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The Anna Pou case was a scandal arising from the deaths of patients at the Memorial Medical Center, New Orleans three days after the landfall of Hurricane Katrina in 2005. In 2006, Louisiana Attorney General Charles Foti arrested Dr. Anna Pou and two nurses, publicly stating that "his is a homicide". The case never went to trial. The charges have now been expunged and the state of Louisiana has agreed to pay Pou's legal fees.

During Katrina

Dr. Anna Pou, an associate professor in the Department of Otorhinolaryngology at the LSU Health Sciences Center, was at Memorial Medical Center from before Katrina's landfall on Monday, August 29 until Friday, September 2. By Wednesday, the hospital was surrounded by floodwaters, without sanitation, running out of food, experiencing indoor temperatures up to 110°, and had no electricity. The staff decided to evacuate the hospital. Patients on upper floors had to be carried down the stairs, and those evacuated by helicopter had to be carried up more stairs to the helipad on a separate building; several patients died while being moved. By Friday, about 2,000 patients, families and staff had been evacuated "under incredibly difficult circumstances".

The seventh floor at Memorial was leased to LifeCare Hospitals of New Orleans. LifeCare provides intensive care for severely ill patients, aiming to improve their health to the point that they no longer need hospital care. Many of LifeCare's patients at Memorial were especially affected by the loss of electric power, since they were on ventilators. None of LifeCare's doctors were present at Memorial during Katrina, so Memorial's doctors were in charge of LifeCare's patients.

Investigation

On September 13, mortuary workers recovered 45 bodies from the hospital. More than two dozen of the cases had large amounts of morphine present in their bodies, although few of them had been prescribed morphine for pain. In the following weeks, it was reported that staff had discussed euthanizing patients. Some reports went further. Dr. Bryant King, an internist at Memorial, told CNN that he believed that "the discussion of euthanasia was more than talk." LifeCare told the state Attorney General's office that nine of their patients might "have been given lethal doses of medicines by a Memorial doctor and nurses."

At the request of the Louisiana AG's office, Orleans Parish Coroner Frank Minyard investigated the cause of the deaths. Experts reported abnormal levels of morphine, midazolam (Versed), and/or Lorazepam in several bodies. In many cases, the experts said, the levels indicated homicide. Experts agreeing that the lethal levels of morphine constituted homicide in many of the deaths on the seventh floor included noted forensic pathologists Cyril Wecht and Michael Baden, along with the director of the toxicology lab where the patients' samples had been tested and three other independent pathologists, including the then-president of the American Academy of Forensics, James Young. Wecht thought eight of the nine deaths on the LifeCare floor could conclusively be ruled homicides, and Baden thought all nine constituted homicide. Young stated, “All these patients survived the adverse events of the previous days, and for every patient on a floor to have died in one three-and-a-half-hour period with drug toxicity is beyond coincidence.” A separate doctor stated that in the case of Emmett Everett, the patient had no fatal conditions or indications of imminent or impending death. University of Pennsylvania bioethicist Arthur Caplan also stated that all nine of the deaths were homicides. These experts agreed that the amounts of morphine used did not constitute any level of palliative care used in the United States.

Another expert, Dr. Steven Karch, who specializes in disputing drug toxicology tests performed after death, disagreed with the six other experts and said that due to the bodies lying in temperatures exceeding 100° for two weeks, drug samples from their bodies were less reliable. Investigators believed up to two dozen patients might have been euthanized, but stated that they had difficulty acquiring the medical records needed to document the patients' conditions. Tenet Healthcare said it turned over all the patient records it had on the case. Investigators believed that of the two dozen possible cases, they had the strongest case in the deaths of four of the patients who had died on the hospital's seventh floor.

On July 17, 2006, Pou was arrested and charged with four counts of second-degree murder in connection with the deaths of four LifeCare patients; nurses Lori Budo and Cheri Landry were arrested and charged, but charges were dropped in exchange for their testimony. State Attorney General Charles Foti announced the arrests the next day, at a widely televised news conference. "This is a homicide; it is not euthanasia," he said. The arrests were controversial. In the words of Times-Picayune reporter James Varney, they "ignited a furious debate in New Orleans and elsewhere about whether sharp ethical boundaries can be drawn around decisions on patient comfort made in a crisis."

60 Minutes aired a report on the case in September 2006. In an interview, Pou told Morley Safer:

"No, I did not murder those patients. Mr. Safer, I've spent my entire life taking care of patients."

In February 2007, Minyard issued his report on the deaths of the four LifeCare patients. He did not issue a determination of cause of death in any of the cases, leaving them classified as "undetermined". The New York Times reported in August 2009 that Minyard privately came to the conclusion that Pou was responsible for the deaths of four of the nine patients: “I strongly do not believe she planned to kill anybody, but it looks like she did.”

In March 2007, a state grand jury was sworn in to consider the Memorial case. Unlike a typical grand jury, this one dealt with just one case, and functioned as an investigation instead of a review of evidence. The grand jury did not hear from Minyard's experts, some witnesses who had been present, or the Department of Justice investigator who had spent a year on the case and amassed 50,000 pages of evidence. The two nurses who had been arrested with Pou testified in her defense, after being compelled to testify in return for not being charged themselves.

Outcome

After several months, the grand jury concluded its work by declining to indict any of the suspects on any of the charges.

Charles Foti lost the 2008 election for state Attorney General after criticism for prosecuting Pou and the nurses.

Since then, the charges have since been expunged, the state of Louisiana has agreed to pay Pou's legal fees (over $450,000), and several Louisiana lawmakers have apologized for the accusations against her.

Three wrongful-death lawsuits filed against Pou are still in progress, including one filed by Carrie Everett, widow of Emmett Everett.

See also

• List of people associated with Hurricane Katrina

References

1. The Memorial Medical Center has since changed ownership, and is now called the Ochsner Baptist Medical Center.
2. ^ Kathleen Johnston (October 13, 2005). "Staff at New Orleans hospital debated euthanizing patients". CNN.
3. ^ Sherry Fink (August 30, 2009). "Strained by Katrina, a Hospital Faced Deadly Choices". ProPublica and The New York Times Magazine.
4. ^ Daniel Schorn; Morley Safer (Aug. 15, 2007). "Katrina Doc Denies Mercy Killings". 60 Minutes. {{cite news}}: Check date values in: |date= (help)
5. ^ James Varney (August 6, 2006). "Doctor's drug mix not ideal killer: Evidence in Memorial case called unreliable". The Times-Picayune.
6. ^ Mary Foster (March 8, 2007). "Grand Jury to investigate hospital deaths". Associated Press.
7. ^ Gwen Filosa (July 16, 2007). "Foti sued by doctor accused in Memorial Hospital deaths". The Times-Picayune.
8. Jeffrey Meitrodt (February 1, 2007). "N.O. coroner finds no evidence of homicide: Memorial doctor still faces grand jury in 4 deaths". The Times-Picayune.
9. "'Dark Cloud' Lifted From Pou, Attorney Says: Grand Jury Declines To Indict Doctor In Hospital Deaths". WDSU. July 25, 2007.
10. Bill Barrow (2007-10-21). "Foti out as attorney general". The Times-Picayune.
11. "Gov. Jindal Signs Bill To Reimburse Anna Pou". Associated Press. July 1, 2009.

External links

• Dr Pou's biography at LSU

• Effects of Hurricane Katrina
• History of New Orleans, Louisiana
• Political scandals in the United States
• Medical ethics