Rick Simmons

Rick Simmons, Anna Pou’s attorney, became the central strategist in a defense that reached far beyond the question of whether she would be charged. He contested the investigators’ access to Pou’s statements, shaped how the case was presented to the public, and argued that ordinary medical and legal safeguards could not simply be applied to a disaster. His work helped carry the controversy from Memorial Medical Center into national debates about triage, end-of-life care, and legal immunity—and ultimately into Louisiana legislation passed unanimously.

Role in the Case

Simmons entered the story as the lawyer whom Pou spoke with during a tour of Memorial alongside Cheri Landry and Lori Budo. Investigators Virginia Rider and Butch Schafer had spent months trying to understand the alleged injections and were eager for any clue that might clarify what had happened. Pou, speaking openly with Simmons at her side, took him through the hospital, including LifeCare room 7312, where she had responded to a Code Blue. The remaining crash cart, ventilator, monitor, and laryngoscope offered visible evidence of resuscitation efforts. The tour placed Simmons beside the physical record of the crisis as he prepared to defend Pou’s actions.

When a reporter publicly identified Pou, Simmons released a statement expressing confidence that the facts would show heroic efforts by the physicians and staff in a desperate situation. As media attention intensified, Pou felt hounded by reporters who called her, appeared at her home and workplace, and sought out her relatives. Simmons advised her not to watch the news, but the attention was difficult to contain. His role was already becoming twofold: representing Pou in legal proceedings while trying to shape the public account of a case whose central facts remained disputed.

Building a Proactive Defense

Simmons repeatedly sought access to forensic and autopsy results, offering to provide input from his own experts in exchange. Assistant District Attorney Michael Morales declined, noting that Pou had not been indicted and that the defense’s legal access to evidence had not yet begun. Simmons continued to press the distinction between an investigation and a prosecution, reminding Morales that the district attorney’s office could reject the case or return it to the attorney general. As Morales learned the medical and ethical vocabulary of the case, Simmons was ready to provide the defense’s framing of it.

A major battleground was Pou’s conversations with Tenet personnel after the storm. Simmons argued that discussions involving Tenet attorney Audrey Andrews and media chief Steven Campanini were confidential because Andrews had not immediately told Pou that she represented Tenet alone. The prosecution disputed that claim, pointing to Pou’s employment contract: although Memorial had supported her recruitment and first-year salary, she was employed by Louisiana State University, not Memorial or Tenet Healthcare. A lower-court ruling pleased neither side, and the dispute went to the Louisiana Supreme Court. In May, the court denied investigators access to what Pou had told Andrews before the clarification of representation, while leaving later conversations potentially available.

Simmons then filed new motions to block interviews with Andrews and Campanini. At a hearing about the precise point when Andrews had clarified that she was not Pou’s lawyer, he argued for broader protection of Pou’s statements. The lower court ruled that statements made before that notice remained protected even if Pou repeated them later; Andrews’s eight pages of notes were protected as well. The ruling frustrated Rider and Schafer’s efforts to obtain what they considered key evidence. An appeals court later sided with Simmons again, keeping the information confidential while the attorney general’s office sought further review.

Arrest, Public Argument, and Media

Before the arrests, Simmons and the attorneys for Landry and Budo had expressed a preference for self-surrender rather than a surprise arrest. Simmons asked Schafer to call so he could bring Pou in without a public perp walk, and was assured that would not happen. When the arrest came, however, Pou was taken into custody after operating on a patient. During the drive to New Orleans, agents told her Simmons had been notified and would meet them at Orleans Parish Prison; she arrived shortly before midnight. After booking, she read that the allegation was principal to four counts of second-degree murder. Simmons arrived later, and Pou was released on her own recognizance.

After the arrests, Simmons challenged Attorney General Charles Foti’s handling of the case. He accused Foti of using the arrests to obtain mug shots for a media event, stressed that Pou had not been formally charged, and emphasized that prosecution rested with Orleans Parish district attorney Eddie Jordan. Simmons said he intended to meet Jordan and present evidence in an effort to dissuade him from acting. The affidavit, he argued, contained allegations rather than a final judgment. His public response sought to keep the legal status of the case distinct from the impression created by arrest photographs and headlines.

He also managed Pou’s contact with television. Simmons persuaded her to take part in an interview for 60 Minutes, arranging a complete audio recording so that her remarks could not later be removed from context if the program were subpoenaed. Pou initially refused to meet the crew when it arrived for the first filming visit. As the broadcast approached, Simmons expected the segment to present her favorably and coordinated support from medical organizations. He even objected to the timing of a planned statement by the American Medical Association, concerned that a highly anticipated football broadcast marking the New Orleans Saints’ return to the restored Superdome would draw local attention away from the program.

Simmons also tried to limit the influence of fictionalized public judgment. When a Boston Legal episode was expected to feature a doctor accused of killing patients after Katrina, he argued to the producers that the premise was insensitive to Pou and to the dead patients’ families, particularly with a grand jury investigation approaching. He sought a local disclaimer to reduce any effect on prospective jurors. These efforts show how closely he treated media exposure as part of the legal environment surrounding Pou, rather than as a separate matter of reputation.

Ethical Framework and Legal Strategy

Simmons did not confine his defense to procedure. He studied triage and end-of-life care, interviewed or gathered statements from more than one hundred potential witnesses, prepared exhibits concerning government abandonment, and filed motions to protect evidence. He used the terms battlefield triage and reverse triage to explain the choice to help healthier patients before sicker ones, while recognizing that this was not typical battlefield practice. The terminology offered a way to describe Memorial’s decisions to a general audience as responses to scarcity, even as the underlying choices remained controversial.

A disaster-medicine seminar gave Simmons another framework. Pou heard a World Medical Association policy stating that patients whose condition exceeded available therapeutic resources could be classified as beyond emergency care and given appropriate pain relief and sedatives. She found the full policy and sent it to Simmons, who saw in it a respected medical organization’s support for separating patients considered unsavable and treating them with comfort medication. The policy appeared to fit the defense he was constructing, though it did not settle whether the Memorial patients met its criteria or whether the medications had been administered appropriately.

Simmons also explored palliative sedation as a possible defense, but for the time being decided against having Pou publicly enter the wider debate about end-of-life care. He believed such a discussion was especially risky in Louisiana. He had found no useful American Medical Association guidelines for comfort care in disasters and argued that ordinary palliative-care guidance did not account for circumstances in which family consultation and documentation might be impossible. Critics, including ethicist Arthur Caplan, questioned whether the Memorial practices fit palliative sedation: they pointed to the rapid use of potentially lethal drugs, the lack of gradual administration and documentation, and the absence of consultation with family members. The conflict exposed a central difficulty in Simmons’s approach: disaster conditions could explain why ordinary procedures were hard to follow, but did not by themselves establish what the clinicians intended or whether their actions met an ethical standard.

From Individual Defense to Policy

Simmons took Pou’s case into the American Medical Association’s national discussion of disaster standards and immunity. At the organization’s annual meeting in Chicago, he supported proposals to reconsider medical standards during disasters and to seek state laws shielding physicians from liability unless they acted maliciously. He argued that overwhelmed systems would leave some patients untreated and that doctors could face lawsuits for decisions made under extraordinary conditions. In his view, consent and documentation requirements designed for ordinary care might not be available during catastrophe, leaving physicians to exercise judgment in good faith.

His political work eventually joined Pou’s experience to state law. Simmons and Pou helped write Louisiana bills that passed unanimously. The laws granted health-care professionals immunity from most civil suits for work performed in accordance with disaster-medicine protocol, while excluding willful misconduct, and urged prosecutors to wait for a medical panel’s findings before deciding whether to bring criminal charges. Pou later helped advocates promote similar legislation in other states. At the same time, the statute invoked a protocol that did not yet exist; Simmons and Pou had included the language in the hope that one would be developed. Simmons’s defense thus outlasted the immediate fight over indictment: it helped turn one hospital’s contested decisions into a broader legal and professional argument about who should define acceptable care when resources collapse.