Whether they were pimps or drug dealers, Jeffrey couldn’t say. What a neighborhood, he thought.
He turned away from the window. Jeffrey had seen enough. Chris’s notes were sprawled across the bed. The moans from next door had stopped. Jeffrey tried to review the list of possibilities for the Noble and Owen mishaps.
Once more he focused on the notion that had so consumed Chris through the course of his last days: the possibility of a contaminant in the Marcaine.
Assuming that neither he nor Chris had made a gross medical error-in the
Owen case, for example, that he had not used the.75% Marcaine that had been found in his disposal-and in view of the fact that both patients had had unexpected parasympathetic symptoms without allergic or anaphylactic reactions, then Chris’s theory of a contaminant had considerable validity.
Returning to the window, Jeffrey thought about the implications of a contaminant being in the Marcaine. If he could prove such a theory, it would go a long way toward absolving him from blame in the Owen case.
Culpability would fall to the pharmaceutical company that had manufactured it. Jeffrey wasn’t sure about how the legal machinery would work once such a theory was proven. Given his recent brushes with the judicial system, he knew the gears would turn slowly, but turn they would. Maybe old Randolph would be able to figure a way to get the
wheels to turn faster. Jeffrey smiled at a wonderful thought: maybe his life and career could be salvaged. But how would he go about proving there had been a contaminant in a vial that had been used nine months earlier?
Suddenly, Jeffrey had a thought. He rushed back to Chris’s notes to read
Henry Noble’s case summary. Jeffrey was particularly interested in the initial sequence of events, when Chris was first administering the epidural anesthesia.
Chris had taken 2 cc’s of Marcaine from a 30 cc ampule for his test dose, adding his own 1:200,000 epinephrine. It had been immediately after that test dose that Henry Noble’s reaction began. With Patty Owen, Jeffrey had used a fresh 30 cc ampule of Marcaine in the OR. It was after this Marcaine was introduced into her system that her adverse reaction began. For the test dose, Jeffrey had used a separate 2 cc vial of spinal grade Marcaine, as was his custom. If a contaminant had been in the Marcaine, it had to have been in the 30 cc ampule in both situations. That would mean that
Patty had gotten a substantially larger dose than Henry Noble-a full therapeutic dose as opposed to a test dose of 2 cc’s. That would explain why Patty’s reaction was so much more severe than Henry Noble’s and why
Noble had managed to live for a week.
For the first time in months, Jeffrey felt a glimmer of hope that his old life was still within reach. He could have it back again. During his defense, he’d never considered the possibility of a contaminant. Now, suddenly it seemed like a real possibility. But it would take time and some serious effort to investigate, much less prove. What was his first step?
First of all, he needed more information. That meant he’d have to bone up on the pharmakinetics of local anesthetics as well as the physiology of the autonomous nervous system. But that would be relatively easy. All he needed was books. The hard part would be looking into the idea of a contaminant.
He’d need access to the full pathology report on Patty Owen. He’d seen only parts of it during the discovery process. Plus, there was the question
Kelly had raised: what about an explanation for the.75% Marcaine vial found in the disposal container on the anesthesia machine? How could it have gotten there?
Investigating these issues would have been difficult under the best of circumstances. Now that he was a convict and a fugitive, it would be all but impossible. He would have to get into Boston Memorial. Could he do that?
Jeffrey went into the bathroom. Standing in front of the mirror, he evaluated his features in the raw fluorescent light. Could he change his appearance enough not to be recognized? He’d been associated with Boston