I just got an email from a local activist with an update on the Corps’ activities. Or lack of. If you live in N’awlins, think about sending your Congress Critters this letter he included, or one modeled on it.

Here are the problems addressed in the letter, that remain on the Corps “to do” list:

1) 17th Street canal
When high storm surge is present and the 17th Street Canal floodgate is closed, the pumping capacity at Pump Station No. 6 for the Hoey’s Basin has effectively been reduced from 9,500 CFS to 1,100 CFS. This will greatly increase the possibility of flooding during a hurricane event. While the Corps has repeatedly committed to increasing the temporary pumping capacity, we are approaching the height of the hurricane season without adequate pumping capacity.

2) Harvey Canal
Despite earlier announcements by the Corps to the contrary, the sector gate in the Harvey Canal will not be ready for this hurricane season. Furthermore, the construction of the flood walls along the east side of the Harvey Canal has yet to begin, leaving adjacent neighborhoods exposed to surge bypassing the gate. Hurricane Rita pushed the current interim protection to the limit.

3) SELA Projects
Although additional funds have been allocated for SELA projects in Jefferson Parish, no additional work has been authorized. The Corps has been extremely slow in completing the necessary steps to proceed with construction of additional SELA projects.

4) Roof repairs on Westbank Drainage Pump Station roofs
Roofs that were damaged during Hurricane Katrina on several Westbank pump stations remain damaged despite earlier promises by the Corps of Engineers to repair same. Electrical panels and generators are exposed to the weather as a result of this. The Corps is now saying that repairs cannot be completed for months. This makes for a dangerous working environment for the pump station operators and could lead to pumping capacity being lost if the electrical panels get wet and short out.

5) Backflow problems
The Corps has yet to begin to address the permanent backflow problems at Jefferson Parish Drainage Pump Stations. The Parish’s temporary solution of idling the pumps will not provide the higher reliability that a positive closure can provide. The Corps recently announced that they would be advertising for an engineer in July to begin plans and specs to address this concern. If this is not expedited, necessary improvements will not be in place for the 2007 hurricane season. This backflow during Katrina was the cause of flooding in over 63,000 homes in Jefferson Parish.

The letter sums up the feelings of many New Orleans area residents, but phrases it a good deal more politely than most of us would:

The Corps currently lacks an appropriate sense of urgency as it relates to the above items. Despite publicly committing to numerous timelines to address the above issues, deadlines come and go without these problems being addressed.

As a resident of Jefferson Parish, I call on you to hold the Corps accountable and take whatever steps necessary to have the above issues addressed in a timely manner. The Corps’ excuses and failure to perform can no longer be tolerated.

These videos are a good example of what the Corps has accomplished in Louisiana with your tax dollars. It must no longer be tolerated.

The arrest warrant for Dr. Pou and the two nurses accused of murdering patients at Lifecare is now available at the NYT. (h/t Kevin, MD Medical Weblog, which has several posts on this issue, including plenty of comments from those who think Pou is guilty and her defenders.)

The affidavit/warrant includes:

On September 14, 2005, Lifecare Hospitals self-reported, through their attorneys,
the possible euthanasia of patients following Hurricane Katrina by personnel working at
Memorial Medical Center.

They could scarcely help reporting it. They knew the story would come out. Better that they should be seen to volunteer it.

three Lifecare employees, K.J., S.H. (Director of Pharmacy) and D.R. (Assistant Administrator) sought out Ms. Mulderick to learn what Memorial Medical Center planned to do regarding the evacuation of Lifecare patients.

Interesting… Lifecare had its own JCAHO accreditation and that necessarily includes an evacuation plan. I’m not privy to the plan, perhaps it consists of “whatever our host facility MMC wants” but I kind of doubt it. I might be reading too much into it, maybe their inquiry was to improve coordination of the two plans, but it sounds to me like they were trying to dump their problems in Memorial’s lap. Memorial’s JCAHO accreditation was recent, and the hospital intranet had all the JCAHO information posted, so it’s fair to say that it was probably pretty fresh in the staff’s minds as Katrina approached. And MMC claims that while they rationed food and water for staff, there was plenty for patients, even for several days beyond when they finally got the hospital evacuated.

Later T.M. (Nurse Executive and Director of Education for Lifecare Hospitals)
found K.J. downstairs assisting family members with evacuation. T.M. told K.J. “they” were going to give the Lifecare patients a “lethal dose.”

By their own account, Lifecare staff knew in advance that this was going to happen and yet did nothing. The next few paragraphs described cold blooded murder while the Lifecare staff apparently stood by and did nothing. Then –

Dr. Pou asked K.J. to make a list of all the remaining patients and their locations
and leave the list on the desk in the Therapy Charting room. Dr. Pou advised K.J. that
she needed the list because they would be coming back to the seventh floor and checking
on the patients and wanted to make sure they didn’t miss anyone. Dr. Pou told K.J. that
the remaining Lifecare staff needed to evacuate, that the Lifecare patients were in “our
care now” and “you’ve done everything you can.”

So Dr. Pou is now in charge at Lifecare? The accounts by Lifecare staff in the affidavit are remarkably consistent. Is that because they were telling the truth or because they coordinated their stories?

Second Degree Murder is defined under La. R.S. 14:30.1 as the killing of a human
being when the offender has a specific intent to kill or to inflict great bodily harm.

At least one patient who was allegedly euthanized was not otherwise in danger of dying. The accusations warrant the second degree murder charge. Euthanasia is not legal here. That it sometimes happens is beside the point, and Attorney General Foti has apparently gone after people suspected of it at least once before Katrina. In that case, the Grand Jury decided there was no case, but whether you agree with him or not, he is being consistent.

The accusations prove nothing, and as compelling as it is, neither does Angela McManus’ account, because when the police made her leave the Lifecare floor, her mother was alive.

Angela McManus became seriously frightened for her mother when she overheard nurses saying a decision was made not to evacuate LifeCare’s DNR patients. “DNR means “do not resuscitate.” It does not mean do not rescue, do not take care of,” McManus said. She tried to rescind her mother’s DNR order to no avail. 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. New Orleans police confirm that armed officers did evacuate non-essential staff from the hospital.

Confronted by police, McManus raced to her mother’s bed. “I woke her up and I told her that I had to leave, and I told her that it was OK, to go on and be with Jesus, and she understood me because she cried,” McManus recalled. “First she screamed, then she cried. And I said, ‘Momma, do you understand?’ And she said, ‘Yes.’ And she asked me, she asked me to sing to her one more time. And I did it, and everyone was crying, and then I left. I had to leave her there. The police escorted me seven floors down.”

McManus says that when she left, only eight patients, including her mother, remained alive in LifeCare.

That is chilling, compelling, and so far unrebutted. But it neither accuses or proves anything against Dr. Pou and the two nurses. Many people are saying that the charges should be dropped, and that they never should have been filed in the first place. But in reading the following statement, I can understand why Foti wanted charges pressed:

Dr. Pou advised D.R. that she had spoken with Lifecare’s nurse leader (T.M.). Dr. Pou said that the Lifecare patients were not going to survive. However, D.R. advised affiant that Dr. Pou did not appear to be familiar with the condition of the Lifecare patients. Dr. Pou advised D.R. that she was under the impression that the patients were not aware of what was happening. D.R. informed Pou that one patient, E.E., was aware, conscious and alert, but that he weighed 380 pounds and was paralyzed. Dr. Pou decided E.E. could not be evacuated. Dr. Pou asked if one of D.R.’s staff members would sedate him. D.R. advised that they had a nurse who E.E. knew. They briefly discussed the matter with the nurse, but D.R. decided that she did not want Lifecare staff involved. At some point during this conversation, two nurses who D.R. did not recognize came into the room. As D.R. was preparing to leave the room, Dr. Pou asked her if she wanted the Lifecare staff to be there. D.R. responded that she did not want her staff there.

That does not describe a mercy killing or “death with dignity” for someone who could not survive an evacuation. That describes the willful killing of someone too difficult to haul up or down the stairs to evacuate. I don’t know Dr. Pou. She might be Mother Teresa incarnate. But Foti’s got four people (the Lifecare administrators) with a consistent story about the doctor’s actions. MMC nurses have been posting on the NOLA.com boards defending Dr. Pou, but in hundreds of posts there I have not read any by someone claiming to have been in Lifecare and testifying to or refuting these events. If the Lifecare administrators are lying, they should be prosecuted. And if they’re telling the truth and watched these events take place without trying to stop them, they should be prosecuted.
The charges are serious and they need to be answered in court, where I hope it turns out that Dr. Pou and the nurses are exonerated by the facts.

Related posts here.

The hot topic here in N’awlins are the patient deaths/mercy killings/euthanasia/murders that occurred at Lifecare, a company that rented the 7th floor of Memorial Medical Center. I was in meeting yesterday. The deaths were briefly referred to when someone reported that Ochsner hospital had purchased MMC, and someone immediately said, “She’s innocent.” “She” is Dr. Anna Pou. The nurses involved are seldom mentioned. Based on the accounts so far – and Angela McManus’ account has gone unrebutted – it seems clear that patients were purposely killed. But it appears that the main witnesses against Dr. Pou are Lifecare administrators.

Based on [Louisiana Attorney General Charles] Foti’s affidavit, much of the case against Pou and the two nurses is built on statements provided by four LifeCare administrators. Three of the administrators said Pou told them she was going to inject a “lethal dose” of medicine into several patients who appeared on the brink of death and “were not aware of what was happening.”

But according to the affidavit, one of the administrators challenged Pou’s conclusions, telling her that at least one of the patients, 61-year-old Emmett Everett Sr., was “aware, conscious and alert.” The administrator said Pou asked a LifeCare nurse who knew Everett to handle his injection, but the nurse refused.

LifeCare administrators said they watched as Pou, Budo and Landry filled several syringes with an unknown substance in a therapy room and then walked door to door, administering the apparently fatal shots.

No misconduct reports

According to the affidavit, “Dr. Pou appeared to be nervous” as she approached Everett’s room, telling a LifeCare administrator that she was going to tell the patient that “she was going to give him something to help with his dizziness.” Budo or Landry volunteered to help with the injection, the administrator told investigators, but Pou decided to do it by herself.

Budo and Landry, however, assisted in the other injections, according to the LifeCare administrators. One of them told investigators that she saw Budo give a shot to one of the four alleged overdose victims. The administrator said the patient complained afterward, saying: “That burns.”

After all of the shots were administered, Pou allegedly told the LifeCare administrators to clear the floor of their remaining staff workers and cover any dead patients with a sheet. Pou’s parting words, according to one LifeCare administrator, were: “I want y’all to know I take full responsibility and y’all did a great job taking care of the patients.”

That’s damning, however, what do the Lifecare administrators have to gain by Pou being charged criminally for these deaths? At minimum, it would be convenient to blame deaths at their facility on a rogue doctor. Will it give them enough coverage to escape being sued, or to win when sued?

I’ve been inclined to think Dr. Pou is guilty, but it’s important to remember that the facts are not all in. Ten years ago today a chain of events began which profoundly impacted Richard Jewell’s life. He was vilified, mocked, and speculated about by people all over the world, although he was never arrested or charged for the 1996 Olympic bombing and Eric Rudolph eventually pled guilty to the crime. It’s something to keep in mind when we leap to judgement based on reports in the media.

Related posts here.