Medical Error pft-2

by Richard L Mabry

  Ross rubbed his chin. "We'll have to see, won't we?"

  "How's the patient today?" Anna opened her eyes and saw Neil Fowler standing at her bedside. He wore a gray scrub suit, and the impression of a surgical cap ringed his forehead.

  "I'm a bit wobbly on my feet sometimes, but my memory's pretty much come back." Anna struggled to grin. "Sometimes that isn't good, though."

  Fowler leaned his back against the doorframe and stretched."Oh, that feels good. I just finished a bowel resection, and my back is killing me." He straightened. "Anna, I know I told you to use your time offto clear yourself of these narcotic prescription charges, but I think it's time for you to stop. I don't know all the details, but if whatever you've been doing is what got you that concussion, it's not worth it. Let me talk with the DEA and see if they're about ready to turn you loose to practice again."

  "No need. I've spoken with one of the agents." She made an effort to brush the cobwebs away from her head. "Agent… his name escapes me. He's supposed to call you to tell you they haven't found any involvement on my part. They're going to issue me a new number. What I have to do-" Something, some instinct, stopped Anna before she told Fowler her deal with the DEA: have her privileges restored in exchange for keeping her eyes and ears open. She didn't really suspect her chairman of involvement in the counterfeit prescriptions, but then again, she had no reason to exclude him from her list of suspects.

  Fowler apparently took her letting the words trail offas just another sign of her recent concussion. He nodded, stretched, and said, "Well, I'm converting your special leave to sick leave. If you're like me, you've got more of those days stored up than you'll ever use. So take the time you need to heal from this head injury. We miss you and we'll be glad to have you back at work, but don't push it."

  After Fowler left, Anna wondered why she hadn't fully con- fided in her chairman. Was it because he had access to all the offices in the department, including hers? How easy would it be for someone in his position to get access not only to her purse but to her personal information, her Social Security number? Was she being paranoid… or just careful?

  13

  Anna stretched and yawned. It was good to wake up in her bed. She luxuriated in the feel of fresh sheets, crisp and clean against her skin. She inhaled the aroma of the coffee that the automatic timer on her coffeepot had already started brewing. Mike Simpson wanted to keep her in the hospital for another day, but she pleaded with him until he gave in, extracting a promise that she take it easy for a few more days. Her definition of taking it easy would probably be different from Mike's, but she had things to do and not even a concussion would stop her. Some coffee and a couple of Tylenols should get her going. Then she'd see where the day took her.

  Anna sat in her robe at the kitchen table and nibbled on a toasted English muffin spread with cherry jam. Her mind was already busy trying to decide where in the tangled skein of her problems she might find a loose thread to pull. Repair her credit? She needed to take Ross the paperwork she'd started, but that wasn't urgent. Clear herself with the police and the DEA? Right now, the DEA seemed content to let her alone. As for the police, Green and Dowling had grudgingly agreed to put offthe interview until tomorrow, and there was no use worrying about that until she knew what they wanted.

  Then there was the Hatley case. She was sure now that his death wasn't due to malpractice, but rather a terrible accident directly attributable to someone using Hatley's identity to put false data into his medical records. Ross had warned her away from digging further into the Hatley case, at least until they saw whether a malpractice case was truly forthcoming. But Anna couldn't get over the feeling that she and Eric Hatley weren't the only two people who'd suffered misappropriation of their medical insurance information. If she could somehow find a pattern, she might be able to trace the enterprise back to its perpetrators. And if she could do that, she'd solve a lot of her problems.

  After breakfast, Anna sat down at her desk and went through the mail that had accumulated during her brief hospitalization. She set a few bills aside to be paid and tossed the junk mail into the wastebasket. Then she recalled her intention to get a shredder, something else that had fallen through the cracks, something more for her "to do" list. Anna retrieved the mail from the wastebasket and shuffled through it to find everything that had her name and address on it. By the time she finished tearing the documents to shreds, her wastebasket looked like the aftermath of a snowstorm.

  Maybe she'd better check her bank balance before she paid the bills. She logged onto the bank's website, entered her user name and password, and frowned when she saw the amount shown in her account. That couldn't be right. What had happened?

  She clicked on "transactions" and ran her finger down the list on the screen. She didn't recall writing the last three checks that were listed. Matter of fact, she was certain she'd never bought anything from those stores. Was someone… did this mean…? No, there was no question. Identity theft and its effect on her finances had just jumped to the head of her to-do list for the day.

  Nick Valentine sensed movement in the doorway of his office. He looked up to see Anna standing there, holding two cups of what appeared to be Starbucks' best.

  "Hey there. How are you feeling?"

  Anna handed him one of the cups and settled into the chair across the desk from him. "Still a dull headache. Sometimes I feel like I need to brush some cobwebs out of my brain. But all in all, not too bad."

  He motioned her to a chair. "What are you doing here? I thought Dr. Fowler told you to take a few more days off."

  Anna shook her head, sending her red hair left and right, revealing a few gold highlights Nick hadn't seen before. "I came by to get some papers I left in my office. I need to take them to my attorney." She smiled. "While I was in the building, I thought I'd come by and share some coffee with you."

  "That's great." He took a sip. Perfect. Just like the beautiful woman sitting across from him. "Anna, I think we're getting to be more than friends. At least, I hope so. And I hope you feel that way too."

  Anna gazed at her coffee cup as though it were a crystal ball. "Nick, I like you a lot. But right now my life is so messed up, I don't think there's any way I can get into the kind of relationship I think you want. Maybe, after things straighten out, that's a possibility. In the meantime, can we continue to be good friends?"

  Nick forced a smile. "Sure. And friends help each other. Is there anything I can do?"

  Anna rose and dropped her half-full cup into the wastebasket."Thanks, but I'm not sure myself what my next move needs to be. I'm on my way to meet with Ross Donovan, and we'll map out our strategy then."

  The name brought bile to Nick's throat, and he tried to push it down with a sip of coffee. "Don't forget that I'm here to help. Ready, willing, able… and sober."

  "Nick, don't be that way. Ross has had some problems with alcohol, but he's doing okay now. And don't be jealous that I'm seeing him. I'm in legal trouble, and he's my attorney. If I were in medical trouble, I'd turn to you."

  "I just don't want you hurt." Nick wondered if that wasn't a half-truth. The truth was that if Anna began to develop feelings for her attorney, there was a chance it would end in heartbreak for her. But Nick's heart might be broken as well.

  Ross Donovan reached for the manila folder Anna held out.

  "This is what I put together," she said. "I was on my way to the medical school to make some copies when my car died. By the time I got to the school, something else came up, and I just threw this into a desk drawer and forgot about it." She grimaced. "Sorry."

  Ross dropped the folder onto the corner of his desk. "No problem. I'll look through this to make sure you have all the paperwork done right. You can sign the forms, and we'll send them to your credit card companies and the credit-reporting bureaus. I'll help you make sure there's no permanent damage to your credit."

  "Unfortunately, something else happened today. I guess you need to know about that too."

&nbs
p; He listened, occasionally jotting a note, as Anna told him about her discovery of the checks someone had written on her account. "Have you spoken with the bank?" he asked.

  "I stopped by and talked with one of the officers at my local branch. There's no question the checks were forged. What confuses me is that they were written on my own blank checks. The name, the address, even the style of the check-all the same as the ones I've always used."

  "Easy enough for someone to get hold of one of your checks and have new ones printed, you know."

  "I know," Anna said. "But the sequence of numbers corresponded to my own checks. These followed the last check I wrote. Matter of fact, I haven't written any checks in the past four days, not only because I've been in the hospital, but because I ran out of checks. In church last Sunday, I saw that my checkbook was empty, so that evening I went online and ordered a new batch. They haven't come yet, though. Guess I need to check on that."

  Ross was shaking his head before Anna finished. "Here's what probably happened. The online order was picked up first thing Monday and, unfortunately for you, they got right on it and printed them. The checks were mailed out Tuesday morning and arrived at your place Wednesday, while you were in the hospital. Someone stole the order from your mailbox and had a whole day to write checks before you came home on Thursday."

  "I never thought about that. I've always had the checks sent to me by mail."

  "You've been lucky so far. Doing it that way is fine if someone has to sign for them, but it's risky if they're simply left in your curbside mailbox. Ideally, you should have them delivered to your branch bank for you to pick up. It's even better to get a post office box and have all your secure mail sent there." Ross leaned across the desk. "Is the bank crediting your account?"

  "The bank officer said she would check and see what she could do."

  "She probably wants you to file a police report before she takes action. We can take care of that."

  Ross picked up the phone and dialed, wondering if he'd go to this much trouble if the client across the desk were a sixtyyear-old farmer wearing jeans and a flannel shirt instead of an attractive redhead whose green eyes seemed to hypnotize him every time he looked into them.

  The day was nice, so they walked the dozen blocks from Ross's office to the police station. It seemed to Anna that the closing of the heavy outer door extinguished not just the sunlight, but all traces of hope. Both the walls and the mood of the building were gray. All around her were men and women engaged in a struggle, some of them trying to preserve their liberty while others tried to deprive them of it, perhaps even of their lives.

  Anna fidgeted in her chair. She wondered if the police deliberately chose chairs for their interview rooms that would provide maximum discomfort to the suspects sitting there. Beside her, Ross Donovan crossed his legs after carefully hiking up his pants leg to preserve the crease in his gray pinstripe pants. His jacket was unbuttoned, showing a blue Oxfordcloth shirt and striped tie. He showed no signs of nervousness, but then again, this was his natural environment. Put him in an operating room, and he'd be sweating like she was now.

  Anna started to rise when the two detectives walked into the room, but she stopped when Donovan touched her lightly on the shoulder. Don't show any respect for them. He'd warned her to volunteer nothing and to look at him before answering if there was any doubt in her mind about the information involved.

  As usual, Dowling's expression was one of boredom mixed with cynicism, while Green nodded coldly at them and took a seat across the table. Dowling, a marked contrast with his partner in skin color and physique, reached across the table and shook hands with Anna and Ross before seating himself beside his partner. Well, if they were going to play good-cop, bad-cop, the two men were continuing in the roles they'd already established.

  Dowling began. "Doctor, we appreciate your coming in. I'm sorry to hear about your accident. How's the head?"

  "I'm fine, thank you," Anna said.

  "My client has suffered a concussion," Donovan said. "I'm sure you know that for several days afterward the thought processes can be muddled. Let's be sure to get that on the record."

  "We're not on the record, yet, Counselor," Green said with a scowl. "But since you bring it up, let's do that, if you don't mind." He reached to the middle of the table and punched the button on a tape recorder. "This is a record of the interview with Dr. Anna McIntyre by Detectives Lamar Green and Burt Dowling. Also present is Ross Donovan, attorney for Dr. McIntyre. Doctor, do we have your permission to record this interview?"

  Anna looked to Donovan, who nodded. "Yes," she said.

  "Doctor," Dowling said, "We have previously asked you about numerous illicit prescriptions for large amounts of the narcotic, Vicodin, that have circulated in the community, all of them bearing your signature and Drug Enforcement Agency number."

  "Wait a minute," Donovan said. "The prescriptions bore the forged signature of my client."

  "Sorry," Dowling said, although his expression didn't show it. "They were signed with the name of Dr. McIntyre." He paused, apparently waiting for a comment, then continued."Doctor, you have denied writing those prescriptions. Would you like to change your statement at this time?"

  "No. I didn't write them," Anna said.

  "And if we put you under oath?"

  "I'd still deny writing them."

  "Okay, we won't swear you in at this time, but we may come back to that," Dowling said.

  Green fixed Anna with a stare. "Doctor, how well did you know Eric Hatley?"

  The sudden shift in subject caught Anna by surprise. "I didn't know the man. I'd never seen him until he was on the operating table."

  "And you maintain that his death was an accident?"

  "It was the result of a massive allergic reaction to a medication administered during his emergency surgery," Anna said.

  "Doctor, why would you administer such a dangerous drug to the patient?"

  Anna leaned across the table, trying to drive home her point."The drug wasn't dangerous. It was Omnilex, a potent antibiotic prescribed and administered quite safely every day. It was necessary to give it because Mr. Hatley had been shot. Bowel contents spilled into his abdominal cavity. Without antibiotic treatment, he could have developed peritonitis and died."

  Green shuffled some papers until he came to what he wanted. "This is the death certificate for Eric Hatley. The cause of death is listed as-" He squinted at the paper. "Is shown as anaphylaxis due to allergic reaction to Omnilex. Do you agree with the pathologist, Dr. ..?" Green squinted again. "Dr. Valentine?"

  "Yes. I discussed the case with Dr. Valentine before he rendered a final cause of death. I agree with his diagnosis."

  "So why would you give Omnilex to a man who was so allergic to it?" Green asked.

  Anna wondered where this was going. She glanced at her attorney, who gave a slight shrug. Apparently, he was as surprised as she was that they were going over this yet again."We checked the hospital records and found a prior visit for a patient with the same name, date of birth, and other identifying data as Eric Hatley. At that time, only a few weeks earlier, he had been given Omnilex and suffered no adverse effects."

  "Let's talk about that drug," Dowling said. "You knew that if Omnilex was administered to a patient who was highly allergic to it, the result could be a fatal reaction. Is that correct?"

  "Of course. The same can be said of almost any drug."

  Dowling's voice was calm, but his words made Anna's stomach clench. "And you didn't know Eric Hatley, had never heard him mention his allergy to that drug, had no reason to try to kill him?"

  "Of course not!"

  Green dug into his pocket and came out with something he held clenched in his huge fist. "Doctor, I submit to you that Eric Hatley was one of the many people who looked to you for illicit drugs. But he got nervous about it and was about to go to the police and expose the whole setup. You arranged for Hatley to be shot, but the assailant missed. Instead of killing him, he hit
Hatley in the abdomen. When he showed up in your operating room, you decided to finish the job by giving Hatley a dose of an antibiotic to which you'd already learned he was highly allergic. I submit to you that you are guilty of the murder of Eric Hatley."

  Anna felt her temper rising to the top. Where was this coming from, anyway? "That's ridiculous. You have nothing to suggest there's even a shred of truth in that accusation."

  Green flashed perfect white teeth and opened his fist, allowing a pill vial to drop onto the table. Donovan picked it up, looked at it, and handed it to Anna, a stunned expression on his face.

  Anna's hand, normally steady under the greatest stress of the operating room, trembled slightly as she took the vial and read the label. "Eric Hatley. Vicodin ES tablets. #100. Take one tablet every four hours for pain. Dr. A. McIntyre. Two refills."

  She hardly heard Dowling's voice droning, "You have the right to remain silent…"

  14

  It took a few seconds before instinct and experience made Ross Donovan move. He was pleased that years of alcohol hadn't erased those reflexes. Dulled them a bit, maybe, but they were still there. And this seemed the way to go.

  Ross leaned toward Anna and whispered in her ear, "Don't say another word. Don't even acknowledge the Miranda warning."

  She turned toward him, her eyes wide, and opened her mouth. He touched his lips with his forefinger and shook his head.

  "Doctor, do you understand these rights?" Dowling asked.

  Ross spoke distinctly, leaning a bit toward the microphone, making sure his words reached both Dowling and the tape."Detective, my client, as I clearly pointed out before you began this taping, has recently been hospitalized with a severe head injury. The chairman of the Department of Neurosurgery at the University of Texas Southwestern Medical School was her attending physician, and I feel sure you'll agree he's qualified as a medical expert. If necessary we can produce an affidavit from him that she's still not completely recovered. Since she is not yet in full possession of her faculties, I find your ambush tactics to be both unethical and bordering on harassment."