September 1, 2005 patient injection incident at Memorial Medical Center

The September 1, 2005 patient injection incident at Memorial Medical Center took place during the hospital’s evacuation after Hurricane Katrina. At least nineteen patients were medicated that Thursday, and all died while helicopters and boats were carrying people out of the building. The book returns to the incident through testimony, a grand juror’s recollection, and Anna Pou’s later public accounts. Together, those perspectives make the event not only a question of what happened at patients’ bedsides, but also of what evidence the jury heard and what the public was later told.

Circumstances and Course

Pou later described making urgent decisions in what she considered appalling conditions. In her account, she injected morphine into patients who were dying and in agony, and gave a double dose when the first dose seemed insufficient. That account framed the medication as an effort to relieve suffering amid a crisis. The book also records that the patients were medicated as Memorial was being emptied by air and water, and that at least nineteen patients died. The deaths, the timing, and the evacuation therefore remain bound together in the account of the incident.

The larger emergency became part of the dispute over how the injections should be understood. In later lectures, Pou emphasized the hardships at Memorial, including the lack of running water, and asked audiences to imagine having to choose who would receive the last bottle of drinking water. The book notes that a large amount of bottled water remained after the evacuation, so that imagined choice had not been necessary there. It also describes Pou presenting the Coast Guard helicopters as arriving late Thursday afternoon, while pilots and LifeCare staff members recalled helicopters arriving earlier that morning. The book further reports Coast Guard rescue attempts beginning Tuesday afternoon and continuing overnight and into Wednesday morning; staff repeatedly sent helicopters away after deciding that evacuation in the dark was too dangerous and that personnel needed rest. These discrepancies matter because the lectures made the crisis sound more narrowly constrained than the record described in the book.

Testimony and the Grand Jury

At the special grand jury’s final meeting, assistant administrator Diane Robichaux and nurse executive Therese Mendez, both from LifeCare Hospitals of New Orleans, testified about the incident. Mendez said that Pou came upstairs, announced that she was assuming responsibility for the patients, and said they would receive a lethal dose of drugs. Neither Mendez nor Robichaux witnessed what happened next: they had left to clear staff from the floor. The prosecutor did not ask them detailed questions, and their testimony did not provide an account of the injections themselves.

Kristy Johnson, who had stood at patients’ bedsides as Pou and nurses injected them, was not called by the prosecutors, although people close to her later recalled that she was scheduled to testify that day and was available. One juror regarded the absence of a witness who testified to seeing Pou inject a patient as a fundamental weakness in the case against the person named in the indictment. The evidentiary gap did not lead that juror to believe nothing criminal had happened. The juror recalled that many patients who were alive in the morning were dead by afternoon, and believed the experts who concluded that the deaths were homicides.

The juror also remembered Emmett Everett at breakfast that Thursday morning, asking staff when they were going to rock and roll. That image remained with the juror years later, alongside the expert reports. Before the July 2007 vote, one grand juror asked whether anyone thought the panel was making a mistake; no one said so. The nurses had been sad and had cried during their testimony, while the coroner’s calm opinion struck one juror as contradicting much of what his experts had concluded. The panel ultimately declined to indict, but the juror who later recounted the proceedings remained convinced that a crime had occurred at Memorial.

Public Accounts and the Omitted Incident

Pou continued practicing surgery and became a popular national lecturer on ethical questions in disaster medicine. In those talks, she described FEMA as telling Memorial that airboats would be taken at noon and that people should get out what they could. The book says that neither the investigators Virginia Rider and Butch Schafer nor journalists who had covered the disaster had encountered that claim. Pou also said that Coast Guard helicopters arrived late Thursday, without acknowledging the earlier arrivals described by pilots and LifeCare staff. Her public account of the crisis thus differed on specific points from the accounts and records the book presents.

The lectures also shaped how audiences understood Pou’s arrest. She sometimes displayed her mug shot and used her experience to argue for laws granting medical professionals immunity from lawsuits and prosecution in future emergencies. But, the book emphasizes, she did not explain that she had been arrested on allegations of murdering patients rather than for making controversial triage decisions. She left out the injections entirely, including the decision she and her colleagues made to medicate at least nineteen patients on September 1 as boats and helicopters evacuated Memorial. That omission separated the public story of difficult disaster decisions from the specific act at the center of the investigation.

Pou challenged the American Medical Association’s directive that physicians serve in emergencies even when the risk is greater than usual, characterizing the duty as more difficult in practice than it appeared on paper. She also advised a Sacramento audience to restrict the media and use them as effectively as possible. These remarks accompanied her advocacy for immunity laws, while the patient injections themselves remained absent from her account of the decisions she discussed.

Disputed Meaning and Aftermath

For forensic expert Cyril Wecht, the incident raised questions that could not be resolved simply by describing Memorial as a battlefield. He argued that the patients were in New Orleans, where helicopters and boats were available, and questioned whether patients on the seventh floor could not have been removed, even if lowering them from a window would have been uncomfortable. His concern was that the case was being covered up and that medical leaders were responding emotionally without knowing what had occurred. He feared that, without scrutiny, doctors might learn that administering large doses of medication in a disaster was simply their decision to make.

Ethicist Arthur Caplan worried that the lack of formal analysis would leave the case morally unresolved. The book notes that many bioethicists avoided public judgments, in part because conditions at Memorial were so extreme that they believed moral assessment was difficult. This hesitation contrasts with Wecht’s demand for a clear examination of the evidence and with the juror’s conviction that a crime had occurred. The incident’s significance in the book lies partly in that unresolved tension: the account of medication as relief for suffering, the deaths and disputed circumstances, and the limited testimony heard by the grand jury continued to shape arguments about disaster medicine long after the evacuation.