The Death Shift
When nurse Genene Jones was on duty in a San Antonio hospital, babies had mysterious emergencies and sometimes died. Then she moved to a Kerrville clinic, and the awful pattern began again.
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The ambulance arrived at 1:25 p.m., and Genene carried Chelsea into the back of it as an emergency medical technician (EMT) followed along with an IV bottle. Holland joined them, and Petti got in with the driver. They arrived at the Sid Peterson emergency room two minutes later. By that time Chelsea had resumed breathing on her own. She was sent to the ICU and remained at Sid Peterson for nine days, but tests showed nothing to explain the seizure and the respiratory arrest. The McClellans, nonetheless, were deeply grateful. Dr. Holland and the nurse, they believed, had saved Chelsea’s life. “We worshipped the ground these people walked on,” says Reid. Petti began telling her friends about the new pediatrician. “I went all over town: ‘Take your kid to Dr. Holland; she is the best thing since canned beer.’”
BRANDY LEE BENITES
Friday, August 27
Nelda and Gabriel Benites were worried. Brandy Lee, their one-month-old daughter, had blood in her stools and diarrhea that persisted for two days. They took her to the emergency room at Sid Peterson Hospital, but the staff there sent them to the new pediatrician in town. They arrived at Kathy Holland’s clinic late in the morning. The doctor and her nurse took Brandy’s history, asked Mr. and Mrs. Benites to remain in the waiting area, and then carried the child back to the treatment room. Mrs. Benites soon saw Genene Jones rushing back and forth. Then Dr. Holland came out and told them their daughter had stopped breathing.
Holland says that Brandy was gray and lethargic when she arrived in the office and that the baby was given only oxygen before she stopped breathing and had a seizure. Holland’s office called EMS at 11:37 a.m. After half an hour at Sid Peterson Hospital, Holland told Brandy’s parents that she wanted to transfer their daughter to Santa Rosa Hospital in San Antonio. The ambulance set out about 3 p.m. with Genene, an EMT, and a respiratory therapist in the back and Kathy Holland following in a car. Holland explained to Mr. and Mrs. Benites that she got carsick in an ambulance.
As the ambulance raced toward Santa Rosa, Genene began barking orders to the EMT and pleading with the tiny patient, “Please, baby, don’t die! C’mon! C’mon!” The EMT thought the nurse strange. “She was getting out of control,” he said later. “She turned the whole situation into ‘the world’s falling in.’ The baby was in bad shape, but calm, collected movements are better than going crazy.” During the trip Brandy’s pulse suddenly grew faint. “Stop the ambulance!” Genene hollered. The car pulled over to the side of the road, Holland rushed in, and they revived the baby. It had been a close call. Holland climbed back into her own car, and the procession went on its way again.
Brandy Benites remained at Santa Rosa for six days. Doctors were unable to detect what had caused her emergency.
CHRISTOPHER PARKER
Monday, August 30
Mary Ann Parker, a registered nurse at a Kerrville convalescent home, brought her baby boy to Dr. Holland’s office at about 10 a.m. Christopher, four months old, had a condition called stridor—raspy breathing caused by constricted air passages. Genene came into the waiting room, looked Chris over, and pointed out that his feet seemed a bit blue. She took the baby back into the treatment area while Mrs. Parker waited outside.
Then Kathy Holland came out to talk to her. “I told the mother that I felt that we should have him in the hospital so that I could evaluate his stridor and decide what the next step was,” Holland said in a court deposition. “And I told her that I wanted to transport him by ambulance in case anything unexpected happened.” Holland said the baby never stopped breathing or had a seizure in the office; the EMTs, called to the office at 10:21 a.m., were told he had “respiratory distress.” The ambulance took Chris, accompanied by his mother and Genene, to the emergency room. Genene rushed the child in and hovered over him as though expecting a disaster. The hospital nurses were puzzled; the baby had breathing problems but seemed to be stable, hardly even an emergency case. Mrs. Parker watched anxiously from close by. “I hope the baby doesn’t go into arrest while we’re waiting,” said Genene.
Shortly after Chris Parker arrived in the emergency room, seven-year-old Jimmy Pearson was brought in. Jimmy had an often-fatal heart defect called Tetralogy of Fallot and a hereditary condition that limits bone growth. He weighed only 21 pounds, and doctors had long predicted his demise. On this day Jimmy had gone into seizures, and he was taken to the emergency room by ambulance. The nurses there called Holland over and asked her to look at him. He was semiconscious and blue from lack of oxygen, and he was frothing with phlegm. Holland consulted by phone with the two doctors who had been treating Jimmy in San Antonio and then told his mother, Mary Ellen Pearson, that they needed to transport him to Santa Rosa. Holland called Fort Sam Houston in San Antonio and arranged for a transfer by Army helicopter ambulance, a Military Assistance to Safety and Traffic unity from the 507th Medical Company.
When paramedics David Maywhort and Gabriel Garcia arrived at the helipad outside the Kerrville Veterans Administration Hospital and were taken to Sid Peterson, Dr. Holland asked them if they could also transport Chris Parker to Santa Rosa. Chris had in the meantime been transferred up to the ICU, and Maywhort went up to check on his condition. He looked fine. Maywhort wondered why Chris needed to be transferred at all, but the medics agreed to take both children. The ambulance shuttled the patients, paramedics, and Genene out to the helipad. It would be a wild ride.
Everything was fine for fifteen minutes, according to the paramedics’ descriptions of the flight to investigators. Then Genene got out of her seat and began looking at Jimmy Pearson. She shouted and gestured to the paramedics; she seemed to think Jimmy was seizing. The paramedics looked at the boy. His condition didn’t appear to have changed. Genene took out a stethoscope and placed it on Jimmy’s chest. The paramedics looked at one another. They knew it was impossible to hear a heartbeat over the din of the helicopter. They shouted at her, but Genene waved back. She was saying she could hear. What was going on? She began gesturing again, shouting that the patient was going bad, that his heartbeat was irregular. Garcia checked the monitor; he saw no change. Maywhort was inches from Jimmy Pearson. He looked closely at the child; his condition seemed the same as when they’d taken off. But Genene was getting out a syringe. She was about to inject Jimmy with something through the IV line. Maywhort waved at her to stop, but she went ahead anyway. “Sir, mark time!” Maywhort radioed the pilot. “She’s pushing medication!” A few moments passed. Then the monitor started showing heartbeat irregularities. Jimmy was turning blue. The paramedics looked at his chest; he had stopped breathing. They checked for a pulse in his neck. There was none.
Genene got out a respiratory bag and began trying to pump air into the child. It wasn’t doing much good. They needed to get a tube down his throat to establish a clear airway, but there wasn’t enough room to maneuver in the helicopter. Maywhort ordered an emergency landing. The pilot dropped down fast into a plowed field. They opened the cabin door, moved Jimmy’s litter, and continued the attempts to revive him. They tried again to insert a breathing tube, but when they reentered the helicopter, it fell out. They took off again for San Antonio, Maywhort holding Jimmy Pearson in his arms and performing mouth-to-mouth resuscitation, Garcia massaging the deformed child’s heart. Somehow, he clung to life. The helicopter flew at top speed, and the paramedics diverted it to Methodist Hospital in northwest San Antonio. Jimmy was taken to the emergency room and stabilized while the helicopter flew Chris Parker to Santa Rosa. By the time it returned, Jimmy Pearson was able to make the short trip downtown to Santa Rosa.
Genene Jones offers a sharply different account of what happened. A short time into the flight, she says, “Jimmy turned black.” Genene says that’s when she gave him an injection—of neosynephrine, a drug used to dry up secretions and open breathing passages. Jimmy’s heart did not falter until ten minutes later, she says. The Army paramedics, she says, are “full of shit. They didn’t even want to look at Jimmy. They couldn’t stand to look at Jimmy.” When they were trying to put the breathing tube down Jimmy’s throat, Genene says, one of the paramedics suggested that they not bother. “He kept telling me, ‘What’s the use of putting it in? Let the kid die.’”
Jimmy Pearson recovered enough to return to Kerrville, but there his condition deteriorated again. He was taken back to the Santa Rosa Medical Center, where he died on October 21. Mary Ellen and Thomas Dewey Pearson, Jimmy’s parents, have retained a San Antonio malpractice lawyer.
MISTY REICHENAU
Friday, September 3
Misty Reichenau, 21 months old, was sick and fussy. She’d had mouth sores for four days, she had fever and a cold, and that day she’d stopped eating and drinking. Kay Reichenau, her mother, called Misty’s doctor, Duan Packard, a 68-year-old local family doctor, who told her was leaving town briefly. Dr. Packard said there was a new pediatrician in Kerrville named Kathy Holland who could probably see Misty.
Mrs. Reichenau arrived at Dr. Holland’s office about 2 p.m. and was ushered into the treatment room. While Misty sat in her mother’s lap, Dr. Holland examined her neck, trying to bend the girl’s head down to her chest. Her neck seemed stiff. Holland and Genene looked at one another knowingly. “Dr. Holland said not to be excited, but it could possible be meningitis,” says Mrs. Reichenau. Holland wanted to admit Misty to the hospital to test for the disease with a spinal tap. But first she wanted Genene to start an IV; Misty seemed a bit dehydrated. Debbie Sultenfuss had been at Holland’s office for lunch, and now she was in the treatment room, eager to help out. Holland left the room to call the EMS. Mrs. Reichenau stepped out to the waiting area to get word to her husband, Larry.
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