Deaths are reviewed at home where
accused nurse worked
The Associated Press
June 21, 2002
JEFFERSON CITY - The death of five patients at an
Ashland, Mo., nursing home have been reviewed after a former nurse who
had worked at the facility was charged with murder in the deaths of 10
people at a hospital where he also had worked.
The review of the deaths at the nursing home ,
Ashland Healthcare, found no rule violations, but a state official said
Friday that the information would be given to a prosecutor handling the
case against the former nurse.
The former nurse, Richard Williams, is charged with
10 counts of first-degree murder in the deaths in 1992 of patients under
his care when he worked at the Truman Memorial Veterans Hospital in
Columbia, Mo. He is accused of killing the patients with the drug
succinylcholine, a powerful muscle relaxant that causes a person to stop
breathing. The drug typically is used before inserting a breathing tube
Williams worked as director of nursing at Ashland
Healthcare from July 1993 to July 1994. In that 12-month period, about
30 patients died at the nursing home. In the 10 months after his
dismissal, six patients died. He is not charged in any of the deaths.
But after Williams was charged earlier this month in
the hospital deaths, the state Division of Health Standards and
Licensing began a review of some of the deaths in the nursing home that
happened while Williams worked there.
"As a result of that review, we have not found that
the facility violated any regulations dealing with nursing homes," said
Darrell Hendrickson, deputy director of the division that licenses
nursing homes and hospitals.
Hendrickson is to meet next week with Boone County
prosecutor Kevin Crane to share information and discuss the next steps.
Crane has said that additional charges remained a possibility.
"We're pursing the investigation, be it at the VA or
elsewhere," Crane said.
The state review looked for any inconsistencies or
anomalies in patient care, such as notations that a person was doing
well before suddenly becoming ill and dying, Hendrickson said.
The state Board of Nursing previously investigated
Williams' employment at the Ashland home and found that an abnormal
number of deaths had taken place during that period.
Also Friday, Williams' pretrial proceedings were
reassigned - at his attorneys' request - to Associate Circuit Judge
Chris Kelly, and a preliminary hearing date was set for July 18.
Nurse charged in 10 deaths
A former nurse at 104-bed Harry S. Truman Memorial
Veterans Hospital, Columbia, Mo., was charged with 10 counts of first-degree
murder for the deaths of 10 patients at the facility in 1992,
prosecutors said. Richard Williams, 36, was the subject of an
investigation by the Boone County prosecutor in conjunction with the FBI
and U.S. Department of Veterans Affairs. More than 40 patients died
under Williams’ care in 1992. Previously, FBI officials had identified
22 of the deaths as “moderately suspicious” and 11 deaths as “highly
suspicious.” Williams has denied the charges.
State reviews records of Boone
County nursing home where Williams worked
VA deaths rekindle investigation
News-Leader Staff and wire services
June 10, 2002
Kansas City — State health officials are re-examining
a series of deaths at a mid-Missouri nursing home during the time it
employed a nurse now charged with killing 10 patients at a Columbia
The nurse, Richard A. Williams, worked at Ashland
Healthcare from July 1993 to July 1994. About 30 patients died at the
60-bed home in Boone County during that one-year span.
In a previous investigation, the county medical
examiner called the number of deaths “statistically significant” but
ruled out foul play.
But now Darrell Hendrickson, deputy director of the
division of health standards and licensure in the Missouri Department of
Health and Senior Services, said the department is reviewing patient
records from Williams’ time at Ashland “in light of recent occurrences.”
Williams, 36, was charged June 3 in Boone County
Circuit Court with fatally poisoning 10 patients under his care at the
Truman Memorial Veterans Hospital in 1992. Public defender Kathryn
Benson, whose office is defending Williams, has said Williams will plead
innocent. He remains in Boone County Jail without bond.
Before working at Truman, Williams was employed as a
licensed practical nurse at St. John’s Health System in Springfield from
June 1988 through May 1989.
St. John’s officials have said there is nothing in
Williams’ employment history to suggest further inquiry is necessary.
The charges against Williams in Boone County are
based on a new round of toxicology tests that use technology not
available 10 years ago. The tests indicated that the patients were
administered a paralyzing drug called succinylcholine, which induced
immediate respiratory arrest.
The first investigation into Williams’ employment at
Ashland began in late 1995 after the state Board of Nursing discovered
what it called an “abnormal” number of deaths there. The county medical
examiner said he found no proof of wrongdoing and closed the
investigation in February 1996.
The state inquiry is a result of the charges filed
“Once the news came out,” Hendrickson said Friday,
“people close to the case history with Ashland said we maybe ought to go
back and see that we haven’t missed anything and make sure nothing has
The health department will review its own reports on
Ashland for the time Williams worked there.
Ex-nurse pleads not
guilty in patient deaths
June 4, 2002
A former nurse pleaded not guilty Tuesday to charges
he murdered 10 hospital patients by injecting them with
lethal doses of a muscle relaxant.
Richard Allen Williams appeared at the arraignment
via closed-circuit television from the Columbia jail
where he is being housed. He was without counsel at the
hearing but has since hired two lawyers.
He was ordered held without bond.
Williams was charged with the murders Monday after
authorities said they used newly available technology to
find evidence in the 10-year-old case.
Authorities accuse Williams of giving the victims
succinylcholine, a powerful muscle relaxant, while they
were patients at Truman Memorial Veterans Hospital in
Columbia in 1992 when he was a nurse there.
The investigation involved state officials, the FBI
and agents from the federal Department of Veterans
According to an affidavit outlining the state's case,
41 mysterious deaths occurred on Ward 4E of the hospital
between May and August 1992 while Williams was on duty.
It was determined that people under Williams' care were
20 times as likely to die as other patients on the ward.
In 1993, authorities obtained permission to exhume
the bodies of 13 of those who died. Lab tests at the
time failed to reveal a cause of death.
The affidavit says that in January 2001 health care
inspectors and medical experts agreed the deaths
suggested the patients were given a paralytic-type drug.
Based on the findings, Veterans Affairs Inspector
General Richard Griffin recommended new tests using
technology unavailable at the time. The new tests
indicated that 10 of the 13 victims were given
succinylcholine, which can cause muscle paralysis and
It is commonly used to induce temporary paralysis of
skeletal muscles while breathing tubes are inserted into
Authorities say succinylcholine was commonly present
in the hospital in 1992 and that it was available to all
registered nurses, including Williams. Authorities say
Williams was the only hospital staff member who was on
duty in ward 4E when all of the 10 victims died.
Nine of the tested victims were men 58 years old or
older and one was a 69-year-old woman.
Boone County Prosecuting Attorney Kevin Crane said
authorities have not forgotten the other suspicious
deaths. "We do not consider this investigation to be
over. It will continue throughout this process," he said.
Crane declined to discuss a possible motive, saying
the state does not have to prove a motive in this case.
Griffin credited the persistence of the investigators.
"It was never a cold case as far as our organization and
the FBI were concerned. We never gave up on the case,"
Deaths at the VA hospital :
Record shows battle to prosecute nurse
By Terry Ganey
COLUMBIA, Mo. - The patients were not expected to die.
Yes, they were sick. Some, seriously ill. That's why
they came to the Harry S. Truman Memorial Veterans' Hospital in 1992.
But according to hospital records, doctors said their conditions were
not life-threatening. In fact, some of them were about to be sent home.
That's why, when they began to die in alarming
numbers in spring and summer 1992, relatives were shocked and caregivers
suspicious. Death often came in the middle of the night on the watch of
a newly licensed nurse that some began calling the "Angel of Death."
So mysterious were the deaths that five years later,
after the bodies of 13 were exhumed and autopsied, a nationally known
pathologist could not determine the cause.
It was not until last week, when 10 first-degree
murder charges were filed against the former nurse, Richard Allen
Williams, that surviving relatives got some answers. A new test
determined that the veterans - nine men and one woman - had died from
injections of a powerful paralyzing drug.
All of the victims died while Williams was on duty.
He was the only nurse who was with them all. He had access to the drug.
A whistle-blower who first documented Williams' activities believes he
killed 42 patients at the veterans hospital - and perhaps others at a
nearby nursing home.
For some of the victims' families, Williams' arrest
brought a measure of satisfaction.
"We had pretty well given up hope that anything would
happen," said Gary Havrum, whose father, Elzie Havrum, died at the
hospital 10 years ago this month. "Nothing will bring my dad back. We
just want justice to be served."
The story of what Richard Williams is accused of
doing is more than a tale of multiple murder.
It's a story of federal bureaucrats who appeared
concerned about damage control and said little about the unexplained
deaths. It's about whistle-blowers who, fearing retribution from the
hospital's administrators, secretly went to the FBI. Without that, the
case may never have come to light. The inspector general's office of the
Department of Veterans Affairs has reported that if left to the hospital
administration or the regional VA office, the suspicious deaths might
never have been brought to law enforcement's attention.
Columbia, with its four major medical facilities, is
a hospital town.
The 200-bed veterans hospital near the University of
Missouri football stadium adjoins the university's medical school and
hospital. In 1992, doctors and nurses at the VA facility were worried
about the large number of "code blues" that were taking place on
Williams' night shift in Ward 4-East.
A code blue is a case in which emergency
resuscitation efforts are used to try to keep a patient alive. Williams,
a registered nurse since March 8, 1992, was often in charge of the 27-bed
ward between midnight and 8 a.m. Shortly after he came on board, the
number of deaths spiked dramatically.
A nurse on 4-East noticed the numbers of deaths and
thought that someone could be doing "mercy killing," according to an FBI
report. Another nurse said that she asked twice that Williams be
transferred from the ward in either April or May, but that the requests
"I wanted to reassign him because there was a lot of
talk about the deaths and he being on when the patients died," said
Cynthia Pescaglia, the head nurse on 4-East. There had been more than a
dozen deaths on the floor in one month, while other units reported three
in one month.
But the family of Elzie Havrum knew none of this on
June 14, 1992, when he was brought to the hospital weak and short of
breath but not in acute respiratory distress. Havrum, 66, had survived a
shrapnel wound while serving in the Army in the Philippines in 1944.
After his discharge, he and his wife, Helen, reared a family in Fulton,
Mo., where he worked in a brick factory and ran an auction business.
A hospital note said initially, Havrum "felt better"
after he was admitted. A granddaughter visited him at the hospital until
about midnight, and when she left he was talking with her and seemed OK.
That's why the family was so surprised to get a call an hour later
saying Havrum had died.
Williams' nursing notes show that he was with Havrum
between 12:45 a.m. and 1 a.m. June 15. Havrum's doctor said she was
called to the room at 1:15 a.m. and found her patient pulse-less, not
breathing and with fixed and dilated pupils. She pronounced Havrum dead.
Months later, after fingers pointed to Williams, and
the Columbia Daily Tribune disclosed that he was on duty when so many
deaths occurred, Williams angrily denied a connection.
"Someone has it in for me," he said. "I'm not guilty
of anything." Although fellow workers were calling him the "Angel of
Death," Williams said, "I didn't become a nurse to mercy-kill or to
determine when someone would die."
"Why are you killing my patient?"
In July 1992, the hospital's quality improvement
staff noted the number of deaths and Williams' association with them.
Hospital director J.L. Kurzejeski later testified that the first he
heard of problems with Williams was in late July or early August 1992.
Later that month, the talk in the halls had grown
from whispers to accusations. A hospital board investigation was
convened on one of the deaths on Williams' vigil - the death on Aug. 22,
1992, of Leo Yamry, 75, of Eldon, Mo. A physician in training, Muhannad
Al-Kilani, was overheard to ask Williams a startling question.
"Why are you killing my patient?" asked Al-Kilani, a
Jordanian in residency.
"Are you kidding?" Williams replied.
"No," said Al-Kilani.
The remark led to Williams' removal from patient care.
In early September, during an internal board examination of the incident,
Al-Kilani said he had made the remark in jest. But he also said, "That
patient died. And those other two patients, and these two patients were
unexpected to die, and both of them died with the same nurse." Williams
was cleared of patient abuse in that one incident. But he was assigned
to clerical duties.
By then, members of the quality improvement staff had
taken their concerns to Dr. Gordon Christensen, associate chief of staff
for research. Christensen, an epidemiologist, was skeptical, but he
agreed to investigate.
Using a computer, Christensen analyzed employee time
records, nursing notes and patient charts to where and when the deaths
occurred and who was present. He substituted coded letters for nurses'
names and used a cross on his chart to symbolize the deaths. The
findings startled him.
Statistics show that hospital deaths most often take
place around 8 a.m., and the numbers peak again late in the afternoon.
People seldom die in hospitals between midnight and 3 a.m. But
Christensen's analysis showed that on 4-East that's when most of the
patients were dying. He determined that of 55 patients who died on the
ward between March 8 and Aug. 22, 45 were under care of "Nurse H."
Christensen believed "Nurse H" was killing people.
He told Linda McGary, a member of the hospital's
quality of care team, that "Nurse H" was way off the charts.
"Oh my, that's the one," McGary said. "Nurse H" was
Just before the Labor Day weekend in 1992,
Christensen called an emergency meeting and told Kurzejeski that the
police should be called. Kurzejeski rejected the recommendation.
"I thought again it was premature . . . there was no
evidence that anybody did anything wrong," Kurzejeski said later.
Eddie Adelstein, a hospital pathologist, later said
he was present for a telephone conference call between Kurzejeski and
Steve Falcone, the VA chief of staff for the central region.
"Mr. Falcone said to Mr. Kurzejeski, 'The last time
we had to call in the FBI, we ended up firing the director and the chief
of staff. Is that something you want us to do?'" According to Adelstein,
Kurzejeski said "no."
On Sept. 30, nearly a month after Christensen made
his initial report to Kurzejeski, he held a news conference to respond
to reports of an internal investigation into deaths at the hospital.
"Unless something else should appear, there is no
intent to do any further investigation," Kurzejeski said.
Kurzejeski could not be reached to comment for this
A secret meeting
The event that would lead to the federal
investigation happened a few days after that news conference. Then-state
Rep. Ken Jacob, D-Columbia, called Phillip Williams, an FBI agent in
Jefferson City. Jacob, who is a lawyer, told Williams that two people
had come to him with information about the hospital deaths.
Jacob said they wanted to talk to the FBI but wanted
to remain anonymous. On Oct. 5, Williams met with the hospital sources.
"They reported there were over 50 deaths that had
occurred and that they had reported this information to the hospital
administration," said Jacob, who is now a state senator. The two sources
also disclosed the information to Rudi Keller, a reporter for the
Columbia Daily Tribune. After stories about the deaths and Jacob's
involvement in the investigation were published, some VA hospital staff
members bought a half-page newspaper ad that said Jacob was attacking
the hospital for political reasons.
"The hospital administration was more concerned about
bad publicity for the hospital rather than whether these murders
actually occurred," Jacob said in an interview last week.
Based on the sources' information, the FBI began an
investigation. Medical files were seized and examined. A few weeks later,
Agent Williams (no relation to nurse Williams), visited David Havrum,
another of Elzie Havrum's sons. Williams wanted permission to exhume
Elzie Havrum's body.
Agent Williams "said that they knew there was
something wrong but they didn't know what it was at that time, but they
knew something was suspicious in his death," David Havrum said later. He
said Williams had told him that the agents knew that the veterans didn't
die from a disease.
Between Feb. 21 and March 5, 1993, the bodies of 13
veterans who died at the hospital were exhumed from cemeteries
throughout Missouri and taken to the Fountain Mortuary in Columbia. Dr.
Michael Baden, chief of forensic science for the New York State Police,
performed the autopsies and took tissue samples. The 13 were considered
most suspicious of the deaths that had occurred on Williams' watch.
Agents had many to choose from. During the 60 days between May and
August 1992 while Williams was on duty, there were 41 deaths, 19 of them
Federal investigations move with glacial slowness.
The investigation of the veterans' deaths moved even slower. The FBI lab
put a higher priority on other cases - the bombing of the World Trade
Center and the deaths of the Branch Davidians at Waco, Texas. At one
point a private contractor was hired to run tests. Agents became angry
when the contractor's attention was diverted to work on the defense of
O.J. Simpson during his murder trial.
By then, Williams was working with patients at
another medical facility.
Before Williams was charged last week, the only
person the VA wanted to prosecute as a result of the hospital
investigation was Christensen. That's because Christensen wrote to the
state Board of Nursing to report what he knew about Williams.
Christensen was alarmed because Williams had resigned from the veterans
hospital and was working at Ashland Healthcare, a nursing home located
about 15 miles south of Columbia. Williams began working part time at
the facility in July 1993 and went full time in March 1994.
Christensen said that Kurzejeski had refused his
request that he write to the board and threatened him with prosecution
if he did so. After consulting with his minister, Christensen wrote
anyway. The Justice Department later rejected the VA's request that
Christensen be prosecuted.
Meanwhile, the number of deaths increased at Ashland
during the time Williams was there. From June 1993 to June 1994, more
than half the home's 55 residents died - nearly triple the average death
rate for nursing homes in Missouri. The Boone County medical examiner's
office focused on 30 deaths that occurred during the year Williams
worked at Ashland.
Six residents died in the 10 months after Williams'
dismissal from the home on July 13, 1994. No charges resulted. Williams
was removed after state inspectors found that he had failed to
adequately supervise staff to ensure the safety, treatment and care of
In fall 1995, three years after the problems at the
hospital became public, the VA's inspector general issued a report
critical of the hospital's management. The report said Kurzejeski and
two other administrators were too slow to act on reports of Williams'
connection with the deaths.
"It seems the director . . . felt before you report
to law enforcement you need a body laying there with a knife in its
back," said assistant inspector general Jack Kroll.
In addition to Kurzejeski, the report blamed chief of
staff Earl Dick and director of nursing Catherine Wine. By the time the
report was issued, both Dick and Wine had been demoted and Kurzejeski
Christensen said the report did not go far enough. He
believes top hospital administrators covered up the deaths. Christensen
says that his claims have killed any chances of his advancement within
the VA and that at one point, officials threatened to fire him.
Sen. Christopher "Kit" Bond, R-Mo., said Christensen
and others at the hospital should be commended for "putting the care of
patients above everything else."
Exasperated over the FBI's delay in reporting its
findings, Bond peppered the Justice Department, the FBI and the VA with
letters. In February 1998, the FBI reported that it could not determine
how the veterans died. Dr. Baden, who performed the autopsies, said the
deaths could not be explained by the diseases listed on death
certificates or by any other cause. The FBI lab returned the samples to
Boone County Medical Examiner Jay Dix, who stored them in a freezer.
Rudi Keller agonized over the Williams case. As a
reporter for the Columbia Daily Tribune, he was the first to associate
Williams' name with the deaths in print. For years he aggressively
reported the story, obtaining records under the Freedom of Information
Act and recounting every development. He found himself facing an intense
"I had the feeling that I had accused someone of
murder in print where there will never be a final decision," said Keller,
who now lives in Louisville and is no longer a journalist. "If he didn't
do it, the man's reputation can never be repaired. I once had some very
intense worries that I had ruined someone falsely."
The case was more heartwrenching for the veterans'
families. Every day, Helen Havrum, Elzie's widow, would wonder about it.
"It eats on the whole family because there's no
closure to it," Gary Havrum said.
Havrum's family filed a wrongful death suit against
the government, which came to trial in summer 1998 before U.S. District
Judge Nanette Laughrey.
The testimony came from hospital officials, doctors
and nurses, medical examiners, FBI agents and members of the Havrum
family. But not Williams. On Aug. 7, 1998, Laughrey determined - by the
preponderance of evidence - that Williams was a murderer.
"I believe nurse Williams killed Elzie Havrum,"
Laughrey said in her ruling. "I am convinced the VA staff was alerted to
the relationship between Richard Williams and deaths prior to Elzie
Havrum's final admission." She awarded the Havrum family $450,000.
Keller, Christensen and many relatives of the dead
veterans believed that Laughrey's ruling was the last word because a
statute of limitations had expired on other claims.
A reopened case
In November, Wayne Kessler, a special agent in the
VA's Office of Inspector General, visited Dix, the Boone County medical
examiner, who had held onto the specimens from the bodies of the 13
veterans. Kessler hand-delivered 10 samples (three had deteriorated) to
National Medical Services, a private lab in suburban Philadelphia.
The lab uses advanced forensic techniques to help
solve crimes. The inspector general's office wanted the lab to use a
newly developed test for a paralytic type drug.
Dr. Kevin Ballard, director of analytical toxicology
at National Medical Services, analyzed tissue specimens from Elzie's
Havrum's kidney, diaphragm and liver. He found concentrations of
succinylmonocholine, a substance that shows the presence of
succinylcholine, a powerful paralytic blocking agent. The drug is often
administered to patients before surgery.
"As soon as the drug is given, people are paralyzed,
and they can't breathe on their own," Dix said. "Someone has to be
present to help the person breathe with a ventilator."
Based on Ballard's report, authorities believe Havrum
was injected with succinylcholine between 1 a.m. and 1:08 a.m. Ballard
made identical findings on the samples from the nine other veterans. The
report was made May 7, and on May 31, Dix said the 10 deaths were
"Mr. Williams is the common denominator essentially
with each of these 10 patients," Dix said. "None of them was
legitimately given succinylcholine. Each died while Mr. Williams was on
It will be up to Boone Country Prosecuting Attorney
Kevin Crane to prove the circumstantial case beyond a reasonable doubt.
He said that he was weighing whether to seek the death penalty and that
he would ask members of the victims' families about that.
As for whether the investigation will look at other
deaths at the hospital or at the Ashland nursing home, Crane said, "Simply
because these are the victims we've identified doesn't mean we have
At the news conference in which Crane discussed the
charges, reporters repeatedly asked Richard Griffin, the VA's inspector
general, why it had taken so long.
"We never gave up on the case," Griffin said. "A
complicated case such as this one, it's not unusual for it to take
Families of some of the victims were there, too,
including Gary Havrum. Asked how he felt about the VA's investigation,
Havrum did not want to comment.
"I don't know, apparently they have been working on
it to find the truth," Havrum said. "It seems that way."
Asked what he thought about the death penalty for
Williams, Havrum said, "I have no objection to it. If he in fact did
these things, he had no mercy on them. I see nothing wrong with doing
the same to him."
Bill Bell Jr. of the Post-Dispatch staff contributed
to this report.
Ten years of mystery
Events surrounding patient deaths at Harry S. Truman
Memorial Veterans' Hospital in Columbia and the subsequent investigation:
April or May 1992 - Increasing number of deaths on
Ward 4-East leads a nursing supervisor to ask nursing director Catherine
Wine to transfer nurse Richard Allen Williams to another ward. The
request is denied.
June 1992 - A report by a hospital CPR committee
notes a significant increase in the number of deaths and a possible link
Aug. 28, 1992 - The quality improvement staff meets
with Dr. Gordon Christensen, assistant chief of staff for research, to
say their review makes them believe patients are being murdered.
Christensen's own analysis finds that Williams cared for 45 of the 55
patients who died on the ward between March 8 and Aug. 22. He reports
his findings to hospital director J.L. Kurzejeski and suggests police be
called. He declines.
Sept. 21, 1992 - Internal investigation of one death
clears Williams, but he is assigned to clerical duties. A regional VA
team notes that some staff members had "grave concerns" about Williams.
Sept. 30, 1992 - Kurzejeski responds to reports of
suspicious deaths with a news conference to say there's nothing to worry
Oct. 5, 1992 - Two staff members secretly meet with
an FBI agent. Agents seize records from the hospital.
January 1993 - The FBI says review of records does
not explain the large number of deaths.
Feb. 21-March 5, 1993 - The bodies of 13 veterans who
died at the hospital are exhumed for tissue samples to be tested as part
of the FBI investigation. Evidence processing is delayed by other cases
such as the Branch Davidian standoff at Waco, Texas, and the 1993
bombing of the World Trade Center.
January 1994 - Williams resigns from the VA hospital
to become director of nursing at Ashland Health Care Center, a nursing
July 13, 1994 - Williams is fired after the state
Division of Aging criticizes care at the home.
September 1994 - The VA's inspector general's office
reports that patients were 20 times more likely to die when Williams was
Fall 1995 - Inspector general reports that a "dysfunctional
top management team" at Truman should have alerted police two months
before the FBI began its investigation.
October 1995 - Boone County Medical Examiner Jay Dix
reviews state Board of Nursing report on deaths at the Ashland nursing
home while Williams worked there.
November 1995 - Elzie Havrum's family files a
wrongful death suit against the U.S. government. Havrum died on June 15,
1992, hours after being admitted to Truman Ward-4 East.
November 1995 - A state report says an "abnormal
number of deaths" occurred at Ashland Health Care Center while Williams
was employed there.
February 1996 - An investigation of patient deaths at
Ashland Health Care nursing home in 1993 and 1994 shows no evidence of
February 1998 - An FBI report says the cause of death
for any of the 13 exhumed veterans cannot be pinpointed. Hospital
director Gary Campbell says, "This is over with for us."
July 1998 - Civil trial begins in the wrongful death
case filed by the family of Elzie Havrum. Thomas Young, the medical
examiner for Jackson County, testifies that Havrum's death was a
homicide caused by codeine poisoning.
Aug. 7, 1998 - U.S. District Judge Nanette Laughrey
rules that the evidence leads her to believe that Williams was
responsible for Havrum's death. She awards $450,000 to the family.
September 1998 - Richard Williams is put on probation
for three years by the state Board of Nursing. He admitted that he had
failed to ensure a safe environment for patients at Ashland Health Care
in 1994 and that he had been convicted of stealing from a St. Louis
employer in 1996.
March 1999 - Christensen and others tell the House
subcommittee on Veterans Administration Oversight and Investigations
that the Department of Veterans Affairs represses free speech and
punishes whistle-blowers and that honest employees' jobs are eliminated
when they report poor patient care.
January 2001 - The Veteran Affairs' office of
inspector general reviews the deaths and concludes that the victims
could have been given a paralyzing drug. Tests to detect the drug, not
available in 1993, are now available.
November 2001 - An investigator for the Veterans
Affairs' office of inspector general retrieves from Dr. Jay Dix tissue
samples of 10 of the 13 veterans whose bodies had been exhumed in 1993.
The FBI had provided the samples to Dix, the Boone County medical
examiner, in 1998.
May 7, 2002 - Dr. Kevin Ballard, director of
analytical toxicology at National Medical Services, finds that
succinylmonocholine is present in tissues of all of the 10 victims.
Ballard says each of the 10 people was exposed to succinylcholine
shortly before their deaths.
May 31, 2002 - Boone County's Dix rules each of the
10 deaths a homicide.
June 3, 2002 - Boone County Prosecuting Attorney
Kevin Crane charges Richard Williams with 10 counts of first-degree
Nurse in Missouri Charged With Killing Patients
July 18, 2002
COLUMBIA, Mo., July 17 (Reuters) — A Missouri grand
jury indicted a former veterans' hospital nurse today on charges of
killing 10 patients in 1992.
The indictment here said Richard Williams, now 36,
administered the drug succinylcholine, a derivative of curare that is
used as a poison by South American Indians, to kill nine men and one
woman while working as a nurse at Truman Memorial Veterans Hospital in
A prosecutor said he would announce next week whether
he would seek the death penalty.
Though Mr. Williams was charged by the authorities
last month, prosecutors sought a formal indictment, returned today by a
grand jury here in Boone County that heard from 121 witnesses.
Prosecutors have yet to describe a motive for the
killings, whose victims ranged in age from 58 to 85.
Mr. Williams, who worked at the hospital from 1989 to
1993, was implicated by new technology that detected a byproduct of the
poison in the victims' remains.
Thanks to new medical testing technology, prosecutors
thought they solved a decade-old string of mysterious deaths at a
Missouri nursing home when they charged former nurse Richard Williams
with 10 counts of first-degree murder in 2002.
The tests found that 10 people who
died at the Truman Memorial Veterans Hospital in Columbia, Mo., between
March and July of 1992, had been given the powerful muscle relaxant
succinycholine, which stops breathing, shortly before their deaths.
An investigation by the FBI and the
Office of Inspector General in the Department of Veterans Affairs
determined that 41 people died on Ward 4E between May and August 1992
while Williams was on duty. Investigators concluded patients were 20
times more likely to die while Williams was working than while 11 other
nurses were on duty.
However, the charges were dropped in
August 2003 after newer science called the succinycholine results into
question. Boone County Prosecutor Kevin Crane dismissed the charges
because subsequent tests by the FBI and National Medical Services found
the unexplained presence of the residue in control samples of tissue
meant to provide a standard for comparison.
"I think as far as I'm concerned,
it's the end of it, due to my innocence," Williams, now 37, told the
Columbia Daily Tribune upon his sudden release from prison.
400 F.3d 1102
Richard Allen WILLIAMS, Appellant,
NATIONAL MEDICAL SERVICES, INC.; Kevin Ballard, Appellees.
United States Court
of Appeals, Eighth Circuit.
Submitted: February 18, 2005.
Filed: March 16, 2005.
Before WOLLMAN, HANSEN, and BENTON, Circuit Judges.
BENTON, Circuit Judge.
Richard Allen Williams appeals the district
of his negligence action against National Medical Services, Inc. ("NMS")
and its employee Kevin D. Ballard, M.D., Ph.D. Jurisdiction being
proper under 28 U.S.C. § 1291, this court affirms.
While a nurse at the Veterans Hospital in Columbia,
Missouri, Williams was the subject of a criminal investigation into
the death of several patients. The prosecutor retained NMS and
Ballard to test tissue samples from 10 patients in order to
determine the cause of death. Relying on Ballard's initial report,
the prosecutor charged Williams with 10 counts of murder in the
first degree. NMS and Ballard wrote the prosecutor — over a year
later, but before trial — that the report was unreliable. Cleared on
all charges and released from custody, Williams now sues NMS and
Ballard for negligence.
This court reviews de novo a district court's
decision to dismiss a cause of action for failure to state a claim. Carter v. Arkansas, 392 F.3d 965, 968 (8th Cir.2004).
Williams alleges that NMS and Ballard breached their duty of care by
negligently testing and wrongfully concluding the patients were
homicide victims. The district court dismissed the complaint for
failure to state a claim, because, under Missouri law, NMS and
Ballard — as expert witnesses — owed him no duty of care.
In diversity cases applying Missouri law, this
court is bound by the decisions of the Supreme Court of Missouri.
Rucci v. City of Pacific, 327 F.3d 651, 652 (8th Cir.2003),
citing Cassello v. Allegiant Bank, 288 F.3d 339, 340 (8th
In Murphy v. A.A. Mathews, 841 S.W.2d 671 (Mo.
banc 1992), the Supreme Court of Missouri permitted a cause of
action against a party's own expert witness for negligently
performing litigation support services — as an exception to the
general rule of witness immunity. The court held that because the
expert agreed to provide professional services to a party for a fee,
it assumed the duty of care of a skillful professional. See
Murphy, 841 S.W.2d at 682. This decision rested "primarily upon
the commercial relationship assumed by the professional and his or
her role as an advocate." Id.
Williams requests expansion of this exception to
permit a cause of action against an expert witness for an adverse
party. Although no Missouri court has decided this precise issue,
this court may consider relevant dicta that predict how the Supreme
Court of Missouri would rule. See W. Forms, Inc. v. Pickell,
308 F.3d 930, 933 (8th Cir.2002), quoting Bass v. Gen. Motors
Corp., 150 F.3d 842, 846-47 (8th Cir.1998). In Murphy,
the court stated:
Our holding would not subject adverse expert
witnesses to malpractice liability because in that situation, the
expert owes no professional duty to the adversary.
Murphy, 841 S.W.2d at 682 n. 11.
Accordingly, the Supreme Court of Missouri would
find that NMS and Ballard owed no duty of care to Williams, an
adverse party. The district court properly dismissed his cause of
action. The judgment is affirmed.
Richard Allen Williams
Public defender Kathryn Benson, left, talks with Richard
Allen Williams following his arraignment in Boone County
(Mo.) Circuit Court. Williams, 36, pleaded innocent
Monday to 10 counts of first-degree murder for allegedly
killing patients a decade ago while working as a nurse
at the Truman Memorial Veterans Hospital in Columbia, Mo.
Boone County Prosecutor Kevin Crane told the court he
would seek the death penalty in the case. (July 23,