Medical Experts

New York Times Ignores Three Major Medical Opinions on Memorial Deaths
In the months following Hurricane Katrina, three well regarded medical experts reviewed the forensic evidence presented by the state as part of the investigation into deaths at Memorial Hospital during the storm.  These experts reached conclusions far different than those made public by former Attorney General Foti and highlighted by the August 27 New York Times article.   

Regrettably but not surprisingly, although offered statements provided by those three experts, the Times simply chose to ignore them or give them little emphasis in the article.  The Times was provided with statements from all three experts on August 18th, in ample time to consider them for placement into the August 27th article. 

For the record, reprinted below are statements from Dr. Steven Karch, former assistant medical examiner in San Francisco and the author of a very widely used textbook on drug death investigation. Dr. William George, a pharmacologist and toxicologist who has served on the faculty of Tulane University School of Medicine for more than 35 years; and Dr. Steven Miles of the University of Minnesota, a world-recognized disaster medicine specialist who has served as Program Director of the American Refugee Committee since 1979. 

Dr. Karch  

In February 2007, Dr. Steven Karch was hired by then - Attorney General Charles Foti to review forensic evidence regarding the deaths of patients at Memorial Hospital.   

Dr. Karch’s findings were deliberately omitted from the Attorney General’s public release of expert reports on the day of the Grand Jury "No True Bill" because they conclusively failed to confirm Foti’s any finding of homicide or wrong doing on the part of Dr. Pou or her colleagues. 

Likewise, Karch’s report was largely ignored by the New York Times in advancing its own agenda as debuted in recent media accounts.  For those interested in the facts regarding patient deaths at Memorial we record Dr. Karch’s comments before the Louisiana State legislature in June 2008. 

Dr. Karch: "Thank you Mr. Chairman.  My name is Dr. Steve Karch  I was originally retained by the Attorney General’s Office after Katrina.  

I was contacted in February of 2007 by Dr. Minyard.  I subsequently went to New Orleans and met with representatives from the Attorney General’s Office, from representatives of the medical examiner’s office and from representatives of the District Attorney’s office in New Orleans.  We met for perhaps six hours and reviewed each case that was an alleged homicide in great detail.   

My specialty is in drug-related deaths and having reviewed each of these cases, I came to the conclusion that there was no evidence to take before a Grand Jury and that the mode of death in every case should have been declared undetermined, because it is impossible to do a scientific analysis of a cadaver that has been in the sun for ten days.  I was told after the meeting was concluded that I need not prepare a report or submit any further reports.   

When the Grand Jury refused to deliver a true bill, representatives from the Attorney General’s Office contacted CNN and told them to file a Freedom of Information Request.  The request was duly filed and copies of all the experts that were hired by the Attorney General, each one of them concluding that there were multiple cases of homicide committed were released with the juicy bits underlined to CNN.   

My existence was never mentioned nor was my opinion mentioned.  I think that if for no other reason this bill (disaster medicine reform legislation) is needed to protect the Attorney General if nobody else from being bombarded by outside experts who are testifying beyond their field and giving junk science advice.   

Thank you."

The below biographical sketch of Dr Karch explains why the State of Louisiana retained him in this matter:

Biographical Sketch: Steven B. Karch, MD 

Dr. Karch received his undergraduate degree from Brown University, attended graduate school in Anatomy and Cell Biology at Stanford University, and his MD from Tulane University School of Medicine in New Orleans.  He did postgraduate training in neuropathology at the Royal London Hospital, and in Cardiac Pathology at Stanford University, Palo Alto.  He was an Assistant Medical Examiner in San Francisco for nearly 10 years.  In 2006 he was elected a fellow of the Royal College of Physicians.  Faculty of Forensic and Legal Medicine and in 2007 he became the only American elected to the Italian Academy of Forensic Toxicology. 

He has written more than 100 peer-reviewed papers and book chapters, most having to do with the investigation of drug-related deaths.  He has published 10 books.  The 4th edition of his textbook, Karch’s Pathology of Drug Abuse is a best seller and is used around the world.  He is the North American Editor for the Journal of Clinical and Forensic Medicine, and serves on the editorial board of the Journal of Cardiovascular Toxicology, the Journal of Clinical Forensic Medicine (London), and Clarke’s Analysis of Drugs and Poisons, and the Journal of Forensic Science (USA). 

Dr. Karch a fellow of the American Academy of Forensic Sciences (AAFS), the Society of Forensic Toxicologists (SOFT), the National Association of Medical Examiners (NAME), and the Royal Society of Medicine (RSM) in London.  The Forensic Science Society in the UK, The International Association of Forensic Toxicologists (TIAFT), and the Italian Society of Forensic Toxicology.  For the last decade he has taught the toxicology component of the U.S. Army’s basic course in Forensic Pathology. 

Dr. Karch was hired by the British government to help with the prosecution of Dr. Harold Shipman, the world’s worst serial murder.  Dr. Karch helped to obtain the conviction of Dr. Shipman who was convicted of having fatally poisoned 248 of his patients.  He has testified in alleged cases of euthanasia in courts around the world.

Dr. George

Dr. George noted that all of the patients had been dead for 10 or more days before their bodies were removed from the hospital, that there were no blood specimens available for toxicological analysis and that only purge fluids and certain other body tissues were submitted by the state for testing.  Dr. George concluded that any attempt to assess a casual relationship between quantitative drug levels of morphine and versed in purge fluids and the patient deaths would be based on speculation rather than good science. 
Dr. George noted that the finding of drugs in post-mortem specimens obtained from these patients in such a hospital environment could not be objectively interpreted as evidence of homicide in view of the many other possible contributing factors. 

Dr. Steven Miles 

Speaking of the doctors recruited by Attorney General Foti and Orleans Parish, according to Dr. Miles, “None of these experts seem familiar with how the dynamics of a collapsed hospital changes record keeping….Time matters.  The longer a patient in a collapsed hospital goes without customary monitoring with laboratory tests and radiograpghs, the more likely it becomes a latent problem and becomes a crisis.  Dr. Pou and her colleagues on the seventh floor of Memorial Medical Center were at the epicenter of a failed health care system.  Outside Katrina and a dysfunctional city.  Inside a collapsed and isolated infrastruture.” 

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