Killer Nurse by John Foxjohn Page B

was using a reuse dialyzer), DaVita Lufkin immediately suspended the use of reuse dialyzers on April 16. As they would soon learn, it wouldn’t help.
    As far back as September 2007—one month after Kimberly Saenz was hired—DaVita had instituted a new policy. They were to collect all the bloodlines and other instruments used on patients who experienced cardiac problems while undergoing treatment, put these items in biohazard bags, put the patient’s name on the bag, and put the bags in a freezer to preserve them. But they’d never followed this policy until Ms. Strange and Ms. Metcalf died on April 1, 2008. On April 16, they followed protocol and preserved Mr. Kelley’s bloodline, and that included a syringe still attached to that bloodline. This would not be the last anyone heard about that bloodline and syringe.

CHAPTER 5

    WHAT IF
    The same morning that Mr. Garlin Kelley arrived at the clinic, on April 16, 2008, so did Ms. Graciela Castaneda. She was an elderly Hispanic woman who didn’t speak English. She’d been married for forty years and had three daughters. Prior to April 2008, she’d been a dialysis patient for ten years, and felt fine that morning—no different than any other day.
    Yet at 8:00 that morning, after Mr. Kelley’s incident, Ms. Castaneda went into cardiac arrest. Just before she passed out, Ms. Castaneda remembers, she was talking to a woman doing something to her lines, but didn’t remember anything else. The DaVita staff, maybe because of all the recent practice, reacted immediately with the crash cart and gave her a shot of epinephrine at 8:08.
    Ms. Castaneda was a lucky woman—at the hospital she recovered and survived that day.
    Several months later, she saw a picture of a woman in the newspaper, and pointed it out to her daughter. Ms. Castaneda identified the woman in the photo as the nurse who had been talking to her right before she lost consciousness. The picture was of Kimberly Clark Saenz.
    Two days before her heart attack, Ms. Castaneda’s LDH level had been measured at 219, well within normal range. LDH, which stands for lactic acid dehydrogenase, is an enzyme that helps produce energy. It is also present in almost all of the tissues in the body and becomes elevated in response to cell damage. Twenty minutes after Ms. Castaneda’s cardiac arrest, her LDH level was 2150.
    Besides being an indicator of hemolysis, or cell damage, an elevated LDH level is also a marker for bleach poisoning.
    * * *
    Unfortunately for DaVita and especially the patients, instead of calming down, the storm plaguing DaVita was gathering strength, and it focused on Ms. Marie Bradley next.
    Ms. Bradley was a Lufkin native who’d graduated from Lufkin High School in 1948. She later went to work for Jim Walter Homes in Lufkin where she remained for twenty-five years, advancing to upper management. In 2000, she began having heart and kidney problems, and started dialysis at Woodland Heights Hospital.
    On May 7, 2007, Ms. Bradley began her treatments at the DaVita Lufkin Dialysis Center. From the time the news first broke about Saenz, and all through her trial, many people referred to Saenz as “an angel of mercy.” It was just so difficult to accept the idea that a medical professional could have been intentionally harming or killing her patients in the first place; if she really were doing so, it was far easier for people to believe that perhaps Saenz had had noble motivations, such as ending unnecessary suffering. However, Ms. Bradley was one of the patients who knocked down the “angel of mercy” theory. Although ill and in need of dialysis, Marie Bradley was notably robust and energetic. Her doctor said of her, “She was one of the exceptional patients as far as health went.” Unlike many dialysis patients, Ms. Bradley drove herself to and from her treatments.
    April 23, 2008, was her regularly scheduled appointment. After