Mercy—or Murder?

updated 08/07/2006 AT 01:00 AM EDT

originally published 08/07/2006 AT 01:00 AM EDT

Two days before Hurricane Katrina struck last summer, Paulette Harris visited her mother, Ireatha Watson, at a New Orleans hospital. "She didn't seem stressed or anything. She was just her," says Harris, 49. They went through their usual routine on Memorial Medical Center's seventh floor, where Watson, 89, was one of some 60 severely ill patients in an acute-care unit run by LifeCare Hospitals. Suffering from Alzheimer's disease and gangrenous legs, Watson sat peacefully while her daughter brushed her hair, then put lotion on her hands and elbows. As she left, "I kissed her on the forehead and told her, 'Now remember, no cutting up,'" Harris recalls. "That was the last time I saw her."

Nearly four frantic weeks passed before Harris finally learned her mother's fate, when an official from a temporary morgue in St. Gabriel, La., called to say Watson's body could be released to a funeral home. With the hospital closed and no other information available, Harris assumed heat stroke had claimed her mother's life; after all, 34 patients died at Memorial, where temperatures climbed above 100°F inside the building before it could be evacuated. Recently, Harris has confronted a more painful possibility: That Watson's caretakers may have intentionally killed her. On July 17 Louisiana's highest law-enforcement official, Attorney General Charles Foti Jr., ordered the arrests of a doctor at Memorial, Anna Maria Pou, 50, and two nurses, Cheri Landry, 49, and Lori Budo, 43, for allegedly using a lethal cocktail of drugs to kill four patients: Watson, Hollis Alford, 66, Rose Savoie, 90, and Emmett E. Everett, 61. Foti said none of the patients had been given the drugs in question, morphine and the sedative Versed, before the storm. "This is homicide, not euthanasia," he said. "We're talking about people who were maybe pretending they were God."

Through their lawyers all three of the women (since released on bond) have denied committing homicide and refuse to discuss the case publicly. They were at work Sept. 1, when the patients were allegedly injected, the same day that the last of more than 200 patients stranded at Memorial by 12 feet of water were evacuated by helicopter. Rick Simmons, who represents Dr. Pou, says his client volunteered to work the storm despite her husband's wishes. "There was no criminal activity," said Simmons. "The state of Louisiana abandoned the hospitals, doctors, the nurses and these patients.... There's no motive here and there's no homicide."

News of the arrests provoked sharply mixed reactions in New Orleans. As the city's district attorney initiated his own investigation into the four, and possibly more, deaths, many citizens and supporters held up the health workers, all New Orleans natives, as heroes who remained on the job while politicos and other would-be rescuers fumbled. Dr. Pou (pronounced poe), a prominent surgeon and researcher in the treatment of head and neck cancers, is known for readily taking her patients' calls, say colleagues. Landry, who lives with her elderly mother, and Budo, a married mother of two, were both born at Memorial and had worked there for 20 years. Together they organized Christmas parties and baby showers for other nurses, they were known for calm under pressure, and when Katrina loomed, they volunteered to work. "These are the nurses all the other nurses looked up to," says former Memorial nurse Robyn Helmstetter, 48. "If these were any two other nurses, I might feel different. These are heroes to me."

But serious questions remain about the deaths of patients at Memorial, where catastrophic conditions put every staffer to the test. On Monday, Aug. 29, as the storm raged, some 2,000 people took shelter in the complex of buildings, including patients, staff, their families and even pets. When the levees breached and water started to fill the city the next day, Memorial became an island with no food or drinking water. Toilets overflowed, and there were no working phones, no electricity and, eventually, no e-mail. Nurses even resorted to manually operating ventilators after their batteries died. Hospital staff fashioned hammocks out of bedsheets to carry patients down six flights of stairs to reach the parking garage; from there they were driven on a truck up to the roof for evacuation by helicopter. Some staff left to take care of their own, but Pou, Budo and Landry remained. Recalls a nurse who was on duty, Julie Campbell: "Cheri and Lori were up and down those stairs, red in the face, putting great effort into saving lives."

Mark LeBlanc, whose 82-year-old mother had been admitted the previous week with advanced Parkinson's, arrived at the hospital on Aug. 30 and found his mother in failing health in the acute-care unit run by LifeCare, where only the sickest patients were left. "We had to break the windows to get some air in there," he recalls. When he asked about the care his mother was getting, LeBlanc says a staffer replied chillingly: "They said, 'We're no longer giving medical care to your mother. We're no longer in medical mode; we're in survival mode.'"

By Sept. 1 just a few patients were left. An affidavit filed by Attorney General Foti based on multiple accounts of events at Memorial claims that Pou told a LifeCare employee "a decision had been made to administer lethal doses" to the remaining patients. The document describes how Pou, Landry and Budo methodically prepared to inject the patients. In one case, Foti's affidavit alleges, Pou walked into the room of patient Emmett Everett, who was paralyzed and weighed 380 lbs. Saying she was going to give him something for his dizziness, Pou closed the door behind her. Budo, the affidavit says, injected bronchitis patient Rose Savoie, who responded by saying, "That burns." Pou allegedly told LifeCare personnel, who weren't involved in the injections, "I want y'all to know I take full responsibility."

Foti's affidavit asserts that his investigators found evidence of a lethal combination of drugs in autopsy samples from the four victims. But Steven Miles, M.D., a medical ethicist at the University of Minnesota familiar with the techniques frequently used by doctors to comfort dying patients (see box), suggests the presence of strong sedatives may merely mean the staff at Memorial was trying to treat a painful condition. "The doc has to increase the drug dose [to keep up with the patient's pain]. Then a person dies, so it's easy to say the person died because of the increased dose," Miles says. "But really, the person died because they were going to die anyway." On the other hand, Arthur Caplan, director of the University of Pennsylvania Center for Bioethics, says it's possible the "doctors felt the patients were frail, there was no relief coming, and they decided—before the patients on ventilators suffered, gasping for air, which is a painful, horrible thing—they would kill them. It's impossible to justify."

It will be up to investigators—perhaps even a jury—to determine what actually happened. Already, the family of alleged victim Rose Savoie is incensed by what they have learned. "It's hard; it's very, very hard," Lou Ann Savoie Jacob, Rose's daughter, says between sobs. Similarly, the loved ones of Ireatha Watson—who was awaiting amputation of her legs but had no immediate life-threatening condition, they say—are awaiting the day that someone is held accountable for her death. Her survivors plan to file a wrongful-death suit against the hospital's owners and perhaps the three caretakers. "It is unthinkable for the family that her health-care providers would do anything to deliberately cause her death," says their lawyer Edward Gothard. Nearly 11 months after Watson's death, it's still just as unthinkable to her daughter Paulette Harris. Harris cut short an interview with PEOPLE, overcome with emotion. "She was the only person who cared so much about me," Harris said through her tears. "I miss her so much."

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