Digging for Answers Into Hospital's Deadly Winter

TIMES STAFF WRITER

The shadows spilled across the grave on a June morning. The investigators stooped, gently lifted a sparrow's nest from the mound and broke the cemetery soil with a backhoe.

The federal agents had come for Oma Wyler's bones. Her daughters didn't want to see too much, so they waited out of sight, across the graveyard, while their mama's coffin was dragged from the earth.

"I didn't realize I'd feel such turmoil," said Wanda Russell, Wyler's eldest daughter. "But we have to find out what really happened. The not knowing is awful."

It was a queasy beginning to a strange summer in this town of about 3,000. Cicadas groaned, the heat thickened--and all week long, investigators dug up bodies throughout the rolling grasslands straddling the Red River. In showers of flying dirt, two coffins a day came to light.

In all, 10 corpses were dredged this month from the clay soil of Texas and Oklahoma, autopsied and returned to the earth.

All this to probe the mysterious winter deaths of elderly men and women at tiny Nocona General Hospital. Investigators suspect that as many as 20 patients may have died terrifying, silent deaths. They think somebody preyed on the frail and the elderly, striking with a poison that froze their muscles and stilled their breath.

But nobody is sure.

"Being uncertain is worse than knowing," Montague County Dist. Atty. Tim Cole said. "And unfortunately, we may not be able to wipe out that uncertainty."

A few things are unmistakable: Far too many people died on the overnight shift last winter. Lethal drugs turned up missing from the hospital pharmacy. In late February, a nurse was fired for undisclosed reasons. The inexplicable deaths stopped in February, hospital officials said.

No arrests have been made in the deaths, although Cole said he has a suspect, whom he declined to identify.

The Texas Board of Vocational Nurse Examiners said it is investigating Vicki Carson Jackson, the nurse who was dismissed this winter. Investigator Kirby Hattox declined to discuss the focus or details of that inquiry.

Jackson's lawyer did not return telephone calls to his office seeking comment, and Jackson could not be reached for comment at her home.

The family of one of the dead patients sued Jackson and the hospital last month, alleging the nurse caused the Christmas Eve death of 87-year-old Boyd Bruce Burnett with an unprescribed injection.

In March, former patient Donnelly Reid also filed a lawsuit alleging he was injured when Jackson administered an unprescribed drug during his stay at Nocona General.

Donna Bowen, Reid's lawyer, said the 61-year-old man was a few hours from his scheduled release in February when Jackson came to his bedside and pushed a needle into his saline drip. Reid lost feeling in his hands and blacked out, his lawyer said. Hospital staff raced into the room and revived Reid.

Jackson was fired two days later, hospital administrator Chuck Norris said, but he declined to give a reason.

"My theory is that, hopefully, by that time they're watching this lady," Bowen said. "They should have known something strange was happening."

Reid, who was crippled by childhood polio, recovered and returned to the nursing home where he lived. Last week, after a bout with pneumonia, he died.

Jackson, 35, was licensed as a vocational nurse in 1989 and cared for patients at a Nocona nursing home and several North Texas hospitals before applying at Nocona General. She worked there for about a year.

Like just about everything else in town, Nocona General is modest--38 beds in a low-slung brick building on the south side of town, where paved streets give way to rolling pastures of buttercups and black-eyed Susans. More often than not, doctors here dabble in geriatrics. The complex cases usually are sent to Wichita Falls.

The one-story hospital is nothing fancy--but it's the pride of Nocona, just the same.

Just across the Red River from Oklahoma, Nocona was a cattle drive outpost when herds still stamped the Chisholm Trail from Texas to the eastern railhead in Kansas. These days, the town's greatest claim to fame isn't even there anymore.

Nocona brand cowboy boots still are on the market, but no longer is the pungent leather cut and stitched on the edge of town. Two years back, the company moved its 160 jobs 600 miles southwest to El Paso, on the U.S.-Mexico border.

This town was left with a painful grudge against the North American Free Trade Agreement and a rough spell of unemployment.

"They still have our name," broods Mayor Paul Gibbs. "I wish there was some way to get it back."

The hospital, with its stinging refrigerated air, shining corridors and hushed efficiency, was a symbol that Nocona could pull itself along after all. Nocona General hires more people than anywhere else in town, save for the schools. In 1999, health care analysts listed the hospital among the 100 best in the nation, and the town had something to brag about.

It was a hard day, then, when the pharmacist strode into hospital administrator Norris' office that February afternoon. There was disquieting news: Drugs were disappearing. And not the pain killers and sleeping drafts so often abused. Instead, Norris recalled, a drug called Mivacron, or mivacurium chloride, was vanishing.

Norris had never heard of it.

"What's it do?" he asked. The pharmacist told him, and the two men sat for a while.

"He said, 'What do you think?' " Norris recalled last week. "And I said, 'Oh, it doesn't look too good.' "

Mivacron is a muscle relaxer, one powerful enough to stop a person's breathing. Used properly, it calms the thrashing of panicked patients long enough for medics to slip in a breathing tube. In large doses, it's strong enough and fast enough to drive life from the body in five minutes, maybe quicker.

"It's kind of a cruel way to do it," said Victoria DeVore, doctor of pharmacy at the University of Houston. "To paralyze patients while they're totally conscious."

Mivacron sweeps stillness through the body and leaves little trace of its passing. There is no struggle, no scream, few biological footprints. Scientists rarely can say unequivocally whether Mivacron was present at all.

As the prosecutor, lawyers and hospital staff say, it might just be the perfect killing drug.

Confronted with the pharmacy thefts last winter, Norris turned to the death statistics. Nothing jumped out from the December figures. January looked bad, though: Fifteen people had died, seven more than during January 2000.

More people die in the winter; everybody knows that. The winds come clean and cold from the northern prairies. Respiratory infections fester. Some senior citizens live in cramped quarters, passing the germs among themselves.

All of the fatalities were elderly. Almost all of the bodies exhumed last week were of octogenarians. "You look at it and go, 'Well, I'm not really sure why they died; I didn't really think they were going to die this time,' " Norris said. "But they're old. Everything in their system's going haywire."

Norris was plagued by nightmares. He dreamed he was a ship's captain. He saw the deck of his vessel littered with corpses.

Meanwhile, word was worming its way through town. Stories are contagious here--viruses that have a way of finding all 3,000 pairs of ears in a single afternoon. The phone lines and convenience store aisles are veins and arteries, binding this place into a single body.

"I don't know who tells things," said Russell, the daughter. "But there are no secrets."

Mystic, almost, these small-town rumors. From nothingness to popular fact. So powerful you can't always say which came first, the act itself or the telling of it.

"People here know what goes on," Mayor Gibbs said, "before it even happens, mostly."

It's no surprise, maybe, that Russell heard the speculation long before any official word. Her mother had been buried in the town cemetery--a grassy slope where the rows of marble humps are broken by a rusting oil derrick--since January. Her demise was chalked up to heart failure.

"Then," Russell said, "we started listening. In a place like this, you hear about everything."

But many residents wonder if they ever will hear the truth. The investigation won't be easy. In Glendale, police earlier this year arrested a therapist on suspicion of killing six terminally ill patients--after three years of investigation.

In Nocona, lab results could take a year. Tissue samples from the exhumed bodies have been sent to FBI laboratories in Quantico, Va., for analysis. Dist. Atty. Cole said he expects to file criminal charges in the deaths--but that too could take months and leave questions. No matter what happens, doubts and fears will linger.

"All these months, all these families believed their loved ones died of natural causes," Cole said. "And now, we may never be able to tell them for sure."

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