by Gary C. King
“So if succinylcholine is just given alone,” Russell continued, “you will sit and be suffocating, unable to move, knowing what’s going on around you, your surroundings, and you will continue to feel that until your brain starts to die at six to ten minutes. Then when the brain cells start to die, you’ll probably go comatose. Could resuscitate you at the end of that time and probably get [the person] breathing, although by that time enough brain cells would have died that the brain will swell up, and your chances for recovering and being a normal human being are very, very limited.... The patients who have told me about that say it’s pure terror, worse than any Stephen King novel you could imagine.”
As the case moved forward into December 2006 and the preliminary hearing to determine whether Chaz Higgs would be bound over for trial for the murder of his wife approached, attorney David Houston argued that there was no evidence of murder and contended that the FBI crime laboratory had not found succinylcholine in Kathy Augustine’s urine and body tissues. He claimed that the FBI lab only found succinylmonocholine, which, he argued, can occur naturally. He presented his arguments before Reno Justice Court judge Barbara Finley in an attempt to seek a delay for his client’s preliminary hearing, by then only two days away.
“I’m not sure this is a homicide,” Houston said. “I don’t know if we are dealing with a crime at all.”
Washoe County chief deputy district attorney Thomas “Tom” Barb, however, argued that the preliminary hearing should be held as planned.
“He can claim whatever he likes,” Barb said, referring to Houston’s contentions. “I am going forward based on the toxicology report that says there was succinylcholine and succinylmonocholine in her urine.”
Barb asserted that toxicology testing to determine the presence of succinylcholine in urine and body tissues had improved considerably over the past few years, and that his office felt comfortable basing their case, at least in part, on the toxicology tests performed by the FBI crime laboratory. Although there have been a number of murder cases in which succinylcholine had been used to kill the intended victim, the case that involved Chaz Higgs and Kathy Augustine appeared to be the first of its type in Nevada.
“I don’t see an inconvenience by a continuance of thirty days,” Houston argued, claiming that he needed the additional time so that a scientist he had hired would be able to examine the evidence against Higgs. “It is not such an ominous burden for the state that it overrides the interests of justice.”
Houston also planned to question the validity of the various findings that Kathy had not died as a result of a heart attack.
“A lot of people die of heart attacks who have no signs of having heart disease,” Houston said.
Houston also indicated that he needed more time to obtain the notes written by Dr. Madeline Montgomery, the chemist at the FBI crime laboratory who said that she had determined the presence of succinylcholine in Kathy’s urine.
Barb argued that a delay would not help the defense team accomplish anything. The justice court system, where Higgs’s case currently was, could not force the FBI to turn over its records as they pertained to Kathy Augustine because the federal government does not have to comply with such lower-court requests. Instead, he said, a district court judge, after Higgs had been bound over for trial and was officially in the district court system, could request such records from the federal government, which could in all likelihood be compelled to comply with such a request.
“He’s in the wrong court,” Barb said.
Judge Finley apparently agreed and said that the defense team had already had five weeks to get ready for the preliminary hearing. She denied Houston’s request for a continuance, leaving intact the date of Thursday, December 7, 2006, for the murder suspect’s preliminary hearing.
The preliminary hearing took five hours, spread across two days, and was held before Judge Finley. The judge heard testimony from nurse Kim Ramey, who recounted what she told police about Higgs stating to her, “If you want to get rid of someone, hit them with a little succs.” Ramey had also said that Higgs had told her that he was planning to divorce Kathy, but that it would be a “short divorce.”
Houston discounted Ramey’s statements by saying that it was absurd to believe that anyone would tell someone whom they barely knew that succinylcholine was the perfect means to murder a wife or husband. He also said that after Ramey had spoken to the police, the investigators took the position that Chaz had killed Kathy and failed, along with the FBI crime lab, to search for other feasible reasons for Kathy’s demise.
“The science to support this to some is bad science,” Houston argued. “It is seeking the results based on the conclusion you have reached. When you approach it, seeking those results, that is the results you get.”
The judge also heard testimony from nurse Marlene Swanbeck, who described Higgs’s indifference at the emergency room the morning Kathy had been rushed in by paramedics; Dr. Ellen Clark, who had performed the autopsy on Kathy’s body and had found two small puncture marks in the upper portion of Kathy’s left buttock that she believed had been the result of an injection that had appeared to be recent; and Madeline Montgomery testified briefly regarding the results of the toxicology tests she had conducted. The judge ordered Montgomery to provide copies of her notes to the defense team.
At the end of the hearing, Judge Finley found that there was probable cause to bind Higgs over for trial on the murder charges in district court.
“The evidence is sufficient to bind him over for trial,” Finley said. “It is not a determination of his innocence or guilt. A crime was committed, and the defendant was implicated.”
Chaz Higgs was present at the hearing; he sat emotionless as the judge rendered her decision. Kathy Augustine’s mother, brother, and daughter were present as well, as were several family friends. Kathy’s daughter, Dallas, expressed relief over the judge’s decision, as did Kathy’s mother. Her brother, however, was a bit more vocal.
“We are convinced Chaz Higgs murdered our sister and our parents’ daughter,” Phil Alfano said. “I am sure a jury will come to the same conclusion. The past five months have been sad. This is another sad day, but we at least are on the path to getting justice for Kathy.”
Two weeks later on Friday, December 22, 2006, Chaz Higgs and his defense team appeared before Washoe County District Court judge Steven Kosach, who had caught the assignment to hear the case, where Higgs pleaded not guilty to the charges against him. Kosach set a tentative trial date of July 16, 2007, and noted that everyone would have to remain flexible with regard to the trial date so that they could work around the schedules of the expert witnesses that would be called.
Following the brief arraignment, Houston indicated that he would challenge the determination of the justice court that the state had shown sufficient evidence for Higgs to be tried for murder.
“Neither money nor property was at issue,” Houston said. “That, to me, is not a recipe for murder.... Chaz Higgs loved his wife.”
Houston also indicated that he would challenge the conclusions of Dr. Ellen Clark, which, he contended, were based on the FBI laboratory analysis that he termed “suspect.”
The defense counsel said, “With all due respect to the FBI lab, I think we can all agree they’ve had their diff icul-ties in the past.”
Chapter 19
As 2006 came to a close, Washoe Medical Center, which had changed its name to Renown Regional Medical Center, adopted new protocol for medical personnel to gain access to succinylcholine. The new procedures were put into place in part because of all the controversy surrounding Kathy Augustine’s death, in which it was generally believed that Chaz Higgs had left the hospital with some of the controlled substance in his possession. In the past, the drug had simply been stored in a refrigerator for which nurses and other medical personnel only needed to enter a password to gain access to it. Following the Kathy Augustine fiasco, it was decided that more accountability was needed for those who had a
ccess to the drug. Detective Jenkins learned that Chaz, having only recently been hired at Washoe Medical Center at the time of Kathy’s ordeal, had only worked five shifts at the hospital and had not been left unaccompanied because he was still on probation. The fact that he always had someone with him during his period of probation certainly decreased his opportunities to access the refrigerator that contained the succinylcholine, but did it eliminate such opportunities entirely? Finding out with any degree of certainty that Chaz Higgs was never left alone—not even for a few minutes—during his shifts would likely prove to be a difficult, if not impossible, task.
On February 14, 2007, Jenkins made it a point of his inquiry to contact Kathryn Almaraz, a registered nurse at the South Meadows Medical Center, where Higgs had previously been employed. Kathryn had been his supervisor for about a year and a half and had gotten to know not only Chaz’s nursing abilities, professionally while on the job, but had gotten to know him somewhat personally as well.
Kathryn described Chaz as an excellent critical care nurse with exceptional skills. He was very good with patients, and she had always considered him a good employee. She noticed, however, that during his last six months of employment at South Meadows, his demeanor had changed, and it began to seem like he was under stress much of the time. She said that he had, on occasion, told her that his stress was caused by Kathy. She explained that Chaz often made negative comments about his wife, and called her a bitch often. Some days he didn’t want to go home because he didn’t want to be around her. One day, she said, Chaz made a disturbing comment about wanting to get rid of his wife.
“He said to me—I actually remember it because it was so vivid—that ‘If I didn’t have a daughter in Las Vegas, I would kill my wife and throw her down a mine shaft,’” Kathryn quoted Chaz as having said.
Jenkins wanted to know the approximate date that Chaz had made that statement to her, and Kathryn, to the best of her recollection, said that it had been about a year ago, likely in February 2006. That would have been about five months prior to Kathy’s death, Jenkins noted. Even though she had described Chaz’s statement as “vivid,” Almaraz hadn’t contacted the police or anyone else because she had no way of knowing whether Chaz was just blowing off steam or whether he really meant to do something like that. Kathryn Almaraz said that she and their manager, Tina Carbone, had talked to Chaz on several occasions about the problems he said he was having at home.
“Both of us had talked to him . . . offering employee assistance programs, encouraging him to get counseling because he was so unhappy with his marriage,” Kathryn said.
She said that she had no reason to disbelieve the problems Chaz claimed that he was having with his marriage.
“She was very disruptive,” Kathryn said. “She threatened staff. She would threaten him. She would show up unannounced in the emergency room demanding for his paycheck. There were . . . verbal discussions [that] I did not hear, but I could see through the window in the parking lot. Very disruptive of his work.”
She said that even though she had not been able to hear them talking to each other, Chaz would be “pretty angry” when he came back into the department to resume his job duties. The disruptiveness of Kathy showing up unannounced regardless of her reason made it necessary for others to cover for Chaz, particularly with patient care, so that he could deal with his wife. Kathryn Almaraz said that in the marital relationship between Chaz and Kathy it had been Chaz, in her opinion, who had been the abused spouse.
“I felt that he needed help,” she said. “He needed to get in with a counselor or some type of marriage help . . . to try and figure it out.”
Recalling the details provided by Dr. Steve Mashour regarding the drug screening of Kathy’s urine having come back positive for the presence of barbiturates, Jenkins broadened his inquiry regarding the tests that had been performed on Kathy upon her arrival at the hospital on the morning of July 8, 2006. Among the people who were included in the scope of his inquiry was Lilian Casquejo, a clinical laboratory specialist at South Meadows whose position entailed clinical laboratory testing.
Lilian confirmed that she was working on the morning in question. She explained that the specimens, packaged in bags that are marked BIOHAZARDS, were typically dropped off at the lab after which they would be taken to a lab employee’s workstation, where they would be analyzed. On that particular morning, ER personnel had brought urine samples from a patient named Sarah Lambert, whose initial screening had come back positive for barbiturates. “Sarah Lambert,” it turned out, had been a pseudonym or an alias that had been assigned to patient Kathy Augustine by the hospital upon her arrival to help protect her anonymity, presumably because she was a public figure.
The positive results for the urinalysis test for the presence of barbiturates in Kathy’s body could have been one of several possible explanations of how someone could have injected her with succinylcholine without her putting up a struggle. After all, if she had been asleep after taking a barbiturate, she might not have felt the injection, depending upon how deeply she had been sleeping, or any struggle that she might have put up could have been reduced to a minimal one. However, subsequent tests that had come back negative, suggestive of an initial false positive, quickly shot down the viability of such a scenario.
Nonetheless, because of the suspicious nature surrounding the symptoms observed at the time of Kathy’s hospitalization, portions of Kathy Augustine’s specimens had been split off and packaged with identifiers, and then placed inside a freezer to preserve the integrity of the specimens in the event that additional testing needed to be completed later. They were later picked up by someone from the coroner’s office.
Tina Carbone, Jenkins learned, like Kathryn Almaraz, had viewed Chaz Higgs as the victim in an abusive relationship with his wife. Tina had been a registered nurse for fourteen years and had been employed at Washoe Medical Center for the past thirteen years. As a nurse manager with fifty-four nurses under her supervision, she was the person who had hired Chaz at South Meadows for the emergency department, just prior to that facility’s opening in February 2004. Although Chaz and Tina had occasionally talked about his personal life, he had not talked about his wife much during his first year of employment, Tina said. It wasn’t until he had been placed on probation by the hospital’s human resources department, at the time that Linda Ramirez had been fired over the e-mail exchanges between her and Chaz, that Chaz and Tina began having conversations about his wife.
Chaz was unhappy at that time because Kathy, he had said, was being very controlling and was very possessive. It had gotten to the point where Chaz began talking about moving out of their house, and had begun looking for a place to stay because their relationship was progressively getting worse. Although he had not frequently used derogatory language about Kathy in Tina’s presence, she recalled one occasion in which he had referred to her as a “bitch.” She said that because he was often at the triage desk and because her office was behind it, they’d had most of their conversations inside her office because her door was always open. His visits to her office became more and more frequent, to the point where his conversations with Tina had become “problematic,” where Tina began to feel that her job was in jeopardy—not because of Chaz Higgs but because of his wife and the power that she wielded.
Tina confirmed that although she had never used succinylcholine and etomidate together on a patient, the two drugs were kept stored inside a rapid-sequence intubation kit, basically a tray of medications and associated supplies, within the emergency department for easy access when it was needed. The kit had an orange tab or seal that had to be broken to get inside it. Succinylcholine, she said, was also stored in what was known as the “Med Select,” a storage refrigerator that the nursing staff could open by entering their password. She claimed that it would not be difficult to take a vial of succinylcholine out of the facility undetected.
At one point, Tina told investigators, Chaz’s wife, Kathy, had begun harassing
her. Tina, a married woman, had offered to rent Chaz an extra room at her and her husband’s house if he decided to leave Kathy. As best as she could recall, the harassment had started around the time that she and her husband had made the offer to Chaz, or at about the time e-mails were being passed back and forth between Chaz and Linda Ramirez. Even though Chaz hadn’t moved out of the house he shared with Kathy, and had not taken Tina and her husband up on their offer, the harassment continued.
The harassment consisted of letters that Kathy had written to Tina’s administrator, and she began coming onto the hospital campus. Sometimes Kathy would wait in the parking lot for her, and she would make telephone calls to Tina, and others, at the hospital. When Tina had had enough and, in part, because she feared that Kathy would cause her to lose her job, Tina took her concerns about the harassment to the State Ethics Board and other outlets available to her, but nothing was done to make Kathy stop. It was then that she and Chaz went to human resources and had a conversation about how they might be able to make Kathy stop.
Although she had indicated that it would be easy for a nurse to walk away from the hospital with a bottle of succinylcholine or some other medicine, the controls in place at the time that Chaz Higgs had worked at South Meadows hadn’t turned up any discrepancies regarding missing or otherwise unaccounted-for medications in the emergency department.
Chapter 20
Nancy Vinnik and Kathy Augustine were best friends, and had known each other since 1988. They had met through the Junior League of Las Vegas, an organization of women committed to promoting volunteerism and whose mission is dedicated to helping women develop their potential. They had been friends for the next eighteen years. Nancy told Jenkins and other investigators that Kathy had spoken to her frequently regarding her relationship and marital problems involving Chaz Higgs.