T Wave (3 page)

MONDAY, JULY 9

CHAPTER 6

The next morning, Mallory began investigating the possible theft of narcotics at Serenity Hospice. She entered the chateau-styled building and approached the nurses’ station.

“Can you tell me where I can find Nancy Goins?” she asked a nurse who was busy at a computer terminal typing information into a patient’s electronic chart.

“Second office on the right,” replied the nurse, pointing.

Mallory turned down the indicated hallway and tapped on a door, which swung open within moments. The room’s occupant wore a fitted black dress, black stockings, and white heels. Shoulder-length, blonde hair lay in curls around her shoulders.

“Hello, Nancy Goins?” asked Mallory.

“Yes.”

“I’m FBI Agent Mallory Wilson. We have an appointment to discuss a…confidential matter,” said Mallory, mindful of keeping a low profile.

“Hi, yes…welcome. Come on in.”

Mallory entered the cramped office. The entire surface of the lone desk was covered in paperwork. Nancy hoisted a pile of folders off a corner and invited Mallory to pull up a chair to the vacated spot.

“Don’t let the clutter fool you. I run a tight ship around here,” said Nancy. She settled into a chair facing Mallory. “You’re here about our drug-theft suspicions, right?”

“Yep.”

“Agent Wilson, I have to be honest. This investigation seems a little bit like overkill. We normally handle this kind of thing internally. But…my boss, William Cline, was worried and insisted we call you.”

“I see,” said Mallory. “Well, hopefully we can put this matter to rest so neither you nor Mr. Cline will have to worry about it anymore.”

“Fair enough. So tell me, how do we begin?”

“First, why don’t you tell me what raised the initial suspicions that someone was stealing drugs?”

“Well, we’ve had patients complain that they didn’t get their medicines. That always happens on a regular basis anyway, but we’ve had a higher incidence than usual the last few months.”

“Is it possible the patients are mistaken?” asked Mallory. “They are sick, after all.”

“Yes, some of them would definitely have a hard time knowing. But others are alert and oriented. We’ve also had a few complaints from family members who said their loved ones never received their medicines.”

“I see. But does a missing dose necessarily indicate that someone stole the medicine? Couldn’t it just still be in the bottle?”

“That’s the kicker. Most of the meds we administer here are narcotics used for palliative care—that is, they’re intended to make someone more comfortable, not cure them. Because these drugs are controlled substances, they’re safeguarded and dispensed as needed using an automated system called Pyxis. The records from this system indicated that the drugs were dispensed. So the Pyxis records all seem to be in order, assuming that the patients truly received their medicines. If they didn’t, our question is what happened to the meds? I can’t prove that there have been any thefts, but the number of complaints has made me wonder if Serenity has a problem.”

Mallory considered the information. “If there are thefts, they would have to be carried out by a hospice employee, right?”

“I would think so. I guess it’s possible that some supplier or third-party vendor—like a cafeteria worker—could do it, but they normally wouldn’t be around the narcotics. They would draw attention to themselves if they were.”

“Assuming an employee is stealing drugs, do you have any suspicions who it might be?”

“Not really,” replied Nancy with a shake of the head. “All our staff members are required to pass a pre-employment drug screen, and Mr. Cline didn’t want to upset everyone by running a new one out of the blue.”

“I see,” said Mallory, rubbing her ear in thought. “Has your drug-tracking system revealed any suspects? Does anyone seem to make an unusually high number of ‘mistakes’ when they’re using it?”

“No. There have been a few random errors in Pyxis, but nothing unusual. The mistakes were all made by different people and were all successfully resolved.”

“How much medicine is missing?” asked Mallory. “It seems to me that a small amount would suggest someone is stealing it for personal consumption, whereas the theft of large quantities would be more suggestive of someone turning around and selling it.”

“It’s impossible to say for sure. I would guess not much, but I really don’t know.”

Mallory pondered for a minute. “Who is familiar with the drug inventory recordkeeping? Is there someone who can explain how the hospice’s equipment and processes are used in conjunction to track drugs? I need to become familiar with the end-to-end process controls that are used to try to prevent theft.”

“Hmmmm…William Cline, my manager, would be a good place to start. As I mentioned, he’s the person who initiated this investigation. He oversees all the Stokely properties, not just this hospice.”

“Stokely?”

“Stokely is the company that owns Serenity Hospice.”

“I see. What other properties does Stokely own?” asked Mallory.

“They own another hospice near Arlington and three hospitals in the greater DC metro area, including Stokely Memorial just down the street.”

“Got it. And William Cline oversees the process controls for all the properties?”

“Yes.”

“Okay—it sounds like he’s the person I need to speak with next. Could you introduce me to him?”

“Of course,” replied Nancy. “I’ll phone to let him know we’re on the way.”

“We’ll be able to meet now?”

“I think so. He’s usually booked solid, but he’s pretty good about clearing his calendar when something important pops up. And this is definitely one of those times. He told me to let him know if he can help, so now’s his chance.”

Upon arriving at Stokely Memorial Hospital, Nancy guided Mallory to the executive suites on the top floor. After tapping on the door, they entered William Cline’s richly-appointed office. Cline himself was staring at the ceiling with a far-away, thoughtful gaze, as if considering some esoteric riddle. His graying temples and mild-mannered appearance were complemented by stylish glasses that did a reasonably good job of concealing thick lenses.

Nancy introduced the two and quickly departed.

“Thanks for helping with this, Agent Wilson,” said Cline. “The profitability of the hospice has been, shall we say, below expectations.”

Mallory noticed a large framed print on the wall behind Cline’s desk: “The best prescription for outstanding patient care is hospital profitability.”

Cline continued, “I’m sure you can appreciate the enormous cost of the narcotics we administer to the patients at Serenity Hospice. If you’re able to catch someone skimming off the top, it could help us put Serenity back on track. Of course, it would also keep some scumbag from stealing pain medicine from dying patients.”

Mallory nodded. “I’ll do my best, Mr. Cline.” She outlined the information she had learned from Nancy Goins. “Can you explain to me what kind of purchase and inventory records the hospice maintains? I’ll need to know what kind of process controls are in place.”

Cline explained the procedures for tracking medicine from the time it arrived at the hospital to its disbursement, destruction, or return to the hospital pharmacy or Pyxis system.

“Could someone be taking the medicine of hospice patients after they die?” asked Mallory. “How is the medicine controlled then?”

“There’s a procedure for disposing of the medicines of deceased patients. They’re deposited into a locked ‘narcotics destruction’ box with another nurse or staff member acting as a witness to the type and quantity. The witness must sign a log, so it would be difficult for someone to forge a record when putting drugs into the locked box. When the pharmacy picks up the box later, they verify that the types and quantities of drugs in the box match the log."

Mallory mused for a moment and then said, “It seems like a long shot, but just in case, I could compare the drugs dispensed—based on the Pyxis records—to the drugs left over according to the log of drugs deposited
into
the ‘narcotics destruction box’, and then compare those results to the drugs recovered
from
the ‘narcotics destruction’ box. A mismatch between any of those three steps would be a logical starting point to investigate further. Assuming I don’t find anything there, I’ll have to dig deeper.”

Cline smiled. “I can see you’re the right person for this job. You’re right—you probably won’t find any mismatches in those steps. If you’re a hospice employee who wants to skim meds, you know you’d probably be caught trying to take the meds of deceased patients. No, the most likely approach would be to slip the medicine of
living
patients in your pocket but log that you gave them their meds. Many of our hospice patients are too unresponsive to tell anyone whether or not they’ve taken their medicines.”

Mallory remembered Nancy Goins suggesting the same theory. “Thanks. With your permission, I’ll eliminate the ‘narcotics box’ option and then explore the idea you just proposed.”

“Excellent. If you’re ready to begin, I’ll take you down to the pharmacy so you can start with the dispensing records.”

“That’ll be fine,” said Mallory.

As they stood up to leave, an imposing figure filled the doorframe, a tall and thick man with a balding crown and steel-rimmed glasses pushed far down his nose. He wore a white lab coat over a plaid cardigan. His overall appearance was strangely reminiscent of the near-sighted scientist on
The Muppet Show
.

The figure entered the office and at first scarcely glanced in Mallory’s direction. After a moment, he did a double-take and studied her in more detail.

“Doctor Oswald,” said Cline, “I’d like to introduce you to FBI Agent Mallory Wilson.”

“Pleased, I’m sure,” said Oswald. Turning to Cline, he asked, “Do you have those charts you mentioned in our call yesterday?”

“Yes,” said Cline, handing Oswald a pile of records two inches thick. “Agent Wilson, this is Doctor Reginald Oswald, a research scientist. He works with some of the patients in our hospital.”

“Really? What exactly are you researching, Doctor Oswald?” asked Mallory.

“Therapies for intractable GI—Gastrointestinal—diseases.”

“Doctor Oswald is a world leader in the field,” said Cline.

The doctor grinned sardonically. “Not to hear Powell describe it. Well, I really must be going.  It was nice meeting you, Agent…?”

“Wilson,” supplied Mallory. “Likewise, Doctor Oswald.”

After Oswald left, Mallory turned a questioning head to Cline. “Powell?”

“Andrew Powell is a competing GI doctor—works across town at San Cristobel General. He and Doctor Oswald have competing theories and go after the same federal funding, so there’s not much love lost between the two. I’d say Doctor Oswald is winning both contests.”

Cline guided Mallory to the pharmacy and ensured she had access to the appropriate records to begin her investigation. Mallory settled into her work, conscious of the staff’s questioning glances but unable to satisfy their curiosity.

“Okay,” she murmured to herself as she accessed the pharmacy’s records. “Let’s just see what kind of tale these records will tell.”

CHAPTER 7

Scrubs drove slowly through one of the seedier neighborhoods of downtown Washington.

“Don’t let them rip you off this time,” Jeanette had warned as he departed.

“Easy for her to say,” he grumbled to himself as he recalled the admonition. “She ain’t the one dealing with these guys. They’d just as soon kill you as take a piss.”

Scrubs hated doing these deals. But between his penchant for street drugs and Jeanette’s proclivity for shopping at the trendiest stores, their finances constantly teetered on the edge of ruin. The sale of patient narcotics provided a financial lifeline the couple desperately needed.

Scrubs decelerated and pulled his aging LeBaron into Leroy’s driveway. He glanced around before leaving the safety of his car. Those three guys at the corner were gang members, but he’d seen them around before and hadn’t had any trouble with them.

Stepping out of his car, Scrubs approached the front door and knocked. Leroy appeared within seconds, opening the door for Scrubs to enter. He wore an uncomfortable, vague expression.

“What’s the matter, man?” asked Scrubs. “You don’t want my stuff?”

“No…it’s cool,” replied the buyer, snapping back into the moment. “What you got?”

Scrubs rolled down his sock and withdrew a small package wrapped in cellophane. He showed the contents to Leroy, and the two haggled over the price for several minutes. During the negotiation, Scrubs noticed Leroy glancing nervously out the front window several times.

“Why you keep looking out the window?” asked Scrubs. “You expecting company?”

“No, man. We’re all right.”

They finally settled on a price. Scrubs handed over the package, and Leroy counted out several hundred-dollar bills. Anxious to leave, Scrubs rolled up the banknotes and bound them with a rubber band.

After stuffing the cash into his pocket, he made for the door and called over his shoulder, “I’ll let you know when I have something else to move.”

“All right, man. Don’t keep me waiting. My boys don’t like that.”

Scrubs stepped into the bright sunshine, and the dilapidated screen door banged shut behind him. As he climbed down the porch steps, a black Cavalier accelerated from the curb across the street and screeched to a halt directly in front of Leroy’s house.

Without warning, the occupants of the Cavalier leveled an ominous array of handguns out the car’s windows and directed a fusillade of firearm rounds towards Scrubs. A car alarm began to sound down the street, and the screams of local residents were just discernible above the din of the melee.

Thankful his assailants hadn’t exited the safety of their Cavalier, Scrubs instinctively leaned over to present a smaller target. He began running for the LeBaron, but in his haste to pull out his key ring, he dislodged the money roll from his pocket, sending it tumbling down the sidewalk. Bullets screamed overhead as he bent down to retrieve the bankroll. One of the rounds severed a small tree branch over his left shoulder, and the limb brushed his face as it fell.

Scrubs swiped up the wad of cash and sprinted in a half-crouch towards the front of his car, aiming to keep it between himself and his attackers. Before he could reach the cover of the LeBaron, though, a ricocheting round passed through his right forearm, sending a flash of white-hot pain radiating throughout the limb while a quick stream of blood began flowing from the wound’s angry gash. As he ducked behind the car, another slug grazed his cheek. “Dammit!” he yelled.

To remain behind the protective shield of his vehicle, Scrubs entered it from the passenger side. As the incoming blitz continued to pound in, Scrubs hunched low in the passenger seat to avoid presenting a profile to his attackers. While the last fragments of the rear window shattered from the impact of multiple incoming rounds, Scrubs snatched a Ruger from his glove box and crawled to the driver’s seat. He crooked his right arm through the crumbling glass of the driver’s-side window and began to blindly return fire. He couldn’t tell if he hit anything, but a pause in the maelstrom of incoming gunfire provided the break he needed to start the vehicle, accelerate backwards out of the driveway, and careen down the street.

After putting several blocks between himself and the attackers, Scrubs patted his pocket. The money was still there, thankfully. The searing pain in his forearm throbbed in time with his frenetic heartbeat. He tried to use an old towel to stem the flow of blood from his arm wound, but the makeshift tourniquet was too small to stay in place. Although the gash on his cheek stung madly, it didn’t appear to be more than skin deep.

He couldn’t risk stopping for help with the wounds; that might raise too many questions he wasn’t prepared to answer. He decided to head home, praying that the mounting waves of dizziness wouldn’t grow too much worse before he made it back.

Scrubs pulled into his driveway. His LeBaron resembled an outgunned tank after battle. It was pockmarked with holes, the left rear tire was flat, and all the glass except the windshield was cracked or missing. A tendril of steam rose from beneath the hood, suggesting a damaged radiator hose.

Scrubs staggered into the house and called for his wife.

“My God! What happened?” asked Jeanette, rushing to her husband’s side and leading him to the bathroom.

“Ambush. They were waiting for me to leave with the money.”

“Who?”

“I don’t know. Some local gang who got wind of my deals with Leroy, I guess. They probably figured they’d make some easy money robbing the outsider.”

They reached the bathroom. Jeanette washed both wounds with peroxide and bandaged the arm wound with one of the many rolls of gauze she periodically carried home from work after accidentally leaving them in her lab coat. She used a large Band-Aid on Scrubs’ less-serious facial abrasion.

“I know it hurts,” said Jeanette, “but it’s really not that bad. The round in your arm went clean through and didn’t hit any major structures. It should heal up pretty well. And your face will be fine, too.” After pausing a moment, she continued. “So what are you going to do about the stuff I bring home from work? You can’t sell it to Leroy anymore, can you?”

“I guess not. Not at his place, at least. I’d really rather just work with a whole different buyer, but I don’t know anyone else who moves this kind of stuff. I’ll have to think about that one.”

“Well, don’t take too long to decide. The bank will foreclose on us while you’re thinking,” said Jeanette as she applied the last strip of adhesive tape to his arm. She promptly moved into the den and turned on the television.

After moving into the kitchen to retrieve a beer, Scrubs lit a cigarette and drew heavily from it. He exhaled and took a long draught of Pabst. He stared into the next room, his wife’s profile silhouetted against the flickering images of the television screen.
It’s too bad she’s not as worried about me getting shot as she is about the goddamn mortgage
.