Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital

by Sheri Fink

Only a few months after starting, she netted an embezzler and discovered she had a knack for lifting the numerical fingerprints of fraud.

Rider had found her passion—pursuing fraudsters. What had led her to her current, hazardous duty investigator position, which had required police-academy training, was a passion and talent for helping bring wrongdoers who harmed others to justice.

a fraud investigator could work surrounded by reminders of the unbroken strain of patronage running through Louisiana political history. Legendary governor Huey P. Long, known as “Kingfish,” both convinced legislators to build the limestone and marble capitol during the Depression and was assassinated there in 1935.

She had dimples when she smiled, but she cultivated the conservative look of someone dedicated to a life behind the scenes, with a medium build, gray-blue eyes, and natural hair she called dishwater blond. It was the first time she had ever been called before a jury, and she was nervous about going onstage. Schafer, by contrast, was a frustrated actor who loved the sanctioned confrontation of the courtroom; it was practically the reason he had gone to law school.

She did well, and Schafer saw that Rider worked hard because she believed in what she did, not out of a desire to get out in front of others and be recognized for it.

Butch Schafer had visited many hospitals in his life. He had never heard of one that lacked current records. That struck him as curious. Interesting, too, was the presence of heavily armed guards intent on blocking the group.

Not until after the bodies were retrieved and the attorney general’s office launched an investigation did Tenet officials print out medical chart “face sheets” with names, addresses, and family contacts of the dead, and assign various employees to notify them.

The document included guidance for handling tough questions, including why notification was occurring more than two weeks after the deaths: “All information electronic; however, computer server stored in New Orleans. Did not ever plan for a whole city to shut down.”

The employee was to tell each family: “Your loved one was cared for throughout. Your loved one was identified and shrouded and placed in our chapel area. Your loved one was treated with dignity.”

The decision to evacuate after Katrina had been mandated by government officials: “In situations like this disaster, the government takes control. The state retrieved your loved one and brought to the parish’s coroner office. Eventually, all deceased will be taken to St. Gabriel, LA (southwest of Baton Rouge), where a thorough medical exam will be performed and a cause of death will be identified. A death certificate will be available. Once a cause of death has been determined, state officials will contact the family.”

Both women had spent the night of Thursday, September 1, on Memorial’s open helipad with about fifty other staff and family members, including Mulderick’s aged mother, still wearing her housedress. Rescue helicopters had stopped coming after dark, and the group did not reenter the hospital for fear of encountering looters. Armed staff members blockaded the staircases. When a group of people appeared at a hospital window, including wide-eyed children, the armed employees threatened to shoot “the looters” if they came closer.

The next morning, Wynn flew out on a helicopter to the New Orleans airport. It angered and disheartened her to see Mr. Rodney Scott sitting on the concourse in his wheelchair, shivering in a paper gown, without a soul taking care of him. Many of the last push of Memorial patients from the previous evening had not gone far after leaving the hospital.

By contrast, a few of the hospital’s executives, she later learned, had been helicoptered to a nearby Tenet hospital and given a hot meal and a room to shower, shave, and change before being picked up in a helicopter and taken to Hattiesburg, Mississippi, then flown in a private jet to their preferred destinations.

CNN was looking for him, too. He wanted nothing of it. He wished to remain completely unknown. When it came to issues of medical ethics and helping people die—good Gertie, there were people with opinions all over the place! “Anna,” he said, “don’t talk to the news media. Say nothing.” A reporter looking for sensationalism could twist their words in any way. “Hide,” he advised.

Pou hired him on the advice of her employer, the Louisiana State University Healthcare Network, which had used Simmons’s services in another matter. The network agreed to pay Simmons at the same rate, $275 an hour, to defend Pou.

Protecting Pou would mean marshaling the facts and safeguarding them until the time was appropriate to release them. Simmons began constructing what he would refer to as her “defense camp,” and Pou retreated into it. Lines were being drawn. Those seeking to discover and expose the truth were on the other

The US attorney for southeast Louisiana had opened concurrent investigations into the hospital and nursing-home deaths as potential criminal violations of the federal health-care fraud statute.

Getting to the government quickly and disclosing all that was known was the best insurance against criminal charges for the corporation, it was thought.

the mayor had changed his mind and residents would not yet be allowed back into her neighborhood. Meanwhile a new Category Five hurricane, Rita, was mustering in the Gulf. One of the strongest ever recorded, it had a bead on Louisiana, and Mendez, spooked by hysterical television news reports, worried she’d be forced to evacuate again.

“The patients that I had seen, you know, when I was looking at them, I was wondering how much longer it was going to go on because they, it was just so horrible. And, um, in the meantime you have the helicopters and the gunshots and windows crashing and people screaming and, you know, it’s just like total chaos.”

Mendez, in tears, went to gather her colleagues. After having worked so hard to keep their patients alive to be rescued, the floor nurses and aides could not be allowed to see what was going to take place; she felt they would never recover.

The investigators did not press her on why she—a smart, forceful advocate for her patients—had not challenged Pou. Nurses had the duty as professionals, no less as humans, to refuse to implement doctors’ orders that they considered wrong. Mendez explained how her perception of the nexus of control had guided her actions.

Mendez had seen this on TV once and had a name for it, a “bug out,” a decision to retreat at once in the face of the enemy, leaving everything—and potentially everyone less fortunate—behind. Saigon.

Mendez’s account seemed, to her interviewers, consistent with Robichaux’s in every important way. It was remarkable.

What was surprising was that the alleged plan was put into action not when the staff was desperately awaiting rescue, but rather when the evacuation was at last under way.

one another’s stories. They all alleged that Dr. Pou had come up to the seventh floor to end the lives of the nine surviving patients, and two recalled that Pou had told them directly that “lethal” was her intention. The patients had all indeed died. But had the plan actually been carried out? Why, and who was involved besides Pou? Who were the unnamed nurses? What Rider and Schafer needed to see was whether physical evidence corroborated the allegations.

To get a warrant, they had to convince an Orleans Parish District Court judge that a crime was likely to have occurred there.

She submitted it with an application for a warrant to search for items “necessary in order to prove the crime of second-degree murder.” Louisiana’s legal definition of second-degree murder included murder with the specific intent to kill. Everyone seemed to agree, in light of the circumstances of Katrina, that they weren’t going to seek the death penalty and thus there was no need to charge first-degree murder. Lesser charges of manslaughter or negligent homicide could always be brought.

The hospital spanned two city blocks and still had no electricity.

Rider carried a duty belt around her waist laden with flashlights, a radio, handcuffs, pepper spray, and firearms with extra magazines—her typical search-warrant raid gear. Some colleagues wore blue gloves and breathed in the faintly medical smell of a respirator mask that covered their noses and mouths and made each breath feel somewhat suffocating. It was hard to walk, let alone climb stairs in the heat,

When everyone else wanted to do something, Rider was inclined to do something different.

A forensic scientist prepared an inventory of morphine. Agents seized pharmacy records, including the three prescriptions for large amounts of morphine dated September 1, 2005, and signed by Dr. Anna Pou.

What struck Schafer the most was the smell of death. It was everywhere in the hospital; if you’d smelled it, you could never forget it.

Some news stories had suggested the hospital had run out of food and water. It astounded Schafer to see water bottles stacked to the ceiling. There were canned goods in the kitchen and food and beverages stashed and scattered throughout the hospital. After hearing the stories of looting in New Orleans, it shocked him to see that nobody had even been desperate enough to clean out a vending machine. Those sheltering ...

It amazed Rider to see the hospital’s main generators sitting well above flood level. She assumed they were functional. Why hadn’t the staff figured out how to bypass the submerged parts of the electrical system and drive power to important patient-care areas and equipment? She couldn’t help thinking her self-reliant family of South Central Louisianans would have figured out a way. Some people depended too much on the government to help them. The search team found

and would go to the state’s High Technology Crimes Unit in the hopes that important records might be found.

A daughter of Savoie’s, Lou Ann Savoie Jacob, had come to New Orleans to visit her and had been with her until the storm approached. Rose was sitting up and talking, with no IVs, recovering well, it seemed to her. Learning of her death, after a difficult search, had surprised the family.

Wilda McManus’s daughter Angela, and Elaine Nelson’s daughter, Kathryn—the two who had stayed with their mothers on the LifeCare floor until Thursday, September 1—were also eager to assist the investigators.

A volunteer coroner from Wisconsin had told Nelson an autopsy had been performed on her mother. Nelson asked why. The coroner said euthanasia was suspected.

opinion. Her mother was extremely strong and believed in always doing right, the kind of lady who slipped a dollar into each purse she donated to Goodwill so that whoever ended up with it would have a little something extra. Kathryn had no doubt her mother would want the truth to emerge.

Butch Schafer sympathized with Nelson, even given her mother’s short life expectancy. Weeks earlier, looking down at his daughter’s coffin, speaking at her funeral, he’d said he would give everything that he owned, everything that he would ever have, everything that he was, for five minutes more with her then.

He could not allow his personal grief to influence the investigation, but that grief always accompanied him, always awaited him as he filled his time and his mind with work. In Nelson’s loss, he recognized his own, and he experienced it again.

It was like a knife, death. Always wa...

Minyard grudgingly agreed to ask a federal disaster mortuary team to perform autopsies and take tissue samples from all the hospital and nursing-home patients who had died in Orleans Parish after Katrina—about one hundred in total, it first appeared. The attorney general’s office had received allegations of wrongdoing at several of the facilities.

The strength of their case depended on the news the forensic toxicologist was about to deliver, the answer to whether the LifeCare patients had died with detectable levels of morphine and other sedative drugs in their bodies.

of the eighteen cases today, nine of them are positive for morphine and a number of them, I guess about another five or six, are positive for midazolam.”

“First one where morphine is found is a Harold Dupas, D-U-P-A-S.” “Yes sir,” Schafer said. Dupas was one of the nine patients the LifeCare staff had believed were injected by Dr. Pou or the two Memorial nurses who came up to the seventh floor on Thursday, September 1. “Next is a Hollis Ford [Hollis Alford]; Wilda McManus; Elaine Nelson; Emmett Everett; Alice Hutzler, H-U-T-Z-L-E-R; Rose Savoie, S-A-V-O-I-E; Ireatha, I-R-E-T-H-A [sic], Watson; and George Huard, H-U-A-R-D. I apologize for the pronunciation.” It was stunning. Of the eighteen samples tested, those positive for the two drugs coincided exactly with the names on the attorney’s list of suspicious deaths. And the laboratory hadn’t been told which names were on the list.

Middleberg had called the morphine concentrations “pretty darn high.” Rider and Schafer would remember those words.

AS UPLIFTING as it was to gather the evidence needed to pursue justice, much remained ahead of them, and Butch Schafer knew from experience that even the most promising new case usually doesn’t end up the way you think it might. “Don’t. Get. Emotionally. Involved,” he warned Virginia Rider.

Only weeks had passed since he lost his daughter. She had lived with an aggressive form of rheumatoid arthritis and died in her sleep after too many doctors prescribed too many drugs to treat her pain. Toxicology results suggested that the medicines, magnifying one another’s actions, had killed her in an accidental overdose. Schafer was furious to learn that the pharmacy that had filled nearly all of her prescriptions had not cross-checked them.