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{{Multiple issues|
{{POV|date=February 2014}}
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{{Hoax|date=February 2014}}
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The '''Anna Pou case''' arose from the deaths of patients at the ], five days after the ] in 2005.{{cn|date=February 2014}} In 2006, Louisiana Attorney General ] arrested Dr. Anna Pou and two nurses, publicly stating that "this 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.{{cn|date=February 2014}}

==During Katrina==
Dr. Anna Pou, an associate professor in the Department of ] at the ], was at ]<ref>
The Memorial Medical Center has since changed ownership, and is now called the ].</ref> 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 {{convert|110|F|C}},<ref name=CNN051013>
{{cite news
|url=http://edition.cnn.com/2005/US/10/12/katrina.hospital/index.html
|title=Staff at New Orleans hospital debated euthanizing patients
|author=Kathleen Johnston |publisher=] |date=October 13, 2005}}</ref>
and had no electricity.<ref name=ProPublica>{{Cite web
|title=Strained by Katrina, a Hospital Faced Deadly Choices
|url=http://www.nytimes.com/2009/08/30/magazine/30doctors.html?_r=1&hp=&pagewanted=print
|author=Sherry Fink |publisher=] and ]
|date=August 30, 2009}}</ref>
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".<ref name=CNN051013/>

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.<ref name=ProPublica/> Many of LifeCare's patients at Memorial were especially affected by the loss of electric power, since they were on ventilators.{{cn|date=February 2014}}

One patient in particular, Emmett Everett, was alert and in the hospital awaiting surgery to relieve a chronic bowel obstruction, a condition not acutely life-threatening. According to witnesses speaking to '']'', Pou is alleged to have administered a lethal cocktail of drugs to Everett with the intent of ending his life. Everett was a paraplegic and weighed approximately 380 pounds; for these reasons, Dr. Pou allegedly didn't think the staff could reasonably assist him in the evacuation.<ref name=ProPublica/>{{rs|date=February 2014}}

==Investigation==
On September 13, mortuary workers recovered 45 bodies from the hospital.<ref name=ProPublica/> More than two dozen of the cases had large amounts of morphine present in their bodies,<ref name=ProPublica/> although few of them had been prescribed morphine for pain.<ref name=ProPublica/>{{vc|date=February 2014}} In the following weeks, it was reported that staff had discussed euthanizing patients.{{vc|date=February 2014}} 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."<ref name=CNN051013/> 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."<ref name=ProPublica/>

King publicly charged that one or more health care workers had killed patients, based on conversations with other health care workers. King told CNN that when he believed that a doctor was about to kill patients, he boarded a boat and left the hospital.<ref name=CNN051013/> King explained his actions in terms of his opposition to Pou's alleged actions, arguing "I'd rather be considered a person who abandoned patients than someone who aided in eliminating patients."<ref> CNN.com, 14 October 2005</ref>

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 ], ] (Versed), and/or ] in several bodies.<ref name=TP060806>
{{cite news
|url=http://www.nola.com/news/t-p/frontpage/index.ssf?/base/news-6/1154844156102520.xml&coll=1
|title = Doctor's drug mix not ideal killer: Evidence in Memorial case called unreliable
|author=James Varney |publisher=]
|date=August 6, 2006}}</ref>
In many cases, the experts said, the levels indicated homicide.{{vc|date=February 2014}} Experts agreeing that the lethal levels of ] constituted homicide in many of the deaths on the seventh floor included noted forensic pathologists ] and ], 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.<ref name=ProPublica/> Wecht thought eight of the nine deaths on the LifeCare floor could conclusively be ruled homicides, and Baden thought all nine constituted homicide.<ref name=ProPublica/>{{vc|date=February 2014}} 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.” <ref name=ProPublica/> A separate doctor stated that in the case of Emmett Everett, the patient had no fatal conditions or indications of imminent or impending death.{{cn|date=February 2014}} ] bioethicist ] also stated that all nine of the deaths were homicides; the administration of the drugs was "not consistent with the ethical standards of palliative care that prevail in the United States," precisely in that the death of a patient must not be the goal of a doctor's treatment; and death, in his opinion, was the goal in these in cases.<ref name=ProPublica/>{{vc|date=February 2014}} The experts were unanimous that the amounts of morphine used did not constitute any level of palliative care used in the United States.<ref name=ProPublica/>{{vc|date=February 2014}}

Having received these six reports indicating that that at least 8 of the 9 deaths under investigation were homicides, Minyard sought the opinion of another expert, Dr. Steven Karch. Karch specializes in disputing drug toxicology tests performed after death; according to the ''New York Times'', Karch "had staked his career on advancing the argument that the level of drugs found in a cadaver may have no relationship to the levels just before death." The ''Times'' continues: "Karch flew to New Orleans, examined the evidence and concluded that it was absurd to try to determine causes of death in bodies that had sat at 100 degrees for 10 days. In all of the cases, he advised, the medical cause of death should remain undetermined."<ref name=ProPublica/> Having received this opinion, Minyard sought no further opinions.<ref name=ProPublica/>

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.<ref name=ProPublica/> Tenet Healthcare said it turned over all the patient records it had on the case.<ref name=ProPublica/> 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.<ref name=ProPublica/>

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.<ref name=AP070308>
{{cite news
|url=http://media.www.thenichollsworth.com/media/storage/paper262/news/2007/03/08/News/Grand.Jury.To.Investigate.Hospital.Deaths-2769053.shtml
|title=Grand Jury to investigate hospital deaths
|author=Mary Foster |publisher=]
|date=March 8, 2007}}</ref>
State Attorney General ] announced the arrests the next day, at a widely televised news conference. "This is a homicide; it is not euthanasia," he said.<ref name=TP070716>
{{cite news
|url= http://blog.nola.com/times-picayune/2007/07/foti_sued_by_doctor_accused_in.html
|title = Foti sued by doctor accused in Memorial Hospital deaths
|author=Gwen Filosa |publisher=] |date=July 16, 2007}}</ref>
The ] says Pou and the nurses "intentionally (killed)" Emmett Everett Sr., 61; Hollis Alford, 66; Ireatha Watson, 89; and Rose Savoie, 90, by administering or causing to be administered lethal doses of ] and/or ].<ref name=TP060806/> According to Kristy Johnson, LifeCare's director of physical medicine, Pou told these patients that she was administering drugs to make them "feel better."<ref name=ProPublica/> The drugs injected are usually given for pain purposes, but not at the levels found in subsequent toxicology reports.<ref name=ProPublica/><ref name=TP060806/>

The arrests were controversial. In the words of '']'' 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."<ref name=TP060806/>

'']'' aired a report on the case in September 2006. In an interview, Pou told ]:<ref name=60Min>
{{cite news
|url=http://www.cbsnews.com/stories/2006/09/21/60minutes/main2030603.shtml
|author1=Daniel Schorn
|author2=]
|title=Katrina Doc Denies Mercy Killings
|publisher=] |date=August 15, 2007}}</ref>
:"No, I did not murder those patients. Mr. Safer, I've spent my entire life taking care of patients."

In February 2007, seven months after Pou's arrest, 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".<ref name=TP070201>
{{cite news
|url=http://www.nola.com/news/t-p/frontpage/index.ssf?/base/news-7/117031723220570.xml&coll=1
|title=N.O. coroner finds no evidence of homicide: Memorial doctor still faces grand jury in 4 deaths
|author=Jeffrey Meitrodt |publisher=]
|date=February 1, 2007}}</ref>
The case against Pou and the two nurses appeared more questionable after Minyard announced that he had classified the patient deaths at Memorial as "undetermined," which means that on available evidence he could not classify the deaths as due to homicide or natural causes. Minyard told the media that he had retained some of the nation's leading experts as consultants in the case.<ref>{{cite news | url = http://www.nola.com/news/t-p/frontpage/index.ssf?/base/news-7/117031723220570.xml&coll=1 | author = Jeffrey Meitrodt | title = N.O. coroner finds no evidence of homicide | publisher = ] | date = 2007-02-01}}</ref>
'']'' 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.” <ref name=ProPublica/>

==Outcome==
Assistant District Attorney Michael Morales said in 2009 that he and District Attorney Jordan "weren't gung-ho" about prosecuting the case, in part due to negative public reaction.<ref name=ProPublica/> 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.<ref name=AP070308/> The grand jury did not hear from Minyard's experts, some witnesses who had been present, or the ] investigator who had spent a year on the case and amassed 50,000 pages of evidence.<ref name=ProPublica/> 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.<ref name=ProPublica/><ref name=TP070716/>

The grand jury was sworn in on March 6, 2007, and prosecutors took the unusual step of having its meetings at an undisclosed location (i.e. away from the courthouse), in order to prevent the media from observing the identity of witnesses coming and going. The grand jury was selected to deal solely with the Memorial case, rather than the dozens to hundreds grand juries normally hear; prosecutors stated it could hear testimony for months.<ref>
{{cite news
|url=http://www.nola.com/newslogs/tpupdates/index.ssf?/mtlogs/nola_tpupdates/archives/2007_03_06.html
|title=Grand jury starts work in Memorial case
|publisher=] |date=March 6, 2007}}</ref>
The unusual moves prompted legal observers to speculate the district attorney considered the evidence ambiguous and wanted to be able to assure the public of a thorough investigation if he decided to drop the case without bringing formal charges. Loyola University Law Professor Dane Ciolono told the media, "Doing it this way certainly speaks to the ambiguity of the evidence and the prosecutor's deliberation as to whether to seek an indictment.&nbsp;.&nbsp;.&nbsp;. Or it could be that he's made up his mind that he does not want to bring charges and wants the grand jury to provide his cover."<ref> Associated Press, 8 March 2007</ref>

After several months, the grand jury concluded its work by declining to indict any of the suspects on any of the charges.<ref name=WDSU070725>
{{cite news
|url=http://www.wdsu.com/news/13744299/detail.html
|title='Dark Cloud' Lifted From Pou, Attorney Says: Grand Jury Declines To Indict Doctor In Hospital Deaths
|publisher=] |date=July 25, 2007}}</ref>

] lost the 2007 election for state Attorney General after criticism for prosecuting Pou and the nurses.<ref name=TP071021>
{{cite news
|url=http://www.nola.com/elections/index.ssf/2007/10/attorney_general_agriculture_r.html
|title=Foti out as attorney general
|author=Bill Barrow |publisher=]
|date=2007-10-21}}</ref>{{rs|date=February 2014}}

Since then, the charges have been expunged, the state of Louisiana has agreed to pay Pou's legal fees of over $450,000, and several Louisiana lawmakers have apologized for the accusations against her.<ref name=AP090701>
{{cite news
|url=http://www.abc26.com/news/local/wgno-news-pou070109-story,0,4892289.story
|title=Gov. Jindal Signs Bill To Reimburse Anna Pou
|publisher=] |date=July 1, 2009}}</ref>

A class action was filed on behalf on non-Tenet employees, patients and relatives who were stranded at the Memorial facility during the hurricane. The class action, ''Elmire Preston et al. vs. Tenet Health Systems, Memorial Medical Center, et al.'', Civil District Court No. 2005-11701 c/w 2006-8861, Division "A", alleged a number of failures by Tenet Corporation, running the gamut from a failed evacuation policy to the improper location of generators in the basement of the facility, which led to the loss of power.{{cn|date=February 2014}}

Tenet, while claiming no admission of liability, set up a 25 million dollar substantial settlement fund for all non-Tenet employees, patients and visitors who were trapped at Memorial during Katrina.{{cn|date=February 2014}}

LifeCare was not the subject of a class action, opting early on to pay substantial amounts of money to family members of 24 deceased patients, in lieu of trials.{{cn|date=February 2014}}

Three lawsuits (Alford, Everett, and Savoie) initially filed against Dr. Pou and the Memorial nurses have all been dismissed.{{cn|date=February 2014}}

==Aftermath==

In the four years following Katrina, Pou helped write and pass three laws in Louisiana offering immunity to health care workers from most civil lawsuits (except in cases of intentional misconduct) for their efforts in future mass casualty situations.<ref>{{cite web|title=Strained by Katrina, a Hospital Faced Deadly Choices|url=http://www.nytimes.com/2009/08/30/magazine/30doctors.html?pagewanted=all|work=New York Times}}</ref>{{rs|date=February 2014}}

==References==
{{Reflist}}

==External links==
* at LSU
*
*
{{DEFAULTSORT:Pou, Anna, Case}}
]
]
]
]

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