Rick Simmons and Michael Morales

Rick Simmons and Michael Morales stood on opposite sides of the investigation into deaths at Memorial Medical Center: Simmons was Anna Pou’s defense attorney, and Morales was an assistant district attorney handling the case. Their relationship was defined by a dispute over access to forensic evidence, but it became more than a contest over disclosure. As Simmons pressed the defense’s interpretation of events and Morales learned the medical concepts necessary to assess them, their exchange helped shape the prosecution’s question of intent.

The Evidence Dispute

By mid-September, Simmons had repeatedly asked Morales for the forensic test results from the bodies. He proposed an exchange: the prosecution would provide laboratory and autopsy results, and the defense would make its own experts available to review the case. The request came against a difficult forensic backdrop. The bodies had remained in the heat for more than a week before recovery, and Orleans Parish coroner Frank Minyard initially doubted that an autopsy could establish whether patients had received lethal drug levels. A volunteer pathologist advised that drugs might still be detectable in tissues such as the liver, brain, and muscle, or in abdominal fluid. Tissue samples from eighteen Memorial patients were sent to a laboratory for testing. Morales declined Simmons’s proposal. Pou had not been indicted, he explained, and under Louisiana law her attorney could seek access to certain evidence if and when that happened. The case had not reached that point. Morales was willing to examine material Simmons chose to show him, but would not disclose the prosecution’s own evidence in return. The response preserved the distinction between an informal exchange and the defense’s legal right to seek discovery after an indictment, while leaving Simmons unable to evaluate the state’s forensic file on the terms he requested. The emerging toxicology findings made the disagreement consequential without settling the case. In a discussion about eighteen tested cases, a doctor reported that nine were positive for morphine and roughly five or six for midazolam. Those results identified drugs in samples; by themselves, they did not resolve when or why each drug had been administered, whether it caused a particular death, or what a clinician intended. Simmons’s demand for the underlying records reflected the defense’s need to assess the evidence, while Morales’s refusal kept the prosecution’s material from the defense at that preliminary stage.

Competing Accounts and Legal Vocabulary

Simmons repeatedly reminded Morales that the district attorney’s office had broad discretion: it could reject the case or return it to the attorney general without proceeding. As Morales undertook a rapid education in care during a crisis, Simmons was ready to supply the defense’s concepts and explanations. Their interaction therefore involved an asymmetry of information but also a steady effort by the defense to influence how the prosecutor understood the facts. Morales began keeping a glossary of unfamiliar or newly important terms, including agonal breathing, double effect, euthanasia, palliative care, and triage. Special prosecutors, division chiefs, and the attorney general used it in meetings about the evidence and the work still required. The scale of that work was unusual: a case that would ordinarily have one charging conference was moving toward five. Simmons was not simply requesting documents; he was advancing a medical and ethical framework that the prosecution had to understand before deciding what the evidence could support. The concept Morales found especially useful was the doctrine of double effect. He saw a correspondence between the medical-ethical distinction between an intended harmful act and a treatment intended to palliate, and Louisiana’s requirement that prosecutors prove specific intent for second-degree murder. The resulting question was whether injections were meant to harm and kill or to relieve suffering. Morales’s growing attention to that distinction shows how the defense’s arguments entered the prosecution’s analysis, even though the two men did not agree on when the defense should see the evidence.

Memory, Evidence, and Procedure

The investigation also faced questions about the reliability of recollection. Public reports could revive memories, but they could also alter them; witnesses might absorb information from news coverage or from discussions with one another. Several LifeCare witnesses had spoken after the evacuation and consulted on a written timeline of their experiences. Investigators consequently needed additional interviews conducted without leading questions, as well as physical and written records made closer to the events. This concern formed part of the evidentiary setting in which Simmons sought access and Morales assessed what a prosecution could prove: witness accounts mattered, but their timing and exposure to later information mattered too. The underlying evacuation decisions further complicated the legal vocabulary. At Memorial, doctors had decided to place patients with do-not-resuscitate orders last for evacuation, although a DNR order meant that a patient whose heartbeat or breathing stopped should not be revived; it was not the same as a living will directing that life-sustaining treatment be withheld. The distinction mattered because terms such as triage and palliative care could describe radically different decisions, and the investigation had to distinguish a treatment’s stated purpose from its effects. Morales’s focus on intent did not itself determine what happened in any individual case, but it gave the charging discussions a way to connect disputed medical actions to the legal standard.

Confidentiality and Public Defense

Simmons’s representation extended beyond the evidence exchange with Morales. He continued trying to prevent disclosure of what Pou had told a Tenet attorney and media-relations chief after the storm. At the end of September, a Louisiana appeals court ruled in Simmons’s favor on that issue, leaving the information protected while investigator Butch Schafer asked the state supreme court to reconsider. The dispute concerned a separate category of information from the autopsy and toxicology records, but it belonged to the same larger struggle over what the defense, investigators, and public could learn. Simmons also guided Pou through an interview with 60 Minutes. She initially changed her mind and refused to meet the crew; when she later agreed, Simmons arranged for the entire interview to be audio-recorded so that the defense would have a record if the program were subpoenaed. He anticipated that the broadcast would present her favorably and coordinated professional medical organizations’ expressions of support around its airing. These efforts show the breadth of his defense strategy, while the evidence dispute with Morales remained unresolved in the material described here.

Significance of the Relationship

Simmons and Morales were not merely exchanging demands across a procedural divide. Simmons argued for access and supplied interpretive tools; Morales controlled the prosecution’s disclosure at that stage and developed a framework for deciding whether the evidence could establish criminal intent. The contrast between Simmons’s proactive case-building and Morales’s step-by-step effort to understand crisis medicine captures the unusual character of the Memorial case: a criminal investigation in which forensic uncertainty, contested memories, medical ethics, and statutory requirements had to be considered together. The record establishes their disagreement and its intellectual influence, but does not present it as a final resolution of the underlying allegations.