on, anyway. Hank, how could I get my license overseas and get into the country?” Michelle asked.

  “Don’t know what you’re looking for there. I’m on the credentialing committee here in this hospital. When someone comes in, there’s a form they fill out that authorizes a search of everything. We go to the college, medical school training, internship, residency, fellowship, and any post-doctorial work they claim. Here we even will search the yearbooks to match the face to the graduate. Not many institutions go to that degree. There have been people that attempt to assume another physician’s identity, so the one guy ends up working two places. Gets a lawsuit against him in another state, and he never left town.” Henry asked. “What are you looking for?”

  “I really don’t know. One of the data geeks here in the department did some high-level scrounging and found out that there’s been someone licensed in Canada that might be a match. No indication he ever worked there, and then he shows up on disciplinary action in North Dakota, and a hint he was working in Missouri. I just wanted to try to get some information. Will they have done all that research if he worked in North Dakota?” Michelle asked as she sensed Henry getting hurried.

  “Yeah, they did, and any respectable hospital he’s worked at will do it as well. Lots of little places go on the fact that the hard work may have been done by the bigger hospital, and they just call up and confirm it, relying on the fact that the verification and work to authenticate the records was done by the sponsoring hospital. Listen, I gotta go. Will you call your sister? Send us pictures of your rats, we’ll compare the genes. Hi to Cameron.”

  “That’s Colin, and I’ll send them soon. Thanks. Need more information, but this will get me started. Where do I find those Web sites that do the searching for doctors?”

  “I dunno, kid, I’m on the other end. Love yeah and see yeah,” Henry said as he hung up.

  Michelle looked at the computer and started searching. First she did people searches and found more listings than she thought could have been possible. Next she went to search for commercial sites that would provide information on physicians. She had an account for her office, but did not have a card for the searches. She called her boss.

  “Ma’am, I need to use an account to do some searching on the Internet for clues on an old case,” Michelle said as she rubbed her eyes.

  “What’s the case, Michelle?” Ms. Walsh asked.

  “It is a long story, but I started tracking a guy down that was a physician here in LA. We suspected this guy was making his own patients. We tracked him to a local hospital, and I dropped my handcuffs in surgery. He saw them and disappeared. Now we have a lead, a real lead. Well, Marvin Whistler thinks he’s found a cold trail on him, and I’d like to warm it up some. Would be a few hundred bucks, maybe a thousand,” Michelle speculated.

  “I’ve heard of Marvin. That’s not too much, but what’s the score? If we track him out of state, it’s going to those big boys at the FBI, anyway. Why not just tip them and save the money.”

  “Good question. Seems like he’s in Missouri or North Dakota. So I’ll just push it to federal level.”

  “Isn’t that where they made that movie Fargo? God, what a show. That was some show. Heck, you can have the debit card for this, just because it was a lady detective that did the dirty work there, too. Come on up and get it from Gloria.”

  “Thanks, ma’am. I’ll let you know if it gets interesting,” Michelle said as she headed for Robin’s secretary’s desk for the card.

  The first site had some information. The physician listing did show Missouri as the place of record. The data showed a general surgeon, licensed two years previously. The license also showed the fact that Dr. Ballows had been trained in Scotland and had done his surgical work in England. No other data. There were no entries for current work.

  The National Practitioner’s Data Bank said she needed an access account from a hospital or credentialing body to access the information they maintained. She called Hank.

  “Michelle, what’s up now? I’m starting to feel like I’m on the LAPD payroll,” Hank said as he came to the phone.

  “I can make that happen, but I think it would be a drop in pay for you. Hank, I need you to query the NPDB for me. I can’t get data out of them.”

  “Can’t do it. I need a release of info to get the data myself,” Hank said.

  “Can you do it through your hospital?” Michelle asked.

  “Costs money, and I’d have to have a reason. The credentialing secretary used to be a teacher, and she’s hell on wheels. I would need an application request for privileges signed by this guy, and I’m not going to do anything i
llegal. This is a good hospital, and I sure need the work with all those kids. Only thing I would suggest is getting the info from where he trained. Like I said, you’ll need a picture of the dude to do it right, they’re some real crooks out there. I read in one magazine that they think one in every one hundred physicians is bogus. It seems to me that the number should be one in twenty, but they all check out somehow. Gotta go, call your sis, she’s lonely as hell. Bye.”

  Michelle ran several other search engines and found no new data. She went back to the Web site for the North Dakota Board of Medical Examiners. There she ordered a book that was published with information on doctors with licenses in that state. A similar book was available from Missouri. She ordered it as well.

  Michelle then called the Missouri Medical Board. “My name is Michelle Lumen, with the Los Angeles Police Department. I’m trying to establish information on one of the physicians that is licensed in your state. Can you tell me anything without a warrant?” Michelle asked.

  “Sure, honey. I can give a good bit of information to you. Who is it and what do you want to know?”

  “It is for a Simon Ballows. Simon Clinker Ballows. Do you know where he came in from?”

  “Hold your ponies. Gawd almighty you’re in a hurry. I have to go get his record. Hold the phone.”

  Michelle waited, finally hearing the phone pick up. “Here he is. I got him. He’s a surgeon, right?”

  “Yeah, that’s right. I’m trying to follow him across states and need to know where he came to you from?”

  “Well, looks like he’s in from Indiana. We have an agreement with that state, or had one, I should say. It’s called reciprocity. Means if a doctor gets his license there, he can apply for a license here, and we’ll issue one to him. We quit doing that, now.”