Doctored Evidence Read online

  DOCTORED

  EVIDENCE

  DOCTORED

  EVIDENCE

  A SUSPENSE NOVEL

  MICHAEL BIEHL

  Pineapple Press, Inc.

  Sarasota, Florida

  Many thanks to June Cussen, David Cussen, Shé Hicks, and Kris Rowland for their help with this edition.

  Copyright © 2013 by Michael Biehl

  All rights reserved. No part of this book may be reproduced in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher.

  Inquiries should be addressed to:

  Pineapple Press, Inc.

  P.O. Box 3889

  Sarasota, Florida 34230

  www.pineapplepress.com

  Library of Congress Cataloging-in-Publication Data

  Biehl, Michael M., 1951–

  Doctored evidence / Michael Biehl.

  pages cm. — (A Karen Hayes mystery)

  A mystery novel in the Karen Hayes series previously published in hardcover (2002) by Bridgeworks, now in paperback.

  Summary: “A medical device failed. A patient died. Was it an accident — or murder? Only one person knows, and it’s not hospital attorney Karen Hayes. Investigating the alleged wrongful death of the hospital’s own CFO, Karen uncovers a betrayal of trust, evidence of criminal fraud, and hints of corruption. Now her job — and her life — are on the line, a line that a murderer is all too willing to cross a second time” — Provided by publisher.

  ISBN 978-1-56164-629-6 (pbk.)

  1. Women lawyers—Fiction. 2. Hospital patients—Fiction. 3. Medicare fraud—Fiction. 4. Middle West—Fiction. I. Title.

  PS3602.I34D63 2013

  813’.6—dc23

  2013027031

  978-1-56164-697-5 e-book ISBN

  First Edition

  10 9 8 7 6 5 4 3 2 1

  Printed in the United States

  To Cathleen

  Contents

  Prologue

  Part I

  Chapter 1

  Chapter 2

  Chapter 3

  Chapter 4

  Chapter 5

  Chapter 6

  Chapter 7

  Chapter 8

  Chapter 9

  Chapter 10

  Chapter 11

  Chapter 12

  Chapter 13

  Chapter 14

  Chapter 15

  Chapter 16

  Part II

  Chapter 17

  Chapter 18

  Chapter 19

  Chapter 20

  Chapter 21

  Chapter 22

  Chapter 23

  Chapter 24

  Chapter 25

  Part III

  Chapter 26

  Chapter 27

  Chapter 28

  Chapter 29

  Chapter 30

  Chapter 31

  Chapter 32

  Chapter 33

  Epilogue

  About the Author

  PROLOGUE

  Oh, my God.”

  These are not words a patient wants to hear from his doctor during a medical procedure. Larry Conkel was undergoing a myocardial biopsy. He was sedated, strapped to a padded table, and surrounded by people in masks. A long plastic tube, which minutes before had been inserted in a vein in Larry’s neck, was being delicately coaxed by his doctor through a valve in Larry’s heart.

  “Jugular intercourse,” Larry had joked nervously when the catheter was inserted. Dr. Bernard had politely chuckled. Now, the doctor’s mild oath transformed the relatively carefree atmosphere of the early minutes of the procedure to one of alarm and confusion. The remark was muttered under the doctor’s breath, whispered, but it was enough to send a whiplash of fear through everyone in the room, including the patient, despite the sedation he was under. Then Bernard said it again, much louder.

  “Oh, my God!”

  Something had gone dreadfully wrong, something that had never happened before in Dr. Edward Bernard’s twenty years as a cardiologist. The catheter had broken up. The plastic tube in Larry Conkel’s vein had fallen to pieces. Shards of various shapes and sizes bounced and spun inside his flaccid, oversized ventricle and went shooting through his pulmonary valve toward his innocent lungs.

  “I don’t believe it, I don’t fucking believe it.”

  The nurses and technicians assisting Dr. Bernard in the cath lab cast stiff sideways glances at each other, as if to say, “Bernard’s losing it.” A doctor was never supposed to lose control in the presence of a patient. But Dr. Bernard was overtly, exaggeratedly upset.

  “I don’t believe it. We’ve lost the fucking thing. Jesus!”

  For several long seconds, Dr. Bernard watched the angiogram, his brow furrowed like a bulldog’s. The lab was hushed, save for the treacherous murmurs and chirps of a multitude of steely monitors. Larry broke the silence, sputtering through a mist of cooling water being sprayed in his face to relieve the horrible flushing caused by the radiopaque dye coursing through his bloodstream.

  “What’s happening?” Larry tentatively asked, sounding as if he was not quite sure he wanted to know.

  Dr. Bernard shoved a short, red-haired nurse aside with his forearm and leaned over the patient. The doctor’s bulging eyes were bloodshot, and his sweaty upper lip twitched as he spoke, stale cigar smoke on his breath.

  “We have an unanticipated problem with the catheter. It’s very unusual. We may have to move you to an operating suite. Excuse me.”

  Dr. Bernard turned and stepped quickly out of the cath lab. Another long silence ensued, as the cath lab staff looked at one another, making small shrugging gestures, rolling their eyes toward the ceiling. The giant X-ray camera hovered menacingly over the patient, as if threatening to collapse and crush him. The room seemed to grow hotter and more stifling by the second, as the harsh overhead lights beat against the hard, sterile surfaces of the lab like sun on desert sand, and the tension grew more palpable. Again, Larry was the first to speak.

  “So,” he asked the red-haired nurse holding the misting device, a tremor in his voice, “do you know the difference between a hematologist and a urologist?”

  “Go ahead, Mr. Conkel. Tell me.”

  “A hematologist pricks your finger.”

  Outside the cath lab, Dr. Bernard ordered a nurse to contact Dr. Herwitz, a surgeon who was the Chief of the Medical Staff at Shoreview Memorial Hospital. Dr. Bernard said to tell Herwitz he needed a consultation, stat. Within ten minutes, Bernard and Herwitz were huddled outside the cath lab, talking rapidly to each other in low tones.

  Bernard was tall and bulky, with short dark hair and a deeply lined face. He had a neck that projected forward from his husky torso, rather than up, as if it were collapsing under the weight of his massive head. His blue surgical scrubs were wrinkled and damp with perspiration. Herwitz was a much handsomer man, sleek as a greyhound, with silver hair and intense blue eyes. His patrician features were composed, and he exuded an air of self-assurance. Herwitz’s lab coat was starched white and crisp, his black dress pants neatly creased. The men concluded their discussion and walked off in opposite directions.

  Twenty minutes later, Larry Conkel was in an operating room, prepped for surgery, with his hand on the wrist of a thin, middle-aged nurse holding an anesthesia mask. The nurse knew who Larry Conkel was. He worked at Shoreview Memorial, as the hospital’s chief financial officer. He had a wife and two children. He also had an enlarged heart, the reason he was in the hospital as a patient that day, which happened to be his fortieth birthday. Just before he was anesthetized, Larry looked up into the kind, concerned eyes of the nurse, and spoke.

  “Nurse,”
he said quietly.

  She leaned forward to hear him. “Yes, Mr. Conkel?”

  “If I don’t make it out of surgery, tell Karen Hayes in the Legal Department to look in on Walter.”

  The nurse smiled and patted the back of Larry’s hand.

  “You’ll be fine, Mr. Conkel,” she said.

  Four hours later, Larry Conkel was pronounced dead. Within another hour, every person working at Shoreview Memorial knew what had happened to Larry.

  Only one knew why.

  PART I

  You know, there’s always somebody playin’ with dynamite.

  —MOSE ALLISON

  CHAPTER

  1

  “No, Jake, not the Cabernet Sauvignon again,” Karen Hayes said, doing a deliberately bad imitation of a bored, affected socialite. She curled the telephone cord flirtatiously around her index finger and leaned back in her black leather swivel chair, surveying the spartan furnishings of her office.

  The office was of modest size, about ten by twelve. It contained a simple walnut desk, behind which Karen sat. The surface was empty save for one neat pile of work papers held firmly in place by a heavy, cut-crystal paperweight. Spread out on the matching walnut credenza behind her desk chair were a personal computer, a telephone console and a five-volume set of statute books. Two plain, modern guest chairs covered in practical gray cloth faced the desk. Behind the guest chairs a single window looked out through the branches of a small sugar maple to the front steps of the main entrance to Shoreview Memorial Hospital. The walls of the office were adorned by two small diplomas and two large steel-framed modern art prints of stark, geometric shapes.

  Karen propped one foot on the clean surface of her desk and the other on the bare hardwood floor. The skirt of her prim navy blue suit rode up to the middle of her thighs.

  “I rather feel like a Pinot Noir tonight,” she said.

  “I plan on spending the rest of the afternoon thinking about what you’ll feel like tonight, sweetheart,” replied Karen’s husband, Jake, in a husky baritone, “but I’m not sure Pinot Noir goes with the entrée.”

  “And that would be?”

  “Cheese pizza, reheated from last night.”

  “You’re right as always, dahling,” she conceded. “Cabernet it is. You’ve such a flair for these things. Pick up some oven cleaner while you’re at it.”

  “I don’t think we’re going to have time to clean the oven tonight,” said Jake. “I’ve got a long agenda.”

  Karen dropped the telephone cord and twisted her finger through a lock of her long, straight black hair. “A long agenda again? Tut, tut. You and your long agenda,” she teased, tilting her head back and rotating in her swivel chair far enough to see her secretary, Margaret, standing in the doorway.

  Margaret was twenty-five years old, had waist-length brown hair and was excessively thin. She wore a snug ribbed-knit sweater that showed all of her ribs. Large hoop earrings dangled from her earlobes and too many bangle bracelets clanged about her bony wrists. Karen blushed, uncertain how long Margaret had been standing there or how silly her conversation with her husband might have sounded to an outsider. The embarrassment passed and irritation at being interrupted took its place.

  “Hold on, Jake,” she said, not bothering to cover the receiver or push the hold button. “What is it, Margaret?”

  Karen’s secretary was flustered. “I told Dr. Bernard you were on the phone, but he insisted on talking to you right away. He said nothing could be more important; he said there was a disaster in the cath lab, big trouble for the hospital, he said …”

  “Margaret,” Karen blurted abruptly, “stop. Take a deep breath. Now, slowly, what am I supposed to do? Where is Dr. Bernard?”

  “He’s on my line. You have to talk to him right now or he’s going to raise hell with Mr. Grimes. That’s what he said.”

  “Okay,” sighed Karen, “put the call through on my line. Jake? Gotta go.”

  “Adios, Ms. Bigshot Lawyer,” said Jake.

  “Dosvidoniya, comrade,” said Karen, reluctantly pushing the reset button on her telephone console. Reluctantly, because she believed Edward Bernard, M.D., to be vulgar and vexatious. He was also unabashed about throwing his weight around at the hospital. He had plenty to throw. Dr. Bernard admitted a lot of patients, and therefore brought a lot of money, to Shoreview Memorial. He was what was known in hospital parlance as a “big admitter.” With two hospitals in town competing for the same patients, big admitters were treated like royalty by hospital executives. Karen knew she was expected to bow and scrape to the big admitters.

  In less than a second the phone chirped and she lifted her finger, releasing the reset button.

  “Karen Hayes.”

  Dr. Bernard sounded exhausted. “I had a catheter break up on me. It’s a bad outcome. Christ. There’s gonna be a lawsuit, and the hospital had better fucking protect me. This wasn’t my fault. The goddamn thing just dissolved. I did nothing wrong. I did nothing wrong. Nothing.”

  Karen pulled a pen and a pad of yellow lined paper from the center drawer of her desk. “Excuse me, Dr. Bernard,” she said with forced patience, “but I’m not following. When and where did this happen?”

  “About four hours ago in the cath lab. Herwitz had to crack his chest. Pieces of the catheter lodged in his lungs and God knows where else. Herwitz put him on heart-lung bypass and spent almost four hours trying to dig chunks of plastic out of his lungs, but they were too hard to locate. He finally gave up. Then they couldn’t get him off bypass. His cardiomyopathy was too advanced. His heart was too weak.”

  Karen remained calm. This was what she called an “incident,” and she had managed hundreds of incidents of varying severity in her twelve years at Shoreview Memorial, some of them much more bizarre than a defective catheter.

  Karen was the “in-house” attorney for the hospital; she was an employee of Shoreview Memorial, and it was her only client. Little happened at the hospital that she had not previously seen. Even before Dr. Bernard got to the punch line, Karen had the legal situation pretty well sorted out: the hospital was not liable for Dr. Bernard’s mistakes, if he had made any. Like most physicians, Dr. Bernard was not an employee of the hospital; he was an independent professional and as such was responsible for his own mistakes. If Dr. Bernard truly had done nothing wrong, this was an injury caused by a defective product. The manufacturer of the catheter would be responsible.

  “What’s the status of the patient?” she asked.

  “The patient expired just after 1300 hours. Shit, I haven’t even had lunch yet.”

  “Doctor,” said Karen, trying to strike a business-like and confident tone, “as of now, this isn’t really a legal matter. We don’t even know if a claim will be made, do we? Other than having the Risk Manager prepare to talk to the patient’s family, there’s not much I can do at this point. I don’t get involved with the coroner or do the paperwork to transport the corpse.”

  “Don’t kid yourself, counselor,” sneered Dr. Bernard, “that little bitch will sue us all.”

  Karen suddenly felt a sinking, heavy sensation in her lower abdomen, and had a toxic, metallic taste in the back of her mouth. Her blue eyes darted around the office as she tried to figure out why she had this sick feeling. Something clicked.

  She closed her eyes tightly. “Dr. Bernard, weren’t you scheduled to do Larry Conkel’s biopsy this morning?”

  “This was Larry Conkel,” said Dr. Bernard.

  Was Larry Conkel. Past tense. Karen wanted no more conversation with Dr. Bernard. “Gotta go,” she said without expression, and put the receiver down, not waiting for a reply.

  Larry was dead. Someone Karen knew personally, someone with whom she worked, ate lunch, shared grievances, fought, and made up. Someone she genuinely liked. Someone who talked about politics and religion with her, showed her pictures of his kids, exchanged birthday presents, complained about his marriage. She momentarily felt a little involuntary exhilaration that something exciti
ng was happening in the hospital. There would be gossip and drama, a break in the routine.

  Then she saw an image of big, sweet Larry in her mind, with his perpetually disheveled brown hair and rumpled suit, laughing at one of his own corny jokes, which he told incessantly, and Karen started to weep, quietly. She got up, walked with deliberation to her office door, and closed it. She walked slowly back to her desk chair, sat down, put her hands over her face, and sobbed. She rocked to and fro in her chair as sadness washed over her. When, after several minutes, her composure returned, a feeling darker and grimmer than sadness began to gnaw inside her. She dropped her arms to her sides and stared blankly across the surface of her desk.

  “This was my fault,” she said.

  CHAPTER

  2

  That evening, Jake and Karen Hayes sat in unfinished oak chairs in the kitchen of their small Victorian house. They faced each other, their knees touching, Karen still in her navy blue suit from work and Jake in a pair of old jeans and a gray sweatshirt. Karen was short and slight, with deep dimples, a thin, straight nose and exceptionally fair, freckled skin. Her usually bright eyes looked dolefully at Jake as he leaned over her protectively. Jake held one of Karen’s small hands in each of his own. He was over six feet tall and weighed two hundred pounds—roughly twice Karen’s size. Her vulnerable mood made their size difference seem even greater.

  “It’s not your fault. Not in any respect,” said Jake, with gentle intensity.

  “Why didn’t I let him go to St. Peter’s for the biopsy? That’s where he wanted to go. What business was it of mine? When was I appointed Marketing Director for Shoreview Memorial? That bunch of assassins!”

  “It was still his decision,” said Jake, “and somebody else’s screw-up.”

  “I know,” said Karen glumly. “But I had to put in my two cents.”