LUFKIN, TX (KTRE) - Day seven of the capital murder trial of a former Lufkin dialysis nurse accused of killing five patients began this morning with the former medical director explaining the policies of collecting bloodlines at the DaVita Lufkin Dialysis Center.
Kimberly Clark Saenz, 38, of Pollok, is charged with capital murder and five counts of aggravated assault. She allegedly injected bleach into the bloodstream of kidney dialysis patients.
Dr. Imran Nazeer, a nephrologist, was called back to the stand Tuesday morning to continue questioning from Monday afternoon. Saenz's attorney, Ryan Deaton, began by questioning the doctor about policies at the clinic.
The witness testified to being the medical director during the time the incidents occurred at DaVita.
Dr. Nazeer, former director of the dialysis center, testified that center officials suspected bleach may have entered some patients' bloodstreams but chose to keep the suspicions from the patients. He said he felt it was in the patients' and clinic's best interest not to say anything until all facts had been gathered.
Deaton questioned the witness about DaVita's policies on collecting bloodlines of patients who suffer adverse occurrences during dialysis treatment. When the witness stated he was not sure and had to look up the policies, Deaton seemed puzzled.
"Sir, why would you not know the policy in April of 2008?" said Deaton.
"It has been 4 years ago, I had to go back and refresh my memory," said the witness.
Deaton questioned the witness about testimony that was given in court and information given to Deaton in a meeting 3 months ago. Deaton pointed out that information the witness told him months ago was not the same as what Nazeer was saying today.
"I was not prepared when I talked to you. It was supposed to be a casual meeting," said the witness.
Deaton questioned the witness about who gave orders to collect the bloodlines. In a previous meeting, the witness says he told Deaton it was the administration. The practice of collecting bloodlines if an adverse occurrence happened began in September 2007, according to the witness.
Deaton then turned to asking the witness why he did not alert patients, like Ms. Risinger, know that she could have been injected with bleach. The witness testified that he did not tell the patients exactly what may have happened, but the patients were taken to the emergency room.
"That's different than saying, hey, you might have been injected with something, like bleach," said Deaton.
"I decided not to tell them until I gathered all the facts together," said the witness.
After Deaton pointed out that it was odd that the patients weren't told about possible concerns to their own health, he began questioning the witness about the reports done on the water and chlorine content at the clinic.
"After the carbon tanks, there are no other filters that filter out chlorine, correct," said Deaton.
"Correct," replied the witness.
The defense then used images of the bloodlines to illustrate to the jury what sharps containers and bloodlines look like. After a few further questions, Dr. Nazeer was dismissed from the stand.
The state called upon Dr. Mark Sochaski, a research investigator for the Hamner Institute for Health Sciences in North Carolina.
The witness testified that he and a visiting scientist from the Environmental Protection Agency (EPA), began research, shortly after the 9/11 attacks, on the effects of exposure to chlorine.
"Any chlorinating agent, chloric gas, chloride, bleach…" said Sochaski.
The witness then explained to jurors what happens when chlorine is exposed to the body.
In February 2008, Sochaski said his study of chlorine, conducted on rats, was published. He said the following May, he was contacted to assess what the effects of bleach injections may do to humans. The witness said he agreed to analyze the 51 plasma samples he was given.
"We sampled each of the samples….and then we carried through the procedure," said Sochaski.
In his research, Sochaski noted high levels of chlorine in the patients' bloodstreams.
"There are lots of tests done on rats that don't relate to humans at all, is that fair to say?" said Deaton.
"I would have to see what tests," said Sochaski.
The defendant stated he hasn't ever seen a test done on rats that doesn't relate to humans. Deaton asked Sochaski how the tests could be related because the rats were exposed to gaseous chlorine and the victims were allegedly injected with chlorine.
"You can't say how much chlorine these patients actually got?" said Deaton.
"That would be difficult to say," said Sochaski.
"And, you can't say that the chlorine came from bleach or from water, can you?" said Deaton.
The witness stated that the test solely represents the amount of chlorine present in the blood, not the source. Deaton questioned Sochaski about other health conditions that make affect the level of chlorine present, to which the witness testified his testing would not be able to reveal.
The prosecution then called upon their next witness, David Jackson. Jackson stated he works at the Food and Drug Administration (FDA), where he's worked for 22 years. He also stated that he worked at the FCC for 20 years.
The prosecution questioned Jackson about the use of chlorine at the clinic. The witness then testified to receiving the bloodlines and dialyzers of victims listed on the indictment.
"We received a red biohazard bag, saying Rhone dialyzers with a bloodline and dialyzer. And, we received numerous syringes," said Jackson.
If convicted, the state is pursuing the death penalty against Saenz.
Investigators believe Saenz injected bleach into at least 10 patients' bloodstream while they were receiving dialysis.
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.