New Orleans Coroner's Office

The Orleans Parish Coroner’s Office, under Frank Minyard, became a pivotal institution in the effort to determine how patients had died at Memorial and LifeCare after Hurricane Katrina. It had to classify deaths and assess forensic evidence from bodies recovered after prolonged exposure to heat, at a moment when families, investigators, and prosecutors needed answers. The office’s work did not produce a simple resolution: drug findings prompted serious concern, but experts disagreed about what those findings could establish about cause of death.

Responsibilities Under Pressure

The office was already operating under strained conditions. Minyard’s offices in the basement of the criminal courts building had been damaged, and he was working from temporary quarters at the vacant Good Citizens Rhodes Funeral Home. Meanwhile, bodies from Memorial and other facilities had decomposed in the heat for more than a week before recovery. Minyard initially told Virginia Rider that an autopsy would be useless because, for example, there would be no blood sample available to test for lethal drug levels.

That assessment changed when a volunteer pathologist explained that drugs might remain detectable in more durable tissues, including liver, brain, and muscle, or in fluid that collected in the abdomen. At the attorney general’s request, an overburdened Minyard agreed to ask a federal disaster mortuary team to perform autopsies and collect tissue samples from hospital and nursing-home patients who had died in Orleans Parish after the storm. The investigation initially encompassed about one hundred deaths, amid allegations of wrongdoing at several facilities.

Building and Interpreting the Evidence

On September 22, state and federal investigators carried tissue samples from eighteen Memorial bodies to National Medical Services, Inc., a forensic toxicology laboratory in Willow Grove, Pennsylvania. In an initial report on eighteen cases, the laboratory director, Robert Middleberg, said nine tested positive for morphine and another five or six for midazolam. The results offered investigators evidence of drug exposure, but they did not by themselves settle how much had been administered, when it had been given, or whether it had caused a death.

The distinction mattered because postmortem tissue results were more difficult to interpret than blood tests from living patients. Heat and decomposition could affect drug concentrations, and a patient’s medical condition could change how drugs accumulated or were processed. Middleberg therefore urged the reviewers to consider each patient’s clinical history alongside the laboratory findings. At a later meeting, Virginia Rider and two nurses prepared charts showing the drugs found in each body, while Middleberg presented the laboratory results. Of the forty-one Memorial and LifeCare bodies analyzed, twenty-three tested positive for morphine, midazolam, or both. The concentrations appeared high in many cases, but the group still had to assess them against medical records and the circumstances of each death.

Death Certificates and Expert Review

The office’s classifications carried consequences beyond the forensic inquiry. Before a grand-jury presentation, District Attorney Eddie Jordan wanted Minyard’s classification of the deaths. At that stage, most Memorial and LifeCare death certificates remained marked pending investigation; some were classified as accidents, and some carried a Katrina-related designation. Families seeking death certificates needed them to settle estates, and some complained that delays in receiving them were obstructing that process. A pending classification also left uncertainty about whether insurance benefits would be paid.

Minyard sought outside opinions rather than relying on a single reading of the evidence. In addition to the laboratory findings, the review considered medical, autopsy, and toxicology records. Forensic pathologists Cyril Wecht and Michael Baden concluded that the LifeCare deaths resulted from drug injections, and Minyard sent records to three additional experts for independent review. Their conclusions were not uniform: other reviewers characterized the deaths as homicides, while one local internist found that the available records did not clearly show that Emmett Everett’s death was imminent, and noted that the lawyer for Anna Pou disputed an overdose explanation for Everett.

Disagreement and the Limits of Inference

The office’s challenge was not merely to establish that drugs were present, but to decide what their presence could reliably prove. Steven Karch, whom Minyard consulted as he prepared to address the grand jury, argued that drug levels measured in bodies exposed to high temperatures for many days could not reliably determine the cause of death. He advised leaving the medical cause undetermined. Michael Baden countered that, whatever uncertainty surrounded the doses, the drugs had been present shortly before death and, in his assessment, there was no competing cause. Wecht also challenged Karch’s account of how decomposition affected concentrations, citing a small comparison study; the study was not definitive, independently vetted, or published.

Minyard had to weigh these conflicting opinions in view of both scientific uncertainty and the prospect of prosecution. He imagined a trial in which forensic experts would sharply contest the meaning of the results, and worried that reasonable doubt could defeat the cases and damage the city’s recovery. The office’s role thus extended beyond collecting findings: its classifications and judgments shaped what could be brought before a grand jury, while the evidence left a persistent gap between detecting drugs and proving how they caused particular deaths.