LUFKIN, TX (KTRE) - Day Two of the capital murder trial against a former Lufkin nurse began with a witness describing how she saw Kimberly Saenz using two buckets of bleach.
Learlene Hamilton said in the video deposition that she is a dialysis patient and is currently receiving treatment.
"Right now? I don't feel good," said Hamilton.
Hamilton said she may have trouble remembering things right now.
"I'm weak," said Hamilton.
Kimberly Clark Saenz, 38, of Pollok, is charged with capital murder and five counts of aggravated assault. She 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.
During her testimony, Hamilton said she needed glasses. At the time she was questioned, she did not have her glasses, which were necessary for her to read documents she signed and view pictures of the Lufkin DaVita clinic.
The witness then continued on to describe how she recalled the nurse she called, "Kimberly."
"When I first met her, she was so great," said Hamilton.
Hamilton described the last time she saw Saenz at the clinic.
"The day when they were, when she left," said Hamilton. "The day she left the building."
Hamilton said she went to the clinic that morning for treatment.
"She was putting some Clorox bleach, she was putting some bleach, in my water," said Hamilton. "In my water and in patients' water."
Hamilton said Saenz had two buckets she was using, filled with bleach. Hamilton said the buckets smelled of bleach. She said that she wasn't very far from the buckets to pick up on the scent.
"I know it was Clorox. And, she filled it up with Clorox bleach," said Hamilton. "They was strong."
Hamilton said one of the buckets was being used to clean. Hamilton said Saenz had two syringes she filled up at the nurses' station from the other bucket.
Because of Hamilton's condition, the testimony was stopped until a later time.
Tuesday's viewing came a day after the prosecution showed a later deposition from the same witness. In that video, then-Saenz attorney John Tatum pointed out inconsistencies between this statement and her latest statement.
Herrington then presented ambulance transport sheets to the court. Herrington also presented reports and patients' dialysis records to the court. Judge Barry Bryan granted that all documents could be used.
The state then called upon Adrianne Rodriguez as the next witness. She was a medical assistant at Nacogdoches Health District. She was later hired to work for DaVita in 2002 as a dialysis technician.
"Basically, we get the machines ready," said Rodriguez.
Rodriguez explained the extensive training she received in order to work at the clinic. She also said she got to work each morning about 90 minutes before patients arrived each morning.
Herrington began to have her read statements to see if they were correct. They were statements she had said at the time of questioning, but Deaton tried many times to object. In the end, Herrington was allowed to read the comments and the witness simply agreed to it or not agreed to it as far as if the statement was correct. He had her look at the copy of the transcript several times, asking her about several statements. The woman, many times, said she remembered making a certain statement.
After solidifying the substantial attribution in the transcript, the prosecution rested.
Deaton approached the witness with a display that he faced toward the jury. He was asking about where her patients were located in the clinic.
"Did you notice when Mrs. Risenger got sick?" asked Deaton. He then added that would've been documented in the transcript.
Deaton tried to differentiate between "feeling bad" and "feeling weak" and "flopping around" that the witness said happened to Carolyn Risinger. Deaton referred back to Marva Rhone, who at 8:38 a.m. was said to have been resting comfortably and that it wasn't until 9:04 a.m. in which Rhone started feeling bad.
"So there's quite a bit of difference between what happened with Mrs. Risinger, and what happened to Mrs. Rhone, right?" asked Deaton.
He observed that both women felt bad at different times.
The witness said she remembered taking a break between 7:30 a.m. and 8 a.m., but she changed that later to 8 a.m. to 8:30 a.m., Deaton said. Deaton said in her statement she said she didn't like taking breaks.
"On July 1, 2008, 36 minute mark of your interview you said, 'I don't like taking breaks. I'm not one to take breaks,'" Deaton said.
He then began to show her parts of the transcript and interview, but had it arranged differently than Herrington did. Deaton said he had it arranged by time, where Herrington had it listed by page numbers. There was a lull in the courtroom for a moment. He reiterated to the witness, about taking breaks, to which she replied that she only took her first morning break.
"When you weren't on break, did you watch your patients closely?," asked Deaton.
She said she did.
When Risinger started to have an episode, the witness said she hadn't taken a break yet. She was tending to another patient, Rhone, very closely.
Deaton then asked about Tammy Grant, another nurse, and whether she watched her patients closely, to which Rodriguez replied she did.
Deaton made note that Saenz wasn't charted at all during these two episodes, but that other nurses were there watching patients at the time of the episodes.
Deaton kept stressing that the time of the break according to the witness doesn't add up, based on the times she was present for charting. Rodriguez ultimately said she wasn't sure when she took her break, but it wasn't before 8 a.m.
Deaton adamantly told the witness that there was no 30-minute time frame where she could've taken a break based on the times she charted her patients, but that if she was watching her patients so closely, like she said she did, she would've noticed someone else giving care to her patients.
The controversy in the courtroom focused in on this particular break that the witness said she took, and how it conflicts with and doesn't deal with Saenz's charts. Herrington then asked the witness that if someone put something in the bloodline, and three minutes later snap the bloodstream, it's plausible that whatever the person put in that bloodstream could start affecting that person rapidly, to which Rodriguez said it could.
Deaton then said that based on her records, it was showing that she charted patients at the time she said, back in 2008, that she took a break.
Deaton asked her if it was possible that she took her break between 7:30 a.m. and 8 a.m., and the witness said that it was possible, but that it had been four years ago, and specifics of the case were unclear at this point. She said she remembered things better in 2008 than she does now.
She said she didn't know what the monitors were doing for second and third shift, and Deaton asked her a question that she said she couldn't honestly answer because she didn't know.
"You were talking about how when you test the reuse bloodlines, you have to have a buddy for verification, was it possible that someone ever not have a buddy?" asked Deaton.
"No. We had to always," Rodriguez said.
The attorneys went back and forth just asking questions to the witness, from her breaks to proper labeling of containers at DaVita.
After a brief lunch recess, Rodriguez took the stand again.
Deaton questioned the witness about what she would be able to see from her line of vision while working on a dialysis machine. The dialysis machine the defense used yesterday to have Saenz demonstrate on was brought back into the courtroom.
Rodriguez said she was employed at DaVita until December 2010.
The witness recalled she had an interview with a police officer in 2008. Deaton asked if she remembered a statement on a police report.
After stating she did not, the witness was released from the stand.
The state then called upon the next witness. Arlene Gamble said she is a dialysis nurse who also trains dialysis nurses.
She discussed what type of certification nurses need. She also explained how dialysis clinics function and what the purpose of dialysis is.
"Dialysis is a procedure that is used to clear the blood of excess waste product and fluid when the kidneys are not able to do that themselves," said the witness.
The witness then continued to explained how the needles are put into patients and how the fluid injected into the needles works to flush a patient's system.
The state asked the witness questions regarding how catheters and other medical devices worked in dialysis processes.
The witness was then asked about the positions of nurse and technicians at a dialysis clinic. Nurses are licensed and allowed to do procedures without delegation. She explained the role of a technician is somewhat different.
"They are not able to do certain procedures without being delegated by a medical director. They do not have a license. So, they are not able to do procedures without delegation," said the nurse.
She also explained that dialysis technicians arrive at work an hour and a half to two hours before nurses to check water, make disinfectant solutions, set-up, and start machines before the clinic opens. The witness stated that while most medicines are clear at the clinic, they are always placed in proper containers. That way they can have the appropriate concentrations of each medicine. She urged that products, such as bleach, are never placed into syringes.
"Syringes are used for medication and they should not be used for solution that could be harmful to a patient," Gamble said.
Gamble spent several minutes explaining how a dialysis machine, using a machine in the courtroom. Gamble explained how there was no reason to introduce anything in one of the lines.
Gamble said she was brought into the Davita clinic on April 28, 2008, after the clinic had experienced a high amount of codes, which is the term for patients going into respiratory arrest.
Gamble said she heard two of the patients talking excitedly about what they had seen.
In cross-examination, Gamble explained that it was important that chlorine not be in the dialysis water, even though the water does not mix with the blood.
Deaton showed Gamble a sheet of chlorine test results and asked her to read it to the jury.
"I can't answer that because I don't know what kind of testing strip they use," Gamble said.
After Deaton objected, Bryan instructed Gamble to read the result.
Gamble said the result of a chlorine result showed the content to be 1.5 chlorine, higher than the .1 that is an acceptable amount of chlorine for dialysis water.
"Is 1.5 15 times higher than the allowable .1?" Deaton asked.
Gamble refused to answer that question, saying she could not speak to the authenticity of the test result.
"You're not going to answer my questions. You answered every one of their questions, didn't you?" Deaton asked, visibly frustrated and pointing at the prosecution desk.
"Yes I did," she said.
"But you won't answer mine," Deaton said. "You work for Davita right?"
"Yes," Gamble said.
"And you're 100 percent behind Davita, aren't you?" Deaton asked.
Gamble sat in silence until Bryan instructed her to answer.
"I work for DaVita," she said.
After further questioning, Gamble confirmed that bleach is used around the clinic for cleaning.
Deaton asked her if she was brought to the Lufkin clinic because 35 patients had recently been hospitalized.
"I don't know the exact amount," Gamble said.