Texas Nurse Accused Of Killing Patients With Bleach IVs

LUFKIN (AP) – Paramedics were making so many trips to a dialysis clinic in the East Texas city of Lufkin, a top fire department official wrote an anonymous letter to state health department inspectors pleading for somebody to take a look at the place.

“In the last two weeks, we have transported 16 patients,” the mid-April 2008 note said. “This seems a little abnormal and disturbing to my med crews. Could these calls be investigated by you?”

State medical surveyors within days showed up at the DaVita Dialysis clinic in the Texas Piney Woods community about 125 miles northeast of Houston. By then, EMS had been called as many as 30 times that month, including seven for cardiac problems, and made at least 19 runs. Four people had died. Over the previous 15 months, there had been two calls, according to the Texas Department of Health Services.

On Monday, Kimberly Saenz, a 38-year-old nurse who worked at the clinic, was set to face trial for one count of capital murder that accuses her of killing as many as five patients and five counts of aggravated assault for injuring five others.

With the inspectors present April 28, 2008, two patients undergoing dialysis said they suddenly didn’t feel well and two others reported separately they saw Saenz inject bleach into dialysis tubing used by fellow patients Marva Rhone and Carolyn Risinger.

Saenz, who had worked there for eight months, was sent home, police were summoned and the clinic was shut temporarily amid fears patients were in immediate jeopardy. The next day, Saenz was fired.

A year later, an indictment listed sodium hypochlorite, commonly known as bleach, as her “deadly weapon” that killed the five, including Rhone and Risinger. The disinfectant is a normal cleaning solution used at medical facilities like the dialysis clinic where Saenz worked as a licensed vocational nurse, an entry-level health care position.

If jurors convict the mother of two in the trial expected to last a month, prosecutors have said they’ll seek the death penalty. Jurors also could choose life without parole as punishment.

She has pleaded not guilty and has been free on bail.

A motive was unclear.

“She has no motive to kill anyone,” one of her lawyers, T. Ryan Deaton, has said.

All parties involved in the case were under a gag order from State District Judge Barry Bryan that blocks them from speaking about it outside the courtroom.

“Kimberly Saenz is a good nurse, a compassionate, a caring individual who assisted her patients and was well liked,” Deaton said in a recent court motion.

Saenz herself swore in an affidavit she had no previous felony record.

But Angelina County District Attorney Clyde Herrington, in pretrial court documents, listed about a dozen instances of wrongdoing he planned to present to jurors, including allegations Saenz overused prescription drugs, had substance abuse and drug addiction problems, was fired at least four times from health care jobs, put false information on an employment application and sought a health care job in violation of terms of her bail.

Bryan said last week he understood a plea bargain offer from prosecutors had been withdrawn after Saenz’s lawyers rejected it.

Federal investigators examined blood tubing, IV bags and syringes used by the patients who could spend three days a week tethered for hours to a machine that filters their blood — a job their kidneys can no longer do.

A Food and Drug Administration report found some samples linked to some of the victims tested positive for bleach while others showed bleach “may have been present at one time.”

According to policy at the clinic, bleach was used in various concentrations to clean blood from surfaces, chairs used by patients and internal parts of machinery. Then chemical reactive agents were used to confirm bleach residue had been removed and the cleaned areas were safe.

Deaton has insisted his client is being made a scapegoat for mistakes and policy violations at the clinic. State health department investigators found dozens of “adverse occurrences” like incomplete and undated entries on logs required to document the disinfecting procedures.

He also has questioned findings that bleach was the source of the problems.

“Chest pain and cardiac arrest are not specific for bleach infusion,” he wrote in a motion.

A review of the clinic’s records by an inspector affiliated with the federal Centers for Disease Control and Prevention found Saenz was on duty for 84 percent of the instances where patients suffered chest pain or cardiac arrest. Deaton downplayed the finding, saying one other clinic staffer was there for all of the instances and another for 89 percent.

About three dozen people worked at the dialysis center, which was shut for about two months before reopening.

Joel Sprott, an attorney DaVita Inc., operator of the Lufkin clinic, said the Denver-based company has turned over more than 10,000 pages of records related to the case. Through 2011, DaVita operated or provided services to 1,809 dialysis facilities in the U.S., serving some 142,000 patients and employing more than 41,000 people.

The company said at the time of Saenz’s indictment it looked forward to the justice process “that will hold this individual accountable for her heinous acts.”

Spokesman Vince Hancock, citing the judge’s gag order, would say last week only that DaVita was proud of the care provided daily at its Lufkin clinic and looked forward “to continuing our steadfast commitment to the Lufkin community.”

Of the 300 convicted killers on Texas death row, only nine are women. And although Texas is the nation’s most active state carrying out capital punishment with 479 executions since 1978, only three women have been put death since the Civil War.

(© Copyright 2012 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

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One Comment

  1. Dr. No says:

    Don’t sign your donor card. Avoid doctors and hospitals.


    1. RT says:

      Dr No,

      I followed your link and read about your dad. He was obviously very smart, but his training in biochemistry certainly didn’t lead him away from mainstream medicine. What is your take on his career path?

      1. RT says:

        I’m actually responding to Dr. Deaux’s post. The article was co-authored by Dr. No’s father. His position at the end of the authors indicates it came from his lab, I’m not sure what his purpose is in citing these articles, however.

      2. John Deaux says:

        @RT,,, While the study may very well have been performed by his father, (I can’t disprove that), his propensity to use that specific website to copy and paste from puts his credibility in the toilet. His use of the copy and pasted text is used in a manner that attempts to elevate his intellect and simultaneously discredit another poster.
        I still call “poser”.

    2. mike says:

      This is ridiculous, stupid, and irresponsible. Donors save many lives.

      1. Texas Mom says:

        Doctors save lives also; it’s the floor care that usually kills East Texans in those “horsepittles” – beware! One good RN can’t handle the whole floor; she’s buried in federally required paperwork. That leaves floor care in the hands of a high percentage of parolees, illiterates and jive talkin’ hostile folks who have the power of life and death for once in their lives. Be afraid. Be very afraid. It will only get worse after Obamacare in 2014 when the good ones quit and more parolees are trained.

    3. I'm just a nurse says:

      Dr. No I’d since you request the information from others testing their knowledge of complex medical phrases that you copy and paste from Google or Bing I’d like to make a request, in kind, of you.

      Dialysis membranes are available in a number of thicknesses and pore sizes. Thicker membranes are tougher, but restrict solute flow and reach equilibrium more slowly. Pore size is defined by “molecular weight cut-off” (MWCO) i.e., the size of the smallest particle that cannot penetrate the membrane. Knowledge of the precise MWCO is usually not required; however, it is necessary only to use a membrane with a pore size that is much smaller than the macromolecule of interest. For most plasmid and protein dialyses, a MWCO of 12,000 to 14,000 is appropriate, whereas a MWCO of 3500, 2000, or even 1000 is appropriate for peptides. Most dialysis membranes are made of derivatives of cellulose. They come in a wide variety of MWCO values, ranging from 500 to 500,000.

      My question is this. Given the regularity of “norms” being 1000-3500 as cited. Why is it accepted, and consequently what would be contraindicated given a MWCO value of 400,000+ ?

      Thank you for your timely response.

  2. J Smith says:

    I am a nurse, and I am horrified by this situation. If she did indeed kill patients, she is clearly a sociaopathi of the worst kind.

    Avoid hospitals unless you need them (preventative health care, active lifestyle, and a healthy diet is MUCH better than trying to fix problems after the fact.

    However, please do not hesitate to sign an organ donor card if you want to donate after your death. It is the kindest gift you can give another preson, and it has NO IMPACT on the quality of care you recieve. The healthcare providers who care for a person’s body after his or her death (by natural causes) are completely different people. There is absolutely no conflict of interest, and the precedures involved are conducted with utmost respect, and ONLY with the permission of the deceased person’s family.

    I am an organ donor, becuse it is a way that my death can result in a great good for another human being.

    1. Dr. No says:

      When they put the DNR on you whilst you’re still viable you’re done …. you don’t get a second chance.

      1. kmrod says:

        more stupidity from someone whose only credential is “my dad is smart”

      2. Dr. No says:

        I guess you can explain to me Mechanism and control of platelet-platelet interactions* 1:: II. Action of thrombin on membrane-associated and purified platelet and rabbit skeletal muscle myosins.

      3. Dr. No says:

        @kmrod … still waiting for anything of substance from you. But I know being a mental deficient, low grade moron is you banner and always will be.

      4. Vicky Bevis says:

        And you know this HOW???????????? I’ve put them on patient’s charts & the vast majority of them recovered/left the hospital ALIVE!

      5. kmrod says:

        he knows this because, as he stated earlier, his father is smart and he knows words like “monophosphate-dependent protein kinase”.


      6. RT says:

        The ‘they’ who put the DNR order on you is the patient, or someone the patient has designated in a limited power of attorney for medical decisions.

      7. DDR says:

        Dr. No gets the “I’ll Pretend to Be a Medical Expert Since My Daddy Was, But I’m Really A Pseudo-intellectual Underachiever Who Lives In My Daddy’s Shadow” Award.

      8. DDR says:

        Isn’t Google a great tool to make you look smart – even for polished turds like Dr. No?

      9. DDR says:

        To our new paranoid schizophrenic poster known as Dr. No: How about YOU explain all that, since we are just simple laypersons? Well? We’ll be waiting for your New England Journal of Medicine level reply.

      10. LOL @ YOU says:

        “But I know being a mental deficient, low grade moron is you banner.”

        YOU banner? LOL. Intelligence FAIL.

    2. health care and justice says:

      i’m with you on this one…i’m a nurse as well and i wouldn’t ever imagine such a thing going on around me let alone doing it!! this is such a terrible tragedy and if she did this then she should pay for the crime…

      it does scare you when your a donor due to all of the stories and things you hear but i am a donor and i hope that once i pass that i can help another person live a good life…i think everyone should think that way because imagine yourself laying there begging for this help? i would want to give the favor back and i plan on that, i don’t think my family agrees but that is what i want once my life is over…on top of that just because i seen that someone was a donor doesn’t mean i would give them less care so the organs could be donated or whatever the scary reasons are out there…we’re a part of the health care system and we have a choice too 🙂

    3. nurse cratchet says:

      I work with kidney patient’s day in and day out. It is the speciality my clinic performs. It sickens me that someone could take advantage of a person who is completely reliant and trusting on the dialysis nurse, literally with their lives. Please be advised however, that most of us in the medical field genuinely care for our patients, and it’s not about the money, it can’t be, especially with dialysis patient’s as all patient’s who have been on dialysis for more than 3 months automatically qualify for medicare and we all know medicare does not pay much compared to other private sector insurances. So for those of you who think the docs are crooked or the profession is crooked, you may want to get to know your doc a little better. We are not here for the money we are here because we care about our fellow humans. I am an organ donor and a blood donor. Hopefully you crackpots won’t need any of these in the future.

  3. Jim says:

    Expensive medical care is a problem. It won’t be long before the government itself is administering bleach into the IV’s of people who are “too old”, have otherwise outlived their usefulness to society or have crossed some arbitrary cost threshold.

    1. CDW says:

      Unfortunately, you are correct and it already has. Obama’s HHS recently advised a group of expensive specialists (neurosurgeons) that they are not to treat anyone over age 70 without obtaining approval through their panel review process. Instead, they are told to give the patient “comfort care”. This will certainly impact emergency treatment of the elderly. I anticipate that, eventuallly, Obama’s “free” birth control will become “mandatory” birth control.

      1. CARN says:

        You are wrong. I have been a nurse for over 30 years. Please read the economics of the ridiculous American health care system. Statistics show that the average person spends more on health care in the last six months of life than they have in their entire previous lifetime. We are unable to accept the inevitable and would rather see loved ones in pain, hooked up to IV’s and machines than to provide a comforting end. Our morbidity/mortality statistics rank us with third world countries. You are spouting rhetoric on a subject you obviously know nothing about.

      2. Vicky Bevis says:

        Horse Pucky. Read the bill. There is no review panel,. Rarely have I heard such “made-up” tripe! The bill does what we ALL should be doing; making people discuss “end-of-life-issues,” which, as a retierd nurse, I can tell you that people are loath to address. But there currently are no “panels” to end care over the age of 70. My 92 yr. old mother-in-law gets all the care her excellent insurance plus Medicare can buy for her.

  4. kmrod says:

    Isn’t Dr. No a fictional character? You sure sound like it.

    1. Vicky Bevis says:

      Yes! Mad doctor in a James Bond novel.

      1. Shelly says:

        I think it’s a reference to Ron Paul, that’s his nickname in the Congress because he votes no on anything unconstitutional.

  5. tnmccoy says:

    “No previous felony”? Umpteen deaths? Why on Earth is she free on bail? Two little kids do not a bail make. She should be locked up, the kids should be taken care of by Family Services. If convicted, stick it to her. Her behavior is an abomination. Kidney disease people are non-entities? The judge doesn’t think their deaths at the hand of the accused deserves incarceration?

  6. Scott says:

    Having been the recipient of an organ that saved my life, I agree100% with J Smith above. It was a wonderful gift of life, and I know of another person who donated his organs after being killed in a freak accident at 17 years of age.
    He saved 4 people’s lives with 5 of his healthy organs, two of them going to one person, who is very grateful that he signed his donor card.

    The ironic thing would be if Dr. No ever needs an organ transplant, and can’t get one because someone listened to him.

    1. nurse cratchet says:

      Yeah, that would be justice though.

  7. TIED TO A MACHINE says:

    I am a patient in one of their units in (STATE OMITTED FOR FEAR OF REVENGE) I see neglect all the time they hang around some people and avoid others.they wipe chairs,televisions. etc with bleach.the televisions at times look like they were dipped in mud.they quickly cover each others mistakes.if you say anything they get you in a room and double or triple team you so they can eliminate any threat. of reprisal. p.s please don’t give out my email as you do not have permission to do so.

  8. JustAGuy says:

    Maybe she’s auditioning for ObamaCare’s medical board of ethics.

    1. Death Panels are the GOP's boogeyman. Scary and nonexistent. says:

      Uninformed and angry guy is uniformed and angry. I suppose it is more ethical to only allow the wealthy to see a quality doctor. Remember, this happened with healthcare AS IT IS NOW, not how it will be when everyone has medical access.

  9. peteo says:

    Which political party would you guess she is a member of?

  10. Valentina says:

    For the people saying that Obamacare and single payer systems will fix messes like they, they just don’t have a single clue. Look at all of the mess that goes on in England and Canada, France and large populated socialist medicine countries. They are not allowed to sue for malpractice, because the doctors/nurses are basically government employees in those countries. You get what you pay for — and if you don’t pay, guess what kind of care you are going to get??

    This was probabl very busy dialysis center, and the staff were overworked all the time. I think the nurse may have been made a scapegoat for others who did the same thing.. She may have had a bad history of drug use, but she would have had to go through the board of nursing TPAPN program before she could have worked again.

    I wonder about the employees who say they “saw” her put bleach into an IV line. Why didn’t they stop her? Isn’t there some sort of neglance or accomplace charge if they did nothing about what they say they saw? I wonder also, if these syringes were premixed by someone else and left for everyone to use to clean the machines and or used for flushes of these IV dialysis ports? Now if the people in charge of the company allowed syringes that were premixed to be used for flushes and may have accidently been placed in the same bin as the flushes of normal saline, then there is colpability on the part of the dialysis center also, and or the management who knew about it. Where was the RN in charge?

    The LVN always has to have an RN as a charge nurse in situations like this as well. I’m sure we are only getting part of the story because of the gag order, but we will find out with the trial ongoing. I feel if the nurse was guilty she may have gone for a plea deal, but her lawyers know the whole story, so they must feel they can prove her innocence.

  11. Mike V says:

    My late wife was on dialysis for 17 years. Procedures are usually performed in front of the patient. A good nurse shows the patient what is being injected and is generally drawn on the spot from its respective container. Something doesn’t pass the smell test with this one. If someone else was preparing these injections of bleach, shame on the nurse for accepting the accuracy of the content. One would think when she bled the air from the syringe, her nose would have alerted her to the content, if she was paying attention.

    1. Vicky Bevis says:

      Mike: We were taught in nursing school NEVER to accept or dispense ANY meds. not of our own making. So that nurse, IF that’s what she did, is guilty as sin of NOT performing her proper duties!

  12. F.N. says:

    Why is an LVN working with dialysis patients and why is an LVN injecting ANYTHING into an IV. Watering down of the nursing profession, I.E Bona Fide nurses, i.e,, Registered Nurses, has come about by regulators and Nursing Boards allowing minimally trained people to do Registered Nurse skillls and duties. These LVN have the very basis basic basic training and the very minimal knowledge that would NOT allow these minimally trained and minimally educated people to work with complex patients and their many complex needs. BUT the healthcare companies and orgainizations demand it and the regulators and Nursing Boards allow it. Yep, I see nothing, hear nothing and do nothing.

    1. Jean Boudriot says:

      F.N. – the training of LVNs and RNs in the state of Texas by the better schools in Texas is of a high quality and turn out excellent nurses. while all graduates of nursing schools are not of an equal quality, your statement has no basis in fact. It will often depend on the individual nurse’s abilities and dedication to patient well-being that determines the quality of care a patient receives – not necessarily if they are licensed as a LVN or RN. Besides, as a licensed LVN working on my RN BSN, I would gladly compare my training and level of education to yours any day of the week.

    2. Vicky Bevis says:

      What you don’t know about nursing could fill a book. Much depends on the quality of the school. And remember: Someone has to graduate at the BOTTOM of their nursing school class. The school I went to had a 100% rate on the State Boards the 1st. time & also was in the top 5 school rankings in the State.

      I know some LPN’s I’d much rather have taking care of me than some with a B.S.N.

  13. Young Jeezy says:

    Why the F is she out on bail? Thats ridiculous! God I hate the Texas justice system. If she has half a brain she will be out of the country asap. She could easily sneak into Mexico and disappear from there. How could a possible death penalty case even have the option for parole. How much was parole as well? This whole story sounds just plain odd. Two people saw her actually injuect the bleach and did nothing right then like beat her to ground beef. Then she is suspected of killing people and she is sent home for the day then subsequently fired? Very odd story but it was not written very well which did not help.

  14. Big Davve says:

    Did anyone else find this part of the story just a bit odd:

    With the inspectors present April 28, 2008, two patients undergoing dialysis said they suddenly didn’t feel well and two others reported separately they saw Saenz inject bleach into dialysis tubing used by fellow patients Marva Rhone and Carolyn Risinger.

    They SAW her inject bleach into the tubing of two other patients (who the story points out were among the five who DIED!) and they didn’t say a thing until days or weeks later when the inspectors were there??!!! That makes NO sense! If you are a patient of a clinic like this and you see a nurse inject BLEACH into another patient, who then DIES, what the heck are you going to do, just sit there and wait for her to give YOU a bleach injection? Reading that part threw this whole story into question for me, maybe her lawyer is right after all, but I’m not going to rush to a judgement either way here!

  15. dallas grozny says:

    sounds like she was trying to clean their kidneys. some patients are so ungrateful.

  16. heb says:

    …”“Kimberly Saenz is a good nurse, a compassionate, a caring individual who assisted her patients and was well liked,” “…

    Riiight!!! and you’d want this person working on you? Sure you would. Capitol murder with the death penalty, no life sentence. The people shuoldn’t have to keep this animal alive.

  17. EMT-P says:

    Did she actually do this or is she a scapegoat? I remember hauling patients out of another dialysis clinic on a regular basis as well. They were pulling the fluid off too fast, which caused electrical problems with the heart along with making the patient hypotensive. Then I remember another clinic being shut down because they were caught reusing the tubing and filters. They cleaned and disinfected with bleach as well, would be very easy to leave bleach residue behind. Either way, I hope the truth comes out and those responsible are punished.

  18. Just sayin' says:

    I am a dialysis nurse, and I have several problems with this story (and some of the comments). First of all, how would other patients know what was being injected into someone else’s lines? I’m not defending this person, but I give hundreds of injections a week, and 99% of the time the patient doesn’t know, care, or want to be bothered with what medicines you are giving them, much less what you are giving their neighbor. 75% of the medicines we give are a clear-yellowy color, so color wouldn’t be a tip off. These chairs are a good 3 feet apart or more, so the smell of bleach wouldn’t tip them off, as it would be too far away, plus we use bleach to clean everything anyway, so everything smells like bleach. Bleach must be used to clean things to halt the spread of diseases like Hepatitis C or MRSA between patients using the same chair/machine/TV.

    Now, if these patients were having heart issues, someone may want to look into their potassium levels at the time of their attack. If bleach was distilled into their lines, patients would have noticed a distinct burning sensation at the needle site, this may not be true of patients with dialysis catheters, though. Another thing to consider is if the clinic uses reuse dialyzers. Reuse dialyzers can be cleaned, disinfected, and reused as many as 100 times, depending on the patients clotting. These are cleaned and disinfected with chemicals between each use. The upside to this is the patient is less likely to have a severe allergic reaction to the dialyzer. The downside is if it is not cleaned properly there may be residue inside the dialyzer that enters the patient’s bloodstream. The insides of the machines are also disinfected weekly with bleach. If they are not clear of bleach before their next use, bleach could enter the patient. Another way bleach could get into the patient is if the water filtration system is not working properly. Tap water has bleach in it, but it is not harmful to drink. Dialysis centers have expensive, high-tech filtration systems that remove bleach and other particles from the tap water to ready it for dialysis. If these filters were not changed out when needed, or there was some other breakdown in the system, the bleach may not have gotten removed and enough could have escaped to do harm.

    Granted, facilities are supposed to check the water filtration system for bleach breakthrough three times a day. They are also supposed to check machines for bleach after disinfecting, once at the end of the day after disinfecting, and once again the next morning before a patient uses the machine. Reuse dialyzers are also supposed to be tested by two separate employees to check for disinfecting residue before a patient uses that dialyzer. But really, with all these things that could have very well caused a reaction in patients, can someone be sure that one LVN is the sole person responsible?

    I do not know this person. I do not work for this company, but I do know that if it turned out to be another one of these causes, it would not be a LVN who would catch the blame. It would be 1) the RN on duty for not checking to make sure bleach checks were being made, 2) the clinical manager for not ensuring protocol was being followed, 3) the biotech personnel for not changing filters 4) the dialysis tech for not doing bleach checks, the list goes on and on. If you have this many people with their necks on the line, easy to see how they could shift the blame and back each other up.

    1. Jean Boudriot says:

      Excellent comment just sayin’!!

  19. Raoul D says:

    Classic case of Munchausen Syndrome by Proxy. Harming others for emotional fulfillment. Just like Deborah Spiva in Texas all those years ago. Usually female, usually in the medical field and always cited by their peers as great humanitarians.

  20. The Judge says:

    If they find her guilty and sentence her to death by lethal injection, then what substance should they use to ……..

  21. Bob says:

    Obamacare in action, yet another violation of our rights. The gov’t constantly violates our rights.
    They violate the 1st Amendment by caging protesters and banning books like “America Deceived II”.
    They violate the 4th and 5th Amendment by allowing TSA to grope you.
    They violate the entire Constitution by starting undeclared wars.
    Impeach Obama, support Ron Paul.
    Last link of “America Deceived II” before it is completely banned:

  22. theJackal says:

    You’ve got to love these liberal weenies, she’s a good nurse, blah, blah, blah….. Shes only killed white people, she should be charged with a hate crime and deported with her filthy maggot children.

  23. Steve says:

    She was under orders from Bush/Cheney.

  24. Steve says:

    If she only killed white people, what’s the problem?

    1. desert says:

      what goes around comes around idiot!

  25. alan says:

    Leave the woman alone. She was just trying to save Obamacare some money.

  26. seanoairborne says:

    Just like Yates and Anthony this creature is going to get life in prison mark my words.Which just goes to prove that our justice system really sucks.If any of those crows were men they’d have already fried!

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