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

On Monday evening, July 17, 2006, Dr. Anna Pou is arrested by a team led by Rider; she is booked for the second-degree murder of four Memorial hospital patients. Pou is released on $100,000 bond. Nurses Landry and Budo are also arrested. Tenet will pay for their defense but also fires them. 

The next day at a press conference, Attorney General Charles Foti says: “We’re talking about people that pretended that maybe they were God” (334). He continues: “This is not euthanasia. This is plain-and-simple homicide” (334). 

Pou’s attorney, Richard Simmons, holds a press conference, where he reminds the press that formal charges must be brought by the New Orleans district attorney. He sidesteps questions about euthanasia with a simple dismissal—“There’s no criminal conduct”(336)—and maintains that his client is completely innocent. He defends Tenet, insisting that “the hospital company had rescued patients from Memorial and the state had not” (336). 

There is plenty of blame to go around for the tragedy, including poor planning, defective levees, lack of resources, turf battles, and communication breakdowns. Reports of looting and other crimes, which led to orders to many first responders to abandon their posts, turn out to have been exaggerated. 

The public sends letters of support and criticism; a debate rages in the media. One asks: “What were they supposed to do, let their patients suffer and die in misery?” Another says: “Who are you to decide whether or not my misery is enough for you to put me out of it without my consent or permission?” (340).

Legal defense funds and public relations campaigns are launched to support Dr. Pou and the nurses. Meanwhile, relatives of patients who died file lawsuits against the hospital, Tenet, and LifeCare; one becomes a class-action effort. Some lawsuits name individual doctors and nurses: “The suits variously alleged euthanasia, inadequate backup power supply, failed evacuation policies, and abandonment” (359). 

Angela McManus speaks often with the news media about the death of her mother, Vera, at Memorial, declaring: “Euthanasia is something you do to a horse, or to an animal. When you do it to people, it’s called murder” (361).

NBC airs a report about Lindy Boggs Medical Center, another Tenet hospital in New Orleans that suffered conditions similar to Memorial after Katrina and whose staffers and rescuers decided, as had Memorial, to evacuate the worst patients last. Agent Rider learns that some staffers had dressed themselves as patients to hasten their own rescue, and that doctors discussed euthanizing patients. Similar events apparently occurred at other nearby medical facilities, where some bodies were found with high levels of morphine and midazolam, as at Memorial. 

An exception is Charity Hospital, which is better prepared for Katrina, does better at organizing and using its available resources, and—despite a much higher population—loses only ten patients: “The sickest were taken out first instead of last” (371). 

CBS program 60 Minutes interviews Dr. Pou and Attorney General Foti. “Pou’s appearance was a sensation” (737), but Foti comes across as a fool. The American Medical Association expresses its support for Pou. Attorney Simmons and others orchestrate public relations campaigns on her behalf. An episode of Boston Legal depicts the trial of a Pou-like defendant, who is found not guilty. 

Orleans Parish coroner Dr. Frank Minyard reviews the evidence and ponders the history of euthanasia and recent court precedents on induced deaths. He agonizes over the case; in February of 2007, despite the fact that the deaths in question appear to have been caused by a person, he “finds no evidence of homicide” (396). 

Agent Rider confronts Minyard on his decision; the coroner replies that “he had to consider what was best for his city, whose reputation had already suffered so much damage” (397). Rider believes his reasons are corrupt: she “had never witnessed the level of politics that she had seen in this case” (397). Disappointed, her work done, Rider quits the agency and finds another job. 

Organizers put on a dinner-dance fundraiser in Houston for Dr. Pou. Tearfully, Pou tells the audience: “If it would not be for you…I would not be standing here today” (406). 

The Orleans district attorney won’t press charges against nurses Landry and Budo, along with nurse managers Mary Jo D’Amico and Karen Wynn, but subpoenas them to testify before the grand jury “so he could find out what they knew about Anna Pou” (411). The nurses’ testimony would be immunized so that prosecutors could not use it as evidence against them, but their lawyers appeal, arguing that the city could later bring charges using other evidence, as occurred with seven police officers who testify under immunity and later are cited for murder during a post-Katrina shooting. The appeal is denied. 

Landry and Budo testify that they had injected seventh-floor patients with morphine and midazolam on the assumption that they wouldn’t survive anyway. The jury appears sympathetic to them. Nurse manager D’Amico, on the other hand, testifies that the LifeCare nurses “were ‘sleeping on the job’ on the second floor on Tuesday night” (422). 

Much incriminating evidence, including testimony from “pathologists, toxicologists, coroners, and the medical ethicist—Frank Minyard’s forensic all-stars” (422), is not presented. Also missing are reports from relatives of the deceased “who had been made to leave LifeCare just before the injections took place” (423). 

Dr. Thiele, who had injected patients alongside Dr. Pou, fears arrest. His legal fees mount up; stressed, he ignores abdominal pains that turn out to be severe colon cancer. Hospitalized, “Thiele passed weeks in a half-conscious limbo” (428); miraculously, he gets better and becomes a classic case of a patient with little prospect of survival who recovers. 

Dr. Baltz attends a rally in support of Dr. Pou and the nurses. He is troubled by their stance: “By warning that an indictment would lead medical professionals to leave New Orleans, Pou’s supporters were threatening to abandon their patients if the issue wasn’t resolved to their satisfaction” (429). Baltz calls it a “euthanasia rally” (429). 

On July 24, 2007, the grand jury returns its decision: it has “declined to indict Pou on every charge” (432). In September, St. Rita’s nursing home owners are acquitted “on all thirty-five counts of negligent homicide and twenty-four counts of cruelty to the infirm that Foti had brought against them” (434). Several weeks later, Foti loses his re-election bid. Before he leaves office, Foti “released the forensic experts’ findings to the media” 437). 

All state and federal investigations into post-Katrina hospital and nursing home deaths are closed down. Civil lawsuits continue, however. Efforts by the media to view “the balance of the Medicaid Fraud Control Unit’s thousands of pages of investigative records”(437) are turned down by courts. 

The State of Louisiana reimburses Dr. Pou and her employer, LSU, for their legal expenses, totaling more than $450,000: “The class action suit against Memorial and Tenet was settled before trial for $25 million with no admission of wrongdoing” (437). The settlement is distributed among Memorial and LifeCare patients and staff; Dr. Pou receives about $10,000