Alleged DaVita nurse victims take stand

LUFKIN, TX (KTRE) - The third day of the trial of a former Lufkin nurse's capital murder trial began with one of the victims taking the stand.

Marie Bradley said she became a dialysis patient in May 2007, following heart problems and kidney problems diagnosed in 2007. She's currently a dialysis patient.

She said she started treatment at DaVita in May of 2007.

Bradley said she drove herself to her dialysis treatments. Bradley said she was taken to the hospital after dialysis treatment administered on April 23, 2008. Her relatives had to come pick up her car from the DaVita clinic.

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.

"Do you remember telling Officer Shirley at the time that you never slept through your treatments?" asked Saenz's attorney, Ryan Deaton.

"Yes," said Bradley.

"And that you always asked the nurse what she was giving you?" asked Deaton.

"Yes," said Bradley.

"I don't remember Kim doing anything for me prior to the day I can't remember," said Bradley.

Bradley told an officer in June 2008 that she did not remember seeing Kim do anything to her on April 23. She never said she remembered some things that happened on that day, however.

Deaton questioned Bradley as to why she refused to talk to him or his investigator prior to the trial when he came by her house. She said she did not want to talk about the incident and wanted everything to go away.

"I don't remember giving a witness statement," said Bradley.

The defense then turned to ask the witness questions about her going out of town for treatment following her hospitalization after the incident at DaVita.

"Did you feel better going to Henderson for dialysis?" asked Deaton.

"Considering what had happened to me on the 23rd, yes," said Bradley.

The witness discussed writing for nearly two years about her experience at DaVita on April 23 and other dialysis treatments. She was required to turn that written notation over to police during the investigation.

"You know if someone or something tries to kill you, you have to relieve yourself somehow. I did that by typing," said Bradley.

In the note, she mentioned that she didn't think DaVita knew how to properly set up the machinery.

"Well if I left there on a stretcher unconscious, something happened," she said.

In the note, she recalled her concern of the practices at DaVita, compared to the treatment she received in Henderson.

"When I was at DaVita, I felt like my life had ended when I was on dialysis," said Bradley.

Bradley said she never formally issued a police report. She said when the Department of Health and the police contacted her, asking for medical records and a statement, she turned over her personal notes.

"When I typed that, those were my innermost feelings. And, I didn't think anyone would see it but me," said Bradley.

Since the incident she described at DaVita, Bradley says she pays more attention to everything that is done to her at the clinic.

"When you leave there, you're hungry, thirsty, weak," said Bradley.

The prosecution then called their next witness, Graciela Castenada, who is also a dialysis patient.

She stated she has been on dialysis for the past 10 years.

Castenada also said she was transported to the hospital on April 16, which was unusual to her typical treatments.

She said that Saenz generally administered her treatments.

Castenada said she didn't have any other health problems prior to being taken to the hospital after dialysis treatment. Since that treatment, she said she's had breathing problems.

The defense challenged her statements saying she was in good health prior to being to the hospital.

"Your medical records don't show that you had an enlarged heart?" asked Deaton.

"No," replied Castenada.

Deaton said medical records showed she had pneumonia and she was also chewing a piece of gum, which may have resulted in her breathing issues.

The prosecution objected, saying medical records do not reflect all these allegations.

The defense asked Castenada further questions about Saenz being her nurse. The victim's testimony then seemed to conflict with previous testimony.

"Do you have some memory problems?" Deaton asked.

"Yes," said Castenada.

"How long have you had those problems?" asked Deaton.

"Two weeks," replied Castenada.

Castenada's husband, Alejandro Castenada, was the next on the stand

The state's attorney, Chris Tortoris, led the prosecution for the witness, first asking him about how long he was married.  The prosecution asked Castenada if his wife often got confused, to which he replied, "yes."

"After April 16, did your wife have breathing  difficulty?" asked Tortoris.

"Yes. She had to be on oxygen," replied Castenada.

Castenada said prior to the April 16 incident, she didn't have heart problems, nor did she have breathing problems. He says now she takes medication and has many problems. He said they recognized Saenz from a newspaper article when the nurse was first being investigated.  He said she saw the picture and told her husband that she couldn't believe that had happened to her.

"Sir, do you remember your wife being treated at Memorial hospital on Sept 1, 2005?" asked Deaton.

"Yes," said Castenada. He says she went in for moderately cardiac enlargement.

"My point is I thought you said she didn't have heart problems until April 16, 2008?" Deaton asked.

Deaton named many dates, prior to the Davita incident in which she had been taken to the hospital. Castenada said that she had been taken to the hospital for minor things over the years. But that she was never severely ill until that day at the dialysis clinic.

"So if I understand the conversation you had with her back in 2008, she didn't tell you anything about Saenz walking by the machine, right?" asked Deaton.

Castenada said that his wife said she just knew it was Saenz.

Deaton said Castenada never bothered to contact anybody regarding what conversations took place between he and his wife about Saenz and the incident.

"You didn't mention this conversation to anyone until today, right? You've had opportunities to tell the police and even went to the station?" asked Deaton.

"Here we are four years later, and you decide to tell about some comment your wife made about Saenz today?" Deaton asked.

He made many attempts to conclude that this was the first time Castenada told anyone about the conversations he and his wife had about the clinic, and why he didn't come forward with information before today.

He said she didn't recognize Saenz until the newspaper article.

Castenada admits that his wife has probably had thousands of different nurses since his wife has been put on dialysis some seven or eight years. He said his wife was certain she had seen Saenz that day.

Debra Oates was called to the stand.  Oates was one of the five injured in the alleged bleach injection incident. The prosecution asked Oates to give a brief description of herself.

Herrington asked how long Oates had been a dialysis patient, and she replied that she's been a patient since 2005.

"Are you familiar with the procedure that dialysis patients go through?" he asked Oates.

Oates explained what she was given when she went through dialysis and her surroundings and the nurses she encountered.

Herrington asked Oates to describe to the jury what she's given in dialysis and to explain the sensations she felt after the bleach incident, the symptoms she felt, and her ER experience.

"They symptoms in January were the same I felt in April," she said.

She said she had pain in her legs on April 28, stemming from the dialysis incident. She cited that was the only thing different that she felt. She added that she felt winded.

Deaton began to cross examine Oates and noted that she had seen Saenz around the facility and she said yes.

Deaton emphasized that Oates used to cut up with Saenz, often talking about their kids, and Oates confirmed it. Oates said toward the end of the treatment, at 10:30 a.m., she started feeling bad and had an episode. Deaton asked Oates if she's talked to the police, after she's had ample opportunity to talk with them.

Oates said she's never spoken to the police.

Oates said she was positive she came in on second shift, to which Deaton profusely asked her about her certainty. Oates grew a little agitated.

Oates said police contacted her when they said her blood sample had come back positive for bleach poisoning, but Deaton reiterated that she didn't state to police about further information about the incident. She said she didn't have any problems going to the Nacogdoches Dialysis clinic.

Herrington then asked Oates that if the woman sitting by Deaton was indeed the nurse she remembered at the clinic. Oates waved her hand at Saenz and said, "Hi," and identified her as the nurse that was there the day she had an episode.

Oates said she had a funny taste in her mouth and asked Saenz, "What did you do?"

That's when another nurse suggested that Oates needed to be taken to the ER.

Deaton asked Oates if Saenz was the nurse she saw before she was taken to the hospital. Oates said before the ER she saw Sandy Smith, but saw Saenz before her.

Deaton asked if she had problems with her memory.

Oates said, "No. but when you get down to that specific of a time frame, I have no recollection."

Herrington kept objecting to Deaton repeatedly asking Oates the same question regarding the time frame.

Herrington asked Oates for clarification, that if she remembered Saenz giving her medicine. He asked her if what Saenz gave her was the result of her episode.

Oates said that it wasn't until Saenz gave her medication that she started feeling bad.

Oates confirmed that Saenz gave her the medicine and it was at that point that she started feeling better.

The state then called upon Sharon Day Smith, who confirmed she is a dialysis nurse.

Herrington asked the witness questions regarding the qualifications required to work as a dialysis nurse.

"Before you become a dialysis nurse, you have to have six months experience," said Smith.

"Do nurses check the water?" asked Herrington.

"RNs were to check it with the opening tech before the first patient came in," said Smith.

After brief discussion of the roles of a dialysis nurse, the prosecution then turned to ask Smith about her interaction with Oates.

On the day Oates recalls feeling different, Smith said Saenz administered Oates her medicine. After putting the medicine into her system, Smith remembers Oates questioning her.

"Debra stopped and looked at the machine and asked, 'What did she give me?'" said Smith.

Smith said she reviewed Oates' chart and called out the medicine that was written.

"She had never asked that question before," said Smith.

"She began exhibiting symptoms of what would be considered an anxiety attack. Her heart started beating faster," said Smith.

She noted Oates' condition didn't improve or get any worse during the treatment, as she monitored her. Smith said her boss also noted Oates' condition. At one point, Smith said Oates' blood pressure did begin to drop.

"She normally stopped bleeding within 15 minutes, but it did not. She began panicking even further," said Smith.

Herrington then asked Smith how notes were kept at the clinic, about each patient. Smith said they were only on the computer unless they were required elsewhere.

Herrington then turned to ask the witness about a particular incident, following a patient feeling ill after treatment. Smith recalled what she saw.

"It was a very unusual blood clot. It was fibrous, almost like it had hair. I've never seen it before, I've never seen it since," said Smith.

Deaton asked if Smith ever changed doctor's orders.

"The only time orders were changed were with the medical director's permission and his direction," said Smith.

The defense then approached the witness with a record where she charted in activity at the clinic.

Before answering the question, the witness responded aggravated.

"I don't appreciate it being stuck in my face or you standing over me," Smith said.

Smith then explained to Deaton what was stated on the chart, regarding activity with Debra Oates. He asked why at 8:42, which is around the time Oates told nurses she had a problem with the medicine given to her, Smith documented that Oates was watching the television.

"As a nurse, you're constantly assessing the patients. When a patient denies any sort of problems or complaints, then there's nothing to say. If a patient complains, then you document what you see, what you hear," said Smith.

Smith said that Oates had an immediate reaction to the medicine, but Deaton points out that Smith did not chart this at 8:42 a.m.

"There was nothing I could chart," said Smith.

Smith pointed out that the patient said she did not feel right, but there were no visible reactions she could chart. Smith explained to Deaton that the chart was accurate in stating that at 9:43 a.m., Oates complained of feeling nauseous. Then, she complained about not feeling good at 10:39 a.m. Smith said while Saenz was giving Oates her medicine, the woman asked what Saenz was giving her.

"Did Kim respond," said Deaton.

"No, Kim walked off," said Smith. "She went to the next patient to her left."

Smith said some patients asked questions about their treatment, but this was not something she expected from Oates.

"That was an abnormal response from a well-established patient," said Smith.

Deaton then continued by asking Smith questions about being able to remove the lines used to administer treatment to a patient. Smith said it should never take 20 minutes, unless a patient is suffering from low blood pressure.

Deaton turned to asking Smith several questions about Saenz's work performance.

"Was I able to consistently observe her, no I was too busy taking care of my patients," said Smith.

Deaton then asked about how quickly Saenz tended to her patients. He noted several testimonies mentioned that Saenz was not all that quick in her work.

"She was at her own pace," said Smith.

Smith said that each nurse had their own pace. She said Saenz was slower than her at tending to her patients.

Deaton further questioned the witness about practices of administering medicine. Then he moved on to talk about patients who had died and are listed on the indictment.

"There were two people who died the first of April," said Smith.

Smith said she was not around when the patients coded. Deaton argued that charts showed that Smith was documented that she was on the floor and not taking a break, like she stated. Frustrated, Smith affirmed her break was cut short, but she stands by her original statement.

Melinda Hollingsworth, the daughter of Thelma Metcalf, took the stand and reviewed the circumstances of her mother's death on April 1, 2008. Metcalf is listed as one of the victim's in Saenz's capital murder indictment.

Deaton confirmed other health conditions of Metcalf, including congestive heart failure, coronary artery disease, hypertension, high cholesterol and she was in a wheelchair.

Jamina Agnew, the granddaughter of Angela Scott, also took the stand and reviewed the circumstances of her grandmother's death in April 2008. Deaton reviewed health issues Scott had before she died, but Agnew was not able to confirm most of them.

Holding back tears, former DaVita dialysis tech Yamine Santana testified how Learlene Hamilton flagged her down and told her that she saw the "lady with the ponytail" put bleach in a syringe and put it in two patients' bloodstream.

Deaton questioned Santana about what patients told her what they saw when Saenz allegedly injected bleach into the saline bags. Santana tried to explain that it was injected into the port, but Deaton explained that it would be impossible for someone to reach above their heads to inject something in the port.

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