The Kaiser Papers A Patient Advocacy Web SiteIn Copyright Since September 11, 2000
This web site is in no manner affiliated with any Kaiser entity and the for profit Permanente
Permission is granted to mirror this web site -
Please acknowledge where the material was obtained.
Link for Translation of the Kaiser Papers 
PATHFINDER(search)  |   ABOUT US  |  CONTACT  MCRC

Custom Search

medicalserialkillers.kaiserpapers.org


DEATH PROBE MISHANDLED, DOCTOR SAYS

Dayton Daily News; Dayton, Ohio; Jul 22, 1994; Julia Helgason DAYTON DAILY NEWS;

Sub Title:  [CITY Edition]
Start Page:  3B
Personal Names:  Andorfer, Paul
 
Abstract:
[Paul Andorfer], 53, is an anesthesiologist with 17 years on Community's active staff. He is a past president of the Clark County Medical Society and current deputy Clark County coroner.

Andorfer lost staff privileges at the hospital last year for reasons that have not been made public. He acknowledges being "disgruntled and embittered" over what he sees as a raw deal, but says that is unrelated to facts that hospital administrators have tried to sweep under the rug.

Pavulon is a muscle relaxant used in surgical anesthesia. In large doses it can paralyze breathing muscles and cause respiratory failure. It is not a drug that might be used in intensive care.

Full Text:
Copyright Dayton Newspapers Inc. Jul 22, 1994

A Springfield physician familiar with the case says the original investigation into mysterious deaths at the city's Community Hospital was quick, quiet and poorly handled.

Dr. Paul Andorfer said on Thursday that the investigation did not have media scrutiny because the media never found out about it.

Andorfer, 53, is an anesthesiologist with 17 years on Community's active staff. He is a past president of the Clark County Medical Society and current deputy Clark County coroner.

Andorfer lost staff privileges at the hospital last year for reasons that have not been made public. He acknowledges being "disgruntled and embittered" over what he sees as a raw deal, but says that is unrelated to facts that hospital administrators have tried to sweep under the rug.

"Some hospital administrators have seemed more concerned with the hospital's reputation and the hospital's survival than with quality patient care," Andorfer said.

Community Hospital's executive vice president, Chris Brouhard, declined comment on specifics of Andorfer's allegations:

"The position of the hospital is that there was no patient harm identified in the investigation in 1985. The police and the prosecutor were involved at that time. Now it's been turned over to (the state Bureau of Criminal Investigation and Identification), and we are confident that the outcome will be the same - no patients harmed."

The first investigation was begun in the summer of 1985 after a 60-year-old intensive-care patient became paralysed and stopped breathing. Though hospital staff revived him, the patient's symptoms were consistent with an overdose of Pavulon.

Pavulon is a muscle relaxant used in surgical anesthesia. In large doses it can paralyze breathing muscles and cause respiratory failure. It is not a drug that might be used in intensive care.

Community Hospital's administration has acknowledged that some 50 empty Pavulon vials were found near the intensive-care unit in July 1985.

The Federal Bureau of Investigation is now looking for traces of Pavulon in tissue taken from the body of Doris Tompkins, who died of respiratory failure that year under what have been called suspicious circumstances.

***********************
MYSTERY REMAINS AFTER SPRINGFIELD HOSPITAL PROBE
Dayton Daily News; Dayton; Mar 19, 1996; Steve Bennish DAYTON DAILY NEWS;
 

Sub Title:  [CITY Edition]
Start Page:  1.A
Personal Names:  SPRINGFIELD COMMUNITY HOSPITAL
 

Abstract:
Ten bodies of former patients were exhumed during the investigation, which delved into the behavior of a former respiratory technician. One body, that of Doris Tompkins, was found with a potentially deadly muscle relaxant that hospital records say should not have been there.

The investigation by Ohio Bureau of Criminal Identification and Investigation officials, Clark County Prosecutor Stephen Schumaker and county Coroner Dr. Dirk Wood concluded Friday. The exhumations attracted national and international media attention. The hospital maintains the patients died of natural causes.

`At the end of what we considered a very thorough investigation, what we have found is Tompkins had Pavulon in her system, and how we may never know," BCI Superintendent Ted Almay said.
 

Full Text:
Copyright Dayton Newspapers Inc. Mar 19, 1996

The investigation into suspicious deaths at Springfield Community Hospital has concluded, but authorities on Monday said the mystery remains following a two-year local and state probe.

Ten bodies of former patients were exhumed during the investigation, which delved into the behavior of a former respiratory technician. One body, that of Doris Tompkins, was found with a potentially deadly muscle relaxant that hospital records say should not have been there.

There is still no explanation for 59 empty vials of that drug, Pavulon, found in three areas of the hospital's intensive-care unit in 1985.

The investigation by Ohio Bureau of Criminal Identification and Investigation officials, Clark County Prosecutor Stephen Schumaker and county Coroner Dr. Dirk Wood concluded Friday. The exhumations attracted national and international media attention. The hospital maintains the patients died of natural causes.

`At the end of what we considered a very thorough investigation, what we have found is Tompkins had Pavulon in her system, and how we may never know," BCI Superintendent Ted Almay said.

Coroner Wood has said he remains suspicious about the deaths and called the behavior of a former respiratory technician `very suspicious.'

Hospital records show that one patient, Neal Harrison, had a near-fatal episode of breathing trouble one night, after undergoing treatment from the technician. Harrison at the time blamed the technician.

`I think a lot of people were suspicious, and BCI interviewed everybody who worked with her,' Wood said recently. Investigators said the former technician was interviewed twice by the agency after the investigation was reopened in 1993. The technician left the hospital in 1986.

Wood said the cause of Tompkins' death could not be determined and that foul play couldn't be ruled out. Wood said it is only the third time since he became coroner in 1991 that he has ruled a death undeterminable. A substantial amount of Pavulon was administered to Tompkins and the fact it was never ordered for her is unusual, Wood has said.

`It can only be concluded that Pavulon could have been a contributing cause of Tompkins' death,' Wood said. `Accidental or homicidal use of Pavulon cannot be excluded.'

Kim Parks, hospital spokeswoman, said in a statement that BCI's investigation `affirms the conclusions" the hospital itself reached during its internal investigation at the time the empty vials of Pavulon were found. Parks said the patients died of natural causes.

But Almay said the investigation didn't render such a judgment.

`We aren't out to clear or condemn or condone the hospital and its medical studies. We were looking for evidence of a crime. We were unable to determine a crime was committed.'

Former hospital chief of anesthesiology Paul Andorfer, at whose urging BCI and Wood's investigation began, said the passage of time and condition of the exhumed bodies made Pavulon detection difficult.

Park's statement said the most likely answer for Pavulon in Tompkins is that it was administered during an attempt at resuscitation. Andorfer, however, said that in his experience and knowledge of medicine, Pavulon is not administered to people being resuscitated. `They have not come up with any reasonable answers,' he said.

*******************************

PANEL SAYS 9 DEATHS SUSPICIOUS PAVULON MAY BE INVOLVED; SOME SUSPECT FOUL PLAY
Dayton Daily News; Dayton; May 20, 1995; Mike Wagner and Miriam Smith Springfield News-Sun;

Sub Title:  [CITY Edition]
Start Page:  1.A
Personal Names:  COMMUNITY HOSPITAL
STEPHEN SCHUMAKER
 
Abstract:
A panel of medical experts has agreed that Pavulon might have caused nine deaths at Springfield's Community Hospital, and officials will try to exhume six of the nine as part of a suspicious-death probe, Clark County Prosecutor Stephen Schumaker said Friday.

Local and state authorities are looking into whether Pavulon, a muscle relaxant, was used to kill patients at Community a decade ago. Four bodies have been exhumed in the probe. One tested positive for the drug; three tested negative.

At a news conference Friday, Schumaker said the physicians unanimously agreed they could not eliminate Pavulon as a possible cause of death in nine cases.

Full Text:
Copyright Dayton Newspapers Inc. May 20, 1995
 

A panel of medical experts has agreed that Pavulon might have caused nine deaths at Springfield's Community Hospital, and officials will try to exhume six of the nine as part of a suspicious-death probe, Clark County Prosecutor Stephen Schumaker said Friday.

He declined to say how the cases were related, but one of the panelists said he thinks foul play was involved.

"Personally, yes, I do believe someone was killing patients with Pavulon," the expert said.

Local and state authorities are looking into whether Pavulon, a muscle relaxant, was used to kill patients at Community a decade ago. Four bodies have been exhumed in the probe. One tested positive for the drug; three tested negative.

Schumaker convened a panel of five experts who met last Saturday and reviewed the hospital charts of 43 former patients.

At a news conference Friday, Schumaker said the physicians unanimously agreed they could not eliminate Pavulon as a possible cause of death in nine cases.

Investigators will pursue exhumations in six of the nine and are in the process of contacting family members, Schumaker said.

He wouldn't identify the six, but said all are buried in Ohio.

A decision on the other three will be made later. Two of them were tested by a Hamilton County pathologist in 1985 and the third is buried out of state, Schumaker said.

He said all of the cases being considered for exhumation "aren't necessarily" from 1985.

The five experts agreed on nine cases, and were split on six others, Schumaker said.

One panelist, Dr. Michael Baden, director of forensic sciences for the New York State Police, said it's too soon to say whether someone was using Pavulon to commit homicide.

"Issues have come up, allegations have been made, we feel we have an obligation to resolve those allegations one way or another," he said. "It's too premature whether something did or didn't happen."

Another panelist, Dr. James Young, chief coroner in Ontario, Canada, said the panel is looking at cases where patients died suddenly.

"The majority of all the charts were elderly people who had serious illnesses. You look to see if you're comfortable with the circumstances of a particular death," Young said.

An investigation was originally started in 1985 after 59 empty vials of Pavulon were found in three unauthorized areas of the hospital. The hospital found no evidence of wrongdoing and stopped an internal probe in January 1986.

The case was reopened by the Clark County coroner's office in 1993 at the urging of Dr. Paul Andorfer, a former chief of anesthesiology at Community. He said he believes as many as 30 patients were killed in 1985 with Pavulon.

The investigation was then passed on to the Ohio Bureau of Criminal Identification and Investigation.

Under Ohio law, a county prosecutor and coroner have the authority to exhume bodies without the permission of families.

In addition to Young and Baden, the panel of experts consists of Drs. Lee Lehman and David Smith, deputy coroners in Montgomery County; and Dr. Robert Davis, laboratory director and pathologist at Mary Rutan Hospital in Bellefontaine.

******************************

PANEL REVIEWS HOSPITAL DEATHS
Dayton Daily News; Dayton; May 14, 1995; Mike Wagner and Miriam Smith COX NEWS SERVICE;

Sub Title:  [CITY Edition]
Start Page:  1.B
Personal Names:  COMMUNITY HOSPITAL
 
Abstract:
A panel of medical experts assembled to probe suspicious deaths at Springfield's Community Hospital met Saturday for the first time to review as many as 50 deaths from 1985.

The five-member panel, accompanied by state investigators, met in Columbus with Clark County Prosecutor Stephen Schumaker and county Coroner Dr. Dirk Wood for about seven hours.

Local and state authorities are looking into whether the drug Pavulon was used to kill patients at Community in 1985. A respiratory technician, fired by the hospital that year, has been targeted as a suspect by several of co-workers, but authorities have declined to call her a suspect.

Full Text:
Copyright Dayton Newspapers Inc. May 14, 1995
 

MIKE WAGNER and Miriam Smith report for the Springfield News-Sun

A panel of medical experts assembled to probe suspicious deaths at Springfield's Community Hospital met Saturday for the first time to review as many as 50 deaths from 1985.

The five-member panel, accompanied by state investigators, met in Columbus with Clark County Prosecutor Stephen Schumaker and county Coroner Dr. Dirk Wood for about seven hours.

The formation of the panel was announced in February, and panel members have been reviewing case files individually.

Panelist Dr. James Young, chief coroner in Ontario, Canada, said the records of 45 to 50 patients were being reviewed, all from 1985.

The panel ended its meeting just before 5 p.m., and panelists would not disclose their findings. But a source close to the investigation said more bodies probably will be exhumed.

Schumaker said an announcement regarding the probe's next developments would be made in a week.

Local and state authorities are looking into whether the drug Pavulon was used to kill patients at Community in 1985. A respiratory technician, fired by the hospital that year, has been targeted as a suspect by several of co-workers, but authorities have declined to call her a suspect.

Wood did say the panel is looking for the pattern of deaths that occurred on Community's third shift - the shift the technician primarily worked.

"Yes, the third shift is something foremost in our minds," he said.

Wood said the technician was among those questioned by the Ohio Bureau of Criminal Investigation and Identification, but was told by her attorney not to answer questions.

According to the source, the bodies of the Rev. Auburn Tolliver of Springfield and Issac Bloomfield of London are "prime candidates" to be exhumed.

Bloomfield and Tolliver died of respiratory failure within an hour of each other the night of Aug. 8, 1985.

That same night, a third patient, Emmett Harrison, called for help during a breathing treatment and claimed a respiratory technician tried to hinder his breathing.

The two deaths and the incident with Harrison intensified a 1985 investigation and led to the technician being placed on administrative leave that same day.

Two empty vials of Pavulon were found in a nurses' destruction box the night Bloomfield and Tolliver died.

Tolliver's son, Ed Tolliver, said Saturday he hopes authorities exhume his father.

"I want to know if my father was harmed or not. I hope they exhume the body and let me know what's going on," he said.

The investigation originally started in 1985 after 59 empty vials of Pavulon were found in three separate areas of the hospital. The probe was stopped in January 1986, after a body was exhumed and tested negative for the drug.

The Clark County coroner's office reopened the case in 1993 when Dr. Paul Andorfer, a former anesthesiologist at Community, became a deputy coroner and claimed many deaths were suspicious.

Although it's now rarely used by hospitals, Pavulon is a muscle relaxant which can be fatal if administered incorrectly.

Kim Parks, Community Hospital spokeswoman, said Saturday the hospital provided BCI with the former patients' charts, but has no other role in the investigation.

"We want them to do whatever they deem appropriate to put to rest any lingering suspicions about Pavulon," she said.

Medical experts say investigators might find if difficult to find Pavulon in bodies buried for 10 years. The drug behaves like many other natural components of the body, so separating it is extremely difficult, and it disappears quickly, the experts said.

Schumaker and others connected to the probe say they are confident the FBI - which tested the exhumed bodies - can detect the drug.

"If you have good equipment, which the FBI does, it's certainly possible to find it," Dr. Lee Lehman, a member of the expert medical panel and a deputy coroner in Montgomery County.

PANEL MEMBERS

The formation of a medical panel to review deaths at Community Hospital in Springfield was announced in February. The panel met for the first time Saturday, which also is the first time the names of the panelists were made public. The panelists are:

Dr. James Young, chief coroner in Ontario, Canada

Dr. Michael Baden, director of forensic sciences for the New York State police

Dr. Robert Davis, pathologist and laboratory director at Mary Rutan Hospital in Bellefontaine

Drs. Lee Lehman and David Smith, deputy coroners in the Montgomery County coroner's office

*********************************

DECEASED PATIENTS' RECORDS REVIEWED STUDY FOCUSES ON USE OF RELAXANT
The Plain Dealer; Cleveland, OH; May 14, 1995; DADE HAYES ASSOCIATED PRESS;

Sub Title:  [FINAL / LORAIN Edition]
Start Page:  7B
Abstract:
Medical experts yesterday began reviewing the records of as many as 50 former patients who were treated at a Springfield hospital 10 years ago.

The panel of five experts is conducting the review as part of an investigation into the deaths of four patients at Springfield Community Hospital in 1985.

Previous toxicology tests revealed traces of the muscle relaxant Pavulon in one of the four bodies. Pavulon can cause paralysis or death if improperly administered.

Full Text:
(Copyright (c) The Plain Dealer 1995)
 

Medical experts yesterday began reviewing the records of as many as 50 former patients who were treated at a Springfield hospital 10 years ago.

The panel of five experts is conducting the review as part of an investigation into the deaths of four patients at Springfield Community Hospital in 1985.

Dr. James G. Young, chief coroner in Ontario, said yesterday at a news conference that after the review is complete, the panel will decide whether to exhume any of the bodies.

Previous toxicology tests revealed traces of the muscle relaxant Pavulon in one of the four bodies. Pavulon can cause paralysis or death if improperly administered.

State and federal authorities began investigating the deaths in 1993 after the former head of anesthesiology at the private, 300-bed hospital claimed that as many as 30 patients might have been given fatal doses of Pavulon in 1985.

The hospital has said it conducted an internal investigation in 1985 after 59 vials of the clear liquid anesthetic were found hidden in three unauthorized storage areas. No wrongdoing was found at the time.

Clark County Prosecutor Steve Schumaker said he was pleased with the panel's credentials.

"They have very distinguished backgrounds," Schumaker said. "They all will be very instrumental in the investigation."

Other panel members include Drs. Robert H. Davis, a pathologist at Mary Rutan Hospital in Bellefontaine; and David M. Smith and Lee D. Lehman, both deputy coroners and forensic pathologists in the Montgomery County Coroner's office in Dayton; and Michael M. Baden.

Baden, a forensics expert who gave testimony in the early stages of the O.J. Simpson trial, also has served as a consultant in trials involving Claus von Bulow, Christian Brando and Billy Martin.

Baden said the Springfield case was similar to the Simpson trial.

"Forensic evidence has become crucial," he said. "It's gotten to where the passage of time can actually help the case. It can give the case more merit."

*******************************

Ohio investigates hospital deaths from decade ago
The Commercial Appeal; Memphis, Tenn.; Feb 6, 1995; Fox Butterfield The New York Times News Service;
 
 

Sub Title:  [First Edition]
Section:  News
Start Page:  A.4
Page Count:  0
Text Word Count:  452
Source Type:  NEWSPAPER
ISSN:  07454856
Dateline:  SPRINGFIELD, Ohio
UMI Article Re. No.:  MMPH-798-23
UMI Journal Code:  MMPH
 

Abstract:
- Minutes after a respiratory technician gave Emmett Harrison a vaporizer that blew a medicated mist in his face to help him with emphysema, Harrison's arms and legs went numb. Just before he felt paralyzed and stopped breathing, he pushed his call light.

An emergency team of doctors and nurses revived Harrison, but on the same night, Aug. 8, 1985, two other elderly patients died in the critical care units at Springfield Community Hospital: One just stopped breathing.

The nurse was one of a select group of hospital staff members who was put on alert after 59 empty ampules of a muscle relaxant, Pavulon were found a month earlier in storage rooms near the hospital's three critical-care units. No one knew how the ampules got there or what might have happened to their contents.
 
 
 
 

*********************************

HOSPITAL CUTS OFF MEDIA REPORTS OF PROBE 'VICIOUS,' OFFICIAL SAYS
Dayton Daily News; Dayton; Jan 31, 1995; Mike Wagner and Miriam Smith COX NEWS SERVICE;

Sub Title:  [CITY Edition]
Start Page:  1.B
Personal Names:  CHRIS BROUHARD
SPRINGFIELD COMMUNITY HOSPITAL
 
Abstract:
SPRINGFIELD - Community Hospital cut off media access to hospital officials after complaining that the media has waged a "vicious and irresponsible campaign" in coverage of a 1985 suspicious death investigation.

As a result, no one from Community will speak with the media regarding the probe being conducted by the Ohio Bureau of Criminal Identification and Investigation, said Kim Parks, manager of community relations at the hospital.

Full Text:
Copyright Dayton Newspapers Inc. Jan 31, 1995
 

SPRINGFIELD - Community Hospital cut off media access to hospital officials after complaining that the media has waged a "vicious and irresponsible campaign" in coverage of a 1985 suspicious death investigation.

As a result, no one from Community will speak with the media regarding the probe being conducted by the Ohio Bureau of Criminal Identification and Investigation, said Kim Parks, manager of community relations at the hospital.

Parks on Monday offered a terse statement in a news conference. When she was finished, she refused to answer any questions.

"The coverage of the events of this weekend is in our view obscene and immoral - the final straw in a relentless, vicious and irresponsible campaign by the media to discredit and harm our hospital and its people," Parks said.

On Sunday, Chris Brouhard, 55, executive vice president of the hospital, was found after he reportedly swallowed about 50 anti-depressant pills.

The Clark County sheriff's department ruled it an overdose, and Brouhard is recuperating at Community Hospital.

Brouhard has been handling much of the hospital's involvement in a suspicious death investigation that was started by Community on July 9, 1985, after 59 empty vials of Pavulon were found in three areas of the hospital. The investigation was reopened by the Clark County coroner's office in 1993. Pavulon can be deadly if administered incorrectly.

Parks also questioned the media's use of Dr. Paul Andorfer, a former physician at the hospital, as a source.

She said the hospital has memos with his name on them from 1985 that invite him to meetings specifically called to discuss the discovery of empty Pavulon vials.

Parks said she also has testimony from physicians that they screened medical records with Andorfer specifically looking for any possible evidence of Pavulon misuse.

Andorfer said he is aware of the memos.

"There were meeting notifications. Just because my name was on one doesn't mean I was there," he said.

BCI has exhumed four bodies, three earlier this month. They are trying to determine if any former patients were harmed by the use of the drug.

Tissue samples from the bodies exhumed this month are being tested in an FBI laboratory in Washington, D.C. Tests may be completed in about two weeks.

***********************************

Suspicious deaths investigated at Ohio hospital
New York Times; New York, N.Y.; Jan 31, 1995; Butterfield, Fox;
 
 

Edition:  Late Edition (East Coast)
UMI Publication No.:  03353953
 
Start Page:  A12
Page Count:  0
Document Type:  News
Source Type:  NEWSPAPER
ISSN:  03624331
Subject Terms:  Serial murders
Investigations
 
Geographic Names:  Springfield Ohio
Ohio
 
Personal Names:  Andorfer, Paul
 
Companies:  Springfield Community Hospital-Ohio
 
UMI Journal Code:  NYT
 

Abstract:
Ohio authorities are now investigating whether the deaths of two elderly patients at Springfield Community Hospital in Springfield OH were the work of a serial killer on the hospital's staff who used the muscle relaxant Pavulon to murder elderly patients. The hospital's former chief of anesthesiology, Paul Andorfer, has charged that as many as 30 patients may have been killed from January to August of 1985.
 
 
 
 

****************************

HOSPITAL EXECUTIVE TAKES OVERDOSE
Dayton Daily News; Dayton; Jan 30, 1995; Jim Dillon DAYTON DAILY NEWS;

Sub Title:  [CITY Edition]
Start Page:  1.A
Personal Names:  CHRIS BROUHARD
SPRINGFIELD COMMUNITY HOSPITAL
 
Abstract:
Chris Brouhard, a Springfield Community Hospital executive, overdosed on two medicines Sunday at his home but was in stable condition at the hospital Sunday night.

Brouhard, as a key administrator, has defended the hospital's investigation into suspicious deaths at the hospital in 1985. The Ohio Bureau of Criminal Identification and Investigation has started its own investigation into those deaths, which has led to the exhumation of four bodies, including three this month. BCI is trying to determine whether former patients were killed with Pavulon, a muscle-relaxing drug.

After searching their home just east of Springfield, Mrs. Brouhard found her husband wrapped in a blanket in the barn. Mrs. Brouhard told deputies her husband was incoherent, the sheriff's office said.

Full Text:
Copyright Dayton Newspapers Inc. Jan 30, 1995
 

Chris Brouhard, a Springfield Community Hospital executive, overdosed on two medicines Sunday at his home but was in stable condition at the hospital Sunday night.

Brouhard, as a key administrator, has defended the hospital's investigation into suspicious deaths at the hospital in 1985. The Ohio Bureau of Criminal Identification and Investigation has started its own investigation into those deaths, which has led to the exhumation of four bodies, including three this month. BCI is trying to determine whether former patients were killed with Pavulon, a muscle-relaxing drug.

Brouhard's wife, Dorothy, became concerned early Sunday afternoon when she came home from church about 12:30 p.m. and could not find her 55-year-old husband, according to Clark County sheriff's office.

After searching their home just east of Springfield, Mrs. Brouhard found her husband wrapped in a blanket in the barn. Mrs. Brouhard told deputies her husband was incoherent, the sheriff's office said.

In his pocket were two empty bottles of medication, that office reported. Brouhard ingested about 50 pills of one medication and an unknown quantity of the other, the sheriff's office said.

His wife drove him to the hospital, the sheriff's office said.

The sheriff's office is treating the incident as an overdose and not as an attempt by Brouhard to harm himself.

The sheriff's office identified the drugs as Zanax and Trazedom, but did not say whether the drugs were prescribed to Brouhard.

There are no drugs named Zanax or Trazedom, according to the Complete Drug Reference and a pharmacist contacted by the Dayton Daily News. Xanax, however, is a central nervous system depressant prescribed in the management of anxiety. Trazodone is an antidepressant or "mood elevator" used to relieve mental depression and depression that sometimes occurs with anxiety.

In 1985, more than 50 empty vials of Pavulon were found in an unauthorized area outside the hospital's intensive care unit. The hospital and police investigated, but no wrongdoing was found and the probe was closed.

Now the hospital's executive vice president, Brouhard was a hospital administrator in 1985. The hospital's former security chief, Bob Mount, has said Brouhard told him to wrap up the investigation despite Mount's misgivings.

BCI reopened an investigation into the deaths in 1993. It was announced in December that traces of Pavulon were found in the body of Doris Tompkins. Tompkins died at the hospital in 1985; her body was exhumed in July.

Medical charts showed that she was not prescribed the drug, which can cause paralysis and respiratory failure.

* THIS STORY contains information from The Associated Press.

****************************

Hospital deaths probed Doctor claims fatal drug used
Cincinnati Post; Cincinnati, Ohio; Jan 24, 1995; Associated Press;

Sub Title:  [METRO Edition]
Start Page:  1.A
Dateline:  SPRINGFIELD, Ohio
Abstract:
After 30 patients at the 300-bed Springfield Community Hospital died in April 1985, dozens of empty vials of a potentially fatal anesthetic were found hidden throughout the hospital

Now state officials have reopened the probe after the former head of the anesthesiology department claimed up to 30 patients may have been given fatal doses of the muscle relaxant Pavulon. One body exhumed last July showed traces of the drug; three more exhumed this month are being tested.

"There's no doubt in my mind there was one or more people involved in euthanasia," said Dr. Paul Andorfer, who headed the anesthesiology department for 17 years before leaving in 1993 over an unrelated dispute.

Full Text:
Copyright Cincinnati Post Jan 24, 1995
 

After 30 patients at the 300-bed Springfield Community Hospital died in April 1985, dozens of empty vials of a potentially fatal anesthetic were found hidden throughout the hospital

The hospital conducted a secret six-month investigation, but nothing amiss was found and the case was closed.

Now state officials have reopened the probe after the former head of the anesthesiology department claimed up to 30 patients may have been given fatal doses of the muscle relaxant Pavulon. One body exhumed last July showed traces of the drug; three more exhumed this month are being tested.

"There's no doubt in my mind there was one or more people involved in euthanasia," said Dr. Paul Andorfer, who headed the anesthesiology department for 17 years before leaving in 1993 over an unrelated dispute.

The hospital has denied his allegations.

Andorfer, who said he wasn't informed of the 1985 investigation, started his own probe when he joined the county coroner's office. His findings prompted Coroner Dirk Wood to call in state officials.

Ted Almay, chief of state's special investigations division, would not say how many hospital deaths are under review. None has been classified as a homicide.

Of the 30 patients who died in the private hospital in April 1985, 20 died during the night shift and 15 of those died while the same respiratory therapist was on duty, Andorfer said.

A hospital security file showed that as many as 200 vials of Pavulon, which regulates the breathing of patients on ventilators, were unaccounted for in the first five months of 1985, Andorfer said.

In July 1985, 59 empty Pavulon vials were found in three storage areas. Investigators never determined who hid the vials, and a body exhumed in 1985 contained no traces of the drug.

The therapist, who Andorfer and the hospital wouldn't identify, was placed on leave in August 1985. She quit after being charged with receiving stolen property from the hospital.

The therapist resented patients who required a lot of medical care because they kept her from a dice game she played while on duty, a former co-worker told the Springfield News-Sun.

Hospital spokeswoman Kim Parks said the hospital has found no evidence of criminal behavior and that the therapist

was placed on leave as a "precautionary measure" not related to the investigation.

One of the bodies exhumed this month is that of Vivian Norman, who died while recovering from a broken hip and arm. She had told her family she thought something was wrong at the hospital, her daughter said. Although she told her family to demand an autopsy if she died, none was performed.

*******************************

PROBE INSTIGATOR FACES TRIBULATION HOSPITAL DEATHS BECOME QUEST
Dayton Daily News; Dayton; Jan 22, 1995; Miriam Smith 1995 COX NEWS SERVICE;

Sub Title:  [CITY Edition]
Start Page:  1.B
Personal Names:  SPRINGFIELD COMMUNITY HOSPITAL
PAUL ANDORFER
 
Abstract:
Dr. Paul Andorfer was a hard-working physician and a strict father with high expectations for his five kids.

But the past five years haven't been easy for Andorfer - the man who spurred officials in 1993 to reopen an investigation into suspicious deaths at Springfield's Community Hospital - and his hard edge has softened.

"That hit me like I'm sure it hit Saul when he was knocked from his horse on the way to Damascus. It was like God slapped me and said, 'Look what happened. Wake up. You should have seen this before,' " Andorfer said.

Full Text:
Copyright Dayton Newspapers Inc. Jan 22, 1995
 

MIRIAM SMITH is a writer for the Springfield News-Sun

As a child, Dana Williams never saw her father cry.

Dr. Paul Andorfer was a hard-working physician and a strict father with high expectations for his five kids.

But the past five years haven't been easy for Andorfer - the man who spurred officials in 1993 to reopen an investigation into suspicious deaths at Springfield's Community Hospital - and his hard edge has softened.

The 53-year-old anesthesiologist was rocked in 1990 by the death of a son, Kirk, killed in an accident with a drunken driver; and by a divorce that ended his marriage of 30 years.

He became so distraught in 1993 that he walked away from Community Hospital after choosing not to anesthetize a non-emergency surgical patient. He eventually lost his privilege to practice at Community, his medical home for 21 years, though hospital officials have declined to say why.

He said the sorrow wrought by his personal problems mounted in 1993 when he learned about suspicious deaths at Community that occurred in 1985.

He said he received an investigative file and was dumbfounded to learn that the body of a woman had been exhumed in 1985 as part of a hospital investigation. He said he didn't know about it at the time, though the hospital has said he was part of the probe.

The information jarred him.

"That hit me like I'm sure it hit Saul when he was knocked from his horse on the way to Damascus. It was like God slapped me and said, 'Look what happened. Wake up. You should have seen this before,' " Andorfer said.

It spurred him to action.

He sought a position with the Clark County coroner's office, and after his appointment sparked a new probe. He has questioned Community's handling of the investigation.

"My sole motivation was to give answers to the people from whom the truth had been withheld, including patients, physicians, families, nursing staff," said Andorfer, who held his position with the coroner's office from September 1993 to November 1994.

His push for the probe caused him even more personal and financial losses. He said he made more money during his internship in 1967 than he earned last year, and he has nearly drained his retirement savings.

His home on Springfield's north side is somewhat cramped compared to the large family home he used to have. He lives with a girlfriend and her young son. He and his girlfriend, whom he declined to identify, are expecting a baby in June.

"I've never had to rely on anyone else. I'm used to being relied upon as a source of income and stability and I've not been able to do that to my satisfaction for the last year and a half," he said.

Andorfer's allegations about the deaths have been challenged by many, including some family members, at least at the beginning.

"When the story first came out, I actually doubted my father. I thought, 'Oh, God, he's really lost his marbles,' " said Dana Williams, 30, of Troy, Andorfer's oldest child.

"That was really hard for me to deal with because I've never doubted my father about anything."

That all changed after the body of Doris Tompkins was exhumed in July and investigators announced in December that the muscle relaxant Pavulon was found in her liver.

Now, investigators are looking into at least eight 1985 deaths at Community. Suspicions center on a former respiratory therapist and concerns about whether the patients were administered fatal doses of Pavulon. Three more bodies were exhumed this month and more exhumations are possible.

"I talked to my father after the (Tompkins) results came back and I think I felt relief that he was right and then, at the same time, I watched him cry because it was true," Williams said.

"He's put his entire life into his profession and he had to give all that up. And then to discover what he discovered, it's about as close to destroying him as he could come."

Rather than destroying him, the discovery has driven Andorfer to push for more answers. He believes God has called him to pursue the probe.

"I invested 21 years of my life there (at Community) and God chose to take that away. I'm not bitter about that choice. God gave me 21 years of a medical career and for whatever reason, God said, 'You're going to lose (it), but in doing so, you're going to make things right.' "

Andorfer now owns Chronic Pain Management Services in Springfield and has privileges at Upper Valley Medical Centers in Miami County.

While staying busy with his work, he is consumed by the suspicious deaths and plans to write a book about what happened. He has dressed in black for the past four weeks, mourning for the families whose relatives may have died suspiciously.

He even sampled the drug Pavulon recently to see if it tasted the way a suspicious breathing medication was described by a former hospital patient. He put a drop of it on his finger to sample, Andorfer said.

His actions aren't appreciated by some of his colleagues, who have blasted his criticism of the hospital.

One, who has known and worked with Andorfer for many years, said he was a "very competent physician."

But he said he doesn't understand how Andorfer was unaware of the 1985 investigation, which included physicians and hospital staff, since he was chairman of the Anesthesia Department in 1985.

"However, eight years later, when he lost his privileges at Community Hospital, he suddenly went to the press with these accusations about a massive cover-up at Community Hospital," said the doctor, who asked not to be identified.

Andorfer maintains he was never notified in 1985 about the probe into the deaths. He also produced documentation showing he joined the coroner's office in September 1993 and began the new probe before officially losing his privileges in October 1993. The loss was retroactive to July.

He said he was asked to review patient charts in 1985, but was unaware it was part of the hospital's look into suspicious deaths. Hospital officials dispute that claim.

Others admire Andorfer's candor and convictions.

Dr. Chuck Parsons, who has known Andorfer for 15 years, described him as an excellent anesthesiologist and an even better friend.

"A lot of bad things have happened in his life the last couple of years. Paul's a great guy. He'd do anything for you," Parsons said. "I've done a lot of cases with Paul. I've never had a problem."

The realization that he can't visit the hospital where he worked for 21 years without people whispering and pointing at him brings Andorfer to tears. But he said he doesn't regret what he has done.

"I see myself as sort of a (Indiana basketball coach) Bobby Knight or (Gen.) George Patton. I don't feel a real strong need to be liked. I feel the need to be respected, first of all, by the people, patients and the public," he said.

"I have to answer to God first, my conscience and patients. It was as if my whole life was designed for this one task."

[Illustration]
COLOR PHOTO: Paul Andorfer: Death probe has been a burden for him

************************************

UNEARTHING THE TRUTH
The Plain Dealer; Cleveland, OH; Jan 17, 1995;

Sub Title:  [FINAL / ALL Edition]
Column Name:  EDITORIALS
Start Page:  10B
Abstract:
It involves 50 empty vials that once contained the potent muscle relaxant Pavulon, rumors of mercy killing at Springfield Community Hospital and, so far, five exhumations of former patients.

Last December, the county prosecutor, the county coroner and the Ohio Bureau of Criminal Investigation reopened an inquiry into what might have happened to the Pavulon. The empty vials were found in 1985 in places around the hospital where they should not have been. At about the same time, an intensive-care patient almost died from a paralysis that stopped his breathing - precisely the sort of reaction an overdose of Pavulon would cause.

Full Text:
(Copyright (c) The Plain Dealer 1995)
 

Nine years ago, they tried to wash their hands of it, but investigators in Clark County once again have a mystery on their hands.

It involves 50 empty vials that once contained the potent muscle relaxant Pavulon, rumors of mercy killing at Springfield Community Hospital and, so far, five exhumations of former patients.

Last December, the county prosecutor, the county coroner and the Ohio Bureau of Criminal Investigation reopened an inquiry into what might have happened to the Pavulon. The empty vials were found in 1985 in places around the hospital where they should not have been. At about the same time, an intensive-care patient almost died from a paralysis that stopped his breathing - precisely the sort of reaction an overdose of Pavulon would cause.

Tissue samples taken from deceased patients at the time turned up no Pavulon, and the investigation was dropped. To this day, no one knows what happened to the Pavulon, but at least some law-enforcement authorities in the county still seem to believe it may have been used to kill patients at Springfield Community Hospital.

The case of Doris Tompkins, who died at the hospital on June 1, 1985, seems to lend credence to such suspicions. After Tompkins' body was exhumed last year, an autopsy revealed Pavulon in her liver. Authorities do not know how the drug got into Tompkins' system. They do know, however, that it was not prescribed for her.

The case has left its mark on northeast Ohio, in the form of an open grave in Fairlawn. The body of Wilbur Kessel, who died at Springfield Community Hospital during the period being studied, was exhumed Wednesday and taken to Clark County for an autopsy. Tissue samples are being sent to the FBI for analysis.

On Friday, two more bodies were exhumed - one in Clark County and the other in Champaign County. There may be more. The Clark County coroner's office asked in late December for an increase of $150,000 in its 1995 budget request because it expects to have to pay for more exhumations. The Dayton Daily News reported at the time that as many as eight more bodies might be recovered for autopsy.

One of the officials who got the investigation reopened was Dr. Paul Andorfer, the deputy county coroner whose privileges as an anesthesiologist were curtailed by the hospital last year. Some might argue that the involvement of an admittedly disgruntled former staff member in rekindling the inquiry taints the investigation.

Perhaps, but there is no denying the taint of a potentially lethal drug in Doris Tompkins' system. And no one has ever determined where the missing Pavulon went. It seems worthwhile, then, to try to answer the questions that wouldn't stay buried with this 9-year-old case.

After all, if even one patient was killed, then someone, somewhere, is a killer.

******************************

DEADLY SUSPICIONS PROBE CHECKS '85 DEATHS AT SPRINGFIELD HOSPITAL
Dayton Daily News; Dayton; Jan 15, 1995; Steve Bennish DAYTON DAILY NEWS;

Sub Title:  [CITY Edition]
Start Page:  1.A
Personal Names:  SPRINGFIELD COMMUNITY HOSPITAL
 
Abstract:
Some now suspect what happened was the grim calling card of a serial killer who roamed the halls of this 300-bed private hospital for several months in 1985. A former Clark County deputy coroner believes the killer might have been a hospital employee - a female respiratory therapist on the midnight shift who secretly used a muscle-paralyzing drug to kill frail or elderly victims.

Now, the Clark County coroner's office says that up to eight bodies might be exhumed. Former Clark County assistant coroner and former longtime chief of the hospital's anesthesiology department, Dr. Paul Andorfer of Springfield, estimates as many as 30 patients might have been victims.

Back in 1985, Harrison was no stranger to hospital treatment. The 60-year-old retired NCR worker had battled emphysema for seven years and knew the medical routine. Around 2 a.m., the respiratory therapist entered Room 344 with a device to allow Harrison to inhale medicated mist. This time, the medicine tasted oddly bitter, Harrison would later say. The therapist left, but two hours later she returned with a vaporizer that blows a fine medicinal mist into a patient's face.

Full Text:
Copyright Dayton Newspapers Inc. Jan 15, 1995
 

THIS REPORT contains information from Jonathan Brinckman of the Dayton Daily News; Miriam Smith, Mike Wagner, Rod Lockwood and Margo Rutledge of the Springfield News-Sun.

It was during the wee hours of Aug. 8, 1985, that Neal Harrison cheated death at Springfield Community Hospital.

Harrison stopped breathing, but his quick thinking and medical intervention saved him. Two other patients that summer night weren't so fortunate.

Some now suspect what happened was the grim calling card of a serial killer who roamed the halls of this 300-bed private hospital for several months in 1985. A former Clark County deputy coroner believes the killer might have been a hospital employee - a female respiratory therapist on the midnight shift who secretly used a muscle-paralyzing drug to kill frail or elderly victims.

Although the public wouldn't become aware until nine years later, the events of Aug. 8, 1985, were a pivotal moment for a few hospital staff members who had already begun investigating a disturbing chain of events. Ultimately, their investigation would go nowhere.

It wouldn't be until late 1993 that what happened that August would again raise eyebrows of investigators - this time officers of the elite Ohio Bureau of Criminal Identification and Investigation.

As of Friday, the BCI investigation has resulted in exhumation of four bodies - three in the past week. State agents have also called in Canadian forensic pathologist Dr. James Young for consultation. Tissue samples from the first body, exhumed in mid-December, tested positive for the muscle-paralyzing drug Pavulon, pushing the investigation into high gear.

Now, the Clark County coroner's office says that up to eight bodies might be exhumed. Former Clark County assistant coroner and former longtime chief of the hospital's anesthesiology department, Dr. Paul Andorfer of Springfield, estimates as many as 30 patients might have been victims.

The Clark County coroner's office has not declared any of the deaths a homicide and BCI special investigations chief Ted Almay says BCI has no official suspect.

But an investigator with the Ohio Respiratory Care Board told the Dayton Daily News the therapist who administered Harrison's treatment is under investigation by the board. "We are following this information carefully," said investigator Patricia Carson. The therapist is not licensed to practice in Ohio, according to board records. Licensing was not required at the time of the deaths.

Back in 1985, Harrison was no stranger to hospital treatment. The 60-year-old retired NCR worker had battled emphysema for seven years and knew the medical routine. Around 2 a.m., the respiratory therapist entered Room 344 with a device to allow Harrison to inhale medicated mist. This time, the medicine tasted oddly bitter, Harrison would later say. The therapist left, but two hours later she returned with a vaporizer that blows a fine medicinal mist into a patient's face.

As she administered this treatment, Harrison tried to sleep, according to a hospital employee's report. Minutes later, Harrison said his limbs began to lose sensation. Soon, it became difficult to breathe and he hit the nurse's call button.

The responding nurse made this note in the medical record at 4:33 a.m.: No resp. noted. Unresponsive. Dr. Blue called .

That was hospital code for a patient in need of extreme emergency measures to stay alive. A team of doctors, nurses and staff members rushed into Harrison's room - including the therapist who had administered the breathing treatments. Harrison was placed on a ventilator that for hours forced him to breathe. All the while, Harrison recalled, he was paralyzed.

Patients Isaac Bloomfield, a farmer, and the Rev. Auburn Tolliver, a Springfield Baptist minister, died during that same work shift. A nurse witness wrote to a supervisor: I had a bad feeling - having 2 tonight - who just quit breathing. The nurse noted the therapist was working nearby.

Soon after his brush with death, Harrison told his son Joe: "They tried to kill me last night," Joe recalled. Later, Harrison even confronted respiratory supervisor Michael Keefer.

"Close the door," he told Keefer. "Do you know what the hell happened to me?" Harrison demanded, according to 1985 hospital reports. He told Keefer that he didn't want that respiratory therapist to treat him again. He felt that she "contributed" to his near death, Keefer said in a statement to hospital security.

Bob Mount, chief of hospital security, had reason to be anxious. Only a month before, on July 9, dozens of empty ampules of Pavulon and four other drugs used for heart patients were found stashed in storage closets outside three critical care units.

The largest bunch - 49 ampules - was found rolled inside a foam mattress in a storage room outside a lung patient intensive care ward. The discoveries were worrisome. As little as 1 cc of Pavulon - half an ampule - could kill a weak, elderly patient.

Once administered, the drug blocks nerve reactions, so muscle movements can't occur and breathing would cease. If a ventilator weren't quickly applied, Pavulon could kill in minutes.

Mount sent the empty glass vials to Springfield police, but no fingerprints could be lifted. Nurse supervisors were put on alert. Fear was palpable among hospital staff, especially on the midnight shift, memos show.

Deaths had been prevalent on the 11 p.m. to 7 a.m. shift, when hospital staff is minimal: Vivian Norman, 59, a hip surgery patient died unexpectedly at 1 a.m. on March 5; Frances Hosier, 81, died at 2:50 a.m. June 6; and Wilbur Kessel, 86, died at 12:10 a.m. Feb. 27; Doris Tompkins, 72, died at 3:58 a.m. June 1. Ten years later, the bodies of these four would be the first targeted by investigators for exhumation.

Tompkins' body, the first exhumed, would be found to contain Pavulon - a major break for state investigators. The other three, BCI said, had at the time of their death been either in stable condition or showing signs of recovery.

In what could be a promising direction for the probe, one of the four bodies exhumed was that of a relative of the suspect. The Dayton Daily News is not naming the therapist because she has not been charged in connection with any of the deaths. The 39-year-old woman still lives in the Springfield area and has denied repeated requests for interviews.

Hospital's probe ends

Back in 1985, hospital investigators had little more than well-founded suspicion.

The hospital's internal investigation would eventually draw in Springfield police, the Clark County prosecutor's office, the county coroner and then Hamilton County Coroner Frank Cleveland. One body was exhumed, hospital equipment was tested for traces of Pavulon, as were tissues from some who died. Bob Mount, along with a nurse, spent countless hours examining hospital charts. It seemed many suspicious deaths occurred on the therapist's midnight shift.

"It appeared that the suspect was in the same place at the same time things were happening," Mount recalled. Repeated tests for drugs from patient tissue samples were negative. The therapist, questioned after the ampules were found, denied involvement.

Shortly after the Aug. 8 incidents, she was suspended from her hospital duties. Months later, in June 1986, she pleaded guilty to receiving stolen property. She had been found to have hospital equipment in her possession. At the time, she was a volunteer on a local emergency squad.

In her 1986 plea agreement, she agreed to resign from the hospital.

Still, word of the investigation did not become public. Suspicions were plenty - nurses and doctors noting odd deaths - but no one was ever arrested or charged.

Suspicions linger

Long after the original investigation ended, questions gnawed at hospital security chief Bob Mount.

Mount eventually quit his hospital job and became a Clark County sheriff's deputy. He never overcame his misgivings: He still believed the wrong body had been exhumed, someone whose death was not suspicious. That person had died on the second shift, not the third.

Mount says Chris Brouhard, the hospital's executive vice president, told him to wrap up the investigation despite Mount's misgivings. Brouhard and other officials have defended the hospital's investigation. An attorney for the hospital said the body exhumed was picked by Cleveland, then Hamilton County coroner.

But by 1993, nine years of rumors and suspicions percolated to a boil. Mount's thick investigatory file, which left the hospital with him, made it into the hands of Dr. Paul Andorfer.

In the summer of 1993, Andorfer says he spoke with a nurse who mentioned the 1985 police investigation and exhumation. Andorfer says he was puzzled. When he got the file, he'd just left his job of 17 years as the hospital's anesthesiology chief after disagreements with his anesthesia group.

"When I found out there was an exhumation, I said, 'Wait a minute, how could that happen without me knowing about it?' I began checking around."

Springfield Community Hospital officials seem none too pleased. Spokeswoman Kim Parks said that Andorfer began inquiries only after his medical privileges were revoked by the hospital. Andorfer says that's not true, that he'd already left, begun his investigations and was appointed deputy coroner. Andorfer has since filed a lawsuit over the denial of hospital privileges. The ongoing investigation should speak for itself, he adds.

Andorfer says he probably was asked to review suspect patient charts in 1985, but was never told poisoning was a possibility. The hospital says today that Andorfer was fully informed.

In September 1993, Andorfer asked the county coroner and longtime hospital co-worker Dirk Wood, for an appointment as his deputy. Wood agreed. At Andorfer's urging, the coroner's office began to subpoena patient records. Luckily, Mount had heard through a mutual friend that Andorfer was asking questions. He gave Andorfer the file - reports of empty ampules, nursing memos and patient charts.

Andorfer said his first reading of the file told him the original probe had been overwhelmed by its magnitude. Although there were consultations with hospital doctors, nurses, and law enforcement personnel, the probe was not commanded by a forensic expert.

"It's quite easy 10 years later to be a Monday morning quarterback and to raise questions about what went on," hospital spokeswoman Kim Parks said. "We did not conduct an investigation in a vacuum." Andorfer, however, said his coroner's investigation could find no official Springfield police reports.

Retired Springfield detective Ron Menda conceded he "personally felt we as investigators should have gone further." Parks said the hospital didn't seek the assistance of BCI at the time. That was up to law enforcement officers, she said.

According to hospital purchasing records, demand for Pavulon seemed to sharply spike around April 1985. Andorfer's analysis indicated deaths occurred disproportionately on the third shift.

Andorfer's boss, Dirk Wood, would later call the original probe, "somewhat wanting."

Andorfer says the hospital didn't forward enough tissue samples for analysis from third shift patient deaths. Hospital officials and Andorfer dispute the exact breakdown of the 15 samples, but Andorfer feels they should have concentrated on the midnight shift.

Additionally, Andorfer said and the hospital confirms, none of Harrison's bodily fluids were tested for poison.

Records of the two patients who died the same night as Harrison's incident strongly suggest Pavulon poisoning.

"They stopped breathing, but had continued cardiac activity after they stopped breathing," Andorfer said. "People at least have gasping. You'd expect to see that. But when they lay there for 10 minutes and have a heart beat that dissipates - that is how I would expect them to die if they were poisoned by a muscle-paralyzing drug."

By December, BCI had been persuaded to enter the case. Of all state agencies, it had the best resources to dig hard and deep.

Andorfer's criticism of the in-house hospital probe brought the wrath of hospital officials. They said the investigation was instigated by a "disgruntled and embittered individual." They did, however, pledge cooperation with BCI.

Hospital vice president Brouhard complained the investigative file was taken from the hospital. For that, Andorfer has a stinging rebuke:

"There's a statute of limitations on theft," he says. "Not on murder." Andorfer has left his coroner's job, he says, in order to be free to discuss his findings.

When it was revealed in December that Doris Tompkins' body tested positive for the presence of Pavulon, the investigation took on new urgency. The hospital set up a telephone line to answer questions. Fifteen families of patients have made appointments to review records.

Although a year has elapsed since the state investigation went into full swing, no one knows when it will end or how. BCI's Almay says he can't say how long it will take or how many more bodies might be exhumed. "There are a number of cases we are examining. We are working slowly and methodically."

Investigators are still reviewing boxes of hospital records. Witnesses to the 10-year-old events are being questioned, Almay said.

"It takes a lot of time," he said. "We don't have a set list of people to talk to. It changes weekly."

After Neal Harrison, the man who nearly died Aug. 8, 1985, finally succumbed to his chronic lung disease in in 1987, his ashes were scattered in the Gulf of Mexico near the Florida retirement home where he and his wife planned to move.

Mary Harrison feels certain her husband encountered something bad during those early morning hours in 1985.

"I'm kind of glad he wasn't the one they had to bring up," she said. Had he been buried "they'd bring him up for sure."

[Illustration]
PHOTOS: (5): (#1) Grisly task: The body of Frances Hosier's is exhumed Friday so tissue samples can be tested for traces of the drug Pavulon (COLOR) CREDIT: TY GREENLEES/DAYTON DAILY NEWS (#2) Paul Andorfer: His analysis indicates anywhere from 20 to 30 questionable deaths and even more possible attempts (B&W) CREDIT: TY GREENLEES/DAYTON DAILY NEWS (#3) (Graph) Chronology of events at Springfield Community Hospital (B&W) CREDIT: TY GREENLEES/DAYTON DAILY NEWS (#4) (Graph) Deadly paralysis (B&W) CREDIT: DAYTON DAILY NEWS (#5) Neal Harrison: Soon after a 1985 incident in which he nearly died, Harrison told his son Joe: "They tried to kill me last night," Joe recalled (B&W)

*****************************

HOSPITAL PATIENT'S BODY EXHUMED FACILITY HAD SEVERAL SUSPICIOUS DEATHS
The Plain Dealer; Cleveland, OH; Jan 12, 1995; DEBRA DENNIS PLAIN DEALER REPORTER;

Sub Title:  [FINAL / LAKE COUNTY Edition]
Start Page:  5B
Abstract:
For nearly 10 years, it was believed that Wilbur Kessel died from coronary heart disease. The 86-year-old Springfield, O., man's health had suffered for 15 years.

Yesterday, cemetery workers pushed back the snow-covered gray stone that marked Kessel's grave. A backhoe pulled his wooden coffin from its slumber and with yellow straps, hoisted it onto an unmarked, blue truck.

Officials in Clark County where Kessel died want to know if Kessel's bad heart caused his death or if his death was one of several suspicious deaths at Springfield Community Hospital.

Full Text:
(Copyright (c) The Plain Dealer 1995)
 

For nearly 10 years, it was believed that Wilbur Kessel died from coronary heart disease. The 86-year-old Springfield, O., man's health had suffered for 15 years.

No autopsy was ordered and his body was buried at Rose Hill Cemetery in Fairlawn.

Yesterday, cemetery workers pushed back the snow-covered gray stone that marked Kessel's grave. A backhoe pulled his wooden coffin from its slumber and with yellow straps, hoisted it onto an unmarked, blue truck.

Yellow crime scene tape with words "do not cross" were wrapped around the coffin.

From there, Kessel's body was taken to the Summit County coroner's office where an autopsy is to be performed today.

Officials in Clark County where Kessel died want to know if Kessel's bad heart caused his death or if his death was one of several suspicious deaths at Springfield Community Hospital.

Kessel, a retired barber, has become part of a massive investigation into mysterious deaths that occurred at the hospital in 1984 and 1985.

"There's been no approximation on the number of exhumations we're doing," said Clark County Prosecutor Steve Schumaker.

"I can't confirm or deny anything. The investigation is still in its early stages. The coroner will make the determination on how many bodies are exhumed. We're looking at a number of files."

Schumaker would not comment on what led investigators to probe the medical care Kessel received while at the hospital.

Kessel may fit the pattern of elderly patients who may have been injected with Pavulon, a muscle relaxer generally used during surgeries, Schumaker said.

Pavulon can cause respiratory failure or paralysis. In 1985, empty vials of Pavulon were found in an unauthorized area of the hospital. A probe was launched by local officials and then closed after about a year.

In December 1993, state officials reopened the investigation at the request of Clark County's prosecutor and coroner.

So far their investigation has led to the drug being found in the liver of Doris Tompkins, 72, who also was a patient at the hospital. Tompkins' body was exhumed from Ferncliff Cemetery in Springfield last July. She died June 1, 1985.

Schumaker said no arrests have been made in the investigation. The coroner has not ruled in Tompkins' death since the drug was discovered.

Clark County Coroner Dirk Wood did not return telephone calls.

John Lenhart, the former superintendent of the Ohio Bureau of Criminal Identification and Investigation, said last month that Tomkins had not been prescribed Pavulon. He said the bureau was reviewing the woman's medical charts.

Little is known about Kessel. He was born Dec. 26, 1898, in West Virginia. He worked as a barber and rubber worker.

Kessel spent his last years at the Ohio Masonic Home in Springfield.

[Illustration]
PHOTO BY: BILL KENNEDY / PLAIN DEALER PHOTOGRAPHER A casket bearing the body of Wilbur Kessel is removed from its burial site in Akron's Rose Hill Cemetery. Kessel's body was exhumed as part of an investigation into mysterious deaths at a Springfield, Ohio, hospital.

*******************************

DEADLY SUSPICIONS PROBE CHECKS '85 DEATHS AT SPRINGFIELD HOSPITAL
Dayton Daily News; Dayton; Jan 15, 1995; Steve Bennish DAYTON DAILY NEWS;

Sub Title:  [CITY Edition]
Start Page:  1.A
Personal Names:  SPRINGFIELD COMMUNITY HOSPITAL
 
Abstract:
Some now suspect what happened was the grim calling card of a serial killer who roamed the halls of this 300-bed private hospital for several months in 1985. A former Clark County deputy coroner believes the killer might have been a hospital employee - a female respiratory therapist on the midnight shift who secretly used a muscle-paralyzing drug to kill frail or elderly victims.

Now, the Clark County coroner's office says that up to eight bodies might be exhumed. Former Clark County assistant coroner and former longtime chief of the hospital's anesthesiology department, Dr. Paul Andorfer of Springfield, estimates as many as 30 patients might have been victims.

Back in 1985, Harrison was no stranger to hospital treatment. The 60-year-old retired NCR worker had battled emphysema for seven years and knew the medical routine. Around 2 a.m., the respiratory therapist entered Room 344 with a device to allow Harrison to inhale medicated mist. This time, the medicine tasted oddly bitter, Harrison would later say. The therapist left, but two hours later she returned with a vaporizer that blows a fine medicinal mist into a patient's face.

Full Text:
Copyright Dayton Newspapers Inc. Jan 15, 1995
 

THIS REPORT contains information from Jonathan Brinckman of the Dayton Daily News; Miriam Smith, Mike Wagner, Rod Lockwood and Margo Rutledge of the Springfield News-Sun.

It was during the wee hours of Aug. 8, 1985, that Neal Harrison cheated death at Springfield Community Hospital.

Harrison stopped breathing, but his quick thinking and medical intervention saved him. Two other patients that summer night weren't so fortunate.

Some now suspect what happened was the grim calling card of a serial killer who roamed the halls of this 300-bed private hospital for several months in 1985. A former Clark County deputy coroner believes the killer might have been a hospital employee - a female respiratory therapist on the midnight shift who secretly used a muscle-paralyzing drug to kill frail or elderly victims.

Although the public wouldn't become aware until nine years later, the events of Aug. 8, 1985, were a pivotal moment for a few hospital staff members who had already begun investigating a disturbing chain of events. Ultimately, their investigation would go nowhere.

It wouldn't be until late 1993 that what happened that August would again raise eyebrows of investigators - this time officers of the elite Ohio Bureau of Criminal Identification and Investigation.

As of Friday, the BCI investigation has resulted in exhumation of four bodies - three in the past week. State agents have also called in Canadian forensic pathologist Dr. James Young for consultation. Tissue samples from the first body, exhumed in mid-December, tested positive for the muscle-paralyzing drug Pavulon, pushing the investigation into high gear.

Now, the Clark County coroner's office says that up to eight bodies might be exhumed. Former Clark County assistant coroner and former longtime chief of the hospital's anesthesiology department, Dr. Paul Andorfer of Springfield, estimates as many as 30 patients might have been victims.

The Clark County coroner's office has not declared any of the deaths a homicide and BCI special investigations chief Ted Almay says BCI has no official suspect.

But an investigator with the Ohio Respiratory Care Board told the Dayton Daily News the therapist who administered Harrison's treatment is under investigation by the board. "We are following this information carefully," said investigator Patricia Carson. The therapist is not licensed to practice in Ohio, according to board records. Licensing was not required at the time of the deaths.

Back in 1985, Harrison was no stranger to hospital treatment. The 60-year-old retired NCR worker had battled emphysema for seven years and knew the medical routine. Around 2 a.m., the respiratory therapist entered Room 344 with a device to allow Harrison to inhale medicated mist. This time, the medicine tasted oddly bitter, Harrison would later say. The therapist left, but two hours later she returned with a vaporizer that blows a fine medicinal mist into a patient's face.

As she administered this treatment, Harrison tried to sleep, according to a hospital employee's report. Minutes later, Harrison said his limbs began to lose sensation. Soon, it became difficult to breathe and he hit the nurse's call button.

The responding nurse made this note in the medical record at 4:33 a.m.: No resp. noted. Unresponsive. Dr. Blue called .

That was hospital code for a patient in need of extreme emergency measures to stay alive. A team of doctors, nurses and staff members rushed into Harrison's room - including the therapist who had administered the breathing treatments. Harrison was placed on a ventilator that for hours forced him to breathe. All the while, Harrison recalled, he was paralyzed.

Patients Isaac Bloomfield, a farmer, and the Rev. Auburn Tolliver, a Springfield Baptist minister, died during that same work shift. A nurse witness wrote to a supervisor: I had a bad feeling - having 2 tonight - who just quit breathing. The nurse noted the therapist was working nearby.

Soon after his brush with death, Harrison told his son Joe: "They tried to kill me last night," Joe recalled. Later, Harrison even confronted respiratory supervisor Michael Keefer.

"Close the door," he told Keefer. "Do you know what the hell happened to me?" Harrison demanded, according to 1985 hospital reports. He told Keefer that he didn't want that respiratory therapist to treat him again. He felt that she "contributed" to his near death, Keefer said in a statement to hospital security.

Bob Mount, chief of hospital security, had reason to be anxious. Only a month before, on July 9, dozens of empty ampules of Pavulon and four other drugs used for heart patients were found stashed in storage closets outside three critical care units.

The largest bunch - 49 ampules - was found rolled inside a foam mattress in a storage room outside a lung patient intensive care ward. The discoveries were worrisome. As little as 1 cc of Pavulon - half an ampule - could kill a weak, elderly patient.

Once administered, the drug blocks nerve reactions, so muscle movements can't occur and breathing would cease. If a ventilator weren't quickly applied, Pavulon could kill in minutes.

Mount sent the empty glass vials to Springfield police, but no fingerprints could be lifted. Nurse supervisors were put on alert. Fear was palpable among hospital staff, especially on the midnight shift, memos show.

Deaths had been prevalent on the 11 p.m. to 7 a.m. shift, when hospital staff is minimal: Vivian Norman, 59, a hip surgery patient died unexpectedly at 1 a.m. on March 5; Frances Hosier, 81, died at 2:50 a.m. June 6; and Wilbur Kessel, 86, died at 12:10 a.m. Feb. 27; Doris Tompkins, 72, died at 3:58 a.m. June 1. Ten years later, the bodies of these four would be the first targeted by investigators for exhumation.

Tompkins' body, the first exhumed, would be found to contain Pavulon - a major break for state investigators. The other three, BCI said, had at the time of their death been either in stable condition or showing signs of recovery.

In what could be a promising direction for the probe, one of the four bodies exhumed was that of a relative of the suspect. The Dayton Daily News is not naming the therapist because she has not been charged in connection with any of the deaths. The 39-year-old woman still lives in the Springfield area and has denied repeated requests for interviews.

Hospital's probe ends

Back in 1985, hospital investigators had little more than well-founded suspicion.

The hospital's internal investigation would eventually draw in Springfield police, the Clark County prosecutor's office, the county coroner and then Hamilton County Coroner Frank Cleveland. One body was exhumed, hospital equipment was tested for traces of Pavulon, as were tissues from some who died. Bob Mount, along with a nurse, spent countless hours examining hospital charts. It seemed many suspicious deaths occurred on the therapist's midnight shift.

"It appeared that the suspect was in the same place at the same time things were happening," Mount recalled. Repeated tests for drugs from patient tissue samples were negative. The therapist, questioned after the ampules were found, denied involvement.

Shortly after the Aug. 8 incidents, she was suspended from her hospital duties. Months later, in June 1986, she pleaded guilty to receiving stolen property. She had been found to have hospital equipment in her possession. At the time, she was a volunteer on a local emergency squad.

In her 1986 plea agreement, she agreed to resign from the hospital.

Still, word of the investigation did not become public. Suspicions were plenty - nurses and doctors noting odd deaths - but no one was ever arrested or charged.

Suspicions linger

Long after the original investigation ended, questions gnawed at hospital security chief Bob Mount.

Mount eventually quit his hospital job and became a Clark County sheriff's deputy. He never overcame his misgivings: He still believed the wrong body had been exhumed, someone whose death was not suspicious. That person had died on the second shift, not the third.

Mount says Chris Brouhard, the hospital's executive vice president, told him to wrap up the investigation despite Mount's misgivings. Brouhard and other officials have defended the hospital's investigation. An attorney for the hospital said the body exhumed was picked by Cleveland, then Hamilton County coroner.

But by 1993, nine years of rumors and suspicions percolated to a boil. Mount's thick investigatory file, which left the hospital with him, made it into the hands of Dr. Paul Andorfer.

In the summer of 1993, Andorfer says he spoke with a nurse who mentioned the 1985 police investigation and exhumation. Andorfer says he was puzzled. When he got the file, he'd just left his job of 17 years as the hospital's anesthesiology chief after disagreements with his anesthesia group.

"When I found out there was an exhumation, I said, 'Wait a minute, how could that happen without me knowing about it?' I began checking around."

Springfield Community Hospital officials seem none too pleased. Spokeswoman Kim Parks said that Andorfer began inquiries only after his medical privileges were revoked by the hospital. Andorfer says that's not true, that he'd already left, begun his investigations and was appointed deputy coroner. Andorfer has since filed a lawsuit over the denial of hospital privileges. The ongoing investigation should speak for itself, he adds.

Andorfer says he probably was asked to review suspect patient charts in 1985, but was never told poisoning was a possibility. The hospital says today that Andorfer was fully informed.

In September 1993, Andorfer asked the county coroner and longtime hospital co-worker Dirk Wood, for an appointment as his deputy. Wood agreed. At Andorfer's urging, the coroner's office began to subpoena patient records. Luckily, Mount had heard through a mutual friend that Andorfer was asking questions. He gave Andorfer the file - reports of empty ampules, nursing memos and patient charts.

Andorfer said his first reading of the file told him the original probe had been overwhelmed by its magnitude. Although there were consultations with hospital doctors, nurses, and law enforcement personnel, the probe was not commanded by a forensic expert.

"It's quite easy 10 years later to be a Monday morning quarterback and to raise questions about what went on," hospital spokeswoman Kim Parks said. "We did not conduct an investigation in a vacuum." Andorfer, however, said his coroner's investigation could find no official Springfield police reports.

Retired Springfield detective Ron Menda conceded he "personally felt we as investigators should have gone further." Parks said the hospital didn't seek the assistance of BCI at the time. That was up to law enforcement officers, she said.

According to hospital purchasing records, demand for Pavulon seemed to sharply spike around April 1985. Andorfer's analysis indicated deaths occurred disproportionately on the third shift.

Andorfer's boss, Dirk Wood, would later call the original probe, "somewhat wanting."

Andorfer says the hospital didn't forward enough tissue samples for analysis from third shift patient deaths. Hospital officials and Andorfer dispute the exact breakdown of the 15 samples, but Andorfer feels they should have concentrated on the midnight shift.

Additionally, Andorfer said and the hospital confirms, none of Harrison's bodily fluids were tested for poison.

Records of the two patients who died the same night as Harrison's incident strongly suggest Pavulon poisoning.

"They stopped breathing, but had continued cardiac activity after they stopped breathing," Andorfer said. "People at least have gasping. You'd expect to see that. But when they lay there for 10 minutes and have a heart beat that dissipates - that is how I would expect them to die if they were poisoned by a muscle-paralyzing drug."

By December, BCI had been persuaded to enter the case. Of all state agencies, it had the best resources to dig hard and deep.

Andorfer's criticism of the in-house hospital probe brought the wrath of hospital officials. They said the investigation was instigated by a "disgruntled and embittered individual." They did, however, pledge cooperation with BCI.

Hospital vice president Brouhard complained the investigative file was taken from the hospital. For that, Andorfer has a stinging rebuke:

"There's a statute of limitations on theft," he says. "Not on murder." Andorfer has left his coroner's job, he says, in order to be free to discuss his findings.

When it was revealed in December that Doris Tompkins' body tested positive for the presence of Pavulon, the investigation took on new urgency. The hospital set up a telephone line to answer questions. Fifteen families of patients have made appointments to review records.

Although a year has elapsed since the state investigation went into full swing, no one knows when it will end or how. BCI's Almay says he can't say how long it will take or how many more bodies might be exhumed. "There are a number of cases we are examining. We are working slowly and methodically."

Investigators are still reviewing boxes of hospital records. Witnesses to the 10-year-old events are being questioned, Almay said.

"It takes a lot of time," he said. "We don't have a set list of people to talk to. It changes weekly."

After Neal Harrison, the man who nearly died Aug. 8, 1985, finally succumbed to his chronic lung disease in in 1987, his ashes were scattered in the Gulf of Mexico near the Florida retirement home where he and his wife planned to move.

Mary Harrison feels certain her husband encountered something bad during those early morning hours in 1985.

"I'm kind of glad he wasn't the one they had to bring up," she said. Had he been buried "they'd bring him up for sure." 

[Illustration]
PHOTOS: (5): (#1) Grisly task: The body of Frances Hosier's is exhumed Friday so tissue samples can be tested for traces of the drug Pavulon (COLOR) CREDIT: TY GREENLEES/DAYTON DAILY NEWS (#2) Paul Andorfer: His analysis indicates anywhere from 20 to 30 questionable deaths and even more possible attempts (B&W) CREDIT: TY GREENLEES/DAYTON DAILY NEWS (#3) (Graph) Chronology of events at Springfield Community Hospital (B&W) CREDIT: TY GREENLEES/DAYTON DAILY NEWS (#4) (Graph) Deadly paralysis (B&W) CREDIT: DAYTON DAILY NEWS (#5) Neal Harrison: Soon after a 1985 incident in which he nearly died, Harrison told his son Joe: "They tried to kill me last night," Joe recalled (B&W)


 
 
To Kaiser Papers
To caregivers that kill