05x10 - Nursery Crimes

[bunniefuu]

Narrator: within weeks
of opening her medical clinic,

Dr. Kathleen holland
had 7 infants
who stopped breathing

And had seizures
severe enough

To require
emergency resuscitation
in her office--

Considerably more than
what most pediatricians see

In an entire year.

When one
of the children died,

Local health officials
demanded answers.

Kerrville, texas,
is a quiet little community

Just an hour's drive
from san antonio.

Although kerrville is primarily
a retirement community,

Dr. Kathleen holland
saw a business opportunity.

She opened what was only
the second pediatric clinic
in kerrville.

Reed and patty mcclellan

Were excited by the prospect
of a female pediatrician
coming to town.

Man: a lot of mothers
do want to take their kid,

Particularly if it's a girl,
to a female doctor,

And this was a young doctor,
a progressive doctor,

Somebody that seemed to breathe
a little bit of fresh air
into the medical community there

And had training
in the latest techniques.

Narrator: the mcclellans'
daughter chelsea

Was one of dr. Holland's
first patients

When she opened
her practice in 1982.

Chelsea was 15 months old.

Chelsea arrived
on the very first day
of practice.

Her mom called reporting
that she was breathing funny

And had done so again
previously

Two months ago.

Doctor, there's
a problem.

Narrator: just moments
after dr. Holland
finished the evaluation,

Chelsea stopped breathing

And had to be rushed
by ambulance

To the sid peterson
memorial hospital.

There, emergency-room doctors
revived chelsea,

But tests could not reveal
what caused the incident.

Just one month later,

Chelsea visited
dr. Holland's office again,

This time
for a routine vaccination.

Is she sleeping
through?

Finally,
I'm getting some rest.

Narrator: after being
given the shot,

Chelsea stopped breathing,
turned blue, and had a seizure.

Once again, the child was rushed
to peterson memorial hospital,

Where she was stabilized.

Later that day,

Chelsea was taken by ambulance
to san antonio

To be evaluated
by specialists.

Dr. Holland was following
the ambulance in her own car.

Along the way, chelsea
went into cardiac arrest.

The ambulance
pulled off the road

So dr. Holland could assist
in the resuscitation.

Holland: I jumped
into the ambulance

And started doing c.p.r.

And asked them where
the closest facility was,

Which was comfort,

And so we pulled into
the closest facility,

And unfortunately, she did not
respond to all of the efforts

To bring her back,

And so after about 20 minutes
or more in the hospital,

As well as all of the efforts
en route, um...

She was pronounced dead.

Narrator:
the autopsy concluded

That chelsea died
of cardiac arrest

Attributed to sudden
infant death syndrome,

Which usually occurs in children
under one year of age.

Elkind: chelsea
had been premature

And had some breathing
problems at birth,

But by all accounts,
medical accounts,

She had outgrown
that problem,

And sids is something
that afflicts kids
who are younger.

I mean, certainly doctors
can speak about that
more authoritatively,

But generally, you don't
have kids dying of sids
at the age of 15 months.

[Baby crying]

Narrator: over the next
several weeks,

Dr. Holland
had more emergencies.

A 5-month-old girl
started choking

And was unable to breathe,

And she, too, had to be rushed
to the hospital.

A few days later,

Yet another child
had a seizure

Which required
emergency treatment.

In the first month
of practice,

Dr. Holland had 7 children
who suddenly and unexpectedly

Stopped breathing,
had seizures,

And required emergency
hospitalization.

Elkind: some of them
were indeed life-threatening.

You had ambulances coming in
on more than a weekly basis.

That was totally
astonishing.

It was totally unprecedented
in kerrville,

Where they don't even have
very many young families
with children,

So ultimately, other doctors
who were just watching
this blizzard of activity

Got very suspicious
and started asking questions.

Narrator: and those suspicions
led medical investigators

To reopen their inquiry
into chelsea mcclellan's death.

Narrator: in the first
month of practice,

Dr. Kathleen holland
had 7 children

Who experienced seizures
and breathing problems
in her office

Severe enough to require
hospitalization.

One of those patients,


Died of cardiac arrest
on the way to the hospital.

Administrators at peterson
memorial hospital

Asked dr. Holland
to attend a formal meeting

To discuss the situation.

Holland: I was considered
a prime suspect,

And my practice, obviously,
fell back as a result.

Um, it strained--
put a great strain
on my marriage at the time,

And financially,
things were falling apart.

Narrator:
during the meeting,

Dr. Holland reviewed
each of the cases
for the committee.

She said all of the incidents
could be explained

By the children's
medical histories.

Chelsea was born
premature

And had a history
of breathing problems,

Even before
coming to me.

Narrator: one member
of the committee
asked dr. Holland

If she used the drug
succinylcholine
in her practice.

Succinylcholine
is a powerful
muscle relaxant

Which can cause respiratory
failure in large doses.

It's so powerful,
it's sometimes used

In lethal injections
for executions.

Dr. Holland said she
had a vial in her office

But had never used it.

They also
asked dr. Holland

If she trusted
her employees.

Dr. Holland said she did.

That night
after office hours,

Dr. Holland spoke
with her nurse,

Genene jones.

Dr. Holland described
jones' behavior that night

As suspicious.

Holland: there was a lull
in the conversation,

And the next thing
she said was,

"Oh, by the way,
I found that missing vial
of succinylcholine,"

And I said, "what missing vial
of succinylcholine?"

I told you before.

I lost a vial
of succinylcholine

And ordered
a replacement for it,

And I found
the missing bottle,

So now
we have two vials.

Narrator: dr. Holland
suspected it was more
than a mere coincidence

That her nurse mentioned
the exact same drug

Doctors asked her about
in the meeting.

I'm just sitting there,
and I'm absorbing all of this,

And I'm putting it
in perspective
with the emergency--

The meeting regarding
my emergencies.

Narrator:
the next morning,

Dr. Holland
went to the refrigerator

And found the two vials
of succinylcholine.

Both appeared to be full,

But in one of the caps,

She noticed two tiny
needle marks.

Holland: and at that
point in time,

My whole world collapsed,

And I remember being emotionally
just in turmoil that morning,

Just absolutely
in turmoil.

Narrator: dr. Holland
immediately turned the vials
over to the authorities.

Dr. Holland was within
our circle of suspicion.

Dr. Holland was very defensive
in our investigation

Because she felt
that as the captain
of the ship, so to speak,

That she was responsible
for this child's death,

And bear in mind--
at that time,

She was anticipating a flood
of lawsuits from the parents.

Narrator: genene jones
was also under suspicion.

Jones was a 33-year-old
licensed vocational nurse,

Divorced with two children,

Who had come to kerrville
after leaving a job

In a pediatric
intensive care unit
in san antonio.

Elkind: she was a sort of
rough-and-ready personality.

She was very coarse, rough.

She cursed like a sailor.

She talked about sex a lot,
even though she wasn't
an attractive woman.

Um, she kind of liked to,
you know, mix it up

And give people
a hard time.

Narrator: the two vials
of succinylcholine

Were sent to the forensic lab
for testing.

Although the vial
with the two needle holes
appeared to be full,

Tests indicated
that 80% of the vial

Had been filled with water.

A large dose
of succinylcholine

Could have caused
chelsea mcclellan's death.

Unfortunately, it was considered
to be untraceable.

Sutton: it's the type of drug
that after injection
into the body,

It rapidly disappears,

And it's not traceable
in its original form

Because succinylcholine is made
up of succinic acid and choline,

Which are natural elements
in the human body.

Narrator: and without hard
scientific evidence,

All investigators had
were dr. Holland's suspicions

And genene jones' denials.

Narrator:
district attorney ron sutton
was beginning to suspect

That 15-month-old
chelsea mcclellan

And some of
the other children

In dr. Holland's
pediatric clinic

Had been intentionally injected
with succinylcholine,

A powerful
muscle relaxant.

Sutton: every child
who is of a nontalking age

That came into this clinic

With a potentially serious
medical problem

Suddenly had a seizure.

If the child was
a talking-age child
or some other problems--

Just a sniffle
or something like that--

Didn't get it,
but if they had

A potentially serious problem
and a nontalker,

They got it.

Narrator: a vial
of succinylcholine
in dr. Holland's office

Appeared to be full

But had two needle holes
in the cap

And had been refilled
with water.

The prime suspect
was dr. Holland's nurse,

Genene jones,

Since she was in the ambulance
with chelsea mcclellan

When she went
into cardiac arrest and died.

While all this
was going on in kerrville,

There were similar suspicions
about genene jones

In san antonio.

Just one year earlier,

Death rates
rose dramatically

In the pediatric
intensive care unit

At bexar county hospital

While genene jones
was working there.

Dr. Vincent dimaio,

The chief medical examiner
for bexar county,

Heard suspicions
about genene jones

From some of his
medical colleagues.

Dimaio: after a while,
it became common knowledge,

And it became
kind of a morbid joke

That if you were
going to have deaths
in the pediatric care unit,

It was always on the shift
that genene jones was working.

Narrator: dr. Dimaio
passed this information on

To deputy district attorney
nick rothe,

Who discovered that
the death rates dropped

As soon as genene jones
left the hospital.

Rothe: we could tell
that when jones left,

Those peak numbers
dropped immediately.

The month she left,
the day after she left,

Things just leveled out
and stayed level.

They were level going in
and then just peaked
right there,

And then
the minute she left--

I'd say almost
to the minute,

I mean, the day,
to the day--

They went back to what--
normal levels.

Narrator: officials
in san antonio called in

The centers for disease control
in atlanta, georgia--

The premier medical
investigation agency
in the world.

Dr. Gregory istre
was the epidemiologist

Assigned to analyze
the death rates

In the intensive
care unit.

Istre: the fact that the deaths
appeared to have been declining

In the late 1970s
and 1980, early 1981

And then seemed to go
up again in 1981, '82

And the fact that that increase
was almost exclusively

On the evening shift
or in the evening hours

Made us think that there
really was something unusual

That was going on there.

Narrator: the rise
in the intensive care
death rates

Coincided with the dates
genene jones worked there,

And jones worked
the 3:00 to 11:00 shift.

But there were
more than 200 individuals

Who passed through the pediatric
intensive care unit--

Doctors, nurses, aides,
ward clerks, therapists,

Technicians,
and medical residents.

Dr. Istre began
his investigation

By assigning
each employee a number.

He charted
which

Of the 200
individuals

Were on duty
at the time

Of the 30

Suspicious
deaths

And the 50 or so
unexplained

Medical emergencies.

Istre: nurse 32
had a significant

And quite extraordinarily
high risk

Of deaths to patients

When nurse 32
was working

Compared to when nurse 32
was not working.

In fact, that risk
was 10 times higher.

The risk of death
was 10 times higher
when she was working,

Compared to when
she was not working.

Narrator: and the identity
of nurse number 32?

Istre: nurse 32
was genene jones--

is genene jones.

Narrator: prosecutors
found evidence

That supervisors
in the intensive care unit

Strongly suspected genene jones
was somehow involved

In these mysterious deaths.

So they conducted a study,

Began to focus
on genene jones,

But decided what to do would be
to eliminate the l.v.n.s
from the staff

And only staff the unit
with registered nurses,

Thus getting genene
out of the picture.

Dr. Holland asked
hospital staff down there

If genene would be a good choice
for her to ask to come
to kerrville with her,

And they said yes,

That she would be a good choice
and a good nurse for her.

Therefore, san antonio
got rid of genene,

Sent her to kerrville.

Narrator: the suspicious deaths
in the intensive care unit

Stopped after
genene jones left,

And the incidents
mysteriously resurfaced

In the medical practice
where jones was next employed.

Narrator: prosecutors
were convinced

That 15-month-old
chelsea mcclellan

Had been m*rder*d
by an intentional injection
of succinylcholine,

A powerful
muscle relaxant,

But they had no way
to prove it,

Since there were
no toxicology tests

Sensitive enough
to find succinylcholine
in the human body,

But prosecutors heard
about a forensic scientist
in philadelphia,

Dr. Fredric rieders,

Who was conducting research
on dr*gs like succinylcholine.

Chelsea mcclellan's
autopsy samples were sent
to dr. Rieders,

Who took them
to the karolinska institute

In sweden.

There, an experimental protocol
permitted chelsea's tissues

To be analyzed
with gas chromatography.

This process heats and separates
the various molecules
in the samples,

Then measures the speed at which
they separate from one another.

In a scientific first,

Traces of succinylcholine
were discovered

In chelsea mcclellan's
embalmed tissues.

Rieders: we have the hypothesis
of our finding--

That we are reasonably certain
that this child was administered
succinylcholine

At or around the time
of her death

Or at or around the time of her
onset of the symptoms and signs

That then led
to her death.

Narrator: genene jones
was charged with the m*rder
of chelsea mcclellan

And pleaded not guilty.

Prosecutors believe
that genene jones first injected
chelsea mcclellan

With succinylcholine
in the examining room

While dr. Holland was busy
with chelsea's mother

And later injected chelsea
again in the ambulance,

Causing her death.

The discovery of succinylcholine
in chelsea mcclellan's tissues,

The diluted vial
with the needle holes

Found in dr. Holland's office,

And the fact that genene jones
was alone with each
of the infants

At the time
of their seizures

All told a story.

Rothe: the last witness,
I believe, that testified

In the kerrville case
in georgetown

Testified that she
went up to genene,

Standing outside
of sid peterson hospital,

And genene had said,
"you know what
this place needs?"

Or at some point,
she said this.

"What this place needs
is a pediatric
intensive care unit,"

And obviously, she would
want to be the head nurse,

And this other person said--
I think it was another nurse--

Said, "well, but genene, we
don't have any critically ill
children like that out here,"

And genene said,
"yes, you do.

You just need to go out
and find them."

Narrator:
on february 16, 1984,

Genene jones
was found guilty

Of the m*rder
of chelsea mcclellan

By injection
of succinylcholine

And was sentenced
to 99 years in prison.

In a later trial,

Genene jones
was also convicted

Of one count of injury
to a child

While working
at bexar county hospital
in san antonio,

Specifically for injecting
an infant with 22,000 units
of heparin--

A near-fatal dose.

For that crime, genene jones
was sentenced to an additional


Rothe: what had happened--
what genene was doing

Was injecting these children
with a drug called heparin,

Which is a blood thinner,

And because
it's a blood thinner,

These children's
little wounds
wouldn't coagulate,

And consequently,
they started oozing blood
from all these stick marks.

Narrator: genene jones
began creating havoc

In the intensive care unit
in san antonio

Because of what prosecutors
believe was her contempt
for some of the doctors

And registered nurses
who worked there.

Rothe: but she
was still an l.v.n.

She didn't have
the education they had,

And she wasn't gonna go as far
as they were gonna go,

And I think
she resented that.

Narrator: and when genene jones
left san antonio,

She continued her rampage
in kerrville.

Elkind: there's so many people
that could have indeed stopped
genene jones at some point,

Could have done the right thing
and failed to do it.

I mean, it's really a story
about the medical bureaucracy.

It's a story about,
um, medical politics.

It's a story
about institutions

That failed to do
what they should do

For all the wrong reasons--

That are afraid
of bad publicity and scandal

And litigation--

And so allowed genene jones
to go off and harm kids
in kerrville

And m*rder
chelsea mcclellan.

That's what makes it
a truly tragic tale.

Narrator:
dr. Holland says

She relied on the positive
employment reference

Bexar county hospital
provided for genene jones

Before hiring her.

Despite a broken marriage,
numerous lawsuits,

And near-bankruptcy,

Dr. Holland stayed
in kerrville, texas,

To rebuild her practice.

She says
it has taken years

To regain the trust
of the community.

Holland:
in february of 1984,

The practice was down to seeing


My husband divorced me

Before the year 1982
was closed.

Um, while those who had worked
with me before

Knew of my own character
and knew that I wasn't involved,

My professional reputation
was totally gone...

Especially in this town,

And so I found myself
at rock bottom...

But I knew I hadn't--

I knew I hadn't participated
in that crime,

And I knew that,
and I knew god knew that,

And I just
made a decision

That I wasn't going to quit,
and I wasn't going to leave.

I had nothing to run from.