Transplanted Death

by Ray Flynt

  Dubei lifted the handset from his phone and punched the console once. A few seconds later he spoke. “Yes, this is Dr. Dubei. You have a patient by the name of Dennis Ayers? Would you please take a specimen from his urine collection bag and bring it down to my office stat.” Dubei grimaced as he listened. “I see. Well, when you can send me a specimen of ten cc’s of his urine.” The doctor cradled the phone and shook his head. “His urine bag has just been emptied, so it will take a little more time before we’ll have a sample to test.”

  “Were these drugs injected into Mr. Severns?” Brad asked.

  The doctor nodded and stood up. “Yes, I re-examined all of the IV tubing from Mr. Severns, and I didn’t find anything unusual. In all probability, the drugs were administered using a port in the IV line. But follow me; I want to show you something else I found.”

  Dr. Dubei exited through a side door in his office. Brad would let Sharon go ahead before following into a room equipped with microscopes, computers, and other scientific instruments. The warm indirect lighting of Jamal’s office gave way to the cool fluorescent of an antiseptic lab.

  “Check this out,” Dubei said, pointing at the tubing curled on a stainless steel table at the side of the room. “This is the IV configuration used for Barbara McCullough. She had a gravity drip line of dextrose and a second bag,” Dubei held up the smaller of the two bags, “containing pain medication that could be administered by an intravenous infusion pump. I didn’t find any irregularities in the plastic tubing, but when I examined the bag of dextrose, I discovered a small needle hole. Let me show you.”

  Dubei pressed a few buttons and a TV monitor glowed on a shelf above the steel table. He grabbed an object slightly larger than a tube of lip balm tethered to a box no bigger than a DVD player. Brad realized it was a camera when Dubei ran the tube over the surface and the IV bag appeared enlarged on the monitor. Dextrose, in black letters about two inches long on the bag, filled the entire screen. “Let me increase the magnification,” the doctor said, while twisting a dial. The void in the top half of the letter e now filled the monitor, and then the pathologist brought it into sharper focus. As he moved the camera, a jagged circular tear in the plastic showed on the screen. Without knowing the degree of magnification, Brad thought he could be looking at a moon crater in grayish tones.

  “This is where a needle was inserted,” Dubei said. Brad looked between the monitor and the actual bag of dextrose, noting that the camera was aimed near the bottom of the bag.

  “Why wouldn’t the killer use the IV catheter like the one you described in Mr. Severns’ case?” Sharon asked.

  The doctor turned off the microscopic camera. “It would be speculation on my part, but an extra port in the tubing may have been covered by a blanket. If you’ll notice, the dextrose bag is nearly empty, and once the lethal combination of drugs was injected at the base of the bag, it wouldn’t be long before the gravity feed line carried it into the patient’s system.”

  Brad thought about the liquid he had recovered from the floor below Barbara McCullough’s IV bags. He was now sure, based on the viscosity of the sample and Dr. Dubei’s analysis that he’d recovered poison, but that the sample had been switched.

  “You share my belief that we’re dealing with a killer?” Brad asked.

  Dr. Jamal Dubei nodded. “Unfortunately, I do.”

  “How long would it take once the chemicals were injected before death occurred?”

  Dubei stroked the hairs of his goatee. “A matter of minutes… five… ten at the most. You’d also have to account for the fact that these patients have been chronically ill, in some cases for years, and have recently had major surgery.”

  Kim Coulter, Dubei’s lab assistant, entered carrying a sheaf of papers. She surveyed the visitors as she approached the doctor.

  “What have you got?” Dr. Dubei asked, then added, “You remember Mr. Frame, and this is his assistant, Sharon Porter.” There were nods all around.

  “I found the same drugs in Ms. McCullough,” Kim Coulter explained, “Pancuronium bromide and Propofol.”

  Brad swore he heard an A-minor chord in his head, and knew it was going to be a long night.

  Chapter Eight

  7:20 p.m., Wednesday, January 10th

  Brad looked around the room at three other grim faces.

  Dr. Dubei laid the lab reports from the two post mortems on the counter, and Brad stared over his shoulder at the results. “The level of deadly chemicals in each of the patients is nearly identical,” Dubei said.

  “As an assistant medical examiner, are you prepared to rule homicide in these two deaths?” Brad asked.

  “Unfortunately, yes,” Dubei replied, sadness in his voice. “I’ve already contacted the police.”

  “When do you expect them?”

  Dubei glanced down at the lab reports. “I’m waiting for a call back. I had to leave a message with the dispatcher. I should hear something soon.”

  Brad cleared his throat before saying, “We need to protect the crime scene.”

  “I already have. That’s why I sent Ed Carlton up to see Ms. Harris.”

  “Then she knows about the test results?”

  Dubei nodded. “I told her those rooms should be secured. She said she would take care of it, and asked to see Ed after he’d brought you here.”

  Sharon jumped in. “The Ayers’ boy… his room… it’s a crime scene too. Room 728 should be secured.”

  The doctor scribbled a note on a small pad with the Squibb pharmaceutical company’s logo on the top of it. “I’ll let Danita know.”

  “What about the man who died early this morning?” Brad asked. “Mr. Esposito, the heart lung transplant patient.”

  Dubei let out a whistle. “What a great memory you’ve got for names. Come with me.” He motioned for Brad to follow, and then said to his assistant, “Kim, would you please open examination room number two?”

  Kim punched three buttons on the five button panel beside the door, then opened it and Brad recognized the room where Michael Severn’s autopsy had occurred earlier that afternoon.

  Dubei stood off to the side and pointed at the autopsy table, saying, “What do you think of that?”

  A very dead man, his head elevated on a rubber block and tilted slightly toward them, lay on the cold metal table. The man was dressed in a black tuxedo with wide velvet lapels complete with a satin black cummerbund and matching bow tie, his hair fixed neatly in place—probably sprayed—and his cheeks glowed pink.

  “This is Joseph Esposito of Norristown, Pennsylvania,” Dubei said it like he was making an introduction, “and that is the tux he was married in forty years ago. The funeral home brought him back to us a couple of hours ago. Their driver told me he was already embalmed, dressed and in the casket ready for viewing when the family agreed to the autopsy. At first they called and said they weren’t coming because the storm was so bad, but the same funeral home was called to pick up the body of a heart attack victim in the emergency room.”

  Brad hoped the mantle of heart attack victim was accurate and not a smokescreen to disguise another transplant patient death.

  “Since we got him back,” Dubei continued, pointing at Esposito‘s body, “I’ve been consulting reference materials to brush up on the effect of formalin on our ability to detect pancuronium bromide.”

  “Formalin?” Sharon asked.

  “The primary tissue-preserving ingredient in embalming fluid,” Dubei explained. “It’s a diluted mixture of formaldehyde and methanol. That gets diluted even further, since embalmers like to keep the bodies preserved but pliable enough to arrange the deceased’s features.”

  “The man fit the same suit after all these years,” Brad remarked.

  “He wouldn’t have a year ago,” Dr. Dubei responded. “According to his chart he lost sixty five pounds since he was first diagnosed with advanced pulmonary hypertension. That was about a year and a half ago. In the morning we’ll take a few liver sections and see if we c
an detect anything.”

  “What about his room, will Ed secure…”

  Dubei shook his head before Brad finished the sentence. “I already checked. His room was thoroughly scrubbed this morning and a new patient admitted there this afternoon. You won’t find anything.”

  Brad extracted a small notebook from his pocket. “What room was he in?”

  “709,” Dubei said, as Brad jotted the number into his book. “But you won’t find anything.”

  “You never know.” Brad replaced the notebook in his pocket. “It’s another piece of the puzzle. The room in relation to the other patients’ rooms, the nurses’ station, stairs, and elevator. A patient across the hall might have noticed something. His room is still important.”

  Dubei ran his hand over his balding pate as he nodded.

  “I notice the police haven’t returned your call since we’ve been here,” Brad said.

  The doctor closed the folder and tucked it under his arm. “Usually, they’d be back to me by now. I don’t know what’s going on.”

  “One more thing,” Brad said. “Could you phone Danita Harris? I’d like to see her if she’s still here.”

  “She’s expecting you, Mr. Frame. I told her I would send you up when we were through.”

  First sending the security chief to Harris’ office, then dispatching Brad to see her, made it sound like the two of them were running the entire hospital with him in the basement and her on the top floor. Brad returned to the doctor’s office and used the opportunity to retrieve the wool coat he’d left there earlier.

  As Brad and Sharon made their way to the elevator, waiting in the hallway was Ed ‘Lumpy’ Carlton. Brad breezed past him.

  “Where do you think you’re going?” Carlton shouted at Brad just as he reached the elevator doors.

  Brad punched the up button. “We’re on our way to see Danita Harris.”

  Carlton looked like a horse ready to whiney as he shook his head. “N-No… No you’re not.”

  The doors glided open and Brad held the door so that Sharon could get on the waiting elevator. Turning to Carlton, Brad said, “Yes, I’m afraid we are.” He pointed behind Carlton toward the silhouette of Dubei standing just outside his office. “Doctor’s orders.”

  Chapter Nine

  8:03 p.m., Wednesday, January 10th

  Brad withdrew his phone to check for messages.

  “Expecting a call?” Sharon asked

  Brad shrugged. “Yes and no. It’s been nearly two hours since I spoke with Alan. He was supposed to join us at the coffee shop. I’m worried I haven’t heard from him. I’ve tried his cell phone a couple of times, and no response.”

  “Call the emergency room,” Sharon said. “At least you’ll know he’s still aliveand ignoring you, big time.” She wore a crooked smile.

  Sharon had a way of cutting to the chase.

  Brad and Sharon stepped off the elevator on the 14th floor, and stood in the hallway outside the glass enclosed executive suite.

  “He’s an emotional basket case,” Sharon continued. “When you asked me to chat with Fenimore up here a couple hours ago he shifted from angry and animated to sullen and withdrawn in a matter of seconds. I saw fire in his eyes one minute and tears the next. Turtles don’t withdraw into their shells any faster than that.”

  Brad thought about Sharon’s analogy. “You think he feels threatened?”

  “You know him better than I do. But he recently lost his wife, and he’s not exactly feeling the love around here.”

  Brad recalled Danita Harris’ comments about Alan’s emotional state. From the hallway he could see that the receptionist was no longer at his desk, nor was Danita Harris there to greet him. He picked up the phone, pressed zero, and asked the hospital operator to be connected to the emergency room.

  After four rings, a woman’s voice answered, “ER.”

  “I’d like to speak with Dr. Fenimore,” Brad said in his most authoritative baritone.

  “Uh…” the woman hesitated, followed by, “He’s not available right now.”

  Brad heard a click on the line. “Is he there?”

  “Yes, but busy in Trauma B.” There was the click again.

  “I’ll catch up with him later,” Brad said.

  Brad heard, “May I tell him who called?” just before he cradled the phone. A visit to the ER was in his future.

  The door to Danita Harris’ inner sanctum opened. She stood in the doorway looking surprisingly serene, and still immaculate in her suede skirt—in spite of at least twelve straight hours in the office. “Brad, thank you for coming back,” Harris said, a warm timber in her voice. “Nice to see you again, Sharon.”

  Harris beckoned them to a small conference room adjacent to her office. Lights warmed the wood walls and LED floods illuminated the top of a burled wood conference table. Brad pictured committee meetings of the board held there. Heavy drapes were drawn at the windows, and he pulled back one of the fabric panels hoping to gauge the progress of the storm. The windows were frosted over, and he rubbed them with his palm and peered out through the small circle of wet glass. It didn’t take long for the windows to re-frost, but in those few seconds he saw a driving snow that obliterated any view of the city. By the time Brad took his seat, on a high-backed soft leather executive chair, Danita Harris had taken her place at the head of the table, and Sharon sat opposite him.

  On a nearby credenza, under a Plexiglas cover, stood an architectural model of Strickland Memorial Hospital. Brad had seen similar models at Beth’s office for projects on which she’d collaborated with architectural firms. From her, he knew these models were expensive to create, but valuable to help donors visualize the expansion plans. The model showed a steel and glass façade that would nearly double the size of the current facility. Existing structures on the model were rendered in a thick beige matte board, while the proposed addition was crafted using smoky Plexiglas and quarter-inch square metal rods.

  Harris began, “I’m afraid we got off on the wrong foot earlier today.”

  “Let’s just say that we had a difference of opinion,” Brad said.

  Harris smiled.

  Brad heard a tap on the door, and it opened moments later to admit a cafeteria worker carrying a plate of sliced fruits and cheeses. The worker also brought in an orange-rimmed pot of steaming decaffeinated coffee, cradling it in a warming tray next to the snacks on the table.

  “Thank you, Carl,” Harris said as the man deposited napkins in front of them and a creamer and sugar set.

  “Will there be anything else, ma’am?” he asked.

  Harris shook her head and the worker left. “It’s been a long day, and I thought we could use some refreshments.”

  Brad recognized a peace offering, and poured himself a cup. “That’s very considerate of you, Danita, but as you say, it’s been a long day. What can we do for you? I’m sure you didn’t invite us here just for a snack.”

  Danita stirred cream into her cup, before turning to Brad. “Strickland Memorial can use your help. We have a real problem and the only way we can protect the hospital is to find out, as quickly as possible, who is killing our transplant patients.”

  He didn’t know who the killer was, but Brad found bureaucracy his nemesis. Bureaucracy with its unwritten motto of Cover Your Ass, which created an atmosphere that obscured the truth rather than expose it. Harris made it clear her mission was to protect the hospital. What she didn’t realize is that the damage to the hospital, like the fate of the victims, might already be sealed.

  Brad sipped his coffee, and eyed Sharon across the top of his cup. She caught his non-verbal shorthand, and said, “We just met with Dr. Dubei. This is now a matter for the police; he’s already contacted them. We wouldn’t want to jeopardize our own relationship with the police department. They don’t appreciate outsiders getting in their way.”

  “I’m not suggesting you interfere,” Harris said, looking at Brad even as she responded to Sharon’s question. “I’m a
sking you to work as consultants to the hospital in solving these murders. And to keep more deaths from happening.”

  Brad helped himself to apple slices.

  “Danita, you’ve got a security force,” Sharon continued, “but quite frankly, we haven’t been made to feel very welcome by Mr. Carlton, your director of security.” Now there was a man weaned on bureaucracy.

  Danita Harris placed her hands, palms down, on the table in front of her. “I apologize. I’m afraid that is my responsibility. When we met here earlier, I made it clear in Ed’s presence that I did not want your involvement. I’ve changed my mind. I assure you that things will be different.”

  Brad sensed an urgency in her tone. “Ed will be involved in some aspect of the investigation… interface with the police, at a minimum.”

  “He may…” Harris paused. “But I assure you he will not interfere with your investigation.”

  “That’s easy for you to say. Ed is a veteran of the police force. I’m sure he still has friends there,” Brad explained. “A few snide remarks from Ed, and he keeps smiling while they make our job tougher. You don’t really expect Ed to sit back and watch me invade his turf?”

  “Ed works for me,” Harris snapped, before adding matter-of-factly, “I know he can be a bit boorish, but we pay him a decent salary and he will do what I tell him. Dr. Fenimore was right about Ed this afternoon; he rubs the medical staff the wrong way. He and his department are great at issuing IDs, staffing selected checkpoints within the hospital compound, and monitoring our video security system, but the man can be insufferable when it comes to people skills. He may have been a police officer, but tackling this kind of case is out of his league.”