Charles Foti

Charles Foti, Louisiana’s first-term attorney general and a former Orleans Parish sheriff, turned the deaths of patients during Hurricane Katrina into a broad criminal investigation. He pledged to investigate what he called a horrific tragedy at St. Rita’s Nursing Home and opened inquiries into every hospital and nursing home where patients had died. His forceful public statements about the Memorial Medical Center case made him a prominent defender of the homicide theory, but also exposed the limits of prosecutorial certainty and helped make his approach a subject of public controversy. After the owners of St. Rita’s were acquitted, Foti lost his reelection bid.

Background and Public Position

Before becoming attorney general, Foti had served for thirty years as the elected sheriff of Orleans Parish, building a substantial constituency among elderly residents. The book also situates his public response beside his experience as a son: white-haired himself, he had cared for his father until his death at ninety-two that May, driving him away from the predicted paths of several hurricanes. The personal detail gives context to his attention to deaths in care facilities, although the evidence does not reduce his decisions to that experience.

Foti’s office had authority to investigate deaths across a large, damaged healthcare system. The Medicaid Fraud Control Unit opened inquiries into every hospital and nursing home where patients had died, while criminal prosecutor Butch Schafer, returning home after mourning his daughter, began probing the questions raised by the St. Rita’s deaths. The scale of the work was considerable: Foti later described investigations involving thirteen nursing homes and six hospitals across the greater New Orleans region, all pursued on multiple fronts at once.

St. Rita’s and the Scope of the Investigation

The owners of St. Rita’s, Sal and Mabel Mangano, had chosen not to evacuate their residents before Katrina, although the other three nursing homes in St. Bernard Parish had moved patients ahead of the storm. They and their family had remained at the facility and tried to save residents, a fact that challenged the assumption that the owners had simply abandoned them. Their attorney, James A. Cobb Jr., argued publicly that deaths in Texas after the storm made the decision not to evacuate appear more reasonable than it had initially seemed.

Before investigators were due to meet the Manganos, Foti issued a warrant for their arrests on thirty-four counts each of negligent homicide for failing to evacuate before Katrina. They surrendered to authorities, and Foti publicly condemned them. Cobb responded by accusing the attorney general of acting before he knew the whole story and describing his clients as heroes. The later trial ended in acquittals: a jury in St. Francisville found the couple not guilty on all thirty-five negligent-homicide counts and twenty-four counts of cruelty to the infirm brought by Foti. That outcome became an important backdrop to the public’s judgment of his broader Katrina investigations.

The Memorial Case and Public Claims

The deaths at Memorial Medical Center presented a different evidentiary problem. The bodies had remained in the heat for more than a week before recovery, and Orleans Parish coroner Frank Minyard initially told Special Agent Virginia Rider that examinations would be of little use. Decomposition prevented ordinary testing such as taking blood to check for lethal drug levels. Later testing nevertheless detected drugs in postmortem tissue: in one group of eighteen cases, nine tested positive for morphine and roughly five or six for midazolam. The findings showed drug presence, but interpreting concentrations in tissue after prolonged exposure to heat was not equivalent to interpreting blood tests from living patients.

Experts disagreed about what the toxicology could establish. Robert Middleberg advised colleagues to consider each patient’s clinical history alongside laboratory results because heat and decomposition could have altered drug concentrations. Minyard consulted another expert, Steven B. Karch, and gave considerable weight to Karch’s view, which was also shared by a toxicologist retained by Pou’s lawyer. Forensic pathologist Michael Baden countered that uncertainty about the amount administered did not change the drugs’ presence or their timing: he maintained that patients had received Versed and morphine shortly before death and that there was no competing cause of death. The evidence thus contained distinct questions—whether drugs were present, whether they caused death, and what the people who administered them intended—that public statements could easily collapse into one.

At the press conference announcing the arrests of Anna Pou, Cheri Landry, and Lori Budo, Foti described the charges as four counts of principal to second-degree murder. He explained that principal meant assistance or participation, while acknowledging that investigators had not yet determined exactly who had injected which patient. He asserted that morphine and midazolam together formed a lethal combination and characterized the deaths as homicide rather than euthanasia. He also stated that the allegation remained subject to proof in court and that the accused were presumed innocent. Most news reports, however, emphasized his most inflammatory characterization without the accompanying caveats. Foti’s public certainty therefore traveled farther than his qualification of it.

Investigation, Media, and Institutional Conflict

Foti’s office worked with Virginia Rider and Butch Schafer, who complied with a request from Tenet attorney Harry Rosenberg that employees be informed of their right to consult company counsel and have an attorney or hospital representative present during questioning. The investigators regarded this as an ethical obligation and wanted their evidence to be admissible. Schafer also recognized the strategic value to Tenet Healthcare: a company facing potential lawsuits would have reason to learn what employees told investigators. The episode placed the investigation inside a wider contest over access to information, corporate interests, and the reliability of future testimony.

Foti’s public handling of the case also brought him into conflict with his own communications operation. His public information director, Kris Wartelle, helped arrange an interview with 60 Minutes, expecting a hard-hitting report that would fairly present her employer’s position. She had been impressed by reporter Ed Bradley’s earlier work with her office on the denial of safe passage across a bridge to a largely Black crowd after Katrina, and was surprised when Morley Safer, rather than Bradley, took on the Memorial story. A producer assured her the report would portray Foti as a hero; once Safer began questioning him under studio lights, Wartelle realized it would be critical. Afterward she argued with Safer for about an hour and sent a sharply worded email to a senior CBS official, believing she had been misled. Foti was angry with her over the episode.

In the interview, Safer challenged the logic of the investigation by asking whether perpetrators of murder would try to conceal their actions. Foti replied that perhaps they had not thought anyone would find out. His answer conveyed suspicion about the accused, even as the case remained unresolved. Elsewhere, he warned that the investigation would take place across many facilities, but the public focus increasingly settled on the Memorial deaths and his language about them.

Charges, Political Consequences, and Narrative Role

As the Memorial investigation approached arrests, a prosecutor proposed elevating the charges from second-degree to first-degree murder. Under the state definition discussed by the team, specific intent to kill someone older than sixty-five, or more than one person of any age, could qualify as the more serious crime. Wartelle saw a serious public-relations risk in sending agents to arrest the women and advised Foti on how to avoid a televised perp walk. She asked him to slow down and prepare for questions at a press conference. He did not follow that advice. Virginia Rider later drove to New Orleans with arrest affidavits and warrants for Pou, Landry, and Budo. At the subsequent announcement, Foti maintained the second-degree charges rather than the proposed first-degree ones.

Foti’s campaign to define the case continued as the grand-jury process became contentious. Investigators and prosecutors in Baton Rouge, including Julie Cullen, later drafted a letter to the New Orleans district attorney protesting that essential evidence was being ignored. Public support for Pou also emerged: in July 2007, WWL radio host Garland Robinette urged listeners to rally at City Park and press the attorney general and district attorney to drop the case. At a courthouse hearing, Cullen reiterated that the state’s position was that the deaths constituted homicide. These episodes show that Foti’s investigation was not simply a sequence of legal steps; it became a public struggle over whether the state’s interpretation of contested medical evidence should determine the case’s course.

The political consequences were sharp. In September, a jury acquitted Sal and Mabel Mangano on all the charges Foti had brought against them. Six weeks later, after a campaign by Pou’s supporters to unseat him, Foti lost his reelection bid, finishing last in a three-candidate primary. The book presents him as neither a detached administrator nor a figure whose claims could settle the evidence: he was an experienced prosecutor with a broad investigative mandate, a confident public advocate for homicide charges, and a politician whose forceful approach became inseparable from the outcomes and disputes that followed.