Last Dance, Last Chance

by Ann Rule

Anthony’s mind, now approaching frank paranoia, believed that Dr. Baden had conspired with the Erie County D.A.’s office to bring about an indictment. Anthony wrote: “Did the doctor [Baden] believe that there was more career potential on the prosecutorial side of the fence?”

  It was a laughable accusation. Dr. Michael Baden had already reached the pinnacle of his career as a forensic pathologist and had far more work to do than he could ever accept.

  Although grand jury hearings are closed to the public, and testimony given there is not available to the press or the public, there were two main areas where the Erie County District Attorney’s office felt Dr. Anthony Pignataro’s care of Sarah Smith had been so far below accepted medical standards that they merited criminal charges. The administration of anesthesia had put the patient at an unacceptable risk, and the resuscitation efforts—or lack of them—were gross deviations from acceptable conduct.

  And, of course, Anthony was outraged that anyone should ever come to those conclusions about him. He wrote of his shock that his story had received bigger headlines than Princess Diana’s death, but he was secretly pleased. The media coverage was “wild,” and he had always reveled in seeing his name in print and his face on television.

  Still, as autumn came to western New York State and the orchard trees became heavy with fruit to be harvested, Anthony had to be aware that both the Department of Health and the Erie County D.A.’s office were closing in on him. His office revenues were falling like stones from a cliff, and he knew he needed to keep paying his malpractice insurance. If he was forced to stop practicing, a patient could bring a retroactive malpractice suit against him for two and a half years after he closed down.

  Including a suit filed by Dan Smith, fifteen other patients were now suing Dr. Anthony Pignataro. Others were charging back on their credit cards, refusing to pay him.

  Although the Pignataros still lived in the duplex in West Seneca, Anthony was a big spender. He had his Lamborghini, he loved to travel, and he had taken yet another mistress. Tami Maxell* was in her early forties, an attractive woman with blond-streaked hair, and she regularly worked out at Gold’s Gym, where Anthony did. She was a widow and a grandmother, but you couldn’t tell that by looking at her. Tami owned a cleaning business, and she found Anthony exciting and attractive.

  Debbie had undergone two surgeries on her injured neck already. She was coping with that, raising Ralph and Lauren, and trying to support Anthony as he bemoaned the disaster that had befallen him. Although she knew all too well of his past liaisons with other women, she didn’t know about Tami. With her neck, Debbie couldn’t exercise at the gym, and she naively assumed that Anthony had so many problems that he was far too busy to cheat on her again. Not now. Not when she was his staunchest ally.

  That might not be exactly true. Anthony’s mother, Lena, might qualify for that position. As far as Lena was concerned, Anthony could do no wrong. She implored Debbie to stick by him, no matter what. And Debbie promised that she would. Somehow, they would get through this—for their children’s sake. Somehow, they would make a life again, even if Anthony couldn’t be a doctor any more.

  Anthony’s mother invested money in a business Anthony thought might help restore their finances. He and Debbie would sell workout clothes through the mail. That venture never really got off the ground.

  It seemed to Debbie that nothing else could go wrong. What had taken them so many years to build had collapsed in such a short time. All they had left was each other and their children. She counted on Anthony’s strength to save them all.

  13

  For Frank Sedita, the turning point in the case against Anthony Pignataro in the death of Sarah Smith came when he met Dan Smith. “We were very hesitant about this case at first,” he recalled. “We thought that maybe it was just a malpractice suit. When a doctor kills a patient, it’s usually a civil suit that follows. But when we got into the investigation, we found out that his conduct was so incredibly egregious that it became a criminal case.”

  Hearing Dan Smith’s story solidified Sedita’s feelings. That the young husband had literally been shooed out of Pignataro’s office by the doctor himself, believing that his wife was in good hands, only to return to find that she was comatose, was far more than a civil matter. Clearly, both Dan and Sarah Smith had been deluded and deceived, and they had been ultimately trusting. Now, their life together was gone.

  Anthony had started with a malpractice attorney, Carmen Tarantino, representing him, but Tarantino soon saw that the case was far more than that and brought in another lawyer to help. Terry Cotters was a high-powered criminal defense attorney and had also advised Tom Watkins, the Nichols student.

  The grand jury hearings continued. Sedita admitted later that he “raked Debbie Pignataro over the coals” as he sought to find out what her part, if any, had been in Anthony’s operational procedures.

  A long time later, Debbie said, “I’ll tell you this. I’d much rather have Frank Sedita for me than have Frank Sedita against me!” She frowned as she remembered the assistant D.A.’s relentless questioning.

  But grand jury hearings are secret. Buffalonians interested in the outcome would have to wait to see whether the infamous plastic surgeon would be indicted.

  It was reported that a woman named Connie Vinetti was seen entering the grand jury room, but few knew that she, too, had suffered grievous injuries from a bungled tummy tuck and that Anthony had attempted to release her from Buffalo Mercy Hospital against medical advice when she was critically ill.

  The outcome of the grand jury hearings was that Anthony Pignataro was indicted on six counts on January 27, 1998:

  Manslaughter in the second degree (for recklessly causing the death of a patient by asphyxia).

  Assault in the second degree (for recklessly causing serious physical injury by means of a dangerous “instrument”—drugs).

  Criminally negligent homicide.

  Falsifying business records in the first degree (for falsifying his report on Sarah Smith’s operation).

  Reckless endangerment in the second degree (for attempting to discharge Connie Vinetti from the hospital).

  Criminal possession of a forged instrument in the third degree (for displaying a forged American Board of Otolaryngology diploma).

  Anthony was baffled and outraged. Still writing in Debbie’s persona, he used whole chapters of what was essentially his autobiography to rant about the blindness of justice and the venality and conspiracy practiced by the Erie County District Attorney’s Office.

  “One can never imagine the enormous emotional pain and pressure events such as these can put on a family,” he wrote. “Anthony became ever more distant and retracted. He would lie awake at night trying to make sense of it.”

  So did Dan Smith, alone with two little children who had lost their mother, just as he had lost his wife.

  There was no question that Anthony’s family was suffering, although he scarcely took that into account except when he scribbled over his tortured chapters about his own innocence. Not only was he narcissistic, he was also bizarrely untalented as an author, with a forced and artificial writing style and little or no grasp of proper sentence structure. The kindest critique would say that he could at least spell.

  Anthony’s mother, his wife, and his children continued to support him emotionally during the long spring of1998. He bemoaned the fact that the entire medical profession had not rallied around him, although he presented his attorneys with numerous letters from physicians who praised him while denouncing the State Board of Health and the District Attorney’s office for hounding him.

  * * *

  There were, however, many doctors who either kept quiet or offered to testify against Anthony. Anesthesiologists in particular were outraged that Sarah Smith had died needlessly.

  At one point, Anthony even became suspicious of his attorneys. They were urging him to consider a plea bargain. They tried to impress upon him that if he insisted on going ahead to trial, he cou
ld serve far more prison time than he might get if he pleaded guilty. Dan Smith was a most sympathetic accuser, despite his terrible loss. He had said he didn’t want Anthony to be away from his family for years and years.

  Sharon Simon was a victims’ advocate who worked in the Erie County District Attorney’s office. A warm-hearted smoky blond with startling green eyes, Sharon spent most of her days—and nights—helping victims and their families deal with the shock of loss. She virtually held their hands as she led them through the tortuous maze of the justice system, even though her heart ached for them and her dreams were haunted by the tragedies of strangers.

  On the other hand, she had an infectious giggle when something struck her funny—which it often did, despite her job. Her best qualification for her career was that she was empathetic and human and had never become jaded by the horrors she saw every day.

  She tried to prepare Dan Smith and Sarah’s family for the ordeal of a trial. The Pignataro hearings and the trial that was surely imminent was a cause celebre for the media in Buffalo, and television cameras followed the participants on both sides as they entered and exited the courtroom. The Smiths and the Graftons were still reeling from Sarah’s death; she had been gone only a short time.

  Debbie Pignataro was not a victim—not in the eyes of the law. Anthony’s family and his lawyers reminded her continually that it was essential for her to stand by her man. If she had her moments of doubt about his lack of concern for the young woman who died on his operating table, she didn’t allow herself to dwell on it. Her mother-in-law, who had been her friend and supporter for many years, was always at her side, steering her to the courtroom’s front-row seats, which Lena had claimed as their own. Anthony beamed at her and clasped her hand; he was far more attentive than he had been in years. Sitting in the front row, bolstered by other people who still believed wholeheartedly in Anthony’s innocence, Debbie felt a surge of hope.

  Dan Smith and his father always sat in the last row of the courtroom. To Dan, it seemed that both Anthony Pignataro’s mother and his wife glared at him during the legal proceedings. He tried to understand that they were afraid and that they must love their son and husband. Dan was a very kind young man, and he put himself in Anthony’s place, unaware that empathy for other people was an emotion completely alien to the doctor who had killed his wife.

  As the courtroom emptied after each session, Sharon Simon put her hand gently on Dan’s arm, signaling to him and his father to wait. Predictably, the reporters and cameras followed Anthony and Debbie. Anthony handled their questions deftly, but Debbie was overwhelmed. Lena Pignataro reminded her to hold her head up, to stand loyally beside her husband.

  The time for trial approached rapidly. At the last minute, Anthony listened to reason. He could not visualize himself spending years in prison—something that could very well happen if he were convicted in a trial. Even though he found it outrageous that a physician should be accused criminally just because he had the “bad luck” to lose a patient, his lawyers hammered at him. They couldn’t be responsible for what might happen if his accusers propelled him to trial, or if he should take the stand—something they were convinced he would do.

  As much as he longed to seize the witness chair and use it as a soap box to denounce those whose small minds couldn’t grasp his talent and potential, Anthony agreed to do as his attorneys advised.

  On June 8, 1998, he pleaded guilty to criminally negligent homicide before Judge Ronald H. Tills. He also agreed to withdraw all his pretrial motions, waived any right to appeal his sentence, and agreed to surrender all his licenses to practice medicine. Sentencing was set for August 4.

  Still, he couldn’t step back without making a statement, and his passionate words before he was sentenced would return to haunt him. He spoke, as always, of his pain: “The loss of one’s patient will forever haunt any moral doctor. Whatever determination you may decree cannot be worse than this pain. This pain alone, I assure you, would be sufficient to deter any physician from making the same mistake in the future.

  “But my pain is even greater than that. If you could see the look of disappointment in the eyes of my son…the look of fear in my daughter’s eyes…If you could see the pain in my wife and my mother’s heart…the disgrace in failing your [my] father’s memory and reputation, you would know the pain I feel every moment.”

  And having learned that the judge was a Shriner, Anthony shamelessly threw in a quote from that organization to cinch his plea for a light sentence—or, preferably, no sentence at all.

  He was shocked to hear himself sentenced to what Frank Sedita had requested: six months in jail, plus five years probation, 250 hours of community service, and a fine of $2,500.

  The final ignominy came as he was handcuffed and led off like a common criminal. Debbie fainted. The television cameras caught it all. Anthony Pignataro was the first medical doctor in the region’s long history to be convicted on a charge of criminally negligent homicide.

  Debbie vowed to wait for Anthony so that they could try to rebuild their marriage. “I was an old-fashioned Italian wife,” she recalled later. “I was there for Anthony, supporting him all the way. He made the decisions, and I went along with them.”

  What Debbie still didn’t know was that another woman was also waiting for Anthony Pignataro.

  14

  Jail in the Erie County Correctional Facility in Alden, New York, was a profound shock for Anthony Pignataro. He was used to the best, and he considered himself to be among the upper echelon of society in intelligence and breeding. Now he was forced to mingle with the kind of people he had never associated with—except, perhaps, in his early residency years when he worked in the ER. But those people had been patients, not his peers in any sense. This prison world of walls and bars was totally alien to him, and he was afraid, although he also believed that he was savvy enough to get by on his charm.

  “The prospects of going to prison,” he wrote, “are without a doubt the most fearful dilemmas one could imagine…Given the high profile nature of my case and the incredibly intense media coverage, it was anticipated that I would be a target for other inmates.”

  He didn’t know the half of it. Con-wise prisoners salivate at the prospect of meeting a wealthy and infamous prisoner. Celebrity prisoners often have money to share, and they are ultimately naive about dealing with the inside of “the joint.” A man like Anthony Pignataro was a pigeon to be plucked, even though he bragged that the guards were all on his side and were looking out for him. One guard, he said, even brought another prisoner to his cell with instructions to “show Tony the ropes.”

  Whether that was the way they met doesn’t really matter, but Anthony soon looked upon fellow prisoner Arnie Letovich* as his friend and protector—a special angel to look over him. He never questioned why Arnie seemed to be looking out for him.

  Some of the other prisoners, especially the African Americans, viewed Pignataro with genuine amazement. He wasn’t allowed to wear his toupee inside, but he still had the metal screws protruding from his bald head. One of them became infected and had to be removed, so his head looked a little lopsided after that. The African-American cons dubbed him “Frankenstein” and figured he had to be just plain crazy.

  Anthony bragged about how rapidly he fit in in jail. He felt he was popular and well liked, but he was careful not to cross invisible lines drawn by different groups. He had been assured that with time off for good behavior, he would have to serve only four months. It seemed a minuscule sentence for the life of a 26-year-old woman, but it was all the law could decree. Even so, four months seemed like four years to Anthony.

  Like the other prisoners, he lived in an 8-by-12 foot cell that had a cot, a desk, a sink-and-toilet combination with a mirror made of shiny steel, all of it bolted to either the floor or the walls to prevent suicide attempts.

  Anthony used his superior education to keep from “screwing up” and losing out on his two months of “good time.”

 
“I was able to read, write, work out, and practice my faith,” he wrote. “I made it my goal to adjust and befriend everyone.”

  From his own description of his activities in jail, he was the model prisoner. He studied in the law library an hour a day, and he finished twenty-two books during the time behind bars—a book a week. However, Anthony wasn’t quite the paragon of perfection that he said he was. He needed items that weren’t provided in prison—items that were, in fact, frowned upon.

  Debbie had realized for a long time that her husband was “borrowing” the painkillers and tranquilizers her doctors had prescribed for her neck pain. And Anthony had held back most of the painkillers he prescribed for his surgery patients. Now, all his usual sources of drugs had dried up—and the jail mess hall didn’t serve tequila.

  He was pleasantly surprised to learn that Arnie Letovich could hook into an illicit chain that could bring heroin inside the walls. Heroin took the sharp edges off his worries and made doing time a lot easier. Heroin more than replaced the painkillers and tranquilizers he took before his imprisonment.

  Ironically, he was also working on keeping in top physical shape. He jogged three miles around and around the yard each morning and spent his afternoons exercising. “I left that facility, at forty years old,” he recalled, “in the best shape of my life.”

  For the record, he added pages to his journal about the “unbelievably dirty business” of drugs in prison, and mentioned that he was in the “wrong place at the wrong time” and was forced to observe some drug transactions in the yard. He wrote that he had tried to look away from all of this because it was none of his business. He was “afraid” of the tough guys who dealt drugs.

  Anthony never lost touch with Debbie and his children, with his mother—or with his girlfriend. Like any prisoner, he could phone out as long as his collect calls were accepted. And they always were. His family visited him as often as they were allowed to, twice a week.