Memorial Hospital Euthanasia Update

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.

In New Orleans and elsewhere, many — including numerous physicians and the AMA — sighed in relief, hoping to put the nightmare — which many regarded as a gross injustice against heroic health care workers in unimaginably difficult circumstances — behind them.

But CNN is reporting that the issue may not be put to bed quite so easily:

A New Orleans grand jury that declined to indict a doctor on charges that she murdered patients in the chaotic days after Hurricane Katrina never heard testimony from five medical experts brought in by the state to analyze the deaths.

All five concluded that as many as nine patients were victims of homicide.

In detailed, written statements, the five specialists — whose expertise includes forensic medicine, medical ethics and palliative care — determined that patients at Memorial Medical Center had been deliberately killed with overdoses of drugs after Katrina struck New Orleans in 2005.

The grand jury had been asked to consider second-degree murder charges against a doctor and two nurses in four deaths. But in July, the grand jury decided that no one should be indicted…

In a decision that puzzled the five experts hired by the state, New Orleans District Attorney Eddie Jordan never called them to testify before the grand jury.

The experts themselves were puzzled and frustrated to have their evidence ignored:

“They weren’t interested in presenting those facts to the grand jury,” said Dr. Cyril Wecht, the former coroner of Allegheny County, Pennsylvania, and a past president of the American Academy of Forensic Scientists.

“The hard scientific facts are those from five leading experts, [the patients died] from massive lethal doses of morphine and Versed. As far as I know the toxicological findings were not presented to the grand jury and certainly not with quantitative analysis.” …

“I was never called to the grand jury,” said Caplan. “As far as I know, the grand jury never saw my reports. As far as I know, none of the reports prepared by these experts, who looked at all the cases, who were independent, and came to the conclusion that massive amounts of drugs were used as the cause of death and that they couldn’t have been requested [by the patients], they had to be given involuntarily. That’s evidence that I think a grand jury would want to be familiar with before it made its decision as to whether or not to proceed with an indictment.

“Now you can still get into a dispute about the evidence,” Caplan added. “You can get into a dispute about the circumstances and all the rest of it, but at face value there is no other conclusion I think that’s possible, other than these people — or someone — killed them.”

Dr. Pou testified that she had sedated patients to keep them comfortable in the intolerable conditions; the forensics experts found this an implausible explanation:

“The primary and immediate cause of death for each of these patients was acute combined drug toxicity, specifically morphine and Versed,” wrote Wecht. “The manner of death would be classified as homicide.”

“Large doses of these drugs were present in patients and the administration of the drug was not documented,” wrote James Young, the former chief coroner of the province of Ontario, Canada, who, like Wecht, once served as president of the American Academy of Forensic Sciences.

“Accidental overdoses would need to have occurred nine times between 12 noon and 3:30 p.m., all on one floor, to every patient who was left on the floor,” Young wrote. ” Again, it is noted that morphine was not ordered for seven of the patients and Versed was not ordered for any. Therefore it seems highly unlikely that nine patients died on the same floor on the same afternoon of accidental overdose.”

Caplan wrote that there was no evidence any patient asked to be given assistance in dying, and no evidence that any consented to be given an overdose of medication to end their lives.

“In reviewing the facts and opinions, my conclusion is that the deaths of the nine persons at Memorial Medical Center in New Orleans are all cases of active euthanasia,” Caplan wrote. “Each person died with massive doses of narcotic drugs in their bodies.”

The grand jury’s findings remain secret, although there are legal challenges to disclose them. The experts’ summary, however, also includes some chilling testimony, although the witnesses are not identified:

In its executive summary report included with the forensic experts’ findings, the attorney general’s office paints a chilling picture of what its investigators say happened four days after the hurricane hit New Orleans.

The summary cites a number of people — whose names are blacked out in the report — as having offered statements through their attorneys and having sought immunity from prosecution.

The summary states that Pou told the nurse executive of Lifecare, the acute care facility on the seventh floor of the hospital that housed the nine patients, that “a decision had been made to administer lethal doses of morphine to Lifecare patients.”

According to the report, none of the nine was a patient of Pou’s and there was no indication she had talked to their doctors before seeing them on the day they died.

The attorney general’s report also said that other medical personnel told Pou that one of the patients, Emmett Everett Sr., was conscious and alert. Everett was 61 years old, weighed almost 400 pounds and was confined to a wheelchair.

“Dr. Pou decided (patient name blacked out) could not be evacuated. He could not be taken out by boat because he was not ambulatory and Dr. Pou felt he was too heavy to be evacuated by helicopter,” according to the report.”

While we may never know the exact details of what happened at Memorial Hospital, the ghosts of that tragedy may continue to haunt us for years to come.

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