The DaVita Lufkin Bleach Murder Trial Wraps up Testimony

[Hemodoc]

The DaVita Bleach Murder trial is coming to its conclusion with the last two scheduled defense witnesses today. Dr. Michael Germain a nephrologist pointed out mechanisms of death in the alleged victims consistent with high ultrafitration rates and no evidence of hemolysis or bleach infusion. He noted severe deficiencies in staff oversight and adherence to standard protocols.

Dr Amy Gruszecki is on the stand right now and as a pathologist, she found no evidence of any murders.

Dr. Jonathan Neidigh testified yesterday that the bleach found in the blood lines was placed in the lines AFTER the machine stopped insinuating that the defendant was framed.

The CDC testimony is truly a house of cards and unfortunately, the news is not reporting today's momentous events well at all. The case will hopefully be to the jury by Tuesday. This is a very complex case that has had a very emotional response by the public against Kimberly Saenz. What sort of response will we see if she is acquitted? It is impossible to know how the jury will respond since the case is so complex. It will be good to be able to talk openly about all of the facts of this case soon. The word from the defense today is good. The medical records do not show any evidence of any murders or bleach infusion. We will see how the evidence is wrestled by the jury. Unless the prosecution brings in rebuttal witnesses, closing arguments and administrative issues are the only thing between giving the case for deliberations. May the truth prevail.

[Riverwhispering]

Hemo keep us posted please. 

River

[Rerun]

My question is, if they didn't die of bleach infusion.... what did they die of.  And if she was framed than that person needs to be locked up.

I cannot imagine someone shooting bleach in the dialysis lines of a dead person.   

[Hemodoc]

Unfortunately, the news reporting isn't very good on the details that is presented in the court. I will hopefully get a copy of the video sessions to be able to review the actually testimony myself at some point. Anyway, hopefully that will be coming my way at some point.

What did they die from? Various conditions. If you have followed the trial closely, there has been a lot published first of all on the terrible conditions in this unit, horrible oversight and a complete lack of professionalism.

One aspect that Dr. Michael Germain spoke about in great length was the excessive ultrafiltration rates and how the nurses failed to pay attention as the blood pressure became progressively lower until many of the patients went into cardiovascular collapse. These were not healthy patients who came in happy and smiling and then left dead that day. These were very sick individuals who had been in and out of the hospital many times prior to these events.

One issue that the judge did not allow was the other patients in the unit who had events in the month of April requiring paramedic runs to the hospital. There was a total of 18 in the month of April 2008. Eight of the cases were excluded from discussion.

I will be posting some more specific information once the case goes to the jury hopefully by Tuesday at the latest. Until then, I will keep it fairly general. When I began reviewing the cases, what struck me was that I couldn't find what I would expect from a bleach infusion. Neither did the two doctors who testified today. Dr. Gruszecki was insistent that the defendant is absolutely innocent and she took a great personal interest in this incredibly complex case. I am hoping that they will capture some of her testimony in the news reports, but I will have to wait and see.

Was she framed? Dr. Neidigh testified yesterday that the only way that the bleach could have stayed in the blood lines in a few of the patients was if the the machine had already stopped. Otherwise, if it was placed there while the machine was running, it would not have tested positive at a later date according to experiments he conducted. Yes, that would mean that someone did try to frame her. Who will probably remain a mystery but the defense team had its suspects but no actual proof.

Was there anyone murdered? Absolutely not, unless you consider what DaVita was responsible for that is. This is not the conclusion that I expected when I reluctantly agreed to review the case.  There is no evidence by the medical data that any bleach ever was infused by anyone. There is evidence that the poorly maintained water system had chlorine levels 15 times higher than allowed. That is the most likely source of the 3-chlorotyrosine levels found by the CDC.

Hopefully can be able to say more in a few more days, but now it is all up to the jury except for the possibility of rebuttal witnesses on Monday. No word yet if that will happen or not.

[jeannea]

I had not heard of this case. When I look it up the news reports are confusing. Thanks for trying to help us figure it out.

[Desert Dancer]

Hemodoc, I have a question for you that I haven't seen addressed in any of the news accounts of testimony.

From what I understand this clinic reused dialyzers. Now (please correct me if I'm wrong) is it the case that formaldehyde is used to clean dialyzers for reuse? And - if that is the case - wouldn't formaldehyde have the same effect as bleach (hemolysis and cardiac arrest)?

If I'm not utterly off-base here, is this something that's even been looked at? That it may have been something other than bleach (or chlorine from the water system)? It seems the prosecution is convinced it's bleach and the defense is maintaining it's poor water treatment practices but I haven't seen that any other possibilities have even been pursued.

Thanks in advance for educating me.

[Dannyboy]

Thanks for following this case and keeping us updated Peter.
---Dan

[Hemodoc]

Hemodoc, I have a question for you that I haven't seen addressed in any of the news accounts of testimony.

From what I understand this clinic reused dialyzers. Now (please correct me if I'm wrong) is it the case that formaldehyde is used to clean dialyzers for reuse? And - if that is the case - wouldn't formaldehyde have the same effect as bleach (hemolysis and cardiac arrest)?

If I'm not utterly off-base here, is this something that's even been looked at? That it may have been something other than bleach (or chlorine from the water system)? It seems the prosecution is convinced it's bleach and the defense is maintaining it's poor water treatment practices but I haven't seen that any other possibilities have even been pursued.

Thanks in advance for educating me.

Dear Desert Dancer, the reuse issue was a big part of what the defense lawyers looked into. This unit used Renalin allegedly until 4-16-2008 when they stated that they stopped reuse. There is some conflicting evidence whether they actually stopped reuse or not that I don't believe the judge allowed.

There is one case in April where the defendant was not present that is not part of the record in this case that did involve residual renalin that caused an immediate reaction. The judge would not allow any of those cases to be discussed or entered into evidence. I am not sure that I can discuss that case in detail since it is not part of this case record and may still be covered under privacy laws, but no, Renalin did not play a role in most of the patients we examined according to documentation int he medical records. One case outside of the discussion of the trial did have a Renalin accident from not cleaning the artificial kidney completely before hooking up to the patient. She immediately go a taste of gasoline and the session was terminated and she was sent to the ER without any further clinical issues and released home.

The issue of chlorine was brought out by the defense and documented in the news reports of the trial this week where chlorine was 15 times higher than allowed after leaving the carbon filters. Then DaVita replaced the carbon tanks after the clinic closed but they denied it was malfunctioning. All of this was documented in several news stories for those that followed the case closely at KTRE and Lufkin Daily News.

One issue you should also look at is the defense expert testimony by Dr. Niedigh who testified his opinion was that the bleach found in the blood lines of some but not all of the alleged victims had to be placed after the machine stopped. In other words, his conclusion is that someone deliberately framed the victim. His testimony and analysis is quite compelling. Look at the Lufkin Daily News account of his testimony and conclusion which accounts for only one small paragraph.

The news reporting on this case is terrible and biased. But the issue of Renalin I don't believe is at hand here nor does Renalin cause 3-chlorotyrosine levels to increase according to one prior study in the medical literature that evaluted that issue directly a couple of years ago. Once again, Renalin was not an issue of this trial as evidenced in the news accounts to date other than the DaVita claims it ceased on 4-16-2008 after one of the cardiac events occurred. That was all discussed in some of the news accounts at KTRE and Lufkin Daily News. If you haven't, you can still read back through these reports to get a flavor of some of the issues of this trial. All that have mentioned here is pretty much noted in all of these news accounts which is the only thing I am really talking about to date. Even the Renalin case above was accounted in two of the news reports if you search for them carefully, but not allowed into the testimony for the jury to consider.

[Hemodoc]

I had not heard of this case. When I look it up the news reports are confusing. Thanks for trying to help us figure it out.

The news reports are terrible but if you did through all of them, there are bits and pieces of the defense case that should give us all pause before passing judgement on the defendant. It is a very complex and confusing case for sure even looking directly at all of the evidence. In the end for me, I just couldn't find the clinical evidence I would expect from bleach infusion in any of the alleged victims. None of them. Are there still questions about issues, yes, but that isn't uncommon in complex patients with multiple medical issues. Is there direct evidence for bleach, not that I could find nor Dr. Gruszecki whose testimony has not been reported at all. Not sure if she was able to complete her testimony or not yet. She is a pathologist from Houston that has some very interesting opinions that everyone needs to wait to hear. Her testimony will be very compelling. Sorry, can't say more until I see what is reported in the news on her testimony.