By Peter Laird, MD
Kimberly Saenz is under indictment for the alleged murder of five dialysis patients and five other patients allegedly harmed by bleach infusion. In an interesting opening evidence hearing on the admissibility of a study on rats exposed to chlorine gas, the defense argued against hearing this evidence as it has never been duplicated in humans. In this opening salvo of evidence by the prosecution and counter moves by the defense, the one issue clear in this case is that it will be a difficult and complex medical and science laden, circumstantial evidence case.
State, defense in Saenz case argue over validity of evidence
“The court needs to understand that at no time did the state or prosecution find bleach in blood, but instead found 3-chlorotyrosine,” Deaton said.
In addressing Deaton’s issues with the research’s validity, Angelina County District Attorney Clyde Herrington chronicled the death of one of Saenz’s alleged victims, a man the prosecutor said entered the dialysis center in good shape but did not leave that way.
“He was carried by his wife that morning (to the center). He was in good spirits. He laughed, he joked, he ate a boiled egg. He’s doing fine and the next thing you know, he’s unconscious,” Herrington said. “He died three to four months later.”
“Massive levels” of 3-chlorotyrosine were present in the man’s body, Herrington said. Defense team member Thomas W. Deaton attributed the patient’s 3-chlorotyrosine level to a “massive infection.”
“If ever there were a poster boy for a massive infection, it would have been (this patient). He came in with one prosthesis and lost another leg in the hospital,” Deaton Sr. said. “To give the jury that testimony to show a cause ... It’s bad science.”
The simple fact remains that there is no single, definitive and pathogneumonic test (A sign or symptom that is so characteristic of a disease that it makes the diagnosis) for bleach infusion. Of all the poisons and toxic chemicals, it is quite unique in that the body manufactures chemicals quite similar to bleach used mainly in immune cell reactions. Bleach is broken down by naturally occurring enzymes in the body. When we think of poisoning cases, most of the time it is a simple matter to run very precise tests showing evidence of a specific chemical. Not so in this case. Evidence of bleach infusion and its effects on the body is not directly measurable. In such, this entire case will depend on secondary tests that the prosecution will claim are evidence of bleach infusion.
The defense has publicly stated from the beginning that they believe Kimberly Saenz is a scapegoat for DaVita and the alleged clinical mistakes by DaVita.
State, defense in Saenz case argue over validity of evidence
From the beginning, Deaton has maintained that Saenz is merely a scapegoat for the company’s oversights and clinical mistakes. On March 5, a dozen jurors and two alternates will walk into Bryan’s courtroom to decide whether she is to blame.
For those expecting a quick and straight forward case, the fact that surrogate markers of bleach are the only evidence of bleach infusion places this case at its onset as one that is going to be complex, filled with high tech science most likely never used before in a murder case and complex patient medical records on top of allegations by the defense of clinical failures by DaVita. In the end, DaVita may be on trial as much as Kimberly Saenz. We will have to wait for the full case to develop in the news reports, but it will likely not be a straight forward case and assigning guilt or innocence is going to be a very difficult position for the jury to consider.
Consider that the prosecution is using chlorine gas exposure on rats without any human counterpart testing as evidence of murder. Many reading the Lufkin article above have probably already asked, what is 3-chlorotyrosine and what do rats have to do with a murder case? The answers to these questions and how complex the science is behind this case are daunting for trained medical specialists none of whom are likely to find their way on this jury of her peers. This will likely prove to be on of the most complex, circumstantial murder cases known to date.
As I sit here and think of this nurse and how Davita did not do background checks, I am reminded of the technician who informed many patients/families in my father's unit that he had to go to anger management classes due to domestic problems
Roberta Mikles
www.qualitysafepatientcare.com
Posted by: Roberta Mikles BA RN | Wednesday, March 07, 2012 at 12:46 PM