Former Attorney General Foti Investigation into Memorial Hospital

 

A. The Hurricane Katrina Experience (August/September 2005)

During a five day period from late August into September 1, 2005, while 200 patients were trapped by Hurricane Katrina flood water surrounding Memorial Hospital in New Orleans, all power went out, temperatures soared in excess of 105 degrees, lack of sanitation created a rancid smell and no running water was available, basically transforming the hospital in a site for “third world medicine.”

On the morning of September 1, 2005, Dr. Pou was informed by the Tenet incident commander that “no help was coming” and apparently the hospital was to be abandoned. Dr. John Kokemor, who also heard this statement from Tenet’s incident commander told 60 Minutes he was “dumbfounded”. Dr. Pou and two nurses, after consulting with the incident commander in charge of evacuation and others, in some instances administered morphine and a sedative to a number of these bedridden acute-care patients on the seventh floor. The medical records of these patients reflect their serious medical conditions: (e.g. a 91 year-old with 106 degree temperature and agonal breathing, another patient with 104 degree temperature and a prior “Code Blue” 24 hours earlier, etc.) which deteriorated with each passing hour.

B. The Arrest of the St. Rita’s Nursing Home Operators, Causes a LifeCare Corporation Response

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In early September 2005, former Louisiana Attorney General opened an investigation into unrelated deaths at a St. Rita’s nursing home in St. Bernard Parish. At that location, over 30 nursing home patients lost their lives due to flooding. On September 13, 2005 agents for the Attorney General’s office arrested the two owners of St. Rita’s Nursing Home. This arrest made the national news as an important development in the wake of Hurricane Katrina disaster.

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On the day after the arrest of nursing home defendants, LifeCare’s corporate counsel contacted the Attorney General’s office to report “possible” euthanizing of patients at Memorial Hospital.

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This was the beginning of the corporate finger pointing between Tenet and LifeCare as to who was responsible for the failure to evacuate the Memorial and LifeCare patients. Fear of corporate and individual liability for the 24 LifeCare deaths at Memorial caused corporate counsel for LifeCare to step forward with statements from LifeCare personnel pointing the finger at Dr. Pou and the Memorial nurses. From a corporate standpoint, LifeCare had liability exposure and had to explain: (1) why it had not evacuated the Chalmette (St. Bernard) patients (e.g. Ms. Savoie and Mr. Alford) from the Chalmette (St. Bernard) facility to another facility outside of New Orleans, instead of the 7th floor of Memorial Hospital; (2) why the LifeCare Medical Director evacuated leaving only staff members to treat the 50 acute care and elderly patients on the 7th floor; (3) why no rescue effort was undertaken prior to August 31st, 2005. (LifeCare indicated its attempts on August 31st to do so were dwarfed by the Government’s “limitations on airspace” - why not try earlier?) and (4) why no doctor was provided for Lifecare patients.  

Dr. Pou and the two Memorial nurses were caught in the “cross fire” between the former Attorney General’s investigation and two corporations with massive exposure for a large number of patient deaths. It is against this background that the criminal investigation began and the “arrest affidavit” and the statements contained therein surfaced.

C. The Arrest Affidavit

While the arrest affidavit seems to imply that Dr. Pou commandeered the 7th floor in order to kill patients over the objection of LifeCare staff, why would the LifeCare pharmacist (Harris) first, suggest the use of Versed for the remaining patients, and second why would the LifeCare pharmacist go to the LifeCare pharmacy to obtain Versed and Morphine? Additionally, in the arrest affidavit, many of the distorted “statements” attributed to Dr. Pou must be examined as an effort to avoid corporate liability, while other statements must be read against the chaos and confusion during events which have led to incorrect conclusions regarding Dr. Pou’s intentions.

According to one of the LifeCare nurses, the Tenet incident commander, Susan Mulderick, told her “the plan is not to leave any living patient behind” and told her “to see Dr. Pou”. Dr. Pou denied hearing Mulderick or anyone else state that the plan is to “leave no living patient behind.” This alleged ambiguous statement could be interpreted either as an effort to evacuate everyone or as an effort to make sure all patients were deceased before departure. Apparently, LifeCare staff, based on discussions with Mulderick, misinterpreted Dr. Pou’s actions and intentions.

The arrest affidavit quotes one of the LifeCare employees as observing Dr. Pou as “nervous”. How can one imply from someone else’s demeanor that wrongful conduct was being engaged in?  Would anyone suggest that after four days of being abandoned by the Government and comforting dying patients, someone would be in a happy mood? One of the physicians observing Dr. Pou, on the afternoon of September 1st, Dr. John Walsh, stated that “Dr. Pou was no more or less upset than anyone else who had been through such an ordeal”. The insinuation that by appearance something sinister was occurring is not justified.

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D. The Arrest and the News Conference

On September 11, 2005, mortuary workers began recovering decomposing bodies from Memorial Hospital. Upon discovery of over thirty-four bodies at Memorial, rumors of “euthanizing patients”, and the call from LifeCare’s corporate counsel in the wake of the arrest of the owners of St. Rita’s Nursing Home, Attorney General Charles Foti commenced a criminal investigation into activities at Memorial Hospital. The LifeCare witnesses were brought in lock step to the Attorney General’s office, to provide statements. A media frenzy, led by CNN, soon erupted and Dr. Pou’s name was mentioned as a “person of interest.”

Despite a prior agreement between her counsel and Attorney General Foti that she would be allowed the dignity of a self-surrender should an arrest be a reality, Dr. Pou was arrested and handcuffed as a common criminal at her house after a long day of surgery at a Baton Rouge Hospital.

The day after her arrest, Foti held a widely publicized press conference where he declared that Dr. Pou and the two nurses “pretended they were God” and gave “lethal cocktail” injections of morphine and Versed to at least four patients at Memorial Hospital. Two days after the arrest, while A.G. Foti held a political fundraiser at a premier hotel in New Orleans, Dr. Pou and her counsel met with “60 Minutes” staff and agreed to an interview.

Initial CNN reports contended that Dr. Pou and two nurses hastened the death of the patients in order to evacuate themselves. Contrary to these reports, Dr. Pou, even though she was exhausted climbed the stairs to the LifeCare unit twice that afternoon to check on and care for patients.  Dr. Pou left the hospital on one of the last helicopters out on Thursday, September 1.

There was a forensic battle over the autopsy and laboratory results between two of the Attorney General’s experts. Dr. Cyril Wecht (who also happened to be a commentator for CNN) believed he could classify the deaths as murder and an internationally known pathologist, Dr. Steven Karch, hired by the State, whose opinion was favorable to Dr. Pou but suppressed for several years. Dr. Karch who believed that the deteriorated conditions of the patient’s bodies, which were recovered from Memorial weeks after the storm, could not support the Attorney General’s “lethal cocktail” theory and the contention that drug concentration in the decomposed bodies was indicative of homicide.

Finally, in July 2007 the matter was presented to a New Orleans Grand Jury which rendered a “No True Bill” as to the nine counts of murder against Dr. Pou. Foti, who was up for re-election, still refused to accept this result, and released to the public his expert reports, but failed to disclose Dr. Karch’s opinion, which the Grand Jury obviously found credible.

E. Foti’s Hidden Opinion of Dr. Steven Karch Becomes Public

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Dr. Karch received his undergraduate degree from Brown University, attended graduate school in Anatomy and Cell Biology at Stanford University, and his MD from Tulane University School of Medicine in New Orleans. He did postgraduate training in neuropathology at the Royal London Hospital, and in Cardiac Pathology at Stanford University, Palo Alto. He was an Assistant Medical Examiner in San Francisco for nearly 10 years. In 2006 he was elected a fellow of the Royal College of Physicians, Faculty of Forensic and Legal Medicine, and in 2007 he became the only American elected to the Italian Academy of Forensic Toxicology.

He has written more than 100 peer-reviewed papers and book chapters, most having to do with the investigation of drug-related deaths. He has published 10 books. The 4th edition of his textbook, Karch’s Pathology of Drug Abuse is a best seller and is used around the world.

Dr. Karch a fellow of the American Academy of Forensic Sciences (AAFS), the Society of Forensic Toxicologists (SOFT), for the last decade he has taught the toxicology component of the U.S. Army’s basic course in Forensic Pathology.

Dr. Karch was hired by the British government to help with the prosecution of Dr. Harold Shipman, the world’s worst serial murder. Dr. Karch helped to obtain the conviction of Dr. Shipman who was convicted of having fatally poisoned 248 of his patients. He has testified in alleged cases of euthanasia in courts around the world.