Mysterious deaths at Ann Arbor

Mysteriorts Deaths at Ann Arbor is the title of a 250 page paperback by an American writer, Robert K. Wilcox, which describes some of the events which occurred at the 460 bed Veterans Administration (VA) hospital, Ann Arbor, Michigan, during the months of July andAugust 1975. They resulted in at least thirty-eight instances where patients became apnoeic under mysterious circumstances and in at least seven unexplained deaths-that is, unexplained until the anaesthetist in charge of the VA witnessed an event, immediately saw the picture of curarisation, proved this by using a nerve stimulator and as final proof reversed the paralysis with neostigmine. This ended the mysterious deaths and led to a prolonged and detailed investigation by the Federal Bureau of Investigation (FBI), eventually ending in June 1976 when two nurses were indicted on ten counts of poisoning, five counts of murder and one count of conspiracy to commit murder. After a trial, which was one of the most complex in American history, and following 14 days of deliberation by the jury, they were convicted in May 1977. However, the trial was subsequently declared void and a retrial has not so far been ordered. Wilcox’s book gets over a very convincing description of what it would be like to become paralysed while conscious and quotes the Detroit Free Press (4 September 1975) which carried a vivid account by an actual patient. The book was published before the legal proceedings had started and, as one may imagine, there were difficulties in piecing together a story on indirect evidence. In his book Wilcox is somewhat critical of the secrecy that surrounded reporting of cases and is very critical of the subsequent investigation by the FBI. He implies that this whole event was an example of poor public relations by the hospital manager. Particular attention is directed to the lack of information given to the press, yet it was a reporter of the local Ypsilanti Press who broke the news of ‘Killer at large in Veteran’s Hospital’ which eventually spread to the national papers and television. Naturally when the ‘strange happening’ at Ann Arbor leaked out to the general public there was some reluctance on the part of patients to go into the VA. At least one suicide occurred in the hospital and a nurse died in her apartment under suspicious circumstances. Subsequent events in this bizarre story included exhumation of several patients and detection of pancuronium in the body of two of these, and the use of hypnosis to assist patients recall the presence of any person tampering with their infusions before the period of apnoea. Wilcox appears to do less than justice to the British-trained Chief of Anesthesiology at the VA hospital. She is described as ‘an especially competent and caring doctor, more involved with her patients welfare than the average