Blind Eye: The Terrifying Story of a Doctor Who Got Away With Murder (10 page)

Though Beery had the impression that none of the doctors believed her, Dr. Freeman pursued her declaration that Swango had been in the room. He described Swango to Cooper as a “tall, blond doctor” and asked if he might have been the person Cooper saw inject something in her IV. Cooper replied, “Yes, it was that person.” Freeman ordered a blood test on Cooper to see if the cause of the paralysis could be determined.

Freeman returned to the ninth floor, where Swango was still on duty, and confronted him with the allegation that he had given Cooper an injection. Swango denied that he had even been in Cooper’s room after the doctors finished their rounds. Later, after hearing more reports from nurses, Freeman again asked Swango if he was sure he had never been in the room. Swango repeated that he had had no contact with Cooper. As Freeman later put it, “I confronted him and did question him and he said he was not in the room. Nor did he see her just previous to the incident.”

W
ITH
Cooper seemingly safe in intensive care and the immediate crisis over, a sense of shock descended on the nurses. Though none of them had ever confronted anything like this in their careers, they felt that something had to be done. Black, the supervising nurse, told Nurses Beery and Jordan to write down everything they could remember, and she did the same. Beery wrote that Swango was in the room and “it appeared” that he injected something into Cooper’s IV tube. Black collected their statements and placed them in a sealed envelope, which she left for the director of surgical nursing, who would be in the next day. Just after eleven
P.M
., Black also took the unusual step of calling Amy Moore, the head nurse, at home, and told her what had happened. Then Jordan, too, called Moore to tell her about the syringe Risley had found in Room 966. Moore was alarmed, especially since she had heard about Swango that same day from Ritchie, who had told her about his involvement in Barrick’s death. She told Jordan to retrieve the syringe and place it in her, Moore’s, briefcase, which was in her office.

Moore was already concerned about the startling increase in the number of codes and deaths on the ninth floor of Rhodes Hall in the prior few weeks, though only now did she begin to link them specifically with Swango. On January 14—just after Swango’s meeting with Dr. Hunt—Cynthia Ann McGee, an attractive young gymnast from the University of Illinois, had been found dead in Room 901. Six days later, twenty-one-year-old Richard DeLong was found dead in Room 964. A nurse had said Dr. Freeman, who responded to a code on DeLong, “was definitely stunned” by the sudden and mysterious death. Another patient on the ninth floor, forty-three-year-old Rein Walter, died unexpectedly on January 24 after a nurse found him gasping for air and turning blue. Swango had been working on the floor at the time of all of these deaths, and the coincidence was hard to miss. As one nurse, Lynnette Brinkman, had put it, there had been more codes on the ninth floor since Swango began his neurosurgery rotation than there had been in the entire prior year.

The next morning, Moore went to Jan Dickson, the associate executive director for nursing, the highest-ranking nurse at Ohio State. Dickson had earned high praise for restoring morale and building up the staff after a bitter and debilitating nurses’ strike that had preceded her arrival. She loved working at large teaching hospitals, and had been in charge of nursing at the University of Kentucky before moving to Columbus. Dickson, forty-two, had grown up on a farm in northeast Missouri, not far from Swango’s hometown of Quincy, where she had relatives. An attractive blonde, she had a warm, down-to-earth manner and the ability to bridge the often large gulf between nurses, doctors, and hospital administrators. She was dating Donald Boyanowski, an associate executive director of the hospital, so she also had unusual access to the hospital’s inner workings and politics.

Dickson had never encountered a head nurse so shaken and upset. Moore related the previous night’s incidents, told how she’d been called at home by both Black and Jordan, and mentioned her fears about the sudden increase in mysterious deaths on the floor where Swango was working. The story was so incredible that had Dickson not known Moore so well and trusted her judgment and maturity, she wouldn’t have believed it. It was obvious to Dickson
that something was terribly wrong in Rhodes Hall—so wrong, in fact, that she thought the police would have to be notified.

That, however, was not a decision she could make alone. Dickson dispatched Moore to talk to Dr. Joseph Goodman, a professor of neurosurgery and the attending physician who had operated on Cooper’s spine. Dickson also called to arrange a meeting with Donald Cramp, the hospital’s executive director and top administrator. Cramp was alarmed and upset, and readily agreed with Dickson that there was an emergency. He immediately called Dr. Manuel Tzagournis, the university vice president for health services and dean of the College of Medicine, who scheduled a meeting for six that evening.

In Columbus, few figures are viewed with more reverence than Tzagournis, the quintessential Ohio boy made good. Though he reported directly to Ohio State’s president, Edward H. Jennings, Tzagournis was close to members of the hospital’s powerful board, some of whom were also university trustees. The board included such local luminaries as Charles Lazarus, chairman of the department store chain; John Wolfe, owner and chairman of
The Columbus Dispatch;
and Dean Jeffers, chairman of Nationwide Insurance. Tzagournis, a native of Youngstown, earned both his bachelor’s and medical degrees from Ohio State and was a specialist in endocrinology, the study of the glands and hormones. He had cemented his ties to the hospital board by treating some of its members, not to mention prominent state legislators. Tzagournis’s cousin, Harry Meshel, was the Ohio state Senate minority leader, and Vernal G. Riffe, Jr., the speaker of the Ohio House of Representatives, was one of Tzagournis’s patients. (Ohio State received $229.4 million in state aid in fiscal 1984.) Tzagournis had become dean in 1981, transforming the office into a highly visible fundraising position. Charming, sociable, and urbane, Tzagournis cultivated not only state legislators, but the local business and professional elite.

At the time, Tzagournis had been overseeing what was arguably the hospital’s most important campaign—the Arthur G. James Cancer Hospital, named after an oncologist at Ohio State and initially financed with $40 million from the state government. Ground was about to be broken on the new hospital when the Swango matter surfaced.
The new hospital’s prestige, success, and future operations depended on Ohio State’s ability to attract additional donations, major research grants, and $12 million in additional funding from the state. This potential scandal could not have come at a worse time.

Before the scheduled meeting, Dickson summoned Beery and Jordan and asked them to read and sign typed versions of their handwritten statements from the previous night. Jordan took the opportunity to tell Dickson in greater detail about the McGee, DeLong, and Walter deaths and the nursing staff’s suspicions of Swango—a topic that was dominating conversation among the nurses that day. Like Moore, Jordan was extremely upset, and Dickson grew even more alarmed.

But the nurses were receiving a very different reaction from Dr. Goodman. Though relatively young, Goodman was perceived by some nurses as the epitome of the cold, detached, aloof, even arrogant surgeon. He was especially disdainful of questions from patients. Some complained they couldn’t get answers from him, and nurses assigned to work with Goodman were warned that, as one put it, “he doesn’t have much of a bedside manner.”

Though nurses tended to be especially circumspect in Goodman’s presence, Moore related the story she’d told Dickson. She told him about Risley’s discovery of the syringe, and said she had the syringe in her briefcase. And she mentioned the other mysterious deaths, and the fact that Swango had been present for all of them. Goodman thanked her, then dismissed her without asking any questions or offering further instructions. He said nothing about what to do with the syringe.

Goodman’s major concern was that the nurses’ “grapevine,” as he later put it, was overreacting and recklessly spreading virulent and unfounded gossip about a fellow doctor. He was annoyed that Swango was being arbitrarily linked to every death or unusual event in the hospital for the past year, and felt the situation was getting “out of hand.” He didn’t find anything unusual or suspicious about finding a used syringe on a hospital sink.
³

After conferring with Dr. Larry Carey, the chief of surgery, who had been notified by Cramp, Goodman asked Swango to come to his office. He told Swango that questions had been raised about his treatment of Rena Cooper, and said he thought he should take some time off from the hospital until the matter was cleared up. Goodman later observed that Swango appeared calm, even placid. He seemed entirely unaware that there had been any problem the previous night, and didn’t show any undue concern or anxiety, a reaction that only reinforced Goodman’s suspicion that nurses’ gossip was the root of the problem. Goodman didn’t ask Swango for any explanation or account of his activities.

Dr. Carey, too, spoke to Swango, mentioning that there had been an “incident report” concerning him that would need to be investigated. Unlike Goodman, Carey did ask Swango specifically whether he had “done anything” to Cooper or “injected anything in her IV.” Swango said no, but then volunteered a detailed account that differed sharply from his answers to Dr. Freeman the night before. He said that he had gone into Cooper’s room because either Cooper or Utz—Carey couldn’t remember which—had told him her feet were cold, and asked him to fetch her slippers. He did so and left immediately, without doing anything to an IV line.

Carey told Swango that a committee would be meeting that evening to consider his status, and suggested he wait outside for the results.

Dr. Carey also spoke to Dr. Hunt, the head of neurosurgery, who had admitted Swango to the residency program. Goodman was widely viewed as Hunt’s protégé, though Hunt was more personable and outgoing. Hunt, too, was a graduate of Ohio State’s medical school, and was a Columbus native. Hunt had been married for years to Charlotte Curtis, long the highest-ranking woman at
The New York Times
, a member of the paper’s editorial board. After her death he married Carole Miller, a former resident of his who had joined the neurosurgery staff at Ohio State. Hunt had long taken a professional interest in the residents’ program; as a member of the American Board of Neurological Surgery, he was in charge of graduate medical education. Hunt was urbane and nationally known, spending time in New York and at his summer home on the coast of Maine.

Both Hunt and Carey were aware of some cases at other hospitals in which residents sued after being fired and the hospitals were ordered to reinstate them. They didn’t want to be sued by Swango as a result of unfounded charges and nurses’ gossip, and then be ordered to reinstate him.

Hunt immediately called Cramp, the hospital’s executive director, and said a lawyer should attend that evening’s meeting. Hunt thus appears to have been the first person involved in the matter who recognized that the situation might threaten Ohio State with possible legal liability. Besides fears of a lawsuit by Swango, there were also possible suits by patients to consider.

The questions about Swango coincided with what is generally referred to as the second malpractice insurance “crisis.” The first of these occurred in the mid-1970s, when doctors’ insurance premiums shot up, on average, 500 percent. During the second “crisis,” in the mid-1980s, the U.S. General Accounting Office reported that malpractice insurance costs for physicians nearly doubled between 1983 and 1985, rising from $2.5 billion to $4.7 billion. The St. Paul Fire and Marine Insurance Company, the largest underwriter of medical malpractice insurance, reported a 55 percent increase in claims from 1980 to 1984. And the GAO reported that damage awards increased over 100 percent in some states in the same period. This “crisis” received enormous publicity, especially in the medical press, and fueled intense concern and resentment on the part of many doctors.

The issue of potential legal liability was especially sensitive at Ohio State, because, as a large state-financed and taxpayer-supported institution, the university was largely self-insured. Though individual doctors carried malpractice insurance and were subject to the explosion in premium costs, judgments against the hospitals, the medical school, or the university itself were paid by the university, which meant the money ultimately came out of taxpayers’ pockets. Because of Ohio State’s unusual status, the office of the Ohio attorney general, an elected official, served as the university’s lawyer. One assistant attorney general, Robert Holder, maintained an office on the Ohio State campus and worked full-time on university matters, including issues at the medical college. Indeed, Holder and Tzagournis had worked closely together and had become
friends. Cramp called Holder, who was out that day. He then called Richard Jackson, vice president of the university for business and finance. Jackson in turn asked Alphonse Cincione, a probate lawyer with a downtown Columbus law firm, to represent the university at the meeting.

The group convened at 6:30 that evening in a large conference room at the university hospital. Tzagournis did not attend, nor did Michael Whitcomb, the hospital’s medical director, whom no one had been able to reach. Dickson was there as head of nursing, as were hospital administrators Cramp and Boyanowski. Cincione functioned as legal counsel. The only doctors present were Goodman, Carey, and Hunt. Goodman and Hunt had already expressed their skepticism of the nurses’ claims.

Just a few years earlier, Carey had hired and brought to Ohio State a surgeon with a criminal record. The surgeon, an old friend of Carey’s, had been fined and sentenced to six months’ hard labor after pleading guilty to eleven counts of attempted sodomy, indecent assault, committing lewd and indecent acts, and using his position to solicit sexual favors from women subordinates while he was chief of surgery at a Philadelphia hospital. Though the prosecutor had characterized the offenses as “crimes of violence, crimes that shock the conscience,” in 1982 Carey recommended to the Ohio Medical Board that the doctor be licensed to practice medicine, saying that the sex crimes were “misbehavior at worst. From my point of view, they are not the kind of charges that ought to permanently damage a man’s career.” Tzagournis had approved hiring the surgeon even after Carey informed him of the doctor’s criminal record.
⁴