by Peter Elkind
Some parents raised questions about whether it was merely publicity that had attracted so many Jones-related clients to the Stolhandskes. On August 20, 1984, Art Brogley interviewed Esperanza Zavala, the mother of Patrick, at her home. Following the conversation, Brogley detailed part of the conversation in his investigative log, a running diary he had kept since being assigned to the case:
On Wednesday, August 15, ’84, a representative of the Stolhandske law firm contacted Mrs. Zavala at her residence and brought her and the Villarreals to the firm’s office by vehicle…[Lauro and Juanita Villarreal were the parents of three-month-old Paul, who had died in the ICU in September 1981 after elective surgery on his skull.]
Stolhandske [the log did not state which one] and [another attorney with the firm] conducted joint interview with Mrs. Zavala and the Villarreals.
Mrs. Zavala learned the firm had tried to contact her earlier, on Tuesday, August 14, through her mother and at her residence.
Mrs. Zavala did not initiate contact with [the] Stolhandske firm or any other law firm regarding possible civil suit.
Mrs. Zavala and the Villarreals were told that the firm was in possession of their sons’ medical records. Further, that the records revealed both children had been administered large doses of medications. Mrs. Zavala interpreted this remark to suggest the children may have died as a result of physicians’ malpractice.
The parents were told the firm was “looking at 21 cases.”
The parents were also told that the law firm would bring suit first against the UTHSC [the medical school]. The monetary recovery, according to Stolhandske and [the other attorney] would be a “total split” among all the families named as plaintiffs. The attorneys stated “each might receive 30–35 thousand dollars.” They indicated the suit against the UTHSC should be resolved in about six months.
Afterwards, the law firm would bring suit against the MCH [Medical Center Hospital]…
Mrs. Zavala agreed to sign “some papers” presented to her by the law firm. She was aware only that she agreed to become one of the firm’s plaintiffs in the suits against the UTHSC and the MCH. Mr. Villarreal also signed an agreement…
In fact, things would go almost exactly as Mrs. Zavala was told. In exchange for a quick—and relatively cheap—out-of-court settlement, the Stolhandskes excluded the UT medical school from almost all their litigation. The suits against the hospital would linger for more than three years without ever coming to trial. In fact, there was little sign that the Stolhandskes ever planned to try the cases. They initiated few deposition or discovery requests, and at one point, most of the suits were slated for dismissal for lack of activity. But the number of cases allowed the Stolhandskes to bargain wholesale with the hospital. In early 1988, they reached an out-of-court settlement covering all the remaining lawsuits. The Stolhandskes apportioned the settlement money themselves among their clients (a practice that would make many plaintiff’s attorneys uncomfortable), pocketed 50 percent plus expenses (an unusually high percentage for a case that never went to trial), and dismissed the litigation.
Bill Stolhandske said the 50 percent take for his firm was not unusual for such a complicated matter. And he denied any suggestion that his firm had improperly solicited business. He said no one representing his firm had approached any prospective client without invitation. In several cases, Stolhandske said, the firm received calls from relatives—aunts, uncles, and cousins—of children who had died in the ICU; those relatives, he explained, invited the lawyers to contact the parents of the deceased children.
A set of parents who retained another San Antonio attorney struggled to make it even to the courthouse. The parents of Terry Lynn Garcia, who had died in August 1981 after bleeding on the 3-11 shift in the pediatric ICU, gave their attorney a release so he could obtain a copy of their daughter’s medical records. When several weeks passed without any action, the parents fired the lawyer. A citizen later called the DA’s office to report finding Terry Lynn Garcia’s medical records in a garbage bin. The parents subsequently decided to retain the Stolhandskes.
With the much-publicized failure of the exhumations, the San Antonio papers were openly wondering whether the DA would ever produce results to match his rhetoric. Assigning its political reporter to weigh the scales, the Light reported that the baby-deaths investigation had taken “a heavy toll on San Antonio—emotionally, financially, and in the delicate balance of public trust.” Parents of children who died were suffering “the agony of uncertainty,” while the public hospital was forced to operate “under the cloud of the most loathsome suspicions.” After nineteen months, the paper concluded, “the toll the case has taken on the community far exceeds the legal actions that have been chalked up by District Attorney Sam Millsap and his staff.”
But the quest for new indictments remained frustrating. In a half dozen cases, the DA’s staff was agonizingly close to meeting the burden for a charge of murder. Each case seemed just one piece of evidence short: Lab results documenting an apparent overdose had disappeared; Jones was signed out to lunch at the time a child had died suspiciously; the memory of an important witness failed.
Irksome, too, was the knowledge that those who had tolerated Jones’s actions—even defended and protected her—had gone unpunished. In February, Millsap and Rothe had briefed hospital board chairman Thornton and Guest on the evidence concerning Rolando Santos’s heparin overdoses that nursing supervisors had virtually ignored. Thornton promised an internal investigation, and, indeed, one had begun. But when summer arrived, the internal hospital probe—like so many before it—was dragging on, with no result in sight.
One night, Nick Rothe went out for a beer with John Guest, a man he had come to like and trust. Rothe told the administrator there was no doubt that Genene Jones had murdered babies in his hospital. But Jones wasn’t the only one who bore a measure of the responsibility. Rothe talked about the failure of the nursing hierarchy, from ICU head nurse Pat Belko to pediatrics supervisor Judy Harris to hospital nursing administrator Virginia Mousseau. “There is a possibility for this to happen again,” declared Rothe, “because certain individuals remain in positions where this could happen again.”
Guest looked puzzled. What did Rothe expect from him?
“John,” said the lawyer, “there comes a time in a man’s life when a man’s gotta do what a man’s gotta do.”
In mid-August, Rothe flew to the Mexican resort of Cozumel for a long-overdue vacation. When he arrived at El Presidente Hotel on the balmy island, he discovered an urgent telephone message waiting for him in his room. It was from Millsap. After several unsuccessful attempts, Rothe finally reached the district attorney back in San Antonio.
“Nick, I don’t know what this means,” said Millsap, over the crackly long-distance line, “but Mousseau, Belko, and Harris resigned for personal reasons today.” Rothe broke into a smile. “And there’s a message for you from John Guest. It says: “‘A man’s gotta do what a man’s gotta do.’”
One month before Genene Jones’s San Antonio trial was to begin, hospital board chairman Thornton gave the DA a call. After a year of painful public head-butting, Thornton had begun working to win Millsap’s favor, consulting with the DA before making any major move at the hospital. Now Thornton asked about John Guest. Had the DA uncovered anything to suggest he was unfit for permanent appointment? Pleased with the recent purge of the nursing administrators, Millsap informed the board chairman that John Guest, the lone survivor at the top of the hospital hierarchy, had his blessing. On September 25, the board named Guest executive director of the Bexar County Hospital District, at a salary of $85,000 a year.
The second trial of Genene Jones, on a charge of injecting a baby with the blood-thinning drug heparin, began on October 15 and was to last but ten days. The defendant, believing that an emotional jury had convicted her in Georgetown, decided to let a judge decide her fate this time. Presiding was Bexar County district judge Pat Priest, respected widely for his fairness.
Two court-appointed San Antonio lawyers, Royal Griffin and David Weiner, represented Genene Jones. Nick Rothe and assistant DA Raymond Fuchs served the state.
For reporters who had covered the proceedings in Georgetown, this trial seemed anticlimactic. But the citizens of San Antonio felt differently. After two years of headlines, the spectacle of the killer nurse—in the flesh!—drew overflow crowds. Afraid that someone would seek simpler justice, the judge ordered extra guards and insisted that spectators pass through a metal detector before entering the courtroom.
To those who had known Genene Jones at Medical Center Hospital, the evidence was familiar. Doctors and nurses testified that babies got sick when Genene was on duty, recovered when she was away, and got worse when she came back. Nurse Suzanna Maldonado described her diary of death, showing how many children had expired on the shift the LVN had worked. Maldonado recalled the death threat she had received after her complaint to Belko. Larry Hooghuis, the former pediatrics resident, testified that his patients went downhill when he was getting along badly with Genene. Hooghuis recounted the incident in which he had caught Jones about to inject Albert Garza with 333 times the proper amount of heparin; he testified that he had demonstrated the proper dosage to Jones by drawing the calculation on a bed sheet.
But the most damning piece of background testimony—for both the defendant and Medical Center Hospital—came from Dr. Gregory Istre, the Centers for Disease Control epidemiologist who had studied the pediatric ICU at Millsap’s request. Introduced over defense objections, Istre’s report validated every suspicion that Genene’s critics in the ICU had reported to their superiors; it also refuted every excuse Jones’s allies had offered in her defense. From 1980 to 1981, Istre testified, the pediatric ICU’s death rate soared 178 percent. But the expert focused on what he labeled the “epidemic period”—the fifteen months from April 1981 through June 1982. During that period, forty-two children had died in the ICU. Thirty-four—81 percent—died between 3 P.M. and 11 P.M.
In studying the association between individuals and medical disaster, Istre identified nurses by numbers to avoid bias. The epidemiologist spoke dryly of statistics and probabilities, but the pattern he detailed was chilling. The strongest link, he testified, involved nurse no. 32. During the epidemic period in the ICU, nurse 32 had direct care of half the children who had died. On a shift nurse 32 worked, the doctor testified, a child was ten times more likely to die. During the same period, the link between the nurse and the growing number of sudden emergencies was even more dramatic. On a shift nurse 32 worked, a child was twenty-five times as likely to suffer an arrest.
What of the argument that the ICU was experiencing more deaths and emergencies because it simply was getting sicker patients? Not true, said Istre. Study of medical charts showed that the children admitted during the “epidemic period” were no sicker than those treated in previous months. Genene Jones once claimed it was well known that patients died in the greatest numbers on the 3–11 shift. In studying other ICUs at the hospital—and the pediatric ICU before the “epidemic period” began—the epidemiologist found no such pattern. Istre also rejected the notion that more children died on nurse 32 because she cared for the sickest patients. Forty-three percent of her patients who died had a fair or good prognosis on admission. Other nurses lost only 19 percent of children admitted with such prospects.
“Would you tell the court who nurse 32 is?” asked prosecutor Ray Fuchs, at the end of Istre’s second day on the witness stand.
The epidemiologist studied a sheet of paper, as though he wasn’t sure, then looked up. “Genene Jones,” he said.
The pattern had been repeated in Rolando Santos’s brush with death during January 1982. Nurses testified that the four-month-old baby, admitted for pneumonia, was stable and improving before Jones came on duty. On four different days after Genene arrived, Rolando suffered emergencies, going twice into cardiac arrest. Kenneth Copeland, the attending UT pediatrician, vividly described the baby’s uncontrollable bleeding. Dr. Copeland recalled discontinuing Rolando’s heparin entirely after the lab reported that the baby had received an overdose. Yet during the 3–11 shift three days later, Rolando began pouring out blood again. Copeland told the judge that the baby was about to die when he injected him with protamine, the heparin antidote, and the bleeding suddenly stopped. A prosecution medical expert testified that a therapeutic dose of heparin for such a baby would be about 125 units. The expert estimated that Rolando, who was supposed to be getting no heparin, had received a minimum of 15,886 units.
Like Ron Sutton, Nick Rothe believed in ending his case with a surprise. His final witness was Kathy Ann Engelke, a twenty-year-old woman who held jobs at a local supermarket and at a Dairy Queen. Earlier that month, Engelke had spent a night in the Bexar County jail, after being arrested for drunk driving. The following morning, a woman she later learned was Genene Jones was brought by the holding cell where Engelke was confined.
“While you were in that cell,” asked prosecutor Ray Fuchs, “did you have a conversation with the defendant, Genene Jones?”
“Yes, sir,” said Engelke.
“How did that conversation begin?”
“She asked me what I was doing in there and I said, ‘DWI.’ And I asked her what she was in there for, and she said, ‘I’m Genene Jones, the nurse that killed the babies.”
Once again, Genene Jones declined to take the stand in her own defense. In fact, the defense did not call a single witness before resting its case on October 24. In a passionate final argument, Nick Rothe noted that the CDC epidemiologist had spoken of the “epidemic” in the pediatric ICU, as though the deaths were caused by a single disease. “There is a disease, and that disease is sitting right there!” shouted Rothe, pointing at the defendant. “Genene Jones! Nurse no. 32!”
Judge Priest did not waste a moment before pronouncing the nurse guilty. He immediately sentenced Genene Jones to sixty years in prison.
Like their predecessors in Georgetown, Genene’s San Antonio attorneys announced their intention to file an appeal.
In the week after the first conviction of Genene Jones, B. H. Corum had resigned. In the week after the nurse’s second conviction, it was Marvin Dunn’s turn. The dean announced that he was leaving not only the UT medical school but academic medicine and Texas as well. Dunn was moving to California to become an executive with a large hospital chain based in Beverly Hills.
On November 9, over lunch at an elegant downtown club, Sam Millsap informed William Thornton and John Guest that he would resolve whether to seek more indictments before New Year’s Day. Aware that the time for final judgment was at hand, assistant district attorney Joe Galenski, who had labored on the baby-deaths task force from the start, resolved to leave no doubt about his sentiments. On December 17, Galenski sent a memo to his superiors, Sam Millsap and Nick Rothe.
Based upon the Grand Jury investigation and the documents received during the two year investigation of Genene Jones and the Bexar County Hospital, I make these recommendations:
A. The following high managerial agents of the Bexar County Hospital be indicted under 7.23(b) Texas Penal Code for the omission of their duty to prevent the injury of a child namely: Rolando Santos while he was a patient in the PICU.
B. H. Corum
John Guest
Virginia Mousseau
Judy Harris
Pat Belko
B. I recommend that the following individuals be indicted as parties to the above offense.
Marvin Dunn
Robert Franks
C. I also recommend that the Bexar County Hospital as a corporation/association be indicted under 7.22(b) (2) for the actions of the following high managerial agents recklessly tolerating the injury of a child namely: Rolando Santos while he was a patient in the PICU.
B. H. Corum
John Guest
Virginia Mousseau
Judy Harris
Pat Belko
But Millsap already had made up
his mind. He had accepted Rothe’s advice that an indictment against the hospital, while certain to damage an important institution, offered little promise of reward. As for charges against individual administrators, they also would be difficult to sustain in court. Besides, Millsap reasoned, those he considered the worst culprits in the cover-up were already gone. At least partly because of his probe, B. H. Corum, Marvin Dunn, Pat Belko, Judy Harris, and Virginia Mousseau had all resigned.
On December 21, 1984, Millsap summoned the press to announce that the most expensive medical investigation in Texas history was over, after almost two years of work and one criminal indictment. Reading from a prepared statement, Millsap said he had worked from the start to resolve two major issues. First, had children in the pediatric ICU been intentionally harmed? Second, what had hospital and medical school officials known—and what had they done about it?
Genene Jones’s San Antonio trial had answered the first question. Because of her conviction in Georgetown, Millsap said, “no useful purpose would be served by prosecuting additional charges against her.” Results in the second area were less concrete. “Although objectionable for moral, ethical, and professional reasons, the behavior of hospital district and medical school officials violated no state penal statute. Accordingly, there will be no additional state prosecutions.”
But this did not end the matter, insisted Millsap, anxious to avoid the impression that his much-publicized investigation of the cover-up had come to naught. The DA revealed that he had turned over evidence to the U.S. Attorney’s office for contemplation of federal criminal charges. He announced that he would also file formal complaints with state licensing authorities against five people—Dunn, Corum, Belko, Harris, and Mousseau—for their inaction in the face of Jones’s criminal behavior. Said Millsap: “We will vigorously argue before the appropriate licensing agencies that each of these individuals should be denied the right to practice their professions in the future.” The DA added a word of praise for eight others: Suzanna Maldonado, Pat Alberti, and Eva Diaz, three nurses who had challenged Jones’s actions; Kent Trinkle and Howard Radwin, the surgeons whose angry complaints had forced the Conn investigation; Dr. Ken Copeland, who had saved Rolando Santos; and former pediatric residents Cheryl Cipriani and Marisol Montes, who had volunteered information to the DA early.