New Tests Were Ex-Nurse's Undoing

New tests using technology not available at the time of a series of mysterious deaths at a Veterans Administration hospital a decade ago have led to murder charges against a nurse who worked there.

The tests found that 10 people who died at the hospital between March and July of 1992 had been given the powerful muscle relaxant succinycholine, which stops breathing, shortly before their deaths.

Richard A. Williams, 36, the only staff member who was on duty at Truman Memorial Veterans Hospital at the time of all 10 deaths, was charged Monday with 10 counts of first-degree murder.

Williams, a suspect from the early stages of the investigation, was arrested Monday in suburban St. Louis, where he has been working as an accounting clerk at a bread company. He was being held without bond in the Boone County jail and faced arraignment Tuesday.

Williams, who has denied wrongdoing, left employment with the hospital in late 1993.

An investigation by the FBI and the Office of Inspector General in the Department of Veterans Affairs determined that 41 people died on Ward 4E between May and August 1992 while Williams was on duty. Investigators concluded patients were 20 times more likely to die while Williams was working than while 11 other nurses were on duty.

"We do not consider this investigation to be over," Boone County Prosecutor Kevin Crane said Tuesday at a news conference before Williams' scheduled arraignment.

In 1998 U.S. District Judge Nanette Laughrey of Kansas City awarded $450,000 in a wrongful death suit against the hospital by the widow of one of the 10 people Williams is now charged with killing. She ruled that the hospital was negligent in the death of Elzie Havrum, 66, of Fulton, because it allowed Williams — already a suspect — to continue caring for patients.

A federal appeals court upheld the award in February 2000.

When asked why it took so long to charge Williams, Crane said, "We've got to be able to have a good-faith basis when we charge."

Crane declined to discuss a motive, but said it "may come out at trial."

He said he would decide whether to seek the death penalty after talking to relatives of the victims.

State and federal investigators had begun investigating Williams shortly after hospital employees raised concerns about the trend of patient deaths during his shifts on Ward 4E at the hospital.

Authorities said it was a new type of toxicology test that finally linked some of the deaths and resulted in the charges filed Monday.

"The linchpin here is the development of the forensic science; this case was never off the radar screen for us," VA Inspector General Richard Griffin said Tuesday.

Investigators say tests on tissue samples from the 10 patients show they had been given succinylcholine shortly before they died.

The muscle relaxant is typically used when a breathing tube is inserted down a patient's throat for artificial respiration, such as during surgery. The drug causes complete paralysis in less than 90 seconds, preventing people from breathing, and stops the heart in seven to 14 minutes.

According to papers filed by Crane, the drug was in stock at the ward at the time of the deaths and Williams had access to it.

The FBI concluded in its initial inquiry that 11 of the deaths were "highly suspicious" and 22 "moderately supspicious." But the exhumation and autopsies on 13 bodies in 1993 failed to determine what caused their deaths.

Veterans agents began another review of the deaths in 2001 by performing new tests on tissue specimens gathered during the earlier investigation. In a report last month, the National Medical Services laboratory determined that succinylcholine was present in tissues from each of the 10 people Williams is charged with murdering.

Relatives of some of the deceased veterans had given up hope that the deaths ever would be explained. Word of the charges brought mixed emotions for Frances Gilmore, whose husband Carl died April 28, 1992, under Williams' care. His death is one for which Williams is charged.

"It's not a very happy day," said Mrs. Gilmore, 85, of Norborne. "When five years passed, I thought it was over. Now I hope we get justice."

Other relatives said information was just as welcome as justice.

"It's been quite a while. Some of us had given up. Now I hope they get some answers for us," said Charles Rupard, 78, stepson-in-law of Milton Fox, whose May 26, 1992, death is also included in the murder charges.

Hospital director Gary L. Campbell said the hospital has been cooperating with veterans investigators and is pleased with the process.

Dr. Gordon Christensen, who called public attention to the deaths shortly after they happened, said the charges are an important step but "there are a lot of problems that have to be laid to rest."

Christensen's own in-house statistical analysis raised questions a decade ago about Williams' role in the deaths. But a review by a veterans regional office questioned the validity of his findings.

"I feel a little odd because the rest of world has caught up with something we've known for a long time — that the patients were murdered," Christensen said in an interview.

In 1998, a report by the General Accounting Office concluded that veterans inspectors unintentionally misled the public in 1995 when they cleared officials of covering up the suspicious deaths.

U.S. Sen. Kit Bond, R-Mo., suggested Monday that another review may be necessary into how the original allegations against Williams were handled.

"It should not have taken this long," Bond said. "We must look at whether we could have done a better job and maybe have saved some lives."

Williams has worked the past 18 months as a low-level accounting clerk at Panera Bread Co. in Richmond Heights, said Bill Morton, executive vice president and chief financial officer of the bakery and restaurant company.

When asked whether the company knew of Williams' connection to the hospital when it hired him, Morton said, "No, certainly not." He referred further questions to Crane.