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Episode 176: The Red Flag

2021-11-05 | 🔗

In 2006, a man named William Ramsey went to the Mayo Clinic in Jacksonville, Florida for a life-saving liver transplant. It was a success, and so when his health started to decline after the procedure, doctors couldn't figure out why.

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for a liver transplant. This is distant United States attorney Frank top it before that he had been evaluated for a liver transplant by hospital out in California. He actually lived in LAS Vegas with his wife, that's where they retired, and he bent the hospital in California. That told him that is the condition of Labor was essentially to too bad that he wouldn't be a candidate for a transplant. So really he had been sent home just really to wait to die and a friend suggests That he reach out to Mayo Clinic in Jacksonville Because- maybe they would be a little more aggressive in trying to do a liver transplant and and that's what happened. Mayo clinic agreed to put him on the transplant list, and that was in two thousand six and
oh, Mr Ramsay and his wife move to Jacksonville to wait on a transplant, and at that came September, and was a huge success. It was a very difficult transplant procedure, but there was a success. After his liver transplant. His health started to deteriorate and the doctors could figure out why they finally tested in in January, two thousand seven and to their surprise, he had Hepatitis c that he did not have before his liver transplant. Part of the transplant process of courses is lots of testing and he had been test. for Hepatitis C several times along the way before his liver transplant and he had a genetic liver condition and did not have hepatitis c.
so Miss Ramsay became the red flag because this de Ramsay did not have this disease when he went into surgery. That's correct the new, absolutely that he didn't have it. and he had Hepatitis c that would have change the course of his treatment entirely. but it wasn't until after he got his new liver that the Hepatitis C was discovered a little bit about Hepatitis C, because there are a number of different types of hepatitis is there, a habitat is a is Hepatitis c of of the most serious. How is it transmitted, and why Is it so dean? Why would this have re such a red flag of oh boy? We ve got, we ve got a problem there. There are three
commonly known types of of hepatitis and your correct a and b are as they can be serious, but there are much more easily tradable than hepatitis. C is a blood borne virus, and so is the only way to contracted is, is blood to blood bloodbath? the pathogen it's an or any organism. So it's extremely extremely small, smaller than the wavelength, obliging all only see it under electron microscope and it wasn't relief discovered entirely him in people in dealing with habit, I see for centuries in all likelihood, but it wasn't until the early seventies that actors were able to actually diagnose and name it, and then it really wasn't into all around the early ninetys that we started to screen for,
but try to see in the blood bank, and there were several people that had contracted Hepatitis C prior to that through ordinary treatment. Bloodline, patients. So it is a very serious virus about twenty percent of the population can clear it on their own, but typically that's people that are healthy. Someone in Mr Ramses position, who had yes received. A new liver and was on suppresses drugs to keep his body from rejecting the liver. Him being exposed to Hepatitis C was horrible in terms of his ability to have his body, accept the new liver and then, in terms of the Hepatitis C, impacting
captain see over time will destroy the liver. It is a virus that attacks the liver and apathy me I'll, adjusted. The Jackson Veil may have clinic named Doktor Walter Helsinki begin an investigation to try and find out exactly how William Ramsay had contracted Hepatitis c. They must have thought that the Hepatitis C came from his newly transplanted liver or something really well, though, they went looking in doktor hell, injured, epidemiologist. That was his first job was to go back and look To see where the liver came so you're right, they looked at the donor donnay, the liver, obviously no longer alive the donor, but did not have hepatitis C. The liver had been tested before his surgery. And it was free of Hepatitis C, they
focused very heavily on the liver transplant unit and What they were looking for was perhaps another patient who had been treated in the liver transplant unit had given the hepatitis C to Miss Ramsay. They took blood samples from patients who they knew already had Hepatitis c and then the CDC involved in the investigation every time they would find a patient We have to try to see as a potential source for Mister Ramses Hepatitis C. They would send that sample too. Cdc in Atlanta CDC in Atlanta is able to conduct genetic testing of the virus, arrests, and so they are able to tell doktor. Helsinki, Either yes, this is a potential source of the habitat of Agnes Ramsay or no it's a different strain.
And so when they did, all of that, they still were not able to find how Mr Ramsay got his hepatitis c now. At the same time, there also testing the health care providers in the liver transplant unit to see, if perhaps one of the providers themselves, has Hepatitis C and his inadvertently transmitting it to the patients and There was no, There was no one that had Hepatitis c, so there was no provider to patient transfer. The new liver was fine, they couldn't find any patient patient transfer and they couldn't find in the provider to patient transfer. It didn't make sense and then it happened again.
I'm Phoebe judge. This is criminal. In January two thousand eight a year, after William Ramsay tested positive for Hepatitis C. Another man named Rick Hildebrand, also positive. The Jacksonville male clinic preparing for a liver transplant. He did not previously have the virus when they sent Mr Hilda orients sample bloodstream, to the CDC. They discovered that it was a strain match to Mr Ramses strain of Hepatitis C, so that lead Doktor Helsinki, or know that either Mr Ramsay may have infected Mr Hildebrand, Mr Hildebrand may have infected Mr Ramsay or there
an unknown source of the Hepatitis C, and what Doktor Helsinki was able to determine is that these two men could not have infected each other, so he was still looking for the south First of now to patients Hepatitis C and both these patients were both liver train? my impatience, so they were both seen heavily in the liver transplant unit and then a third patient tested positive. But he wasn't in the liver transplant unit. He was at the male clinic for cancer treatment. That involved, its planning stem cells, so, this patient who was happened to be an attorney from Georgia, was down at me a clinic for this procedure. He too, didn't negative for Hepatitis C, and then he had the stem cell, replace the winner went through. The stem cell replacement
immune system is essentially destroyed and any gets v, very, very sick, and they determine that this patient has Hepatitis C and he did not have it before and again It was a strain match to the other two patients and these, patients could there's no way that these patients would have come in contact with each other? That's correct: they. They again look to see? Was there any overlap and there wasn't What became very significant about this third patient is that instead of to pay. since in the liver transplant unit. We now have a third pace. that's never been to the liver transplant in it. But now what we have, and I the where the score I'd this is we now have a triangle with with these three, these three patients. We we Roy Triangle and we
look in that triangle for where these three patients overlapped at Mayo Clinic, because at this point, Doktor Helen is really shifting his focus too. provider to patient transmission, because he dealing with three different in full actions of Hepatitis C that have spanned almost two years, he He believes he's not looking for a patient but he's looking for a provider. So when they draw the triangle: that's when they find in that all three of these patients had been treated in intervention Radiology Department at Mayo Clinic that was there that was their common overlap in in the Mayo clinic. So what they did is an it's one of the US both the advantages of having very detailed
medical records. Isn't the Mayo clinic was able to go back and looked to see when these, when they Surrey patients went through intervention radiology and they were able to tell who was working on these days that that these three patients went went through. They obviously want letting go through on the same day they were years apart, but they re policy which employees were there, and there were twenty one employees that overlaps with these three patients. So what's that you ve got twenty one, employees do just ask them debt. Are you positive wrapped? I do see what what did they do? That's exactly what may a clinical they went to each of the twenty one employees and told on why they wanted to get their blood sample and they asked all twenty one of the employee is to voluntarily give them a blood sample twenty
the employees did one of employees withheld. Who was that imply that boy was Stephen Female somewhat after twenty employees. That retested did did any of them tat positive hepatitis C. They did not all twenty one if, when they found out that all twenty were negative, Mayo Clinic, went back to see, even be mail Perhaps a little more insistently this time, and I asked him if he would provide a blood sample and on April twentieth, twenty ten Stephen email submitted to a blood sample and that sample tested positive for habit?
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the first step- is that sample here. to be sent to the CDC in Atlanta, and it was- and it was just ethically tested, and it was a strain match to the three patients. So Helen juror was of the opinion that he had found his source of hope Try to see, but of course, the CDC confirm that, with the genetic testing of the virus, then they had to determine. Where was the point of infection Obviously, as we talked about Hepatitis C is, is very small. You can't see it and it is a blood borne pathogen. So they had to determine how did how did the hepatitis C and Stephen Females bloodstream get into the bloodstream of the patients? After multiple interview Stephen View Male told investigators how it might have happened.
Stephen female worked as a radio logic technician. His work involved, preparing patients for procedures in the interventional radio. she department gathering the necessary supplies, making sure the peace each of rooms were sterile and disposing of you needles and syringes those discarded syringes. Sometimes contained small after over amounts offended on synthetic obiang. Lloyd can be a hundred times more potent than morphine and fifty times more potent than heroin prescribed, patient and severe pain and is highly addictive, can't. You mail told investigators that he would replace them those on the discarded syringes and inject himself with the to know that remained in them and then he said at some point. He began to look for full syringes before each Caesar that required vent enough for the patients, I ve a nurse,
would fill a syringe with the drug label and sentinel place it on the patients card Stephen Female said that he would then take the serene from the cart, replace the needle with a different one and use it to inject himself, then he would put original needle back on the empty, Syringe Philip was sailing and put it back on. Aren't before the nurse noticed He would do that. Just a sleight of hand, while typically the nurse might be distracted, doing something else in the procedure: room and intervention radiology and that's when he would make his sleight of hand swamp and any health care provider knows that the They never reuse any part of a syringe, obviously not the needle, but but not the syringe itself. The the plastic syringe
an easily become contaminated with blood when it is injected in into a patient and so what was happening. Stephen female was injecting a sentinel syringe into his vein A little bit of his blood was getting back flowed into the syringe, contaminating it and then, when he refilled syringe with sailing and then dropped, it did the sleight of hand swap then the patients were, we're not first while not getting funnel, but they getting sailing. That was laced with Stephen emails, Hepatitis C. I mean, there's there, so many horrifying things about that. But but I mean that the first most immediate is that these are people who were going undergoing. What's would simply pretty serious and painful procedures in there and they're not getting there. The reckoning payment
even the recently getting water, that's correct in one of the things that we discovered, as we went through the investigate action was that during the procedures. The patients would typically receive up not only final, or course. In this case, are the patients for receiving sailing and not federal but they were also receiving verse said as a benzodiazepines wit. has an amnesia quality to it. So as We interviewed several of the doctors and nurses over the course of this investigation. We we did discover, we can pin it down directly, but there were reports of patients not are victim patients, but of other patients over the years that seemingly had not had any pain medication and on at least one occasion, we had a doctor who remembered arguing with a nurse
that the nurses slang I've, given this patient tomb to my final already and the doktor IRA actually said it seems like you're giving in water and so there were some reports of that during the we discovered during the course of our investigation. But when we talk to the Don't they had no memory of the procedure. The intervention radiology in that was not surprising. B. as they had all receive verse said, which again axes and amnesia. It is good that they have no memory of of the pain that they endured in August. Two thousand and ten after more than three years of investigation, the
MAX, involve male clinic, fired Stephen View mail and reported him to the police. According to his arrest report, view Melick knowledge to the police, who was addicted, defensible and admitted that he had taken drugs from the hospital. The FBI, Lord Estate investigators and a special agent with the food and Drug Administration got involved and the criminal investigation. So we had a kind of a team of investigators and the first question was: Did Stephen be male? No, he had Hepatitis c before he was doing this at the mail. clinic, and so we went back trying to find medical records on Stephen email and we really found none. He just didn't go to the doktor ever
so that that was a dead and we were unable to prove anything there and then then, we went back then went to look at his employment wrecked Stephen view now had worked at Memorial Hospital in Jacksonville from ninety ninety two until two thousand for before he started working for the Mayo clinic and when investigators looked at his records, they noticed something He had been observed by a nurse at Memorial Hospital, and he was rummaging through a sharps container in the medical waste, so they sent him into a, two year Drug treatment programme and it was why, while he was in that drug treatment programmes that he left memorial hospital toward the end of two thousand for and in October of truth
four is when he started working at the Mayo clinic. Tell me about confidentiality rules that would have limited what male clinic new about Stephen Females. Past history, drug issues, you do not imagine that something you'd want to know with someone who can be so close to controlled narcotics. That's correct in their work, confidentiality rules that prevented the memorial hospital did administration from disclosing that information to anyone, including to the mayor clinic when a clinic hired Stephen, be Melvin, probably fairly standard for most most jobs. These days, especially the medical field, they asked him about any prior drug history, whether he had any addictions and
they included alcohol as well, and he he answered on that application that he did not have any past. issues with with drug addiction. While the Tommy he's answer That question he's actually actively in a drug treatment programmes, so Mayo Never now, according to court documents, During Stephen Females time in the drug treatment programme, he was specifically informed about the risk of exposure to Hepatitis C from injections. his drug monitoring and counselling didn't end until April two doesnt seven at least seven months, Three first began injecting himself with sentinel from the male clinic.
A two thousand fourteen male clinic study, using CDC data from all over the country, found that over a period of ten years, nearly thirty thousand patients were determined to have been potentially exposed to Hepatitis C because of health care providers. having tracks one radiology technician named David, could Caskey manage to work at nineteen hospitals in eight states even though there are indications that he was using Sentinel intended for patients at many of those hospitals in two thousand even one month after use hired at University of Michigan Hospital vials of narcotics started. This hearing from operating rooms. Two months later, the scene, leaving a room quickly right before a nurse noticed that a syringe offend tunnel that again then left on the counter in that room was gone during the police investigation David quit Cowskin
refused to submit to a lighted actor test and quit from there. He went on to work for a series of hospitals as attempt, and none of them knew why he had left the university of Chicken no charges have been filed. No one had alerted the national right history of radiology technicians, hospitals policy when receiving inquiries. for many potential employer was. It confirmed the dates of his employment. It was reported that the hospital been advised against disclosing anything else. For fear of me, sued for defamation in two thousand and eight coworker at a hospital in Pittsburgh saw David could cowskin. but the syringe into his pants, not long after three empty syringes with a sentinel label were found in his pockets
after he failed to drug test. He was fired. The hospital told the staffing agency why he was but didn't call. The police The staffing agency didn't notify the police either No one inform the national registry of radiology technicians kept getting hired a different hospitals. in two thousand ten David could cost. It was found almost unconscious in the men's bathroom at Arizona Heart Hospital with an empty syringe, labelled sentinel floating in the toilet next to him, but he'd inadvertently injected himself with a different role altogether a paralytic the syringe had been miss labelled the Colleagues, who found him later reported that when he came to, he said I'm going to jail, but when
hospital staff questioned him the next day he told them. he taken the sentinel syringe to help with some abdominal pain and deny any history of intravenous drug use. The hospital did not press charge and none were filed. He was reported to the region, three of radiology technicians, but they did their investigation because they said David quit, Kuski gave them possible explanation for what had happened when was reported to the Arizona Regulatory Board. He syringe his license to practice in Arizona and moved on to other states. Afterward king in Pennsylvania, Kansas in Georgia. David quit Caskey got a job in New Hampshire. his coworkers reported that he would sometimes sweat who is scraps and was asked strange. Sometimes he ran to the bathroom
the middle of a procedure and then about a year after he was hired in May two thousand twelve, several patients who had gone through the lab where he worked tested positive for Hepatitis C. The strain was traced back to David quit Kuski. He was arrested and charged with multiple counts of obtaining controlled substances by fraud and tampering with the consumer product. He plead guilty doll. The charges and was sentenced to thirty nine years in prison, David What county is believed to have infected at least forty six people,
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Clinic began, sending out letters, one woman who receive The certified letter warning her that she may have been exposed told her reporter. I have never felt or safe than I was it the male clinic. For this to happen, I think, is horrible. Thousands of people submitted blood samples collected at their home, the male clinic or another testing. site. Thankfully they discovered that There were only two additional victims of sea even blackmail that that we didn't previously know about. Is it? Is it true that and a number of people who they would have reached out to had already died? Well, that is, that is true and animal, and we we'll never know what what impact occurred there. The other thing that
will will never really know is how many patients were able to clear the virus. I said before the doctors have told me that about twenty four set of individuals can clear Hepatitis C on their own, and so will never really know what the what the total universe of victims really was but for purposes of our prosecution he identified, five Victor beyond reasonable doubt, an end in Stephen emails indictment. Those five victims were name specifically as as his victims. One of the interesting dynamics of this case is that Stephen view MEL. We think a lot, and of criminal cases, and I'm sure you have a lot of programmes. Were people talk about dna evidence and some One leaves there either they take the view.
Dna, whether more they leave their own dna crops What this was such a unique situation, where the only real evidence that Stephen View Male left, the crime scene was alive The city had inside his own body and then that virus was a fingerprint if he will, that remained in these victims, but other that virus, we would have no way of linking Stephen, be mail to this crime in May. Two thousand eleven Steve do you, mail was indicted by a federal grand jury on foot I've counts of tampering with consumer product resulting in death or serious bodily injury and I've counts of obtaining the controlled substance by fraud a year later. One week
for the trial was scheduled to begin Stephen Female bled guilty to all counts, blood guilty and he planned without a playground. It was, I say, straight up, guilty plea, and that meant that there was no agreement as to what sonnets he would receive. That would, the entirely up to Judge Howard who sentenced he was sentenced to thirty years in federal prison. What did he say with services? Did he say anything
Missy apologetic. He was apologetic and his family. His mother spoke sister spoke at his sentencing. Eyed the victim's family members spoke. We had one of the victims. The attorney from Georgia actually came to court spoke about what he had suffered and it was horrendous. What he had gone through and really continue to go through. Babbling battling the virus thee. I think, one of the most powerful witnesses sentencing was mister Ramses, wife and
story. She told about her husband and what he had gone through. The suffering was almost beyond description. Remember he had gone through the liver transplant. in September two thousand six, but then, when he went through intervention radiology after the transplant, that's when you got it appetite to see, and it really it took away really his second chance at life, and the doctors would later described to me there.
It was a constant battle to try to help Mr Ramsay overcome the hepatitis c that they just kept losing ground, no matter what they did. It was they just couldn't gaining ground on the virus and so beginning in early two thousand seven for the next three years, the doctors at my clinic try to save his life and one of the dates that I've already mentioned, but was very significant case, was that date of April twentieth. Twenty ten two things happen on that Mr Ramsay was discharged from Mayo Clinic to go to home hospice. That was the day that he said good bye to the staff it may clinic, and I say goodbye to him And he went home to white. Did I?
that was the same day. The female finally gave his blood sample, which would eventually solve the case. William Ramsay died from complications of Hepatitis C in June two thousand ten. He never learned how he had contracted the vote. Yes Criminals created by Lord Spore and me, media Wilson is our you're producer does any Robertson, as our producer audio mix by John Events, Evans generic virus. Henry special thanks to Lily Clark, Julian Alexander, makes original illustrations for each up a sort of you can see them at this is criminal dot, com or unfair book in twitter add criminal, show criminal
It is recorded in the studio of North Carolina public Radio, w you and see proud member of Radio Toby from PR acts, a collection. the best podcast around I'm Phoebe Judge this criminal. yeah. Radio do.
Transcript generated on 2021-11-05.