To Cook, a drug that had been dripping into Burgesss IV for days provided an answer. Televisions in patient rooms flicked off. Last summer, Pou and two nurses were arrested and charged with giving the patients lethal injections. The jury heard from Minyard but not from any of his forensic experts; nor from two family members who were present on the LifeCare floor during most of the ordeal; nor the main Justice Department investigator, who worked the case for a year and helped collect 50,000 pages of evidence. is very proud of the many heroic physicians and other health care professionals who sacrificed and distinguished themselves in the aftermath of Hurricane Katrina.. In New Orleans and elsewhere, many including numerous . He directed the nurse to reinstate his instructions. The prescriptions were dated Thursday, Sept. 1, and were signed by Dr. Anna Pou. Mendez recalled that Pou said no and that there was no telling how far it would go. A 61-year-old pulmonary specialist, hed had his semi-automatic Beretta strapped to him since he heard on Monday that a nurse was raped while walking her dog near the hospital (a hospital official denies that this happened). This was more than seven times the maximum dose she was receiving for comfort care. Only two of the main LifeCare witnesses were brought before the jury late in the process. A nurse from New Orleans' Memorial Medical Center fans a patient waiting in the hospital's parking garage to be evacuated via helicopter, Sept. 1, 2005. This is plain and simple homicide.. "[20], King publicly charged that one or more health care workers had killed patients, based on conversations with other health care workers. [43] To receive a share of the money, the eligible had to submit notarized claim forms indicating whether they had suffered injuries. REQUEST AN APPOINTMENT >. Push! and rolled his heavy wheelchair into a Coast Guard helicopter. Given how difficult it had been for him to climb the steps in the heat, there was no way he could make it back to the I.C.U. patient who was recovering from heart problems and several operations, lay motionless on a stretcher, covered in sweat and almost nothing else. The flotillas organizers, Mark and Sandra LeBlanc, had a special reason to come to Memorial: Vera LeBlanc, Marks 82-year-old mother, was at LifeCare, recovering from colon-cancer surgery. Mendez told investigators that she responded, I think youre right.. Over the past two and a half years, I have obtained previously unavailable records and interviewed dozens of people who were involved in the events at Memorial and the investigation that followed. Her mother was 16 in the photo; she is holding a trophy for a singing contest. 801-906-7400 (801) 657-5017. That night, dozens of LifeCare and Memorial patients lay on soiled and sweaty cots in the second-floor lobby. Until now, he has never publicly revealed that conclusion. We spend too much on these turkeys, he said some would say. Memorial Medical Center was heavily damaged when Hurricane Katrina struck the Gulf Coast of Mississippi, specifically Pearlington, MS on August 29, 2005. It is never permissible under any circumstances. And nowhere in the documents or in independent interviews conducted by NPR does anyone confirm seeing doctors or nurses administering lethal drugs. Other staff members gaped at the dark pool of water rimmed with garbage crawling up South Claiborne Avenue in the direction of the hospital. King was out of touch with reality, Cook told me he thought at the time. But the heavyset African-American man didnt. Administrators had long-standing plans to manage hurricanes, flooding, loss of . A D.N.R. Despite all the expert determinations of homicide, Minyard was still struggling with what to tell the grand jury. I dont think we should be doing anything like that. He had figured the D.N.R. Or it could be that he's made up his mind that he does not want to bring charges and wants the grand jury to provide his cover. At the time, those attending the meeting didnt see it as a momentous decision, since rescuers were expected to evacuate everyone in the hospital within a few hours. https://www.nytimes.com/2009/08/30/magazine/30doctors.html. Karch had staked his career on advancing the argument that the level of drugs found in a cadaver may have no relationship to the levels just before death. Minyard reached out to the noted University of Pennsylvania bioethicist Arthur Caplan for more advice. There were about a dozen patients, and he took charge of the four closest to the windows three elderly white women and a heavyset African-American man starting IVs on those who didnt have one. He said he is confident that the facts will reveal heroic efforts by the physicians and the staff in a desperate situation. The hurricane knocked out power and running water and sent the temperatures inside above 100 degrees. Call 801-261-2919 x214 to schedule an appointment. [20][34], The grand jury was sworn in on March 6, 2007, and prosecutors took the unusual step of having its meetings at an undisclosed location (i.e. Homicide, Dr. Frank Brescia, an oncologist and specialist in palliative care, concluded in each of the nine cases. A New Orleans grand jury did not indict Dr. Anna Pou, a physician accused of euthanizing four critically ill hospital patients in the wake of Hurricane Katrina. Carrie Kahn, NPR "[26], 60 Minutes aired a report on the case in September 2006. A doctor has admitted that he gave orders for a lethal dose of medication to be administered to a patient under his care during the hurricane Katrina disaster in 2005 - a decision that he says he does not regret having made. This is not euthanasia, Foti said emphatically. The attorney general's spokeswoman, Kris Wartelle, says investigators have subpoenaed more than 70 witnesses and are examining volumes of evidence. On Wednesday evening, two full days after Katrina hit, Angela McManus says three New Orleans police officers approached her with guns drawn and told her she would have to leave. She then prepared a syringe with morphine and midazolam, pushed it slowly into the womans IV line and watched her breathing ease. Last week New Orleans surgeon Anna Pou and two nurses were accused of second-degree murder in the deaths of four critically ill patients under their care at Memorial Medical Center in the days following Hurricane Katrina. That patient, along with two other LifeCare patients who relied on ventilators, also died early that morning, but the others were evacuated by helicopter. Wilda McManus, whose daughter Angela had tried in vain to rescind her mothers D.N.R. The hospital chaplain opened a double door with stained-glass windows down the hallway, and the staff began wheeling bodies into the chapel. Minyard told the media that he had retained some of the nation's leading experts as consultants in the case. When a very sick patient or the patients family made the decision to disconnect a ventilator, for example, Cook would prescribe morphine to make sure the patient wasnt gasping for breath as the machine was withdrawn. She says they told her that there were no doctors available to do it. Those who were sicker and would need more assistance were 2s. A final group of patients were assigned 3s and were slated to be evacuated last. A D.N.R. Mendez left to dismiss her employees, she said, because she feared they would be forced downstairs by authorities. He held their hands and reassured them, Its all right to go. Most patients, Thiele told me, died within minutes of being medicated. It is a step toward a criminal finding of homicide, in which a Louisiana court assigns fault for a killing. We were abandoned by the government, we were abandoned by Tenet, and clearly nobody was going to take care of these people in their dying moments. He added, I did what I would have wanted done to me if the roles were reversed.. Cook had had two heart attacks and could not help transport patients in the heat. patients. Our patients arent going to be evacuated. It was actually to the point where you were considering that you couldnt just leave them; the humane thing would be to put em out.. [20], On July 17, 2006, Pou was arrested and charged with four counts of second-degree murder in connection with the deaths of four LifeCare patients; nurses Lori Budo and Cheri Landry were arrested and charged, but charges were dropped in exchange for their testimony. Many of the 1s were taken to the emergency-room ramp, where boats were arriving. Burgesss situation was a little different, as Cook described it. According to McManus, attempts were made to evacuate other patients from the seventh floor. According to investigators, a proffer from Harriss lawyer said that Harris gave her additional morphine and midazolam a fast-acting drug used to induce anesthesia before surgery or to sedate patients for medical procedures. The 61-year-old Honduran-born manual laborer was at LifeCare awaiting colostomy surgery to ease chronic bowel obstruction, according to his medical records. As New Orleans flooded, Minyard says, he got out of his car and swam to work. The group considered the 90-year-old pneumonia patient Alice Hutzler, whom the LifeCare nurse Gina Isbell had promised to care for during the hurricane. At first everything seemed fine; Robichaux established computer communications with LifeCares corporate offices in Texas and was assured that LifeCare patients would be included in any FEMA evacuation of Memorial. No, I did not murder those patients. AT ABOUT 9 P.M. on July 17, 2006 nearly a year after floodwaters from Katrina swamped Memorial hospital Pou opened the door of her home to . What happened at Memorial Medical Care Center during Hurricane Katrina? Now Isbell prayed that help would come before Hutzler and her other patients died. "My office has not reopened an investigation into the deaths at Memorial hospital" after Katrina struck the Gulf Coast in 2005, Leon . I gave her medicine so I could get rid of her faster, get the nurses off the floor. He added, Theres no question I hastened her demise., The question of what to do with the hospitals sickest patients was also being raised by others. The decision that certain sicker patients should go last has its risks. The doctors had now spent days on duty, under stress and sleeping little. Other Memorial patients were being evacuated with help from volunteers and medical staff, including Bryant King. I mean if theyre capable of shooting at somebody, why are they not capable of raping them or, or, you know, dismembering them? Experts reported abnormal levels of morphine, midazolam (Versed), and/or Lorazepam in several bodies. He called his experts again and again for support and advice. ACCORDING TO STATEMENTS made to investigators by Steven Harris, the LifeCare pharmacist, Pou brought numerous vials of morphine to the seventh floor. According to eye-witness accounts, LifeCare's pharmacy director said that later that Thursday morning, he found Dr. Anna Pou in the seventh-floor medical-charting room. It is also the final resting place of 86 bodies that remained unclaimed after the storm, almost half of them unidentified. I figured, What would they do, these crazy black people who think theyve been oppressed for all these years by white people? Itll all turn out O.K.. Pou and others cite what happened at Memorial and Pous subsequent arrest which she has referred to as a personal tragedy to justify changing the standards of care during crises. Meanwhile, investigators are relying on accounts by witnesses like Angela McManus, who is still waiting for answers about how her mother died. "This is not euthanasia; this is plain and simple homicide," said state . The next day the Louisiana attorney general, Charles Foti Jr., opened investigations into hospital and nursing-home deaths during Hurricane Katrina. Vera LeBlanc, the LifeCare patient whose son arranged the airboat flotilla that had arrived hours earlier, was among the patients massed on the second floor. . Katrina Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital . By Friday, about 2,000 patients, families and staff had been evacuated "under incredibly difficult circumstances". Medical professionals generally consider euthanasia unacceptable and immoral, and most jurisdictions outlaw it, but in recent decades it has won support from advocates who favor that choice as an option during end-of-life care. Surprisingly, perhaps, there is no consensus on how best to do this. . Dr. John Walsh, a surgeon, told me that he was sitting on a bench, too tired to move, when Pou and the pathologist came downstairs. [8][9][10] However, a year later a grand jury in Orleans Parish refused to indict Pou on any of the counts. He was startled, he wrote, when Mulderick asked him his thoughts about whether it would be humane to euthanize the hospitals D.N.R. [27] The grand jury did not hear from Minyard's experts, some witnesses who had been present, or the Department of Justice investigator who had spent a year on the case and amassed 50,000 pages of evidence. The burden was unwelcome for Minyard, a 76-year-old obstetrician-gynecologist who was already struggling to oversee the autopsies and identification of hundreds of hurricane victims. Here, a wisp of gray hair peeked out. [37], The former Louisiana Attorney General, Charles Foti, hired forensic pathologists as consultants to assess autopsies and other medical information. Last summer, Pou and two nurses . . Besides the nine patients who remained on the LifeCare floor and Burgess, the group also reviewed 13 Memorial and LifeCare patients whose deaths were recorded by Memorials pathologist on the second-floor lobby near the A.T.M. A Memorial nurse appeared and announced that the Coast Guard could evacuate some critical patients if they were brought to the helipad immediately. Rest assured that our highly-trained and compassionate staff will offer your pet the most humane treatment possible. McManus says nurses told her that her mother had been sedated. (Pou, through her lawyer, disputes Mendezs account.) Reflecting on the scene at the airport, Thiele told me that if the patients he injected with drugs had made it there, They wouldnt have survived.. FOUR YEARS AFTER Katrina, its summer again in New Orleans, and the myrtle trees are in bloom. The attorney general's office will not confirm whether he has seen them. You cant do this! King shouted at Goux. [20], On September 11, mortuary workers recovered 45 bodies from the hospital. I was like, 'What's going on with her?' Once on the first floor, McManus said, she could hear gunshots outside the hospital. Carrie Everetts husband, Emmett, died at Memorial Medical Center after Hurricane Katrina. Within the old Charity Hospital Cemetery, and visible from Canal Street, is a little-known memorial dedicated to those who lost their lives in Hurricane Katrina. Thats the honest-to-God truth.. Doctors, nurses and clinical researchers who specialize in treating patients near the ends of their lives say that this double effect poses little danger when drugs are administered properly. patients should go last, but the plan, he told Mulderick, was still to evacuate them eventually. Defense attorneys say Tuesday's development shows that the three should never have been prosecuted. On Sunday, August 28, 2005, the weather forecast warned about . Whats wrong? he asked. vs. Tenet Health Systems, Memorial Medical Center, et al., Civil District Court No. It is now evident that more medical professionals were involved in the decision to inject patients and far more patients were injected than was previously understood. Despite a freakish spinal-cord stroke that left him a paraplegic at age 50, his wife and nurses who worked with him say he maintained a good sense of humor and a rich family life, and he rarely complained. Sandra, an E.M.T., knew that her mother-in-law couldnt swallow, so she was surprised when she saw that Vera and other patients who needed IVs to keep hydrated were no longer getting them. You dont have to be here., I want to be here, Thiele insisted. Pet euthanasia at home honors your pet's life by offering an opportunity to say goodbye in a loving, peaceful, and comfortable environment. order, had a serious blood infection. Foti told me that he repeatedly asked the district attorneys office to present all the evidence and the experts. At around 9 p.m., Rodney Scott, the obese I.C.U. But if man decided that, I want to know that. Oh, my goodness, a LifeCare employee recalled Pou replying. Separately, Fotis staff asked the Orleans Parish coroner, Dr. Frank Minyard, to perform autopsies and drug tests on approximately 100 bodies that were recovered from more than a half-dozen hospitals and nursing homes in New Orleans. They reminisced about Pous deceased father, a family doctor who had been especially kind to Minyard and had referred patients to him when Minyard opened his ob-gyn practice. That's just one of the challenges facing Louisiana State Attorney General Charles Foti as he tries to piece together exactly what happened at Memorial Medical Center. There must have been a way to get the 380-pound man downstairs, he said he thought. She recalls seeing workers desperately trying to get one woman out of the hospital, only to see that the woman died in the process. Pet Loss Booklet with your pet's name and date of passing, which will serve as a death certificate. (Through their lawyers, Landry and Budo declined to be interviewed. Still, while two patients died on the LifeCares seventh floor on Wednesday, the others had lived through the night, with only a few given small doses of morphine or the sedative lorazepam for comfort. Instead, she said, she was motivated by how bad the patients looked. The four patients were among 34 who died at Memorial Hospital after Katrina hit in 2005, but the only ones that Louisiana Attorney General Charles Foti's office found to be homicides. [27][28][29] In a statement, Tenet Healthcare, who owns the medical center, said "Euthanasia is repugnant to everything we believe as ethical health-care providers, and it violates every precept of ethical behavior and the law. NPR has reviewed secret court documents related to the investigation and not yet released to the public. Tenet acknowledges that investigators from the attorney general's office searched Memorial Hospital on Oct. 1, 2005, and removed records and other materials, particularly from the LifeCare facility. But because she had already been receiving morphine and because of her advanced cancer, she was not a clear, strong case, Wecht wrote in his notes. As he waited for evacuation on the second floor, she bagged him for nearly an hour. He was terrified, he said, of what would happen to them if they were left behind. (Fournier declined to talk with me.) Other doctors at the meeting agreed with Deichmanns plan. Ren Goux, the hospitals chief executive, told me he had decided, for reasons of safety, that people floating up to Memorial should generally be directed to dry ground about nine blocks south. The man kept breathing, and Wynn says she and her colleagues took that as a sign. State and federal investigators interviewed LifeCare witnesses and descended on the mold-ridden hospital to search for evidence. Anna Pou was a 49-year-old head- and neck-cancer surgeon whose strong work ethic earned respect from doctors and nurses alike. Language links are at the top of the page across from the title. orders. Can I help you? he says he asked Pou several times. We kill em.. Thiele tried more morphine. Then Johnson guided them to Emmett Everett in Room 7307. When the LeBlancs tried to enter the patient area on the second floor, a staff member blocked them, and several doctors told them they couldnt leave with Vera. Inside, more than a dozen bodies lay motionless on low cots and on the ground, shrouded in white sheets. Thiele saw that morphine, midazolam and syringes had been set up on a table near the A.T.M. Let God make that decision., The debate among medical professionals about how to handle disasters is intensifying, with Pou and her version of the Memorial narrative often at the center. Harris never returned my calls.) But by Thursday, four days after Katrina hit, despair was setting in. Cots and stretchers seemed to cover every inch of floor space. In one study of triage, experienced rescuers were asked to categorize the same patients and came up with widely different answers. Cook says its not so simple. Itll work itself out. Wilda Faye was an acclaimed gospel singer. State Attorney General Charles Foti announced the arrests the next day, at a widely televised news conference. He felt relief. He expected that the people firing guns into the chaos of New Orleans the animals, he called them would storm the hospital, looking for drugs after everyone else was gone. The discussions related to patients on Memorial hospital's seventh floor, a separate long-term patient care facility run by LifeCare Hospitals. [20] Many of LifeCare's patients at Memorial were especially affected by the loss of electric power; seven were on ventilators. Thiele trained a needle toward the heart of a clawing cat held by Fournier, he told me later. What follows is based on the recollections of others, some of which were recounted in interviews with Louisiana Justice Department investigators, as well as in interviews with me. Her chart read Do Not Resuscitate, as it had during several hospital admissions for more than a decade, so that her heart would not be restarted if it were to stop. The doctors quickly agreed that babies in the neonatal intensive-care unit, pregnant mothers and critically ill adult I.C.U. and elsewhere. Isbell fondly called her Miss Alice and had told Hutzlers daughter that she would take good care of her mother. And she said, 'Yes.' September 12, 2013. I cant do this, he kept saying. [14] Whaddya have left? The nurses said they were down to one patient: Jannie Burgess, a 79-year-old woman with advanced uterine cancer and kidney failure. "[20] The drugs injected are usually given for pain purposes, but not at the levels found in subsequent toxicology reports. disaster circumstances arose out of the many allegations of euthanasia at Memorial Medical Center (Memorial) in New Orleans against a physician and two nurses during the Hurricane Katrina disaster. Memorial Medical Center was placed in the spotlight for their evacuation efforts, failed protocol, and allegations of euthanasia of patients. The company had its own incident commander, Diane Robichaux, an assistant administrator who was seven months pregnant. Wynn felt that they needed to medicate the patients, she said when she described her experiences publicly for the first time in interviews with me over the past year. Wecht concluded that all four deaths were homicides, caused by human intervention. At a conference for hospital executives and state disaster planners a few months ago in Chicago, she did not mention that she injected patients, saying that helicopters arrived in the afternoon of Thursday, Sept. 1, and we were able to evacuate the rest.. That group included those whom doctors judged to be very ill and also, as doctors agreed the day before, those with D.N.R. She knew she was a target of the investigation, but her lawyer thought he had assurance that she could surrender voluntarily. Maybe in the morning.. The discussions related to patients on Memorial hospital's seventh floor, a separate long-term patient care facility run by LifeCare Hospitals. Tenet spokesman Harry Anderson said that evacuation plans for the seventh floor of Memorial were the sole responsibility of LifeCare Hospital. In his report to Minyard, he wrote that it was evident that Emmett Everett was in stable medical status with no clear evidence that death was imminent or impending. (Pous lawyer says that Everett almost certainly died of an enlarged heart, not an overdose of medication. Isbell said she thought about her patients, remembering with guilt a promise she made to the daughter of one of her favorites, Alice Hutzler, a 90-year-old woman who came to LifeCare for treatment of bedsores and pneumonia. The sun rose and with it the sultry New Orleans temperature, which was on its way to the mid-90s. purchase. Mendez heard that Pou was looking for her. Hundreds of hospital and nursing-home patients had been dropped there from across the disaster zone; they were met by federal disaster-management teams that were so understaffed and undersupplied that they couldnt provide even basic nursing care to many patients. Typically, medical workers try to divvy up care to achieve the greatest good for the greatest number of people. and had no electricity. [43], Three lawsuits (Alford, Everett, and Savoie) initially filed against Pou and other parties were settled; the families had to agree to keep silent about the terms. In an interview with Newsweek in 2007, Pou acknowledged that after discussions with other doctors, she did inject some Category 3 patients. 385-533-0440. In all of the cases, he advised, the medical cause of death should remain undetermined. He brushed past her into the hallway, and Isbell followed, grabbing his arm and guiding him to an empty room. By Wednesday afternoon, Dr. Ewing Cook was physically and mentally exhausted, filthy and forlorn. One person present during the event stated that Everett only died after having his face smothered with a towel. God said, O.K., but Im not ready for him. Or he wasnt ready. She remembers passing him through the hole in the machine-room wall on his way to the evacuation helicopters. Pou was wearing rumpled surgical scrubs from several hours of surgery she performed earlier in the day. At about 2 a.m. on Wednesday, Aug. 31 nearly 48 hours after Katrina made landfall near New Orleans Memorials backup generators sputtered and stopped. The morning after Katrina hit, Tuesday, Aug. 30, a nurse called to Pou: Look outside! What Pou saw from the window was hard to believe: water gushing from the sewer grates. Hardcover, 272 pages. When the storm hit, patients screamed as windows shattered under a hail of rocks from nearby rooftops. Then Deichmann broached an idea that was nowhere in the hospitals disaster plans. Even in the best of circumstances, the patient probably had a day or so to live. area on the second floor where some of the sickest patients most of whom had been given 3s lay. Homicide, wrote Dr. James Young, the former chief coroner of Ontario, Canada, who was then president of the American Academy of Forensic Sciences. According to his statement, Pou and two unnamed nurses informed him that it had been decided to administer lethal doses to LifeCare patients. If you dont think that by giving a person a lot of morphine youre not prematurely sending them to their grave, then youre a very nave doctor, Cook told me when we spoke for the first time, in December 2007. On the way, she prayed silently. At least nine well-recognized triage systems exist. 2. It was dark when the last of the Memorial patients who had been chosen for immediate evacuation were finally gone. All these patients survived the adverse events of the previous days, and for every patient on a floor to have died in one three-and-a-half-hour period with drug toxicity is beyond coincidence., A local internal-medicine specialist concluded that while medical records and autopsies for several of the patients revealed medical issues that could reasonably have led to their deaths, most of the patients records did not. John, everybody has to be out of here tonight, he said she told him. People were trying to get into the hospital just to get to higher ground, and they weren't allowing that so they boarded the doors up, and we were just in there smothering all night long. At LifeCare that afternoon, confusion reigned. In the afternoon, helicopters from the Coast Guard and private ambulance companies began landing on a long-unused helipad atop an eight-story parking garage adjacent to the hospital. and a planter filled with greenery. Like morphine, midazolam depresses breathing; doctors are warned to be extremely careful when combining the two drugs. According to Cook, Mulderick told him, We gotta do something about this. Mulderick, who declined to be formally interviewed about the days after Katrina, did tell me: We were well prepared. [20], Having received these six reports indicating that at least eight of the nine deaths under investigation were homicides, Minyard sought the opinion of another expert, Steven Karch, who specializes in disputing drug toxicology tests performed after death. Speakers aimed their comments directly at the grand jury, warning that medical professionals, whose ranks had already been depleted by Katrina, would flee Louisiana in droves if a doctor was indicted after serving in a disaster. Euthanasia, the final gift. Thiele told me that on Thursday morning, he saw Susan Mulderick walking out of the emergency room. A SUCCESSFUL MURDER prosecution in Orleans Parish typically requires a coroners medical determination of homicide that a death was caused by the actions of another human being without regard to fault or legal responsibility. Unlike a typical grand jury, this one dealt with just one case, and functioned as an investigation instead of a review of evidence. Wed experienced the helicopters stopping flying to us, Goux told me, and I didnt want that to occur again., Around a corner from where the patients lay on the second floor, Thiele and Fournier struggled to euthanize two cats whose owners brought them to the hospital and were forced to leave them behind. Her mother was 16 in the photo; she is holding a trophy for a singing contest. [20], Investigators believed up to two dozen patient deaths might have been homicides, but stated that they had difficulty acquiring the medical records needed to document the patients' conditions. After daybreak, she heard the sound of helicopters and watched the evacuation line begin to move. She is the author of War Hospital: A True Story of Surgery and Survival and is a senior fellow at the Harvard Humanitarian Initiative. [39], Since then, the charges have been expunged, the State of Louisiana has agreed to pay Pou's legal fees of over $450,000, and several Louisiana lawmakers have apologized for the accusations against her. Many sources confirm that at this point, there were 2,000 people -- employees, patients and relatives -- trapped in the hospital. Memorial keepsakes to help mend the broken heart: a clay paw print (made at home) and a lock of fur, if desired. Whats to prevent them from doing things like that?. For weeks, Foti has said he cannot comment on the ongoing investigation. Years of life saved? Kristy Johnson, LifeCares director of physical medicine, said she saw what happened next. Medical workers finally insisted that the woman and her husband be allowed to enter, but the men who swam in the toxic soup to rescue her were told to leave. We covered his face with a towel until he stopped breathing, Thiele told me. Bill Armington, a neuroradiologist, told me he thought that patients who did not wish their lives to be prolonged by extraordinary measures wouldnt want to be saved at the expense of others though there was nothing in the orders that stated this. [20] Patients, staff and their families rode out the storm inside. There, on the seventh floor of Memorial Medical Center, doctors and nurses were faced with few options. [15] The following year, Orleans Parish District Attorney Leon Cannizzaro testified in the same case that "human beings were killed as a result of actions by doctors" at Memorial after Hurricane Katrina. And they are sick people, and their system is not working like it should work," Minyard said. Thiele said the remaining bodies were wrapped in sheets and placed on the floor in the corridor and in a nearby room. Lifecare Hospitals is based in Plano, Texas. Pou and her co-workers were performing triage, a word once used by the French in reference to the sorting of coffee beans and applied to the battlefield by Napoleons chief surgeon, Baron Dominique-Jean Larrey. Apple TV+'s new show Five Days at Memorial explores the events that took place over the course of five days at Memorial Medical Center in New Orleans during Hurricane Katrina in 2005.. Five Days . Predicting how a patient will fare is inexact and subject to biases. Angela McManus' mother had been on the LifeCare floor for two weeks before Katrina hit. "[19] LifeCare told the state Attorney General's office that nine of their patients might "have been given lethal doses of medicines by a Memorial doctor and nurses. patients. Memorial Medical Center leased the floor to LifeCare Hospitals, a separate long-term patient care facility. It also had its own philosophy: LifeCare deployed the full array of modern technology to keep alive its often elderly and debilitated patients. LifeCare was known for helping to rehabilitate patients on ventilators until they could breathe on their own. Pou has also been advising state and national medical organizations on disaster preparedness and legal reform; she has lectured on medicine and ethics at national conferences and addressed military medical trainees. "[20] Having received this opinion, Minyard sought no further opinions. The 3s were moved to a corner of the second-floor lobby near an A.T.M. . Rehab Agency (Salt Lake WorkMed) Medical Records Department. As darkness fell, rumor spread that evacuations would halt for the night because people were shooting at rescuers. He consulted one more pathologist, Dr. Steven Karch. Volunteers began carrying the LifeCare patients who relied on ventilators down five flights of stairs in the dark. Our Admissions Department provides urgent and/or low-income discounted fee euthanasia services but guardians are not able to be present during the procedure. The full details of what Pou did, and why, may never be known. The post-Katrina floodwaters caused power outages at Memorial and created the need for urgent patient evacuation. [22] One of his nurses later told investigators he had said, "Cindy, don't let them leave me behind. Their stories focused on Anna Pou. Mr. New Orleans police confirm that armed officers did evacuate non-essential staff from the hospital. It would not be good for the city, for the recovery. Listen to NPR reports on the chaos at hospitals in New Orleans in the days and weeks after Hurricane Katrina struck the city: But it was on the seventh floor of the hospital were the situation was most dire. She acknowledged having heard rumors that patients were being euthanized, but she said no one had told her that that was what was happening to these patients and that her only aim was to make patients comfortable by sedating them. The hospital is closed, someone shouted. According to Memorial workers on the second floor, about a dozen patients who were designated as 3s remained in the lobby by the A.T.M. . Memorial Medical Center and Hurricane Katrina, The Memorial Medical Center has since changed ownership, and is now called the, "Doctor cleared in Katrina deaths recounts scene", "Nurse: 'It's like being in a Third World country', "Hospital Settles Katrina Deaths Class Action", "Doctor and Nurses Charged in Post-Katrina Deaths", "State of Louisiana vs Anna M. Pou, Affidavit and Arrest Warrant", "Grand jury refuses to indict Dr. Anna Pou", "Panel Recommends Paying Dr. Anna Pou's Legal Fees", "HB341 2009, Regular Session, Appropriates funds for payment of legal expenses of Dr. Anna Pou", "High court considers making public records of Memorial Medical Center deaths during Katrina", "Orleans DA testifies that he believes patients were killed at Memorial Medical Center after Katrina, but he can't prove it", "Staff at New Orleans hospital debated euthanizing patients", "Strained by Katrina, a Hospital Faced Deadly Choices", Louisiana AG Orders Autopsies of 50 Memorial Medical Patients; Susan Polk Goes on Trial, "Doctor's drug mix not ideal killer: Evidence in Memorial case called unreliable", "Grand Jury to investigate hospital deaths", "3 Arrests in New Orleans Hospital Deaths", "Three charged with second-degree murder in Katrina hospital deaths", "Patient Deaths in New Orleans Bring Arrests", "N.O. Diane Robichaux, the senior leader on the LifeCare floor, later walked into the office, she recalled in interviews with investigators. Everetts roommates had already been taken downstairs on their way to the helicopters, whose loud propellers sent a breeze through the windows on his side of the LifeCare floor. Often Cook found that achieving this level of comfort required enough morphine that the drug markedly suppressed the patients breathing. And I said, 'Momma, do you understand?' Been on the phone with Tenet, a LifeCare representative outside the hospital wrote to Robichaux. Memorial Hospital had been a storm refuge for up to 2,000 people. Karch flew to New Orleans, examined the evidence and concluded that it was absurd to try to determine causes of death in bodies that had sat at 100 degrees for 10 days. "[20] One of the experts, an internist, wrote that Everett was "in stable medical status with no clear evidence that death was imminent or impending". Pou projected the booking photo from her arrest onto the screen as she argued for laws to shield health workers from civil and criminal liability in disasters. [20] University of Pennsylvania bioethicist Arthur Caplan also wrote in his expert report that all nine of the deaths constituted active euthanasia; the administration of the drugs was "not consistent with the ethical standards of palliative care that prevail in the United States," precisely in that the death of a patient must not be the goal of a doctor's treatment; and death, in his opinion, was the goal in these cases. ProPublica reporter Sheri Fink discusses her breakthrough investigation, "The Deadly Choices at Memorial," into the deaths of at least 18 patients who died a. To Cook, the difference between something ethical and something illegal is so fine as to be imperceivable.. But as the day wore on, the texts between LifeCare staff members and headquarters grew frantic as it became clear that the governments rescue efforts and communications were in chaos. He was trapped there for four days. Confronted by police, McManus raced to her mother's bed. Based on actual events, Apple TV+'s Five Days at Memorial gives a behind-the-scenes account of what happened at one New Orleans hospital in the wake of Hurricane Katrina. The conditions she described at Memorial took him back to the days he spent trapped in the courthouse after Katrina. In all of the cases, he advised, the medical cause of death should remain undetermined. orders had terminal or irreversible conditions, and at Memorial he believed they should go last because they would have had the least to lose compared with other patients if calamity struck. Cook scribbled pronounced dead at in Burgesss chart, left the time blank and signed the note with a large squiggle. order is signed by a doctor, almost always with the informed consent of a patient or health care proxy, and means one thing: A patient whose heartbeat or breathing has stopped should not be revived. The class action, Elmira Preston et al. By the afternoon, with few helicopters landing, these patients were languishing. KAHN: Forty-five bodies were removed from Memorial Hospital nearly two weeks after Katrina. The names of each victim from Katrina is etched on the wall and filled with gold leaf. Kamel Boughrara, a LifeCare nursing director, walked past the A.T.M. Evacuating someone as large as Scott had a cost a nurse was briefly pinned against the helicopter, bruising his ribs and spleen but it had been done. Protocol in evacuation Aug. 30th, 2005 the streets surrounding the hospital began to flood, and Memorial Medical Center's evacuation plan began to fail. As bad as disasters are, he said, even worse is survivors who dont trust each other.. Im O.K., Doc, Scott said. Grand-jury hearings are conducted in secret, making it difficult to know exactly what jurors hear. He tried prayer. The patients were too ill to move as Memorial Medical Center at the time without power and surrounded by floodwaters was being evacuated. They say they were never made aware of his presence. Sheri Fink, an M.D., is a staff reporter at ProPublica, the independent nonprofit investigative organization. A doctor and two nurses who worked through the chaos that followed Hurricane Katrina were arrested overnight, accused of giving four patients stranded at their . [32] (Landry and Budo were arrested the same night. For years, a health care company known as LifeCare Hospitals of New Orleans had been leasing the seventh floor at Memorial. ONLY A FEW nurses and three doctors remained on the second floor: Pou; a young internist named Kathleen Fournier; and John Thiele, a 53-year-old pulmonologist, who had never before spoken publicly about his Katrina experiences until we had two lengthy interviews in the last year. But the arguments she is making about disaster preparedness that medical workers should be virtually immune from prosecution for good-faith work during devastating events and that lifesaving interventions, including evacuation, shouldnt necessarily go to the sickest first deserve closer attention. Finally a physician stopped by the stretcher and told her that there was no oxygen for the patient and that he was already too far gone. Burgesss medical chart showed that she was given 15 milligrams of morphine seven times on Wednesday between 2:10 p.m. and 3:35 p.m. on spoken orders from Cook. He says that it took less than a minute for the man to die and that he didnt suffer. Ewing Cook, one of the hospitals most senior physicians, told me that he decided that in order to lessen the burden on nurses, all but the most critical treatments and care should be discontinued. Muldericks lawyer says that Mulderick did ask a physician about giving something to patients to make them more comfortable, but that, however, was not code for euthanasia., Thiele didnt know Pou by name, but she looked to him like the physician in charge on the second floor. Minyard, the coroner, brought together Cyril Wecht, Michael Baden another well-known forensic pathologist and Robert Middleberg, the director of the toxicology laboratory where the autopsy samples were tested, to discuss the toxicology findings. The effect, he told me, was that patients would go to sleep and die. He explained that it cuts down your respiration so you gradually stop breathing and go out. He said he believed that Pou understood that he was telling her how to achieve this. For months, the Louisiana attorney general has been investigating these charges. At 4:55 a.m., the supply of city power to the hospital failed. Fixing the problem would be costly; a few less-expensive improvements were made. They sat down in an office with an open window. For more information or to speak with Dr. Cionni, call 513-666-1533. Dr. Ewing Cook said that as staff at Memorial Medical Center in New Orleans were struggling to evacuate patients from the . "[36], After several months, the grand jury concluded its work by declining to indict any of the suspects on any of the charges. In 2008, Caldwell testified before the Louisiana Supreme Court in support of the position taken by lawyers for Pou and other doctors and nurses from Memorial, who were fighting to keep the state's investigative records in the case sealed from public view. He told me that he knew that what they were about to do, though it seemed right to him, was technically a crime. He said that the goal was death; our goal was to let these people die.. Eventually, the charges were expunged and the State of Louisiana paid Pou's legal fees. When Gremillion wouldnt answer, Isbell tried to comfort him. While they were working, Thiele recalls Fournier telling him that Mulderick had spoken with her about something to the effect of putting patients out of their misery and that she did not want to participate. My family needs peace of mind about that.". [20] Investigators believed that of the two dozen possible cases, they initially had the strongest case in the deaths of four of the patients who had died on the hospital's seventh floor. The book and the TV show focus on the doctors and patients stranded at Memorial Medical Center during Hurricane Katrina. He said his client was innocent and accused Foti, who was about to run for re-election, of orchestrating a media event with the arrests. According to Robichaux, the group concluded that Everett was too heavy to be maneuvered down the stairs, through the machine-room wall and onto a helicopter. According to statements given to an investigator in the attorney general's office, LifeCare's pharmacy director, the director of physical medicine and an assistant administrator say they were told that the evacuation plan for the seventh floor was to "not leave any living patients behind," and that "a lethal dose would be administered," according to their statements in court documents. Given how exhausted everyone was and how much this woman weighed, it would be impossible to drag her down six flights of stairs. 3. The implication was that if people outside the medical community dont know what the rules are or feel excluded from the process of making them or dont understand why some people receive essential care and some dont, their confidence in the people who care for them risks being eroded. Despite repeated phone calls and letters, Dr. Pou could not be reached for comment. Three days after Hurricane Katrina flooded New Orleans, staff members at the city's Memorial Medical Center had repeated discussions about euthanizing patients they thought might not survive the . The Justice Departments phones were soon ringing with allegations of patient abandonment and euthanasia. Johnson took one of the Memorial nurses into Room 7305. The unusual moves prompted legal observers to speculate that the district attorney considered the evidence ambiguous and wanted to be able to assure the public of a thorough investigation if he decided to drop the case without bringing formal charges. In the course of my reporting, I went to several events involving Pou, including two fund-raisers on her behalf, a conference and several of her appearances before the Louisiana Legislature. Pou looked upset. We cannot afford to forget those loved ones that were lost in this disaster. A number of forensic experts, including Cyril Wecht, Michael Baden, and James Young, agree that the administration of morphine and midazolam constituted homicide in many of the deaths on the seventh floor. As at many American hospitals in flood zones, Memorials main emergency-power transfer switches were located only a few feet above ground level, leaving the electrical system vulnerable. Euthanasia did not occur out of desperation, but rather out of errors and a false sense of compassion. [5] Out of an estimated 215 bodies found in nursing homes and hospitals in New Orleans,[6] Memorial had the largest number. "[16], Pou, an associate professor in the Department of Otorhinolaryngology at the LSU Health Sciences Center, was at Memorial Medical Center[17] from before Katrina's landfall on Monday, August 29 until Thursday, September 1. The couple ignored the doctors, and Vera smiled and chatted as Mark and several others picked her up and carried her onto an airboat. Conditions were deteriorating rapidly, evacuations were sporadic and security was compromised. [20] In the following weeks, it was reported that staff had discussed euthanizing patients. For generations, the hospitals sturdy walls served as a shelter when hurricanes threatened: employees would bring their families and pets, as well as coolers packed with muffulettas. At one point, one of the panelists, Father John F. Tuohey, regional director of the Providence Center for Health Care Ethics in Portland, Ore., said that there are dangers whenever rules are set that would deny or remove certain groups of patients from access to lifesaving resources. The woman died a short time later, which didnt disturb Wynn because she had appeared to be close to death. Still, investigators were surprised at the number of bodies in the makeshift morgue and were stunned when health care workers charged that a well-regarded doctor and two respected nurses had hastened the deaths of some patients by injecting them with lethal doses of drugs. The witnesses also heard staff discussing the agonizing decision to end patients' lives. But the 246-page document offered no guidance for dealing with a complete power failure or for how to evacuate the hospital if the streets were flooded. This didnt sit well with the attorney general and his staff. She sat down beside him. Caplan reviewed the records and concluded that all nine LifeCare patients on the seventh floor were euthanized, and that the way the drugs were given was not consistent with the ethical standards of palliative care that prevail in the United States. Those standards are clear, Caplan wrote, in that the death of a patient cannot be the goal of a doctors treatment. A former nurse, he says he does not know whether euthanasia occurred at Memorial; but if it had, he wonders what the doctors and nurses could have been thinking. He put his hand on the mans forehead; Wynn and another nurse manager took the mans hands in theirs. [20] Tenet Healthcare said it turned over all the patient records it had on the case. Baden said he thought all nine were homicides. The helipad had minimal lighting and no guard rail, and the staff needed rest. As many have heard, the grand jury in New Orleans declined to bring charges against the physician, Anna Pou, and two nurses, arrested and charged with euthanizing patients at Memorial Hospital in the days following Katrina. The hospital filled with the cacophony of military and private crafts hovering and landing. McManus says that when she left, only eight patients, including her mother, remained alive in LifeCare. hide caption. Built in 1926 and known for decades as Southern Baptist, the hospital was renamed after being purchased in 1995 by Tenet Healthcare, a Dallas-based commercial chain. Pulitzer Prize winning author, [] The grand jury did not indict Pou on any of them. Homicide, he wrote for seven of the eight other seventh-floor patients, including Emmett Everett, Wilda McManus and Rose Savoie. Armington suspected that euthanasia might occur, in part, he told me, because Cook told him earlier that there had been a discussion of things that only doctors talk about. Armington headed for the helipad, stirred up, as he recalls, to intensify my efforts to get people off the roof. Neither Armington nor King intervened directly, though King had earlier sent out text messages to friends and family asking them to tell the media that doctors were discussing giving medication to dying patients to help accelerate their deaths. 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