An Almost Perfect Murder

by Gary C. King

  Her cause of death was released to the news media as complications from the massive heart attack that she had suffered over the weekend, even though the definitive autopsy had not yet been performed. Since she had no immediately known history of prior serious medical problems, her sudden death was a shock to nearly everyone who knew her and worked with her. News of her death quickly reverberated throughout state political circles. At a hastily called press conference, many of the state’s political leaders expressed their shock and sadness over Kathy’s sudden passing.

  “We are all deeply saddened by the distressing news of someone so young and vibrant as Kathy Augustine passing away so unexpectedly,” Governor Kenny Guinn said. “On behalf of so many people in our state who knew Kathy and appreciated her dedication and hard work as controller, I offer her family our heartfelt sympathy.”

  “We are all saddened by Kathy’s unexpected death,” chimed Senate Majority Leader Bill Raggio, a Republican from Reno. “She should not be remembered for any failings, but for her many years of public service as an assemblyman, a state senator, and two terms as state controller. Even her critics have to recognize she had great talent, humor, and was very dedicated to the state.”

  Dallas Augustine, Kathy’s daughter, made a statement to the media on behalf of her family, shortly after her mother’s death was announced.

  “She was a great leader, mother, daughter, wife, and friend who will be greatly missed,” her daughter tearfully said. “She will always be remembered for her strong commitment to her work, family, friends, and causes. Please remember her that way.”

  That same day, Detective David Jenkins, a thirty-year veteran of the Reno Police Department, was sitting behind his desk. He was shuffling paperwork and contemplating going home for the day when a note with a woman’s name and telephone number was brought to him, along with a message that indicated that the caller possessed information that could be relevant regarding the cause of Kathy Augustine’s medical condition. Jenkins knew from experience that suspicious death investigations, even the more simplistic ones, always took considerable time, particularly at a case’s outset, as well as a lot of paperwork, to complete. Already tired at the end of what had been a long day, Jenkins knew that he needed to get his second wind, so to speak. In keeping with his reputation of dogged determination at solving crimes, the detective somehow instinctively knew that he would not be going home anytime soon.

  Chapter 2

  That same afternoon, while the state politicians and Kathy Augustine’s family members were busy holding a press conference with reporters from all over the state, Detective David Jenkins picked up the telephone and arranged to see the person who had called in the potential tip earlier that day. As it turned out, the tipster was a traveling nurse, Kim Ramey, an attractive, thirty-something blonde who had worked with Chaz Higgs at his place of employment, Carson-Tahoe Regional Health Care, in Carson City. A critical care nurse since 1999, whose specialty was in open-heart recovery, particularly for patients who had gone through open-heart surgery, such as a heart bypass, Ramey specified that she had worked with Higgs on Friday, July 7, 2006, one day before Kathy was stricken with a “heart attack.” Although suspicion about Kathy’s untimely death had already been hanging in the air, Ramey’s initial telephone call—which had started out simple enough when she had said, “You know, I think you need to know something”—tipped the scales that would eventually open up a full-blown homicide investigation.

  “She had some very serious concerns that Ms. Augustine’s medical condition may have been the result of someone having intentionally administered a drug to her,” Jenkins recalled as he recounted his first conversation with Ramey when he returned her call about four hours later. Jenkins, who had been assigned to the robbery/homicide unit in the detective division for the past seventeen years, had a gut feeling that this would be quite a challenging case.

  When Jenkins met with Ramey, he began by routinely taking down her personal information and how she had come to know Chaz Higgs. She had been working the day shift on July 7, and had arrived for work a few minutes before 7:00 A.M. When she reported to her unit, the open-heart unit, her supervisor told her that she would be “floating” over to the intensive care unit. She explained that as the patient load for the day goes up or down, nurses are often shifted from one unit to another to ensure that the hospital has the correct number of staff assigned to a particular unit. In her case, as a critical care open-heart nurse, she would be able to float to the ICU, but an ICU nurse would not be able to float to the open-heart unit due to the fact that she wouldn’t possess the knowledge and skills of that specialty. Ramey had been attending two patients that morning, one of which the doctors and hospital staff were trying to determine whether the patient had viral or bacterial spinal meningitis. She met Higgs, and the circumstances of their speaking came about when she had asked him to assist her, and to bring her supplies and medical equipment that she had needed throughout the day.

  She explained that during casual conversation at work that day, she had immediately sized him up as a “player.” Going through a divorce herself, she had easily spotted the trait in Higgs and he, at one point, had said that he was going to leave his wife. Sensing that it wouldn’t be long before he might try to hit on her, she told Higgs that she had a boyfriend and that the two of them were going to be moving to Richmond, Virginia, in the near future. She felt that if she divulged some of her personal information, such as having a boyfriend, it might serve to put to rest any intentions he might have been considering.

  Being a listener, one of the traits of her profession, she had also sensed that Higgs was full of anger. She tried to find out where it was coming from, by listening to him throughout the day. It hadn’t taken long for her to discern that the anger she perceived he was harboring appeared to center around his wife, Kathy. Higgs explained who Kathy was—stating that she was a high-profile person who was currently the state controller and was running for the position of state treasurer. Ramey had interrupted him a number of times to explain that none of what he was saying meant anything to her because she wasn’t from the Reno-Tahoe-Carson City area; she hadn’t been there long and she wasn’t planning to stay. She was a self-chosen “traveler” nurse who did not work directly for a particular hospital, but instead moved around a lot and worked as an independent contractor at hospitals in virtually any area for durations lasting only a few weeks to stays as long as several months.

  At one point, she said, they had engaged in a brief chat that had begun innocently enough when they had referenced the local case of Darren Roy Mack, forty-five, a pawnshop owner who at that time had become the subject of an international manhunt after being charged with the alleged stabbing death of his thirty-nine-year-old estranged wife, Charla, in their garage. Apparently angry over his divorce settlement, Mack was also sought for the alleged sniper shooting and attempted murder of Washoe County Family Court judge Chuck Weller. Ramey told Jenkins that it was during their brief exchange about this case that Higgs had remarked that Mack had been “stupid” to have killed his wife in the manner that was being alleged. When Ramey had looked at him quizzically, Higgs purportedly told her that there was a much better way to commit murder.

  Higgs reportedly told Ramey while he was sitting at the unit’s u-shaped nursing station that if he had intended to kill someone, he would have administered “succinylcholine” to the person because the “succs,” as it is more commonly referred to among medical professionals, is virtually undetectable in a postmortem examination. Ramey reiterated to Jenkins that Higgs had said that he was undergoing marital problems with his wife, and that he planned on ending his relationship with her. At the time, Ramey had thought that he had meant that he was going to divorce his wife, but now, after Kathy’s death, she wasn’t so sure what he had meant.

  “He said that if you want to kill someone, the way to do it is to hit ’em with a little succs, because they can’t trace it postmortem,” Ramey recalled. Afte
rward, she said, he had made a gesture like he was going to administer an injection. “Wow, Chaz, that’s too much anger to carry around,” she added, explaining that Higgs’s comment had made the hair on her arm stand up.

  She explained that Higgs had made her feel very uncomfortable, and that it had made her “skin crawl” when he talked to her about how he would kill someone if he wanted to get rid of them. She reiterated that he had frequently talked about leaving his wife that day, and that she had heard him swear at her over the telephone. She claimed that Higgs referred to Kathy as a “fucking bitch.” She said that he had referred to her at various times throughout the day as a “fucking stalker,” and he seemed intent on painting an unflattering picture of her as a vicious, mean, and hateful person. At one point, he had characterized his wife as “psycho,” she said. She claimed to have detected anger and rage as the dominant emotions emanating from Chaz Higgs most of that day.

  At another point that day, Ramey said, she had been within earshot of Higgs while he was using the telephone in the middle of the unit, a busy area. She presumed that he had been talking with his wife when she said that she heard him say, “I will fuckin’ talk to you when I get home,” among other things. Ramey said that she had felt that Higgs’s telephone conversation and the language he used was inappropriate, considering the hospital setting. When she asked him about the conversation later, he purportedly told her that Kathy had discovered that he had opened a separate bank account at Wells Fargo and had placed only his name on the account. He was particularly astounded because he had been assured by the bank employee that since the account was only in his name, there would not be any way that she could find out about it.

  Since Ramey was leaving town in only a few days, Ramey’s coworkers had planned a going-away party for her at a nearby restaurant that evening. Since it was a Friday night, and sensing that perhaps Higgs might benefit from a party atmosphere, Ramey said that she had invited him to attend the party. Besides, although he was new and still on probation at the hospital, Ramey considered him a member of the team. Higgs declined, however, and purportedly said: “I’m just going to fucking go home and tell her.” Ramey said that she presumed he meant that he was going to tell his wife that he wanted a divorce.

  Even though he had seemed full of anger and rage about wanting to get rid of his wife, Ramey had not initially given much thought to Higgs’s remarks until after she had learned that his wife had been found unconscious in her home by him, and had been taken to the hospital in grave condition. She said that after she had become aware of Kathy’s situation, she had consulted with a physician, Dr. Richard Seher, who was aware of the circumstances related to Kathy’s hospitalization, and that Dr. Seher had encouraged Ramey to contact the police department.

  Ramey said that she waited until July 11 to report her encounter with Chaz Higgs because of her plans to leave town in a few days. She was returning to Virginia to finalize a divorce, which she had been going through for more than two years, and she was hoping that the police would just arrest Higgs without any assistance from her. When that hadn’t happened, she decided after consulting with others that she needed to come forward with her information.

  After taking Ramey’s statement, Jenkins, now intensely interested in what had happened to Kathy Augustine, began doing his homework to learn more about the drug succinylcholine. The first thing he did was to go to the Washoe Medical Center in the hope that he could speak with a medical professional to determine whether or not the information he had received from Kim Ramey was even credible or plausible.

  Among the many things he learned was that if used correctly by a medical professional, succinylcholine’s medical uses include temporarily paralyzing respiratory muscles to allow the easy insertion of breathing tubes. However, if used improperly or with malicious intent, it can be deadly. If injected into the body in larger doses, it can cause organ failure and death. He also learned that it dissipates quickly from a person’s bloodstream, leaving behind few traces. The person who dies as a result of succinylcholine being misused goes through horrific and agonizing pain and suffering after the drug begins to take effect, before succumbing to unconsciousness and death—all the while being able to stare helplessly at the person who had administered the injection.

  After receiving theoretical explanations from medical personnel regarding the possible link between Kathy’s death and succinylcholine, his newly formed suspicions were verified. Succinylcholine could very well have resulted in the medical condition that had led to Kathy’s death. Jenkins was also told that the initial medical examinations upon Kathy’s admission to the hospital had not revealed any evidence of heart disease, which would typically be associated with a sudden and unexpected heart attack.

  The next day, Wednesday, July 12, 2006, pathologist Dr. Ellen Clark performed a definitive autopsy on Kathy’s body with Detective Jenkins in attendance. Dr. Clark was a doctor of medicine with specialties in anatomic, clinical, and forensic pathology. She had received her doctorate of medicine degree from Texas Tech University in 1984. Afterward, she participated in accredited residency training in combined anatomic and clinical pathology at the University of Texas, in San Antonio, until 1987, when she transferred to the University of New Mexico, where she continued her studies of combined anatomic and clinical pathology and subspecialized in forensic pathology. She completed her course of study there in 1989. That same year, she obtained the position of forensic and hospital pathologist with Sierra Pathology Associates—her current job in Reno—a private company that performs autopsies for the Washoe County Coroner’s Office, where she has been ever since.

  The day-to-day duty of a forensic pathologist involves the evaluation of disease and trauma and is characteristically broken down into two major categories: anatomic pathology and clinical pathology. The former involves diagnosis, as well as performing tests on solid tissue that may range from single cells smeared on a slide to intraoperative biopsies and, ultimately, to the autopsy examination. The latter is involved in the designing, performing, and interpretation of tests on body fluids, such as blood and urine. Forensic pathology, it should be noted, is the subspecialty within the area of medicine that attempts to unravel the mystery behind sudden, unexplained, unexpected, and often particularly violent death cases.

  At the autopsy’s conclusion, Dr. Clark told Jenkins that she had not found any evidence of coronary artery disease or heart disease, which could be attributed to a sudden and unexpected heart attack. Dr. Clark explained to the detective that she did find, however, “two punctate areas of discoloration” that had “an overall configuration in appearance that would be consistent with needle punctures or injection sites.” The needle injection sites that she deemed suspicious were located on Kathy’s left buttock in the left upper hip region. Dr. Clark also explained that she performed what is known as a “cut-down” of the suspected injection site, which is a straight surgical incision with a scalpel or other similar instrument that allows examination of the skin and tissue beneath the surface injury. She explained that the cut-down revealed a very narrow track of bleeding into the tissue directly beneath the suspected needle puncture wounds. The same procedure was followed for the other wounds present in Kathy’s body that were obviously associated with therapeutic or IV tubing, and so forth. She explained that the suspected injection wounds in the buttocks area were significant because of the allegations that were being made that Kathy had been given a drug that had been injected, and because the buttocks injection site did not correspond to any of Kathy’s medical records as a therapeutic injury.

  Dr. Clark’s findings regarding the internal examination showed that Kathy’s brain was swollen, which can be associated with decreased blood flow or decreased oxygen to the brain. Although the examination of Kathy’s heart, she explained to Jenkins, did not reveal any evidence of the typical hardening of the arteries or blocking of the arteries, which is so often associated with heart attacks, she concluded that there was some evidence of
a degenerative change within one of the valves of Kathy’s heart, the mitral valve, which allows blood to pass out of the large muscular chamber on the left side of the heart into the main circulatory system. Dr. Clark’s determination was that the mitral valve degeneration was minimal, however, and was not likely the cause of Kathy’s death.

  Dr. Clark did not immediately list a cause of death. She told Jenkins that she would have to wait until all of the toxicology tests had been conducted on Kathy’s urine and blood samples to finalize her determination.

  When Jenkins followed up with the hospital and examined the medical records that had been generated during Kathy’s hospital stay, he found nothing that could account for an injection that had been made by hospital staff on her left buttock, which corroborated the autopsy findings. In other words, no one at either of the hospitals had given Kathy an injection at the site of her left buttock or even in close proximity to it.

  Based on what he knew so far, Jenkins had the now-frozen urine samples, which had been collected from Kathy on July 8, 2006, forwarded to the FBI’s forensic laboratory in Quantico, Virginia, where it would be carefully and thoroughly analyzed for traces of succinylcholine. Jenkins also took steps to confirm the details of Higgs’s employment at the time of Kathy’s demise and found that he had access to a variety of drugs, as any nurse would, including succinylcholine, as well as the syringes and needles needed to administer them, during his tenure at Carson-Tahoe Hospital.

  As the buzz circulated that Kathy’s husband was somehow involved in her death, many people began asking why Chaz Higgs would want her dead. Jenkins later publicly stated that sometimes a murder doesn’t make much sense until all of the details have been sorted out.