Arthur “Butch” Schafer

Arthur “Butch” Schafer was an assistant attorney general in the Medicaid Fraud Control Unit and the lead prosecutor in the Memorial case. His work placed him between grieving families, a complicated forensic record, and the prospect of criminal charges; the book also shows how his own recent bereavement sharpened his sympathy without displacing his duty to investigate impartially.

Identity and Role

Schafer worked in the Louisiana attorney general’s Medicaid Fraud Control Unit alongside Special Agent Virginia Rider, who led the investigation. In the Memorial case, Schafer served as lead prosecutor. His responsibilities included assessing whether the evidence could support criminal charges, a question that remained unsettled even as investigators gathered testimony and forensic findings.

That distinction mattered in 2007, when Schafer gave sworn testimony at a mandamus hearing. He said that officials had not yet reached a decision about what charges might apply. The statement marks a boundary between investigating deaths and deciding which, if any, could be prosecuted under a particular criminal theory.

Grief and Investigative Work

Schafer’s dealings with families were colored by a loss of his own. Weeks before speaking with Kathryn Nelson, he had looked down at his daughter’s coffin and spoken at her funeral. He could not allow that grief to determine the investigation, but it remained present as he worked. When Nelson described her mother’s death, he recognized something of his own bereavement in hers; the book presents that recognition as recurring whenever he spoke with a family who had lost someone.

The account therefore gives his investigative role an intimate counterpoint. Schafer was not simply weighing evidence from a distance: he repeatedly encountered the human consequences of the deaths he was investigating. Yet the narrative explicitly distinguishes sympathy from decision-making. His identification with bereaved relatives did not, in the book’s account, authorize him to let personal grief control the case.

Toxicology and the Limits of the Evidence

The investigation initially faced a serious forensic obstacle. The bodies recovered from Memorial had remained in the heat for more than a week, and Orleans Parish coroner Frank Minyard at first considered autopsies of little use. Blood samples could not be obtained to test for lethal drug levels. A volunteer pathologist told Rider that drugs might still be detectable in more durable tissues or in fluid accumulated after death. At the attorney general’s request, Minyard agreed to have a federal disaster mortuary team collect tissue samples as part of a wider examination of roughly one hundred deaths at hospitals and nursing homes.

On September 22, investigators took samples from eighteen Memorial bodies to National Medical Services, Inc., a forensic toxicology laboratory in Pennsylvania. In a call reporting the results, the laboratory director said that nine of the eighteen cases were positive for morphine, and that about five or six others were positive for midazolam. Schafer asked the doctor to explain the latter drug. The exchange shows him seeking clarification rather than assuming familiarity with a technical finding; the results identified drug exposure, but did not by themselves settle how a drug had been administered or what caused a particular death.

The larger review reinforced the need for caution. Of forty-one bodies from Memorial and LifeCare tested by the laboratory, twenty-three had tested positive for morphine, midazolam, or both. The director considered concentrations in many cases unusually high, but warned that postmortem tissue results were not as straightforward as blood tests from living patients. Heat exposure could have altered concentrations, and the experts therefore examined each patient’s medical history alongside the laboratory results. They considered whether drugs had been given in one large dose or had accumulated through repeated doses, whether impaired kidney or liver function affected that process, and whether the drug combination could suppress breathing in patients not on respirators.

Prosecution and Forensic Disagreement

The evidence faced competing interpretations. Michael Baden argued that uncertainty about the exact dose did not erase the detection of the drugs, and maintained that there was no competing cause of death in the cases he discussed. Cyril Wecht considered some detected levels extremely high and tested whether heat and humidity substantially changed drug concentrations in tissue. His small study found no significant difference between heated samples and refrigerated ones, but it was neither definitive nor published. These positions did not remove the underlying challenge: toxicology findings, clinical records, timing, cause of death, and criminal responsibility were related questions, but they were not interchangeable conclusions.

Minyard anticipated that a trial could become a battle among forensic experts and feared that reasonable doubt might defeat the case. That concern helps explain why Schafer’s prosecutorial role did not end with the discovery of positive test results. The investigation had to contend with both evidence pointing toward drug exposure and uncertainty about what the postmortem evidence could establish. Schafer’s sworn acknowledgment that charging decisions remained open captures the case at that threshold: the deaths demanded scrutiny, but the path from forensic findings to a prosecutable charge had not yet been resolved.