Was It Murder?

This segment was originally broadcast on Sep. 24, 2006. It was updated on Aug. 15, 2007.

In the aftermath of Hurricane Katrina two years ago, more than a thousand bodies were recovered in the city of New Orleans. Among the dead were 34 patients from Memorial Medical Center, a hospital that was stranded, isolated, in ten feet of water and without power for four sweltering days.

A year ago, Louisiana's attorney general stunned the city when he claimed that four of Memorial's dead did not die from illnesses or even from the horrific conditions but that they were murdered. Even more stunning, a highly respected doctor and two nurses were arrested.

A few weeks ago all three were cleared by a New Orleans grand jury. But still the case continues to resonate and raise questions about ethics, and compassion in what has been described as battlefield conditions. As correspondent Morley Safer reported last September, at the center of it was Dr. Anna Pou.

Dr. Pou, along with nurses Cheri Landry and Lori Budo, were arrested after an investigation by the state attorney general, who accused them of murder by injecting four patients in their care with two different drugs.

"When you use both of them together, it becomes a lethal cocktail and guarantees they're going to die," the attorney general, Charles Foti, announced.

The story made headlines around the world. It's New Orleans after all and theories abound: were patients murdered? Was it mercy killing? Did the doctor and nurses kill patients who were dying anyway and were too ill to be evacuated? Or were they simply given medication to make them comfortable in the most horrific of conditions.

The attorney general had no doubt. "This is not euthanasia. This is plain and simple homicide," Foti said.

"You went from being a highly respected physician to, in the eyes of the law, a criminal. What did that do to you?" Safer asks Dr. Pou.

"It completely ripped my heart out. Because my entire life, I have tried to do good. And my entire adult life, I have given everything that I have within me to take care of my patients," she replies.

Dr. Pou has been practicing medicine for more than 15 years — as a head and neck surgeon who specializes in treating cancer patients. As Katrina approached, Dr. Pou headed to Memorial Medical Center, where she was on call. In all, about 2,000 people were in the hospital that Sunday night, many of them simply seeking refuge. After the storm passed the next morning, there was a sense of relief.

Dr. Pou was offered the chance to leave but she chose to stay with her patients. By early Tuesday morning, the city's levees were collapsing.

"It was really shocking. The water was squirting out of the vents in the street, the gutters. And water started coming. And probably rose about a foot an hour," she recalls.

By late Tuesday, the hospital was flooded with ten feet of water and completely without power. Ventilators stopped, there were no telephones, limited food, and perhaps worst of all the 110 degree heat.

"I don't know if there's any way for me to describe to you how intense the heat was," Dr. Pou tells Safer. "It was relentless. It was suffocating. It made it extremely difficult to breathe. And with the heat came the terrible smell from all of the human waste and the fact that we didn't have water."

Occasional helicopters or small boats would evacuate some patients, but nurses Cheri Landry and Lori Budo say that was rare.

"It was like, where are the boats? Where are the helicopters? Why isn't anybody coming?" Landry recalls.

Neither Landry nor Budo says they were thinking of getting on one of those boats. "Not until everybody else was out as far as patients or visitors or families. I mean, we were there for the duration," Landry explains.

Patients lay soaking in squalor. Nurses broke windows for air and fanned patients. The seventh floor was most critical. A separate company called Lifecare ran an acute care facility for the severely ill. Their doctor didn't show, so Dr. Pou and a handful of other doctors and nurses did what they could.

There were sporadic evacuations, but it took a tremendous effort. Patients had to be carried down as many as seven flights of stairs, then back up again to a helipad on a garage. It was a battlefield and several died in the process. By nightfall Wednesday, Memorial was a hellhole.

"The hospital you have to remember was pitch black. We couldn't see our hands in front of our face. We had to examine patients using flash lights," Dr. Pou remembers. "The patients realized there wasn't a whole lot that we could do for them, except to provide the most basic care and they were worried, you know. You know, 'I don't feel well. When am I gonna get out of here?'"

Doctors say the hospital had become a death trap – dehydration was a killer.

Dr. Pou says people were dying. Asked if the patients passed from their diseases or from their conditions, she says, "You have to understand that there were very sick people in the hospital. You had this intense heat. We had the lack of all the tools that we normally used. And so people were dying from the horrible conditions because they were not strong enough to tolerate them."

"Did you figure at any point that you were really done for?" Safer asks Dr. Pou.

"Because you don't know me, you don't know how tough I am," she replies. "I don't think anyone gave up hope. I can tell you that I didn't give up hope, because as a cancer specialist, what I do is I give hope to my patients. You know, I am hope."

By Thursday morning, another ten patients were dead. Then something worse happened: word spread that no organized rescue would be coming.

Dr. John Kokemor was stunned. "That was actually what was told to us, that help was not on the way," he recalls. "That we would be on our own. At that point, we were dumbfounded and in a bit of shock."

Dr. Kokemor says they were being abandoned in effect. Asked what choices they had to make in light of this grave situation, he says, "Our choice would've been to leave the hospital and leave behind our patients. That was unacceptable to me and unacceptable to virtually all of our doctors."

Many felt that the patients could not bear another day in Memorial. Preparations were made for a makeshift evacuation. Several doctors waded out into the floodwaters to try to commandeer boats.

According to Attorney General Charles Foti, that's when Dr. Anna Pou and her nurses injected four patients with lethal doses.

The attorney general says in an affidavit that several witnesses claim that Dr. Pou, along with nurses Budo and Landry headed up to the Lifecare facility on the seventh floor, where there were nine patients that doctors say were too sick to be moved.

Foti claims Dr. Pou told the staff "they didn't have a lot of time" and that they "needed to evacuate." She then allegedly said "a decision had been made to administer lethal doses" to patients who probably were not going to survive. Witnesses claim that Dr. Pou said she took "full responsibility." And then, according to Foti's affidavit, the doctor and nurses were seen entering patients' rooms with syringes and vials of drugs.

"People testified what they saw – what they heard," Foti says. "We then spent almost ten and a half months investigating. And after all of this – can only come to conclusion that this crime had been committed."

Foti says he has post-mortem evidence that shows that the Lifecare patients, two men and two women aged 61 to 90, had high levels of the painkiller morphine and the sedative "Versed."

But that evidence has yet to be released. Some doctors say those medications would be perfectly acceptable in making patients comfortable, given the circumstances.

"They were lethal doses of both of those drugs in those patients. Lethal doses," Foti says.

Foti acknowledges the four patients were very sick.

"I mean they had 'do not resuscitate,'" Safer remarks.

"Some did, some don't. Do not resuscitate does not mean do not rescue," the attorney general argues.

Foti later alleged as many as nine patients were murdered.

"But would you not think that in case of murder, the perpetrators would try to conceal their actions?" Safer asks.

"Maybe they just didn't think that anybody would ever find out," Foti says.

Dr. Pou and the nurses agreed to talk to 60 Minutes but their lawyers would not let them discuss any specifics of their actions that day. The lawyers say that's because there are still a number of civil suits brought by families of the deceased that have yet to be heard. But Dr. Pou will answer the central question.

Asked if she murdered those patients, as the attorney general alleges, she says, "No, I did not murder those patients. Mr. Safer, I've spent my entire life taking care of patients. I have no history of doing anything other than good for my patients. I do the best of my ability. Why would I suddenly start murdering people? This doesn't make sense."

She also says she is just not capable of any sort of mercy killing.

"I do not believe in euthanasia. I don't think that it's anyone's decision to make when a patient dies," Dr. Pou explains. "However, what I do believe in is comfort care. And that means that we ensure that they do not suffer pain."

"Doctors make decisions every day in terms of the so called double effect where the medicine I am going to give to this person I know is it's going to ease their pain. But, I also know there is another possible effect and the effect is to shorten their lives. Are we talking about something like that?" Safer asks.

"Are we talking about in this case?" Dr. Pou asks.

"Yes," Safer replies.

"Any time that you provide pain medicine to anybody there is a risk," Dr. Pou explains. "But, as I said, my role is to help them through their pain."

Murder or not, the alleged crimes took place when help was actually on the way. But no one in the hospital knew that. The owners of Memorial had chartered five helicopters; within hours hundreds of people were evacuated, 34 people lay dead.

"I don't think I could have done anything more. I worked almost around the clock running up and down the stairs," Dr. Pou says. "I did the best I could under these dreadful conditions that I did not create, but were created by the fact that we were abandoned."

Safer asked Foti if he took the conditions into consideration when he made his decision.

He says he did and says he has no second thoughts.

Though no longer facing life in prison, the three women still face civil lawsuits brought by the families of those who died. Whatever may have happened at Memorial over those four days two years ago, it is one more example of the utter failure of city, state and federal authorities which placed Dr. Anna Pou and the nurses in a hopeless situation – the worst part of which, for Dr. Pou, was the prospect of never practicing medicine again.

"That is the thing that is truly the most painful for me," Dr. Pou. "I'm very committed and I love what I do. I mean, I really love it. It is the best thing about my life. And the fact that I may not to be able to continue to do the thing that I love the most when I know I can do a lot of good is just phenomenally, phenomenally painful to me."

Produced By Deirdre Naphin and Katherine Textor