July 17, 2006

On July 17, 2006, the investigation into patient deaths at Memorial Medical Center moved from evidence-gathering to arrests. The day unfolded on two sharply different tracks: Anna Pou and Dan Nuss worked through the night to treat James O’Bryant, while Attorney General Charles Foti’s office prepared to arrest Pou, Cheri Landry, and Lori Budo on four second-degree murder counts. The contrast did not resolve the underlying dispute. It made the conflict between the clinicians’ work and the state’s allegations newly immediate, and placed the evidence and the manner of prosecution under public scrutiny.

The Crisis Behind the Case

The charges arose from events at Memorial during Hurricane Katrina, when flooding and the hospital’s vulnerability to power failure formed part of the setting for evacuation decisions. Before the storm, plant operations director Eric Yancovich had studied government storm-surge estimates and calculated that less than four feet of flooding in Magnolia Street could send water through the loading dock. Although the generators themselves were elevated, critical parts of the emergency power distribution system were at or near ground level. Yancovich had recommended raising transfer switches and pumps, but the electrical work alone drew a bid of more than a quarter of a million dollars, and he did not expect it to be approved for lack of capital. When floodwaters threatened the hospital, the backup system’s vulnerable components became a point of acute concern.

The generators were designed to support vital functions for limited periods, yet Memorial’s disaster plan called for them to support the hospital for at least three days. By the time staff were trying to maintain them, they had already run for two days. After one engine shut down, workers added water to its radiator and restarted it. This history explains the strained disaster conditions that formed the backdrop to later questions about patient care and evacuation; it does not, by itself, establish what caused any individual patient’s death or what any clinician intended.

The Day’s Two Tracks

On Sunday night, James O’Bryant suffered severe bleeding after his facial defect began bleeding again. Staff rushed him into an ambulance, and he received two units of blood during the trip to Baton Rouge. Pou called her chairman, Dan Nuss, and the surgical team prepared an operating room. They operated through the night. By Monday morning, Pou and Nuss had closed the defect and transfused O’Bryant with more blood. Pou reassured his wife, Brenda, that the bleeding might have occurred regardless and that he could have died on the way to Baton Rouge. After O’Bryant was settled in intensive care, Pou left for another hospital, without having slept and with another long operation scheduled.

That same night, Charles Foti’s team discussed the charges to be used in the approaching arrests. One prosecutor proposed first-degree murder, which could apply under Louisiana law to an intentional killing of a person over sixty-five or of more than one person. Kris Wartelle, Foti’s public information director, opposed raising the charges; she considered it an extreme step that could expose the women to a possible death sentence and intensify public anger. Manslaughter was also raised as an alternative, but the group settled on second-degree murder, which carried a potential sentence of life imprisonment without parole.

The dispute extended to how the arrests would happen. Virginia Rider was responsible for organizing them, but she and prosecutor Butch Schafer opposed surprise arrests. Schafer had given the women’s lawyers his word that he would contact them if an arrest was planned, and expected the lawyers would arrange for their clients to surrender for booking. He argued within the attorney general’s office for that approach. Rider, too, understood that an arrest could permanently alter a suspect’s life and had previously wrestled with the weight of making such a decision. She nevertheless believed the evidence had been sufficient to seek arrests for months and that the investigation had reached the point where it had to advance. Foti retained the authority to decide; the arrests went forward.

Warrants and Allegations

That afternoon, Rider drove to New Orleans with arrest affidavits and warrants for Pou, Landry, and Budo. Her affidavit assembled accounts from four initial LifeCare witnesses: Diane Robichaux, Therese Mendez, Kristy Johnson, and Steven Harris. They reported that Susan Mulderick had said the LifeCare patients were not expected to make it out and that staff would not leave living patients behind. According to the affidavit, Pou came to the seventh floor, told Mendez that the patients would receive a lethal dose, and said LifeCare staff should leave. One patient was reportedly described as aware but weighing 380 pounds; Pou asked that he be sedated, while LifeCare staff refused.

The affidavit also set out how the drugs and injections were alleged to have been arranged. Harris said he gave Pou morphine, Versed, and injection supplies. Johnson said she showed Pou and two Memorial nurses to the patient rooms and saw a nurse, later identified as Budo, inject Rose Savoie. Savoie reportedly reacted that it burned. Toxicology tests had found morphine and midazolam in the four patients named in the affidavit: Emmett Everett, Savoie, Ireatha Watson, and Hollis Alford. Watson, eighty-nine, had dementia and had been treated for gangrenous toes; Alford, sixty-six, had schizophrenia and was gravely ill with a blood infection. Pathologist Cyril Wecht concluded that all four died from lethal amounts of the drugs. After asking Rider questions, Judge Calvin Johnson signed the warrants at about six in the evening. They alleged that the women intentionally killed the four patients; those allegations were not, by the warrants alone, a final determination of guilt.

Pou’s Arrest and the Evidence Debate

Rider delivered the warrants for Landry and Budo to arrest-team leaders in New Orleans, then returned to Baton Rouge. At about 8:30 p.m., agents met near Pou’s home to coordinate. They arrived around 9 p.m. Rider, wearing body armor and accompanied by a male colleague, knocked. Pou opened the door barefoot and in rumpled surgical scrubs. The agents told her she was under arrest, entered the house, and asked whether she had weapons. Pou requested time to change into fresh scrubs; Rider and another female agent accompanied her while she changed and prepared to leave.

Pou’s immediate concern was her patients. She said she was awaiting an urgent laboratory result and asked to call the doctor covering for her. She gave him follow-up instructions, including a request to check one patient’s calcium level, and asked that her surgeries for the week be canceled. During the journey to New Orleans, she prayed for her family. At the prison, she was booked before her lawyer, Rick Simmons, arrived. The booking form listed four counts of being a principal to second-degree murder. Butch Schafer kept her apart from other prisoners and offered her a phone; she called her mother and then her husband, Vince Panepinto. She signed a $100,000 property bond and was released on her own recognizance after midnight on Tuesday, July 18.

The arrest rested on evidence whose interpretation remained contested. The Memorial bodies had decomposed in the heat, and Frank Minyard initially doubted that autopsies would yield useful blood samples. A volunteer pathologist advised that drugs might still be detectable in more durable tissues, prompting a wider tissue-sampling effort. Later testing found morphine in nine of eighteen Memorial samples and midazolam in another five or six. In a subsequent review of forty-one bodies from Memorial and LifeCare, twenty-three tested positive for morphine, midazolam, or both. The results required interpretation alongside clinical records: decomposition could affect concentrations, and the lab results alone did not settle whether drugs caused a particular death, how much had been administered, or with what intent. Experts later disagreed sharply over those questions. The July warrants thus marked a decisive prosecutorial step, not the end of the forensic or ethical argument.