LUFKIN, TX (KTRE) - The trial for a former Lufkin DaVita Dialysis nurse began Monday morning in a packed Angelina County courtroom.
Kimberly Clark Saenz, 38, of Pollok, is charged with capital murder and five counts of aggravated assault. The Pollok woman is accused of injecting bleach into the bloodstream of kidney dialysis patients.
The state is pursuing the death penalty against Saenz.
Saenz was arrested in 2008, following a long investigation into five deaths at the DaVita Dialysis Clinic in Lufkin.
Five other patients were also injured.
Investigators believe Saenz injected bleach into at least 10 patients' bloodstream while they were receiving dialysis.
District Judge Barry Bryan began by readdressing rulings made in pre-trial hearings.
Discussion between the defense, the state, and Bryan resulted when Saenz's attorney mentioned he did not receive several reports he requested from documented investigations prior to today.
Without the report, Deaton admitted he wasn't as prepared to begin.
"Part of me says I want to go forward in this case, I want to get started. Part of me wants to know what's on those documents," said Saenz's attorney, Ryan Deaton.
"There's issues regarding expert investigations," said District Attorney Clyde Herrington.
With further discussion regarding what information is relevant and allowed to be presented in the case, Deaton said he wanted to present the fact that the clinic was improperly testing their water.
"Just because they were cited, doesn't mean it was accurate," said Herrington.
Herrington made a motion that the court stay away from presenting this information. Deaton said if the information was not allowed to be addressed, he was then not ready to proceed.
"I want to be able to say in my opening statement if they were improperly testing, which they were, that they were improperly testing," said Deaton.
Herrington further defended that the report may not even be credible.
"Until we determine the relevancy of the report, there's a lot of information on it that's not relevant," said Herrington.
Further discussion over the Texas Department of Health's report on the clinic continued for the first half of the morning. Deaton stated that there was a rise in deaths at the clinic between 2007 and 2008. However, the report did not state how the deaths occurred. Judge Bryan listened to the defense and prosecution state their issues with the information on the report and looked for 'a fair compromise.'
"Talking about the fact that there was an increase in deaths in 2007 and 2008, does anyone have an objection to that?" asked Judge Bryan.
With no objection, the attorneys further discussed what other information would be allowed in the case.
The state said they seek to have family member's testify on information relevant to the case, addressing the victim's conditions prior to receiving treatment.
"It will just be factual information prior to the dates we're discussing?" said Judge Bryan.
The defense argued that the testimony would have to be strictly regarding the prior condition. Defense attorney, Steve Taylor argued that the family members would have to give statements before testifying. Deaton agreed, saying the witnesses could change their testimony after hearing others on the stand.
Attorneys and the defense then had all possible witnesses in the courtroom stand and be identified. Judge Bryan then swore them in under oath. He required the witnesses not to speak to other witnesses or even be in the courtroom before testifying. Witnesses were allowed to hear opening statements. Judge Bryan said he would announce when witnesses are instructed to leave the courtroom.
With no further discussions, the trial was ready to proceed.
"I assume we're at a point to bring the jury in," said Judge Bryan.
The jury of 12 with three alternates was then escorted into the courtroom.
The five males and 10 females were sworn in, and Judge Bryan explained to them and the courtroom rules of interaction during the trial.
Herrington began to read over five instances of murder that they believe Saenz is guilty. Saenz stated she was not guilty of all counts.
Herrington addressed the jury. He began to explain the profession of nursing is among the most respected. He gave background information about the patients who died in 2008 after what appeared they had been given an injection of bleach. The dialysis clinic had two deaths in one day, which Herrington says is not impossible at such a clinic, but very rare. That was their first clue in to such sudden deaths. Herrington explained to the jurors how dialysis works and how the process affects your body.
On one account: April 16, one patient was taken to the hospital, but recovered.
On April 21, another patient was taken to the hospital where they later died.
On April 28, four other patients were taken to the hospital and Saenz was assigned a medication nurse, but she was reassigned, to which Saenz was upset. One patient told a personal caregiver that she saw a Saenz put bleach in the tube.
Supervisor Amy Clinton heard and asked Saenz if she gave any medications and Saenz replied no. Clinton said Saenz seemed frazzled and sent her home. Herrington said bleach was used on a daily basis at the facility, but for purposes unrelated to patients and their bloodstream.
The Centers for Disease Control got involved and contacted a doctor after samples were tested to see whether bleach was injected into these patients' blood and found that there had been bleach injected into their bloodstream.
As Herrington described the time of death of each patient, members of the courtroom began to cry, console others or shake their heads.
After a ten-minute adjournment, Deaton had 30 minutes to explain his and his defendant's stance.
He used the word "puppet master" to describe DaVita, but Herrington objected and Bryan sustained Deaton. He then changed his wording.
He then described his client and how has a 2005 Angelina College degree in nursing, how she is a mother of three kids, and a native of Pollok.
Deaton explained the painful process of dialysis to the jury.
"Twenty-five percent of all dialysis patients die each year," he said.
He explained the importance of purifying water for dialysis, because it can kill patients. They cannot have any chlorine in the water, he said. He alleged that Davita did not purify their water, and that is why five patients were killed and five were injured.
"Five days after Kim is accused of what she's doing, the City of Lufkin did water tests at DaVita, and it came back 15 times the allowable limit that these patients were getting," Deaton said.
In April 2008, people were getting sick, Deaton said. Davita called in big-city monitors at the Lufkin clinic. Employees and patients were on edge, Deaton said.
One year later, Davita has been testing the water the whole time, Deaton said.
Deaton emphasized that Saenz was still learning the process, because she was technically still a new employee.
Deaton explained that there are conflicting stories all over the board, from one patient to another to even nurses giving different stories.
He named off a list of witnesses that he said were around Saenz that day.
He alleged that Davita illegally accessed Saenz's records without authorization and the clinic called higher-ups who obtained evidence and held onto it. Deaton said Davita is at fault for not turning over accurate records. He said the clinic should be held responsible for the deaths of dialysis patients, not Saenz.
"The police in this case ignored so much. They ignored that Davita didn't call police eight hours after this incident. They ignored that Davita hindered the investigation," said Deaton. "Why do you suppose that is?"
He began to name a list of the clients who Saenz actually served as a nurse, and he said Saenz was not even most of their nurse and there are major time discrepancies from her charts to what the prosecution alleges. He said in one case, one nurse said Saenz was the patient's nurse, but later recanted.
"You're gonna have to rely on in the end is signs that Davita is tampering with evidence this whole time," Deaton said as he addressed the jury.
He said Saenz and her husband searched bleach and injections on her computer because she had heard about it at work and was wondering why all of these patients were dying or getting sick. Not because she wanted to poison and kill patients.
The judge then said the opening statements were concluded, and broke for lunch. He instructed jurors to be in the jury room at 1:30 p.m.
Joyce Hall was the first witness. The DaVita patient stated she was a dialysis patient during the time Saenz worked at the clinic.
Herrington asked the patient to describe what her purposes were for visiting the clinic. He then questioned her about some of the practices of the employees, especially regarding sanitization.
"Normally, they washed the machines down for the next patient," said Hall.
Herrington presented Hall with pictures of the clinic, which she identified were pictures of bleach and rooms of the clinic.
He then turned to ask the witness about her relationship with her nurse.
"We just called her Kim," said Hall. "We never called her Ms. Saenz."
Herrington then asked Hall to recall what she remembered from seeing Saenz interact on a day she allegedly filled a needle with bleach.
"Kim was always a very nice person. We laughed and talked. And, she hooked me up. She checked my blood pressure, and it was alright," said Hall.
However, that day, she said Saenz's behavior was different.
"She was just fidgety. She opened the drawer and took out a syringe ... the bleach container, she looked around, and she slid it down to the end of the counter. Then she looked around and slid it to the floor. That made me real puzzled. What was she doing?" said Hall.
The witness said she continued watching Saenz's behavior.
"She stood there in front of it and she looked around, as if to see who was looking. Then she pulled the syringe out and was looking around. I could see her pulling back the syringe, and I was wondering what she was doing. Then, she looked around and put it back up on the nurse's station," said Hall.
Hall testified that the nurses usually log in what they gave the patient. However, when she filled the syringe, Hall said Saenz went back to the nurse's station. She said Saenz kept looking back in a strange manner.
Tearfully, the witness recalled telling another nurse, "Please don't let her touch me."
Deaton then challenged that the witness is blind in one eye and was not wearing her eyeglasses when she was at the clinic.
"My sight in 2008 was by far better than it is today," said Hall.
She recalled that she did not wear glasses at that point in time.
"I did not to use glasses to see. I had reading glasses," said Hall.
Deaton pointed out she told jurors that she stated she did not have glasses. However, she re-stated that she had reading glasses, which she did not consider everyday glasses.
Deaton then had Saenz to stand up and illustrate, on a machine, the position she would be in while administering dialysis treatment. He had the witness to tell him what she could see from where she was on the stand.
Deaton read from the witness' deposition and questioned her about the statements. He pointed out discrepancies between the deposition and her testimony today. Furthermore, he pointed out the witness may not, with her vision, have been able to see the nurse's station that clearly from her treatment chair.
LaFrancis Kelly testified that her husband, Garner Kelly Jr., was in good health on April 16, 2008, when he went to receive his dialysis.
She said she was working out at the gym when her sister came to get her, telling her that something had happened to him.
"Did your husband ever regain consciousness?" Herrington asked.
"No," she said.
Deaton at first clarified that Kelly believed her husband was in good health. He than ran down a list of health issues Garner Kelly suffered from, including a leg amputation, Hepatitis C, gangrene, hypertension and high blood pressure. LaFrancis Kelly confirmed most of the conditions.
"My point is, you say he was in excellent health, but this does not seem to be the picture of health," Deaton said.
LaFrancis Kelly said she could tell no difference with her husband, because doctors and nurses took such good care of him.
Herrington showed a video deposition of Learlene Hamilton.
In the video, Hamilton said she saw Saenz with a pail. She said she saw Saenz pour bleach in the pail, then put it under her desk at her station.
"I thought how unsanitary that was," she said.
She said she saw Saenz fill syringes with bleach, then inject it into the IVs of two patients. She said one patient immediately began having health problems.
"They had to bring out a crash cart for her," Hamilton said.
Scott Tatum, who was Saenz's attorney at the time, began questioning Hamilton about her eyesight. She said she did not have her glasses on at the time.
Hamilton told Tatum the medication makes her sleepy.
"Is it fair to say the medication affects what you're thinking," he asked.
"Yes, it is," she said.
"Can it affect your memory?" he asked.
"Yes," she said.
He pointed out that in a previous interview, Hamilton said she saw Saenz with a bottle of Clorox, but was now saying she saw Saenz with a generic bottle of bleach.
"How many total injections do you think you saw that day?" Tatum asked.
"Four. Two each patient," she said.