2007 Memorial Case Special Grand Jury No-Bill

The 2007 Memorial Case Special Grand Jury No-Bill was the decisive legal turn in the criminal investigation of patient deaths at Memorial and LifeCare during Hurricane Katrina. On July 24, 2007, the grand jury rejected every charge proposed against Anna Pou. The decision closed the case in New Orleans without resolving the conflict among toxicological evidence, disputed interpretations of causation, and the jurors’ assessment of what had been proved about Pou’s actions.

Evidence and uncertainty

The grand jury’s decision followed an investigation complicated by the condition of the bodies. Orleans Parish coroner Frank Minyard initially told Special Agent Virginia Rider that autopsies would be of little use: the bodies had remained in the heat for more than a week, making blood samples unavailable for testing lethal drug levels. A volunteer pathologist pointed out that drugs might still be detected in other tissues or in fluid collected in the abdomen. At the attorney general’s request, Minyard agreed to have a federal disaster mortuary team conduct autopsies and collect samples from people who had died at hospitals and nursing homes in Orleans Parish after Katrina.

Testing did establish drug exposure in some Memorial cases. When investigators received an update on the first eighteen samples, nine were positive for morphine and roughly five or six for midazolam. Later, Robert Middleberg’s laboratory had analyzed forty-one bodies from Memorial and LifeCare; twenty-three tested positive for morphine, midazolam, or both. But the findings did not by themselves establish how much medication had been given, when it had been administered, or whether it caused a particular death. Middleberg cautioned that postmortem tissue results were harder to interpret than blood tests from living patients and that prolonged exposure to heat might have altered concentrations. He urged the experts to examine each patient’s medical history alongside the laboratory results.

The experts therefore considered the records case by case, asking whether high concentrations reflected a large dose shortly before death or medication accumulated over time, and whether illness affecting the liver or kidneys could have impaired drug processing. They also weighed the drugs’ potential to suppress breathing against patients’ conditions and the known timing of deaths. The competing expert views sharpened, rather than removed, the distinction between detecting a drug and proving its role in a death. Michael Baden argued that the drugs’ presence shortly before death mattered even if the precise dose could not be reconstructed. Cyril Wecht disputed the claim that heat made the results unusable, reporting that his small, unpublished comparison of heated and refrigerated samples showed no significant difference. Minyard, meanwhile, consulted Steven Karch, who advised that causes of death should remain undetermined because the bodies had been exposed to extreme heat for days.

The proposed charges

The district attorney’s office prepared a ten-count bill for the grand jury: one count of second-degree murder concerning Emmett Everett and nine counts of conspiracy to commit second-degree murder, one for each of the LifeCare patients on the seventh floor, including Everett. The question was not simply whether the deaths were troubling or whether medication had been found. To approve the murder charge, jurors had to find evidence of the specific intent to kill required under Louisiana law.

The jurors had sworn to consider indictable offenses and deliberate in secret. The assistant district attorney who presented witnesses could advise them, but the decision belonged to the jurors alone. An indictment required agreement from nine jurors. Ten appeared for the vote; the grand jury had originally consisted of twelve, but one member had died and been replaced. The prosecutor’s closing instructions set out the choice plainly: jurors were to act on what they believed the evidence showed, rather than follow a single predetermined conclusion.

The vote and public response

On the morning of July 24, ten jurors gathered in the Section E courtroom of the New Orleans criminal courts building. Judge Calvin Johnson read the proposed counts and then the foreman’s handwritten decision: not a true bill. The grand jury had declined to indict Pou on every charge. The case was over in New Orleans.

The result produced sharply contrasting public statements. Assistant Attorney General Julie Cullen, approached by reporters as she left the courthouse, said her office’s position remained that the deaths were homicides. District Attorney Eddie Jordan said that he respected and agreed with the grand jury’s decision. The difference between those statements reflected the case’s unresolved divide: investigators and experts could regard the deaths as homicides while the grand jury could still conclude that the charges had not met the threshold for indictment.

For Michael Morales, the no-bill coincided with the end of his work prosecuting homicides in New Orleans. His unit had been disbanded, and he was being reassigned to other felonies. He later described the prosecutors as cautious about rushing to charge Pou, who was not a typical defendant, but said they also could not abandon a case supported by a judge-approved arrest warrant and witnesses willing to testify. The office had received condemnatory letters throughout the prosecution. Morales took from the case a practical lesson for future emergencies: evacuation had to happen before a storm.

What the no-bill left unresolved

A later account of the jury’s deliberations showed that the verdict did not necessarily mean jurors thought nothing criminal had happened. Before the vote, one man asked whether anyone believed the jury was making a mistake; no one said so. One juror believed that a crime had occurred on the fifth day at Memorial and trusted the experts who had concluded that the deaths were homicides. Yet the same juror could not understand why no witness had testified to seeing Pou inject a patient. Kristy Johnson, who had been present at patients’ bedsides, was available to testify, but prosecutors did not call her when she was available. In that juror’s view, the evidence needed to connect Pou directly to the deaths was missing.

Minyard later felt hurt that the grand jury had failed to indict after he had called a death a homicide. He attributed the decision to the way Attorney General Charles Foti had treated the women and to the persuasive force of media coverage, without considering the possible effect of his own public statements. He thought another prosecutor, perhaps a federal one, might take up the case and believed the story could return.

Wecht’s concern was less whether Pou would be punished than whether the facts would be established and lessons drawn. He argued that Memorial was not a battlefield and that evacuation by helicopter or boat remained imaginable; he feared that the case’s ending would leave medical leaders with an unchecked discretion to give large doses of morphine and Versed during a disaster. The no-bill thus ended a prosecution, not the argument about what the evidence established, what the jury had been able to hear, or what hospitals owed patients in a catastrophe.