Katrina Euthanasia Arrest Warrants

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.