“Let’s go down to the coffee shop,” Richard suggested.
Caught by surprise, Kate could not come up with an excuse fast enough. Richard took her silence for a yes. “Come on. I’ll buy you a cup of coffee.”
They reached the café, ordered a coffee, and sat down in a booth.
“Tell me everything you know about Premier Regional,” Richard said.
“I told you, I only call them with clinical medical reviews.”
Richard gave her a hard stare. “I’ve been over there a few times still deciding if I want to change insurance companies. They are all in an uproar over that nurse reviewer that was run over. Did you know her?”
“Only by talking to her on the phone.”
“So you two weren’t friends? You never met her face to face?” Richard inquired.
“No. Why would you think that?” Kate was puzzled by his question.
“One of the ER nurses mentioned that you came in with her after the accident. She said you were covered in blood and looked like you had been in the accident too.”
“I was at the scene of the accident after the hit-and-run,” Kate said.
“What a coincidence. Did you know who she was? Did you witness the accident?”
“No to both questions.”
Richard continued his probing. “How did you find out who she was?”
“The police recovered her wallet at the scene. Why are you asking me all these questions about her? Did you know Linda?”
“No, I’m interested in the insurance company. What else do you know?”
“Nothing, Richard. Look, I have to get back to work. Thanks for the coffee.” Kate got up to leave. She was feeling a little uneasy with all his interrogation.
“Ok,” Richard said, “I’ll talk to you more about this another time. Do you want to out go with Maria and me this weekend?”
Hell no! she wanted to shout. “Can’t this weekend, I’m busy with my daughter, bye,” she said instead and quickly hurried away. That was certainly a strange conversation, she thought.
***
Rita had walked into the coffee shop, seen Kate and Dr. Timmers deep chatting, and sat down in the next booth from them. They were so engrossed in their conversation, they hadn’t noticed her. When Richard rose to leave, he spotted Rita, smiled, and sat down at her booth, not waiting for her response. “Mind if I join you?”
“No, what were you and Kate discussing so intently?” she asked nervously.
“Oh, nothing much. I’d much rather find out more about you. I saw you at Jake’s party, and you looked damn fine. Tell me about yourself, and I’ll tell you all about me.”
***
As Larissa Markov rounded the corner, she had also observed Dr. Timmers and Kate deep in conversation. She ambled over to the counter, sat down, and proceeded to eavesdrop. What’s up with them and their conversation? she thought. Why all the questions? She would convey the conversation to Sonya that night after work.
Chapter 27
“She knows nothing.”
“You just better be positive. We are close to our goal. What are we going to do with our other pain-in-the-ass nurse? She’s figured out what’s going on.”
“She’s in too deep to make any trouble. Besides, she knows about Linda’s hit-and-run. She’s got to be scared.”
“The one I’m worried about is the case manager, Kate Ross—that she’ll figure this out and demolish the whole deal for us. Do you think we should just do away with her, or maybe make a threat to her daughter, Megan?”
“Absolutely not! You need to settle down. Kate knows nothing. I’ve gotten close to her, and she is not going ruin your deal with Eastern National. No need to eliminate anyone else.”
“You better be fucking right. Keep me informed on what’s going at the hospital. Just so you know, we’re making much better progress at St. Joseph’s Hospital, without all the complications. Let’s keep on track here.”
“Just don’t jump the gun and do anything rash.”
“By the way, do you know our physician advisor, Dr. Sonya Raditz?”
“Yes, I’ve met her. Why?”
“Just wondered. I know she’s very chummy with a doctor at the hospital.”
“What doctor?”
“Dr. Larissa Markov.”
“Of course I know Larissa Markov. She’s on our staff. Great diagnostician.”
“My investigator says those two swap spit and a lot more.”
“Everyone suspects that Larissa is gay, so that’s no surprise. Why? Are you interested?”
“Yeah, right. No. She’s asking too many questions. I don’t like it.”
“What kind of questions?”
“About what’s going on in our company and about the hospital deaths.”
“Larissa Markov is quiet as a mouse and keeps to herself. She is not a problem.”
“Well, mice can fucking squeak, so see what you can find out. I’m getting nervous now that we are getting so close.”
***
Across town in the ICU at St. Joseph’s Hospital, a nurse stood over the patient’s bed, injecting the medication into the IV of the two-day post-operative surgical patient, Mrs. Louise Pierson. Mrs. Pierson’s eyes flew open. The intense burning sensation in her arm radiated to her chest. She reached frantically for her call bell. Oh God, where was it? She turned her head to see someone standing by her bed, then clutched her chest, barely able to speak, “Help . . . !” She dropped off into darkness.
The nurse glanced at the heart monitor and noted an arrhythmia, then no pulse. The nurse slowly picked up the call bell from the floor, tied it back on the side rail, then called out to the nurses’ station on the intercom, “Call a Code Blue. Mrs. Pierson has coded.”
***
Later that afternoon, the utilization review nurse from St. Joseph’s Hospital, Stacy Hurley, called the insurance company to inform them of Mrs. Pierson’s demise. Weird, she thought after the call. That was the fifth or sixth patient death in the past few months in ICU with the same insurance carrier—Premier Regional. Strange!
Chapter 28
“Help me, Kate!”
Kate eyes shot open. At the head of her bed was a woman covered in blood with half her skull crushed in. “Who are you?!” Kate asked, terrified. She pulled the covers up to her chin.
“You know who I am. I’m Linda McCarthy. Help me uncover the truth.”
“What truth? What are you talking about?”
“Think, Kate! You know exactly what’s going on. Dig deep in your mind. Remember what we joked about on the phone.”
Kate bolted out of bed, drenched in sweat. Her heart was pounding. Her breathing was rapid. She looked around her room. No Linda. But she had seemed so real.
Kate went into her bathroom and threw cold water on her face. Calm down, she thought. It was just a dream, a nightmare! She changed her pajamas and went back to bed but was afraid to close her eyes lest the nightmare strike again. The bedside clock read 2 a.m. Kate’s mind churned as she reviewed the dream. Dig deep into your mind . . . remember what we joked about on the phone . . . you know exactly what is going on . . . help me, Kate!
Kate dozed off and on the rest of the night and finally dragged herself out of bed at seven o’clock. She showered, dressed, grabbed a cup of coffee, and ran out the door to the hospital. When she arrived at work, her co-workers were gathered around for their weekly case management staff meeting. At these meetings, they usually discussed their long-term patients and updated their progress with cutting down on hospital length of stay.
“This is a little off-base from our usual discussions, but my friend from St. Joseph’s Hospital, a nurse case manager, told me there have been five deaths in their ICU and all from the same insurance carrier. Strange, huh?” Kate’s co-worker said.
Kate felt a cold chill
and sudden terror. “Would that insurance company be Premier Regional?”
“Yes. In fact, it is Premier Regional. How did you know?” the co-worker asked.
Kate’s heart rate escalated. “There have been several deaths in our ICU, also from Premier Regional.”
The supervisor intervened. “People, we’re getting a little carried away here. We have patients dying every day in the hospital.”
“I just think this is a little too coincidental, that’s all,” Kate blurted.
They all went off to their assigned floors, and Kate kept herself busy all day. She couldn’t shake the gnawing, chilling feeling in the pit of her stomach. She asked her co-worker the name of the nurse case manager at St. Joseph’s Hospital who had told her of the deaths. Could this really be happening?
***
That night after dinner, Kate called the case manager, Stacy Hurley, from St. Joseph’s Hospital. After introducing herself, Kate explained that her co-worker had told her about the deaths at their hospital’s ICU and that they all had the same insurance company, Premier Regional.
“What do you think is going on with these patients, Kate?” Stacy asked.
“I don’t know. I’m just curious, that’s all. Would you be willing to pull the charts of those patients and copy them for me? I know it’s a lot to ask and a HIPPA violation, but I’d like to compare them with the charts at my hospital to see if there’s a common factor present in the patients.” Kate paused and hoped Stacy wouldn’t detect her next lie. “I’m going to do a paper from a risk management standpoint. You could check with my co-worker if you need to.”
Stacy paused a moment while Kate held her breath. “All right. I’ll copy the charts for you. Do you want me to meet you somewhere with them?”
Kate immediately thought of Linda McCarthy, trembled, and thought, Oh God, I can’t do that again. “Why don’t I come over to St. Joseph’s, whatever time you say. I really appreciate your assistance. Thanks.”
“I’ll call you tomorrow after I copy the charts. Please keep this between us, okay?” Stacy said.
Kate thanked her again, hung up, and stared into space. Was she really up to this?
***
The following day, Kate waited patiently for Stacy to call. After lunch, she went down to Medical Records and copied the charts of Sara Banks, James Allen, and Martin Staden. Together with Stacy’s charts she hoped to come up with some kind of similarity or common denominator.
Right before the end of her shift, she received the call from Stacy. She drove to St. Joseph’s and met Stacy in the case management office. Stacy had specified that everyone in the office must be gone when they met. Normally she wouldn’t have considered copying the charts, but she had called her friend and found out that Kate’s request to look over the charts was legit. Besides, Stacy was a little curious about the results.
“This is between you and me, right?” Stacy verified. “I could get jammed up big time, you know. What exactly are you looking for?”
“I’m not sure. Just a hunch I need to check out. This will stay between us. Don’t worry. And thank you.”
Stacy wished Kate good luck and handed her the charts. “Let me know what you find out.”
Driving home, Kate wondered what the hell she was doing. What was she hoping to find or not find?
Stacy had walked out of the hospital to the parking lot with Kate, where they chatted for a few minutes before Kate drove off. Realizing she had forgotten her keys, Stacy went back into the hospital. Someone called out to her, “Excuse me, I’m a physician here. Was that Kate Ross you were just talking to?”
“Yes, it was. She’s a nurse from Northwest General.”
“What was she doing here? Trading hospital secrets?” He flashed her a wide grin.
“Yeah, right,” she laughed, liking the looks of him. “No, just looking at charts. She’s doing a study on patients from a certain insurance company.” Man, thought Stacy, I’d like to study you. An in-depth, up-close, personal study!
“That insurance company wouldn’t be Premier Regional, would it?” He asked.
“Wow. Are you physic?” The nurse hoped he could read her mind. It read, Take me; I’m yours!
The handsome doctor said thanks, goodbye, and walked briskly off before she had a chance to continue. He stepped into his car and drove off.
Stacy sighed. Damn! I didn’t have a chance to get his name, or give Dr. Gorgeous my name and number. Pity!
***
“We have a problem!”
“What kind of problem?”
“I was over at St. Joseph’s today, and Kate Ross was over there talking to one of the nurse case managers about our deceased patients. Not sure what she knows, but she could be suspicious.”
“Damn it! You assured me she was not going to be a problem. What are we going to do now?”
“I don’t know. Let me think on it.”
“No time for thinking. Time to get rid of her.”
“This is different. I know her. Let me find out what she knows, and I’ll get back to you.”
“No way. If she’s suspicious, we can’t risk her finding out what’s going on.”
“Let me deal with her. Please give me some time.”
“I’ll give you twenty-four hours. Find out what she knows, and we’ll deal with the situation. If you can’t, we will!”
“What about the nurse reviewer at St. Joseph’s I met today. She knows my face. If something happens to Kate, she could put two and two together and be suspicious.”
“I’ll take care of her. What’s her name?”
“Her name tag read “Stacy Hurley.” She’s a case manager at St. Joseph’s Hospital.”
***
Stacy Hurley was soaking in a luxurious vanilla, plum bubble bath. Soft-scented candles flickered throughout the room, providing the only light in the bathroom. Loud rock and roll music blasted from the radio on a small table by the tub. This was Stacy’s nightly ritual that relaxed her after a hard day’s work. She sank deeper into the hot, steamy water and spread the bubbles over her body. Then she closed her eyes and thought about the doctor she’d met that afternoon at the hospital. She imagined him in the tub with her, spreading the bubbles slowly over her body, touching her everywhere. He pulled her closer to him and their legs wrapped around each other. The water became hotter and swirled around, spilling over the edge of the tub onto the floor.
***
The man stood in the bathroom with a leering smile on his face, watching Stacy in the tub. At least she’s going to die happy, he thought. He had opened her apartment door with ease, and, after checking the rest of the apartment, he’d followed the loud music to the bathroom. Stacy was so engrossed in her fantasy that she didn’t even know a stranger stood in her bathroom watching her in the tub. This is way too easy, the killer thought, grinning. His original plan was to strangle her and make it look like a robbery, but this was a no brainer. Chick in the tub, radio on the table beside the tub. No challenge. He watched her for a minute longer, wishing he was on the other end of her fantasy. It looked like a wild ride. Goodbye Miss Bubbles, he thought, and pushed the radio into the tub.
Stacy immediately opened her eyes in shock, feeling the electricity shoot through her, causing her body to shake violently then go limp as her heart stopped.
The killer watched her die. He tipped the table against the tub to look like it had just fallen there. Perfect scenario. Everyone would think the table had tipped over and the radio had fallen into the tub. The killer removed his gloves, put them into his pocket, and left the apartment. Piece of cake!
Chapter 29
Kate examined all the charts thoroughly, searching for some common element or clue to what was going on. She made a list of patients’ names, diagnoses, admitting physicians, medical history, consulting physicians. Nothing was the same—different ages
, different diagnoses, different admitting MDs, different medical histories. Two common factors were: 1) all patients had the same insurance—Premier Regional and 2) all the patients had multiple admissions and a complex medical history. The bulb in her head shone brighter while the sickening feeling in her stomach grew stronger.
Next she studied all the code sheets. A specific pattern formed for all: 1) All patients started with a cardiac arrhythmia, then developed asystole; 2) All codes happened on the day shift, usually around lunch time when the unit had fewer staff during lunch break.
What are you thinking. Kate? Her thoughts churned around in her head. With trembling hand, she wrote out a list of all participants in the codes at each hospital:
Northwest General Hospital
St. Joseph’s Hospital
Rachael Reynolds, RN
Jordan Linden, RN
Rita Jenkins, RN
Gayle Keller, RN
Julie Summers, RN
Garth Mitchell, RN
Lydia Brooks, RN
Linda Sutton, RN
Maria Sanchez, RN
Mary Ann Davis, RN
Richard Timmers, MD
Fred Sanders, MD
Jake Fenelli, MD
Dan Halloway, MD
Ben Lucien, MD
Richard Timmers, MD
Larissa Markov, MD
Jake Fenelli, MD
Henry Margolian, MD
Ben Lucien, MD
Larissa Markov, MD
This can’t be. Her mind was spinning. Dr. Timmers, Dr. Lucien, Dr. Markov at all the codes. And her Jake. No, no, absolutely NO! This is crazy!
Code Blue With Intent Page 12
