Terrifying Code Blue Affair

Poetry

Title of the toxic riddle: *The Code Blue Affair* terrifying; Seven victims, ladies & gentlemen, were war veterans, Who protected the country during war & peace, as military patrons;

They were vulnerable, severely due to their physical or mental illness, but still reverent; And some had no family, well-wishers or kids to complain, to bother the legal hassles & rift;

And because of that ladies & gentlemen, they were perfect victims, in her duty shift;

She used the perfect poison, to avoid the allegation of intentional killing one by one, in swift; Toxic Detectives determined that these were not mercy killing for euthanasia, for spendthrift;

Although the serial murderer was a Christian, but she never went to church for confession & shrift;

To avoid eyewitnesses of her brutal crimes, she would plan to do homicide on specific moments during night shift, When she used to be all alone with her patient on bedside, to give them lethal shot of undesirable gift;

She would inject the fatal drug into one of her patient, without any medical indication in drift;

Every Hospital has the JCI protocol to rescue by best; So she would call the team of doctors & security by dialling “code Blue”, So that she would meet up with a security guard, with whom, she had affair, to hug, kiss & glue;

Poetry

When her patient went into cardiac arrest; to prevent them dying, by cyanosis, turning cold & blue, Bright snapshot of her life belied a dark negative & cursed; She was a serial killer, who preyed on weakest victims, those she nursed;

Although she was pretty, intelligent & well-liked by her patients; But rather than care for her patients, she decided to kill by emplacements; Convicted on four counts of kill & got fired from her job of nursing displacements;

Because of a home life fraught with difficulties- she and her husband has fought, He had filed for divorce, and even taken out a restraining order against her, thought; Kimberly’s unrestrained and misdirected anger was taken out on her patients, brought; And this was just the latest in a long list of healthcare jobs that she had held, in fraught;

After a spate of firings for various misdemeanours, distraught; Even though she worked many times in a dialysis center, in slot; Where there is normally little to cause complications and death, or not;

The number of patients dying on her duty alerted and disturbed other hospital staff; Although other nurses noticed a high number of deaths on watch, they passed it off and jokingly called her the “Angel of Death” Untaught; Hospital manager reported their concern about an increase in cardiac arrest deaths, unthought;

And a decrease in the stocks of an essential drug, which was actually misused for chemical assault; Serial killer telephoned in hospital, for a bomb threat, to attempt, to derail investigation, on her plot; She was immediately arrested for fake public threat, kept in prison for a bomb threat, as first blot; And then the serial killing interrogation by police went through, as hospital authorities sought;

Prosecutors argued that killer used to inject patient a heart stimulant & demonstrate her skills to rescue, to impress her boyfriend, on duty guard, a lot; Postmortem showed excessively high levels of the essential drug used as fatal weapon, also used as rescue drug in code blue; Since the same drug was administered during resuscitation for dying victims, so killer couldn’t’t be sued;

On absence of any eye witness evidence, her lawyer said was nothing more than circumstantial; Defence argued that patient’s deaths were due to natural causes, with so many co-morbidities substantial; The jury decided that murders were especially cruel, heinous, condemnable and irrational;

Her crimes were committed on federal property and thus subject to the death penalty, of damsel; Since Jurors were not unanimous, the sentence defaulted to life in prison; as evidence not ample;

Was spared the death penalty, when federal jury decided to cancel; She should spend rest of her life in prison, for nurses, as warning example; Now guess the *dangerous medication* & real- life-case discussed, influential;

Hint 1

As doctors and nurse, we have the licence of life saving skill; Not the universal and unanimous licence to kill; Killer missed the moment to make in Criminal History; Of getting capital punishment, first lady, to be hanged first in 21st century;

Hint 2

Hint in rhyme to guess right in 2nd session; The toxicologist’s metaphor to mention; Saviour Nurse becomes the serial killer like demon; By misusing a Life-saving medication as the killing weapon; Which is naturally secreted during stress & tension?

Answer

• Classification: Serial killer

• Characteristics: Nurse - Prosecutors had argued that she wanted to attract attention, especially from her lover, a hospital security guard [1]
• Number of victims dead: 4 +2
• Date of murders: 1995 – 1996 [2]
• Date of arrest: July 11, 1996 [2]
• Date of birth: November 13, 1967[2]
• Victims profile: Stanley Jagodowski, 66 / Henry Hudon, 35 / Kenneth Cutting, 41 / Edward Skwira, 69 (hospitalized veterans) [2]
• Method of murder: Poisoning (injecting them with overdoses of epinephrine) [2]
• Location: Northampton, Hampshire County, Massachusetts, USA [2]
• Status: Sentenced to four consecutive life terms without the possibility of parole, plus 20 years on March 27, 2001[3]

Case Facts

American serial killer who was convicted for three first-degree murders, one second-degree murder, and two attempted murders of patients admitted for care at the Veterans Affairs Medical Center (VAMC) in Northampton, Massachusetts. She killed her patients by injecting them with epinephrine, causing them to simulate heart attacks. Autopsy results showed the three men died as a result of epinephrine poisoning, not heart attacks as originally thought [4].

Judgement in Brief

The defendant allegedly murdered four particularly vulnerable patients and tried to kill three other patients while they lay in their hospital beds. She did so using her position of trust and her specialized knowledge as a nurse. Calling her actions “heinous and depraved,” federal prosecutors announced a fourth murder charge against a former veterans hospital nurse and said they would seek the death penalty [5].

Adrenaline (aka Epinephrine)

• Facts: Sympathomimetic Toxidrome
• Fatal dose: 3-4mg IV bolus, virtually non-toxic when ingested [6].
• Immediate Toxic signs & symptoms: Cyanosis, Mydriasis, pallor, chest pain, hypertension, Palpitations, paraesthesia. Pulmonary oedema may develop within 20 min of acute overdose, leads to ventricular fibrillation, Cardiac arrest & sudden Death [6].
• Diagnosis: ECG-premature ventricular complexes & bigeminy, may show signs of myocardial ischemia or frank myocardial infarction due to vasospasm, even in patients of normal coronaries [6]
• Treatment: Cardiopulmonary resuscitation & announcing Code Blue [7] for getting defibrillator immediately & DC Shock for correcting shockable rhythm of ventricular fibrillation. Nitro-glycerine, Nifedipine or labetalol can antagonise and control accelerated hypertension & vasoconstriction [8].
• Postmortem Findings: No typical gross pathological changes found. But effects of injected adrenaline on the histological appearance of the myocardium are well recorded, cause widespread histological damage to the myocardium, consisting of coagulation necrosis and contraction bands, which can be confused with infarction or electrocution [9].

Analytical Toxicology

For quantitative assay of blood can be helpful to corroborate the history, clinical findings, ECG changes, histological changes as adrenaline toxicity [10].