by Ray Flynt
“It’ll make a great story to tell his grandchildren,” Brad said.
“I suppose. What were we talking about,” she said. “I’ve completely lost my train of thought.”
“Antigens.”
“Of course.” She plunged back into the mini-seminar. “Once a donor looks like a plausible match based on antigens, we do a cross match to make sure that the potential recipient’s antibodies wouldn’t cause a rejection. Medical events that could cause the presence of antibodies would be pregnancy, blood transfusions, or a prior transplant.”
“Did any of the deceased transplant patients have a previous transplant?” Brad asked.
“No.”
She had done a good job of helping him understand the process, but Brad made a mental note to do more research.
“Do you know if any of these patients came in contact with each other prior to their current hospitalization?”
“Let me look.” Ms. Carpenter flipped open a laptop on her desk. “I may not be able to give you a definitive answer this morning,” she said, as her fingers strolled across the mouse pad. “The gentleman with the heart/lung transplant was hospitalized here for three and one-half months awaiting a transplant. Angie, my associate, handled his evaluation. She met with him in his room; he never came to these offices. The woman with the liver transplant was referred from a hospital in the Reading area. She came here back in August for evaluation, and all the follow-up testing was coordinated with facilities in Reading.”
Brad noticed that Ms. Carpenter never referred to the patients by name, even though he had assured her that he worked for the hospital.
“The gentleman from New Jersey had his initial evaluation a year ago, and has awaited a donor kidney since he was approved for our list back in May.”
“I didn’t realize it took that long.”
“It can take longer. Kidney patients have the benefit of dialysis, so they can afford to wait. For the person who needs a new heart, it is often a race against time.”
Ms. Carpenter glanced at her cell phone. “There is another kidney transplant patient who was the victim of an attack,” Brad explained, “but has survived. His name is Dennis Ayers. When was his evaluation?”
She resumed looking at the laptop. “He’s one of the lucky ones. His evaluation was completed just a month ago. Based on what I’m seeing from these four patients, I don’t think they ever ran into each other in our offices.”
“Thanks for your time. With this storm, you shouldn’t have to worry about any transplant surgeries today.”
“That’s where you’re wrong. It’s in weather like this, with a greater likelihood of automobile accidents that we expect to see potential donors.” She paused, her eyes blinked, and she drew her hand up to her mouth. “I’m so worried about my son,” she said, her voice cracking. “I value the life-saving service we provide. But I’m not ready for him to be an organ donor.”
Chapter Twenty-Four
11:42 a.m., Thursday, January 11th
Nothing about this case adds up, Brad thought as he rode the elevator to the third floor. He didn’t have a respectable hunch after nearly twenty-two hours at Strickland Memorial Hospital. A death hadn’t occurred for twenty-one hours, but even his ego could hardly give him credit.
Brad strolled past the security office toward the cubbyhole Carlton had provided for him and waved at the Pakistani-American guard through the plate glass window. The earnest young man, who he’d met earlier, waved back, but quickly resumed scanning the monitors arrayed before him. He wore earbuds connected to an iPod, and swayed to the beat. Did the man, who moonlighted at the hospital while pursuing a corporate security degree at Penn, know what a dinosaur of a system he was dealing with? Securing a hospital in the middle of a large urban area had its challenges, and Carlton’s approach deployed limited resources in the most visible manner. Brad smiled as he thought about the cameras mounted in nearly every hallway; large, old-fashioned cameras with blinking red lights, including those that whirred as they pivoted as if to say, Don’t screw around buddy. You’re being watched. According to Carlton, nearly half of them didn’t even work.
Brad fished the keys from his pocket and located the large brass-colored one that admitted him to his office-away-from-office. He propped a five gallon jug of water against the door to keep it open and banish the claustrophobic feel from the windowless space. As he eased into the faux-leather seat behind the desk he saw the printed note signed with the initials E.C.
www.stricklandmemorial.com/secure/personnel/level5
User Name: SuperSleuth (case sensitive)
Password: Zvr&340721iwGh#l (case sensitive)
SuperSleuth. Brad felt anything but. At least Carlton mustered sarcasm after Danita Williams-Harris ordered him to provide Brad with the hospital’s personnel records.
Brad pulled the laptop in front of him, powered it on, accessed the Internet, and typed in the URL. Given the sensitivity of personnel information, he suspected the site was enabled only for computers linked within the hospital’s Intranet. Still, he wondered if “level 5” would give him the information he needed. Prompted for a user name and password, he entered the codes Carlton had supplied.
ACCESS DENIED flashed on the screen.
Brad looked at the password again, and realized that what looked like the number one at the end was actually a lowercase “L.” He reentered the information and this time the screen came alive with Strickland Memorial Hospital Personnel Department, and in the upper right hand corner a “Powered by Prometheus Data Management” logo. On the page were search boxes for Department, Employee Name, and a third allowing for searches by range of hiring date.
The hospital had over nine hundred full and part-time employees, but Brad knew where he wanted to start, and typed “Tangiere” into the employee name search box. A new page appeared with two names: Tangiere, Harold and Tangiere, Iola. He clicked on Harold’s name and up popped a fresh page with TANGIERE, HAROLD in at least 20 point font at the top and six tabs, like those found on manila file folders, each with a different label: face sheet, application, references, evaluations, notes, and financial. Unlike the antiquated systems for hospital security, Strickland’s electronic personnel records appeared state-of-the-art.
The face sheet tab revealed basic information including the employees’ photograph, home address, phone, department, supervisor, hire date, termination date (which in Harold’s case was blank), emergency contact information, and next evaluation date. Only the last four digits of his Social Security number displayed. Harold’s picture, taken from above the midline of his chest, showed a smiling man with uneven teeth dressed in blue coveralls, but minus the blue knit cap that Sharon had described him wearing. His head was bald, and a scar showed just above his left eyebrow. His address was in West Philadelphia, an area not far from where he had located the kidnappers of his mother and sister a decade earlier.
Brad clicked on additional tabs revealing scanned images of Tangiere’s original application from five years previously. In the margin, was a hand-written notation that Harold’s wife was a nurse in the emergency department. The references tab contained a copy of his signed release, and notes from the personnel department’s phone conversations with three of his references. Prior to joining the hospital, Tangiere had held similar janitorial jobs at Temple University, a high school in West Philly, and at a big box home improvement store. All the references said good things, with his most recent boss adding that they would hate to lose him.
Annual evaluations revealed scanned images of a form that used a five-point expectations scale from “Consistently Exceeds” to “Fails to Meet” for factors such as attendance, demeanor, job performance, and interaction with coworkers. Harold‘s annual reviews met or exceeded the evaluator’s expectations. Hand-written statements were sparse, but included phrases like, “My most valuable employee,” and “Wish all my staff were like Harold.” In short, the man didn’t sound like a candidate for serial murderer.
> Brad clicked on the “Notes” tab, and the page was blank. He then clicked on the “financial” tab, and was instructed to reenter his user name and password. After which, a cryptic message flashed in red: Brad Frame, you are not authorized to access this information. A report of your attempted log-in has been forwarded to the Personnel Department.
He now understood level5 access meant the first five tabs only. If only Carlton had provided an explanation, he wouldn’t have made that mistake. Not allowing access to an employee’s financial information made sense. Access to salary information might be valuable to his investigation if he thought the killer’s motive had to do with money, but the motivation scenarios he and Sharon had considered didn’t point in that direction.
Using the back button, Brad returned to the screen with the link to information on Iola Tangiere. She’d worked at the hospital for fourteen years, with a credible record of evaluations. On her Notes page was an item from four years earlier about her being honored four ten years of service, along with fourteen other employees, by the then hospital administrator, a man named Ivan R. Dahl.
Returning to the home page, Brad searched for information on each of the nurses on the seventh floor. He paid particular attention to Sharon’s preferred suspect, Keith Blanton, who’d worked for the hospital for only three years but had a satisfactory record and no indication of any problems.
Sharon’s reaction to Blanton seemed visceral, but Brad also wanted an explanation for Blanton’s access to the hospital’s drug storage that he’d witnessed on videotape. Carlton made it clear he intended to pursue drug theft charges, but when? Brad pulled out his notebook and scribbled a note to check on the standard procedures for requisitioning drugs and find out if the storm had changed those protocols.
Next, he pulled up Pedro Paez’s information. The newbie among the seventh floor nursing staff had started the previous June. His application indicated that he worked for six years at St. Luke’s Medical Center in Wilmington, Delaware. Careful attention had been given in the record to documenting his citizenship, including a scan of his passport. Pedro was born in Juarez, Mexico in 1982, but his family had legally immigrated to the Washington, DC area in 1994, and he subsequently became a US citizen. Finally, his first evaluation, ninety days after his employment, showed that he consistently exceeded expectations. Written comments noted, in particular, his patient interaction skills.
On the notes page for Pedro, Brad found a headline: Transplant Nurse Practices What He Preaches linked to an article from the Philadelphia Inquirer. He clicked on the link.
When Pedro Paez offered the gift of life to his sister Anita, he knew more about donating a kidney than the average donor. Mr. Paez is a nurse on the transplant unit at Strickland Memorial Hospital. ‘When I heard that Anita and I were a match, I didn’t hesitate for one second to offer her one of my kidneys.’ He added, ‘I knew the procedure was safe, and we have good doctors here.’
Transplant surgeon Charles Geisel spoke for many at the hospital who praised the courageous decision. ‘Every year we have hundreds of patients that want – need – a life giving transplant. A donation from a family member or friend can make a difference, because there are a limited number of donors.’
Leslie Carpenter, Strickland’s transplant coordinator reminded that, ‘People need to make their wishes about being an organ donor known to family members, so that if the unthinkable happens, the survivors can make the right decision.
It has only been a week since Anita Paez’s transplant surgery, and though there have been a few touch and go moments, she is making progress and is proud of her nurse/donor brother.
Brad rubbed his eyes, and worried this exercise was futile in his quest to locate a killer. That was until he opened Crystal Himes’ personnel record.
Hers was the most extensive, in part because she’d worked for Strickland since graduating from nursing school in 1989. Her evaluations weren’t as glowing as he expected for a person who had achieved status as a charge nurse—though still acceptable—but what grabbed his attention was an article from the West Chester Gazette that had been copied on to her personnel file’s notes page:
The family of Henrietta Sanders has filed a $2 million dollar wrongful death suit against the Morning Star Nursing Home, Dr. Derek Palmer, and Crystal Himes, RN. The suit alleges that the nursing facility located in West Chester, PA, improperly supervised Nurse Himes who administered a lethal dose of morphine to Ms. Sanders who died at age 92 on April 11th at the Morning Star facility. “Ms. Sanders family lodged numerous complaints against Nurse Himes,” stated Neville Worthington, a West Chester attorney handling the case, “and the doctors and administrators willfully ignored those complaints. This constitutes negligence of the first-magnitude.”
A co-worker at the nursing home, who spoke under the condition of anonymity, reported that Crystal Himes’ relationship with the nursing home ended in June.
Jane Mrosko, Morning Star Nursing Home’s administrator, declined our request for comment, and instead referred the Gazette to their attorney Jacob Salazaar, who could not be reached for comment. The case will be handled in the Court of Common Pleas for the Fifteenth Judicial District, where the case has been assigned to Judge Quentin J. Eastland.
With her long history at Strickland, Crystal’s work with the nursing home would have been on a part-time basis. The incident was considered significant enough to note in her personnel file, but no one at Strickland had mentioned Crystal’s prior involvement in a high-profile medical facility death.
Negligence of the first magnitude, indeed.
Brad minimized the personnel records on the screen and googled Morning Star Nursing Home. In addition to the West Chester facility, there were similar named ones in Oregon and Nebraska. He refined his search, adding the word lawsuit, but only found the same story that appeared in Crystal’s records. It dated from December 4th. He knew it could take months for a civil suit to come to trial, and there would be pressure from the court for a settlement. He wished he could see Crystal Himes’ financial information. If she needed to work two jobs, perhaps there was a financial incentive for her to be a co-conspirator to murder.
“Finding everything you need?” Ed Carlton appeared in the doorway, sounding more cooperative than Brad had witnessed in their prior encounters.
“So far,” Brad said noncommittally. “I do have a question. I’ve been on the seventh floor and haven’t seen any security personnel. I thought you were going to dispatch an officer or two there?” Actually, Danita Harris had ordered him to place an officer there, but Brad tried to be nice.
Carlton shook his head. “I don’t have enough manpower to spare with this storm. But we mounted three high-quality security cameras there overnight… hidden within the emergency lighting system… and Abu is monitoring those images as we speak.”
“Tell me about your meeting with Harold Tangiere?” Brad said.
A buzzer sounded, and Carlton pulled a beeper from his belt.
“I gotta run. Meeting someone downstairs.” Carlton added, “Catch you later,” his voice receding down the hall.
Brad resumed surfing the personnel database. To test the system’s capability, he entered “John” in the employee search box, and no fewer than nineteen names popped up. He searched for “Fenimore” and Alan’s name appeared on the screen, but surprisingly Ken’s did not. Hadn’t Ken said he worked in the accounting department?
He clicked on Alan Fenimore’s name to expose the entire record. Brad was taken aback by the image on the face sheet. The photograph had a date superimposed on it from twenty-eight months earlier, and Brad was struck by how much younger Alan looked with a full head of hair—before his treatment for cancer, and before the tragic death of Marie. This was the Alan he remembered, not all that much different from the man he knew at college. It hurt to see how much Alan had deteriorated in the last six months.
Alan’s record did not have a tab for employment application, but one marked “Curriculum Vita
e,” most likely the case for all the doctors and specialists. Brad opened the tab, but unlike the other personnel records, when looking at Alan’s file he felt like an intruder. He scrolled through the material, and realized he already knew most of Alan’s educational history.
Brad skipped the tab marked “Peer Review” and checked the “Notes” for Alan. Those employee folders that had contained notes were limited to a single entry, in most cases related to a press report. In Alan’s case it took quite a while for the page to load, and when Brad began surfing through the material he found twenty years’ worth of thank you notes, ranging from hand- written to ones neatly typed on corporate letterhead. Most appeared to be from patients or their spouses. He spent several minutes reading. Typical was a note written on pink FROM THE DESK OF SUE stationery: Dr. Fenimore, Thank you so much for the excellent valve replacement surgery on Frank. He is a new man. Thanks to you, I know we’ll get to celebrate our 50th wedding anniversary - in ten more years. Fondly, Sue.
A lump formed in his throat, and Brad could hardly bear to read any more of the emotional stories, until he spotted a hand-printed note on colorful balloon-filled stationery: Dear Dr. Fenimore, Thank you for saving our teacher, Mr. Wilson. It was scary the day he fell and the ambulance came. Mrs. Rosendale told us he will be back soon. Tell him that we all promise to do our homework, and we are feeding the turtle every day. Very Truly Yours, Mr. Wilson’s Fourth Grade Class.