However compelling Kathy Rix’s narrative of finding broken ampoules of epinephrine might be, the government had been dealt a brutal setback over the holiday break. On a trip to Pennsylvania to visit Dr. Rieders to see how he was coming along with the toxicology tests he was conducting on the tissue samples, Welch and Vuono learned that the doctor had miscalculated some of his figures and made several mathematical errors.
Rieders’s laboratory was said to be one of the only labs in the U.S. with the proper equipment to detect epinephrine in human tissue. Even so, a simple mathematical error tainted the entire batch of evidence. Rieders would get hammered for making the mistake, and the rest of his testimony would be suspect. Welch and Vuono realized they couldn’t use it—which meant their entire case now relied on circumstantial evidence.
A hard-nosed, straight-to-the-point woman who held little back, Kathy Rix had not changed much since 1996. She was still the good-looking cop’s wife from Westfield who had held on to perhaps one of the most important “nuggets” of information in the trial.
Rix may have broken down during those first few meetings with the HCI inspectors who had first arrived on the scene years ago, but she’d had several years to think about what she was going to say when she got on the stand.
“How long have you been a registered nurse?”
“Twenty-five years.”
For the next fifteen minutes, Welch had Rix run through her rather impressive credentials. By the time she was finished, spectators were asking themselves if there was anything Rix hadn’t done within the medical community.
“How would you describe [the defendant’s] professional skills as a nurse?”
Rix looked over at Gilbert, yet Gilbert kept her head down.
“Kristen was an excellent nurse. She had very good clinical skills, assessment skills.”
“What was her knowledge with respect to medications? Was it up to par?”
“Excellent.”
Short, quick responses. Rix said only what she had to, no more.
While Hoose continually objected to Welch’s next line of questioning, Welch got Rix to talk about Gilbert’s “bedside manner.” Rix said it was normal. But that was it. When Welch asked if it was better than anyone else’s, Rix simply said “no,” over an objection by Hoose.
“What do you know about epinephrine and its effects?” Welch asked next.
“Epinephrine is a very powerful cardiac drug. It’s an emergency drug. It causes the blood vessels in the periphery of the arms and legs to constrict and bring the blood flow to the torso and head. It raises a person’s blood pressure and their pulse and helps, hopefully, to revive a person when used in an emergency.”
Next, Welch had Rix explain where ampoules of epinephrine were stocked, and which form the drug came in. He established through Rix that the Ward C nurses had full access to the drug and knew where the key to the satellite pharmacy was kept.
“During the time you worked at the VAMC . . . did you ever know the 1:1000 epinephrine [ampoules] to be used on Ward C or in the ICU?”
“No.”
Welch asked her if she had ever—in her ten years as a nurse at the VAMC—personally used the 1:1000 ampoules of epinephrine.
“Once.”
But it was after the fact, in 1998. And as Rix continued to tell the jury when and why she used it, Hoose objected to any further testimony.
But Ponsor continued to let Rix tell her story.
For the following half hour, Welch and Rix talked about Francis Marier. She went through Marier’s vital signs—“stable, normal”—his mental status—“alert and orientated”—and how his blood sugar level continued to drop, even after he received several ampoules of D-50. At one point, Welch got Rix to confirm Gilbert had given Marier his shot of insulin at five P.M., but still, eight hours later, his body was consuming the D-50 at levels like she had never seen.
Then it was on to how Gilbert had changed throughout the summer and fall of 1995. As Rix answered his questions, Welch kept an eye on the time. With the end of the day approaching, he had a plan.
By the time court broke at four o’clock, Welch had Rix drop a bombshell.
“When you looked in the medicine cabinet area of the ICU [in Thomas Callahan’s room], into the round disposal needle bucket, what did you see?”
“I saw epinephrine vials broken and used.”
“How were you able to see these epinephrine broken vials?”
“You can look sort of in the half-moon hole, sort of shake it around and look.”
“When you saw the broken epinephrine vials, what was your reaction?”
“I was stunned.”
CHAPTER 88
When court resumed the following day, Kathy Rix continued on the pace Welch had set when they broke the previous day. Following Ed Skwira’s code, several weeks after Thomas Callahan’s, Rix told the jury she had searched the medicine supply cabinet and noticed that the ampoules of epinephrine she had counted earlier that day were gone.
“I opened the drawer and there was no epinephrine. It was awful,” Rix said, looking jurors square in the eyes. “It made me sick.”
Then she told the story of how she, Renee Walsh and John Wall had gotten together sometime later and decided to turn Gilbert in.
“Thank you,” Welch said.
David Hoose had listened closely to every word. There were holes in Rix’s story. But he didn’t attack her account of finding the spent ampoules of epinephrine right away. Instead, he wanted to first bring into the record one of his theories: that because several nurses had a problem with Gilbert and Perrault’s adulterous relationship, all these stories were somehow dreamed up to get back at her.
Rix gladly told jurors she felt Gilbert and Perrault’s affair was wrong.
Hoose then asked Rix about her decision to forgo reporting what she had found in Thomas Callahan’s room. He wanted to know why she hadn’t told anyone beside John Wall about the discovery.
Rix said she was afraid Gilbert would find out.
When Hoose pressed, Rix said she was concerned with Timothy O’Donnell, the Chief of Security. She thought he would likely go running to Perrault, and then Gilbert would find out.
“Kristen could be very vindictive,” Rix said. “It was very likely that Jim would find out who was bringing the investigation.”
“Why didn’t you take the used ampoules of epinephrine?” Hoose asked.
“What was the point?”
“To get the evidence that is not in front of the jury!” Hoose screamed.
It was a cheap shot. Rix, along with the rest of the nurses on Ward C, did not go to work every day looking for evidence of murder; they went to work to save lives. At the moment Rix found those spent ampoules of epinephrine, she didn’t consider them to be “evidence” in the sense of the law. She viewed them as internal evidence that a friend and colleague had been killing patients.
After Kathy Rix came Carol McCarthy, a material witness, and Nancy Cutting, Kenny Cutting’s wife. But all eyes weren’t on Nancy’s recollections of Kenny’s life and death—the buzz in the room was that Gilbert’s old beau, James Perrault, was set to take the stand as soon as Nancy finished.
Sure enough, with the end of the day approaching, Assistant U.S. Attorney Ariane Vuono called James Perrault.
Wearing a suit that looked a bit out of place on the muscular security guard’s large frame, Perrault walked into the courtroom the same way he walked into any room: cocky, smug, full of himself. Having been in his twenties when he dated Gilbert, Perrault, now at thirty, had put on a little weight, but it was nothing that made him appear to be out of shape.
Gilbert didn’t look at Perrault as he made his way through the aisle and onto the witness stand. She knew what Perrault had to say was going be devastating to her defense. He just had too many stories to tell that implicated her.
Vuono spent what little time she had left in the day going through Perrault’s background, then setting the atmosphere of the m
edical emergencies he had participated in with Gilbert.
“It [the mood in the room] became more charged. There was more excitement in the air when we were working on a patient,” Perrault said before they broke for the day.
First thing the next morning, Vuono questioned Perrault about his relationship with Gilbert, along with her suicide attempts throughout the summer of 1996. Then it was on to what everyone in the room had been waiting for: Had Gilbert said anything to Perrault about her involvement in the deaths at the VAMC when he asked her about it?
“What was her response to your—”
Perrault couldn’t even wait until Vuono finished the question.
“Initially, she was denying it. And I asked her . . . and her response—she became very upset at me and she stated, ‘I did it. I did it. I injected those guys with a certain drug.’ ”
“What did she say after that?”
“She hung up the phone.”
There really wasn’t anything more powerful James Perrault could offer the government than Gilbert’s confession. After Vuono got it out of him, Perrault went through his entire relationship with Gilbert, all the times he had broken up with her, the night they had first made love, the drinking they had done at the VFW and his lack of concern for dating a married woman.
After a recess at 2:45, Vuono had only a few more questions for the brawny security guard, who was holding up rather well despite the fact that Hoose had sat the entire time directly in front of the witness stand, staring at Perrault, licking his chops.
Vuono wanted the jury to understand that Gilbert had gone over to her former home in Florence to try to retrieve “something”—meaning the The Handbook of Poisoning—while Glenn and the kids were on vacation.
“What did she tell you [about that incident]?”
“She stated that . . . she had tried to go into the house . . . [and] that her father-in-law would not allow her into the house . . .”
“Did she tell you why she was attempting to enter the home at that time?”
“She stated that she needed to retrieve ‘something,’ but she didn’t identify it.”
“I have no further questions.”
Hoose stood and walked, sluggishly, toward the podium. He looked tired and weak, as if he had aged ten years during the past two months. With large circles under his eyes, he was much thinner since the start of the trial.
One man later said Hoose reminded him of “Ichabod Crane” at that point of the trial.
With all due respect, David Hoose had carried the load. Weinberg and Miles did a lot of sitting while Hoose did a lot of the questioning.
He immediately questioned Perrault’s integrity, insinuating that although he knew he was dating a married woman, he still did it without reservation. Perrault answered Hoose’s questions with short “yes-no” answers, not elaborating too much.
As the day moved on, Hoose led Perrault down a path of the defense’s good-cop, bad-cop theory.
“They told you Kristen Gilbert is going down and you’re going down with her, and that’s going to be the end of your career [as a cop], is that right?”
“That was implied.”
Hoose plugged Perrault for hours, trying to get him to admit the reason why Gilbert had been so “charged” during all those codes was perhaps because she had been thrilled about the new relationship she was getting involved in.
“Is it a fair statement to say that by the end of October the two of you were, if not in love . . . pretty infatuated with each other?”
“We were attracted, yes.”
“And it was fun, wasn’t it?”
“Yes.”
“It was exciting, wasn’t it?”
“Yes, it was.”
“And Kristen seemed excited by the attention that you were giving her, didn’t she?”
“Yes, she did.”
“And she seemed to enjoy it, didn’t she?”
“Yes.”
“She got a new haircut, didn’t she?”
“I don’t recall . . .”
“She began to lose weight, is that correct?”
“I don’t recall . . .”
“Did she begin dressing differently?”
“Yes.”
“She began dressing more sexy, is that correct?”
“Yes.”
“You liked that, didn’t you?”
“Yes.”
“You encouraged it, didn’t you?”
“Yes.”
“You have no recollection of her losing about thirty pounds and getting her hair cut?”
“No . . .”
“If you ever get married, you better notice those things. . . .” Hoose said, as the courtroom broke out in laughter.
Before court recessed, Perrault told the jury Gilbert had been under a tremendous amount of stress back in January 1996 because of her grandfather’s death, her pending divorce, and an “abnormal pap smear” she’d had that month.
On Monday, January 8, Perrault was back on the stand.
“You indicated something to Ms. Vuono along the lines of whether . . . [Ms. Gilbert’s] husband was abusing her. Do you recall that?”
“Yes.”
“Isn’t it true that you asked Ms. Gilbert all the time if Glenn was physically abusing her?”
“During our conversation she admitted that he had been abusive and we discussed that.”
“Isn’t it true, sir, that she told you that he only ever touched her once and that it wasn’t a big deal?”
“No . . .”
“And isn’t it true that every time she would see Glenn and be upset that you would say, ‘Is he physically abusing you’?”
“No, that’s not true.”
Hoose realized he wasn’t getting anywhere and moved on to how “upset” and “distressed” Gilbert was about the investigation during the beginning of March, April and May. When he didn’t get anywhere with that, he asked Perrault about his military training and his desire to become a bonafide cop, hoping to get the jury to believe that everything Perrault had done after that point was done with the mindset that he wanted to make an impression on the local cops.
For the first time during the trial, Hoose then brought into light the possibility of a second suspect.
“Did you know Jeff Begley?”
“Yes.”
“He was a nurse on Ward C?”
“Yes, he was.”
“And would you agree with me that Mr. Begley was a pretty weird guy?”
“Objection, Your Honor,” Ariane Vuono lashed out.
Ponsor told Hoose to rephrase the question.
“Well, was Mr. Begley someone that you knew to be having problems with other people on the ward?”
“He seemed to be, yes.”
“In fact, were you aware that other people were refusing to work with him?”
“No, I wasn’t.”
“Objection!” This time Vuono stood up, threw up her hands, and rolled her eyes.
“Overruled.”
“In any event, had you heard any rumors about the investigation initially, in the early stages, focusing on Mr. Begley?”
“Not that I recall.”
After several more questions, trying unsuccessfully to get Perrault to indict Jeff Begley, Hoose moved on. He tried, almost desperately at times, to poke holes into the theory that it could have been someone else and that Gilbert hadn’t done anything out of the ordinary, but it failed time and again.
Then Hoose brought up Perrault’s testimony during the grand jury investigation, and how what he had said was different from what he had said just days ago in court.
“[Do] you remember being asked specifically [during the grand jury] what Ms. Gilbert had said to you . . . ?”
“Yes.”
“And did you say that ‘she called back . . .’ stating that... ‘I did it. I did it. You wanted to know. I killed all those guys . . .’”
“Yes.”
“Is that what you told the grand jury . .
. ?”
“Yes.”
No matter how it was sliced, James Perrault had brought to the table some pretty solid evidence that Kristen Gilbert had admitted to her part in the crimes she was on trial for. How she chose to put that confession into words was irrelevant.
CHAPTER 89
When John Wall took the stand, he looked as if he had not slept in weeks. At one time, Wall was a good-looking man with movie star-like features. He had a promising career ahead of him in nursing. But as Ariane Vuono began to question Wall now, five years later, it became utterly apparent that the past few years had been the worst of his life.
After corroborating incriminating testimony from several other witnesses, Wall, the government’s thirtieth witness, went through each victim and the role he thought Gilbert played in their deaths.
“I suspected that Ms. Gilbert might be sabotaging my patients because she was angry at me,” Wall said at one point. Regarding Francis Marier, he said he was “stunned” to find out that Marier had had a cardiac arrest while under Gilbert’s watch shortly after Wall had gone home.
Stopping every once in a while to take a sip of water, Wall told the jury he developed a severe addiction to heroin in 1998. He said he was now taking methadone. He said he was involved in a drug treatment program. He said his drug addiction had no adverse effect on his memory of the events at the VAMC in 1996.
By January 10, Vuono was finished. That afternoon, after getting the okay from Judge Ponsor to question Wall at length about his drug use, David Hoose began firing away.
Wall said he used drugs while working at the VAMC, beginning in 1994.
Since Wall had begun taking methadone, Hoose wanted to know if he had stopped using heroin.
“No,” Wall admitted.
Then Hoose got him to admit that, like his former girlfriend, Bonnie Bledsoe, Wall had kept his drug use hidden from the U.S. attorneys throughout most of the investigation.
“You have chosen to deliberately tell lies, isn’t that true, Mr. Wall?”
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