Frank Minyard—Anna Pou

Frank Minyard—Anna Pou describes a fraught professional relationship shaped by the question of how far medical evidence could support a finding of homicide. As Orleans Parish coroner, Minyard had to assess deaths at Memorial Medical Center involving patients who had received drugs including morphine and midazolam; Pou, a physician arrested in connection with four deaths, became the central subject of his deliberations. Minyard neither treated the toxicology results as self-interpreting nor settled easily on a single account of Pou’s intent. His eventual decision emerged from competing expert opinions, legal considerations, personal and public pressures, and an unresolved distinction between giving drugs, causing death, and intending to kill.

The Coroner’s Evidentiary Problem

The bodies recovered from Memorial had remained in the heat for more than a week. At first, Minyard told Special Agent Virginia Rider that autopsies would be useless: decomposition meant, for example, that investigators could not take blood samples to test for lethal drug levels. Rider and her colleague Butch Schafer needed more than eyewitness accounts and empty morphine vials to establish what had happened. A volunteer pathologist advised that drugs might still be detectable in more durable tissues or in fluid that had collected in the abdomen. At the attorney general’s request, Minyard agreed to seek autopsies and tissue samples from patients who had died at hospitals and nursing homes across Orleans Parish after Hurricane Katrina. Investigators eventually sent samples from eighteen Memorial bodies to National Medical Services, Inc., for forensic testing.

The laboratory findings supplied evidence of drug exposure but did not settle the cause or manner of each death. In an early report on eighteen cases, the laboratory director, Robert Middleberg, told investigators that nine tested positive for morphine and roughly five or six for midazolam. Later, his laboratory’s analysis found morphine, midazolam, or both in twenty-three of forty-one bodies from Memorial and LifeCare. Yet postmortem tissue concentrations could not be read as straightforwardly as blood tests from living patients: heat, decomposition, and differences in patients’ illnesses might affect interpretation. Middleberg urged the group to examine each patient’s clinical history alongside the laboratory results. The question was not simply whether a drug was present, but whether the evidence could establish when and how it had been administered, whether it contributed to death, and what the person administering it intended.

Competing Interpretations

Minyard sought further advice from Steven Karch, a specialist whose work emphasized that drug levels measured in a corpse might not reflect levels immediately before death. Karch examined the evidence and argued that causes of death could not reliably be determined in bodies left for days in extreme heat; he recommended leaving the medical causes undetermined. Minyard gave considerable weight to this position, which was also shared by a toxicologist retained by Pou’s attorney.

Other experts challenged the implications Minyard drew from Karch’s argument. Michael Baden argued that uncertainty about the original dose did not negate the evidence that patients had received the drugs; in his view, the drugs were present shortly before death and no competing cause of death explained the cases. Cyril Wecht likewise disputed the suggestion that the detected concentrations could be dismissed as a product of decomposition. He considered some levels exceptionally high and conducted a small experiment comparing samples exposed to hot, humid conditions with refrigerated samples. He found no significant differences. The study was limited and had not been independently reviewed or published, but it added another piece of evidence to the dispute.

The resulting disagreement was consequential precisely because the evidence had several distinct layers. Detecting a drug did not, by itself, determine the dose given before death; a dose did not automatically establish that it caused a particular death; and causation did not by itself answer whether the person who administered it intended to kill. Minyard had to consider these questions patient by patient, alongside medical records and the patients’ conditions. His inquiry therefore remained uncertain even when experts agreed on some underlying facts.

Public Ruling and Private Deliberation

On February 1, 2007, The Times-Picayune reported that Minyard had found no evidence of homicide in the Memorial cases. Rider heard the news on the radio, bought the paper, and was shaken by what she read. She understood the coroner’s determination as a practical threshold for prosecution: in Orleans Parish, a successful murder case typically required a coroner to determine that a death had been caused by another human being, though that medical classification did not itself assign legal fault. The district attorney’s staff had told Rider that they would not proceed without such a ruling. Minyard’s public position was then repeated by Pou’s attorney and her public-relations team as evidence that the coroner had cleared the cases.

The newspaper account did not capture the full uncertainty of Minyard’s position. In an interview with a New York Times reporter, he said he had not yet found evidence that the deaths were homicides, while also indicating that he was still awaiting evidence and expert reports. He could still make a homicide determination when testifying before the grand jury, whose proceedings were secret. Meanwhile, he continued to seek advice, including from Karch, and weighed the prospect of a trial in which forensic experts would contest the meaning of the postmortem results. Minyard feared that reasonable doubt would defeat the case and believed that such an outcome would harm New Orleans during its recovery. That anticipated consequence entered his judgment alongside the scientific dispute.

Minyard also faced pressure from family and friends who opposed prosecuting Pou, as well as concern about the adverse publicity surrounding the city. His religious convictions pulled in another direction: he regarded the deliberate taking of life as gravely wrong and believed that human beings could not know God’s plan for when a person would die. Those convictions did not provide an easy answer to the evidence. They intensified the burden of deciding how to classify deaths when the medical record and expert testimony left room for competing accounts.

The Case of Emmett Everett

Minyard’s eventual approach was not a simple declaration that all the deaths had the same cause. He struggled to distinguish patients who were extremely ill from those for whom the drugs seemed to offer a clearer explanation. He believed some of the deaths might qualify as homicides but could not reach the same conclusion in every case. In his thinking, severe illness could cut in either direction: it might make a patient’s death seem less attributable to an intervention, or make that patient more vulnerable to a drug’s effects.

Emmett Everett became the clearest case for Minyard. He regarded Everett’s death as an unequivocal homicide and considered presenting that conclusion to the grand jury while being more cautious about the other deaths. Even there, Minyard imagined how Pou’s attorney, Rick Simmons, might argue that Pou had sought to sedate patients and had misjudged the amount Everett required. Minyard’s proposed course—treating Everett’s case as clear while acknowledging uncertainty elsewhere—came closest to reconciling his competing convictions and loyalties. It did not resolve the larger question of Pou’s intent: Minyard believed she had meant to sedate patients, not plan their deaths, while recognizing that the consequences might have been different for some of them.

An Unresolved Relationship

Minyard’s role placed him between medical interpretation and criminal judgment, but those functions did not collapse into one another. His homicide classification could influence whether prosecutors pursued a case; it was not the same as a court’s finding of legal responsibility. The February headline gave the public dispute a seemingly definite answer, while Minyard’s continuing consultation and deliberation revealed a less settled process. His concern about trial, recovery, religious belief, and public pressure shaped the context in which he assessed evidence, without making the underlying forensic disagreement disappear.

The relationship between Minyard and Pou thus remained marked by a tension between judgment and uncertainty. He had to decide what he could responsibly tell a grand jury, not merely what he suspected about Pou’s character. The laboratory results, the condition of the bodies, and the expert disagreement could support different conclusions about exposure, causation, and intent. Minyard’s effort to distinguish those conclusions—and his eventual focus on Everett as the strongest case—shows why the coroner’s decision became pivotal without becoming a final resolution of what happened at Memorial.