Claire Dawson
Hurricane Katrina's floodwaters crippled Memorial Hospital in New Orleans, leaving it without power, running water, sanitation, or food. The indoor temperatures rose to over 105 degrees, killing some patients. Approximately 250 patients were stranded, and at least 34 died. In the aftermath, Dr. Anna Pou and two nurses, Lori Budo and Cheri Landry, were accused of second-degree murder for administering lethal injections of morphine and midazolam to four critically ill patients. The case sparked debates about disaster preparedness, triage ethics, and the role of healthcare workers in life-and-death decisions during crises.
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What You'll Learn
Memorial Hospital lost power, running water, and sanitation
Memorial Hospital in New Orleans lost power, running water, and sanitation during Hurricane Katrina. The hospital was surrounded by floodwaters, and its power box was only a few feet above ground level, leaving it vulnerable to the rising waters. The loss of power also meant that the emergency power generators were disabled, causing the hospital to lose electricity. This left the hospital in darkness, with indoor temperatures rising to as high as 110 °F (43 °C). The lack of sanitation and running water created a rancid smell, and non-functional toilets further added to the unsanitary conditions.
The loss of power and sanitation had severe impacts on the patients and staff at Memorial Hospital. Approximately 250 patients were stranded, and at least 34 of them died. Many of these patients were severely ill or bedridden and depended on electric power for their ventilators. The extreme heat, coupled with the lack of sanitation and running water, created a dangerous and uncomfortable environment.
The hospital staff faced tremendous strain due to the dire medical circumstances of their patients, as well as the uncertainty of their own evacuation. They were confronted with chaotic communication, gaps in leadership, poor security, and threats of violence. The lack of running water and sanitation also made it difficult to provide basic care and maintain hygiene standards.
Dr. Anna Pou and two nurses, Cheri Landry and Lori Budo, remained behind to care for the patients who were too sick to evacuate. They were later accused of hastening the death of some patients by administering lethal injections of morphine and midazolam. However, some observers defended their actions as an attempt to calm seriously ill patients during a crisis or as euthanasia to prevent needless suffering. After an investigation, they were arrested for the deaths of four patients, but a grand jury refused to indict them on charges of second-degree murder due to a lack of evidence of intent to kill.
The events at Memorial Hospital during Hurricane Katrina highlighted the need for better disaster training and preparation in hospitals. It also led to the passing of laws in Louisiana that provide immunity to healthcare professionals from civil lawsuits for their work in disasters, except in cases of intentional misconduct.
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45 bodies were found in the hospital
Hurricane Katrina caused Memorial Hospital in New Orleans to lose power, running water, and be flooded. The hospital was surrounded by floodwaters, without sanitation, running out of food, and experiencing indoor temperatures of up to 110 °F (43 °C). The lack of sanitation created a rancid smell, and no running water was available, basically transforming the hospital into a site for “third world medicine”.
On September 11, mortuary workers recovered 45 bodies from the hospital. The bodies were found in a makeshift morgue in the chapel of Memorial Medical Center. Toxicology tests were performed on 41 bodies, and 23 tested positive for one or both of morphine and the fast-acting sedative midazolam (Versed), although few of these patients had been prescribed morphine for pain.
The discussion of euthanasia was a key topic in the aftermath of the hurricane. Bryant King, an internist at Memorial, told CNN that he believed "the discussion of euthanasia was more than just talk". LifeCare told the state Attorney General's office that nine of their patients might "have been given lethal doses of medicines by a Memorial doctor and nurses."
Dr. Anna Pou and two nurses, Lori Budo and Cheri Landry, were accused of hastening the death of some patients and were arrested for the deaths of four patients. They were accused of injecting these critically ill patients with a lethal combination of morphine or midazolam, or both. Pou denied the allegations, stating that the intention was to help the patients in pain and sedate those who were anxious. Pou's lawyer, Richard Simmons, said at the time: "This was a doctor who was at all times concerned with her patients."
In the four years following Katrina, Pou helped write and pass three laws in Louisiana offering immunity to healthcare workers from most civil lawsuits (except in cases of intentional misconduct) for their efforts in future mass casualty situations.
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Dr. Anna Pou and two nurses were accused of murder
Hurricane Katrina's floodwaters left Memorial Hospital in New Orleans without sanitation, running out of food, with soaring temperatures of up to 110 °F (43 °C), and no electricity. Approximately 250 patients were stranded, and at least 34 of them died.
Dr. Anna Pou, a physician at Memorial Medical Center, and two nurses, Lori Budo and Cheri Landry, were accused of second-degree murder for the deaths of four patients. The patients, ranging from 61 to 90 years of age, had been injected with a combination of morphine and midazolam that killed them. Some observers noted that these drugs are commonly given to reduce pain and anxiety, arguing that their administration was an attempt to calm seriously ill patients during a crisis.
Dr. Pou stated that her intention was to "help the patients that were having pain and sedate the patients who were anxious" because she "knew they were going to be there another day, that they would go through at least another day of hell." She acknowledged injecting some patients with morphine and a sedative, saying, "If in doing so it hastened their deaths, then that's what happened. But, this was not, 'I'm going to go to the seventh floor and murder some people.'"
A coroner was hired to determine the patients' cause of death through autopsies, and toxicology tests revealed the presence of morphine and midazolam in quantities that state experts concluded had not been administered for pharmaceutical purposes. The attorney general, Charles Foti, Jr., declared that the case was "not euthanasia," and that "there is no excuse for intentionally killing another living human being."
Dr. Pou and her nurses were arrested and charged, but a grand jury declined to indict them, and the case never went to trial. Dr. Pou was never convicted and, as of the summer of 2022, was practicing medicine as a head and neck oncologist in Louisiana. In the years following Katrina, she helped pass laws in Louisiana offering immunity to healthcare workers from most civil lawsuits in future mass casualty situations.
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Lethal doses of morphine and midazolam were administered to patients
In the aftermath of Hurricane Katrina, more than a dozen people were found dead at Memorial Medical Center in New Orleans, with morphine or the quick-acting sedative midazolam in their system. This prompted allegations that they had been euthanized by medical professionals. Specifically, Dr. Anna Pou and nurses Lori Budo and Cheri Landry were accused of second-degree murder and arrested in July 2006, four days after the hurricane. They were accused of intentionally killing four patients by administering lethal doses of morphine and midazolam.
The patients, ranging from 61 to 90 years old, were stranded on the seventh floor of the hospital, which was leased to LifeCare Hospitals of New Orleans. LifeCare provides long-term acute care for severely ill patients. Many of LifeCare's patients were especially vulnerable due to the loss of electric power, with seven on ventilators. One patient, Emmett Everett, was awaiting surgery to relieve a chronic bowel obstruction, which was not considered acutely life-threatening. He had been ambulatory, feeding himself, and interacting with staff before the hurricane hit.
The hospital was surrounded by floodwaters, without sanitation, running out of food, experiencing indoor temperatures up to 110 °F (43 °C), and had no electricity. Patients on upper floors had to be carried down the stairs, and those evacuated by helicopter had to be brought up to the helipad on a separate building; several patients died during the evacuation process. By Friday, about 2,000 patients, families, and staff had been evacuated under challenging circumstances.
The decision to administer lethal doses of morphine and midazolam was likely influenced by the dire circumstances at the hospital. The lack of power, food, water, sanitation, and extreme indoor temperatures created a desperate situation. There were also uncertainties about evacuation, exacerbated by threats of violence and chaos in the city. Some observers defended the actions of Dr. Pou and the nurses as an attempt to calm and prevent needless suffering in patients who had little chance of survival in such harsh conditions.
However, the arrests and allegations sparked intense debate and outrage. Some questioned whether the actions constituted euthanasia or homicide. Bryant King, an internist at Memorial, believed the discussion of euthanasia went beyond talk and publicly charged that healthcare workers had killed patients. On the other hand, others criticized the government and its ineffective response to the crisis, arguing that blaming healthcare workers who stayed to care for vulnerable citizens was misplaced. Ultimately, Dr. Pou and the nurses were not indicted, and Dr. Pou went on to help pass laws in Louisiana offering immunity to healthcare workers from civil lawsuits in future mass casualty situations.
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LifeCare Hospitals were left out of evacuation discussions
LifeCare Hospitals, a separate rehab hospital that operated on the seventh floor of the Memorial Medical building, was left out of evacuation discussions. LifeCare provided long-term acute care for severely ill patients, with the goal of improving their health enough to return home or to nursing facilities. Almost all of the 52 patients under LifeCare's watch were bedridden or required electric ventilators to breathe, and they were at significant risk if the hospital lost power.
The seventh floor at Memorial was leased to LifeCare Hospitals of New Orleans. Many of LifeCare's patients at Memorial were especially vulnerable due to the loss of electric power; seven were on ventilators. One patient, Emmett Everett, was alert and awaiting surgery to relieve a chronic bowel obstruction. He had fed himself breakfast and asked the staff, "Are we ready to rock and roll?". One of his nurses later told investigators that he had said, "Cindy, don't let them leave me behind."
According to Sheri Fink, author of the non-fiction book Five Days at Memorial, none of the LifeCare patients were considered in the evacuation discussions happening a few floors down, which led to further issues down the line. Memorial nurses and doctors worked tirelessly to find a way to transport patients from the hospital to the helipad above the parking garage. It was a challenging journey as staff carried patients down flights of stairs and through a small hole that led to the garage, where a pickup truck awaited to transport them to the helipad.
The lack of inclusion of LifeCare Hospitals in the evacuation discussions highlights the challenges and complexities faced during the evacuation of Memorial Hospital during Hurricane Katrina. The vulnerable patients under LifeCare's care were left in a precarious situation, and the subsequent impact on their evacuation and well-being is a critical aspect of the overall story of Memorial Hospital during Katrina.
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Frequently asked questions
Memorial Hospital in New Orleans was severely affected by Hurricane Katrina in 2005. The hospital lost power and running water, and was flooded. With temperatures rising to 100-110°F (37-43°C), sanitation was poor, food was scarce, and toilets were non-functional. Approximately 200-250 patients were stranded, and at least 34 of them died.
In July 2006, Dr. Anna Pou and two nurses, Lori Budo and Cheri Landry, were arrested and accused of the second-degree murder of four patients. They were accused of injecting critically ill patients with a lethal combination of morphine or midazolam, or both. Pou denied the allegations, stating that her intention was to help ease the pain and anxiety of patients. A grand jury refused to indict Dr. Pou on one count of second-degree murder and nine counts of conspiracy to commit second-degree murder, as they couldn't prove that she had "a specific intent to kill".
Yes, there is a non-fiction book called "Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital" by Sheri Fink, which explores the events that took place over five days at Memorial Hospital during Hurricane Katrina. There is also a miniseries adaptation of the book, which aired on Apple TV+.
