Episode 13 - Memorial, Part 3: The Ethics of Murder

New Orleans, Louisiana. August, 2005.

As the temporary residents of Memorial Medical Center reach their limits, choices must be made on what to do next. With no rescue efforts in sight, and supplies running out, the hospital staff must decide what to do with the rest of the patients who hadn’t been evacuated yet.

Key Players:

Tenet Hospital - Texas hospital chain that owned Memorial

LifeCare - A specialized hospital with multiple locations, including a leased space on the seventh floor at Memorial Hospital

John Thiele - Specialized in critical care and diseases of the lungs

Anna Pou - Surgeon, specializing in head and neck cancers, who remained at the hospital during Katrina to offer specialized care for those in need that couldn’t be provided by many others

Karen Wynn - The nurse manager of the ICU and head of the hospital’s bioethics committee

Susan Mulderick - The rotating hospital manager on call during the hurricane

Ewing Cook - Chief Medical Officer

Cheri Landry - Surgical ICU nurse

Lori Budo - Surgical ICU nurse

Victims:

Emmett Everett

  • A paraplegic patient who weighed 380 pounds, so there were some concerns about evacuating him through the 3x3 space they had to maneuver patients

  • Several medical and staff members helping with the rescue efforts that day said they’d never even been made aware of him and would’ve figured something out

  • He was transferred to the LifeCare location in Memorial due to the hurricane and had been awaiting colostomy surgery to ease chronic bowel obstruction

  • Was “very aware of his surroundings” and had fed himself breakfast that morning

  • He was 61 years old and had been a paraplegic since he was 50 due to a freakish spinal-cord stoke

  • He maintained a good sense of humor and a rich family life

  • He didn’t have a DNR order

  • He had complained of dizziness that morning, but that was his only complaint

  • He did appeal to his nurse several times “not to leave him behind” though regarding the rescue efforts

  • Pou entered his room and shut the door

Alice Hutzler

  • 90 years old

  • Suffered from heart disease, diabetes, dementia, and who was partially paralyzed due to a prior stroke

  • She was recovering from pneumonia and bedsores she’d contracted ata nursing home

  • Morphine and midazolam were found in her system, but neither drug had ever been prescribed to her, according to her chart which contained notes until the night before her death

  • There were no notes indicating she’d had any pain or distress either

Rose Savoie

  • 90 year old woman with acute bronchitis and a history of kidney problems

  • She commented “That burns” upon being injected by a nurse

Jannie Burgess

  • Her daughter flew to New Orleans from the Netherlands after hearing her mother’s uterine cancer had spread and was inoperable

  • 79 years old

  • Had worked as a licensed practical nurse for 35 years in New Orleans hospitals and nursing homes

  • She grew up in the area while there was still heavy racial segregation and while she could work at many of the private hospitals, she was ineligible to receive care in them years prior

  • She had a “Do Not Resuscitate” order when the spread of her cancer was realized and was on the verge of needing dialysis; she decided that she didn’t want to pursue further treatment and was now being made comfortable

  • She had a DNR order

  • Day 4 - The support machines keeping her alive failed and she began to breathe irregularly, sometimes going 15 seconds without inspiration

  • She was also weighed down by fluids from her diseases

  • Cook says he came to several conclusions

    1. There was no way he’d make it back up to the ER after how hard of a time he’d had getting up there this time

    2. Given how exhausted everyone was and how heavy the woman was with the excess fluids, it would be “impossible” to transport her for rescue

    3. Even in the best of circumstances, she likely had only a day or so to live

    4. The nurses with her were needed elsewhere

  • Cook felt the difference between murder and medical care lay behind intent

  • He often provided morphine to patients who were taken off ventilators to help ease the way, but it quickened the death at the same time

  • In this case he felt it was a little different because the woman seemed comfortable despite her current state, but he asked one of the nurses to up the morphine she received until she passed

  • He wrote on her paperwork “no respirations or cardiac activity, pronounced dead at” and left the space blank before signing his name

  • He later said the choice had been a “no brainer” and “I gave her medicine so I could get rid of her faster, get the nurses off the floor” and “there’s no question I hastened her demise”

Wilmer Cooley

  • 82 year old African American man

  • Former truck driver

  • Had heart problems and a serious infection requiring dialysis

  • DNR

  • Pou wrote one of her high dose prescriptions for him

Carrie Hall (“Ma’Dear”)

  • LifeCare patient

  • Had a tracheostomy who had reached out to one of the nurses for help with her symptoms during the hurricane, impressing the nurse with her will to survive

  • Pou wrote one of her high dose prescriptions for her

Wilda McManus

  • Had a serious blood infection

  • Daughter was Angela McManus

  • She had to be physically escorted away from her mother’s bedside by two police officers leveling sawed off shotguns at her

  • Wilda asked her to sing for her before she left and she obliged

  • Angela was convinced her mother was dying

  • She had a DNR order her daughter had tried and failed to rescind

  • Pou was heard telling her “I am going to give you something to make you feel better”

Unnamed Elderly Woman

  • Karen Wynn said she found an elderly woman who was unconscious with labored breathing who she injected with the dangerous cocktail

  • The woman died a short time later

  • She said she didn’t feel bad about what she did because the woman had appeared close to death and she felt all she could offer at that point was “comfort, peace, and dignity” and that it had been the right thing to do under the circumstances

Sources:

Five Days at Memorial. Book by Sheri Fink. Published in 2013.

“The Case of Dr. Anna Pou: Physician Liability in Emergency Situations” - AMA Journal of Ethics article by Ryan Bailey. September 2010.

“The Deadly Choices at Memorial” - New York Times article by Sheri Fink. August 25, 2009.

“Effects of Hurricane Katrina in New Orleans” Wikipedia Article

“Hurricane Katrina” Wikipedia Article

Satellite images of flooding

Cleanser:

Villalobos Rescue Center Website

The forgotten dogs of Katrina: Fresh appeal to help pets abandoned in the wake of the devastating storm as it's revealed many are still waiting for a home TEN YEARS later - Daily Mail article by Wills Robinson. August 29, 2015.

“‘Pit Bulls and Parolees’ shines light on dogs in New Orleans” - Lubbock Avalanche-Journal article by Stacie Plaisance. November 3, 2013.

Animal Planet: About ‘Pit Bulls and Parolees’

“Pit Bulls and Parolees” Wikipedia Article

Ted Bundy Poem (Music: Night on the Docks - Sax by Kevin MacLeod is licensed under a Creative Commons Attribution License)

Social Media:

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Intro Music:

She-Wolf In My Heart (bonus) by Sergey Cheremisinov is licensed under a Attribution License.

Outro Music:

Trio for Piano Violin and Viola by Kevin MacLeod is licensed under a Creative Commons Attribution License.