by Sheri Fink
39 “I think you ought to go”: Dosch, interview with author June 4, 2013. Mr. Goux did not respond to a request to fact check the material in the book. However, in an interview 2009, when the author asked about the injections on the seventh floor (I did not ask specifically about the second floor), Mr. Goux said, “I was not aware that was going on.” He told state investigators in 2005 that he had heard rumors of euthanasia happening at Memorial very soon after he left the hospital, “everywhere I turned. I can tell you when the first time I heard that it was shocking.”
40 “because you’re nurses”: Ms. Janice Jenkins and Ms. Karen Wynn, interviews with author.
41 Wynn and Pou requested: Anonymous e-mail to author. Therese Mendez, in an interview with state investigators, also recalled Dr. Pou asking for injection supplies when she was upstairs in LifeCare.
42 Pou called for someone with a light: Nurse Jeffrey Caffall interview with state investigators, March 6, 2006.
43 Another very young nurse: Julie Couvillon interview with investigators, October 26, 2005. Couvillon said she heard from her nursing director, who was not involved, that the patients were given potassium, morphine, and Versed. Couvillon noticed a box against the wall near the catwalk with vials of potassium chloride. This box was still present and filled with mostly sealed bottles when investigators later searched the hospital, and there are photographs of it. The potassium chloride was used to euthanize pets. However, nobody involved in the injections of patients and interviewed by the author recalled that potassium chloride was used to hasten the deaths of human beings. The drug cannot be detected by postmortem toxicology.
44 She was also haunted: Wynn did not name Ewale, but her recollections were consistent with other sources. The amount of morphine and Ativan he received was not indicated, but nurse Leah Boudreaux wrote in Ewale’s chart what appears to be a summary of his last hours, including, at ten a.m.: “Pt still unresponsive, choking on secretions but unable to suction pt due to conditions. Morphine given for comfort.” Several aspects of the account are strange. Portable suction was used in other areas of the hospital. There are no orders for the medication. Wynn, in her interview with the author, said she was told that the patient had begged for help, but the nurses’ notes all indicate that he was unresponsive. In Budo, Katrina, p. 79, a nurse with the pseudonym “Pal” wrote that on Wednesday she stayed with an ICU patient who “was very ill, close to death. Foam was bubbling out of his mouth. The hospital systems had failed the night before; I had no way to suction him. He had some sedation ordered for his comfort. I gave it to him. His eyes were open, he was looking at me. I just held his hand. It was a horrific thing to watch. I don’t think he would have survived even if I had been able to suction him.”
45 A nurse approached: The nurse spoke of these events on condition of anonymity. This section is based on her interview with investigators conducted several months after the storm, interviews with other nurses who interacted with her, and, to a much lesser extent, her later recollections of the events, which she felt were very fuzzy, in interviews with the author in 2010 and 2013.
46 Culotta saw Lagasse was in respiratory distress: Roy Culotta interview with state investigators, November 28, 2005. His account was largely consistent in his later deposition (February 23, 2010) in a civil case brought by Merle Lagasse’s family.
PART 2: RECKONING
CHAPTER 8
Interviews
Dr. Horace Baltz; family of Jannie Burgess (Linette Burgess Guidi, Gladys Clark Smith, Bertha Mitchell, Johnny Clark); Tony Carnes; Catherine Chatelain; James Cobb Jr.; Dr. Ewing Cook; Minnie Cook; Curtis Dosch; family of Emmett Everett (Carrie Everett, Emmett Everett Jr.); Linda Gagliano (stepdaughter of John Russell); L. René Goux; Cathy Green; Dr. Robert Hendler; Gina Isbell; Karen Lagasse (daughter of Merle Lagasse); Angela McManus (daughter of Wilda McManus); Therese Mendez; Robert Middleberg; Dr. Helen Miller; Dr. Frank Minyard; LT/O3E Sean Moore; Stephanie Moore; Alfred Lee Moses; Dr. Bong Mui; family of Elaine Nelson (Craig Nelson and Kathryn Nelson); Dr. Daniel W. Nuss; Brenda and Tabatha O’Bryant; Cheri Pizani; Dr. Anna Pou; Michelle Pitre-Ryals; Dr. Christopher Sanford; Douglas Savoie Jr. (grandson of Rose Savoie); Arthur Schafer; Richard T. Simmons Jr.; Dr. John Skinner; Dr. John Thiele; Dr. John Walsh; Dr. Cyril Wecht; Tony Zumbado.
Note: Investigative interviews and other events sourced clearly in the text are generally not noted here.
Notes
1 in exchange for what she thought: Mary Rose Bernard interview with state investigators, June 26, 2006: “I pleaded with Fox News and they said well we will see what we can do to get your family out, if you agree to be interviewed.”
2 “You could have gotten out”: Anita Vogel, correspondent, “Hurricane Katrina’s Aftermath,” Fox News Network, On the Record with Greta Van Susteren, September 1, 2005, ten p.m. Also, StoryCorps interview of Pamela Mathews, Edwin Mathews, and Jo Lincks, MBX006447.
3 National Guardsmen from San Diego: Gross, Gregory Alan, “S.D. Guardsmen Find Life, Death in Waters,” San Diego Union Tribune, September 7, 2005; http://legacy.utsandiego.com/news/nation/katrina/20050907-9999-1n7guard.html.
4Christianity Today magazine reporter: Tony Carnes’s photograph of Memorial’s chapel was picked up by the New York Times and is not easily forgotten: http://www.nytimes.com/imagepages/2005/09/18/national/19victimsCA01ready.html.
5 “It was like a picture of hell.”: Chaplain Hy McEnery on CNN, September 16, 2005. an interview with a Baton Rouge television reporter: Aired on WBRZ, September 12, 2005. Portions were later re-aired on CNN.
6 St. Rita’s: For more on St. Rita’s, see: Cobb, James, Jr. Flood of Lies: The St. Rita’s Nursing Home Tragedy (Gretna, LA: Pelican Publishing, 2013); Junod, Tom, “The Loved Ones,” Esquire (September 2006); http://www.esquire.com/features/ESQ0906NEWORLEANS_216; Mead, Robert A., “St. Rita’s and Lost Causes: Improving Nursing Home Emergency Preparedness,” Marquette Elder’s Advisor (Spring 2006).
7 in an essay for Modern Healthcare: Hirsch, Les, “‘We had to Evacuate Soon,’” Modern Healthcare (September 12, 2005); http://www.modernhealthcare.com/article/20050912/NEWS/509120323.
8 She left messages on Goux’s cell phone […] she wanted to get her own lawyer before answering: Affidavit of Anna Pou, MD, January 13, 2006, and hearing transcript, “In re: Doctor Anna Maria Pou,” Orleans Parish criminal district court, the Honorable Calvin Johnson, Judge, presiding, January 17, 2006.
9 The network agreed to pay Simmons: Letter from Pou’s attorney to Phelps Gay and Lauren McHugh, “Re: Dr. Anna Pou’s Claim for Reimbursement of Legal Fees.” Attachment A, “Memorandum from Richard T. Simmons Jr. counsel for Dr. Anna Pou,” 4. Documents filed with the Attorney Fee Review Board, Louisiana State Legislature and obtained by author through public records request.
10 One of the first things Simmons did: Pou said that she retained Simmons on September 19, 2005, the date of her initial conversation with Tenet officials, however, in the fee review matter, Simmons told the State of Louisiana that he represented her beginning in October 2005.
11 The US attorney for southeast Louisiana had opened: Investigative memoranda provided by the US Department of Health and Human Services Office of the Investigator General in response to author’s FOIA request reflect this.
12 “I told you so”: Cobb, Flood of Lies.
13 Ferncrest Manor: Investigative memorandum, Ferncrest Manor Living Center, HHS OIG case 6-05-00497-9, September 17, 2007.
14 mandated evacuations of nursing: According to US Senate, Hurricane Katrina: A Nation Still Unprepared, Chapter 16, p. 248, a draft version of Mayor Nagin’s evacuation order did exempt nursing homes. That was changed on the suggestion of Col. Terry Ebbert, New Orleans’s homeland security and public safety director, who noted their vulnerability.
15 About two-thirds of the affected nursing homes had kept residents in place […] but rescue came too late: Hull, Anne and Doug Struck, “At Nursing Home, Katrina Dealt only the First Blow,” Washington Post,
September 23, 2005; http://www.washingtonpost.com/wp-dyn/content/article/2005/09/22/AR2005092202263.html.
16 at Chateau Living Center: In litigation over deaths at Chateau, representatives of the nursing home asserted that after the private company refused to provide buses, they attempted to hire Greyhound buses for the evacuation, but it was too late because highways were closed and high winds had moved into the area. An earlier HHS OIG investigation memo (September 25, 2006) stated: “There is conflicting evidence as to whether the bus company was notified of the facility’s intent to evacuate in a timely manner, or whether the bus company did not fulfill its obligations to provide transportation in a timely manner.” The investigation was later closed.
17 Lesser charges of manslaughter: Arthur Schafer sworn witness examination, mandamus hearing, John and Jane Does v. Charles Foti, et al, 19th Judicial District Court, Parish of East Baton Rouge, State of Louisiana, case 558,055, August 28, 2007. Schafer said a decision on what charges might be applicable had not been reached.
18 Lou Ann Savoie Jacob: Nossiter, Adam and Shaila Dewan, “Patient Deaths in New Orleans Bring Arrests,” New York Times, July 19, 2006; http://www.nytimes.com/2006/07/19/us/19patients.html. Ms. Savoie Jacob’s recollections are supported by Rose Savoie’s medical records: “Actually doing better” (August, 25, 2005) and “No new medical complaints” (August 27, 2005, the last physician progress note).
19 Kathryn Nelson: Ms. Nelson and her brother Craig’s recollections in interviews with the author were supplemented by a handwritten account of the events she prepared for state investigators, dated October 26, 2006, and her July 8, 2008, deposition in Elaine Nelson, et al v. Memorial Medical Center, et al, Orleans Parish Civil District Court.
20 massive temporary morgue: Described in Wecht, Cyril H. and Dawna Kaufmann. A Question of Murder (New York: Prometheus Books, 2008), pp. 248, 271–2.
21 In an acidic-smelling: Description based on author’s visit in July 2008.
22 Chalmette Medical Center: This brief description of what happened at Chalmette Medical Center is based on the recollections of Dr. Bong Mui in an interview with the author, August 3, 2011, and in a translated partial transcript of his interview in Vietnamese with son Nguyen dated September 10, 2006, for the oral history project “Surviving Hurricanes Katrina and Rita in Houston Collection” (AFC 2008/006), Archive of Folk Culture, American Folklife Center, Library of Congress, Washington, DC (interview SR05, accession no. SKR-SNU-SR05). Lightly redacted Louisiana Medicaid Fraud Control Unit investigative memoranda on Chalmette Medical Center obtained through a public information request suggest that hospital leaders had decided to keep the hospital open and staffed (not only because ambulances did not return to transfer more patients). Some patients who were transferred out of Chalmette Medical Center prior to the storm were moved to that hospital’s sister campus in the New Orleans area (Pendleton Memorial Methodist Hospital), which was also subsequently severely disabled by floodwaters and generator failures.
23 Tulane was also dark: Hamm, L. Lee, “Personal Observations and Lessons from Katrina.” The American Journal of the Medical Sciences, vol. 332, no. 5 (2006): 245–50; Tulane commissioned a book on its hospital experiences during Katrina: Carey, Bill. Leave No One Behind: Hurricane Katrina and the Rescue of Tulane Hospital (Nashville, TN: Clearbrook Press, 2006). New employees of the Hospital Corporation of America (HCA, Tulane Hospital’s owner) are sometimes presented with a copy of the praise-filled account.
24 had not supplied with food, water: Hurricane Katrina: A Nation Still Unprepared, p. 11.
25 authorized the lieutenant to land: LTJG Sean Moore was riding in a Coast Guard–chartered commercial helicopter, aiding a marine salvage crew surveying the local waterways for sunk and disabled vessels. He said in an interview with the author (June 3, 2013) that the pilot, on learning Moore’s wife, Stephanie, was in the hospital, said, “Let’s get her the ‘f’ out of there.” The commander of Sector NOLA, Captain Frank Paskewich, said in a US Coast Guard Oral History interview (October 18, 2005) that he readily approved the request. “I said, ‘Absolutely, go rescue your wife, please.’” http://www.uscg.mil/history/katrina/oralhistories/PaskewichFrankoralhistory.asp.
26 Anderson Cooper said: “Euthanasia Performed in Aftermath of Hurricane Katrina?,” CNN, Newsnight with Aaron Brown, October 12, 2005, ten p.m.; http://transcripts.cnn.com/TRANSCRIPTS/0510/12/asb.01.html.
27 “Why weren’t there plans”: “Accusations of Mercy Killing in New Orleans,” CNN, Newsnight with Aaron Brown, October 12, 2005, eleven p.m.; http://transcripts.cnn.com/TRANSCRIPTS/0510/12/asb.02.html.
28 “The culture that we live in”: ibid.
29 “Did an angel of death”: “Louisiana AG Orders Autopsies of 50 Memorial Medical Patients,” CNN, Nancy Grace, October 14, 2005; http://transcripts.cnn.com/TRANSCRIPTS/0510/14/ng.01.html.
30 “There was no way”: “In Depth: Officials Are Looking Into Allegations of Euthanasia in a New Orleans Hospital for Gravely Ill Patients as Hurricane Katrina’s Floodwaters Rose,” NBC News, October 17, 2005; http://www.nbcuniversalarchives.com/nbcuni/clip/5117065625_s09.do.
31 “I didn’t know if I was doing the right thing”: Graham, Caroline and Jo Knowsley, “We Had to Kill Our Patients,” Mail on Sunday, September 11, 2005; http://www.dailymail.co.uk/news/article-361980/We-kill-patients.html.
32 Nearly three out of four convictions: Innocence Project, Inc., “Reevaluating Lineups: Why Witnesses Make Mistakes and How to Reduce the Chance of a Misidentification,” (Benjamin N. Cardozo School of Law, Yeshiva University, July 16, 2009); http://www.innocenceproject.org/docs/Eyewitness_ID_Report.pdf.
33 they were far from complete: Tenet Healthcare Corporation provided the following response on August 18, 2009: “This is not correct. Tenet has produced all requested medical records in its possession—both hard copies and electronic—to the Louisiana Attorney General’s office. On numerous occasions, Memorial Medical Center made available all records in its possession and provided investigators full access to the facility when requested.”
34 CNN reported on the subpoenas: Griffin, Drew and Kathleen Johnston, “Dozens Subpoenaed in Hospital Deaths,” CNN, October 26, 2005; http://www.cnn.com/2005/US/10/26/katrina.hospital.
35 Castaing would, years later: Castaing said this during fact checking for Deadly Choices in 2009. He repeated it in two phone calls with the author in 2013 and an e-mail. He said the meeting’s purpose was to organize logistics for interviews of Memorial employees and that he requested either a blanket non-prosecution or immunity agreement for all the nurses from Memorial, which he did not obtain. When Castaing was told that notes were made within days of the meeting by the investigator, he said he, too, had taken notes “religiously.” However after the author asked to see them, he checked and said he had taken no notes.
36 Jim Letten: Letten’s position had previously been held by Orleans Parish District Attorney Eddie Jordan Jr. Letten was reportedly the longest-serving US attorney when he resigned from his position in December 2012, after senior prosecutors in his office were discovered to have commented on active criminal issues on the website of the Times-Picayune, using aliases. Robertson, Campbell, “Crusading New Orleans Prosecutor to Quit, Facing Staff Misconduct,” New York Times, December 6, 2012; http://www.nytimes.com/2012/12/07/us/jim-letten-new-orleans-us-attorney-resigns.html.
37 federal jurisdiction over them was limited: Williams, C. J., “Making a Federal Case out of a Death Investigation,” United States Attorneys’ Bulletin, vol. 60, no. 1 (January 2012); http://www.justice.gov/usao/eousa/foia_reading_room/usab6001.pdf.
38 “John, everybody has to be out of here”: Susan Mulderick, through her attorney, and L. René Goux both said that they were not given a deadline to empty the hospital and that their goal was to focus their exhausted colleagues on the evacuation. “We’d experienced the helicopters’ stopping flying to us, and I didn’t want that to occur again,” Goux said in an interview with the author (August 17, 2009).
39 DMATs: Sanford, Christopher. “Nine Days at the Airport” (unpublished manuscript). Sanford, Christopher, Jonathan Jui, Helen C. Miller, and Kathleen A. Jobe, “Medical Treatment at Louis Armstrong New Orleans International Airport After Hurricane Katrina: The Experience of Disaster Medical Assistance Teams WA-1 and OR-2,” Travel Medicine and Infectious Disease 5 (2007): 230–235; Klein, Kelly R. and Nanci E. Nagel, “Mass Medical Evacuation: Hurricane Katrina and Nursing Experiences at the New Orleans Airport,” Disaster Management and Response vol. 5, no. 2 (2007): 56–61; “Hurricane Katrina—After Action Report: OR-2 DMAT,” September 25, 2005; Dentzer, Susan, “Hurricane Hospital Challenges,” PBS NewsHour, September 8, 2005; http://www.pbs.org/newshour/bb/weather/july-dec05/hospitals_9-8.html; Barringer, Felicity and Donald G. McNeil Jr., “Grim Triage for Ailing and Dying at a Makeshift Airport Hospital,” New York Times, September 2, 2005; http://www.nytimes.com/2005/09/03/national/nationalspecial/03hospitals.html; Smith, Stephen, “Patients Evacuated in Massive Airlift: LA Airport Used as Field Hospital,” Boston Globe, September 4, 2005; Allison, Cody, “Untitled,” Hurricane Digital Memory Bank, object no. 39470; http://www.hurricanearchive.org/items/show/39470. The US House of Representatives report on Hurricane Katrina (A Failure of Initiative: The Final Report of the Select Bipartisan Committee to Investigate the Preparation for and Response to Hurricane Katrina, February 15, 2006, p. 269; www.c-span.org/pdf/Katrinareport.pdf) noted the “confusion” that resulted over the command structure of the medical teams. Prior to Katrina, the National Disaster Medical System, of which the DMATs are a part, was removed from HHS and placed under FEMA and the Department of Homeland Security as part of a massive governmental redesign after the September 11, 2001, attacks. After Katrina, the NDMS was placed back under the Department of Health and Human Services, which coordinates federal health care resources in emergencies (“Emergency Support Function-8”), according to the National Response Framework. The medical section of the House of Representatives report (pp. 267–309) criticized the failures of the federal medical response in particular. It described the medical effort at the airport as “chaotic,” with many people dying while doctors who weren’t members of the federal teams, like Thiele, were turned away. Personnel “black tagged” the sickest and moved them away from others “so they could die in a separate area,” one doctor quoted in the report said (p. 288). Despite the post-Katrina “lessons learned,” supply chain problems and rigid procurement policies again encumbered the NDMS’s lifesaving work in response to the 2010 Haiti earthquake (albeit in a much more logistically challenging environment); some supply caches arrived with heaters, for example, instead of air-conditioners; and bottled oxygen, fuel, and certain equipment for performing operations ran short. One case is discussed in the Epilogue. NDMS in recent years “significantly revamped its supply, resupply and logistics processes” including the warehousing of supplies around the country for use by any team, and anticipating specific needs, such as special bariatric beds for very obese patients, according to Gretchen Michael, director of communications, HHS Office of the Assistant Secretary for Preparedness and Response (e-mail, August 2013). DMATs used smaller strike teams to respond more flexibly to Superstorm Sandy in 2012, and HHS behavioral health teams supported first responders and American communities affected by mass shootings and bombings in 2012 and 2013.