Patient May Have Escaped Alleged ‘Angel of Death’

Michelle Elmore recalls her mother telling her, after she was moved from Glendale Adventist Medical Center, “Oh, they tried to kill me over there.”

She didn’t think much about it, though, because “my mom . . . she’s kind of a complainer,” Elmore said.

She’s not questioning her mom any longer.

Police documents unsealed Friday suggest that Jean Coyle, 63 and currently in a Covina nursing home, could be a survivor--and the only one known to date--of a potentially fatal injection from former respiratory therapist Efren Saldivar.

Saldivar, 31, was charged Wednesday with murdering six patients at Glendale Adventist by injecting the paralyzing drug Pavulon into their intravenous lines.

Saldivar’s treatment of Coyle is currently not the basis of a charge.

But a night shift co-worker said Saldivar confided that he injected Coyle with succinylcholine chloride, another potent muscle relaxer that respiratory therapists would never be authorized to use, according to transcripts of interviews conducted by police.

Coyle was revived--possibly by Saldivar himself--after a nurse became aware that she had gone into respiratory distress. The co-worker said Saldivar told her the injection was an accident.

Many details of the incident remain unclear, including the date.

But Coyle insists that she recalls it--and Saldivar.

Speaking from a wheelchair at the nursing home, breathing with the aid of a plastic tube, she remembered Saldivar as being kind-hearted and professional during her stays at Glendale Adventist for treatment of emphysema and other ailments. On one bedside visit, she says, she just remembers seeing him, then “I blacked out.”

Now, she says, “This guy was going around killing everybody.”

A Glendale police task force spent 34 months investigating Saldivar after he told them in March 1998 that he may have contributed to “anywhere from 100 to 200” deaths at Glendale Adventist and actively killed up to 50 patients with Pavulon and succinylcholine chloride, which both stop natural breathing.

Saldivar described himself as an “angel of death” who could not stand to see terminally ill patients suffer.

He was arrested at the time but freed after two days when prosecutors said they would need independent evidence that patients were killed. Saldivar then recanted his confession, saying he made it up because he was depressed and hoped to get the death penalty.

He was rearrested last week driving from the Tujunga home he shares with his parents to his most recent job, as a contractor’s assistant in Granada Hills.

Though some preliminary evidence against him was summarized in a 1998 affidavit used to revoke his state respiratory care license, it was not until Friday that Pasadena Superior Court Judge Joseph F. De Vanon ordered the unsealing of hundreds of pages of records eventually submitted by police as the basis for exhuming the bodies of 20 former Glendale Adventist patients.

20 Cases Chosen From 171 Deaths

The records include affidavits describing the evidence that prompted police and a physician consultant to pick the 20 from among the 171 patient deaths on Saldivar’s shifts the last two years he worked at Glendale Adventist. Those cases include the six that produced the murder charges after Pavulon was found in the bodies.

The affidavits indicate that some cases were selected because they seemed to meet Saldivar’s own criteria for selecting targets, as expressed in his 1998 statement: elderly patients with poor quality of life and “Do Not Resuscitate” orders on their charts. They also looked closely at deaths of Armenians, because Saldivar told police of his dislike of their “falsifying Medicare.”

Investigators also tried to link Saldivar to specific patients through the statements of co-workers, the documents show. While some offered only general suspicions about Saldivar that would be of little use in court, others gave time-and-date accounts that are essential to prosecutions.

A nurse, for instance, placed Saldivar in the hospital room with Luina Schidlowski, 87, when she went into respiratory distress and died Jan. 22, 1997, according to one affidavit. Tests conducted at Lawrence Livermore National Laboratory in Livermore, Calif., found Pavulon in Schidlowski’s body.

The nurse’s statement may make that the strongest of the six murder counts. In some other deaths, investigators could say only that Saldivar was on duty when the patient died, the documents show.

The task force clearly sought as specific testimony as possible from Saldivar’s fellow respiratory therapists. More than 350 pages are transcripts of several interviews of Ursula Anderson, who often worked alongside Saldivar and admitted having an affair with him, “including having sex with him during work,” according to a police affidavit.

Speaking under a grant of “use immunity,” meaning anything she said could not be used against her, Anderson told investigators that she once saw Saldivar take succinylcholine chloride from a tray in the emergency room, and had herself supplied him with that paralyzing drug.

But the documents also describe her as a “very difficult” witness who rarely gave details--especially patients’ names.

She did, however, remember one.

“It’s like I don’t remember any patient’s name other than Jean Coyle,” she said.

Born in 1938, Coyle had a hard life, raising four children while working. Her last job was as a self-employed house cleaner, but such labor became difficult when she came down with emphysema in her 50s. Her daughter said she had ignored “lectures about her cigarettes.”

Living in a small apartment in the Glendale area, Coyle became a frequent patient at Glendale Adventist, her daughter said. But that’s not the only reason, she guessed, that the staff remembered her.

“My mom would stand out; she’s kind of a complainer. ‘I need a breathing treatment.’ ‘I need this.’ ‘I need that,’ ” Elmore said. “It’s like probably they want to shut her up.”

That’s not far from what Anderson told task force questioners, who kept coming back to the incident after she volunteered it.

On Aug. 24, 1998, she was asked about Saldivar’s criteria for picking patients to kill. “He looked for patients with--with an IV site, no code order, or unconscious patient, or a terminal patient, a patient that’s not on a monitored bed,” the transcript quotes Anderson as saying.

When questioned about his use of Pavulon--which Saldivar had mentioned in his confession--Anderson said she knew only about succinylcholine chloride, which was “just sitting in a nurse’s refrigerator . . ..”

Asked what aroused her suspicion, she elaborated: “It could have been when the Jean Coyle thing happened.”

Anderson says two other respiratory therapists first told her about the incident, in which a nurse apparently became aware that Coyle had gone into distress.

When she asked Saldivar about it, Anderson said, he replied that he had given her succinylcholine chloride by accident when he meant to give her Benadryl, “a drug which he was authorized to administer,” an affidavit states.

Anderson believed the incident occurred in 1997, but was not sure.

She said Saldivar also told her: “Oh, she had stopped breathing and he had to [do a procedure to] give her some breaths to help revive her. Oh, and that he scared the nurse, ‘cause she was--she almost caused a code . . . and Jean Coyle came out of it.”

Anderson said Saldivar “never told” the nurse he had given Coyle succinylcholine chloride.

She said Coyle, indeed, was the sort of demanding patient who would annoy her co-worker.

“I’ve heard him say like, ‘She’s calling again?’ You know, like on the Jean Coyle thing. She would call all the time for treatment. And if he would go there and assess her, you would know that she didn’t really need a treatment.

“She just, you know, needed company or something.”

Anderson seemed to have some sympathy for that need.

She said she had worked with Coyle “since I was a student. She asked me about my family. We’ve talked.”

Drug Breaks Down Quickly

According to prosecutors, the Livermore lab did at least some testing for succinylcholine chloride in the tissue samples from the 20 exhumed bodies--but could not find it. Toxicology experts say it is virtually impossible to detect because it breaks down quickly into normal body chemicals.

In one of her interviews with task force members and Deputy Dist. Atty. Brian Kelberg, Anderson was asked if Saldivar would have any reason to administer that drug “other than to euthanize a patient.”

“There wouldn’t be no other reason for him to use it,” she said.

Both Coyle and her daughter said over the weekend that they were questioned by detectives during the 34-month investigation but were not told much. “They just said, ‘Oh, she could have had this happen,’ ” Elmore recalled. “That’s kind of scary.”

Elmore said her mother deteriorated and now can no longer live on her own.

“Her lungs are pretty bad. But she still knows what happened to her. She just says she knows.”

When asked this weekend if she believed Saldivar had tried to kill her, her eyes expanded, her face puffed and reddened, and she broke into a nervous nod.

“I hope he don’t come find me,” whispered Coyle, whose speech comes in labored gasps.

She grew more animated moments later when Elmore arrived to visit with her two teenage daughters: Coyle’s granddaughters. They gave her a gift bag and she hugged them.

Elmore said her mom has not changed her ways in the nursing home. Coyle still lets her wishes--and complaints--be known.

“They made her resident of the month,” her daughter said. “They try to make her happy any way they can.”